Kusankhidwa kwa matenda oopsa mwa magawo ndi magawo: tebulo

Matenda oopsa oopsa (matenda oopsa kwambiri, matenda oopsa) ndi matenda osachiritsika omwe amabwera chifukwa cha kuthamanga kwa magazi. Hypertension nthawi zambiri imapezeka popanda kupatula mitundu yonse ya matenda oopsa.

Malinga ndi malingaliro a World Health Organisation (WHO), kuthamanga kwa magazi kumawerengedwa kuti ndi kwabwinobwino, komwe sikupitirira 140/90 mm Hg. Art. Kuchulukitsa kwa chizindikirochi kupitirira 140-160 / 90-95 mm RT. Art. kupumula ndi kuwirikiza kawiri pamayeso awiri azachipatala kumawonetsa kukhalapo kwa matenda oopsa mwa wodwala.

Hypertension imakhala pafupifupi 40% ya kuchuluka kwa matenda amtima. Mwa amayi ndi abambo, zimachitika ndi ma frequency omwewo, chiwopsezo cha kukula chikukula ndi zaka.

Kusankha moyenera mankhwalawa kwa matenda oopsa kungachepetse kupita patsogolo kwa matendawa ndikulepheretsa kukula kwa zovuta.

Zoyambitsa ndi Zoopsa

Mwa zina zazikulu zomwe zimathandizira kukulitsa matenda oopsa, amatcha kuphwanya kwa kayendetsedwe kazinthu zopanga zamkati mwa dongosolo lamanjenje lamkati lomwe limayang'anira ntchito ya ziwalo zamkati. Chifukwa chake, matendawa nthawi zambiri amakula motsutsana kumbuyo kwa kupsinjika kwakasinthasintha m'maganizo, kuwonekera kwa kugwedezeka ndi phokoso, komanso ntchito ya usiku. Udindo wofunikira umaseweredwa ndi kubadwa kwa chibadwa - mwayi wazokhathamira umachulukitsidwa pamaso pa achibale awiri kapena kupitilira kwa omwe akudwala nthendayi. Hypertension nthawi zambiri imayamba motsutsana ndi maziko a chithokomiro chithokomiro, gwero la adrenal, matenda a shuga, komanso matenda a mtima.

Zowopsa zake ndizophatikizira:

• kusintha kwa akazi,
• onenepa kwambiri
• kusowa zolimbitsa thupi
• ukalamba
• zizolowezi zoipa
• kumwa kwambiri mankhwala a sodium chloride, omwe angayambitse kuphipha kwamitsempha yamagazi ndi kusungunuka kwa madzi,
• zovuta zachilengedwe.

Gulu la matenda oopsa

Pali magawo angapo a matenda oopsa.

Matendawa amatha kutenga mawonekedwe osakhazikika (osakhazikika pang'onopang'ono) kapena olakwika (omwe akupita patsogolo msanga).

Kutengera ndi kuchuluka kwa kuthamanga kwa magazi kwa diastoli, matenda oopsa am'mapapo (diastolic magazi osakwana 100 mm Hg), okwanira (100-115 mm Hg) komanso oopsa (oposa 115 mm Hg) amatha kusiyanitsidwa.

Kutengera kuchuluka kwa kuchuluka kwa kuthamanga kwa magazi, madigiri atatu a matenda oopsa amadziwika:

1. 140-159 / 90-99 mmHg. Art.
2. 160-179 / 100-109 mmHg. Art.
3. zoposa 180/110 mm RT. Art.

Gulu la matenda oopsa:

Kuthamanga kwa magazi (BP)

Kuthamanga kwa magazi a systolic (mmHg)

Kuthamanga kwa magazi kwa diastolic (mmHg)

Zizindikiro

Po sonkhanitsa madandaulo ndi anamnesis mwa odwala omwe ali ndi vuto la matenda oopsa, chidwi chachikulu chimaperekedwa kuti wodwalayo awone zinthu zoyipa zomwe zimapangitsa matenda oopsa, kukhalapo kwa zovuta zamatenda, kuchuluka kwa kuchuluka kwa kuthamanga kwa magazi, kutalika kwa zizindikiro.

Njira yayikulu yodziwitsira matenda ndi kuchuluka kwa kuthamanga kwa magazi. Kuti mupeze zosasokoneza, muyenera kuyeza kuthamanga m'malo abata, kusiya kuchita masewera olimbitsa thupi, kudya chakudya, khofi ndi tiyi, utsi, ndi kumwa mankhwala omwe angakhudze magazi anu mu ola limodzi. Kuyeza kwa kuthamanga kwa magazi kutha kuchitika pamalo oyimirira, mutakhala pansi kapena kugona, pomwe dzanja lomwe cuff amayikiralo liyenera kukhala pamlingo womwewo ndi mtima. Mukamawona dokotala koyamba, kuthamanga kwa magazi kumayeza pa manja onse. Kuyeza mobwerezabwereza kumachitika pambuyo pa mphindi 1-2. Pankhani ya asymmetry yam'madzi kupanikizika kopitilira 5 mm. Art. miyeso yotsatira imachitidwa padzanja pomwe mfundo zapamwamba zidapezeka. Ngati kuchuluka kwa miyeso yobwereza kumasiyana, tanthauzo la masamu limatengedwa kuti ndi loona. Kuphatikiza apo, wodwalayo amafunsidwa kuti ayese kuthamanga kwa magazi kunyumba kwakanthawi.

Laboratory mayeso amaphatikizapo kuwunika kwa magazi ndi mkodzo, kuyesa kwa magazi pamagazi (kutsimikiza shuga, cholesterol yathunthu, triglycerides, creatinine, potaziyamu). Kuti muphunzire ntchito yaimpso, zitha kukhala zofunikira kuchita mayeso a mkodzo malinga ndi Zimnitsky ndi Nechiporenko.

Kufufuza kwa zida zamagetsi kumaphatikizapo kulingalira kwa maginito oyang'ana m'mitsempha muubongo ndi khosi, ECG, echocardiography, ultrasound ya mtima (kuwonjezereka m'madipatimenti amanzere kutsimikizika). Aortography, urography, kulingalira kwamakina kapena maginito oyambira a impso ndi adrenal gland zingafunikirebe. Kuunika kwa ophthalmological kumachitika kuti mupeze hypertensive angioretinopathy, kusintha kwa mutu wamitsempha wam'maso.

Ndi nthawi yayitali yodwala matenda oopsa osagwiritsidwa ntchito ndi mankhwalawo kapena vuto la matenda, mitsempha yamagazi ya ziwalo zomwe zalunjika (ubongo, mtima, maso, impso).

Chithandizo cha matenda oopsa

Zolinga zazikulu zochizira matenda oopsa ndizochepetsa kuthamanga kwa magazi komanso kupewa zovuta. Kuchiritsa kwathunthu kwa matenda oopsa sikungatheke, komabe, chithandizo chokwanira cha matendawa chimapangitsa kuti magazi azitha kupitilizidwa komanso kuchepetsa ngozi zamatenda oopsa, omwe amakhala atayamba chifukwa cha zovuta zina.

