Funda ngeqhinga elibizwa ngokuba yi-permissive hypertension emva kokuphazamiseka kwengqondo.
Uxinzelelo lwegazi oluphezulu, olubizwa ngokuba ngumxinzelelo ophezulu , luyingozi ebonakalayo yobungozi. Ngaloo nto inokumangalisa abanye abantu ukuba babone xa umntu ebenomdla, oogqirha banokumisa unyango lwegazi kunye nokuvumela uxinzelelo lubonakale lube lukhulu. Kutheni kunjalo?
Ukulawula uxinzelelo lwegazi Emva kwesifo seSikemikhi
I-Iskemic stroke ibangelwa ukukhutshwa kwisitya segazi, ukuze igazi lingakwazi ukufikelela.
Ngaphandle kwegazi ukuhambisa i-oksijini kunye nokususa iimveliso ezinobuthi, malunga ne-1.9 yezigidi zeeseli zesifo seengqondo ziyafa nganye ngomzuzu.
Igazi lingahlala lifikelela kwingingqi yengqondo ngeminye imithwalo yegazi, njengeemoto ezithatha enye indlela xa kugqityiwe indlela ebalulekileyo. Ngamanye amaxesha inqanawa evaliweyo ivula kwakhona. Kukho nawuphi na umzekelo, injongo kukukhuthaza igazi ukuba liqhube kwiindawo eziphambili.
Enye indlela yokwenza oku kukunyusa uxinzelelo lwegazi ukuphalaza igazi ngeemida zegazi. Ukunciphisa uxinzelelo lwegazi kwakungabangela ukuba umonakalo ogqithiseleyo uphazamise. Ezinye izilingo zophando ziye zacetyiswa ngolu hlobo.
Isicwangciso "sokushushumbisa ingozi yecembelelo" siquka ukuyeka imithi yengcinezelo yegazi ngomntu ngexesha elimisiweyo emva kwesifo - ngokungekho ngaphezulu kwamahora angama-24 ukuya kuma-48. Ngelo xesha, uxinzelelo lwegazi lwe-systolic (inamba ephezulu) inokuphakama ephakamileyo njenge-220, okanye 185 xa i- activminogen activator (tPA) i-clot-busting tissue activator (tPA) inikwe.
Ekugqibeleni, ixinzelelo legazi kufuneka libuyiselwe kumazinga avumelekileyo. Ukuthi uxinzelelo lwegazi kufuneka lubuyiselwe kwizinto eziqhelekileyo emva kokuba uhlangothi luye lwaba yingxabano, nangona kunjalo.
Kwilingo le-CATIS, izigulane ezingaphezu kwe-2000 zazingenakucetyiswa ukuba zinciphise uxinzelelo lwegazi ngama-10 ukuya kuma-25 ekhulwini kwiiyure ezingama-24 zokuqala emva kokubetha kwaye zanciphisa zibe ngaphantsi kwe-140/90 kwiintsuku ezi-7.
Ngokwahlukileyo, uninzi lwabantu luya kujolisa ukunyanzeliswa kwegazi oluqhelekileyo kwiiveki ezimbalwa ezilandelayo emva kwesifo.
Emva kweentsuku ezingama-40, abaphandi baCATIS bavavanya amanqanaba okufa nokukhubazeka kwaye abafumananga umahluko phakathi kwezicwangciso ezimbini. Ngoxa abalobi bekhankanya ukuba ukunciphisa ukucinezelwa akuzange kuncede izigulane, mhlawumbi ziphawuleka ngakumbi ukuba izigulane azizange zonakaliswe, nokuba kunjalo.
Ukuxinwa kwe-Blood Pressure Control kwi-Lacunar Ischemic Strokes
Kwi-CATIS, izigulane ezinemibala encinci "lacunar" zibonakala zifumana inzuzo ekulawuleni kwegazi. Ezi zincinci ezincinci, ezidla ngokubonakala zingciphekweni kwingqondo apho zingenza umonakalo omkhulu ongonakaliyo, zixhomekeke ngakumbi kwi-hypertension.
Uvavanyo lwe-SPS3 lubhekisele kumawaka ezo zigulane kunye nezigulane zamantla ezityhafayo kwi- MRI, ekulinganisa ukunyanzeliswa kwengcinezelo yegazi kwiindlela ezininzi zokuvumela. Nangona iziphumo zolu cwaningo bezingabalulekanga, kwakukho umkhwa wokulawula okubonakala kunzima ukunciphisa yonke imivimbo - nangona, oku kungenzeka ngenxa yokuba kwakuninzi ukubola kwe-intrrhages kwiqela elixinzelelweyo lokuxinzelelo lwegazi.
Okukwintsusa
Ezi ziphumo zibonisa ntoni?
Mhlawumbi uxinzelelo lwegazi lwakho lulawula iintsuku ezimbalwa emva kweeveki emva kokushaywa kwesifo kuxhomekeke kwindlela yokuhlaselwa. Izigulane ezisebekhulile emva kwesifo se-lacunar, umzekelo, iinjongo kufuneka ukuba zibe ngaphantsi kwe-130 mmHg systolic. Ngokukhawuleza emva kokuqhwala, kunjalo, indlela efanelekileyo kakhulu isenokuthi iqhubeke negalelo legazi eliphezulu.
Imithombo:
J, Zhang Y, Xu T, Zhao Q, Wang D, et al; Abaphandi beCATIS. Iimpembelelo zokunciphisa kwegazi ngokukhawuleza ekufeni kunye nokukhubazeka okukhulu kwizigulane ezinezigulane ezinzima zesisikicikethi: i-CATIS ilingo le-clinical trial.JAMA. 2014 Feb 5; 311 (5): 479-89. i-doi: 10.1001 / jama.2013.282543
UMhlophe oMhlophe, uPergola PE, uSzychowski JM, Talbert R, uCervantes-Arriaga A, et al .; AbaPhandi beSSP3. Uxinzelelo lwegazi emva kokuphazamiseka kwangoku: iziphumo ezisekelwe kwinqanaba elincinci lokukhusela iincinci ezincinci zesilingo. Am J Hypertens. 2013 Sep; 26 (9): 1114-22.