Unonzwa dzungu here kana kuti musoro wakaneta paunongoerekana wamira, kungave wakagara kana kuti wakarara pasi? Dzimwe nguva unotonzwa sekunge uchafenda kwenguva yakati, handiti? Iri ndiro dambudziko ratiri kutaura nezvaro nhasi, rinonzi ``Orthostatic Hypotension''. Vamwe vanhu vanoridaidzawo kuti ``Postural Hypotension.'' Usazvidya moyo, ichi chinhu chinogona kuitika kuvanhu vazhinji, kunyanya pavanenge vachikura. Ngatitaurei nezvazvo zvakadzama uye zviri nyore.
Chii chinonzi `(Orthostatic Hypotension)`? Zvichitaurwa zviri nyore...
Zvichitaurwa zviri nyore, `(Orthostatic Hypotension)` zvinoreva apo BP yako inodonha kamwe kamwe paunomira kubva panzvimbo yakagara kana kuti wakarara. Fungidzira, wakagara pachigaro uchiverenga pepanhau wobva wasimuka kamwe kamwe nekuti mumwe munhu ari kutaura. Ndipo paunonzwa dzungu. `(Orthostatic)` zvinoreva nzvimbo yakatwasuka. `(Hypotension)` zvinoreva BP yakaderera. Saka, apa ndipo apo BP yako inodonha paunochinja nzvimbo.
Saka, BP iyi chii?
Tinowanzonzwa nezve BP, kana kuti ``Blood Pressure''. Izvi zvinoyera BP inoyerera pamadziro etsinga dzeropa sezvo mwoyo wedu uchirova. Zvakafanana ne pressure inoyerera papombi dzemvura kana ichiyerera nemupombi yemvura. Izvi zvinoyerwa nemamirimita e mercury ``(mmHg)``.
Paunoenda kuna chiremba, vanokuudza nhamba mbiri pavanoongorora BP yako, handiti?
- Nhamba yepamusoro `(Systolic)`: Izvi zvinoreva kumanikidzwa kwemoyo wako kana uchirova uye uchipomba ropa mutsinga dzako.
- Nhamba yepasi `(Diastolic)`: Izvi zvinoreva kumanikidzwa kuri mutsinga dziri pakati pekurova kwemoyo kuviri, ndiko kuti, kana moyo wazorora zvishoma.
Chiremba anoinyora senhamba yepamusoro/yepasi (semuenzaniso 120/80 mmHg). BP yevanhu vazhinji ine hutano iri pasi pe120/80 mmHg. Kuverenga kuri pasi pe90/60 mmHg kunoonekwa seBP yakaderera.
Kuderera kweropa kunoderera zvakadii mu "Orthostatic Hypotension"?
Hapana kukosha kwakanyatsojeka kweizvi. Zvisinei, vanachiremba vanoongorora izvi nekutarisa BP yako yakajairika uye kuti inoderera zvakadii paunomira. Kazhinji, kana nhamba yepamusoro ``Systolic`` ikadonha ne20 mmHg kana nhamba yepasi ``Diastolic`` ikadonha ne10 mmHg mukati memaminitsi matatu ekumira , zvinoonekwa se``Orthostatic Hypotension``.
Ndiani ane mukana mukuru wekuwana Orthostatic Hypotension?
Chirwere ichi chinogona kuitika kune chero munhu, asi chinowanzoonekwa sezvaunokura. Zvinhu zvinotevera zvinogona kuwedzera njodzi yako yekubatwa nacho:
- Kushaya ropa kana Vitamin B12: Dambudziko iri rinogona kuitika kana ropa radzikira kana kuti Vitamin B12 yadzikira.
- Kushaya mvura mumuviri nekuda kwemishonga yekurara, kurutsa, kana mishonga yekubuda ropa: Kana huwandu hwemvura mumuviri hukadzikira, BP inogona kudzikira.
- Matambudziko eEndocrine:Zvirwere zvakaita sechirwere cheshuga, chirwere chethyroid, uye chirwere cheAddison.
