Kuyerwa BP - matanho algorithm. arterial kumanikidzwa

Kuti tizive basa mwoyo, kweropa maitiro uye itsvo zvinokosha kuyera BP. The algorithm chiito nokuda tsanangudzo yacho inofanira akasangana kuti rakarurama kupfuura nhamba. Kubva okurapa anoziva kuti nenguva kuziva kuitiswa yakabatsira vakawanda varwere vava vakaremara uye akatiponesa upenyu zhinji.

History of kuyera mano

kumanikidzwa yakatanga akayera kwemhuka Hales muna 1728 Kuti aite izvi, iye akatanga girazi chubhu zvakananga mukati yakavharika webhiza. Pashure paizvozvo Poiseuille akawedzera kuti girazi chubhu ine mekuri manometer scale, uye gare gare Ludwig tega kymograph aine ichiyangarara, izvo zvakaita kuti tikwanise kunyora ichi- kweropa. apparatuses aya vakapakata kugozha gauges uye zvemagetsi nehurongwa. Direct nzira kuyera BP achishandisa catheterization rwengarava zvinoshandiswa pakutsvakurudza zvinangwa mune chirwere mumarabhoritari.

Sei BP?

Mutinhimira sunga komoyo zvinosanganisira maitikiro maviri: systole uye diastole. Wokutanga danho - systole - munhu marwadzo mumwoyo tsandanyama, panguva iyo mwoyo pumps ropa mukati yeropa uye pulmonary tsinga. Diastole - nguva iyo mwoyo in chokuwedzera uye kuzadza neropa. Zvadaro zvakare unouya systole uye diastole mune ramangwana. Ropa midziyo guru yeropa uye pulmonary tsinga inopfuura nzira duku - arterioles uye capillaries, huchiita ose nhengo uye nyama pamwe okisijeni uye nekunhonga carbon dioxide. Capillaries kuyambukira venules, ipapo - mune mutsinga diki uye nemidziyo makuru, uye pakupedzisira - ari mutsinga dziri yakakodzera mwoyo.

The kumanikidzwa nemidziyo ropa uye mwoyo

Kana ejection ropa kubva mumwoyo makamuri nevamwe 140-150 mm HG. Art. Yeropa ipfupi kuti 130-140 mm HG. Art. Zvino kure kubva pamoyo, rezasi kwokudzvinyirira ari venules zviri 10-20 mm HG. Art, uye ropa huru mutsinga -. Pazasi ratinoona.

Kana ropa runoyerera kubva pamoyo, kurova kwemwoyo chinozunguzirwa yakanyorwa, iyo dzinopera zvishoma kure sezvo iwe mberi kuburikidza midziyo yose. Its kupararira nokukurumidza kunobva BP uye elasticity kana elasticity kuti vascular madziro.

With zera, BP inowedzerawo. Vanhu kubvira 16 kusvika 50 makore, ndiyo 110-130 mm HG. Article, uye pashure pemakore 60 -. 140 mm HG. Art. uye pamusoro.

Nzira dzekufambisa kuyera BP

Pane yakananga (invasive) uye zvisina kunanga nzira. In nzira yokutanga, mudziyo pamwe anobudisa mushonga zvishoma nezvishoma transducer uye BP inoyerwa. Algorithm Nhambwe pakudzidza uyu kuti vachishandisa kombiyuta rinoitwa kushandisa michina kubva kwacho kudzora chiratidzo.

kunanga

BP chipimo chidobi kunogona zvisina kunanga kupfurikidza akawanda nzira: palpatory, auscultatory uye ostsilometricheskim. nzira Wokutanga kunosanganisira zvishoma nezvishoma compression uye kutandara maoko nemakumbo vari arteries uye kutsunga nomunwe kupomba compression pazasi panzvimbo yayo. Rivva-Rocci mukupera kwezana remakore rechi19, akataura kushandiswa 4-5 masendimita cuff nemekiyuri manometer akamboona. Zvisinei, izvozvo rakamanikana cuff rudo vanokosha mashoko echokwadi, zvakanzi pfungwa kuwedzera kune masendimita 12 pahupamhi. Uye ikozvino nguva BP chipimo unyanzvi kunosanganisira kushandisa ino chaiyo cuff.

