Kodi matenda oopsa a giredi 3 ndi chiani, amakhala pachiwopsezo 4 ndipo amatanthauzanji, komanso zomwe zimayambitsa, Zizindikiro ndi chithandizo cha matendawa

Kuwonongeka kwa digiri ya 3 kumadziwika ndi kuwonjezeka kwakukulu kwa kuthamanga kwa magazi, zomwe zimabweretsa kuwonjezeka kwa katundu pamtima, chifukwa chake odwala amakhala ndi vuto la mtima. Chiwopsezo cha zovuta zimachuluka, ngakhale pakakhala zinthu zina zovuta. Izi matenda amafunikira chithandizo chamankhwala ndi chithandizo chautali.

Kodi ndi chiyani - matenda oopsa a digiri ya 3 ndi zoopsa zake

Arterial hypertension (matenda oopsa) ndikuwonjezeka kwa kuthamanga kwa magazi (BP) komwe kumadutsa pamtundu wanthawi zonse, i.e., pamtunda wa 130/90 mmHg. Art. Khodi ya ICD-10 ndi I10-I15. Hypertension imapanga gawo lalikulu kwambiri la matenda onse oopsa ndipo amalembedwa 3540% ya akuluakulu. Ndi zaka, izi zimachulukirachulukira. Posachedwa, pafupipafupi matenda opatsirana a matenda amapezeka mwa odwala ochepera zaka 40.

Hypertension imagawidwa m'magawo atatu:

1. Kuthamanga kwa magazi ndi 140-159 pa 90-99 mmHg. Art.
2. HELL - 160-179 pa 100-109 mmHg. Art.
3. HELL - 180 pa 110 mm RT. Art. ndi mmwamba.

Pazindikiritso, deta imagwiritsidwa ntchito yomwe imapezeka pakukhazikitsa madandaulo, kuphunzira mbiri yachipatala, kufufuza kwa wodwala, ndipo koposa zonse - muyeso wa kuthamanga kwa magazi. Kupanikizika kumayesedwa katatu, m'manja onse awiri, kuwunika magazi tsiku ndi tsiku kumapangidwanso. Kuphatikiza apo, electrocardiography, kuyesa kwa zamimba zam'mimba, kuyezetsa magazi ndi zamankhwala, kuyeserera kwamikodzo kokhazikika kumayikidwa.

Odwala omwe ali ndi digiri yachitatu ya matenda oopsa amafunika kuyang'aniridwa ndi achipatala nthawi zonse.

Pali magulu anayi oika pachiwopsezo, kutengera kuchuluka kwa kuwonongeka kwa ziwalo zolunjika (i.e., ziwalo zomwe zimakhudzidwa kwambiri ndi kusokonezeka kwa magazi, mwachitsanzo, mtima ndi ubongo):

• Chiwopsezo chimodzi - mwayi wamavuto ndi ochepera 15%, palibe zinthu zoyipa,
• 2 chiopsezo - kuthekera kwa zotsatira zoyipa ndikuyerekeza mulingo wa 15-20%, palibe zinthu zopitilira zitatu zomwe
• 3 chiopsezo - mwayi wamavuto - 20-30%, pali zinthu zopitilira zitatu zomwe zikukulitsa,
• Chiwopsezo cha 4 - chiwopsezo cha zovuta zimaposa 30%, pali zinthu zopitilira zitatu, ndipo kuwonongeka kwa ziwalo kumawonedwa.

Zomwe zimakulitsa ndikuphatikizaponso kusuta, kukhala ndi moyo wongokhala, kunenepa kwambiri, kupsinjika, kuperewera kwa zakudya m'thupi, komanso kusokonezeka kwa dongosolo la endocrine.

Ndi matenda oopsa omwe ali pachiwopsezo cha 3, mutha kutenga gulu la olumala, popeza izi zimachitika limodzi ndi kusokonezeka kwa mtima, ubongo, impso, komanso kusanthula kowonera. Nthawi zambiri, kulumala kumachitika pofufuza matenda oopsa oopsa 3 digiri 4, popeza odwala oterewa mwina samatha kuyankhula, kuganiza, kuyendetsa galimoto, kupuwala.

Kukula kwake kumadalira nthawi komanso kufunika kwa mankhwalawa, kutsatira kwa wodwalayo malangizo a dokotala. Pa matenda a grade 3 omwe ali ndi chiopsezo cha 4, matendawa ndi osauka chifukwa choopsa kwambiri pamavuto oopsa.

Zomwe zimayambitsa komanso zowopsa za matenda oopsa

Mwa onse matenda oopsa, 95% ndi matenda oopsa (matenda oyamba kapena ofunika kwambiri). Mu 5% yotsala, yachiwiri kapena yodziwika ya matenda oopsa imagwidwa (mitsempha, nkhawa, kupweteka, hemodynamic, mankhwala, matenda oopsa oopsa).

Zomwe zimayambitsa ngozi zimaphatikizapo kupsinjika, psycho-maikutlo lability, kugwira ntchito mopitirira muyeso, kudya zopanda thanzi, kunenepa kwambiri, kudziwikiratu ma genetic, kusowa masewera olimbitsa thupi, zizolowezi zoyipa.

Hypertension imayamba mothandizidwa ndi zovuta zamkati komanso zikhalidwe zina, koma monga lamulo, sizingatheke kudziwa chifukwa chomwe chimayambitsa matenda.

Zomwe zimayambitsa ngozi zimaphatikizapo kupsinjika, psycho-maikutlo lability, kugwira ntchito mopitilira muyeso, kudya zopanda thanzi (kumwa kwambiri mchere, mafuta, zakudya yokazinga, kudya kwambiri), kunenepa kwambiri, kudziwikiratu ma genetic, kusowa masewera olimbitsa thupi, zizolowezi zoyipa. Matenda oopsa amitsempha yamagazi amatha chifukwa cha metabolic syndrome, matenda a shuga, dyslipidemia ndi zotupa za mitsempha yamitsempha yamagazi.

Zizindikiro za matenda oopsa a digiri yachitatu

Kuchulukirachulukira kwa kuthamanga kwa magazi sikungadziwonetse kwa nthawi yayitali, kapena sikungakope chidwi cha wodwalayo. Zizindikiro zoyambirira zimaphatikizira kupweteka kwa mutu kosalekeza, komwe nthawi zambiri kumachitika chifukwa cha zifukwa zina zosagwirizana ndi kukakamizidwa. Nthawi zambiri, matendawa amakopa chidwi chokhachokha ndikuyamba kwa vuto la matenda oopsa.

Pa magawo atatu a matendawa, wodwalayo amakhala ndi mutu, tinnitus, kupweteka pachifuwa, kutopa, kufooka, kusakwiya, chizungulire chamizere. Zizindikiro zimatha kukhala zosatha, koma nthawi zambiri zimawonekera ndi kukwera kwa magazi. Kuphatikiza apo, matendawa amakhala ndi kugona, kukwiya, kuwonongeka mu luso lotha kuzindikira.

Matenda oopsa amadzionetsa ngati mutu wothamanga kwambiri, womwe wodwalayo amawafotokozera kuti akuphulika. Ma analgesics samamuletsa. Madontho akuda amawonekera pamaso, kutsukidwa ndi kusanza kumachitika, zamkati zimafulumira, thukuta limachulukitsa, kukodza kumachitika pafupipafupi, lilime limatha kuyamba kuzimiririka. Kuwonongeka kwa thanzi kumakhala kovuta, chifukwa chake, wodwala yemwe ali ndi vutoli amafunika kuyimba ambulansi posachedwa - chithandizo cha matenda oopsa chimachitika kuchipatala.

Zomwe zimakulitsa ndikuphatikizira kusuta, kukhala ndi moyo wongokhala, kunenepa kwambiri, kupsinjika, kuperewera kwa zakudya m'thupi, komanso mavuto amthupi.

Matenda olembetsedwa muyezo wachitatu nthawi zambiri amabweretsa zovuta m'moyo. Awa ndi matenda a metabolic, pathologies a mtima ndi / kapena kwamikodzo dongosolo: mtima wamitsempha, kugunda, mtima ndi impso, mwadzidzidzi mtima wamwalira, angina pectoris, aortic aneurysm, nephropathy, matenda osokoneza bongo, retinopathy.

Chizindikiro chowopsa ndi digiri iyi yamatenda ndikuchepa kwambiri kwa kuthamanga kwa magazi, zomwe zimatanthawuza kuchepa kwa ntchito ya contractile ya minofu yamtima.

Pankhani ya kulephera kwa mtima, kupuma movutikira, chizungulire chachikulu, kupweteka mumtima, kufupika ndi zina zomwe zimayambitsa matendawa. Odwala ena ali ndi hemoptysis. Zizindikiro zoterezi zimakhala chifukwa chofunafuna chithandizo chamankhwala mwadzidzidzi.

Mu matenda oopsa amitsempha yamagazi, kuchiritsa kwathunthu kwa wodwalayo kungatheke chifukwa chomwe chimayambitsa kuthamanga kwa magazi amachotsedwa. Chofunikira pa matenda oopsa pakadali pano ndiwosachiritsika, chifukwa zomwe sizimadziwika sizomwe zimayambitsa. Komabe, kusankha koyenera kwa mankhwala a antihypertensive ndi kayendetsedwe kake motsatira malangizo a dokotala amatha kupitiliza kuthamanga kwa magazi mokhazikika, zomwe zimachepetsa mwayi wokhala ndi zovuta zowopsa.

Chithandizo cha mankhwala nthawi zambiri chimaphatikizidwa. Mankhwala a diuretic, ma renin inhibitors mwachindunji, angiotensin-kutembenuza ma enzyme inhibitors, otsutsana ndi calcium, beta-blockers amagwiritsidwa ntchito. Kuphatikizidwa kwa diuretic ndi angiotensin kutembenuza enzyme kapena diuretic inhibitor, calcium antagonist ndi beta-blocker nthawi zambiri amalembera.

Popewa kukula kwamavuto, chithandizo chachikulu chitha kuphatikizidwa ndi mankhwala ochepetsa shuga, antiplatelet, lipid-kuchepetsa mankhwala ndi ena, kutengera ndi zomwe zimagwirizana ndi matenda.

Chizindikiro chowopsa ndi digiri iyi yamatenda ndikuchepa kwambiri kwa kuthamanga kwa magazi, zomwe zimatanthawuza kuchepa kwa ntchito ya contractile ya minofu yamtima.

Gawo lofunika kwambiri la chithandizo ndikusintha kwa moyo, machiritso ake. Choyamba, ndikofunikira kusiya zikhalidwe zoyipa - kusuta ndi kumwa mowa (chidziwitso chakuti kuchuluka kwa mowa kumathandizira ndi matenda oopsa sichowona).

