Ngaba nawe usela amayeza oxinzelelo lwakho lwegazi , kodwa awehli? Mhlawumbi ugqirha wakho uthi, "Nasemva kokukunika iintlobo ezahlukeneyo zamayeza , uxinzelelo lwakho lwegazi aluyi kwehla." Ngamanye amaxesha, nokuba utshintsha kangakanani indlela ophila ngayo, ulawule ukutya kwakho , kwaye uzilolonga, uxinzelelo lwakho lwegazi lusenokuba phezulu. Ngamaxesha anje, sifanele sicinge ukuba unobangela unokuba yingxaki kwizintso. Namhlanje siza kuthetha ngemeko enjalo.
Ngamafutshane, yintoni i-renovascular hypertension?
Nangona eli gama livakala liyinkimbinkimbi kancinci, ibali lilula kakhulu. I-Renovascular Hypertension luxinzelelo lwegazi oluphezulu olubangelwa yingxaki kwizintso zakho.
Cinga ngale ndlela. Izintso zezinye zezitho ezibalulekileyo emzimbeni wethu. Umsebenzi wazo ophambili kukucoca igazi nokususa inkunkuma njengomchamo . Ukuze zenze lo msebenzi ngokufanelekileyo, izintso zifuna igazi elinomlinganiselo ofanelekileyo. Imithambo yegazi ephambili ( imithambo yegazi ) ethwala igazi izise ezintsoni ibizwa ngokuba yi-'renal arteries'.
Ngoku khawucinge nje ukuba ngesizathu esithile le mithambo yegazi iyancitshiswa okanye inciphe kancinci kancinci. Njengombhobho wamanzi ocinezelwa phakathi. Kwenzeka ntoni ke ngoko? Ubungakanani begazi elifikelela kwizintso buyancipha.
Xa ukuhamba kwegazi kwehla ngolu hlobo, izintso zethu ezikrelekrele zicinga, “Owu, uxinzelelo lwam lwegazi luphantsi emzimbeni wonke, yiyo loo nto ndifumana igazi elincinci.” Ngoko ke, kuba zifuna ukwenza umsebenzi wazo ngokufanelekileyo, zithatha amanyathelo okunyusa uxinzelelo lwegazi emzimbeni. Ukuze zenze oko, zivuselela inkqubo yehomoni emzimbeni. Ngokwezonyango, oku sikubiza ngokuba yi-RAAS (Renin-Angiotensin-Aldosterone System) . Xa le nkqubo yehomoni isebenza, imithambo yegazi emzimbeni wonke iyaxina, kwaye uxinzelelo lwegazi luyaphakama.
Ngamafutshane, kuba igazi lingangeni ngokwaneleyo ezintsoni, izintso ngokwazo zinyusa uxinzelelo emzimbeni wonke. Oku kubizwa ngokuba yi-renovascular hypertension.
Oku akufani noxinzelelo lwegazi oluqhelekileyo. Oku kuwela kudidi olubizwa ngokuba yi-secondary hypertension. Oko kukuthi, uxinzelelo lwegazi oluphezulu olubangelwa yenye imeko yezonyango.
Zithini iimpawu zale meko? Siyicinga njani?
Eyona ngxaki inkulu apha kukuba akukho zimpawu zithile zesi sifo. Oko kuthetha ukuba usenokungaqapheli nto yahlukileyo. Nangona kunjalo, xa ugqirha ejonga imbali yakho yezonyango kunye namayeza owasebenzisayo, unokufumana ezinye iimpawu. Ezi zizinto ezenza ugqirha acinge ukuba oku kuya kwenzeka.
Makhe sibone ukuba zeziphi ezo zikhokelo.
