Usoro Mberede maka Ọrịa strok Ischemic
Ọrịa strok Ischemic, ọrịa nke na-eyi ndụ egwu nke a na-akpọkwa mkpọchi ọbara na ụbụrụ, chọrọ ọgwụgwọ ozugbo na nke dị irè. Nlekọta ahụike ngwa ngwa dị oke mkpa iji belata mmebi ụbụrụ, melite ọnụego ndụ, ma melite nsonaazụ ogologo oge. Isiokwu a ga-akọwapụta usoro mberede dị mkpa maka ijikwa ọrịa strok ischemic, gụnyere nlekọta tupu ụlọ ọgwụ, ọgwụgwọ n'ụlọ ọgwụ, na atụmatụ nlekọta mgbe ọrịa ahụ gasịrị.
Ịghọta Ischemic Stroke
Ọrịa strok na-eme mgbe mkpụkọ ọbara na-egbochi akwara ọbara na-enye ụbụrụ, nke na-ebute ọnwụ nke mkpụrụ ndụ ụbụrụ. Isi ihe abụọ na-akpata ọrịa strok bụ:
1. Mkpọnwụ akwara: Mkpọnwụ akwara na-etolite n'otu n'ime akwara ndị na-enye ụbụrụ kpọmkwem, nke na-abụkarị n'ihi ọrịa akwara.
2. Mkpọnwụ akwara: Mkpọnwụ akwara na-etolite n'ebe ọzọ n'ime ahụ (karịsịa obi), na-agafe n'ọbara, ma na-abanye n'ime akwara ụbụrụ.
Ịmata ihe mgbaàmà nke ọrịa strok ischemic bụ nzọụkwụ mbụ iji jikwaa ihe mberede dị irè. Ihe mgbaàmà ndị a na-ahụkarị gụnyere nkụchi ma ọ bụ adịghị ike mberede n'ihu, aka, ma ọ bụ ụkwụ, karịsịa n'otu akụkụ ahụ; mgbagwoju anya; nsogbu ikwu okwu ma ọ bụ ịghọta okwu; nsogbu ọhụụ n'otu ma ọ bụ anya abụọ; nsogbu ije ije; isi ọwụwa; na enweghị nguzozi ma ọ bụ nhazi.
Nlekọta tupu ụlọ ọgwụ
Oge a ga-eji gwọọ ọrịa strok dị irè, nke na-abụkarị n'ime awa 3 ruo 4.5 site na mmalite nke mgbaàmà maka thrombolysis n'ime akwara. Ya mere, nlekọta tupu ụlọ ọgwụ na-elekwasị anya na nchọpụta ngwa ngwa, ịkwalite ọrụ ahụike mberede (EMS), na ibuga ngwa ngwa gaa ebe ahụike kwesịrị ekwesị.
Nzọụkwụ n'Ilekọta Tupu Ụlọ Ọgwụ:
1. Nghọta na Azịza Mbụ:
– Jiri okwu mmalite FAST cheta ihe ịrịba ama ịdọ aka ná ntị: Ihu ịda, adịghị ike aka, nsogbu ikwu okwu, na oge ịkpọ oku maka ndị ọrụ mberede.
- Kpọọ ndị ọrụ ahụike mberede (EMS) ozugbo ha chọpụtara ihe mgbaàmà nke ọrịa strok.
2. Mmelite na Njem EMS:
- Zipu EMS dị ka ihe dị mkpa.
- Nye ọkwa tupu ọbịbịa na ebe kacha nso maka ọrịa strok.
– Hụ na onye ọrịa ahụ nọ n'ọnọdụ dị mma mana zere inye ya nri ma ọ bụ ihe ọṅụṅụ.
3. Nyocha na Nkwụsi Ike Mbụ:
– Mee nyocha mbụ nke lekwasịrị anya na ikuku, iku ume, na mgbasa ọbara (ABCs).
- Nye onye ọrịa oxygen ma ọ bụrụ na ọ nwere hypoxic.
– Mee ka akwara dị n'ime ahụ banye n'ime ahụ, ọ bụrụ na o kwere mee, n'ụzọ ị ga-esi gaa ụlọ ọgwụ.
Ọgwụgwọ n'ime ụlọ ọgwụ
Mgbe a bịarutere n'ụlọ ọgwụ, nyocha ngwa ngwa na ọgwụgwọ dị oke mkpa. Ebe a na-agwọ ọrịa strok na-agbaso usoro ndị dabere na ihe akaebe iji mee ka nsonaazụ ndị ọrịa ka mma.
Nhazi na Nyocha Ozugbo:
1. Ngwa ngwa nke nhazi:
– Ndị ọrịa a na-enyo enyo na ha nwere ọrịa strok ga-abịa ọsọ ọsọ gaa n'òtù strok.
– Nyocha ozugbo site na iji usoro nhazi, nke na-amalitekarị site na National Institutes of Health Stroke Scale (NIHSS).
