Ingabe umfutho wegazi ophezulu uyawuthinta ubuchopho? Ake sifunde nge-hypertension encephalopathy!

Wake wezwa ngegama elithi "Hypertensive Encephalopathy"? Kungase kuzwakale njengegama elingathi sína ngoba linezinhlamvu eziningi, akunjalo? Kalula nje, lesi yisimo lapho ingcindezi emzimbeni wakho, okungukuthi, ingcindezi yegazi, ikhuphuka ngokuzumayo ize ifike ezingeni lapho ithinta khona ukusebenza kobuchopho bakho. Lokhu akuyona into yokudlala ngayo, ngoba lesi yisimo esidinga ukwelashwa okuphuthumayo. Namuhla, sizokhuluma ngalokhu ngokucacile nangendlela ongayiqonda.

Iyini ngempela i-Hypertensive Encephalopathy?

Kulungile, ake siqale kusukela ekuqaleni. Igama elithi "Hypertensive" lisho umfutho wegazi ophakeme. Igama elithi "Encephalopathy" lisho ushintsho noma ukuphazamiseka ekusebenzeni kobuchopho. Uma lokhu kokubili kuhlanganiswa, i-hypertensive encephalopathy ukuphazamiseka kwesikhashana kokusebenza kobuchopho ngenxa yomfutho wegazi ophakeme. Kulokhu, into eyinhloko ebonwayo ushintsho esimweni sakho sengqondo.

Manje usuyazi, njengoba igazi ligeleza emithanjeni yomzimba wethu, licindezela izinga elithile ezindongeni zaleyo mithambo. Yilokho esikubiza ngokuthi umfutho wegazi, noma "umfutho wegazi." Ngokuvamile, umfutho wegazi womuntu ophilile ungaphansi kuka-130/80 mmHg (amamilimitha e-mercury). Kodwa lapho lesi simo se-hypertensive encephalopathy siqala, umfutho wegazi ungafinyelela ku-220/130 mmHg. Ngezinye izikhathi, kuthiwa lesi simo singavela ngisho nasezingeni lika-160/100 mmHg.

Into ebaluleke kakhulu ukuthi lesi yisimo esiphuthumayo sezokwelapha, ngisho nesisongela impilo. Ngakho-ke, uma ubona izimpawu, kungcono ukufuna iseluleko sezokwelapha ngokushesha.

Sivame kangakanani lesi simo?

Eqinisweni, izimo eziphuthumayo zomfutho wegazi ophezulu zenzeka ngaphansi kwama-2% azo zonke iziguli eziza ezindlini zezimo eziphuthumayo esibhedlela. Kodwa-ke, i-hypertensive encephalopathy yenzeka cishe kuma-15%. Lokhu kusho ukuthi akuyona into eyenzeka kuwo wonke umuntu, kodwa uma kwenzeka, ukwelashwa okusheshayo kubalulekile.

Ziyini izimpawu? Ungazibona kanjani kusenesikhathi?

Kulesi simo, izimpawu aziveli ngokuzumayo. Zikhula kancane kancane. Ngakho-ke, kubaluleke kakhulu ukuqaphela lezi zimpawu.

Izimpawu zokuqala ezingaba khona yilezi:

• Ikhanda elibuhlungu: Lokhu kungaba ikhanda elibuhlungu elibi kakhulu. Kungase kuzwakale sengathi othile ucindezela ingaphakathi lekhanda lakho.
• Ukukhathala: Ukukhathala ngokweqile kuzwakala ngisho nangemva kokungenzi lutho.
• Isicanucanu: Ukuzizwa sengathi uzohlanza.
• Ukuhlanza: Ngezinye izikhathi kungase kube nokuhlanza.

Ngemuva kwalokho ungase ube nezimpawu ezithinta isimo sakho sengqondo:

Lezi zimpawu yizo ezisitshela ukuthi lesi simo sibi kakhulu.

• Ukudideka: Isimo sokungazi ukuthi ukuphi, isikhathi sini, noma ukuthi ungubani.
• Ukushintsha kobuntu: Izinguquko ezifana nokuthukuthela noma ukucasuka ngokuzumayo.
• Ukungaphumuli: Ukungakwazi ukuhlala endaweni eyodwa nokuhambahamba.
• Ukulahlekelwa umbono: Ukubona kungase kufiphale noma kulahleke ngokuphelele ngokuzumayo.
• Ukuquleka: Ukuqhaqhazela komzimba, okufana nokuqina komzimba.
• Ukulahlekelwa ingqondo: Ungase ulahlekelwe ingqondo bese uwe. Lesi yisimo esiyingozi kakhulu.

