Girman AD - algorithm na aiki. Ƙin jini

Don sanin aikin da ke cikin zuciya, tsarin kwakwalwa da kodan, ya wajaba don yin jijiyoyin jini. Dole ne a kiyaye algorithm na aiki don ƙaddararsa don samun cikakkun siffofin. An san shi daga aikin likita cewa ƙarfafawar matsalolin da ya dace ya taimaka ma yawan marasa lafiya da yawa ba su zama marasa amfani ba kuma sun ceci rayuwar mutane da yawa.

Tarihin halittar na'urori masu aunawa

A karo na farko, Hales ya ƙaddamar da matsa lamba a cikin dabbobi ta 1728. Don yin wannan, sai ya sanya gilashin gilashi kai tsaye a cikin ɗigon doki. Bayan da cewa Poiseuille kara zuwa wani gilashi tube da Mercury manometer sikelin, kuma daga baya Ludwig ƙirƙira kymograph da taso kan ruwa, da sanya shi yiwu rikodin ci gaba da jini. Wadannan na'urorin suna sanye da na'urori masu kwakwalwa na lantarki da kuma tsarin lantarki. Direct hanyoyin da aunawa jini ta wajen catheterization na tasoshin amfani na bincike makasudai a bincike dakunan gwaje-gwaje.

Yaya aka samo jini?

Rhythmic contractions na zuciya sun hada da biyu bulan: systoles da diastoles. Kashi na farko - systole - shi ne rikitarwa na tsoka da zuciya, lokacin da zuciya ke motsa jini a cikin mahaukaci da magunguna. Abun ciki shine lokacin yayin da cavities zuciya ke fadada kuma ya cika da jini. Sa'an nan kuma tsarin tsarin ya sake dawowa kuma a cikin mahaifa. Blood daga mafi girma tasoshin: da aorta da ƙwaƙwalwar ƙwayar cuta ta wuce hanya ga mafi ƙanƙanci - arterioles da capillaries, enriching dukan gabobin da kyallen takarda tare da oxygen da kuma tattara carbon dioxide. Capillaries sun shiga cikin kwakwalwa, sa'an nan a cikin kananan veins kuma cikin manyan jirgi, kuma a karshe a cikin veins da ke kusantar da zuciya.

Ƙarfafa a cikin tasoshin da zuciya

Yayin da aka kawar da jini daga cavities zuciya, matsa lamba na 140-150 mm Hg. Art. A cikin aorta, shi ya rage zuwa 130-140 mm Hg. Art. Kuma mafi nisa daga zuciya, ƙananan ƙin ya zama: a cikin raƙuman ruwa 10-20 mm Hg. St., Kuma jini a cikin manyan veins - a ƙasa na yanayi.

Lokacin da jini ya gudana daga zuciya, ana yin rijistar yaduwar bugun jini, wanda ya ɓace sau da yawa kamar yadda yake wucewa cikin dukkan jiragen. Rawan da ya yadu ya dogara ne akan girman matsin lamba da kuma ƙirar ƙarancin ganuwarta.

Tare da shekaru, karfin jini ya tashi. A cikin mutane daga shekara 16 zuwa 50 yana 110-130 mm Hg. St., Kuma bayan shekaru 60 - 140 mm Hg. Art. Kuma mafi girma.

Hanyoyi don auna karfin jini

Akwai hanyoyi na kai tsaye (m) da kuma hanyoyi masu tsaida. A cikin hanyar farko, an saka wani catheter tare da transducer a cikin jirgin ruwa kuma an yi amfani da karfin jini. Mahimman aikin aikin wannan binciken shine kamar yadda kwamfutar ke sarrafa tsarin sarrafa sigina.

Hanyar kai tsaye

Hanyar aunawar karfin jini ta hanya ta hanyar kai tsaye ta yiwu ne ta hanyoyi da yawa: kaddamarwa, tsayayyewa da mahimmanci. Hanyar farko ita ce taɗa hankali da kuma shakatawa na ƙananan ƙafa a cikin maganin da kuma ƙaddamar da ƙaddamar da ƙwayarsa a ƙarƙashin shafin ƙwanƙwasa. Riva-Rocchi a ƙarshen karni na 19 wanda aka yi amfani da shi ta hanyar amfani da furotin na 4-5 cm da sikelin mercury na manometer. Duk da haka, irin wannan nau'i mai zurfi ya ɓullo da gaskiyar bayanai, saboda haka an nuna shi don ƙara shi zuwa 12 cm a fadin. Kuma yanzu fasaha na auna karfin jini ya shafi amfani da wannan musamman cuff.

