Hypertension 2 madigiri kuopsa 3 - zimayambitsa, matenda ndi njira zochizira

Mwa matenda oopsa, madokotala amatanthauza mkhalidwe wolimbikira kuthamanga kwa magazi. World Health Organisation yatanthauzira manambala omveka: systolic kapena apamwamba kuposa 140 mm. Hg. Art., Ndi diastolic (m'munsi) - oposa 90 mm. Hg. Art. Anthu ambiri amangodziwa matendawa mu gawo la 2. Kodi izi ndizowopsa bwanji?

Madigiri ndi zoopsa za matenda oopsa

Kugawika kofala kwambiri kwa matendawa ndikogawika m'magawo molingana ndi malire omwe nthawi zambiri amakhala ndi magazi. Malo kuyambira 120/70 mm. Hg. Art. mpaka 139/89 mm. Hg. Art. madokotala amachitcha "prehypertension", ngakhale kwa odwala oopsa (anthu omwe vuto lawo limakhala labwino 90/60 mm Hg), manambala ndi chifukwa choitanira ambulansi. Gulu lalikulu la matenda oopsa:

1 digiri. Systolic - 140-159 mm. Hg. Art., Diastolic - 90-99 mm. Hg. Art. Mwayi woti mubwerere kupanikizika kwawoko ndiwambiri, chifukwa nthawi zina wodwalayo amamva bwino.
2 digiri. Systolic - 160-179 mm. Hg. Art., Diastolic - 100-109 mm. Hg. Art. Kupsinjika pafupifupi sikubwerera ku ziwonetsero zomwe zimachitika, katundu pazotengera ndi mtima ndiwokwera, mosalekeza.
3 digiri. Kupanikizika pamtunda wa 180/110 mm. Hg. Art. Ngakhale pakakhala kuti pali zovuta zakunja, wodwalayo amakumana ndi zovuta, ndikuchepetsa mphamvu mwadzidzidzi kumawonetsa zovuta zamtima.

Rat stratization imadalira kwambiri kuchuluka kwa matenda oopsa, popeza wodwala amene amapatuka chifukwa cha kuchuluka kwa magawo 20, zovuta za mtima wamtima ndizochepa kuposa kupatuka 60 magawo. Madokotala amasiyanitsa magulu otsatirawa:

1 - otsika. Mwayi wamavuto ndi 15%.
2 - wapakati. Chiwopsezo chimakwera 15-20%. Pa siteji yachiwiri, matenda oopsa amathanso kukhalapo, ngakhale thanzi labwinolo.
3 - okwera. Mwayi wamatenda a mtima ndi 20-30%. Odwala omwe ali ndi matenda oopsa a grade 2, pali zinthu zitatu zowopsa kapena kuwonongeka kwa ziwalo.
4 - kwambiri. Zimawonetsedwa ngati kuthekera kwa zovuta kuli pamwamba pa 30%. Zachilendo kwa odwala matenda ashuga omwe ali ndi digiri ya 2 ya matenda oopsa ndi magulu ena omwe ali ndi digiri ya 3.

Zoyambitsa matenda opatsirana a grade 2

Mu etiology yamatendawa (momwe zimachitikira), chibadwidwe chimagwira ntchito yofunika kwambiri: pamaso pa abale apafupi ndi matenda oopsa, chiwopsezo chake ndi chachikulu kwambiri. Izi ndichifukwa chakusintha kwamitundu yomwe imalumikizidwa ndi dongosolo la renin-angiotensin lomwe limayendetsa kuthamanga kwa magazi. Kuphatikiza pa genetic factor, pali zifukwa zambiri zoyambitsa ndi zoopsa, makamaka zomwe zimakhudzana ndi zovuta za endocrine, dongosolo lamanjenje:

onenepa kwambiri, onenepa kwambiri (onjezani katundu pamtima, onthanitsani minofu yamtima mwachangu),
kusintha kokhudzana ndi zaka mseru, mtima ntchito,
zizolowezi zoipa (mankhwala osokoneza bongo, nikotini),
zolimbitsa thupi (kukhala pansi, kusachita zolimbitsa thupi),
shuga mellitus (imawonjezera chiopsezo cha zovuta zamtima),
kupsinjika kwakasinthasintha m'maganizo, zochitika zovuta (pakati pa dongosolo lamanjenje ndi ubale wa renin-angiotensitive),
cholesterol yayikulu, matenda a mtima (
kusadya bwino (kugwiritsa ntchito mchere, mchere wamafuta, zonunkhira),
kuperewera kwa potaziyamu ndi magnesium m'thupi (pangani zovuta zamagulu ndi kugwira ntchito kwa mtima).

Zizindikiro za GB 2 degree3 3

Poyerekeza ndi kuthamanga kwa magazi. Mu chithunzi chapadera cha matenda alipo:

kutopa, kuchepa kwa ntchito,
dzanzi lamanja (makamaka zala)
zithunzi zowoneka
tachycardia
zosokoneza tulo
tinnitus, kusokonezeka kwa kukumbukira (zizindikiro za ngozi ya ubongo).

Mavuto oopsa

Mkhalidwe wowopsa mwadzidzidzi, womwe umadziwika ndi kuchuluka kwambiri kwa magazi, ndi chimodzi mwazowopsa za matenda oopsa a grade 2. Zimafunika kugwiritsa ntchito mankhwala a antihypertensive kuti muchepetse kuwonongeka kwa ziwalo zanu kapena kuziletsa. Pali gulu lapadziko lonse lapansi lomwe lalandira:

Vuto lalikulu la matenda oopsa - omwe amaphatikizidwa ndi kupweteka kwambiri kwa impso, ubongo, mtima, kupenya kwamaso, kumafunikira kuchipatala mwachangu komanso chithandizo kuchipatala.
Zosasinthika - sizifuna kuchipatala, ziwalo zomwe sizikukhudzidwa sizikhudzidwa (kapena kufooka), zimafuna chithandizo chamankhwala mkati mwa maola 24.

Maziko a pathogenesis (limagwirira kuti likachitike) ndikuphwanya malamulo a mtima, chifukwa chomwe arterioles ndi spasmodic, kugunda kwa mtima kumakwera kwambiri komanso kuthamanga kwa magazi kumakwera. Ziwalo zamkati zimavutika ndi hypoxia (kusowa kwa mpweya), zomwe zimawonjezera chiopsezo cha ischemic complication (matenda obisika). Zowonekera zamankhwala pamavuto oopsa:

mutu wakuthwa,
kupuma movutikira
mavuto akukwera mpaka 200/140 mm. Hg. Art. (sizowona zolondola kwambiri)
kusanza, kukokana,
chisokonezo.

Chiwopsezo chovuta kwambiri chikuwonjezeka mwa odwala omwe ali ndi mbiri ya matenda a mtima, matenda aubongo. Mavuto osaneneka a matenda oopsa amakhala ndi chiyembekezo chabwino mothandizidwa ndi panthawi yake, ndipo zovuta zimatha kubweretsa:

sitiroko
ziwalo
kuyamwa
matenda am'mimba,
myocardial infaration
zakupha
matenda edema.

Kuwonongeka kwa ziwalo

Kuzindikira kwa "matenda oopsa a grade 2, ngozi yachitatu" siwowopsa pamavuto azovuta komanso kuwonongera kosasangalatsa, koma kusintha kwa ziwonetsero, nthawi zambiri sikungasinthe. Ngati zotumphukira zakhudzidwa, wodwalayo amakhala ndi nthawi yodziwika, yomwe singathe. Kuphatikiza pa iwo akuvutika:

Mtima ndi chinthu cholumikizidwa chomwe chimawonongeka chifukwa cha kupunduka kwa mtima. Kugonjetsedwa kumakulira pang'onopang'ono: kukulira kwa myocardial, mawonekedwe a kuphatikizika kumanzere kwamitsempha yamanzere. Mu chithunzi cha chipatala, pali zizindikiro za matenda a ischemic (arrhythmia, angina pectoris), kulephera kwa mtima (kutupa kwamiyendo, tachycardia, cyanosis - cyanosis ya pakhungu, mucous nembanemba).
Impso - kukula kwa zolumikizana minofu imakhala chifukwa chophwanya ntchito, kusefedwa kwazinthu zomwe ziyenera kuchotsedwa. Wodwalayo ali ndi zizindikiro za kulephera kwa impso: kuchuluka kwa mkodzo, kuyabwa khungu, kuchepa magazi, azotemia (kuchuluka kwa zinthu za nayitrogeni m'magazi).
Ubongo - wokhala ndi vuto loyenda mozungulira, kusokonezeka kwa mitsempha, chizungulire, kutayika kwa malo, kuchepa kwa ntchito, kuyang'aniridwa. Ndi kuwonongeka pang'onopang'ono m'zakudya za minofu ndi kufa kwawo, luntha limakulirakulira, kukumbukira kukumbukira, dementia (dementia) imayamba.

Kupsinjika kwa magazi

Odwala omwe apezeka kuti ali ndi matenda oopsa a grade 2, ali pachiwopsezo cha 3, palibe kubwerera ku zomwe zimakhazikika: kukakamizidwa kumawonetsedwa nthawi zonse pamtunda wa 160-179 mm. Hg. Art., Ndi wotsikirapo - 100-109 mm. Hg. Art. Kuwonjezeka kwa chiwerengero kumachitika pang'onopang'ono, nthawi yayitali. Madokotala ena amalankhula za 2 digiri ya matenda oopsa ndi kuwonjezeka kwa kuthinitsidwa ndi mayunitsi 30-40 kuchokera pachizolowezi (kwa odwala omwe ali ndi hypotensive, mfundo za 130/95 mm Hg ndizotheka).

Kodi ndizotheka kuchiritsa matenda oopsa a digiri yachiwiri

Mukaonana ndi dokotala panthawi yake ndikutsatira mosamalitsa njira yochiritsira, matulukiridwewo amakhala abwino ngati palibe kuwonongeka kwakukulu ziwalo zomwe zakulonderani.Matenda oopsa a Giredi 2, pomwe ngozi ndi 3 kapena 4, adalandira chithandizo kwa zaka zingapo, chifukwa ndikofunikira osati kungochotsa kuthamanga kwa magazi, komanso:

Chepetsani chiopsezo cha zovuta komanso tilewe kufa kwa iwo,
kutsatira kukonza kwa zinthu zoopsa (onenepa kwambiri, cholesterol yambiri, ndi zina),
Chotse matenda oyanjana.

Njira yothandizira matenda oopsa kwambiri. Chitsimikiziro chake ndicho kugwiritsa ntchito mankhwala, mankhwalawa omwe adapangidwa ndi dokotala pamaziko a mankhwala a magulu osiyanasiyana a mankhwala. Amatengedwa pamaphunziro ndi nthawi yayifupi. Kuphatikiza apo, wodwalayo adayikidwa kudya, fotokozerani zomwe zikuchitika paumoyo woyenera. Pokhala ndi vuto la kuthamanga kwa magazi, mankhwalawa amathandizidwa pakhungu, pambuyo pake amasintha pamapiritsi.

Kuzindikira kwakanthawi

Odwala omwe amayang'aniridwa kale ndi dokotala omwe ali ndi matenda "oopsa a grade 1", atalephera kulandira chithandizo chamankhwala ndikuwonekera kwa zatsopano 2 akhoza kuzipereka okha. Otsalawo, atatenga deta ya anamnesis ndikusanthula madandaulo, ayenera kukayezetsa, komwe kumayamba ndi mayeso akuthupi:

kuthamanga kwa magazi ndi polojekiti yamagazi.
kuwunika momwe zotumphukira zimayendera,
kuyesa kwa khungu pakhungu (redness), kutupa,
kuzindikira (kugunda) kwamtolo wam'mimba,
kuyang'ana mwachangu ndi ana opukusidwa ndi mankhwala apadera,
kumvera pachifuwa ndi stethoscope (mapapu, mtima),
kudziwa kukhazikika kwa mtima pogwiritsa ntchito kuzindikira.

Kuphatikiza apo, kuwunika kwa sabata la 2 kwa kuthamanga kwa magazi, komwe kumayesedwa m'mawa mutadzuka komanso madzulo, kumafunika. Izi sizichitika mukangotha kudya kapena kuchita masewera olimbitsa thupi (kupirira theka la ola kapena ola limodzi), mumalo abata. Kenako, wodwalayo amayesa magazi ndi mkodzo, amayeza njira zingapo kuti adziwe zotupa za ziwalo zotsalira za gawo 2:

Ultrasound ya endocrine dongosolo, impso, chiwindi, kapamba.
ECG.
Dopplerography yamitsempha yamagazi - kuzindikira stenosis yamitsempha yamafungo.
Fluorescence angiography - njira yowerengera mosiyana cholinga chake ndikuwona kusintha kwamasamba mu fundus.

