Ingaba uxinzelelo lwakho lwegazi luyanyuka ngequbuliso? Masifunde ngengxaki ye-hypertension!

Ngaba wakha weva ngomntu one-high blood pressure ngequbuliso aze abaleke aye esibhedlele? Okanye ngaba wakha wanamava afanayo? Oku sikwenza ngokwezonyango ngokuthi yi-hypertension crisis okanye "i-Hypertensive Crisis". Le asinto yokudlala ngayo, kuba inokuba yingozi ebomini. Ngoko ke, masithethe ngale nto ngendlela ethe ngqo.

Yintoni le ngxaki yoxinzelelo lwegazi?

Ngamafutshane, oku kuthetha ukuba uxinzelelo lwakho lwegazi luba phezulu kakhulu ngequbuliso. Ngoku, makhe sijonge ukuba uxinzelelo lwegazi lomntu ophilileyo lufanele lube njani:

• Ixabiso eliphezulu (uxinzelelo lwe-systolic) : ngaphantsi kwe-120 millimeters ye-mercury (120 mm Hg)
• Ixabiso eliphantsi (uxinzelelo lwe-diastolic) : ngaphantsi kwe-80 millimeters ye-mercury (80 mm Hg)

Nangona kunjalo, ngeli xesha loxinzelelo lwegazi, uxinzelelo lwakho lwegazi luba ngolu hlobo:

• Ixabiso eliphezulu : 180 mm Hg okanye ngaphezulu, kunye/okanye
• Ixabiso eliphantsi : 120 mm Hg okanye ngaphezulu.

Le yingxamiseko yezonyango ! Ukuba uxinzelelo lwakho lwegazi lufikelela kula manqanaba, kuya kufuneka uye kwigumbi longxamiseko (ER) ngoko nangoko.

Amaxesha amaninzi, olu hlobo lwengxaki luyenzeka kubantu abasele benoxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu). Oko kukuthi, uxinzelelo lwabo luphezulu kunoluqhelekileyo nakubomi bemihla ngemihla. Ngokutsho kweengcali, phakathi kwe-1% kunye ne-2% yabantu abanoxinzelelo lwegazi oluphezulu banokuba nolu hlobo lwengxaki. Nangona kunjalo, kubalulekile ukukhumbula ukuba le meko inokwenzeka nakubantu abangazange babe neengxaki zoxinzelelo ngaphambili.

Kukho iintlobo ezimbini eziphambili zale nto.

Iingxaki ze-hypertensive zingahlulwa zibe ziintlobo ezimbini eziphambili:

1. Uxinzelelo lwegazi oluphezulu kakhulu : Kwimeko enjalo, uxinzelelo lwegazi lwakho luphezulu kakhulu, kodwa akukho zimpawu zomonakalo kwizitho zakho zangaphakathi (ezifana nentliziyo yakho, ingqondo, okanye izintso). Abanye oogqirha bakwabiza oku ngokuthi "uxinzelelo lwegazi olungalawulekiyo." Nokuba ligama lini na, eyona nto ibalulekileyo kukubuyisela uxinzelelo lwegazi lwakho esiqhelweni ngokukhawuleza.

2. Ingxaki yoxinzelelo lwegazi : Le yeyona meko iyingozi kakhulu. Apha, uxinzelelo lwakho lwegazi luba phezulu kakhulu kangangokuba lubangela umonakalo omtsha kwizitho zakho zangaphakathi, okanye luwenze mandundu umonakalo okhoyo. Umzekelo, amalungu anjengentliziyo, i-aorta, amehlo, ubuchopho, kunye nezintso angonakala. I-preeclampsia eqatha kunye ne-eclampsia, ezenzeka kubafazi abakhulelweyo, nazo ziwela kolu luhlu.

