Orthostatic nciphisa: Izimbangela, Izimpawu kanye Ukwelashwa

Kukhona izinqubo eziningi eziyingozi ezenzeka emzimbeni womuntu, okungenza nomthelela okuphazamisayo. Kodwa izifo ngezinye izikhathi sina afihliwe ngemuva nokulahlekelwa ukwazi, okuyinto okungenzeka ekuqaleni babebonakala umphumela njengophawu lokuba buthaka noma ukukhathala. Eqinisweni, ziningi ezinye izimbangela eziyingozi kakhudlwana ukuthi kungaholela umphumela ofanayo.

Ukuwa orthostatic

isimo esinjalo kunqunywa futhi njengoba hypotension orthostatic. kokutshelwa ngokukhubazeka kwengane isetshenziswa abonisa enganele ukugcwaliswa igazi cerebral okwaholela kusuka izinguquko elibukhali isikhundla umzimba. ukusabela okunjalo kungenzeka emzimbeni futhi lapho abantu balinde isikhathi eside. Lesi simo ikhuthaza ukucobeka isitsha izindonga noma umfutho ophansi wegazi.

Ngokuvamile, le nkinga kuzibonakalisa labo ithoni kabani semithambo buthaka. Ngokuvamile, kokutshelwa ngokukhubazeka kwengane wenziwa abantu eminyakeni yobudala zokuthomba, ngoba kulesi sikhathi iyona lag ekuthuthukiseni kohlelo semithambo kusukela izidingo esandayo umzimba.

kanjani izimpawu

Kukhona ezinye izimpawu yenkinga enjengokuwa orthostatic. izimpawu olufanele ukuze kuhlonzwe, imi kanje:

- isiyezi;

- nokulahlekelwa ukwazi;

- ngaba nomuzwa wokulahlekelwa noma ukusinda ekhanda;

- ngokuzumayo wabonakala ubuthakathaka;

- angaboni kahle noma izimpukane siyafiliza;

- central umsuka ukuhlanza noma isicanucanu;

- endabeni Ezimweni ezimbi kakhulu, kungenzeka ukuchama okungalindelekile kanye nokuthuthukiswa nokuquleka.

Inkinga enjengokuwa orthostatic, angagcina ku isizinda kahle liningi igazi hhayi kuphela ingqondo. Kulokhu, kufanele sinake izimpawu ezifana angina (izimpawu zokuba ischemia esivimba amanzi), ubuhlungu bemisipha isiphundu sabo ukuphefumula ushintsho.

Livela zalezi zimpawu may kokubili ne kokuhlala isikhathi eside isikhundla ziqondile, futhi uma kwenzeka ushintsho okungazelelwe isikhundla umzimba. umsebenzi eqinile futhi abukhali ngokomzimba singaholela ekuqulekeni. Kwezinye izimo, izimpawu hypotension kungenzeka emva ukungenisa esiningi ukudla. Lokhu kuchazwe ukusebenza emsipheni vagus.

hypotension Orthostatic: Izimbangela

Kaningana, ukwabiwa igazi iqala ngesikhathi ephakamisa kusukela embhedeni, ngoba igxile omningi walo imithambo asezindaweni wemikhawulo aphansi. Le nqubo umphumela ukuchayeka namandla adonsela phansi igazi.

ukubuya emithambo yegazi ukuze inhliziyo ne encishisiwe kakhulu, okuholela ukwehla eminye ingcindezi. Baroreceptors, okuyinto zitholakala itheku carotid futhi lwaleli yomthambo i-aorta, ukuphendula inqubo ngenhla bese wenza kusebenze autonomic nesimiso sezinzwa.

Ngenxa yalokho, kukhona ukwanda ithoni semithambo futhi ukubuya wegazi nokushaya kwenhliziyo kuyehla abangu evamile.

Uma siphendukela umbono wezazi bese uzama ukuveza umnyombo wenkinga ngaphezulu ngamafuphi, singayazi waphetha kanje: nciphisa orthostatic, eqinisweni, akusona isifo, kuba kunalokho phetho yokuthi imithambo yegazi bangalahlekelwa ukukwazi kwabo ukugcina ingcindezi kwemtfwalo uhla evamile. Futhi kungenzeka ukuthi kakade ngenxa yezizathu eziningana, ngezinye izikhathi emibi kakhulu.

