ʻO kahi maʻi hypertension kahi maʻi. Kēia mau makahiki i hala ua loaʻa i ka hoʻohele pālahalaha ma waena o nā māhele āpau o ka heluna. ʻO ka maʻi, ka hōʻailona koʻikoʻi ka hoʻonui nui loa i ke kahe o ke koko ma muli o nā kumu he nui.
Ua hōʻike ka hōʻike o ka World Health Organization e pili ʻia ana ka hypertension ma kēlā me kēia kaona o ka honua.
No laila, ʻo ka pilikia o ka hopena a me ka mālama ʻana i kēia maʻi e lawe ʻia i ka mua. Pili ka mea i kēlā me kēia kanaka, a ʻike pinepine ʻia nā hōʻailona kūlohelohe i ka poʻe kahiko, akā aia kekahi holomua hewa ʻana - ʻoi aku ka ʻōpio o ka maʻi ʻuhane, ʻo ka hoʻopilikia ʻana i nā poʻe ma lalo o 30 a ʻoi aʻe paha.
Hoʻomaʻamaʻa pinepine nā poʻe i ka hōʻike ʻana o ka hōʻike kiʻekiʻe o ka piʻi a hiki i ka hoʻomaka ʻana o ka maʻi a hiki i ka wā hope, 3 a me 4. ʻO kēia kahi mau marginal i hōʻino loa. He aha ka helu 3 hypertension a hea mai lākou?
Hypertension a me hypertension
ʻO ka inoa ʻepekema ʻo kēia maʻi ka hypertension arterial, nā analogues i koe ko nā meaʻokoʻa wale nō a me ka like me nā manamana. ʻO nā ʻano ʻano ʻelua.
Hypertension (ʻo ke ʻano lapaʻau ka maʻa mua a koʻikoʻi paha hypertension pono) he ulu mau a hoʻonui lōʻihi loa i ke kahe koko o kahi ʻano ʻike ʻano genesis.
ʻO ke ʻano kēia, ʻaʻole i ʻike ʻia ka kumu o kēia pilikia i ka ʻepekema, a ua hoʻokumu wale nā mea a pau i nā kuhi wale ʻana.
Ke manaʻoʻiʻo nei aia i ka loko o ke kanaka he aneane he iwakālua mau genes i pili i ka hana o ke kahe o ke kahe koko. Ua maʻi kēia maʻi ma kahi o 90% o nā maʻi āpau. ʻO ka hoʻomaʻamaʻaʻana e hōʻoluʻolu i nā hōʻailona weliweli a hoʻopau i nā hopena.
ʻO ka lua, a me ka hypertension arterial hypertension, e hele mai me nā maʻi a me ka hana ʻole o ke keiki a ka hopena, nā mea kūpaʻa endocrine, ka wehe ʻana i ke kuhihewa a me ka hana hewa ʻana o ke kikowaena vasomotor o ka obullata medulla, hōʻeha a me ka pili ʻana i ka lāʻau lapaʻau, kāhea ʻia nō hoʻi iatrogen.
ʻO ka papa hope loa e pili ana i ka hypertension ma muli o ka hoʻohana ʻana i nā lāʻau hormonal i ka wā o ka hoʻomehana i ka wā menopause a i ʻole no ka hoʻohālikelike ʻana.
Pono e mālama i kēlā hypertension etiologically, ʻo ia hoʻi, e kāpae i ke kumu kumu, ʻaʻole hoʻi hoʻohaʻahaʻa i ke kaomi.
ʻO ka ʻatikala a me ka pathogenesis o ka hoʻomohalaʻana o ka maʻi
I ka wā o ka ʻenehana genetic, ʻaʻole ia he mea paʻakikī ke hoʻoholo ʻo ka hoʻoilina ʻo ia ke kumu nui i mua o ka piʻi ʻana o ka piʻi. He mea maʻamau paha inā ʻolelo nā mākua i ka hoʻomau mau o ke koko, a laila e hoʻoili ʻia ʻia ka maʻi iā ʻoe.
