Iwindows eyandisiweyo yoNgenelelo lweStroke Strike

Impendulo ngexesha elifanelekileyo isebenza ngokwenene xa ifika ukubetha ukungenelela. Ukunqongophala kwegazi emva kwexesha elide kunokubangela umonakalo ongenakuguqulwa, odla ngokukhokelela kukukhubazeka. Kwiimeko ezininzi zokubetha, iindlela zokungenelela zisetyenziselwa ukugcina izicubu. 

Kuze kube ngoku, ixesha elilinganiselweyo lexesha liye lacetyiswa ukuba kungenelele i-stroke. Kodwa ngokwemigaqo emitsha enikwe yiAmerican Heart Association kunye neAmerican Stroke Association ngoJanuwari 2019, ifestile eyandisiweyo yotyando ifanelekile kwizigulana ezine-acute ischemic stroke. 

Izifundo ziye zavavanywa liqela leengcali eziqeqeshelwe kakhulu kukhathalelo lwestroke kwaye ziingcebiso ezibanzi zokunyanga. ukubetha kweschemic ikhutshwe ukusukela ngo-2013. 

Ngokumalunga ne-20% ye-acute ischemic stroke ihlelwa njenge-wake-up strokes, ephuma kwifestile yexesha eliqhelekileyo lonyango ngoko eli xesha lide lilindeleke ukunciphisa umngcipheko wokukhubazeka kwaye linike ithuba lokubuyisela kwinani elongezelelweyo lezigulane ze-stroke ezizayo. 

Inkqubo yotyando ebizwa ngokuba yi-mechanical thrombectomy yandisa ixesha lefestile ukuya kwiiyure ezingama-24 kwizigulane ezikhethiweyo ze-acute ischemic stroke. Esi sincomo sicetyiswa kuphela kumahlwili avimba iinqanawa ezinkulu. Kusenokwenzeka ukuba kubangele ukuba izigulana ezininzi zifaneleke ukwenza i-thrombectomy kuba izigulana ezininzi ziya kunyangwa ngokusekwe kwinkcazo yeklinikhi kunexesha elisikiweyo lodwa. Ngaloo ndlela, inamandla okuba luncedo kubantu abaninzi kwaye itshintshe ngokupheleleyo imvelaphi yonyango olubukhali. 

Esi sikhokelo esitsha sithi imivimbo emikhulu yenqanawa ingaphathwa ngokukhuselekileyo nge-thrombectomy yomatshini ukuya kuthi ga kwiiyure ze-16 emva kokubetha kwizigulane ezikhethiweyo. Ifestile yonyango eyandisiweyo ukusuka kwii-16 ukuya kwiiyure ze-3 isekelwe kubungqina bekliniki ukusuka kwi-DAWN kunye ne-DEFUSE 24 izilingo. Kwiimeko ezithile, ukucinga okuphezulu kwengqondo kudlala indima ebalulekileyo ekuchongeni izigulana ezinokuzuza kwiiyure ze-XNUMX zonyango nge-thrombectomy yomatshini, ngokusekelwe kwiikhrayitheriya zovavanyo lwe-DAWN. 

Ezi zikhokelo zamkelwe ngenjongo yokubonelela ngeseti ebanzi ebanzi yeengcebiso kwiiklinikhi ezinyamekela izigulane zabantu abadala abane-acute arterial ischemic stroke kuxwebhu olulodwa. Bayaphendula:- 

• ukhathalelo lwangaphambi kwesibhedlele; 
• uvandlakanyo olungxamisekileyo nolungxamisekileyo; 
• unyango nge-intravenous kunye ne-intra-arterial therapy; 
• Ulawulo lwasesibhedlele olubandakanya amanyathelo othintelo lwesibini aqaliswe ngokufanelekileyo kwiiveki ezimbini zokuqala.

Enye ithiyori entsha yandisa ukufaneleka kokulawula i-alteplase ye-intravenous, ekuphela kwe-US FDA-evunywe yi-FDA-i-clot-dissolving unyango lwe-ischemic stroke. Uphando olutsha lunceda ezinye zezi zigulana ezine-stroke ezithambileyo ebezikade zingalufanelanga unyango lwe-clot-busting. Isikhokelo esitsha sithi ichiza linokunciphisa ukukhubazeka, ngaphandle kokuba linikwe ngokukhawuleza kwaye ngokufanelekileyo kwizigulana emva kokulinganisa umngcipheko kunye neenzuzo kwisigulana ngasinye.