Microstroke yog ib qho mob luv luv ntawm cov hlab ntsha hauv lub hlwb lossis qaum qaum. Txawm hais tias qhov tseeb tias apoplexy tsis kav ntev, kev ua txhaum ntawm cov ntshav ncig ua rau muaj kev puas tsuaj loj rau lub hlwb. Txhawm rau tiv thaiv cov teeb meem loj, koj yuav tsum paub txog qhov ua rau microstroke. Kev tiv thaiv kab mob yog txoj hauv kev zoo tshaj los daws nws.
Microstroke description
Nyob rau hauv neurology, nws tsis yog ib txwm ua kom cais qhov mob stroke thiab microstroke. Txawm li cas los xij, feem ntau cov kws kho mob ntseeg tias qhov kawg yog qhov txaus ntshai dua. Nrog rau me me-focal circulatory disorders, kev hloov ntawm kev puas tsuaj rau cov hlab ntsha me tseem nyob ntev. Cov neeg mob tom qab ntawd txhim kho neuronal dysfunction.
Qhov tshwm sim tom qab cov kab mob microscopic tsis hnyav heev. Coma yeej tsis tshwm sim, kev nco qab sai sai, cov tshuaj tiv thaiv rau khaus yog rov qab yuav luagncaj nraim. Yog tias ib tug neeg tsis paub tias cov tsos mob ntawm microstroke yog dab tsi, nws yuav tsis nkag siab tias muaj dab tsi tshwm sim. Qhov no yog insidiousness ntawm pathological hloov.
Txawm hais tias qhov kev puas tsuaj rau cov hlab ntsha hauv hlwb tom qab lub tshuab, yuav tsum tau kuaj xyuas. Narcotization thiab ruptures tawm hematomas, uas cuam tshuam cov ntshav ncig thiab pab txhawb rau qhov tshwm sim ntawm microstrokes tshiab. Ntau qhov mob me me uas tsis muaj kev kho mob txhawm rau tshem tawm lawv ua rau mob hlwb ntau heev.
Vim li cas microstroke tshwm sim
Cov kab mob ntawm cov hlab ntsha hauv cov hlab ntsha ntawm lub hlwb yog qhov nyuaj thiab ntau yam. Lub hauv paus tseem ceeb ntawm qhov tshwm sim ntawm qaug dab peg yog kev cuam tshuam ntawm cov ntshav ntws. Dab tsi ua rau microstroke? Muaj ntau yam laj thawj, raws li txoj cai lawv tuaj yeem muab tso ua ke rau hauv pawg hauv qab no:
- Kev ua txhaum ntawm cov hlab ntsha kev tswj hwm ntawm cov hlab ntsha intracerebral, ua rau kev cog lus ntawm phab ntsa thiab nqaim ntawm lumen ntawm cov hlab ntsha thiab cov hlab ntsha. Ntshav siab, vegetative-vascular dystonia ua li provocateurs. Tsis tas li ntawd, apoplexy tuaj yeem tshwm sim tawm tsam keeb kwm ntawm kev ntxhov siab hnyav, ua haujlwm tsis tu ncua, tsis tsaug zog.
- Kev tsis zoo ntawm patency ntawm cov hlab ntsha, kev hloov pauv ntawm cov hlab ntsha. Qhov ua rau txhaws yog atherosclerosis, parietal thrombosis, muaj cov cholesterol plaques ntawm phab ntsa ntawm cov hlab ntsha. Feem ntau muaj microstroke tom qab tshuaj loog. Qhov no yog vim thrombosis ntawm sab hauv carotid artery.
- Ruptures ntawm pathologically hloov cov hlab ntsha thiab areolas. Microstrokes tshwm sim los ntawmmuaj kev ua txhaum ntawm kev ncaj ncees ntawm cov hlab ntsha hu ua hemorrhagic (tshwm sim nyob rau hauv keeb kwm ntawm ntau yam hemorrhages). Yog vim li cas rau qhov rupture yog miliary aneurysm, phab ntsa puas nyob rau hauv vasculitis, thinning ntawm cov phab ntsa vascular vim atherosclerotic hloov, muaj zog nce ntshav siab.