Mankhwala

Kwa odwala omwe kalasi 2 yokhala ndi matenda oopsa amakhala pachiwopsezo cha 3, mankhwalawa amakhala ndi mankhwala omwe amachepetsa kuthamanga kwa magazi (hypotensive), amateteza ziwalo zomwe akuyenera (mavitamini, antioxidants) ndikuchotsa zizindikiro zosasangalatsa (antiarrhythmic, anticonvulsant, analgesics). Njira zothandiza komanso zofunika kwambiri kwa matenda oopsa:

angiotensin kutembenuza ma enzyme (ACE) zoletsa

Lisinopril, Captopril, Ovomerezeka, Enalapril

letsa ntchito ya angiotensin-akatembenuka enzyme, chifukwa cha momwe angiotensin-2 amapangidwira (amathandizira vasoconstriction), kuchepetsa kuchepa kwa bradykinin (vasodilator yemwe amachepetsa mitsempha yamagazi), kuchepetsa proteinuria (kuchuluka kwa mapuloteni mumkodzo)

Ma ARB inhibitors (angiotensin-2 receptor blockers, sartans)

Lozap, Mikardis, Teveten, Valsacor

kuchepetsa kuchuluka kwa adrenaline ndi aldosterone, kupanikizika kwa kufalikira kwam'mapapo, kusinthitsa kukodzetsa, kuchepetsa kuchepa kwa mtima, kusintha ntchito yaimpso, kupangitsa kuyambiranso kumanzere kwamitsempha yamagazi

calcium blockers

Diltiazem, Verapamil, Amlodipine, Nifedipine, Felodipine

letsa kulowetsedwa kwa calcium calcium mu minofu ya mtima, kukulitsa mphamvu yamitsempha yamagazi ndi zotumphukira, kuchepetsa kuphipha kwa mtima

Rasilez, Rasilam, Co-Rasilez (wotsiriza 2 - wokhala ndi calcium blocker)

siyani unyinji wa masinthidwe a angiotensin (zilepheretse ntchito yake), onjezani mitsempha, muchepetse chiopsezo cha zovuta zamagazi

Bisoprolol, Concor, Sandonorm, Egiloc, Corvitol

sinthani kutulutsa kwa renin kulowa m'magazi, kuchepetsa kugunda kwa mtima, kuchepetsa ntchito za malo obisika mu mtima dongosolo, onjezerani mamvekedwe a arterioles

thiazides (thiazide okodzetsa)

Furosemide, Hypothiazide, Indapamide

Kuchepetsa reabsorption (kusinthanso mayamwidwe) wa sodium, kuonjezera chimbudzi (chotupa) cha potaziyamu, kuchepetsa kukana kwa zotumphukira, kuchepetsa magazi

aldosterone antagonists (a impso okodzetsa)

Veroshpiron, Aldactone, Vero-Spironolactone

potaziyamu woletsa zakudya zomwe zimapangitsa kuti pakhale mchere wa sodium, chlorine ndi madzi, zomwe zimapatsa mphamvu

Atorvastatin, Cardiostatin, Zovastikor

sinthani kuchuluka kwa ma lipoprotein otsika kwambiri m'magazi, kuchepetsa cholesterol,

Aspecard, Cardiomagnyl, Acecardol

kusokoneza kuphatikiza kwa maselo am'magazi (gluing), kusokoneza masakanizo a thromboxane

Zithandizo za anthu

Pewani matenda oopsa a giredi 2 kuti musapite patsogolo, mupewe kukula kwa vuto la impso, muchepetse chiopsezo cha mavuto a mtima ndi ziwalo zam'maso, khalani ndi mantha, khazikitsani zimachitika - awa ndi zolinga zamankhwala azitsamba omwe amagwiritsidwa ntchito ngati mankhwala a wowerengeka. Amalimbikitsidwa kuti agwiritsidwe ntchito ngati njira yowonjezerapo chithandizo, kuwonjezera mphamvu ya mankhwala. Zabwino zimaperekedwa ndi:

antihypertensives - hawthorn, sinamoni, clover,
sedative (zoziziritsa kukhosi) - amayi, valerian, chamomile, timbewu,
okodzetsa - nettle, bearberry,
Kwa mtima - hawthorn,
lipid-kutsitsa - tansy, masamba a birch,
vasodilator - wort wa St. John, fennel, dandelion.

Zitsamba zimagwiritsidwa ntchito kuphika broths, tiyi ngakhale kusamba, koma zotsalazo zimakhudza dongosolo lamanjenje kuposa kukakamiza. Makamaka magwiridwe antchito omwe amalepheretsa kukula kwa maselo a ziwalo zama cell ndi ziwonetsero za kuthamanga:

Phatikizani hawthorn, oregano, rose rose, periwinkle ndi yarrow (1: 1: 1: 1: 2). Tengani 1 tbsp. l kusonkhanitsa, kuthira madzi otentha (250 ml). Kuumirira theka la ola, kumwa 50 ml theka la ola musanadye 3-4 p / tsiku. Chithandizocho chimatha mwezi.
Sakanizani mamawort, coughweed, hawthorn (maluwa), masamba a birch, akavalo (2: 2: 2: 1: 1), brew 1 tbsp. l kapu yamadzi otentha. Manga ndi thaulo, tsimikizirani ola limodzi. Imwani patsiku, kugawa nthawi 5-6. Maphunzirowa adapangidwira masabata anayi.

Zakudya zamankhwala

Kuthana ndi malamulo azakudya zamankhwala kwa anthu omwe ali ndi giredi 2 kwachangu ndi moyo wonse, makamaka ngati pali cholowa chamtunduwu kapena matenda ashuga. Kutengera ndi mbiri yachipatala ya wodwala wina, dokotala amatha kupanga chakudya chamunthu (poganizira matenda a chiwindi, impso, ndi zina). Mfundo zazikuluzikulu ndi izi:

Muchepetse kuchuluka kwa mchere womwe umamwetsa: zomwe zimachitika tsiku lililonse ndizokwana 5. Izi siziphatikiza kokha mchere wokha pakuphika, komanso mlingo womwe umapezeka muzinthu za fakitale. Pa nthawi yowonjezera, kuti muchepetse zovuta, mchere umasiyidwa kwathunthu ndipo pambuyo pake sugwiritsidwa ntchito pakudya kwa masabata ena 2-5 wopewa.
Gwiritsani ntchito tsiku ndi tsiku magwero a potaziyamu ndi magnesium kuti musunge mtima ndi magazi: nthochi, maapricots zouma, zoumba zouma, ma buckwheat, oatmeal, mtedza (ma almond, walnuts ndiwo amawakonda). Magwero amafuta acids adzakhala othandiza: nsomba, mafuta a azitona.
Kuyang'anira kudya kalori tsiku ndi tsiku: izi zikuthandizira kupewa kunenepa. Onetsetsani kuti mukusungira kuchuluka kwa BZHU. Ndikofunikira kwambiri kuwona kuchuluka kwa nyama ndi masamba - 3: 7, pofuna kupewa kuchuluka kwa cholesterol.
Idyani zakudya zopanda pake: idyani kangapo patsiku 6 m'magawo ang'onoang'ono.
Imwani madzi oyera m'magawo a 1,2 l / tsiku kapena kupitirira. Madzi ochepa amaloledwa, koma ndi sodium wochepa. Ngati matenda oopsa a 2nd degree 3 atakulirakulira, kuchuluka kwa madzimadzi aulere kumachepetsedwa mpaka 800 ml / tsiku.

Zakudya zake zimatengera gulu la zinthu (masamba, zipatso, zipatso, mtedza, chimanga) ndi nyama yaying'ono, nsomba, ndi nsomba zam'nyanja. Wodwala matenda oopsa a grade 2 ayenera kuchotsa chakudya chomwe chimapangitsa mkati mwa mitsempha, chimayambitsa vuto mu endocrine, chimadzaza impso:

Kodi ndi chiyani - matenda oopsa a digiri yachiwiri

Hypertension imadziwika ndi kulumikizana kwamphamvu kwamankhwala osakanikirana, i.e., kuwonjezeka kwa kuthamanga kwa magazi pamtunda wa 130/80 mm RT. Art. Kutengera mulingo wakupitilira muyeso, kuchuluka kwa matendawo kumatsimikizika. Matendawa amatenga nthawi yayitali, kwa miyezi yambiri kapena zaka. Pazosinthika zotenga nthawi yayitali, zimakhala zovuta kudziwa momwe matendawo akuwonekera, koma zimachitika - pang'onopang'ono koma mphamvu zolimbitsa thupi zimatha, ndipo matendawa amapitilira gawo lina.

2 digiri imatanthawuza kuti kupanikizika kumasinthasintha m'malo osiyanasiyana a 160-99 mm Hg. Art. apamwamba, kuthamanga kwa systolic, ndi 100-109 mm Hg. Art. diastolic. Izi ndi ziwerengero zochulukirapo, kotero kuzindikiritsa kumafunikira kupewa mavuto osokoneza bongo, kuwongolera moyo, kuwunika pafupipafupi kukakamiza komanso kugwiritsa ntchito mankhwala osokoneza bongo.

Chofunikira pakufunika kwa chithandizo chamankhwala ndikusinthika kwamoyo - kuchotsa kusachita bwino, kusiya zizolowezi zoyipa, kupsinjika kwamthupi ndi m'malingaliro, kusintha kwa ntchito ndi kupuma, kudya wathanzi ndikudya mchere wochepa.

Magawo a Hypertension

Kutengera kugonjetsedwa kwa ziwalo zamkati ndi magazi ochuluka (magazi otchedwa ziwalo zololeza kapena ziwalo zadzidzidzi, zomwe kuposa zomwe ena amafunikira nthawi zonse komanso zosasinthika), magawo atatu a matendawa ndi osiyana:

Gawo 1 - moyo wa wodwalayo ndi wabwinobwino, kukakamizidwa kumawerengedwa, koma zotupa zamkati ndi machitidwe sizinapezeke, komanso kusakwanira kwa magwiridwe ake,
Gawo lachiwiri - kusintha kwachilengedwe mu stroma ndi parenchyma yamkati mwazinthu zimawonedwa, kusintha kwa ziwopsezo za ziwopsezo - impso, chiwindi, mtima ndi ubongo zimayamba. Pa macrodrug, zotupa m'mimba zimawoneka, kugwira kwake ntchito kumachepa. Gawo lachiwiri limadziwika ndi kuwonongeka kosafunikira kwa chiwalo chimodzi kapena zingapo zomwe mukufuna,
Gawo lachitatu - zovuta kwambiri kuchokera ku ziwalo zamagetsi zimawonedwa, zovuta zawo za parenchyma, zoyang'ana necrosis zimawonekera, zomwe zimasinthidwa ndi minofu yolumikizana. Zizindikiro zakuchepa kwa mitundu yosiyanasiyana - ubongo, mtima, Kukhala bwino kwa wodwalayo kumakhala pachiwopsezo cha zovuta zovuta kwambiri. Wodwala pakadali pano amakakamizidwa kumwa mankhwala pafupipafupi kuti akhale ndi moyo wabwino.

Matenda oopsa a digiri yachiwiri amatha kukhala magawo aliwonse.

Mitundu ya Zowopsa za Pathology

Pali magawo angapo omwe ali pachiwopsezo cha matendawa. Amazindikira kuchuluka kwa zovuta zomwe ali nazo, komanso momwe masinthidwe ofunikira a ziwalo zofunikira apitira, ndipo potero amathandizira kukulitsa njira yokwanira yochizira.

Chiwopsezo 1 chimatanthawuza kuti mwayi wamavuto ndi wotsika, osakwana 15%. Kusintha kwa ziwalo zogwedeza sikocheperako kapena ayi konse kuwonekera. Matenda osachiritsika ndi zinthu zina zomwe zingasokoneze njira yamatendawa ndikuwonjezera chithandizo chake palibe.

Zizindikiro zamtima zimaphatikizira kupuma movutikira, palpitations, arrhythmias, kufooka ndi nkhawa, chifuwa cholimba, kupweteka pachifuwa, ndipo nthawi zina chifuwa chosabereka.

