Yog tias cov ntshav ntws mus rau koj lub hlwb tsis txav lawm, yuav ua li cas? (Ischemic Stroke) Cia peb kawm ntxiv txog nws.

Auj, xav txog seb yuav muaj li cas yog tias cov ntshav ntws mus rau koj lub hlwb nres tam sim ntawd? Nws yog ib qho xwm txheej txaus ntshai heev. Peb hu qhov no ua ischemic stroke . Qhov no yog ib qho xwm txheej ceev kho mob uas tuaj yeem ua rau tuag taus. Qhov mob no ua rau cov hlwb hlwb tuag, thiab yog tias qhov ntawd tshwm sim, lub cev ua haujlwm uas cov hlwb ntawd tswj hwm yuav ploj mus. Ischemic Stroke suav txog li 80% ntawm tag nrho cov mob stroke hauv ntiaj teb. Yog li ntawd, nws yog ib qho tseem ceeb heev rau koj thiab koj cov neeg hlub kom paub txog qhov no.

Yog li ntawd, cov tsos mob ntawm "Ischemic Stroke" yog dab tsi?

Cov tsos mob ntawm tus mob stroke ischemic yuav txawv nyob ntawm seb qhov twg ntawm lub hlwb raug cuam tshuam. Txawm li cas los xij, muaj qee cov tsos mob uas pom ntau:

• Muaj kev xav tias tsis muaj zog lossis tsis muaj zog ntawm ib sab ntawm lub ntsej muag lossis lub cev.
• Muaj teeb meem hais lus, lossis tsis hais lus tau tag nrho (Aphasia) .
• Kev hais lus tsis meej thiab cov lus tsis tuaj yeem hais tau zoo (Dysarthria) .
• Tsis muaj peev xwm tswj cov leeg nqaij ntawm ib sab ntawm lub ntsej muag.
• Nws tsis ua li cas yog tias koj cia li poob lossis ua rau koj qhov kev hnov ​​​​​​ntxhiab tsw, saj, kov, lossis hnov ​​​​​​lus tsis zoo.
• Pom kev tsis meej los yog pom ob sab (Diplopia) .
• Tsis muaj peev xwm tuav tau yam khoom kom raug, tsis muaj peev xwm sib koom tes ntawm lub cev, thiab tsis taug kev (Ataxia) .
• Hnov kiv taub hau.
• Xeev siab thiab ntuav.
• Caj dab tawv.
• Kev hloov pauv sai sai ntawm tus cwj pwm lossis tus cwj pwm.
• Xav tsis meej pem thiab tsis nyob twj ywm.
• Muaj qaug dab peg.
• Amnesia yog qhov poob ntawm kev nco qab.
• Mob taub hau tam sim ntawd, hnyav heev.
• Yuav kom tsis nco qab thiab ntog.
• Poob rau hauv lub xeev tsis nco qab.

Cov cim ceeb toom - nco ntsoov UA CAI SAI!

Kab mob "Ischemic Stroke" muaj ntau yam tsos mob. Yuav kom paub seb puas muaj tej yam zoo li no tshwm sim rau koj lossis ib tus neeg koj paub, nco ntsoov cov lus no: UA CAI SAI .

• B - Qhov Sib Npaug: Saib seb koj puas poob koj qhov sib npaug tam sim ntawd.
• E - Qhov Muag: Nrhiav seb puas muaj kev poob qhov muag tam sim ntawd hauv ib lossis ob lub qhov muag, lossis muaj kev hloov pauv hauv kev pom.
• F - Lub Ntsej Muag: Luag nyav thiab saib seb ib sab ntawm lub ntsej muag puas poob qis .
• A - Caj Npab: Tsa ob sab caj npab. Saib seb ib sab caj npab puas qis lossis zoo li tsis muaj zog.
• S - Kev Hais Lus: Saib seb cov lus hais puas tsis meej lossis yog tias nws nyuaj rau kom tau cov lus raug.
• T - Lub Sijhawm: Lub sijhawm yog qhov tseem ceeb - hu rau kev pab tam sim ntawd (yog tias nyob hauv Sri Lanka, hu rau 1990)Yog tias ua tau, khaws cia saib xyuas lossis sau cia hauv xov tooj txog lub sijhawm uas koj cov tsos mob pib. Qhia rau koj tus kws kho mob lub sijhawm no yuav pab lawv xaiv txoj kev kho mob zoo tshaj plaws rau koj.

