Matenda oopsa: Njira zamakono zamankhwala zikuyandikira

Mfundo zofunika kwambiri zochizira matenda oopsa.

1. Asanayambe chithandizo cha wodwala, dokotala ayenera kudziwa kuchuluka kwa kuthamanga kwa magazi m'mawa, nthawi ya 5 ndi kumapeto kwa tsiku logwirira ntchito, atatha kulimbitsa thupi. Chithandizo choyenera kwambiri ndikuganizira za kuwunika kwa magazi tsiku lililonse.

2. Kuchiza kwa odwala omwe ali ndi siteji I ochepa matenda oopsa nthawi zambiri kumachitika ndi njira zosagwiritsa ntchito mankhwala. Palibe mphamvu, mankhwalawa amathandizidwa pambuyo pa masabata 12-16.

3. Mankhwala osokoneza bongo nthawi zambiri amalembedwa masitepe, kuyambira mankhwalawa, ndipo ngati sangathe, mankhwala osokoneza bongo a antihypertensive ndi omwe amapatsidwa. Mwa matenda oopsa kwambiri osakanikirana, kuphatikiza antihypertensive mankhwala kumayikidwa nthawi yomweyo.

4. Monga lamulo, kuchuluka kwa nthawi yayitali kwa hypotensive pokhapokha ngati munthu ali ndi vuto lochepetsa matenda oopsa, nthawi zina zimatha kuletsa antihypertensive mankhwala kwakanthawi kwakanthawi chifukwa chokhala osagwiritsa ntchito mankhwala.

5. Kuthamanga kwa magazi kuyenera kuchepetsedwa pang'onopang'ono, makamaka okalamba komanso ovuta kwambiri. Kuchepetsa kuthamanga kwa magazi kwa odwala a gululi kumapangitsa kuti magazi azisokonekera, magazi komanso impso.

Chithandizo chamankhwala chiyenera kuonedwa ngati chipambano ngati kuthamanga kwa magazi kutsikira ku 140/90 mmHg. Art. pankhani ya systolic-diastolic arterial matenda oopsa mpaka 140-160 / 70-90 mm RT. Art. ndi systolic, kapena mpaka pamitengo, 15% yotsika kuposa yoyambayo. Kuchepetsa kuthamanga kwa magazi ku zomwe zikuwonetsedwa kumachepetsa kuchepa kwa thupi ndi kufa komwe kumakhudzana ndi stroko, aimpso komanso kuwonongeka mtima, komanso kumalepheretsa kupitilira kwa matenda oopsa.

Mankhwalawa, chiopsezo cha matenda a mtima (kuchepa kwa glucose, kusuta, hypercholesterolemia, kumanzere kwamitsempha yamagazi) chikuyenera kuganiziridwanso. Kugwiritsa ntchito antihypertensive mankhwala omwe amaphwanya kuloleza glucose, omwe amakhudza metabolidi ya lipid ndi zina mwamavuto, amafunika kusamala ndi kulingalira koyenera. Mankhwala a antihypertensive, ndikofunikira kupangira zokonda zomwe zimachepetsa kumanzere kwamitsempha yamagazi.

Simungayimitse mwadzidzidzi chithandizo ndipo mwadzidzidzi muthane ndi ma antihypertensive mankhwala, omwe angayambitse "achire" komanso kuwonjezereka kwa kuthamanga kwa magazi, kuwonongeka m'magazi othandizira ku ziwalo zofunika.

Kuchokera pamankhwala ambiri a antihypertensive, ndikofunikira kudziwa kuchuluka kwa mankhwalawa (ogwira, omwe ali ndi zotsatirapo zoyipa zomwe zingachitike) ndikutsatira, ndikuthandizira mulingo woyenera kenaka ndikukonzekera Mlingo. Mankhwala aposachedwa sikuti amakhala abwino nthawi zonse komanso ogwira ntchito, ngakhale mwina ndi mafashoni kwambiri.

Ndikofunika kuyang'ana kupitiliza kwa outpatient ndi inpatient chithandizo.

Zisonyezero zamankhwala othandizirana:

Zovuta zamankhwala oopsa zimakhala zazikulu komanso zodalirika.

Kuwonjezeka kwa matenda oopsa obwera chifukwa cha chithandizo chofuna kufotokozera zomwe zimayambitsa mavuto komanso kusankha kwa mankhwala.

Kupanda kuchepa kwa kuthamanga kwa magazi, ngakhale chithandizo chovuta pachimake.

Kufunika koyezetsa wodwalayo kuti azigwira ntchito komanso kupatulidwa kwa matenda oopsa.

Njira yothandizira matenda oopsa:

Kuthetsa mavuto osokoneza bongo ndi amisala.

Mankhwala osagwiritsa ntchito mankhwala

Mankhwala osokoneza bongo.

Kupititsa patsogolo kayendedwe ka magazi a matenda a chithokomiro.

Chithandizo cha zovuta: kupumula kwa mavuto azisokonezo, matenda ammatumbo, kulephera kwamitsempha, kulephera kwa aimpso, kugundika kwa magazi.

Mankhwala osagwiritsa ntchito mankhwala

Choyimira kwambiri pathogenetically chofunikira kwambiri mu matenda oopsa Zakudya za hypersodium nambala 10g. Mfundo zazikuluzikulu zamafuta azakudya zochotsa matenda oopsa ndizo:

ndimankhwala onenepa - kuletsa kwa kalori tsiku ndi tsiku,

antiatherossteotic cholinga chakudya,

kutsika kwakanema kwamadzi am'madzi mpaka 1-1,5 malita patsiku,

amachepetsa mchere. Kumwa kwa mchere wa 1-3 g patsiku kumatengedwa kuti ndi otsika, "abwino" - 2-5 g, odziletsa - 8-12 g, okwera - oposa 15 g,

Kuchepetsa kudya kwamafuta akudya ndi kupatsa thanzi zakudya zamafuta osakwaniritsidwa, zomwe zimapangitsa kuchepa kwamphamvu kwa magazi,

kupindulitsa kwa zakudya ndi zinthu zomwe zimakhala ndi magnesium ndi potaziyamu, chifukwa zimathandizidwa mosavuta kuchoka mthupi motsutsana ndi chakudya chamagulu ambiri.

kuphatikizidwa muzakudya za zakudya zopezeka mu lipotropic zinthu ndi ma membrane am'mimba, komanso nsomba zam'nyanja (nsomba zam'nyanja, nkhanu, nkhanu, shrimps, seaweed),

Nthawi ndi nthawi kusintha kwa hyponatrium zakudya ndi magnesium zakudya, zotchulidwa mu mawonekedwe a 3 zakudya kwa masiku 3-4 aliyense.

Kulemera kwa thupi

Kuchepetsa thupi kwa anthu onenepa kwambiri kungapangitse kuti magazi azithamanga kwambiri. Ndi kuwonjezeka kwapakati komanso kutchulidwa kwa kuthamanga kwa magazi mwa anthu onenepa, kunenepa kwambiri kwamankhwala kumawonjezera mphamvu ya mankhwala osokoneza bongo, kumachepetsa hypertrophy yamanzere yamanzere.

Kuchepetsa mowa komanso kusuta

Mochuluka, mowa umakhala ndi vasopressor mwachindunji. Kusuta kumawerengedwa kuti ndi gawo lomwe lingachititse matenda oopsa.

Kuchita masewera olimbitsa thupi pafupipafupi

Ngati vutoli likuloleka, wodwalayo ayenera kulimbikitsa kuchita masewera olimbitsa thupi nthawi zonse. Zochita zolimbitsa thupi zolimbitsa thupi pang'ono (kuyenda, kuthamanga, kusambira, kuyendetsa njinga, kusewera, tenisi, volleyball) kumayambitsa kuchepa kwa kuthamanga kwa magazi mosasamala kanthu za kuchepa thupi kapena kusintha kwa sodium excretion. Masewera olimbitsa thupi a Isotonic (kuthamanga ndi kudumpha, kusambira) ndizofunikira kwambiri kuposa masewera olimbitsa thupi a isometric (kuwonjezera thupi, kunyamula zolimbitsa thupi.

Psychorelaxation, oganiza bwino psychotherapy

Matenda oopsa a arterial ndi chisonyezo cha kuphatikizana. Acupuncture imathandizira kusintha mamvekedwe a malo a vasomotor, achifundo achifundo, endocrine system, yomwe imabweretsa kuchepa kwa magazi.

