Isifo sohlangothi, isimo esibi kakhulu esibonakala ngokuncipha okungazelelwe kokunikezwa kwegazi ezicutshini zobuchopho ngenxa yesifo sokopha noma i-ischemic pathology, siyimbangela yesibili ehamba phambili yokufa emhlabeni wonke kanye nembangela yesithathu ehamba phambili yokukhubazeka. Izinhlobo ezimbili eziyinhloko zesifo sohlangothi yisifo sohlangothi esibangelwa yi-ischemic (esingu-68%) kanye nesifo sohlangothi esibangelwa yi-hemorrhagic (32%). Naphezu kwe-pathophysiology yazo ehlukene ezigabeni zokuqala, zombili ekugcineni ziholela ekunciphiseni kokunikezwa kwegazi kanye ne-cerebral ischemia elandelayo ngesikhathi sesigaba se-subacute kanye nesigaba esingamahlalakhona.
I-Ischemic Stroke
I-Ischemic stroke (AIS) iphawulwa ukuvaleka okungazelelwe komthambo wegazi, okuholela ekulimaleni kwe-ischemic endaweni ethintekile. Esigabeni esiphuthumayo, le ndawo eyinhloko ye-hypoxic ibangela uchungechunge lwe-excitotoxicity, ukucindezeleka kwe-oxidative, kanye nokusebenza kwe-microglia, okuholela ekufeni okusabalele kwe-neuronal. Ngesikhathi sesigaba se-subacute, ukukhishwa kwama-cytokines, ama-chemokines, kanye nama-matrix metalloproteinases (ama-MMP) kungasiza ekuvuvukeni kwe-neuroinflammation. Okuphawulekayo ukuthi amazinga aphezulu e-MMPs akhulisa ukungena kwesithiyo segazi-ubuchopho (i-BBB), okuvumela ukufuduka kwe-leukocyte endaweni ethintekile, okwandisa umsebenzi wokuvuvukala.
Ukwelashwa Kwamanje Kwesifo Sokushaywa Yisifo Sohlangothi
Izindlela zokwelapha eziyinhloko ezisebenzayo ze-AIS zifaka phakathi i-thrombolysis kanye ne-thrombectomy. I-thrombolysis ye-intravenous ingazuzisa iziguli zingakapheli amahora angu-4.5, lapho ukwelashwa kwasekuqaleni kuholela ezinzuzweni ezinkulu. Uma kuqhathaniswa ne-thrombolysis, i-thrombectomy yemishini inefasitela lokwelashwa elibanzi. Ngaphezu kwalokho, izindlela zokwelapha ezingezona ezemithi, ezingangenisi igazi ezifanaukwelashwa komoya-mpilo, i-acupuncture, kanye nokuvuselelwa kukagesi sekuya ngokuya kuthandwa njengezindlela zokwelapha ezihambisana nezindlela ezivamile.
Izisekelo Zokwelashwa Nge-Hyperbaric Oxygen (HBOT)
Ekucindezelweni kolwandle (1 ATA = 101.3 kPa), umoya esiwuphefumulayo uqukethe cishe u-21% we-oxygen. Ngaphansi kwezimo zomzimba, ingxenye ye-oxygen encibilikisiwe eplasma incane, cishe u-0.29 mL (0.3%) kuphela ku-100 mL yegazi. Ngaphansi kwezimo ze-hyperbaric, ukuphefumula i-oxygen engu-100% kwandisa amazinga e-oxygen encibilikisiwe eplasma kakhulu—kufika ku-3.26% ku-1.5 ATA kanye no-5.6% ku-2.5 ATA. Ngakho-ke, i-HBOT ihlose ukuthuthukisa le ngxenye ye-oxygen encibilikisiwe, ngempumelelo.Ukwanda kokuhlushwa komoya-mpilo ezicutshini ezindaweni ezingasebenzi kahle. Ezingcindezini eziphakeme, umoya-mpilo usakazeka kalula ezicutshini ezingenayo i-hypoxia, ufinyelela amabanga amade okusabalalisa uma kuqhathaniswa nokucindezela okuvamile komkhathi.
Kuze kube manje, i-HBOT isetshenziswe kabanzi kokubili ekushayweni yi-ischemic kanye nokopha. Izifundo zibonisa ukuthi i-HBOT inikeza imiphumela yokuvikela izinzwa ngokusebenzisa izindlela eziningi eziyinkimbinkimbi zama-molecule, ama-biochemical, kanye nama-hemodynamic, okuhlanganisa:
1. Ukwanda komfutho wegazi ophansi emithanjeni yegazi, okuthuthukisa ukuhanjiswa komoya-mpilo ezicutshini zobuchopho.
2. Ukuqina kwe-BBB, kunciphisa ukuvuvukala kobuchopho.
3. Ukuthuthukiswa kobuchophoukujikeleza kwegazi okuncane, ukuthuthukisa ukusebenza kobuchopho kanye nokukhiqizwa kwamandla ngenkathi kugcinwa i-homeostasis yama-ion eseli.
4. Ukulawulwa kokugeleza kwegazi ebuchosheni ukuze kwehliswe ingcindezi yangaphakathi kobuchopho futhi kuncishiswe ukuvuvukala kobuchopho.
5. Ukunciphisa ukuvuvukala kwemizwa ngemva kokuhlaselwa yisifo sohlangothi.
6. Ukunciphisa i-apoptosis kanye ne-necrosisngemva kokuhlaselwa yisifo sohlangothi.
7. Ukunciphisa ukucindezeleka kwe-oxidative kanye nokuvinjelwa kokulimala kokuphinda kufakwe igazi, okubaluleke kakhulu ekuguleni kwesifo sohlangothi.
8. Ucwaningo lusikisela ukuthi i-HBOT inganciphisa i-vasospasm ngemva kokuphuma kwegazi okungaphansi kwe-aneurysmal (SAH).
9. Ubufakazi buphinde busekele inzuzo ye-HBOT ekukhuthazeni i-neurogenesis kanye ne-angiogenesis.
Isiphetho
Ukwelashwa nge-hyperbaric oxygen kunikeza indlela ethembisayo yokwelapha isifo sohlangothi. Njengoba siqhubeka nokuxazulula izinkinga zokululama kwesifo sohlangothi, kuzobaluleka uphenyo olwengeziwe ukuze sithuthukise ukuqonda kwethu isikhathi, umthamo, kanye nezindlela ze-HBOT.
Ngamafuphi, njengoba sihlola izinzuzo zokwelapha nge-hyperbaric oxygen therapy for stroke, kuba sobala ukuthi ukusebenzisa lokhu kwelashwa kunamandla okuguqula indlela esiphatha ngayo i-ischemic stroke, kunikeze ithemba kulabo abathintekile yilesi simo esishintsha impilo.
Uma unesifiso sokuhlola ukwelashwa nge-hyperbaric oxygen therapy njengendlela yokwelapha isifo sohlangothi, sikumema ukuthi uvakashele iwebhusayithi yethu ukuze ufunde kabanzi ngamakamelo ethu e-hyperbaric oxygen athuthukisiwe. Njengoba kunamamodeli ahlukahlukene aklanyelwe ukusetshenziswa ekhaya nangobungcweti, i-MACY-PAN inikeza izixazululo ezinikeza ukwelashwa nge-oxygen okuseqophelweni eliphezulu, okuqondiswe kukho ukusekela uhambo lwakho lwempilo nokululama.
Thola imikhiqizo yethu nokuthi ingathuthukisa kanjani inhlalakahle yakho ku-www.hbotmacypan.com.
Isikhathi sokuthunyelwe: Feb-18-2025