- Kev ua txhaum ntawm cov hemodynamics. Qhov ua rau mob hlab ntsha tawg yog qhov tsis sib xws ntawm qhov xav tau ntawm lub hlwb hauv cov ntshav thiab lub peev xwm ntawm lub paj hlwb tshwm sim los ntawm kev txo qis hauv ntshav siab.
Leej twg txaus ntshai
Nws yog ib qho tseem ceeb tsis yog tsuas yog yuav tsum paub yuav ua li cas thiaj paub txog microstroke, tab sis kuj yuav ua li cas txo qhov kev pheej hmoo ntawm nws qhov tshwm sim. Kev ua txhaum ntawm cov ntshav ncig yog kuaj pom hauv cov neeg ntawm cov hnub nyoog sib txawv. Cov kab mob hauv qab no ua rau muaj kev tawm tsam:
- kab mob ntawm qhov nruab nrab thiab loj raws li qhov sib xyaw ntawm lipids hauv lawv, kev puas tsuaj ntawm phab ntsa (atherosclerosis);
- ateriovenous malformation, aneurysm thiab lwm yam malformations ntawm cerebral hlab ntsha;
- hlab ntshav siab;
- hypotension tshwm sim los ntawm cov teeb meem loj hauv cov hlab plawv, myocardial infarction, vau;
- myocardium, cardiosclerosis, kab mob rheumatic plawv thiab lwm yam kab mob uas ua rau lub plawv dhia tsis zoo;
- kab mob endocrine uas ua rau tsis muaj peev xwm nqus cov piam thaj (mob ntshav qab zib mellitus);
- congenital anatomical defects ntawm lub plawv;
- hloov pauv hauv cov tshuaj biochemical thiab physicochemical ntawm cov ntshav (adhesion, electrolyte imbalance, redoxtxheej txheem);
- degenerative-dystrophic lesion ntawm lub ncauj tsev menyuam;
- hemorrhages.
Cov yam pheej hmoo suav nrog:
- kev quav cawv;
- haus luam yeeb, suav nrog luam yeeb hluav taws xob, hookah;
- siv tshuaj;
- tsis noj thiab noj txhua hnub;
- obesity;
- nquag nquag ua haujlwm;
- ua haujlwm nrog kev ua haujlwm tsis zoo (tus kws kos duab hlau, tus neeg dhia dej, chaw tsim khoom thiab lwm yam);
- tshuaj lom nrog tshuaj, hlau;
- kev nyuaj siab tsis tu ncua.
Cov neeg muaj kev pheej hmoo yuav tsum tau kuaj xyuas txhua xyoo txhawm rau txheeb xyuas thiab kho cov kab mob uas tuaj yeem ua rau microstroke.
Caw cawv tuaj yeem ua rau microstroke?
Txhua yam cawv yog pom los ntawm lub cev ua cov tshuaj lom. Ethanol hloov cov qauv ntawm cov ntshav, tom qab nkag mus rau hauv cov hlab ntsha, platelets yog deformed. Nrog rau kev haus cawv tsis tu ncua, thiab txawm tias muaj ntau, cov ntshav txhaws. Kev ua txhaum ntawm vascular patency ua rau tsis txaus cov ntaub so ntswg, nrog rau lub hlwb, nrog rau cov as-ham thiab oxygen, uas ua rau cell tuag.