Kusintha kwamoyo

Maziko a zosagwiritsa ntchito mankhwala osokoneza bongo ndikuchotsa zinthu zomwe zimawonjezera kuthamanga kwa magazi ndikuwonjezera chiopsezo cha zovuta zamtima. Kusintha kwamoyo kumalimbikitsidwa kwa onse odwala omwe ali ndi matenda oopsa. Mwa anthu omwe alibe chiopsezo, omwe ali ndi kuthamanga kwa magazi komwe kumagwirizana ndi gawo la 1 la matenda oopsa, njira yokhayo yamankhwala imagwiritsidwa ntchito. Onaninso zotsatirazi miyezi ingapo. Ndiwowonjezera kukakamizidwa kwa madigiri a 2 popanda zoopsa kapena digiri yoyamba, koma ndi ma 1-2 a FR, kudikira-ndi-kuwona kumapitilira kwa masabata angapo.

Zakudya zamankhwala

Ngakhale gawo la nthendayi, zakudya zopezeka potaziyamu zimaperekedwa motsutsana ndi mchere ndi madzi - tebulo No. 10. Nthawi yomweyo, zakudya ziyenera kukhala zokwanira, koma osati zochulukirapo. Kuchuluka kwa mchere womwe umagwiritsidwa ntchito patsiku sikuyenera kupitirira 8-10, mulingo woyenera - osapitilira 5 g. Madziwo amachepetsa malita 1-1.2. Izi zimaphatikizapo madzi oyera, zakumwa, ndi madzimadzi omwe adadzazidwa ndi chakudya (msuzi).

Ndikofunika kuti musamachotsere zakudya zanu zomwe zimapangitsa kuti mtima uzikhala ndi moyo: khofi, tiyi wamphamvu, koko, chokoleti, zakudya zonunkhira, nyama zosuta, komanso mafuta a nyama. Zakudya zamkaka ndi zamasamba, mbewu monga chimanga ndizothandiza, mutha kudya nyama zopanda nsomba ndi nsomba. Ndikofunika kuti muphatikize zoumba zouma zouma, ma apricots, zouma, uchi ndi zakudya zina zomwe zili ndi potaziyamu muzakudya. Mitundu yosiyanasiyana ya mtedza, ma nyemba, oatmeal ndi ma magnesium ambiri, omwe amakhudza bwino mtima ndi mitsempha yamagazi.

Moyo wokangalika

Anthu omwe amakhala moyo wongokhala ayenera kuthana ndi zinthu zolimbitsa thupi. Komabe, zolimbitsa thupi zitha kukhala zothandiza kwa aliyense. Katunduyo akuwonjezeka pang'onopang'ono. Masewera a Aerobic ndiofunikira: kusambira, kuyenda, kuthamanga, kupalasa njinga. Kutalika kwa maphunziro - osachepera mphindi 30 patsiku. Ndikofunika kuti muziyeseza tsiku ndi tsiku, koma mutha kupumula kwa masiku awiri. Zonse zimatengera kuthekera kwakumunthu ndi kukula kwamlingo. Katundu wamagetsi amachotsedwa bwino, chifukwa amatha kubweretsa kuwonjezeka.

Kulimbana ndi mapaundi owonjezera

Polimbana ndi kunenepa kwambiri, kudya mokwanira komanso kuchita masewera olimbitsa thupi kungathandize. Koma ngati izi sizokwanira kapena kulemera kwake ndi kwakukulu kwambiri, ndiye kuti kukonzekera kwapadera kungagwiritsidwe ntchito: Orlistat, Xenical. Nthawi zina, pitani kuchipatala. Chimodzi mwazomwe mungagwiritse ntchito pochita opareshoni ndi jejunocolonostomy (opaleshoni ya m'mimba), yomwe imakupatsani mwayi wokumitsa m'mimba kupukusira. Wachiwiri ntchito ndi ofukula bandeji gastroplasty. Pachifukwa ichi, mphete zapadera zimagwiritsidwa ntchito zomwe zimakhazikitsidwa pamatumbo am'mimba, potero kuchepetsa mphamvu yake. Pambuyo pa chithandizo chotere, munthu sangathenso kudya kwambiri.

Kuchepetsa thupi ndikofunikira kuyang'aniridwa ndi dokotala kapena wathanzi. Mulingo woyenera ndi kuchepa kwa thupi patsiku ndi 2,5 makilogalamu, koma osapitilira 5 kg. Izi ndizachilengedwe, ndipo thupi limatha kusintha kusintha. Kuchepetsa thupi mwadzidzidzi kumatha kukhala koopsa.

Zizolowezi zoyipa ndi kupsinjika

Kuti muthane ndi matenda oopsa, muyenera kusiya zizolowezi zoipa. Kuti muchite izi, lekani kusuta ndikuletsa kumwa mowa kwambiri. Ndi zopsinjika pafupipafupi komanso zolimbikira, muyenera kuphunzira momwe mungapumulire ndikuyankha moyenera pazovuta. Njira zilizonse ndizoyenera izi: kuphunzitsidwa kwazokha, kufunsira kwa psychologist kapena psychotherapist, makalasi a yoga. Woopsa, mankhwala a psychotropic angagwiritsidwe ntchito. Koma chinthu chachikulu ndikupumula komanso kugona.

Mankhwala

Mankhwala amakono ndi othandiza kwambiri polimbana ndi matenda oopsa komanso zovuta zake. Funso la kuperekedwa kwa mapiritsi limabuka pamene mtundu wa moyo sukusintha zotsatira zabwino ndi gawo 1 ndi 2 madigiri ochepa osasokoneza. Nthawi zina, chithandizo chimaperekedwa nthawi yomweyo, pomwe amayamba kuzindikira.

Kusankhidwa kwa mankhwala ndi kwakukulu kwambiri, ndipo amasankhidwa payekha kwa wodwala aliyense. Piritsi limodzi limakhala lokwanira kwa munthu, osachepera awiri kapena awiri amomwe amawonetsa kwa iwo. Munjira yothandizira, mankhwalawa amatha kusinthidwa, kuwonjezeredwa, kuchotsedwa; kuchuluka kwa mlingo kapena kuchepa ndizotheka.

Chinthu chimodzi sichisasinthe - mankhwalawa amayenera kukhala osasinthika. Kudziletsa pakokha kapena m'malo mwake sikovomerezeka. Nkhani zonse zokhudzana ndi kusankha kwa mankhwala ziyenera kusankhidwa ndi adokotala okha.

Zinthu zosiyanasiyana zimapangitsa kusankha kwa mankhwala:

• Zowopsa zomwe zilipo komanso kuchuluka kwake,
• gawo la matenda oopsa,
• kuchuluka kwa zowononga mtima, mitsempha yamagazi, ubongo ndi impso,
• matenda ophatikizika amodzimodzi
• zokumana nazo zam'mbuyomu zama antihypertensive mankhwala,
• kuthekera kwachuma kwa wodwala.

ACE zoletsa

Ili ndiye gulu lotchuka la mankhwala ochizira matenda oopsa. Ma Inhibitors otsatirawa atsimikizira zotsatirazi m'machitidwe:

• Kuchepetsa ndi kuchepetsa magazi,
• Kuchepetsa chiopsezo cha zovuta za mtima ndi mtsempha wamagazi,
• Cardio ndi nephroprotective zotsatira,
• Kuchepetsa kusintha kwa ziwalo zomwe mukufuna,
• kusintha kwamtsogolo kwa chitukuko cha mtima kulephera.

ACE inhibitors amalepheretsa ntchito ya renin-angiotensin-aldosterone system (RAAS) poletsa eniotensin-yotembenuza enzyme. Komanso, angiotensin II sapangidwa kuchokera ku angiotensin I. Izi zimaphatikizidwa ndi kuchepa kwa kupanikizika kwadongosolo, kutsika, komanso kuchepa kwamanzere amitsempha yamagazi.

Poyerekeza ndi chithandizo, makamaka yayitali, zodabwitsa zakuthambo zimatha. Izi ndichifukwa choti ACE inhibitors saletsa njira yachiwiri yopangira angiotensin II pogwiritsa ntchito ma enzymes ena (ma chymases) mu ziwalo ndi minofu. Zotsatira zake pafupipafupi komanso zosasangalatsa za mankhwalawa zimakhala zilonda zapakhosi ndi chifuwa chowuma.

Kusankhidwa kwa ma inhibitors a ACE ndikofunikira kwambiri masiku ano:

• enalapril - Enap, Burlipril, Renipril, Renitek, Enam,
• lisinopril - Diroton, Lysoril, Diropress, Lister,
• ramipril - Amprilan, Hartil, Dilaprel, Pyramil, Tritace,
• fosinopril - Monopril, Fosicard,
• perindopril - Prestarium, Perineva, Parnavel,
• zofenopril - Zokardis,
• hinapril - Akkupro,
• Captopril - Kapoten - wogwiritsidwa ntchito pazovuta.

