Yonke into ekufuneka uyazi ngeSchemic Stroke

Umxholo

• Ziintoni iimpawu?
• Yintoni ebangela ukubetha kweschemic?
• Ziziphi izinto ezinobungozi?
• Kufunyaniswa njani?
• Zeziphi iingxaki ezinxulumene nokubetha kweschemic?
• I-ischemic stroke iphathwa njani?
• Kuthetha ntoni ukubuyela kwimeko yestrikhi?
• Yintoni imbonakalo?

Yintoni ischemic stroke?

Ischemic stroke yenye yeendlela ezintathu zokubetha. Ikwabizwa ngokuba yi-ischemia yengqondo kunye ne-cerebral ischemia.

Olu hlobo lwesifo sibangelwa kukuvaleka komthambo onika igazi kwingqondo. Ukuvalwa kunciphisa ukuhamba kwegazi kunye neoksijini eya kwingqondo, ekhokelela ekonakaleni okanye ekufeni kweeseli zobuchopho. Ukuba ukujikeleza akubuyiswanga ngokukhawuleza, umonakalo wengqondo unokuhlala ngokusisigxina.

Ngokumalunga neepesenti ezingama-87 zazo zonke izibetho ziyi-stroke ye-ischemic.

Olunye uhlobo lwesifo sokubethwa sisifo esophayo, apho umthambo wegazi kwingqondo uqhekeka kwaye ubangele ukopha. Ukopha kucinezela izicwili zobuchopho, kuyonakalisa okanye kuyibulala.

Uhlobo lwesithathu lwesibetho kukuhlaselwa kweschemic okwethutyana (TIA), ekwabizwa ngokuba yi-ministerroke. Olu hlobo lwesifo sibangelwa kukuvaleka okwethutyana okanye ukunciphisa ukuhamba kwegazi kwingqondo. Iimpawu zihlala zinyamalala zodwa.

Ziintoni iimpawu?

Iimpawu ezithile zestroke se-ischemic zixhomekeke ekubeni yeyiphi na ingingqi yengqondo echaphazelekayo. Iimpawu ezithile zixhaphakile kuninzi lwe-ischemic stroke, kubandakanya:

• iingxaki zombono, ezinje ngobumfama kwiliso elinye okanye umbono ophindwe kabini
• ubuthathaka okanye ukukhubazeka emilenzeni yakho, enokuba kwicala elinye okanye omabini amacala, kuxhomekeke kumthambo ochaphazelekayo
• isiyezi kunye ne-vertigo
• ukudideka
• ukulahleka koququzelelo
• ukujinga kobuso kwelinye icala

Nje ukuba iimpawu ziqale, kubalulekile ukuba ufumane unyango ngokukhawuleza. Oku kwenza ukuba kungabikho lula ukuba umonakalo ube ngokusisigxina. Ukuba ucinga ukuba umntu othile unesifo sokubethwa, mvavanye usebenzisa i-FAST:

• Ubuso. Ngaba elinye icala lobuso babo lijingile kwaye kunzima ukuhamba?
• Izixhobo. Ukuba baphakamisa iingalo, ngaba ingalo enye iyehla iye ezantsi, okanye banobunzima obubonakalayo bokuphakamisa ingalo?
• Intetho. Ngaba intetho yabo iyasilela okanye iyinqaba?
• Ixesha. Ukuba impendulo kuyo nayiphi na le mibuzo ngu-ewe, lixesha lokuba ubize iinkonzo zangxamisekileyo zengingqi.

Nangona i-TIA ihlala ixesha elifutshane kwaye ihlala isombulula yodwa, ikwafuna ugqirha. Oku kunokuba ngumqondiso wesilumkiso sokubetha ngokupheleleyo kwe-ischemic stroke.

Yintoni ebangela ukubetha kweschemic?

Ischemic stroke senzeka xa umthambo obonelela ngegazi kwingqondo uvaliwe ligazi okanye kukunqatha okunamafutha, okubizwa ngokuba yiplaque. Olu vimba lunokubonakala entanyeni okanye kukhakhayi.

