Ukuwohloka komqondo ngemithambo yegazi

I-Dementia ilahleka kancane kancane futhi isebenza unomphela ngokusebenza kobuchopho. Lokhu kwenzeka ngezifo ezithile. Kuthinta inkumbulo, ukucabanga, ulimi, ukwahlulela nokuziphatha.

Ukuwohloka komqondo ngemithambo yegazi kubangelwa uchungechunge lwemivimbo emincane esikhathini eside.

Ukuwohloka komqondo nge-Vascular kuyimbangela yesibili evame kakhulu yokuwohloka komqondo ngemuva kwesifo i-Alzheimer kubantu abaneminyaka engaphezu kwengama-65.

Ukuwohloka komqondo ngemithambo yegazi kubangelwa uchungechunge lwemivimbo emincane.

• I-stroke ukuphazamiseka noma ukuvinjelwa kokunikezwa kwegazi kunoma iyiphi ingxenye yobuchopho. I-stroke ibizwa nangokuthi i-infarct. I-Multi-infarct isho ukuthi indawo engaphezulu kweyodwa ebuchosheni ilimele ngenxa yokushoda kwegazi.
• Uma ukugeleza kwegazi kumiswa isikhathi eside kunemizuzwana embalwa, ubuchopho abukwazi ukuthola umoya-mpilo. Amaseli obuchopho angafa, abangele ukulimala okungapheli.
• Lapho imivimbo ithinta indawo encane, kungahle kungabikho zimpawu. Lokhu kubizwa ngemivimbo ethulile. Ngokuhamba kwesikhathi, njengoba izindawo eziningi zobuchopho zilimele, izimpawu zokuwohloka komqondo ziyavela.
• Akuyona yonke imivimbo ethule. Imivimbo emikhulu ethinta amandla, ukuzwa, noma omunye umsebenzi wobuchopho nowezinzwa (neurologic) nayo ingaholela ekuwohlokeni komqondo.

Izici zobungozi bokuwohloka komqondo kwe-vascular zifaka:

• Isifo sikashukela
• Ukuqina kwemithambo yegazi (i-atherosclerosis), isifo senhliziyo
• Umfutho wegazi ophezulu (umfutho wegazi ophakeme)
• Ukubhema
• Unhlangothi

Izimpawu zokuwohloka komqondo nazo zingabangelwa ezinye izinhlobo zokuphazamiseka kobuchopho. Esinye sezifo ezinjalo yisifo i-Alzheimer. Izimpawu zesifo i-Alzheimer zingafana nalezo ze-dementia ye-vascular. I-Vascular dementia ne-Alzheimer yizimbangela ezivame kakhulu zokuwohloka komqondo, futhi kungenzeka zenzeke ndawonye.

Izimpawu zokuwohloka komqondo kwe-vascular zingakhula kancane kancane noma zithuthuke ngemuva kokushaywa unhlangothi okuncane ngakunye.

Izimpawu zingaqala kungazelelwe ngemuva kwesifo ngasinye. Abanye abantu abane-dementia yemithambo yegazi bangathuthuka isikhathi esifushane, kepha banciphe ngemuva kokushaywa unhlangothi. Izimpawu zokuwohloka komqondo ngemithambo yegazi zizoncika ezindaweni zobuchopho ezilimele ngenxa yesifo sohlangothi.

Izimpawu zokuqala zokuwohloka komqondo zingabandakanya:

• Kunzima ukwenza imisebenzi evame ukuza kalula, njengokulinganisa ibhuku lokuhlola, ukudlala imidlalo (njengebhuloho), nokufunda imininingwane emisha noma imizila
• Ukulahleka emizileni ejwayelekile
• Izinkinga zolimi, njengenkinga yokuthola igama lezinto ezijwayelekile
• Ukulahlekelwa intshisekelo ezintweni obukade uzijabulela ngaphambili, umuzwa ophansi
• Ukubeka izinto ngokungafanele
• Izinguquko zobuntu kanye nokulahleka kwamakhono omphakathi kanye nezinguquko zokuziphatha

Njengoba ukuwohloka komqondo kuya kuba kubi, izimpawu zisobala kakhulu futhi nekhono lokuzinakekela liyancipha. Izimpawu zingafaka:

• Shintsha amaphethini wokulala, uvame ukuvuka ebusuku
• Kunzima ukwenza imisebenzi eyisisekelo, njengokulungiselela ukudla, ukukhetha izingubo ezifanele noma ukushayela
• Ukukhohlwa imininingwane ngemicimbi yamanje
• Ukhohlwa imicimbi emlandweni wakho wempilo, ulahlekelwa ukuzazi ukuthi ungubani
• Ukuba nokukhohlisa, ukudangala, noma ukukhathazeka
• Ukuba nemibono, ukuphikisana, ukushaya, noma ukuziphatha okunodlame
• Ukuba nobunzima bokufunda noma ukubhala
• Ukuba nesahlulelo esibi nokulahlekelwa yikhono lokubona ingozi
• Kusetshenziswa igama elingalungile, hhayi ukuphimisa amagama kahle, noma ukukhuluma ngemisho edidayo
• Ukuhoxa ekuxhumaneni nomphakathi

Izinkinga zesistimu yezinzwa (i-neurologic) ezenzeka ngesifo sohlangothi nazo zingaba khona.