Kumayambiriro kwa chithandizo, Mlingo wocheperako umagwiritsidwa ntchito, womwe umayamba kuwonjezeka. Kuti mukwaniritse bwino, zimatenga nthawi, pafupifupi, kuyambira milungu iwiri mpaka 4. Gulu la mankhwalawa limaphatikizidwa mwa amayi apakati, omwe ali ndi potaziyamu ambiri m'magazi, aimpso yamitsempha yamagazi yotupa, angioedema motsutsana ndi momwe amagwiritsidwira ntchito mankhwalawa m'mbuyomu.

Angiotensin II receptor blockers (ARBs, sartans)

Kwa mankhwalawa gululi, zovuta zonse zomwe zimawonedwa mu ACE inhibitors ndizodziwika. Pankhaniyi, ntchito ya RAAS imasokonezedwanso, koma chifukwa chakuti zolandilira zomwe zimakhudzidwa ndi angiotensin II zimasiyidwa nazo. Chifukwa cha izi, ARB ilibe mphamvu yosuntha, popeza mankhwalawa amagwira ntchito mosasamala kanthu momwe Angiotensin II amapangidwira. Kukhosomola kouma sikumakhala kofala, chifukwa chake sartan ndi njira yabwino kwambiri yotsatsira ACE yoletsa kuvutikira kumapeto.

Oyimira akuluakulu a sartani:

• losartan - Lorista, Lozap, Lozarel, Presartan, Blocktran, Vazotens, Cozaar,
• valsartan - Valz, Valsacor, Diovan, Nortian,
• Irbesartan - Aprovel,
• azilsartan medoxomil - edarby,
• Telmisartan - Mikardis,
• Eprosartan - Teveten,
• Olmesartan Medoxomil - Cardosal,
• Makandulo - Atacand.

Calcium Channel blockers (a calcium calcium Antagonists)

Zotsatira zazikulu za gululi la antihypertensive agents zimagwirizanitsidwa ndi kuchepa kwa kashiamu wama cell minofu yosalala. Izi zimachepetsa kuzindikira kwa khoma lakumaso kwa zochita za vasoconstrictor. Vasodilation kumachitika ndipo zotumphukira zawo kwathunthu zimachepa.

Mankhwalawa samakhudza njira zopangira kagayidwe kachakudya mthupi, atulutsa chitetezo cha chiwalo, ndikuchepetsa chiopsezo cha kuundana kwa magazi (antiplatelet athari). Omwe akutsutsana ndi calcium amachepetsa mwayi wokhala ndi stroke, amachepetsa kukula kwa atherosulinosis, ndipo amatha kuchepetsa LVH. Mankhwala oterewa amakonda mitundu yokhayo yokhala ndi matenda oopsa.

Ma calcium antagonists agawika m'magulu atatu:

1. Dihydropyridines. Amasankha mosamala pakhoma la mtima popanda kukhudza kwambiri mtima dongosolo komanso mtima wamkati.
2. Phenylalkylamines amachita makamaka pamtima, amachepetsa kuchepa kwa mtima, kuchepetsa pafupipafupi komanso mphamvu yamphamvu yamtima. Osatengera zotumphukira. Izi zimaphatikizapo verapamil - Isoptin, Finoptin.
3. Benzodiazepines ali pafupi ndi verapamil, komanso ali ndi vuto la vasodilating - Diltiazem.

Otsutsa calcium calcium amawonjezera pang'onopang'ono.Izi zikuphatikiza nifedipine ndi mawonekedwe ake: Cordaflex, Corinfar, Phenigidin, Nifecard. Mankhwalawa amatha maola 3-4 okha ndipo pano amagwiritsidwa ntchito kuti achepetse kuthamanga kwa magazi. Pazithandizo mosalekeza, ma nifedipines a nthawi yayitali amagwiritsidwa ntchito: Nifecard CL, Cordaflex retard, Corinfar UNO, calcigard retard, etc.

Zochizira pafupipafupi matenda oopsa, kugwiritsa ntchito amlodipine ndikulimbikitsidwa, komwe kumakhala ndi mitundu yambiri: Tenox, Stamlo, Kulchek, Norvask, Normodipine. Mankhwala ena amakono ndi awa: felodipine (Felodip, Plendil) ndi lercanidipine (Lerkamen, Zanidip).

Koma ma dihydroperidins onse ali ndi chinthu chimodzi chabwino - amatha kuyambitsa kutupa, makamaka pamiyendo. M'badwo woyamba, izi zimachitika nthawi zambiri, ku felodipine ndi lercanidipine, izi ndizochepa.

Diltiazem ndi verapamil sikuti sagwiritsidwa ntchito pochotsa matenda oopsa. Kugwiritsa ntchito kovomerezeka ndi concomitant angina pectoris, tachycardia, ngati B-blockers ndi otsutsana.

Diuretics (okodzetsa)

Ma diuretics amathandizira kuti thupi lichotse sodium yambiri ndi madzi, ndipo izi zimapangitsa kutsika kwa magazi. Nthawi zambiri amagwiritsidwa ntchito ndi thiazide diuretic - hydrochlorothiazide (Hypothiazide). Liazide-ngati diuretics imagwiritsidwa ntchito mwachangu: indapamide (Ravel, Arifon), mwinanso nthawi zambiri, chlortalidone. Mlingo wocheperako umagwiritsidwa ntchito limodzi ndi mankhwala ena a antihypertensive kuti muthe kusintha.

Ngati chithandizo cha antihypertensive sichitha, aldosterone receptor antagonists, veroshpiron, akhoza kuwonjezeredwa pamankhwala. Watsopano loop diuretic - torasemide (Diuver, Trigrim, Britomar) alinso ndi anti-aldosterone kanthu. Mankhwalawa satenga nawo mbali m'thupi. Veroshpiron imasungabe potaziyamu m'thupi, torasemide nayenso samachichotsa. Ma diuretics amenewa ndi othandiza kwambiri kuchepetsa kufooka kwa anthu onenepa kwambiri omwe amapanga aldosterone kwambiri m'thupi. Osamachita popanda ndalama izi komanso ndi kulephera mtima.

B-blockers

Mankhwalawa amaletsa ma adrenergic receptors (β₁ ndi β₂), yomwe imachepetsa mphamvu ya mtima wogwirizira pamtima. Nthawi yomweyo, pafupipafupi komanso mphamvu ya kugunda kwa mtima imachepa, mapangidwe a renin mu impso ndi otsekeka. Padera paokha pochiza matenda oopsa, gululi siligwiritsidwa ntchito kawirikawiri, pokhapokha ngati pali tachycardia. B-blockers nthawi zambiri amaperekedwa kwa odwala omwe ali ndi vuto la angina pectoris, myocardial infarction, kapena chifukwa cha kulephera kwa mtima.

Gululi limaphatikizapo:

• bisoprolol - Concor, Bidop, Coronal, Niperten, Cordinorm,
• metoprolol - Egilok, Metocardium, Vasocardine, Betalok,
• nebivalol - Nebilet, Bivotens, Nebilong, Binelol,
• carvedilol - Coriol, Carvenal,
• betaxolol - Lokren, Betoptik.

Contraindication kuti mugwiritse ntchito ndi mphumu ya bronchial komanso kuzindikira kwa blockade kwa madigiri 2-3.

Imidazoline receptor agonists

Kalasi yaying'ono iyi ya mankhwala a antihypertensive imakhudza dongosolo lamkati lamanjenje, makamaka, makamaka kwa ine₂-imidazoline medulla receptors. Zotsatira zake, ntchito yamanjenje amachepetsa, kuthamanga kwa magazi kumachepa, mtima umagwirizana kwambiri. Imakhala ndi phindu pa chakudya chamafuta ndi mafuta, pa ubongo, mtima ndi impso.

Omwe akuimira gululi ndi moxonidine (Moxarel, Tenzotran, Physiotens, Moxonitex) ndi rilmenidine (Albarel). Amavomerezeka kuti agwiritsidwe ntchito kwa odwala omwe ali ndi kunenepa kwambiri komanso matenda osokoneza bongo omwe amaphatikizidwa ndi mankhwala ena. Moxonidine adadzitsimikizira ngati thandizo ladzidzidzi pamavuto komanso kuwonjezeka kwakukulu kwa kupanikizika.

Mankhwalawa amatsutsana ndi matenda a sinus syndrome, bradycardia (kugunda kwa mtima kosakwana 50), mu mtima ndi kulephera kwa impso, komanso pachimake coronary syndrome.

Kuphatikiza kosasintha

Chosangalatsa chachikulu ndi kuphatikiza kwamakono kwa mankhwala osokoneza bongo a antihypertensive. Ndiwosavuta kugwiritsa ntchito, popeza kuchuluka kwa mapiritsi omwe amamwa kumachepetsedwa. Ochulukirapo ndi ACE kapena ARB inhibitors okhala ndi okodzetsa, ochepera kwambiri ndi amlodipine. Pali mitundu yosakanizika ya B-blockers yokhala ndi diuretics kapena amlodipine. Pali mitundu yophatikiza katatu, kuphatikiza ndi ACE inhibitor, diuretic ndi amlodipine.

