Kutheni iofisi yoogqirha ayinakuba yindawo efanelekileyo yokumisela uxinzelelo lwegazi.
Kubonakala ngathi ukuxilongwa kwexinzelelo lwegazi kuphezulu kunokugqitywa ngaphandle kweofisi yegqirha, kwaye kungena ekhaya, ubuncinane ukuba i-United States ye-Prevention Services Task Force (USPSTF) inendlela yayo.
NgoDisemba, ngo-2014, i-USPSTF ikhuphe iziphakamiso ezitsha zoqhagamshelwano ekuxilongweni komfutho wexinzelelo , okhuthaza oogqirha ukuba basebenzise ukunyanzeliswa kwengcinezelo yegazi (ABPM) ngaphambi kokuba benze izigulane kwi-anti-hypertensive therapy.
Okubalulekileyo, i-USPSTF yenza uluntu luyimfihlelo encinane engcolileyo-oko kukuthi, ukuba imilinganiselo yegazi efunyenwe kwiofisi yoogqirha kaninzi ayilunganga ngokwaneleyo. I-ABPM yindlela echanekileyo ngakumbi yokugqiba ukuba umntu unayo okanye akanalo isigaba somngcipheko we-1 , kwaye ukusetyenziswa kwayo kuya kuthintelwa amanyathelo amaninzi okwelashwa kunye kunye (ngokuqhelekileyo) ngaphantsi kweyeza.
Kubonakala kunokwenzeka ukuba ubuncinci abanye oogqirha (kunye nabahlawulwa ngokukhawuleza) baya kuchasa kwezi zikhokelo ezintsha, kwaye ubuncinci abathile baya kuthwala ukuba bafumane i-USPSTF ukuguqula iingcomo ezicetywayo ngaphambi kokuba zigqitywe. Ingxaki yoogqirha kukuba i-ABPM iyanzima kakhulu ukubonelela, ayifumaneki ngokulula, kwaye imfuneko yokuyisebenzisa isongela ukuqhubela phambili iingxaki zoogqirha obusoloko bunzima. Ingxaki kubahlawuli kukuba i-ABPM iyabiza, kwaye abayi kuthanda ukuhlawula ngamakhulu amawaka eemvavanyo ze-ABPM ngonyaka.
Ubunzima ngezichaso ezinjalo kukuba i-USPSTF ichanekile ngokufanelekileyo kule meko. Imilinganiselo yempembelelo yegazi efunyenwe kwiofisi yegqirha ihlala idukisa, kwaye ingakhokelela ekunakekeleni unyango olungalunganga.
Kutheni i-Office yeHome Pressure Measure Ingxaki
Xa uxinzelelo lwakho lwegazi lugqityiwe kwiofisi yegqirha, umlinganiselo obhalisiwe ngokukhawuleza uba ngumfutho wegazi "osemthethweni" - njengokungathi uxinzelelo lwegazi luyinani le-static, njengobunzima bakho okanye ubude bakho.
Kodwa uxinzelelo lwegazi alonaxabiso elingu-static. Iyakushintsha ncinane ukusuka kumzuzu ukuya kumzuzu , kuxhomekeke kwiimfuno ezikhawulezileyo zesistim sakho senhliziyo. Ngaphandle kokuba kwenziwe phantsi kweemeko ezichazwe ngokucophelela, imilinganiselo yomsinga omnye wegazi ingase ibe bhetele kunokuba isampuli esingahleliyo kwezi xabiso eziqhelekileyo eziguqukayo.
Ukuze uzame ukujikeleza le ngxaki, umlinganiselo wexinzelelo wegazi "oqhelekileyo" uchazwa njengokuba uqhutyelwa phantsi kwimeko "yokuphumla okuphumlileyo," kwaye izifundo ezibonisa iingenelo zokuxilonga kunye nokunyanga ingozi yempembelelo zisekelwe kule migangatho.
Nazi iimfuno zomlinganiselo we-"standard" wegazi:
- Isigulane sifanele sibekwe kwindawo epholileyo, efudumeleyo neyokuzola.
- Isigulane akufanele sibe ne-caffeine okanye iimveliso zecuba iminyaka engama-30.
- Isigulane sifanele sihlale sinoxolo, kunye nomqolo wabo usixhaswe kwaye siqonde, kwaye kunye neenyawo zombini zixhaswa phantsi.
- Isigulane sifanele sihlale siphumle kule ndawo ubuncinane imizuzu emi-5.
- Emva kokuba le miqathango idibeneyo, ugqirha okanye umongikazi kufuneka athathe ngokunyanisekileyo uxinzelelo lwegazi lwesigulane ubuncinane kabini, ngokukhethekileyo ngexesha elingu-5 eliphakathi kokufunda.
- Ukuba imilinganiselo emibini iyahluka ngaphezu kwama-5 mm Hg, kufuneka kufundwa ngokuphindaphindiweyo, kunye nezikhathi ezifanayo phakathi kokurekhodwa, de kube ukurekhodwa kuvumelane.
Sonke siyazi into eyenzekayo. Izigulane zifika ngexesha lokuqokwa kwakhe, kodwa zithe zahlala zinyama kwiindawo ezilindileyo kunye neendawo zokulinda. Ekugqibeleni, isigulane sigijimela ekamelweni lokubanda elibandayo, kwaye iyalelwe ukuba ihluthe kwaye ibeke ingubo ehlosekileyo yokuhlolwa kunye nezibopho ezahlukileyo. Emva koko, bonke behamba kunye neemeko, isigulane sihlala njengoko siyalwe kwitheyibhile yoviwo lokubhakabhaka, singenayo inkxaso yenkxaso kunye nemilenze ephazamisayo. Ugqirha otyhatywayo okanye umongikazi ekugqibeleni uyangena, ahlabe umxinzelelo wegazi, kwaye ngelixa uthatha uxinzelelo lwegazi ngexesha elifanayo libandakanya isigulane kwi-Q & A, okanye iqalisa ukwenza izinto ezimbini okanye ezintathu "ekuhlawuleleni ukusebenza" .
