Ngaba wakha waba nentloko ebuhlungu ngequbuliso, ebuhlungu, evakala ngathi ngumbane obetha entloko yakho? Abantu abaninzi bayichaza "njengentloko ebuhlungu kakhulu owakha waba nayo." Intloko ebuhlungu ngequbuliso efana nale yinto esingafanele siyithathe lula. Inokuba luphawu lokopha kakhulu engqondweni. Namhlanje, siza kuthetha ngenye yeengxaki zonyango, i-subarachnoid hemorrhage (SAH).
Ngamafutshane, yintoni iSubarachnoid Hemorrhage (SAH)?
Kulungile, eli gama lisenokuvakala liyinkimbinkimbi kancinci, kodwa masiligcine lilula. Ingqondo yakho ayihlali nje ngasemva kwentloko yakho. Ikhuselwe sisigqubuthelo esineengqimba ezintathu zezicubu. Ngokwezonyango, oku sikubiza ngokuba yi-meninges.
Cinga ngayo njengetswele. Inxalenye engaphakathi yetswele inesikhumba esincinci esijikelezileyo, kwaye yiyo loo ndlela ezi membranes zifumaneka ngayo zijikeleze ingqondo.
1. I-Dura mater: Le yinwebu engaphandle, enamandla elele phantsi nje kwekhakayi.
2. I-Arachnoid: Le yi-membrane ebhityileyo, efana ne-spider-web embindini.
3. I-Pia mater: Le yi-membrane engaphakathi enamathele kwizicubu zobuchopho ngokwayo.
Ngoku, isithuba esiphakathi kwe-arachnoid membrane embindini kunye ne-pia mater kumaleko ongaphakathi sibizwa ngokuba yi-'Subarachnoid space'. 'Sub` ithetha "phantsi". Ngoko ke oku kubhekisa kwindawo engaphantsi kwe-arachnoid membrane. Ukuba ngesizathu esithile, ukuphuma kwegazi kwenzeka kule ndawo, yiloo nto siyibiza ngokuba yi-Subarachnoid Hemorrhage (SAH) .
Le yingxamiseko yezonyango enzulu kakhulu nesongela ubomi. Ukuba ufumana ezi mpawu, kuya kufuneka uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele ngaphandle kokulibazisa.
Yintoni umahluko phakathi kwe-SAH kunye ne-Subdural Hematoma?
Usenokuba ukhe weva ngemeko ebizwa ngokuba yi-'Subdural Hematoma'. Zombini ziphuma igazi kwindawo yengqondo. Kodwa umahluko kukuba kwenzeka phi ukopha. Masiyichaze ngokucacileyo le nto.
| Uphawu | Ukopha kwegazi okungaphantsi kweSubarachnoid (SAH) | I-Hematoma engaphantsi kwe-subdural |
|---|---|---|
| Ingongoma yokopha | Ngaphantsi kwe-membrane ye-arachnoid (kwisithuba se-subarachnoid) | Ngaphantsi kwe-dura mater (kwisithuba esingaphantsi kwe-dural) |
| Uphawu oluphambili | Intloko ebuhlungu kakhulu | Intloko isenokukhula kancinci kancinci, ukudideka, kwaye ubuthathaka bunokubakho. |
| Rhoqo isizathu | Ukuqhuma kwe-brain aneurysm okanye ukwenzakala entloko. | Umthambo oqhekekileyo, odla ngokubangelwa kukwenzakala entloko. |
Iimpawu zezi meko zombini ngamanye amaxesha ziyafana. Kwaye zombini ziimeko ezingxamisekileyo ezinokubangela umonakalo engqondweni. Ngoko ke kubalulekile ukufuna ingcebiso kagqirha ngokukhawuleza xa iimpawu zibonakala.
Ngubani onokuthi abe nale meko? Zithini izinto ezinokubangela umngcipheko?
Nangona nabani na enokuba ne-subarachnoid hemorrhage (SAH), ixhaphake kakhulu kubantu abaphakathi kweminyaka engama-40 ukuya kwengama-60 .
I-SAH idla ngokubangelwa kukwenzakala entloko kubantu abadala. Inokwenzeka xa bewa baze babetheke entloko. Kubantu abancinci, imbangela ephambili ziingozi zezithuthi.
Ukongeza, kukho nezinye izinto ezininzi ezibangela umngcipheko wokuba ne-SAH. Masibone ukuba zithini.
