Izibalo zithi namuhla umfutho wegazi ophakeme usiba yisifo esivame kakhulu. Ngokuvamile kuthinta abanesifo sikashukela, ikakhulukazi abaneminyaka engaphezu kwengama-40 ubudala, kodwa kunengozi yokuqhubekela phambili kwe-pathology esemncane nakancane. Ngaphezu kwalokho, umfutho wegazi ophakeme uvame ukutholakala kwabesifazane, futhi emadodeni kuba nzima ngokwengeziwe.
Umfutho wegazi ophakeme ubonakala ngokwanda okuqhubekayo komfutho wegazi. Akunakwenzeka ukululama ngokuphelele ku-hypertension ye-arterial, kepha lesi sifo silawulwa ngokuphelele. Ngalezi zinhloso, ukwelashwa kwezidakamizwa kwegazi elinamandla nezindlela ezingezona izidakamizwa kuyakhonjiswa.
Iziqu kanye nezigaba zehypertension
Ukuhlukaniswa kweWorld Health Organisation kusetshenziswa kwezokwelapha, ngokuya ngakho kukhona ama-degree amathathu e-hypertension.Isiqu sokuqala simalunga nomfutho wegazi ophakeme, umfutho wegazi ebangeni ukusuka ku-140/90 kuya ku-160/1100 R RT. Ubuciko.
Ezingeni lesibili, bakhuluma nge-hypertension esezingeni eliphansi, esigulini izinga lokucindezela lisukela ku-160/11 kuye ku-180/10 mm RT. I-degree yesithathu - umfutho omkhulu wegazi, manje bathola umfutho wegazi ngezinga elingaphezu kwe-180/10 mm RT. Ubuciko.
Ngaphezu kokuhlukaniswa kube ngama-degree, izigaba ze-hypertension nazo ziyahlukaniswa. Isigaba sokuqala singesesikhashana noma ngesikhashana, ngaso lesi sifo sinikeza ukwanda okuncane kwengcindezi yegazi.
Ukucindezela okuphezulu kuyiphutha:
- isiguli asikhonondi ngempilo;
- impilo ejwayelekile iyagcinwa;
- uhlelo lwenhliziyo aluphazamiseki.
Ukuzinza kubizwa ngokuthi isigaba sesibili sehypertension. Kulesi sigaba, ngenxa yokuqina kwengcindezi, i-ventricle yangakwesobunxele inyuka kancane, ushintsho olusasele alubonwa. Ezimweni ezingavamile kakhulu, ukuvela kwe-retinal kwenzeka.
Isiteji se-sclerotic sibonakala ngokuguqulwa okungathandeki kwezitho eziningi zangaphakathi, kutholakala izimpawu ze-myocardial infarction, ukuhluleka kwenhliziyo, ne-opic edema.
Umfutho wegazi ophakeme uvama ukuvela iminyaka eminingi, isiguli sibona inkinga kuphela ngemuva kokuqina kwaso, lapho kudingeka ukwelashwa okude nangaphezulu okukhulu.
Uhlobo olubi lwe-hypertension nalo luyahlukaniswa. Kubonakala ngokuthuthuka okusheshayo, zonke izigaba zidlula ngesikhathi esifushane. Ukufa komuntu kwenzeka ngokushesha okukhulu.
Noma ngabe bucayi besifo, ukuthuthukiswa kwezinkinga akubandakanywa. Bakhonjiswa yisifo esinegazi, lapho izinga lomfutho wegazi likhuphuka kakhulu. Lesi simo se-pathological sidinga ukusabela ngokushesha. Ikakhulu ikakhulukazi isifo se-hypertensive senzeka ngezinga lesithathu lalesi sifo.
I-pathogenesis ne-etiology yalesi sifo kufaka phakathi umfutho wegazi ophambili futhi wesibili.
I-hypertension eyinhloko ukugula okuzimele, okwesibili - umphumela wokuphazamiseka okuyingozi kakhulu.
