ntshav siab vs ntshav siab
ntshav siab yog dab tsi?
ntshav siab yog txhais tau tias Systolic ntshav siab siab dua 140 mmHg thiab diastolic ntshav siab tshaj 90 mmHg ntawm qhov nruab nrab ntawm 2 lossis ntau dua nyeem ntawm 2 qhov kev mus ntsib hauv tsev kho mob. Raws li Pawg Neeg Saib Xyuas Kev Tiv Thaiv, Kev Tshawb Fawb, Kev Ntsuas thiab Kev Kho Mob Ntshav Siab (JNC VII), ntshav siab tau muab faib ua plaub pawg.
1. Ib txwm Systolic tsawg dua 120 mmHg, Diastolic tsawg dua 80 mmHg
2. Pre-hypertension Systolic 120 - 139 mmHg, Diastolic 80-89 mmHg
3. Qib I Systolic 140 – 159 mmHg, Diastolic 90 – 99 mmHg
4. Qib II Systolic siab dua 160 mmHg, Diastolic siab dua 100 mmHg
Hypertension tuaj yeem faib ua thawj lossis qhov tseem ceeb kub siab thiab ntshav siab theem nrab. Qhov tseem ceeb kub siab tsis muaj qhov tshwm sim thaum muaj ntshav siab theem nrab muaj ib qho. Kev kub siab hnyav tshaj 180/110 mmHg yog qhov tseem ceeb heev rau kev kho mob. Hypertensive xwm txheej yog ntshav siab tshaj 180/110 mmHg nrog cov tshiab los yog tsis tu ncua ntawm lub cev puas tsuaj. Hypertensive ntsoog yog ntshav siab tshaj 180/110 mmHg yam tsis muaj qhov kawg ntawm lub cev. Kev puas tsuaj rau lub cev muaj zog tuaj yeem suav nrog encephalopathy, hemorrhagic stroke intracranial hemorrhages, myocardial infarction, sab laug ventricular tsis ua haujlwm, mob ntsws pulmonary edema.
Pathogenesis ntawm qhov tseem ceeb kub siab yog qhov nyuaj heev. Lub plawv tso zis, ntshav ntim, ntshav viscosity, hlab ntsha elasticity, innervations, humoral thiab cov ntaub so ntswg ntawm ntau yam cuam tshuam rau ntshav siab. Cov tib neeg feem coob yuav muaj ntshav siab thaum lawv muaj hnub nyoog.
Ntau yam kev mob tuaj yeem ua rau muaj ntshav siab ntxiv. Cov kab mob endocrinological xws li acromegaly, hyperthyroidism, hyperaldosteronemia, corticosteroid over-secretion (Cushing's), pheochromocytoma, mob raum xws li mob raum, kab mob polycystic raum, kab mob xws li kab mob collagen vascular, vasculitis tuaj yeem ua rau mob ntshav siab thib ob.
Hypertension hauv cev xeeb tub yog lwm qhov chaw tseem ceeb. Ntshav siab, protienurea, thiab convulsions characterizes eclampsia. Eclampsia tuaj yeem ua rau abruptio placentae, polyhydramnios, fetal compromise thiab fetal tuag.
Ntshav Qab Zib yog dab tsi?
ntshav siab qis tuaj yeem tshwm sim los ntawm ntau yam txheej txheem. Kev txo qis ntawm cov ntshav, dilatation ntawm cov hlab ntsha peripheral, thiab txo qis ntawm cov zis vim lub plawv tsis ua hauj lwm yog lub ntsiab pathophysiological triad. Kev txo qis ntawm cov ntshav tuaj yeem tshwm sim los ntawm sever hemorrhage, ntau lub raum poob dej vim polyurea, diuresis, dej poob vim yog kab mob ntawm daim tawv nqaij thiab kub hnyiab. Dilation ntawm peripheral hlab ntsha tuaj yeem yog vim cov tshuaj xws li nitrates, beta blockers, calcium channel blockers, txo cov suab paj nruag thiab vagal stimulation.
Thaum cev xeeb tub, muaj vasodilatation dav dav, txo cov ntshav viscosity thiab nce cov ntshav ntim nce siab hauv qhov txo qis ntshav siab tshwj xeeb tshaj yog thaum thawj ob peb lub hlis twg. Cov kab mob endocrinological xws li hypoaldosteronism, corticosteroid insufficiency tuaj yeem txo cov ntshav siab.
Mob ntshav qab zib tau paub tias ua rau cov ntshav qis tshwj xeeb vim yog mob ntshav qab zib autonomic neuropathy. Sever hypotension hu ua shock. Muaj ntau hom kev poob siab. Hypovolemic shock yog vim qhov txo qis ntawm cov ntshav ntim. Cardiogenic poob siab yog vim txo lub peev xwm ntawm lub plawv kom nqus ntshav. Neurogenic poob siab yog vim txo cov suab paj nruag los yog cov tswv yim parasympathetic ntau dhau. Anaphylactic shock yog ib qho kev tsis haum tshuaj loj heev. Kev txo qis ntawm cov ntshav siab hnyav tuaj yeem txo cov khoom hauv nruab nrog cev uas ua rau ischemic stroke, myocardial infarction, mob raum tsis ua haujlwm, plab hnyuv ischemia.
