Ukuhlaziya isisu nokuphathwa

Ukwelashwa kwesisu

Ukwelapha isifo sokushaya isisu ngokuphathelene nokuvimbela izinkinga ezingase zivele ukuthi isifo singabangela ngaphambi kokulimala. Ukwelashwa kwesifo sokushaya isisu sekude kakhulu eminyakeni eyishumi eyedlule, kodwa izinketho zisencane. Ngokuvamile, ukhiye wokuthola ukwelapha isifo ngokubamba isifo ngokushesha uma kwenzeka, ngemuva kokuba izimpawu ziqale. Amaqembu ezokwelapha eziphuthumayo kuphela aqeqeshwe kakhulu angakwazi ukuphatha ukwelapha ngenxa yesibalo esicashile kanye nokuhluka kwesifo sohlangothi.

Lokhu okulandelayo yizo zokwelapha eziphazamisayo ezingase zibhekwe:

I-Blood Thinners

Kukhona inani legazi elincane elinganikezwa ngenkathi isifo sisaqhubeka. Uma kucacile ukuthi umkhumbi wegazi uvinjelwe noma uvinjelwe ngokuphelele, igazi elincane lingasiza ekuvimbeleni ukushaywa komzimba ekuthuthukiseni ngokuvumela igazi eligelezayo, okubalulekile ukuvimbela noma ukunciphisa ukulimala kobuchopho. I-blood thinners kufanele inikezwe ithimba lezokwelapha eliqeqeshwe ngoba imiphumela emibi engase ibe nayo ihlanganisa ukuphuma kwegazi ebuchosheni, ohlelweni lwesisu, noma kwezinye izindawo zomzimba.

• Okufanele Ukwazi Ngezigubhu Zezinsipho

• Funda Ngezibonakaliso, Ukuxilongwa Nokunakekelwa Kwe-Intracerebral Hemorrhage

Enye yezinselele eziyinhloko zesifo sokushaya isifo esiphuthumayo isheshe sithole ukuthi isifo sokushaya isifo sisifo esiwumhubhe noma isifo socwaningo . Ngenxa yokuthi i-blood thinner akufanele isetshenziselwe ukushaywa yisifo sofuba, ithimba lakho lokunakekelwa ngesifo sohlangothi lisebenza ngokushesha ukuze lihloniphe noma yikuphi ukuphuma kwegazi ebuchosheni ngaphambi kokunquma ukuthi ngabe ungumuntu ozobhalelwa yini kulaba abalandelayo abagcini begazi. Futhi, ngisho noma une-stroke yesischemic, i-blood thinner inakekelwa ngokucophelela ukuze igweme ukudala ushintsho olunzima lwe-stroke.

Umculi we-Tissue Plasminogen

Umculi we-plasminogen we-tissue (TPA) uyigciwane elimangalisayo elincane elibhekwa ngokuqondile ngaphakathi kwamacala akhethiwe we-stroke eqhubekayo.

Ihamba ngegama elithi Activase (alteplase). I-TPA inganikwa kuphela uma ithimba lezokwelapha eliqeqeshwe kahle likulungele ukuhlola isifo phakathi kwamahora ambalwa okuqala kokushaywa yisifo. Ukuphathwa kwe-TPA ye-Intravenous iye yabonisa inzuzo enkulu uma ilawulwa ngaphakathi kwamahora amathathu okuqala wezimpawu zokuqala zesifo. Kodwa-ke, ucwaningo oluthile olwedlule luye lwabonisa ukuthi le mithi ingaba usizo lapho isetshenziselwa amahora amane nesigamu emva kokuqala kwezimpawu. Uma kungabonakali lapho izimpawu zakho zesifo sokuqala ziqala, khona-ke i-TPA enamandla ayinconywa.

I-TPA iboniswe ukuvimbela noma ukuvimbela ngokuphelele ukulimala okuphakade emiphakathini ekhethiwe ngokuvumela igazi ukuba ligeleze umthambo ovinjelwe futhi, ngaleyo ndlela, ukuvimbela ischemia. Ngenxa yokuthi i-TPA kumele iphathwe ngokushesha ngemva kokuba ifike emnyangweni ophuthumayo, asikho isikhathi sokubamba isinqumo ngesinqumo. Izinqumo zokwelashwa eziphuthumayo ze-TPA zenziwe ngokusho kwemithetho eqinisekisiwe yokuphepha nokuphumelela okukhulu.

Uma une-stroke, unelungelo lokunqaba ukwelashwa nge-TPA.

