Ukopha okungazelelwe ngaphakathi ekhanda? (I-Subarachnoid Hemorrhage - SAH) Namuhla sizoxoxa ngakho!

Wake waba nekhanda elibuhlungu ngokuzumayo, elibuhlungu kakhulu elizwakala sengathi ikhanda lakho liyaqhuma, noma sengathi umbani ukushayile? Abanye abantu bakubiza ngokuthi "ikhanda elibuhlungu elibi kakhulu empilweni yakho." Lokhu akulona ihlaya. Lokhu kungaba yisimo esiyingozi kakhulu. Kwezokwelapha, lesi simo sibizwa ngokuthi `(Subarachnoid Hemorrhage)` noma `(SAH)` . Lesi yisimo esiphuthumayo sezokwelapha ngempela. Ngakho-ke ake sixoxe ngalokhu ngemininingwane ethe xaxa, ngamazwi alula, kulungile?

Kuyini ngempela lokhu (i-Subarachnoid Hemorrhage)? Ake sikuqonde kalula, akunjalo?

Kalula nje, `(Subarachnoid Hemorrhage)` yilapho kukhona ukopha esikhaleni esiphakathi kobuchopho bethu kanye nolwelwesi oluncane olumboza ubuchopho . Cabanga ngakho, ubuchopho bethu bufana negugu eliyigugu. Ngakho ukuze sibuvikele, imvelo isinikeze izendlalelo ezintathu zolwelwesi oluncane olumboza. Lokhu sikubiza ngokuthi `(Meninges)`. Kufana nesikhumba sika-anyanisi, noma izendlalelo eziningana ezifana ne-husk kakhukhunathi.

Lezi zingxenye ezintathu ziyi:

• I-Dura mater: Lesi yisici sangaphandle esiqine kancane ngaphansi kwekhanda.
• I-Arachnoid mater: Lesi yisimbozo esiphakathi. Ulwelwesi oluthambile olufana nolwembu lwesicabucabu.
• I-Pia mater: Lesi yisici esincanyana kakhulu, esingaphakathi esinamathele ebuchosheni uqobo.

Manje, okwenzekayo kule `(Subarachnoid Hemorrhage)` ukuthi ukuphuma kwegazi kwenzeka ngaphansi kwe-arachnoid membrane phakathi (okungukuthi, esikhaleni se-"sub-arachnoid"). Lokhu kuyingozi kakhulu, ngoba lokhu ukuphuma kwegazi kungacindezela ubuchopho, futhi amangqamuzana obuchopho angonakala. Yingakho lokhu kubhekwa njengesimo esiphuthumayo sezokwelapha.

Uyini umehluko phakathi kwe-(Subarachnoid Hemorrhage) kanye ne-(Subdural Hematoma)?

Kungenzeka ukuthi uke wezwa ngesinye isimo esibizwa ngokuthi "i-Subdural Hematoma". Zombili ziphuma igazi ngaphakathi kobuchopho. Umehluko uwukuthi lapho ukuphuma kwegazi kwenzeka khona .

• Ku-"Subdural Hematoma", igazi ligeleza liye esikhaleni esingaphansi kwesembozo sangaphandle, i-"dura mater" esikhulume ngayo ekuqaleni.
• Ekuphumeni kwegazi okungaphansi kwe-subarachnoid, igazi ligeleza liye esikhaleni esingaphansi kwe-arachnoid membrane .

Izimpawu zakho kokubili ngezinye izikhathi zingafana, zombili zingabangela ukulimala kobuchopho, futhi zombili ziyizimo ezidinga ukwelashwa okuphuthumayo.

Ubani onamathuba amaningi okuthola i-SAH? Yiziphi izinto eziyingozi?

Lesi simo, esibizwa ngokuthi "i-Subarachnoid Hemorrhage," singavela kunoma ubani. Kodwa-ke, sivame kakhulu kubantu abaneminyaka ephakathi kuka-40 no-60 .

Ukulimala ekhanda (SAH) kuvame kakhulu kubantu abadala ngenxa yengozi eyengeziwe yokuwa nokulahlekelwa ibhalansi njengoba abantu bekhula. Phakathi kwabantu abasha, izingozi zezimoto ziyimbangela ehamba phambili.

