Iwindi Elinwetshiwe Lokungenelela Kwe-Strute Stroke

Impendulo efike ngesikhathi isebenza ngempela uma kuziwa unhlangothi kokungenela. Ukuntuleka kwegazi isikhathi eside kulandela ukushaywa unhlangothi kungadala umonakalo ongalungiseka, okuvame ukuholela ekukhubazekeni. Ezimweni eziningi zokushaywa unhlangothi, izindlela zokungenelela zisetshenziselwa ukonga izicubu. 

Kuze kube manje, kunconyelwe iwindi elilinganiselwe lesikhathi sokungenelela kwesifo sohlangothi. Kepha ngokwemiyalo emisha enikezwe yi-The American Heart Association ne-American Stroke Association ngoJanuwari 2019, iwindi elenziwe lokuhlinzwa lilungele iziguli ezinesifo sohlangothi esibuhlungu. 

Izifundo zahlolwa yiqembu lochwepheshe abaqeqeshiwe ekunakekelweni unhlangothi futhi yizincomo ezibanzi zokwelashwa unhlangothi we-ischemic ikhishwe kusukela ngo-2013. 

Cishe ama-20% wesifo sohlangothi esibucayi ahlukaniswe njengemivimbo yokuvuka, ephuma efasiteleni lesikhathi sokwelashwa elijwayelekile ngakho-ke lesi sikhathi esibekiwe kulindeleke ukuthi sinciphise ubungozi bokukhubazeka futhi sinikeze nethuba lokululama kwinani elikhulayo leziguli zesifo sohlangothi esizayo. 

Inqubo yokuhlinza ebizwa nge-mechanical thrombectomy yandisa iwindi lesikhathi liye emahoreni angama-24 eziguli ezikhethiwe ze-ischemic stroke. Lokhu kuncoma kunconywa kuphela kuma-clots avimba imikhumbi emikhulu. Kungenzeka ukuthi kuholele ekutheni iziguli eziningi zifanele ukuthola i-thrombectomy ngoba iziguli eziningi zizokwelashwa ngokususelwa ekwethulweni komtholampilo kunesikhathi sokunqunywa sisodwa. Ngakho-ke, inamandla okuzuzisa abantu abaningi futhi isishintshe ngokuphelele isizinda sokwelashwa okuqatha kohlangothi. 

Lo mhlahlandlela omusha uthi imivimbo emikhulu yemikhumbi ingelashwa ngokuphepha nge-mechanical thrombectomy kuze kufike emahoreni ayi-16 ngemuva kokushaywa unhlangothi ezigulini ezikhethiwe. Iwindi lokwelashwa elandisiwe kusuka emahoreni ayisithupha kuya kwayi-16 kusekelwe ebufakazini bemitholampilo obuvela ezivivinyweni ze-DAWN ne-DEFUSE 3. Ezimweni ezithile, ukucabanga kobuchopho obuthuthukile kudlala indima ebaluleke kakhulu ekuboneni iziguli ezingazuza emahoreni angama-24 okwelashwa nge-mechanical thrombectomy, ngokuya ngemibandela ye-DAWN Trial. 

Le mihlahlandlela yamukelwa ngenhloso yokunikeza izincomo ezisezingeni eliphakeme zezincomo zabanakekeli abanakekela iziguli ezindala ezinesifo sohlangothi esibuhlungu esisezincwadini ezithile. Bakhuluma ku: - 

• ukunakekelwa kwangaphambi kwesibhedlela; 
• ukuhlolwa okuphuthumayo nokuphuthumayo; 
• ukwelashwa ngemithi yokwelapha efakwa emithanjeni nasesikhathini; 
• Ukuphathwa kwesibhedlela kubandakanya izindlela zokuvikela zesibili ezifakwe ngokufanele emasontweni amabili okuqala.

Enye inkolelo entsha ikhulisa ukufaneleka kokuphathwa kwe-alteplase emithanjeni, okuwukuphela kokwelapha kwe-US FDA okugunyazwe ukwelashwa kokuqedwa kwesifo sohlangothi. Ucwaningo olusha lusiza ezinye zalezi ziguli ngemivimbo emincane eyayingafanele ukwelashwa ngamahlwili. Umhlahlandlela omusha uthi umuthi unganciphisa ukukhubazeka, inqobo nje uma unikezwa iziguli ngokushesha nangendlela efanele ngemuva kokukala ubungozi nezinzuzo ezigulini ngasinye.