Cov ntshav siab qis

Kev ntsuas ntshav qis tshwm sim thaum ntshav siab yog qis dua li ib txwm. Qhov no txhais tau hais tias lub siab, lub hlwb thiab lwm qhov ntawm lub cev tsis muaj ntshav txaus. Qhov ntshav siab feem ntau yog 90/60 mmHg thiab 120/80 mmHg.

Lub npe tshuaj rau kev muaj ntshav siab yog ntshav siab.

Ntshav siab nws txawv ntawm ib tus neeg mus rau lwm tus. Qhov poob qis li 20 mmHg, tuaj yeem tsim teeb meem rau qee tus neeg. Nws muaj ntau yam thiab cov ua rau cov ntshav qis.

Kev mob ntshav siab ntau tuaj yeem tshwm sim los ntawm kev tso ntshav tawm (poob siab), mob hnyav, mob plawv, lossis muaj kev fab tshuaj tsis haum (anaphylaxis).

Orthostatic hypotension tshwm sim los ntawm kev hloov pauv ntawm lub cev qhov chaw. Qhov no tshwm sim feem ntau thaum koj hloov los ntawm pw ntxeev mus rau sawv. Hom ntshav siab li no feem ntau kav ntev li ob peb feeb lossis feeb xwb. Yog hais tias hom mob ntshav qis no tshwm sim tom qab noj mov, nws yog hu ua postprandial orthostatic hypotension. Hom no feem ntau cuam tshuam rau cov neeg laus, cov neeg muaj ntshav siab, thiab cov neeg muaj tus kab mob Parkinson.

Neurally mediated hypotension (NMH) feem ntau cuam tshuam rau cov neeg hluas thiab menyuam yaus. Nws tuaj yeem tshwm sim thaum ib tus neeg tau sawv ntev. Cov menyuam yaus feem ntau outgrow no hom hypotension.

Qee yam tshuaj thiab cov khoom tuaj yeem ua rau cov ntshav qis, suav nrog:

• Cawv
• Tshuaj tiv thaiv kev ntxhov siab
• Qee yam tshuaj tiv thaiv kab mob
• Kev tshuaj ntsuab
• Tshuaj kho plawv, suav nrog cov siv los kho ntshav siab thiab mob plawv
• Cov tshuaj siv rau kev phais mob
• Pob Taum Pleev

Lwm yam ua rau cov ntshav qis muaj xws li:

• Kev puas ntsoog los ntawm cov ntshav qab zib
• Pauv hauv plawv atherosclerosis (arrhythmias)
• Tsis haus dej txaus (lub cev qhuav dej)
• Lub plawv tsis ua hauj lwm

Cov tsos mob ntawm ntshav siab tuaj yeem suav nrog:

• Qhov muag plooj
• Tsis meej pem
• Kiv taub hau
• Tsaus muag (syncope)
• Lub Cim Txhab Zog
• Xeev siab los ntuav
• Koj tsaug zog tsaug zog
• Neeg tsis muaj zog

Tus kws saib xyuas kev noj qab haus huv yuav tshuaj xyuas koj los txiav txim qhov ua rau koj cov ntshav qis. Koj lub cim tseem ceeb (ntsuas kub, mem tes, npaum li cas ua pa, thiab ntshav siab) yuav tau kuaj xyuas ntau zaus. Koj yuav tsum tau nyob hauv tsev khomob ib ntus.

Tus kws kho mob yuav nug cov lus nug, suav nrog:

• Koj li ntshav siab yog dab tsi?
• Koj noj tshuaj dab tsi?
• Koj puas tau noj mov thiab haus dej ib txwm?
• Koj puas tau muaj mob, huam yuaj, lossis raug mob?
• Koj muaj lwm cov tsos mob zoo li cas?
• Koj puas tau tsaus muag lossis tsis tshua meej pem?
• Koj puas xav tias kiv taub hau lossis tsaus muag thaum sawv lossis zaum tom qab pw?

Cov kev xeem hauv qab no tuaj yeem ua:

• Vaj huam sib luag metabolic vaj huam sib luag
• Ntshav mus kuaj seb puas muaj mob
• Ua kom tiav cov ntshav suav (CBC), suav nrog cov ntshav txawv
• Electrocardiogram (ECG)
• Mob Lub Hlaus
• Xoo hluav taws xob ntawm lub plab mog
• Xoo hluav taws xob ntawm lub hauv siab

Tsawg dua li cov ntshav siab nyob hauv cov neeg noj qab nyob zoo uas tsis ua rau muaj tsos mob feem ntau tsis xav tau kev kho mob. Txwv tsis pub, kho yog nyob ntawm qhov ua rau koj cov ntshav siab thiab koj cov tsos mob.

