arteriuli hipertenzia | GeoForum.Ge
Shetyobinebebi
1. medik![4005](Off)Pas|Cit|PM
21 Ivn 11, 15:08:02
arteriuli hipertenziebi - sisxlis arteriuli cnevis momateba aortidan arteriolebis chatvlit. normashi 20-40 clis asakis pirebshi arteriuli cneva 140/90 mm vcy sv -ze qvevitaa, 41-dan 60 clamde 145/90 mm vcy sv-ze qvevitaa; 60 clis asakze zemot janmrtelebshi sistoluri cneva umravles shemtxvevashi ar aghemateba 160-s, xolo diastoluri 90 mm vcy sv. aucilebelia ganvasxvavot arteriuli cnevis sporaduli (situaciuri), mcvave zomieri da qronikuli momateba. aseve pirveladi da meoradi arteriuli hipertenzia. pirveladi arteriuli hipertenziis farglebshi ganixilaven daavadebas, romelsac ecodeba esenciuri hipertenzia, an hipertonuli daavadeba. meoradi (simptomaturi) arteriuli hipertenzia dakavshirebulia organoebis an sistemebis dazianebastan, romlebic pirdapir an gasashualebul axdenen zemoqmedebas arteriul cnevis doneze. arteriuli cnevis momateba carmoadgens am organoebis an sistemebis daavadebis ert – ert simptoms. etiologiuri an camyvani patogenetikuri faqtoris moxsna xshirad icvevs arteriuli cnevis normalizacias an mis mnishvnelovan daqveitebas. meoradi arteriuli hipertenziis klasificireba shemdegnairia: 1. tirkmlismieri; a) parenqimuli; b) renovaskuluri; 2. endokrinuli; 3. hemodinamikuri (kardiovaskuluri, meqanikuri); 4. neirogenuri (kerovani); 5. danarcheni.
tirkmlismieri parenqimuli arteriul hipertenzia vitardeba mcvave da qronikuli glomerulonefritebis da pielonefritebis dros; renovaskuluri arteriuli hipertenzia shesadzloa iyos tandayolili da shedzenili. endokrinuli arteriuli hipertenzia ganpirobebulia feoqromocitomit da sxva qromafiluri simsivneebit, pirveladi aldosteronizmit, icenko-kushingis daavadebita da sindromit, akromegaliit da sxv.
hemodinamikuri an kardiovaskularuli arteriuli hipertenzia vitardeba shecvlili hemodinamikis shedegad, dziritadad, meqanikuri faqtorebis xarjze. mat miekutvneba sistoluri arteriuli hiperotenzia aortis aterosklerozis, aortis sarqvelebis ukmarisobis, ghia arteriuli xvrelis, arteriovenuri fistulebis, blokadis, pejetis daavadebis, tireotoqsikozis dros. neirogenuri arteriuli hipertenzia carmoiqmneba tavisa da zurgis tvinis kerovani dazianebebis, mogrdzo tvinis sisxldzarghvta mamodzravebeli centris agznebis dros.
2. medik![4005](Off)Pas|Cit|PM
21 Ivn 11, 15:16:17
etiologia da patogenezi. hipertonuli daavadebis mizezebis formireba srulad dadgenili ar aris. tumca, yuradgheba unda mieqces or faqtors: noradrenalinsa da natriums. hipertonuli daavadebis formirebisatvis aucilebelia memkvidruli cinascargancyobis shercyma gareshe faqtorebis arasasurvel zemoqmedebastan. arsebobs garkveuli kavshiri simsuqnesa da arteriuli cnevis momatebas shoris.
simptomebi, mimdinareoba. daavadeba ishviatad icyeba 30 celze axalgazrda da 60 celze ufrosi asakis pirebshi. myari sistoluri arteriuli hipertenzia axalgazrdebshi carmoadgens safudzvels meoradi, gansakutrebit renovaskuluri hipertenziis dziebisa. hipertonuli daavadeba mimdinareobs qronikulad, gaumjobesebisa da gauaresebis periodebit. ganasxvaveben daavadebis nela moprogresire (ketiltvisebian) da scrafad moprogresire (avtvisebian) mimdinareobas. neli mimdinareobis dros daavadeba gaivlis 3 stadias klasifikaciis mixedvit, romelic mighebulia msoflios janmrtelobis dacvis organizaciis mier.
3. medik![4005](Off)Pas|Cit|PM
21 Ivn 11, 15:17:47
pirveli (msubuqi) stadia xasiatdeba arteriuli cnevis shedarebit mciredi momatebit: 160-177 (180) mm vcy sv sistoluri, 95-104 (105) mm vcy sv -diastoluri cnevis farglebshi. arteriuli cnevis done aramyaria; mosvenebul mdgomareobashi cneva tandatanobit normalizdeba, magram daavadeba ukve fiqsirebulia da arteriuli cnevis mateba aucileblad kvlav ichens tavs. avamyofta nacils aravitari chivilebi ar aghenishnebat; sxvebshi aghinishneba tavis tkivili, xmauri tavshi, dzilis darghveva, shromisunarianobis daqveiteba. tavbrusxvevebi, cxviridan sisxldena. marcxena parkuჭis hipertrofiis nishnebi gamoxatuli ar aris, ekg mciredaa gadaxrili normidan; tirkmlis funqcia darghveuli ar aris, tvalis fskeri praqtikulad ucvlelia.
