Ukulindela ukuhlinzwa ngethuba lokuxhalabisa. Ngaphezulu kwelo, ukuba unomfutho ophezulu wegazi , unokuba neengxalaba ezongezelelweyo malunga nendlela uxinzelelo lwegazi lwakho oluya kuthathwa ngayo phantsi kwe-anesthesia jikelele.
Masiqwalasele ngokuthe ngqo kwiimpembelelo ezithile zonyango kwixinzelelo legazi, kunye nendlela yokwenza le meko yonyango (ebizwa ngokuba yingozi yegazi) inokuchaphazela ixesha lokuhlinzwa kwakho.
Ukulawula uxinzelelo lwegazi eliphambili: Ngaphambi koPilisi
Ukuba nesifo sengqondo esiphezulu kakhulu kunokunyusa umngcipheko wokuhlinzwa, kwaye unobungozi obukhulu kangakanani, kuxhomekeke ekubeni unomdla ophezulu kangakanani.
Ngaloo nto, ezinye zeemeko ezithile eziphakamileyo zengcinezelo yegazi zibeka emngciphekweni wokuba unyango luquka:
- Ukukhubazeka kwentliziyo
- Iingxaki zeengso
- Stroke
- Ukuhlaselwa yintliziyo
Oko kwathiwa, uxinzelelo oluphezulu lwegazi aluyiyo isizathu sokuyeka ukuhlinzwa emva kokuba umntu eqhutywe ngophakanyiso oluphambili kunye nokunyanzelwa kwengcinezelo yegazi, oko kuthetha ukuba uxinzelelo lwegazi lwe- symmic i-180mmHg okanye ngaphezulu okanye uxinzelelo lwegazi lwe - diastolic ngu-110mmHg okanye ngaphezulu . Kule meko, ukutyunjwa kokuhlinzwa kunokuqwalaselwa.
Ukongezelela ekulandeleni iingcebiso zabo ngexesha lokuhlinzwa, kubalulekile ukulandela imiyalelo yeqela leenkonzo zonyango apho unyango luqhubekeka kwaye luphi na ukuyeka phambi kotyando lwakho.
Kubantu abanengcinezelo ephezulu yengcinezelo yegazi, kwiimeko ezininzi, ukuqhubeka nomfutho wegazi ophezulu (obizwa ngokuba yi-antihypertensives) ngokubanzi ukhuselekile. Enyanisweni, ukumisa ezinye zazo kungabangela impembelelo ehlawulekayo, apho ukunyuka kwegazi lakho kuphakama.
Ngokuphambene noko, ezinye iipilisi zegazi eziphezulu (umzekelo, i- ACE inhibitors okanye i- angiotensin receptor blockers ) zibanjelwe ixesha elithile, njengeeyure ezingama-24, ngaphambi kokuhlinzwa.
Ekugqibeleni, qiniseka ukucacisa ugqirha wakho ngokuchanekileyo ukuba yiyiphi imithi oyimfuneko kwaye akufanele uthathe ngaphambi kokuhlinzwa.
Ukulawula Uxinzelelo Ophezulu lwegazi: Ngethuba lokuphanda
Ngaphambi kokuba ungene kwigumbi lokusebenza, i-anesthesiologist yakho iya kukubuza imibuzo embalwa ngembali yakho yezobugqirha, ngaphezu kokwenza okokuhlaziywa kwetshathi yakho. Ngale ndlela uyazi ukuba uxinzelelo lwegazi lwenu, unyango lwezonyango, kunye / okanye ukuphendula kwangaphambili kwi-anesthesia.
Ngethuba lokuhlinzwa , i-anesthesiologist iya kugcina iso kunye nesiso rhoqo kwi-blood pressure yakho, kunye nezinye iimpawu ezibalulekileyo njengezinga lentliziyo yakho kunye nesantya sokuphefumla.
Ngokubhekisele kwengcinezelo yegazi ngexesha lotyando, kukho izizathu ezinobangela.
Esinye isizathu sokuba i-blood pressure yakho iphakame ngexesha lotyando luvela ekusebenziseni inkqubo yakho yeentlungu ngexesha lokuqala kwe-anesthesia-into eqhelekileyo. Ukongeza kwiphepha legazi lakho ephakama ngexesha lokuqala kwe-anesthesia, isantya senhliziyo yakho nayo iya kuvela.
Ukunyanga kwengcinezelo yegazi ngexesha lotyando, i-anesthesiologist yakho iya kulawula i-intravenous (nge-vein) yakho ye-antihypertensive.