Uma wena noma othile omaziyo enesinye salezi zimpawu, kanye nomfutho wegazi ophakeme, shayela u-911 ngokushesha noma uye egumbini lezimo eziphuthumayo esibhedlela esiseduze. Isikhathi sibaluleke kakhulu ngesikhathi esinjengalesi.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Kalula nje, imbangela eyinhloko ye-hypertensive encephalopathy umfutho wegazi ophakeme kakhulu. Cabanga nje, kwenzekani uma uthumela amanzi ngokushesha kunokuba ipayipi lamanzi lingawaphatha? Ipayipi lingalimaza, akunjalo? Yileyo ndlela, umfutho wegazi ophakeme uqala ukulimaza imithambo yegazi ebucayi ebuchosheni. Bese kuthi uketshezi olufana namanzi luqale ukuvuza lusuka kuleyo mithambo yegazi luye ebuchosheni. Lokhu sikubiza ngokuthi i-cerebral edema. Yilapho umsebenzi wobuchopho uphazamiseka khona.

Ubani onamathuba amaningi okuthuthukisa lokhu? (Izici eziyingozi)

Abanye abantu banamathuba amaningi okuthola lesi simo. Ake sibheke ukuthi bangobani:

• Abantu abangazi ukuthi bane-high blood pressure: Abantu abaningi abazi nokuthi banayo yini ngoba abahloli i-blood pressure yabo. Abantu abanjalo bangangena ngokuzumayo esimweni esiyingozi njengalesi.
• Abantu abayeke ngokuzumayo ukuthatha imithi yomfutho wegazi: Kuyingozi kakhulu ukuyeka ukuthatha imithi wedwa ngaphandle kokubonisana nodokotela.
• Abantu abanesifo sezinso: Izinso ziyisitho esibalulekile esisiza ukulawula umfutho wegazi emzimbeni wethu. Uma unesifo sezinso, umfutho wegazi wakho ungaba mkhulu kakhulu.
• Abesifazane abathola umfutho wegazi ophakeme (i-eclampsia) ngesikhathi sokukhulelwa: Lesi futhi yisimo esidinga ukunakekelwa okukhulu.
• Abantu abathola ukwelashwa okuthile komdlavuza (i-chemotherapy): Eminye imithi yomdlavuza ingabangela ukwanda komfutho wegazi njengomphumela ongemuhle.

Yiziphi izinkinga ezingabangelwa yilokhu? Ingabe zinkulu kakhulu?

Yebo, uma lokhu kungaphathwa kahle, kungaba nezinkinga ezinkulu.

• Ukulimala kobuchopho okuhlala njalo: Uma kungelashwa ngokushesha, kungenzeka umonakalo ohlala njalo emaseli obuchopho.
• Ukuvuvukala kobuchopho: Njengoba sishilo ngaphambili, lena yinkinga eyinhloko.
• Ukulimala kwezinye izitho zomzimba: Umfutho wegazi ophezulu ungabangela ukwehluleka kwezinso, ukulahlekelwa umbono, kanye nokuhlaselwa yinhliziyo.
• I-Coma: Isimo sokungazi lutho, esifana nokulala ubuthongo obujulile.
• Ukulahlekelwa yimpilo:Uma kungelashwa, ukufa kungavela.

Yingakho lokhu kubhekwa njengesimo esiphuthumayo.

Odokotela bakuthola kanjani lokhu? (Ukuxilongwa)

Uma uya egumbini lezimo eziphuthumayo, odokotela bazoqala bahlole isimo sakho sengqondo kanye nomfutho wegazi. Bazokwenza ukuhlolwa okujwayelekile komzimba kanye nokuhlolwa kwezinzwa ukuze bahlole ukusebenza kobuchopho bakho. Bazophinde bakubuze ngomlando wakho wezokwelapha, noma yimiphi imithi oyiphuzayo njengamanje, kanye nanoma yimiphi imithi osanda kuyiyeka.

Ngaphezu kokulinganisa ingcindezi, kungenziwa ezinye izivivinyo eziningana ukuze kubonakale ukuthi ezinye izitho zonakalisiwe yini:

• Ukuhlolwa kwegazi: Hlola izinto ezifana nokusebenza kwezinso kanye namazinga kasawoti egazini.
• Ukuhlolwa kwe-ECG (i-Electrocardiogram): Bheka umsebenzi kagesi wenhliziyo.
• Ukuhlolwa kwe-X-ray esifubeni.
• I-Brain CT scan noma i-MRI scan: Ukuhlola ukuvuvukala noma ukopha ebuchosheni.

Konke lokhu kuyindlela odokotela abaxilonga ngayo ngokunembile i-hypertension encephalopathy.