Thaum koj muaj cov tsos mob los ntawm kev poob siab hauv cov ntshav siab, zaum lossis pw tam sim ntawd. Tom qab ntawd tsa koj txhais taw siab dua qib siab.

Kev mob siab ntshav qis los ntawm kev poob siab yog qhov mob xwm txheej ceev. Koj yuav tau muab:

• Ntshav los ntawm rab koob (IV)
• Cov tshuaj kom ua rau ntshav nce siab thiab txhim kho lub plawv muaj zog
• Lwm yam tshuaj, xws li tshuaj tua kab mob

Kev kho mob rau cov ntshav siab tom qab sawv nrawm nrawm dua suav nrog:

• Yog tias cov tshuaj yog qhov ua rau, koj tus kws kho mob yuav hloov pauv ntau npaum lossis hloov koj mus rau lwm cov tshuaj sib txawv. TSIS TXHOB noj cov tshuaj ua ntej tham nrog koj tus kws kho mob.
• Koj tus kws kho mob yuav hais kom haus dej kom ntau ntxiv kom lub cev qhuav dej.
• Hnav cov thom khwm compression tuaj yeem pab ua kom ntshav txhawm rau hauv cov ceg. Qhov no ua kom muaj ntshav ntxiv hauv lub cev.

Cov neeg uas muaj NMH yuav tsum zam qhov kev sim, xws li sawv ntsug rau sijhawm ntev. Lwm txoj kev kho mob suav nrog haus kua thiab ua kom ntsev ntau ntxiv hauv koj cov zaub mov noj. Tham nrog koj tus kws kho mob ua ntej sim cov kev ntsuas no. Nyob rau hauv cov mob hnyav, yuav tau muab tshuaj kho.

Kev ntshav siab qis feem ntau tuaj yeem kho nrog qhov ua tiav.

Ntog vim yog ntshav qis rau cov neeg laus dua tuaj yeem ua rau lub duav lossis txha nraub qaum tawg. Cov kev raug mob no tuaj yeem txo tus neeg lub cev kev noj qab haus huv thiab muaj peev xwm txav mus los.

Cia li poob rau hauv koj cov ntshav siab tshaib plab koj lub cev ntawm cov pa. Qhov no tuaj yeem ua kev puas tsuaj rau lub siab, lub hlwb, thiab lwm yam. Hom ntshav siab li no tuaj yeem tsim kev piam sij yog tias tsis kho tam sim ntawd.

Yog tias ntshav siab tsawg ua rau ib tus neeg dhau mus (tsis nco qab lawm), nrhiav kev kho mob tam sim ntawd. Lossis, hu rau tus npawb xov tooj xwm ceev hauv cheeb tsam xws li 911. Yog hais tias tus neeg tsis ua pa lossis tsis muaj mem tes, pib CPR.

Hu rau koj tus kws kho mob sai li sai tau yog tias koj muaj cov tsos mob hauv qab no:

• Dub lossis maroon cov quav
• Kev mob hauv siab
• Kiv taub hau, pom ntaj
• Tsaus muag
• Ua npaws kub tshaj 101 ° F (38.3 ° C)
• Lub plawv dhia tsis xwm yeem
• Ua tsis taus pa

Koj tus kws khomob yuav qhia cov kauj ruam los tiv thaiv lossis txo koj tus mob nrog rau:

• Haus dej kom ntau
• Maj mam sawv tom qab zaum lossis pw qis
• Tsis haus dej haus cawv
• Tsis sawv ntsug ntev (yog tias koj muaj NMH)
• Siv cov thom khwm nias ua kom ntshav tsis suav hauv ob txhais ceg

Hypotension; Ntshav siab - qis; Postprandial hypotension; Orthostatic hypotension; Neurally mediated hypotension; NMH

Calkins HG, Zipes DP. Kev tsis ua haujlwm thiab syncope. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chaaj 43.

Cheshire WP. Autonomic tsis meej thiab lawv cov kev tswj hwm. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 418.