Kuopsa kwa matenda 2 a degree 2 kumalumikizidwa ndi kukhalapo kwa zinthu zitatu izi, monga kusuta, kunenepa kwambiri, kukhala moyo wongokhala, ndi matenda osokoneza bongo. Ziwalo zamkati zimakhudzidwa. Kusintha kumakhudzanso dongosolo lamagazi - ndikupanga kusanthula, ndikotheka kudziwa zoyambitsa ziwalo zina m'magazi.Pali chizindikiro chodziwika bwino cha matenda oopsa.

Chiwopsezo cha matenda opatsirana a digiri 3 ya digiri yachiwiri - izi zikufalikira mwa okalamba. Izi zimachitika chifukwa cha kutayika kwa elasticity m'makoma amitsempha yamagazi. Njira yamatendawa imasinthidwa ndi ma pathologies ena osachiritsika, mwachitsanzo, matenda a mtima, omwe amafotokozera mwachidule zovuta zake zakumadzi kapena kuchepa kwa mtima. Kusokonezeka kwa magazi kumakhudza ntchito zonse za thupi.

Chiwopsezo 4, choopsa kwambiri, chimalumikizidwa ndi kufalikira kwa matenda kapena matendawo a nthawi yayitali, omwe nthawi zambiri amawonetsedwa m'mbiri yazachipatala. Kuchuluka kwa chiwopsezo kumeneku kumakhala kwa odwala omwe ali ndi mtima wamatenda ophatikizika ndi chindapusa, pambuyo pa kulowetsedwa mwa myocardial, sitiroko, kapena kuukira kwakanthawi. Chiwopsezo 4 chimafuna kupimidwa pafupipafupi ndi chithandizo chachipatala.

Zomwe zimachitika

Hypertension ndi matenda a multifactorial, chifukwa chimodzi chomveka chomwe sichingakhazikitsidwe; pathogenesis yake imakhudza machitidwe ambiri. Komabe, zimadziwika kuti njira yayikulu yowonjezera kupanikizika ndikupanga mkombero woipa womwe umakhudzana ndi kuchuluka kwa impso zomwe zimayikidwa m'magazi ndi impso. Renin m'mapapu amasintha kukhala angiotensin I, kenako angiotensin II - imodzi mwazinthu zamphamvu kwambiri za vasoconstrictors (i.e., vasoconstrictor zinthu) zoyambira kwachilengedwe m'thupi la munthu. Izi zimapangitsa secretion ya aldosterone, zimakhudza katulutsidwe ka vasopressin ndi madzimadzi posungira. Gawo lomaliza ndikutupa kwa mtima endothelium, komwe ma ayoni sodium ndi madzi adathamanga.

Okalamba akamayenda, ziwiya zake zosasinthika, ndipo vuto lawo limatha kupirira mopwetekedwa mtima popanda kupanikizika. Amayi amakhala ndi chitetezo cha chilengedwe mwanjira ya estrogen - amachepetsa kwambiri kukakamizidwa, kotero amakhala ndi matenda oopsa nthawi zambiri amasintha pambuyo kusintha kwa kubereka.

Popeza zomwe zimayambitsa kusokonezeka kotereku nthawi zambiri zimakhala zosatheka kuzindikira, pali zinthu zomwe zimayambitsa chiopsezo cha matenda. Izi zikuphatikiza:

kusuta - zigawo za utsi wa fodya sizimangoyambitsa mkwiyo wam'zindawo, komanso vasospasm yoopsa. Izi zimabweretsa ischemia, yomwe imakhala yoopsa kwambiri ku ubongo ndi zotumphukira ziwiya. Kukokana pafupipafupi (nthawi zambiri patsiku) kumasokoneza magwiridwe antchito a vasomotor, ndipo zotengera zimabweza mtima kugunda kwa mtima,
kunenepa kwambiri - kunenepa kwambiri kwa thupi sikuwoneka kokha kuchokera kunja, ma deposits amafuta alinso mkati mwa thupi. Mtima wamtima sugwirizana bwino ndi kuchuluka kwa magazi omwe amafunika kupakika kudzera mwa ma cellvessels mu minyewa ya adipose, komanso kukumana ndi zochulukirapo,
cholesterolemia - cholesterol yayikulu m'magazi imatsogolera pakupanga kwa mawanga ndi mizere, kenako zolembera. Chikalacho chimaphwanya umphumphu wa khoma lamitsempha, chimayambitsa kufinya kwa chotengera, komwe kumawonjezera kukakamiza kwa kama.
shuga mellitus - imaphwanya mitundu yonse ya kagayidwe, chifukwa chake, imakhudza mphamvu yamagetsi yamatenda amtima, komanso kugwiritsa ntchito cholesterol ndi zinthu zina zomwe zimakhudza kuthamanga kwa magazi,
zaka ndi jenda - munthu wamkulu, samatulutsa zotengera zake, ndipo moyenera amakhala ndi mtima wokakamira popanda kukakamizidwa. Amayi amakhala ndi chitetezo chachilengedwe mwa mtundu wa estrogen - amachepetsa kwambiri kuthamanga kwa magazi, kotero kuphatikiza kwawo kwamankhwala nthawi zambiri kumapangitsa kuti kubereka kwake kusanachitike, pamene kupanga kwa estrogen kumachepera kwambiri. Amuna amakhala ndi matenda oopsa kwambiri ali a zaka zoyambirira, chifukwa zotengera zawo zilibe chitetezo cha mahomoni,
chibadwidwe chakubadwa - mitundu yopitilira 20 yapezeka yomwe ikukhudzana ndi kuchuluka kwa kukakamizidwa ndi dongosolo la mtima.Wachibale wamagazi akakhala ndi matenda oopsa, mwayi wodwala umakulitsidwa.

Kuwonongeka kwa organic kumakhala kofala kwambiri ndi kalasi 3, komanso kumatha kuchitika ndi giredi 2 panthawi yamavuto oopsa, makamaka ovuta.

Zizindikiro za matenda oopsa a digiri yachiwiri

Kuwonetsedwa kwa matendawa kumatengera ziwalo ndi machitidwe omwe amadwala kuthamanga kwa magazi komanso kusayenda bwino kwa magazi. Pali mtima, chithokomiro (chotupa), impso, ndi zizindikiro zomwe zimakhudzana ndi kuwonongeka kwa retina. Komabe, yake yoyamba imachulukitsidwa kukhala 160-179 / 100-109 mm Hg. Art. HERE.

Zizindikiro zamtima zimaphatikizira kupuma movutikira, palpitations, arrhythmias, kufooka ndi nkhawa, chifuwa cholimba, kupweteka pachifuwa, ndipo nthawi zina chifuwa chosabereka.

Cerebral: Kupitiliza kupweteka mutu, kusokonezeka kwa tulo, chizungulire, tinnitus, nseru (munthawi yamavuto - kusanza). Mwina kuchepa kwa kukumbukira, kuchita, kusakonda, kuchita masewera olimbitsa thupi, kutopa msanga.

Ndi kuwonongeka kwa impso, dysuria imawonedwa (pafupipafupi kapena, m'malo mwake, kukodza kwaposachedwa, nocturia), amasintha kapangidwe ndi mawonekedwe a mkodzo, aimpso edema (ofunda, ofunda, amawoneka m'mawa usiku kugona tulo).

Zowonongeka zam'mbuyo zimadziwika ndi kuchepa kwa masomphenya, ntchentche zongokhalira kuwoneka kapena kuwoneka kwa chifunga patsogolo pa maso, kuda khungu m'maso.

Zizindikiro

Mukamayesedwa, adotolo amatsata ma algorithm ena. Kuzindikira kumayambira ndi mbiri ndikuyang'ana kwa wodwalayo, pambuyo pake kukakamizidwa kumawunikiridwa katatu katatu, phindu lake limatsimikiziridwa. Zitatha izi, wodwalayo amatumizidwa kukayesedwa kuti afotokozere za matendawa - ECG ndi ultrasound ya mtima kuti adziwe kuchepetsedwa kapena hypertrophy, kuyezetsa ndalama za kukhalapo kwa ziwiya zosinthika ndi kuwonongeka kwa optic disc.

Laboratory mayeso zikuphatikizapo kusanthula magazi ndi mkodzo, kuyesa kwa magazi, kudziwa ufulu wa mafuta m'thupi, kutsimikiza glomerular kusefera mlingo, creatinine chilolezo.

Ndi matenda oopsa a digiri yachiwiri ndi chiwopsezo chachikulu, kulumala kumatha kupezeka, izi zimasankhidwa ndi bungwe lapadera pamaziko a kafukufuku wa zolemba zomwe dokotala amapezekapo.

Matenda a giredi 2 nthawi zambiri amafuna chithandizo chamankhwala.

Magulu otsatirawa a mankhwalawa amagwiritsidwa ntchito:

okodzetsa - chotsani madzi kuchokera mthupi, kuchepetsa kuchuluka kwa magazi, kuchepetsa kutupa, kukhazikitsa kagayidwe kamchere wamadzi. Kugwiritsa ntchito kwawo kumachitika mosamalitsa oyang'aniridwa ndi azachipatala, chifukwa pali chiopsezo chokhala ndi zovuta zamagetsi zamagetsi. Gululi limaphatikizapo Furosemide, Lasix, Mannitol, Veroshpiron, Hypothiazide, Indapamide,
ACE blockers - kuletsa kutembenuka kwa renin kukhala angiotensin, potero kuswa patathogenetic unyolo wa matenda oopsa. Mankhwala othandiza m'gululi ndi capopril, lisinopril, hartil,
beta-blockers - kumanga ndi kutsekereza beta-adrenergic zolandilira, potero kusinthasintha zochitika za mtima zapamtima, kuchititsa kupuma kwamitsempha yamagazi. Kuphatikiza pa kukokomeza, ali ndi kuthekera kochotsa arrhasmia ndikusintha mawonekedwe a mtima. Gululi limaphatikizapo atenolol, bisoprolol, nebivolol,
calcium antagonists - machitidwe osalala a minofu khoma la chotengera amatsitsidwa chifukwa chogwirizana ndi calcium ion. Mankhwala omwe amalepheretsa njira zama calcium ndipo amatsutsana nawo amalepheretsa mapangidwe amitsempha yamagazi, kuchepetsa kufalikira kwawo ndikuwonjezereka. Awa ndi nifedipine, amlodipine, verapamil,
mankhwala a gulu lowonjezera - mankhwala omwe amagwira pakhungu lamkati, ma sedative, sedative, tranquilizer ndi ena.

Kuphatikiza apo, pali mankhwala osakanikirana ambiri ochepetsera kupanikizika, omwe akuphatikizapo zinthu zingapo zogwira ntchito, zomwe zimapereka chokwanira.

2 digiri imatanthawuza kuti kupanikizika kumasinthasintha m'malo osiyanasiyana a 160-99 mm Hg. Art. apamwamba, kuthamanga kwa systolic, ndi 100-109 mm Hg. Art. diastolic.

Chofunikira pakufunika kwa chithandizo chamankhwala ndikusinthika kwamoyo - kuchotsa kusachita bwino, kusiya zizolowezi zoyipa, kupsinjika kwamthupi ndi m'malingaliro, kusintha kwa ntchito ndi kupuma, kudya wathanzi ndikudya mchere wochepa.

Zotsatira ndi kulumala

Zotsatira za matenda oopsa zimatha kukhala zovuta kwambiri ngati chithandizo sichinachitike pa nthawi yake. Kuwonongeka kwa organic kumakhala kofala kwambiri ndi kalasi 3, komanso kumatha kuchitika ndi giredi 2 panthawi yamavuto oopsa, makamaka ovuta.

Mwina chitukuko cha matenda amtima, chomwe chapangitsa posachedwa kumayambitsa kuphwanya magazi m'mimba, chitukuko cha kugunda kwamtima kapena kupweteka kwamtima, kugunda kwamitsempha, kukula kwa aimpso, kukanika, kupuma, mawonekedwe a aneurysm aorta kapena chotupa china chachikulu, chotupa chake.

Ndi matenda oopsa a digiri yachiwiri ndi chiwopsezo chachikulu, kulumala kumatha kupezeka, izi zimasankhidwa ndi bungwe lapadera pamaziko a kafukufuku wa zolemba zomwe dokotala amapezekapo.

Timapereka makanema kuti muwone kanema pamutu wankhaniyi.