ʻO ka mea nui i ka mea nui, akā, ʻaʻole i ka maʻamau, ʻo ia ka ʻokoʻa o ka poʻe noho o ke kūlanakauhale - ka nui o ke kūlana kaumaha a me ke kiʻekiʻe o ke ola. Ua hōʻike ʻokoʻa ʻia i ka ʻepekema me ka nui o ka psychoemotional overloads, ua pau nā pūʻulu o nā neurons i waho o nā kaila neural aoao, kahi e alakaʻi ai i ka pale hewa ʻana o kā lākou hui kūlike. ʻO ka pōmaikaʻi i ke kuhikuhi o nā kikowaena hana e pili pū kekahi me ka piʻi o ke koko.
Hōʻike nā ʻōiwi i kēlā mau hui o ka poʻe i loaʻa ka nui aʻe o ka hopena o ka hypertension.
E pili ana kēia:
- E nā ʻōpio. Hoʻomaopopo ʻia ka maʻamau o kēlā me kēia kanaka ma luna o 50 mai kahi maʻi hypertension, ʻoiai inā ʻaʻole ia e manaʻo i nā hōʻailona mua. ʻO kēia ma muli o ka emi ʻana o ka elasticity o nā kīʻaha koko, ma muli o ko lākou mākaukau e kū ai i mua i ka ikaika o nā aʻa puʻuwai. Eia nō hoʻi, me ka nui o ka makahiki, ka piʻi ʻana o ka atherosclerosis o nā moku nui, e alakaʻi ai i ka neʻe ʻana o ko lākou lumen a me nā mea i kapa ʻia o ke ʻano neʻe o ke koko (e like me ke kūlohelohe o kahi mokulele) ma o kahi lua liʻiliʻi i ke kikowaena o ka pahu i hana ʻia i nā plika aila.
- Wahine wahine. Hōʻike nā haʻawina e loaʻa pinepine ana nā kaikamahine a me nā wahine i ka hypertension ma mua o nā kāne. ʻO ke kumu ke kumu ikaika ikaika hormonal, e hoʻonui ana i ka wā hapai, a nalo loa i ka wā e hele mai ai nā menopause. ʻO nā hua ʻEstrogens i hana ʻia e ka ovaries i ke koko kaomi haʻahaʻa, akā lanakila lākou i ka hapalua wale nō. Ke hoʻopau nei kā lākou hana, hoʻomaka nā hopohopo e pili ana i nā hōʻailona o ke koko kiʻekiʻe.
- ʻO ka hemahema o ka mineral. I kēia māhele hiki iā ʻoe ke koho i ka hoʻohui i nā meaʻai paʻakai, e hoʻonui ana i ka reabsorption o ka wai i loko o nā tubule o ke nephron a me ke kōkua i ka hoʻonui ʻana i ka nui o ke koko kahe, a me ka hoʻemi ʻana o ka calcium calcium. ʻO ia, ʻo ia ke kīleʻa maʻamau, pono no ka hana piha o ka myocardium. Inā ʻaʻole, hiki i nā arrhythmias a me ke kūleʻa arterial kiʻekiʻe, kahi e hiki ai ke hoʻonui i ke kaomi.
- ʻAkohila a me ka ulaula. Hōʻino maikaʻi ka maikaʻi ʻole iā lākou iho, e hōʻino hoʻi i nā ʻāpana kū i loko a me nā elastic o nā kahe koko, ke hoʻopiha nei i ko lākou hiki ke kūpono me ka lele a me ka ʻaelike i ka neʻe me ka nalu pulse. Ke hoʻomau mau nei nā hāhi koko sporadic ma muli o ka hana a ke kikowaena a me ka uahi pia i alakaʻi ai i ka hōʻino o ke kahena a me ka ʻimi kūleʻa.
Eia kekahi, ʻo kekahi o nā kumu i ke komo ʻana o ka momona a me ka maʻi diabetes. Hoʻopili loa ka luna momona me ka hana ʻole kino. Ke alakaʻi nei kēlā ʻano hypertonic i ke ala haʻahaʻa o ke ola, kona mau moku, ma muli o ka nele o ka ukana maʻamau, nalowale ko lākou neʻe ʻana a ʻaʻole hoʻi i pane aku i ka hoʻoponopono ʻana i ka pūnaehana autonomic.
