Ikhodi ye-Cerebral atherosclerosis ngokuya nge-ICD 10 iyisifo esidala ukuholela kokuvela kokuphazamiseka ekunikezelweni kwegazi kuya ebuchosheni.
I-Cerebral atherosulinosis iba ngumzimba ngenxa yokuvela kwezilonda ezi-occlusive nezokuqina kwemithambo yemithambo yegazi ezibhekene nokunikezwa kwegazi kwezicubu zobuchopho.
Ngokuya ngokuhlukaniswa ngezifo zomhlaba wonke kwezifo zalolu hlobo lwengozi ye-pathological cerebrovascular, kunikezwa ikhodi yedijithali 167.2
Ukuphazamiseka okudala izingozi ze-cerebrovascular kubangelwa izinguquko ezifanayo nalezo ezivusa ukubonakala kokuqhekeka kwe-myocardial inflaction kanye nokukhalinyelwa kwezikhathi ezithile.
Izimbangela zokushintsha kwe-atherosulinotic
Umnyombo walesi sifo ulele ekutheni ngokuqhubeka kwawo, ukwakheka kokuqongelelwa kwamafutha ezindongeni zemithambo ye-arterial kwenzeka, okuqinisekisa ukulethwa kwegazi kumaseli obuchopho.
Amafutha akhiwe ngokuhamba kwesikhathi awakhuphuki ngosayizi kuphela, kodwa futhi agxekwa ngesitho sokuxhuma izicubu. Ngenxa yalezi zinqubo, kukhona ukwehla kwe-lumen yangaphakathi yemithambo yegazi kanye nokwephulwa kokugeleza kwegazi endaweni eya ebuchosheni.
Ukuthuthukiswa kwe-cerebral atherossteosis kuvame ukuqoshwa kwabadala. Lesi sifo sibalwa cishe ama-50% azo zonke izifo ezibhalisiwe zohlelo lwezinhliziyo.
Imvamisa, ukubhaliswa kokuba khona kwalesi sifo kwenziwa ezigulini ezisezingeni eliphakathi kweminyaka engama-40 kuye kwengama-50.
Indlela yokuqalisa enomthelela ekuthuthukisweni kwe-pathology okwamanje ayaziwa ngokuthembekile, kepha kuye kwahlonzwa izici ezinomthelela kusebenze kwezinqubo ezibangela ukuqhubeka kwesifo.
Lezi zici zobungozi yilezi:
- ukubhema
- ukuba khona kwe-cholesterol ephezulu ku-plasma;
- ukuba khona kwezinga eliphakeme lama-triglycerides ku-plasma yegazi;
- i-hyperhomocysteinemia;
- isakhi sofuzo;
- ukusetshenziswa kwezindlela zokuvimbela inzalo ngomlomo;
- ukuba khona kwe-hypertension ye-arterial;
- ukuvela kokuhlaselwa kwe-ischemic okwesikhashana;
- ukuthuthukiswa kwesifo sikashukela;
- ukuba khona kokukhuluphala esigulini;
- impilo yokuhlala;
- ukwephulwa kwesiko lokudla;
- ukuchayeka ekucindezelweni okujwayelekile emzimbeni;
- ukuphazamiseka ngemuva kwehomoni.
Ngaphezu kwalezi zizathu, lesi sifo singakhula ngenxa yokuvela kokuluthwa kokudla okunamafutha angenampilo, okufaka isandla ekwakhiweni komthwalo owandayo esibindini somuntu.
Izimpawu zomuntu zesifo
Ukuhlonza ukugula kwezigaba zokuqala zokukhula kuyinkinga impela.
Izimpawu zokubonakala nokubonakala kwayo kuncike esigabeni sokuqhubeka kwezifo.
Isibonakaliso sokuqala esikhombisa ukwenzeka kwephulwa ukubonakala kokulimala kwekhanda.
Imbangela yalolu phawu ukwakheka kwamakhemikhali e-cholesterol, ehlanganisa ukukhanyisa komkhumbi.
Umphumela wale nqubo ukuphazamiseka ekunikezelweni kwamaseli obuchopho ngezakhi kanye nomoya-mpilo.
Ukuntuleka komoya-mpilo kuvusa ukuvela kwekhanda elibuthakathaka, elibuhlungu, elihamba isikhathi lihlale unomphela.
Isiguli sikhulise ukukhathala futhi sehla ukusebenza.
Ebusuku, ukuqwasha kuqala ukuhlukumeza umuntu, kanti ngesikhathi sasemini, umuntu ohlushwa yi-pathology uthambekele esimweni esishintsha ngokushesha. Ngokuqhubeka kwesifo, isiguli sinokuntuleka kokuxhumana kokunyakaza.
Ukuthuthuka okuthe xaxa kanye nokwanda kwalesi sifo kuholela:
- Ukwehla kwemisebenzi yememori.
- Ngokubonakala kwe-tinnitus.
- Lapho kwenzeka isiyezi.