Kuchita zolimbitsa thupi kwambiri kumachotsedwera wodwalayo, koma kusachita zolimbitsa thupi kumaphetsanso matenda. Kuchita pafupipafupi, koma osati kuchita masewera olimbitsa thupi mopitirira muyeso kumafunikira - kukwera mafunde, kuyendetsa njinga, kusambira, yoga (kusankha magulu azamasewera, muyenera kufunsa dokotala). Odwala onenepa kwambiri amafunika kuwongoleredwa, pomwe zakudya zoyenera ziyenera kupewedwa, ndikuchepetsa thupi kuyenera kuchitika ndi kuchepa pang'ono kwa zopatsa mphamvu za tsiku ndi tsiku komanso mokhazikika, koma osachita masewera olimbitsa thupi mopitirira muyeso.

M'pofunika kutsatira zakudya, osati kwakanthawi, koma kwamuyaya - ziyenera kukhala zofunikira. Zakudya zamchere, zosuta, zonunkhira komanso zamafuta, chakudya chosavuta, chakudya chofulumira (chomwe chili ndi mafuta komanso mchere wambiri), ndipo zakumwa zilizonse za tonic siziphatikizidwa ndi zakudya. Maziko ake azikhala zakudya zamkaka ndi mkaka wowawasa, ndiwo zamasamba, mbewu monga chimanga, zipatso ndi zipatso, nsomba, nyama yamafuta ochepa, nsomba zam'madzi. Kugwiritsa ntchito mchere kumachepetsedwa mpaka 5 g patsiku. Odwala ena amafunika kutsatira njira ya kumwa - nkhaniyi iyenera kuvomerezedwa ndi adokotala.

Odwala omwe ali ndi digiri yachitatu ya matenda oopsa amafunika kuyang'aniridwa ndi achipatala nthawi zonse. Kupimidwa pafupipafupi mosasamala kanthu za kukhala bwino kumayenera kuchitika katatu pachaka (adagwirizana ndi dokotala). Odwala othamanga ayenera kuyang'anitsitsa kuthamanga kwawo kwa magazi kunyumba.

Tikukupatsani kuti muwone kanema pamutu wankhani.

Kodi ndi chiyani ndipo zikutanthauza chiyani?

Gawo lachitatu la matenda oopsa limadziwika ndi kuwonjezeka kwa kukakamizidwa kwa 180 ndi 110 mm RT. Art. Pakadali pano, matendawa ndi osachiritsika. Kuopsa kwa CCO 4 kukuwonetsa kuti oposa 30% amitsempha yamagazi awonongeka kale mthupi. Kusintha kotereku kumadziwika. Wodwalayo amasokonezeka chifukwa cha kufalikira kwa matenda a m'magazi komanso kuchepa kwa magazi komanso matenda opha ziwalo.

Kuwonjezeka kwa kupsinjika kwa maso kumabweretsa kuwonongeka kwa mawonekedwe.

Minofu yamtima siyigwirizana ndi katundu komanso mwayi wokhala ndi vuto loyipa la ubongo, kukula kwa kulephera kwa mtima ndi zina za pathologies kumawonjezeka.

Impso zimachepetsa magwiridwe ake. Ngati matendawa adayamba motsutsana ndi maziko a shuga, ndiye kuti wodwalayo sangapewe nephropathy.

Chifukwa chakuti lumen m'madziwo imachepa, ziwalo zonse zofunika zimasowa magazi. Pang'onopang'ono, amayamba kugwira ntchito molakwika. Zimadziwonetsera yokha mwazizindikiro zosiyanasiyana, zomwe kuchuluka kwake kukuchulukirachulukira.

Kuperewera kwakanthawi kokwanira komanso koyenera kumayambitsa matenda oopsa. Monga lamulo, amakula motsutsana ndi maziko a matenda monga:

• atherosulinosis
• kulephera kwa aimpso
• matenda ashuga
• kunenepa kwambiri, etc.

Gulu lomwe likupezeka pachiwopsezo chotenga matenda oopsa oopsa limaphatikizapo anthu omwe ali ndi vuto lomwa mowa mwauchidakwa komanso kugwiritsa ntchito mankhwala osokoneza bongo, amamwa mankhwala osowa mchere, ndipo amakhala moyo wongokhala.

Udindo waukulu pakupita patsogolo kwa matenda oopsa oopsa umachitika ndi: cholowa, kusalingana kwa mahomoni, zaka za odwala, komanso kupsinjika kwakanthawi, kugwira ntchito molimbika komanso kuchitira nkhanza mitundu ina ya mankhwala.

Kodi matenda oopsa amtundu wamunthu pa magawo atatu a kukula kwake amamva bwino kwambiri. Ali ndi chithunzi cholimbitsa chachipatala chomwe chimadziwoneka mosalekeza, osati pokhapokha pakuvuta kwambiri. Wodwalayo akumva:

• mutu
• chizungulire, nthawi zina kukomoka,
• tinnitus
• kupindika m'makachisi
• Madontho akuda oyang'ana pamaso,
• nseru
• kupuma pang'ono m'malo abata,
• khungu
• Kutupa kwam'mawa,
• dzanzi ndi kuzizira kwa zala,
• mgwirizano wolakwika,
• kupweteka kwa mtima
• kuchepa kwa impso.

Matenda oopsa amakhala nthawi zambiri ndipo amakhala masiku angapo. Pamavuto aliwonse, mwayi wokhala ndi stroke kapena vuto la mtima ndiwambiri. Ndizosatheka kuchita popanda thandizo la madokotala ndikuchotsa kulumpha kwa kuthamanga kwa magazi kunyumba pakadali pano.

Matenda a wodwalayo akuipiraipira msanga. Zizindikiro zatsopano zikumawonekera, ndikuwonetsa kuwonongeka kwina kwamkati.

Kodi matendawa amachitika bwanji?

Kuti mupeze matenda oopsa a gawo 3 ndi chiopsezo chokhala ndi zovuta zam'mtima 4, kukakamizidwa kamodzi kapena kawiri sikokwanira. Madokotala amathandizadi wodwalayo kuwunika kwa ziwalo zamkati ndi echocardiography ndi mtima dopplerography.

Njira zodziwunikira ndi zida zanu zimakupatsani mwayi wofufuza kuwonongeka kwa ziwalo zamkati ndikusankha njira zoyenera zamankhwala.

Kuphatikiza apo, kuyesa kwa ECG, kuyezetsa magazi ndi mkodzo, ma radiology, komanso kukambirana ndi ophthalmologist, endocrinologist, pulmonologist ndi dokotala wa opaleshoni amalembedwa.

Cholinga chachikulu cha chithandizo cha mankhwala osokoneza bongo kwambiri ndikukhazikitsa mkhalidwe wa wodwalayo, popeza ndizosatheka kale kubwezeretsa zisonyezo kukhala zabwinobwino. Pochiza odwala omwe ali ndi matenda oopsa, mankhwalawa a magulu otsatirawa amagwiritsidwa ntchito:

1. Ma diuretics - thandizani kuthana ndi madzi owonjezera ndi sodium. Hydrochlorothiazide, Indapamide ndi Chlortalidone zimapereka zotsatira zabwino.
2. ACE zoletsa - muchepetse kupanga kwa mahomoni opita ku vasoconstriction. Mwa mankhwala a gululi, Fosinopril, Captopril, Quinapril, Perindopril amagwiritsidwa ntchito.
3. Alfa ndi beta blockers - khazikitsani mtima. Mphamvu yofulumira imadziwika mutagwiritsa ntchito Bisoprolol, Metoprolol, Carvedilol.
4. Otsutsa a calcium - kupumula kwamitsempha yamagazi ndi kuthamanga kwa magazi. Malangizo omwe akupatsidwayi akuphatikizapo Amlodipine, Lacidipine, Felodipine, Nifedipine.

Dokotalayo amapereka mankhwala payekhapayekha, poganizira matenda omwe amapezeka, msinkhu komanso kulemera kwa wodwalayo.

Ngati, mutatha kudya mankhwalawo, wodwalayo akumva bwino kwambiri kapena mankhwalawo akapereka zotsatira zomwe sizikuyembekezeredwa, dongosolo la mankhwalawo limasinthidwa.

Sizoletsedwa kugwiritsa ntchito mankhwala osankhidwa ndi anzanu omwe ali ndi vuto lofananalo pamankhwala. Ndalama zomwe zidawathandiza zitha kukupatsirani.

Maphikidwe a anthu

Kugwiritsa ntchito njira zosagwiritsidwa ntchito masiku onse, mungachepetse kuchuluka kwa mawonetsedwe ndi kulimbikitsa chitetezo chathupi. Ma infusions osiyanasiyana ndi ma decoctions amawonetsedwa bwino pamankhwala odwala oopsa:

• valerian ofotokoza wothandizila amakulitsa ziwiya zam'mimba ndikuwonetsetsa kuti magazi azithamanga,
• Mfuwa ya kavalo imafinya magazi, imalepheretsa magazi, imatchinjiriza mtima komanso kumenya.
• maiwort decoction ndiye chinthu chabwino kwambiri chofuna kuti muthe kusintha zovuta zomwe zimabwera chifukwa chapanthawi yovuta,
• tincture wa hawthorn amachepetsa kusangalala kwa mtima minofu, kumenya tachycardia, arrhythmia,
• decoction wa maluwa a peony amathandizira kupweteka pamutu, amatulutsa matenda a impso.

Zomera zam'mimba zimapangidwa kwa mphindi 5. Kenako, kulowetsedwa kumasefedwa ndikusiyidwa mufiriji kwa masiku awiri. Imwani 50 mg kawiri pa tsiku.

Mankhwala achikhalidwe nthawi zambiri amapereka zotsatira zabwino, koma simungathe kuwagwiritsa ntchito ngati chithandizo chachikulu cha matenda oopsa.

Hypertension imakhudzana mwachindunji ndi zomwe timadya tsiku lililonse.Ichi ndichifukwa chake zakudya zoyenera ndichimodzi mwazinthu zazikulu zobwezeretsanso thupi ndi kuwonjezereka kwa magazi.

Kufunika kwa mphamvu kwa munthu aliyense payekhapayekha, zimatengera kukula kwa thupi lake komanso zochita zake zolimbitsa thupi. Ndikofunikira kuti munthu alandire mphamvu zochulukirapo kuposa zomwe amawononga. Yang'anirani kuchuluka kwa zopatsa mphamvu zamagulu ndi mtundu wawo. Idyani zakudya zachilengedwe zachilengedwe zokhala ndi mitundu yambiri yazakudya. Zabwino kwambiri pamikhalidwe ya mtima ndi mtsempha wamagazi:

• sipinachi
• Brussels imamera
• broccoli
• nyemba zobiriwira
• dzungu.