Kodwa, kubalulekile ukwazi ukuthi amaqembu okushaywa azinakekeli imithi enamandla, futhi athembele emibhalweni yokuphepha eye yasungulwa ukuze kwandiswe ukutholakala kokuqina nokuphepha. Ngenxa yezizathu eziphathelene nokusetshenziswa kwe-TPA, awukwazi ukucela i-TPA ngesifo noma isilungu somndeni uma iziqondiso eziqinile zingatholakali.

I-Thrombolysis ye-intra-arterial: I- TPA ingabuye ijowe ngqo emthini lapho kutholakala khona i-clot yegazi ephazamiseka ngokushaya i-catheter ngqo kwisitsha segazi se-cerebral, inqubo ebizwa ngokuthi i-cerebral angiogram. Ukusetshenziswa kwe-TPA ye- intra-arterial kuyinto inqubo yokungenelela engeyona eyatholakala kabanzi njenge-TPA enamandla, ngoba kudinga ukuthi odokotela babe nobuchwepheshe ekwenzeni lolu hlobo lwezokwelapha.

Ucwaningo olunzulu lokucwaninga olubizwa ngokuthi u-MR luvivinyo oluvivinya luhlolisise ukuphepha nokusebenza kwe-thrombolysis yangaphakathi kwe-stroke ngokusebenzisa idivayisi ethile, ebizwa ngokuthi i-stent retriever, nemiphumela emihle. I-stent retriever yi-stent efakwe ngaphakathi kwesikhumba futhi isisiza ukuyisusa futhi isungula ukugeleza kwegazi ebuchosheni.

I-thrombolysis ye-intra-arterial yinkqubo lapho, njenge-TPA ene-intravenous, kunezinqubo ezinamandla ezikhona ngenhloso yokuphepha kwesiguli.

I-Heparin

I-Heparin imithi ongayithola nge-intravenously. I-heparin IV ingasetshenziswa uma une-stroke ejulile uma izimo ezithile zifinyelelwa.

Lezi zimo zihlanganisa:

• Kukholelwa ukuthi i-clot yegazi isanda kwakhiwa
• Izimpawu zesisu zikhona (ukuqala okusha)
• Ukubola kwesisu kukhishwe ngaphandle

I-Heparin ayinconywa uma unengozi yokugoma kwamathumbu noma ukuphuma egazini elihlinzayo noma elilimazayo. Uma uke waba nezinguquko ezinkulu ze-ischemic ekuhlolweni kobuchopho-ukucabanga, i-heparin kaningi ayinconywa ngoba ingabangela izicubu zomshuwalense ezonakaliswe kamuva.

I-Heparin isetshenziswa ngezikhathi ezithile ukuphatha isifo esibucayi, kodwa ngokuvamile isetshenziselwa ukubeka i- TIA , ikakhulukazi uma i-clot yegazi noma umthambo omncane ibonakala enhliziyweni yakho noma emthini wakho we-carotid.

Aspirin

I-aspirin isetshenziswa ngokuyinhloko ekuvimbeleni ukushaywa yisisu ngenxa yokuthi ayithathwa njengamandla anamandla okwanele ukuchitha i-clot yegazi noma ukuvimbela i-clot yegazi ekhulayo ekukhuleni.

• Ukwelashwa Kokulahlekelwa Isisindo Kungase Kunciphise Ingozi Yokushaya Isisu

• Yeka ukuthi i-Memantine Research Exhibit It Can Help Strokes esikhathini esizayo

Kodwa-ke, i-aspirin ijwayeleke kakhulu ngaphakathi kwamahora angu-48 okuqala okuqala ukuhlasela ischemic ukuvimbela izenzakalo ezengeziwe.

Ukwelashwa kwesistimu

Esinye sezici ezibaluleke kakhulu zokwelashwa kwesifo sokushaya isifo sigxile ekugcineni isimo esingcono kunazo zonke emahoreni nasezinsukwini ngemuva kokushaywa isifo sokunikeza ubuchopho ithuba lokuthola kabusha. Imingcele ethile isungulwe mayelana nokucindezelwa kwegazi, i-blood glucose, nezinye izinyathelo zokugcina ukulungiswa okungcono komzimba okungenzeka.

Ukushaya kwegazi

Ukuphathwa kwengcindezi yegazi kuyamangaza ukuthi yiyodwa yezinyathelo ezibaluleke kakhulu, eziyinkimbinkimbi, futhi eziphikisanayo ngemuva kwesifo. Odokotela bazokhokha ngokucophelela ukucindezeleka kwegazi, besebenzisa imithi yokulondoloza emazingeni angahlali kakhulu noma aphansi kakhulu; zombili lezi zimo ziyingozi. Kodwa-ke, njengoba ukucindezelwa kwegazi ngokwemvelo kuyashintsha ngesonto ngemuva kokushaywa yisifo, isoka lakho lezokwelapha libukela ngokucophelela ukulingana phakathi kwesimo sakho sezinzwa negazi lakho njengendlela yokunquma nokulawula ukucindezeleka kwegazi kwakho ezinsukwini emva kokushaya kwakho.