Tab sis qhov micro-stroke tom qab binge tshwm sim tsis yog vim qhov tsis zoo ntawm vascular patency. Ethanol txhawb nqa vasodilation, siab pib poob, hlwb raug kev txom nyem los ntawm hypoxia. Txhawm rau kho cov ntshav mus rau cov ntaub so ntswg, lub cev sim ua kom lub siab mus rau qhov kev txwv. Rau reinforcedntshav ncig xav tau adrenaline. Qhov ntau tshaj ntawm cov tshuaj hormones no txhawb lub plawv dhia ceev, uas ua rau spasm. Contraction ntawm cov nqaij ntshiv ntawm phab ntsa ntawm cov hlab ntsha yog ib tug ntawm cov tseem ceeb ua rau ib tug microstroke. Kev haus cawv yog qhov txaus ntshai tshwj xeeb rau cov neeg uas muaj ntshav siab.
thawj cov cim qhia ntawm microstroke hauv cov poj niam
Kev mob hlwb tsis zoo hauv qhov zoo nkauj ib nrab ntawm qhov tshwm sim tsis yog qhov txawv. Ib qho ntawm cov laj thawj tseem ceeb ntawm microstroke yog kev hloov pauv hauv cov hlab ntsha. Ntau tus poj niam raug kev txom nyem los ntawm varicose leeg. Hormonal ntshawv siab ua rau kev loj hlob ntawm tus kab mob. Cov tub ntxhais hluas feem ntau mus noj zaub mov uas ua rau muaj qhov tsis txaus ntawm cov carbohydrates, cov rog thiab, vim li ntawd, kev ua tsis zoo ntawm cov metabolism ntawm cov tshuaj no. Cov kab mob metabolic ua rau hormonal tsis txaus.
Nws tsis yog qhov tsis yooj yim rau kev mob ntshav qab zib tshwm sim thaum cev xeeb tub. Lub sijhawm cev xeeb tub yog nrog los ntawm kev hloov pauv hormonal, toxicosis, siab surges. Cov kev tshwm sim no ua rau circulatory mob. Cov poj niam uas muaj ntau lub cev xeeb tub yog qhov txaus ntshai, thiab yog li ntawd yuav tsum paub meej tias yuav ua li cas thiaj paub txog microstroke.
Symptomatology yog tib yam rau ob leeg poj niam thiab txhua lub hnub nyoog. Thawj cov cim qhia ntawm microstroke hauv cov poj niam suav nrog:
- flushing;
- khoom pom muaj liab halo lossis xim, tus poj niam pib rub nws ob lub qhov muag, tab sis cov nyhuv tsis ploj mus;
- tsis paub meej tias qhov mob taub hau tuaj qhov twg, uas ua rau muaj kev ntxhov siab los yog, qhov sib txawv, tag nrho ntawm pob txha taub hau;
- ib nrab poob siab, tus poj niam tsis tuaj yeem paub tias nws nyob qhov twg, nws ua dab tsi;
- ua pa nrawm, lub plawv dhia.
Yog cov tsos mob no tshwm sim, hu rau kev pab.
thawj cov cim qhia thiab cov tsos mob ntawm microstroke hauv cov txiv neej
Kev ua haujlwm ntawm ntau tus neeg sawv cev ntawm kev sib deev muaj zog yog cuam tshuam nrog kev ua haujlwm nyuaj ntawm lub cev, raug rau cov tshuaj lom, thiab kev ntxhov siab tas li. Cov neeg tua hluav taws, tub ceev xwm, miners, pilots ntawm lub dav hlau thiab cov tsheb sib tw yog qhov muaj feem cuam tshuam rau cov xwm txheej cerebrovascular.
Txhawm rau txo qis kev ntxhov siab thiab kev ntxhov siab, cov txiv neej feem ntau nyiam cawv. Thaum so thaum lub sijhawm ua haujlwm lub cev, cov pa luam yeeb tau npaj. Cov xwm txheej no ua rau muaj kev pheej hmoo mob stroke ntxiv. Cov txiv neej feem ntau tsis paub tias microstroke yog dab tsi thiab cov tsos mob dab tsi nws tshwm sim. Yog li ntawd, feem ntau tawm tsam yog nqa ntawm ob txhais ceg. Kev sib deev muaj zog tsis nyiam cov kws kho mob thiab tawv ncauj tsis kam kho mob txawm tias mob taub hau ntau zaus, kev noj qab haus huv tsis zoo.