Izimiso eziyisisekelo zokwelashwa
Izimiso zokwelashwa kwe-hypertension zigxile esigabeni nasezingeni lesifo. Isisekelo sokwelashwa ukujwayezwa kwezinkomba zokucindezela, ukuncipha kwamathuba wezinkinga ezivela emisipha yenhliziyo nemithambo yegazi, kanye nokuvinjezelwa ukufa.
Ukuqeda ukwephulwa, kuyadingeka ukusebenzisa umuthi, ezinye izindlela zokwelapha, ususe izinto ezibangela ingozi: isisindo ngokweqile, i-cholesterol ephezulu, imikhuba emibi.
Akunandaba nobunzima balesi sifo, udokotela unquma ukunamathela ekudleni okukhethekile. Imikhiqizo kufanele ithuthukiswe nge-magnesium ne-potassium. Kuboniswa ukunciphisa ukungena kukasawoti emzimbeni, futhi kungcono ukulahla ngokuphelele i-sodium.
Isifo sikashukela sidinga ukuqapha isisindo, siyeke ukubhema, ungabuphuzi utshwala. Ungenzi ngaphandle kokuzivocavoca umzimba kahle, lokhu kungaba:
- ehamba
- ukubhukuda;
- ukugijima.
Ukwelashwa kwe-hypertension kudinga ukusetshenziswa kwemithi, ukukhethwa kwamacwecwe kuyenziwa kucatshangelwa izici zomzimba wesiguli.
Ama-diuretics, ama-beta-blockers, ama-engiotensin-converting enzyme (ACE) inhibitors, angiotensin, calcium blockers blockers aba izidakamizwa zohlobo lokuqala. Ukusebenza kwalezi zimali kufakazelwe kaninginingi ezivivinyweni zokwelashwa. Ngalesi sizathu, bamiswa kuqala.
Izidakamizwa zesizukulwane sokuqala zifakwa ohlelweni lokwelashwa oselusezingeni lokuqala le-hypertension, uma ngemuva kwezinyanga ezi-4 zokwelashwa okungezona izidakamizwa umphumela obulindelekile awutholakali. Njengomthetho, ekuqaleni kwe-hypertension, ikhambi elilodwa lanele.
Emazingeni akamuva, udokotela uncoma izidakamizwa ezi-2 noma ezi-3.
Ukwelashwa Okukhulu
Lapho kutholakala uhlobo olubi lomfutho wegazi ophakeme, umfutho wegazi ukhuphuka ngokushesha, nemithambo yegazi ingqondo, fundus, inhliziyo nezinso kuthinteka kakhulu.
E-hypertension enkulu, kwenqatshelwe ukunciphisa ukucindezela kakhulu, ngaphandle kwalokho ukuhamba kwegazi kuzoshuba ngokushesha, izinkinga ezisongela impilo zizokwenzeka. Ngakho-ke, ukwehla okuthe xaxa kwengcindezi yegazi kukhonjisiwe. Okokuqala, kwanele ukwehlisa cishe nge-15% kusuka ezingeni lokuqala. Ngemuva kwalokho, ngokubekezelela okuhle, bayaqhubeka behlisa ingcindezi, bafinyelela imikhawulo ejwayelekile.
Kulokhu, udokotela uncoma ukusetshenziswa kwezindlela eziningi zamaqembu ahlukene, i-algorithm imi ngolu hlobo:
- i-diuretic, i-beta-blocker, i-ACE inhibitor;
- I-ACE inhibitor, i-calcium blocker blocker, i-diuretic, i-alpha-blocker;
- i-beta-blocker, i-calcium blocker blocker, i-diuretic, i-alpha-blocker.
Lapho isifo sikashukela sinezinkinga zenhliziyo ezi-coronary, renal kanye nokwehluleka kwenhliziyo, uboniswa nokwelashwa okubonisa izimpawu. Kwezinye izimo, ukwelashwa okuhlinzwa kuyadingeka.
Ngemuva kokuthola umphumela omuhle, isiguli kufanele siqhubeke nokuthatha imishanguzo ye-antihypertensive, ibonwe ngudokotela njalo ezinyangeni eziyisithupha.