Amahlwili aqala entliziyweni kwaye ahamba ngenkqubo yokujikeleza kwegazi. Ihlwili linokuqhekeka lodwa okanye linokufakwa kumthambo. Xa ibhloka umthambo wobuchopho, ingqondo ayifumani gazi laneleyo okanye ioksijini, kwaye iiseli ziqala ukufa.

Ischemic stroke esibangelwa kukunqatha okunamafutha kwenzeka xa ipleyiti iqhekeza kumthambo ize iye kwingqondo.Iplaque nayo inokwakha kwimithambo ebonelela ngegazi kwingqondo kwaye inciphise loo mithambo inokubangela ukubetha kweschemic.

I-ischemia yomhlaba wonke, eluhlobo olungqongqo ngakumbi lwe-ischemic stroke, yenzeka xa ukuhamba kweoksijini kwingqondo kuncitshiswe kakhulu okanye kuyekwe kwaphela. Oku kuhlala kubangelwa sisifo sentliziyo, kodwa kunokubangelwa zezinye iimeko okanye izehlo ezinje ngecarbon monoxide poisoning.

Ziziphi izinto ezinobungozi?

Iimeko zokujikeleza kwegazi zezona zinto ziphambili zomngcipheko wokubetha kweschemic. Kungenxa yokuba bonyusa umngcipheko wamahlwili okanye iidipozithi ezinamafutha. Ezi meko zibandakanya:

• igazi elonyukayo
• isifo semithambo
• cholesterol ephezulu
• i-fibrillation ye-atrial
• ukuhlasela kwentliziyo kwangaphambili
• I-sickle cell anemia
• ukuphazamiseka kwengxaki
• iziphene zentliziyo ozelwe nayo

Ezinye izinto ezinobungozi zibandakanya:

• isifo seswekile
• ukutshaya
• ukutyeba kakhulu, ngakumbi ukuba unamafutha amaninzi esiswini
• ukusetyenziswa gwenxa kotywala
• ukusetyenziswa kweziyobisi ezithile, ezinje ngecocaine okanye imethamphetamines

I-Ischemic stroke ixhaphake kakhulu kubantu abanembali yosapho yokubetha okanye abanemivimbo eyadlulayo. Amadoda kunokwenzeka ngakumbi kunabafazi ukuba babethwe sisistim, ngelixa abamnyama benomngcipheko ophezulu kunezinye iintlanga okanye amaqela ezizwe. Umngcipheko nawo uyanda ngokobudala.

Kufunyaniswa njani?

Ugqirha uhlala esebenzisa uvavanyo lomzimba kunye nembali yosapho ukufumanisa isifo se-ischemic. Ngokusekwe kwiimpawu zakho, banokufumana uluvo lokuba indawo ekuyo ikuphi.

Ukuba uneempawu ezinje ngokudideka kunye nokuthetha okungaginyisi mathe, ugqirha wakho unokwenza uvavanyo lweswekile egazini. Kungenxa yokuba ukudideka kunye nentetho engacacanga ikwayimpawu zeswekile esezantsi yegazi. Funda ngakumbi malunga nefuthe leswekile esezantsi emzimbeni.

Ukuvavanywa kwe-cranial CT kunokunceda ukwahlula ukubetha kwe-ischemic kweminye imiba ebangela ukubhubha kwethishu yobuchopho, njengokuphalala kwegazi okanye ithumba lobuchopho.

Nje ukuba ugqirha wakho afumanise isifo se-ischemic, baya kuzama ukufumanisa ukuba iqale nini kwaye yintoni unobangela. I-MRI yeyona ndlela ilungileyo yokufumanisa ukuba isifo se-ischemic siqale nini. Uvavanyo olusetyenziselwa ukumisela oyena nobangela lunokubandakanya:

• i-electrocardiogram (i-ECG okanye i-EKG) yokuvavanya isingqisho sentliziyo esingaqhelekanga
• i-echocardiography ukujonga intliziyo yakho ukuba ayigungqi okanye ayiqhelekanga
• i-angiografi ukubona ukuba yeyiphi imithambo evaliweyo kunye nokuba kunzima kangakanani ukubhloka
• iimvavanyo zegazi ze-cholesterol kunye neengxaki zokuqhaqha

Zeziphi iingxaki ezinxulumene nokubetha kweschemic?