- Ngokubonakala kokungazami ku gait.
Zonke lezi zimpawu ziyanda ngokuhlaselwa kobuchopho okuvela, okukhonjiswa yizimpawu ezahlukahlukene. Izimpawu zokuhlasela kobuchopho zincike kwisiza somonakalo kwezicubu zobuchopho.
Izinguquko ezenzeka emthanjeni we-carotid ziholela ekuxineni futhi kuthinteke ukuzwela kwengxenye yomzimba.
Uma ukuhlaselwa kobuchopho kuthinta i-hemisphere engakwesobunxele, kungenzeka ukuthi ukubanjwa kwesithuthwane nokusebenza kokukhubazeka kwengqondo kungenzeka.
Ngomonakalo engxenyeni yobuchopho noma yesikhashana yobuchopho, umbono ofiphele uyabonakala, futhi kukhona futhi ukwephulwa kwemisebenzi yokugwinya.
Isikhathi sokuhlaselwa kobuchopho be-ischemic asidluli izinsuku ezimbili. Ngemuva kokuqedwa kokuhlaselwa kwe-ischemic, isiguli kungenzeka singakhumbuli lutho.
Uma isikhathi sokuhlasela ngesikhathi sidlula izinsuku ezimbili, ukukhula kwesifo sohlangothi kwengqondo kungenzeka.
Ukushaywa unhlangothi kungaqhamuka nezinhlobo ezimbili:
- i-ischemic - ivela ngenxa yokuvalwa komkhumbi ngotshani lwe-cholesterol;
- hemorrhagic - eba ngemuva kwesizinda sokuqhekeka komkhumbi kanye nokuvela kokuqubuka kwezicubu zomgogodla wobuchopho.
Isigaba sokugcina salesi sifo sibonakaliswa ukubonakala kokunganakwa ngokuphelele kwemvelo, ukungajwayeli kahle isikhathi nendawo nendawo kanye nokwephulwa kokulawulwa kwenqubo yokuchama.
Isiguli sicishe siphelelwe amandla okukhuluma futhi kunokukhubazeka okuphelele.
Ukuxilongwa kwalesi sifo
Ukuqagela kwentuthuko yesifo kuncike esikhathini sokukhonjwa kwalesi sifo kanye nokuxilongwa okuyikho.
Ukuthola imininingwane ephelele ngesimo somzimba sesiguli, kusetshenziswa izindlela zokuhlaziya kwelabhoratri kanye nokuhlonza izinsimbi.
Ngesikhathi sokuxilongwa kwelabhoratri, kuhlolwa igazi elijwayelekile nelinemikhemikhali kuyenziwa. Lapho wenza ukuhlolwa kwegazi kwe-biochemical, iphrofayili ye-lipid izimisele ukuhlola amazinga we-cholesterol.
Izindlela ezilandelayo zisetshenziswa njengezindlela zokuhlonza insimbi:
- I-tomography ehlanganisiwe yemithambo yegazi.
- I-UZGD - i-dopplerography ye-Ultra yesistimu ye-vascular yekhanda nentamo.
- Magnetic resonance imaging yekhanda.
- Ukuhlolwa kwe-Ultrasound kwenhliziyo.
- I-X-ray angiography yemithambo yegazi.
Ngemuva kokuxilonga nokuthola yonke imininingwane ngesimo somzimba, udokotela unquma ukusetshenziswa kwendlela eyodwa noma enye yokwelashwa.
Ukuzikhethela kwendlela yokwelashwa kufanele kwenziwe kuphela ngudokotela oholayo, kubhekwe imininingwane etholakele ngesimo sempilo kanye nezimpawu zomzimba wesiguli.
Uma lesi sifo sitholakala kahle esigabeni sokuqala sokuthuthuka, khona-ke umphumela wokwelapha unempilo, okugwema ukuthuthukiswa kwezinkinga ezinzima ezibangelwa yi-pathology esigulini.
Ukwelashwa kwezidakamizwa ze-pathology
Ngokuya esigabeni lapho lesi sifo satholakala khona kanye nezinga lokuthuthuka kwezinkinga, udokotela oholayo uzimisele ngezindlela zokwelapha.
Ukwelashwa kwalesi sifo, zombili izindlela zokwelapha nezokuhlinzwa zingasetshenziswa.
Lapho wenza ukwelashwa kwezidakamizwa, indlela ehlanganisiwe isetshenziselwa ukuthola umphumela omuhle ozinzile.
Ngenqubo yokwelashwa, kunconywa ukusetshenziswa kweqembu lonke lezidakamizwa ezingamaqembu ahlukahlukene wemithi yokwelapha.
Izidakamizwa ezisetshenziselwa inqubo yokwelashwa zingamaqembu alandelayo wezidakamizwa:
- Abangahambisani - i-Aspirin, i-Clopidogrel, izidakamizwa zinciphisa amathuba okuqhekeka kwegazi nokushaywa unhlangothi.
