Yakawedzerwa Hwindo reAcute Stroke Kupindira

Mhinduro yakakodzera nguva inoshanda chaizvo kana zvasvika kune Kurohwa kupindira. Kureba kushomeka kweropa kuyerera zvichitevera sitiroko kunogona kukonzera kukuvara kusingachinjiki, kazhinji kuchikonzera kuremara. Muzviitiko zvakawanda zvekurohwa, nzira dzekupindira dzinoshandiswa kuchengetedza nyama. 

Kusvika ikozvino, hwindo rakatemwa renguva rakakurudzirwa kupindira kwesitiroko. Asi zvinoenderana nemirau mitsva yakapihwa neAmerican Heart Association uye American Stroke Association munaNdira 2019, hwindo rakawandisa rekuvhiya rakakodzera kune varwere vane chirwere chakakomba cheschemic. 

Zvidzidzo zvakaongororwa neboka revanyanzvi vane hunyanzvi hwekuchengetwa nesitiroko uye ndiwo mazano akakura ekurapa sitiroko ischemic yakaburitswa kubvira 2013. 

Inenge makumi maviri kubva muzana yeacute ischemic sitiroko yakakamurwa senge dzekumuka-kusimuka, izvo zvinowira kunze kweyakajairika nguva yekurapa hwindo saka iyi yakareba nguva inotarisirwa kudzikisira njodzi yekuremara uye nekupa mukana wekupora kune yakawedzera nhamba yeanotevera sitiroko varwere. 

Nzira yekuvhiya inonzi mechanical thrombectomy inowedzera hwindo renguva kusvika kumaawa makumi maviri nemana evasarudzika akanyanya ischemic sitiroko varwere. Uku kurudziro inongokurudzirwa chete mumaclots anovhara makuru makuru. Izvo zvinokonzeresa kuti varwere vazhinji vave vanokodzera thrombectomy sezvo varwere vazhinji vacharapwa zvichibva pakiriniki yekuratidzira kwete pane nguva yakatemwa yega. Nekudaro, ine mukana wekubatsira vanhu vazhinji uye yakachinja zvachose mamiriro ekurapwa kwakanyanya kwechirwere. 

Iyi nhungamiro nyowani inotaura kuti kurohwa kukuru kwemidziyo kunogona kurapwa zvakachengeteka neyakagadziriswa thrombectomy kusvika maawa gumi nematanhatu mushure mekurohwa nevarwere vakasarudzwa. Iwindo rekuwedzera rekurapa kubva pamatanhatu kusvika kumaawa gumi nematanhatu rakavakirwa pauchapupu hwekiriniki kubva kuDAWN uye DEFUSE 16 miedzo. Mune mamwe mamiriro ezvinhu, kufungidzira kwepamusoro kwehuropi kunoita basa rakakosha pakutsvaga varwere vanogona kubatsirwa nemaawa makumi maviri nemana ekurapwa nema mechanical thrombectomy, zvichibva paDAWN Trial criteria. 

Iyi nhungamiro inogamuchirwa nechinangwa chekupa yakakwira yakazara seti yemazano evarapi vanochengeta varwere vakuru vane acute arterial ischemic sitiroko mune rimwe gwaro. Ivo vanotaura: - 

  • kutarisira prehospital; 
  • kuongorora nekukurumidzira; 
  • kurapwa neine intravenous uye intra-arterial Therapies; 
  • In-chipatara manejimendi kusanganisira yechipiri matanho ekudzivirira ayo akagadzwa nenzira kwayo mukati memavhiki maviri ekutanga.

Imwe dzidziso nyowani inowedzera kukodzera kwekubaya intravenous alteplase, iyo chete US FDA-inogamuchirwa kugadziriswa kwekuvhara chirwere cheschemic sitiroko. Tsvagurudzo nyowani iyi inobatsira vamwe vevarwere vane sitiroko dzakapfava dzaimbove dzisina kukodzera kurapwa. Iyo nhungamiro nyowani inotaura kuti mushonga unogona kudzikisira hurema, chero ukapihwa nekukasira uye nenzira kwayo kuvarwere mushure mekuyera njodzi pamwe nekubatsirwa kweumwe murwere.