Ngaphezu kwalokho, kunezinye izici eziningana eziyingozi ezingaba nomthelela ekuthuthukisweni kwe-SAH. Lezi yizi:

• Ukuba ne-aneurysm engaphazamiseki ebuchosheni bakho noma kwenye indawo emzimbeni wakho (i-aneurysm iwumthambo wegazi ovuvukala njengebhaluni).
• Ukuba nomlando we-aneurysm yobuchopho eqhume ngaphambilini.
• Ukubhema ugwayi. (Lokhu kuyimbangela yezifo eziningi, akunjalo?)
• Ukuba nomfutho wegazi ophezulu (Umfutho wegazi ophakeme). (Sithi "umfutho wegazi ophezulu").
• Ezinye izimo zofuzo, isibonelo, izifo zezicubu ezixhumeneyo njenge-``Fibromuscular dysplasia (FMD)`` kanye ne-``Ehlers-Danlos syndrome``.
• Ukuba nesifo sezinso esibizwa ngokuthi "(isifo sezinso se-Polycystic)".
• Ukusetshenziswa kwezidakamizwa ezifana ne-cocaine kanye/noma i-methamphetamine.
• Ukuphuza utshwala ngokweqile.
• Ukusetshenziswa kwemithi yokunciphisa igazi njenge-Warfarin (Lezi kufanele zisetshenziswe kuphela ngaphansi kweseluleko sikadokotela).
• Uma othile emndenini wakho eke waba ne-aneurysm (lokho kusho ukuthi unomlando oqinile womndeni).

Okubalulekile: Uma unesinye noma ngaphezulu salezi zici eziyingozi, akusho ukuthi nakanjani uzoba ne-SAH. Kodwa-ke, kusho ukuthi ingozi yakho iphakeme. Ngakho-ke, kubaluleke kakhulu ukufuna iseluleko sezokwelapha.

Yiziphi izimpawu zalesi simo esiyingozi? Uzibona kanjani?

Uphawu oluyinhloko noluyingozi kakhulu lokopha kwegazi ngaphansi kwe-subarachnoid "ikhanda elibuhlungu kakhulu" esikhulume ngalo ekuqaleni. Lokhu kukhanda elibuhlungu kakhulu, elingazelelwe. Kungase kuzwakale sengathi kukhona okuqhumayo ngaphakathi ekhanda lakho. Abantu abaningi bathi, "Angikaze ngibe nekhanda elibuhlungu kanje empilweni yami."

Uma uzwa ubuhlungu bekhanda obukhulu, obungazelelwe njengalobu, ikakhulukazi uma unezinye izimpawu ezibalwe ngezansi, sicela ushayele ku-911 (1990 Suwaseriya eSri Lanka) ngaphandle kokulibala, noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha okukhulu. Lokhu kungasindisa impilo yakho!

Ezinye izimpawu yilezi:

• Ukuncipha kokuqwasha kanye nobunzima bokuhlala uphapheme.
• Isicanucanu nokuhlanza.
• Ukuzwa ukuqina kwentamo, ubunzima bokugoba intamo (Intamo eqinile) .
• Ukuzizwa sengathi ulahlekelwa yimpilo yakho ngokuzumayo.
• Ukushintsha kwesimo sengqondo kanye nobuntu (isib., ukucasuka, ukucasuka).
• Isiyezi .
• I-Photophobia (ukuzwela kwamehlo ekukhanyeni okukhulu) .
• Ubuhlungu bemisipha , ikakhulukazi entanyeni nasemahlombe.
• Ukungabi namandla kwengxenye yomzimba.
• Ukuba nesithuthwane (ukuxhuzula) `(Ukuxhuzula)` .
• Ukushintsha kombono : Ukubona kabili, amabala amnyama embonweni, ukulahlekelwa okwesikhashana kombono kwelinye iso.

Uma eyodwa noma ngaphezulu yalezi zimpawu ihambisana nalelo khanda elibuhlungu kakhulu, kunethuba elikhulu lokuthi yi-SAH.

Kungani lokhu (i-Subarachnoid Hemorrhage) kwenzeka? Yiziphi izimbangela eziyinhloko?

Kunezizathu ezimbili eziyinhloko zokuthi kungani kwenzeka ukopha kwe-subarachnoid.

1. Ukulimala ekhanda: Lena imbangela evame kakhulu. Isibonelo, ukuwa okukhulu noma ingozi yemoto kungabangela ukushayeka okukhulu ekhanda.