Kwaye akukho nhlobo yokufumana uxinzelelo lwegazi lwesibini ukufunda imizuzu emihlanu kamva.
Ngoko, kwiimeko ezininzi (ukuba akuninzi), into oya kuyo kwiofisi yegqirha iphantse i-sampling engahleliweyo yokunyuka kwengcinezelo yegazi, kwiimeko ezihluke kakhulu "ekuphumleni okuphumayo." Ngcaciso, imilinganiselo enjalo ayifanele isetyenziswe ukuxilonga isigaba 1 somfutho wegazi ophezulu.
Nangona ezi mpazamo, ukuba uxinzelelo lwegazi luphantsi kwinqanaba eliqhelekileyo (ngaphantsi kwe-120 mm Hg systolic kwaye ngaphantsi kwama-80 mm Hg diastolic), akukho monakalo eyenziwe. Yaye ukuba uxinzelelo lwegazi lukhulu ngokwaneleyo (160 mm Hg systolic), kunokuthathwa ngokukhuselekileyo ukuba ingozi yomshurensi yinyani, kwaye unyango lunokumiselwa. Ingxaki ivela xa uxinzelelo lwegazi e-ofisi lukwinqanaba elincinci, isigaba 1 somfutho wegazi ophezulu. Ngaba le nto ingxinzelelo? Okanye ngaba yinto nje yokwenza isampula?
Oogqirha, ngokuqinisekileyo, abazigxeka. Izigulane apho uxinzelelo lwegazi luphakanyisiwe kwiofisi yegqirha, kwaye eqhelekileyo ekhaya, kuthiwa " unengubo emhlophe yengozi yokugxininisa ." Nangona kubonakala ukuba iingubo ezimhlophe zinegazi eliphezulu zikhona, kubonakala ngathi zikhukhumeza oogqirha qulunqa isifo esitsha, kwaye sibonelele kwizigulane zabo, xa amaxesha amaninzi behluleka ukulinganisa uxinzelelo lwegazi njengoko kufuneka lilinganiswe.
I-Advantage ye-ABPM (kunye ne-HBPM)
Inzuzo ye-ABPM kukuba ayithembeli kwisifundo esisodwa okanye ezimbini kwigazi phantsi kweemeko ezilawulwayo. Kunoko, i-ABPM isamphula iimpompo zegazi ngexesha eliqhelekileyo ngaphezu kweeyure ezingama-24 - ngexesha lonke ukuguquka okuqhelekileyo ngosuku. Ukuba khona okanye ukungabikho komfutho wexinzelelo ophezulu kunqunywe ngumyinge wegazi ophakathi kwimihla yonke. Ukuxilongwa komfutho wegazi ophezulu kunye ne-ABPM kuye kwaqinisekiswa ngokuqinisekileyo, kwaye kuchaneke ngakumbi kunokuxilongwa kwesigaba 1 somngcipheko owenziwe kwiofisi yegqirha.
Enye indlela eya kwi-ABPM kukubeka esweni kwenyameko lwegazi (HBPM). Kukho iinzuzo ezininzi ze-HBPM ezenza zibe zikhangele ngakumbi kune-ABPM ekuxilongeni nasekulawuleni umfutho wexinzelelo, kwaye oogqirha abaninzi bakholelwa ukuba yinto efanelekileyo. Umqulu we-USPSTF uxwebhu lubonisa ngokucacileyo ukukhethwa kwe-HBPM phezu kweofisi yegqirha yokuxilonga ingozi yegazi.
Oko Konke Oku kuthetha Kuwe
Kungenzeka ukuba kuya kuba neqhawe elide ngaphambi kokuba oogqirha nabahlawuli bavumelane ne-USPSTF ukuba isigaba 1 somfutho wegazi ophezulu kufuneka sifumaneke kuphela emva kokuba i-ABPM (okanye i-HBPM) iqinisekisa ukuxilongwa. Yintoni omele uyenze, ukuba unikwe ukuba unqanaba le- hypertension (okanye u- hypertension ), kwaye ugqirha wakho uphakamisa unyango lobomi bonke, ukuba le mivavanyo yokuqinisekisa iyatholakala namhlanje, kwaye kuyaqondakala ukuba ucele. Funda malunga ne-ABPM kunye ne-HBPM, kwaye ubuze ugqirha wakho ukuba kuya kuqiqa ukuba usebenzise uvavanyo olunjalo ukuqinisekisa ukuba unesondlo esiphezulu ngaphambi kokuqala unyango.
Imithombo:
I-Statute yeNkcazo yeNkqonkquthela: I-High Press Pressure e-Adult: I-Screening. "I-US Force Preventive Task Force, ngoDisemba 2014. http://www.uspreventiveervicestaskforce.org/Page/Document/RecommendationStatementDraft/hypertension-in-adults-screening-and-home- iliso (Ukufikelela ngoJanuwari, 2015).
I-Pickering TG, uMiller NH, u-Ogedegbe G, et al. Ukubizela kwisenzo ekusebenziseni nasekubuyiselweni kwenkqubo yokujonga uxinzelelo lwegazi lwekhaya: isishwankathelo esiphezulu: isitatimenti esenzelweneyo sesayensi kwi-American Heart Association, i-American Society Of Hypertension, kunye ne-Preventive Cardiovascular Association Association. Uxinzelelo lwe-2008; 52: 1.