Pressure mairi iri pumped kusvikira apo kupomba iri akamiswa uye yozononokera kunoderedza. Systolic kumanikidzwa - ndiro nguva apo pane pulsation, diastolic - kana kupomba iri attenuated, kana yekudyidzana nokukurumidza.

Muna 1905, NS Korotkov kutora nzira kuyera BP ne auscultation. A chaiwo mudziyo kuti kuyera BP pa Korotkoff - tonometer. It rine cuff, ari nemekiyuri pakafunuka. Mhepo iri cuff iri inflated ane blower, uye ipapo zvishoma nezvishoma kusunungura mhepo kuburikidza rinokosha vharafu.

Ndiwo mutemo auscultatory nzira kuyera BP kwemakore anopfuura 50, asi, maererano kuongorora, vanachiremba Kashoma kutevedza kunenge uye vachanetseka neBP chipimo michina.

The oscillometric nzira inoshandiswa zvoga mano uye poluavtomaticheskh mu yevanorwara zvikuru anokwana zviyero, nekuti kushandiswa mano izvi haatarisiri kuramba jekiseni mhepo kupinda cuff. mumwe BP akarekodwa rinoitwa panguva dzakasiyana zvokukura zvinoderedza mhepo vhoriyamu. Kuyerwa BP kunobvira uye auscultatory kukundikana uye simba Korotkoff zvinoita. Nzira iyi ndiyo shoma novimba elasticity mudziyo masvingo vavo hwakapararira atherosclerosis. Oscillometric nzira akabvumira kuti pave mano kuti Kutsunga arteries siyana okumusoro migumo. Kunoitawo kuti muitiro neyakarurama Akaroromesawo munhu chinhu

Mirayiro BP chipimo

Step 1 - kusarudza zvakarurama michina.

Chii uchada:

1. High-unhu stethoscope

2. zvakarurama cuff kukura.

3. chaicho kana aneroid sphygmomanometer zvoga - mudziyo pamwe Chinyorwa ichishanda kuchaja.

Step 2 - Kugadzirira murwere: nechokwadi zviri vasununguke, mupe maminitsi 5 rokuzorora. Nokuti hafu yeawa kuti kuona BP hauna varumbidzwa nokusvuta uye doro uye caffeinated zvinodhaka. Murwere anofanira kugara wakarurama, kusunungura yokumusoro ruoko, nzvimbo iri nyore kuti murwere (inogona kupfeka tafura kana zvimwe rutsigiro), tsoka vanofanira kuva pasi. Bvisai zvakawandisa zvipfeko kuti kuvhiringidza mhepo pumped kupinda cuff kana ropa riyerere kuti ruoko. Iwe murwere haafaniri kutaura panguva yakayerwa. Kana murwere riri supine nzvimbo, zvakakodzera nzvimbo rokumusoro ruoko pamwoyo pamwero.

Step 3 - kusarudza chaiko cuff, zvichienderana uwandu maoko vanowanzotambura zvikanganiso kuitika nokuda kukodzera pakusarudza kwake. Isa cuff pamusoro murwere ruoko.

Step 4 - Turikai stethoscope pamusoro chete ruoko, apo iwe vakaisa cuff, akanzwa rwake pamusoro kugokora, kuwana nzvimbo iri kupomba hwakasimba ichirira, uye akaisa stethoscope pamusoro brachial tsinga munzvimbo ino.

Step 5 - kudza ari cuff: Tanga pombi, apo kuteerera kurova kwemwoyo. Kana kupomba mafungu kunyangarika, imi musinganzwi chero machemero kuburikidza stethoscope. Kana kupomba hakusi anzwike, zvakakodzera kudza kuti tsono kufurirwa geji yaiva nenhamba kumusoro 20 kusvika 40 mm HG. v. kupfuura inozoshandisirwa kumanikidzwa. Kana mutengo uyu isingazivikanwi, kudza kuti cuff kusvika 160 - 180 mm HG. Art.