Kukula kwa vutoli

Monga momwe machitidwe akusonyezera, matenda oopsa a 1, digiri yachiwiri "yasintha" kwambiri m'zaka zaposachedwa. Mu gawo loyamba ili la matenda, odwala samalabadira. Izi ndizowona makamaka muzochitika pomwe matenda samatsatiridwa ndi zowawa zilizonse zomwe zimatsutsana ndi moyo watsiku ndi tsiku. Kuti athandizidwe, anthu amayamba kutembenukira pokhapokha atakhumudwitsidwa. Izi zimathandizira kuti pakhale zovuta pamtunda chifukwa cha kuchuluka kwamphamvu pamagetsi kwamphamvu. Zotsatira zake, anthu akabwera kwa madokotala, amakhala ndi matenda oopsa a 2, 3rd degree. Ndipo nthawi zambiri zamatsenga zimadutsa gawo lachiwiri, zimadutsa nthawi yomweyo kuchokera woyamba mpaka wachitatu. Izi zikuwonekera chifukwa cha zovuta zazikulu - sitiroko, kugunda kwa mtima. Ndi gawo ili lomwe lidakwaniritsa kuti matenda oopsa a digiri yachiwiri amakhala m'malo apadera a mtima masiku ano.

Mwachidule

Matenda oopsa ndi matenda osachiritsika. Chowonetsera chachikulu ndi matenda oopsa. Malinga ndi miyezo yapadziko lonse lapansi, matenda oopsa amaonedwa ngati mkhalidwe momwe kuchuluka kwa kuthamanga kwa magazi kumazindikiridwira: systolic - zopitilira 140, diastoli - zopitilira 90. Kuyesedwa kwa magawo atatu masana masabata kapena kutsimikizika kwamitundu iwiri mkati mwa sabata kumawerengedwa kuti ndi gawo losagwirizana ndi kukonza kwa GB. Nthawi zina, vutoli limangokhala lakuthwa kwazomwe zimachitika kapena zangokhala chizindikiro, zokhala ndi ntchito yofananira. M'malo mwake, kuwerengera kwa maulamuliro azizindikiro kumachitika ngati chitsimikiziro chokhacho cha matenda oopsa pa nthawi iliyonse. Pankhani ya chiwonetsero chachikulu, matenda am'mimba amatchedwa ofunikira kapena kungopatsa matenda oopsa. Mukamayesedwa, ndikofunikira kupatula zinthu zina zomwe zimayambitsa kusintha kwa zizindikiro. Makamaka, zimaphatikizapo matenda a impso, adrenal hyperfunction, hyperthyroidism, matenda a neurogenic, pheochromocytoma ndi ena. Pamaso pa zovuta zonsezi, sizingatheke kuzindikira matenda oopsa.

Zoyambitsa matenda

Mwa zina zomwe zingayambitse kuphatikizidwa ndi matenda oopsa, ziyenera kudziwika:

Makamaka.
Kuperewera kwa magnesium ndi calcium m'makudya.
Kugwiritsa ntchito mchere wambiri.
Kusuta.
Kulandila mowa.
Kunenepa kwambiri mwa mtundu wa zakudya kapena zopatsa thanzi.
Kuvutitsidwa chifukwa cha khofi kapena tiyi wamphamvu.
Zolemba ndi udindo pagulu.
Pafupipafupi psychoemotional kusokonezeka.

Njira yopititsira patsogolo

Zinthu zomwe zatchulidwa pamwambapa zimapangitsa kuti ma horoni a huromatic azigwira bwino ntchito. Pogwira ntchito mosalekeza, kupindika kumachitika m'matumba ang'onoang'ono omwe amakhala olimba. Iyi ndiye njira yoyamba yomwe imayambitsa kuchuluka kwa kukakamiza. Kusintha kwa zizindikiro kumakhudza matupi ena. Impso zimakhudzidwa makamaka. Ndi ischemia yawo, makina amakonzedwe akhazikitsidwa. Zimapatsa kuwonjezeka kwotsatira kwa kupanikizika chifukwa chowonjezera mtima wam'mimba komanso kusungunuka kwa madzi. Zotsatira zake, bwalo loipa limapangidwa ndi maulalo owonetsedwa bwino.

Kutanthauzira kwa matenda a mtima

Pankhaniyi, magawo ndi madigiri ayenera kusiyanitsidwa bwino. Yotsirizirayi imadziwika ndi msinkhu womwe kukakamizidwa kumakula. Magawo akuwonetsa chithunzi cha matenda ndi zovuta zake. Malinga ndi malingaliro adziko lapansi, magawo a matenda oopsa amatha kuwoneka motere:

Kusintha kwa kapangidwe ka ziwalo ndi zovuta sizinadziwikebe.
Kapangidwe ka zotsatira zowopsa munthawi ya matenda am'mimba komanso kugunda kwamtima.
Pali zizindikiro zokukonzanso kwamkati mwa ziwalo zomwe zimakhudzana ndi kuthamanga kwa magazi: matenda oopsa a mtima a digiri yachiwiri, kusintha kwa fundus, kuwonongeka kwa mitsempha yolowa muubongo, impso yotupa.

Kukhathamiritsa

Tanthauzo la chiwopsezo mu mtima zimatanthawuza kuwunika kwa kukula kwa zovuta mu wodwala wina. Izi ndizofunikira kuunikira odwala omwe kuwunikira kwapadera kwa zowunikira akuyenera kuwapereka. Pankhaniyi, zinthu zonse zomwe zingakhudze kukula, mapangidwe ndi chitukuko cha matenda zimatengedwa. Magawo otsatirawa alipo:

Odwala amuna ndi akazi, omwe zaka zawo sizochepera 55, kukhala ndi digiri yoyamba ya matenda oopsa, osagwirizana ndi zotupa zamkati ndi mtima. Pankhaniyi, kuchuluka kwa owopsa ndi ochepera 15%.
Odwala woyamba, digiri yachiwiri ya matenda oopsa, osati limodzi ndi kusintha kwa mawonekedwe a ziwalo. Nthawi yomweyo, zinthu zitatu zoopsa zilipo. Mulingo wowopsa pankhaniyi ndi 15-20%.
Odwala omwe ali ndi yoyamba, yachiwiri digiri ya GB yokhala ndi zoopsa zitatu kapena zingapo. Pankhaniyi, kusintha kwamkati mwa ziwalo zamkati kumawululidwa. Odwala omwe apezeka kuti ali ndi matenda oopsa a grade 2, ali pachiwopsezo 3, atha kupatsidwa kulumala. Mlingo wowopsa pamenepa ndi 20-30%.
Odwala omwe ali ndi digiri yachiwiri yamatenda oopsa omwe amakumana ndi zovuta zingapo. Potere, kusintha kwa ziwalo zamkati kumachitika. Zovuta zam'magawo a 2, chiwopsezo 4 chikufanana ndi gawo la ngozi zoposa 30%.

Chithunzi cha kuchipatala

Kodi matenda oopsa a digiri yachiwiri amadziwonetsa bwanji? Zizindikiro za zovuta za pathology ndizotsatirazi:

Ululu m'mutu wa chilengedwe chotseketsa, chodziwika pakakhosi kapena pamakachisi.
Arrhythmia, tachycardia, palpitations.
Zofooka zambiri.
Khalidwe la msana pamsana wa zovuta.

Pakati pazowonetsa za matenda, ziwonetsero zakuwonongeka mu ubongo, impso, mtima, ndi fundus ziyeneranso kudziwidwa. Kutsimikizira zotupa izi, ECG imaperekedwa kwa wodwala. Electrocardiography imakuthandizani kuti muzindikire zizindikiro monga hypertrophy mu ventricle yamanzere, voliyumu yowonjezereka m'meno oyambira.

Kafukufuku

Monga njira zowonjezera zowunika, wodwalayo adalembedwa:

ECHO zamtima.
Maphunziro a Fundus.
Ultrasound a impso.
Kupenda kwachilengedwe kwamamvekedwe a lipid komanso magazi.
Maphunziro a glycemic.

Matenda oopsa a digiri yachiwiri: ankhondo

Nthawi zambiri, mikangano imabuka panthawi yomwe akukakamizidwa kulowa gulu lankhondo kapena pakakhala usirikali pamene ali ndi zisonyezo zazikulu. Kuphatikiza apo, gulu lankhondo limakonda kuzindikira achinyamata ngati amenewo. Asitikali kapena olembera amafuna asatumikire popanda tsankho paumoyo wawo.Malinga ndi lamuloli, matenda ogwiritsira ntchito giredi 2 amawerengedwa ngati cholakwika chilichonse ndi mayitanidwewo ngati atatsimikiziridwa molondola. Achinyamata oterowo amatha kutumizidwa, kapena kuthandizidwa, ndikutsatira pakufunika kwa ntchitoyo.

Kulemala

Kukhazikitsa gulu la olumala, komitiyo, kuwonjezera pa gawo la matendawo, imaganizira izi:

Kukhalapo kwa zovuta komanso kuuma kwawo.
Chiwerengero komanso pafupipafupi pamavuto.
Zowoneka mwaluso zokhudzana ndi zochitika zina.

Chifukwa chake, kwa odwala omwe ali ndi matenda oopsa a grade 2, chiopsezo 3, kulumala kwa gulu lachitatu kumatha kupezeka. Pankhaniyi, matenda a pathology ali ndi njira yokhazikika, yophatikizidwa ndi zotupa zamagawo a mkati. Chifukwa cha izi, odwala amakhala m'gulu lomwe lili ndi zoopsa zochepa. Gulu lopuwala pankhaniyi limakhazikitsidwa makamaka kuti lizigwira ntchito moyenera. Woopsa matendawo, kuwonongeka kwapakati kapena kwambiri ziwalo kumatha kuchitika. Kulephera kwa mtima pamlanduwu kumavotelezedwanso pafupifupi. Muzochitika izi, wodwalayo amapatsidwa gulu lachiwiri lopuwala. Amawerengedwa ngati osagwira ntchito. Mu digiri yachitatu ya matendawa, odwala amalandira gulu la olumala lachitatu. Pankhaniyi, zotsatirazi zadziwika:

Kupita patsogolo kwa zamatsenga.
Kukhalapo kwa kuwonongeka kwakukuru, kusokonekera kwa ziwalo zamkati.
Kulephera kwamtima kumatchulidwa.
Zolepheretsa zazikulu pazodzisamalira, kusuntha komanso kuyankhulana zimapezeka.

Njira zochizira

Chithandizo cha matenda oopsa a digiri yachiwiri iyenera kukhazikitsidwa makamaka kuti zithetse zinthu zomwe zimayambitsa chitukuko cha matendawa. Mankhwala okha ndi osathandiza. Phukusi la zinthu limaphatikizapo izi:

Kusiya zizolowezi zoipa (kusiya kusuta ndi kumwa mowa).
Chosiyana ndi khofi ndi tiyi wamphamvu.
Kuletsa kugwiritsa ntchito mchere ndi madzi.
Kusunga zakudya. Zakudya zopatsa mphamvu zamafuta ndi mafuta, zakudya zonunkhira sizimachotsedwa muzakudya.
Kusintha kwamasiku.
Kuchotsera kwa kupsinjika kwa m'maganizo. Ngati ndi kotheka, dokotalayo amatha kukupatsani mankhwala osokoneza bongo, monga Corvalol, Fitosed ndi ena.
Malangizo a shuga ndi kunenepa kwambiri.

Kuwonetsedwa kwa mankhwala osokoneza bongo

Kumwa mankhwala kumafunikira chidwi chapadera. Chithandizo cha mankhwala osokoneza bongo ndicholinga chofuna kuthetsa matenda oopsa pazonse ndi zotsatirapo zake. Mankhwala amaikidwa munjira yotsatirira. Choyamba, njira zofooka zimawonetsedwa, kenako zamphamvu. Malingaliro amatanthauza kugwiritsa ntchito mankhwala amodzi komanso gulu la mankhwala. Odwala omwe amapezeka kuti ali ndi matenda oopsa a grade 2 nthawi zambiri amapatsidwa mankhwala:

Adrenoreceptor blockers. Izi zikuphatikiza Bisoprolol, Metoprolol.
Angiotensin receptor blockers. Pakati pawo pali mankhwala "Valsartan", "Losartan."
ACE zoletsa. Gululi limaphatikizapo mankhwala "Lisinopril", "Enalapril."
Diuretics "Veroshpiron", "Hypothiazide", "Trifas", "Furosemide".
Mankhwala ophatikiza "Tonorma", "Equator", "Enap N", "Kaptopres", "Liprazid".

