Cov Txheej Txheem Xwm Ceev Txog Kev Mob Hlwb Txhaws Qaug Dab Peg
Pendahuluuan
Kab mob stroke ischemic yog ib yam mob uas tshwm sim thaum cov ntshav ntws mus rau lub hlwb raug cuam tshuam lossis cuam tshuam, feem ntau yog vim muaj kev txhaws hauv cov hlab ntsha. Qhov mob no yog ib qho ua rau tuag thiab tsis taus thoob ntiaj teb. Yog li ntawd, kev kho mob sai thiab tsim nyog yog qhov tseem ceeb kom txo qhov cuam tshuam. Tsab xov xwm no yuav tham txog cov txheej txheem ceev rau kab mob stroke ischemic, cov kauj ruam yuav tsum tau ua hauv chaw kho mob, thiab kev saib xyuas tom qab rau cov neeg mob stroke.
Cov Cim thiab Cov tsos mob ntawm Ischemic Stroke
Ua ntej yuav tham txog cov txheej txheem kho mob, nws yog ib qho tseem ceeb kom paub txog cov cim thiab cov tsos mob ntawm ischemic stroke. Qee cov tsos mob uas pom ntau suav nrog:
1. Lub ntsej muag, caj npab, lossis ceg qaug zog tam sim ntawd, tshwj xeeb tshaj yog rau ib sab ntawm lub cev.
2. Tsis meej pem tam sim ntawd, nyuaj hais lus lossis nkag siab cov lus.
3. Teeb meem pom kev ntawm ib lub qhov muag lossis ob lub qhov muag.
4. Nyuaj taug kev, kiv taub hau, tsis muaj zog lossis tsis sib haum.
5. Mob taub hau hnyav heev yam tsis paub tias yog vim li cas.
Kev txheeb xyuas sai yog qhov tseem ceeb rau kev tswj hwm ischemic stroke . Ib txoj kev siv dav dav rau kev kuaj mob stroke yog qhov kev xeem FAST (Lub ntsej muag, caj npab, hais lus, lub sijhawm).
Cov Lus Teb Thawj Zaug thiab Cov Txheej Txheem Kev Tswj Xyuas
1. Kev Pab Thaum Muaj Xwm Ceev
Thaum ib tug neeg pom cov cim qhia tias muaj mob stroke, thawj kauj ruam yog hu rau cov kev pabcuam thaum muaj xwm txheej ceev (piv txwv li, 112 lossis 119) sai li sai tau. Lub sijhawm yog qhov tseem ceeb hauv kev tswj mob stroke, thiab cov kev pabcuam thaum muaj xwm txheej ceev yuav tsum tau ceeb toom tias tus neeg mob tej zaum yuav muaj mob stroke.
2. Kev Ntsuam Xyuas Ua Ntej Mus Rau Tsev Kho Mob
Cov kws kho mob uas tuaj txog ntawm qhov chaw yuav tsum ua qhov kev ntsuam xyuas thawj zaug tam sim ntawd siv cov txheej txheem ntsuas mob stroke ua ntej mus pw hauv tsev kho mob xws li Cincinnati Prehospital Stroke Scale (CPSS) lossis Los Angeles Prehospital Stroke Screen (LAPSS). Qhov kev ntsuam xyuas no suav nrog kev kuaj xyuas kev ua haujlwm ntawm lub ntsej muag, kev ua haujlwm ntawm caj npab, thiab kev hais lus. Thaum xav tias muaj mob stroke, tus neeg mob yuav tsum tau muab oxygen rau yog tias O2 saturation tsawg dua 94% thiab xa mus rau chaw kho mob uas muaj peev xwm tswj tau mob stroke sai thiab zoo.
3. Kev Ntsuam Xyuas hauv Chav Xwm Ceev (UGD)
Thaum tuaj txog hauv chav kho mob ceev, pab pawg kho mob yuav tsum tau soj ntsuam tus neeg mob tam sim ntawd. Lub sijhawm yog qhov tseem ceeb, vim tias kev kho mob ntev dua, qhov kev puas tsuaj rau lub hlwb ntau dua los ntawm ischemia. Cov txheej txheem yuav tsum ua raws li suav nrog:
- Kev ntsuas cov cim tseem ceeb (ntshav siab, lub plawv dhia, kev ua pa, kev txaus ntawm cov pa oxygen).
- Kev kuaj mob hlwb siv cov nplai ntsuas kev kho mob uas paub zoo xws li NIHSS (National Institutes of Health Stroke Scale).
- Sau keeb kwm kev mob nkeeg suav nrog cov yam uas ua rau muaj kev pheej hmoo xws li ntshav siab, ntshav qab zib, dyslipidemia, keeb kwm muaj kab mob plawv, thiab kev siv qee yam tshuaj.
- Kev kuaj ntshav los ntsuas kev ua haujlwm ntawm cov ntshav coagulation, cov ntshav qabzib hauv cov ntshav, thiab lwm yam kev ntsuas tseem ceeb.