Mankhwala ochizira matenda oopsa makamaka kugwiritsa ntchito mankhwala a antihypertensive omwe amaletsa ntchito ya vasomotor ndikupanga norepinephrine. Komanso, odwala omwe ali ndi matenda oopsa amatha kutumikiridwa ndi ma antiplatelet othandizira, okodzetsa, lipid-kutsitsa ndi hypoglycemic othandizira. Ndi chithandizo chokwanira chokwanira, kuphatikiza mankhwala omwe ali ndi antihypertensive mankhwala angapo kungakhale koyenera. Ndi chitukuko cha vuto la matenda oopsa, kuthamanga kwa magazi kuyenera kuchepetsedwa kwa ola limodzi, apo ayi chiopsezo chotenga zovuta zazikulu, kuphatikizapo imfa, zimachuluka. Pankhaniyi, mankhwala a antihypertgency amalowetsedwa kapena dontho.

Ngakhale gawo la matendawa, njira imodzi yofunika kwambiri yothandizira odwala ndi chithandizo cha zakudya. Zakudya zokhala ndi mavitamini, magnesium ndi potaziyamu zimaphatikizidwa muzakudya, kugwiritsa ntchito mchere wa patebulo kumakhala kochepa, zakumwa zoledzeretsa, zakudya zamafuta ndi nyama yokazinga siziyikidwa kunja. Pamaso pa kunenepa kwambiri, zopatsa mphamvu zamagulu onse azakudya zamasiku onse ziyenera kuchepetsedwa, shuga, confectionery, ndi makeke sazipatula pamenyu.

Odwala amawonetsedwa zolimbitsa thupi zolimbitsa thupi: masewera olimbitsa thupi, kusambira, kuyenda. Kuthandiza kwachithandizo kumakhala ndi kutikita minofu.

Odwala omwe ali ndi matenda oopsa ayenera kusiya kusuta. Ndikofunikira kuti muchepetse kupenyerera. Kufikira izi, machitidwe othandizira omwe amalimbikitsa kukana kupsinjika, kuphunzitsidwa njira zopumula kumalimbikitsidwa. Phindu labwino limaperekedwa ndi balneotherapy.

Kuchita bwino kwa mankhwalawa kumayesedwa ndikupeza kufupika kwakanthawi (kutsitsa kuthamanga kwa magazi mpaka kulolerana bwino), nthawi yayitali (kuletsa kukula kapena kupitilira kwa njira za pathological mu ziwalo zomwe zikuyembekezeredwa) komanso nthawi yayitali (kuletsa kukula kwa zovuta, kuwonjezera moyo wa wodwalayo).

Mavuto omwe angakhalepo komanso zotsatirapo zake

Ndi nthawi yayitali yodwala matenda oopsa osagwiritsidwa ntchito ndi mankhwalawo kapena vuto la matenda, mitsempha yamagazi ya ziwalo zomwe zalunjika (ubongo, mtima, maso, impso). Kusakhazikika kwa magazi ku ziwalo izi kumabweretsa kukulira kwa angina pectoris, ngozi ya cerebrovascular, hemorrhagic kapena ischemic stroke, encephalopathy, pulmonary edema, mtima mphumu, kupindika kwa retinal, aortic disgment, mtima wamitsempha, etc.

Kusankha moyenera mankhwalawa kwa matenda oopsa kungachepetse kupita patsogolo kwa matendawa ndikulepheretsa kukula kwa zovuta. Pankhani ya kuwonongedwa kwa matenda oopsa kwambiri ali aang'ono, kupita patsogolo kwa njira ya matenda ndi kuopsa kwa matendawa, matendawo amafooka.

Hypertension imakhala pafupifupi 40% ya kuchuluka kwa matenda amtima.

Kupewa

Pofuna kupewa chitukuko cha matenda oopsa, tikulimbikitsidwa:

• kudzikongoletsa kwambiri
• zakudya zabwino
• kusiya zizolowezi zoipa,
• zolimbitsa thupi zokwanira
• kupewa kupsinjika kwamthupi ndi m'malingaliro,
• rationalization wa ntchito ndi kupumula.

Pathogenesis ya matenda oopsa

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.

Kuwonjezeka kwa kupanikizika, komwe ndiko chifukwa chachikulu komanso chizindikiritso cha matenda oopsa, kumachitika chifukwa cha kuchuluka kwa mtima wamagazi kutulutsa mumagazi amitsempha komanso kuwonjezeka kwa zotumphukira zamitsempha. Chifukwa chiyani izi zikuchitika?

Pali zinthu zina zomwe zimakhudza malo apamwamba a ubongo - hypothalamus ndi medulla oblongata. Zotsatira zake, pali kuphwanya kwamvekedwe wa ziwiya zotumphukira, pali kuphipha kwa ma arterioles pazowonjezera - kuphatikizapo impso.

Dyskinetic ndi dyscirculatory syndrome imayamba, kupanga kwa Aldosterone kumawonjezera - ndi neurohormone yomwe imagwira nawo ntchito mumadzi a mineral metabolism ndikusunga madzi ndi sodium mu kama wamitsempha. Chifukwa chake, kuchuluka kwa magazi omwe amayendayenda m'mitsempha kumachulukanso, zomwe zimapangitsa kuti chiwonjezere champhamvu cha kupsinjika ndi kutupa kwa ziwalo zamkati.

Zinthu zonsezi zimakhudzanso magazi. Zimakhala zonenepa, zakudya zamafuta ndi ziwalo zimasokonekera. Makoma a zotengera amakhala osalimba, lumen imakhala yocheperako - chiopsezo chotenga matenda oopsa osachulukirachulukira chikuwonjezeka kwambiri, ngakhale atalandira chithandizo. Popita nthawi, izi zimabweretsa ellastofibrosis ndi arteriolosulinosis, yomwe imayambitsa masinthidwe achiwiri.

Wodwalayo amakhala ndi myocardial sclerosis, hypertensive encephalopathy, chachikulu nephroangiosulinosis.

Gulu la ochepa matenda oopsa

Kugawana kotereku kumawoneka koyenera komanso koyenera kuposa gawo. Chizindikiro chachikulu ndicho kupanikizika kwa wodwala, msinkhu wake ndi kukhazikika kwake.

1. Optimum - 120/80 mm. Hg. Art. kapena wotsika.
2. Zabwinobwino - palibe zigawo zopitilira 10 zomwe zingathe kuwonjezeredwa ku chisonyezero chapamwamba, zosaposa 5 kupita ku chidziwitso chotsika.
3. Pafupi ndi zabwinobwino - zizindikiro zikuyambira ku 130 mpaka 140 mm. Hg. Art. kuyambira 85 mpaka 90 mm. Hg. Art.
4. Matenda oopsa a I degree - 140-159 / 90-99 mm. Hg. Art.
5. Zolemba zam'magazi II - 160 - 179 / 100-109 mm. Hg. Art.
6. Matenda oopsa a degree ya III - 180/110 mm. Hg. Art. ndi mmwamba.

Hypertension yachitatu digiri, monga lamulo, imayendera limodzi ndi zotupa za ziwalo zina, zizindikiro zoterezi zimadziwika ndi vuto la matenda oopsa ndipo zimafunikira kuchipatala kuti wodwalayo athe kuchitira chithandizo mwadzidzidzi.

Matenda oopsa oopsa

Pali zinthu zowopsa zomwe zimatha kuyambitsa kuthamanga kwa magazi komanso kukula kwa matenda. Mitu ikuluikulu ndi:

1. Zizindikiro za mibadwo: kwa amuna ndi zaka zopitilira 55, kwa akazi - azaka 65.
2. Dyslipidemia ndi vuto lomwe mawonekedwe a magazi a lipid amawonekera.
3. Matenda a shuga.
4. Kunenepa kwambiri
5. Zizolowezi zoipa.
6. Kudziletsa.

