Ukulungiswa kwe-aneurysm yobuchopho

Ukulungiswa kwe-aneurysm yobuchopho ukuhlinzwa ukulungisa i-aneurysm. Le yindawo ebuthakathaka odongeni lwemithambo yegazi edala ukuthi isikebhe siphume noma siphume ibhaluni kwesinye isikhathi kuqhume (ukuqhekeka). Kungadala:

• Ukopha ku-cerebrospinal fluid (CSF) ezungeze ubuchopho (okubizwa nangokuthi i-subarachnoid hemorrhage)
• Ukopha ebuchosheni okwakha iqoqo legazi (hematoma)

Kunezindlela ezimbili ezivamile ezisetshenziselwa ukulungisa i-aneurysm:

• Ukusikwa kwenziwa ngesikhathi se-craniotomy evulekile.
• Ukulungiswa kwe-Endovascular (ukuhlinzwa), okuvame kakhulu ukusebenzisa ikhoyili noma ukufaka i-coil kanye ne-stenting (amashubhu anezikhala), kuyindlela engahlaseli kangako futhi ejwayelekile yokwelapha ama-aneurysms.

Ngesikhathi sokuchofoza kwe-aneurysm:

• Unikezwa i-anesthesia ejwayelekile nethumbu lokuphefumula.
• Isikhumba sakho, ukhakhayi, nokumbozwa kobuchopho kuyavulwa.
• Isiqeshana sensimbi sibekwa phansi (entanyeni) se-aneurysm ukuyivimbela ingavuleki (iqhume).

Ngesikhathi sokulungiswa kwe-endovascular (ukuhlinzwa) kwe-aneurysm:

• Ungaba ne-anesthesia ejwayelekile nethumbu lokuphefumula. Noma, unganikezwa umuthi wokukuphumuza, kepha awenele ukukulala.
• I-catheter iqondiswa ngokusika okuncane emgodini wakho kuya emthanjeni bese iya esitsheni segazi ebuchosheni bakho lapho kutholakala khona i-aneurysm.
• Izinto zokuqhathanisa zijojowe ngepayipi. Lokhu kuvumela udokotela ohlinzayo ukuthi abheke imithambo yegazi kanye ne-aneurysm esweni esisegumbini lokuhlinzwa.
• Izintambo zensimbi ezizacile zifakwa kwi-aneurysm. Bese bafaka ibhola lebhola. Ngalesi sizathu, inqubo ibizwa nangokuthi i-coiling. Amahlule egazi akha ezungeze le coil avimbela i-aneurysm ukuthi ingavuleki futhi yophe. Kwesinye isikhathi kufakwa ama-stents (amashubhu anezikhala) ukuze kubambe amakhoyili futhi kuqinisekiswe ukuthi umthambo wegazi uhlala uvulekile.
• Ngesikhathi nangemva kwenqubo, unganikezwa igazi elincanyana, njenge-heparin, i-clopidogrel, noma i-aspirin. Le mithi ivimbela amahlule egazi ayingozi ukuthi angakheki ku-stent.

Uma i-aneurysm ebuchosheni ivuleka (iqhuma), kuyisimo esiphuthumayo esidinga ukwelashwa esibhedlela. Imvamisa ukuphuka kuyelashwa ngokuhlinzwa, ikakhulukazi ukuhlinzwa kwe-endovascular.

Umuntu angaba ne-aneurysm engaphazamiseki ngaphandle kwezimpawu. Lolu hlobo lwe-aneurysm lungatholakala lapho ukuhlolwa kwe-MRI noma kwe-CT kobuchopho kwenziwa ngesinye isizathu.

• Akuwona wonke ama-aneurysms adinga ukwelashwa ngokushesha. Ama-Aneurysms angakaze ophe, ikakhulukazi uma amancane kakhulu (angaphansi kuka-3 mm endaweni yawo enkulu), awadingi ukwelashwa ngokushesha. La ma-aneurysms amancane kakhulu mancane amathuba okuthi aqhekeke.
• Udokotela wakho ohlinzayo uzokusiza unqume ukuthi kuphephile yini ukuhlinzwa ukuvimba i-aneurysm ngaphambi kokuba ivuleke noma ukuqapha i-aneurysm ngokucabanga okuphindaphindiwe kuze kube yilapho kudingeka ukuhlinzwa. Amanye ama-aneurysms amancane awasoze adinga ukuhlinzwa.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini
• Izinkinga zokuphefumula
• Ukopha, amahlule, noma izifo

Izingozi zokuhlinzwa kobuchopho yilezi:

• Ukuqina kwegazi noma ukopha ngaphakathi noma nxazonke zobuchopho
• Ukuvuvukala kobuchopho
• Ukutheleleka ebuchosheni noma ezingxenyeni ezizungeze ubuchopho, njengekhakhayi noma isikhumba sasekhanda
• Ukuquleka
• Unhlangothi

Ukuhlinzwa kunoma iyiphi indawo eyodwa yobuchopho kungadala izinkinga ezingaba mnene noma zibe nzima. Zingahlala isikhashana noma zingahambi.

