Stroke Treatment
Stroke treatment ndeyekugadzirisa zvinetso zvinogona kuitika kuti chirwere chinogona kukonzera kusati kwaitika. Stroke treatment yakasvika nenzira yakareba mumakore gumi akapfuura, asi zvisarudzo zvisati zviri zvishoma. Pasi pose, chinhu chikuru chekurohwa chirwere chepachirwere chiri mukubata sitiroko nekukurumidza, pakarepo zviratidzo zvatanga. Mapoka makuru ezvipatara chete anodzidziswa anokwanisa kutarisira chirwere chekurohwa nekuda kwechiratidzo chisina kusimba uye kuchinja kwechirwere.
Izvi zvinotevera zvimwe zvirwere zvinogona kuonekwa:
Ropa Vakaneta
Pane huwandu hwemagavi anopa ropa anokwanisa kupa kana chirwere ichi chichiri kuenderera mberi. Kana zvakajeka kuti mudziyo weropa unokanganisa kana zvachose wakavharidzirwa, ropa rakapfava rinogona kubatsira kudzivirira chirwere kubva pakukura nekubvumira rimwe ropa kuti riyerere, iro rinokosha kudzivirira kana kuderedza kuora kweuropi. Ropa rakapfupa rinofanira kupiwa nechechi yezvechiremba yakarovedzwa nokuti zvinogona kukanganiswa zvinosanganisira kubuda ropa muuropi, maitiro emimba, kana zvimwe zvikamu zvemuviri.
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Zvaunofanira Kuziva Pamusoro Pemumutsipa Wecheyo Kurwisa
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Dzidza Nezviratidzo, Kuongororwa uye Kurapa kweIntracerebral Hemorrhage
Imwe yezvinetso zvakakosha zvechirwere chechirwere chiri kukurumidza kuziva kana chironda chiri chirwere chemhepo kana chirwere cheschemic . Nemhaka yokuti ropa rakapfupa harifaniri kushandiswa pakurohwa, chirwere chako chekurova chirwere chinoshanda nokukurumidza kuziva chero kubuda kweropa muuropi usati wasarudza kana iwe uri mukana wevamwe vanotevera vanopfupa ropa. Uye, kunyange kana iwe uine chirwere cheschemic, ropa rakaonda rinotarisirwa nekutarisira kwakanyanya kuitira kuti usasvike kugadzirisa kushanduka kwechirwere chechirwere.
Tissue Plasminogen Activator
Tissue plasminogen activator (TPA) inopa ropa rakaisvonaka rakanyanyogadziriswa mukati mekuda kune dzimwe nhengo dzakasarudzwa dzechirwere chinoramba chichiwedzera.
Inofamba nezita rokuti Activase (alteplase). TPA inogona kupiwa chete kana boka rezvechiremba rakarovedzwa rakagadzirira kuongorora chirwere mukati mekutanga maawa mashomanana ekurohwa. Intravenous TPA administration yakaratidza zvakanyanya kubatsirwa apo inotarisirwa mukati maawa matatu okutanga ekutanga kurwara zviratidzo. Zvisinei, dzimwe tsvakurudzo dzakaitwa munguva pfupi yapfuura dzakaratidza kuti kurapwa uku kunogona kubatsira kana ukashandiswa kusvika maawa mana nehafu mushure mokunge zviratidzo zvatanga. Kana zvisinganzwisisi apo zviratidzo zvako zvekurohwa zviratidzo zvatanga, ipapo kubata TPA hakurudzirwi.
TPA yakaratidzwa kuti zvive zvishoma kana zvakakwana kudzivirira kuora kwekusagadzikana kusingagumi mukusarudza mamiriro ezvinhu nekubvumira kuti ropa riyerere kuburikidza neiyo inopesana uye, nokudaro, kudzivirira ischemia. Nokuti TPA inofanirwa kutarisirwa pakarepo mushure mekusvika kune dhipatimendi rekukurumidzira, hapana nguva yekusunungura pamusoro pechisarudzo. Emergency TPA mishonga yekurapa inogadzirwa maererano nemitemo yakagadziriswa yekuchengetedza kwakakwana nekubudirira.
Kana uine chirwere, une kodzero yekuramba kurapa ne TPA.