Pomaliza

Hypertension si chiganizo. Ndi kuyambitsidwa kwakanthawi kwa chithandizo chovuta, kuphatikiza njira zosagwiritsa ntchito mankhwala ndi mankhwala amakono, zakutsogolo ndizabwino. Ngakhale ndi matenda a siteji yachitatu, pamene ziwalo zomwe zakukondweretsani zimakhudzidwa kwambiri, mutha kukulitsa moyo wa munthu zaka zambiri.

Koma nthawi yomweyo, musaiwale za chithandizo cha matenda ophatikizika, monga matenda a shuga, matenda a mtima, etc. Pofuna kuthana ndi atherosclerosis, ma statin amagwiritsidwa ntchito, othandizira antiplatelet (aspirin) amathandizira kupewa thrombosis. Kukwaniritsa cholinga ichi ndikotheka pokhapokha potsatira malangizo a dokotala.

Chifukwa chiyani matenda oopsa amachitika?

Hypertension ndi njira yodziwika ndi matenda osatha, ndiye kuti, kuchuluka kwa kuthamanga kwa magazi (BP). Matendawa nthawi zambiri amapezeka zaka zapakati pa 40 ndi 50, koma pamakhala zochulukirapo pamene matendawa adakhazikitsidwa ali aang'ono - izi zimachitika chifukwa cha kuchuluka kwa zizolowezi, kuphwanya kugona ndi kudzutsidwa, kuperewera kwa zakudya, komanso kuperewera bwino kwa chilengedwe.

Pochiza nyumba, ma tincture osiyanasiyana ochokera ku zitsamba amagwiritsidwa ntchito kwambiri, mwachitsanzo, tiyi wochokera ku chamomile, timbewu tonunkhira, tiyi wobiriwira, decoction wa zipatso za viburnum, phulusa laphiri. Kugwiritsa ntchito kwawo pafupipafupi kumatha kulimbitsa khoma lam'mimba ndikupangitsa kupanikizika kukhazikika.

Pali mitundu iwiri yayikulu yamatenda - matenda oyamba ndi owopsa. Matenda oopsa a pulayimale ndi osangalatsa kwambiri chifukwa cha zomwe zimayambitsa ndi matenda, zimapangitsa zoposa 90% ya maulendo onse okalandira madokotala okhudzana ndi kuthamanga kwa magazi. Uku ndikuwonjezereka kwa kuthamanga kwa magazi, komwe kudachitika mwaokha, popanda matenda am'mbuyomu. Ilibe chifukwa chachilengedwe, ndipo tizilombo toyambitsa matenda tizilombo tating'onoting'ono timakhala zovuta kupanga ndipo ndizovuta kuzungulira. Udindo waukulu umachitika ndimapangidwe a renin, omwe amasinthidwa kukhala angiotensin machitidwe a ACE (angiotensin otembenuza enzyme). Izi zimabweretsa kutulutsidwa kwa vasoconstrictor yamphamvu, angiotensin II, yomwe imayambitsa zotsatira zoyipa. Kuchiza ndi chizindikiro kapena pathogenetic (umalimbana ndikuphwanya mzere woipa).

Hypertension yachiwiri ili ndi chifukwa chomveka - imakhala ndi matenda oyamba omwe amakhudza imodzi mwazinthu zomwe zimayendetsa kuthamanga kwa magazi. Izi zitha kukhala matenda a mtima dongosolo, impso, endocrine dongosolo (pituitary kapena adrenal gland, nthawi zina chithokomiro cha chithokomiro). Chithandizo cha matenda oopsa achiberekero chimaganizira tanthauzo lake, chifukwa chenicheni. Kupanikizika kumachepa, koma ntchito yayikulu ya dotolo ndikuchotsa matenda oyamba. Kuchulukitsidwa kwamtunduwu kumawonjezera pafupifupi 5% ya zopempha zamankhwala zothandizira matenda oopsa.

Kupezeka kwa matenda oopsa kumathandizidwa ndi zovuta:

• kupsinjika ndi kukhumudwa,
• kusuta
• kuphwanya kugona
• kuperewera kwa zakudya m'thupi
• kunenepa
• moyo wosachita bwino
• zaka zopitilira 40
• amuna
• kubadwa kwamtundu (kupezeka kwa banja la anthu omwe ali ndi matenda ofanana),
• matenda ashuga
• Kusokonezeka kwamchere wamchere wamchere (mwachitsanzo, kumwa kwambiri kwa sodium mu mawonekedwe a sodium chloride).

Maziko othandizira matenda oopsa ndi momwe zimakhudzira ma pathogenetic mothandizidwa ndi kuphatikiza mankhwala, omwe amakupatsani chithandizo chokwanira cha matenda.

Amawonjezera kuchuluka kwa matenda, ndipo ngati pali zinthu zingapo zoopsa, ndiye kuti mwayi wokhala ndi matenda oopsa umawonjezeka kwambiri.

Zizindikiro za matenda oopsa

Chizindikiro cha matenda oopsa ndi ziwonetsero zamagazi owonjezera a 130 mm Hg. Art. systolic ndi 90 mm RT. Art. za diastolic.

Hypertension imatha kuchitika kwanthawi yayitali, nthawi zambiri munthu samazindikira kuti kuthamanga kwa magazi ake sikwabwinobwino. Izi ndizotheka ndi matenda ofatsa. Odwala amangosokonezedwa nthawi ndi nthawi chifukwa cha zizindikiro zosasangalatsa monga kupweteka kwambiri pamutu ndi kuwawa kwa mutu, monga lamulo, samvera chidwi kwambiri ndi izi.

Pakapita nthawi, matendawa amawonekera mu chipatala chowala, chomwe chimasiyana kuchokera ku mawonekedwe osakhazikika kupita ku zizindikiro zowoneka bwino zomwe zimakhudzana ndi kuwonongeka kwa ziwalo ndi machitidwe omwe akufuna:

• mtima (kumva kufinya kapena kupweteka kwakumbuyo kumbuyo kwa kumbuyo, tachycardia, arrhythmia, mphamvu zosagwirizana ndi kugunda kwa mtima kapena kumva kugunda kwamtima, kumva kuwawa),
• ubongo (chizungulire, kugona, kupweteka mutu, kusawona bwino, kusokonezeka kukumbukira ndi kulingalira),
• impso (oliguria - utachepa mkodzo, kupweteka pakukodza, kukula kwa impso dystrophy),
• retina (amawuluka patsogolo pa maso, kudetsa khungu m'maso, kusawona bwino).

Ngati zizindikiro zotere zikuwoneka, muyenera kufunsa katswiri, osafuna kudzipulumutsa. Choyamba, ndikofunikira kudziwa kuchuluka kwa matendawo - digiri yoyamba, chithandizo chamankhwala sichigwiritsidwa ntchito, kapena chimagwiritsidwa ntchito mosawerengeka, ndipo mawonetseredwe a matendawa amachotsedwa ndikukhazikitsa regimen ya tsiku ndi tsiku, kubwezeretsa zakudya ndikuwonjezera zochitika zamagalimoto.

Chithandizo cha matenda oopsa achiberekero chimaganizira tanthauzo lake, chifukwa chenicheni. Kupanikizika kumachepa, koma ntchito yayikulu ya dotolo ndikuchotsa matenda oyamba.

Zizindikiro

Kenako amafufuza kwathunthu. Zimayamba ndikuwunika kwa dokotala komanso kuchuluka kwa kuthamanga kwa magazi, kutsatiridwa ndi njira zingapo zothandizira - ECG (electroencephalogram) imachitidwa, kuyezetsa magazi kwa minofu ya mtima ndi chipinda cha mtima kwa hypertrophy kumachitika, penyani yotsatsira magazi imayikidwa kuyesa kuthamanga tsiku lonse - izi zimapereka chidziwitso chokwanira yomwe imatha kudziwa kukhalapo kwa matenda oopsa ndi mtundu wake (usana kapena usiku). Fundus imayang'aniridwa kupezeka kwa sitima zosinthidwa, zomwe nthawi zambiri zimapezeka ndikuwonetsa kukhudzidwa kwanthawi yayitali.

Njira zodziwonera zasayansi zimaphatikizapo kusanthula magazi ndi mkodzo, kuyezetsa magazi kosiyanasiyana.

Hypertensive chithandizo regimens

Pali muyezo wochizira matenda oopsa. Uku ndi kuyendetsa machitidwe ndi mndandanda wamankhwala omwe analimbikitsidwa, omwe amavomerezedwa ndi mabungwe apadziko lonse lapansi komanso malinga ndi momwe mankhwalawa amachitikira. Dokotala amatha kuchokerapo pokhapokha ngati wodwala ali ndi vuto lapadera, losachita zachinyengo. Protocol yogwirizana imagwiritsidwa ntchito onse kuchipatala komanso kuchipatala.