- Ukuba ne-aneurysm engaqhekekanga engqondweni okanye kwenye indawo emzimbeni: I-aneurysm kubuthathaka kodonga lomthambo wegazi oluvuthuluka njengebhaluni. Oku kungaqhuma nangaliphi na ixesha.
- Ukuba nembali ye-brain aneurysm eyayiqhuma ngaphambili.
- Ukutshaya: Ukutshaya kuyayonakalisa kakhulu imithambo yegazi.
- Uxinzelelo lwegazi oluphezulu (iHypertension): Uxinzelelo lwegazi oluphezulu olungalawulwayo lungonakalisa imithambo yegazi, lunyuse umngcipheko wokwakheka nokuqhuma kwe-aneurysms.
- Ezinye iimeko zemfuza: Izifo ezichaphazela izicwili ezidityanisiweyo, ezifana neFibromuscular Dysplasia (FMD) kunye ne-Ehlers-Danlos syndrome.
- Ukuba nesifo sezintso esinePolycystic.
- Ukusetyenziswa kweziyobisi: Ingakumbi iziyobisi ezivuselelayo ezifana ne-cocaine kunye ne-methamphetamine.
- Ukusela utywala ngokugqithisileyo.
- Ukusetyenziswa kwamayeza okunciphisa igazi: Umzekelo, iWarfarin.
- Ukuba nembali eqinileyo yosapho ene-aneurysms.
Zithini iimpawu ze-SAH?
Njengoko besitshilo ngaphambili, uphawu oluphambili nolukhawuleza kakhulu yintloko ebuhlungu ngequbuliso ebizwa ngokuba yi-"Thunderclap Headache." Oku kufikelela kwintlungu yayo ephezulu kwimizuzwana embalwa.
Khawucinge nje, wenza umsebenzi wakho wesiqhelo. Ngaphandle kwesilumkiso, ngequbuliso, uziva intlungu ebukhali entlokweni yakho, ngokungathi kukho ibhombu eqhume ngaphakathi kuwe, okanye umntu ukubethe ngesando. Yindlela oku kuvakala ngayo oku.
Ukuba unenye okanye ngaphezulu kwezi mpawu zilandelayo kunye nentloko ebuhlungu efana nale, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko. Le asinto onokulinda ekhaya.
| Udidi lweempawu | Inkcazo |
|---|---|
| Iingxaki ezinxulumene nokuqonda | Ukuncipha kwengqondo, ukozela, ukulahlekelwa yingqwalasela kwinto eyenzekayo kufutshane, ukulahlekelwa yingqondo. |
| Iimpawu zomzimba | Ukucaphuka nokuhlanza, ukuqina kwentamo (ubunzima bokugoba intamo), ubuthathaka ngequbuliso, ukungaziva mnandi kwinxalenye yomzimba. |
| Utshintsho lwengqondo kunye nokuziphatha | Utshintsho kwindlela ovakalelwa ngayo kunye nobuntu bakho, umsindo okhawulezileyo, kunye nokulahlekelwa yinkumbulo. |
| Iingxaki zokubona | Uvelwano ekukhanyeni okuqaqambileyo (i-Photophobia), ukubona kabini, amabala amnyama embonweni, ukulahleka kombono okwexeshana kwelinye iliso. |
| Ezinye iimpawu | Ukudinwa, iintlungu zemisipha (ingakumbi entanyeni nasemagxeni), ukuxhuzula. |
Zithini izizathu eziphambili ze-SAH?
Ngoku makhe sijonge izizathu eziphambili zale meko iyingozi.
- Ukulimala kakhulu entloko: Eyona nto ixhaphakileyo yi-SAH kukubetheka kakhulu entloko, njengokuwa kakhulu okanye ingozi yemoto.
- Ukuqhekeka kwe-Aneurysm: Le yimbangela yokuba malunga ne-85% yee-SAHs zenzeka ngaphandle kwengozi. Indawo ebuthathaka kwimithambo yegazi ebuchotsheni idumba njengebhaluni ize iqhume ngequbuliso. Igazi emva koko livuza kwindawo engaphantsi kwe-subarachnoid phantsi koxinzelelo oluphezulu.
- Ukungaqheleki kwemithambo yegazi: Ukopha kwegazi kunokubakho ngenxa yeemeko apho imithambo yegazi idityaniswe khona, njenge-arteriovenous malformation (AVM).
- Iingxaki zokopha: Iimeko apho igazi lingajiyi lula.
- Ukusetyenziswa kwamayeza okunciphisa igazi.