Asi, zvinokosha kuziva kuti mapoka emakwikwi haatongotungamiri mishonga iyi yakasimba, uye vanovimba nemitemo yekuchengeteka iyo yakagadzirwa kuti iwedzere kurwisa kupora uye kuchengeteka. Nokuda kwezvakaitwa maererano nekushandiswa kwe TPA, haugoni kukumbira TPA kuti uzvirove iwe kana kuti nhengo yemhuri kana mirayiridzo yakasimba isati yasangana.
Intra-arteriial Thrombolysis: TPA inogonawo kuvharirwa zvakananga muyiti apo chirwere chinouraya-chinokonzera ropa chinowanika kuburikidza nekuiswa kwekateti zvakananga mumubhedha weropa, chirongwa chinonzi cerebral angiogram. Kushandisa intra-arterial TPA inzira inopindira iyo isiri yakawanda yakawanikwa seIntravenous TPA, sezvo inoda vanachiremba vane unyanzvi pakuita rudzi urwu rwekurapa.
Chidzidzo chikuru chekutsvakurudza chakanzi zita reM MR CLEAN rakaongorora kuchengetedza nekubudirira kwe intra-arterial thrombolysis yekurohwa nekushandisa imwe nhumbi, inonzi stent retriever, nemigumisiro yakanaka. A retent retent is stent inowanikwa mukati mechidzitiro uye inobatsira kubvisa iyo uye kugadzirisazve kubuda kweropa kuuropi.
Intra-arterial thrombolysis inzira inofanirwa, iyo yakafanana neyemukati TPA, kune zvikonzero zvakasimba panzvimbo yechinangwa chekuchengetedza murwere.
Heparin
Heparin iyi mushonga unogona kugamuchira mukati. IV heparin inogona kushandiswa kana iwe une chironda chakanyanya kana mamwe mamiriro akazadziswa.
Mamiriro aya anosanganisira:
- Ropa revhapa rinotendwa kuti rakangobva kuumbwa
- Stroke zviratidzo zviripo (itsva inotanga)
- Uropi hwehupombwe hwakave hwakarongwa kunze
Heparin haina kukurudzirwa kana iwe uine dambudziko rekudzivirira kwepachiviri kana kubuda kubva pane ronda rinoporesa kana rinotyisa. Kana iwe wakanga uine shanduko huru yeichemchemic pamuedzo wekuropi-kufungidzira, saka heparin haigoni kukurudzirwa nokuti inogona kukonzera uchangobva kuora hutachiona hwemauropi kubuda ropa.
Heparin dzimwe nguva inoshandiswa kubata chirwere chakanyanya, asi inowanzoshandiswa mukugadzirisa kweTIA , kunyanya kana ropa rinoputika kana mucheka wakaoma unoratidzwa mumoyo mako kana mumatari yako emakaroti.
Aspirin
Aspirin inonyanya kushandiswa pakudzivirira kupora nokuti haifaniri kutora simba rakakwana kuti iparadze ropa rinoputika kana kudzivirira kuwedzera ropa clot kubva kukura.
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Kurasikirwa Kwekureruka Kunogona Kuderedza Dambudziko reStroke
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Kunyorwa kweMemininine Zvinogona Kubatsira Kurwisana Mune Ramangwana
Zvisinei, aspirin inowanzonyatsorongedzerwa mukati maawa makumi maviri ekutanga e-ischemic stroke yekutanga kudzivirira zvimwe zviitiko.
Syndrome Treatment
Chimwe chezvinhu zvinonyanya kukosha zvekurohwa kwechirwere chinoshandiswa pakuchengetedza mamiriro ezvinhu akanaka mumaawa nemazuva mushure mekurohwa kuti upe huropi mikana yakaisvonaka yekugadzirisa. Zvimwe zvikamu zvakagadziriswa maererano neropa, ropa glucose, uye zvimwe zviyero zvekuchengetedza zvakanakisisa zvigadziriro yepanyama inogoneka.
