Chifukwa chake ofesi ya madotolo sikhoza kukhala malo abwino kwambiri oyeza kuthamanga kwa magazi.
Zikuwoneka ngati matenda a kuthamanga kwa magazi angathamangidwe kuchokera ku ofesi ya dokotala, ndikupita kunyumba, ngati bungwe la United States Preventive Services Task Force (USPSTF) liri ndi njira yake.
Mu December, 2014, USPSTF inapereka ndondomeko zatsopano zokhudzana ndi matenda opatsirana , zomwe zimalimbikitsa madokotala kuti azigwiritsa ntchito njira yoyendera magazi (ABPM) asanapange odwala mpaka kuchipatala chokhazikika.
Zowonadi, USPSTF ikupanga chinsinsi chachabechabe cha anthu - kutanthauza, kuti miyezo ya magazi yomwe imapezeka ku ofesi ya madokotala nthawi zambiri si yolondola. ABPM ndi njira yolondola kwambiri yodziwira ngati munthu alidi kapena alibe nthenda yapamwamba yapamwamba , ndipo kugwiritsa ntchito kwake kungalepheretse vuto lalikulu la mankhwala ochiritsira komanso (mocheperapo).
Zikuwoneka kuti mwina madokotala ena (ndipo mwinamwake akulipira) adzatsutsana ndi malangizo atsopano awa, ndipo mwina mavuto ena adzasinthidwa kuti apeze USPSTF kusintha malingaliro omwe akufunsidwa asanatsirizidwe. Vuto la madokotala ndilokuti ABPM ndi yovuta kupereka, nthawi zambiri sichipezeka mosavuta, ndipo chiyeso choigwiritsira ntchito chikhoza kuopseza moyo wa akatswiri ovuta ovuta. Vuto la olipidwa ndi lakuti ABPM ndi yamtengo wapatali, ndipo sangafune kuti azilipira mabungwe ambirimbiri a ABP chaka chilichonse.
Kuvuta ndi kutsutsa kotero kuti USPSTF ndi yolondola pakadali pano. Mayeza a magazi omwe amapezeka ku ofesi ya madokotala nthawi zambiri amasocheretsa, ndipo amatha kuchipatala mosayenera.
Chifukwa Chakudya Chakuda kwa Magazi ku Office Ndi Vuto
Mukakhala ndi mphamvu ya magazi yomwe imayikidwa mu ofesi ya dokotala, muyeso womwe umalembedwa nthawi yomweyo umakhala "mphamvu" ya magazi - ngati mphamvu ya magazi ndi kulemera kwake, monga kulemera kwake kapena kutalika kwake.
Koma kuponderezedwa kwa magazi si mtengo wa static. Zimasintha pang'ono kuchokera mphindi imodzi mpaka mphindi , malinga ndi zosowa za mtima wanu wamtima. Kupanda kuchitidwa pansi pazifukwa zomveka bwino, kuthamanga kwa magazi kumodzi kungakhale kosavuta kusiyana ndi kafukufuku wotsatizana.
Poyesa kuyendetsa vuto ili, mayendedwe a "muyezo" wamagazi amatanthawuzira kuti akuchitika pansi pa "mpumulo wamtendere," ndipo maphunziro omwe akuwonetsa phindu la kupeza ndi kuchiza matenda oopsa kwambiri amachokera pazikhalidwezi.
Pano pali zofunikira za "muyeso" wa kuyeza kwa magazi:
- Wodwala ayenera kuikidwa pamalo otetezeka, ofunda, ndi otetezeka.
- Wodwala sayenera kukhala ndi caffeine kapena mankhwala a fodya kwa mphindi 30.
- Wodwala ayenera kukhala pansi mwamtendere, ndi kumbuyo kwawo atathandizidwa ndi molunjika, ndipo mapazi onse awiri athandizidwa pansi.
- Wodwala ayenera kupumula pamalo awa kwa mphindi zisanu.
- Zitatha izi, dokotala kapena namwino ayenera kutenga mwakachetechete magazi a wodwalayo kawiri, makamaka ndi mphindi zisanu pakati pa kuwerenga.
- Ngati miyeso iwiri imasiyana mosiyana ndi 5 mm Hg, kuwerengera kwakukulu kuyenera kuchitidwa, ndi zofanana zofanana pakati pa zojambula, mpaka zojambulazo zikugwirizana.
Tonsefe timadziwa zomwe zimachitikadi. Odwala amadza nthawi yake, koma amathawa mu chipinda chodikirira chokhala ndi anthu ambiri. Pomaliza, wodwalayo akuthamangidwanso kumalo ozizira ozizira, ndipo amalamulidwa kuti avule pansi ndi kuvala chovala chophwanyika chosakaniza. Kenaka, onse koma amaliseche ku zinthu, wodwala amakhala pansi monga momwe akuphunzitsira pa tebulo lofufuzira, popanda kuthandizira kumbuyo ndi miyendo ikuwopsya. Dokotala wovutitsidwa kapena namwino potsiriza amalowa mkati, amawombera pampopu wothandizira magazi, ndipo pamene kuthamanga kwa magazi kumagwiritsanso ntchito wodwalayo mu Q & A, kapena kumayamba kuchita zinthu ziwiri kapena zitatu zomwe zili pa "pay pay performance". .