Txhua ob feeb muaj nqis! Yog tias koj xav tias koj muaj mob stroke, mus rau tsev kho mob tam sim ntawd yam tsis muaj kev ncua.

Dab tsi ua rau muaj "Ischemic Stroke"?

Hais yooj yim xwb, "Ischemic Stroke" tshwm sim thaum muaj ib yam dab tsi cuam tshuam cov ntshav ntws mus rau koj lub hlwb. Cov kws kho mob hu qhov no tias "Ischemia." "Ischemia" txhais tau tias cov cell tsis tau txais ntshav txaus thiab tuag. Thaum qhov no tshwm sim rau lub hlwb, "Ischemic Stroke" tshwm sim. Feem ntau, qhov ua rau tseem ceeb yog cov ntshav txhaws.

Cov ntshav txhaws tuaj yeem tsim tau li no vim muaj ntau yam mob. Piv txwv li:

• Kab mob Atherosclerosis yog thaum cov hlab ntsha nqaim thiab tawv, ua rau cov ntshav tsis ntws. Nws zoo li cov av nplaum daig rau hauv cov kav dej.
• Cov teeb meem ntshav txhaws.
• Atrial fibrillation yog ib yam kab mob uas lub plawv dhia tsis sib xws.
• Cov teeb meem plawv uas muaj txij thaum yug los xws li qhov hauv lub plawv (Atrial septal defects lossis Ventricular septal defects).
• Ib qho mob hu ua "Microvascular ischemic disease" tuaj yeem tshwm sim thaum cov hlab ntsha me me hauv lub hlwb raug thaiv.

Cov hom mob 'Ischemic Stroke' yog dab tsi?

Muaj ob hom mob "Ischemic Stroke" tseem ceeb:

1. Mob stroke uas muaj ntshav txhaws: Qhov no yog thaum cov ntshav txhaws hauv lub hlwb . Cov kws kho mob hu qhov txheej txheem no ua thrombosis.

2. Kab mob embolic: Qhov no tshwm sim thaum cov ntshav txhaws (embolism) uas tsim nyob rau lwm qhov hauv lub cev (feem ntau hauv lub plawv) mus ncig los ntawm cov hlab ntsha thiab nkag mus rau hauv cov hlab ntsha hauv lub hlwb.

Cia peb kawm txog "mob stroke me me" hu ua '(Transient Ischemic Attack - TIA)'

Ib qho "(Transient Ischemic Attack)" lossis "(TIA)" zoo li mob stroke, tab sis cov tsos mob yuav ploj mus tom qab lub sijhawm luv luv (feem ntau tsis pub dhau 24 teev) . Nws kuj hu ua "mini-stroke". Tab sis tsis txhob cia nws ploj mus vim nws me me. "(TIA)" feem ntau yog ib qho cim ceeb toom ua ntej mob stroke loj dua thiab mus tas li tshwm sim . Nws yog ib qho tseem ceeb rau ib tus neeg uas tau muaj "(TIA)" nrhiav kev kho mob ceev nrooj sai li sai tau.

Leej twg muaj feem yuav muaj qhov teeb meem no ntau dua?

Txhua tus neeg yeej muaj tau tus mob "Ischemic Stroke". Tiam sis muaj ib txhia neeg uas muaj feem yuav mob ntau dua. Lawv yog:

• Cov neeg hnub nyoog tshaj 65 xyoo.
• Cov neeg ntawm cov xeeb ntxwv African (qhov no tsis yog qhov tseem ceeb rau Sri Lanka, tab sis nws yog qhov zoo kom paub).
• Cov neeg uas haus luam yeeb lossis siv lwm yam yeeb lossis nicotine (xws li vaping).
• Cov neeg uas siv tshuaj yeeb tsis raws cai.

Tsis tas li ntawd xwb, cov neeg uas muaj tej yam mob nkeeg muaj feem yuav muaj feem ntau dua:

• Rau cov neeg uas muaj ntshav siab (hypertension) .
• Rau cov neeg uas muaj cov roj cholesterol ntau hauv cov ntshav (Hyperlipidemia) .
• Rau cov neeg uas quav dej cawv ('Kev siv dej cawv tsis zoo').
• Rau cov neeg uas muaj mob ntshav qab zib hom 2 .
• Muaj cov kev tshawb fawb qhia tias cov neeg uas tau muaj COVID-19 yav dhau los kuj muaj qee qhov kev pheej hmoo.

