Umlando weStroke

-Delile

• Incazelo yokuqala yesifo sohlangothi
• Stroke namuhla
• Umlando wokwelashwa kwesifo sohlangothi
• Intuthuko ekwelapheni unhlangothi
• Imivimbo Ischemic
• Imivimbo yokopha
• Intuthuko ekuvimbeleni unhlangothi
• Ukuthatha

Yini isifo sohlangothi?

I-stroke ingaba isenzakalo sezokwelapha esilimazayo. Kwenzeka lapho ukugeleza kwegazi kuya engxenyeni ethile ubuchopho bakho bukhubazekile ngenxa yegazi noma isigaxa segazi esaphukile. Ngokufana nokuhlaselwa yisifo senhliziyo, ukuntuleka kwegazi elicebile oksijini kungaholela ekufeni kwezicubu.

Lapho amangqamuzana obuchopho eqala ukufa ngenxa yokwehla kwegazi, izimpawu zenzeka ezingxenyeni zomzimba ezilawulwa yilawo maseli obuchopho. Lezi zimpawu zingafaka ubuthakathaka obungazelelwe, ukukhubazeka, nokuba ndikindiki kobuso noma izitho zomzimba. Ngenxa yalokhu, abantu abahlaselwa yisifo sohlangothi bangaba nobunzima bokucabanga, ukuhamba, ngisho nokuphefumula.

Incazelo yokuqala yesifo sohlangothi

Yize odokotela manje sebazi izimbangela nemiphumela yesifo sohlangothi, lesi simo besingaqondakali kahle ngaso sonke isikhathi. UHippocrates, “uyise wezokwelapha,” waqala ukubonwa unhlangothi ngaphezu kweminyaka engu-2 400 edlule. Wabiza lesi simo ngokuthi i-apoplexy, okuyigama lesiGreki elisho “ukushaywa phansi ngodlame.” Ngenkathi igama lichaza ushintsho olungazelelwe olungenzeka ngesifo sohlangothi, aluzange ludlulise okwenzekayo empeleni ebuchosheni bakho.

Emakhulwini eminyaka kamuva ngawo-1600, udokotela ogama lakhe linguJacob Wepfer wathola ukuthi kukhona okuphazamisa ukunikezwa kwegazi ebuchosheni babantu ababulawa yi-apoplexy. Kwezinye zalezi zimo, kwakukhona ukopha okukhulu ebuchosheni. Kweminye, imithambo yegazi ivinjiwe.

Emashumini eminyaka alandela, isayensi yezokwelapha yaqhubeka nokwenza intuthuko maqondana nezimbangela, izimpawu, nokwelashwa kwe-apoplexy. Umphumela owodwa wale ntuthuko kwaba ukwehlukaniswa kwe-apoplexy ngezigaba ngokususelwa embangela yalesi simo. Ngemuva kwalokhu, i-apoplexy yaziwa ngamagama anjengokuthi stroke kanye nengozi ye-cerebralvascular (CVA).

Stroke namuhla

Namuhla, odokotela bayazi ukuthi kunezinhlobo ezimbili zesifo sohlangothi ezikhona: i-ischemic ne-hemorrhagic. Ukushaywa yischemic, okuvame kakhulu, kwenzeka lapho ihlule legazi lihlala ebuchosheni. Lokhu kuvimba ukugeleza kwegazi ezindaweni ezahlukahlukene zobuchopho. I-stroke esopha, ngakolunye uhlangothi, senzeka lapho umthambo wegazi ebuchosheni bakho uqhekeka uvuleka. Lokhu kubangela ukuthi igazi linqwabelane. Ubukhulu besifo sohlangothi buvame ukuhlobene nendawo ebuchosheni kanye nenani lamaseli obuchopho athintekile.

Ngokusho kweNational Stroke Association, isifo sohlangothi siyimbangela yesihlanu yokufa kwabantu e-United States. Kodwa-ke, abantu abalinganiselwa ezigidini eziyisikhombisa eMelika basindile kunhlangothi. Ngenxa yentuthuko ezindleleni zokwelashwa, izigidi zabantu abaye bahlangabezana nesifo sohlangothi manje sebengaphila nezinkinga ezimbalwa.

Umlando wokwelashwa kwesifo sohlangothi

Enye yezindlela zokuqala ukwelashwa kwesifo sohlangothi kwenzeka ngawo-1800, lapho odokotela abahlinzayo beqala ukuhlinza imithambo ye-carotid. Le yimithambo ehambisa igazi eliningi eliya ebuchosheni. Izindwangu ezikhula emithanjeni ye-carotid zivame ukubhekana nokudala isifo sohlangothi. Odokotela abahlinzayo baqala ukusebenza emithanjeni ye-carotid ukunciphisa ukwanda kwe-cholesterol nokususa ukuvinjelwa okungaholela ekushayweni unhlangothi. Ukuhlinzwa komthambo wokuqala we-carotid e-United States kwaba ngo-1807. UDkt. Amos Twitchell wahlinza eNew Hampshire. Namuhla, inqubo yaziwa njenge-carotid endarterectomy.

Ngenkathi ukuhlinzwa kwemithambo ye-carotid ngokuqinisekile kwasiza ukuvimbela ukushaywa unhlangothi, zazimbalwa izindlela zokwelapha ezazikhona zokwelapha isifo sohlangothi nokunciphisa imiphumela yaso. Imithi eminingi ibigxile kakhulu ekusizeni abantu ukuthi babhekane nobunzima ngemuva kokushaywa unhlangothi, njengokukhubazeka ekukhulumeni, izinkinga zokudla, noma ubuthakathaka obuhlala njalo ohlangothini lomzimba. Kwaze kwaba ngo-1996 lapho kwenziwa khona ukwelashwa okuphumelela ngokwengeziwe. Ngalowo nyaka, i-U. S. Food and Drug Administration (i-FDA) yavuma ukusetshenziswa kwesicubu se-tissue plasminogen (TPA), umuthi ohlukanisa amahlule egazi abangela ukushaywa yischemic.