Ropa Ropa
Ropa kudzvinyirira kushamisika kunoshamisa kuti chimwe chezvinhu zvakakosha zvikuru, zvakaoma, uye zvinopesana nenyama shure kwekurohwa. Vanachiremba vachabhadhara zvakanyanya kuwedzerwa kweropa, vachishandisa mishonga kuti varambe vari pamatunhu asina kukwirira kana kuderera; zvose zviri zviviri izvi zvine ngozi. Zvisinei, sezvo ropa rinowanzochinja muvhiki mushure mekurohwa, boka rako rezvechiremba rinonyatsocherechedza kuwirirana pakati pehutano hwehutano uye ropa rako senzira yekugadzirisa nekugadzirisa zvakanyanya kunaka kweropa mumazuva mushure mekurohwa kwako.
Ropa Glucose
Ropa rega shuga rinogona kunge risina kujeka semhinduro kune chirwere chakanyanya. Kuwedzera kune dambudziko iri, mumazuva mushure mekurohwa kukuru, iwe haungave wakada kudya iwe sezvaunowanzoita. Nhamba yehuga yepamusoro uye yakadzika inogona kukanganisa kuporesa mushure mekurohwa. Ndicho chikonzero chekuti boka rako rekurohwa nesitiroko rive rakanyatsotarisa kugadzirisa huwandu hwehuga hweropa munguva ino.
Fluid Management
Kuzvimba kunogona kuitika muuropi mushure mekurohwa. Urwu runyararo, runonzi edema, hunopesana nekuporesa uye runogona kukonzera humwe hupombwe hunoipisisa nekuda kwekumanikidzwa kwenzvimbo dzinokosha dzeuropi. Kana iwe kana munhu waunoda ane chirwere chekupedzisira, iwe unogona kunge uchida mvura inopisa. IV mvura yakasviba mushure mekurohwa kwechirwere inowanzopiwa zvishoma nezvishoma uye yakadzika yepamusoro pane inowanzoitwa IV hydration muzvipatara, kunyanya nekuda kwekudzivisa dema. Kana edema ichikurumidza kukurumidza, iwe unogona kurapwa nemishonga yekudzikisa kupfugama. Mumamiriro ezvinhu edema yakaoma uye inokuvadza, nzira yekuvhiya inogona kudikanwa kusunungura dambudziko nekubvisa chikamu chehenya (ona craniectomy pasi.)
Electrolyte Management
IV inoshandiswa muhutano hwehutano hwakadai sitiroko ine mvura inogadziriswa nema electrolyte anokosha, akadai sodium, potassium, uye calcium. Mafungiro aya e electrolytes anofanira kuchengetedzwa zvakanyatsochengetedzwa kuchengetedza kukodzera kwakakwana kwemvura uye electrolytes muuropi kuitira kudzivirira edema. Mitsipa inoda kuwanda kwema electrolyte kudzora maitiro eropi. Saka, mushure mekurohwa, huwandu uye huwandu hwe electrolytes hunotonyanya kukosha kudarika nguva, sezvo huropi hunoita basa uye kuporesa zviri muhutano hwakanaka.
Neurosurgery
Kunyange zvazvo iyo isiri iyo yakanyanya kufanana nayo yekurapa, kana iwe wakanga uine chirwere chakakura cherotic uye yakakura edema, unogona kuvhiyiwa kuti uwedzere kupora mushure mekurohwa.
Hematoma Kubuda
Zvimwe zvirwere zvinokonzera zvirwere, zvichireva kuti kune kubuda ropa muuropi. Kunyanya kubuda ropa kubva pamarwadzo ane simba hakusi nyore kubviswa muuropi. Asi, dzimwe nguva, apo ropa rakawanda rinokonzerwa mune imwe nzvimbo, zvakanakisisa kana ropa richibviswa kuburikidza nekuvhiyiwa. Kana uchida kurapwa kweuropi mushure mekurohwa, iwe kana vaunoda vachapiwa nguva yekufungisisa izvi, uye iwe uchaziviswa nezvengozi uye zvibatsiro zvemuitiro.
Craniectomy
Dzimwe nguva, apo edema inobva pakurohwa inova yakaoma uye haigoni kudzorwa nemakiriniki ehutachiona, kusunungurwa kwenguva pfupi kwechikamu chehavha yeguruva kunodzivirira kuwedzera kwezvinhu zvinokosha zveuropi kuitira kuti edema isakonzera kuora kwekusingaperi. Iyo nzira, inonzi craniectomy kana hemicraniectomy, inosanganisira kubviswa kwenguva pfupi kwechikamu chedehenya kusvikira edema isisina. Dhehenya racho rinodzivirirwa uye rinodyarwa zvakare munguva pfupi, sezvo dhehenya riri chikamu chinokosha chekudzivirira kweuropi kwenguva refu.
