Kunyanya kurapwa kwepermonary hypertension ndechokubata iyo nzira kare uye kuziva uye kugadzirisa chinokonzera chinokonzera. Zvisinei, kune varwere vazhinji vane chirwere ichi, kurapwa kwakanyanyisa kunowedzera.
Baseline Assessment
Nhanho yekutanga mukurapa chirwere chepemenemenha yehutachiona ndechokuongorora kuoma kwekutanga kwechiitiko. Uku kuedza kunobatsira chiremba kuti asarudze kuti ane utsinye kuva nemishonga, uye anopa nzira yekuongorora mhinduro yekurapa.
Izvi zvinowanzoitwa nekuita echocardiogram , iyo inopa kuongororwa kwemapirmaria arteri kukurira, uye kuedza kwekuongorora kurairika kuti kuenzanise simba rekutanga rinoshanda.
Mishonga Inofungidzirwa Pasi Pechipatara Chine Utano
Kazhinji, kubata nechisimba chikonzero chinokonzera chirwere chepachimona chepamusoro ndicho chinonyanya kukosha cherapi. Sezvo kune huwandu hwehutano hwehutano hunogona kubudisa mishonga yehutachiona, chirwere ichi chinogona kutora mhando dzakasiyana-siyana.
Mishonga Kazhinji Inobatsira Munhu Wose Ane Hupemenha Hwepulmonary
Mukuwedzera kunerapi inotarirwa kunyanya kuronga chikonzero chinokonzera, kune marapirwo anowanzobatsira kune ani zvake ane pulmonary hypertension.
Izvi zvinosanganisira:
- Diuretics yakadai seLasix kana Bumex inowanzoshandiswa kurapa kuchengetedza kwemvura kunowanzoitika nepermonary hypertension. Kunyange zvazvo diuretics inogona kuvandudza dyspnea uye edema (kukuputika), inofanira kushandiswa zvakanyatsogadziriswa sezvo kubvisa kuwandisa kwemvura muvarwere vane mishonga yeupemenia kunogona kukuvadza mwoyo wemweya.
- Oxygen therapy inokosha kune ani naani ane pulmonary hypertension ane hypoxia (yakaderedza ropa yeropaji mazinga). Apo hypoxia iripo, kutungamirira okisijeni kunowanzotadzisa zvakananga kupisa mishonga yemapurisa. Varwere vane hutachiona hwehupfungwa hunokonzerwa nezvirwere zvepapupa kana zvirwere zvepfungwa zvinowanzove ne hypoxia, asi ani naani ane pulmonary hypertension inofanira kuva neropa reyerojeni maitiro akaongororwa.
- Anticoagulants yakafanana neCoumadin inowanzoshandiswa kune varwere vane hutachiona hwepachimona. Ichi ndechokuti pulmonary hypertension pachayo inogona kuita kuti ropa risina simba riyerere kuburikidza nepermonary circulation, izvo zvinogona kutungamirira kuvhara mukati memidziyo yeropa mumapapupa. Verenga pamusoro pemishonga inoshandiswa kudzivirira ropa .
- Digoxin inogona kuvandudza kushanda kwemwoyo mune vamwe varwere vane pulmonary hypertension.
- Kuita muviri kwakaratidzwa kunonyanya kuvandudza simba rinoshanda revanhu vane hutachiona hwehutachiona.
Advanced Therapy
"Kurapa kwakapfurikidza" kwepermonary hypertension inotarisirwa ku pulmonary hypertension pachake, panzvimbo pechikonzero chinokonzera. Ichi chirwere chinowanzoshandiswa kushandisa vasodilator madhiragi kuedza kuderedza mishonga yepermonary uye kuderedza mishonga yemapurisa inomanikidza.
Kurapa kwakagadziridzwa kunonzi "yakagadzirwa" kwete nekuti inoshanda kupfuura yepamusoro mishonga yakawanda, asi nokuti yakaoma, ine ngozi, inodhura zvikuru, uye inowanzosavhiringidza (somuenzaniso, inogona kuda chirwere chinonzi intravenous therapy). Kurapa kwakanyanyisa kunofanirwa kuongororwa nevanachiremba vane nyanzvi yekurapa chirwere chepachimona chepayona.
Kurapa kwakagadziriswa kunofungidzirwa nevarwere vane chirwere chakanyanya chemapemetheni chakanyanya kusagadzikana pakurapa chinangwa chechikonzero chinokonzera, kana, kunyanya, kana pasina chikonzero chakakonzerwa (kureva, kune vanhu vane primary blood pressure).
Kurapa kwakagadziriswa hakuwanzoshandiswi zvachose kune vanhu vane hutachiona hwehutachiona hunokonzerwa nechirwere chepfungwa (apo kurapa kwakakurumbira kwave kuchiratidzwa kuti kunowanzokonzera kukuvadza), kana kumapapu chirwere (apo pane kushaikwa kwemashoko anoratidza kubatsirwa) .
Usati waedza kunyanya kurapwa, imwe nyanzvi yekuongorora catheterization yemwoyo inoitwa kuti iongorore "vasoreactivity" yemapurmonary circulation. Munguva iyi muedzo, zvinodhaka zvinopiwa kuti zviongorore kana mishonga yeropa yemaplummoni inogona kuwedzera. Kana zvakadaro, mamwe maitiro ehutano hwakakosha anowanzobudirira.
Mishonga yakawanda yakave yakagadzirirwa mukurapa chirwere chepemenemenia, zvinosanganisira:
- Calcium channel blockers vakaita sa diltiazem uye nifedipine
- Prostanoids yakafanana neFlolan (epoprostenol), Remodulin (treprostinil), uye Ventavis (iloprost)
- Endothelin vanopikisana nevatambi vakadai saTracleer (bosentan), Letaris (ambrisentan), uye Opsumit (macitentan)
- PDE5 inhibitors seViagra (sildenafil), Cialis (tadalafil), uye Levitra (vardenafil)
- Guanylate cyclase stimulant yakadai seAdempas (riociguat)
Iri runyararo rurefu rwekusarudza rinoita sarudzo yekusarudza "zvakanakisisa" mishonga kana "kukunda" kusanganiswa kwezvinodhaka zvakanyanya kuoma. Zvikonzero zvakasiyana siyana zvinofanira kutorwa mukufungisisa mukuita izvi kusarudzwa, kusanganisira chirwere chepfungwa, kuoma kwemapurmonary hypertension, chirwere chevasoreactivity, kana mamwe mishonga inoputirwa nehutano inshuwarheni, pamwe nemigumisiro yakaipa. Ichi ndicho chikonzero sarudzo dzakadai dzinofanira kuitwa nevanachiremba vanove nyanzvi mukurapa chironda chemapupa.
Summary
Iyo yakanakisisa kurapa kwepermonary hypertension inogona kuva yakaoma uye yakaoma. Varwere vane pulmonary hypertension ndivo vanonyanya kuita sangano rekushanda pamwe chete navanachiremba, vachiita basa rinokosha pakusarudza kurapwa, mukucherechedza nekucherechedza zvakananga nezvehutano hwezviratidzo uye simba ravo, nekutevera kubvumirana kwemaitiro emishonga zvikuru.
Sources:
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