Funda ukuqaphela iimpawu zestroke

Imfundo yezeMpilo

Kukho ithuba elihle lokuba wazi umntu oye wahlaselwa yistroke, okanye uya kuthi ebomini bakho-kwaye kungenxa yokuba ukubetha kuxhaphakile. Ngaphezulu kwabantu abangama-795,000 e-United States abanesifo esibuhlungu minyaka le, ngokwe- Amaziko oLawulo lweNtsholongwane kunye noThintelo (CDC) . Kwamanye amanani, umntu eUnited States unesifo sokufa icala rhoqo kwimizuzwana engama-40. Rhoqo emva kwemizuzu emi-4, umntu ubulawa sisibetho. Kwaye kwabo basindayo, ukubethwa ngoyena nobangela uphambili wokukhubazeka ixesha elide.

Izitrowukhi ziyingozi kwaye zixhaphakile, kodwa kusekho ukudideka okubangqongileyo- siyintoni istrowuku? Ziintoni iimpawu zestroke? Ungasinqanda njani istrowuku? Apha, fumana iimpendulo ozifunayo.

Yintoni iStrowuku?

Ukuyibeka ngokucacileyo, i-stroke ngumonakalo kwingqondo obangelwe kukungabikho kwegazi elaneleyo lokuya kwingqondo, utshilo uStephen Devries, MD, ugqirha wezithintelo kunye nomphathi olawulayo wokungenzi nzuzo. IZiko leGaples lokuDityaniswa kweCardiology . Ukubethwa sisifo kubangelwa yingxaki yemithambo yegazi eya ebuchotsheni, enokuthi yenzeke nokuba ngenxa yokuba isitya segazi sivalekile kwi-cholesterol plaque okanye kwihlwili legazi, okanye xa isitya segazi kwingqondo sivuleka ngenxa igazi elonyukayo okanye ubuthathaka obuzuzwe njengelifa kwimithambo.

Uhlala usiva ukubethwa ngumoya kwisivakalisi esinye njengokuhlaselwa kwentliziyo kuba zinxulumene nengxaki, kodwa azifani.Ukubethwa sisifo kwenzeka ngenxa yokuvaleka kwimithambo ebonelela ngengqondo ngegazi elinomoya, ngelixa isifo sentliziyo senzeka ngenxa yokuvaleka kwimithambo ebonelela ngezihlunu zentliziyo, ucacisa uRegina S. Druz, MD, FACC, a ugqirha wentliziyo kunye neNkonzo yezeMpilo yamaKatolika eLong Island kunye neGosa eliyiNtloko lezeMpilo kwiZiko leNtliziyo laseMelika (HHCA). Ngelixa amalungu ahluke kakhulu, izehlo zemithambo-luvo nezibandakanya ukubetha kwentliziyo kunye nokuhlaselwa sisifo sentliziyo zinxulumene ngokusondeleyo, njengoko kunjalo nakwiimeko ezinobungozi.

Ziziphi izinto ezinobungozi besifo?

Ngoku ka iNational Heart, Lung, kunye neZiko leGazi , ezinye zezinto ezinobungozi ezinkulu ezonyusa amathuba akho okuba nesifo sibandakanya:

• Igazi elonyukayo
• Seswekile
• Isifo sentliziyo
• Ukutshaya
• Amanqanaba aphezulu e-LDL cholesterol
• I-Atrial fibrillation (isingqisho sentliziyo esingaqhelekanga)
• Ii-aneurysms zeBongo okanye i-arteriovenous malformations (AVMs)
• Usulelo okanye iimeko ezibangela ukudumba (njenge-lupus okanye i-rheumatoid arthritis)
• Imbali yosapho yokubetha
• Ngesondo ( abafazi kunokwenzeka ukubetha)
• Imbali yangaphambi kokubetha okanye iTourical Ischemic Attack (TIA) ekwabizwa ngokuba sisibetho esincinci

Eminye, iimeko ezinobungozi ezingaziwayo zibandakanya uxinzelelo, uxinzelelo, amanqanaba oxinzelelo oluphezulu, ukusetyenziswa gwenxa kweziyobisi ngokungekho semthethweni, ukusela kakhulu, ukutyeba kakhulu, ukulala kakhulu (ngaphezulu kweeyure ezisithoba rhoqo), ukutshintshwa kwe-estrogen, iipilisi zokucwangcisa zomlomo, kunye nokuhlala kwiindawo. ngongcoliseko lomoya.

Yeyiphi imiqondiso yokuqala yokubetha?

