Ukopha kwegazi kwangaphantsi kwentsholongwane

I-Subarachnoid hemorrhage yopha kwindawo ebuphakathi kwengqondo kunye nezicubu ezincinci ezigubungele ingqondo. Le ndawo ibizwa ngokuba yi-subarachnoid space. Ukopha kwe-Subarachnoid kungxamiseko kwaye kufuneka unyango ngokukhawuleza.

I-Subarachnoid hemorrhage inokubangelwa ngu:

• Ukuphuma kwegazi kwimithambo yegazi ebizwa ngokuba yi-arteriovenous malformation (AVM)
• Ukuphazamiseka kwegazi
• Ukopha kwi-aneurysm yecerebral (indawo ebuthathaka eludongeni lomthambo wegazi obangela ukuba isitya segazi sikhuphe ibhaluni ngaphandle)
• Ukwenzakala entloko
• Isizathu esingaziwayo (idiopathic)
• Ukusetyenziswa kwezicoci gazi

I-Subarachnoid hemorrhage ebangelwa kukwenzakala ihlala ibonwa kubantu abadala abaye bawa kwaye babetha entloko. Phakathi kwabancinci, eyona ngozi ixhaphakileyo ekhokelela kwi-subarachnoid hemorrhage kukuphazamiseka kwemoto.

Iingozi zibandakanya:

• I-aneurysm engaphazanyiswanga kwingqondo kunye neminye imithambo yegazi
• I-Fibromuscular dysplasia (FMD) kunye nokunye ukuphazamiseka kwezicubu
• Igazi elonyukayo
• Imbali yesifo sezintso se-polycystic
• Ukutshaya
• Ukusetyenziswa kweziyobisi ezingekho mthethweni ezifana necocaine kunye ne methamphetamine
• Ukusetyenziswa kwezicoci gazi ezifana newarfarin

Imbali eyomeleleyo yosapho ye-aneurysms nayo inokwandisa umngcipheko.

Uphawu oluphambili yintloko ebuhlungu eqala ngesiquphe (edla ngokubizwa ngokuba yintloko yeendudumo). Ihlala imbi ngakumbi ngasemva kwentloko. Abantu abaninzi bahlala bechaza ukuba "yintloko ebuhlungu kakhulu" kwaye ngokungafaniyo nolunye uhlobo lweentlungu zentloko. Intloko ingaqala emva kokuphuma okanye ukubetha entloko.

Ezinye iimpawu:

• Ukunciphisa ukuqonda kunye nokuqapha
• Ukungahambi kakuhle kwamehlo ngokukhanya okuqaqambileyo (photophobia)
• Imood kunye notshintsho kubuntu, kubandakanya ukudideka kunye nokucaphuka
• Ubuhlungu bemisipha (ngakumbi iintlungu zentamo kunye nentlungu)
• Isicaphucaphu nokugabha
• Ubungqindilili kwinxalenye yomzimba
• Ukuhlutha
• Intamo elukhuni
• Iingxaki zombono, kubandakanya umbono ophindwe kabini, amabala angaboniyo, okanye ukulahleka kombono okwethutyana kwiliso elinye

Ezinye iimpawu ezinokuthi zenzeke kwesi sifo:

• Ukujongwa kweenkophe
• Ubungakanani babafundi umahluko
• Ukuqina ngesiquphe komqolo nentamo, ngokugoba umqolo (opisthotonos; akuqhelekanga kakhulu)

Iimpawu zibandakanya:

• Uvavanyo lomzimba lunokubonisa intamo elukhuni.
• Uvavanyo lwengqondo kunye neenkqubo zovalo kunokubonisa iimpawu zokwehla kwe-nerve kunye nokusebenza kwengqondo (kugxilwe kukusilela kwe-neurologic).
• Uvavanyo lwamehlo lunokubonisa ukwehla kwentshukumo yamehlo. Umqondiso wokonakaliswa kwemithambo-luvo ye-cranial (kwiimeko ezinobunzima, akukho ngxaki zinokubonwa kuvavanyo lwamehlo).

Ukuba ugqirha wakho ucinga ukuba une-subarachnoid hemorrhage, intloko ye-CT scan (ngaphandle kwedayi eyahlukileyo) iya kwenziwa kwangoko. Ngamanye amaxesha, ukuskena kuyinto eqhelekileyo, ngakumbi ukuba kuye kwaphuma igazi elincinci. Ukuba i-CT scan iqhelekile, i-lumbar puncture (impompo yomqolo) inokwenziwa.