Usenokuba ukhe weva igama elithi "uxinzelelo olubi kakhulu." Yayiligama elalisetyenziswa ekuqaleni kwenkulungwane yama-20. Lalithetha umonakalo kwizintso namehlo obangelwa luxinzelelo lwegazi oluphezulu ngequbuliso. Abanye oogqirha basalisebenzisa eli gama xa bethetha "ngoxinzelelo oluphezulu kakhulu." Kodwa ngoku, igama elithi "uxinzelelo oluphezulu kakhulu" lisetyenziswa kakhulu kuba linentsingiselo ecacileyo.

Zithini iimpawu zale ngxaki yoxinzelelo lwegazi?

Iimpawu zixhomekeke ekubeni amalungu angaphakathi onakele okanye akunjalo.

Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu ngaphandle komonakalo welungu)

Ixesha elininzi, akukho zimpawu zibalulekileyo. Eyona ndlela yokwazi ukuba uxinzelelo lwakho lwegazi luphezulu kakhulu kukuluvavanya. Nangona kunjalo, ngamanye amaxesha unokufumana iimpawu ezifana nezi:

• Ukuziva uloyiko nokungakhululeki (ixhala)
• Intloko ebuhlungu kancinci
• Ukopha kancinci kwempumlo
• Ubunzima obuncinci bokuphefumla

Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi olunyukayo kunye nomonakalo wamalungu omzimba)

Kwimeko enjalo, iimpawu zinzima kuba amalungu angaphakathi emzimbeni onakele.

• Ukutshintsha kwesimo sengqondo, ukuziva udidekile
• Intlungu yesifuba okanye ukuziva uxinezelekile esifubeni
• Isiyezi
• Ukudumba, ingakumbi emilenzeni (i-edema)
• Ukubetha kwentliziyo
• Ukuphuma komchamo okuncinci kunesiqhelo
• Ukuxhuzula
• Intloko ebuhlungu nenganyamezelekiyo
• Iimpawu zestroke : Umzekelo, ukugoba ngequbuliso kwelinye icala lobuso, ukuthetha okungacacanga, okanye ukuphelelwa ngamandla ngequbuliso kwengalo okanye umlenze (kwelinye icala).
• Utshintsho lombono : Amehlo ayaqaqamba, ukulahleka kombono ngequbuliso, okanye ukubona okufipheleyo.

Xa ugqirha ekuxilonga, banokukhangela neempawu ezifana nezi:

• Ukudumba kwemithambo yegazi ye-jugular
• Ukuva izandi ezingaqhelekanga (ukurhawuzelela) xa umamele imiphunga
• Izandi zentliziyo ezintsha nezingaqhelekanga ezazingekho ngaphambili (ukugquma kwentliziyo)
• Ukonakala kwemithambo yegazi ngaphakathi kweliso (i-retinal membrane)
• Ubuthathaka obungaqhelekanga, obungalinganiyo obubangela ukurhanelwa kwestroke

Yintoni ebangela le ngxaki ye-hypertension?

Kukho izizathu ezahlukeneyo zoku:

• Esona sizathu siqhelekileyo kukuba awuzithathi ngokuchanekileyo amayeza akho oxinzelelo lwegazi, njengoko ugqirha wakho ekuyalele, kwaye ngexesha elifanelekileyo. Oku kunokwenzeka ngenxa yezizathu ezahlukeneyo (ukulibala, ukuphelelwa ngamayeza, ukungawathathi ngabom).
• Ukuyeka amayeza oxinzelelo lwegazi ngequbuliso.
• Iyeza elithile olisebenzisayo lisenokudibana nelinye iyeza (ubudlelwane beziyobisi).
• Isifo sezintso.
• Iingxaki ze-endocrine (iingxaki zehomoni).
• I-Preeclampsia okanye i-eclampsia luxinzelelo lwegazi oluphezulu oluvela ngexesha lokukhulelwa.
• Ukusetyenziswa kwezinto ezithile ezibangela umlutha (iziyobisi).
• Ukulimala kakhulu entloko (Ukulimala entloko).
• Umhlaza wobuchopho.
• Amanye amayeza owasebenzisayo kwezinye izifo.