Ukujongwa ebusweni, ubuthathaka bengalo, kunye nobunzima bokuthetha zonke ezo zizalathi zestroke, utshilo uGqirha Druz. Ngokutsho kweCDC, iimpawu zokuqala zesifo zibandakanya:

• Ukuphazamiseka ngesiquphe okanye ubuthathaka ebusweni, engalweni, okanye emlenzeni, ngakumbi kwelinye icala lomzimba
• Ukudideka ngesiquphe, ingxaki yokuthetha, okanye ubunzima bokuqonda intetho
• Ingxaki ngesiquphe yokubona kwiliso elinye okanye kokubini
• Ngokukhawuleza ingxaki yokuhamba, isiyezi, ukuphulukana nokulingana, okanye ukunqongophala kokulungelelanisa
• Ngequbuliso intloko ebuhlungu engaziwayo ngaphandle kwesizathu

Iimpawu zestroke zinokwahluka kubafazi kunamadoda. Ngokwe-American Stroke Association, abasetyhini banokuxela iimpawu ezinje:

• Ubuthathaka ngokubanzi
• Ukuphefumla nzima okanye ukuphefumla kancinci
• Ukudideka, ukungaphenduli, okanye ukudideka
• Ukutshintsha ngesiquphe kokuziphatha
• Ukuphazamiseka
• Ukubona izinto ezingekhoyo
• Isihlunu okanye ukugabha
• Intlungu
• Ukuxhuzula
• Ukuphulukana nokuqonda okanye ukuphelelwa ngamandla

Uhlala ixesha elingakanani uneempawu ngaphambi kokubetha?

Iimpawu zokulumkisa ngesibetho zinokufika kwiintsuku ezisixhenxe ngaphambi kokubetha, ngokophando olupapashwe kwi Neurology . Iimpawu ezilumkisayo zestroke ziyafana nokubetha uqobo-kodwa umahluko kukuba, ngaphambi kokubetha, iimpawu ezilumkisayo zisombulula ngokukhawuleza, ngamanye amaxesha ngendlela yemizuzu embalwa, uGqirha Devries uyacacisa. Rhoqo, ezi alamu azikhathalelwa kwaye abantu abalufuni unyango olunokusindisa ubomi. Ukufuna uncedo lwezonyango kwangoko kwimpawu yokuqala kunokunceda ekuthinteleni ukonakala kwengqondo.

Yintoni omele uyenze xa uqaphela iimpawu zestroke?

Ukuba le yimeko emitsha kuya kufuneka ubize ngokukhawuleza i-911. Eli qela leempawu kunye neempawu liyaziwa njengegama elithi 'FAST'-kukunceda ukhumbule ezi mpawu zintathu, kunye ne-'T' eyongeziweyo ebonisa ukuba ixesha lelona libalulekileyo. Ucacisa uGqr Druz.

I-National Heart, i-Lung, kunye ne-Blood Institute (i-NHLBI) ichitha i-FAST ngeempawu kunye nenyathelo omele ukulithatha ukuqinisekisa imeko yesigulana esibuhlungu ngolu hlobo:

F — Ubuso: Cela loo mntu ancume. Ngaba elinye icala lobuso liwile?
A — Izixhobo: Cela umntu ukuba aphakamise zombini iingalo. Ngaba ingalo enye ihla iye ezantsi?
S -Ntetho: Cela loo mntu ukuba aphinde ibinzana elilula. Ngaba intetho ayilunganga okanye ayiqhelekanga?
T-Ixesha: Ukuba ubona nayiphi na le miqondiso, tsalela umnxeba u-9-1-1 kwangoko. Unyango lwakwangoko lubalulekile.

Ukuba ucinga ukuba wena okanye omnye umntu uhlaselwa kukuhlaselwa sischemic (TIA) okanye ukubetha, musa ukuqhuba uye esibhedlele okanye uvumele omnye umntu akuqhubise. Biza i-ambulensi ukuze abasebenzi bezonyango baqale unyango olusindisa ubomi endleleni eya kwigumbi likaxakeka. Ngexesha lokubetha, yonke imizuzu yokubala.

Ngaba isifo sohlangothi sinokungaqapheli?

Kukho into efana ne ukubetha okuncinci -Okanye i-TIA-enokuthi ingaqatshelwa ngabo bobabini bayifumanayo kunye nababukeli. I-TIA yingxaki kwimithambo yegazi ebangela ukwehla okwethutyana kokuhamba kwegazi ukuya kwingingqi ethile yobuchopho, ngokwe Ezempilo zeHarvard . Ugqirha uLouis Caplan, uprofesa we-neurology e-Harvard ehambelana ne-Beth Israel Deaconess Medical Centre uthi ezi ziqendu zifutshane kakhulu, zihlala ngaphantsi kweyure ukuya kwiiyure ezingama-24.

