Malo oyambitsa zida zapamwamba ndi zipatala zomwe zatsimikiziridwa ndi Joint Commission, yomwe ndi bungwe lovomereza mapulogalamu aumoyo ku United States. Komiti Yoyanjanitsa inayamba kuzindikiritsa malo oyang'anira matenda opatsirana pogonana mu December 2003.
Zofunikira zapakati pa Stroke Center
Malo opangira zipsyinjo zoyenera ayenera kukwaniritsa zina zotero kuti athe kuvomerezedwa ndi kutsimikiziridwa ndi dzina limenelo.
Zina mwa zofunikazi zikuphatikizapo:
- Kukhala ndi stroke unit yoyang'anira wodwala wotsatila.
- Kuwonetsa kutsata ndondomeko zotsatiridwa za kachipatala za matenda a stroke.
- Kuonetsetsa kuti ogwira ntchito ogwira ntchito mwamsanga akudziŵa za masewera olimbitsa thupi.
- Kukhazikitsa njira yopezera ndi kulandira odwala matenda a stroke.
- Kusonkhanitsa ndi kupereka malipoti ofanana ndi zotsatira za zotsatira za kupweteka.
Maselo a Stroke Amapereka Mankhwala Osokoneza Bongo ndi Okonzeka
Cholinga chimodzi pa malo onse ogwidwa ndi stroke ndikutenga, kuyesa, kupeza, ndi kuchiza odwala aliyense pamtima maola atatu pakutha kwa zizindikiro zawo. Kuwongolera mankhwala oyenera a stroke kumafuna gulu lachipatala lodziwa bwino komanso lodziŵa bwino.
Mankhwala opatsirana pogwiritsa ntchito mankhwalawa akuphatikizapo kuyendetsa magazi amphamvu kwambiri monga IV TPA ndi intra-arterial thrombolysis. Mankhwalawa ayenera kuperekedwa mkati mwawindo laling'ono la nthawi pambuyo poti zizindikiro zimayamba, kapena kuti zimayambitsa mavuto, ndipo mwina zimakhala zovuta.
Zina mwa ntchito zazikulu malo oyambirira a stroke ayenera kukwaniritsa pawindo la maola atatu awa ndi awa:
- Kutumiza wodwala kuchipatala
- Yerekezerani bwinobwino ndi dokotala - nthawi zambiri katswiri wa zamagulu
- Kupeza ndi kuwerenga, kanema wa CT
- Dulani magazi, kuzifufuza, ndi kuwonetsa zotsatira
- Perekani mankhwala oyenera
Kutha kwa Sitiroko ndi Othandizira a Stroke
Malo ambiri opwetekedwa ndi odwala opaleshoni ya opaleshoni, omwe ali ndi matenda a ubongo, omwe amadziwika ndi matenda a khunyu), ndipo nthawi zambiri amapezeka m'nyumba, usiku wonse. Madokotalawa amagwira ntchito pansi pa mawu akuti "nthawi ndi ubongo." Choncho, iwo ndi othamanga kwambiri, koma olondola kwambiri, pakuzindikira sitiroko zoopsa kwambiri. Izi zikachitika, madokotala awa amaphunzitsidwa kuti athetse opaleshoni yowonjezereka, ndikukonzekera mwamsanga kupita ku chipatala chachikulu, kapena kuchipatala chapadera kwambiri.
Kuvomerezeka koyenera ndi Kusamalira Mavuto Okhwima
Madokotala ndi anamwino omwe ali mbali ya stroke center akuphunzitsidwa kuzindikira mavuto azachipatala omwe angabwere mwa munthu amene adwala matendawa. Izi ndizofunika kwambiri, monga momwe odwala amatha kupweteka mofulumira mkati mwa maola angapo oyambirira kapena masiku ochepa. Ndipotu, ngakhale mphuno yochepa kwambiri imakhala ndi mwayi wa 10% wotembenukira ku zikuluzikulu m'maola oyambirira 48.
Zina mwa zovuta zomwe zimakhalapo kawirikawiri pambuyo pobaya ndizo:
- Kukwapulidwa kwatsopano, kapena kukulirakulira
- Kusuta, makamaka pamene akuchitidwa ndi t-PA
- Kugonjetsa
- Kutupa kwa ubongo
- Matenda azachipatala monga chibayo ndi matenda ena
Ancillary Staff Akudziwa Zosowa za Odwala Stroke
Phindu lalikulu la malo osokoneza bongo ndi mgwirizano wawo ndi ogwira nawo ntchito ndi othandizira ena omwe amadziwa zofunikira zazing'ono komanso zanthawi yaitali za odwala opweteka. Ophunzira omwe amaphunzitsidwa nthawi zambiri amapereka thandizo lalikulu kuthetsa mavuto okhudzana ndi inshuwalansi ya umoyo , kupeza odwala odwala matenda opatsirana pogonana, odwala matenda a maganizo, ogwira ntchito zachipatala, komanso posankha njira zabwino zowonongeka kuti akhalenso ndi kachilomboka.
Zotsatira za Pakati pa Stroke Center
Malingana ndi kufufuza kwa deta lofalitsidwa ndi Journal of the American Heart Association, odwala omwe amalandira chithandizo cha stroke pa malo oyamba a stroke amatha kulandira chithandizo ndi T-PA kuposa odwala omwe sachiritsidwa pa Maphunziro a Primary Stroke.
Chitsanzo china cha odwala chomwe chinaphunzira odwala oposa 120,000 omwe anavomerezedwa ndi kuchiritsidwa kuti apulumuke anafalitsidwa mu Journal of Stroke ndi Cerebrovascular Disease. Odwala anaphatikizapo odwala opaleshoni omwe anavomerezedwa kuchipatala chachikulu ndi odwala omwe adaloledwa kupita kuchipatala omwe sanatchulidwe kuti ndi malo oyambirira a stroke.
Olemba mabukuwo anapeza kuti odwala opweteka omwe anachiritsidwa m'zipatala zoyambirira zapakati pazirombo zapachipatala sankakhala ndi mavuto aakulu mu chipatala ndipo amakhala ndi zotsatira zabwino zowonjezera kuchipatala.
Kuchiza kwapakati pa Horizon
Njira yatsopano yopezera odwala opweteka inalandira chinyengo chamankhwala pamsampha wochiritsira matenda otchedwa Mobile Stroke Unit. Ndili ochepa chabe padziko lapansi ndipo awiri mu United States, Mobile Stroke Units amagwira ntchito monga momwe dzina limatanthawuzira, kuyambira kugwilitsika ntchito, ndipo nthawi zina ngakhale kuchipatala, kupita kuchipatala, kupulumutsa nthawi yamtengo wapatali.
> Zotsatira:
> Joint Commission Primary Stroke Centers Kugwiritsa Ntchito Rt-PA mu Nationwide 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
> Misonkho ya Zoipa ndi Zotsatira Zoipa Pakati pa Odwala Stroke Adavomerezedwa ku Zomwe Zikuluzikulu za Stroke. Chaudhry SA, Afzal MR, Chaudhry BZ, Zafar TT, Safdar A, Kassab MY, Hussain SI, Qureshi A, Journal of Stroke ndi Cerebrovascular Disease, 2016 Aug; 25 (8): 1960-5
Kusinthidwa ndi Heidi Moawad MD