2. Foto na Nchọpụta Ihe:
– Nweta nyocha CT ma ọ bụ MRI nke ụbụrụ nke na-abụghị ọdịiche iji wepụ ọrịa strok ọbara na-efe efe ma gosi na ọ bụ ischemia.
- Nnwale ọbara gụnyere ọkwa glucose, profaịlụ coagulation, na panel metabolic basic.
- ECG iji chọpụta maka atrial fibrillation ma ọ bụ nsogbu obi ndị ọzọ.
Ọgwụgwọ N'ụzọ Dị Mfe:
1. Ọkpụkpụ ọbara n'ime eriri afọ (IV tPA):
– Nye ọgwụ plasminogen activator (tPA) nke anụ ahụ IV n'ime awa 4.5 nke mgbaàmà ahụ malitere, mgbe e wepụsịrị ya dịka ihe egwu ọbara ọgbụgba.
- Na-enyocha ihe ịrịba ama nke ọbara ọgbụgba ma ọ bụ nsogbu ndị ọzọ n'oge na mgbe ejiri ya.
2. Ọgwụgwọ Endovaskụla:
- Maka ndị ọrịa nwere nnukwu ihe mgbochi akwara, ọgwụgwọ endovascular nwere ike ịdị mma, ọkachasị ma ọ bụrụ na n'ime awa 24 nke mgbaàmà ahụ malitere.
– Ịkpụpụ ihe e ji eme ihe n'ime ígwè nwere ike iwepụ nnukwu mkpụkọ ọbara nke ọma, ọ na-abakwa uru nke ukwuu ma a rụọ ya n'oge o kwere mee.
3. Njikwa nke Ọbara mgbali elu:
– Nọgide na-enwe ọbara mgbali elu kachasị mma iji hụ na ọbara na-agbapụta na ischemic penumbra ma na-ezere mmebi ma ọ bụ nsogbu ndị ọzọ.
4. Ọgwụgwọ Mgbochi Platelet na Mgbochi Coagulant:
– Nye aspirin n'ime awa 24-48 nke ọrịa strok malitere ma ọ bụrụ na e nwere ihe mgbochi.
- N'ọnọdụ ọrịa strok obi, a ga-atụle ọgwụ mgbochi coagulation mgbe a tụlechara ihe egwu nke mgbanwe ọbara ọgbụgba.
Njikwa Mgbe O Siri Ike Na Mgbochi nke Abụọ
Mgbe emechara ka ihe sie ike nke mbụ, usoro dị iche iche gụnyere usoro mgbake na mgbochi nke abụọ dị oke mkpa iji belata ihe egwu nke ọrịa strok ugboro ugboro ma melite ndụ.
Ndozigharị:
1. Ịkwalite na Ọgwụgwọ Ahụ n'oge:
– Malite ọgwụgwọ anụ ahụ ozugbo enwere ike iji nwetaghachi ọrụ mmegharị ahụ ma gbochie nsogbu dịka thrombosis nke akwara miri emi na ọnya nrụgide.
2. Ọgwụgwọ Okwu na Ọrụ:
- Dozie nsogbu nkwukọrịta na ikike ọrụ kwa ụbọchị site na mmemme mmezi ahaziri ahazi.
Mgbochi nke Abụọ:
1. Mgbanwe Ihe Ndị Na-akpata Ihe Ize Ndụ:
- Jikwaa ọbara mgbali elu, ọrịa shuga, na oke lipid site na iji ọgwụ na mgbanwe ndụ.
– Kwalite ịkwụsị ise siga ma gbaa ume ka a na-emega ahụ mgbe niile ma na-eri nri kwesịrị ekwesị.
2. Nrubeisi Ọgwụ:
– Hụ na onye ọrịa na-agbaso ihe ndị na-egbochi ọbara mgbali elu, statins na ọgwụ ndị na-egbochi ọbara mgbali elu edepụtara.
3. Nlekota Mgbe Niile:
– Hazie oge niile na ndị na-ahụ maka ahụike iji nyochaa ọnọdụ ahụike ma gbanwee atụmatụ ọgwụgwọ dịka ọ dị mkpa.
mmechi
Usoro mberede dị irè maka ọrịa strok ischemic chọrọ nnabata ngwa ngwa, ime ka EMS rụọ ọrụ ozugbo, nyocha na ọgwụgwọ zuru oke n'ụlọ ọgwụ, yana nlekọta anya mgbe ọrịa strok gasịrị. Iji usoro ndị a eme ihe nwere ike ibelata ọrịa na ọnwụ metụtara ọrịa strok ischemic nke ukwuu, na-emesi ike mkpa ọ dị iji usoro nlekọta ahụike agbakwunyere. Mmụta ọha na eze gbasara ịmata ihe mgbaàmà strok na mkpa ọ dị itinye aka ngwa ngwa na-arụkwa ọrụ dị mkpa n'ịkwalite nsonaazụ maka ndị ọrịa strok. Site na mgbalị siri ike n'ofe nlekọta, ọ ga-ekwe omume ime ka mgbake dịkwuo mma ma melite ụdị ndụ maka ndị ọrịa strok ischemic metụtara.