Cov kws kho mob kuaj mob li cas?

Tus kws kho mob yuav qhia koj paub tseeb tias koj muaj "Ischemic Stroke" tom qab koj tau kuaj mob "Neurological exam" thiab ntau yam kev kuaj mob. Yog tias koj raug coj mus rau chav kho mob ceev, cov kws kho mob nyob ntawd tuaj yeem kuaj mob tau.

Muaj ntau yam kev kuaj uas koj ua tau los xyuas kom meej tias koj puas tau muaj tus kab mob "Ischemic Stroke":

• `(CT scan)` (CT scan): Qhov no thaij duab ntawm lub hlwb.
• Electrocardiogram (EKG): Kev ua haujlwm hluav taws xob ntawm lub plawv raug saib xyuas.
• `(MRI)` (MRI): Qhov no kuj tseem tuaj yeem thaij duab kom ntxaws ntawm lub hlwb.
• Electroencephalogram (EEG): Saib xyuas tus qauv hluav taws xob ntawm lub hlwb.
• Kev kuaj ntshav: Xyuas seb puas muaj teeb meem ntshav txhaws thiab cov piam thaj.

Yuav kho qhov no li cas?

Thaum kho tus mob "ischemic stroke" qhov tseem ceeb tshaj plaws yog kom rov qab tau cov ntshav mus rau lub hlwb sai li sai tau . Cov kws kho mob ua qhov no sai sai kom txo qhov kev pheej hmoo ntawm kev puas tsuaj rau lub hlwb mus tas li thiab kev tuag.

Cov kev kho mob sai

Ob txoj kev kho mob uas feem ntau siv yog:

1. Kev kho mob Thrombolytic: Cov no yog cov tshuaj uas ua rau cov ntshav nyias. Feem ntau cov kws kho mob tsuas yog muab cov no yog tias cov tsos mob pib tsis pub dhau plaub teev thiab ib nrab tom qab mob stroke. Qhov no yog vim tias lawv tuaj yeem ua rau muaj kev pheej hmoo ntawm kev los ntshav sab hauv.

2. Kev phais mob ntshav txhaws: Qhov no yog ib txoj kev phais mob. Tus kws phais mob muab ib lub raj me me, nyias nyias (catheter) ntxig rau hauv cov hlab ntsha qhov twg hauv koj lub cev (feem ntau yog hauv koj lub qhov ncauj) thiab coj nws mus rau cov ntshav txhaws hauv koj lub hlwb. Tom qab ntawd cov ntshav txhaws raug nqus tawm (zoo li 'lub tshuab nqus tsev') lossis tawg ua tej daim me me thiab tshem tawm.

Lwm yam kev kho mob

Tej zaum koj yuav xav tau lwm yam kev kho mob xws li:

• Cov tshuaj ua kom cov ntshav nyias: Cov no hu ua anticoagulants. Cov tshuaj no tiv thaiv koj cov ntshav kom tsis txhob khov yooj yim. Cov kws kho mob yuav muab cov tshuaj no rau koj tom qab koj tau noj cov tshuaj ua kom cov ntshav nyias lawm.
• Kev kho mob oxygen: Thaum muaj mob stroke, lub hlwb tsis tau txais oxygen txaus. Yog li cov kws kho mob tuaj yeem muab ib lub cuab yeej uas nkag mus rau hauv koj lub qhov ntswg thiab muab oxygen ntxiv rau koj. Qhov no ua rau nws yooj yim dua rau kev ua pa thiab pab rov qab tau oxygen rau lub hlwb.
• Kev tswj cov ntshav qab zib:Cov kws kho mob tsis tu ncua kuaj xyuas koj cov ntshav qab zib kom pab koj lub hlwb rov zoo.
• Kev ua kom lub cev kub me ntsis xwb: Qee zaum cov kws kho mob tuaj yeem txo koj lub cev kub me ntsis kom tsis txhob kub dhau. Qhov no tuaj yeem pab txo qhov kev puas tsuaj rau lub hlwb thaum thiab tom qab muaj mob stroke. Txawm li cas los xij, qhov no tsis tshua ua, tsuas yog ua rau qee kis tshwj xeeb xwb.