Kuchiza matenda oopsa a grade 2 kumaphatikizanso kusintha kwa mtima ndi ntchito, komanso kufalitsa mtima. Magawo ndi ntchito za machitidwe zimayang'aniridwa. Chofunikira kwambiri pakuwonetsa bwino ndikutsimikiza kwa njira zochiritsira zochiritsika motsogozedwa ndi akatswiri. Chofunika kwambiri chimaperekedwa kuzowonetsa magazi. Ayenera kukhazikika nthawi zonse. Mafuta osokoneza bongo kapena gulu la mankhwala liyenera kukhala tsiku ndi tsiku. Mlingo wokhawo wa mankhwala omwe amasinthidwa. Mukamapereka mankhwala, sikuti mtundu wa maphunzirowo ndi nthawi ya matendawa imawaganiziranso.Kukhazikitsidwa kwa mlingo ndi mulingo wa muyezo kumachitika molingana ndi kulolerana ndi machitidwe ena a wodwala. Ngati mukukumana ndi zovuta zilizonse pakumwa mankhwala, muyenera kupita kwa dokotala nthawi yomweyo.

Zoyambitsa matenda oopsa

Madotolo akuti anthu atatha zaka 50 amakhala ndi vuto loti asachite bwino kwambiri, chifukwa akamakalamba, kuunikaku kumachepa m'mitsempha yamagazi, ndipo zimavuta kuyenda nawo.

Ndiye kuti, matenda oopsa a grade 2, chiopsezo sichiri kwa aliyense, mosiyana ndi giredi III, momwe chithandizo chimakhala chovuta kwambiri. Mtima umayesanso kupopa magazi m'magazi, omwe amafotokozera kuchuluka kwa kuthamanga kwa magazi.

Komabe, pali zifukwa zambiri:

mtima atherosulinosis (kutayika kwa masoka achilengedwe amitsempha yamagazi),
chibadwa
zizolowezi zoipa (kusuta, zakumwa zoledzeretsa),
onenepa kwambiri (mapaundi ochulukirapo, amakhala ndi chiopsezo chodwala),
matenda a shuga a mtundu 1, 2,
kusokoneza chithokomiro,
mchere wambiri mu chakudya
ma neoplasms azachilengedwe osiyanasiyana,
kuwonongeka kwa mtima
kusalinganika kwa mahomoni.

Zina mwazinthu zomwe zimapangitsa kukula kwa matenda oopsa a digiri yachiwiri ndi kukhala matenda a kwamikodzo, impso, nthawi yayitali yodandaula, komanso kugwira ntchito.

Poyamba, matenda oopsa amakhala ngati ofatsa, kupsinjika ndi iwo kumawonjezeka osaposa magawo 20 mpaka 40. Ngati mumayezera kupanikizika pafupipafupi, mutha kuwona kuti zimakwera nthawi ndi nthawi. Kuphwanya lamulo lotere sikukhudza thanzi la munthu; mwina sangazindikire konse. Panthawi imeneyi, thupi limasintha. Mavuto akachuluka, amakhudza ntchito ya ziwalo zambiri ndi machitidwe.

Ndizotheka kuti wodwalayo azikhala ndi vuto la matenda oopsa, omwe angayambitse:

sitiroko
vuto la mtima
kutayika kwamaso
ubongo edema, mapapu.

Zowopsa 2, 3, 4 madigiri

Zosokoneza magazi si chiganizo!

Kwa nthawi yayitali amakhulupirira kuti ndizosatheka kuthana ndi matenda oopsa. Kuti mumve kupumula, muyenera kumamwa mankhwala ogulitsa mankhwala okwera mtengo nthawi zonse. Kodi izi zilidi choncho? Tiyeni timvetsetse momwe matenda oopsa amathandizira pano ndi ku Europe.

Madokotala amagawa matenda oopsa malinga ndi kuchuluka kwa ngozi zomwe zingathe kunyamula. Nthawi yomweyo, zinthu zomwe zimapangitsa kukula kwa thanzi, kuthekera kwa kuwonongeka kwa ziwonetsero, komanso ziwalo zoganiza zimayesedwa.

wodwala ndi bambo wazaka zoposa 50,
mu plasma, cholesterol ndi mamilimita 6.5 pa lita imodzi,
Mbiri imalemedwa ndi chibadwa chatsopano,
wodwala amasuta kwa nthawi yayitali,
ali ndi ntchito yokhala pansi.

Kuopsa kwa matenda oopsa a grade 2 ndikudziwitsa komwe kungachitike popanda kusokonezeka kwa dongosolo la endocrine, sitiroko komanso chifukwa cha kuthamanga kwa magazi. Kulemera kwambiri kumawonjezera vutolo.

Ndi mwayi wa 20-30% wa chiopsezo chosintha pamtima - uwu ndi ngozi ya madigiri atatu. Monga lamulo, kuwunika kumeneku kumaperekedwa kwa odwala matenda ashuga omwe ali ndi ma atherosulinotic placer, zotupa za zombo zazing'ono. Mwacionekele, momwe impsozo sizikhala zachilendo.

Choyambitsa matenda a mtima chapamtima chidzakhala chikuwonekera msanga pamagazi. Zowopsa za digiri ya 2 yokhala ndi chiwopsezo cha 3 sizachilendo ngakhale pakati pa anthu azaka 30 mpaka 40.

Ngati mbiri ya matenda oopsa imakhala ndi ambiri mwa matendawa, ali ndi chiwopsezo cha magawo anayi. Kuwonjezeka kwa kukakamizidwa kumakulirakulira kwambiri ndikuphwanya ziwalo zonse zamkati zomwe zilipo. Kuopsa kwa kalasi yachinayi ndi matenda oopsa a gawo 2 kumanenedwa pomwe wodwala anali ndi vuto la mtima, mosasamala kanthu komwe khomalo lidayamba.

Tiyenera kumvetsetsa kuti chiopsezo ndikungolosera chabe, sichizindikiro chokwanira:

Kuopsa kwa matenda oopsa kungangoyerekeza kuopsa kwa zovuta.Koma nthawi yomweyo, mavuto ngati awa atha kupewedwa ngati mukulandira thanzi lanu komanso malangizo a dotolo ndiudindo wonse (kutsatira njira yathanzi, onetsetsani kuti muphatikiza zakudya zoyenera, tsiku logwira ntchito, kugona mokwanira usiku, komanso kuwunika magazi).

Zizindikiro za gawo 2 GB

Matenda a arterial a gawo la 2 amadziwika ndi kuwonjezeka kwa kuthamanga mpaka kufika pa 160-180 / 100-110 mm. Hg. Art. Zizindikiro zamatendawa ndi:

kutupa kwa nkhope, makamaka makope,
chizungulire ndi zowawa m'mutu,
Kuwala kwa khungu la nkhope (Hyperemia),
kumva kutopa, kutopa ngakhale utagona komanso kupuma,
njira zosinthira "midges" pamaso,
kutupa kwa manja
kugunda kwa mtima
phokoso, kulira m'makutu.

Kuphatikiza apo, zizindikiritso sizimaphatikizidwa: kuwonongeka kwa kukumbukira, kusakhazikika kwa malingaliro, mavuto pokodza, kusintha kwa mapuloteni amaso, makulidwe a makoma amkati wamanzere amitseko.

Zimachitika kuti odwala matenda oopsa amadandaula za kutayika kokwanira kapena pang'ono kwa phalanges zala ndi zala, nthawi zina magazi ambiri amathamangira kumaso, ndipo kuwonongeka kumayamba. Pangakhale chithandizo chokwanira panthawi yake, zotsatira zake zidzakhala kulephera kwa mtima, kupita patsogolo kwa atherosulinosis, matenda aimpso.

Zizindikiro za matenda oopsa zimabweretsa mavuto ambiri nthawi yapakati, koma izi sizilepheretsa mkazi kupanga ndi kubereka mwana wathanzi kwathunthu. Koma ndi matenda oopsa a gawo la III, sikoletsedwa kutenga pakati ndikubereka, popeza pali chiopsezo chachikulu cha kufa kwa amayi pakubala. Ngati vuto la matenda oopsa likagwera mzimayi yemwe alibe matenda oopsa 2, amatha kubereka mwachilengedwe.

China chake ndi pomwe mbiri ya mzimayi imalemedwa. Pa nthawi yonse yoyembekezera komanso pobereka, mayi wotere ayenera kuyang'aniridwa ndi adokotala nthawi zonse. Ndikofunikanso kuwunikira momwe mwana amakhalira, kugunda kwa mtima wake. Mungafunike kumwa mapiritsi omwe:

zimakhudzanso thanzi la azimayi
sizikhudza mwana wosabadwa.

Muzochita zachipatala, pakhala pali zochitika pamene, mu trimester yoyamba, zizindikiro za kuthamanga kwa magazi zidagwera monga zabwinobwino kapena mosinthanitsa, kupsinjika kumawonjezeka kwambiri.

Mzimayi akakhala ndi matenda oopsa, kuthamanga kwa magazi ake kumapitirirabe, amatha kudwala toxosis pakatha nthawi. Izi zimakhudza mkhalidwe wa mayi ndi mwana. Zizindikiro zina zimayamba, mwachitsanzo, mavuto ndi maso, kupenya kwam'maso, kupweteka mutu, nseru, kusanza komwe sikubweretsa mpumulo.

Mwa zina zowopsa komanso zovuta kwambiri za matendawa, kudziwikiratu kwam'mimba komanso kukha magazi m'mimba ziyenera kudziwika.

Njira zochizira

Hypertension iyenera kuthandizidwa mosasamala kuchuluka, komabe, ngati matenda oopsa atha kuwongoleredwa pokhapokha kusintha zakudya ndikusiya zizolowezi zoyipa, 2nd degree ofology imafuna kugwiritsa ntchito mapiritsi. Chithandizo chimathandizidwa ndi katswiri wa zam'deralo kapena mtima, nthawi zina kufunsana kwa ma neuropath kumafunikira.

Chithandizo chimachitika nthawi zonse, kuphatikizapo okodzetsa:

Mapiritsi a antihypertensive kuti muchepetse kuthamanga kwa magazi ndi mankhwala osokoneza bongo amitundu ina angathandize kuchiza matendawa: Hartil, Physiotens, Bisoprolol, Lisinopril. Ndi kugwiritsa ntchito pafupipafupi, amathandiza kupewa mavuto oopsa, osokonezeka.

Wodwala wodwala matenda oopsa adzaikidwa mankhwala omwe amachepetsa cholesterol yoyipa yamagazi: Atorvastatin, Zovastikor. Kuchepetsa magazi kumachitika ndi Cardiomagnyl, Aspicard. Ndikofunika kumwa mapiritsi mwachisawawa panthawi, njira yokhayo yomwe ingapereke zotsatira zabwino, kupewa matenda oopsa.

Kupanga chithandizo chokwanira, dokotala amasankha mankhwala omwe amatha kuphatikizana komanso kukhazikitsa mphamvu za wina ndi mnzake. Ngati kuphatikiza kumeneku sikunasankhidwa molondola, pamakhala chiwopsezo cha zovuta.

Mukamapangira dongosolo la mankhwala a matenda, zinthu zotsatirazi zimakumbukiridwa nthawi zonse:

zaka odwala
kuchuluka kwa zolimbitsa thupi
kukhalapo kwa zovuta za dongosolo la endocrine,
matenda a mtima, ziwalo
magazi cholesterol.

Kumwa mapiritsi, kuwunika kwa magazi kumawonetsedwa kuti ayese mayankho a thupi pakalandira chithandizo. Ngati ndi kotheka, mankhwala ena amagwiritsidwa ntchito pochiza, kupereka zotsatira zofanana ndi matenda oopsa.

Gulu la matenda oopsa

Nayi gulu la matendawa:

1 digiri - kupanikizika kwa 140-159 / 90-99 mm. Hg. Art.
2 digiri - 160-179 / 100-109 mm. Hg. Art.
3 digiri - 180/100 mm. Hg. Art.

Choopsa kwambiri ndi digiri yachitatu, momwe mumakhala kugonjetsedwa kwa ziwalo zomwe mukufuna: impso, maso, kapamba. Ndi zovuta za matendawa ndi atherosulinosis (zolengeza mkati mwa chotengera), mapapu am'mimba, matenda amtima, matenda osokonezeka a ziwalo zamkati amapangidwa. Potengera momwe mitundu iyi ya matenda imagwirira ntchito, kukha magazi kwa ma cell a ziwalo kumachitika. Ngati ikuwoneka m'maso a retina, pali kuthekera kwakukulu kwa khungu, impso - kulephera kwa impso.

Pali magulu anayi oopsa pa matenda oopsa:

Zochepa (chiopsezo 1)
Wapakatikati (chiwopsezo 2),
Kwambiri (3 chiopsezo)
Kwambiri (4 chiopsezo).

