Zviratidzo
Mumapfumbamwe makumi mapfumbamwe ematatu matambudziko asati aitika kwezvinetso, kukwirira kweropa kunonyanya kusaratidzwa. Dzimwe nguva, nehutachiona hwehutachiona (hukuru hwemhepo yakasimba), kuputika musoro, kushungurudza uye kusvinura kunogona kuitika. Kana pasina kurapa, kuwedzera kweropa kunokonzera kukuvadza nhengo dzomukati uye kukura kwezvinetso (muna 20% yevarwere): chirwere chepfungwa uye zvepfungwa, kuparadzwa kwe retinha kana kuti kurohwa. Kana huwandu hwehutachiona hune humwe humwe hutachiona, zviratidzo zvayo zvinowanikwa pamufananidzo wehutachiona huripo. Hypertension chirwere chinowanzozara chinokonzera 10-15% yevanhu. Zvinetso zvekudzivirira kweropa (CD) ndizvo zvinokonzera rufu. Kubudirira kwechirwere kunosanganiswa nematambudziko akadaro se:
• uhu-huwandu hweCD hunowanzowedzera nezera, asi hahufaniri kuonekwa sechimiro chemashamba makuru eCD mukukwegura;
• kuyerwa - CD yakakwirira kune vanhu vane uremu hwakawandisa hwemuviri;
• nhangemutange - maAmerica emadzinza eAfrica, somuenzaniso, dambudziko rekuwedzera kwehutano, anowedzera kune avo vane midzi yeEurope.
Essential hypertension
Vanopfuura 90% vevarwere vane high blood pressure vanotambura nehuwandu hwehutano hwepamusoro, hunovapo pasina chikonzero chakajeka. Rimwe basa mune izvi rinotambidzwa nehupenyu hwemhuri, kunyanya kudhakwa, kunwisa doro, uye zvakatipoteredza.
Zvimwe zvikonzero
• Kuipa kwehutachiona kunokonzerwa nehuwandu hwemhando yeropa inoparadza, inozivikanwa se fibrinoid necrosis.
• Kuberekwa. High CD inobatanidza 5-10% yezvokuita uye, kuva chikamu chetachiona chirwere chakakonzerwa neparcenta, inopa ngozi yakanyanya kune amai uye fetus.
Kuwedzera kwehutachiona kunogona kuva chiratidzo chechipiri ne:
• hutano hwetsvo;
• mapfupa emakwenzi ekupedzisira anokonzera mahomoni anokonzera mvura-munyu metabolism mumuviri kana kusunungura zvinhu zvakadai seAdrenaline;
• kutora mamwe mishonga;
• congenital anomalies.
Ropa rinokonzerwa rinotaridzwa ne sphygmomanometer. Iyi faira inonyora maitiro maviri ekudzvinyirira mumamiriyoni e mercury (mm Hg): yekutanga - pakukwirira kwemwoyo kunopesana - mu systole, yechipiri - nekuzorora kwayo - mu diastole. Paunenge uchitaridzika dambudziko rekuwedzera kwehutano, zvose zvinowanikwa zvinotorwa munyaya. Chero bedzi chetatu chemakemikari eupupuriro inogona kuonekwa uye kuongororwa. Nokuti kuongororwa kunokwana katatu kunyoresa kwehuwandu hwemhepo pasi pemamiriro akasiyana.
Dzimwe tsvakurudzo dzinosanganisira:
- urini kuongorora mapuroteni;
- kuongororwa kweropa pamiganho yepimpowo basa;
- chifukidzo che X-ray uye ECG kuti aone kuwedzera kwemoyo.
Pane zvikanganiso mukuyera ropa. Nhema-yepamusoro-soro inogona kuwanika muimba inotonhorera, ine chidzara chakazara kana kanyoro kaduku. Varwere vanoda kurapwa kwekukurumidzira vanosanganisira:
• Varwere vane ropa rinokonzerwa ne 250/40 mm Hg. unyanzvi. ane chirwere chinopisa. Vanogona kuchinjwa zvakanyanya mu fundus uye kushaya kukwana neuremia (kuvepo kweuwandu hwakawandisa hweurea nemimwe michero ine nitrogen muropa);
• Varwere vane chirwere chechipiri chemukati (mwoyo, itsvo) uye zvinomanikidzirwa zvinenge 220/10 mm Hg. Art.
