Ukuphathwa Kwe-Stroke

Ukuphathwa Kwe-Stroke

Namuhla, ukushaywa unhlangothi sekuvame kakhulu kunangaphambili. Ziningi izici ezinomthelela kukho, okuhlanganisa izinguquko endleleni yokuphila, ukwanda kokucindezeleka, ukuncipha kokuzivocavoca umzimba, imikhuba emibi yokudla, nokunye. Ukuze ukhululeke futhi unikeze izinsizakalo ezingcono kakhulu zokulawula unhlangothi, ithimba lochwepheshe e-CARE Hospitals likulungele ukukusiza. 

Ukuphathwa kwe-stroke yithimba lethu kuqala ngezinsizakalo zezokwelapha eziphuthumayo futhi ngezinye izikhathi isiguli kufanele silaliswe esibhedlela ngokushesha. Sinethimba lezinhlaka eziningi zokuphatha ukushaywa unhlangothi kanye nokuhlinzeka ngokunakekelwa kwe-stroke okuyingozi emnyangweni wezimo eziphuthumayo kanye neyunithi ye-stroke echaziwe. 

Ochwepheshe bethu banikeza izinsizakalo zezokwelapha eziphuthumayo ezigulini eziza ne-stroke futhi zizisize zizinze ukuze ziqedele ukuhlolwa kokuqala nokuhlola impilo yazo. Lokhu kufaka phakathi izifundo zaselabhorethri kanye nokuthwebula lokho nakho esikhathini esifushane. Amacala abucayi anikezwa ukunakekelwa ngokushesha kucatshangelwa isidingo sokulawula umfutho wegazi, intubation, nokunquma inzuzo/izingozi zokungenelela kwe-thrombolytic. Iziguli ezilinganiselwa ku-8 noma ngaphansi esikalini se-coma zinikezwa ukulawulwa kwendlela yomoya ngokushesha kusetshenziswa intubation. 

Sikhetha nini ukuphathwa kohlangothi oluphuthumayo? 

Kunezizathu ezehlukene zokuya ekuphathweni kohlangothi oluphuthumayo, okuhlanganisa:-

• Ukubuyisela ukujikeleza kwe-cerebral

• Isekela imisebenzi ebalulekile 

• Ukuvimbela ukuqhubeka nokufa kwamaseli

• Ukunciphisa ukukhubazeka kwezinzwa

• Ukubuyisela isiguli ezingeni elihle lomsebenzi wangaphambi kokushaywa unhlangothi

Izindlela ezahlukene esizisebenzisayo ukuhlola imivimbo ngaphambi kokuphatha 

Ukucabanga 

Ukuthwebula ubuchopho kunconywa ezigulini ezinezimpawu ezijwayelekile zemizwa uma kwenzeka lezi zimpawu ezilandelayo zibonakala:

• Ukuhlupheka ngenxa yokopha

• Ukwelashwa kwe-Anticoagulant 

• Umuzwa wokucindezeleka wokwazi

• Ubunzima bekhanda elibuhlungu ekuqaleni kwezimpawu ze-stroke 

• Ukuqina kwentamo, umkhuhlane, noma i-papilledema

Uma isiguli sinezinkomba ezibalulwe ngenhla, khona-ke siyelulekwa ngokuskena ngokushesha nokuthwebula isithombe sobuchopho okwenziwa ithimba lethu engakapheli amahora angu-24 izimpawu ziqale. 

I-Ischemic stroke 

Uma sithola isiguli esine-ischemic stroke, khona-ke sisebenzela ukubuyisela igazi ngokushesha futhi lokhu kungase kunikeze ukutakula okuthuthukisiwe nokufa kwengqamuzana lobuchopho elincane. Ukwelashwa kwethu okuyinhloko kugxile kakhulu ekwephuleni amahlule ngemithi (i-thrombolytic) noma (i-thrombectomy) okuwukususwa ngomshini kwala mahlule. Siphinde futhi sinikeze ezinye izindlela zokwelapha zokunciphisa ihlule elingase libe likhulu futhi sisebenzela ukuvimbela ukwakheka kwehlule elisha ngokusebenzisa imithi elwa nokuvuvukala. Ochwepheshe bethu baphinde bagxile ekulawuleni ezinye izimo ezifana nezinga le-oxygen, ushukela osegazini kanye nokuhlinzeka nge-hydration eyanele. 

Isiguli ngasinye esine-acute ischemic stroke kufanele selashwe kungakapheli amahora angu-3 kuya kwangu-4 uma izimpawu sezihloliwe. Siyaqinisekisa ukuthi akukho ukubambezeleka okukhona kunoma yikuphi ukwelashwa. 