| Uphawu olurhanelayo | Ingcaciso elula |
|---|---|
| Ukuqala koxinzelelo kwiminyaka engaqhelekanga | Uxinzelelo lwegazi oluphezulu ludla ngokuvela ngequbuliso ngaphambi kokuba ufikelele kwiminyaka engama-30 okanye emva kweminyaka engama-50. |
| Ukwanda ngequbuliso koxinzelelo olwalulawulwa kakuhle | Uxinzelelo, olwalulawulwa kakuhle ngamayeza ixesha elide, ngequbuliso lwanda lwaya kwinqanaba elingalawulekiyo. |
| Ukungaphumeleli ukuphendula kumayeza | Ugqirha unike amayeza ahlukeneyo oxinzelelo lwegazi (amathathu nangaphezulu), kodwa uxinzelelo lwegazi aluzange lwehle. Oku sikubiza ngokuba yi-'resistant hypertension'. |
| Ingxaki yoxinzelelo lwegazi | Ukunyusa uxinzelelo lwegazi ngokuphindaphindiweyo ukuya kumanqanaba ayingozi (umz., ngaphezu kwe-180/120 mmHg). |
| Ukudumba kweMiphunga okuKhawulezayo | Amatyala aliqela olwelo olukhawulezileyo nolungachazwanga oluzalisa imiphunga. |
| Ukufakwa kwamafutha kwezinye imithambo yegazi | Ukuba nembali yokugcwala kwamafutha (i-plaque) kwimithambo yegazi yentliziyo, intamo, okanye imilenze. |
| Ukungasebenzi kakuhle kwezintso | Ukwehla kancinci kancinci kokusebenza kwezintso ngaphandle kwesizathu esinye esibonakalayo. |
| Isandi esikhethekileyo esiviwa ngugqirha (Bruit) | Xa ugqirha ebeka i-stethoscope esiswini sakho, uva isandi esithi "swooshing" njengoko igazi lihamba ngemithambo yegazi evalekileyo. |
Kutheni oku kusenzeka? Zithini izizathu eziphambili?
Eyona nto ibangela ukuvaleka kwemithambo yegazi ekhokelela kwizintso yimeko ebizwa ngokuba yi -renal artery stenosis . Oku kuthetha ukuba imithambo yegazi ekwizintso iyancipha. Kukho izizathu ezibini eziphambili zoku.
1. I-Atherosclerosis: Le yeyona nto ixhaphakileyo. Ngamafutshane, kukuncitshiswa kancinci kwemithambo yegazi ngenxa yokuqokelelana kwamafutha kunye ne-cholesterol (ebizwa ngokuba yi-'plaque') ngaphakathi kweendonga zemithambo yegazi. Oku kuxhaphake kakhulu xa umntu ekhulile, enesifo seswekile, enesifo se-cholesterol ephezulu, kwaye etshaya.
2. I-Fibromuscular Dysplasia (FMD): Le yimeko engaqhelekanga. Yenzeka xa iiseli (izihlunu kunye neeseli ezine-fibrous) ezindongeni zemithambo yegazi zikhula ngendlela engaqhelekanga, nto leyo ebangela ukuba imithambo yegazi inciphe kwiindawo ezithile. Le meko ixhaphake kakhulu kubasetyhini abaselula.
Ukongeza kwezi zizathu zimbini ziphambili, kunokubakho nezinye izizathu ezingaqhelekanga.
| Izizathu ezingaqhelekanga | Ingcaciso elula |
|---|---|
| I-Vasculitis | Imithambo yegazi iba buthathaka ngenxa yokudumba. |
| I-Aneurysm yemithambo yezintso | Ubuthathaka bodonga lomthambo wezintso, okubangela ukuba ludumbe njengebhaluni. |
| Uxinzelelo oluvela kwithumba | Ithumba elenzeka kufutshane nezintso okanye umthambo wegazi, nto leyo ebangela uxinzelelo ngaphandle komthambo wegazi. |
| Ukulimala (i-Fibrosis) okubangelwa lunyango lwemitha | Emva kokufumana unyango lwemitha kwimeko efana nomhlaza, imithambo yegazi kuloo ndawo iyaqina, ibe namanxeba, ize ivaleke. |
Ziziphi iingxaki ezinokwenzeka ukuba oku akunanzwa?
Njengalo naluphi na uhlobo loxinzelelo lwegazi oluphezulu, le meko inokukhokelela kwiingxaki ezinkulu ukuba ayilawulwa ixesha elide.
- Umonakalo wentliziyo: Uxinzelelo lwegazi oluphezulu ixesha elide lunokubangela ukuba intliziyo isebenze nzima, nto leyo ekhokelela kwiimeko ezinje ngokutyeba kwemisipha yentliziyo, ukuhlaselwa yintliziyo, kunye nokungasebenzi kakuhle kwentliziyo.
- Umonakalo ongakumbi kwizintso: Izintso, esele zinokuhamba kwegazi okunciphileyo, zinokonakala ngakumbi luxinzelelo oluphezulu, nto leyo ekhokelela ekungasebenzini kwezintso.
- Ukonakala kwamehlo: Ukonakala kwemithambo yegazi ebuthathaka esweni kunokukhokelela ekulahlekelweni kokubona (isifo se-retinal).
- Istroke: Ukonakala kwemithambo yegazi ekhokelela ebuchotsheni kwandisa umngcipheko westroke.
Ugqirha uyifumana njani kanye kanye le nto?