Kwete-maitiro emakemikari
Varwere vane huwandu hwehuwandu hwehutachiona (diastolic pressure kusvika 95-110 mm Hg) havakwanisi pangozi, saka unogona kuedza kuwana zvinangwa zveCCD pasina kushandisa madhiragi uchishandisa dzimwe nzira:
• kuora muviri;
• kuvharirwa kwemunyu kudya;
• kudziviswa kwezvokudya zvakakora;
• kuvharirwa kwezvinodhaka;
• Kuramba kwekudzivirira kubata pamuviri;
• kuwedzerwa muviri.
Kana zvakagadziriswa zvisingawanikwi mumwedzi mitatu, zvingada kuisa mishonga. Kudzora ropa, diuretics uye calcium channel blockers zvinoshandiswa.
Mabatsiro ekurapa
Mishonga inofanira kuva yakareba kwenguva refu, uye zvichida, nokusingaperi. Kazhinji vanhu vanotora mishonga kwemakore 30-40. Zvikomborero zvepfungwa dzakanaka zvinosanganisira:
• Kuderedza muhutano, kunyanya pakati pevasvuta vechidiki vane dambudziko rekuwedzera kwehutano;
• kuderedza dambudziko rekukundikana kwemoyo uye kuora mwoyo kwekushaya ropa;
• kuderedza dambudziko rekushayiwa kwepvo kusagadzikana.
Zvisinei, kunyange nekutungamirira kwakanaka kwezviratidzo, huwandu hwepfungwa hunogona kunzwa husiri, kunyanya kana hunova nemigumisiro yemishonga, ndeyekuti:
- kuneta - pakutora beta-blockers;
- kuora kuoma - nekushandiswa kweACE inhibitors;
- kukanganisa;
- matambudziko ane simba, izvo zvinogona kuva nemigumisiro yechirwere yemishonga yakawanda.
Kufuridzira kuongorora
Kakawanda, varwere vanokanganisa kuti vanogona kuchengetedza kushanda kwehana nyore nyore. Kubudirira kugadziriswa kunyoresa maitiro kunenge kwakaoma. Pasinei nokuvapo kwemishonga inodhaka, chete mu20% yezviitiko zvinokwanisika kuwana diastolic kushandiswa kweanodarika 90 mm RT. Art. Mu 60% yevarwere, ropa rinoderedzwa pamwero wakaenzana (diastolic pressure 90-109 mm Hg), uye imwe 20% ine migumisiro yakaipa (inopfuura 110 mm Hg).
Kana ropa redu richidzikama, mukoti anokwanisa zvakare kunyora mishonga. Migumisiro yehutachiona inogona kudzivirirwa nekufungidzirwa kwokutanga kwechirwere ichi. Kana pasina kurapwa, kuwedzera kweropa kunowedzera mukana wokufa musati wasvika (makore makumi manomwe asati apera). Zvisinei, nekurapa kwakakwana, varwere vazhinji vane hupenyu hwemazuva ose pasina zvinetso. Zvinonyanya kukonzera rufu muhutachiona ndezvekurohwa (45%) uye myocardial infarction (35%). Mapoka evanhu vane chirwere chisina kunaka chinosanganisira: varwere vaduku; varume. Vakadzi vanotora zvirongwa zvekudzivirira pamuviri vanowanzova pangozi yekurohwa kana myocardial infarction, kunyanya kana vakasvuta.
Matanho ekudzivirira
Kuongororwa kwemashoko pamusoro pekurapwa kwehutano hwehutano kwakaratidza kuti kuderera kwe diastolic kushanda ne 5-6 mm Hg. Art. inotungamirira kumigumisiro inotevera:
• kuderedza 38% muhutano hwekurohwa;
• kuderedzwa kwe16% muhutano hwehutachiona hwemwoyo.
Kuchengeta huwandu hwehutachiona, vose vakuru kusvika kune makore makumi mana (80) vanofanira kugara nguva dzose (kashanu pagore) vanoita ropa rekuyera. Paunenge uchitarisa miganhu yenharaunda kana kuwedzera kumwe kweropa, kunyatsochenjerera kunodiwa.