Zowopsa nthawi zonse zimaganiziridwa ndi adokotala mukamayang'ana wodwala kuti adziwe ngati ali bwino. Zidadziwika kuti nthawi zambiri zomwe zimayambitsa kuthamanga kwa kuthamanga kwa magazi ndi kuchuluka kwa mitsempha, ntchito yowonjezera, makamaka usiku, komanso kugwira ntchito molimbika. Izi ndiye zoyipa zazikulu malinga ndi WHO.

Chachiwiri ndi kugwiritsa ntchito mchere. WHO imati - ngati mumadya zoposa magalamu 5 tsiku lililonse. mchere, chiopsezo chokhala ndi matenda oopsa chikuchulukitsa kangapo. Mlingo wamavuto umawonjezeka ngati banja lili ndi abale ake omwe ali ndi vuto lalikulu la magazi.

Ngati achibale anu apamtima awiri akalandira chithandizo cha matenda oopsa, ngozi yake imakulirakulira, zomwe zikutanthauza kuti wodwala yemwe akuyenera kutsatira amayesetsa kutsatira malangizo onse omwe dotolo angapewe, kuda nkhawa, kusiya zizolowezi ndikuyang'anira zakudya.

Zina zomwe zimayambitsa ngozi, malinga ndi WHO, ndi:

• Matenda a chithokomiro
• Atherosulinosis,
• Matenda opatsirana omwe amakhala ndi matenda osachiritsika - mwachitsanzo, tonsillitis,
• Kusamba kwa nthawi ya azimayi,
• Pathology ya impso ndi adrenal glands.

Poyerekeza zinthu zomwe zatchulidwa pamwambapa, zomwe zikuwonetsa kukakamizidwa kwa odwala komanso kukhazikika kwawo, chiwopsezo chimayikidwa pakulimbikitsa matenda monga matenda oopsa. Ngati zinthu ziwiri zosavomerezeka zikudziwika ndi matenda oopsa, ndiye kuti chiopsezo 1 chimayikidwa, malinga ndi lingaliro la WHO.

Ngati zovuta zomwe zili zofanana ndizofanana, koma AH ili kale ya digiri yachiwiri, ndiye kuti chiwopsezo chotsika chimakhala chochepa komanso chimawonetsedwa ngati chiwopsezo 2. Kupitilira, malinga ndi lingaliro la WHO, ngati madigiri atatu AH apezeka komanso zifukwa zotsutsana ndi zitatu zadziwika, chiopsezo cha 3 chimakhazikitsidwa. 4 imatanthawuza kupezeka kwa matenda oopsa a digiri yachitatu komanso kukhalapo kwa zinthu zopitilira katatu.

Mavuto ndi kuopsa kwa matenda oopsa

Ngozi yayikulu ya matendawa ndi zovuta zazikulu pamtima zomwe zimapereka. Kwa matenda oopsa, kuphatikiza kuwonongeka kwambiri kwa minofu ya mtima ndi chamanzere kwamanzere, pali tanthauzo la WHO - matenda opanda magazi. Mankhwalawa ndi ovuta komanso autali, osagwiritsa ntchito magazi mosavutikira nthawi zonse amakhala ovuta, pafupipafupi, ndi mtundu uwu wa matendawa, kusintha kosasintha m'mitsempha yamagazi kwachitika kale.

Kunyalanyaza kupsinjika, odwala amadziika pachiwopsezo chotenga ma pathologies:

• Angina pectoris,
• Myocardial infaration
• Ischemic stroke
• Hemorrhagic stroke,
• Pulmonary edema
• Exortating Aortic Aneurysm,
• Kuzungulira kwa retinal,
• Uremia.

Ngati vuto la matenda oopsa lachitika, wodwalayo amafunika thandizo mwachangu, mwina atha kufa - malinga ndi WHO, ndi mkhalidwewo wokhala ndi matenda oopsa kuti nthawi zambiri amabweretsa imfa. Chiwopsezo ndichopambana makamaka kwa anthu omwe amakhala okha, ndipo pakakhala kuukira, palibe amene amakhala pafupi nawo.

Tiyenera kudziwa kuti ndizosatheka kuchiritsa matenda owopsa. Ngati matenda oopsa a digiri yoyamba kumayambiriro koyambirira ayamba kuwongolera mwamphamvu kukanikiza ndikukhalanso ndi moyo, mutha kuletsa kukula kwa matendawa ndikuletsa.

Koma nthawi zina, makamaka ngati ma pathologies omwe adalumikizana nawo adalowa magazi, kuchira kwathunthu sikungatheke. Izi sizitanthauza kuti wodwalayo ayenera kudziletsa ndikusiya chithandizo. Njira zikuluzikulu ndizolinga zopewera kudumphadumpha mu magazi komanso kuthana ndi vuto la matenda oopsa.

Ndikofunikanso kuchiritsa matenda onse othandizira kapena othandizira - izi zimapangitsa kuti moyo wa wodwalayo ukhale wathanzi, kumuthandiza kukhalabe wakhama komanso wogwira ntchito kufikira atakula.Pafupifupi mitundu yonse ya matenda oopsa omwe amakupatsani mwayi wapa masewera, kukhala ndi moyo komanso kupuma bwino.

Kusiyanako ndi madigiri 2-3 pangozi ya 3-4. Koma wodwalayo amatha kupewa vuto lalikulu mothandizidwa ndi mankhwala, wowerengeka azitsamba komanso kuwongolera zizolowezi zake. Katswiri wodziwika bwino adzakambirana za kagawidwe ka matenda oopsa mu kanema m'nkhaniyi.

Gulu la matenda

Padziko lonse lapansi, gulu limodzi lamakono la matenda oopsa limagwiritsidwa ntchito molingana ndi kuchuluka kwa kuthamanga kwa magazi. Kutengera kwakeku ndi kugwiritsidwa ntchito kwake ndikutengera deta kuchokera ku World Health Organisation. Kugawika kwa matenda oopsa ndikofunikira kuti athe kudziwa chithandizo china komanso zotsatirapo za wodwalayo. Ngati tikhudza ziwerengero, ndiye kuti matenda oopsa a digiri yoyamba ndiofala kwambiri. Komabe, popita nthawi, kuchuluka kwa kukakamizidwa kumawonjezeka, komwe kumagwera azaka 60 kapena kupitirira. Chifukwa chake, gulu ili liyenera kulandira chidwi chochulukirapo.

Gawoli m'magawo ake mulinso njira zosiyanasiyana zochiritsira. Mwachitsanzo, pochotsa matenda oopsa, mutha kudziletsa pakudya, kuchita masewera olimbitsa thupi komanso kupatula zizolowezi zoipa. Ngakhale mankhwala lachitatu digiri amafuna kugwiritsa ntchito antihypertensive mankhwala tsiku lililonse mu waukulu.

Kugawika kwa Magazi Olimbitsa Magazi

1. Mulingo woyenera: kupanikizika mu systole kumakhala kosakwana 120 mm Hg, ndipo m'masamba - osakwana 80 mm. Hg
2. Zabwinobwino: matenda ashuga omwe alipo 120 - 129, diastolic - kuchokera 80 mpaka 84.
3. Miyezo yokwera: mayesero a systolic m'gulu la 130 - 139, diastolic - kuchokera 85 mpaka 89.
4. Mulingo wa kupanikizika wokhudzana ndi matenda oopsa: DM pamwamba pa 140, DD pamwambapa 90.
5. The okhazikika systolic zosinthika - DM pamwamba 140 mm Hg, DD pansipa 90.