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• I-cerebral angiography yemithambo yegazi yengqondo
• I-CT scan angiography (usebenzisa idayi eyahlukileyo)
• I-Transcranial Doppler ultrasound, ukujonga ukuhamba kwegazi kwimithambo yengqondo
• Imagnetic resonance imaging (MRI) kunye ne-magnetic resonance angiography (MRA) (ngamanye amaxesha)

Iinjongo zonyango zezi:

• Gcina ubomi bakho
• Lungisa unobangela wokopha
• Nciphisa iimpawu
• Khusela iingxaki ezinjengokwenzakala kwengqondo okungapheliyo (ukubetha)

Utyando lunokwenziwa ku:

• Susa ingqokelela enkulu yegazi okanye unciphise uxinzelelo kwingqondo ukuba ukopha kungenxa yokwenzakala
• Lungisa i-aneurysm ukuba ukopha kungenxa yokuqhekeka kwe-aneurysm

Ukuba umntu ugula kakhulu, utyando kungafuneka alinde ade umntu lowo azinze.

Utyando lunokubandakanya:

• I-Craniotomy (ukusika umngxunya kukhakhayi) kunye nokunqunyulwa kwe-aneurysm, ukuvala i-aneurysm
• I-coil ye-Endovascular: ukubeka iikhoyili kwi-aneurysm kunye ne-stents kwisitya segazi ukukhupha iikhoyili kunciphisa umngcipheko wokopha ngakumbi

Ukuba akukho i-aneurysm efunyenweyo, umntu kufuneka abekwe esweni liqela lokhathalelo lwempilo kwaye unokufuna iimvavanyo zokucinga ngakumbi.

Unyango lwe-coma okanye ukunciphisa ukulumkisa kubandakanya:

• Ukucoca ityhubhu ebekwe kwingqondo ukunciphisa uxinzelelo
• Inkxaso yobomi
• Iindlela zokukhusela umoya
• Indawo ekhethekileyo

Umntu onolwazi unokufuna ukuphumla ebhedini ngokungqongqo. Umntu uya kuxelelwa ukuba aphephe izinto ezinokunyusa uxinzelelo ngaphakathi kwentloko, kubandakanya:

• Ukugoba
• Ukucoca
• Ukutshintsha ngesiquphe indawo

Unyango lunokubandakanya:

• Amayeza anikwe ngomgca we-IV ukulawula uxinzelelo lwegazi
• Iyeza lokukhusela i-spasms ye-artery
• Iipilisi zentlungu kunye namayeza okulwa nexhala ukunciphisa intloko kunye nokunciphisa uxinzelelo kwikakayi
• Amayeza okuthintela okanye ukunyanga ukuxhuzula
• Izithambisi zesitulo okanye i-laxatives ukunqanda ukuxinana ngexesha lokuhamba kwamathumbu
• Amayeza okuthintela ukuxhuzula

Ukusebenza kakuhle komntu one-subarachnoid hemorrhage kuxhomekeke kwinani lezinto ezahlukeneyo, kubandakanya:

• Indawo kunye nenani lokopha
• Iingxaki

Ukwaluphala kunye neempawu ezinzima kunokukhokelela kwiziphumo ezihlwempuzekileyo.

Abantu banokuchacha ngokupheleleyo emva konyango. Kodwa abanye abantu bayafa, kwanonyango.

Ukuphindaphinda ukopha yeyona ngxaki inzima. Ukuba i-aneurysm yecerebral yopha okwesibini, imeko iba mbi kakhulu.

Utshintsho kulwazi kunye nokuphaphama ngenxa yokuqaqanjelwa sisisu kwangaphantsi kwento enokubakho kunokuba mandundu kwaye kukhokelele ekufeni okanye ekufeni.

Ezinye iingxaki zibandakanya:

• Iingxaki zotyando
• Iziphumo ebezingalindelekanga zamayeza
• Ukuxhuzula
• Ukubetha

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba wena okanye umntu omaziyo uneempawu zokopha okungaphantsi.

La manyathelo alandelayo anokunceda ekuthinteleni ukopha okungaphantsi kwe-subarachnoid:

• Ukuyeka ukutshaya
• Ukunyanga uxinzelelo lwegazi oluphezulu
• Ukuchonga nokunyanga ngempumelelo i-aneurysm
• Ukungasebenzisi iziyobisi ezingekho mthethweni

Ukopha - i-subarachnoid; Ukopha okungaphantsi

• Intloko-yintoni ekufuneka ubuze ugqirha wakho

UMayer SA. Isifo sehembravascular esophayo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; Ngo-2016: isahluko 408.

I-Szeder V, iTateshima S, iDuckwiler GR. I-intracranial aneurysms kunye ne-subarachnoid hemorrhage. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 67.