Eia kekahi, hoʻonui ka nui o nā lipids atherogenic, e lele ma o ka endothelium o nā kīʻaha koko, e hoʻopilikia iā lākou.
Hoʻonui nui ʻia kēia dystrophy i ka diabetes mellitus, no ka mea ma muli o ka hana o ka kālaoa metabola o nā kalapona, ʻoi loa ka momona o ka momona a hoʻokaʻawale ʻia, ʻaʻole hiki ke hoʻopili a e neʻe i loko o ke koko.
Nā degere o ka hypertension arterial a me nā hopena hiki
Hoʻololi ka lāʻau lapaʻau i nā papa hana ʻehā o ka hypertension, kēlā me kēia me kahi ala kūikawā e pili ana i ka maʻi, mālama
Eia kekahi, aia he mau pūʻulu pōpilikia no ka hoʻomohala ʻana o nā ʻōpiopio o ka maʻi
Aia nā pūʻulu pilikia i ke alo ʻana o kekahi mau mea e hoʻopiʻi ana i ka papa o nā maʻi.
Hiki i ka papa helu haʻahaʻa o ka hypertension arterial i ke ʻano o ke koko kiʻekiʻe.
- Kākau 1 - systolic 140-159 / diastolic 90-99 mm RT. ʻAniā.
- Kākau 2 - systolic 160-179 / diastolic 100-109 mm RT. ʻAniā.
- Kākau 3 - systolic 180+ / diastolic 110+ mm RT. ʻAniā.
- Hypertension systolic Isolated - systolic 140+ / diastolic 90.
Mai kēia papa kuhikuhi ka mea i maopopo loa ka mea pōpilikia loa ka helu 3, ka nui iā ia ka puʻuwai kiʻekiʻe, mua o ka hopohopo mua-hypertensive. Hoʻoholo ʻia ke kaukaʻi e ka neʻe ʻana o ka pēpē maʻamau e like me ke ʻano ʻo Korotkov, akā ʻaʻole ia e lawe i nā hōʻike hōʻike maʻi. Ke hōʻike i nā loli i nā ʻōpala i pili loa i ka hoʻonui ʻana i ke koko (ke kumu ʻōpiopio i kapa ʻia) a me nā mea hiki ke hopena, ua hoʻomohala ʻia kahi papa ʻōlelo. Hoʻokomo kēia mau mea i ka lolo, nā pepona, nā pēpē, nā māmā. ʻO nā hōʻailona nui he hemorrhages i loko o ka parenchyma o ke kino me ke kaʻe ʻana o kāna hana a me ka hoʻomohala ʻana.
Kahi ala 1 - ʻaʻole i ʻike ʻia nā loli i nā huina target. ʻO ka hopena o kēlā hypertension ka hoʻihoʻi hou o ka mea maʻi me ka ala kūpono i ka mālama ʻana.
Papa 2 - inā liʻiliʻi kahi liʻiliʻi o ke kino, aia ka mea maʻi i kēia manawa o ka maʻi. Ma kēia kahua hoʻi, pono ia e hana i kahi loiloi o ka wahi i hoʻopili ʻia ai e nīnau i ka loea. ʻO ECG, echocardiography, ka nānā ʻana o ka maka no ka retinopathy i ke nānā ʻana i ke kālā (ʻo ka hōʻike ʻokoʻa a maʻalahi hoʻi e hōʻike i ka hōʻailona ma kēia manawa), kahi ʻike koko a me ka biochemical test, urinalysis.