Kuyambira pachiyambi pomwe, odwala onse omwe ali ndi matenda oopsa amakhala m'magulidwe omwe amakhala nawo koyambirira komanso omwe ali ndi yachiwiri. Kenako tsimikizani magawo a matenda oopsa chifukwa cha kuwonongeka kwa ziwalo zomwe zakulingana ndi muyeso:

1. Hypertension (GB) siteji I - kuwonongeka kwa ziwalo ndi machitidwe kulibe kapena sikokwanira kuzindikira, ndipo vuto la hypertgency silimachitika kapena silovuta chifukwa cha kulephera kwa ziwalo.
2. Gawo II GB - kuvulala kamodzi mu ziwalo, zotupa mu parenchyma, zomwe zimatsatana ndi zizindikiro zofananira. Kupezeka kwamavuto ovuta kwambiri oopsa ndipo zotsatira zake ndizotheka.
3. Gawo III GB - kuwonongeka kambiri kwa ziwalo zomwe zikujambulidwa, kulephera komwe kumayenderana ndi kusayenda bwino kwawo, kukula kwa fibrosis ndi kusintha kwina pamapangidwe awo. Chiwopsezo chachikulu cha zovuta zovuta, chithandizo chothandizira ndikuwongolera kuthamanga kwa magazi ndikofunikira.

Mu digiri yoyamba, chithandizo cha mankhwala osokoneza bongo sichikugwiritsidwa ntchito, kapena kugwiritsidwa ntchito mosawerengeka, ndipo mawonetseredwe a matendawa amachotsedwa ndikukhazikitsa regimen ya tsiku ndi tsiku, kubwereza zakudya ndikuwonjezera ntchito zamagalimoto.

Chithandizo chamakono cha matenda oopsa

Maziko othandizira matenda oopsa ndi momwe zimakhudzira ma pathogenetic mothandizidwa ndi kuphatikiza mankhwala, omwe amakupatsani chithandizo chokwanira cha matenda. Pachifukwa ichi, magulu angapo a mankhwalawa amagwiritsidwa ntchito omwe amasiyana mumachitidwe awo. Gulu lalikulu la mankhwalawa limaphatikizapo:

1. Zodzikongoletsera - ndalama zomwe zimachulukitsa tsiku ndi tsiku diureis (kukodza) pokhudza ma nephrons a impso ndi ion moyenera mwa iwo. Ma diuretics amatha kugwiritsa ntchito njira zosiyanasiyana, imatha kukhala yopikisana ndi aldosterone (yomwe imasunga sodium m'thupi, ndipo ndimadzi - umu ndi momwe Spironolactone ndi Veroshpiron amathandizira), kusinthana kwa sodium potaziyamu (panthawiyi, sodium imachoka m'thupi ndikupanga madzi ambiri nawo - okodzetsa ambiri khalani mwanjira iyi, mwachitsanzo Furosemide). Komanso m'gululi muli Hydrochlorothiazide, Hypothiazide, Indapamide (ndi mankhwala ophatikizika Arifon).
2. Beta blockers - zinthu zomwe zimaletsa ma beta-adrenergic receptors, omwe amapezeka muunyinji wamafuta, makamaka pamtima ndi m'mitsempha yamagazi. Malingaliro a dokotala pankhaniyi ndikukula ziwiya (izi zimawonedwa mwadongosolo pambuyo potenga mlingo woyenera wa blocker), komanso kusintha momwe minyewa yamtima imathandizira (chotsani ectopic foci ya chowonetsa, extrasystole ndi arrhasmia). Anaprilin ndiwa mankhwalawa (amagwiritsidwa ntchito pocheperako, chifukwa samasankha ndipo angayambitse bronchospasm), Metoprolol, Atenolol, Bisoprolol, Talinol.
3. ACE zoletsa - eniotensin-yotembenuza enzyme imayambitsa zochitika zosinthika zomwe zimatha kupeza angiotensin II, vasoconstrictor wamphamvu. Ngati muiletsa, imodzi mwazowopsa za pathogenesis ya matenda oopsa idzasokonekera. Mankhwala a gululi ndi othandiza kwambiri, amachepetsa kupanikizika, mosasamala kanthu za zifukwa, ali oyenera kuchitira odwala matenda oopsa, omwe sanawonetse diuretics. Awa ndi Captopril (Kapoten), Enalapril (Enap), Lisinopril.
4. Angiotensin Receptor blockers - mwayi wowonekera kwa mankhwalawo ndiwofanana ndi gulu loyambalo, koma nthawi ino zotsatira za angiotensin zimasokonekera chifukwa chotseka ma receptor ake. Ili ndi gulu latsopano la mankhwala, othandiza kwambiri komanso popanda zotsatira zoyipa. Izi zikuphatikizapo losartan. Mankhwalawa amalembera ana kuti athetse vuto la kuthamanga kwa magazi ku sekondale.
5. Omwe akutsutsana ndi calcium - chifukwa cha mayoni a calcium, kumachepetsa minofu yosalala m'makoma amitsempha yamagazi, chifukwa chomwe lumen yawo imachepetsedwa ndipo kuthamanga kwa magazi kumakwera. Gulu la mankhwalawa limaletsa kumanga mapuloteni enaake ku ma ion, motero, kupangika kwa zinthu zosalala za minofu sikuchitika. Izi zikuphatikiza Nifedipine (Corffar), Amlodipine.

Chizindikiro cha matenda oopsa ndi ziwonetsero zamagazi owonjezera a 130 mm Hg. Art. systolic ndi 90 mm RT. Art. za diastolic.

Mankhwala ochulukirapo akuphatikizapo omwe sagwiritsidwa ntchito kwenikweni chifukwa chogwira ntchito kwambiri komanso kufunika kotsatira mlingo, komanso chifukwa cha zovuta zina. Amatha kuchepetsa kuthamanga kwa magazi kwambiri kuposa mankhwala a gulu lalikulu, koma samagwiritsidwa ntchito pochiza matenda oopsa, kuchipatala moyang'aniridwa ndi adokotala ndi a pharmacist othandizira. Awa ndi magulu awa:

• alpha-adrenergic agonists, omwe amaphatikizapo clonidine ndi methyldopa (amachititsa kuchuluka kwakanthawi kwakanthawi, pambuyo pake amachepetsa kwambiri mitsempha yamagazi pochita ma receptors mkati mwa dongosolo lamitsempha lamkati),
• sympatholytics (sinthani maulendo amtsitsi)
• alpha blockers prazosin ndi doxazosin,
• renin inhibitor Aliskiren (yokhala ndi mndandanda waukulu wazotsatira),
• ma vasodilators omwe ali ndi jakisoni wamtundu wofanana ndi magnesium sulfate (mankhwalawa amagwiritsidwa ntchito kwambiri mu ambulasi chifukwa amachitika mwachangu, koma osasankha),
• antispasmodics (No-shpa ndi Drotaverinum).

Kuphatikiza apo, mankhwala osokoneza bongo amalembedwa, ndiye kuti, mankhwala omwe amanyoza ubongo.

Mankhwala osagwiritsa ntchito mankhwala osokoneza bongo komanso kupewa

Ndizothekanso kuchitira matenda oletsa kuthamanga kwa magazi ndi wowerengeka azitsamba, koma pokhapokha poyambira. Ngati dokotalayo akuwona kuti wodwalayo atha kuchiritsidwa popanda kugwiritsa ntchito mankhwala opatsirana mankhwalawa, atha kumamupangira zakudya, kum'patsa mankhwala olimbitsa thupi, kapangidwe kake ka zinthu zolimbitsa thupi, kapena kumutumiza ku spa.

Pochiza nyumba, ma tincture osiyanasiyana ochokera ku zitsamba amagwiritsidwa ntchito kwambiri, mwachitsanzo, tiyi wochokera ku chamomile, timbewu tonunkhira, tiyi wobiriwira, decoction wa zipatso za viburnum, phulusa laphiri. Kugwiritsa ntchito kwawo pafupipafupi kumatha kulimbitsa khoma lam'mimba ndikupangitsa kupanikizika kukhazikika.

Mulingo wothandizira mankhwalawa ndi chiwonetsero cha zochita ndi mndandanda wa mankhwala omwe amalimbikitsidwa, omwe amavomerezedwa ndi mabungwe apadziko lonse lapansi komanso malinga ndi momwe mankhwalawa amachitikira.

Njira yosavuta yopewera matenda kunyumba ndikugawa nthawi yoyenda mokhazikika yomwe idzakhale ndi masewera olimbitsa thupi, kukonza zakudya ndikofunikira: muyenera kuchepetsa kugwiritsa ntchito mchere ndi zonunkhira, zonunkhira. Chepetsani kugwiritsa ntchito zakudya zamafuta, makamaka, nyama yokazinga, zotsekemera zotsekemera, makamaka.