Hauv cov txiv neej, thawj cov tsos mob thiab cov tsos mob ntawm microstroke tshwm sim raws li hauv qab no:
- hyperemia ntawm daim tawv nqaij ntawm lub ntsej muag, tshwj xeeb tshaj yog nyob rau hauv pliaj, pob ntseg;
- kiv taub hau nrog bouts ntawm pounding mob;
- qeeb, tsis muaj lossis tsis muaj zog tiv thaiv qhov tshwm sim ib puag ncig;
- tsis muaj kev sib koom tes: tsis khov kho, zoo li ob txhais ceg thiab caj npab txav mus tsis tau;
- pasmCov leeg ntawm lub ntsej muag pab txhawb kev hais lus tsis zoo, tsis txhob hais lus, tus neeg mob ua suab tsis sib xws.
Ua haujlwm ntawm cov tuam txhab thiab cov koom haum, cov txiv neej tau txais kev kuaj mob yuav tsum tau ua. Cov neeg ua lag luam ntiag tug ntseeg tias qhov kev tshawb fawb no yog qhov nkim sijhawm. Qhov txaus ntshai ntawm kev tsis quav ntsej cov tsos mob ntawm microstroke kuj yog nyob rau hauv qhov tseeb tias cov neeg txawv txawv yuav raug kev txom nyem thaum muaj kev tawm tsam. Kev tawm tsam tuaj yeem tshwm sim thaum tsav tsheb, kev sib tsoo yuav tshwm sim uas cov neeg caij tsheb thiab lwm tus neeg tsav tsheb yuav ua rau tuag taus.
Txoj kev mob stroke thaum hluas
Lub ntsiab etiological hauv qhov tshwm sim ntawm microstroke yog vascular tsis muaj zog. Exhaustion, blockage ntawm elastic tubular formations muaj feem xyuam rau lub hnub nyoog kev hloov. Txawm li cas los xij, kev txheeb xyuas tsis tu ncua qhia tau tias me me-focal apoplexy tau tshwm sim hauv cov neeg qis dua 30.
Hauv cov txiv neej thiab cov poj niam hnub nyoog hluas, cov tsos mob ntawm microstroke tsis txawv ntawm cov yam ntxwv ntawm kev kho mob hauv kev ua txhaum ntawm lub paj hlwb. Tab sis cov laj thawj ua rau koj xav txog kev noj qab haus huv ntawm lub teb chaws tag nrho:
- kab mob cuam tshuam rau myocardium thiab vascular channels ntawm lub plawv;
- congenital defects nyob rau hauv lub anatomical qauv ntawm lub plawv los yog cov hlab ntsha loj;
- platelets hauv cov ntshav siab;
- kab mob plawv tshwm sim los ntawm kev kis tus kab mob: myocarditis, borreliosis, rheumatoid fever;
- mob ntsws ntsws, otitis media, pyelonephritis raug kev txom nyem thaum yau;
- intracranial lossis arterial hypertension;
- congenital lossis kis tau morphological lossisKev hloov pauv ntau hauv cov hlab ntsha carotid;
- neoplasia nyob rau hauv lub hlwb cheeb tsam;
- kab mob ntawm cov kab mob vascular. Raws li txoj cai, pathology raug kuaj pom tam sim ntawd, tab sis dhau sij hawm, kev ntshai ntawm cov teeb meem hauv cov neeg mob tau txo qis, thiab kev kho kev kho tsis tau ua tiav ntawm qib tsim nyog;
- tus cwj pwm phem, haus luam yeeb, haus cawv sai sai ua rau cov hlab ntsha tawg, thawj cov tsos mob tshwm sim vim tsis tsaug zog lossis haus cawv ntau ntau hnub ua ntej;
- tsis noj. Cov tub ntxhais hluas noj 1-2 zaug hauv ib hnub, feem ntau yog cov khoom noj ceev. Tsis muaj cov vitamins, tsis txaus ntawm cov protein, carbohydrates thiab cov rog ua rau kev puas tsuaj ntawm phab ntsa ntawm cov hlab ntsha.