2. Ukuqhekeka kwe-aneurysm yobuchopho: Lokhu futhi kuyimbangela evame kakhulu. Njengoba sishilo ngaphambili, i-aneurysm yindawo ebuthakathaka odongeni lomthambo wegazi ebuchosheni evuvukala njengebhaluni. Uma iqhuma ngokuzumayo, igazi ligeleza ngqo esikhaleni esingaphansi kwe-arachnoid membrane. Lesi yimbangela yokuqhekeka kwe-aneurysm okungazelelwe (SAH) okungazelelwe ngaphandle kokulimala ekhanda.

Ngaphezu kwalezi zizathu ezimbili eziyinhloko, kunezinye izizathu eziningana ezingavamile:

• Ukopha okuvela endaweni ephithene yemithambo yegazi. Lokhu kubizwa ngokuthi ``i-Arteriovenous malformation (AVM)``.
• Ezinye izinkinga zokopha.
• Ukusetshenziswa kwemithi yokunciphisa igazi (uma isetshenziswa ngaphandle kweseluleko sikadokotela).
• Ukusetshenziswa kwezidakamizwa ezifana ne-cocaine kanye/noma i-methamphetamine.

Odokotela bakuthola kanjani lokhu? Yiziphi izivivinyo abazenzayo?

Uma, ngemva kokubukeza izimpawu zakho kanye nokuhlolwa kokuqala, udokotela esola ukuthi une-"Subarachnoid Hemorrhage", uzoyala ngokushesha ukuthi "uhlolwe nge-CT" (i-Computerized Tomography scan).

I-CT scan ingathatha izithombe ezinemininingwane zezicubu zomzimba wethu. I-CT scan yobuchopho iyindlela ephumelela kakhulu yokubona ukuthi ikhona yini i-SAH. Ngezinye izikhathi, i-CT angiography (CTA) scan, ehilela ukufaka uketshezi olukhethekile emthanjeni, ingabheka nesimo semithambo yegazi.

Kodwa-ke, uma kuyi-SAH encane kakhulu, noma uma kwenzeke kungakapheli amasonto amabili edlule, kungase kungatholakali nge-CT scan. Uma kunjalo, udokotela kungadingeka enze ezinye izivivinyo ezimbalwa.

Kunjalo:

• Ukubhoboza i-Lumbar: Lokhu kuhilela ukufaka inalithi encane kakhulu emhlane wakho ongezansi bese uthatha isampula yoketshezi oluzungeze ubuchopho bakho kanye nomgogodla (olubizwa ngokuthi uketshezi lwe-cerebrospinal - CSF). Lolu ketshezi lube seluhlolwa i-xanthochromia (ukubukeka okuphuzi). Uma lukhona, kungasho ukuthi une-SAH.
• Ukuthwebula izithombe ze-Brain magnetic resonance (MRI): Lokhu kungahlola nokukhipha igazi ebuchosheni muva nje.

Uma i-SAH isitholakele, ukwelashwa esibhedlela kuqala ngokuthola nokwelapha imbangela, kanye nokuphatha noma yiziphi izinkinga ezingase zivele. Ngenxa yokuthi ama-SAH angaphezu kuka-80% angenalo ukulimala ekhanda abangelwa yi-aneurysm, odokotela bavame ukwenza ukuhlolwa okubizwa ngokuthi i-cerebral angiogram, ethatha izithombe zemithambo yegazi ebuchosheni, futhi yelaphe i-aneurysm.

Yiziphi izindlela zokwelapha lokhu? Kuzothatha isikhathi esingakanani ukululama?

Ukopha kwe-Subarachnoid kuyisimo esiphuthumayo esisongela ukuphila futhi ngokuvamile kwelashwa egunjini lokunakekelwa okujulile esibhedlela (ICU) , lapho kunolwazi khona ngezifo zezinzwa. Imigomo eyinhloko yokwelashwa yile:

• Ukusindisa impilo yakho.
• Thola imbangela yokopha bese uyelapha.
• Ukuqeda izimpawu.
• Ukuvimbela izinkinga (isib. i-Vasospasm - ukuminyana kwemithambo yegazi, i-Hydrocephalus - ukunqwabelana koketshezi ebuchosheni, ukulimala kobuchopho unomphela).