Ukuba ugqirha wakho uyayikrokrela le meko, uza kusebenza njengomcuphi, eqokelela izikhokelo zokufikelela kwisigqibo. Le nkqubo ibandakanya amanyathelo aliqela abalulekileyo.
1. Uvavanyo lomzimba: Ugqirha uza kukuhlola, ingakumbi ukubeka i-stethoscope esiswini sakho ukujonga isandi 'se-bruit' esikhankanyileyo ngaphambili.
2. Ukubuza ngembali yakho yezonyango: Uza kubuzwa imibuzo emininzi, efana neminyaka owaba noxinzelelo lwegazi oluphezulu, nokuba kukho umntu kusapho lwakho onalo, ngawaphi amayeza owasebenzisayo, kunye nokuba unazo naziphi na ezinye izifo.
3. Uvavanyo olukhethekileyo: Kuya kufuneka kwenziwe uvavanyo oluninzi ukuqinisekisa ukurhanelwa.
- Uvavanyo lwegazi: Jonga ukusebenza kwezintso (i-creatinine, i-eGFR) kunye namanqanaba eehomoni kwinkqubo ye-RAAS.
- Uvavanyo lomchamo: Jonga izinto ezifana neeproteni kumchamo.
- I-Kidney Ultrasound Doppler: Olu lolona vavanyo lubalulekileyo. Lulinganisa isantya sokuhamba kwegazi kwimithambo yegazi ethwala igazi ukuya ezintsoni kwaye lunokubona ngokuchanekileyo naziphi na izithintelo.
- Ezinye iiskeni: Kwezinye iimeko, iiskeni ezintsonkothileyo ezifana ne-CT angiogram okanye i-MR angiogram zinokucetyiswa.
Kulungile, masithethe ngonyango.
Xa sele ifunyenwe le meko, akukho nto yokoyika. Kukho unyango olusebenzayo loku. Injongo ephambili yonyango kukulawula uxinzelelo lwegazi nokukhusela izintso kunye nezinye izitho zomzimba.
Amayeza (amayeza)
Kwiimeko ezininzi, le meko inokulawulwa kakuhle ngamayeza. Ukongeza kumayeza anikwa uxinzelelo lwegazi oluqhelekileyo, ugqirha uya kunika amayeza ahambelana nale meko.
- Ii-Angiotensin-Converting Enzyme (ACE) Inhibitors: Umzekelo, amayeza afana ne-Enalapril kunye ne-Lisinopril.
- Ii-Angiotensin Receptor Blockers (ARBs): Umzekelo, amayeza afana neLosartan kunye neTelmisartan.
Zombini ezi ziyobisi zilawula ukusebenza kwenkqubo ye -RAAS hormone esithethe ngayo ngaphambili kwaye zithintela uxinzelelo lwegazi ukuba lunganyuki.
Kubalulekile: Xa uqala la mayeza, kunokubakho impembelelo encinci ekusebenzeni kwezintso. Ke ngoko, ugqirha wakho uza kuphinda ajonge ukusebenza kwezintso zakho emva kweveki okanye ezimbini emva kokuqala la mayeza. Ungakhathazeki, yinkqubo eqhelekileyo.
Ukongeza, amanye amayeza afana ne-cholesterol-lowing statins, i-calcium channel blockers, kunye ne-diuretics anokunikwa ngokuxhomekeke kwimeko yakho.
Iinkqubo ekufuneka zenziwe ukuba kuyimfuneko
Ngamanye amaxesha kunzima ukulawula uxinzelelo lwegazi lakho ngamayeza kuphela. Okanye ukuba umthambo wegazi uvalekile kakhulu, ugqirha wakho unokucebisa ukuba kwenziwe inkqubo ekhethekileyo.
- I-Renal Artery Angioplasty kunye ne-Stenting: Oku kufana ne-angioplasty yemithambo yegazi entliziyweni. Ityhubhu encinci ifakwa ngomthambo osemlenzeni okanye engalweni ize iqhubekele phambili kwi-renal artery evalekileyo. Emva koko ityhubhu ivuthelwa ngebhaluni encinci ukuze yandise indawo evalekileyo. Ukuthintela ukuba ingavaleki kwakhona, ityhubhu encinci efana ne-mesh (i-stent) ifakwa kuloo ndawo.
- Ukususwa kwezintso: Olu lunyango olutsha. Lusebenzisa amandla obushushu okanye e-ultrasound ukunciphisa umsebenzi wemithambo-luvo ejikeleze umthambo wezintso. Le mithambo-luvo yiyo ethumela imiqondiso engqondweni ukuze yonyuse uxinzelelo. Ngoko ke ngokunciphisa umsebenzi wayo, uxinzelelo lwegazi lunokuncipha.
