Orthostatic dhirika: Zvinokonzera, Zviratidzo neMarapirwo

Kune pezvakaitwa zhinji ngozi kuitika mumuviri womunhu, izvo zvinogona kuchikosha anonetsa zvikuru. Asi dzimwe nguva zvakakomba diagnoses zvakavigwa seri kurasikirwa pfungwa, izvo zvingaita pakutanga sokuti pamusana utera kana kuneta. Kutaura zvazviri, pane zvimwewo zvikonzero zvakawanda ngozi zvikuru kuti anogona kutungamirira akafanana mugumisiro.

Pokuwa orthostatic

mamiriro kwakadaro kunotemwa zvakare sezvo orthostatic hypotension. chirwere kwakadaro chinoshandiswa kuratidza kukwana saturation chepfungwa ropa iro zvakaita kubva unopinza kuchinja muviri chinzvimbo. Kuodzwa mwoyo kunogona kuitika mumuviri uye kana vanhu vanomirira refu. mamiriro ichi kunoita lethargy mudziyo masvingo kana yakaderera BP.

Kakawanda, dambudziko iri kunooneka pacharo vaya vane matauriro vascular simba. Kazhinji, zvakadai chirwere chinoitwa nevanhu munguva pakuyaruka, nekuti iyi ndiyo lag iri kukura vascular ezvinhu kubva nokusingaperi-kukura zvinodiwa nomuviri.

Sei zviratidzo

Pane zvimwe zviratidzo dambudziko akadai orthostatic akawisa. zviratidzo akakodzera nokuti chirwere, ndeinotevera:

- dzungu;

- kurasikirwa pfungwa;

- kunzwa usingabatsiri kana Kutambudzika musoro;

- pakarepo kwakaonekwa utera;

- madzerere kana flickering nhunzi;

- huru mavambo kurutsa kana svoto;

- kune Muzviitiko zvakaipisisa, zvinokwanisika involuntary weti uye kugadzira pfari.

Dambudziko akadai orthostatic dhirika, anogona kuva pamusoro pakanyorwa vasingadzoreki ropa romugove kwete chete uropi. Muchiitiko chino, unofanira kuteerera zviratidzo zvakadai angina (zviratidzo myocardial ischemia), kurwadziwa tsandanyama kwemitsipa uye kufema shanduko.

The panowanikwa Zviratidzo izvi zvingaita aakapa refu kugara wakarurama chinzvimbo, uye chiitiko zvachinja muviri chinzvimbo. Strong unopinza kurovedza muviri kungakonzera kufenda. Mune zvimwe zviitiko, zviratidzo hypotension zvingaitika pashure ingestion pamusoro yakawanda chikafu. Izvi zvinotsanangurwa maererano activation pakati ari vagus etsinga.

Orthostatic hypotension: Zvinokonzera

Kazhinji, redistribution ropa kunotangira panguva nokusimudza kubva pamubhedha, nokuti chinotaura unorema kubva mutsinga kuti dziri munzvimbo dzakaderera migumo. Izvi ndizvo zvinoita kugara regiravhiti ropa.

Venous dzokera mwoyo pamwe yekudyidzana akaderedzwa, iyo inosvitsa imwe kuderera kuitiswa. Baroreceptors, izvo riri carotid sinus uye kutsemuka yokufeva, kupindura pamusoro muitiro uye Activate ari autonomic tsinga.

Somugumisiro, pane kuwedzera vascular matauriro uye kudzoka kufurirwa uye kwemwoyo vakanga chakaipa.

Kana tava kuenda zvinofungwa nyanzvi uye edza kutaura musimboti dambudziko zvikuru muchidimbu, tinogona kusvika zvinotevera mhedziso: orthostatic dhirika Chokwadi, kwete chirwere, zviri nani migumisiro chokwadi kuti midziyo ropa vanorasikirwa mano avo kuchengeta vachiwana nevamwe inowanzotorwa siyana. Uye anogona kare kuva zvikonzero, dzimwe nguva chakakomba zvikuru.