Ana matsawa matsa lamba a cikin maƙasudin inda ɓangaren ya ƙare, sannan kuma ya rage raguwa. Tsarin dakin jiki shine lokacin da tayi girma, matsa lamba na diastolic - lokacin da bugun jini ya ɓace ko yana godiya accelerates.

A cikin shekara ta 1905 N.S. Korotkov ya ba da wata hanya ta auna karfin jini ta hanyar ƙwarewa. Kayan aiki mai auna don auna karfin jini ta hanyar Korotkov shine tonometer. Ya ƙunshi cuff, sikelin mercury. Jirgin iska a cikin kwakwalwa an yi shi tare da pear, sa'an nan kuma an kwantar da iska ta hanyar batu na musamman.

Wannan hanyar da ta dace shine daidaituwa don auna karfin jini ga fiye da shekaru 50, amma bisa ga binciken, likitoci ba su bi shawarwari ba, kuma hanyar da za ta auna karfin jini yana damuwa.

Ana amfani da hanyar oscillometric a cikin na'urori na atomatik da kuma mai kwakwalwa a cikin ƙananan gidaje kulawa, tun da amfani da waɗannan na'urori bazai buƙatar iska mai tsabta a cikin kwandon ba. Ana yin rikodi na hawan jini a wasu matakai na rage karfin iska. Sakamakon cutar hawan jini yana yiwuwa tare da rashin gazawa da rashin ƙarfi na Korotkov. Hanyar wannan ita ce mafi ƙanƙantar dogara ga nauyin ganuwar tasoshin da kuma lokacin da atherosclerosis ke shafar su. Hanyar oscillometric ya sa ya yiwu ya kirkiro kayan aiki domin ƙayyade ƙananan kuma ƙananan ƙananan ƙwayoyi a kan wasu arteries. Yana ba da damar yin tsari mafi daidai, rage tasiri na mutum factor

Dokoki don auna karfin jini

Mataki na 1 - zaɓi kayan aiki mai kyau.

Abin da kuke bukata:

1. Stethoscope mai kyau

2. Daidaitaccen zabin da aka yi.

3. Barometer-aneroid ko sphygmomanometer mai sarrafa kanta - na'urar tare da yanayin kulawa na kumbura.

Mataki na 2 - shirya mai haƙuri: tabbatar da cewa yana da annashuwa, ba shi da minti 5. Don rabin sa'a don sanin cutar karfin jini ba a bada shawarar shan taba da sha barasa da kuma abincin caffeinated. Mai haƙuri ya kamata ya zauna a tsaye, saki ɓangare na hannun hannu, shirya shi da kyau ga mai haƙuri (zaka iya saka shi a kan tebur ko wasu goyon bayan), ƙafafun ya kamata su tsaya a ƙasa. Cire kayan tufafin wuce haddi waɗanda zasu iya tsangwama tare da iska a cikin famfo ko jini ya gudana a hannu. Kai da mai haƙuri ya kamata ku guji yin magana a lokacin auna. Idan mai haƙuri yana kwance, dole ne a sanya sashi na sama na hannun a matakin zuciya.

Mataki na 3 - zaɓi ƙwayar dama ta cuff, dangane da ƙarar hannun: sau da yawa kuskure sukan tashi saboda rashin dacewar zaɓi. Sanya saffon a hannun hannu.

Mataki na 4 - sanya phonendoscope a kan wannan hannun inda ka sanya kullun, ka ji hannunka a kan gwiwoyin kafa don neman wuri daga cikin sauti mai karfi, kuma sanya sautin a kan ƙwaƙwalwar ƙwaƙwalwa a wannan wuri.

Mataki na 5 - ƙaddamar da kullun: fara farawa, yayin sauraron bugun jini. Lokacin da raƙuman motsi ya ɓace, kada ku ji wani sauti ta hanyar phonendoscope. Idan bugun jini ba a ji ba, to, kana buƙatar ƙaddara don ƙwaƙwalwar magungunan ƙwaƙwalwa yana kan lambobi mafi girma daga 20 zuwa 40 mm Hg. Fiye da matsa lamba. Idan wannan darajar ba a san shi ba, ƙaddamar da saff ɗin zuwa 160 - 180 mm Hg. Art.