Ukunikeza i-Thrombolysis [igama lomuthi]

I-Thrombolysis, eyaziwa nangokuthi i-tPA (i-tissue plasminogen activator), umuthi okwazi ukuncibilikisa amahlule egazi. Yaziwa nangokuthi i-ejenti ye-thrombolytic noma ebizwa ngokuthi i-clot buster. Lona umuthi ofakwa emthanjeni noma obuye ubizwe ngokuthi umuthi we-IV ovame ukuhlinzekwa nge-catheter ngokufakwa emthanjeni wengalo. Lokhu kwelashwa kufakazela ukuthi kungumsindisi esigulini uma kunikezwa ngesikhathi. Iziguli ziyizinsika zokwelashwa kokuqala kwe-stroke enzima ye-ischemic. Uma inikezwa ngesikhathi esingcono kakhulu (kuze kube ngamahora angu-4) izobe ihlinzeka ngemiphumela yokusebenza phakathi kwezinyanga ezi-3 kuya kwezi-6. Phakathi nalokhu kwelashwa, siphinde sibhekisise isiguli ukuze silawule ukululama ngokushesha ngezinzuzo ezihamba phambili. 

I-Endovascular Therapy

Sisebenzisa lokhu kwelashwa ekulawuleni unhlangothi ngokususa ihlule legazi ngokulikhipha ngokomzimba. Lokhu kwelashwa kwenziwa nge-thrombectomy ngomshini noma ngomuthi osuselwe ku-catheter ukuze kukhishwe noma kuhlakaze ihlule. Ngokuqinisekile asikhethi lokhu kwelashwa ngokungahleliwe kodwa sikhetha kuphela ngemva kokuhlolwa ngokucophelela nangemininingwane yokushaywa unhlangothi isiguli ebesinaso. Ucwaningo lwakamuva luphinde lubonise ukuthi lokhu kwelashwa kulethe umphumela omuhle kakhulu ezigulini ezine-proximal occlusion ye-arterial njengoba ukuphinda kutholakale kungakapheli amahora ayisithupha kuqale izimpawu ze-stroke. 

I-Hemorrhagic Stroke

Uma isiguli sine-Hemorrhagic stroke, khona-ke into yokuqala esigxila kuyo kuwukumisa ukopha kwaso ngokushesha ngangokunokwenzeka. Ngokuvamile, kudinga ukungenelela kwe-Neurosurgical. Ngalesi sifo, odokotela bethu nodokotela abahlinzayo banquma ukwelashwa ngokusetshenziswa kwemithi elwa namagciwane, umfutho wegazi, ukonakala kwemithambo yegazi, nokuhlukumezeka kwekhanda. Siqapha iziguli ekunakekelweni okukhulu. Ukwelashwa kokuqala kuhlanganisa izici ezilandelayo:

• Ukulawulwa kwengcindezi yegazi 

• Ukunquma imbangela yokopha 

• Ukumisa noma yimuphi umuthi onjalo ongase ubangele noma ukhulise ukopha. 

• Ukulawula nokulinganisa ingcindezi ebuchosheni 

I-Decompressive Craniotomy

Esimeni lapho, impilo yesiguli ivame ukuba engcupheni ngenxa yokucindezela komthelela wehlule lobuchopho, ithimba lethu lochwepheshe lingakhetha inqubo yokuvula ugebhezi nokukhipha ihlule kulo. Lokhu kuncike endaweni yokopha kanye nobukhulu, ubudala besiguli, noma isimo sezempilo saso. Noma yisiphi isinqumo esisithathayo ngesokululama kwesiguli. 

Ukuvuselelwa kwe-stroke

Isici esisodwa esibalulekile sokwelashwa kokushaywa unhlangothi sihlanganisa ukusiza abantu ukuthi balulame noma bajwayele izinguquko ebuchosheni babo. Lokhu kubaluleke kakhulu ekubuyiseleni amakhono okungenzeka ukuthi alahlekile ngenxa yokushaywa unhlangothi. Ukuvuselelwa kwe-stroke kudlala indima ebalulekile enqubweni yokululama kubantu abaningi futhi kungabandakanya izindlela ezahlukahlukene, njenge:

• Ukwelashwa kwenkulumo: Igxile ekubuyiseleni amakhono olimi nokukhuluma ngenkathi ithuthukisa ukulawula imisipha yokuphefumula, ukudla, ukuphuza, nokugwinya.
• Ukwelapha ngokomzimba: Ihlose ukuthuthukisa noma ukubuyisela ukusetshenziswa kwezandla, izingalo, izinyawo, nemilenze, ukubhekana nezinkinga ezifana nokulinganisela, ubuthakathaka bemisipha, nokuxhumana.
• Ukwelapha emsebenzini: Isiza ukuqeqesha kabusha ingqondo yemisebenzi yansuku zonke, ithuthukisa amakhono amahle emisipha nokulawula imisipha edingekayo emisebenzini efana nokubamba noma ukubhala.
• Ukwelashwa kwengqondo: Isiza ngezinselele zenkumbulo nobunzima bokugxilisa ingqondo noma ukugxila, isiza abantu ngabanye ukwenza imisebenzi abalawule ngaphambi kokushaywa unhlangothi.