Mwa zipatso, zipatso za malalanje, mapeyala, ngale ndi mapichesi zimapindula. Onjezani kuchuluka kwa mtedza, zipatso zouma, nyemba, tirigu wathunthu muzakudya zanu. Chotsani mafuta a nyama, amchere komanso shuga. Pewani kudya mwachangu, koloko komanso zakudya zosavuta. Yesani kugawa chakudya cha tsiku ndi tsiku m'magawo ang'onoang'ono a 5-6. Osamadya kwambiri.

Masewera olimbitsa thupi

Pamagawo atatu a matenda oopsa, zolimbitsa thupi ziyenera kukhala zochepa. Kulimbitsa mtima wamtima, masewera olimbitsa thupi okha ndi omwe ali oyenera. Sizitengera kuyesayesa kwakukulu kwa wodwala, pomwe zimakhudza bwino moyo wake.

Kawiri pa tsiku kwa mphindi 15 mukukhala pansi, pumirani kwambiri ndikupumira kwa masekondi 10 mukupumira. Poyamba, mumatha kumva kuti mulibe chizungulire, koma zidzadutsa maphunziro ochepa.

Kutikita minofu yothandizirana kungathandize kuthetsa kupsinjika kwa minofu ya mtima ndikupanga kutulutsa magazi kuchokera mu ubongo.

Pogwira ntchito pazinthu zina, mumathandizira kukulitsa mitsempha yamagazi ndipo potero mumachotsa kusayenda. Kuchita massage kumachitika musanagone, kuti nthawi yopumula mitsempha ya magazi imapumula komanso kupanikizika kumatha. Ndikofunika kuti kuyambira kumapazi, pang'onopang'ono mukweze. Malizitsani kutikita minofu powotha khosi ndi mapewa.

Kulemala

Odwala omwe ali ndi vuto lachitatu 3 komanso omwe ali pachiwopsezo cha MTR 4 akuwonetsedwa kuti ali ndi vuto la gulu 1, chifukwa pakadali pano amapezeka kusintha kosasintha m'thupi. Odwala ambiri amalephera kudzisamalira ndipo amafunika thandizo.

Kuti mupeze vuto linalake, muyenera kufunsa kuti mukayezetse kuchipatala ndi mayeso a anzanu.

Kupewa

Gawo 3 limawerengedwa kuti ndi njira yolembetsa matenda oopsa, kotero kuyankhula pakadali pano popewa kupewa. Nthawi yomweyo, munthu sayenera kutaya mtima ndipo ayenera kupitiliza kutsatira njira zochotseredwa ndi dokotala. Ndi omwe amawonjezera kukondwerera kwa thupi, kupitiriza moyo wa wodwala.

Yesani kupewa zopsinjika, idyani moyenera, kuti mukhale ndi nthawi yambiri yopuma komanso kumwa mankhwala a antihypertensive munthawi yake. Kuchita kwawo sikufuna kutsitsa zowonetsa pakanthawi pano, koma poletsa kuwonjezeka kwawo ndikupanga zovuta zina.

Matenda olembetsa a grade 3 si chiganizo, koma amatanthauza matenda osachiritsika. Ngati muli ndi cholowa cha matenda amtima, tikulimbikitsidwa kuti nthawi zonse muziyang'anitsitsa zovuta zanu komanso nthawi ndi nthawi kukaona othandizira pofuna kupewa.

Mavuto

Gawo lachitatu la matenda oopsa limayendera limodzi ndi zovuta pa ziwalo zonse zofunika: impso, myocardium, ubongo, chithokomiro cha chithokomiro. Ndi njira yayitali yodwala matenda, ngakhale kufa mwadzidzidzi chifukwa cha kulephera mtima kumatha. Mavuto ena:

• matenda ashuga
• kutupa kwa mitsempha ya m'maso,
• myocardial infaration
• kugwidwa muubongo
• kusintha kwamunthu, dementia,
• zotupa za retinal - retinopathy,
• kusintha kwa mtima,
• kulephera kwa impso,
• kupitilira kwa atherosulinosis,
• kuukira kwa ischemia
• mtima kapena lamanzere kwamitsempha.

Kodi gawo lotere limadziwika ndi chiyani?

Zochita zamakono zamankhwala zimazindikira magawo angapo a chitukuko cha matenda oopsa, omwe aliwonse amadziwika ndi zizindikiro ndi zizindikiro zake, komanso ali ndi zotsatirapo zake. Mlingo wachitatu wa kupititsa patsogolo kwa matendawa ndizovuta kwambiri, zoopsa za 3 ndi 4 zokha ndizomwe zimagwirizana, chifukwa ziwiri zoyambirira zimakhudzana ndi mawonekedwe oyamba a matendawa.

Mutha kudziwa kuti matenda olembetsa magazi adutsa gawo lachitatu ndi zizindikiro zotsatirazi:

• Kuwerengera kwa tonometer sikugwera pansi pa 180 pa 100 mmHg. Art.
• Ma pathologies a renal amawonetsedwa.
• Kuwala kwa zombozo kumatsekedwa ndi cholesterol plaques.
• Khoma lamanzere lamitsempha lamanzere limakulitsidwa.
• Dziwa ndi kufalitsidwa kwa ziwalo.
• Pali chiopsezo cha ischemia ndi stroke.

Kuzindikira pamilandu iyi kumaphatikizapo kafukufuku wamakina, omwe amathandizidwa ndi kuwerengetsa kwambiri kwa tonometer. Poyankha funso loti matenda oopsa achiwopsezo cha 3 amakhala pachiwopsezo chani, ziyenera kudziwidwa kugonjetsedwa kwa ziwalo zingapo zomwe zili ndi vuto la mtima. 30% ya odwala omwe ali pachiwopsezo chachinayi cha gawo lachitatu amakonda kuphedwa ndi myocardial infarction ndi stroke zamitundu yosiyanasiyana, zomwe zimatha kupha.

Pazifukwa

Kukula kwa matenda oopsa kukusonyeza kuzindikira komwe kunanyalanyazidwa pamene chithandizo sichinachitike m'mayambiriro a matendawo. Izi zitha kukhala chifukwa chosakhalapo ndi matchulidwe, pomwe wodwalayo amati matenda ake amangotopa. Kuwonetsa kuyendera kwa dokotala ndi malaise yokhazikika komanso ngakhale kupanikizika pang'ono pang'onopang'ono kumayambitsa kupita patsogolo kwa matenda oopsa.

Nthawi zina, mutazindikira zizindikilo za matenda oopsa, wodwala angayesere mankhwala ena m'malo momuyendera dokotala. Iwonso amangochepetsa vutoli, koma samachiritsa matenda oopsa. Matenda oopsa amapita patsogolo, chifukwa chomwe dokotala nthawi zambiri amakumana ndi gawo lake lachitatu pamaso pa chiwopsezo cha 4th, chomwe kulumala kumayikidwa.

Chifukwa chachitatu chakuwonekera kwa gawo labwino kwambiri ndikutsatira mosamalitsa malangizo a dokotala yemwe wapanga kale matenda ogwirizana ndi kuthamanga kwa magazi. Matenda oopsa paokha ndi matenda omwe mwayi wawo wowachiritsa ndi wocheperako, makamaka akafika pamitundu yake yomwe ikupita patsogolo. Komabe, wodwalayo, atazindikira kuti wayamba kusintha, amasiya kumwa mankhwalawo, pomwe kuwunika kumeneku kumapereka chithandizo chautali wonse malinga ndi chiwembu chomwe adokotala adapereka. Kukana kumabweretsa kubwereranso kwakanthawi kwa matendawa komanso kufalikira kwamatenda.

Zinthu zotsatirazi zimatha kupangitsa kuti magazi azikhala ochepa komanso kuti magazi azitha kuchepa:

• Kukonzedweratu kwamtundu wa cholowa, chomwe chimafalikira kuchokera kwa makolo kupita kwa ana.
• Ukalamba, popeza matenda oopsa ochitika pafupipafupi amawonekera kwa anthu opuma pantchito.
• Kuperewera kwa masewera olimbitsa thupi, kuphwanya moyo. Zakudya zosokonekera mukamadya chakudya osakwanira.
• Kulemera kwambiri, komwe kumapangitsa kukhalapo kwa mavuto ndi ziwiya ndi kuchuluka kwa lumen yawo ndi cholesterol plaques.
• Mavuto ndi impso, kumbuyo kwake komwe edema imapangidwa, zomwe zimakhudza kuwerengedwa kwa tonometer molakwika.

Kodi chithunzithunzi ndi chiyani?

Kuti mumvetsetse chiopsezo cha matenda oopsa 3 a degree 4, mutha kudalira Zizindikiro zomwe zimapezeka kawirikawiri kwa wodwalayo. Zizindikiro za matendawa zimatchulidwa kale komanso ndizotalikirapo kuposa momwe zimakhalira.

Maonekedwe a ntchentche m'maso, kuwonera kokhazikika komanso kuwona kwamaso, kusatha kuyang'ana. Zowawa zamphamvu m'malo a occipital komanso osakhalitsa, limodzi ndi chizungulire. Ululuwo umatha kukhala wowopsa komanso wowopsa. Nthawi zambiri maonekedwe ake amakhala ngati m'mawa, amakhala ndi nseru komanso kupumula, komwe kumatha kudzetsa wodwalayo akangodzuka. Kuchulukitsa thukuta, osati chikhalidwe kale, komwe kumatsatiridwa ndi kuzizira kwambiri. Kupweteka kwakanthawi kachifuwa, ngati kuti kuseri kwa sternum. Kukhumudwitsa ndi kusokoneza. Kufupika kwa nkhope, khungu la khosi. Kusowa kwa chidwi, kutayika kwa malo ndi nthawi. Kuchuluka kwa miyendo, makamaka zala. Kuchepa mphamvu kwa kuganiza moyenera, pang'ono kapena kuiwala pang'ono.

Kuphatikiza pazizindikiro zakunja, ambiri mwa odwala matenda oopsa 3 gawo 4 amakhala ndi vuto la impso lotuwa, lomwe chiwalo chimachepa kwambiri. Kuphatikiza apo, gawo ili lodziwikiratu ladzala ndi mikwingwirima komanso kulowerera kwam'mutu, ndiye chifukwa chake odwala onse omwe ali ndi vutoli amapatsidwa gulu lolumala.

Chithandizo cha matenda amtundu uliwonse chimaphatikizira kuvomerezedwa kwathunthu, sizingatheke kuchotsa matendawa ndi machiritso amodzi. Titha kulankhula za kuchira kwathunthu kumayambiriro kwa matendawa, pomwe gawo lachitatu, makamaka lomwe lili ndi zoopsa zinayi, limaphatikizapo kugwiritsa ntchito mankhwala othandizira ngati chithandizo chomwe chitha kutha kupititsa patsogolo matendawa.