Utyando
Utyando aluxhaphakanga. Utyando lusetyenziswa kuphela xa ulwakhiwo lwemithambo yegazi lunzima kakhulu ukuba iinkqubo ezifana ne-angioplasty zingenziwa, okanye ukuba ezo ndlela ziyasilela.
- Ukuvuselelwa Kwemithambo Yezintso Ngotyando: Oku kukwabizwa ngokuba lutyando lwe-renal bypass.Apha, ugqirha usebenzisa iqhekeza lomthambo wegazi elithathwe kwenye inxalenye yomzimba wakho okanye ityhubhu yokwenziwa ukuze enze indlela entsha (yokudlula) yokuthutha igazi liye ezintsoni, idlula inxalenye evalekileyo.
Kwenzeka ntoni emva konyango?
Musa ukucinga ukuba yonke into iphelile wakuba uqalile unyango. Kubalulekile ukuya kwintlanganiso yokulandelela njengoko uyalelwe ngugqirha wakho.
Kwezi kliniki, uGqr.
- Balinganisa uxinzelelo lwakho lwegazi baze babone ukuba unyango luphumelele kangakanani.
- Uvavanyo lwegazi lwenziwa ukujonga ukusebenza kwezintso.
- Ukuba kuyimfuneko, umlinganiselo wamayeza akho uya kutshintshwa okanye kongezwe amayeza amatsha.
Ezi ntlanganiso zibaluleke kakhulu nakuwe. Eli lithuba elihle lokubuza ugqirha nayiphi na imibuzo okanye iinkxalabo onokuba nazo.
Ngaba le meko inganyangeka ngokupheleleyo?
Uxinzelelo lwegazi oluhlaziyiweyo yimeko enokunyangwa . Oko kuthetha ukuba ngamayeza afanelekileyo, kwaye ukuba kuyimfuneko, amanyathelo afanelekileyo, uxinzelelo lwakho lwegazi lunokwehliswa luye kwinqanaba elisempilweni. Kodwa kuchanekile ngakumbi ukuthi "lunokulawulwa kakuhle" kunokuba "lunyangeke ngokupheleleyo."
Khumbula, igalelo lakho libaluleke kakhulu kolu hambo. Nokuba unyango lukagqirha lulungile kangakanani na, ukuba awenzi izinto ezilungileyo kuwe, iziphumo aziyi kuba zintle.
- Sela amayeza akho ngexesha: Sela amayeza akho njengoko ugqirha wakho ekuyalele, ungalibali usuku olunye.
- Lumka ukutya kwakho: Nciphisa ukutya okunetyuwa eninzi, ioyile, kunye neswekile. Ukuba ugqirha wakho ucebisa ukutya okukhethekileyo okufana nokutya kwe-DASH , kulandele.
- Ukuzilolonga: Buza ugqirha wakho ukuba zeziphi izithambo ezifanelekileyo emzimbeni wakho kwaye kufuneka uzenze ixesha elingakanani, uze wenze ngokufanelekileyo.
Wakuba uyazi ukuba le yimbangela yoxinzelelo lwakho lwegazi oluphezulu olungalawulekiyo, uya kuziva ukhululekile kakhulu. Kuba ngoku ekubeni usazi isizathu, ungafumana unyango olufanelekileyo. Ngoko ke, ukuba unemibuzo malunga noku, ungoyiki ukuthetha nogqirha wakho.
Umyalezo Wokuya Ekhaya
- Uxinzelelo lwegazi oluphezulu olungenakulawuleka nokuba kusetyenziswe amayeza amaninzi lusenokuba lubangelwa yingxaki yezintso.
- Isizathu esiphambili soku kukuncitshiswa kwemithambo yegazi ethwala igazi ukuya ezintsoni.
- Le meko ibeka umngcipheko wokulimala kwentliziyo, ingqondo kunye nezintso.
- Le meko ingachongwa ngokuchanekileyo ngovavanyo lokuskena.
- Akukho mfuneko yokoyika kuba kukho unyango olusebenzayo olufana namayeza kunye ne-angioplasty.
- Kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo kwaye uye kwiikliniki ngexesha.
Uxinzelelo lwegazi oluhlaziyiweyo, uxinzelelo lwegazi oluphezulu, uxinzelelo lwegazi oluphezulu, izintso, i-renal artery stenosis, uxinzelelo lwegazi oluphezulu, uxinzelelo lwegazi oluphezulu IsiSinhala, isifo sezintso IsiSinhala, isifo sezintso, unobangela woxinzelelo
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