Gulu la matenda:

• Matenda oopsa a digiri yoyamba - kukakamiza kwa systolic m'malo osiyanasiyana 140-159 mm Hg, diastolic - 90 - 99.
• Matenda oopsa a digiri yachiwiri: matenda a shuga kuyambira 160 mpaka 169, kuthamanga mu diastole 100-109.
• Matenda ogwirizana a digiri yachitatu - ma systolic pamtunda wa 180 mm Hg, diastolic - pamwambapa 110 mm Hg

Gulu la magawo

Malinga ndi gulu la WHO lolemba matenda oopsa, matendawa amagawidwa kukhala pulayimale ndi sekondale. Hypertension yapamwamba imadziwika ndi kuchuluka kopitilira kukakamiza, zomwe etiology sizikudziwika. Hypertension yachiwiri kapena yodziwika bwino imachitika m'matenda omwe amakhudza masoka ochepa, potero amayambitsa matenda oopsa.

Pali mitundu isanu ya magawo oyambira matenda oopsa:

1. Matenda a impso: kuwonongeka kwa ziwiya kapena parenchyma kwa impso.
2. Matenda a endocrine dongosolo: amakumana ndimatenda a adrenal glands.
3. Kuwonongeka kwa dongosolo lamanjenje, pomwe pakubwera kukakamizidwa kwa intracranial. Kupanikizika kwa intracranial kungakhale chifukwa chovulala, kapena chotupa cha muubongo. Chifukwa cha izi, ziwalo zaubongo zomwe zimathandizira kupanikizika m'mitsempha yamagazi zimavulala.
4. Hemodynamic: ndi matenda a mtima.
5. Mankhwala: wodziwika poyizoni wa thupi ndi kuchuluka kwazakumwa zomwe zimayambitsa makina a poizoni pazinthu zonse, makamaka bedi lamitsempha.

Kugawika kwa magawo a chitukuko cha matenda oopsa

Gawo loyamba. Zokomera pang'ono. Khalidwe lofunikira la icho ndi chisonyezo chosakhazikika cha kuthamanga kwa tsiku lonse. Poterepa, pamakhala nthawi zina zowonjezereka zowerengeka zopanikizika ndi nthawi yolumpha kwakanthawi. Pakadali pano, matendawa amatha kudumphadumpha, chifukwa wodwalayo sangathe kukayikira kupsinjika kulikonse pamatenda, kutanthauza nyengo, kugona tulo komanso kudziletsa kwambiri. Zowonongeka kwa ziwalo zomwe sizikulephera sizikupezeka. Wodwalayo akumva bwino.

Khola. Kupitilira apo, chizindikirocho chikuwonjezeka ndipo chimakhala nthawi yayitali. Ndi wodwala uyu amadandaula chifukwa cha thanzi labwinobwino, maso osalala, mutu. Panthawi imeneyi, matendawa amayamba kukhudza ziwalo zomwe akufuna, zikupita patsogolo ndi nthawi. Pankhaniyi, mtima umavutika choyamba.

Gawo lachi Sclerotic. Amadziwika ndi machitidwe a sclerotic khoma lakhoma, komanso kuwonongeka kwa ziwalo zina. Njira izi zimalemetsa mzake, zomwe zimapangitsanso zovuta zina.

Kuyika Pangozi

Kugawika ndi zoopsa kumayikidwa pazizindikiro za kuwonongeka kwa mtima ndi mtima, komanso kulowetsedwa kwa ziwalo zomwe zikuyembekezeredwa, zimagawidwa pangozi zinayi.

Chiwopsezo 1: Zimadziwika ndi kusapezeka kwa ziwalo zina mchitidwewu, kuthekera kwa kufa m'zaka 10 zikubwera pafupifupi 10%.

Ngozi yachiwiri: Kuthekera kwa kufa m'zaka khumi zikubwerazi ndi 15-20%, pali chotupa cha chiwalo chimodzi chokhudzana ndi gawo lomwe mukufuna.

Chiwopsezo 3: Chiwopsezo cha kufa ndi 25-30%, kupezeka kwa zovuta kukulitsa matendawa.

Ngozi 4: Chiwopsezo cha moyo chifukwa chotenga ziwalo zonse, chiopsezo cha kufa oposa 35%.

Gulu la matendawa

Ndi maphunziro a matenda oopsa agawidwa pang'onopang'ono (benign) ndi matenda oopsa. Izi ziwiri zimasiyana pakati pokha osati ndi maphunzirowa, komanso poyankha moyenera pakalandira chithandizo.

Matenda oopsa a Benign amapezeka kwa nthawi yayitali ndi kuwonjezeka pang'onopang'ono kwa zizindikiro zake. Pankhaniyi, munthuyo akumva bwino. Nthawi zowonjezereka komanso kuchotsedwa zimatha kuchitika, komabe, pakapita nthawi, nthawi yochulukitsa sichikhala motalika. Matenda amtunduwu ndi othandizanso kuchiritsa.

Matenda oopsa oopsa kwambiri. Zimachitika mwachangu, mokwanira, ndi chitukuko chofulumira. Fomu yoyipa ndiyosavuta kuyilamulira komanso yovuta kuchiza.

Matenda oopsa a arterial malinga ndi WHO pachaka amapha oposa 70% ya odwala. Nthawi zambiri, chomwe chimapangitsa kuti munthu amwalire ndi matenda osokoneza bongo aortic aneurysm, kugunda kwa mtima, aimpso komanso kulephera kwa mtima, kukomoka kwa hemorrhagic.

Zaka 20 zapitazo, matenda oopsa kwambiri anali oopsa komanso ovuta kuchiza matenda omwe anapha anthu ambiri. Chifukwa cha njira zaposachedwa kwambiri zofotokozera ndi mankhwala amakono, mutha kudziwa momwe matendawa ankakhalira ndikuwongolera njira yake, komanso kupewa zovuta zingapo.

Ndi chithandizo chanthawi yake, mutha kuchepetsa chiopsezo cha zovuta komanso kukulitsa moyo wanu.

Zovuta Zosautsa

Mavuto ndi monga kutenga gawo mu minofu ya mtima, kama, mtima, impso, mitsempha yamagazi ndi mitsempha yamagazi. Ndi kuwonongeka kwa mtima, vuto la mtima, pulmonary edema, aneurysm wamtima, angina pectoris, mphumu wamtima ungachitike. Ngati vuto la maso, khungu la retina limachitika, chifukwa chomwe khungu limayamba.

Matenda oopsa oopsa amatha kukhalanso, omwe amakhudzana ndi zovuta, popanda chithandizo chamankhwala chomwe ngakhale munthu atha kufa. Zimawonjezera kupsinjika, kupsinjika, zolimbitsa thupi kwa nthawi yayitali, kusintha kwa nyengo ndi kupsinjika kwa mlengalenga. Mwanjira imeneyi, kupweteka mutu, kusanza, kusokonezeka kwa mawonekedwe, chizungulire, tachycardia kumawonedwa. Vutoli limakula kwambiri, kusiya kuzindikira kungatheke. Panthawi yamavuto, pakhoza kukhala zovuta zina, monga myocardial infarction, hemorrhagic stroke, pulmonary edema.