Stroke Rehabilitation
Stroke rehabilitation inobva pane nzira dzakasiyana-siyana, kusanganisira muviri uye kugadzirisa nzira dzakagadzirirwa kukurudzira kupora mushure mekurohwa. Stroke rehabilitation ndiyo nzira yakanakisisa uye yakavimbika zvikuru inobatsira yekusimudzira kuporesa uye kupora mushure mekurohwa.
Neuroprotection
Iko pfungwa yokuti mamwe mishonga inogona kupa neuroprotection (kudzivirira kworufu rwemasero emagetsi) kugadzirisa uropi hwehupombwe inowedzera ruzivo rwekutsvakurudza kwezvokurapa. Parizvino, hapana mishonga inogamuchirwa kana kurapwa kwakaratidzwa kuva neuroprotective kana panguva kana mushure mekurohwa. Mimwe mishonga inonzi ichitsvaga yeurouroprotective therapy for stroke inosanganisira magnesium sulfate uye memantine . Zvisinei, panguva yazvino, mishonga inonzi inogoneka neuroprotectants haina kuratidza humwe uchapupu hwebatsiro mukurapa chero upi hwekukuvara kubva kune chirwere.
Kuita Zvisarudzo Pamusoro Pekurohwa Kwako Kurohwa
Kana iwe kana munhu waunoda achangobva kushaya chirwere, zvisarudzo pamusoro pekuroorwa kwako kwechirwere zvinogona kuonekwa zvakanyanya. Nhau dzakanaka ndeikuti mumakore achangobva kupfuura, kugadziriswa kwepachike kwave kwakanyatsodzidza, uye vezvechiremba vave vachigadzira mitemo yakakosha yezvakanakisisa. Kakawanda, kuchinja mumashandiro ako emagetsi kunogona kunge kwakangwara mumaawa nemazuva mushure mekurohwa. Izvi zvinoreva kuti boka rako rezvechiremba richada kukuongorora nguva nenguva uye nekudzoka. Kunyange zvazvo kuongororwa kwepfungwa dzenguva dzenguva dzingangoita sekunotyisa uye kunotyisa panguva iyo yose yaunonyatsoda kuita ndeyokuzorora (kana kubatsira mudiwa wako zororo uye odzoka zvakanaka,) kuongorora kwako kwepfungwa kunokosha mukutungamirira kurapwa kwakachengeteka uye kwakanyatsobudirira pane zvakaoma mazuva anotevera chirwere chakaoma.
Shoko Rinobva
Kana iwe kana munhu waunoda aine chirwere, iwe zvechokwadi uchada kunzwisisa chirongwa chekurapa. Tora yako yezvehutano inowanikwa kutsanangura zvinokonzera kusarudzwa kwekurohwa kwechirwere, uye ivo vachakumbira chisarudzo chako chekupedzisira maererano nehutano hukuru hwehutano.
Iwe unogona kunge uchiverenga nezvechirwere chechirwere mushure mechikamu chakaoma chekurohwa kwako, apo iwe unofunga nezvekuporesa uye kugadziriswa, panzvimbo yekurapa kwakakurumidza. Iwe une nzira dzakawanda dzekuwedzera kukunda kwako shure kwekurohwa. Kuunganidza ruzivo nekudzidza nezvekurohwa ndiyo nzira yakanakisisa yekushandisa zvakanakisisa zvishandiswa zvinowanikwa kwauri munzira yako yekudzoka. Iwe unogona kutanga pano pa:
- Kudzorera uye Kuvandudza
- Ruzivo rweVabatsiri
- Kurarama SeStroke Survivor
> Sources:
> Demaerschalk BM, Alteplase Kuchengetedza Mutsara Yakakosha: Kubatanidza Zvokudya uye Zvinodhaka Maitiro Kunyora Mashoko Mukurarama Kwemaitiro Akakosha Okushungurudzika, Nyaya DzeAtherosclerosis Ino, Muna 2016.
> Oostema JA, Carle T, Talia N, Reeves M, Dispatcher Stroke Recognition Using Stroke Screening Tool: Ongororo Yakarongeka, Cerebrovascular Disease, June 2016.