Igazi leglucose

Izinga likashukela egazini lingase libe yiphutha njengempendulo yesifo esibi kakhulu. Ukwengeza kule nkinga, ezinsukwini emva kokushaywa kanzima, ngeke kube lula ukufuna ukudla njengoba wenza njalo. Amazinga ashukela ephakeme aphezulu futhi aphansi angaphazamisa ukuphulukiswa ngemva kokushaya. Yingakho ithimba lakho lokunakekelwa ngesifo socansi linikela ngokucophelela ekuqiniseni izinga lakho lokushukela ngegazi ngalesi sikhathi.

Ukuphathwa kwe-Fluid

Ukuvuvukala kungase kwenzeke ebuchosheni ngemva kokushaywa yisifo. Lolu hlobo lokuvuvukala, olubizwa ngokuthi i-edema, luphazamisa ukuphulukiswa futhi lungabangela ngisho nokulimala komqondo okuqhubekayo ngenxa yokucindezelwa kwezifunda ezibalulekile zobuchopho. Uma wena noma othandekayo ube nesifo sokushaywa kwamuva, cishe uzodinga uketshezi olunomsoco. I-IV emzimbeni ngemuva kokushaywa umoya ngokuvamile inikezwa ngezinga elincane futhi liphansi kune-IV hydration esivumelwaneni esibhedlela, ikakhulukazi ngenhloso yokugwema i-edema. Uma i-edema iqhubekela phambili ngokushesha, ungase udinge ukwelashwa ngemithi ukuze unciphise ukuvuvukala. Ezimweni ze-edema enzima neyingozi, inqubo yokuhlinzwa ingadingeka ukukhulula ingcindezi ngokususa ingxenye ye-skull (bheka i-craniectomy ngezansi.)

Ukuphathwa kwe-Electrolyte

I-IV hydration esimweni sokugula njengesifo sokushaya isifo sinamanzi ahanjiswa ngama-electrolyte abalulekile, njenge-sodium, i-potassium ne-calcium. Ukuhlushwa kwalezi electrolyte kumele kugcinwe ngokucophelela ukugcina ukuhlushwa kahle kwamanzi kanye ne-electrolytes ebuchosheni ukuze kuvikelwe i-edema. Amagundane adinga inani elifanele lama electrolyte ukulawula imisebenzi yengqondo. Ngakho-ke, ngemva kokushaywa yisifo, ukuhlushwa nokuningi kwamandla okushisa kubaluleke nakakhulu kunokujwayelekile, njengoba ukusebenza kobuchopho nokuphulukisa kusezingeni elilinganiselwe.

I-Neurosurgery

Nakuba akuyona indlela ejwayelekile kakhulu yokwelapha ngesifo sokushaya, uma unesifo esikhulu se-cortical nge-edema eningi, ungase udinge ukuhlinzwa ukuze ukwandise ukululama ngemva kokushaywa.

I-Hematoma Evacuation

Ezinye izibhalo ziyizinhlungu eziphazamisayo, okusho ukuthi kukhona ukuphuma ekhanda. Iningi lokuphuma egazini elimnyama alikhishwa kalula ebuchosheni. Kodwa-ke, ngezinye izikhathi, lapho inani eliningi legazi ligxila endaweni ethile, kungcono uma igazi lisuswa ngokuhlinzwa. Uma udinga ukuhlinzekwa kobuchopho ngemuva kokushaya, wena noma othandekayo bakho bayonikezwa isikhathi sokucabangela ngokucophelela lolu khetho, futhi uzokwaziswa ngezingozi nezinzuzo zenqubo.

I-Craniectomy

Ngesinye isikhathi, lapho i-edema evela kwesifo iba nzima futhi ayikwazi ukulawulwa izinyathelo zomtholampilo, ukususwa okwesikhashana kwengxenye yethanga le-skull kuvimbela ukucindezelwa kwezifunda ezibalulekile zobuchopho ukuze i-edema ingabangeli umonakalo unomphela. Izinqubo, okuthiwa i-craniectomy noma i-hemicraniectomy, zibandakanya ukususwa okwesikhashana kwesigaba se-skull kuze kuphele i-edema. I-skull igcinwa bese isetshala kabusha esikhathini esifushane, njengoba i-skull iyisici esibalulekile sokuvikelwa kobuchopho isikhathi eside.