Matenda oopsa a arterial ndi amodzi mwa matenda ofala kwambiri. Chaka chilichonse kuchuluka kwa odwala kukukulirakulira. Nthawi zambiri awa ndi anthu okalamba, makamaka amuna. Kugawika kwa matenda oopsa kumakhala ndi mfundo zambiri zomwe zimathandiza kudziwa matendawa ndikuchiza munthawi yake. Komabe, tiyenera kukumbukira kuti matendawa ndi osavuta kupewa kuposa kuchiza. Zotsatira zake kuti kupewa matenda ndi njira yosavuta kwambiri yopewera matenda oopsa. Kuchita masewera olimbitsa thupi pafupipafupi, kusiya zizolowezi zoipa, kudya mokwanira komanso kugona mokwanira kumatha kukupulumutsirani ku matenda oopsa.

Njira yopanga magazi

Zitatha izi, tidalemba "pamwamba", "kutsika", "systolic", "diastolic", izi zikutanthauza chiyani?

Kupsyinjika kwa Systolic (kapena "kumtunda") ndi mphamvu yotere yomwe magazi amakanikizira pazitseko zamitsempha yayikulu (ndiye kuti imayendetsedwa) pakukakamiza kwa mtima (systole). M'malo mwake, mitsempha yotereyi yopyapyala 10mm mamilimita ndi kutalika kwa 300 mm kapena kuposerapo iyenera "kufinya" magazi omwe amachokera.

Kupsinjika kwa systolic kumawonekera pawiri:

• mtima ukatulutsa magazi ambiri, omwe amakhala ndi vuto la hyperthyroidism - mkhalidwe momwe chithokomiro cha chithokomiro chimatulutsira kuchuluka kwa mahomoni omwe amachititsa mtima kukhazikika mwamphamvu komanso nthawi zambiri,
• pamene machitidwe aortic amachepetsa, omwe amawoneka okalamba.

Diastolic ("m'munsi") ndi kuthamanga kwamadzi pamakoma a ziwiya zazikulu kwambiri zomwe zimachitika panthawi yopumula kwa mtima - diastole. Gawo ili la mkatikati mwa mtima, zotsatirazi zimachitika: mitsempha yayikulu imayenera kufalitsa magazi omwe alowa nawo mu systole m'mitsempha ndi ma arterioles ang'ono. Pambuyo pa izi, aorta ndi mitsempha yayikulu imayenera kuletsa kuthamanga kwa mtima: pomwe mtima umapumula, kutenga magazi kuchokera m'mitsempha, ziwiya zazikulu ziyenera kukhala ndi nthawi yopumula poyembekeza mawonekedwe ake.

Mlingo wa kukakamizidwa kwamankhwala am'mimba kumadalira:

1. Toni za zombo zamtundu wotere (malinga ndi Tkachenko B.I. "Mwachilengedwe anthu."- M, 2005), omwe amatchedwa ziwiya zotsutsa:
   • makamaka zomwe zimakhala ndi mainchesi osakwana 100 microseter, arterioles - zotengera zomaliza kutsogolo kwa ma capillaries (awa ndiye ziwiya zazing'ono kwambiri kuchokera pomwe zinthu zimalowa molunjika mu tiziwalo). Amakhala ndi minyewa yozungulira yozungulira, yomwe imakhala pakati pa ma capillaries osiyanasiyana ndipo ndi mtundu wa "mafinya". Zimatengera kusintha kwa "matepi" omwe ndi gawo liti lathupi lomwe limalandira magazi ochulukirapo (ndiye kuti, zakudya), ndipo ochepa -
   • pang'ono, kamvekedwe ka mitsempha yaung'onoting'ono ndi yaying'ono ("magawo ogawa") omwe amayenda ndi magazi kupita ziwalo ndipo amapezeka mkati mwa ziwalo
2. Mgwirizano wamtima: ngati mtima umagwirizana kwambiri nthawi zambiri, mitsempha ilibe nthawi yopereka gawo limodzi la magazi, monga momwe amalandirira,
3. Kuchuluka kwa magazi komwe kumaphatikizidwa ndi magazi,
4. Maso amwazi

Isolated diastolic matenda oopsa ndi osowa, makamaka matenda a kukana ziwiya.

Nthawi zambiri, onse systolic ndi diastolic magazi amadzuka. Izi zimachitika motere:

• aorta ndi ziwiya zazikulu zomwe zimapopa magazi, siyani kupumula,
• kukankhira magazi mwa iwo, mtima uyenera kuvuta
• kupanikizika kumakwera, koma kumatha kuvulaza ziwalo zambiri, kotero zombo zimayesetsa kupewa izi,
• Kuti muchite izi, amawonjezera minofu yake - kotero magazi ndi magazi zimabwera ziwalo ndi ziwalo osati mumtsinje umodzi waukulu, koma mwa "mtsinje wowonda",
• ntchito ya minyewa yosenda yokhazikika imatha kusungika nthawi yayitali - thupi limadzilowetsa m'malo mwa minyewa yolumikizana, yomwe imalephera kuthana ndi mavuto owonongeka, koma sangayang'anire kuwunikira kwa chotengera (monga minofu idachitira),
• chifukwa cha izi, kupsinjika, komwe kumayeserera mwanjira ina, kumakhala kukuchulukirachulukira.

Mtima ukayamba kugwira ntchito motsutsana ndi kuthamanga kwa magazi, kukankhira magazi m'matumba okhala ndi khoma lolimbitsa minofu, minyewa yake imakulanso (ichi ndi katundu wamba wamisempha yonse). Izi zimatchedwa hypertrophy, ndipo zimakhudza makamaka kumanzere kwamtima, chifukwa kumalumikizana ndi msempha. Lingaliro la "lamanzere lamitsempha yamagazi" mu mankhwala siliri.

Chachikulu matenda oopsa

Mtundu wamba wamba ukunena kuti zomwe zimayambitsa matenda oopsa sichitha kutsimikizika. Koma katswiri wasayansi Fedorov V.A. Ndipo gulu la madotolo lidalongosola kuchuluka kwa mavuto chifukwa cha izi:

1. Kuchepa kwa impso. Cholinga cha izi ndikuwonjezereka kwa "slagging" wa thupi (magazi), omwe impso sangathe kupirira nawo, ngakhale zonse zili bwino. Izi zimachitika:
   • chifukwa chosakwanira kwachilengedwe chonse (kapena ziwalo zina),
   • kuyeretsa kwadzidzidzi kwa zinthu zowola,
   • chifukwa chowonjezera kuwonongeka kwa thupi (zonse kuchokera kuzinthu zakunja: zakudya, kupsinjika, kupsinjika, zizolowezi zoipa, etc., komanso kuchokera mkati: matenda, zina),
   • chifukwa chosakwanira ntchito zamagalimoto kapena kugwiritsa ntchito zinthu zambiri (muyenera kupuma ndikuchita bwino).
2. Kuchepetsa mphamvu ya impso kusefa magazi. Izi sizingobwera chifukwa cha matenda a impso. Mwa anthu opitilira zaka 40, kuchuluka kwa impso kumatsika, ndipo pofika zaka 70 amakhalabe (mwa anthu opanda matenda a impso) 2/3 yokha. Mulingo woyenera kwambiri, malinga ndi thupi, momwe mungasungire kusefera kwa magazi pamlingo woyenera ndikuwonjezera kukakamiza kwa mitsempha.
3. Matenda osiyanasiyana a impso, kuphatikizapo chilengedwe cha autoimmune.
4. Voliyumu yamagazi imakwera chifukwa cha kuchuluka kwa minofu yambiri kapena kusungidwa kwamadzi m'magazi.
5. Kufunika kowonjezera magazi kupita ku ubongo kapena msana. Izi zimatha kuchitika m'matenda a ziwalozi zamagulu amanjenje komanso kuwonongeka kwa ntchito yawo, yomwe singathe kulephera. Kufunika kowonjezereka kumawonekeranso ndi atherosulinosis yamitsempha yamagazi yomwe magazi amayenda kupita ku ubongo.
6. Edema mu msana wa thoracicchifukwa cha disc herniation, osteochondrosis, kuvulala kwa disc. Apa ndipamene mitsempha yomwe imayang'anira lumen ya ziwiya zamagetsi imadutsa (amapanga kuthamanga kwa magazi). Ndipo ngati atatseka njira yawo, malamulo ochokera ku ubongo sangathe kufika pa nthawi - ntchito yolumikizidwa yamanjenje imasokonekera - kuthamanga kwa magazi kumawonjezeka.

