Isiqeshana noma ikhoyili?
Izwi aneurysm lisho ukuhlanza, noma ukukhulisa, kwesitsha segazi. I-Berry aneurysms, eyaziwa nangokuthi i-aneurysms ye-saccular, ibhalloon-like outouching of artery ebuchosheni. Udonga lwe-artery lubuthakathaka kulezi zine-aneurysms, okusho ukuthi ngaphansi kwezimo ezithile, njengengcindezi ephezulu yegazi (umfutho wegazi ophezulu) , udonga lwesitsha lungaphula futhi luvumele igazi ukuba ligijimele endaweni engaphansi komhlaba phakathi kwe-arachnoid mater kanye nokukhula.
Lokhu kuphuma kwegazi, okubizwa ngokuthi i- subarachnoid hemorrhage , kungaholela ekufeni noma ukukhubazeka okukhulu.
Lokho kusho ukuthi abantu abaningi banezinwele ezincane ezingapheli. Ama-autopsies eyenziwe kubantu abashonile ngezimbangela ezihlukahlukene atholakala ukuthi abantu abangaba ngu-5% bane-aneurysm enjalo. Kodwa-ke, empilweni yangempela, izinkinga eziningi ezitholakala ngemuva kokuthile kwenzeka, njenge-hemorrhage engaphansi komhlaba, okuholela odokotela ukuba babheke imbangela.
Ngemuva kwesimiso sokuphazamiseka kwe-subarachnoid, kunengozi enkulu yokuvuselela kusukela kusayithi elaphukile. Ukuphuza okunjalo kuthwala ukufa okuphezulu nakakhulu. Abantu abangaba ngu-70% bafa ngenxa yokubuyiselwa kwe-aneurysmal. Ngenxa yalesi sizathu, izimpikiswano ezinjalo azikwazi ukushiywa yedwa. Ukungenelela kokuhlinzwa noma kwe-vascular kuyadingeka.
Ngimiphi i-Aneurysms edinga ukwelashwa?
Akukho mbuzo ukuthi i-bourgeer berry aneurysm idinga ukwelashwa, futhi ngokushesha, kungcono. Ingozi yokuguqulwa iphezulu kakhulu ngemva kokuqeda kwesisu sokuqala kwe-subarachnoid.
Kodwa kuthiwani uma ukuhlolwa kwe-imaging njenge-MRI kubonisa i-aneurysm engazange iphulwe? Ingabe inqubo ye-neurosurgical isadingeka? Impendulo ixhomeke ezimeni ezithile ze-aneurysm.
- Ubukhulu: Izimpikiswano ezinamandla ezinkulu zivame ukuphuka. Kodwa-ke, kukhona impikiswano mayelana nokuthi i-aneurysm enkulu kangakanani okufanele iphakanyiswe ukuze kunconywe ukungenelela njengohlelo lokuhlinzwa. Esinye isifundo esikhulu esivame ukuqondisa ukwelashwa sesiphakamise ukukhishwa kwamamitha ayi-7. Futhi, uma ubukhulu buyakhula, ukwelashwa kufanele kucatshangelwe.
- Indawo: I- Aneurysms emithanjeni engemuva kwengqondo ayijwayelekile kakhulu, kepha inengozi enkulu yokuphuka kunama-aneurysms ngaphambili kobuchopho.
- Ukwehla kwesimiso esingaphansi kwe-subarachnoid: Ingozi ephakeme yokuphuma kwamanzi kumuntu osuvele enegazi kusuka ku-aneurysm ehlukile angabonisa imithwalo yegazi engaphelele jikelele.
- Umlando womndeni: Ngokufanayo, abantu abanomlando womndeni we-aneurysms bavame ukuhlukana ngesikhathi esincane nangamanani amancane ane-aneurysm, mhlawumbe ngenxa yezintandane ezithatha igazi. Abantu abanamalungu amabili noma ngaphezulu omndeni abane-aneurysms kufanele bacabangele ukuhlolwa ukuze babone ukuthi bane-aneurysms ngokwabo.
Kungakhathaliseki ukuthi ukungenelela kuthathwa njengokudingekile kuzoxhomeka ekuhlanganisweni kwazo zonke izici ezingenhla. Kunezinketho ezimbili eziyinhloko zokungenelela okunjalo.