Ukuvuselelwa kwesisu

Ukuvuselelwa kwesisu kuncike ezindleleni eziningi, kufaka phakathi amasu omzimba nokuqonda okuhloswe ukugqugquzela ukululama ngemva kokushaywa yisifo. Ukuvuselelwa kwesisu kuyindlela enhle kakhulu futhi ethembekile kakhulu yokugqugquzela ukuphulukisa nokuphumula ngemuva kokushaywa yisifo.

I-neuroprotection

Umqondo wokuthi imithi ethile ingahlinzeka nge-neuroprotection (ukuvimbela ukufa kwama-cell cells) ukulungisa umonakalo wobuchopho yindawo ehlumayo yophando lwezokwelapha. Njengamanje, ayikho imithi eyamukelwe noma ukwelashwa okuye kwafakazelwa ukuthi kungenayo i-neuroprotective noma ngesikhathi noma ngemuva kokushaywa yisifo. Eminye imithi eye yabhekwa njengabazongela ukwelapha nge-neuroprotective for stroke ihlanganisa i- magnesium sulfate kanye ne- memantine . Kodwa-ke, ngesikhathi samanje, imithi eye yabhekwa njengama-neuroprotectants angazange ibonise ukuthi yiyiphi inzuzo yokuphulukisa noma yikuphi ukulimala kusuka kwesifo.

Ukwenza Izinqumo Mayelana Nokunakekelwa Kwesisu

Uma wena noma othandekayo usanda kuba ne-stroke, izinqumo mayelana nokunakekelwa kwesisu zingase zibonakala ziphazamisekile. Izindaba ezinhle ukuthi eminyakeni yamuva nje, ukuphathwa kwe-stroke kuye kwacwaningwa ngokucophelela, futhi umphakathi wezokwelapha usuhlakulele izivumelwano eziphumelelayo kakhulu zomphumela omuhle. Ngokuvamile, izinguquko ekusebenziseni kwezinzwa zakho zingase zihlakaniphe emahoreni nezinsuku ngemva kokushaywa yisifo. Lokhu kusho ukuthi ithimba lakho lezokwelapha lizodinga ukukuhlola njalo futhi ngokuphindaphindiwe. Nakuba lezi zivivinyo ze-neurological ngezikhathi ezithile zingase zibukeke zilukhuni futhi ziphazamise ngesikhathi lapho bonke othanda ngempela ukukwenza kuphumula (noma usize ukuphumula kwakho othandekayo futhi ululame kahle,) ukuhlola kwakho kwegazi kuyadingeka ekuqondiseni ukwelashwa okuphephile futhi okuphephile kakhulu kunomthelela izinsuku ezilandela ukushaywa kanzima.

Izwi elivela

Uma wena noma othandekayo ube nesifo sohlangothi, uzoqiniseka ukuthi ufuna ukuqonda uhlelo lokwelapha. Ithimba lakho lezokwelapha liyatholakala ukuze lichaze isisekelo sezinketho zokwelapha izifo, futhi zizocela isinqumo sakho sokugcina mayelana nezinkinga ezinkulu zokwelashwa.

Kungenzeka ukuthi ufunda mayelana nokwelashwa kwesisu ngemuva kwesigaba esibucayi sesifo sakho, lapho ugxila ekuphulukiseni nasekuvuseleleni, esikhundleni sokwelashwa okuphuthumayo. Unezindlela eziningi zokwandisa ukutakula kwakho ngemuva kokushaywa yisifo. Ukuqoqa ulwazi nokufunda mayelana nokushaywa yisisu kuyindlela engcono kakhulu yokusebenzisa izinsiza ezikhona kuwe endleleni yakho yokuthola. Ungaqala khona lapha:

• Ukubuyiswa nokuvuselelwa
• Ulwazi lwabaSekeli
• Ukuphila Njengomuntu Oshaywa Ngesifo Sesihlungu

> Imithombo:

> I-Demaerschalk BM, i-Alteplase Treatment in Stroke Eyingozi: Ukuhlanganisa Ukudla Nezokuphathwa Kwezidakamizwa Ukuchaza Ulwazi Kukhona Umhlahlandlela Wokulawulwa Kwezibilini Ezikhona, Imibiko Yamanje Ye-Atherosclerosis, Ngo-Agasti 2016.

> Oostema JA, Carle T, Talia N, Reeves M, Ukuhlonishwa kweStro Stroke Recognition Ukusebenzisa i-Stroke Screening Tool: Ukubuyekezwa Okuhlelekile, Izifo Ze-Cerebrovascular, June 2016.