Ngakolunye uhlangothi, ukuba ulahlekelwa igazi ngexesha lokuhlinzwa, uxinzelelo lwegazi lungahla. Nangona ukusetyenziswa kwamanzi kunye / okanye ukumpontshelwa igazi kungakho konke okufunekayo ukwandisa uxinzelelo lwegazi, ukuba kukho ukulahleka okukhulu kwegazi ngexesha lotyando (ngaphezulu kwama-20 ekhulwini lwegazi lomzimba wakho), imeko ebungozi yobomi ebizwa ngokuba yi-hypovolemic shock phuhlisa.
Ukutshatyalaliswa kwe-Hypovolemic kwenzeka xa ukulahlekelwa kwegazi kwenza kube nzima ukuba intliziyo ibethwe ngokufanelekileyo, oko kukunciphisa inani legazi elifikelela kwiziko ezinkulu. Olu hlobo lokutshitshiswa ludinga ukutshintshwa kwegazi ukuze kuqinisekiswe ukuba izitho zakho zifumana i-oksijini abayidingayo ukuba isebenze.
Ukulawula uxinzelelo lwegazi oluphezulu: Emva koPilisi
Njengoko umntu ebuyisela kwi-aneshesia, uxinzelelo lwegazi kunye nentliziyo yexabiso lincinci kwaye landise ngokwemvelo. Ukuba umntu ufumana iimpompo eziphezulu zegazi emva kokuhlinzwa (xa uxinzelelo lwe-systolic u-180mmHg okanye ngaphezulu), uya kunikwa imishanguzo emilonyeni, endaweni yokunyanga imithi, ukunciphisa uxinzelelo lwegazi.
Enyanisweni, ukuba uxinzelelo lwegazi luphakamileyo ngenxa yezinye izizathu ezinjengeentlungu okanye utywala obuninzi olunikezwa ngexesha lotyando, ukuguqulwa kwale micimbi kufuneka kuvelise uxinzelelo lwegazi.
Kwiphepha le-flip, abanye abantu bafumana ukulahla kwexinzelelo lwegazi emva kokuhlinzwa. Oku kungakho ngenxa yonyango olunikezwa ngu-anesthesiologist (umzekelo, inyango yemilenze) okanye nje umphumo wecala wenkqubo.
Ukongeza, kunokuba yingozi kwaye isongela ubomi kwixinzelelo legazi emva kokuhlinzwa ngenxa yesifo . Ukuze unqande okanye uphathwe intsholongwane, ugqirha wakho unokuthatha i-antibiotic ngaphambi okanye emva kokuhlinzwa kwakho.
Ekugqibeleni, kubalulekile ukuba uqaphele ukuba xa unesifo sengcinezelo segazi esingapheliyo, kufuneka uqhubeke kwakhona emva kokuhlinzwa. Enyanisweni, ngamanye amaxesha, uxinzelelo lwegazi oluphezulu emva kokuhlinzwa luyiphumo lomntu ongaqhubekiyo kwiirimim ziyeza.
Ewe, qiniseka ukuba ucacise ukuba yiyiphi imithi oyithathayo kunye neqela lakho lokugada.
ILizwi
Umgca ongundoqo kukuba ukuba okanye ungayishiyi ukuvavanywa kwakho, ngokusekelwe kwingcinezelo yegazi, akusiyo isihloko esimnyama nesomhlophe. Yingakho kubalulekile ukuba ulandele ulwalathiso lweqela lakho lempilo, elibandakanya ugqirha wakho, ugqirha wakho wokunakekela, kunye ne-anesthesiologist yakho.
Ekugqibeleni, ukwazi ukuba i-anesthesiologist yakho iya kulungiswa kakuhle ukugcina uxinzelelo lwakho lwegazi lulawulwa ngexesha lotyando kwaye ukuba ugqirha wakho uya kuthatha yonke ingqalelo ngaphambi kokuba emva kokuvavanywa kwakho, kufuneka ubeke ingqondo yakho lula.
> Imithombo:
> Whelton PK et al. Ikholeji yaseMerika yeCardiology: 2017 Isikhokelo soPhulo oluphezulu lweGciwane kwiBantu abadala.
> Bisognano JD. Ulawulo lweperioperative loxinzelelo lwegazi. Aronson MD, ed. Isemgangathweno. Waltham, MA: UpToDate Inc.
> Kheterpal S et al. Ukucwangcisa kwangaphambili kunye nokungasebenzi kwangaphambili kweziganeko ezingathandekiyo zentliziyo emva kwezinto eziqhelekileyo, izicathulo kunye nokuhlinzwa okwenzakalayo. Anesthesiology . 2009 uJan; 110 (1): 58-66.