Ukuba ischemic stroke ayinyangwa ngokukhawuleza, inokubangela ukonakala kwengqondo okanye ukufa.

I-ischemic stroke iphathwa njani?

Injongo yokuqala yonyango kukubuyisela ukuphefumla, ukubetha kwentliziyo, kunye noxinzelelo lwegazi kwesiqhelo. Ukuba kukho imfuneko, ugqirha wakho uya kuzama ukunciphisa uxinzelelo kwingqondo ngamayeza.

Olona nyango luphambili lwesibetho se-ischemic sisithinteli sethambo seplasminogen activator (tPA), eqhekeza amahlwili. Izikhokelo ze-2018 ezivela kwi-American Heart Association (AHA) kunye ne-American Stroke Association (ASA) zichaza ukuba i-tPA isebenza kakhulu xa inikwa kwisithuba seeyure ezine ezinesiqingatha ukuqala kwesibetho. Ayinakunikwa ngaphezulu kweeyure ezintlanu emva kokuqala kwesibetho. Ngenxa yokuba i-tPA inokubangela ukopha, awunakuyithatha ukuba unembali:

• Isifo esibuhlungu
• ukopha kwingqondo
• utyando olukhulu lwakutsha nje okanye ukwenzakala entloko

Ayinakusetyenziswa nangubani na othatha ii-anticoagulants.

Ukuba i-tPA ayisebenzi, amahlwili angasuswa ngotyando. Ukususwa kwe-clot clot kungenziwa ukuya kwiiyure ezingama-24 emva kokuqala kweempawu zestroke.

Unyango lwexesha elide lubandakanya i-aspirin (Bayer) okanye i-anticoagulant yokuthintela amanye amahlwili.

Ukuba ukubetha kweschemic kubangelwa yimeko efana noxinzelelo lwegazi oluphezulu okanye isifo sokuqina kwemithambo yegazi, kuyakufuneka ufumane unyango kwezo meko. Umzekelo, ugqirha wakho unokucebisa i-stent ukuba ivule umthambo ocuthwe nge-plaque okanye i-statins ukunciphisa uxinzelelo lwegazi.

Emva kokubetha kweschemic, kuya kufuneka uhlale esibhedlele ukuze ujonge ubuncinci iintsuku ezimbalwa. Ukuba ukubetha kwabangela ukukhubazeka okanye ubuthathaka obunzima, unokufuna ukulungiswa kwakhona emva koko ukuze uphinde uphinde usebenze.

Kuthetha ntoni ukubuyela kwimeko yestrikhi?

Ukubuyisela kwimeko yesiqhelo kuye kufuneke ukuba kubuyiselwe izakhono zemoto kunye nokulungelelaniswa. Umsebenzi wokunyanga, owomzimba, kunye nowokuthetha kunokuba luncedo ekuncedeni ukuphinda usebenze kwakhona. Abantu abancinci kunye nabantu abaqala ukuphucula ngokukhawuleza kunokwenzeka ukuba baphinde bafumane umsebenzi.

Ukuba ikhona imiba ekhoyo emva konyaka, iya kuhlala isigxina.

Ukuba nesifo esinye se-ischemic stroke kukubeka emngciphekweni omkhulu wokuba nomnye. Ukuthatha amanyathelo okunciphisa umngcipheko, njengokuyeka ukutshaya, yinxalenye ebalulekileyo yokufumana kwakhona ixesha elide. Funda ngakumbi malunga nokubuyiselwa kwesifo.

Yintoni imbonakalo?

Ischemic stroke yimeko embi kwaye ifuna unyango kwangoko. Nangona kunjalo, ngonyango oluchanekileyo, uninzi lwabantu abanesifo se-ischemic stroke banokuphinda bafumane okanye bagcine umsebenzi owaneleyo wokukhathalela iimfuno zabo ezisisiseko. Ukwazi imiqondiso yestroke se-ischemic kunokunceda ukusindisa ubomi bakho okanye ubomi bomnye umntu.