Iphathwa kanjani? (Ukwelashwa)

Umgomo oyinhloko lapho welapha lokhu ukwehlisa umfutho wegazi wakho ophakeme ngokushesha, kodwa ngokuphephile, ngangokunokwenzeka.

Ukwelashwa okuphuthumayo

• Imithi yokwehlisa umfutho wegazi: Le mithi ayinikezwa ngomlomo ekuqaleni. Inikezwa nge-cannula encane efakwe emthanjeni engalweni. Lokhu kwenza kube lula ukulawula ingcindezi ngokunembile.
• Ukunakekelwa kwegumbi lokunakekela abagula kakhulu (ICU): Ngesikhathi uselashwa, odokotela nabahlengikazi bazokunakekela kahle. Lokhu kwelashwa kuvame ukwenziwa egunjini lokunakekela abagula kakhulu (ICU).
• Isivinini sokwehlisa umfutho wegazi: Cabanga ukuthi umfutho wegazi wakho ungama-220/120 mmHg. Bese kuthi, phakathi nehora lokuqala, umfutho wegazi wehle phakathi kuka-10% no-15%. Awehliswanga ngaphezu kuka-25% phakathi namahora angama-24. Ngoba, uma uwunciphisa kakhulu ngesikhathi esisodwa, imithambo yegazi ebuchosheni ayinaso isikhathi esanele sokuphulukiswa, futhi ezinye izinkinga ezifana nesifo sohlangothi zingase zivele. Ngakho-ke, umthamo womuthi wenziwa ngokucophelela okukhulu.
• Imithi yomlomo: Uma ingcindezi isilawulwa, imithi yomlomo ingaqalwa ngemva kwamahora angu-8 kuya kwangu-24.
• Ukwelashwa kokuquleka: Uma uhlangabezana nezimpawu ezifana nokuquleka, ungase unikezwe imithi yalokho isikhathi esifushane.

Ukuphathwa kwesikhathi eside

Ngisho nangemva kokuba usubuyile ekhaya usuka esibhedlela, udokotela wakho cishe uzokutshela ukuthi uqhubeke nokuthatha imithi yakho yomfutho wegazi (imithi yomlomo yokwehlisa umfutho wegazi). Le mithi ingakusiza ukuthi ulawule umfutho wegazi. Bazokutshela nokuthi wenze izinguquko ezimbalwa endleleni yokuphila:

• Ukulawula ukudla: Nciphisa usawoti (i-sodium), nciphisa ukudla okunamafutha.
• Ukuzivocavoca: Kuhle kakhulu ukuzivocavoca nsuku zonke.

Yimiphi imithi esetshenziswa ekwelapheni?

Kunezinhlobo eziningana zemithi yokwelapha umfutho wegazi ophakeme esebenza ngokushesha/eqala ngokushesha etholakalayo yokwelapha lesi simo. Isibonelo:

• I-Nicardipine
• I-Labetalol
• I-Hydralazine
• I-Fenoldopam
• I-Clevidipine
• I-sodium nitroprusside

Lena akuyona imithi ongayithatha nje. Inikezwa udokotela esibhedlela.

Ingabe ikhona imiphumela emibi yokwelashwa?

Yebo, kungase kube nemiphumela emibi lapho wehlisa umfutho wegazi ngokushesha kakhulu. Kodwa ungakhathazeki, odokotela bayakunaka lokho futhi.

• Ukukhathala
• Isiyezi, ukuzizwa unekhanda elithambile
• Ukuquleka
• Ukulimala kwezinso
• Isifo sohlangothi

Ngenxa yokuthi le miphumela emibi imbi kakhulu, uzoqashwa ngokucophelela phakathi nokwelashwa kwakho.

Ngizolulama ngokushesha kangakanani ngemva kokwelashwa?

Njengoba umfutho wegazi wakho uqala ukwehla, uzoqala ukuzizwa ungcono. Lokhu kuvame ukwenzeka zingakapheli amahora angama-24 kuya kwangu-48. Kodwa-ke, kuye ngokuthi i-encephalopathy ithinte kangakanani ukusebenza kobuchopho bakho, kungathatha izinsuku eziningana, noma ngisho namasonto, ukululama ngokuphelele. Uma kuvela izinkinga, isikhathi sokululama singase sibe side.

Iyini inhloso yalesi simo? (Indlela yokubuka)

Izindaba ezinhle ukuthi uma welashwa ngokushesha nangokufanele, imiphumela ye-hypertensive encephalopathy ingabuyiselwa emuva. Lokho kusho ukuthi, njengoba ingcindezi incipha, izimpawu ezibangelwa ukulimala kobuchopho ziyanyamalala kancane kancane. Kodwa-ke, uma unezinye izifo ezihambisanayo kanye nomfutho wegazi ophakeme, kungenzeka kakhulu ukuthi ube nezinkinga. Yingakho odokotela bezokuqapha eduze ngesikhathi sokwelashwa.