Peb puas yuav tsum paub txog kev kho mob stroke thiab?

Kev kho mob stroke yog ib qho tseem ceeb heev tom qab muaj mob stroke. Nws muab zog rau koj ntau los ntsib lub neej dua. Nws pab koj hloov kho rau cov kev hloov pauv uas tau tshwm sim rau koj lub hlwb thiab lub cev vim yog mob stroke. Tej zaum koj yuav tsum tau rov qab tau koj cov peev xwm yav dhau los lossis hloov kho rau kev nyob nrog cov kev tsis taus tshiab. Qhov no tuaj yeem ua tiav nrog kev pab los ntawm ntau tus kws kho mob:

• Kev Kho Mob Hais Lus: Qhov no pab txhim kho kev txawj hais lus, lus, thiab kev tswj cov leeg nqaij uas pab koj hais lus, ua pa, noj mov, thiab nqos.
• Kev Kho Mob Lub Cev: Qhov no pab kom cov leeg muaj zog, txhim kho kev sib npaug, thiab rov siv tau ceg.
• Kev kho mob ua haujlwm: Qhov no pab koj ua tiav cov haujlwm txhua hnub kom muaj kev nyab xeeb, tshwj xeeb yog cov haujlwm uas xav tau kev txav me me (piv txwv li, khawm lub tsho, sau ntawv).
• Kev kho mob hlwb: Qhov no pab txhim kho cov txuj ci kev puas siab puas ntsws xws li kev nco qab, kev mloog zoo, thiab kev daws teeb meem.

Peb yuav tiv thaiv peb tus kheej li cas ntawm tus kab mob 'Ischemic Stroke' no?

Kev tswj kom muaj kev noj qab haus huv zoo yog txoj hauv kev zoo tshaj plaws los txo koj txoj kev pheej hmoo ntawm kev muaj mob stroke ischemic. Sim ua cov no:

• Tswj koj cov ntshav siab, cov roj cholesterol , thiab txhua yam mob uas koj muaj (xws li ntshav qab zib) kom zoo.
• Noj cov zaub mov uas muaj txiaj ntsig zoo (xws li cov zaub mov Mediterranean, uas muaj ntau zaub, txiv hmab txiv ntoo, taum pauv, thiab cov nplej tag nrho) thiab tswj koj qhov hnyav kom zoo uas haum rau koj.
• Tsum haus luam yeeb kiag li thiab nyob deb ntawm cov chaw uas koj ua pa luam yeeb.
• Ua si nawv tsis tu ncua. Txawm tias yog ib yam yooj yim xws li taug kev li 30 feeb hauv ib hnub los kuj zoo.
• Txwv lossis tsum tsis txhob haus cawv kiag li .

Mus ntsib kws kho mob tsawg kawg ib xyoos ib zaug (lossis ntau zaus raws li koj tus kws kho mob pom zoo) kom kuaj xyuas koj tus mob. Muaj ntau yam mob uas ua rau mob stroke tuaj yeem tshwm sim raws sijhawm thiab hnyav zuj zus yam tsis tau koj paub txog. Muaj ntau tus neeg uas muaj ntshav siab thiab roj cholesterol ntau tsis muaj tsos mob dab tsi. Koj tus kws kho mob tuaj yeem pab koj txheeb xyuas cov cim ceeb toom no thaum ntxov, tswj lawv, thiab txo koj txoj kev pheej hmoo ntawm mob stroke tom qab.

Lub zeem muag ntawm kev rov zoo yog dab tsi?

Nws nyuaj rau hais tias tus nqi rov zoo uas haum rau txhua tus. '(Ischemic Stroke)' tuaj yeem ua rau tuag taus thiab ua rau muaj kev tsis taus mus tas li. Tab sis tsis yog txhua tus muaj lub sijhawm rov zoo lossis kev cia siab tib yam. Kev kho mob sai dua, qhov muaj feem yuav rov zoo dua.

Feem ntau cov mob stroke uas mob ischemic stroke muaj cov txiaj ntsig zoo dua li cov mob stroke uas los ntawm cov ntshav. Tab sis qhov ntawd tsis tau txhais hais tias koj txoj kev kho mob yuav yooj yim dua, sai dua, lossis zoo dua.

