Umfutho wegazi ophansi

Umfutho wegazi ophansi wenzeka lapho umfutho wegazi uphansi kakhulu kunokujwayelekile. Lokhu kusho ukuthi inhliziyo, ubuchopho nezinye izitho zomzimba azilitholi igazi elanele. Umfutho wegazi ojwayelekile ikakhulu uphakathi kuka-90/60 mmHg no-120/80 mmHg.

Igama lezokwelapha lomfutho wegazi ophansi yi-hypotension.

Umfutho wegazi uyehluka kuye ngomuntu. Ukwehla okuncane okungama-20 mmHg, kungadala izinkinga kwabanye abantu. Kunezinhlobo ezahlukahlukene nezimbangela zengcindezi yegazi ephansi.

I-hypotension enamandla ingabangelwa ukulahleka okungazelelwe kwegazi (ukushaqeka), ukutheleleka okunzima, isifo senhliziyo, noma ukusabela okweqile komzimba (anaphylaxis).

I-Orthostatic hypotension ibangelwa ukuguquka okungazelelwe kokuma komzimba. Lokhu kwenzeka kaningi lapho usuka ekulaleni phansi uye ekumeni. Lolu hlobo lomfutho wegazi ophansi imvamisa luthatha imizuzwana noma imizuzu embalwa. Uma lolu hlobo lomfutho wegazi ophansi lwenzeka ngemuva kokudla, lubizwa ngokuthi yi-postprandial orthostatic hypotension. Lolu hlobo luvame ukuthinta abantu abadala asebekhulile, labo abanomfutho wegazi ophakeme, nabantu abanesifo i-Parkinson.

I-hypotension ngokwe-mediated mediated (NMH) ivame ukuthinta abantu abadala abasha nezingane. Kungenzeka lapho umuntu emi isikhathi eside. Izingane zivame ukudlula lolu hlobo lwe-hypotension.

Imithi ethile nezinto kungaholela ekucindezelekeni kwegazi okuphansi, kufaka phakathi:

• Utshwala
• Imithi yokulwa nokukhathazeka
• Ama-anti-depressants athile
• Izidakamizwa
• Imithi yenhliziyo, kufaka phakathi leyo esetshenziselwa ukwelapha umfutho wegazi ophakeme nesifo senhliziyo
• Imithi esetshenziselwa ukuhlinzwa
• Ama-painkillers

Ezinye izimbangela zomfutho wegazi ophansi zifaka:

• Ukulimala kwemizwa yesifo sikashukela
• Izinguquko kusigqi senhliziyo (arrhythmias)
• Ukungaphuzi uketshezi olwanele (ukomisa amanzi emzimbeni)
• Ukwehluleka kwenhliziyo

Izimpawu zomfutho wegazi ophansi zingafaka:

• Umbono ofiphele
• Ukudideka
• Isiyezi
• Ukuquleka (i-syncope)
• Ubumhlophe
• Isicanucanu noma ukuhlanza
• Ukulala
• Ubuthakathaka

Umhlinzeki wezokunakekelwa kwempilo uzokuhlola ukuthola imbangela yengcindezi yegazi lakho. Izimpawu zakho ezibalulekile (ukushisa, ukushaya kwenhliziyo, izinga lokuphefumula, nomfutho wegazi) kuzohlolwa njalo. Ungadinga ukuhlala esibhedlela isikhashana.

Umhlinzeki uzobuza imibuzo, kufaka phakathi:

• Iyini ingcindezi yakho ejwayelekile yegazi?
• Imiphi imithi oyiphuzayo?
• Ingabe ubulokhu udla futhi uphuza ngokwejwayelekile?
• Uke waba nokugula okuthile, ingozi, noma ukulimala muva nje?
• Yiziphi ezinye izimpawu onazo?
• Ingabe waquleka noma waqapha kancane?
• Ingabe uzizwa unesiyezi noma unekhanda elincane lapho umile noma uhleli ngemuva kokulala?