Kusanthula mosamala machitidwe a thupi, Fedorov V.A. ndi madotolo adawona kuti ziwiya sizingadyetse khungu lililonse la thupi - pambuyo pake, si maselo onse omwe ali pafupi ndi capillaries. Adazindikira kuti chakudya cham'mimba chimatha chifukwa cha kuwonongeka kwa ma microhibration - mawonekedwe ofanana ndi ma cell am'mimba omwe amapanga 60% yakulemera kwambiri kwa thupi. "Mitima" yolowera yotere, yomwe akufotokozedwa ndi katswiri wamaphunziro N.I. Arincin, imapereka kayendedwe ka zinthu ndi maselo pawokha mu madzi am'kati mwa zinthu zophatikizana, kupangitsa kuti muzitha kudya zakudya zabwino, kuchotsa zinthu zomwe zimachitika munthawi ya moyo, komanso kuchititsa chitetezo cha m'thupi. Masegravigine akayamba kudera limodzi kapena angapo akasakwanira, matenda amayamba.

Pantchito yawo, maselo am'mimba omwe amapanga ma microvibration amagwiritsa ntchito ma electrolyte omwe amapezeka m'thupi (zinthu zomwe zimatha kuyendetsa zinthu zamagetsi: sodium, calcium, potaziyamu, mapuloteni ena ndi zinthu zopanda organic). Mlingo wamagetsi amenewa umasungidwa ndi impso, ndipo pamene impso zimayamba kudwala kapena kuchuluka kwa minofu yogwira ntchito kumachepa ndi zaka, microvibration imayamba kuchepa. Thupi, momwe lingathere, ikuyesayesa kuthetsa vutoli mwakuwonjezera kuthamanga kwa magazi - kotero kuti magazi ochulukirapo amayenda kupita ku impso, koma chifukwa cha izi, thupi lonse limavutika.

Kuperewera kwa Microvibration kumatha kubweretsa kudzikundikira kwa maselo owonongeka ndi zinthu zowola impso. Ngati simuwachotsa pamenepo kwa nthawi yayitali, ndiye kuti amasamutsidwa kupita ku minofu yolumikizana, ndiye kuti kuchuluka kwa maselo akugwira ntchito kumachepetsedwa. Chifukwa chake, kupindulitsa kwa impso kumachepa, ngakhale mawonekedwe ake samavutika.

Impso zokha zilibe ulusi wawo wa minofu ndi michere yotuluka imapezeka kuchokera kumisempha yoyandikana nayo yam'mbuyo ndi yam'mimba. Chifukwa chake, kuchita masewera olimbitsa thupi ndikofunikira makamaka kuti mukhale ndi kamvekedwe ka minofu kumbuyo ndi pamimba, ndichifukwa chake kuyimitsidwa koyenera ndikofunikira ngakhale mutakhala pansi.Malinga ndi V. Fedorov, "kusokonezeka kwa minyewa yam'mbuyo yokhala ndi kukhazikika koyenera kumapangitsa kuti pakhale ziwonetsero zambiri zamkati: impso, chiwindi, ndulu, kuwongolera ntchito yawo ndikuwonjezera zomwe zimachitika mthupi. Imeneyi ndi gawo lofunika kwambiri lomwe limawonjezera kufunika kwa kukhazikika. ” ("Zomwe thupi limapanga ndi chitetezo chathanzi, thanzi komanso moyo wautali."- Vasiliev A.E., Kovelenov A.Yu., Kovlen D.V., Ryabchuk F.N., Fedorov V.A., 2004)

Njira yotulutsira izi ndikuti mufotokozere zowonjezera za kuchepa kwa mafuta (bwino komanso kuphatikizika kwa mafuta) ku impso: chakudya chawo ndimakonzedwe, ndipo zimabweza magazi moyenera "m'makonzedwe oyamba". Hypertension imaloledwa. Poyamba, chithandizo chotere ndikokwanira kuti magazi achepetse, popanda kumwa mankhwala ena. Ngati matenda a munthu "apita kutali" (mwachitsanzo, ali ndi digiri ya 2-3 komanso chiwopsezo cha 3-4), ndiye kuti munthu sangathe kuchita popanda kumwa mankhwala omwe dokotala wamupatsa. Nthawi yomweyo, uthenga wowonjezereka wa Microhibration uthandizira kuchepetsa mlingo wa mankhwala omwe amwedwa, chifukwa chake amachepetsa zovuta zake.

Kugwiritsa ntchito kufalikira kwa ma Microvibration owonjezereka ogwiritsa ntchito zida zamankhwala "Vitafon" zochizira matenda oopsa zimathandizidwa ndi zotsatira za kafukufuku:

Mitundu ya Second Hypertension

Sekondale ya kumenya matenda oopsa ndi:

1. Neurogenic (wochokera ku matenda amanjenje). Agawidwa kukhala:
   • centrifugal - zimachitika chifukwa cha kusokonezeka kwa ntchito kapena kapangidwe ka ubongo,
   • reflexogenic (Reflex): mumkhalidwe winawake kapena kupsa mtima kwamatumbo a zotumphukira zamitsempha.
2. Hormonal (endocrine).
3. Hypoxic - kumachitika pamene ziwalo monga chingwe cha msana kapena ubongo zimavutika chifukwa chosowa mpweya.
4. Hypertension yoopsa, ilinso ndi magawo ake:
   • Mbale, pamene mitsempha yomwe imabweretsa magazi ku impso ndi yopapatiza,
   • renoparenchymal, yomwe imalumikizidwa ndi kuwonongeka kwa minofu ya impso, chifukwa chomwe thupi liyenera kuwonjezera kukakamizidwa.
5. Mliri (chifukwa cha matenda am magazi).
6. Hemodynamic (chifukwa cha kusintha mu "njira" yamagazi).
7. Mankhwala
8. Amayambitsa mowa.
9. Matendawa osakanikirana (pomwe zidachitika pazifukwa zingapo).

Tiyeni tinene zambiri.