Ndipo palibe mwayi uliwonse wopeza kukhwima kwa magazi kachiwiri kuwerenga maminiti asanu kenako.
Choncho, muzochitika zambiri (ngati sizinthu zambiri), zomwe mumalowa mu ofesi ya dokotala zimakhala zowonjezereka zotsatizana ndi kuthamanga kwa magazi, mkhalidwe wosiyana kwambiri ndi "mpumulo wamtendere." Mwakutanthawuza, chiyeso choterocho sichiyenera kugwiritsidwa ntchito kuti apeze matenda oopsa kwambiri.
Ngakhale zofookazi, ngati kuyeza kwa magazi kuli bwino kwambiri (zosakwana 120 mm Hg systolic ndi zosachepera 80 mm Hg diastolic), palibe chovulazidwa. Ndipo ngati kuthamanga kwa magazi kuli kokwanira (160 mm Hg systolic), zimatha kuganiza kuti matenda a hypertension ndi enieni, ndipo mankhwala akhoza kukhazikitsidwa. Vuto limabuka pamene kuthamanga kwa magazi mu ofesi kuli kovuta kwambiri, gawo 1 lachiwopsezo chachikulu. Kodi izi ndizoopsa kwambiri? Kapena kodi kungokhala njira yokhayokha yachitsanzo?
Madokotala, ndithudi, samadziimba mlandu okha. Odwala omwe kuthamanga kwa magazi kukukwera mu ofesi ya dokotala, ndipo mwachizolowezi kunyumba, amanenedwa kuti ali ndi " chovala choyera ". Ndipo ngakhale kuti mwinamwake chovala choyera chimakhalapo, zimawoneka ngati kudzikuza kwa madotolo yambani matenda atsopano, ndipo perekani kwa odwala awo, nthawi zambiri iwo akulephera kuyeza kuthamanga kwa magazi monga momwe akuyenera kuyeza.
Ubwino wa ABPM (Ndipo HBPM)
Ubwino wa ABPM ndi chakuti sichidalira pazigawo limodzi kapena ziwiri zomwe zimawoneka kuti ziwoneke magazi. M'malo mwake, ABPM imayesa kupsyinjika kwa magazi pafupipafupi pafupipafupi maola 24 - pa kusintha konse komwe kumachitika tsiku. Kukhalapo kapena kupezeka kwa matenda oopsa kwambiri kumatsimikiziridwa ndi kuthamanga kwa magazi tsiku lonse. Kupezeka kwa matenda a hypertension ndi ABPM kwatsimikiziridwa bwino, ndipo kuli kolondola kwambiri kuposa momwe anadziwira za siteji yoyamba yachulukitsiro yopangidwa ku ofesi ya dokotala.
Njira ina ya ABPM ndiyo kuyang'anira magazi (HBPM). Pali ubwino wambiri wa HBPM zomwe zimapangitsa kuti zikhale zokopa kuposa ABPM kuti apeze ndi kuyang'anira matenda oopsa, ndipo madokotala ambiri amakhulupilira kuti ndi njira yabwino. Pulogalamu ya USPSTF imasonyeza momveka bwino zomwe amakonda pa HBPM pa ofesi ya dokotala kuti apeze matenda oopsa.
Zomwe Zonsezi Zikutanthauza Kwa Inu
Zikutheka kuti padzakhala nkhondo yatha nthawi yaitali madokotala ndi olipirira akugwirizana ndi USPSTF kuti siteji yoyamba yapamwamba ya magazi imapezeke kokha pambuyo pa ABPM (kapena HBPM) ikutsimikizira kuti matendawa ndi otani. Chimene muyenera kudziwa, ngati mwauzidwa kuti muli ndi nthenda yambiri ya magazi (kapena matenda a hypertension), ndipo dokotala wanu akuyamikira chithandizo cha moyo wanu wonse, ndikuti mayesero ovomerezekawa alipo lero, ndipo n'kwanzeru kuwapempha. Phunzirani za ABPM ndi HBPM, ndipo funsani dokotala ngati zingakhale zomveka kugwiritsira ntchito mayesowa kuti atsimikizire kuti muli ndi matenda oopsa kwambiri musanayambe kumwa mankhwala.
Zotsatira:
Ndondomeko Yopangira Chigamulo: Kuthamanga Kwambiri kwa Magazi M'magulu Akuluakulu: Kuwunika. "US US Preventive Services Task Force December 2014. http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementDraft/hypertension-in-adults-screening-and-home- Kuwunika (Kufika mu January, 2015).
Pickering TG, Miller NH, Ogedegbe G, et al. Limbikitsani kugwiritsa ntchito ndi kubwezera ndalama zowonongeka kwa magazi a m'midzi: ndemanga yachidule: mawu ovomerezeka a sayansi ochokera ku American Heart Association, American Society Of Hypertension, ndi Preventive Cardiovascular Nurses Association. Kuthamanga kwa magazi 2008; 52: 1.