Isincomo esisebenzayo ukugcina idayari ekhethekile lapho konke ukufundwa kwengcindezi kuqoshwa.
Ukwelashwa kwe-grade 2 hypertension
Ngaphambi kokuqala ukwelashwa, isiguli sihlolwa ngokuphelele emzimbeni. Lokhu kuzokuvumela ukuthi ubone isithombe esigcwele sesifo, izinguquko ze-pathological ezenzekile ngemuva kwesizinda sokucindezela okukhulu. Kungenzeka ukuthi ukubonisana okwengeziwe nodokotela oyi-neurologist, i-cardiologist kuyadingeka.
Uhlu olujwayelekile lwemithi lubandakanya ama-diuretics (Diuver, Veroshpiron, Thiazide), izidakamizwa ze-antihypertensive (i-Artil, iBisoprolol, i-Physiotens), amaphilisi alwa ne-cholesterol (i-Zovastikor, Atorvastatin), kanye nama-blood thinner (Aspecard).
Isidingo sokwelashwa okuphumelelayo ukuthatha izidakamizwa kuphela ngehora. Noma yiziphi zezinhlelo zibekelwe isiguli esithile esithile. Isikimu esilungile kakhulu, esifanelekile ngeke silungele noma yimuphi umuntu. Uma isiza eyodwa, ke eyesibili iyakwazi ukulimaza.
Lapho ulungiselela ukwelashwa, udokotela uyacabanga:
- iminyaka
- indlela yokuphila (kusengaphambili kokungasebenzi ngokomzimba);
- ukuba khona kweziyaluyalu nezinye izifo;
- izinga le-cholesterol yegazi;
- izinguquko ezithweni zangaphakathi.
Lezo noma ezinye izidakamizwa ezingaphikiswanga esigulini zisebenza kahle zihlanganiswe. Kodwa-ke, ukuvimbela ukusabela okungekuhle, okokuqala usadinga ukubheka isimo somuntu.
Kwenzeka ukuthi irejimeni yokwelashwa inesizathu - ukufakwa kwezidakamizwa ezithile ngama-analogues, kungenzeka ukuthi ushintshe umthamo, ukhansele umuthi.
Amaphilisi wokucindezela athandwayo
I-Veroshpiron
Imvamisa, odokotela banquma i-Verhoston yezidakamizwa ze-antihypertensive, yenziwe ngendlela yamathebulethi, amaphilisi. Ithebhulethi ngayinye iqukethe i-25 mg yento esebenzayo, kumakhompiyutha - 100 mg. Isakhi esiyinhloko se-spironolactone, umsizi: i-talc, isitashi sommbila, i-silicon dioxide.
I-Veroshpiron ihlukile kwesenzo esinamandla se-hypotensive kanye ne-diuretic. Inzuzo yayo eyinhloko ukulondolozwa kwe-potassium emzimbeni, ngakho-ke lo muthi ubizwa njengezidakamizwa ezichitha i-potassium.
Umphumela wokwelapha wenzeka ngenxa yomphumela we-diuretic, ngenxa yalokho ingcindezi iyancipha. Kunesizathu sokusebenzisa lesi sidakamizwa uma kwenzeka edema, ukuphazamiseka kohlelo lwe-endocrine, i-edema yamakhemikhali, i-arterial hypertension.
Umuthi uphambaniswe ngokomfutho wegazi ophakeme ngokungabekezelelani ngakunye ezingxenyeni eziyinhloko noma ezisizayo. Akuvunyelwe ukusebenzisa nge-diagnostic:
- ukwehluleka okunzima kwezinso;
- i-anuria
- i-hyponatremia;
- hyperkalemia
Futhi, awukwazi ukuthatha iVeroshpiron ngesikhathi sokukhulelwa.