- Matambudziko emwoyo: Zvinhu zvakaita sekusagadzikana kwemoyo (Arrhythmias), chirwere chevharuvhu yemoyo.
- Mimwe mishonga: Inogonawo kukonzerwa nemimwe mishonga inotorwa yeBP, chirwere chemwoyo, kana kuora mwoyo.
- Matambudziko etsinga: Zvirwere zvakaita sechirwere cheParkinson uye dementia.
- Kubata pamuviri: Kunyanya mukati memavhiki makumi maviri nemana ekutanga.
- Kugara pamubhedha kwenguva yakareba nekuda kwechirwere: Sekugara pamubhedha panguva yekuzvitakura.
Fungidzirai, Sekuru Somapala vanobva kumusha kwedu. Vane chirwere cheshuga uye vanonwa mishonga yeBP yakakwira. Vanoti vanonzwa dzungu pavanomuka mangwanani. Vanhu vakadaro vanowanzova nechirwere ichi.
Dambudziko iri rakajairika zvakadii?
Kushaya simba kwemuviri (orthostatic hypotension) kunokanganisa vanhu vanosvika 20% vevakwegura , kunyanya avo vanogara mudzimba dzevakwegura. Izvi zvinowanzoitikawo kuvanhu vakagara pamubhedha kwenguva yakareba, uye kuna vanaamai vatsva vane mwana. Zvinogonawo kuitika kune vechidiki vari kukura nekukurumidza.
Ndezvipi zviratidzo zveizvi?
Kushaya simba kweropa mumuviri (orthostatic hypotension) kunowanzoonekwa zvakanyanya uye zviratidzo zvacho zvinotowedzera kuipa mangwanani. Izvi zvinokonzerwa nekuti BP yedu inowanzova shoma patinomuka mangwanani.
Vamwe vanhu vanogona kunge vasina zviratidzo zvachose. Kune vamwe, zviratidzo izvi zvinowedzera kana kuchipisa, fivha, kana kugeza mumvura inopisa.
Chiratidzo chikuru dzungu kana kusuruvara paunomira . Izvi zvinofanira kupera paunogara kana kurara pasi zvakare. Vamwe vanhu vanogona kutorasikirwa nepfungwa (syncope).
Zvimwe zviratidzo ndeizvi:
- Kuona kusina kujeka
- Kurwadziwa kwechipfuva, kurwadziwa kwepafudzi kana kurwadziwa kwemutsipa
- Kuomerwa nekuisa pfungwa pachinhu chimwe chete
- Kuneta kana kushaya simba
- Musoro (Ndine urombo, shoko rinobva kune mumwe mutauro rakaiswa pano netsaona. Izwi rakarurama: Musoro )
- Kurova kwemoyo
- Kusvotwa kana kunzwa kupisa uye kudikitira
- Kushaya mweya / Kushaya simba rekufema
Sei izvi zvichiitika? Ndezvipi zvinokonzera?
Patinogara kana kurara pasi, ropa riri mutsinga dzemakumbo edu rinoyerera zviri nyore richidzokera kumoyo wedu. Asi patinomira, simba rinokwevera zvinhu pasi rinoita kuti zviomere ropa riri mumakumbo edu netsoka kusvika pamoyo wedu. Izvi zvinoderedza huwandu hweropa rinogona kupombwa kuenda kumoyo wedu, kune dzimwe nhengo dzemuviri, netsandanyama. Nekuda kweizvozvo, BP yedu inodzikira kwenguva pfupi.
Panogona kunge paine zvikonzero zvakasiyana-siyana zveizvi:
- Mwoyo wako haugone kupomba ropa rakakwana.
- Sisitimu yako yetsinga (inowanzo dzora BP) haisi kushanda zvakanaka.
- Kana uine zvirwere zvakaita seParkinson's disease, Lewy body dementia, kana multiple system atrophy .
- Kana wanga uri panzvimbo imwe chete (semuenzaniso wakarara pasi) kwenguva yakareba (sekunge warara pamubhedha panguva yekuzvitakura).