Ndezvipi zvirwere zvinogona kutungamirira pokuwa

On ezvinhu midziyo, anotaurwa pamusoro apa, unogona kuchinja zvimwe zvirwere uye pezvakaitwa:

- tsinga kugozha uye kunetseka mupfungwa;

- zvirwere ane rwarisa hunhu;

- chinokosha kurasikirwa neropa;

- zvirwere chokuita kwemakemikari anobudiswa hurongwa;

- kudhaka, iyo inoratidza pacharo sezvo kunyanya vangadikitira, kurutsa kana manyoka;

- kushungurudzwa zvataidya uye hakuvaki kudya;

- kushandiswa antihypertensives, vasodilators uye diuretics sezvo kurapa cheBP kwemakore akawanda.

Asi kana iwe govera kiyi chikonzero chikuru zvinhu zvaizobatsira orthostatic dhirika, kureva, kurasikirwa pfungwa, zvakafanira kuti kuteerera ischemic anoxia. Kwakavakirwa zvigadziriswe inoverengeka munokosha paakataura.

Kutanga, zviri nekusagona ari myocardium kuita zvaaida cardiac goho. Chitarisiko dhirika uye zvingakonzera kutadza kurova kwehana, ndokusaka pasina urongwa pokugara chepfungwa perfusion.

Haukwanisi kufuratira zvinoderedza BP nokuda zvinoshingaira peripheral vasodilation. Mugumisiro izvi zvava kukwana ropa riyerere chepfungwa.

Anokonzerwa nemishonga yakasiyana-siyana

Kuwedzera matambudziko zvirwere zvakasiyana-siyana, zvakakosha kuti kufungawo chokwadi kuti vamwe zvinodhaka kungakonzera kuti kurasikirwa vascular matauriro uye kwete chete.

Zvinodhaka kuti anokonzera orthostatic dhirika, tinofanira kutsunga nachiremba nomunhu, pashure izvo avo kushandiswa zvakakodzera kumisa kana kuderedza dose nomazvo. Zvinogona kuva FIs siyana, nitrates blockers, vasodilators, diuretics, dzimwe antihypertensive nevamiririri.

Saka zvinokosha kuyeuka kuti Orthostatic hypotension nguva dzose kunogona kukonzera 'Dibazol "uye zvimwe zvinodhaka zvakafanana.

Things kuziva ganglioplegic

Pakutanga, zvinodhaka kuti muri boka iri vari kuti kutyorwa nomunhu kuburikidza autonomic ganglia. Izvi anofanira kuderedza tsandanyama mataurire arterioles, venules uye precapillary sphincters.

Mugumisiro pezvakaitwa akadaro kuvandudza microcirculation munyama, izvo zvinokosha chaizvo panguva kurapwa akasiyana chirikadzi nehana, nokupisa chirwere, kutapuriranwa toxicosis, mabayo nezvimwe zvirwere.

Kushandisa gangliobloktory, unogona kuwedzera mwero kuunganidza ropa ari mutsinga uye pakudaro kuderedza kudzoka kwayo kune mwoyo, uye nokudaro kuderedza preload kwayo. Nemamwe mashoko, pane kuvandudzika mwoyo.

Asi mafuta ichi uye achibhururuka mafuta - kureva, orthostatic kuondomoka kana kushandisa ganglioblokatorov. Uyu ndiwo mumwe pezvingazoitika wokushandiswa zvinodhaka ichi. yematambudziko akadaro ukaonekwa mamwe mapoka varwere. Zvikonzero zvakadaro maitiro ndiwo braking muviri zvinodiwa mune tsitsi makwara kuti mutsinga.

Uyewo zvinogoneka yematambudziko zvakadai Urinary chengetedzo, atonic kupatirwa richikwidibira gastric acidity.

Chii rokuongorora anogona kunzi akakodzera

Kana vakanyorwa maitiro ane orthostatic hypotension, zvakakodzera kuitisa inoda kufunga miviri. Zvinokoshawo kuti kuongorora BP. Zvinokosha uye kuitisa orthostatic bvunzo. Chaizvoizvo racho nechokwadi kuti murwere anosimuka, uye chiremba panguva ino uchiona hemodynamic tsandanyama kwadzakabva.

Kunewo pusa chimiro dzokuenzanisira. Zvakakosha kuita pamusoro kutenderera tafura, uye tsandanyama vari vakaneta.

