Imbali yeStroke

Umxholo

• Inkcazo yokuqala yesifo
• Stroke namhlanje
• Imbali yonyango lwesifo
• Inkqubela phambili kunyango lwe-stroke
• Imivumbo yeschemic
• Imivumbo eyophayo
• Inkqubela phambili kuthintelo lwesifo
• Ukuthatha

Yintoni iStrowuku?

Ukubethwa sisibetho kunokuba yinto yokwenzakala kwezonyango. Kwenzeka xa ukuhamba kwegazi ukuya kwinxalenye yengqondo yakho kuphazamisekile ngenxa yegazi okanye igazi elaphukileyo. Ngokufana nokuhlaselwa sisifo sentliziyo, ukungabikho kwegazi elinobutyebi obuninzi kunokukhokelela ekufeni kwethishu.

Xa iiseli zobuchopho ziqala ukusweleka ngenxa yokwehla kwegazi, iimpawu zenzeka kwiindawo zomzimba ezilawulwa ziiseli zobuchopho. Ezi mpawu zinokubandakanya ukuba buthathaka ngesiquphe, ukukhubazeka komzimba, nokuba ndindisholo kobuso okanye amalungu omzimba. Ngenxa yoko, abantu abanesiphene banokuba nobunzima bokucinga, ukuhamba, kwanokuphefumla.

Inkcazo yokuqala yesifo

Nangona ngoku oogqirha bebazi oonobangela kunye neziphumo zestroke, imeko ibingasoloko iqondwa kakuhle. Hippocrates, "uyise weyeza," waqala ukubonwa ngaphezu kweminyaka engama-2 400 eyadlulayo. Le meko wayibiza ngokuba yiapoplexy, gama elo lesiGrike elithetha “ukubethwa ngenxa yobundlobongela.” Ngelixa igama lalichaza utshintsho olukhawulezileyo olunokubakho ngesifo, kodwa aluzange ludlulise eyona nto yenzekayo kwingqondo yakho.

Kwiinkulungwane kamva kwi-1600s, ugqirha ogama linguJacob Wepfer wafumanisa ukuba kukho into ephazamise ukubonelelwa kwegazi kwingqondo yabantu ababhubhe ngenxa yeapoplexy. Kwezinye zezi meko, bekukho ukopha okukhulu kwingqondo. Kweminye, imithambo ibivaliwe.

Kumashumi eminyaka alandelayo, isayensi yezonyango yaqhubeka nokwenza inkqubela phambili ngokubhekisele koonobangela, iimpawu kunye nonyango lweapoplexy. Esinye isiphumo sale nkqubela phambili yayikukuhlulwa kwe-apoplexy kwiindidi ngokusekwe kunobangela wale meko. Emva koku, i-apoplexy yaziwa ngamagama anje ngokubetha kunye neengozi ze-cerebralvascular accident (CVA).

Stroke namhlanje

Namhlanje, oogqirha bayazi ukuba zimbini iintlobo zestroke ezikhoyo: ischemic kunye nokopha. Ukubetha kweschemic, okuxhaphake kakhulu, kuyenzeka xa i-clot yegazi ihlala kwingqondo. Oku kuthintela ukuhamba kwegazi kwiindawo ezahlukeneyo zobuchopho. I-stroke esophayo, ngakolunye uhlangothi, iyenzeka xa isitya segazi kwingqondo yakho sivuleka. Oku kubangela ukuba igazi liqokelele. Ubungqongqo besibetho buhlala budibene nendawo yobuchopho kunye nenani leeseli zengqondo ezichaphazelekayo.

Ngokwe-National Stroke Association, ukubetha kukungunobangela wesihlanu wokufa kwabantu e-United States. Nangona kunjalo, abantu abaqikelelwa kwizigidi ezisixhenxe eMelika basindile kwisifo sokubethwa. Ndiyabulela kwinkqubela phambili kwiindlela zonyango, izigidi zabantu abaye bafumana ukubethwa ngoku banokuphila ngeengxaki ezimbalwa.

Imbali yonyango lwesifo

Olunye lwezonyango zokuqala ezaziwayo lwenzeka nge-1800s, xa ogqirha baqala ukwenza utyando kwimithambo ye-carotid. Ezi yimithambo ebonelela ngokuhamba okuninzi kwegazi kwingqondo. Amahlwili akhula kwimithambo ye-carotid ahlala enoxanduva lokubangela ukubetha. Abagqirha baqala ukusebenza kwimithambo ye-carotid ukunciphisa i-cholesterol buildup kunye nokususa iibhloksi ezinokuthi zikhokelele ekubethweni. Utyando lokuqala olubhaliweyo lwe-carotid e-United States lwalungo-1807. UGqirha Amos Twitchell wenza utyando eNew Hampshire. Namhlanje, le nkqubo yaziwa ngokuba yi-carotid endarterectomy.

Ngelixa utyando lwe-carotid arttery ngokuqinisekileyo lwanceda ukuthintela ukubetha, bekukho unyango oluncinci olufumanekayo ukunyanga ukubetha kunye nokunciphisa iziphumo. Uninzi lonyango lujolise kakhulu ekuncedeni abantu ukuba balawule nabuphi na ubunzima emva kokubetha, njengokuphazamiseka kwentetho, iingxaki zokutya, okanye ubuthathaka obungapheliyo kwelinye icala lomzimba. Kwakungekho ngo-1996 apho unyango olusebenzayo lwenziwa ngakumbi. Ebudeni baloo nyaka, U. S. Food and Drug Administration (FDA) yavuma ukusetyenziswa kwezicwili plasminogen activator (TPA), iyeza eliqhekeza amahlwili egazi abangela ukubetha kweschemic.

