Mitsempha ndi mitsempha yamagazi imene magazi olemera ndi okosijeni amapita ku ziwalo monga impso, mtima, ndi ubongo. Oxygen ndi zakudya ndizofunika kuti thupi likhale lopulumuka.
Mitsempha yaikulu yomwe imabweretsa magazi ku ubongo ndi mitsempha ya carotid ndi vertebral. Vuto lirilonse la magazi likutuluka mu mitsempha iyi ikhoza kuyambitsa sitiroko.
Mtundu wosazolowereka wa chifuwa cha mitsempha, yotchedwa dissection yowonongeka, ingayambitse sitiroko.
Kodi Kuthamangitsidwa kwa Arterial Ndi Chiyani?
Kugwiritsidwa ntchito kwa magazi kumatanthawuza zachilendo, komanso kawirikawiri, kupanga misozi mkati mwa khoma la mitsempha. Pamene misozi imakula, imapanga kachikwama kakang'ono kamene madokotala amachitcha kuti "lumen." Mwazi umene umasonkhana mkati mwa lumen iyi yonyenga ukhoza kutsogolera mwa njira izi:
- Madzi amagazi mkati mwa khoma la mitsempha mpaka itayamba kulepheretsa magazi kutuluka. Dothi lokulitsa la magazi pakhoma la mitsempha limatchedwa "pseudoaneurysm." Pseudoaneurysms ikhoza kuwonetsa zizindikiro za kupwetekedwa mwa kupitiliza pazochitika za ubongo ziri pafupi. Zitha kuphulika komanso zimayambitsa magazi ambiri mu ubongo (zilonda zam'mimba). Izi zikachitika, pseudoaneurysm imatchedwa "dissecting aneurysm" kapena "dissecting pseudoaneurysm."
- Magazi mkati mwa lumeni yonyenga amatha kutseka ndi kupititsa pang'onopang'ono kumalo komwe magazi amatha kuyenda. Izi zingathe kuchepetsa kapena kusokoneza mwazi wonse magazi.
- Mbali zing'onozing'ono zowonjezera magazi zimatha kuchoka, zimathamanga, ndipo zimalowa m'kati mwazing'ono zing'onozing'ono mu ubongo. Chochitikachi chimadziwika kuti "mitsempha yothetsera thromboembolism."
Kusagwirizana kwa mabomba ndi udindo wopitirira 2 peresenti ya zikwapu zonse. Komabe, kusagwirizana kwapadera kumawerengera kwa kotala limodzi la zikwapu zonse zapakati pa achinyamata komanso pakati.
Chaka chilichonse ku United States, pakati pa 12,000 ndi 15,000 anthu amakhudzidwa ndi kutuluka kwadzidzidzi kwa mitsempha ya carotid kapena vertebral.
Zizindikiro
Zizindikiro zofanana ndi izi:
- Ululu pa mbali imodzi kapena mbali zonse za khosi, nkhope, kapena mutu
- Ululu wa diso, kapena wophunzira wamng'ono wodabwitsa
- Ng'ombe yamphongo yopanda madzi kapena masomphenya awiri
- Kulephera kutseka diso limodzi
- Kusintha kwadzidzidzi kokwanitsa kulawa chakudya
- Kulira m'makutu, chizungulire kapena vertigo
- Kufooka kwa minofu iliyonse ya khosi ndi nkhope kumbali imodzi
Zizindikiro za kusokonezeka kwa ischemic kapena kupweteka kwachilendo zingathe kuchitika masiku angapo mpaka masabata angapo chiyambi cha zizindikiro zilizonse zomwe zafotokozedwa pamwambapa.
Zimayambitsa
Mitsempha yotchedwa carotid ndi vertebral imatha kuwonongeka ndi kuvulala pamutu kapena ngakhale kuthamanga kwa khosi. Zotsatirazi ndi zina zomwe zakhudzana ndi kusokonezeka kwa mitsempha ya carotid ndi vertebral:
- Kutambasula kakhosi pamasamba otsuka tsitsi kumalo okongola
- Kugwiritsidwa ntchito kwa chifuwa cha khosi
- Kuvulala kwa Wiflash
- Kusokonezeka maganizo kumutu
- Kuwonjezera khosi la khosi pa yoga
- Kujambula padenga
- Kudula, kusanza ndi kunjenjemera
- Kukula kwa msasa pamene kulandira mkamwa ndi-pakamwa panthawi yomwe mtima ukukhazikika (CPR)
Kusokonezeka kwapadera kwa mitsempha ya carotid ndi vertebral ndizovuta kwambiri chifukwa cha kupweteka.