Kūlana 3 - kahi kūlana e kū nei i ka hoʻomaka ʻana o kahi pilikia hypertensive. Kuhi ʻia ia ma ka loaʻa ʻana o nā lewa lehulehu a me nā konohiki o nā ʻāpana ʻehā ʻē aʻe. Hiki iā ia: nā ʻeha hemorrhagic a ischemic ma muli o ka angathyathy o nā kahe koko, encephalopathy o nā ʻano ʻano like ʻole, ka maʻi coronary artery (coronary heart heart) me nā hōʻike o ka angina pectoris (ʻeha ʻeha e hōʻeha ana i ka lima hema, ka ʻāʻī, ke kani), myocardial infarction me nā loli hou i ka necrotic a me nā mea ʻole - ʻO ka maʻi o ka maʻilerler, reperfusion syndrome a me nā haʻalulu cardiogenic. E hahai nō kēia e ka pōʻino i ka pale ʻana o ka renal, ma muli o ka proteinuria e hele mai ai, nā kaʻina o ka filtration a me ka reabsorption o ka plasma koko i ka nephron e ulu, a me ka hana ʻole ʻana o ka renal. E hoʻopilikia ʻia nā moku nui e ka mea e hiki mai ana, ka mea e hōʻike iā ia me ka aneurysm aortic, nui atherosclerosis, a me nā meaʻino aku i ka lāʻau coronary. ʻO ka retina he mea koʻikoʻi ka pili i ke koko koko kiʻekiʻe, ka mea i hōʻike ʻia e ka pōʻino o ke nerve optic a me ka hemorrhage intraocular. Pono kēia hana i nā hana hoʻoholo e uku ai i nā kaʻina luku me nā lāʻau lapaʻau.
ʻO ka papa hana 4 - kahi kūlana ʻoihana, ka mea, me ka hoʻomau no ka ʻoi aku i mua o ka hebedoma, e alakaʻi ana i ka maʻi mauʻu.
Eia kekahi, he nui nā hui kūliʻi no ka hoʻomohala ʻana o nā pilikia.
- mua, i ka manawa o ka hoʻokolokolo ʻana, ʻaʻohe mea hoʻopiʻi, a ʻo ka hopena o kā lākou hoʻomohala ma mua o 10 mau makahiki a hiki i 15%;
- ka lua - ʻekolu mau kumu, a ʻo ka piʻi ʻana o nā pilikia heʻoi aku i ka 20%;
- ʻo ke kolu - ka hōʻike ʻia o ka loaʻa o nā mea hou aʻe o ʻekolu mau mea, ʻo ka maʻi o ka hoʻopiʻi ʻia e pili ana i 30%;
- ka hāhā - ʻike ʻia ka pōʻino o nā kino a me nā ʻōnaehana, ʻoi ka loaʻa ʻana o ka hōʻeha ʻana o ka naʻau a me ka hōʻeha ʻana ma mua o 30%.
E pili ana i nā mea i kuhi ʻia, ʻike ia ka mea he hypertension o ka pae pae ʻekolu i pilikia 4. Ma nā huaʻōlelo maʻalahi, make ka maʻi.
Hoʻohana ʻia ka maʻi hypertension
Hoʻokomo ʻia ka maʻi hypertension grade 3 pilikia 4 e mālama pono i ka mālama ʻokoʻa a ʻaʻole e ae i ka lohi. ʻO nā hoʻopiʻi ka maikaʻi loa loa - hōʻeha puʻuwai, hōʻeha, hōʻemi ʻole i ka renal.
I mea e kali ai i ka pīhoihoi hypertensive, pono ʻoe e kāhea i kahi ʻōpio i ka wā hiki ke hiki i ke alo o nā hōʻailona weliweli nui - ke kumu systolic ma luna o 170, nā ʻōpū o nā puʻupuʻu nui, nausea ma muli o ke kaila o ka intracranial kiʻekiʻe (ma hope o ka luaʻi ʻana me kēlāʻano loiloi, ʻaʻole e hoʻēʻī ke ʻano). nā tinnitus ma muli o ke kahe o ke kahe, ke kuni ʻana i nā ʻeha ma hope o ka sternum, nāwaliwali o nā limu a me ko lākou huhū.