Ukwelashwa okusindisa impilo kanye nokwelashwa kokulawula izimpawu kungafaka:

• Izinhlelo zokusekela impilo.
• Ukufaka ipayipi ukuze kuncishiswe ingcindezi ebuchosheni.
• Izindlela zokuvikela umgudu wokuphefumula.
• Umuthi wokunciphisa ukuvuvukala ngaphakathi kogebhezi.
• Imithi enikezwa ngemithambo ukuze kulawulwe umfutho wegazi.
• Imithi yokuvimbela ukuqaqamba kwemithambo yegazi.
• Ama-painkiller ekhanda kanye nemithi yokulwa nokukhathazeka.
• Imithi yokuvimbela noma yokwelapha ukuqina.

Ungase udinge nokuhlinzwa ukuze welaphe i-SAH kanye nembangela yayo:

• Uma i-SAH ibangelwa ukulimala, susa noma yimaphi amahlule amakhulu egazi aqongelelekile, noma wehlise ingcindezi ebuchosheni.
• Uma i-aneurysm iqhumile futhi yaba "i-SAH", lungisa i-aneurysm.

Ubude besikhathi ohlala ngaso esibhedlela buzohluka kuye ngesimo sakho sempilo. Iningi labantu abane-SAH lizohlala esibhedlela izinsuku eziyi-10 kuya kwezingama-20 , kuye ngesimo sabo nokuthi bayakudinga yini ukulungiswa.

Yini esingayenza ukuvimbela i-SAH ukuthi ingakhuli?

Iningi lamacala okopha kwe-subarachnoid abangelwa ukulimala ekhanda kanye/noma ukuqhekeka kwe-aneurysms yobuchopho. Ngakho-ke, into engcono kakhulu esingayenza ukuze sigweme ukopha kwe-subarachnoid ukuzama ukulawula izici eziyingozi zalezi zimo zombili.

Qaphela ukuthi ungalimazi ikhanda lakho:

• Gqoka isigqoko sokuzivikela njalo uma ugibela ibhayisikili, isithuthuthu, noma udlala imidlalo eyingozi kakhulu.
• Shayela ngokuphepha njalo futhi ulalele imithetho yomgwaqo.
• Uma uwa njalo, bonana nodokotela wezokwelapha ngokomzimba noma uchwepheshe wezokwelapha emsebenzini ukuze ufunde izindlela zokuvimbela ukuwa, nokwenza indawo yasekhaya lakho iphephe.

Ukunciphisa ingozi yokuba ne-aneurysm yobuchopho kanye/noma ukuvimbela i-aneurysm ekhona ukuthi ingaqhumi:

• Khuluma nodokotela wakho ngalokho ongakwenza ukuze uhlale uphilile. Uzovame ukuncoma okulandelayo:
• Lawula umfutho wegazi ophakeme (ngokusebenzisa imithi kanye nokushintsha indlela yokuphila).
• Gwema ukubhema.
• Vivinya umzimba njalo (kodwa gwema ukuphakamisa izinsimbi ezisindayo ngokuzumayo, ngoba lokhu kungabangela ukuqhuma kwe-aneurysm).
• Yidla ukudla okunempilo.
• Uma unezinkinga ngokusebenzisa utshwala noma izidakamizwa, thola usizo. Ungasebenzisi izinto ezivuselelayo njenge-cocaine.

Yini engalindelwa ngemva kwalesi simo? (Isibikezelo kanye Nezinkinga)

Isibikezelo ngemva kokuphuma kwegazi ngaphansi kwe-subarachnoid sincike embangela, ukuthi kukhulu kangakanani, nokuthi ngabe kukhona yini ezinye izinkinga noma ukulimala.

Lesi yisimo esibi kakhulu . Cishe ingxenye yabantu abathola i-SAH bafa ngokuzumayo . Kulabo abakwaziyo ukuya esibhedlela:

• Cishe ingxenye yesithathu ishonela esibhedlela.
• Cishe ingxenye eyodwa kwezintathu iphila nokukhubazeka okuthile.
• Cishe ingxenye eyodwa kwezintathu ibuyela esimweni esijwayelekile.