- Izidakamizwa ze-Hypolipidemic zisetshenziselwa ukunciphisa izinga lokuqhubeka kwezinguquko ze-atherosulinotic futhi zithuthukise ukuhamba kwegazi. Izidakamizwa ezivame kakhulu yimithi engeyeqembu lama-statin. Ukusetshenziswa kwalezi zidakamizwa kungalungisa i-cholesterol metabolism, kwehlise izinga le-LDL ne-VLDL ku-plasma yegazi. Leli qembu lezidakamizwa linenqwaba yemiphumela emibi okufanele icatshangwe lapho kunqunywa umuthi.
- Izidakamizwa ezilwa nokuvuvukala, ukuthatha le mithi ikuvumela ukuthi wenze amasistimu wezinzwa ukumelana kakhulu nezinto ezingezinhle.
- I-Vasodilator - izidakamizwa zisiza ukuqeda umsipha wokuqina wemithambo odongeni lwe-vascular futhi kwandise ukuphuma kwegazi kuma-neurons ebuchosheni. Leli qembu lifaka u-Eufillin, uPapaverine noDiprofen.
- Kusho ukuhlinzeka kokujikeleza kokhokho okuthuthukisiwe futhi kusebenze ukusebenza kwamaseli obuchopho ngendlela evamile. Leli qembu lezidakamizwa lifaka iPiracetam, iPicamilon.
Ngaso leso sikhathi, kunconywa ukwelashwa kwe-antihypertensive, okusiza ukunciphisa ingozi yokuhlaselwa yisifo sohlangothi kanye ne-encephalopathy. Ngale njongo, ama-Captopril, losartan, moxonidine asetshenziswa.
Ukwelashwa kokuhlinzwa kwe-pathology kanye ne-prognosis
Lapho kutholakala isifo esigabeni sokugcina sentuthuko, ukungenelela kokuhlinzwa kusetshenziselwa ukwelapha ukugula.
Ukwelashwa kwe-pathology ngokungenelela kokuhlinzwa kuboniswa lapho kungekho zinguquko ezinhle ezivela ekusetshenzisweni kwezidakamizwa.
I-Stenosing atherossteosis isebenza ngendlela evulekile emithanjeni ye-carotid yangaphakathi nejwayelekile.
Ngokuhlakaza intamo, udokotela osebenzayo wenza i-autopsy yendawo ethintekile futhi asuse i-plaque kanye nolwelwesi olungaphakathi.
Ngemuva kokususa i-cholesterol plaque, udokotela uyathutha futhi amise amanzi amancane. Ukuhlinzwa okunjalo kwenziwa ngaphansi kokulawulwa kwe-ultrasound yemithambo yobuchopho.
Uma kunesidingo, ukungenelela okuhlinza emithanjeni yangaphakathi yamakhonkolo kusebenzisa indlela yokubabaza ngokungenisa ibhaluni elandisa izindonga zomkhumbi futhi lichoboze i-cholesterol plaque. Esakhiweni somonakalo, kufakwa i-stent esekela ukukhanyiselwa kwangaphakathi komkhumbi ebangeni elifunayo lamagugu.
Ngemuva kokuhlinzwa, udokotela uyalela ukuthi uthathe izidakamizwa ezivimbela ukwanda kwegazi kukho konke impilo.
Uma isifo se-pathological sitholakala ezinyangeni zokuqala zokuthuthuka, i-prognosis iyathandeka. Ngokuya ngezincomo zikadokotela oholayo, izimbangela ezashukumisa ukuthuthuka kwalesi sifo ziyaqedwa futhi ukuqhubeka kwawo phambili kuyamiswa.
Endabeni yokushintshwa kwalesi sifo kulesi sigaba sesibili, cishe akunakwenzeka ukuthi useluleme ngokuphelele kulesi sifo. Lapho wenza izindlela zokwelapha ngalesi sigaba, kumayelana nokuvimba inqubekela phambili yesifo kanye nokuvimbela ukuqala kokushaywa unhlangothi kanye ne-encephalopathy.
Lapho ukuthuthukiswa kwesifo sesigaba sesithathu kutholakala, amathuba okuba umphumela obulalayo wesiguli uphezulu, uma kungengenziwa ukuhlinzwa okufika ngesikhathi kwenziwa.
I-Cerebral atherossteosis iyinhlangano yezifo ezinomthelela obalulekile ebuntwini bomuntu. Lesi sifo siholela ushintsho ekuziphatheni kwesiguli, ngenxa yokwephulwa kokuhlinzekwa kwegazi nomsebenzi wobuchopho, ukuphazamiseka kwengqondo, ukulahleka kombono nokukhuluma.
Ukuvimbela umthelela omubi wesifo ku-psyche nokuziphatha kwesiguli, kubalulekile ukukhomba lesi sifo ekuqaleni kwesigaba bese uqala inqubo yokwelashwa ngendlela esheshayo.
I-Cerebral atherossteosis ichazwa kuvidiyo kule ngxenye.
