Umshini we-plasminogen we-tissue, ovame ukubizwa ngokuthi i-TPA, uyisifo esinamandla segazi esisetshenziselwa ukwelashwa kwesimo esiphuthumayo. Iminyaka engu-20 eyamukelekile yokwelapha isifo sohlangothi, ekuqaleni yayibukwa njengokubili kokuguquka nokuyingozi. Manje, eminyakeni engamashumi amabili kamuva, ukwelashwa kwesifo sohlangothi kuqhubekile kakhulu , kodwa i-TPA isengcono kakhulu okwenzeka kakhulu ekunakekeleni iziguli zesifo sohlangothi.
Imiphumo yesisu iscono kangcono nanamuhla kunangaphambili ngaphambi kokusetshenziswa kwe-TPA ngokulimala. Uma wena noma othandekayo uye waba nesimo esiphuthumayo se-TPA ngesifo, ungafunda kabanzi ngakho lapha.
Iyini i-TPA futhi Kungani isetshenziselwa ukushaya ama-strokes?
Umculi we-plasminogen we-tissue uyinhlangano enamandla engavimbela i-blood clot eqhubekayo ekukhuleni. Ijojowe yi-administration intravenous (IV) yezokwelapha eziphuthumayo.
I-stroke ibangelwa ukuphazanyiswa kokugeleza kwegazi kungenxa ye-clot yegazi ( isicic stroke ) noma i-bleed (i- stroke ephawulekayo ) ebuchosheni. I-TPA isetshenziselwa kuphela ukushaywa okubangelwa amaqabunga egazi, okuyinto imivimbo ye-ischemic.
Lapho i-TPA ijoqelwa emthanjeni, ihamba ngokushesha ngegazi ukuze ifinyelele isitsha segazi esivinjiwe, lapho isebenza ngokuvimbela i-clot yegazi ekhulayo ekuvimbeleni ukugeleza kwegazi ebuchosheni. Lokhu kuvumela ubuchopho ukuthi buhlale buphilile ngaphambi kokulimala kwesifo .
Ungayicela i-TPA?
I-TPA kufanele iphathwe ngaphakathi kwamahora ambalwa okuqala ngemuva kokushaywa kwesifo. Ukuqala kokushaywa komzimba kubalwa kusukela ngesikhathi owaqala ukuphawula izimpawu zokuphazamiseka . Ngemuva kwefasitela elifushane kakhulu lamahora ambalwa emva kokuqala kwesifo, awukwazi ukuthola i-TPA ngoba kungabangela umonakalo omkhulu kunalokho okuhle ngaleso sikhathi.
Esikhathini esiningi, iziguli aziceli i-TPA. Kodwa abasebenzi bezokwelapha eziphuthumayo baqeqeshwe ukuba baqaphele amakamelo okushaya futhi aphuthumayo afakwe abasebenzi kanye nezinhlinzeko zokuphatha i-TPA uma kudingeka.
Ingabe i-TPA Insizakalo Yokusiza?
Eminyakeni engamashumi amabili edlule, iziguli eziningi ziye zaba ne-TPA. Imiphumela yesikhathi eside neyesikhashana ye-TPA iye yahlolwa ngokucophelela. Konke, ezimweni ezifanele, i-TPA iboniswe ukuthi iyasiza.
Ukuqhathaniswa kwamanje kweziguli ezihlaselwa yi-TPA ukulimaza iziguli ezingazange zithole i-TPA kubonise ukuthi iqembu leziguli eziphathwe nge-TPA zathola umsebenzi ongcono womzimba, amakhono angcono okuqonda, kanye namanani angcono okusinda kuneziguli eziphazamiseka ezingazange zithole ukuphathwa kwe-TPA.
Iziguli eziphuthumayo ngokushesha zithola i-TPA, kungcono ukululama. Yonke isikhathi esingaba yisigamu esingu-15 esilonda iziguli zithola ukwelashwa kwe-TPA maduzane, abasindile abanesihlungu banemiphumela engcono kakhulu. Eqinisweni, uhlelo olusanda kuthuthukiswa kwekhwalithi kazwelonke oluhlose ukunciphisa isikhathi sokulinda ukuphathwa kwe-TPA kuthuthukise ukusinda kweziguli kanye nokunciphisa izinkinga zezokwelapha ze-TPA.
Yiziphi izinkinga ze-TPA?
Ngenxa yokuthi i-TPA yindoda enamandla kakhulu, i-side effect effect iphuma.
Ukukhipha isisu kuyinkimbinkimbi enkulu engabangela isifo esibi kakhulu, okuyinto evame ukwedlula ukonakala kwesischemic.
Ukwengeza, i-TPA ingabangela ukuphuma kwesisu, ukuphuma kwamathumbu emathunjini, ukuphuma kwamanzi emcimbini noma ukuphuma kwezilonda zokuphulukisa noma ukucubungula okuhlinzekwayo. Ngenxa yalezi zizathu, ezinye iziguli azikona ukhetho lwe-TPA.
I-TPA iyashesha kakhulu futhi umphumela wayo awuhlali isikhathi eside kakhulu. Uma uke wathola i-TPA futhi awuzange ube nemiphumela emibi noma izinkinga ezinsukwini ezimbalwa zokuqala, akudingeki ukuba ukhathazeke ngokubambezeleka noma imiphumela yesikhashana yesikhathi eside kusukela ku-TPA ngesikhathi uthola noma ngemva kokubuyela ekhaya.
I-TPA
I-TPA yindlela yokwelashwa okubalulekile engasindisa impilo yakho. Noma kunjalo, kungaba yingozi futhi akuwona wonke umuntu ophethwe yi-TPA ephephile. Futhi, uma isikhathi esincane siphelile ngesikhathi ufinyelela esibhedlela, awukwazi ukuthola ukwelashwa kwe-TPA ngoba kunenzuzo kuphela uma unikezwa phakathi kwamahora ambalwa okuqala ngemva kokushaywa kwesisu.
Imithombo:
Ukuphepha kwe-thrombolysis engenayo i-throbolysis emangqamuzana ye-stroke ephawulekayo ezimweni ezithile, i-Tsivgoulis G, Safouris A, i-Alexandrov AV, i-Expert Opinion on Ukuphepha Kwezidakamizwa, ngo-Ephreli 2015
Ucwaningo lokulawulwa kwamacala okusebenza komzimba we-activminogen activator ezinyangeni ezingu-6-izigameko ezibikiwe nokusetshenziswa kwezempilo, Lang CE, Bland MD, Cheng N, Corbetta M, Lee JM, Journal of Stroke and Cerebrovascular Disease: isikhulu umagazini we-National Stroke Association, ngoNovemba-Disemba 2014
Isikhathi sokwelashwa ngomculi we-plasminogen we-tissue plasminogen kanye nomphumela wesifo esibucayi se-ischemic, Saver JL, Fonarow GC, Smith EE, Reeves MJ, Grau-Sepulveda MV, Pan W, Olson DM, Hernandez AF, Peterson ED, Schwamm LH, JAMA, Juni 2013
Izikhathi zokungena emnyango wesiguli ngenxa yokuphathwa kwe-activminogen ye-activator kanye nemiphumela yomtholampilo ku-stroke enzima ye-ischemic ngaphambi nangemva kwesinyathelo sokuthuthukisa ikhwalithi, i-Fonarow GC, i-Zhao X, i-Smith EE, i-Saver JL, i-Reeves MJ, iBhatt DL, i- Xian Y, i-Hernandez AF, i- Peterson ED 2 , Schwamm LH, JAMA, Ephreli 2014