Malia paha kahi manaʻo o "goosebumps" ma lalo o ka ʻili, kahi hōʻino holomua i ka hoʻomanaʻo a me ka hoʻohaʻahaʻa i nā mākaukau naʻauao, ʻike maka ʻole.
I kēia ʻāina, nā hana kino, contraindicated pehu ka neʻe ʻana, hoʻomākaʻi ʻia nā mea maʻi e hoʻomanawanui i ka hana, hānau, hānau ka kaʻa.
ʻO nā loiloi o nā loea e hoʻohana i kahi nui o nā lāʻau lapaʻau, kēlā me kēia mea e pili ai i kāna māhele o ka kaula pathogenesis.
Hoʻomākaukau kālā no ka hui nui, i hoʻohana nui ʻia no ka hypertension:
- ʻO nā loina diuretika ka mea e poloka ai i ka Na + K + Cl- cotransporter ma ka ʻaoʻao kahakai o ka poni Henle nephron, kahi e hoʻemi ana i ka hoʻoulu ʻana o ka wai, ʻaʻole hoʻi ka wai i ka kahe koko, akā e hoʻopiʻi nui ʻia mai ke kino. ʻO ka nui o ke kahe e holo ai ke koko, a me ia me ke kahe koko. Aia nā waihona like me Furosemide (aka Lasix), Indapamide (ʻike ʻia ʻo Indap a ʻo Arifon), Hydrochlorothiazide. Hoʻohana pinepine ʻia lākou, no ka mea hiki ke ʻano hoʻohālikelike ʻia me nā kūmole.
- Nā māka hua Beta. Hoʻemi i ka hana o ka puʻuwai ke hoʻonui me ka pae 3 hypertension, ke kāohi ʻana i nā synapses adrenergic o ka myocardium. ʻO nā lāʻau lapaʻau o kēia hui kahi ʻo Anaprilin (Propranolol), Atenolol (Atebene), Cordanum, Metoprolol (aia kekahi ʻano o Spesicor, Corvitol a me Betalok), Nebivalol. Pono e hoʻohana pono i kēia mau lāʻau lapaʻau e like me ke kuhikuhi ʻana, no ka mea, he papa blocker ʻē aʻe i hiki ke alakaʻi i ka conduction impaired a automatism a me nā arrhythmias.
- ʻO Angiotensin-hoʻololi i nā inhibitor enzyme. Hoʻonui nui aʻe ʻo Angiotensin i ke kahe o ke koko, a inā e uhai ʻoe i kona hana i ke kiʻekiʻe o ka ʻōpala angiotensinogen, hiki iā ʻoe ke wikiwiki a kāpae i nā hōʻailona o ka hypertension grade 3, ʻoiai me ka pīpī. 4. ʻO nā mākaukau kaulana loa o ka pūʻulu ʻo Captopril (Kapoten), Kaptikena, Enap (Renitek), Lisinopril. Hoʻopaʻa paʻa ʻana i nā mea hoʻonaninikena neʻe me Losartan.
- Pākuʻi ʻia nā calcium calcium - Nifedipine a me Amlodipine - hōʻemi i ka ikaika o ka puʻuwai a me ka nui o ka pīhoihoi o ke koko, e hoʻohaʻahaʻa ai i ke koko.
Hiki ke pale aku i ka maʻi hypertension a me hypertensive ma ka home. ʻO ke kumu o ke ʻano he meaʻaiʻai ikaika ʻo ia ke ala nui o ka hopena therapeutic, ma ke ʻano o ka hoʻohana ʻana i ka papa paʻakai No. 10 e like me Pevzner.
Hoʻokomo pū ia me ka palaoa palaoa, nā ʻai momona haʻahaʻa, mau ipo momona huehū, nā hua kuke, nā kīʻaha waiū-ʻona, mau mea nunui. E noʻonoʻo e kaupalena i ka paʻakai paʻakai i 6 g i kēlā me kēia lā. ʻO nā ʻano hana hou he mau sedatives - valerian, motherwort, pepper mint, hawthorn.
ʻO ka stage 3 hypertension e wehewehe ʻia i ke wikiō ma kēia ʻatikala.