Malangizo a mankhwalawa ali ndi zigawo izi:

1. Mankhwala Mankhwala osiyanasiyana ochokera m'magulu opanga mankhwala, omwe aliwonse amathandizira thupi, omwe amathandizira kuchepetsa kukakamiza. Awa ndi mankhwala ochokera ku ACE inhibitors (mwachitsanzo, Captopril), diuretics (okodzetsa, omwe nthawi zambiri amakhala Furosemide kapena Hydrochlorothiazide), mankhwala omwe amalepheretsa kupanga calcium mthupi (monga Verapamil), beta blockers (Antenolol ndi Metoprolol), komanso oletsa kupanga antiotensin. Monga mankhwala omaliza, madokotala amachita poika Irbesatran. Mankhwala othandizira ndi nootropics, njira zosungitsira mitsempha yamagazi, mankhwala omwe amabwezeretsa muyeso wa potaziyamu ndi metabolism mu ubongo wamutu.
2. Kukana zizolowezi zoyipa ndikusintha kwathunthu m'moyo. Mowa komanso kusuta fodya sizimangokhudza magawo amitsempha yamagazi, komanso zochita zaubongo nthawi zambiri. M'migawo yoyambirira ya matenda oopsa, kusiya zizolowezi zoipa kungapangitse kuchira kwathunthu popanda kugwiritsa ntchito mankhwala. Ndikofunikanso kuwonjezera masewera olimbitsa thupi mokwanira ndi zochitika za tsiku ndi tsiku, makamaka mu mpweya wabwino. Mwachitsanzo, imatha kuyenda m'mapaki mofulumira kwambiri kapena dziwe. Komabe, kuyambitsa ntchito iliyonse yolimbitsa thupi ndi masewera olimbitsa thupi kumafunikira kulumikizana ndi adokotala. Ndi chiopsezo chachinayi cha matenda oopsa a digiri yachitatu, kupsinjika kwamphamvu kwakuthupi ndi kwamalingaliro kumatsutsana.
3. Kukonzanso zakudya. Kusintha sikuyenera kupangidwa kokha kutengera dzina la malonda ndi mtundu wawo, komanso njira yophikira. Kuti mumasule zombozo, ndikofunikira kusiya mafuta, osuta, amchere kwambiri komanso zonunkhira. Maziko a mindandanda ndi zipatso, masamba, mkaka wopanda mafuta, mtedza. Nyama imaloledwa yophika kapena yowotedwa. Nsombazo zimakonzedwanso chimodzimodzi. Ngati pali lingaliro la edema, kuchuluka kwa madzimadzi olowa mthupi kuyenera kuchepetsedwa. Ndikofunika kukumbukira kuti kudya zakudya zamagulu olemekezeka chotere sikulinso chakudya, koma chakudya chopatsa thanzi mosalekeza, komanso moyo wosintha. Monga chakumwa, chololedwa chovomerezeka kugwiritsa ntchito madzi osaphika, mankhwala opangira mankhwala azitsamba ndi tiyi, ndizoletsedwa kugwiritsa ntchito madzi owala ndi khofi.

Zokhudza zoletsa komanso zilema

Matenda oopsa a gawo lachitatu, omwe ali ndi chiwopsezo chachinayi, amalola kuti wodwala alandire gulu lopuwala, popeza ndi kudwala kumeneku pamakhala zovuta zina pazofunikira. Kugawidwa kwa gululi kumachitika pambuyo pakupereka chithandizo chamankhwala, pomwe madotolo amaphunzira mwatsatanetsatane mbiri yakale ndikuzindikira momwe wodwalayo angachitire ntchito imodzi kapena ina. Kodi ndizotheka kugwira ntchito ngati dalaivala panthawiyi ya matendawa, zimatengera zotsatira zakupatsirana.

M'mbiri ya zamankhwala, madokotala samangokhala ndi chidwi ndi mawonekedwe a wodwala, koma pafupipafupi komanso kutalika kwa zovuta zomwe zili panthawiyi. Ngati matendawa awonekera kwambiri, komitiyi imaganiza zochotsa wodwala pantchito iliyonse, chifukwa chomwe wapatsidwa chilema.

Magulu atatu olumala amapatsidwa izi motengera zotsatirazi:

1. Loyamba limakhala ndi zizindikiro zazikulu za matenda oopsa, omwe ngakhale mankhwalawa sangathe kuchotsa. Pali chiopsezo chachikulu cha kufa, kugunda kwa mtima ndi mikwingwirima, magwiridwe antchito a ziwalo zolimbana ndi vuto lalikulu. Ntchito iliyonse pantchito iyi imadziwika ndi komisheni ngati yoletsedwa kwa wodwala.
2. Lachiwiri - loyipa kwambiri matenda oopsa. Mwanjira ina, kugwira ntchito kwa impso ndi ubongo zimadodometsa ndipo amadziwika kuti ali ndi vuto la mtima wofooka. Wodwala amadziwika pang'ono kapena ali wolumala.
3. Lachitatu - silikugwirizana ndi matenda oopsa a gawo lachitatu, chifukwa nthawi zambiri amapatsidwa nthawi yodziwitsa yachiwiri. Wodwalayo amadziwika kuti ndi wathanzi labwino, popeza pali ziwalo zina zomwe zimagwira ntchito.

Kuwonongeka kwa digiri yachitatu pamaso pa chiwopsezo chachinayi ndi gawo loopsa la matenda, likufunika kuyang'aniridwa ndi dokotala, kulandira mankhwala mosalekeza ndi kusintha kwa moyo. Ndi kuunika koyenera komwe malangizo onse a dotolo angakwanitse, kuyimitsa kupitiriraku kwa matenda.

Matenda oopsa a 1, 2, 3 ndi 4 degrees

Munthu ali moyo pomwe mtima wake ukugunda. Cardiac "pampu" imapereka magazi m'magazi. Pankhani imeneyi, pali zinthu monga kuthamanga kwa magazi. Mu mawonekedwe achidule - HELL. Kupatuka kulikonse kwa magazi wamba kumapha.

Chiwopsezo chotenga matenda oopsa kapena oopsa kwambiri - kuthamanga kwa magazi - kumakhala ndi zinthu zingapo. Chifukwa chake, pamene ambiri a iwo, amawonjezeranso mwayi wokhala ndi matenda oopsa.

chibadwire. Chiwopsezo chodwala nchachikulu pakati pa iwo omwe ali ndi matenda oopsa pakati pa abale oyambira: bambo, amayi, agogo, abale anu. Achibale apamtima omwe ali ndi vuto lalikulu la magazi, amakhala pachiwopsezo chachikulu,

zaka zopitilira 35

kupsinjika (kupsinjika kwamphamvu) ndi kupsinjika kwa malingaliro. Matenda a kupsinjika - adrenaline - imathandizira kugunda kwa mtima. Nthawi yomweyo amapanga mitsempha yamagazi,

kumwa mankhwala, mwachitsanzo, njira zakulera zamkamwa, ndi zakudya zina zowonjezera - zowonjezera pazakudya (iatrogenic hypertension),

zizolowezi zoipa: Kusuta fodya kapena kuledzera. Zigawo za fodya zimakwiyitsa mitsempha yamitsempha yamagazi - mapangidwe azida a malinga awo. Imachepetsa kuwala kwa magazi,

Kupimidwa kwa zamankhwala ndi chikhalidwe cha anthu oopsa (matenda oopsa).

Kupimidwa kwa zamankhwala ndi chikhalidwe cha anthu oopsa (matenda oopsa).

Arterial hypertension (AH) - kuwonjezeka kwokhazikika kwa kuthamanga kwa magazi a systolic (SBP) yoposa 140 mm RT. Art. ndi / kapena diastolic kuthamanga kwa magazi (DBP) yoposa 90 mm Hg. Art.

Epidemiology. Kuchuluka kwa matenda oopsa ndi pafupifupi 20% mwa anthu wamba. Pa zaka 60, matenda oopsa amakhala ochulukirapo mwa amuna, pambuyo pa zaka 60 - mwa akazi. Malinga ndi bungwe la akatswiri a WHO (1996), chiwerengero cha azimayi aposachedwa padziko lapansi ndi 427 miliyoni ndipo pafupifupi 50% ya iwo ali ndi matenda oopsa. Hypertension (GB) imakhala ndi 90-92% ya milandu yonse yogonja.

Etiology ndi pathogenesis. Choyambitsa chachikulu cha matenda oopsa sichinakhazikitsidwe.AH imatha kukhazikika chifukwa cha kuyanjana kwa zinthu zingapo: kudya kwambiri mchere, kuledzera, kupsinjika, kulephera kuchita masewera olimbitsa thupi, mafuta osokoneza thupi ndi carbohydrate metabolism (kunenepa kwambiri, matenda osokoneza bongo), cholowa chovuta. Zotsatira zokhudzana ndi chibadwa komanso mikhalidwe zimachitika chifukwa cha masinthidwe amitundu yosiyanasiyana. Kusintha kwa mtundu wa angiotensinogenic, B-subunits ya amyloid-sodium sodium njira yolekerera ya impso, kusintha komwe kumabweretsa kukhumudwa kwa mtundu wa aldosterone synthase enzyme ndikupangitsa chibadwa cha hyperaldosteronism cha mtundu woyamba kapena aldosteronism, kukonza glucocorticoid genesis kwambiri, ndi rhen. lithiamu ndi sodium-hydrogen anti-transport, dongosolo la endothelin, kallikrein-kinin, dopamine ndi machitidwe ena a monoamine.

Gulu.

Chofunikira kwambiri (chachikulu) matenda oopsa - kuthamanga kwa magazi chifukwa chosokoneza machitidwe omwe amayendetsa kuthamanga kwa magazi, pakalibe chifukwa choyambirira.

Hypertension yachiwiri (chizindikiro) - kuchuluka kwa magazi chifukwa cha kupezeka kwa matenda opatsirana (aimpso, ogwirizana ndi kugwiritsa ntchito njira zakulera pakamwa, pulayimale hyperaldosteronism, matenda a Itsenko-Cushing, pheochromocytoma, etc.).

Mwa masiteji (WHO, 1993).

Gawo 1. Kusowa kwa cholinga cha kuwonongeka kwa ziwalo zanu.

Gawo 2. Kukhalapo chimodzi mwazizindikiro za kuwonongeka kwa ziwonetsero: LVH, microalbuminuria, proteinuria ndi / kapena creatinemia (105.6-176 μmol / L), ultrasound kapena radiological signature atherosranceotic plaque mu msempha, mitsempha yama coronary, generalized kapena kupindika kwa mitsempha ya retina.

