Primary stroke centrals zvipatara zvakave zvichipupurirwa ne Joint Commission, iyo sangano iro rinobvuma zvirongwa zvekuchengetedza utano muUnited States. I Joint Commission yakatanga kuvimbisa zvivako zvekuchengetedzwa kwepurojekiti muna December 2003.
Primary Stroke Center Criteria
Primary stroke centers inofanira kuzadzisa zvimwe zvinotarisirwa kuitira kuti zvive zvakagamuchirwa uye zvinopupurirwa nemashoko iwayo.
Zvimwe zvezvinodiwa zvinosanganisira:
- Kuva nechikwata chakasarudzwa chechikwata chekuenderera mberi kwechiremba kurongedza.
- Kuratidza kuratidzirana nemitemo yakagadziriswa yekliniki yekurohwa.
- Kuvimbisa vashandi vakakodzera vedhi rekukurumidzira ruzivo rwekurohwa kwechirwere.
- Kugadzira nzira yekugamuchira uye kuendesa varwere varwere.
- Kuchengeta nekupa ruzivo rwehuwandu hwemashoko maererano nemigumisiro yemaitiro.
Stroke Centers Inopa Maitiro uye Akarongeka Sitiroke Kuchengetedzwa
Chimwe chinangwa chega chega chepachikwereti ndechekutakura, kuongorora, kuongorora, nekurapa kurapa umwe neumwe murwere mukati meawa matatu ekutanga kwezviratidzo zvavo. Kutungamirirwa kwekodzero yakakodzera yekurapa kunoda chikwata chekurapa uye vane ruzivo.
Zvirwere zvinosanganisira kushandiswa kwevane simba vane simba zvakadai se IV TPA uye intra-arterial thrombolysis. Iyi mishonga inofanirwa kutarisirwa mukati mehwindo shoma yenguva mushure mekunge zviratidzo zvekurohwa zvinotanga, kana zvisakadaro zvinokonzera zvakakomba, uye zvichida zvinouraya zvinetso.
Mimwe yemabasa makuru ekutanga stroke centre inogona kukwanisa kuita munguva iyi yemaawa matatu yemahwindo inosanganisira:
- Kutakura murwere kuchipatara
- Ita zvakakwana kuongororwa nachiremba-kazhinji kechiremba
- Ita uye uverenge, CT yekuongorora yeuropi
- Dhonza ropa, kuongororongedza, uye kuudza migumisiro
- Kununura kurapa kwakakodzera
Kutungamirirwa kweStrokes neStroke Specialists
Nyaya dzakawanda dzekurohwa nesangano dzine chirwere chechirwere chinonzi neurologists, kana vascular neurologists (neurologists vanoita sitiroko) kune vashandi, uye kazhinji vanowanikwa mumba, nguva yakazara neawa. Ava vanachiremba vanoshandisa pasi peshoko rokuti "nguva iropi." Saka, iyo inokurumidza zvikuru, asi yakarurama kwazvo, pakuziva zvirwere zvinowanzovadza. Kana izvi zvikaitika, vanachiremba ava vanodzidziswa kurongedza kuvhiyiwa kwepamusoro, uye kuronga nekukurumidza kuendeswa kune chikwata chikuru chekuchengetedza, kana kune imwe chipatara chakakosha.
Yakakodzera Kuzivikanwa uye Kutungamirirwa Kwezvinetso zveStroke
Vanachiremba uye vanachiremba vari chikamu che stroke centre vanodzidziswa kubvuma zvinetso zvezvechiremba zvinogona kuitika kune mumwe munhu anotambura chirwere. Izvi zvakakosha zvikuru, sezvo varwere vanorwara vanowanzokurumidza kukurumidza mukati memaawa mashomanana ekutanga kana mazuva mushure mekurohwa. Ichokwadi, kunyange kunyoroka kwepuroko kunokonzera njodzi ye10% yekutendeuka kune yakakura mumaawa ekutanga 48.
Zvimwe zvezvinetso zvinowanzoitika mushure mekurova chirwere zvinosanganisira:
- Chirwere chitsva, kana kuwedzera
- Kudzorera, kunyanya kana kubatwa ne t-PA
- Kugumburwa
- Ubongo kurira
- Matambudziko emishonga akadai sepneumonia nezvimwe zvirwere
Ancillary Staff Vanozivikanwa Nezvinodiwa zvevarwere veStroke
Chimwe chinhu chinokosha chekurohwa zvipfeko ndiko kushamwaridzana kwavo nevashandi vomunharaunda uye vamwe vashandi vanobatsira vanoziva nezvezvido zvenguva pfupi uye kwenguva refu zvevarwere vane chirwere. Ava vadzidzisi vakarovedzwa vanowanzopa rubatsiro rukuru mukugadzirisa zvinetso zvine chokuita nehutano inshuwarheni , mukuwana kunze kwekugadzwa kwechirwere nemakumbo emakumbo, masayendisiti, kana vashandi vezvemishonga, uye pakusarudza zvirongwa zvakanakisisa zvekugadzirisa zvirwere kuti zviwedzere kugadzirisa uye kushanda pashure pokunge urohwa.
Primary Stroke Center Outcomes
Maererano nekuongorora dhesi rakabudiswa ne Journal of the American Heart Association, varwere vanowana chirongwa chekurohwa nesitiroko pazvikamu zvepachirongwa chepamuviri vanowanzoita kurapwa neT-PA kupfuura varwere vasina kutarisirwa paStart Stroke Centers.
Imwe samuenzaniso yevarwere yakadzidza vanopfuura 120 000 varwere avo vakabvumirwa uye vanorapwa nokuda kwekurohwa kwakabudiswa mu Journal of Stroke uye Cerebrovascular Disease. Varwere vaisanganisira varwere vane chirwere chepachirwere vakagamuchirwa kunheyo dzepachirwere chepachirwere nevarwere vakagamuchirwa kuchipatara chakanga chisina kusarudzwa sepamusoro stroke centers.
Vanyori vekudzidza vakaona kuti varwere vakagadziriswa avo vaibatwa muzvikamu zvepachirongwa chepachikoro vakanga vasingakwanisi kuva mune-zvipembenene zvechipatara uye zvichida kuva nemigumisiro iri nani pakudzingwa kubva kuchipatara.
Stroke Treatment paIri Horizon
Imwe nzira itsva yekutora chirwere chepachirwere inobata zvinyorwa zvinokurumidza mune imwe nzvimbo yekurapa inonzi Mobile Stroke Unit. Nevamwe vashomanana munyika uye maviri muUnited States, Mobile Stroke Units inoshanda sezvinoreva zita, kutanga maitiro ekuongorora, uye dzimwe nguva kunyange kurapa, munzira yekuenda kuchipatara, kuchengetedza nguva inokosha.
> Sources:
> Joint Commission Primary Stroke Centers Kushandisa More rt-PA muZimbabwe Inpatient Sample, Mullen MT, Kasner SE, Kallan MJ, Kleindorfer DO, Albright KC, Carr BG, Journal of the American Heart Association , 2013 Mar 26; 2 (2) : e000071
> Mitengo Yezvakaitika Zvakaipa Nemigumisiro Pakati Pevarwere veStroke Vanobvumirwa kuNheyo dzeSpanish Stroke. Chaudhry SA, Afzal MR, Chaudhry BZ, Zafar TT, Safdar A, Kassab MY, Hussain SI, Qureshi A, Journal of Stroke and Cerebrovascular Disease, 2016 Aug; 25 (8): 1960-5
Yakagadzirwa naHeidi Moawad MD