Kukho iintlobo ezahlukeneyo zamayeza anokubangela ingxaki ye-hypertension:

• Iintlobo zeeSteroids
• Amanye amayeza okudakumba
• I-Cyclosporine
• I-Pseudoephedrine, inxalenye yamayeza omkhuhlane kunye nomkhuhlane

Ngubani osengozini enkulu yokuphuhlisa oku?

Usenokuba sengozini enkulu yokuba nale meko ukuba:

• Ukuba i-body mass index yakho iphezulu, oko kuthetha ukuba utyebile kakhulu .
• Ukuba uyindoda .
• Ezinye izifundo zamazwe ngamazwe zibonise ukuba abantu baseAfrika basengozini enkulu kancinci. Kodwa khumbula, le meko inokuchaphazela nabani na, walo naluphi na uhlanga.
• Ukuba ungumntu ongawathathi amayeza akho oxinzelelo lwegazi ngexesha .
• Ukuba usebenzisa iziyobisi ezivuselela ingqondo (umz. i-cocaine, i-amphetamines) ezinganikwanga ngugqirha.

Zeziphi iingxaki eziyingozi ezinokubangela oku?

Ukuba uxinzelelo luba phezulu ngendlela eyingozi ngale ndlela, lunokubangela iingxaki ezinkulu ezifana nezi:

• Ukusilela kwentliziyo ngequbuliso, ngokukhawuleza (ukusilela kwentliziyo ngokukhawuleza)
• Ukuzaliswa ngequbuliso kwemiphunga ngamanzi (i-acute pulmonary edema)
• Ukulahlekelwa ngumsebenzi wezintso ngequbuliso (ukungasebenzi kakuhle kwezintso)
• Ukukrazuka okanye ukugqabhuka komthambo wegazi omkhulu emzimbeni wakho (i-aorta) (ukuqhekeka komthambo wegazi)
• Ukopha igazi engqondweni (ukuphuma kwegazi ngaphakathi kwentloko)
• Ukuhlaselwa yintliziyo kwenzeka ngenxa yokuncipha kokuhamba kwegazi entliziyweni.
• I-ischemic stroke yenzeka ngenxa yokuncipha kokuhamba kwegazi ukuya engqondweni.
• Ukungasebenzi kakuhle kwengqondo okwethutyana (i-hypertensive encephalopathy)

Zonke ezi zinto zingabeka ubomi esichengeni. Yiyo loo nto sithi lumka ngoxinzelelo lwakho lwegazi.

Oogqirha bayixilonga njani le meko?

Ugqirha uza kuqala alinganise uxinzelelo lwegazi lwakho kuzo zombini iingalo ukuze abone ukuba unengxaki yoxinzelelo lwegazi na. Ukongeza, uza kubuza ngembali yakho epheleleyo yezonyango (ezifana nezifo zangaphambili kunye namayeza owasebenzisayo), athethe nawe ngeempawu zakho, aze enze uvavanyo olupheleleyo lomzimba. Kunokufuneka ezinye iimvavanyo ukuze kuchongwe unobangela.

Iindidi zovavanyo ezinokwenziwa:

• Uvavanyo lwegazi (ukujonga izinto ezifana nokusebenza kwezintso kunye namanqanaba etyuwa)
• Uvavanyo lomchamo
• Umcu we-``EKG/ECG'' ojonga ukusebenza kombane kwentliziyo
• Uvavanyo lweFundoscopic (ukujonga umonakalo kwimithambo yegazi engaphakathi kweliso)
• Uvavanyo lwe-neurological
• Iskeni yentliziyo nge-ultrasound (`Transthoracic echocardiogram`)
• I-CT scan yesifuba nentloko

Ukuba kukho iimpawu zomonakalo omtsha kwizitho zakho zangaphakathi, ugqirha uya kuyibiza ngokuba "yingxamiseko yehypertension", kwaye ukuba azikho ezo mpawu, kuya kuba "yingxamiseko yehypertension."