Kuthamanga kwadzidzidzi kumatanthawuza kusokonezeka kwapadera kumene sikukhala chifukwa chodziwikiratu. Kusokonezeka kwa mitsempha ya carotid ndi vertebral imatha kupezeka mwadzidzidzi mogwirizana ndi matendawa:
- Marfan's syndrome
- Matenda a impso a Polycystic
- Osteogenesis imperfecta
- Fibromuscular dysplasia
Kudziwa
Chiyeso chofala kwambiri chomwe chimagwiritsidwa ntchito kuti azindikire kusokonezeka kwa carotid kapena mitsempha yowongoka ndi chidziwitso. Muyeso ili, dye wosiyana imayikidwa mkati mwa imodzi mwa mitsempha yomwe imabweretsa magazi ku ubongo. X-ray imagwiritsidwa ntchito kuyang'ana mawonekedwe a mitsempha ya carotid ndi vertebral monga daye imene imadutsa mwa iwo (onani chithunzi).
Kugwiritsidwa ntchito kwa matendawa kumapezeka ngati mitsempha yomwe imaoneka kuti imagawidwa m'magawo awiri, ndipo imodzi imatchulidwa kuti 'yonama lumen' (yomwe ili pansipa). mitsempha, utoto umatha ndipo umatha pokhapokha ngati mitsempha imatsekedwa kwathunthu. Pamene dissection imayambitsa pseudoaneurysm, mawotchiwa amasonyeza kujambula utoto mkati mwa khoma la mitsempha yosweka.
Mayesero ena omwe amagwiritsidwa ntchito kuti apeze matenda a carotid ndi vertebral dissection akuphatikizapo maginito resonance angiography (MRA), ndi duplex ultrasound.
Chithandizo
Mankhwala otchedwa carotid ndi vertebral dissection angapangidwe ndi heparin, mankhwala omwe amaletsa kufalikira kwa magazi mu malo a dissection. Heparin ndi mankhwala osokoneza bongo. Nthawi yoti achoke kuchipatala, Coumaden (warfarin) ndi magazi owonda kwambiri omwe angathe kutengedwa pakamwa.
Kawirikawiri, munthu amene akuchira matenda osokoneza bongo akuyembekezeredwa kutenga mankhwala opatsirana magazi kwa miyezi 3 mpaka 6. Komabe, ngati mayesero otsatila sakuwonetsa kusintha kwakukulu pambuyo pa miyezi 6, mankhwala amaperekedwa kwa nthawi yaitali. Ngati sipangakhale kusintha, opaleshoni kapena bulloon angioplasty ndi stenting angakhale njira ina.
Kubwezeretsa
Anthu ambiri omwe amavutika ndi matendawa amatha kuchira. Ndipotu, osachepera 5 peresenti ya iwo omwe ali ndi matenda osokoneza ubongo amafa chifukwa cha chochitikacho. Pafupifupi 90 peresenti ya mitsempha ya carotid imakhala yochepetsedwa kwambiri, ndipo kuposa 66% mwazimene zimatsekedwa kwathunthu ndi kusokonezeka, kuthetsa miyezi yochepa chiyambireni zizindikiro. Nthawi zina, kupweteka mutu kumatha kukhala kwa milungu ingapo kapena miyezi ingapo.
Mafupa okhudzana ndi matendawa amatha kusokonekera, koma amatha kuyambitsa mapangidwe a magazi ndi kupweteka kwa thromboembolic nthawi zambiri.
Mawu Ochokera
Kusagwirizana kwa mabomba ndi zovuta kwambiri. Koma ndi chithandizo cha zamankhwala, anthu ambiri omwe ali ndi matenda osokoneza bongo amakhalapo ndipo amapitiriza kuchita bwino. Ngati inu kapena wokondedwa wanu mwadwala sitiroko yomwe imayambitsa matenda osokoneza bongo, mudzafunikanso nthawi yowonongeka ku stroke. Kukonzekera kugwidwa kambirimbiri kumafuna kutenga nawo gawo mwakhama, ndipo kungakhale kotopetsa, koma mudzawona kuchira ndi kusintha pamene nthawi ikupitirira.
> Zotsatira:
> Kuthamangitsidwa kwa chipanichi chokhazikika: Zithunzi za Echocardiographic, Gu X, He Y, Luan S, Zhao Y, Sun L, Zhang H, Nixon JV, Medicine (Baltimore). 2017 Mar; 96 (10): e6191