Pfungwa nechirwere zvakare akaita kudzidza nhoroondo, kudzidza zvinodhaka kuti dzave kare pamutemo uye aigona kukonzera kudzikira. Pamwe ichi, nezvimwe zvinhu anouya kuchiedza dzokupisa, rokuongorora rinoitwa, uyewo kudzidza hurongwa uye nhengo zvomurwere. Zvinangwa izvi zvinogona kushandiswa percussion, palpation, auscultation, uye vamwe chirwere dzokuvhiya.

Nguva dzose kunokosha kuyeuka kuti Orthostatic hypotension anogona kukonzera zvimwe matambudziko, sezvo dzimwe nguva, munhu mugumisiro zvirwere zvakakomba (cardiomyopathy, kutsemuka stenosis, arrhythmias, myocardial infarction). Izvi zvinoreva kuti kana zviratidzo pachena kuti dambudziko iri, unofanira kushevedzera chiremba.

How kupona pokuwa vana

Orthostatic hypotension kunoitika pazera duku zvikuru kuoma pane nedzevakuru. Chikonzero chirwere chakadaro kunogona kuva zvakasiyana-siyana pathological ezvinhu. Somuenzaniso, nzara, nemvura, dzakajeka kana yokuvanda ropa kurasikirwa, uyewo sequestering mvura iri peritoneal uye pleural in.

Vana kazhinji dhirika anoita pachayo akanzwa pakanyorwa zvinotapuriranwa uye toxicosis, uye zvikuru kakawanda kupfuura nedzevakuru. Izvi mamiriro ezvinhu achiperekedzwa manyoka, kurutsa, uye fivha.

Panyaya ropa riyerere vasingadzoreki muuropi richikwidibira kweropa, muviri wemwana, zvaitika zvikuru yakadzama hypoxia, achiperekedzwa panguva iyoyo nokugwinha uye kurasikirwa chavanoziva.

Nzira kurapwa

Kuti akunde Orthostatic hypotension, kurapwa yaifanira nemazvo uye kutora chikamu munhu anokwanisa nyanzvi. Kazhinji, nzira simba pamusoro nyaya iyi inogona kuva nzvimbo huru mbiri: mararamiro kuchinja uye kushandisa zvinodhaka mishonga.

Kana isu kutaura dzinongoitika nzira kupora, zvinotevera zvinogona kunzi kwaari:

- kubvuma zvikamu zviduku kudya;

- pfupi kugara rinopisa ezvinhu;

- maumbirwo pakurara uchishandisa mutsago pasi petsoka pazvikomo;

- kushandiswa isotonic mitoro kuti tsandanyama mapoka ose;

- Kugara rinofamba yakachena mhepo;

- kana ezvinhu anoda kudaro, shandisa compression masokisi, izvo zvinobatsira kuramba mataurire mutsinga iri rezasi migumo;

- kudzivirirwa unopinza richisimuka kubva pamubhedha kana cheya (unofanira kutanga akadonhedza makumbo uye chete ozokwira wehunyambiri nzvimbo).

Nokuti kurapa mishonga vanoshandisa erythropoietin, vasopressin analogs ( "Vazomirin", "Minimirin"), mineralocorticoid ( "Dezoksikorton", "Florinef"), cholinesterase FIs ( "Galantomin", "Neostigmine"), uye vamwe. Asi nguva dzose unofanira kurangarira kuti, orthostatic hypotension anogona kukonzera mushonga kuti yave kushandiswa pasina pamusoro nyaya contraindications chaiyo murwere kana kururama chipimo chemushonga.

Usakanganwa pamusoro runotikurudzira ezvinhu kuti chinogona kukonzera nechitarisiko kuparara. Pasina kurapwa kuti vabudirire zvinokosha zvabuda kashoma kuti vabudirire.

zvabuda

Saka kana orthostatic hypotension wagadzirirwa, musavhunduka, dambudziko iri anokundwa. To pashure vabudirire kunaka pokuwa haana kuitwa pachayo sokuti zvakare, zvine musoro kuti kuziva zvimwe matanho chokudzivirira.

Kune vaya zvinosanganisira chambotaurwa nezvacho chenguva kufamba mumugwagwa, kudzora yokugamuchira zvinodhaka antihypertensive, kudya zvinovaka muviri uye Chokwadi, hwakanaka mararamiro. Zvakakosha nezviratidzo pakutanga matambudziko akadaro pasina kunonoka rokuongorora, nekuti mhaka syncope kungava chirwere chakakomba, uye vachifuratira nayo hwakazara zvinokosha matambudziko.