Kuchita masewera olimbitsa thupi okwanira kumafunikira, kutsatira malamulo ankhondowo masana, kugona mokwanira usiku kumafunika. Ngati ndi kotheka, kunenepa kwambiri kuyenera kusinthidwa. Kutentha kwambiri (malo osambira, saunas, kukhalabe pamoto) ndi kuphwanya.

Zizolowezi zoyipa ziyenera kusiyidwa - izi zimakhudzanso onse kusuta ndi kumwa mowa. Bwino kuletsa matenda a m'mimba kuposa kuchiza matenda oopsa.

Timapereka makanema kuti muwone kanema pamutu wankhaniyi.

Kulembera mankhwala kukakamiza

Kupereka mankhwala omwe amachepetsa kuthamanga kwa magazi ndi udindo wachindunji wa mtima wamtima! Matenda oopsa a arterial sizili momwe mungayesere thanzi lanu.

Mankhwala amathandizidwa potengera zomwe zimayambitsa kuthamanga kwa magazi mwa wodwala komanso matenda ena okhudzana ndi izi. Mankhwala a antihypertensive omwe amachepetsa kuthamanga kwa magazi amagawika m'magulu osiyanasiyana, kutengera kapangidwe ndi kayendetsedwe kake.

Chifukwa chake, ndi matenda oopsa a 1 degree popanda zovuta, ndikokwanira kumwa osaposa 1 mankhwala. Ndi kuthamanga kwa magazi komanso kupezeka kwa chiwopsezo cha ziwalo, mankhwalawa amapangidwa pogwiritsa ntchito mankhwala awiri kapena ambiri.

Komabe, posasamala kuchuluka kwa matenda oopsa, kuchepa kwa kuthamanga kwa magazi kuyenera kukhala pang'onopang'ono. Ndikofunikira kukhazikika popanda kudumpha mwadzidzidzi. Iyenera kuthandizidwa makamaka kwa odwala okalamba, komanso odwala omwe adwala matenda opha ziwalo zam'mutu.

Tsopano pochiza matenda oopsa, 2 njira zamankhwala zamankhwala zimagwiritsidwa ntchito kwambiri:

Monotherapy imakhala kupeza mankhwala omwe ali oyenera kuchita ndi odwala. Pokhapokha patakhala zotsatirapo zabwino, njira yakuchiritsira yomwe imagwiritsidwa ntchito imasinthidwa kukhala njira yophatikizira chithandizo.

Kuti muchepetse kuthamanga kwa magazi mwa wodwala, ndikofunika kugwiritsa ntchito mankhwala okhala nthawi yayitali.

Mankhwalawa, ngakhale ndi limodzi lokha, amalimbikitsa kuthamanga kwa magazi kwa maola 24. Ubwino wina ndi kudzipereka kwakukulu kwa wodwala chithandizo chamankhwala.

Momwe mungasankhire njira yochizira matenda oopsa

Ndizofunikira kudziwa kuti chithandizo cha mankhwala nthawi zonse chimapangitsa kuti magazi achepe. Odwala omwe ali ndi vuto la ubongo la arteryosulinosis, kuwonongeka m'magazi kupita ku minofu yaubongo nthawi zambiri kumawonedwa chifukwa cha kuchepa kwambiri kwa kuthamanga kwa magazi (oposa 25% kuchokera ku gawo loyamba). Izi zimakhudza thanzi la munthu. Ndikofunika kuyang'anitsitsa nthawi zonse zowonetsera, makamaka ngati wodwalayo wavutika kale ndi myocardial infarction kapena stroke.

Adotolo akakupereka mankhwala atsopano pazowonjezera zomwe wodwalayo akufuna, amayesetsa kuti alimbikitse kumwa mankhwalawo mozama kwambiri.

Izi zimachitika kuti mankhwalawa asayambitse mavuto. Ngati mawonekedwe a kuthamanga kwa magazi apezeka munjira yabwino, dokotala amawonjezera mlingo wa antihypertensive mankhwala.

Mukamasankha othandizira othandizira matenda oopsa, zinthu zambiri zimaganiziridwa:

1. M'mbuyomu zimachitika wodwala akamagwiritsa ntchito mankhwala enaake,
2. kuneneratu kwa kulumikizana ndi mankhwala omwe amamwa pofuna kuchiza matenda ena,
3. vuto lachivalo,
4. makulidwe a wodwalayo pamavuto,
5. kukhalapo kwa matenda opatsirana (matenda a kwamikodzo, matenda ashuga, metabolic syndrome),
6. chizindikiritso cha matenda omwe akupezeka mthupi la wodwalayo pakadali pano (kupatula kuthekera kwa kupereka mankhwala osagwirizana),
7. mtengo wa mankhwalawo.

Gulu la mankhwala

Mankhwala athu, pochiza matenda oopsa, mankhwalawa amakono amagwiritsidwa ntchito, omwe amatha kugawidwa m'magulu asanu:

• Calcium Antagonists (AK).
• Zodzikongoletsera.
• β-blockers (β-AB).
• AT1 receptor blockers (ARBs).
• Angiotensin-akatembenuza enzyme (ACE inhibitor).

Kusankha kwa mankhwala aliwonse kuthana ndi matenda oopsa kuyenera kukhazikitsidwa ndi zotsatirapo zake zomwe zingayambitse. M'pofunikanso kuwunika momwe matendawo akuwonera. Mtengo wa mankhwala umatengedwa kuti ndi womaliza.

Chithandizo chothandiza chitha kuperekedwa ndi adokotala, chifukwa chotsatira zotsatira zake.

Simungathe kupereka izi kapena mankhwalawo nokha, popanda chilolezo cha dokotala.

Kugwiritsa Ntchito Mankhwala Ochiritsira Ogwira Mtima

Kuyang'ana mapiritsi abwino kwambiri pamutu panu - ntchito yopanda chitetezo. Kupatula apo, mankhwala aliwonse amachitapo kanthu pazomwe zimayambitsa matendawa.

Komabe, zabwino zakuchiritsa kuthamanga kwa magazi zimatheka pokhapokha mothandizidwa ndi mankhwala ena.

Gome: Kulimbikitsa Kwambiri Kukakamiza

Ntchito yayikulu pakuchiza odwala omwe ali ndi matenda oopsa kwambiri ndiyo kuchepetsa kwambiri zomwe zingachitike chifukwa cha mtima komanso kupewa. Kuti akwaniritse zotsatira zabwino kwambiri, wodwalayo sayenera kungoyang'ana kukakamiza, komanso kuwunika moyo wake. Ndikofunika kusiya zizolowezi zoyipa ndikusintha maulamuliro ndikupuma.

Mankhwala othandiza pa vuto la matenda oopsa

Asanapereke mankhwala ena, dokotala wophunzirayo ayenera kuwunika zoopsa zilizonse zomwe zingachitike chifukwa chothira mankhwala.

Ndi vuto la kuthamanga kwa magazi komanso kuthamanga kwa magazi, dokotala wa ambulansi amatha kupatsa wodwala zida zamphamvu:

1. Kapoten 25 - 50 mg (imodzi mwamankhwala abwino kwambiri pazovuta).
2. Physiotens (Moxonidine), mlingo wa 0,4 mg. Kapena clonidine, ndi mlingo wa 0,075 - 0,15 mg. Mankhwala omaliza ali ndi dzina lachiwiri - clonidine. Amangoperekedwa kwa odwala omwe amakonda kumwa mankhwalawa. Pakadali pano amachotsedwa pakufalitsa mankhwala.
3. Nefedipan (Corinfar). Imaletsa bwino zisonyezo zamavuto oopsa. Amamwa mapiritsi a 10 kapena 5 mg.

Ngati kuthamanga kwa magazi sikuchepa pambuyo pa mphindi 30 mpaka 40 mutatha kumwa mapiritsi, ndiye kuti dokotala amatha kupanga jakisoni ndi mankhwala amphamvu kwambiri.

Momwe mungachepetse kuthamanga kwa magazi popanda mankhwala

Zochita za m'mawa zamasiku onse zimathandizira kuchepa kwa magazi kusintha magazi. Munthawi imeneyi, munthu ayenera kusiyiratu mchere ndi zonunkhira. Idyani zamasamba ambiri ophika komanso zakudya zopezeka potaziyamu ndi magnesium.

Kwa hypertensives, nyama ya nsomba ndiyothandiza kwambiri.

Kupsinjika kwa magazi nthawi zambiri kumachitika pakatha masiku awiri ndi atatu nditadya ndi cranberries ndi phulusa laphiri.