Izindlela zokwelapha ezengeziwe zingase zituswe, kuye ngezidingo nezimo zomuntu. Xhumana nomhlinzeki wakho wokunakekelwa kwezempilo ukuze uthole ukuthi iziphi izindlela zokwelapha ezifanele kakhulu ohambweni lwakho lokutakula.

Izinkinga zokwelashwa

Izinkinga ngesikhathi sokuphathwa kwe-stroke zingenzeka ngenxa ye-stroke ngokwayo, ukwelashwa okusetshenzisiwe, noma ezinye izinkinga zempilo. Izinkinga ezijwayelekile zihlanganisa:

• Ukuphuza: Ezinye zokwelapha, njengemithi evala amahlule noma ukuhlinzwa, kungabangela ukopha.
• Amagciwane: Ukunyakaza okulinganiselwe kungaholela ezifweni ezifana nenyumoniya noma izifo zomchamo.
• Amahlule egazi: Ukuhlala embhedeni isikhathi eside kungabangela amahlule emilenzeni noma emaphashini.
• Ukuvuvukala kobuchopho: I-stroke enzima ingase ibangele ukuvuvukala ebuchosheni.
• Ukuquleka: Ukulimala kwe-stroke kwesinye isikhathi kungabangela ukuquleka.
• Imiphumela emibi yemithi: Izidakamizwa zokuvimbela amahlule zingabangela izinkinga ezifana nokopha noma izinkinga zesisu.

Prevention

Ziningi izindlela zokwehlisa ingozi yokuba nesifo sohlangothi, nakuba kungase kungagwemeki ngokuphelele. Nakhu ongakwenza:

• Yamukela indlela yokuphila enempilo: Yidla ukudla okunomsoco, hlala umatasa ngokuzivocavoca okuvamile, futhi uqiniseke ukuthi uthola amahora okulala angu-7-8 njalo ebusuku.
• Gwema imikhuba eyingozi: Ukubhema, ukufutha, ukusebenzisa izidakamizwa zokungcebeleka, ukusebenzisa kabi imithi kadokotela, nokuphuza utshwala ngokweqile kungakhuphula ingozi yakho yokushaywa unhlangothi. Uma udinga usizo lokuyeka, khuluma nomhlinzeki wakho wokunakekelwa kwezempilo ukuze uthole ukwesekwa nezinsiza.
• Phatha izinkinga zezempilo ezikhona: Izimo ezifana nokukhuluphala ngokweqile, umfutho wegazi ophakeme, i-cholesterol ephezulu, isifo sikashukela, isigqi senhliziyo esingavamile, noma i-apnea yokulala ingandisa ingozi yokushaywa unhlangothi. Sebenza nomhlinzeki wakho ukuze ulawule lezi zinkinga futhi uphuze imithi enqunyiwe, efana nemithi enciphisa igazi, ukuze unciphise ubungozi bakho.
• Uhlolwe njalo: Ukubona udokotela wakho minyaka yonke ukuze uvakashele impilo enhle kungasiza ukubamba nokwelapha izinkinga ezingase ziholele ekushayweni kohlangothi ngaphambi kokuthi kuvele izimpawu.

Kungani izibhedlela ze-CARE zokulawulwa yi-stroke? 

Sihlose ukuhlinzeka ngokuhlolwa okungcono kakhulu kanye nokuphathwa kwesikhathi eside ezigulini zethu eziye zabhekana nesifo sohlangothi. Ngalokhu, sikhetha ukwelashwa okungcono kakhulu kwe-stroke, okuhlanganisa ukwelapha ngokomzimba kanye nokuhlola ukuze kutholwe i-etiology eqondile ye-stroke ukuze kuvinjelwe ukuphindeka kwayo. Ukuphatha kuyahluka esimweni ngasinye njengoba kwenzeka ngenxa yezinkinga zezokwelapha, ukulimala kwengqondo, ingcindezi noma ezinye izimpawu ezihlobene nesiguli. Ngemva kokuhlolwa okuphelele, sinikeza abaphathi abangcono kakhulu neqembu elinolwazi kakhulu lodokotela nodokotela abahlinzayo. Ngakho-ke, ungathola ukunakekelwa ngokushesha kokuphathwa kwe-stroke eqenjini elihle kakhulu lochwepheshe e-CARE Hospitals.