Yuav siv sijhawm ntev npaum li cas thiaj kho tau?

Txhua tus neeg lub cev teb txawv rau mob stroke. Yam koj yuav xav tau (qhov 'kev kwv yees') nyob ntawm ntau yam:

• Koj muaj hom mob "Ischemic Stroke" hom twg?
• Nws cuam tshuam rau qhov twg ntawm koj lub hlwb?
• Koj tau txais kev kho mob sai npaum li cas.
• Koj txoj kev noj qab haus huv tag nrho.

Feem ntau cov neeg yuav zoo los ntawm kev mob stroke hauv ob peb lub hlis. Feem ntau kev zoo rov qab los tshwm sim hauv peb mus rau rau lub hlis tom qab mob stroke. Txawm li cas los xij, cov tsos mob thiab cov kev mob tshwm sim tuaj yeem kav ntev li ib xyoos lossis ntau dua. Mob stroke kuj tseem tuaj yeem ua rau muaj kev tsis taus mus tas li thiab hloov pauv txoj kev koj siv koj lub cev.

Koj tus kws kho mob yuav qhia koj seb koj yuav tsum xav li cas. Nws yuav pab koj teem cov hom phiaj thiab kev cia siab uas tsim nyog rau koj txoj kev noj qab haus huv thiab koj tus mob.

Kuv yuav saib xyuas kuv tus kheej li cas tom qab mob stroke?

Kev kho mob thiab kev kho kom rov zoo tom qab mob stroke yog ib txoj haujlwm ntau heev. Koj txoj kev cog lus thiab kev txhawb nqa ntawm koj tsev neeg yog qhov tseem ceeb heev. Thaum koj thiab koj tus kws kho mob tau tsim ib txoj kev npaj kho mob, ua raws li nws kom ze li sai tau.

• Noj koj cov tshuaj kom raug thiab raws sijhawm, tshwj xeeb tshaj yog tias koj noj cov tshuaj ua kom cov ntshav nyias. Qhov no yog ib qho tseem ceeb kom txo qhov kev pheej hmoo ntawm cov ntshav txhaws yav tom ntej, thiab noj koj cov tshuaj raws li koj tus kws kho mob qhia koj kuj yuav pab koj lub cev kho.
• Nco ntsoov mus rau koj qhov chaw kho mob thiab lwm qhov chaw teem caij kho mob. Qhia rau koj cov kws kho mob yog tias muaj dab tsi ua rau koj tsis xis nyob lossis tsis muaj kev nyab xeeb. Kev kho kom rov zoo yog ib txoj haujlwm nyuaj, tab sis koj tsis tas yuav mob lossis tsis xis nyob txhua lub sijhawm.
• Xav txog koj txoj kev noj qab haus huv ntawm lub hlwb thiab. Kev nyuaj siab thiab kev ntxhov siab yog ib txwm muaj tom qab muaj mob stroke. Kev tu siab, kev chim siab, lossis kev npau taws tsis tau txhais hais tias koj tsis muaj zog lossis swb. Cov kev xav ntawd yog ib txwm muaj. Koj txoj kev noj qab haus huv ntawm lub hlwb tseem ceeb ib yam li koj txoj kev noj qab haus huv ntawm lub cev. Yog tias koj tab tom tawm tsam txiav txim siab txog qee yam thaum koj rov zoo, tham nrog koj tus kws kho mob lossis tus kws pab tswv yim txog kev noj qab haus huv ntawm lub hlwb . Nws tuaj yeem pab tau zoo heev.

Kuv yuav tsum tshem tawm cov khoom noj thiab dej haus twg?

Koj tus kws kho mob yuav qhia koj kom ntxiv lossis tshem tawm qee yam khoom noj ntawm koj cov zaub mov noj. Nws kuj tseem yuav qhia koj kom hloov me ntsis rau koj txoj kev ua neej txhua hnub kom pab tswj koj cov mob, lossis kom txo koj txoj kev pheej hmoo ntawm kev mob ntshav ntxiv tom qab muaj mob stroke ischemic.