Izivivinyo zinga-oda ukusiza ukuthola ukuthi ngabe ezinye izinkinga zezokwelapha zingadala ukuwohloka komqondo noma zikwenze kube kubi kakhulu, njengokuthi:

• Ukushoda kwegazi
• Isigaxa sobuchopho
• Ukutheleleka okungamahlalakhona
• Ukudakwa kwezidakamizwa nemithi (ukweqisa izidakamizwa)
• Ukucindezeleka okukhulu
• Isifo sendlala yegilo
• Ukuntuleka kwamavithamini

Olunye uvivinyo lungenziwa ukuthola ukuthi yiziphi izingxenye zokucabanga ezithintekile nokuqondisa ezinye izivivinyo.

Ukuhlolwa okungakhombisa ubufakazi bemivimbo edlule ebuchosheni kungabandakanya:

• Iskena sekhanda le-CT
• I-MRI yobuchopho

Akukho muthi wokwelapha ukubuyisela umonakalo ebuchosheni obangelwa yimivimbo emincane.

Inhloso ebalulekile ukulawula izimpawu nokulungisa izinto eziyingozi. Ukuvimbela imivimbo yesikhathi esizayo:

• Gwema ukudla okunamafutha. Landela ukudla okunempilo, okunamafutha aphansi.
• UNGAPHUZI uphuzo oludakayo olwedlula u-1 kuye kwezi-2 ngosuku.
• Gcina umfutho wegazi ungaphansi kuka-130/80 mm / Hg. Buza udokotela wakho ukuthi kufanele ube yini umfutho wegazi.
• Gcina i-cholesterol "embi" ye-LDL ingaphansi kuka-70 mg / dL.
• UNGABHALI.
• Udokotela angase asikisele izinciphisi zegazi, njenge-aspirin, ukusiza ukuvimbela amahlule egazi ekwakhiweni kwemithambo yegazi. UNGAQALI ukuthatha i-aspirin noma uyeke ukuyiphuza ngaphandle kokukhuluma nodokotela wakho kuqala.

Izinhloso zokusiza umuntu onesifo sokuwohloka komqondo ekhaya uku:

• Phatha izinkinga zokuziphatha, ukudideka, izinkinga zokulala, kanye nokuphazamiseka
• Susa izingozi zokuphepha ekhaya
• Sekela amalungu omndeni nabanye abanakekeli

Imithi ingadingeka ukulawula isimilo esinolaka, esikhathazayo, noma esiyingozi.

Imithi esetshenziselwa ukwelapha isifo i-Alzheimer ayikhonjisiwe ukuthi isebenza ukuwohloka komqondo okuyimithambo yegazi.

Okunye ukuthuthuka kungenzeka ngezikhathi ezithile, kepha lesi sifo ngokujwayelekile sizoba sibi ngokuhamba kwesikhathi.

Izinkinga zifaka okulandelayo:

• Imivimbo Yesikhathi Esizayo
• Isifo senhliziyo
• Ukulahleka kwekhono lokusebenza noma lokuzinakekela
• Ukulahlekelwa kwamandla okuxhumana
• I-pneumonia, izifo zomgudu womchamo, izifo zesikhumba
• Izilonda zengcindezi

Xhumana nodokotela wakho uma kwenzeka izimpawu zokuwohloka komqondo ngemithambo yegazi. Iya egumbini lezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (njenge-911) uma kuba noshintsho olungazelelwe esimweni sengqondo, ukuzwa, noma ukunyakaza. Lezi yizimpawu eziphuthumayo zesifo sohlangothi.

Izimo zokulawula ezandisa ubungozi bokuqina kwemithambo yegazi (atherosclerosis) ngu:

• Ukulawula umfutho wegazi ophakeme
• Ukulawula isisindo
• Ukuyeka ukusetshenziswa kwemikhiqizo kagwayi
• Ukunciphisa amafutha agcwele nosawoti ekudleni
• Ukwelapha ukuphazamiseka okuhlobene

PHAKATHI; Ukuwohloka komqondo - okuningi; I-dementia - ngemuva kokushaywa unhlangothi; Ukuwohloka komqondo okunama-infarct amaningi; Ukuwohloka komqondo kwemithambo yegazi; I-VaD; Isifo sobuchopho esingamahlalakhona - imithambo yegazi; Ukukhubazeka okuthambile kwengqondo - i-vascular; I-MCI - imithambo yegazi; Isifo se-Binswanger

• Ukuwohloka komqondo - okufanele ubuze udokotela wakho

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo
• Ubuchopho
• Ubuchopho nesistimu yezinzwa
• Izakhiwo zobuchopho

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IKnopman DS. Ukukhubazeka kwengqondo nokuwohloka komqondo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 374.

Peterson R, Graff-Radford J. Isifo i-Alzheimer nezinye izifo zomqondo. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 95.

USeshadri S, Economos A, Wright C. Ukuwohloka komqondo ngemithambo nokukhubazeka kwengqondo. Ku: Grotta JC, Albers GW, Broderick JP et al, eds. Unhlangothi: I-Pathophysiology, i-Diagnosis, ne-Management. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2016: isahluko 17.