Matenda oopsa a Neurogenic

Lamulo lalikulu ku ziwiya zazikulu, kuzikakamiza kuti zitheke, kuthamanga magazi, kapena kudzipumula, kutsitsa, zimachokera ku vasomotor Center, yomwe ili mu ubongo. Ngati ntchito yake yasokonezedwa, matenda oopsa a centrogenic amakula. Izi zitha kuchitika chifukwa cha:

1. Neurosis, ndiko kuti, matenda pamene mawonekedwe aubongo samavutika, koma mothandizidwa ndi kupsinjika, chidwi chokhazikitsidwa chimayikidwa mu ubongo. Amagwiritsa ntchito zida zazikulu, "kuphatikiza" kuwonjezeka kwa kukakamizidwa,
2. Zilonda zamaubongo: kuvulala (kupsinjika, mabala), zotupa za mu ubongo, sitiroko, kutupa kwa malo aubongo (encephalitis). Kuonjezera magazi akhale:

• kapena zida zomwe zikukhudza kuthamanga kwa magazi zimawonongeka (malo a vasomotor mu medulla oblongata kapena ma nuclei a hypothalamus kapena mapangidwe a reticular omwe amagwirizana nawo)
• kapena kuwonongeka kwakanthawi kwa ubongo kumachitika ndikuwonjezeka kwa kuthamanga kwa intracranial, pofuna kupereka magazi ku chiwalo chofunikira ichi, thupi liyenera kuwonjezera kuthamanga kwa magazi.

Reflex matenda oopsa amatanthauzanso neurogenic. Atha kukhala:

• Reflex, pomwe kumayambiriro kumakhala kuphatikiza chochitika china ndi kumwa mankhwala kapena zakumwa zomwe zimawonjezera kukakamizidwa (mwachitsanzo, ngati munthu amamwa khofi wamphamvu msonkhano usanachitike). Pambuyo pobwereza kambiri, kupanikizika kumayamba kuchulukirapo kungoganiza za msonkhano, osamwa khofi,
• chosawerengera, pamene kupanikizika kumuka pambuyo poti uchotsa zolimba zomwe zimapita ku ubongo kwanthawi yayitali kuchokera ku mitsempha yoyipa kapena yodinidwa (mwachitsanzo, ngati chotupa chidachotsedwa chomwe chimakanikizira pa sayansi kapena mtundu wina uliwonse).

Adrenal Hypertension

M'matumbo awa, omwe amakhala pamwamba pa impso, mahomoni ambiri amapangidwa omwe amatha kuthana ndi kamvekedwe ka mitsempha yamagazi, mphamvu kapena pafupipafupi mphamvu yamtima. Zitha kuyambitsa kukakamiza:

1. Kuchulukitsa kwa adrenaline ndi norepinephrine, komwe kumakhala kotupa monga pheochromocytoma. Ma hormones onsewa nthawi imodzi amawonjezera mphamvu komanso kugunda kwa mtima, kuwonjezera mphamvu ya mtima,
2. Kuchuluka kwa mahomoni aldosterone, omwe satulutsa sodium m'thupi. Vutoli, lomwe limawoneka m'mwazi wambiri, "limakopa" madzi kuchokera kuzinthu zokha. Chifukwa chake, kuchuluka kwa magazi kumawonjezeka. Izi zimachitika ndi chotupa chomwe chimatulutsa - zilonda kapena chosauka, zomwe zimakhala zopanda chotupa zomwe zimatulutsa aldosterone, komanso kukondoweza kwa tiziwalo timene timatulutsa adrenal m'matenda akulu a mtima, impso, ndi chiwindi.
3. Kuchulukitsa kwa glucocorticoids (cortisone, cortisol, corticosterone), komwe kumakulitsa kuchuluka kwa ma receptors (ndiye kuti mamolekyu apadera pa cell omwe amakhala ngati "loko" yomwe imatsegulidwa ndi "fungulo") kwa adrenaline ndi norepinephrine (akhale "fungulo" loyenera la " nyumba yachifumu ”) mumtima ndi m'mitsempha yamagazi. Zimathandizanso kupanga mahomoni angiotensinogen ndi chiwindi, zomwe zimathandiza kwambiri pakukula kwa matenda oopsa. Kuwonjezeka kwa kuchuluka kwa glucocorticoids kumatchedwa Itsenko-Cushing's syndrome ndi matenda (matenda - pamene gland ya pituitary ikulamula kuti tiziwalo tating'onoting'ono tokhala ndi adrenal tipeze timagulu tambiri tating'ono tating'onoting'ono tating'onoting'ono tomwe timayambitsa matenda - pamene ma gren adrenal amakhudzidwa).

Hyperthyroid matenda oopsa

Zimaphatikizidwa ndikupanga kwambiri chithokomiro cha mahomoni ake - thyroxine ndi triiodothyronine. Izi zimabweretsa kuwonjezeka kwa kugunda kwa mtima ndi kuchuluka kwa magazi omwe amatulutsidwa ndi mtima umodzi.

Kupanga mahomoni a chithokomiro kumatha kuwonjezeka ndi matenda a autoimmune monga matenda a Graves 'ndi Hashimoto's chithokomiro, ndi kutupa kwa gland (subacute thyroiditis), ndi zina zotupa zake.

Kutulutsa kwambiri kwa ma antidiuretic mahomoni ndi hypothalamus

Hormone iyi imapangidwa mu hypothalamus. Dzinalo lachiwiri ndi vasopressin (lotanthauziridwa kuchokera ku Chilatini limatanthawuza "zotengera zofinya"), ndipo limagwira motere: kumangiriza kwa zotengera m'matumbo impso kumawapangitsa kuti akhale opendekera, zomwe zimapangitsa kuti mkodzo ukhale. Momwemo, kuchuluka kwa madzimadzi m'zotengera kumawonjezeka. Mwazi wambiri umayenda kumtima - umatambasulidwa kwambiri. Izi zimabweretsa kuwonjezeka kwa kuthamanga kwa magazi.

Hypertension imatha kuphatikizidwanso ndi kuwonjezeka kwa kupanga kwa zinthu zomwe zimagwira mthupi zomwe zimachulukitsa kamvekedwe ka mtima (awa ndi angiotensins, serotonin, endothelin, cyclic adenosine monophosphate) kapena kuchepa kwa chiwerengero cha zinthu zomwe zimayambitsa mitsempha yamagazi (adenosine, gamma-aminobutyric acid, nitric oxide).

Menopausal matenda oopsa

Kutha kwa ntchito ya ziwalo zoberekera nthawi zambiri kumayendetsedwa ndi kukwera kwa magazi. Zaka zoyenera kulowa mu kusintha kwa kusintha kwa thupi kwa mkazi aliyense ndizosiyana (izi zimatengera mawonekedwe amtundu, momwe akukhalira komanso momwe thupi lakhalira), koma madokotala aku Germany adatsimikizira kuti kupitirira zaka 38 ndizowopsa pakukula kwa matenda oopsa. Pambuyo pa zaka 38, kuchuluka kwa ma follicles (komwe mazira amapangidwira) amayamba kuchepa osati mu 1-2 mwezi uliwonse, koma ambiri. Kuchepa kwa chiwerengero cha ma follicles kumabweretsa kuchepa kwa kupanga kwa mahomoni ndi thumba losunga mazira; chifukwa chake, zomasulira (thukuta, kumva kwa paroxysmal kutentha kwa thupi kumtunda) komanso mtima (kufupika kwa theka lam'mimba pakulimbana ndi kutentha, kuthamanga kwa magazi).