Ngapha koko, uninzi lwee-TIAs zingaphaya kwimizuzu embalwa. Uluhlu lweziganeko ezikhokelela kwi-TIA ziyafana ezikhokelela ekubetheni, kodwa kwinqanaba elincinci. Oku kuyingozi kuba i-TIA inokubangela umonakalo osisigxina kwaye inokubangela ukubethwa sisifo kungekudala.

Zeziphi iimeko ezinokulingisa ukubetha?

Ngoku ka uphando ipapashwe ngo-2017, kukho iimeko ezininzi zonyango ezinokulinganisa iimpawu kunye neempawu zestroke, ezinje: ngamathumba obuchopho, ukuphazamiseka kwemetabolism (njenge-hypoglycemia okanye hyperthyroidism), izifo ezosulelayo (njenge-meningoencephalitis), kunye nokuphazamiseka kwengqondo (njenge-migraine okanye ukuxhuzula ).

Oku kwenza ukuba kube nzima ngakumbi ukubetha ngesibetho, kodwa ukulinda unyango kunokubangela iingxaki ezingalungiseki. Ukuba ucinga ukuba kukho naliphi na ithuba elinokubakho si-stroke, lixesha lokuba uye esibhedlele. Nokuba iphela iyimeko yokulinganisa, kungcono ukuba ukhuseleke kunokuba ube nosizi.

Indlela yokuthintela ukubetha

Ngelixa zininzi izinto ezinobungozi ezingaphandle kolawulo lwethu (ezinje ngembali yosapho kunye nemfuza), zininzi iindlela zokunciphisa kakhulu umngcipheko wokubetha. Abantu banamandla ngaphezulu kwempilo yabo ngokutya kunye nendlela yokuphila kunokuba bahlala beqonda, utshilo uGqirha Devries.

Izigulana ezinesifo seswekile, i-atrial fibrillation, i-cholesterol ephezulu kunye noxinzelelo lwegazi zisengozini yokuhlaselwa sisifo. Ukulawula ezi meko ziphantsi kunyango lwabo kuya kunceda ukuthintela ukubetha.

La manyathelo mahlanu anokunceda ukuthintela ukubetha kwestroke:

1. Yeka ukutshaya . Ukutshaya yeyona nto iphambili emngciphekweni, kwaye akukho nto inokuba linyathelo elihle kwimpilo engcono kunokuyeka, utshilo uGqirha Devries.
2. Nciphisa ityuwa ekudleni kwakho, kwaye utye ukutya okuncinci okucutshungulweyo . Uxinzelelo lwegazi oluphezulu yenye yezona zinto zibeka emngciphekweni wokufa icala, utshilo uGqirha Devries. Ukutshintsha indlela otya ngayo kunokukunceda uxinzelelo lwegazi — ngakumbi ukukhawulela ityiwa ekutyeni okutyayo (okufumaneka kukutya okuninzi okuphekiweyo, kunye nakwisonka, inyama egqityiweyo enjengebhekoni kunye nesoseji, kunye nepitsa).
3. Yitya iziqhamo ezininzi, iimbotyi kunye nemifuno . Kwicala elifanelekileyo, ukutya okuphezulu kwi-potassium, njengeziqhamo ezininzi, iimbotyi kunye nemifuno, kuyanceda uxinzelelo lwegazi olusezantsi , utshilo uGqirha Devries.
4. Nciphisa ukusela utywala . Ukusela kakhulu kunokubangela uxinzelelo lwegazi — nto leyo abantu abaninzi abangayaziyo, utshilo uGqirha Devries.
5. Yenza umthambo rhoqo . Olunye utshintsho kwindlela yokuphila olunokunceda ukuthintela ukubethwa ngumzimba kubandakanya ukuzivocavoca rhoqo, kubandakanya ukuhamba okuzinzileyo, kunye nolawulo loxinzelelo ngezixhobo ezinje ngokucamngca, utshilo uGqirha Devries.

Ukuba sele unestroke, ugqirha usenokukunyanga Iasprini , clopidogrel ( IPlavix ), kunye namayeza e-statin okuthintela ukubetha kwesibini.

Indlela ezimbini zokuthintela ukuphindaphinda kwesifo kukufumana unyango rhoqo kwaye wenze konke okusemandleni akho ukuphucula amathuba akho okuphila, utshilo uGqirha Devries. Ukuhlolwa rhoqo kwezonyango kubalulekile ukugcina uxinzelelo lwegazi, icholesterol , kunye namanqanaba eswekile. Kodwa nokuba unamayeza afanelekileyo, ukwenza utshintsho kwindlela yokuphila kuhlala kubalulekile. Izigulana zestroke zinyangwa nge-aspirin, i-clopidogrel (Plavix) kunye namayeza e-statin okuthintela ukubetha kwesibini.