Diagnosis
Lub ntsiab feature ntawm me me-focal lesions ntawm lub paj hlwb thiab tus txha caj qaum yog qhov rov qab los ntawm tus neeg mob sai. Tom qab kev tawm tsam, cov poj niam thiab txiv neej tuaj ntsib kws kho mob hlwb ntawm lawv tus kheej.
Lub luag haujlwm tseem ceeb ntawm kev kuaj mob microstroke yog qhov sib txawv ntawm lwm cov kab mob pathological nrog cov tsos mob zoo sib xws. Apoplexy muaj cov tsos mob tshwm sim nrog qaug dab peg, myocardial microinfarction, qhov tshwm sim ntawm TBI kaw, carbon monoxide lom.
Lub hauv paus ntawm kev kuaj mob yog ntsuas ntsuas ntsuas. Qhov kev xaiv zoo tshaj plaws yog ua cov duab sib nqus resonance ntawm lub hlwb. Txoj kev kawm ntawm microstroke ntawm MRI tso cai rau koj kom paub meej qhov chaw, qhov loj ntawm qhov txhab. Ntsuam xyuas cov kev hloov hauv lub hlwb cov qauv, qib ntawm edema, qhia cov ntshav nkag mus rau hauv cov meninges, ventricles.
Thib ob hauv kev kuaj mobTus nqi thiab lub hom phiaj yog suav tias yog angiography ntawm cerebral hlab ntsha. X-ray ntawm phab ntsa vascular nrog kev siv qhov sib txawv tso cai rau kev hloov pauv hauv cov ntshav mus rau cov ntaub so ntswg hlwb. Kuv sau cov txheej txheem rau xav tias aneurysm. Nrog kev pab ntawm angiography, koj tuaj yeem pom qhov chaw ntawm cov hlab ntsha.
Ntxiv rau cov cuab yeej, kev sim kuaj tau raug sau tseg. Cov neeg mob kuaj ntshav los txiav txim seb tus naj npawb thiab kev sib sau ntawm platelets. Lub coagulogram tso cai rau koj los ntsuas lub peev xwm coagulation ntawm cov ntshav.
Kev kuaj mob zoo li no siv cov txheej txheem kim tso cai rau koj txheeb xyuas tag nrho cov kab mob nrog qhov tseeb siab tshaj plaws, nrog rau nkag siab qhov ua rau ntawm microstroke thiab xaiv txoj kev kho kom zoo.
Kev cuam tshuam kho mob
Kev kho yuav tsum tau ua tam sim ntawd, sib txawv nyob ntawm qhov ua rau ntawm microstroke, qhov xwm txheej ntawm cov txheej txheem pathological. Feem ntau, kev qaug dab peg me me tsis tas yuav mus pw hauv tsev kho mob. Kev kho mob yog ua raws li tus neeg mob sab nraud, tab sis tus neeg mob yuav tsum tsis tu ncua tuaj txais tos thiab kuaj.
Lub hauv paus ntawm kev kho mob yog cov tshuaj uas tshem tawm qhov tshwm sim, tiv thaiv cov teeb meem ntawm apoplexy. Kev kho tshuaj muaj xws li cov tshuaj hauv qab no:
- tshuaj tiv thaiv hypertensive. Kev siv cov pab pawg no ntawm cov tshuaj rau microstroke tso cai rau koj kom txo qis siab sai yam tsis muaj kev cuam tshuam cov txheej txheem metabolic. Feem ntau cov tshuaj "Aplodipine", "Carvedilol", "Diazepex"
- Anticoagulants - tshuaj tiv thaivthrombus tsim, pab txhawb rau cessation ntawm kev loj hlob ntawm twb tsim cov ntshav txhaws. Qhov zoo tshaj plaws yog siv cov tshuaj ua haujlwm ntev rau microstroke: Warfarin Nycomed, Acenocoumarol, Angioks.