Matenda a Vasorenal (kapena Renovascular)

Amayamba chifukwa cha kuwonongeka kwa magazi m'm impso chifukwa kuchepa kwa mitsempha yomwe imadyetsa impso. Amavutika ndi mapangidwe a atherosulinotic plaques mwa iwo, kuwonjezeka kwa minofu yosungirako mwa iwo chifukwa cha matenda obadwa nawo - fibromuscular dysplasia, aneurysm kapena thrombosis yamitsempha iyi.

Maziko a matendawa ndi kutsegula kwa mphamvu ya mahomoni, chifukwa momwe ziwiya zimasinthira spasmodic (zothinikizidwa), sodium imasungidwa ndipo madzimadzi m'magazi amawonjezereka, ndipo dongosolo lamanjenje lomumvera limalimbikitsidwa. Mchitidwe wamanjenje wachifundo, kudzera mu maselo ake apadera omwe amakhala pamatumbo, umayendetsa kuthamanga kwawo kwakukulu, komwe kumabweretsa kuwonjezeka kwa magazi.

Hypoparenchymal matenda oopsa

Zimangokhala 2-5% yokha ya matenda oopsa. Zimachitika chifukwa cha matenda monga:

• glomerulonephritis,
• kuwonongeka kwa impso mu shuga,
• imodzi kapena zingapo mu impso,
• kuvulala kwa impso
• chifuwa chachikulu cha impso,
• kutupa kwa impso.

Ndi matenda aliwonse awa, kuchuluka kwa nephrons (zigawo zikuluzikulu za impso zomwe magazi amasefedwa) kumachepa. Thupi limayesa kukonza zomwe zawonjezereka ndikuwonjezera kukakamiza kwa mitsempha yomwe imanyamula magazi kupita ku impso (impso ndi chiwalo chomwe magazi ake ndi ofunika kwambiri, pazovuta zochepa amasiya kugwira ntchito).

I. Magawo a matenda oopsa:

• Hypertension (GB) gawo I ikuwonetsa kusasintha kwa "ziwalo zomwe mukufuna."
• Hypertension (GB) gawo lachiwiri Kukhazikika pamaso pa zosintha kuchokera ku chimodzi kapena zingapo "ziwalo zomwe mukufuna."
• Hypertension (GB) gawo lachitatu Kukhazikitsidwa pamaso pa zogwirizana ndi matenda.

II. Kukula kwa matenda oopsa:

Ma degree a arterial hypertension (magazi (BP)) amawonetsedwa pagome. 1. Ngati ma systolic magazi (BP) ndi diastolic magazi (BP) agwera m'magulu osiyanasiyana, ndiye kuti kuchuluka kwa matenda oopsa (AH) kukhazikitsidwa. Molondola kwambiri, digiri ya Arterial Hypertension (AH) imatha kukhazikitsidwa pokhapokha ngati pali matenda a Arterial Hypertension (AH) komanso mwa odwala omwe samamwa antihypertensive mankhwala.

Tebulo 1. Tanthauziro ndi matchulidwe a kuthamanga kwa magazi (BP) (mmHg)

Chimodzi mwazovuta za matenda oopsa:

• kulephera kwa mtima, kuwonetseredwa mwa kupuma movutikira, kapena kutupa (pamiyendo kapena thupi lonse), kapena zizindikiro zonsezi,
• matenda amtima: kapena angina pectoris, kapena myocardial infarction,
• aakulu aimpso kulephera
• kuwonongeka kwakukulu m'matumbo a retina, chifukwa masomphenya amakula.

Kuchuluka kwa kuthamanga kwa magazi pazigawo zilizonse kuli pamwamba pa 140/90 mm RT. Art.

Chithandizo cha gawo loyambirira la matenda oopsa makamaka limasinthidwa kusintha moyo: kusintha kadyedwe, kuphatikiza zochita zolimbitsa thupi, zolimbitsa thupi masiku onse. Ngakhale matenda oopsa a magawo 2 ndi 3 ayenera kuthandizidwa kale ndi mankhwala. Mlingo wawo, ndipo, zoyipa zimatha kuchepetsedwa ngati muthandizira thupi kubwezeretsa magazi mwachilengedwe, mwachitsanzo, pomuuza zakulimbana ndi chipangizo chachipatala cha Vitafon.

Kukula kwa matenda oopsa

Mlingo wachitukuko cha matenda oopsa umawonetsa kuchuluka kwa kuthamanga kwa magazi:

Kupsinjika kwapamwamba, mmHg Art.

Kupanikizika kotsika, mmHg Art.

Digiri imakhazikitsidwa popanda kumwa mankhwala ochepetsa. Kuti izi zitheke, munthu yemwe amakakamizidwa kumwa mankhwala omwe amachepetsa magazi amafunika kuchepetsa mlingo wawo kapena kusiya kwathunthu.

Kuchuluka kwa matenda oopsa kumawerengedwa ndi chiwerengero cha kukakamiza ("kumtunda" kapena "kutsika"), komwe ndi kwakukulu.

Nthawi zina matenda oopsa a digiri 4 amasungidwa. Amatanthauziridwa ngati kuyerekezera kwapadera kwa systolic. Mulimonsemo, tikutanthauza boma pomwe kukakamizidwa kokha kumangowonjezereka (pamwamba pa 140 mm Hg), pomwe yotsikitsitsa ili mkati mwazolondola - mpaka 90 mm Hg. Izi nthawi zambiri zimalembedwa mwa okalamba (zomwe zimagwirizanitsidwa ndi kuchepa kwa aortic elasticity). Kuyambika kwa achinyamata, omwe ali okhaokha okhathamira ophatikizira matenda opatsirana kumaonetsa kuti muyenera kuwunika chithokomiro.

Kuzindikiritsa zoopsa

Palinso gulu la magulu owopsa. Kuchuluka kwake kukuwonetsedwa pambuyo pa liwu loti "chiopsezo", kukulira mwayi wokhala ndi matenda owopsa m'zaka zikubwerazi.

Pali magawo anayi a chiopsezo:

1. Pa chiopsezo cha 1 (otsika) mwayi wokhala ndi stroko kapena matenda a mtima pazaka 10 zikubwerazi ndi 15%,
2. Pa chiwopsezo cha 2 (pafupifupi), kuthekera kwa zaka 10 zikubwerazi ndi 15-20%,
3. Ndi chiopsezo cha 3 (mkulu) - 20-30%,
4. Ndi chiopsezo cha 4 (kwambiri) - zoposa 30%.

Kupsyinjika kwa systolic> 140 mmHg. komanso / kapena kukakamiza kwa diastolic> 90 mmHg. Art.

Kuposa ndudu imodzi pa sabata

Kuphwanya mafuta kagayidwe (malinga ndi kuwunika kwa "Lipidogram")

Kuthamanga shuga (mayeso a shuga m'magazi)

Kusala plasma glucose wa 5.6-6.9 mmol / L kapena 100-125 mg / dL

Glucose maola 2 mutatha kutenga magalamu 75 a shuga - osakwana 7.8 mmol / l kapena ochepera 140 mg / dl

Kulekerera kochepa (digestibility) kwa glucose

Kusala madzi a m'magazi osachepera 7 mmol / L kapena 126 mg / dL

Maola 2 mutatenga magalamu 75 a shuga, ochulukirapo 7.8, koma ochepera 11.1 mmol / l (≥140 ndipo Mwa kuwonekera mabatani awa, mutha kugawana mosavuta ulalo wapa tsambali ndi anzanu patsamba lanu