- Kana huwandu hweropa rako hukadzikira nekuda kwekurasikirwa neropa kana mvura (kupera mvura mumuviri).
- Kana uine dambudziko neadrenal gland yako .
- Nekuda kwemaitiro anoita muviri wako kune mumwe mushonga waunotora .
Ungaongorora sei hypotension ye orthostatic?
Paunoenda kuna chiremba, vanotanga vayera BP yako paunenge wakagara, vozorara pasi, vozomira. Kwete izvozvo chete, vachakubvunzawo nezvezvirwere zvako nemishonga yauri kutora.
Uye zvakare, imwe kana kupfuura yemiedzo inotevera inogona kuitwa:
- Kuongororwa kweropa: Tarisa zvirwere zvakaita sechirwere cheshuga uye kupererwa neropa.
- Echocardiogram (Echocardiogram / echo): Ona kuti moyo unopomba sei ropa.
- Electrocardiogram (EKG): Tsvaga shanduko mumutinhimira wemoyo.
- Kuedza kushushikana kwekurovedza muviri: Yera kurova kwemoyo wako paunenge uchirovedza muviri.
- Midziyo inotakurika yeEKG / Holter monitor: Yera mutinhimira wemwoyo mukati mezuva.
- Kuyedzwa kwetafura yekutsvedza: Kuyedzwa kunoyera BP, kurova kwemoyo, uye kurova kwemoyo zvakachengeteka nekukuita kuti urara patafura wobva watsvedza tafura kuti iende panzvimbo yakatwasuka.
Ndezvipi zvirongwa zvekurapa Orthostatic Hypotension?
Kurapwa kunoenderana nechikonzero chechirwere ichi.
Zvinotevera zvinogona kuitwa sekurapa:
- Kana paine chirwere kana mamiriro ari kukonzera hypotension ye orthostatic, chirape.
- Kuchinja mushonga uri kukonzera chirwere ichi kana kuchinja kushandisa mumwe mushonga (izvi zvinofanira kuitwa mushure mekutaura nachiremba wako).
- Kana uri pamubhedha, gara wakadzikama pamubhedha.
- Kupfeka masokisi anonamira. Izvi zvinoderedza kuungana kweropa mumakumbo.
- Kana usina mvura mumuviri, inwa mvura yakawanda uye mvura ine munyu.
Mishonga ipi inopihwa nekuda kweizvi?
Izvi zvinogona kudzorwa nekuchinja mararamiro. Zvisinei, vamwe vanhu vangangoda kutora mishonga yekuwedzera huwandu hweropa uye BP. Zvisinei, izvi hazviwanzoitiki.
Mimwe yemhando idzi dzemishonga ndeiyi:
- `Droxidopa`
- Mishonga inokurudzira erythropoiesis (ESAs) (semuenzaniso Procrit® kana Epogen®)
- `Desmopressin (Nocdurna® kana `DDAVP®)`
- `Octreotide (Bynfezia Pen™` kana `Mycapssa®)`
- `Fludrocortisone`
- `Midodrine hydrochloride`
- `Pyridostigmine (Mestinon®` kana `Regonol®)`
Zvakakosha: Mishonga iyi inofanira kungotorwa chete kana chiremba akuudza. Kutora mishonga wega kunogona kuva nemigumisiro ine njodzi.
Pane migumisiro yakaipa here yekurapwa kwacho?
Mimwe mishonga inoshandiswa pakurapa Orthostatic Hypotension inogona kukonzera migumisiro yakaipa yakaita seyiyi:
- Kushaya simba
- Kukwenya
- Musoro
- Kuzvimba
- Mazinga epotassium akaderera
- Kukundikana kwemoyo (izvi hazviwanzoitiki)
Ndosaka zvichikosha kuti munhu arapwe achitarisirwa nachiremba.
Ndezvipi zvinetso zvinogona kuitika nekuda kweOrthostatic Hypotension?
