Iimpawu
Kwi-90% yamatyala ngaphambi kokuqala kweengxaki, uxinzelelo lwegazi oluphezulu alubonakali. Ngamanye amaxesha, ngexinzelelo olubi kakhulu (uxinzelelo oluphezulu), ukukhwaza intloko, isicathulo esinomsoco kunye nombono ongenakwenzeka. Ukungabikho kwonyango, uxinzelelo oluphezulu lwegazi lubangela ukulimala kwizitho zangaphakathi kunye nokuphuhliswa kweengxaki (kwi-20% yezigulane): intliziyo kunye nesifo sesifo, ukutshabalaliswa kwe-retinal okanye isifo. Ukuba umfutho wegazi ophezulu unesiphumo sesinye isifo, iimpawu zalo zigqatshelwe kumfanekiso wesifo esisezantsi. Uxinzelelo lwe-hypertension sisifo esiqhelekileyo esichaphazela i-10-15% yabemi. Iingxaki zengcinezelo yegazi ephezulu (CD) yimbangela ebalulekileyo yokufa. Ukuphuhliswa kwesi sifo kudibene neengozi ezinjenge:
• ubudala - inqanaba le-CD lisoloko landa ngeeminyaka ubudala, kodwa akufanele kuthathwe njengesiqhelo kumanani aphezulu e-CD ekudala;
• ubunzima - i-CD iphakamileyo kubantu abanomzimba obunzima;
• Umncintiswano - abaMerika baseNtshonalanga, umzekelo, uxinzelelo lwexinzelelo, baninzi ngaphezu kwezityalo zaseYurophu.
Umxinzelelo ophezulu
Ngaphezu kwe-90% yezigulane ezinexinzelelo lwegazi eziphezulu zixinzeleleka kwixinzelelo, zibangela kungekho sizathu esicacileyo. Inxaxheba ethile kule nto idlaliswa ngumlando wentsapho, ukukhuluphala, ukusetyenziswa kakubi kotywala, kunye nemeko yendalo.
Ezinye izizathu
• Ukuxinzeleleka komfutho wegazi ophezulu kubangelwa uhlobo oluthile lomonakalo wendiza yegazi, olubizwa ngokuba yi-fibrinoid necrosis.
• Ukukhulelwa. I-CD ephezulu idibanisa malunga ne-5-10% yokukhulelwa kwaye, ekubeni yinto ye-syndrome enamandla kunye nomonakalo we-placenta, inika umngcipheko omkhulu kumama nomntwana.
Uxinzelelo lwe-hypertension lungabonakalisa uphawu lwesibini kunye:
• isifo sezintso;
• izicubu zeengcambu ze-endocrine ezenza i-hormone edibeneyo echaphazela i-metabolism yamanzi yetyuwa emzimbeni okanye ukukhupha izinto ezifana ne-adrenaline;
• ukuthatha amayeza athile;
• ukungabikho komntwana.
Uxinzelelo lwegazi lukulinganiswa yi-sphygmomanometer. Le fowuni ibhalisa ixabiso leengcinezelo ezimbini kwiimitha ze-mercury (mm Hg): owokuqala-ekuphakameni kwentliziyo ye-contraction - kwi-systole, yesibini - kunye nokuphumla kwayo kwi-diastole. Xa ufumanisa i-hypertension, zombini iziguquko zithathwa ingqalelo. Kuphela malunga nesithathu kweemeko zengcinezelo yentsholongwane ingabonwa kwaye ifunyanwe. Kuba ukuxilongwa kwanele ukubhaliswa kwexesha eli-3 loxinzelelo lwegazi phantsi kweemeko ezahlukeneyo.
Olunye uphando lubandakanya:
- Uhlalutyo lwamanzi lwamaprotheni;
- Ukuhlolwa kwegazi malunga nemigqaliselo yesenzo sentso;
- isifuba se-X-ray kunye ne-ECG ukufumana ukukhuliswa komzimba.
Kukho iimpazamo ekulinganiseni uxinzelelo lwegazi. Iimilinganiselo zamanga eziphezulu zingatholakala kwigumbi elibandayo, kunye nesigcina esipheleleyo okanye inkompo encinane. Izigulane ezifuna unyango lwangxamisekileyo ziquka:
• izigulane ezinexinzelelo lwegazi malunga ne-250/40 mm ngeHg. ubugcisa. enegazi eliphezulu. Basenokufumana utshintsho olunzulu kwi-fundus kunye nokungafezeki kwamanzi kunye ne-uremia (ubukho bemali engaphezulu kakhulu yerea kunye neminye imikhiqizo ye-nitrogen egazini);
• Izigulane ezinezilonda zesibini zamalungu angaphakathi (intliziyo, izintso) kunye neqondo lokunyanzeliswa malunga ne-220/10 mm nge-Hg. Ubugcisa.
