Ukulindela ukuhlinzwa yisikhathi esikhathazayo. Ngaphezulu kwalokhu, uma une- high blood pressure , ungase ube nokukhathazeka okwengeziwe mayelana nokuthi ingcindezi yakho yegazi izokwenzenjani ngaphansi kwe-anesthesia ejwayelekile.
Ake sihlolisise imiphumela ethile yokuhlinzekwa kwengcindezi yegazi, kanye nokuthi lesi simo sezokwelapha (esibizwa ngokuthi ukucindezeleka komzimba) singathinta kanjani isikhathi sokuhlinzwa kwakho.
Ukuphatha Ukucindezelwa Kwegazi Eliphezulu: Ngaphambi Kokuhlinzwa
Ukuba nomfutho wegazi ophezulu kungase kwande ingozi yokuhlinzwa, futhi ukuthi ingozi yakho ingakanani, kuxhomeke ekutheni isifo somfutho wegazi oqinile sibhekene kanjani.
Ngalokho, ezinye zezimo ezithile eziphakanyiswa yi-high blood pressure zikubeka engozini uma ukuhlinzeka ngaphansi kokuhlinzwa kuhlanganisa:
- Ukuhluleka kwenhliziyo ukulahla
- Izinkinga zezinso
- Isibungu
- Isifo senhliziyo
Lokho kusho ukuthi ukucindezelwa kwegazi ngokuvamile akuyona isizathu sokuyeka ukuhlinzwa ngaphandle uma umuntu ehlinzwa ngokuhlinzwa okukhulu futhi ingcindezi yegazi ayilawulwa kahle, okusho ukuthi umfutho wegazi we- systolic u- 180mmHg noma ngaphezulu noma umshini wegazi we- diastolic ungama-110mmHg noma ngaphezulu . Kulesi simo, ukuhlinzwa okuqhubekayo kungacatshangwa.
Ngaphandle kokulandela iseluleko sabo ngesikhathi sokuhlinzwa kwakho, kubalulekile ukulandela imiyalelo yeqembu lakho lokunakekelwa kwezempilo lapho imithi iqhubeke khona nokuthi yikuphi ukuyeka ngaphambi kokuhlinzwa kwakho.
Kubantu abanesifo segazi esingapheli, ezimweni eziningi, ukuqhubeka nemithi yakho ephakeme yegazi (ebizwa ngokuthi i-antihypertensives) ngokuvamile iphephile. Eqinisweni, ukumisa ezinye zazo kungabangela umphumela ovukelayo, lapho ukucindezeleka kwegazi kuphakama khona.
Ngokuphambene nalokho, imithi ephakeme ye-blood pressure (isibonelo, i- ACE inhibitors noma i- angiotensin receptor blockers ) ibanjwe isikhathi esithile, njengamahora angu-24, ngaphambi kokuhlinzwa.
Ekugcineni, qiniseka ukucacisa nodokotela wakho ngokuqondile ukuthi yimiphi imithi okufanele uyibeke futhi akufanele ithathe ngaphambi kokuhlinzwa.
Ukuphatha Ukucindezeleka Kwegazi Eliphezulu: Phakathi Nokuhlinzwa
Ngaphambi kokuba ungene ekamelweni lokusebenza, i-anesthesiologist yakho izokubuza imibuzo embalwa ngomlando wakho wezokwelapha, ngaphezu kokuzibukeza ngokwayo ishadi lakho. Ngale ndlela uyazi ukuthi ukucindezeleka kwegazi okuyisisekelo, imithi yezokwelapha, kanye / noma ukusabela kwangaphambili ku-anesthesia.
Ngesikhathi sokuhlinzwa , i-anesthhesiologist izogcina ilanga eliseduze futhi lihlale libhekene nengcindezi yegazi, kanye nezinye izibonakaliso ezibalulekile njengezinga lenhliziyo yakho nokukala kokuphefumula.
Ngokucindezela kwegazi kushintsha ngesikhathi sokuhlinzwa, kunezimbangela ezimbalwa ezikhona.
Esinye sezizathu zokuthi ingcindezi yakho yegazi ingakhuphuka kanjani ngesikhathi sokuhlinzwa ivela ekusebenzeni kwesistimu yakho yezinzwa ngesikhathi uqala i-anesthesia-into evamile. Ngaphezu kokucindezela kwegazi okwenyuka phakathi nokuqala kwe-anesthesia, izinga lokushaya kwenhliziyo lakho lizovela futhi.
Ukuze uphathe umfutho wegazi ophezulu ngesikhathi sokuhlinzwa, i-anesthhesiologist yakho izophatha ama-antihypertensive (ama-antiinpertensive).