Cov khoom noj thiab dej haus uas feem ntau pom zoo kom tshem tawm lossis txo qis yog:

• Cov khoom noj uas muaj ntsev ntau (sodium). (txiv lws suav, ntses qhuav, kua ntses, khoom noj ntim)
• Cov khoom noj uas muaj suab thaj ntau (dej qab zib, ncuav mog qab zib, ncuav qab zib, toffee)
• Cov khoom noj uas tau ua tiav ntau heev ( xws li cov hnyuv ntxwm, nqaij npua, nqaij pob)
• Cov khoom noj kib thiab cov khoom noj uas muaj cov rog trans (French fries, qee hom margarine)
• Cawv.
• Kev haus caffeine ntau dhau (nws yog qhov zoo tshaj plaws los txwv tshuaj yej thiab kas fes rau ob peb khob ib hnub)

Kuv yuav tsum mus rau qhov chaw kho mob thaum muaj xwm txheej ceev dua thaum twg?

Yog koj xav tias koj muaj mob stroke dua (raws li tau piav qhia hauv BE FAST ) hu rau 911 (lub tsheb thauj neeg mob thaum muaj xwm txheej ceev) tam sim ntawd, lossis mus rau chav kho mob ceev ze tshaj plaws. Qhov kev pheej hmoo ntawm kev mob hnyav thiab kev tuag yuav siab dua yog tias koj muaj mob stroke dua. Tsis txhob ncua sijhawm nrhiav kev pab lossis mus rau chav kho mob ceev.

Ib tug neeg uas tau muaj mob stroke ischemic muaj feem yuav muaj teeb meem loj dua. Piv txwv li:

• Mob ntsws o
• Cov ntshav txhaws hauv cov leeg ntshav tob ntawm ob txhais ceg (Deep Vein Thrombosis - DVT)
• Kev Mob Ntsws Plawv
• Mob plawv nres
• Qaug dab peg

Yog tias koj muaj cov tsos mob ntawm cov teeb meem no (piv txwv li, ua pa nyuaj, mob hauv siab, o ntawm ib ceg), koj yuav tsum hu rau cov kev pabcuam thaum muaj xwm txheej ceev lossis mus rau chav kho mob ceev tam sim ntawd.

Kuv yuav tsum nug kuv tus kws kho mob li cas?

Thaum koj mus ntsib koj tus kws kho mob, tsis txhob hnov ​​qab nug cov lus nug no:

• Ua cas kuv thiaj mob stroke?
• Tej yam zoo tshaj plaws uas kuv ua tau los txo qhov kev pheej hmoo ntawm kev muaj mob stroke dua yog dab tsi?
• Qhov no puas yuav muaj tej yam cuam tshuam rau kuv mus sij hawm ntev?
• Kuv yuav tsum tau kho mob stroke ntev npaum li cas?
• Kuv yuav tsum hloov dab tsi hauv kuv lub neej txhua hnub (noj mov, tawm dag zog, ua haujlwm tawm dag zog)?

Thaum kawg, tej yam uas yuav tsum nco ntsoov

Mob stroke yog ib qho txaus ntshai thiab hloov pauv lub neej. Txoj hauv kev zoo tshaj plaws los tiv thaiv mob stroke yog paub txog cov cim ceeb toom ntawm mob stroke thiab tswj koj cov yam ua rau muaj mob ua ntej nws tshwm sim. Mus ntsib koj tus kws kho mob tsawg kawg ib xyoos ib zaug thiab tau txais kev pab tswj txhua yam mob uas ua rau koj muaj feem mob stroke (xws li ntshav siab, ntshav qab zib, lossis roj cholesterol).

Yog koj muaj mob stroke, nws yuav zoo li koj lub ntiaj teb tag nrho tau hloov pauv lawm. Tab sis koj tseem yog koj tus kheej. Kev kho mob thiab kev kho kom rov zoo yog ib txoj haujlwm nyuaj, thiab tuaj yeem yog ib txoj kev taug kev ntev. Qee hnub yuav nyuaj dua lwm hnub. Tab sis tsis txhob hnov ​​​​​​qab ua kev zoo siab rau cov yeej me me uas koj muaj, cov hom phiaj tseem ceeb uas koj tau mus txog. Koj tsis nyob ib leeg, thiab koj muaj tsev neeg, phooj ywg, kws kho mob, thiab cov kws kho mob los pab koj.

Mob stroke, mob stroke ischemic, ntshav txhaws hauv lub hlwb, cov tsos mob, UA HAUJ LWM SAI, kev kho mob stroke, kev tiv thaiv mob stroke