- Ukusetyenziswa kweziyobisi: Iziyobisi ezifana ne-cocaine zinokubangela ukunyuka ngesiquphe koxinzelelo lwegazi kwaye zibangele ukuba imithambo yegazi iqhume.
Oogqirha bayixilonga njani le sifo?
Xa usiya esibhedlele uneempawu ezinje, oogqirha bakuthatha njengento engxamisekileyo baze benze uvavanyo ngokukhawuleza.
1. I-CT Scan (i-Computerized Tomography Scan): Olu luvavanyo lokuqala nolubaluleke kakhulu. Olu luthatha imifanekiso yangaphakathi entloko kwaye lunokubona ngokucacileyo ukuba kukho igazi elijikeleze ubuchopho. Ngamanye amaxesha kwenziwa i-scan ekhethekileyo ebizwa ngokuba yi-CT Angiography (CTA). Kule meko, kufakwa idayi emthanjeni ukujonga imeko yemithambo yegazi.
2. Ukubhaqwa Kweempundu: Ngamanye amaxesha i-CT scan isenokungafumani ukopha okuncinci kakhulu. Kwiimeko ezinjalo, oogqirha benza olu vavanyo. Kule meko, kufakwa inaliti encinci kakhulu emqolo ongezantsi kwaye kususwe ulwelo lwe-cerebrospinal (CSF) kwindawo ejikeleze ingqondo kunye nomqolo. Ulwelo lujongwa ukuba alunazo iiseli zegazi ezibomvu okanye i-xanthochromia (ukutyheli). Olu lwelo lujika lube tyheli emva kwexesha elifutshane lokopha.
3. I-MRI Scan (I-Magnetic Resonance Imaging): Ukuba kukho ukurhanelwa kokopha okusandul’ ukuphuma, olu vavanyo lunokukufumanisa.
Nje ukuba uxilongo luqinisekiswe, iimvavanyo ezongezelelweyo, ezifana ne-cerebral angiogram, zinokwenziwa ukuze kuchongwe unobangela ochanekileyo wokopha.
Iphathwa njani?
Ngenxa yokuba i-SAH isongela ubomi, isigulana sidla ngokungeniswa kwigumbi lonyango olunzima (ICU) lesibhedlele kwaye sinyangwa liqela loogqirha abagxile kwizifo zemithambo-luvo. Iinjongo eziphambili zonyango zezi:
- Ukusindisa ubomi besigulana.
- Lungisa unobangela wokopha.
- Ukulawula iimpawu.
- Ukuthintela iingxaki (umz. i-vasospasm, i-hydrocephalus).
Unyango lokusindisa ubomi nokulawula iimpawu:
- Ukubonelela ngenkxaso yobomi.
- Ukufaka ityhubhu yokukhupha amanzi ukuze kuncitshiswe uxinzelelo engqondweni.
- Ukuthatha amanyathelo okukhusela indlela yokuphefumla.
- Ukunika amayeza okulawula uxinzelelo lwegazi nge-IV (efakwa emithanjeni).
- Ukunika amayeza okuthintela ukuxinana kwemithambo yegazi (vasospasm).
- Ukunika amayeza okuthomalalisa iintlungu kunye namayeza okulwa nokuxhalaba xa uneentloko ezibuhlungu kakhulu.
- Ukunika amayeza okuthintela okanye okulawula ukuxhuzula.
Unyango lwembangela yokopha:
- Ukuba i-aneurysm iqhumile: Kwenziwa utyando ukuze ilungiswe. Oku kungenziwa kusetyenziswa iindlela ezifana ne-'Surgical Clipping' (ukuvala intamo ye-aneurysm nge-clip) okanye i-'Endovascular Coiling' (ukuvala i-aneurysm nge-wire coil ngemithambo yegazi).
- Ukuba igazi liqokelelene ngenxa yengozi: Kunokufuneka utyando ukuze kuncitshiswe uxinzelelo engqondweni kwaye kususwe igazi eliqokeleleneyo.
Ngokwesiqhelo, umntu one-SAH unokufuna ukuhlala esibhedlele iintsuku ezili-10 ukuya kwezingama-20 nangaphezulu, kuxhomekeke kwimeko yakhe kunye neemfuno zakhe zokubuyisela impilo.
Zithini iziphumo kunye neengxaki ezihlala ixesha elide zale meko?