Ukulungiswa Kwe-Aneurysm Neurosurgical
Njengoba izinhlobo eziningi ze-cerebral aneurysms zidonsa isikebhe esikhulu njengombhaluni, zingahlukaniswa naso sonke isitsha ngokufaka isiqeshana sensimbi entanyeni ye-aneurysm.
Kule nqubo, i-skull ivuliwe ukuvumela i-neurosurgeon ukuthi ifinyelele ebuchosheni futhi ithole indlela eya esikebheni segazi. Naphezu kokubaluleka kokuhlinzwa okunjalo, ocwaningweni olulodwa, iziguli ezingaphezu kuka-94% zineziphumo ezinhle zokuhlinzwa.
Njengoba ngokuvamile kunjalo, amathuba okuba nomphumela ongcono kakhulu uma abahlinzayo nabahlinzeki abengeziwe behlangene kakhulu nenqubo.
Izingozi ezikhona zenkambiso zihlanganisa ukulimala komqondo noma ukuphuma kwegazi. Kodwa-ke, lezi zingozi zivame ukwedlula imikhakha engase ibe yingozi ye-hemorrhage engaphansi komhlaba.
Ukulungiswa kwe-Endovascular Aneurysm
Ekuqaleni kwawo-1990, kwafakelwa idivaysi evumela ukuthi umcengezi omncane uguqulwe emithanjeni yegazi yomzimba kuze kufinyelele esakhiweni se-aneurysm, lapho izinhlamvu ze-platinum zifakwe esikhwameni se-aneurysm. Izindwangu zakhiwe zizungeze lawa mafutha, ngaleyo ndlela zifaka uphawu lwe-aneurysm emzimbeni wonke.
Le nqubo ye- radiological yokungenelela ivame ukubhekwa ngokuthi "ukugaya," nakuba sekuphelile isikhathi, ezinye izindlela zokuvala izimpikiswano ezinjengama-polymers, nazo ziyasebenza.
Ngokuvamile, imiphumela yokulungisa i-endovascular aneurysm ibonakala ifana namasu amaningi okugcoba ama-neurosurgical, kodwa lokhu kuyahluka. Kwesinye isifundo, ukubhala kwakuhlotshaniswa nemiphumela engcono ngemuva kwengqondo, futhi ukuchofoza kwakungcono ngaphambili. Ubukhulu kanye nokuma kwe-aneurysm nakho kunganciphisa izinketho zokwelashwa, ngoba intamo ende noma i-aneurysm enkulu kungenzeka ingaphenduli kahle ekuguleni. Ngokuvamile, ukubonakala kubonakala kunemiphumela engcono jikelele, ngaphandle kokuthi kunethuba eliphakeme le-aneurysm ebuyela emuva ekubambeni kunokuqhafaza.
Ezinye izici, njengobunzima besifo se-subarachnoid kanye naso sonke isikhathi sempilo kanye nobudala besiguli, zingase zibe nendima ekunqumeni indlela yokuphatha i-aneurysm. Mhlawumbe isici esibaluleke kunazo zonke ekunqumeni ukuthi ukuchofoza noma ukuchofoza i-aneurysm yikhono nesipiliyoni sabasebenzi abazokwenza inqubo.
Imithombo:
Broderick JP, Brown RD Jr, uSererbeck L, et al. Ukuhlukumeza okukhulu kakhulu komndeni uma kuqhathaniswa ne-aneurysms engasebenzi ngokungahambi kahle. Isigameko sika-2009; 40: 1952.
McLaughlin N, Bojanowski MW. Izinkinga ezihlobene nokuhlinzwa kokuqala emva kokufakwa kwesithombe se-aneurysm: ukuhlaziywa kwezimbangela nemiphumela yeziguli. J Neurosurg 2004; 101: 600.
I-Wiebers DO, i-Whisnant JP, i-Huston J 3rd, et al. Izimpikiswano ezingenakunqotshwa kwemithi: umlando wemvelo, umphumela wemitholampilo, kanye nezingozi zokuphathwa kokwelapha kanye nezindlala. Lancet 2003; 362: 103.