Gawo 3. Kukhalapo kwa mawonetseredwe azachipatala a kuwonongeka kwa ziwalo zomwe mukufuna:

- ubongo: ischemic, hemorrhagic stroke, chosakhalitsa kuukira, hypertensive encephalopathy,

- mtima: angina pectoris, myocardial infarction, mtima wowonda,

- impso: creatininemia> 176 μmol / l, kulephera kwa aimpso

- zotengera zotumphukira: strurified aortic aneurysm, yodziwika bwino yotupa ya zotumphukira mitsempha (zochitika pang'onopang'ono),

- retina: Kutupa kapena kutulutsa, kutupa kwa mapira a mitsempha ya optic.

Malinga ndi kuchuluka kwa kupita patsogolo, matenda oopsa amatha kukhala pang'onopang'ono, kupita patsogolo koopsa komanso koipa.

Matenda oopsa oopsa amadziwika ndi kuwonjezeka kwa kuthamanga kwa magazi (pamtunda wa 180/110 mm Hg) motsutsana ndi maziko azinthu zoyipa zamankhwala komanso kupezeka kwa chimodzi mwazomwezi: kutupa kwa mitsempha ya m'maso, hemorrhage kapena exudation mu fundus, kusokonezeka kwapakati pamitsempha yamagazi, kuchepa kwa nzeru, mofulumira kuwonongeka kwa impso. Itha kukhala chifukwa chofunikira kwambiri kapena chachiwiri (nthawi zambiri) matenda oopsa.

Malinga ndi gulu la WHO / SIDS (1999) ndi DAG 1, pali magawo anayi a chiopsezo chotenga matenda amtima wazaka 10 zapitazi: otsika - ochepera 15%, apakati - 15-20%, okwera - oposa 20%, apamwamba kwambiri - 30% .

Zomwe zikuchitika pagawoli ndizakuti kukana kwamawu akuti "malire a matenda oopsa" - odwalawa akuphatikizidwa ngati gulu lina la odwala omwe ali ndi "kufatsa" matenda oopsa. Zadziwikanso kuti kugwiritsa ntchito mawu oti "kufatsa" osawerengera sikukutanthauza chidziwitso chabwino kwa gulu ili la odwala, koma amangogwiritsa ntchito kutsindika kukakamiza kowonjezereka.

kusinthasintha kwachilendo kwa kuthamanga kwa magazi paulendo umodzi kapena kangapo; chizindikiritso cha kuchuluka kwa kuthamanga kwa magazi kwa odwala omwe ali pachiwopsezo chochepa (kupatula matenda oyera ovala chovala choyera, Zizindikiro zomwe zikukayikira kuti magawo a hypotension ndi mankhwala osokoneza bongo.

Kugawidwa kwa odwala m'magazi owopsa.

Lingaliro lochizira wodwala owonjezera matenda oopsa liyenera kukhazikitsidwa osati kokha pamphamvu ya kuthamanga kwa magazi, komanso ku kukhalapo kwa wodwalayo pazinthu zina zowopsa zamatenda amtima, matenda omwe wodwalayo amadwala komanso kuwonongeka kwa ziwalo. Magulu akulu anayi adadziwika ndi chiopsezo: chochepa, chapakati, chachikulu komanso chowopsa kwambiri. Gulu lililonse limatsimikiza ndi kuchuluka kwa kuthamanga kwa magazi komanso kupezeka kwa zinthu zina zowopsa.

Chiwopsezo chochepa: abambo osaposa zaka 55 ndipo akazi osaposa zaka 65 okhala ndi matenda oopsa a 1 komanso osakhala ndi zina zowonjezera zowopsa akhoza kuyikidwa m'gulu lowopsa (onani tebulo 2). Kwa odwala otere, chiwopsezo cha zochitika zazikulu zamtima mkati mwa zaka 10 sichidutsa 15%.

Chiwopsezo chapakatikati: gululi limaphatikizapo odwala omwe ali ndi vuto la 1 ndi 2 zovuta za matenda oopsa ndi zina zowonjezera za chiopsezo, komanso odwala omwe ali ndi magazi ochulukirapo a 2 popanda zovuta zowonjezera. Odwala omwe ali mgululi ali pachiwopsezo cha zochitika zazikuluzikulu za mtima m'zaka 10 zikubwerazi 15-20%.

Chiwopsezo chachikulu: Gululi limaphatikizapo odwala omwe amawonjezera kuthamanga kwa magazi kwa madigiri a 1-2, omwe ali ndi zoopsa zitatu kapena zowonjezera kapena zowonongeka kwa ziwalo zomwe zimayambitsa matenda osokoneza bongo kapena matenda a shuga, komanso odwala omwe ali ndi digiri ya 3 yamatenda oopsa popanda zina zowonjezera. Chiwopsezo cha zochitika zamtima wopitilira zaka 10 kwa odwala chotere ndi 20-30%.

Gulu lomwe lili pachiwopsezo chachikulu liyenera kuphatikizapo odwala onse omwe ali ndi matenda 3 oopsa omwe ali ndi vuto limodzi lowonjezera komanso odwala onse omwe ali ndi matenda amtima kapena matenda a impso. Chiwopsezo cha gulu lotere la odwala chimaposa 30% motero, mwa odwala, chithandizo chikuyenera kuperekedwa posachedwa komanso mokulira.

Zowopsa za Mtima.

Mlingo wa systolic ndi diastolic magazi (kuopsa kwa 1-3)

Wodwala akapezeka kuti ali ndi matenda 3 oopsa, chiopsezo 4 - ndi chiyani? Mtundu wamatendawa ndiowopsa kwambiri, chifukwa umakhudza ziwalo zambiri. Pozindikira, ndikofunikira kwambiri kuti mupereke mankhwala okwanira ndikukhala ndi moyo wabwino.

Matendawa ndi mtima dongosolo amakhala ndi zovuta kuzungulira malinga ndi kuchuluka kwa kuthamanga kwa magazi (BP), kukula ndi chikhalidwe cha maphunzirowo, ndi zovuta zake. Matenda oopsa a giredi 3 amadziwika ngati kupanikizika kwa systolic (kumtunda) kuli 180, ndi diastolic (kutsika) 100 mmHg.

Kuyerekeza: ndi kuchuluka kwa digiri yachiwiri, kuwerengera kwa tonometer kumayambira 160 mpaka 179 kwa kuthamanga kwa magazi komanso kuchokera ku 100 mpaka 109 mmHg chifukwa cha kuthamanga kwa magazi. Mwa odwala omwe akhala akudwala kwanthawi yayitali ndi grade 2 yoopsa, pamakhala chiwopsezo chachikulu cha kusinthika kwake kukhala kowopsa kwambiri - kalasi 3.

Ndi mawonekedwe amtunduwu, ziwalo zamkati ndi kachitidwe ka thupi zimakhudzidwa. Zolinga zoyambirira za matenda oopsa, zomwe zimadziwika kuti zimapha mwakachetechete, nthawi zambiri zimakhala impso, diso, mapapu, kapamba. Matenda a wodwalayo amakulirakulira kwambiri ngati matenda oopsa achulukitsidwa ndi atherosulinosis.

Kuphatikiza apo, gulu la matenda oopsa limapatsa matendawa pang'onopang'ono:

• chiopsezo 1 (otsika)
• chiopsezo 2 (chapakatikati),
• chiopsezo 3 (mkulu),
• chiopsezo 4 (kwambiri).

Ziwalo zomwe zikuyembekezeredwa zimayamba kukhudzidwa m'magulu oopsa a 3 degree 3. Kuthamanga kwa magazi nthawi zambiri kumakhala ndi zowononga makamaka pa imodzi mwazo. Mitundu yamkati, yamtima ndi yamtundu wamatumbo imasiyanitsidwa kutengera izi. Mitundu yoyipa ya matendawa imasiyanitsidwa makamaka kuwonjezeka kwa kuthamanga kwa magazi kumawonjezeka pamlingo wowopsa.

Kukhazikitsa kuchuluka ndi chiwopsezo cha matenda oopsa ndikofunikira kuti musankhe bwino mankhwala omwe amachepetsa kuthamanga kwa magazi kwa wodwalayo ndikuwonetsetsa kuti ali ndi mankhwalawa. Kupatula apo, ayenera kumwa mankhwalawa kwa moyo wonse. Ngati dokotala wothandizapo akuchita chithandizo chokwanira, izi zimakhala ndi zovuta kwambiri, zomwe, chifukwa cha kuthamanga kwa magazi, zimabweretsa zotsatirapo zoyipa.

Zovuta zamankhwala oopsa ndizochitika zowopsa, zomwe nthawi zambiri zimayenda ndi matenda 3 omwenso ali ndi chiwopsezo cha 4. Sikuti ndizokhudza mawonekedwe akunja okha monga kupweteka kwa mtima, kusokonezeka pakulankhula, kusazindikira. Ndi zovuta zilizonse m'thupi, kusintha kwatsopano kwa thupi kumawonekera komwe kumapita patsogolo ndikuwopseza moyo wa munthu.

Hypertension 3 madigiri kuopsa 4 - mawonekedwe a matenda momwe mavuto otere amabwera:

• kusintha kosasinthika mu mtima (kusokonezeka kwa phokoso, phokoso, kuchepa kwamitsempha chamanzere, etc.), zomwe zimatsogolera mtima, mphumu yamtima,
• myocardial infaration
• kulephera kwa aimpso
• kutulutsa magazi, kutaya magazi (kutulutsa magazi mkati),
• retinal dystrophy, kuwala kwa patini, khungu kapena kusawona kwathunthu,
• pulmonary edema,
• sitiroko
• Kuwonongeka kwa umunthu, dementia (dementia).

Kulephera chifukwa cha matenda oopsa a grade 3 ndi chiyembekezo choyembekezeka, popeza matendawa akamakula, wodwala amalephera kugwira ntchito, zimamuvuta kuti adzipulumutse. Kutengera ndi kuopsa kwa vutoli, wodwala amatha kupatsidwa gulu la olumala awiri kapena awiri. Wodwala amawonekera pa dispensary ndipo amafunikira chithandizo cha sanatorium-resort.

Chowonadi cha kupezeka kwa matenda opatsirana kwa kalasi 3 chikuwonetseratu kuti matendawa anyalanyazidwa. Wodwalayo mwina sanamuthandize bwino kapena anakana kulandira chithandizo kumayambiriro kwa matendawo. Tsoka ilo, pamene odwala akunyalanyaza zizindikiro zosonyeza kuti amakhala ndi matenda oopsa amakhala ochepa.

Kuphatikiza apo, matendawa mwa odwalawa akupita patsogolo ngati zolakwika zimayambitsa:

• onenepa kwambiri
• kumangokhala
• zaka 40
• kuwonetsa pafupipafupi kupsinjika
• uchidakwa, kusuta,
• chibadwire.