Nangona i-TPA inokusebenza kunyango lwe-ischemic stroke, kufuneka ilawulwe kwisithuba seeyure eziyi-4,5 emva kokuqala kweempawu. Ngenxa yoko, ukufumana unyango ngokukhawuleza kwistroke kubalulekile ekunciphiseni nasekuguqulweni kweempawu. Ukuba umntu omaziyo uhlangabezana neempawu zestroke, ezinje ngokudideka ngequbuliso kunye nokuba buthathaka okanye ukuba ndindisholo kwelinye icala lomzimba, bamse esibhedlele okanye utsalele umnxeba ku-911 kwangoko.

Inkqubela phambili kunyango lwe-stroke

Imivumbo yeschemic

I-TPA yindlela yonyango ekhethwayo yokubetha imichiza. Nangona kunjalo, inkqubela phambili yakutshanje ekunyangeni ezi ntlobo zemivumbo yi-mechanical thrombectomy. Le nkqubo inokususa ngokwasemzimbeni iqabaka yegazi kumntu onesifo sokuphazamiseka emzimbeni. Ukusukela oko yasungulwa ngo-2004, obu buchule buye babaphatha abantu abamalunga ne-10,000.

Nangona kunjalo, ukubuyela umva kukuba uninzi lotyando kusafuneka luqeqeshwe kwi-thrombectomy yoomatshini kwaye izibhedlele kufuneka zithenge izixhobo eziyimfuneko, ezinokubiza kakhulu. Ngelixa i-TPA iseyeyona nto isetyenziswa kakhulu kunyango lwe-ischemic stroke, i-mechanical thrombectomy iyaqhubeka nokwanda ekuthandeni njengoko abagqirha abaninzi beqeqeshwa ekusetyenzisweni kwayo.

Imivumbo eyophayo

Unyango lwe-stroke esophayo nalo lude lude. Ukuba iziphumo zestroke esophayo zichaphazela inxenye enkulu yengqondo, oogqirha banokucebisa ukuba kwenziwe utyando ngenzame zokunciphisa umonakalo wexesha elide kunye nokunciphisa uxinzelelo kwingqondo. Unyango lotyando lwesifo esibuhlungu lubandakanya:

• Ukucandwa kotyando. Olu tyando lubandakanya ukubeka ikliphu kwisiseko sendawo ebangela ukopha. Ikliphu imisa ukuhamba kwegazi kwaye inceda ukukhusela indawo ekuphumeni kwegazi kwakhona.
• Ukubumba. Le nkqubo ibandakanya ukukhokela ucingo kwintambo kunye nokuya kwingqondo ngelixa ufaka iikhoyili ezincinci ukuzalisa iindawo ezibuthathaka kunye nokopha. Oku kunokumisa nakuphi na ukuphuma kwegazi.
• Ukususwa kotyando. Ukuba indawo yokuphuma kwegazi ayinakulungiswa ngezinye iindlela, ugqirha unokuhambisa icandelo elincinci lendawo eyonakeleyo. Nangona kunjalo, olu tyando luhlala luyindlela yokugqibela kuba ithathwa njengomngcipheko omkhulu kwaye ayinakwenziwa kwiindawo ezininzi zobuchopho.

Olunye unyango lunokufuneka, kuxhomekeke kwindawo kunye nobukhulu bokuphuma kwegazi.

Inkqubela phambili kuthintelo lwesifo

Ngelixa ukubetha kuqhubeka kube ngunobangela ophambili wokukhubazeka, malunga neepesenti ezingama-80 zemivumbo iyathinteleka. Enkosi kuphando lwamva nje kunye nenkqubela phambili kunyango, oogqirha ngoku banokucebisa ngeendlela zokuthintela abo basemngciphekweni wokubethwa. Imingcipheko eyaziwayo yomngcipheko ibandakanya ukuba ngaphezu kweminyaka engama-75 kunye nokuba:

• i-fibrillation ye-atrial
• ukusilela kwentliziyo
• isifo seswekile
• igazi elonyukayo
• imbali yestroke okanye uhlaselo lwexeshana lweschemic

Abantu abanezi zinto zinomngcipheko kufuneka bathethe nogqirha wabo malunga nendlela abanokuwunciphisa ngayo umngcipheko. Oogqirha bahlala becebisa la manyathelo alandelayo othintelo:

• yeka ukutshaya
• amayeza anticoagulant okuthintela ukopha kwegazi
• amayeza okulawula uxinzelelo lwegazi oluphezulu okanye isifo seswekile
• ukutya okunempilo okusezantsi kwesodiyam kwaye kutyebile kwiziqhamo nemifuno
• iintsuku ezintathu ukuya kwezine ngeveki umthambo ubuncinci imizuzu engama-40 ngosuku

Ngelixa ukubetha kungasoloko kuthintelwa, ukuthatha la manyathelo kunokunceda ukunciphisa umngcipheko kangangoko kunokwenzeka.

Ukuthatha

Ukuhlaselwa sisibetho sisigulo esisongela ubomi esinokubangela ukonakala kwengqondo okungapheliyo kunye nokukhubazeka ixesha elide.Ukufuna unyango ngokukhawuleza kunokunyusa amathuba okuba wena okanye umntu omthandayo afumane olunye lonyango olusetyenziselwa ukunyanga ukubetha kunye nokunciphisa iingxaki.