Izimpawu zezinkinga zobuchopho nezesistimu yezinzwa (zezinzwa) zifaka:

• Izinguquko zokuziphatha
• Ukudideka, izinkinga zememori
• Ukulahlekelwa ibhalansi noma ukuxhumanisa
• Ubudikadika
• Izinkinga ukuqaphela izinto eziseduze kwakho
• Izinkinga zokukhuluma
• Izinkinga zombono (kusuka ekungaboni kuya ezinkingeni ngombono oseceleni)
• Ubuthakathaka bemisipha

Le nqubo ivame ukwenziwa njengesimo esiphuthumayo. Uma kungesona isimo esiphuthumayo:

• Tshela umhlinzeki wakho wezempilo ukuthi yimiphi imishanguzo noma amakhambi owaphuzayo nokuthi ngabe uphuze kakhulu utshwala.
• Buza umhlinzeki wakho ukuthi yimiphi imithi okufanele uyithathe ekuseni yokuhlinzwa.
• Zama ukuyeka ukubhema.
• Landela imiyalelo yokuthi ungadli ungaphuzi ngaphambi kokuhlinzwa.
• Thatha imithi umhlinzeki wakho akutshele ukuthi uyiphuze ngesiphuzo esincane samanzi.
• Fika esibhedlela ngesikhathi.

Ukuhlala esibhedlela ngokulungiswa kwemithambo yegazi kwe-aneurysm kungaba mfushane njengezinsuku ezi-1 kuye kwezi-2 uma bekungekho ukopha ngaphambi kokuhlinzwa.

Ukuhlala esibhedlela ngemuva kwe-craniotomy ne-aneurysm clipping kuvame ukuba yizinsuku ezi-4 kuya kwezi-6. Uma kunegazi noma ezinye izinkinga, njengemithambo yegazi encishisiwe ebuchosheni noma uketshezi oluningi ebuchosheni, ukuhlala esibhedlela kungaba amasonto ayi-1 kuye kwayi-2, noma ngaphezulu.

Cishe uzoba nokuhlolwa kwe-imaging yemithambo yegazi (i-angiogram) ebuchosheni ngaphambi kokuthi ubuyiselwe ekhaya, futhi mhlawumbe kanye ngonyaka iminyaka embalwa.

Landela imiyalo yokuzinakekela ekhaya.

Buza udokotela wakho ukuthi kungaphepha yini ukuba uvivinye izithombe ezifana ne-angiogram, i-CT angiogram, noma i-MRI scan yekhanda ngokuzayo.

Ngemuva kokuhlinzwa ngempumelelo kwe-aneurysm eyopha, akuvamile ukuthi kuphume futhi.

Umbono ubuye uncike ekutheni ukulimala kwengqondo kwenzeke ngenxa yokopha ngaphambi, ngesikhathi, noma ngemuva kokuhlinzwa.

Isikhathi esiningi, ukuhlinzwa kungavimbela i-aneurysm yobuchopho engazange ibangele izimpawu ukuthi zikhule futhi zivuleke.

Ungaba ne-aneurysm engaphezu kweyodwa noma i-aneurysm ehlanganisiwe ingabuyela emuva. Ngemuva kokulungisa ukubopha, uzodinga ukubonwa umhlinzeki wakho minyaka yonke.

Ukulungiswa kwe-aneurysm - ubuchopho; Ukulungiswa kwe-cerebral aneurysm; Coiling; Ukulungiswa kwe-sac aneurysm; Ukulungiswa kwe-Berry aneurysm; Ukulungiswa kwe-Fusiform aneurysm; Ukukhipha ukulungiswa kwe-aneurysm; Ukulungiswa kwe-endovascular aneurysm - ubuchopho; Ukopha okungaphansi kwe-Subarachnoid - aneurysm

• Ukulungiswa kwe-aneurysm yobuchopho - ukukhipha
• Ukuhlinzwa kobuchopho - ukukhishwa
• Ukunakekela ukuqina kwemisipha noma ama-spasms
• Ukuxhumana nomuntu one-aphasia
• Ukuxhumana nomuntu one-dysarthria
• Ukuwohloka komqondo nokushayela
• Ukuwohloka komqondo - izinkinga zokuziphatha nezokulala
• Ukuwohloka komqondo - ukunakekelwa kwansuku zonke
• Ukuwohloka komqondo - ukugcina uphephile ekhaya
• Isifo sokuwa ezinganeni - ukukhipha
• Ukushaywa unhlangothi - ukukhishwa
• Izinkinga zokugwinya

I-Altschul D, iVats T, i-Unda S. Ukwelashwa kwe-Endovascular kwama-aneurysms obuchopho. Ku: Ambrosi PB, ed. Ukuqonda Okusha Kwezifo Ze-Cerebrovascular - Ukubuyekezwa Okuphelele Okubuyekeziwe. www.intechopen.com/books/new-insight-into-cerebrovascular-diseases-an-updated-comprehensive-review/endovascular-treatment-of-brain-aneurysms. I-IntechOpen; I-2020: isahluko: 11. Kubuyekezwe u-Agasti 1, 2019. Kufinyelelwe ngoMeyi 18, 2020.

Iwebhusayithi yeAmerican Stroke Association. Okufanele ukwazi ngama-aneurysms we-cerebral. www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds/ what-you-should-now-about-cerebral-aneurysms#. Kubuyekezwe uDisemba 5, 2018. Kufinyelelwe ngoJulayi 10, 2020.

Le Roux PD, Winn HR. Ukwenza izinqumo zokuhlinzwa zokwelashwa kwama-aneurysms we-intracranial. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans ne-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 379.

I-National Institute of Neurological Disorders and Stroke iwebhusayithi. Ishidi lamaqiniso we-Cerebral aneurysms.www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet. Kubuyekezwe ngoMashi 13, 2020. Kufinyelelwe ngoJulayi 10, 2020.

I-Spears J, iMacdonald RL. Ukuphathwa kwe-Perioperative kwe-subarachnoid hemorrhage. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans ne-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 380.