Vanhu vane chirwere ichi vanogona kunge vari panjodzi huru yezvinotevera:
- Kutyoka kwemapfupa kana kukuvara kwemusoro (kugwinha kwemusoro) kunogona kuitika kana munhu adonha achinge anzwa dzungu kana kuti asingazivi .
- Kuderera kweropa mushure mekudya: Uku kudzikira kweBP mukati memaminitsi makumi matatu kusvika maawa maviri mushure mekudya (kunyanya chikafu chine makabhohaidhiretsi akawanda).
- Kana BP ikaramba yakaderera zvakanyanya, kurohwa nehana kana kuti nhengo dzemuviri dzinogona kutadza kushanda (izvi hazviwanzoitiki).
- Njodzi yekurohwa kana chirwere chemwoyo nekuda kwekuchinja-chinja kweBP .
- Kushaya simba mumuviri: Izvi zvinoreva kuti BP inoderera kana munhu akarara pasi (izvi zvinogona kukonzerwa nemimwe mishonga).
Chii chinoitika kana ndiine `(Orthostatic Hypotension)`?
Vanhu vazhinji vanogona kudzora zviratidzo zvechirwere ichi (Orthostatic Hypotension) nekutevera matanho ekudzivirira. Semuenzaniso, unofanira kutora nguva yako paunomuka. Izvi hazvingakonzere matambudziko akakomba kwenguva refu.
Hazvigoneki here kupora zvizere kubva padambudziko iri?
Hapana mushonga we "orthostatic hypotension". Zvisinei, zviratidzo zvinogona kudzorwa zvakanyanya nekutevera mazano anopiwa nachiremba wako. Mazano aya anogona kusanganisira:
- Kutora mishonga yakanyorwa nemazvo.
- Idyai zvidiki pane kudya zvidiki panguva imwe chete.
- Inwa mvura yakawanda uye zvinwiwa.
- Kupfeka masokisi emhando dzakasiyana (Compression stockings).
Ndingaderedza sei njodzi yeOrthostatic Hypotension?
Kana uchinzwa dzungu rakadai, kutevera matanho aya kunogona kubatsira kuderedza zviratidzo:
- Dzora tembiricha yemuviri wako: Usageze nemvura inopisa zvakanyanya.
- Gara uine mvura yakakwana: Inwa mvura yakawanda. Deredza doro. Usadya chikafu chakawanda chine makabhohaidhiretsi akawanda panguva imwe chete.
- Ramba wakasimudza musoro wako zvishoma paunenge wakarara pamubhedha: shandisa pillow imwe kana maviri ekuwedzera, kana kusimudza musoro wematiresi zvishoma.
- Gadzirira usati wamuka: Tora nguva yekumira kubva panzvimbo yawakagara kana kuti wakarara. Iva nechimwe chinhu chakasimba chekubata paunomuka.
- Rovedza tsandanyama dzako: Kana uchifanira kumira kwenguva yakareba, pane kumira wakadzikama, famba-famba uchisimudza makumbo ako uchichinjana. Usati wasimuka, ita maekisesaizi e isometric (semuenzaniso, kudzvanya bhora diki rerabha). Izvi zvinogona kuwedzera BP yako zvishoma.
- Kuvandudza kutenderera kweropa uye kumanikidzwa kweropa: Pfeka masokisi ekudzvanya akakosha kana chipfeko chekuvhara dumbu.
Ndinofanira kuona chiremba rini?
Kana uchigara uchinzwa dzungu paunomira, unofanira kuona chiremba . Kunyangwe izvi zvikaitika dzimwe nguva, zvakanaka kuudza chiremba wako nezvazvo.
Ndinofanira kuenda kuEmergency Treatment Unit (ETU) riini?
Kana uine zviratidzo izvi, tsvaga kurapwa nekukasika :
- Kurwadziwa kwechipfuva.
- Kudonha kana kufenda.
- Matambudziko ekuenzanisa kana kubatana.
- Kana paine fungidziro yekuti pane kukuvara kwemusoro kana kutyoka nekuda kwekudonha.