Kuwonongeka kwa ziwalo zomwe zimayang'aniridwa kumachitika pachiwopsezo cha gulu 3. Kutengera kuthekera kwachiwiri kwa kuthamanga kwa kuthamanga kwa magazi, maguluwo amasiyanitsa mitundu itatu yamatenda:

Payokha, mtundu woipa wa matenda oopsa umasiyanitsidwa, momwe kusintha kwamphamvu kwa magazi kumawonedwa. Pa gawo loyambirira la matendawa, zizindikiro zamankhwala sizimayang'aniridwa, koma zosintha zotsatirazi zimathandizira pang'onopang'ono:

Mutu
Kulemera m'mutu
Kusowa tulo
Kutupa kwathamanga kwa magazi kumutu
Kusweka mtima

Matendawa akamadutsa kuchokera ku 1 mpaka 2, zizindikiro zomwe zili pamwambapa zimatha. Pa gawo lachitatu la matenda, zotupa zamkati zimawonedwa, momwe zotsatirazi zimapangidwira:

Hypertrophy yamanzere yamanzere,
Khungu
Mtima wong'ung'udza,
Retinitis ndi angiospastic.

Magulu a mitundu ya kuthamanga kwa magazi ndikofunikira kwambiri pakusankha njira zoyenera zamankhwala zodutsira matendawa. Ngati chithandizo choyenera sichinachitike, vuto la matenda oopsa lingachitike, pomwe ziwopsezo zimapitilira magawo a thupi.

Matenda oopsa a 1st degree: zizindikiro ndi chithandizo

Matenda oopsa a 1st degree samawonetsedwa ndi kuwonongeka kwa ziwalo zomwe zikuyandikira. Mwa mitundu yonse, yoyamba ndiyo yosavuta. Komabe, motsutsana ndi maziko ake pali zizindikiro zosasangalatsa:

Kupweteka kwa pakhosi
Kuuluka kwa "ntchentche" pamaso,
Kusweka mtima
Chizungulire

Zomwe zimayambitsa matendawa ndizofanana ndi mitundu ina ya matenda oopsa.

Momwe mungathanirane ndi matenda oopsa a digiri yoyamba:

Kuchepetsa thupi. Malinga ndi maphunziro azachipatala - ndi kuwonda kulikonse kwa ma kilogalamu awiri, kupsinjika kwa tsiku ndi tsiku kumachepa ndi 2 mm. Hg. Art.
Kusiya zizolowezi zoipa,
Kuletsa mafuta ndi nyama zamchere,
Zochita zolimbitsa thupi pafupipafupi (kuthamanga, kuyenda),
Kuchepetsa zakudya zomwe zimakhala ndi calcium ndi potaziyamu,
Kuletsa kupsinjika kwamalingaliro,
Ma antihypertgency othandizira ngati mono-ndi chithandizo chophatikiza,
Kutsika kwapang'onopang'ono kwa kupsinjika kwa zolimbitsa thupi (140/90 mm Hg),
Zithandizo za Folk kuonjezera mphamvu ya mankhwala.

Kuti muchiritse matendawa, malingaliro onse omwe ali pamwambawa ayenera kutsatiridwa.

Matenda oopsa a digiri yachiwiri: mavuto oopsa - ndi chiyani

Zovuta zam'magawo a 2 amatha kukhala magulu a 1, 2, 3 ndi 4. Chizindikiro chowopsa cha matendawa ndimavuto oopsa. Ndi iyo, sikuti ziwalo zomwe tikujambulazo zimakhudzidwa mwachangu, komanso kusintha kwachiwiri kumachitika mkati ndi mkati mwa dongosolo lamanjenje.

Vuto lazopanikizika ndi kuthamanga komanso kosayembekezeka kwa kuthamanga kwa magazi ndikusintha kwa magazi kulowa ziwalo zamkati. Poyerekeza ndi maziko a matenda, zomwe zimanenedwa kuti zimaphwanya maziko a psychoemotional. Zomwe zimapatsa vutoli ndikugwiritsa ntchito mchere wambiri, kusintha kwa nyengo. Masautso ndi owopsa makamaka chifukwa cha kuwonongeka kwa mutu ndi mtima pamaso pamikhalidwe ya pathological.

Kodi zizindikiro za matenda oopsa 2 digiri 2 ndiwotani pazovuta:

Ululu kumbuyo kwa sternum ukugwedezeka mpaka tsamba
Mutu
Kutaya chikumbumtima
Chizungulire

Gawo lino la matenda oopsa ndi vuto la zovuta zina zomwe zingayambitse kusintha kambiri. Sikovuta kuchiza ndi mankhwala amodzi a antihypertensive. Pokhapokha ngati pali mitundu yothandizirana ndi omwe mungayendetse magazi moyenera.

Matenda oopsa 2

Matenda oopsa a 2nd degree 2 nthawi zambiri amakumana motsutsana ndi maziko a mtima wamatenda, omwe angina amawukira (kupweteka kwambiri kumbuyo kwa sternum chifukwa chosowa magazi m'mitsempha yama coronary artery). Zizindikiro zamtunduwu wamatendawa sizisiyana ndi matenda oopsa a gawo lachiwiri la gulu langozi. Ndiwowona kuwonongeka kwa mtima dongosolo.

Mtundu wa matenda amtunduwu umanena za kuopsa kozama. Gululi la matenda limawerengedwa kuti ndi lowopsa chifukwa, patatha zaka 10, mavuto amtima amayamba mwa anthu 15%.

Ndi chiwopsezo 3 cha 2 digiri ya matenda oopsa, mwayi wokhala ndi vuto la mtima pambuyo pa zaka 10 ndi 30-35%.

Ngati ziwonetserozo zikukwera kuposa 36%, ndiye kuti zoopsa 4 ziyenera kuganiziridwa. Kupatula kuwonongeka kwa mtima ndi kuchepa kwa masinthidwe a ziwalo zojambulidwa, matenda a pathology amayenera kuzindikirika munthawi yake.

Kuzindikira kwakanthawi kumatha kuthandizanso kuchepetsa kuchuluka kwa mavuto obwera chifukwa cha matenda. Kutengera kuthekera kwakukulu kwa zotupa, mitundu yotsatizayi imasiyanitsidwa:

Opanikizika - ndi minofu yanjenjemera
Edematous - Kutupa kwa m'mizere, kugona,
Neuro-vegetative - overexcitation, kamwa yowuma, kuchuluka kwa mtima.

Ndi mitundu ili yonse yamatenda, mawonekedwe amafunsira awa:

Pulmonary edema
Myocardial infaration (kufa kwa minofu yamtima),
Kutupa kwaubongo
Cerebrovascular matenda
Imfa.

Zowopsa za digiri yachiwiri ndi chiopsezo cha 2 ndi 3 zimapezeka kwambiri mwa akazi.

Matenda oopsa 2

Hypertension yachiwiri 2; chiopsezo 3 chimaphatikizidwa ndikuwonongeka kwa ziwalo. Ganizirani zomwe zasintha mu impso, ubongo ndi mtima.

Momwe mamembala amakhudzidwa:

Kuthamanga kwa magazi ku ubongo kumachepa, komwe kumayambitsa chizungulire, phokoso m'mutu, ndi kuchepa kwa ntchito. Ndi nthawi yayitali ya matendawa, matenda a mtima (kufa kwa maselo) amakula ndi kukumbukira, kuiwala nzeru, kuchepa kwa malingaliro,
Kusintha kwa mtima kumayamba pang'onopang'ono. Poyamba, kuwonjezeka kwa myocardium kumachitika mu makulidwe, ndiye kuti kusintha kosasunthika kwamkono wamanzere kumapangidwa. Ngati coronary arteriosranceosis ilowa, myocardial infarction imawonekera ndipo kuthekera kwa kufa kwa coronary ndikokwera,
Mu impso motsutsana ndi ochepa ochepa matenda oopsa, minofu yolumikizana imakula. Sclerosis imabweretsa kusokonezeka kwa kusefera komanso kusinthanitsa kwa zinthu. Kusintha kumeneku kumapangitsa kulephera kwa impso.

Matenda oopsa 3 digiri 2

Matenda oopsa a grade 3 wokhala ndi chiopsezo cha 2 ndi owopsa. Zimaphatikizidwa osati ndi kuwonongeka kwa ziwalo zokha, komanso kupezeka kwa matenda ena: shuga, glomerulonephritis, kapamba.

Pa digiri ya 3 yamatendawa, kuthamanga kwa magazi kumapangidwa (kupitirira 180/110 mm Hg). Ndi mtundu uwu wamankhwala oopsa, kuchuluka kowonjezereka kumachitika.Ngakhale motsutsana ndi maziko a mankhwala a antihypertensive, ndizovuta kwambiri kutsogolera ku zofunikira zathupi. Ndi madigiri atatu a matenda oopsa, zotsatirazi zimabweretsa:

Glomerulonephritis,
Zovuta zamtima (arrhasmia, extrasystole),
Zilonda zamaubongo (kutsika kwakutali, kuchuluka kwa malingaliro, kuchepa kwa kukumbukira).

Mwa anthu okalamba, matenda oopsa a giredi 3 amadziwika ndi kuchuluka kwakukakamiza kwakukulu kopitilira 180/110 mm. Hg. Art. Ziwerengero zotere zimayambitsa kupindika kwamankhwala. Chiwopsezo cha matendawa chimawonjezeka motsutsana ndi maziko a vuto la matenda oopsa, momwe kuthamanga kwa magazi "kumadutsa". Komabe, ndi matenda oopsa oopsa omwe ali pachiwopsezo cha 3, manambala ndiofunikira kwambiri, ndipo zovuta zake zimatha kupha. Ngakhale kuphatikiza mankhwala ndi mankhwala angapo sikuti kumapangitsa kutsendereza kosalekeza.

Matenda oopsa 3 digiri ya 3

Matenda oopsa omwe ali pachiwopsezo cha 3rd sikuti amangokhala okhwima, komanso mawonekedwe owopsa a matenda. Monga lamulo, zotsatira zoyipa ngakhale munthawi ya mankhwala omwe ali ndi mtundu uwu wa matendawa zimawonedwa kwa zaka 10.

Ngakhale kuti madigiri 3 kuthekera kwa kuwonongeka kwa ziwalo sikumadutsa 30% kwa zaka 10, koma ziwopsezo zazikulu zowopsa zimatha kuyambitsa kuperewera kwa impso kapena mtima. Nthawi zambiri, odwala matenda oopsa a grade 3 amakhala ndi matenda a hemorrhagic.

Komabe, madotolo ambiri amakhulupirira kuti ndi matenda oopsa a digiri ya 3 ndi 4, kuthekera kwa zotsatira zoyipa ndikokwera kwambiri, chifukwa kuthamanga kwatha kupitirira 180 mm. Hg. Art. amafa msanga.

Matenda oopsa 3 digiri ya 4

Ndi matenda oopsa a giredi 3 ndi chiopsezo cha 4, zizindikiro zambiri zimachitika. Timalongosola zizindikiro zofunikira kwambiri zamtunduwu:

Chizungulire
Kugwedeza mutu
Kuperewera kwa mgwirizano
Zowonongeka
Redness ya khosi
Kuchepetsa mphamvu
Kutukwana
Paresis,
Nzeru zakuchepa
Kutaya kulumikizana.

Zizindikiro izi ndi chiwonetsero cha kuthamanga kwa magazi pamtunda wa 180 mm. Hg. Art. Pangozi 4, munthu amakhala ndi zovuta zotsatirazi:

Mitundu isintha
Dementia
Kulephera kwa mtima
Myocardial infaration
Encephalopathy
Kulephera kwina
Mavuto a Umunthu
Nephropathy ndi matenda ashuga,
Matumbo,
Optic edema,
Kutalika kwa msempha.

Iliyonse ya zovuta izi ndi zochitika zakupha. Ngati masinthidwe angapo amachitika nthawi yomweyo, munthu akhoza kufa.

Momwe mungapewere matenda oopsa oopsa 1, 2, 3 ndi 4

Pofuna kupewa zoopsa, matenda oopsa azisamaliridwa bwino. Dokotala amakulemberani mankhwala, koma muyenera kumamuyendera pafupipafupi kuti musinthe mayeso.

Kunyumba, njira zimayenera kuchitidwa kuti moyo wawo usinthe. Pali mndandanda wina wa njira zomwe zingachepetse kuthamanga kwa magazi komanso kuchepetsa kufunika kogwiritsa ntchito antihypertensive mankhwala. Zili ndi zotsatirapo zake, choncho, ngati mugwiritsa ntchito nthawi yayitali, kuwonongeka kwa ziwalo zina kumachitika.

