Kuburitsa iyo 24h Ambulatory yeropa yekumanikidza yekutarisa
I. Nhanganyaya kune 24h Ambulatory Ropa Pursita Metitor
A 24 ambulatorivali yeropa yeropa yekutarisa chishandiso chinoramba chichiyeresa ropa kudzvanywa kwenguva yakareba-maawa makumi maviri nemana. Izvo zvakakosha muRopa Pressure Ongororo nekuda kwezvikonzero zvakati wandei. Chekutanga, inopa maonero akakwana emafungiro eropa emunhu anodzvinyirira pamasikati neusiku. Kusiyana neyechinyakare ropa reropa dzinotarisa zvinongotora chiyero cheSpanter, iyo ambulatory yekutora inobata kweropa shanduko panguva dzakasiyana, nguva dzekuzorora, uye kurara.
Semuenzaniso, kutsvakurudza kunoratidza kuti anenge mumwe muvakuru vatatu vane dzimba dzakakwirira dzeropa. Iyo 24H Ambulatory yeropa yeropa yekutarisa inogona kubatsira kuona hypertension iyo ingarasikirwa nezvimwe zviyero. Izvo zvinogona zvakare kuzivisa \
Aya monitor anowanzove ane chidiki chidiki, chinotakurika chishandiso chakabatanidzwa kune muviri wemurwere. Iyo ine cuff iyo inomedza nguva nenguva yekuyera kuyerera kweropa. Mamwe marudzi epamberi, kunge wire isina waya yeropa yekumanikidza yekutarisa, ipa zvakanyatsojeka uye kusununguka kwekushandisa.
Iko kukosha kweiyo 24h ambulatory yeropa yekumanikidza yekutarisisa iri mukukwanisa kwayo kupa ruzivo rwakakosha pakuongorora uye kugadzirisa hypertension. Nekutsvaga kweropa kudzvanywa kwenguva yakareba, vanopa hutano vanokwanisa kuita sarudzo dzakarurama dzekurapa uye kugadzirisa mishonga sezvinodiwa. Izvi zvinogona kutungamira mukudzora zviri nani kudzvanywa kweropa uye nenjodzi yakaderedzwa yekumanikidzwa yakabatana neyekumusoro kweropa, senge chirwere chemoyo uye kurohwa kwemoyo.
Ii. Zvakanakira zveVatariri
(a) kuongorora kwakaringana
Iyo 24H Ambulatory yeropa yeropa yekutarisa inopa kuongororwa kwakaringana kweropa kweropa kuenzaniswa nenzira dzechinyakare. Izvo zvinoramba zvichiyera kudzvanywa kweropa nguva nenguva mukati mehusiku hwese hwese husiku nehusiku, kutapa kuchinjika kunokwanisa kupoteredzwa nezvimwe zviyero. Semuenzaniso, kutsvakisisa kunoratidza kuti aya monitors anogona kuona kusiyana kwenguva pfupi kunokonzerwa nezvinhu zvakadai sekushushikana, kurovedza muviri, uye kurara. Iyi data yakazara inopa mufananidzo wakasarudzika weropa remunhu reropa rekumanikidza.
(b) Kuonekwa kwemaitiro asina kujairika
Iyo yekutarisa inoshandawo zvakanyanya mukuona zvisina kufanira eropa dzeropa dzekumanikidza. Inogona kuziva isiri-kusvetuka, inosimuka, uye yakanyanyisa madhiri maitiro. Pasisi-Dhizaina mapatani, uko husiku hwenhusiku hweropa harideredze sekutarisirwa, kunogona kuve chiratidzo chekuwedzera njodzi yemari. Iyo yekutarisa inogona kuona iyi uye yekurudziro yehutano hwehutano hwevanopa kutora danho rakakodzera. Saizvozvo, zvinokatanga, apo husiku hweropa reropa zvakakwira kupfuura zuva rekutyaira kweropa, uye props yakanyanyisa, uko kwehusiku hweropa kudzvanywa kudonha zvakanyanya kupfuura zvakajairika, zvinogona zvakare kuonwa. Zvinoenderana nezvidzidzo, zvinenge makumi maviri neshanu muzana evarwere vane hypertension uye 50% -80% yevarwere vane Refractory hypertension vanogona kuratidza aya maitiro asina kujairika. Kuonekwa kweaya mapatani akakosha pakuongororwa kwekutanga uye manejimendi ekunyora, sezvazvingaite kubatsira kudzivirira matambudziko akadai sehosha yemoyo uye kurohwa.