Yini izifo kungaholela ngokuwa

On isimo nemikhumbi, okukhulunywe ngaso ngenhla, uyakwazi ukuthonya ezinye izifo izinqubo:

- ezinzwa uhlobo nokucindezeleka;

- yezifo i nature esithathelanayo;

- ukulahlekelwa okukhulu kwegazi;

- izifo ezihlobene ohlelweni endocrine;

- ukudakwa, esizibonakalisa njengoba ukujuluka ngokweqile, ukuhlanza noma isifo sohudo;

- ukuhlukunyezwa Ukudla kanye nokudla okungenamsoco;

- ukusetshenziswa antihypertensives, vasodilators futhi isisu njengendlela yokwelapha i-high blood pressure iminyaka eminingi.

Kodwa uma ukwaba imbangela ukhiye izici eziyinhloko agcwele nciphisa orthostatic, okungukuthi, nokulahlekelwa ukwazi, kubalulekile ukuba sinake anoxia ischemic. Kusekelwe izindlela eziningana ukuthi bayakufanelekela kokukhuluma.

Okokuqala, kubalulekile ukungakwazi myocardium ukwenza oyifunayo okukhipha inhliziyo. Ukubukeka wokugoqa futhi kungabangela ukushaya kwenhliziyo okungajwayelekile, yingakho alikho ilungiselelo kwezindawo ezifanelekayo perfusion-cerebral palsy.

Awukwazi indiva nokwehla komfutho wegazi ngenxa vasodilation asebenzayo neuropathy. Umphumela yale nqubo kuba singenele cerebral ukugeleza kwegazi.

Imiphumela izidakamizwa ezahlukene

Ngaphezu umthelela izifo ezihlukahlukene, kubalulekile ukuba acabangele yokuthi ezinye izidakamizwa kungabangela ukulahlekelwa ithoni semithambo hhayi kuphela.

Izidakamizwa ezibangela ukuwohloka orthostatic, kufanele kunqunywa udokotela umuntu ngamunye, ngemva kwalokho ukusetshenziswa yabo kuyadingeka ukuze ayeke noma ukunciphisa umthamo ngendlela efanele. Kungaba inhibitor ezihlukahlukene, ama-nitrate nama blocker, vasodilators, isisu, nezinye izinto ezithwala antihypertensive.

Ngakho-ke njalo Kuhle ukukhumbula ukuthi hypotension Orthostatic kungabangela "Dibazol" nezinye izidakamizwa ezifanayo.

Izinto ukwazi ganglioplegic

Ekuqaleni, izidakamizwa ukuthi singabakaNkulunkulu baleli qembu yilabo ukuphulwa inkanuko ngokusebenzisa ganglia autonomic. Lo mphumela kudingeka ukunciphisa ithoni kwemisipha we arteriole, ama-venule futhi sphincters precapillary.

Waba yini umphumela wesibindi izinqubo ezinjalo ukuthuthkisa microcirculation kwezicubu, okuyinto ebaluleke kakhulu ngesikhatsi ukwelashwa ezahlukene abafelokazi ukushaqeka, ashise isifo, toxicosis ezithathelwanayo, inyumoniya kanye nezinye izifo.

Ukusebenzisa gangliobloktory, kungandisa degree of ekuqongeleleni igazi lihambe ngemithambo futhi ngaleyo ndlela kuncishiswe ukubuya ngayo enhliziyweni, ngaleyo ndlela unciphise Layisha yayo. Ngamanye amazwi, kukhona ngcono inhliziyo.

Kodwa kule wamafutha nokuthi ezindiza wamafutha - okungukuthi, nciphisa orthostatic uma sisebenzisa ganglioblokatorov. Lena enye yezinhlobo ezingu nangemiphumela engaba khona ukusetshenziswa kwalesi izidakamizwa. yezinkinga okunjalo babebhekwa kumaqembu athile eziguli. Izizathu ukusabela ngaleyo ndlela iyona unyathela amabhuleki umzimba amaza e izindlela enozwelo ngemithambo.

Futhi yezinkinga kungenzeka ezifana nokugcinwa urinary, ukuqunjelwa atonic uphinde wehlise asidi esiswini.

Yini ukuhlolwa kungenziwa kubhekwe olufanele

Uma izici i hypotension orthostatic bhalisiwe, kubalulekile ukuqhuba emizimbeni kumba. Kubalulekile futhi ukuhlola umfutho wegazi. Kuyadingeka futhi ukuqhuba ukuhlolwa orthostatic. Ingqikithi yalo iwukuba ukuqinisekisa ukuthi isiguli uyavuka, futhi lo dokotela ngalesi sikhathi ukubukela hemodynamic imisipha lithathelwe.

Kukhona futhi uhlobo yokwenziwa isampula. Kuyadingeka ukuba afeze etafuleni ligijima, futhi imisipha abapholile.