Le yimeko embi kakhulu. Ngokwezibalo, malunga nesiqingatha sabantu abane-SAH bafa ngequbuliso. Kwabo beza esibhedlele:
- Isinye kwisithathu sifela esibhedlele.
- Umntu omnye kwabathathu uphila ubomi obuthile enokukhubazeka okuthile.
- Isinye kwisithathu sibuyela kubomi obuqhelekileyo.
I-SAH inokubangela umonakalo engqondweni, nto leyo enokubangela iingxaki ezihlala ixesha elide okanye ezingapheliyo.
- Iingxaki zomzimba: Ukudinwa nokulala rhoqo, ukungaziva okanye ubuthathaka kwiindawo zomzimba, ubunzima bokuginya, ukulahlekelwa yibhalansi.
- Imiba yokuqonda: iingxaki zenkumbulo, ubunzima bokugxila, ubunzima bokucwangcisa nokwenza imisebenzi enzima.
- Ubunzima bokuthetha: intetho engacacanga, intetho ecothayo, ubunzima bokufumana amagama afanelekileyo.
- Iingxaki zempilo yengqondo: Ekubeni le yintlungu enkulu ebomini, iimeko ezinje ngokudakumba, ixhala eliqhelekileyo, kunye nesifo soxinzelelo emva kwengozi (PTSD) zinokwenzeka.
Ukulawula ezi ngxaki zexesha elide, unyango olufana nonyango lomzimba, unyango lomsebenzi, unyango lokuthetha, kunye nonyango lwengqondo lunokubonelela ngoncedo olukhulu.
Singenza ntoni ukunciphisa umngcipheko?
Ekubeni izizathu eziphambili ze-SAH kukwenzakala entloko kunye nokuqhekeka kwe-aneurysm, kungcono ukuthatha amanyathelo okuthintela zombini ezi ziganeko.
Ukuthintela ukwenzakala entloko:
- Nxiba isigcina-ntloko rhoqo xa ukhwela iibhayisekile okanye iibhayisekile okanye udlala imidlalo enobungozi.
- Qhuba ngokukhuselekileyo kwaye uthobele imithetho yendlela.
- Ukuba uwela rhoqo, cela ingcebiso kugqirha wezonyango kwaye ufunde iindlela zokuthintela ukuwa nokwenza ikhaya lakho likhuseleke ngakumbi.
Ukunciphisa umngcipheko we-aneurysm:
- Lawula uxinzelelo lwegazi oluphezulu. Sela amayeza akho njengoko ugqirha wakho ekuyalele. Yenza utshintsho kwindlela ophila ngayo (nciphisa ukutya ityuwa, yenza umthambo).
- Yeka ukutshaya ngokupheleleyo.
- Zilolonge rhoqo, kodwa kuphephe ukuphakamisa iintsimbi ezinzima ngaxeshanye, kuba ukuzilolonga kakhulu kunokubangela ukuba i-aneurysm iqhume.
- Yitya ukutya okunesondlo.
- Kuphephe ngokupheleleyo ukusebenzisa utywala neziyobisi, ingakumbi izinto ezivuselela ingqondo ezifana ne-cocaine.
Ukuba ugqirha wakho ukuxelele ukuba une-aneurysm engaqhekekanga, thetha naye malunga neendlela zonyango kunye neendlela zokulawula ezikhoyo.
Umyalezo Wokuya Ekhaya
- Ukopha kwegazi okungaphantsi kwe-subarachnoid (SAH) kukopha phakathi kwengqondo kunye nee-membrane ezijikelezileyo. Le yimeko yezonyango engxamisekileyo neyingozi kakhulu.
- Uphawu oluphambili yintlungu ebuhlungu ngequbuliso, "intloko ebuhlungu kakhulu" echazwa njengeyona ntloko ibuhlungu ebomini bam.
- Ukuba uneempawu ezifana nesicaphucaphu, ukuhlanza, ukuqina kwentamo, kunye nokulahlekelwa zingqondo kunye nolu hlobo lwentloko ebuhlungu, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko.
- Izizathu eziphambili kukwenzakala entloko kunye nokuqhekeka kwe-aneurysms yobuchopho.
- Ukulawula uxinzelelo lwegazi oluphezulu, ukuphepha ukutshaya, kunye nokuphepha ukusebenzisa iziyobisi kunokunciphisa umngcipheko.
- Ukuxilongwa kwangoko kunye nonyango olufanelekileyo kwandisa amathuba okusindisa ubomi kunye nokunciphisa iingxaki.
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