III. Mashandiro azvinoita
Iyo 24H Ambulatorivali yeropa yekumanikidza yekutarisa inoshanda kuburikidza nekubatanidzwa kwedunhu repamusoro tekinoroji uye mushandisi-ane hushamwari dhizaini. Iyo yekutarisa inowanzoitika yechishoma, chinotakurika chishandiso chakabatanidzwa kune muviri wemurwere. Ichi chishandiso chakashongedzerwa necuff iyo inobhururuka panguva yenguva dzose yekupindirana kuyera kweropa.
Iyo inoshanda mechanism inotanga ne sensor mune cuff ichiona dzvinyiriro mumutengesi wemurwere. Sezvo cuff inflates, inoshandisa kumanikidza paruoko, uye sensor inoyera shanduko mukumanikidzwa. Iyo yekutarisa inobva yashandisa algorithms kuverenga iyo systolic uye diastoic ropa kudzvinyirira tsika.
Mamwe marudzi epamberi, akadai seyeropa yeropa yekumanikidza yekutarisa, shandisa bluetooth kana imwe tekinoroji yeasina waya kuendesa iyo data kune iyo mbozhanhare yefoni kana komputa. Izvi zvinobvumira kutarisa nyore nyore uye kuongororwa kweropa rekumanikidza data.
Iyo yekutarisa yakarongedzwa kutora zviyero panguva yenguva nenguva neusiku. Semuenzaniso, inogona kuyera ropa kweropa mazuva ese gumi nemashanu kusvika makumi matatu. Uku kuenderera mberi kwekutarisa kunopa mufananidzo wakazara weropa remurwere emurwere pane imwe nguva yeawa makumi maviri nemana.
Iyo data yakarekodwa neyekutarisa inochengeterwa mundangariro yayo kana kuendeswa kune yepakati database yekuwedzera kuongororwa. Utano hwehutano hunogona kungoongorora iyo data uye kuita kuti vamwe vakarongeka vanodzinga uye sarudzo dzekurapa.
Mukupedzisa, iyo 24h ambulatory yeropa yeropa yekutarisa inoshanda nekushandisa yepamusoro sensors uye algorithms kuti vaenderere mberi nekuyera kweropa uye kupa data rakakosha kune vanopa hutano.
Iv. Zvishandiso
(a) kuongororwa kwehypertension
Iyo 24H Ambulativali yeropa yekumanikidza inotora basa rakakosha mukuongorora mhando dzakasiyana dze hypertension. Semuenzaniso, inogona kubatsira kuziva hycurnal hypertension, inowanzo kufuratirwa neyechinyakare yeropa zviyero. Sekureva kwekutsvagisisa, dzinenge gumi muzana kusvika ku20% yevanhu vane hypertension vane ruzivo rwehusiku. Iyo yekutarisa inogona kuona kana yeropa remunhu yakakwidziridzwa pakati pehusiku, kunyangwe kana ichiratidzika yakajairwa mukati mezuva.
Zvinogonawo kuongororwa kusarudzika kwehusiku hypertension, uko husiku hweropa hweropa hwakakwira asi nguva yemasikati yeropa iri mukati menguva dzose. Ichi chiitiko chinonetsa kwazvo kuti uone pasina kuenderera mberi kwekutarisa. Iyo 24H Ambulatory yeropa yeropa yekutarisa inopa yakakosha data yehutano hwehutano kune inoongororwa nenzira chaiyo uye kugadzirisa mamiriro aya.
Uye zvakare, iyo yekutarisa inogona kubatsira kusiyanisa pakati pevachena jasi hypertension uye yechokwadi hypertension. White Coat Hypertension inoitika kana iyo yeropa yemunhu yakakwidziridzwa chete muchirongwa chekiriniki nekuda kwekushushikana. Nekuyera neropa reropa pamusoro pegumi nemana nguva, mutambi anogona kuona kana iyo yakakwirira yeropa inoenderana kana kungoita kiriniki nharaunda.
(b) Kuongorora kushanda kwekurapa
Iyo 24H Ambulatory yeropa yekumanikidza yekutarisa chinhu chakakosha chekuongorora kushanda kwekubudirira kwekurapa kweAnitipertensive. Nekuenderera mberi nekuongorora kweropa, zvinogona kuratidza kuti mishonga yakatarwa kana shanduko yemararamiro iri kunyatso kuderedza ropa nekufamba kwenguva.