Plasters ya mpiru imathandizira msanga kumasula zizindikiro za matenda oopsa. Ndikokwanira kuziyika pamisempha ya ng'ombe.

Kuthamanga kwa magazi komwe kumachitika nthawi zonse kumakhala matenda owopsa, chithandizo chomwe chingaperekedwe kwa katswiri wodziwa ntchito, kupewa uphungu wa anthu wamba.

Q & A

Nthawi zambiri, atachepetsa mlingo wa mankhwalawa, kuwonjezeka kwa magazi kumachitika pang'onopang'ono. Koma kuletsa kapena kuchepetsa kuchuluka kwa mankhwalawa (mwachitsanzo, Anaprilin, Klofelin, Atenolol) kumatha kudzutsa kwambiri. Nthawi zambiri msinkhu wa kuthamanga kwa magazi ndiwokwera kwambiri kuposa woyamba. Chodabwitsachi chimatchedwa kuti kusiya matenda. Kupanikizika kumakula kwambiri masana. Kukula kumatha kudutsa onse komanso kungawonongeke ponseponse.

Ndikofunika kukumbukira kuti kudzipatula kungayambitse mavuto akulu monga kupweteka mutu, chizungulire, chikumbumtima, kugunda, kugunda kwa mtima komanso kufa mwadzidzidzi.

Kuchepa kwa kuthamanga kwa magazi kuyenera kuchitika pang'onopang'ono, makamaka kwa odwala okalamba. Kusintha kowopsa kwanjira yotsikira kumatha kusokoneza magazi m'magazi ofunikira. Kukwaniritsa zomwe mukufuna kukwaniritsa nthawi zambiri kumatenga milungu ingapo.

Kuzindikira sikuyenera kukhala chifukwa chokana chithandizo. Ndikofunikira kufunsa dokotala wanu yemwe angasinthe mlingo wa mankhwalawo kapena kuti akupatseni mankhwala ena.

Kugwiritsa ntchito mitundu iwiri kapena kupitilira apo yamankhwala kumatchedwa kuphatikiza mankhwala. Mankhwala amodzi nthawi zambiri amakhala osagwira ndipo amachepetsa kukakamizidwa ndi 4-8% yokha yoyambirira. Izi zikutanthauza kuti odwala amawonetsedwa chithandizo ndi mankhwala angapo omwe ali ndi zotsatira zosiyana, pomwe kuthamanga kwa magazi kupitirira 160/100 mm Hg.

Ngakhale kumwa mankhwala amodzi kumayambiriro kwa chithandizo kumapereka zotsatira zolimbikitsa, pakapita kanthawi magazi amayambika. Izi ndichifukwa chophatikizidwa ndi ntchito ya njira zina zomwe zimakhudzira kudumpha kwake. Nthawi zambiri, chithandizo ndi mankhwala awiri omwe amathandizira wina ndi mnzake imakhala ndi zotsatira zabwino. Kuphatikiza mankhwala ndi kwabwino chifukwa sikuti kumayambitsa zotsatirapo zoyipa zomwe zimadza ndi mlingo waukulu wa mankhwala amodzi. Odwala omwe ali ndi vuto loyambirira la magazi amatha kuyembekezera kumwa kamodzi kokha.

Ngati mankhwalawa a matenda oopsa sagwira ntchito mokwanira, dokotala amatha kusintha mlingo, amasintha kukhala mankhwala ena a antihypertensive kapena kugwiritsa ntchito mankhwala osakaniza.

ZOPHUNZITSIRA NDIPONSE
KULINGALIRA DINSI LAKO PAKUFUNIKIRA

Hypertension?

Kuthamanga kwa magazi kwachilendo ndi 120/70 (± 10 mamilimita ena a mercury). Chiwerengero cha 120 chikufanana ndi systolic kuthamanga (kuthamanga kwa magazi pazitseko zamitsempha nthawi ya mtima) Chithunzi 70 - kuthamanga kwa diastolic (kuthamanga kwa magazi pazitseko zamitsempha nthawi yopuma ya mtima). Ndi kupatuka kwakanthaŵi kwa chizolowezi, ena magawo a matenda oopsa amapezeka:

Gawo (kapena digiri)

Hypertension ndi njira yofala kwambiri. Mpaka pano, zifukwa zomwe zimachitikira sizikudziwika bwinobwino. Chofunikira kwambiri pa matenda oopsa ndi matenda omwe ali ndi etiology osadziwika. Hypertension yachiwiri yomwe imachitika mu 10% ya odwala imaphatikizapo:

• aimpso
• endocrine
• hemodynamic
• zamitsempha
• zopsinja
• matenda oopsa a amayi oyembekezera,
• kugwiritsa ntchito zakudya
• kumwa mapiritsi oletsa kubereka.

Mu thupi la munthu muli dongosolo lomwe limayendetsa kuthamanga kwa magazi. Ndi kuchuluka kwa magazi m'makoma amitsempha yamagazi akuluakulu, zolandilira zomwe zili mkati mwake zimayamba. Amapereka kufooka kwa mitsempha ku ubongo. Malo olamulira omwe amachitidwa ndi mtima amapezeka mu medulla oblongata. Zomwe zimachitika ndi vasodilation komanso kuchepetsa kukakamiza. Kupanikizika kukachepa, kachitidweko kamachita zinthu zotsutsana.

Kuwonjezeka kwa kuthamanga kwa magazi kumatha chifukwa cha zifukwa zambiri:

• kunenepa kwambiri, kunenepa kwambiri,
• kuwonongeka kwaimpso,
• Matenda a chithokomiro,
• matenda a shuga ndi matenda ena osachiritsika,
• kuchepa kwa magnesium
• matenda a oncological a adrenal gland, pituitary gland,
• kupsinjika kwa malingaliro
• cholowa
• poyizoni ndi zebaki, lead ndi zina zoyambitsa.

Malingaliro omwe alipo pazomwe zimayambitsa matendawa alibe maziko asayansi. Odwala omwe akumana ndi vutoli amakakamizidwa kuti azigwiritsa ntchito mankhwala kuti athetse vuto lawo. Chithandizo cha matenda oopsa ndicholinga chofuna kuchepetsa komanso kukhazikika kwa magazi, koma samachotsa chomwe chimayambitsa.

Zizindikiro pa magawo osiyanasiyana a matendawa ndizosiyana. Munthu sangamve kuwonetsa kwa matenda a pathology kwa nthawi yayitali. Zovuta za mseru, chizungulire, kufooka komwe kumachitika chifukwa chogwira ntchito molimbika. Zowonekeranso: phokoso m'mutu, dzanzi la miyendo, kuchepa kwa ntchito, kusokonezeka kwa kukumbukira. Ndikumangokhalira kukakamiza kwa nthawi yayitali, mutu umagwirizana nthawi zonse. Pa gawo lotsiriza la matenda oopsa, zovuta zowopsa zimatha kuchitika: myocardial infarction, ischemic stroke, kuwonongeka kwa mitsempha yamagazi, impso, magazi.

Chithandizo cha matenda oopsa

Njira zonse zochizira zomwe zimagwiritsidwa ntchito popanga matenda oopsa amatha kugawidwa m'magulu: mankhwala, osagwiritsa ntchito mankhwala, wowerengeka, ovuta. Njira zamtundu uliwonse zosankhira mankhwalawa sikufuna kungoteteza zizindikirozo m'mitsempha.Izi ndi njira zochizira zomwe zimalepheretsa kusintha kwam'kati mwa minofu ya mtima ndi mitsempha, adapangidwa kuti ateteze ziwalo zomwe akutsata, zimathandizira kuti athetse ziwopsezo zomwe zimapangitsa kuti pakhale matenda.

Mfundo zochizira matenda oopsa

Pomwe chiwonetsero choyambirira cha matendawa ndi cholinga chopewa, ndikofunikira kutsatira mfundo zazikulu zamankhwala, zomwe zingathandize kukonza vutoli komanso kupewa kufalikira:

• Mchere wochepetsedwa, suyenera kupitirira 5 g patsiku (munthawi yayitali, kufalikira kwathunthu),
• kukonza thupi pamaso pa mapaundi owonjezera, kunenepa kwambiri,
• zotheka zamagalimoto,
• kusiya kusuta, kumwa mowa ndi zakumwa zoziziritsa kukhosi,
• kugwiritsa ntchito mankhwala azitsamba, kukonzekera kwazitsamba kosangalala kwambiri,
• Kuchepetsa mphamvu ya kupsinjika,
• kugona usiku 7, makamaka maola 8,
• kudya zakudya zokhala ndi potaziyamu.