Ngemva kokwelashwa ngalesi simo, udokotela wakho uzohlola umfutho wegazi lakho njalo. Bheka ukuthi umfutho wegazi wakho ulawulwa kahle kangakanani ngemithi oyiphuzayo. Uma kungenzeka, thola i-blood pressure monitor ekhaya bese uqopha umfutho wegazi lakho njengoba udokotela wakho ekutshela. Uma unemiphumela emibi, tshela udokotela wakho . Ungalokothi uyeke ukuthatha imithi yakho yomfutho wegazi ngaphandle kweseluleko sikadokotela wakho.

Lokhu akukwazi yini ukuvinjelwa? Yini engenziwa?

Nakuba kungenakuvinjelwa ngokuphelele, unganciphisa kakhulu le ngozi ngokulawula umfutho wegazi lakho. Nazi ezinye izinto ongayenza ukuze wenze lokhu:

• Yidla ukudla okunempilo: Yidla izithelo nemifino eminingi. Yehlisa amafutha, usawoti kanye noshukela.
• Nciphisa usawoti odliwayo: Yidla ngaphansi kwamagremu amabili kasawoti ngosuku.
• Ukuvivinya umzimba njalo: Okufana nokuhamba okungenani imizuzu engama-30 ngosuku.
• Gwema ukusebenzisa imikhiqizo kagwayi: Yeka ukubhema ugwayi ngokuphelele.
• Ukulawula ukucindezeleka: Izinto ezifana nokuzindla kanye ne-yoga zingasiza.
• Ukunciphisa ukusetshenziswa kotshwala.
• Ukuthatha imithi yomfutho wegazi oyinikezwe udokotela ngesikhathi esifanele.

Kufanele ngimbone nini udokotela?

Uma une-high blood pressure, kubalulekile ukubona udokotela wakho njalo ukuze ayohlolwa. Udokotela wakho uzokunikeza ukwelashwa okufanele futhi aqaphe ukuthi kukuthinta kanjani. Khumbula, ungayeki ukuthatha imithi yakho ngaphandle kweseluleko sikadokotela wakho. Uma uthola izimpawu ezintsha noma imiphumela emibi, tshela udokotela wakho .

Kufanele uye nini esibhedlela ngokushesha? (ETU)

Uma unezimpawu ze-hypertensive encephalopathy esixoxe ngazo ngaphambilini (njengekhanda elibuhlungu kakhulu, ukudideka, ukubona okufiphele, ukuxhuzula), shayela u-911 noma uye egumbini lezimo eziphuthumayo esibhedlela esiseduze ngokushesha. Umfutho wegazi ophakeme uyingozi futhi ungasongela impilo uma ungelashwa ngokushesha.

Yimiphi imibuzo ebalulekile okufanele uyibuze udokotela?

Uma uya kudokotela, kuwumqondo omuhle ukubuza le mibuzo:

• Ngingayilawula kanjani ingcindezi yegazi lami?
• Hlobo luni lokwelashwa olungincomayo?
• Ingabe ikhona imiphumela emibi kulezo zindlela zokwelapha?
• Yini okufanele ngiyigweme ukudla nokuphuza ukuze ngihlale ngiphilile?
• Yiziphi izinhlobo zokuzivocavoca okuphephile engingakwenza?

Umyalezo Wokugcina Wokuya Nasekhaya

Yiqiniso, ukulawula umfutho wegazi lakho akuwona umsebenzi olula. Ukugcina indlela yokuphila enempilo kudinga isikhathi, amandla, nokuzinikela. Kodwa, cabanga ukuthi isimo esifana ne-hypertensive encephalopathy, esibangelwa umfutho wegazi ophakeme, singaba yingozi kangakanani. Nakuba singelapheka uma selashwa ngokushesha, into engcono kakhulu ongayenza ukuyivimbela ngaphambi kokuba yenzeke. Ukuze wenze lokhu, sebenzisana nodokotela wakho ukuze ulawule kahle umfutho wegazi lakho. Ungayeki ukuthatha imithi yakho yomfutho wegazi ngaphandle kwemvume kadokotela wakho nganoma yisiphi isizathu. Impilo yakho isezandleni zakho!

I- Hypertensive Encephalopathy, umfutho wegazi ophakeme, izinkinga zobuchopho, umfutho wegazi ophakeme, ukwelashwa okuphuthumayo, ikhanda elibuhlungu, ukuxhuzula