meore stadia (sashualo) cina stadiisagan gansxvavdeba arteriuli cnevis shedarebit meti da myari momatebit, romelic avadmyofis mshvid mdgomareobashi 180-200 mm vcy sv sistoluri da 105-114 mm vcy sv diastoluri cnevis farglebshia. avadmyofebi uchivian tavis tkivils, tavbrusxvevas, tkivils gulis areshi, xshirad stenokardiuli xasiatis. am stadiisatvis tipiuria hipertonuli krizebi. vlindeba samizne-organoebis dazianebis nishnebi: marcxena parkuჭis hipertrofia (zogjer mxolod parkuჭtashua dzgidis), pirveli tonis shesusteba gulis mcvervalze, meore tonis aqcenti aortaze; avadmyofta nacils ekg-ze aghenishnebat subendokarduli ishemiis nishnebi. centraluri nervuli sistemis mxriv - sisxldzarghvovani ukmarisobis sxvadasxva gamovlinebebi, tvinis tranzitoruli ishemia, shesadzloa tvinis insulti. tvalis fskerze, arteriolebis shevicoebastan ertad, aghinishneba venebis cvlilebebi, mati gafartoeba, hemoragiebi, eqsudatebi. tirkmlis sisxlmimoqceva da gorglovani filtraciis sichqare daqveitebulia, tumca shardis analizebshi normidan gadaxra ar aghinishneba.
mesame stadia (mdzime) xasiatdeba sisxldzarghvovani krizebis shedarebit xshiri carmoqmnit, rasac gansazghvravs arteriuli cnevis mnishvnelovani da stabiluri mateba da shedarebit msxvili sisxldzarghvebis arteriosklerozisa da aterosklerozis progresireba. arteriuli cneva aghcevs 200-230 mm vcy sv. sistoluri da 115-129 mm vcy sv diastoluri; cnevis spontanuri normalizacia ar xdeba. klinikuri surati ganisazghvreba gulis (stenokardia, miokardis infarqti, sisxlis mimoqcevis ukmarisoba, aritmia), tvinis (ishemiuri da hemoragiuli infarqtebi, encefalopatia), tvalis fskeris (angioretinopatia), tirkmelebis (tirkmlis sisxlmimoqcevisa da gorglovani filtraciis daqveiteba) dazianebit.
ganasxvaveben hipertonuli daavadebis ramodenime formas. ert -ertia hiperadrenerguli forma, romelic xshirad vlindeba daavadebis sacyis periodshi, magram shesadzlebelia shenarchunebuli iyos misi mteli mimdinareobisas (avadmyofta daaxloebit 15%). mistvis
4. medik![4005](Off)Pas|Cit|PM
21 Ivn 11, 15:18:37
tipiuria iseti nishnebi, rogoricaa sinusuri taqikardia, aramyari arteriuli cneva, sistoluri hipertenziis siჭarbit, oflianoba, tvalebis sibzinvare, saxis gacitleba, tavis areshi pulsis shegrdzneba, gulis friali, shinagani dadzabuloba, shfotva. hipertonuli davadebis hiperhidrataciuli forma sheidzleba gamovlindes iseti damaxasiatebeli nishnebit, rogoricaa periorbitaluri sheshupeba da saxis sheshupeba dilaobit, xelis titebis sheshupeba, mati gabuzheba da paresteziebi, diurezis cvlilebebi gardamavali oliguriit, cyal-marilovani hipertenzuli krizebi, natriumis da cylis shedarebiti scrafi shekaveba simpatolizuri sashualebebit mkurnalobis dros (rezerpini, dopegiti, klofelini da sxv.). hipertonuli daavadebis avtvisebiani forma, carmoadgens scrafad moprogresire daavadebas arteriuli cnevis momatebit dzalian maghal cifrebamde, rac icvevs encefalopatiebis ganvitarebas, mxedvelobis darghvevas, filtvebis sheshupebasa da tirkmelebis mcvave ukmarisobas. amzhamad avtvisebianad mimdinare hipertonuli daavadeba sakmaod ishviatia, gacilebit xshiria meoradi arteriuli hipertenziis avtvisebiani finali (renovaskularuli, pielonefrozuli da sxv.).
mkurnaloba. shesadzloa ganxorcieldes arafarmakologiuri da farmakologiuri metodebit. arafarmakologiur mkurnalobas miekutvneba: a) conashi dakleba, dietashi cximebisa da naxshircylebi shemcirebis xarjze; b) sufris marilis gamoyenebis shezghudva; g) kurortuli mkurnaloba, izoterapiisa da samkurnalo fizkulturis metodebi; d) fsiqoterapiuli zemoqmedeba. farmakologiuri metodebi efeqturia daavadebis pirvel stadiashi. farmakologiuri mkurnaloba emyareba e. c. safexurovan princips, romelic itvaliscinebs camlebis danishvnas garkveuli tanamimdevrobit.

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