Muyezo wazithandizo

Ndi matenda oopsa a matenda oopsa, chinsinsi chodalirika m'khalidwe la wodwalayo ndicho kuyang'aniridwa kwachipatala mosalekeza. Kudzilamulira nokha kwa mapiritsi ochepetsa kuthana ndi vuto sikovomerezeka. Muyenera kudziwa mphamvu ndi magwiritsidwe ake a mankhwalawo. Ndi kuwonetsedwa kwa chithandizo chochepa cha magazi kapena chithandizo cham'malire, muyezo wamankhwala amachepetsa kuchepa kwa kuchuluka kwa mchere muzakudya.

Woopsa matenda oopsa, mankhwala a mankhwala ndi mankhwala. Mankhwala amphamvu ndi Atenolol ndi Furosemide. Atenolol ndi mankhwala ochokera ku gulu la b-kusankha adrenergic blockers, lomwe limayesedwa ndi nthawi. Chida ichi ndichabwino kwa odwala omwe ali ndi mphumu ya bronchial, bronchitis ndi matenda ena am'mapapo. Mankhwala amathandiza pokhapokha ngati mchere sutsalira kwathunthu kuchokera muzakudya. Furosemide ndi diuretic yotsimikiziridwa. Mlingo wa mankhwala umatsimikiziridwa ndi adokotala.

Chithandizo cha matenda oopsa

Njira zochizira matenda oopsa zimayikidwa poganizira kuchuluka kwa mayeso a labotale, umunthu wa mkhalidwe wa wodwalayo, gawo lomwe kukula kwa matenda. Kugwiritsa ntchito mankhwala a antihypertensive kuli koyenera chifukwa chophwanya kwa nthawi yayitali njira zamagazi ndi njira zosagwiritsa ntchito mankhwala sizinaphule kanthu.

Mankhwala amakono ochizira matenda oopsa

Odwala ambiri amaikidwa mankhwala ochizira matenda oopsa, omwe ayenera kugwiritsidwa ntchito mosalekeza. Kusankha ndi kulandira mankhwala kuyenera kuonedwa mozama. Ndi chithandizo cholakwika, zovuta zimakula: pamakhala chiopsezo chachikulu cha matenda a mtima, kulephera kwa mtima. Mankhwala onse omwe amagwiritsidwa ntchito mu mankhwala othandizira amatha kugawidwa m'magulu:

Kutembenuza kwa Eniotensin Enhibme Enhibitors (ACE zoletsa)

Kuletsa enzyme yomwe imatembenuza angiotensin I kukhala angiotensin II

Enap, Prestarium, Lisinopril

Angiotensin II Receptor Inhibitors (Sartans)

Kuchepetsa kwina kwa mtima kuphipha chifukwa cha zotsatira za renin-angiotensin-aldosterone system

Losartan, Telmisartan, Eprosartan

Khalani ndi vuto la vasodilating

Atenolol, Concor, Obzidan

Calcium calcium blockers

Letsani kusuntha kwa calcium mu cell, muchepetse mphamvu zosungira mu khungu

Nifedipine, Amlodipine, Cinnarizine

Thiazide okodzetsa (okodzetsa)

Chotsani madzi owonjezera ndi mchere, kupewa kutupira

Imidazoline Receptor Agonists (AIR)

Chifukwa cha kulumikizidwa kwa zinthuzi ndi zolandilira za ubongo ndi mtsempha wamagazi a impso, kusinthanso kwamadzi ndi mchere, ntchito yamakonzedwe okonzanso imachepa

Kuphatikiza kwa antihypertensive mankhwala

Mphamvu ya zochita za antihypertensive mankhwala ochepetsa kuthamanga kwa magazi ndiwosiyana, chifukwa chake, chithandizo chamankhwala cha matenda oopsa chimaphatikizapo kugwiritsa ntchito mankhwala osakanikirana. Imathandiza pa mavuto a matenda oopsa, kuwonongeka kwa ziwalo zina, komanso kulephera kwaimpso. Pafupifupi 80% ya odwala amafunikira chithandizo chovuta. Kuphatikiza koyenera ndi:

• ACE inhibitor ndi calcium calcium blocker,
• ACE inhibitor ndi okodzetsa,
• calcium wotsutsa komanso okodzetsa,
• alpha blocker ndi beta blocker,
• dihydropyridine calcium motsutsana ndi beta blocker.

Kuphatikiza kwapadera kwa mankhwala a antihypertensive

Kuphatikiza kwa mankhwala kuyenera kupangidwa molondola. Mankhwala okhala ndi matenda oopsa pazotsatira zotsatirazi alibe kufunika kochizira:

• dihydropyridine wotsutsana ndi calcium blocker osagwiritsa ntchito dihydropyridine,
• beta blocker ndi ACE inhibitor,
• alpha-blocker kuphatikiza mankhwala ena a antihypertensive (kupatula beta-blocker).

Mankhwala osagwiritsa ntchito mankhwala

Matenda aliwonse ndi bwino kupewa kuposa kuchiza. Pakuwoneka koyamba kudumpha m'magazi, muyenera kusinkhasinkhanso moyo wanu kuti mupewe kukula kwa matenda oopsa. Mankhwala osagwiritsa ntchito mankhwala osokoneza bongo, ndi kuphweka kwake konse, cholinga chake ndicho kupewa kukula kwa matenda a mtima. Njira izi ndizofunikira pakukhazikitsa mkhalidwe wa odwalawo omwe akumalandira chithandizo chamankhwala nthawi yayitali.

Zochita zolimbitsa thupi

Kuchita zolimbitsa thupi moyenera ndikofunikira kwa matenda oopsa. Ndikofunikira kupatsa chidwi ndi masewera a isotonic. Zimakhudza kuthamanga kwa magazi, kuyambitsa mapapu, kuchepetsa kuthamanga kwa magazi. Ichi ndi masewera olimbitsa thupi omwe cholinga chake ndi minofu yayikulu ya miyendo. Kuyenda maulendo othandiza, kuyenda njinga, kusambira, kuthamanga. Kusankha koyenera ndi phunziroli pa Simulator yanyumba. Ndondomeko yoyenera yophunzitsira ndiyabwino katatu pa sabata.

Chithandizo cha anthu

Pakati pa maphikidwe a mankhwala azikhalidwe, pali njira zosavuta kwambiri zothetsera kuthamanga kwa magazi. Zothandiza kwambiri ndi izi:

• Mbewu za fulakesi Supuni zitatu za mbewu patsiku (zitha kuphwanyidwa pophatikizana) monga zowonjezera pamaladi, mbale zazikulu zimasinthasintha mafuta kagayidwe, ndizoletsa atherosulinosis yamitsempha yamagazi, imakhazikika pakukakamizidwa.
• Ma conine ofiira ofiira. Tincture wa mowa umapangidwa kuchokera pachomera ichi. Ma conine a paini (ophatikizidwa mu June-Julayi) amathiridwa mumtsuko wa lita, amathiridwa ndi vodika kapena mowa ndikuumirizidwa kwa masabata atatu. Tengani katatu pa tsiku musanadye, supuni imodzi.
• Adyo. Magulu awiri a adyo osadulidwa, kutsanulira kapu ya madzi owiritsa, alekeniwo aphulitse kwa maola 12. Imwani kulowetsedwa ndikukonzekera watsopano. Njira ya chithandizo ndi mwezi umodzi, kulowetsedwa kumagwiritsidwa ntchito m'mawa ndi madzulo.

Zizindikiro zakuchipatala

Matenda oopsa oopsa m'mankhwala oopsa ndi oopsa chifukwa, nthawi zina, zipatala zimafunika:

1. Dziwa ndi vuto la matenda oopsa. Izi zimabweretsa kuwonongeka kwambiri pamlingo wa wodwala, zimawopseza moyo wake, chiopsezo chokhala ndi vuto la mtima kapena stroko yayikulu. Kulimbikitsidwa kuchipatala ndikulimbikitsidwa.
2. Kulumpha pafupipafupi mumagazi kumachitika, chomwe chimapangitsa sichidziwika bwino ndipo chimafuna kufufuza wodwalayo komanso kuzindikira komwe ali. Pulogalamu ya kugonekedwa ku chipatala sichimapereka milandu yotere, koma pali chiopsezo chachikulu cha kufalikira kwamatenda oyamba.
3. Wodwala, kuwonjezera pa kuthamanga kwa magazi, ali ndi zokayikitsa za matenda a mtima, mwachitsanzo, angina pectoris.

Kuthamanga kwa magazi ndi nthawi yoyitanitsa ambulansi. Madokotala azadzidzidzi amatenga njira zochizira zothandizira, chifukwa chomwe kuthamanga ndi kuthamanga kwa mtima kumabwerera kwazonse. Pankhaniyi, palibe chomwe chikuwonetsa wodwalayo kuchipatala, ndiye kuti amatha kuthandizidwa pokhapokha ngati ali ndi nkhawa. Nthawi zina, ngati zinthu sizinamuyendere bwino, amagonekedwa kuchipatala.