- Kana tsvina yako ine ropa kana kuti dema.
- Zviratidzo zvekuvhunduka (muviri uchitonhora, kudikitira, kufema nekukurumidza, ganda rebhuruu, kurova kwemoyo kusina simba).
Mibvunzo ipi yandinofanira kubvunza chiremba?
Paunoenda kunoona chiremba, unogona kubvunza mibvunzo yakaita seiyi:
- Sei ndine chirwere ichi chinonzi ``Orthostatic Hypotension''?
- Ndeipi nzira yakanakisisa yekurapa izvi?
- Zviratidzo izvi zvinokonzerwa nemishonga yandiri kutora here? Ndinofanira kuchinja mishonga yangu here?
- Ndezvipi zvandinofanira kuchinja kuti ndigadzirise zviratidzo izvi?
- Ndezvipi zviratidzo zvematambudziko andinofanira kutarisa?
Ko `(Orthostatic Hypotension)` uye `(Postural Tachycardia Syndrome - POTS)` zvakafanana here?
Zviratidzo zvechirwere chinonzi `(Postural Tachycardia Syndrome)` kana `(POTS)` zvakafanana ne `(Orthostatic Hypotension).` Muzviitiko zvese izvi, dzungu uye kufenda zvinogona kuitika kana wamira. Zvisinei, mu `(POTS)`, pamusoro pekuderera kweBP, kurova kwemoyo kunowedzera nekurova kwe30-40 paminiti mukati memaminitsi gumi ekumira. Mu `(Orthostatic Hypotension)`, kurova kwemoyo hakuwanzo kuwedzera zvakanyanya.
Chirwere che "POTS" hachiwanzoonekwa kakawanda se "Orthostatic Hypotension".
Kushaya simba kwemuviri (Orthostatic hypotension) kunogona kuva chirwere chakakomba zvikuru. Chinogona kuva nengozi kana ukarasikirwa nechiyero chako wodonha kana kuti ukarasikirwa nepfungwa. Zvisinei, zviratidzo zvinowanzovandudzika kana ukachinja maitiro ako ekumira. Taura nachiremba wako nezvezviratidzo zvako. Ungangoda kuchinja mishonga yako. Muzviitiko zvakanyanya, chiremba wako anogona kukupa mishonga yekuvandudza kuyerera kweropa uye BP.
Zvinhu zvakakosha zvekurangarira (Mharidzo Yekuenda Kumba)
Zvakanaka, saka ikozvino wava kunzwisisa zviri nani zvatiri kutaura nezvazvo, Orthostatic Hypotension. Hazvina chekunetseka nazvo, chirwere chinoitika kuvanhu vazhinji. Chinhu chakakosha ndechekuti:
- Kana ukanzwa dzungu kamwe kamwe kana kuti maziso ako asina kujeka, usazviregeredza. Tsvaga rubatsiro rwechiremba.
- Muka mangwanani-ngwanani, kunyanya kana uchimuka mangwanani, kana kuti kana uchimuka mushure mekugara kwenguva yakareba, tora nguva wotora chimwe chinhu kuti umire.
- Inwa mvura yakawanda. Izvi zvinogonawo kuitika kana usina mvura mumuviri.
- Taura nachiremba wako nezvemishonga yauri kutora. Mimwe mishonga inogonawo kukonzera chirwere ichi.
- Dzivisa nzvimbo dzinopisa uye kugeza mumvura inopisa.
- Chenjerera nekuti unogona kudonha. Kana uchinzwa dzungu, edza kugara pasi kana kurara pasi nekukurumidza.
Tinovimba kuti ruzivo urwu ruchakubatsira. Zvakanaka kubvunza chiremba kana uine matambudziko ehutano.
Kushaya simba kweropa mumuviri, kuderera kweropa mumuviri, dzungu, kupera simba, kuderera kweropa, BP, hutano hwemwoyo, hutano hwevakwegura, kushaya mvura mumuviri, migumisiro yemishonga, ruzivo rwehutano rweSinhala
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