Mataki na 6 - sannu-sannu ka busa ƙafa: lalata farawa. Kwararrun likitoci sun bada shawarar sannu-sannu suna buɗe ɗabin don kada a rage yawan matsa lamba a cikin nau'i na 2 zuwa 3 mm Hg. Art. Kashi na biyu, in ba haka ba saurin ragewa zai iya haifar da ma'auni marasa daidaituwa.

Mataki na 7 - sauraron matsalolin systolic - sautunan farko na bugun jini. Wannan jini yana fara gudana ta hanyar jigilar jini.

Mataki na 8 - sauraron bugun jini. Yawan lokaci, lokacin da matsa lamba a cikin ɓaɓɓuka na ɓaɓɓuka ya ragu, sautunan ya ɓace. Wannan zai zama diastolic, ko ƙananan matsa lamba.

Tabbatar da alamomi

Dole ne a bincika daidaito na alamun. Don yin wannan, auna ma'auni a hannun biyu don matsakaita bayanai. Don sake duba matsin lamba don daidaito, jira game da minti biyar tsakanin ma'aunin. Yawanci, da jini ne mafi girma a cikin safe da kuma ƙananan dare. Wasu lokuta karfin jini yana nuna rashin tabbas saboda damuwa game da mutane a cikin fararen tufafi. A wannan yanayin, an yi amfani da ma'aunin BP na 24-hour. Abinda ake aiwatarwa a wannan yanayin shine ƙaddarar matsa lamba a lokacin rana.

Abubuwan rashin amfani na hanyar

A halin yanzu, hanyar da ta dace a kowace asibiti ko asibitin shine auna jini. Ayyukan algorithm na aiki yana da disadvantages:

• ƙananan ƙididdigar SBP da ƙimar DBP mafi girma fiye da waɗanda aka samu tare da hanyar ɓarna;

• mai saukin kamuwa da ƙararraki, hanyoyi daban-daban na zirga-zirga;

• da buƙatar daidai wuri na stethoscope;

• ƙananan sauti na ƙananan ƙarfi;

• kuskuren ƙaddamarwa shi ne raka'a 7-10.

Wannan hanyar da zazzage karfin jini yana da kyau ga tsarin kulawa a yayin rana. Don saka idanu da mai haƙuri a cikin kulawa mai kulawa mai tsanani, ba zai yiwu a ci gaba da ɓar da kwakwalwa ba kuma haifar da ƙararrawa. Wannan zai iya rinjayar mummunar yanayin yanayin haƙuri kuma ya haifar da damuwa. Lambobin matsa lamba ba za su iya dogara ba. Tare da rashin fahimta na mai haƙuri da kuma kara yawan motsa jiki, baza a iya sanya hannunsa a matakin zuciya ba. Harshen haɗari na tsangwama zai iya haifar da aikin marasa lafiya na mai haƙuri, don haka kwamfutar zata daina aiki, wanda zai kawo jigilar jini, bugun jini.

Saboda haka, a cikin kulawa mai kulawa mai tsanani, ana amfani da hanyoyi marasa amfani, ko da yake sun kasance mafi ƙarancin daidaito, amma sun fi dogara, aiki da dacewa don kulawa da matsin lamba.

Yaya za a auna BP a cikin likitoci?

Nuna yaduwar jini a cikin yara ba ya bambanta da fasaha na ƙayyadewa a cikin manya. Sai kawai balagagge cuff ba zai aiki ba. A wannan yanayin, ana buƙatar macijin, wanda girmansa zai zama kashi uku cikin nisa na nisa daga gwiwar hannu ga axillary fossa. A halin yanzu, akwai babban zaɓi na na'urorin atomatik da Semi-atomatik don auna ƙin jini a cikin yara.

Ƙididdiga na matsalolin al'ada dogara ne akan shekarun. Don ƙididdige adadi don matsa lamba na systolic, kana buƙatar ninka yawan adadin yaron a cikin shekaru 2 da kuma ƙara shi ta 80, adadin diastolic shine 1/2 - 2/3 na siffar da ta gabata.

Kayan aiki don aunawar matsa lamba

Ana kuma kira magungunan jini da ake kira tonometers. Akwai na'urorin lantarki da na lantarki. Mechanical ne Mercury kuma aneroid. Digital - atomatik da Semi-atomatik. Kyaftin mafi daidai kuma mai dogon lokaci shine mota na mercury, ko sphygmomanometer. Amma dijital ya fi dacewa da sauƙi don aiki, wanda ya ba su damar amfani da su a gida.