Matenda a sitiroko, omwe amadziwika ndi kuchepa mwadzidzidzi kwa magazi kupita ku minofu ya ubongo chifukwa cha matenda a magazi kapena ischemic pathology, ndiye chifukwa chachiwiri chachikulu cha imfa padziko lonse lapansi komanso chifukwa chachitatu chachikulu cha kulumala. Mitundu iwiri ikuluikulu ya matenda a sitiroko ndi ischemic stroke (yomwe ili ndi 68%) ndi hemorrhagic stroke (32%). Ngakhale kuti matendawo ndi osiyana kwambiri m'magawo oyamba, zonsezi zimapangitsa kuti magazi achepe komanso ubongo ukhale wosakhazikika panthawi ya subacute ndi nthawi yayitali.
Ischemic Stroke
Ischemic stroke (AIS) imadziwika ndi kutsekeka kwadzidzidzi kwa mtsempha wamagazi, zomwe zimapangitsa kuti dera lomwe lakhudzidwalo liwonongeke. Mu gawo loopsa, malo oyambira ochepetsa mpweya m'thupi (hypoxic) amayambitsa kuchuluka kwa poizoni, kupsinjika kwa okosijeni, komanso kuyambitsa microglia, zomwe zimapangitsa kuti mitsempha ifale kwambiri. Mu gawo la subacute, kutulutsidwa kwa ma cytokines, chemokines, ndi matrix metalloproteinases (MMPs) kungathandize kukulitsa kutupa kwa mitsempha. Chochititsa chidwi n'chakuti, kuchuluka kwa MMPs kumawonjezera kutseguka kwa chotchinga cha magazi-ubongo (BBB), zomwe zimapangitsa kuti ma leukocyte asamuke kupita kudera lomwe lakhudzidwa, zomwe zimapangitsa kuti kutupa kuchuluke.
Mankhwala Ochiritsira a Ischemic Stroke
Mankhwala oyambira othandiza a AIS ndi monga thrombolysis ndi thrombectomy. Kuchotsa thrombolysis m'mitsempha kungapindulitse odwala mkati mwa maola 4.5, pomwe chithandizo choyambirira chimapereka ubwino waukulu. Poyerekeza ndi thrombolysis, kuchotsa thrombectomy m'makina kuli ndi mwayi waukulu wochizira. Kuphatikiza apo, njira zochiritsira zosagwiritsa ntchito mankhwala mongachithandizo cha okosijeni, acupuncture, ndi kusonkhezera magetsi zikuyamba kugwira ntchito ngati njira zina zothandizira njira zachikhalidwe.
Zofunikira pa Chithandizo cha Oxygen cha Hyperbaric (HBOT)
Pakuthamanga kwa madzi panyanja (1 ATA = 101.3 kPa), mpweya womwe timapuma umakhala ndi mpweya wa pafupifupi 21%. Pansi pa mikhalidwe ya thupi, gawo la mpweya wosungunuka mu plasma ndi lochepa, pafupifupi 0.29 mL (0.3%) pa 100 mL ya magazi. Pansi pa mikhalidwe ya hyperbaric, kupuma mpweya wa 100% kumawonjezera kuchuluka kwa mpweya wosungunuka mu plasma kwambiri—mpaka 3.26% pa 1.5 ATA ndi 5.6% pa 2.5 ATA. Chifukwa chake, HBOT ikufuna kuwonjezera gawo ili la mpweya wosungunuka, moyenera.Kuwonjezeka kwa kuchuluka kwa okosijeni m'thupi m'malo omwe ali ndi vuto la ischemic. Pakupanikizika kwakukulu, okosijeni imafalikira mosavuta m'maselo omwe ali ndi hypoxia, kufika patali kwambiri poyerekeza ndi kuthamanga kwa mpweya wabwinobwino.
Mpaka pano, HBOT yagwiritsidwa ntchito kwambiri pa sitiroko ya ischemic ndi hemorrhagic. Kafukufuku akusonyeza kuti HBOT imapereka zotsatira zoteteza mitsempha kudzera mu njira zambiri zovuta zama molekyulu, za biochemical, ndi za hemodynamic, kuphatikizapo:
1. Kuwonjezeka kwa mpweya woipa m'mitsempha yamagazi, zomwe zimapangitsa kuti mpweya ufike bwino ku ubongo.
2. Kukhazikika kwa BBB, kuchepetsa kutupa kwa ubongo.
3. Kulimbitsa ubongokufalikira kwa magazi pang'ono, kukonza kagayidwe ka ubongo ndi kupanga mphamvu pamene akusunga homeostasis ya ma ion a m'maselo.
4. Kulamulira kuyenda kwa magazi muubongo kuti muchepetse kuthamanga kwa magazi m'mutu ndikuchepetsa kutupa kwa ubongo.
5. Kuchepetsa kutupa kwa mitsempha pambuyo pa sitiroko.
6. Kuchepetsa apoptosis ndi necrosispambuyo pa sitiroko.
7. Kuchepetsa kupsinjika kwa okosijeni ndi kuletsa kuvulala kobwerezabwereza kwa magazi, kofunikira kwambiri pa matenda a sitiroko.
8. Kafukufuku akusonyeza kuti HBOT ikhoza kuchepetsa kutsekeka kwa mitsempha yamagazi pambuyo pa kutuluka magazi m'thupi (SAH) chifukwa cha aneurysmal.
9. Umboni umathandizanso kuti HBOT ipindule polimbikitsa kupangika kwa mitsempha yamagazi ndi angiogenesis.
Mapeto
Chithandizo cha okosijeni wochuluka chimapereka njira yabwino yothandizira matenda a sitiroko. Pamene tikupitirizabe kupeza njira zovuta zochiritsira matenda a sitiroko, kufufuza kwina kudzakhala kofunikira kuti timvetse bwino nthawi, mlingo, ndi njira za HBOT.
Mwachidule, pamene tikufufuza ubwino wa mankhwala a hyperbaric oxygen therapy pa sitiroko, zikuonekeratu kuti kugwiritsa ntchito mankhwalawa kuli ndi mphamvu yosintha momwe timachitira ndi sitiroko ya ischemic, kupereka chiyembekezo kwa omwe akhudzidwa ndi vutoli losintha moyo.
Ngati mukufuna kudziwa njira yochiritsira matenda a hyperbaric oxygen ngati njira yochiritsira matenda a sitiroko, tikukupemphani kuti mupite patsamba lathu kuti mudziwe zambiri za zipinda zathu zamakono zochiritsira matenda a hyperbaric oxygen. Ndi mitundu yosiyanasiyana yopangidwira kugwiritsidwa ntchito kunyumba komanso pantchito, MACY-PAN imapereka mayankho omwe amapereka chithandizo chapamwamba komanso cholunjika cha oxygen kuti chikuthandizeni paulendo wanu wathanzi komanso wochira.
Dziwani zinthu zathu ndi momwe zingakuthandizireni kukhala ndi moyo wabwino pawww.hbotmacypan.com.
Nthawi yotumizira: Feb-18-2025