Semuenzaniso, kana murwere ari pamishonga yeAntiypertensive, mutambi anogona kupa data pamishonga iri kushanda mumasikati neusiku. Kana iyo fungidziro ichiramba yakakwira kunyangwe kurapwa, varapi vehutano vanogona kugadzirisa dosage kana kuchinja mushonga.
Uyezve, mambidze inogona kubatsira kuona kana mararamiro acho shanduko senge shanduko, kurovedzera muviri, uye kuderedzwa kushushikana kuri kuita zvakabatsira kweropa. Nekufananidza ropa rekudzvinyirira dzisati rasvika uye mushure mekuita shanduko idzi, varidzi vehutano vanogona kuongorora kushanda kwekudyidzana.
Mukupedzisa, iyo 24th ambulatority yeropa yekumanikidza yekutarisa ine zvakakosha zvekushandisa mukutsvaga hypertension uye kuongorora kushanda kwekurapwa. Kugona kwaro kuri kuenderera mberi kwekutarisira kunopa zvakakosha ruzivo rwehutano hwehutano hwekuita sarudzo uye kugadzirisa zvabuda murwere.
V. Management of husiku hypertension
(a) kuzivikanwa
Iyo 24H Ambulatory yeropa yeropa yekutarisa inokosha mukuzivisa usiku hypertension. Sezvineiwo nhungamiro, husiku hypertension inotsanangurwa seyakawana husiku avhareji yedhirivhari yeropa yekumanikidza ≥120 mmhg uye / kana diastoic ropa kudzvanywa kwe ≥70 mmhg. Iyo yekutarisa ichiramba ichitsvaga yeropa nguva yese yese yenguva-maawa makumi maviri nemana, kusanganisira panguva yekurara. Izvi zvinobvumira varapi vehutano kuti vaone zvakanyatsonaka kana murwere akakwira ropa pakati pehusiku. Semuenzaniso, kana kuverenga kwemurwere kuchiratidza nguva dzose yakakwira yeropa nguva yekunetseka kwemaawa ehusiku yakanyorwa neyekutarisa, inogona kuve chiratidzo chakajeka chehusiku hypertension.
(b) marongero ekurapa
Kune akati wandei kurapa nzira dzehusiku hypertension. Chekutanga, mararamiro ekugadzirisa anotamba basa rakakosha. Iyo yakaderera-sodium uye potassium-pfuma yekudya inogona kubatsira kuderedza ropa. Tsvagurudzo inoratidza kuti kuderedza sodium kudya kunogona kutungamira kune inodonha kwakakosha mukumanikidzwa kweropa. Uyezve, kuvandudza mhando yekurara kwakakosha. Varwere vanofanirwa kurayirwa kuti varambe vachirongwa nguva nenguva yekurara uye kugadzirisa chero kusagadzikana kwekurara kana kazhinji kumutswa. Kurera uremu uye kurovedza muviri nguva dzose kunogona kubatsirawo. Zvidzidzo zvakaratidza kuti kurasikirwa kunyange kunyange huwandu hushoma hwehuremu hunogona kuderedza ropa.
Kurapwa kwe pharmacological ndiyo imwe sarudzo. Nguva refu-inobata antiypertensive mishonga inowanzo kukurudzirwa sezvavanogona kupa kuenderera mberi kweropa kudzora kwezuva nezuva neusiku. Semuenzaniso, Calcium Channel blockers, ace inhibitors, uye maArb anowanzo shandiswa. Kusanganisa kurapwa neinodhaka kwakawanda kungave kuri mishonga mune dzimwe nguva kuti dzinyatso kudzora hypertension.
Mukuwedzera, kurapa mamiriro ezvinhu anobatsira pakurwara kwehusiku kwakakosha. Semuenzaniso, kana murwere aine chirwere chekurara Apnea syndrome (Osas), kurapa iyi mamiriro kunogona kubatsira kudzikisa kweropa. Kugadzirisa chirwere chisingaperi chitsuwa chirwere, chirwere cheshuga, uye zvimwe zvinomera zvinogona zvakare kuita zvakanaka pakubata kwehusiku hypertension.
Pakupedzisira, kugara uchiongorora neiyo 24h Ambulatory yeropa yekumanikidza yekutarisa inokosha kuongorora kushanda kwekurapwa kwekurapwa. Gadziridzo dzinogona kugadzirwa zvichienderana neyekutariswa data kuti uve nechokwadi cheropa reropa rekumanikidza kweropa.