Step 6 - zvishoma nezvishoma deflate ari cuff: deflation kunotanga. Cardiologists dzinorumbidza zvishoma nezvishoma kuzarura vharuvhu kuitira kuti kumanikidzwa iri cuff yakaderera kusvika 2 - 3 mm HG. Art. pa yechipiri, kana kupfuura kukurumidza kuchembera kungaita kuti kururama zvokuyera.

Step 7 - Inzwai systolic BP - wokutanga mwoyo inzwi. Icho ropa anotanga iyerere kuburikidza murwere arteries.

Step 8 - teerera kurova kwemwoyo. Over nguva, apo cuff kufurirwa ipfupi, ruzha zvachose. Ndiwo diastolic, kana yakaderera kuvafurira.

Check rate

Zvakakodzera ritsigire rakarurama nenhamba. Kuti aite izvi, uyere kumanikidza maoko ose nokuda date avhareji. Kutarisa kufurirwa kamwe zvakare kuti zvakarurama, kumirira anenge mashanu maminitsi pakati kuyerwa. Kazhinji, kuti BP riri kumusoro mangwanani uchingodzikira usiku. Dzimwe nguva ropa nevezera nhamba havasi zvakavimbika nokuda murwere nezvemhosva vanhu vanamajasi chena. Pakadaro, munhu nezuva nokuyerwa BP. The algorithm matanho sezvamakaropafadzwa - kuziva kumanikidzwa mukati pazuva.

Nokuremara

Pari nzira auscultatory chero chipatara kana kiriniki BP chipimo rinoitwa. Algorithm zviito ane payakaipira:

• yakaderera Nhamba SBP uye DBP nhamba kupfuura vaya vakawana vane invasive nzira;

• susceptibility kuti ruzha mumba, yakasiyana ruzha kana uchityaira;

• The vanofanira kugadzirisa nzvimbo stethoscope;

• listenability zvenzwi yakaderera umbirimi yakaipa;

• kukanganisa mu kutsunga - 7-10 dzakabatana.

Iri BP chipimo unyanzvi hakusi akakodzera kuti vachiongorora nzira yose zuva. Kuongorora mamiriro varwere vari yevanorwara zvikuru zviumbu havangagoni kudza kuti cuff uye nokusika ruzha. Izvi zvinogona kukanganisa mukuru ezvinhu omurwere uye aite hanya. Pressure PTsifry kuva vasingavimbiki. Kana asingazivi murwere dzikawedzera kurovedza muviri Hazvibviri kuti aise ruoko pamusoro mwoyo chechetere. Zvikuru chiratidzo chipingaidzo anogona kusika uye inondimukira nezviito murwere, saka kombiyuta kwaizova kupera, kuti dai apikise nokuyerwa BP, kufamba kweropa.

Naizvozvo bezmanzhetnye nzira inoshandiswa yevanorwara zvikuru nemawadhi, iyo, kunyange vakaderera zvakarurama, asi ivo vava yakavimbika, kutsanya uye dzinokodzera kuramba richiona kwokudzvinyirira.

How kuyera BP pavarwere chiremba?

Kuyerwa BP vana hakusi zvakasiyana kubva midziyo yokusarudza ayo nedzevakuru. cuff vakura chete hakusi akakodzera. Muchiitiko ichi mumwe ruoko, noupamhi iyo inofanira kuva mumativi vatatu kure kugokora kusvika axillary fossa. Pari, kunounza pakusarudza otomatiki uye Semi-otomatiki mano kuti kuyera BP vana.

Muzvarirwo kumanikidzwa nhamba kuvimba zera. Kuverenga systolic kumanikidzwa nenhamba zvaunofanira kufunga mwana zera mumakore kane 2 uye yakawedzera kusvika 80 diastolic ndiyo 1/2 - 2/3 of yapfuura nenhamba.

Apparatuses nokuti kuyera BP

Metres AD anonziwo tonometers. Kune zvemaziso uye digitaalinen sphygmomanometers. Mechanical muri nemekiyuri uye aneroid. Digital - Automatic uye Semi-zvokuzvisarudzira. The Chishandiso yakarurama uye kupfuura refu-refu ndiro nemekiyuri sphygmomanometer kana sphygmomanometer. Asi digitaalinen yamunenge uye nyore kushandisa, achivabvumira kushandisa pamba.