Indlela Yokuqaphela Uma Ukucindezeleka Kwegazi Kungaphansi Kakhulu
Sizwa okuningi ngomsindo ophezulu wegazi, futhi yini engenzeka uma ingalawulwa, kodwa izinkinga zingenzeka uma ukucindezeleka kwegazi kwehle kakhulu. Yiziphi izimpawu ongazilindela, futhi yini engenzeka uma unama-hypotensive (une-pressure ephansi yegazi)?
Ukucindezelwa Kwegazi Eliphansi (Hypotension)
Ngokungafani nezimpawu ze- high blood pressure , ezingachazwa kahle futhi ngokuvamile ezingekho, izimpawu eziphansi zomshuwalense wegazi zivame ukuba zikhulu kakhulu futhi zibonakale kalula.
Ukuthuthukiswa kwezimpawu ngokuvamile kuyimpawu eziyisixwayiso okufanele uhlolwe ukuze uthole imbangela yokucindezeleka kwegazi eliphansi nokulawula noma yiziphi izinkinga ezingaphansi. Ngokuvamile, noma kunjalo, ukucindezelwa kwegazi kumelwe kuwele ngaphansi kwenani eliphansi ngaphambi kokuba izimpawu ziqale.
Yikuphi Ukucindezeleka Kwegazi Eliphansi?
Umfutho wegazi ophansi awunayo incazelo ecacile, nakuba odokotela abaningi bangase bathi ukusika 90/60 kuvame ukuma phakathi kwegazi evamile nokucindezela kwegazi. Esikhundleni senombolo, incazelo yomsindo wegazi ophansi ingcindezi yegazi engezansi lapho inhliziyo ingakwazi ukuhambisa ukugeleza kwegazi okwanele kuzo zonke izicubu zomzimba zomzimba. Inombolo lapho lokhu kwenzeka kuyoba okuhlukile kumuntu ngamunye.
Ngaphandle kokugeleza kwegazi okwanele, izicubu zomzimba zithathwa kokubili oksijini kanye nezakhi ezidingekayo ukuze kusetshenziswe umsebenzi wamaseli. Ukutholakala okwanele kwe-oksijini kuma- tishu -okubizwa ngokuthi i- hypoxia yezicubu- iziphumo ezingenalutho lomzimba futhi ekugcineni isifo sokufa.
Njengoba sibonile ngenhla, ukucindezeleka kwegazi okuphansi kungathwala incazelo ehlukile kubantu abahlukene. Abanye abantu bangase babe nomfutho wegazi ka-86/50 futhi bangabi yi-hypotensive. Isibonelo, umuntu osesimweni esihle kakhulu ngokomzimba. Lelizinga legazi lingaholela ekungeneni okwanele kwezitho ezibalulekile zomzimba.
Ngokuphambene nalokho, ukucindezelwa kwegazi ka-120/70 kungahlangabezana nencazelo ye-hypotension kwabanye abantu. Ngezinye izimo zezokwelashwa, ingcindezi yegazi ephakeme ingadingeka ukuba ihlinzeke ama-tissue nge oksijeni eyanele, futhi ngisho nokuthi yini ebonakala sengathi ingokwemvelo yengcindezi yegazi ingase inganele ngokwanele ukulahlekelwa zonke izicubu.
Izimbangela Zokucindezeleka Kwegazi Eliphansi
Kunemibandela eminingi engabangela ukucindezelwa kwegazi okuphansi, kodwa enye yezinto ezivame kakhulu lapho abantu bethatha imithi ephakeme kakhulu yemithi yegazi. Kunezinhlobo ezahlukene zezindlela ezingaholela ekucindezelweni kwegazi okuphansi.
Ukwehliswa kwemithambo yegazi emzimbeni wonke (kusukela emithini) kungabangela ukudonsa okusheshayo kwegazi. Umthamo wegazi okwanele, ngenxa yokulahlekelwa kwegazi noma ukuphelelwa amandla kwamanzi kungabangela umfutho wegazi ophansi, obizwa nangokuthi ukushaqeka kwe-hypovolemic. Ngokuphazamiseka kwengqondo, ukucindezeleka kwegazi kungase kube mncane kakhulu ngoba inhliziyo ayiqhubeki kahle ngokwanele ukuze ijikeleze igazi noma ngenxa yokuthi isigqi senhliziyo esingavamile siyaphazamisa ukusakaza okwanele.
Ezinye izimo ezingabangela ukucindezeleka kwegazi okuphansi (ukushaqeka) kungabandakanya isifo esibi kakhulu ( ukushuswa kwe-septic ,) ukusabela okunzima kakhulu ( ukushuswa kwe-anaphylactic ,) ukuphazamiseka kwezinzwa (ukushaqeka kwe-neurogenic, nokuningi).