Mfundo zofunika za mankhwala ochizira matenda oopsa:

Tsatirani malangizo a dokotala
Mankhwala ayenera kumwedwa malinga ndi nthawi yake,
Kuti muchepetse mavuto kuchokera ku mankhwala, amatha kuphatikizidwa ndi mankhwala azitsamba a antihypertensive.
Siyani zizolowezi zoyipa ndikuchepetsa mchere
Kuchepetsa thupi
Pewani kupsinjika ndi kuda nkhawa.

Pakadali koyamba kugwiritsa ntchito mankhwala a antihypertensive, Mlingo wochepetsetsa ungagwiritsidwe ntchito, koma ngati sangathandize kuthana ndi matenda, mankhwala ena achiwonjezere. Pomwe sizikwanira, mutha kulumikiza 3, ndipo ngati kuli kofunikira, mankhwala achinayi.

Ndikwabwino kugwiritsa ntchito mankhwala omwe akhala akuchita kwa nthawi yayitali, chifukwa amayaka m'magazi ndikukhala ndi magazi okhazikika.

Chifukwa chake, pofuna kupewa chiwopsezo cha matenda oopsa, ndikofunikira kuchiza matendawa kuyambira magawo oyamba.

Zolinga ndi magawo

Mwachikhalidwe, kupezeka kwa matenda oopsa a grade 2 (kuthamanga kwa magazi) kumalumikizidwa ndi anthu amsinkhu wopuma pantchito. Mwa njira ina, izi ndi zowona, chifukwa ndi zaka, pali kufupika kwa lumen m'mitsempha yaying'ono, komwe kumapangitsa kutsika kwa magazi.

Minofu ya mtima iyenera kuyesetsa kwambiri (kukakamiza) kupopa magazi, chifukwa, kuthamanga kwa magazi, magazi amapezeka. Komabe, pali zinthu zina zambiri zomwe zimayambitsa matenda oopsa a digiri yachiwiriyo.

Ndi ochepa matenda oopsa a gawo lachiwiri, kusintha kwachilengedwe kumachitika kale, zomwe zikuwonetsa kuwonongeka kwa mitsempha yamitsempha yamagazi (atherosulinosis):

Kuthamanga kwa magazi (matenda oopsa) kumatha kukhazikika ndi cholowa cham'tsogolo.
Kukhala moyo wongokhala kungayambitse matenda.
Zizolowezi zoipa: Kusuta fodya, kumwa mowa wambiri.
Kulemera kwambiri.
Matenda a shuga, zovuta ndi chithokomiro.
Mimba yovuta.
Ma tumors, mosasamala kanthu za genesis.
Kuchulukitsa kwa mchere, komwe kumachepetsa kuchotsa kwamadzi m'thupi.
Matenda a mtima.
Zakudya zopanda pake, kudya zakudya zamafuta, zakudya zomwe zimakhala ndi cholesterol yambiri.
Matenda aimpso ndi mkodzo.
Zosintha mu mahomoni.
Mikhalidwe yovuta yovuta.
Chithunzithunzi chachikulu, champhamvu kwambiri chamakono, kukhala mumzinda waukulu.

Odwala omwe ali ndi giredi 2 matenda oopsa amatha nthawi zambiri zovuta zilizonse. Matendawa ali pamalire am'malire asanakwerere ku matenda oopsa a 3, omwe amapezeka mwamphamvu ndipo amadzetsa zovuta. Izi ziyenera kupewedwa.

Zotsatirazi zimayambitsa kuthamanga kwa magazi:

atherosulinosis (kupangika, kuchepa kwa mtima wamankhwala),
zakudya zopanda thanzi, kunenepa kwambiri,
chibadidwe (chibadwa),
kumangokhala
zizolowezi zoipa (mowa, kusuta),
mtima pathologies
kupsinjika kwanthawi yayitali (kupsinjika),
kusokonezeka kwa mahomoni (makamaka munthawi ya akazi -
mavuto a impso
zotupa
endocrine pathologies,
kuchuluka kwa madzi mthupi,
matenda a genitourinary system.

Mlingo wamoyo wamakono ndi nkhawa zake komanso kuthamanga kwa liwiro poyamba kumayambitsa kupanikizika kwapang'onopang'ono (magawo 20 mpaka 40). Koma chifukwa chofuna kuzolowera kupsinjika kowonjezereka ndikukhala ndi kuthamanga kwa magazi, ziwalo zonse zaumunthu ndi machitidwe zimavutika: mtima, mitsempha yamagazi, ubongo, mapapu. Kuopsa kwa mikwingwirima, kugunda kwa mtima, edema ya m'mapapo ndi zina zazikulu zomwe zikukula zikukula.

Matenda oopsa oopsa a 2 amachititsa ngozi zotsatirazi:

kuwonongeka kwapadera,
kutayika kwa ntchito yabwinobwino,
kuwonongeka kwa ziwalo zamphamvu kuposa ena omwe akuvutika ndi kupanikizika kwambiri kapena madontho ake.

Chithunzi cha kuchipatala cha matendawa chimakhala chovuta kwambiri ndi zinthu izi: zaka (abambo opitirira zaka 55, azimayi opitilira 65), cholesterol yayikulu magazi, mbiri yakale yosuta, matenda ashuga, cholowa chamtsogolo.

Kwa zaka 10, matenda oopsa 1 amakhudza ntchito za ziwalo ndi 15%.

Madotolo akuti anthu atatha zaka 50 amakhala ndi vuto loti asachite bwino kwambiri, chifukwa akamakalamba, kuunikaku kumachepa m'mitsempha yamagazi, ndipo zimavuta kuyenda nawo.

Komabe, pali zifukwa zambiri:

mtima atherosulinosis (kutayika kwa masoka achilengedwe amitsempha yamagazi),
chibadwa
zizolowezi zoipa (kusuta, zakumwa zoledzeretsa),
onenepa kwambiri (mapaundi ochulukirapo, amakhala ndi chiopsezo chodwala),
matenda a shuga a mtundu 1, 2,
kusokoneza chithokomiro,
mchere wambiri mu chakudya
ma neoplasms azachilengedwe osiyanasiyana,
kuwonongeka kwa mtima
kusalinganika kwa mahomoni.

Zina mwazinthu zomwe zimapangitsa kukula kwa matenda oopsa a digiri yachiwiri ndi kukhala matenda a kwamikodzo, impso, nthawi yayitali yodandaula, komanso kugwira ntchito.

Poyamba, matenda oopsa amakhala ngati ofatsa, kupsinjika ndi iwo kumawonjezeka osaposa magawo 20 mpaka 40. Ngati mumayezera kupanikizika pafupipafupi, mutha kuwona kuti zimakwera nthawi ndi nthawi.

Kuphwanya lamulo lotere sikukhudza thanzi la munthu; mwina sangazindikire konse. Panthawi imeneyi, thupi limasintha.

Mavuto akachuluka, amakhudza ntchito ya ziwalo zambiri ndi machitidwe.

Ndizotheka kuti wodwalayo azikhala ndi vuto la matenda oopsa, omwe angayambitse:

sitiroko
vuto la mtima
kutayika kwamaso
ubongo edema, mapapu.

Etiology ya matenda oopsa a gawo lachiwiri

Zomwe zimayambitsa, zizindikiritso ndi chithandizo cha matenda oopsa 2 zimagwirizanitsidwa. Chifukwa chake, tisanadziwe kuti ndi chithandizo chiti chomwe tikulimbikitsidwa, timaganizira zomwe zimapangitsa kuti matenda asachiritsike.

Madotolo ati odwala omwe adutsa choposa zaka 50 amatenga matendawa. Izi zimalumikizidwa ndi njira zachilengedwe zakukalamba m'thupi, zomwe zimayambitsa kuchepetsedwa kwa lumen pakati pa ziwiya, zomwe zimasokoneza magazi.

Mosiyana ndi giredi 3 la GB, gawo lachiwiri la matendawa silowopsa kwa odwala onse, popeza pano pali zovuta zochepa, matendawa ndiosavuta kuchiza ndi mankhwala.

Mitundu inayi yakuwopsa kwa matenda oopsa

Chiopsezo chimodzi (chotsika) cha ziwalo zosakwana 15%,
Chiopsezo 2 (pafupifupi) cha kusintha kwa ziwalo (mtima, maso, impso) ndi 15-20%. digiri yachiwiri: Kupsinjika kumakwera pamwamba pa zomwe zimapangitsa 2, zomwe zimapangitsa kuti wodwalayo akule, mapangidwe a endocrine sapezeka,
Chiwopsezo cha 3 - chiwopsezo cha 2 digiri 20-30%. Wodwalayo ali ndi zinthu zitatu zomwe zimayambitsa kuchuluka kwa kukakamiza (atherosulinosis, matenda ashuga, kusowa kwa impso kapena ena), kuthamanga kwa magazi m'mitsempha yama coronary kumawonjezereka, komwe kumayambitsa ischemia,
Chiwopsezo cha 4 - 30% yovulaza ziwalo. Kukula kwa matendawa kumakwiyitsa zinthu zinayi - matenda osachiritsika omwe akukhudza kuwonjezeka kwa kupanikizika ndi kupitilira kwa matenda oopsa (atherosulinosis, ischemia, shuga, matenda a impso). Awa ndi odwala omwe adapulumuka vuto la mtima la 1-2.

Pa digiri yachiwiri, chiwopsezo 3 chimanenedweratu: kuchuluka kwake zomwe zimapangitsa zimabweretsa zovuta. Ndipo ndi zinthu ziti zomwe zimayenera kumenyedwa kuti mupewe.

Zowopsa zimatha kusintha (zomwe zimatha kuchotsedwa) komanso sizolakwika. Kuti muchepetse chiwopsezo cha kudwala kwamatenda, muyenera kusintha kwambiri moyo wanu, kuchotsa zoopsa zoyenera (kusiya kusuta, kumwa mowa, kubwezeretsanso thupi).

Mitsempha yamagazi, mtima, impso, maso amavutika kwambiri ndi kupanikizika kwa magazi. Zomwe ziwalozi zikuyenera kuziwona ziyenera kuwonongera zomwe zidawawonongera chifukwa cha kuthamanga, ngakhale mavuto atha kupewedwa.

Magulu otsatirawa a matenda oopsa alipo:

1 digiri - kupanikizika kwa 140159 / 90-99 mm Hg. Art.
2 - 160-179 / 100-109 mm RT. Art.
3 - 180/100 mm RT. Art.

Pankhaniyi, ndikofunikira kusiyanitsa magawo ndi magawo. Omwe amakhala ndi gawo la kuchuluka kwa kuthamanga kwa magazi, omaliza amakhala ndi mawonekedwe azachipatala. Malinga ndi lingaliro ladziko latsopano, madigiri a matenda oopsa amasiyanitsidwa:

Zowonjezera zowonjezereka kuyambira 140/90 mpaka 160/100 mm Hg,
Ziwerengero zimaposa izi pamwambapa.

Ponena za matendawo, zikuwoneka motere:

Zovuta ndi kusintha kwamaonekedwe a ziwalo sizimawonedwa,
Pali zizindikiro zakusintha kwamkati mwa thupi komwe kumalumikizidwa ndi kuthamanga kwa magazi: matenda a mtima (matenda oopsa), impso yotupa, kuwonongeka m'mitsempha muubongo, kusintha kwa fundus,
Kukula kwa zovuta zowopsa mu mawonekedwe a myocardial infarction ndi matenda a sitiroko.

3 digiri, chiwopsezo 3

Munthawi yosalamulirika, popanda chithandizo choyenera (kumwa mapiritsi a antihypertensive), gawo lachiwiri la matenda oopsa limabweretsa zovuta zosiyanasiyana. Kuthamanga kwa magazi kumayambitsa atherosulinosis, thrombosis, encephalopathy. Chimodzi mwazinthu zazikulu zomwe zimalemedwa ndi mtima (angina pectoris).

Kupanikizika kumayambitsa impso, maso, ndi mitsempha. Mwazi womwe umaperekedwa kwa ziwalo zimasokonezeka chifukwa chophwanya kapangidwe ka zotupa zam'mimba, kutayika kwa elasticity. Kuthamanga kwa magazi kumayambitsa kusokonezeka kwa magazi.

Kuphatikizika kwotsatira ndi kuwongolera kwa aneurysm. Makoma amitsempha amatambasulidwa, kukhala owonda kwambiri, ophulika mosavuta chifukwa cha magazi.