Inyangwa njani le ngxaki yoxinzelelo lwegazi?

Oku kunyangwa kwigumbi likaxakeka esibhedlele . Oogqirha baza kukunika amayeza baze behlise uxinzelelo lwakho lwegazi luye kwinqanaba elikhuselekileyo.

• Ukuba awunazo iimpawu zomonakalo wangaphakathi kwilungu lomzimba (oko kukuthi, ungxamiseko lwegazi), unokukwazi ukuya ekhaya ngaloo mini inye. Kodwa uza kuthunyelwa ekhaya namayeza oza kuwasela ekhaya.
• Nangona kunjalo, ukuba une-"hypertension emergency" (umonakalo wamalungu omzimba), kuya kufuneka uhlale kwigumbi lokhathalelo oluphezulu (ICU) lesibhedlele kangangeentsuku ezimbalwa. Apho, oogqirha baya kukunika amayeza e-intravenous (IV) kwaye baya kujonga uxinzelelo lwakho lwegazi rhoqo.

Iqela lakho lezonyango liza kugqiba ukuba uxinzelelo lwakho lwegazi kufuneka lwehliswe ngokukhawuleza kangakanani. Kuya kuxhomekeka kwezinye iimeko zempilo onazo. Khumbula, ngamanye amaxesha ukwehlisa uxinzelelo lwakho lwegazi ngokukhawuleza kunokubangela ukuba amalungu akho kunye nezicubu zakho zilahlekelwe kukuhamba kwegazi. Ngoko ke, kudla ngokuthatha iiyure ezingama-24 ukuya kuma-48 ukuba uxinzelelo lwakho lwegazi lwehliswe.

Nangona kunjalo, ukuba uneemeko ezikhethekileyo, ezinje ngokuqhaqha kwe-aorta, i-preeclampsia enzima, okanye i-eclampsia, oogqirha baya kunciphisa uxinzelelo lwakho lwegazi ngokukhawuleza. Kwiimeko ezinjalo, iingenelo zokunciphisa uxinzelelo lwakho lwegazi ngokukhawuleza zingaphezulu kakhulu kuneengozi ezincinci.

Amanye amayeza asetyenziswa koku yi `(Captopril)`, `(Clevidipine)`, `(Clonidine)`, `(Esmolol)`, `(Hydralazine)`, `(Labetalol)`, `(Nicardipine)`, `(Nifedipine)`, `(Nitroglycerin)` kunye ne `(Nitroprusside)`. Ugqirha wakho uya kukhetha amayeza afanelekileyo kuwe ngokusekwe kwimeko yakho, amanye amayeza owasebenzisayo, kunye nempilo yakho iyonke.

Ndifanele ndimbone nini ugqirha?

Ukuba uxinzelelo lwakho lwegazi luyi-180/120 mm Hg okanye ngaphezulu, fowunela ku-1990 (inombolo yongxamiseko) ngoko nangoko, okanye uye kwigumbi longxamiseko elikufutshane. Ufuna unyango olukhawulezileyo!

Emva kokuba unyangelwe ingxaki yoxinzelelo lwegazi oluphezulu ngolu hlobo, bonana nogqirha wakho oqhelekileyo. Usenokugqiba ekubeni atshintshe umthamo wamayeza akho oxinzelelo lwegazi okanye ongeze amayeza amatsha. Uza kuthetha nawe malunga notshintsho ekufuneka ulwenze kubomi bakho bemihla ngemihla (njengokutya kunye nokuzilolonga). Umzekelo, banokukucebisa ukuba utye ukutya okunetyuwa encinci kunye neziqhamo nemifuno eninzi (njengokutya kwe-'DASH') kwaye wenze umthambo imihla ngemihla.

Ndingalindela ntoni xa le meko isenzeka?