(Funda kabanzi mayelana nezinhlobo ezahlukene zokushaqeka .)
Kunezimo eziningi zezokwelapha ezingabangela ukucindezelwa kwegazi okuphansi. Lokhu kungase kwenzeke ngenxa yokulahlekelwa kwegazi, ukuhanjiswa kwemithambo yegazi, nezinye izindlela.
Izimbangela zomfutho wegazi ophansi zingabandakanya:
- Imithi yokucindezelwa kwegazi
- Ukukhipha amandla emzimbeni (kanye nezimbangela zokuphelelwa amandla kwamanzi njengama-diuretics, ukuhlanza, isifo sohudo, nokuningi)
- Izinkinga zenhliziyo (ikakhulukazi ama- arrhythmias enhliziyo lapho igazi elingenele lisakazwa khona)
- Ukukhipha igazi (ngenxa yokuhlinzwa, ukulimala, izilonda, nokuningi)
- Izinkinga ze-thyroid
- Ukungakwazi ukusebenza kwe-adrenal
- I-Anaphylaxis (ukusabela okukhulu kwe-allergenic)
- I-neurologic (hypotension ye-neurogenic orthostatic)
- Imithi (njengama-narcotics, anesthetics
- Ukuhlinzwa
- Ukwethuka kwe-hypovolemic (ukulahlekelwa igazi ngenxa yokulimala, ukugaya kwamanzi kwangaphakathi)
Izimpawu Ezivamile Zokucindezeleka Kwegazi Eliphansi
Izimpawu zokucindezeleka kwegazi ngokuvamile zixhomeke endleleni ukucindezeleka kwegazi okusheshayo kuqhubeka ngayo ngokushesha. Uma ukucindezeleka kwegazi kwehla ngokushesha, kunamathuba okuba umzimba wakho uphendule futhi izimpawu zingase zivele ngokushesha (ungase udlule.) Ngokuphambene, uma ukucindezela kwegazi okuphansi kukhula kancane kancane, ungase uzizwe ukhathele futhi ubuthakathaka, kodwa uma ungazi ukuthi Umfutho wegazi uphansi.
Izimpawu zomshoshaphansi wegazi zingabandakanya:
- Ukuzondwa noma ukuzwa sengathi umi esikebheni sokuqhaqhazela
- Lightheadedness
- Umbono ogqamile
- Ukuphelelwa amandla
- Ukukhathala
- Ukungabi namandla
- Ukudideka kanye nezinye izinguquko esimweni sengqondo noma umuzwa "wesikhathi esizayo"
- Izinguquko kumaphethini wokuphefumula (ukushesha, ukuphefumula okungajwayelekile kuvamile ngesikhathi sesiqephu somfutho wegazi ophansi)
- Ukushaya kwenhliziyo okusheshayo (izinga lenhliziyo livame ukusheshisa ngokunciphisa ukucindezeleka kwegazi)
- Amapulpitations
- Pallor
- I-nausea
- Ngokuzumayo uzizwa ubanda noma u-clammy
- I-Coma nokufa (uma kunzima)
Izinkinga Zokucindezeleka Kwegazi Eliphansi
Kungakhathaliseki ukuthi ukucindezeleka kwegazi okuphansi kuyingozi noma akuncike ezimweni eziningi. Uma ingcindezi yegazi ingama-88/50 futhi unikeza oksijeni ngokwanele ezicukwaneni zomzimba wakho, ngeke kube yingozi. Ngakolunye uhlangothi, ingcindezi yakho yegazi ingaba ngu- 120 / 80 futhi isabhekwa njengengcindezi yegazi ephansi uma umzimba wakho udinga ukucindezeleka kwegazi ngaphezu kwalokhu ukulahlekelwa izicubu zakho.
Ukuwa kwegazi ngokungazelelwe uma ukuma ( hyperension orthostatic ) kungaba yingozi uma ulahlekelwa ukwazi nokuwa. Kulesi simo ingxenye enkulu yengozi ikhona lapho uwela khona nokuthi kwenzeka kanjani kunokuthi kwenzekani emzimbeni wakho.
Umfutho wegazi ophansi uvame ukungathí sina kakhulu uma kubangelwa ukunciphisa isikhathi eside ekugejeni kwegazi kuya ezithombeni ezibalulekile zomzimba. Ngemizuzu embalwa, ukugeleza kwegazi okuphansi kuya enhliziyweni noma ebuchosheni kungabangela ukulimala okungenakuguquka kulezi zicubu. Ukucindezeleka kwegazi okwejwayelekile okujwayelekile okuvamile okujwayelekile okubhebhethekisa kakhulu kwegazi ngokuphathelene nomphumela ezinsoweni.