Ukuhlolwa okulandelayo kungenziwa:

• Iphaneli eyisisekelo ye-metabolic
• Amasiko egazi ukuhlola ukutheleleka
• Qedela ukubalwa kwegazi (CBC), kufaka phakathi ukwahluka kwegazi
• I-Electrocardiogram (ECG)
• Ukuhlolwa komchamo
• I-X-ray yesisu
• I-X-ray yesifuba

Ukwehla komfutho wegazi ovamile kumuntu ophilile ongabangeli zimpawu kwesinye isikhathi akudingi ukwelashwa. Ngaphandle kwalokho, ukwelashwa kuncike embangela yengcindezi yegazi lakho kanye nezimpawu zakho.

Lapho unezimpawu zokwehla komfutho wegazi, hlala noma ulale phansi ngokushesha. Bese uphakamisa izinyawo zakho ngaphezu kwezinga lenhliziyo.

I-hypotension enamandla ebangelwa ukwethuka yisimo esiphuthumayo sezokwelapha. Unganikezwa:

• Igazi ngenaliti (IV)
• Imithi yokwandisa umfutho wegazi nokuthuthukisa amandla enhliziyo
• Eminye imithi, njengama-antibiotic

Ukwelashwa komfutho wegazi ophansi ngemuva kokuma ngokushesha kakhulu kufaka:

• Uma imithi iyimbangela, umhlinzeki wakho angashintsha isilinganiso noma akushintshele komunye umuthi. Ungayeki ukuthatha noma yimiphi imithi ngaphambi kokukhuluma nomhlinzeki wakho.
• Umhlinzeki wakho angaphakamisa ukuthi uphuze uketshezi oluningi ukuphatha ukwelashwa.
• Ukugqoka amasokisi aminyene kungasiza ekugcineni igazi lingaqoqeki emilenzeni. Lokhu kugcina igazi eliningi emzimbeni ophezulu.

Abantu abane-NMH kufanele bagweme izimbangela, njengokuma isikhathi eside. Ezinye izindlela zokwelapha zifaka uketshezi lokuphuza nokwandisa usawoti ekudleni kwakho. Khuluma nomhlinzeki wakho ngaphambi kokuzama lezi zinyathelo. Ezimweni ezimbi kakhulu, imithi ingabhalwa.

Umfutho wegazi ophansi uvame ukwelashwa ngempumelelo.

Ukuwa ngenxa yengcindezi yegazi kubantu abadala asebekhulile kungaholela ekuqhekekeni kwesinqe noma komgogodla. Lokhu kulimala kunganciphisa impilo yomuntu kanye namandla okuhamba.

Ukwehla okungazelelwe okukhulu kwengcindezi yegazi lakho kulambisa umoya-mpilo emzimbeni wakho. Lokhu kungaholela ekulimaleni kwenhliziyo, ubuchopho nezinye izitho zomzimba. Lolu hlobo lomfutho wegazi ophansi lungasongela impilo uma lungelashwa ngokushesha.

Uma umfutho ophansi wegazi udala ukuthi umuntu adlule (aquleke), funa ukwelashwa khona manjalo. Noma, shayela inombolo ephuthumayo yendawo efana ne-911. Uma umuntu engaphefumuli noma engenayo i-pulse, qala i-CPR.

Shayela umhlinzeki wakho ngokushesha uma unalezi zimpawu ezilandelayo:

• Izitulo ezimnyama noma zemaroni
• Ubuhlungu besifuba
• Isiyezi, ikhanda elikhanyayo
• Ukuquleka
• Imfiva ephakeme kuno-101 ° F (38.3 ° C)
• Ukushaya kwenhliziyo okungajwayelekile
• Ukuphelelwa umoya

Umhlinzeki wakho angancoma izinyathelo ezithile ukuvimbela noma ukunciphisa izimpawu zakho kufaka phakathi:

• Ukuphuza uketshezi oluningi
• Ukuvuka kancane emva kokuhlala noma ukulala phansi
• Ukungaphuzi utshwala
• Awumi isikhathi eside (uma une-NMH)
• Kusetshenziswa amasokisi wokucindezelwa ukuze igazi lingaqoqeki emilenzeni

I-Hypotension; Umfutho wegazi - uphansi; I-postprandial hypotension; I-Orthostatic hypotension; I-hypotension evumelanisiwe ngokwemvelo; I-NMH

UCalkins HG, uZipes DP. I-Hypotension ne-syncope. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 43.

I-Cheshire WP. Izinkinga ze-Autonomic kanye nokuphathwa kwazo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 418.