Izindlela ezingekho kwizonyango
Izigulane ezinexinzelelo lwe-hypertension (i-diastolic ingcinezelo ukuya kwi-95-110 mm Hg) ayikho ngqo engozini, ngoko unokuzama ukufezekisa ixabiso le-CD ngaphandle kwezilwanyana usebenzisa ezinye iindlela:
• ukulahleka kwesisindo;
• ukuthintela ityuwa;
• isithintelo sokutya okunamafutha;
• ukuthintela ukusetyenziswa kotywala;
• ukwenqaba ukukhulelwa komlomo;
• ukwandiswa kwemisebenzi yomzimba.
Ukuba iziphumo ezifunwayo aziphumelelanga kwisithuba seenyanga ezintathu, kunokufuneka ukuba unikwe izidakamizwa. Ukulawula uxinzelelo lwegazi, i-diuretics kunye ne-block block ye-calcium.
Izinzuzo zonyango
Unyango kufuneka ube yithuba elide, kwaye mhlawumbi, ubomi. Ngokuqhelekileyo abantu bathabatha amayeza eminyaka engama-30-40. Iintlobo zonyango loqulunqo ziquka:
• Ukunciphisa ekufeni, ingakumbi phakathi kwabashushu bentsha yabantu abanegazi eliphezulu;
• ukunciphisa umngcipheko wokusilela intliziyo kunye nokubola kwesibindi;
• ukunciphisa umngcipheko wokuphulukana kwezintso.
Nangona kunjalo, nangokulawulwa kakuhle kweempawu, ingozi yexinzelelo yentlungu ingaba yinto embi, ingakumbi ukuba ifumana iziphumo ezimbi iziyobisi, oku:
- ukukhathala - xa uthatha i-beta-blockers;
- ukukhwehlela owomileyo - kunye nokusetyenziswa kwe-ACE inhibitors;
- ukulibala;
- iingxaki nge-potency, ezinokuba ngumphumo wecandelo lamachiza amaninzi.
Uhlolo lokunyamezela
Ngokuqhelekileyo, izigulane zikholelwa ngokungafaneleka ukuba zinokugcina lula ukucinezelwa kwegazi. Ukufezekiswa kwezinto ezijoliswe kuzo kugxile kunzima. Nangona kubekho inani lamachiza, kuphela kwi-20% yamatyala okunokwenzeka ukufezekisa ixabiso le-diastolic value of less than 90 mm RT. Ubugcisa. Kwi-60% yezigulane, uxinzelelo lwegazi luyahluka kwizinga elimodareyitha (uxinzelelo lwe-diastolic 90-109 mm Hg), kwaye enye i-20% ineziphumo ezimbi (ngaphezulu kwe-110 mm Hg).
Xa uxinzelelo lwegazi luzinzile, umongikazi unokubhala kwakhona amayeza. Iziphumo zengcinezelo yentsholongwane zinokuthintela ukuxilongwa kwangaphambili kwesi sifo. Xa kungabikho unyango, ukunyuswa kwengcinezelo yegazi kwandisa umngcipheko wokufa ngaphambi kokudala (ngaphambi kweminyaka engama-70). Nangona kunjalo, ngokunyanga okwaneleyo, ezininzi izigulane zinexesha eliqhelekileyo lokuphila ngaphandle kweengxaki. Izimbangela ezibalulekileyo zokufa kwixinzelelo lwengxangxwaba (45%) kunye ne-myocardial infarction (35%). Amaqela abantu abanobuhle obungaphantsi kakhulu abandakanya: izigulane eziselula; madoda. Abasetyhini abasebenzisa izithintelo zokukhulelwa komlomo basengozini yokukhwabanisa okanye isifo se-myocardial, ingakumbi ukuba bayabhema.
Amanyathelo okukhusela
Ukuhlalutya kwedatha kwonyango lwexinzelelo olunefuthe kubonise ukuba ukuncipha kwe-diastolic ingcinezelo ngo-5-6 mm Hg. Ubugcisa. kukhokelela kwezi ziphumo ezilandelayo:
• ukunciphisa u-38% kwengozi yokubetha;
• Ukunciphisa u-16% kwengozi ye-coronary disease disease.
Ukukhuphela ingcinezelo yegazi, bonke abantu abadala ukuya kuma-80 kufuneka bahlale rhoqo (amahlanu ngamawaka) baqhuba umlinganiselo wexinzelelo lwegazi. Xa ufumanisa ixabiso elingenamda okanye ukunyuka okukodwa kwimixinzelelo yegazi, kuyadingeka ukubeka iliso ngononophelo.