Matendawa amayambitsa kufooka kwa lumen m'mitsempha yamagazi, ndikupanga zofunikira za atherosclerosis. Kusungidwa kwamafuta pamitsempha kwamitsempha kumatha kupangitsa kuti magazi azigwera, zomwe zimawonjezera ngozi ya thrombosis. Chifukwa chake, ndi zizindikiro zoyambitsa matenda oopsa, ndikofunikira kufunafuna thandizo loyenerera.

Matenda oopsa oopsa sangachiritsike, koma mutha kukhala ndi matenda zaka zambiri. Koma izi zimafunikira kutsatira miyezo iwiri:

kukhalabe ndi kuthamanga kwa magazi,
kutsatira malamulo a moyo wathanzi.

Chimodzi mwazinthu zomwe zimayang'aniridwa, kudwala kumakulirakulira, nthawi ya moyo wathunthu imachepetsedwa.

Odwala ambiri omwe ali ndi matendawa kapena amakonda kutero ali ndi chidwi chofuna kudziwa ngati matenda oopsa a giredi 2 amaphatikizidwa ndi usilikali. Nthawi zambiri pamenepa pamakhala mikangano yokhudza chidwi. Asitikali safuna kutaya msilikari, bambo safuna kuwononga thanzi lake.

Kutengera mtundu wa malamulo, titha kunena kuti matenda opatsirana a kalasi 2 ndi kuphwanya ntchito yankhondo. Izi zikutsimikiziridwa ndi mgwirizano wa Unduna wa Zaumoyo ndi Unduna wa Zankhondo.

Kuyesedwa kuchipatala molingana ndi malamulo kuyenera kusungidwa kuchipatala, pomwe wopemphetsa amafufuzidwa kwathunthu. Kutengera ndi zotsatira za kafukufuku komanso chifukwa cha zomwe wapenya m'mbuyomu miyezi isanu ndi umodzi, bungwe lachipatala la ankhondo limapereka lingaliro pazakuyenera kapena kusayenerera kwa munthu wogwira ntchito yankhondo.

Pamaso pa kukakamira kosalekeza, matenda oopsa a degree yachiwiri ndi chithandizo chosayenera kapena kusakhalapo kwathunthu kumawonjezera zovuta zovuta kangapo.

Chifukwa chake, musapeputse gawo ili la matendawa, popeza ndi chifukwa chomwe chimasinthira kuchoka pa chochepa kwambiri.

Ngakhale chiwopsezo chachikulu cha matenda oopsa achiwonetsero chachiwiri, matendawa sanayambitse kusintha kosasintha kwa kapangidwe ka magazi ndi mtima, koma amafunikira chithandizo chamankhwala.

Zizindikiro zazikuluzikulu za kukhazikika kwa matenda oopsa zimayamba kuonekera kale pa gawo loyamba, chifukwa chake, matendawa akakula, amakulirakulira.

Zizindikiro zofala kwambiri za matenda oopsa ndi izi:

kutopa kwambiri, kutopa, kugona,
thukuta kwambiri
mutu ndi chizungulire, kuyamba mseru ndi kusanza,
kukhumudwa kwamaso ndi kuiwala,
tinnitus.

Ngati impso zimakhudzidwa ndi pathological process, zovuta zam'magazi zimawonekera, zomwe zimangokulitsa chithunzi chonse cha matendawa ndikupangitsa vuto la matenda oopsa.

Kutengera ndi gawo la nthendayi, kuopsa kwa kuwonongeka kwa ubongo, mtima, impso ndi mtima zimakulanso.

Chifukwa chake, magawo a matenda oopsawa amasiyanitsidwa, momwe zovuta zimatha kuchitika peresenti:

otsika (chiopsezo chochepera 15%) - mawonekedwe opepuka ndi zisonyezo za kupsinjika kwapamwamba kwa 140-160 mm Hg,
sing'anga (15-20%) - kuchuluka kolembetsa kwa chiwopsezo cha 2nd kuthamanga kwa 160-170 mm Hg,
okwera (20-30%) - mawonekedwe owopsa okhala ndi chizindikiro cha tonometer cha cholembera chapamwamba chikufika pa 180 mmHg,
chovuta (chiopsezo choposa 30%) - mawonekedwe owopsa kwambiri ndi cholembera pamtunda wa 180-200 mm Hg.

Mavuto

Ngati matendawa adapangidwa molondola, koma wodwalayo samvera zomwe dokotala wakupeza, zovuta zimatheka ngakhale mu gawo lachiwiri la matenda oopsa. Izi zikutanthauza kuti munthu amakhala ndi zotupa pakatikati pa ziwalo nthawi iliyonse. Chifukwa chake, ndikofunikira kuyambitsa chithandizo chokwanira munthawi yake kuti mupewe zovuta.

Ndi matenda amtunduwu, pali chiwopsezo cha zovuta zotsatirazi:

angina pectoris
arrhasmia,
mtima thrombosis,
atherosulinosis
matenda amtsempha wamagazi
Vegas-vascular dystonia (werengani zamankhwala a VVD apa :)

Ndi gawo lowopsa la digiri yachiwiri, ndikovuta kutsika chizindikiro chotsikitsitsa pansipa 160 mm Hg, chifukwa chake, mankhwalawa ovuta amagwiritsidwa ntchito kukonza mtima, kutsitsa cholesterol ndikuchepetsa magazi.

Chithandizo cha matenda oopsa imagwiritsidwa ntchito mothandizidwa ndi mankhwala, komanso kuwonjezera pa wowerengeka azitsamba.

Pa chithandizo, zotsatirazi ziyenera kuonedwa:

Zakudya zotchulidwa, kupatula mchere, nyama, madzi ambiri,
kukana khofi ndi tiyi wamphamvu, komanso kusuta fodya komanso mowa.
kuwongolera zolemera
mankhwala
amayenda mumweya watsopano,
kuwunikira pawokha tsiku lililonse kwa zowunikira.

Kutengera malangizo onse a dotolo, matenda opatsirana mwanjira yachiwiri amatha kuthandizidwa, ngakhale patakhala nthawi yayitali, motero muyenera kukhala oleza mtima komanso kumwa mankhwalawo munthawi yake.

Anthu omwe amakhala ndi matenda oopsa amathanso kudziwa kuti ochepa ndi omwe amayendetsa matendawa kwathunthu. Kodi kuopsa kwa matenda mu magawo awiri ndi chiani? Kuwonetsedwa kwa zovuta zamavuto a 2 degree, yodziwika ndi zizindikiro:

ulesi, kutopa, kutupa (zovuta za impso),
kuchuluka kwa zala, redness of khungu (mitsempha yamagazi),
kupenya kwamaso, kuwona kwamaso,
amadumphira mwadzidzidzi m'magazi a magazi (matenda oopsa).

Vuto la matenda oopsa ndi chitukuko chosalamulirika limatha kudzetsa stroke, myocardial infarction, kutupa kwa ubongo kapena mapapu. Chifukwa cha zovuta za matenda oopsa 2, ziwalo zazikulu zaumunthu (ubongo, mtima, mitsempha yamagazi, impso, maso) zimavutika.

Sikuti ndizovuta zokha, komanso mtundu wowopsa wa matenda. Monga lamulo, zotsatira zoyipa ngakhale munthawi yamankhwala zimawonedwa kwa zaka 10.

Komabe, madotolo ambiri amakhulupirira kuti ndi digiri ya 3 ndi 4, kuthekera kwa zotsatira zoyipa ndikokwera kwambiri, popeza kuthinana kwakukulu kuli kopitilira 180 mm Hg. Art. amafa msanga.

Zizindikiro zofunikira kwambiri zamtunduwu wa malaise ndi:

Chizungulire
Kugwedeza mutu
Kuperewera kwa mgwirizano
Zowonongeka
Redness ya khosi
Kuchepetsa kuzindikira,
Kutukwana
Paresis,
Nzeru zakuchepa
Kutaya kulumikizana.

Wothandizira amasankha njira yochiritsira. Ngati ndi kotheka, zowonjezera zimapangidwa ndi madokotala monga a mtima ndi neuropathologist. Tsoka ilo, kuchiritsa matendawa mpaka kalekale sikutheka. Njira zonse zimapangidwa kuti muchepetse magawo ake komanso kusintha mkhalidwe wa wodwalayo.

Mukamapereka mankhwala, kuchuluka kwa odwala kumawerengedwa. Ma algorithm othandizira odwala ndi achinyamata okalamba adzakhala osiyana. Mfundoyi ikugwira ntchito ngati amayi ali ndi pakati, chifukwa nthawi imeneyi mankhwala ambiri amatsutsana kuti agwiritse ntchito.

Wodwala ayenera kutsatira malangizo onse a dokotala. Kubwezeretsedwa kosavomerezeka kwa matenda oopsa kwambiri komanso kuphatikiza kwa zizindikiro kungayambitse kulemala ndi kufa.

Mndandanda wazomwe zikulembedwera ndi madigiri a GB 2 mulinso mapiritsi:

Ma diuretics pochotsa madzi ochulukirapo m'thupi - Veroshpiron, Furosemide.
Mankhwala a antihypertensive ndi gawo lofunikira kwambiri pazachipatala. Izi zikuphatikizapo Hartil, Bisoprolol ndi zina zotero.
Mankhwala ochepetsa magazi a cholesterol - Atorvastatin.
Pofotokoza ndi mawonekedwe ake ofunikira magazi.

Ndi kuthamanga kwa magazi kuchokera ku 160 mpaka 100 mm, mlingo umayikidwa payekha, monga lamulo, umayamba ndi mlingo wapakati. Mukamasankha mapiritsi, mawonekedwe ndi zoletsa kugwiritsa ntchito, mwayi wazotsatira zoyipa, zimaganiziridwa.

Matenda a arterial a gawo la 2 amadziwika ndi kuwonjezeka kwa kuthamanga mpaka kufika pa 160-180 / 100-110 mm. Hg. Art. Zizindikiro zamatendawa ndi:

kutupa kwa nkhope, makamaka makope,
chizungulire ndi zowawa m'mutu,
Kuwala kwa khungu la nkhope (Hyperemia),
kumva kutopa, kutopa ngakhale utagona komanso kupuma,
njira zosinthira "midges" pamaso,
kutupa kwa manja
kugunda kwa mtima
phokoso, kulira m'makutu.

Mukasuntha kuchokera pagawo lina mpaka pagawo, kupsinjika kwakukulu kumakhala ndi mawonekedwe osiyanasiyana. Zizindikiro za matenda oopsa a digiri yachiwiri ndizodziwika bwino, zikuwonetsa kuphwanya kwakukulu pakugwira ntchito kwa thupi. Izi zikuphatikiza:

mutu
tinnitus pafupipafupi
chizungulire
mavuto amakumbukiro
rosacea kumaso,
redness ndi pakhungu pakhungu,
kutopa
nkhawa
kugunda kwa mtima
kuchepa kwamitsempha yamaso,
dzanzi la zala.

Matenda a digiri yachiwiri amadziwika ndi mseru, kuchuluka thukuta, mtima kulephera. Kuthamanga kwa magazi kumatsimikiziridwa ndi kusintha kosanthula, makamaka, zisonyezo za proteinin ya albin mkodzo.

Matenda oopsa panthawiyi akuwonetsedwa pakusintha kwotalikira kwa kuthamanga kwa magazi. Kuchita sizimagwirizana.

Matenda oopsa a digiri yoyamba amakhala ndi maphunziro apamwamba ndipo samawonekera. GB 2 ili ndi mawonekedwe ake, omwe akuvuta kale kunyalanyaza. Poyerekeza zakumbuyo kowonjezereka, wodwalayo akuti:

kupweteka kwambiri pamutu kokhala ndi ma radiation (kowala) kumbuyo kwa mutu ndi akachisi,
chizungulire, kukayika kwakanthawi kochepa nkotheka,
kusokonekera kwa mtima kumawonedwa,
kufooka kowonjezereka
kutopa pa katundu wopepuka,
kuchepa kwamphamvu kwa ntchito,
machitidwe amasintha kukhala amtopola ndi kusokonekera,
matenda oopsa a nkhope amawonekera (ndi kukwera kwa magazi),
kuchuluka kwa zala zakumalo ndi zotsika,
nseru, mwina kusanza,
Nkhope ndi matope zimatupa,
motsutsana ndi kumbuyo kwa kupanikizika kwambiri komanso kuchepa kwake, kuthina kwa "ntchentche" patsogolo pa maso, mabwalo amdima,
tinnitus.