Ndi matenda oopsa a giredi 3, matenda oopsa a 3 nthawi zambiri amapitilira msanga kuti akhale pachiwopsezo 4. Zizindikiro zopweteka zotsatirazi zimakhala "zothandizira moyo":

• lakuthwa, lomwe nthawi zambiri silimadumphira kuthamanga kwa magazi,
• kupweteka kwambiri m'mutu
• kupweteka kwambiri mumtima,
• "Ntchentche", zikuchita khungu m'maso,
• chizungulire, kusagwirizana koyenda kwamayendedwe,
• tachycardia (palpitations)
• kusowa tulo
• kusokonezeka kwa kukumbukira
• kuchepa kwa chidwi ndi zala zakumanja, manja,
• kutupa kwa nkhope, miyendo.

Zizindikiro zonsezi ndizotsatira zamagazi a pathological apakati pa 180 mmHg. Nthawi zambiri ndi matenda oopsa 3 magawo atatu okhala ndi chiwopsezo cha mabvuto 4 oopsa. Zimakhala zovuta kwambiri. Pakukomoka koteroko, wodwalayo amathedwa nzeru ndi matendawa chifukwa cha matenda.

Kunyamula mwana ndi mayi yemwe akudwala kwambiri matenda oopsa kumalumikizidwa ndi chiopsezo cha kupezeka kwa gestosis - kusagwira bwino kwa ziwalo zofunika, makamaka ma magazi. Vuto lotere limamuwonetsa iye ndi kulephera kwa aimpso, mapapu, edema, kufinya, komanso ngakhale kuwonongeka kwaubongo. Ndipo mwana wosabadwayo yemwe ali ndi vasospasm amawopsezedwa ndi hypoxia (kuperewera kwa chakudya ndi okosijeni, kusokonekera), kubereka.

Mimba ikayamba kuthamangitsidwa kwa matenda oopsa, gestosis imasokoneza nthawi yobala mwana pafupifupi wamkazi aliyense. Pankhaniyi, monga lamulo, kuthamanga kwa magazi kumakwera kwambiri, kumakhala koyipa kwambiri mwa mankhwala a antihypertensive. Impso zimavutika, kutupikana kumawoneka, mapuloteni amapezeka m'magazi ndi mkodzo.

Pankhaniyi, pali magulu atatu oopsa:

1. Mimba yopambana imatheka ndikutulutsa matenda oopsa, giredi I, ngati m'magawo oyambilira limapereka mphamvu.
2. Mimba imakhala yovomerezeka mwa amayi omwe ali ndi matenda oyamba a grade 1 ndi II, malinga ngati sakhala ndi vuto lochita kutulutsa nthawi yoyamba.
3. Mimba imakhala yotsutsana kwambiri ngati matenda oopsa amachitika pang'ono, mwamphamvu kapena molakwika.

Kodi kuchitira matenda oopsa a giredi 3 ndi chiopsezo cha 4? Pofuna kupewa kapena kuchedwetsa zovuta zomwe zingatheke, ndikofunikira kutsatira zonse zomwe akatswiri odziwa, akatswiri a zamankhwala, amisala, ophthalmologist. Ndikofunika kwambiri kuti nthawi zonse mumamwa mankhwala oopsa pamankhwala osankhidwa ndi dokotala.

Kuphatikiza apo, wodwala ayenera:

• amachepetsa kwambiri mchere ndi zakumwa zina,
• kutsatira zakudya zopepuka, zophatikiza ndi masamba, zipatso,
• siyani mowa, nikotini, tiyi wamphamvu, khofi,
• khalani ndi moyo wochita masewera olimbitsa thupi,
• konza thupi
• pewani kupsinjika kwambiri, kukhumudwa.

Ndi matenda oopsa a giredi 3 ndi chiopsezo cha 4, mankhwala a antihypertensive, okodzetsa nthawi zambiri amalembedwa kuti achepetse kuthamanga kwa magazi. Kuchepetsa vuto lomwe limayambitsidwa ndi kulephera kwa mtima, ma nitrate amathandiza. Mankhwala a nootropic osakanikirana ndi vitamini-mineral complexes amatithandizanso kufalitsa kwa ubongo.

Mutha kulumikizanso mankhwala wowerengeka azitsamba: madzi a beetroot, tinctures a hawthorn, valerian ndi vinca. Mwachangu muchepetse kuthamanga kwa magazi a viniga a 5% pa zidendene. Gawo 3 matenda oopsa ndi chiopsezo cha 4 - matenda akulu. Koma ndi chithandizo chokwanira, mutha kukhala ndi moyo wabwino kwambiri.

Kuchokera munkhaniyi muphunzira za momwe ziliri komanso momwe matenda oopsa a digiri ya 3 amawonetsedwera, omwe amadziwika ndi kuthamanga kwa magazi (kufupikitsidwa ngati BP). Kuchulukitsa kwapanikizika ndi vuto lalikulu chifukwa cha chiwopsezo chachikulu cha zovuta zobweretsa moyo chifukwa chake.

• Zifukwa zakukakamizidwa
• Kuopsa kwa mtima chifukwa cha matenda oopsa 3
• Zizindikiro za ochepa matenda oopsa 3 madigiri
• Kuchiza matenda
• Ziwonetsero

Ndi matenda oopsa a giredi 3, kuthamanga kwa magazi kumakwera kwambiri. Zotsatira zake, chiopsezo cha masoka am'matumbo chimawonjezeka ndipo, chifukwa cha kuchuluka kwa mtima, kulephera kwa mtima kumawonjezeka pang'onopang'ono (kulephera kwa mtima kuchita bwino ntchito yake).

Matenda oopsa a arterial, malinga ndi kuchuluka kwa mavuto, amapatsidwa gawo limodzi mwa madigiri atatu. Pokhazikitsa mtunduwo, kupanikizika kwa systolic ndi diastolic kumawerengedwa, kuyang'ana kwambiri chizindikiro. Pa giredi 3, mwina mloza wapamwamba ndi wokulirapo kuposa 180, kapena wotsika kwambiri kuposa 140 mm Hg. Art. Ndi ziwerengero zazikulu zoterezi, kuopsa kwa zovuta kumawerengedwa ngakhale patakhala zinthu zina zovuta, ndipo matendawa ndi owopsa.

Nthawi zambiri, kuwonjezeka kwakukulu kwa kupanikizika kumayendetsedwa ndi matenda ena a mtima, kuchepa kwamatumbo kapena mafuta metabolism, matenda a impso komanso mavuto ena azaumoyo. Matenda oopsa oterewa amafanana ndi gawo 3 pachiwopsezo cha 4 (chiwopsezo chamtima kwambiri). Kuchuluka kwa chiwopsezo kumatengera zisonyezo zamagazi ndi zinthu zomwe zimayambitsa matendawa. Gawani zoopsa zochepa, zapakatikati, zapamwamba komanso zowopsa kwambiri, zowonetsedwa ndi manambala kuyambira 1 mpaka 4.

Iyenera kusiyanitsidwa 3 digiri ya matenda oopsa kuchokera pamagawo atatu. Madigirii amawonetsa kuthamanga kwa kuthamanga kwa magazi, ndipo siteji ikakhazikitsidwa, kukula kwa matendawo ndi kuwonongeka kwa ziwalo zomwe zikuyembekezeredwa zimaganiziridwa. Gawo lachitatu limadziwika ndi kukhalapo kwa zochitika zokhudzana ndi matenda a stroko kapena myocardial infarction, angina pectoris, kulephera kwa mtima, kulephera kwa impso, nephropathy, kuwonongeka kwa ziwongo kwamitsempha, matenda aortic, shuga, retinopathy.

Chithandizo cha matendawa chimachitika makamaka ndi akatswiri a zamankhwala ndi othandizira. Ndi chitukuko cha zovuta, othandizira amatenga nawo mbali populumutsa miyoyo ya odwala; pakuvulala, a neuropathologist amauza chithandizo. Ndikothekanso kuchiritsa matenda oopsa a kalasi 3 nthawi zina.Pokhapokha kuwonjezeka kwa kuthamanga kwa magazi kumakhala kwachiwiri, kumakhala kwakanthawi kochepa, ndipo zomwe zinayambitsa zidzathetsedweratu.

Pafupifupi 35-40% ya anthu amadwala matenda oopsa. Ndi zaka, kuchuluka kwa odwala kumawonjezeka. Nthawi yomweyo, chiopsezo chamtima chimakwera.

Milandu yambiri yokhudza matenda oopsa imagwirizana ndi matenda oopsa, pomwe sizotheka kudziwa zomwe zayambitsa vutoli. Kusiyanitsa kwa matendawa kumatchedwa matenda oopsa (ofunika).

Njira yeniyeni yokhazikitsira matendawa imapezeka mu 5-10% yokha ya milandu. Hypertension yoopsa yotereyi imawonedwa ngati singasinthe ngati zomwe zidachitika zimatha.

Popanga matenda oopsa, zinthu zambiri ndi njira zake zimakhudzidwa. Zomwe zimayambitsa matenda oopsa zimaphatikizapo zinthu zamkati ndi zakunja, zina zomwe zimatha kusinthidwa, pomwe zina zimangotengera chidwi:

• Chakudya chopatsa thanzi Mchere wambiri mu chakudya, zakudya zopatsa mphamvu zambiri zimatha kuyambitsa matenda oopsa. Zikuwonekeranso kuti zimawonjezera mwayi wochulukitsa kuthamanga kwa magazi kwa zipatso mu chakudya.
• Kunenepa kwambiri, metabolic syndrome, matenda ashuga.
• Dyslipidemia ndikuphwanya chiŵerengero cha ma lipids opindulitsa ndi owopsa a magazi, omwe amakhumudwitsa atherosulinosis yamitsempha yamagazi, yomwe imathandizira kuwonjezeka kwa kupanikizika.
• Matenda a mtima, matenda a impso.
• Zaka ndi jenda. Mkulu akakula, ndiye kuti kuchuluka kwa kuthamanga kwa magazi kumawonjezera. Mpaka zaka 50, abambo amatha kuvutika ndi matenda oopsa. Pambuyo pa kusamba, chiwerengero cha azimayi odwala chimachulukirachulukira ndipo nthawi zina chimaposa kuchuluka kwa matenda oopsa pakati pa amuna. Ziwerengero zamapanikizidwe zimachulukanso ndi ukalamba, kotero matenda oopsa a grade 3 omwe ali pagulu lakale ndiofala.
• Psychoemotional zinthu, kupsinjika kwanthawi yayitali.
• Kusuta. Nicotine mwachidule amawonjezera kukakamizidwa ndi 10-20 mm Hg. Art. ndudu iliyonse yosuta. Zotsatira zake, masana, kuthamanga kwa magazi kumatha kuwonjezeka kwambiri.
• Mowa Kafukufuku wina wawonetsa kuti kumwa milingo yaying'ono ya mowa sikukhudza kuwonjezeka kwa mavuto, koma awonetsedwa kuti awonjezera chiwopsezo cha matendawa ndi uchidakwa.
• Zinthu zamtundu. Sikuti nthawi zonse zimatsogolera pakupangika kwa matendawa, koma nthawi zambiri kumawonjezera kuyankhidwa kwa zifukwa zina zoyambitsa. Chofunika kwambiri ndi milandu yakukula kwa mtima matenda a abale.
• Kulephera kuchita masewera olimbitsa thupi. Izi zimathandizira kukulira kunenepa kwambiri komanso matenda amtima, kukulitsa mwayi wowonjezera kuthamanga kwa magazi komanso chiwopsezo cha zovuta zam'mitsempha.

