Ko te whiu, he mate kino e tohuhia ana e te whakahekenga ohorere o te rere o te toto ki te kiko roro nā te mate toto, te mate ischemic rānei, ko te tuarua o ngā tino take o te mate puta noa i te ao, me te tuatoru o ngā tino take o te hauātanga. Ko ngā momo matua e rua o te whiu ko te whiu ischemic (68%) me te whiu toto (32%). Ahakoa te rerekētanga o te pathology i ngā wāhanga tuatahi, ka arahi ēnei e rua ki te whakahekenga o te rere o te toto me te ischemia roro i muri mai i ngā wāhanga subacute me ngā wāhanga mau tonu.
Te whiu ischemic
Ko te whiu ischemic (AIS) e tohuhia ana e te aukati ohorere o te oko toto, ka hua ake he kino ischemic ki te wāhi e pāngia ana. I te wāhanga whakapeka, ka whakaohohia e tēnei taiao hypoxic tuatahi he rerenga o te excitotoxicity, te ahotea oxidative, me te whakahohenga o ngā microglia, ka arahi ki te mate whānui o ngā neuron. I te wāhanga subacute, ka taea e te tukunga o ngā cytokines, chemokines, me te matrix metalloproteinases (MMPs) te whai wāhi ki te neuroinflammation. He mea nui, ko ngā taumata teitei o ngā MMP ka whakanui ake i te urunga o te arai toto-roro (BBB), ka taea ai te hekenga o ngā leukocyte ki te rohe kua infarcted, ka whakanui ake i te mahi mumura.
Ngā Maimoatanga o Nāianei mō te Whiu Ischemic
Ko ngā maimoatanga matua whai hua mō te AIS ko te tango i te toto toto me te tango i te toto toto. Ka taea e te tango i te toto toto mā roto i ngā uaua te whai hua ki ngā tūroro i roto i ngā haora 4.5, ā, ka nui ake ngā painga o te maimoatanga wawe. Ki te whakatauritea ki te tango i te toto toto, he whānui ake te wā maimoatanga o te tango i te toto toto mā te miihini. Hei tāpiri, ko ngā maimoatanga kore-rongoā, kore-whakaeke pērā i terongoā hāora, kei te piki haere te rongonui o te wero ngira, me te whakaoho hiko hei maimoatanga tāpiri ki ngā tikanga tuku iho.
Ngā Kaupapa Taketake o te Whakaora Hāora Hyperbaric (HBOT)
I te pēhanga o te taumata moana (1 ATA = 101.3 kPa), ko te hau e manawahia ana e tātou he tata ki te 21% te hāora. I raro i ngā āhuatanga ā-tinana, he iti noa te ōwehenga o te hāora rewa i roto i te toto, tata ki te 0.29 mL (0.3%) mō ia 100 mL o te toto. I raro i ngā āhuatanga hyperbaric, mā te manawa i te 100% hāora ka nui ake te taumata o te hāora rewa i roto i te toto—tae atu ki te 3.26% i te 1.5 ATA me te 5.6% i te 2.5 ATA. Nō reira, ko te whāinga a te HBOT he whakarei ake i tēnei wāhanga o te hāora rewa, kia whai hua ai.te whakanui ake i te kukū hāora kiko i ngā rohe ischemic. I ngā pēhanga teitei ake, ka tere ake te horapa o te hāora ki roto i ngā kiko e kore e pai te hau, ka roa ake te horapa ki te whakaritea ki te pēhanga hau noa.
Tae noa ki tēnei wā, kua whānuitia te whakamahinga o te HBOT mō ngā whiu ischemic me ngā whiu toto. E whakaatu ana ngā rangahau he maha ngā pānga tiaki io o te HBOT mā roto i ngā tikanga matatini maha o te ngota ngota, te matū koiora, me te hemodynamic, tae atu ki:
1. Te pikinga o te pēhanga wāhanga hāora o roto o ngā uaua toto, te whakapai ake i te tuku hāora ki te kiko roro.
2. Te whakau i te BBB, te whakaiti i te pupuhi o te roro.
3. Te whakapakari i te rorote tohanga toto iti, te whakapai ake i te pākia o te roro me te whakaputa pūngao me te pupuri tonu i te homeostasis katote pūtau.
4. Te whakahaere i te rere o te toto i roto i te roro hei whakaiti i te pēhanga o roto i te angaanga me te whakaiti i te pupuhi o te roro.
5. Te whakaiti i te mumura roro i muri i te whiu.
6. Te pehi i te apoptosis me te necrosiswhai muri i te whiu.
7. Te whakaiti i te ahotea waikura me te aukati i te whara reinfusion, he mea nui i roto i te pathophysiology o te whiu.
8. E whakaatu ana ngā rangahau ka taea e te HBOT te whakaiti i te vasospasm whai muri i te aneurysmal subarachnoid hemorrhage (SAH).
9. E tautoko ana hoki ngā taunakitanga i te painga o te HBOT ki te whakatairanga i te neurogenesis me te angiogenesis.
Whakamutunga
He huarahi whai hua te rongoā hāora hyperbaric mō te rongoā i te whiu. I a tātou e haere tonu ana ki te wetewete i ngā uauatanga o te whakaoranga mai i te whiu, he mea nui kia nui ake ngā rangahau hei whakapai ake i tō tātou māramatanga ki te wā, te horopeta, me ngā tikanga o te HBOT.
Hei whakarāpopototanga, i a tātou e tūhuratia ana ngā painga o te whakaora hāora hyperbaric mō te whiu, ka mārama ko te whakamahi i tēnei maimoatanga ka taea te huri i te huarahi e whakahaere ai tātou i ngā whiu ischemic, ka puta ai te tumanako ki te hunga e pāngia ana e tēnei mate ka whakarerekē i te ao.
Mena kei te hiahia koe ki te tūhura i te whakaora hāora hyperbaric hei rongoā pea mō te whakaora i te whiu, ka tono atu mātou kia toro atu koe ki tā mātou paetukutuku ki te ako atu mō ā mātou rūma hāora hyperbaric matatau. Me te whānuitanga o ngā tauira kua hangaia mō te whakamahinga kāinga me te whakamahi ngaio, ka tukuna e MACY-PAN ngā otinga e whakarato ana i te whakaora hāora kounga teitei, kua arotahihia hei tautoko i tō hauora me tō haerenga whakaora.
Tirohia ā mātou hua me pēhea e taea ai e rātou te whakapai ake i tō oranga iwww.hbotmacypan.com.
Te wā tuku: 18-Pepuere-2025