Ingxaki yoxinzelelo lwegazi luphawu olubalulekileyo lwesilumkiso sokuba uxinzelelo lwakho lwegazi alulawulwa kakuhle. Ugqirha wakho angakunceda wehlise uxinzelelo lwakho lwegazi kwaye alugcine lukwinqanaba elifanelekileyo. Eyona nto ibalulekileyo kukugcina amadinga akho kwaye uthathe amayeza akho njengoko emiselwe.

Kuqhelekile ukuba noloyiko kwaye uxhalabe xa usiva igama elithi "ingxaki." Usenokucinga, "Ngaba uxinzelelo lwam lwegazi luya kuze lunyuke ngolu hlobo kwakhona?" Okanye, "Le ngxaki yoxinzelelo lwegazi oluphezulu iya kuyichaphazela njani impilo yam kunye nekamva lam?"

Khawucinge nje, zininzi izizathu zokuba uxinzelelo lwakho lwegazi lunyuke kangaka. Oogqirha bazama ukufumanisa ukuba zeziphi izizathu ezithile zomntu ngamnye. Wakuba uyazi unobangela ochanekileyo, ungathatha amanyathelo okunciphisa umngcipheko wokuba ingxaki efanayo iphinde yenzeke.

Oku kunokuthetha ukuseta isikhumbuzo kwifowuni yakho ukuze sikukhumbuze ukuba usele amayeza akho. Okanye, kunokuthetha ukuthetha nogqirha wakho malunga namanye amayeza owathathayo uze uwalungise ukuba kuyimfuneko. Khumbula, inyathelo ngalinye elincinci olithathayo ukulawula uxinzelelo lwakho lwegazi ngoku linokunceda kakhulu ekunciphiseni umngcipheko wakho wokuba neengxaki zempilo ezinzulu kwixesha elizayo.

Okokugqibela, ezona zinto zibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

• Yazi amaxabiso akho oxinzelelo lwegazi: Luthini uxinzelelo lwakho lwegazi oluqhelekileyo? Yazi kakuhle ukuba yintoni ebangela imeko engxamisekileyo (180/120 mm Hg okanye ngaphezulu).
• Sela amayeza akho ngokuchanekileyo: Ukuba ugqirha wakho ukunike amayeza oxinzelelo lwegazi, qiniseka ukuba uwathatha ngexesha elifanelekileyo nangedosi efanelekileyo. Musa ukulibazisa usuku olunye.
• Qaphela iimpawu ezilumkisayo: Ukuba ufumana iimpawu ezifana nentloko ebuhlungu kakhulu, iintlungu zesifuba, ubunzima bokuphefumla, utshintsho lombono, intetho engavakaliyo, okanye ukuphulukana nemilenze, oko kusenokuba yimeko embi kakhulu.
• Funa ingcebiso kagqirha ngoko nangoko: Ukuba ufumana naziphi na iimpawu ezingentla, okanye ukuba uxinzelelo lwakho lwegazi luyi-180/120 mm Hg nangaphezulu, musa ukuchitha ixesha kwaye funa ingcebiso kagqirha ngoko nangoko. Yiya esibhedlele okanye utsalele umnxeba ku-1990.
• Utshintsho kwindlela yokuphila: Ukutya okunempilo (ukutya okunetyuwa encinci, ioyile encinci, kunye neswekile encinci), ukuzilolonga rhoqo , ukuphepha ukutshaya, kunye nokunciphisa ukusetyenziswa kotywala kunokunceda kakhulu ekulawuleni uxinzelelo lwakho lwegazi.

Ndiyathemba ukuba olu lwazi luluncedo kuwe. Khumbula, impilo yakho isezandleni zakho. Yinyamekele!

Uxinzelelo lwegazi oluphezulu , uxinzelelo, imeko kaxakeka, ingxaki yoxinzelelo lwegazi, iimpawu, unyango, isifo sentliziyo