- inhibitors ntawm platelet thiab erythrocyte aggregation. Antiplatelet cov neeg ua haujlwm pab txhawb kev deformation ntawm erythrocyte daim nyias nyias, txhim kho cov ntshav khiav. Cov tshuaj no tuaj yeem tsis tsuas yog tiv thaiv qhov adhesion ntawm platelets, tab sis kuj ua rau kev sib cais ("Acetylsalicylic acid", "Dipyridamole").
- Kho kom raug mob cerebrovascular - tshuaj siv rau kev sib tsoo cerebrovascular (Vinpocetine, Memoplant, Naftidrofuril).
- Nootropics. Cov tshuaj siv los txhim kho microcirculation hauv lub hlwb ("Gliatilin", "Cerebrolysin", "Pantogam active").
Kev kho raws sijhawm thiab tsim nyog zam kom tsis txhob mob stroke loj, uas feem ntau kho nrog kev phais.
Rehab
Nyob rau lub sijhawm rov zoo, qhov tseem ceeb yog muab kev thaj yeeb nyab xeeb rau tus neeg mob. Tom qab muaj kev tawm tsam, nws yog qhov zoo dua los mus so luv luv. Thaum lub sij hawm kho dua tshiab tom qab microstroke, kev kho mob nrog rau lwm yam dej num uas txhawb kev rov zoo sai:
- LFK yog ib qho tshwj xeeb ntawm kev tawm dag zog, xaiv tus kheej, raws li qib kev puas tsuaj thiab tus neeg mob txoj kev noj qab haus huv. Kev tawm dag zog kho mob txhim kho cov ntshav ncig, normalizes ua pa, tom qab qoj ib ce zoo dua.
- Reflexotherapy - kev kho mob rauthaj chaw reflexogenic (cov ntsiab lus). Lub ntsiab lus ntawm cov txheej txheem yog kev ua kom cov neurohumoral mechanisms uas potentiate lub restoration ntawm lub cev. Acupuncture yog txoj kev nyiam tshaj plaws.
- Massage yog ib qho yuav tsum tau ua thaum lub sijhawm rov qab los tom qab microstroke. Feem ntau 2 hom kev zaws yog ua: classical general thiab massage ntawm lub taub hau, ntsej muag, caj dab. Cov tom kawg yog siv los txhim kho cov ntshav ncig hauv cov ntaub so ntswg ntawm lub hlwb, normalize venous outflow.
- Kev kho lub cev. Nrog me me-focal circulatory ntshawv siab, tuag tes tuag taw, raws li txoj cai, tsis tshwm sim, yog li tsis tas yuav tsum muaj cov txheej txheem uas yuav tsum tau ua rau ib txwm mob stroke. Tom qab microstroke, lawv noj coniferous, ntsev da dej, sau tshuaj kho cua sov thiab txias.
Kev Tiv Thaiv
Txhawm rau tiv thaiv kev mob hlwb, koj yuav tsum noj kom raug, ua kom muaj kev ua neej nyob nruab nrab. Koj yuav tsum tso tus cwj pwm phem, zam kev ntxhov siab, tsaug zog txaus, saib koj qhov hnyav.
Qhov laj thawj tseem ceeb ntawm microstroke yog kev cuam tshuam ntawm cov ntshav ntws. Feem ntau yog vim txoj kev ua neej tsis raug. Ua tib zoo saib xyuas tus kheej kev noj qab haus huv, kev kuaj xyuas kev tiv thaiv tsis tu ncua yuav pab kom tsis txhob muaj apoplexy.