Pali njira zingapo zomwe zimathandizira pokonza matenda oopsa, omwe nthawi iliyonse amadzionetsa mosiyanasiyana, zomwe zimapangitsa kuti munthu adziwe matendawa ndi momwe angachitire mankhwala osokoneza bongo. Njira zazikulu za matenda oopsa:

Kuopsa kwa mtima chifukwa cha matenda oopsa 3

Ndi nthawi yayitali yochepetsa matenda oopsa kapena kuwonjezereka kwa kukakamiza, ziwalo zomwe zikuwopseza zimavutika: myocardium, ubongo, mawonekedwe a impso, retina. Zotsatira zake, zovuta za ochepa matenda oopsa zimayamba:

Kuwonjezeka kwa kupanikizika kumatha kuchitika mosazindikira ndipo kumatha kupezeka mwangozi mukamayesa kuthamanga kwa magazi. Izi zimachitika kawirikawiri ndi grade 1 matenda oopsa. Kuwonetsedwa kwa matendawa koyambira kumachitika kawirikawiri ndi kupsinjika mwadzidzidzi.

Kuwonjezeka kwakukulu kwa kuthamanga kwa magazi, komwe kumakhala koopsa kwa grade 2, kumakhala kovuta kwambiri kuti odwala athe kulolera. Mutu, kumverera kufooka, ndi zizindikiro zina za matenda oopsa amatha kuvutikira osati pamavuto, komanso pambuyo pogwiranso ntchito kwambiri, mwakuthupi komanso m'maganizo.

Pa giredi 3, kupanikizika kumakulira kuchuluka, kotero vutoli limakulirakulira, zizindikiro zimachuluka. Popeza matendawa amakhala nthawi yayitali, odwala amatha kuzolowera kuthamanga magazi ndipo mwina amalephera kuzindikira zizindikiro kapena kuwayanjanitsa ndi zina zomwe zimayambitsa. Koma kuthamanga kwa magazi kumawonjezera katundu pamtima, kumayambitsa kulephera kwa mtima komanso ngozi yowonjezereka ya kufa mwadzidzidzi. Chifukwa chake, mosasamala za kuopsa kwa zizindikiro, muyenera kuyesetsa kuti magazi azithamanga.

Matenda oopsa a 3 digiri amawonetsedwa ndi zizindikiro zotsatirazi:

• mutu
• chizungulire chapakati
• tinnitus
• kutopa
• kupweteka mtima.

Ndi chitukuko cha zovuta - kuchuluka kwambiri kwa kuthamanga kwa magazi, Zizindikiro zimachulukirachulukira, kuwonekera kwatsopano kwamatenda kumawonekera. Madandaulo otsatirawa ndi vuto losavuta:

Ndi zovuta zovuta, zizindikiro za kupangika kwakukonzedwera zikuwonekera: ischemic kuchepa kwakantha, stroko, mtima, pulmonary edema, stratified aortic aneurysm.

Kuchiritsa kwathunthu komanso kupanikizika kwanthawi yocheperako kumatheka ndi chiwonetsero champhamvu chamankhwala, chifukwa chothandizira kuchipatala ndizotheka kuthetseratu zomwe zimayambitsa kuthamanga kwa magazi. Pankhani ya matenda oopsa, kuti musunge mankhwalawa komanso kuti muchepetse chiopsezo chamtima, kugwiritsa ntchito mankhwala a antihypertensive kumafunika.

Ngati matenda oopsa a giredi 3 apezeka, mankhwalawa ochepetsa kuthamanga kwa magazi amayikidwa mwachangu, nthawi yomweyo amapereka malingaliro pazakusintha kwa moyo. Cholinga chomwa mankhwala a antihypertensive ndikuchepetsa kuthamanga pansipa mpaka 140 mpaka 90. Pokhala ndi kuthamanga kwambiri kwa magazi, ndikofunikira kuti mupereke mankhwala othandizira, chifukwa nthawi zambiri sizotheka kuchepetsa kukakamiza kwa matenda oopsa 3 pomutenga kamodzi pamankhwala.

Magulu akuluakulu a mankhwala omwe amachepetsa kuthamanga kwa magazi ndi monga:

Matenda oopsa a digiri yachitatu - chizindikiro cha munthawi yomweyo kugwiritsa ntchito mankhwala a 2 kapena 3 kuti muchepetse kuthamanga kwa magazi. Zothandiza kwambiri ndi kuphatikiza kwa ACE inhibitor ndi okodzetsa kapena calcium okonda, beta-blocker ndi diuretic.

Kuphatikiza pa antihypertensive therapy, njira zina zakonzanso zoopsa pazovuta zimagwiritsidwanso ntchito: antiplatelet mankhwala, lipid-kuchepetsa mankhwala, ndi othandizira a hypoglycemic, monga tafotokozera. Kuchita miyeso yonse yochitira matenda oopsa ndi ngozi ya 4 ndizofunikira kwambiri.

Mukamasankha mankhwalawa, amayang'ana kwambiri luso la gulu linalake la mankhwalawo nthawi zina. Ngati pali ma concomitant pathologies, zokonda zimaperekedwa kwa iwo omwe amakhala ndi zotsatira zabwino, poganizira matenda omwe adalipo kale. Mukamapereka mankhwala, zotsutsana zimatha kukumbukiridwa. Mwachitsanzo, beta-blockers sagwiritsidwa ntchito pochiza matenda oopsa mwa odwala omwe ali ndi vuto la mtima pansi pa 55 miniti, pamaso pa atrioventricular blockade a degree yapamwamba, omwe ali ndi vuto lalikulu la zotumphukira za magazi.

Kusankhidwa kwa mankhwalawa kwa matenda oopsa a grade 3 nthawi zina kumakhala kovuta, chifukwa zinthu zambiri ziyenera kukumbukiridwa. Cholinga chosiyana ndikutsimikizira wodwalayo kufunika kosowa, nthawi zambiri moyo wonse, kumwa mankhwala angapo.

Momwe mungasinthire moyo wanu kuti mankhwalawa apambane:

• Mchere umachepa mu chakudya (zosakwana 5 g patsiku). Ndikofunikira kukana mchere ndi mchere wa mbale.
• Kukana kumwa mowa kapena kuchepetsedwa kwa 10-20 g patsiku.
• Malangizo owonjezera okhudzana ndi zakudya amakhudzana ndi kuchuluka kwa masamba, mafuta ochepa mkaka, tirigu, tirigu, zipatso. Zakudya zomwe zimakhala ndi cholesterol ndi mafuta odzola sizikulimbikitsidwa. Kuphatikizidwa muzakudya za nsomba kawiri pa sabata kapena kupitilira.
• Kuchepetsa kunenepa kwambiri. Ndi matenda a mtima omwe alipo, kuwongolera thupi kumalimbikitsidwa, chifukwa kuwonda kwambiri kumatha kukulitsa vutoli. Izi zimachitika makamaka kwa odwala okalamba.
• Kusuta kufafaniza. Zotsatira zoyipa za chizolowezi sizongokulitsa kuthamanga kwa magazi, komanso kuwonjezereka kwa chiwopsezo chamtima komanso kuwononga thanzi lanu. Nthawi zina, kudalira chikonga kumanenedwa kotero kuti muyenera kusankha kwakanthawi kwakanthawi kwakumwa.
• Zochita zolimbitsa thupi. Zotsatira zabwino kwambiri pakuchepetsa kuthamanga kwa magazi ndi chiwopsezo cha mtima zimaperekedwa ndi zochitika zapagalimoto zakunja (kuyenda, kuthamanga, kupalasa njinga). Ponena za kuphunzitsidwa kwamphamvu kwambiri matenda oopsa, maphunziro awonetsa bwino kulolerana zolimbitsa thupi zozama poyerekeza ndi katundu wachuma.

Dinani pa chithunzi kuti mukulitse

Kukula kwa matenda oopsa kumatsimikiziridwa makamaka ndi kuchuluka kwake, osati gawo la matendawa. Koma kuthamanga kwa magazi kumakhudzanso zovuta za mtima. Chifukwa chake, matenda oopsa a giredi 3 ndiwomwe angayambitse kulemala ndikuyambitsa imfa kuposa matenda omwe akuwonjezeka.

Matenda olembetsa mu Giredi 3 sangayende limodzi ndi zinthu zowonjezera zowopsa komanso matenda ophatikizika. Zowonera zikuwoneka kuti zotere sizimachulukira kawirikawiri poyerekeza ndi 20-30% ya milandu. Ngati chiwopsezochi chimawoneka kuti ndi chachikulu - chiwopsezo 4, zovuta zomwe zimadutsa zimaposa 30%.

Kuchiza matenda

Hypertension 3 digiri ya chiopsezo 4 ndiyowopsa chifukwa imatha kubweretsa imfa. Pazifukwa izi, odwala omwe ali ndi vutoli nthawi zambiri amagonekedwa m'chipatala. Kuchiza matendawa sikuyenera kumwa mankhwala a antihypertensive. Wodwala ayenera kutsatira mosamalitsa malangizo onse a dokotala omwe akukhudzana ndi kusintha kwa moyo. Ndi matenda awa, muyenera kutsatira malangizo otsatirawa:

• pewani zovuta
• vuto la kunenepa kwambiri, muchepetse kunenepa kwambiri.
• lekani kusuta
• Onetsetsani kuti mulowa zolimbitsa thupi muulamuliro watsiku ndi tsiku, mwachitsanzo, kuyenda, kuthamanga, kuyendetsa njinga,
• Panthawi yophunzitsira mphamvu, musasankhe kuchita masewera olimbitsa thupi koma amphamvu.
• gwiritsitsani zakudya zopatsa thanzi.

Ndi matenda oopsa oopsa, mankhwalawa ochokera m'magulu angapo a pharmacological amagwiritsidwa ntchito. Mankhwala amathandizira kutsitsa magazi, koma m'njira zambiri. Woopsa, mankhwalawa amatumikiridwa kudzera m'mitsempha kapena m'mitsempha kuti chinthu chofunikira chizigwira ntchito mwachangu. M'tsogolomu, adotolo amafotokozera mankhwala omwe adwala. Wodwala wawo ayenera kutenga pafupifupi moyo wake wonse.