Izinkinga ezisheshayo ze-SAH yilezi:

• Ukuba nesicanucanu (Ukuquleka).
• I-Vasospasm (ukuncipha komthambo wegazi ebuchosheni, okuvimba ukugeleza kwegazi).
• Ukopha futhi ngemva kokwelashwa kokuqala.
• I-Hydrocephalus (ukunqwabelana koketshezi ebuchosheni).
• Ukwanda kwengcindezi yangaphakathi kwekhanda.
• Ukuqhekeka kobuchopho.
• Ukuhlaselwa yisifo sohlangothi/ischemic stroke kubangelwa ukwehla kokunikezwa kwegazi ebuchosheni.
• Ukufa.

Yiziphi izinkinga zesikhathi eside ze-SAH?

Ngenxa yokuthi ukuphuma kwegazi ngaphansi kwe-subarachnoid kungalimaza ubuchopho, kungabangela izinkinga zesikhathi eside, ngisho nezihlala njalo. Izinkinga ezingaba khona zesikhathi eside zifaka:

• Izinkinga zomzimba: Ukozela nokukhathala njalo, ukungazweli noma ubuthakathaka ezingxenyeni zomzimba, ubunzima bokugwinya, ukulahlekelwa ibhalansi.
• Izinkinga zokuqonda: izinkinga zenkumbulo, ubunzima bokugxilisa ingqondo, ubunzima bokuhlela nokwenza imisebenzi eyinkimbinkimbi.
• Ubunzima bokukhuluma: Inkulumo engacacile noma inkulumo ecothayo. Ubunzima bokuthola amagama owadingayo.
• Izinkinga zempilo yengqondo: I-SAH iwukuhlukumezeka okukhulu empilweni. Ingaholela ezimweni ezinjengokucindezeleka, ukukhathazeka okuvamile, kanye nesifo sokucindezeleka ngemva kwenhlekelele (PTSD).

Kunezindlela ezahlukene zokwelapha lezi zinkinga zesikhathi eside. Isibonelo:

• Ukwelashwa ngokomzimba.
• Ukwelashwa emsebenzini.
• Ukwelashwa ngenkulumo.
• Ukwelapha ngengqondo (ukwelapha ngokukhuluma).

Eminye imithi ingasiza kulokhu. Uma unezinkinga zalezi, khuluma nethimba lakho lezokwelapha.

Uma ingelashwa, i-SAH inethuba elingama-65% lokufa phakathi nonyaka. Kodwa-ke, uma ixilongiwe kahle futhi yelashwa, ithuba lokufa phakathi nonyaka lingancishiswa libe cishe yi-18%.

Uma utholakale une-SAH, kuzodingeka ubone ithimba lakho lezokwelapha njalo ukuze uqaphe impilo yakho kanye nenqubekela phambili. Ungase udinge nokwelashwa ngokomzimba, ngokomsebenzi, kanye/noma ngokwenkulumo uma kuvela izinkinga.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho-ke ngithemba ukuthi usuyaqonda kahle lokho esikhulume ngakho namuhla, `(I-Subarachnoid Hemorrhage).` Nazi ezinye zezinto ezibaluleke kakhulu okufanele uzikhumbule:

• Ikhanda elibuhlungu ngokuzumayo, elinzima, elizwakala ngokuduma kungaba uphawu oluyinhloko lwe-SAH.
• `(SAH)` kuyisimo esiphuthumayo sezokwelapha . Uma unezimpawu, funa usizo lwezokwelapha ngokushesha.
• Ukulimala ekhanda kanye nokuqhekeka kwemithambo yobuchopho yizona zimbangela eziyinhloko zalokhu.
• Ingozi yokuthola i-SAH ingancishiswa ngokulawula izici eziyingozi kanye nokulandela indlela yokuphila ephephile.
• Nakuba lesi simo sibucayi, kukhona ithuba lokusindisa izimpilo nokuphila impilo enhle ngokwelashwa okusheshayo kanye nokuvuselelwa okufanele.

Ngakho-ke, qaphela nalokhu. Uma wena noma othile omaziyo eba nanoma yiziphi zalezi zimpawu, thatha isinyathelo ngokushesha. Hlala uphilile!

` Ukopha Okungaphansi Kwe-Subarachnoid, I-SAH, Ukopha Ubuchopho, Ikhanda Elibuhlungu, I-Aneurysm Yobuchopho, Ukwelashwa Okuphuthumayo, Ukulimala Ekhanda, Ukumbozwa Kobuchopho