Ngakolunye uhlangothi, uma ulahlekelwa igazi ngesikhathi sokuhlinzwa, ukucindezeleka kwegazi kungase kwehle. Ngenkathi uketshezi kanye / noma ukumpontshelwa ngegazi kungase kube yilokho okudingayo ukwandisa ukucindezelwa kwegazi, uma kukhona ukulahleka okukhulu kwegazi ngesikhathi sokuhlinzwa (okungaphezu kuka-20 amaphesenti egazi lomzimba wakho), isimo esisongela ukuphila esibizwa nge-hypovolemic shock ukuthuthukisa.
Ukuphazamiseka kwe-hypovolemic kwenzeka lapho ukulahlekelwa kwegazi kukwenza kube nzima enhliziyweni ukushaya kahle, okuyinto ekunciphiseni inani legazi elifika ezingxenyeni ezinkulu. Loluhlobo lokuthuthumela ludinga ukushintshwa kwegazi ngokushesha ukuze kuqinisekiswe ukuthi izitho zakho zithola umoya-mpilo abadinga ukuzenza.
Ukuphatha Ukucindezeleka Kwegazi Eliphezulu: Ngemva kokuhlinzwa
Njengomuntu othola i-anesthesia, ukucindezeleka kwegazi nokushaya kwenhliziyo kungakhula kancane kancane futhi ngokwemvelo. Uma umuntu ehlangabezana nokucindezelwa kwegazi okuphezulu ngemuva kokuhlinzwa (lapho ukucindezelwa kwe-systolic ingu-180mmHg noma ngaphezulu), cishe uzohlinzekwa imithi yokugcoba, esikhundleni semithi yomlomo, ukwehlisa umfutho wegazi.
Yiqiniso, uma ingcindezi yegazi iphakeme ngenxa yezimbangela ezifana nobuhlungu noma uketshezi oluningi okwenziwe ngesikhathi sokuhlinzwa, ukuguqulwa kwalezi zinkinga kufanele kulethe ukucindezela kwegazi phansi.
Ehlangothini lwe-flip, abanye abantu bathola ukudonsa kwengcindezi yegazi ngemva kokuhlinzwa. Lokhu kungenzeka ngenxa yemithi eyanikezwa yi-anesthesiologist (isibonelo, umuthi wobuhlungu) noma nje umphumela wecala wenqubo.
Ngaphezu kwalokho, kungaba yingozi futhi isongela impilo engcupheni yegazi ngemva kokuhlinzwa ngenxa yesifo . Ukuze ugweme noma uphathe ukutheleleka okungenzeka, udokotela wakho kungenzeka ukuthi uthathe ama-antibiotic ngaphambi noma emva kokuhlinzwa kwakho.
Okokugcina, kubalulekile ukuthi uqaphele ukuthi uma unesifo somuthi wegazi esingapheli, kufanele uphinde uqale emva kokuhlinzwa. Eqinisweni, ngezinye izikhathi, ukucindezeleka kwegazi emva kokuhlinzwa kungumphumela womuntu ongaqhubeki umuthi wabo ojwayelekile wemithi.
Yiqiniso, qiniseka ukuthi uchaza ukuthi imiphi imithi okufanele ithathe neqembu lakho lokuhlinzeka.
Izwi elivela
Okubalulekile ukuthi ngabe ukuyeka ukuhlinzwa kwakho noma cha, ngokusekelwe kwengcindezi yegazi, akusiyo isihloko esimnyama nesimhlophe. Yingakho kubalulekile ukulandela isiqondiso sethimba lakho lezempilo, okubandakanya udokotela wakho ohlinzayo, udokotela wakho oyinhloko wokunakekelwa, kanye nesifo sakho se-anesthesiologist.
Ekugcineni, ukwazi ukuthi i-anesthesiologist yakho izobe ilungele kahle ukugcina ukucindezeleka kwegazi kulawulwa ngesikhathi sokuhlinzwa nokuthi udokotela wakho uzothatha zonke izinyathelo zokuqapha ngaphambi nangemva kokuhlinzwa kwakho, kufanele ngethemba ukuthi ingqondo yakho ikhululekile.
> Imithombo:
> Whelton PK et al. I-American College of Cardiology: Isiqondiso sika-2017 se-High Blood Pressure kubantu abadala.
> Bisognano JD. Ukuphathwa kwe-Perioperative ye-hypertension. I-Aronson MD, ed. Kusesikhathini. Waltham, MA: UpToDate Inc.
> Kheterpal S et al. Ukucubungula kwangaphambili kwe-preoperative kanye ne-intraoperative yezenzakalo ezimbi zenhliziyo emva kokuhlinzwa okuvamile, kwe-vascular, kanye nokusebenzisa ubuchopho. Anesthesiology . 2009 Jan; 110 (1): 58-66.