Mankhwala a mzere woyamba ndi okodzetsa - okodzetsa. Chimodzi mwazida zotchuka m'gululi ndi hydrochlorothiazide. Imatchulidwa kuti ndi yogwira ntchito pakapangidwe. Ubwino wa mankhwalawa ndiwothandiza mwachangu, omwe amadziwonekera patatha maola 2-5 atatha kutsata. Zochepa - amachotsa potionsum aions, omwe angayambitse hypokalemia. Monga wothandizira antihypertensive, hydrochlorothiazide imatengedwa 25-50 mg. Zizindikiro zazikulu zochizira ndi mankhwala otere:

• nephrogenic shuga insipidus,
• kutupa kwa magwero osiyanasiyana,
• matenda oopsa oopsa (ndi mankhwala ena oopsa kapena ngati monotherapy).

Kuphatikiza pa diuretics, beta-blockers amagwiritsidwa ntchito kuchepetsa kukakamiza. Mankhwalawa othandizira matenda oopsa a giredi 3 amachepetsa kuchuluka kwa magazi, kumasuka makoma amitsempha ndikuchepetsa pafupipafupi mtima. Woimira wawo ndi Bisoprolol. Mankhwala ali ndi zomwe zimagwira ntchito. Ubwino wa bisoprolol ndikuti kudya sikukhudza mayamwidwe ake. Kuchepetsa - mankhwalawa amakhala ndi lactose, chifukwa chake amalekanitsidwa kwa anthu omwe ali ndi lactase tsankho.

Mlingo wamba wa bisoprolol ndi 0.0025 g patsiku. Ngati ndi kotheka, imachulukitsa nthawi ziwiri. Kuphatikiza pa matenda oopsa, mankhwalawa amagwiritsidwa ntchito:

• kulephera kwa impso,
• khola angina pectoris.

Metoprolol ndi Atenolol ali ndi zofanana. Alinso m'gulu la opanga ma beta. Mankhwala otsatirawa angagwiritsidwe ntchito kuchepetsa kuthinana:

• angiotensin II ndi calcium okonda (losartan, lisinopril ndi amlodipine, nimodipine, verapamil),
• alpha-blockers (Alfuzosin, Doxazosin),
• ACE inhibitors (Captopril, Kapoten).

Kapoten ndi mankhwala ozikidwa pa Captopril. Izi zimatha kupangitsa ziwiya zamagetsi ndi ma venous, kuchepetsa kupanikizika kwa kufalikira kwa mapapu komanso atrium. Kusowa kwa Kapoten - kumakhala kosavuta ngati mutatenga piritsi ndi chakudya. Mwa mwayi, kuthamanga kumadziwika - kale mphindi 10 mutatha kupanikizika kumayamba kuchepa. Pachifukwa ichi, Kapoten angagwiritsidwe ntchito ngati chadzidzidzi pamavuto oopsa. Mlingo wa mankhwalawa umatsimikiziridwa ndi matendawa. Kapoten amagwiritsidwa ntchito pazotsatirazi:

• ndi myocardial infaration,
• ndi matenda oopsa
• Kulephera kwamtima,
• ndi matenda ashuga nephropathy pamtundu wa matenda ashuga 1.

Kodi gawo 3 la matenda oopsa

Matenda a digiri ya 3 amaperekedwa kwa odwala omwe omwe systolic anzawo imaposa 180 mm, ndi kukakamiza kwa diastolic - 110 mm ndi muyeso wobwereza. Mlingo woopsa uwu, malinga ndi gulu la madokotala apadziko lonse lapansi, umayendera limodzi ndi chiopsezo chowonjezeka cha matenda a mtima, stroko, komanso kukula kwa aimpso. Odwala omwe ali ndi vutoli ali ndi zifukwa zina zowonjezera: matenda ashuga, onenepa kwambiri, kupezeka kwa zizolowezi zoyipa ndi matenda oyanjana.

Matenda oopsa a Giredi 3 amaphatikizidwa ndi kuwonekera kwa zizindikiritso zambiri zathanzi. Poyerekeza ndi kuthamanga kwa magazi, kusintha kwa ziwalo m'thupi kumakhudza mkhalidwe wathunthu, thanzi. Matendawa akamapitilizabe kuyenda, njira za m'magazi zimatha kuyambitsa mikhalidwe yoopsa. Zizindikiro zomwe matenda oopsa akupita patsogolo amaganiziridwa:

• kusokonezeka kukumbukira, atherosulinosis yamitsempha yamagazi,
• kutupa kwamiyendo, kuchepa kwa kuyenda,
• kumangokhala wotopa, kufooka,
• mutu, chizungulire,
• mwa amuna - kuwonongeka mu potency.

Zomwe zimapangitsa matenda oopsa 3

Matenda oopsa a Giredi 3 samawoneka tsiku lomwelo. Vutoli likupita patsogolo chifukwa cha kuphatikiza zaka za wodwalayo, jenda - anthu okalamba kuposa zaka 50, makamaka abambo, amawerengedwa ndi madokotala ngati gulu lowopsa chifukwa cha kukhalapo kwa zizolowezi zoyipa. Chithandizo chokwanira choperekedwa munthawi yake chimathandiza kupewetsa matendawo. Zomwe zimayambitsa matendawa:

• matenda ashuga
• zizolowezi zoipa - mowa, kusuta, kudya nyama yamafuta,
• kunyalanyaza zolimbitsa thupi, masewera olimbitsa thupi,
• onenepa kwambiri
• kusintha kwa pathological mu endocrine system.

Magulu owopsa

Madokotala amasiyanitsa magulu anayi omwe ali pachiwopsezo malingana ndi kuuma kwa zizindikilo, kutenga ziwalo zina, machitidwe. Kupereka gawo la m'modzi wa iwo sizitanthauza kusowa kwa kuchuluka kwa matendawa, chifukwa chake, anthu omwe ali ndi vutoli ayenera kufufuzidwa pafupipafupi ndi madokotala. Kutengera ndi kuchuluka kwa matendawa, kulandira mankhwala kumathandizidwa, chithandizo chomwe chimasankhidwa chimaganizira zofanana ndi izi:

• Gulu lowopsa. Zosachepera 15% zamatumbo zimakhudzidwa, thupi lonse silikhudzidwa.
• Gulu 2. 15-20%, mpaka 3 zokhudzana.
• Gulu lachitatu. 20-30%, zochulukitsa zopitilira zitatu zopitilira muyeso.
• Gulu 4. Kuposa 30%, machitidwe ena amthupi amakhudzidwa.

Chithandizo cha matenda oopsa 3

Matenda oopsa mu gawo lachitatu sangathe kuchiritsidwa ndi mankhwala amodzi. Njira yayikulu yofunika ndiyofunika: wodwalayo adzafunika kusiya zizolowezi zoipa, kugwiritsa ntchito zakudya zopatsa thanzi ndikulimbikitsidwa. Kuchepetsa kupsinjika, ACE inhibitors (angiotensin-converting enzyme), β-blockers, calcium block blockers, ndi diuretics amagwiritsidwa ntchito.Dokotala amayenera kupereka mankhwala:

• Nifedipine ndi calcium blockchain. Amathandizira kuphipha kwamitsempha yamagazi, kuthandizira kuthamanga kwa magazi kupita kumtima, kumachepetsa kuthamanga kwa mitsempha ya m'mapapo. Mankhwala othandiza mwadzidzidzi omwe amathandiza ngakhale odwala omwe ali ndi matenda oopsa, sanapatsidwe odwala matenda ashuga, okalamba. Mlingo waukulu, wowopsa, wowopsa umakhala wowopsa pamoyo wa wodwalayo. Mtengo 7 mwa 10.
• Enalapril ndi ACE inhibitor, mankhwala omwe amakhala nthawi yayitali, omwe wodwalayo ayenera kumwa moyo wake wonse. Ili ndi antispasmodic, pang'ono okodzetsa kwenikweni, amachepetsa katundu pa myocardium, impso. Sizimayamba kuchitapo kanthu patsiku loyamba lakayendetsedwe, mwadzidzidzi sizoyenera. Chiwerengero chochepa cha contraindication: mimba yokha ndi mkaka wa m'mawere. 8 mwa 10.
• Terazosin ndi adrenergic blocker othamanga amene amachepetsa kuthamanga kwa magazi mphindi 15-20 mutamwa mankhwalawo. Ndiwothandiza kwambiri m'magawo oyamba a matenda oopsa mpaka kuchira kwathunthu kwamatendawa, m'mitundu yoopsa imagwiritsidwa ntchito posamalira odwala mwachangu. Amapatsirana odwala matenda ashuga, anthu odwala matenda a mtima. Mtengo 6 mwa 10.
• Losartan ndi wokonda nthawi yayiotensin. Amasintha magazi m'magawo ang'onoang'ono, ali ndi vuto la antispasmodic, amasintha momwe wodwalayo alili, amapangitsa kuti azilimbitsa thupi. Imalepheretsa kukhazikika kwa mtima kulephera, antihypertensive zotsatira zimapitirira kwa maola 6 mpaka 10 pambuyo pa kukhazikitsa. Contemplate: pakati, zaka 18. Mtengo 8 mwa 10.

Zakudya zopatsa thanzi 3 digiri

Zakudya zoyenera za matenda oopsa oopsa zimathandiza kwambiri kukhazikika kwa wodwalayo komanso kukonza moyo wabwino. Ndikulimbikitsidwa kupatula mowa, mafuta amthupi, confectionery, mbale zokhala ndi mchere wambiri. Ndikwabwino kudya nsomba zamafuta ochepa, nkhuku, masamba atsopano, zipatso, timadziti. Zonunkhira, sinamoni ndikulimbikitsidwa, popeza zimakhala ndi antihypertensive.

Thandizani wowerengeka azithandizo

Chithandizo cha anthu sichichiritsa matenda oopsa, koma kuwonjezera mankhwala othandizira, kukonza zomwe zimachitika wodwalayo. Ndikulimbikitsidwa kugwiritsa ntchito mbeu za fulakesi - zimagulitsidwa m'mafakisi, zimatha kukhala pansi, kuwonjezera chakudya. Tincture wa ma cone ofiira pa mowa kapena vodika amakhalanso ndi mphamvu yochepetsera kupanikizika. Kuti mugwire bwino ntchito wowerengeka, ndikofunikira kusakaniza ma cesino m'chilimwe, kutsanulira lita imodzi ya vodika, mulole apangike kwa masabata awiri a 2, kamodzi patsiku kwa supuni.