Inqubo ukuxilongwe futhi wenza ukufunda umlando, cwaningo izidakamizwa eziye ngaphambilini bhalisiwe angabanga ukuwohloka. Njengoba sihambisana nale, nezinye izinto ukuza ukuchayeka ukukhanya, ukuhlolwa wenziwa, kanye ekutadisheni izinhlelo kanye nezinhlaka isiguli. Ngenxa yalezi zinjongo ingasetshenziswa eshaywayo, palpation, auscultation, nezinye izindlela zokuxilonga.

Njalo Kuhle ukukhumbula ukuthi hypotension Orthostatic kungabangela nezinkinga ezithile, njengoba kwezinye izimo, is phetho izifo ezingathi sína kwababhemayo (zenhliziyo, stenosis yomthambo i-aorta, arrhythmias, isilethikusebenza). Lokhu kusho ukuthi uma izimpawu ezisobala le nkinga, kudingeka ukuba ushayele udokotela.

Indlela ukusinda Ngokuwa izingane

hypotension Orthostatic kwenzeka zisencane kakhulu nzima ngaphezu kwabadala. Isizathu sokuba kokutshelwa ngokukhubazeka kwengane kungaba ezihlukahlukene izimo zokucabanga okubangelwa isifo. Njengoba isibonelo, indlala, ukuntuleka kwamanzi emzimbeni, nezisobala noma oluyimfihlo igazi ukulahlekelwa, kanye sequestering uketshezi izimbotshana peritoneal futhi pleural.

Izingane kaningi nciphisa izenze wazizwa ku ngemuva zezifo ezithathelwanayo namakhambi toxicosis, nokunye kanengi ukudlula e abadala. Lesi simo sihambisana uhudo, ukuhlanza, kanye nemfiva.

Ngokuphathelene kahle ukugeleza kwegazi ebuchosheni uphinde wehlise blood pressure, umzimba wengane, zivele nge hypoxia kakhulu okujule nakakhulu kunalokho, ephelezelwa ngesikhathi Ukudlikizela efanayo futhi nokulahlekelwa ukwazi.

Izindlela yokwelashwa

Ukuze unqobe hypotension Orthostatic, ukwelashwa kufanele kwenziwe ngendlela efanele futhi iqhaza onguchwepheshe oqeqeshiwe. Ngokuvamile, izindlela kwethonya lolu daba ungaba ezindaweni ezimbili eziyinhloko: izinguquko yokuphila futhi ukusetshenziswa ukwelashwa.

Uma sikhuluma izindlela engokwemvelo yokutakula, izenzo ezilandelayo akunakubangelwa kuye:

- ukwamukela izingxenyana ezincane ukudla;

- kokuhlala endaweni eshisayo;

- Ukwakheka ngesikhathi sokulala usebenzisa umcamelo ngaphansi kwezinyawo sentaba;

- ukusetshenziswa imithwalo isotonic kuwo wonke amaqembu kwemisipha;

- njalo uhamba emoyeni opholile;

- uma izimo zidinga, sebenzisa kokucindezelwa amasokisi amade, esiza silondoloze ithoni ngemithambo elise wemikhawulo aphansi;

- ukuvikelwa ukwanda abukhali kusukela embhedeni noma esihlalweni (kuzomele uqale udedele imilenze bese kuphela ume mpo).

Ukuze ekwelapheni izidakamizwa zisebenzisa i-erythropoietin, vasopressin analogs ( "Vazomirin", "Minimirin"), mineralocorticoid ( "Dezoksikorton", "Florinef"), cholinesterase inhibitor ( "Galantomin", "Neostigmine"), kanye nabanye. Kodwa kufanele ukhumbule njalo ukuthi, hypotension orthostatic ukuthi kungabangela izidakamizwa eliye lasetshenziswa ngaphandle kwekubuka esimweni Izimo nesineke ethile noma umthamo ayilungile.

Ungakhohlwa mayelana nesimo ecashile ukuthi kungenzeka abangela ukubukeka wokugoqa. Ngaphandle kokwelashwa ukuze zithole imiphumela ebalulekile cishe ukuphumelela.

Imiphumela

Ngakho uma hypotension orthostatic umiselwe, ungethuki, le nkinga onqotshwa. Ukuze emva kokwelashwa ngempumelelo wokugoqa akenzanga ngokwayo wazizwa futhi, kunengqondo ukuba baqaphe ezinye izinyathelo.

Ukuze labo zihlanganisa eshiwo ngenhla ukuhamba njalo emgwaqweni, kokulawulwa ethola izidakamizwa antihypertensive, umsoco ofanele kanye, yebo, indlela yokuphila enempilo. Kubalulekile ngaso izimpawu zokuqala zalezi zinkinga ngaphandle kokulibala ukuxilonga, ngoba imbangela nakwisyncope kungaba isifo esiyingozi, futhi enganaki igcwele yezinkinga abalulekile.