Izithasiselo ezinhle zesimanje zomuthi yi-Spironolactone, Veroshpilactone. Izindleko zeVeroshpiron zisukela kuma-ruble ayi-100 kuye kwangama-300, kuye ngenani lamathebulethi amaphakethe. Kuthengiswe ngaphandle kadokotela
IBisoprolol
I-Bisoprolol yezidakamizwa isetshenziswa kabanzi ekwelapheni umfutho wegazi ophakeme, inempahla engasasebenzi, antiarrhythmic, hypotensive. Isidakamizwa sivimba ama-beta-adrenergic receptors, sinciphisa ukushaya kwenhliziyo, ukuphuma kwenhliziyo.
Izinkomba ezisetshenziswayo:
- ukwehluleka kwenhliziyo;
- isifo senhliziyo;
- umfutho wegazi ophakeme
- ukuphazamiseka kwesigqi senhliziyo.
Umphumela wesidakamizwa ubonakaliswa ngemuva kwamahora we-2-3, uqhubeka okungenani ngosuku. Umthamo ukhethiwe kwabanesifo sikashukela ngawodwana. Udinga ukuphuza amaphilisi ngaphambi kokudla kwasekuseni, kwanele ukuthatha elilodwa ngosuku. Ithebhulethi ligwinye ligcwele, ligezwe ngamanzi amaningi ngaphandle kwegesi.
Ngesikhathi sokulashwa, ukusabela okungafuneki komzimba akubandakanywa.
Lokhu kungaba ukukhathala okungenangqondo, ubuthakathaka, ukuphazamiseka kokulala, ukuqaqanjelwa yimizwa, ukungezwani komzimba, ukushuba kwesisu, ukuhlaselwa isicanucanu.
Ezinye izindlela nokuvimbela
Ukwelashwa kwe-hypertension ekhaya kwenziwa ngaphandle kokusebenzisa ezinye izindlela zokwelapha. Imbewu yefilakisi esetshenziswa kahle, uju wemvelo, ulamula. Izindlela eziningi zokupheka zisebenzisa amakhambi okwelapha, imikhiqizo.
Uzodinga ukuthatha izingxenye ezi-3 ze-mamawort, izingxenye ezi-2 ze-rosemary ne-mash eyomile, ingxenye yetiye yezinso. Isipuni esikhulu sengxube ephumayo sidluliselwa epanini, uthele ingilazi yamanzi abilayo bese ufudumele kubhavu wamanzi imizuzu emi-5. Ngemuva kokuthi isitsha lisongwe ngethawula, faka amahora amathathu, thatha izikhathi ezi-3 ngosuku ngaphambi kokudla.
Ukusetshenziswa isikhathi eside kwe-tincture ye-calendula nakho kusebenza kahle, kudakwa ama-30 kwehla kathathu ngosuku. Ungaxuba ujusi wamantongomane noju ngezilinganiso ezilinganayo, thatha kathathu ngosuku ngaphambi kokudla, ku-spoonful eyodwa.
Ezinye izindlela eziningi zokucindezela umfutho wegazi omkhulu sezenziwe. Ukwelashwa, kuvunyelwe ukukhipha izithako isiguli esingazithandi, kusale kwamukeleka kuphela.
Ukuze uvimbele umfutho wegazi ophakeme, abanesifo sikashukela kufanele bathobele imithetho elula:
- udle kahle;
- phila impilo enempilo;
- yeka imikhuba emibi;
- ngena kwezemidlalo.
Ungazinaki izincomo zabodokotela, lokhu kuyasebenza nakubantu abasengozini yokuthola umfutho wegazi ophakeme. Ngokwanda okuqhubekayo kwengcindezi nokuqinisekiswa kokuxilongwa, kubalulekile ukuvikela izingxabano ezinama-hypertensive, izinkinga eziyingozi ezithweni zangaphakathi.
Isifo sikashukela kanye nomfutho wegazi ophakeme ngeke kube yisigwebo; ngokwelashwa okwanele, kungenzeka ukuthi ususe izimpawu futhi uvikele ukukhula kwezinkinga.
Ungayelapha kanjani i-hypertension izotshela uchwepheshe kule vidiyo ekulesi sihloko.