4. Kev Tshuaj Xyuas Lub Hlwb
Kauj ruam tseem ceeb tom ntej yog ua kev thaij duab lub hlwb kom paub seb hom mob stroke thiab thaj chaw raug mob. Kev thaij duab CT (Computed Tomography) uas tsis muaj qhov sib piv yog thawj qhov kev xaiv vim tias nws tuaj yeem ua tau sai thiab zoo hauv kev kuaj pom cov ntshav hauv lub hlwb. Yog tias cov txiaj ntsig CT tsis muaj ntshav, kev kuaj mob ntawm ischemic stroke yuav muaj feem ntau dua.
5. Kev Kho Mob Thrombolysis/Kev Kho Mob Alteplase Hauv Cov Kab Mob Ntshav
Yog tias tus neeg mob tau kuaj pom tias muaj tus kab mob ischemic stroke thiab tus neeg mob ua tau raws li lub sijhawm teev tseg (feem ntau yog li ntawm 4,5 teev ntawm cov tsos mob pib), yuav tsum xav txog kev kho mob thrombolysis nrog cov tshuaj alteplase (tPA - cov tshuaj ua kom cov nqaij plasminogen activator) rau hauv cov hlab ntsha. Alteplase ua haujlwm los ntawm kev yaj cov ntshav txhaws, rov qab cov ntshav ntws mus rau lub hlwb. Txawm li cas los xij, muaj cov kev tsis pom zoo rau kev siv tPA, xws li:
- Cov neeg mob uas muaj feem yuav los ntshav ntau.
- Keeb kwm yav dhau los ntawm kev los ntshav hauv lub hlwb.
- Ntshav siab heev uas tswj tsis tau.
Cov kws kho mob yuav tsum ua qhov kev ntsuam xyuas kom meej txog cov kev pheej hmoo thiab cov txiaj ntsig ua ntej txiav txim siab siv txoj kev kho mob no.
6. Kev Kho Mob Endovascular
Muaj tej lub sij hawm, tshwj xeeb yog cov mob stroke uas tshwm sim los ntawm kev thaiv loj, tej zaum yuav muaj kev phais endovascular xws li kev phais thrombectomy. Qhov no suav nrog kev ntxig ib lub cuab yeej rau hauv cov hlab ntsha kom tshem tawm cov ntshav txhaws. Feem ntau, kev phais no yog ua yog tias kev phais thrombolysis tsis ua haujlwm lossis tsis ua raws li lub sijhawm teem tseg.
Kev Saib Xyuas Tom Qab Mob Hauv Tsev Kho Mob
1. Kev Saib Xyuas Zoo
Cov neeg mob uas tau txais kev kho mob thrombolysis lossis endovascular therapy yuav tsum tau muab tso rau hauv chav kho mob stroke intensive care. Kev saib xyuas ze ntawm cov cim tseem ceeb thiab kev kuaj mob hlwb tsis tu ncua yog qhov tseem ceeb kom paub txog kev hloov pauv ntawm cov xwm txheej hauv kev kho mob.
2. Tswj Cov Yam Uas Yuav Ua Rau Muaj Kev Pheej Hmoo
Kev tswj cov yam uas ua rau muaj kev pheej hmoo xws li ntshav siab, ntshav qab zib ntau dhau, thiab ntshav capnia yog qhov tseem ceeb heev. Cov tshuaj tiv thaiv ntshav siab, insulin rau kev tswj cov piam thaj, thiab kev kho mob oxygen yuav siv tau.
3. Kev Kho Mob Thaum Ntxov
Kev kho mob pib thaum ntxov tuaj yeem txhawb kev rov zoo dua thiab txo qhov kev tsis taus mus sij hawm ntev . Qhov no tuaj yeem suav nrog kev kho lub cev, kev kho kev hais lus, thiab kev kho mob ua haujlwm, nyob ntawm tus neeg mob xav tau.
Kev kaw
Cov txheej txheem ceev faj txog kev mob stroke ischemic yuav tsum muaj kev sib koom tes zoo thoob plaws ntau yam kev kawm thiab kev nkag siab zoo txog kev mob stroke. Kev kho mob sai thiab raws sijhawm yog qhov tseem ceeb rau kev txo qis kev tuag thiab kev mob nkeeg ntawm cov neeg mob stroke ischemic. Kev kawm rau pej xeem txog cov cim thiab cov tsos mob ntawm mob stroke thiab qhov tseem ceeb ntawm kev nrhiav kev kho mob tam sim ntawd kuj tseem ceeb heev rau kev txhim kho cov txiaj ntsig ntawm mob stroke hauv cov pej xeem feem ntau. Nrog cov txheej txheem tsim nyog thiab kev kawm tsim nyog, vam tias qhov tshwm sim ntawm mob stroke ischemic thiab nws cov teebmeem tsis zoo yuav raug txo kom tsawg.