Umthelela we-low blood pressure emzimbeni uphinde uxhomeke ekusebenzeni kahle kwemishini yokubuyisela imali. Isibonelo, lapho i-systolic (inombolo ephakeme) yegazi egxuma amaphuzu angu-15 kuya kwangu-20, izinga lenhliziyo livame ukwanda ngamaphesenti angama-15 ngomzuzu ukuze unikeze inani elifanayo legazi ezicukwaneni. Uma izinga lakho lenhliziyo alikwazi ukusheshisa ukukhokhela (ngenxa yesifo senhliziyo noma isibonelo esingavamile senhliziyo) umphumela uzoba nzima kunokuba uma umzimba wakho ungakwazi ukukhokhela ngokwanele. Umzimba uvuselela ngezinye izindlela, njengokwandisa amandla wepompo yenhliziyo yakho, nokuvimbela imithwalo yegazi endaweni (izingalo zakho nemilenze) ukugcina ukucindezelwa kwegazi okujwayelekile emzimbeni womzimba.
Lezi zindlela zokukhokha, noma kunjalo, zingabangela izinkinga ezengeziwe lapho zisetshenziselwa umzimba isikhathi eside, njengokuthi lapho umkhawulo unqatshelwe ukugeleza kwegazi okwanele (ngenxa ye-vasoconstriction) isikhathi esithile (esingase sibe nomphumela e-gangrene nangaphezulu.) Ukugeleza kwegazi emathunjini kungabuye kuhanjiswe lapho kwenzeka khona ukwehla komfutho wegazi, okungabangela ukulimala emathunjini nezinye izitho zangasese.
Ukwelashwa kwe-Low Blood Pressure (Hypotension)
Njengazo zonke izimo eziphuthumayo, kubalulekile ukuqala u-"ABC" okumele uhambise umoya, ukuphefumula, nokusakaza. Uma izindiza zomoya zivinjelwe, ukuvinjelwa kudinga ukususwa. Uma umuntu engaphefumuli, ukuphefumula okufakelwayo kuyadingeka. Uma inhliziyo ingabetha (noma ishaya ngokungenakufaneleka njengokuthi i- arrhythmia eqinile ) i-CPR izodinga ukubuyisela ukujikeleza.
Izinyathelo ezengeziwe zizoxhomekeka ekutholeni ukuxilongwa kokuqala kokucindezela kwegazi. Isibonelo, uma umcabango wegazi ophansi ucatshangwa ukuthi ungenxa yevolumu ephansi yegazi, ukuphuza igazi noma igazi kungenziwa. Uma ukucindezeleka kwegazi okuphansi kungenxa yesenzo esibi kakhulu, i-adrenaline (epinephrine) izonikezwa.
Uma ukucindezeleka kwegazi okuphansi kunenkinga engapheli, kuzodingeka ukuqhuma okuqhubekayo ukucacisa imbangela eqondile. Uma imithi yengcindezi yegazi iyimbangela, lezi zizovalwa.
"Iatrogenic" I-Low Blood Pressure
Igama elithi "iatrogenic" lisho ukwelashwa okubangela inkinga. Akuvamile ukuthi abantu baqokwe imishanguzo yegazi ephezulu yokuphela komfutho wegazi ophansi kakhulu. Abanye abantu banomfutho wegazi ophakeme uma bekhona emtholampilo (okuthiwa i- white coat hypertension ) ngenxa yokukhathazeka. Uma lokhu kwenzeka, imithi ingagcina ishiwo ukuthi kubangelwa ukucindezeleka kwegazi okuphansi kakhulu emtholampilo. Ukuqapha kwengcindezi yegazi (ukuhlola ingcindezi yegazi ngaphandle kokubekwa okucindezelayo emtholampilo) kungadingeka ukwazi ukuthi ukhathazekile kanjani ekuphatheni umfutho wegazi ophezulu ukuze ugweme ngokungabonakali umfutho wegazi ophansi.
Ngaphansi Kokucindezela Kwegazi Eliphansi (Hypotension)
Umfutho wegazi ophansi ungabangela izinkinga ezinkulu ngenxa yokungasebenzi ngokwanele kwezitho ezibalulekile zomzimba. Ukuqaphela izimpawu nokuthola ukunakekelwa okufanelekile kuyadingeka ukuba ugweme izinkinga zesikhathi eside. Kunezinhlobo ezihlukahlukene zezimbangela, nakuba ukwelashwa kokuqala-ukuqiniswa kwesiguli umoya, ukuphefumula, nokujikeleza kuyafana. Uma ukhathazekile ngokuthi wena noma othandekayo unesifo esiphansi segazi, shayela udokotela wakho noma ushayele usizo oluphuthumayo ngokushesha.
> Imithombo:
> Kasper, uDennis L .., u-Anthony S. Fauci, noStephen L .. Hauser. Izimiso zikaHarrison zeMithi yangaphakathi. ENew York: imfundo kaMc Graw Hill, 2015. Print.