Yize i-TPA ingasebenza ekwelapheni imivimbo ye-ischemic, kufanele inikezwe kungakapheli amahora angu-4.5 ngemuva kokuqala kwezimpawu. Ngenxa yalokhu, ukuthola ukwelashwa ngokushesha ngesifo sohlangothi kubalulekile ekunciphiseni nasekuguquleni izimpawu zayo. Uma othile omaziyo ehlangabezana nezimpawu zesifo sohlangothi, njengokudideka okungazelelwe nokuba buthakathaka noma ukuba ndikindiki kolunye uhlangothi lomzimba, mhambise esibhedlela noma ushayele u-911 ngokushesha.

Intuthuko ekwelapheni unhlangothi

Imivimbo Ischemic

I-TPA iyindlela yokwelashwa ekhethwayo yokushaywa yischemic. Kodwa-ke, ukuthuthuka kwakamuva ekwelapheni lezi zinhlobo zemivimbo yi-mechanical thrombectomy. Le nqubo ingasusa ngokomzimba i-clot yegazi kumuntu onesifo sohlangothi. Kusukela yethulwa ngo-2004, le ndlela iselaphe abantu ababalelwa ku-10 000.

Kodwa-ke, okubuyela emuva ukuthi odokotela abaningi abahlinzayo kusadingeka baqeqeshwe ku-mechanical thrombectomy futhi izibhedlela zidinga ukuthenga imishini edingekayo, engabiza kakhulu. Ngenkathi i-TPA kuseyindlela yokwelashwa esetshenziswa kakhulu imivimbo ye-ischemic, i-mechanical thrombectomy iyaqhubeka nokwanda ekuthandeni njengoba odokotela abahlinzayo abaningi beqeqeshwa ekusetshenzisweni kwayo.

Imivimbo yokopha

Ukwelashwa kwesifo sohlangothi okopha kakhulu nakho sekude kakhulu. Uma imiphumela yesifo sohlangothi esopha kakhulu ithinta ingxenye enkulu yobuchopho, odokotela bangancoma ukuhlinzwa ngomzamo wokunciphisa ukulimala kwesikhathi eside nokunciphisa ingcindezi ebuchosheni. Ukwelashwa kokuhlinzwa kwesifo esibuhlungu kubandakanya:

• Ukunqunywa kokuhlinzwa. Lokhu kusebenza kubandakanya ukubeka isiqeshana phansi endaweni okubangela ukopha. Isiqeshana simisa ukuhamba kwegazi futhi sisiza ukuvimbela indawo ukuthi ingophi futhi.
• Ukugoqa. Le nqubo ifaka ukuqondisa ucingo ocansini kuze kufike ebuchosheni ngenkathi ufaka amakhoyili amancane ukugcwalisa izindawo ezibuthakathaka nokopha. Lokhu kungamisa noma yikuphi ukuphuma kwegazi.
• Ukususwa kokuhlinzwa. Uma indawo yokopha ingalungiswa ngezinye izindlela, udokotela ohlinzayo angahambisa ingxenye encane yendawo eyonakele. Kodwa-ke, lokhu kuhlinzwa kaningi kuyisinqumo sokugcina ngoba kubhekwa njengengozi enkulu kakhulu futhi ngeke kwenziwe ezindaweni eziningi zobuchopho.

Ezinye izindlela zokwelashwa zingadingeka, kuye ngendawo nobukhulu bokuphuma kwegazi.

Intuthuko ekuvimbeleni unhlangothi

Ngenkathi isifo sohlangothi siqhubeka siyimbangela ehamba phambili yokukhubazeka, cishe amaphesenti angama-80 emivimbo iyavikeleka. Ngenxa yocwaningo lwakamuva nentuthuko ekwelashweni, odokotela manje sebengancoma amasu okuvikela labo abasengozini yokushaywa unhlangothi. Izici zobungozi ezaziwayo zokushaywa unhlangothi zihlanganisa ukuba ngaphezu kweminyaka engama-75 nokuba ne:

• i-fibrillation ye-atrial
• ukuhluleka kwenhliziyo
• isifo sikashukela
• umfutho wegazi ophakeme
• umlando wokushaywa unhlangothi noma ukuhlaselwa yischemic okudlulayo

Abantu abanalezi zinto ezinobungozi kufanele bakhulume nodokotela wabo ngokuthi bangabunciphisa kanjani ubungozi babo. Odokotela bavame ukuncoma lezi zindlela zokuzivikela ezilandelayo:

• yeka ukubhema
• imishanguzo yokuvimbela ukujiya kwegazi
• imithi yokulawula umfutho wegazi ophakeme noma isifo sikashukela
• ukudla okunempilo okune-sodium eningi ngezithelo nemifino
• izinsuku ezintathu kuya kwezine ngesonto lokuzivocavoca okungenani imizuzu engama-40 ngosuku

Ngenkathi unhlangothi ungeke uvinjelwe ngaso sonke isikhathi, ukuthatha lezi zinyathelo kungasiza ekunciphiseni ubungozi bakho ngangokunokwenzeka.

Ukuthatha

Ukushaywa unhlangothi umcimbi wezokwelapha osongela impilo ongadala ukulimala kwengqondo okuhlala njalo nokukhubazeka isikhathi eside. Ukufuna ukwelashwa ngokushesha kungakhuphula amathuba okuthi wena noma othandekayo uthole olunye lwezindlela zokwelapha ezintsha ezisetshenziselwa ukwelapha unhlangothi nokunciphisa izinkinga.