Indwara ya stroke, indwara mbi irangwa no kugabanuka gutunguranye kwamaraso kumubiri wubwonko bitewe na hemorhagie cyangwa ischemic pathology, niyo mpamvu ya kabiri itera impfu kwisi yose kandi nimpamvu ya gatatu itera ubumuga. Ubwoko bubiri bwibanze bwubwonko ni ischemic stroke (bingana na 68%) hamwe na hemorhagie (32%). Nuburyo butandukanye na pathophysiologie mubyiciro byambere, byombi biganisha ku kugabanuka kwamaraso hamwe na ischemia yubwonko bwakurikiye mugihe cya subacute na karande.
Ischemic
Ischemic stroke (AIS) irangwa no gutungurwa gutunguranye kw'amaraso, bikaviramo kwangirika kw'ishemi ahantu hafashwe. Mu cyiciro gikaze, iyi hypoxique yibanze itera casade ya excitotoxicity, guhagarika umutima, no gukora mikorobe, biganisha ku rupfu rwa neuronal. Mugihe cyicyiciro cya subacute, kurekura cytokine, chemokine, na matrix metalloproteinase (MMPs) bishobora kugira uruhare muri neuroinflammation. Ikigaragara ni uko urwego rwinshi rwa MMP rwongera ubwikorezi bwamaraso yubwonko bwamaraso (BBB), bigatuma leukocyte yimuka mukarere ka infarct, bikongera ibikorwa byo gutwika.
Ubu buryo bwo kuvura indwara ya Ischemic
Uburyo bwibanze bwo kuvura AIS burimo trombolysis na trombectomy. Indwara ya trombolysis irashobora kugirira akamaro abarwayi mugihe cyamasaha 4.5, aho kuvura hakiri kare bisobanura ibyiza byinshi. Ugereranije na trombolysis, imashini ya trombectomy ifite idirishya ryokuvura. Mubyongeyeho, imiti itari farumasi, imiti idatera nkakuvura ogisijeni, acupuncture, hamwe no gukurura amashanyarazi bigenda byiyongera nkubuvuzi bujyanye nuburyo busanzwe.
Shingiro ryubuvuzi bwa Hyperbaric Oxygene (HBOT)
Ku gipimo cy'inyanja (1 ATA = 101.3 kPa), umwuka duhumeka ugizwe na ogisijeni igera kuri 21%. Mugihe cyimiterere yumubiri, igipimo cya ogisijeni yashonze muri plasma ni gito, gusa mL 0.29 (0.3%) kuri 100 mL yamaraso. Mugihe gikabije, guhumeka ogisijeni 100% byongera urugero rwa ogisijeni yashonze muri plasma ku buryo bugaragara - kugeza kuri 3.26% kuri 1.5 ATA na 5.6% kuri 2.5 ATA. Kubwibyo, HBOT igamije kuzamura iki gice cya ogisijeni yashonze, nezakongera ingirabuzimafatizo ya ogisijeni mu turere twa ischemic. Ku muvuduko mwinshi, ogisijeni ikwirakwira mu buryo bworoshye mu ngingo za hypoxic, igera ku ntera ndende ikwirakwizwa n’umuvuduko usanzwe w’ikirere.
Kugeza magingo aya, HBOT imaze gukoreshwa cyane kuri ischemic na hemorhagic stroke. Ubushakashatsi bwerekana ko HBOT itanga ingaruka za neuroprotective binyuze mumikorere myinshi ya molekile igoye, ibinyabuzima, na hemodinamike, harimo:
1. Kongera umuvuduko wa ogisijeni wa arterial igice, kunoza umwuka wa ogisijeni mubice byubwonko.
2. Gutuza kwa BBB, kugabanya ubwonko.
3. Kongera ubwonkomicrocirculation, kunoza ubwonko bwubwonko no gutanga ingufu mugihe ukomeza ion homeostasis.
4. Kugena umuvuduko wamaraso wubwonko kugirango ugabanye umuvuduko wimitsi no kugabanya kubyimba ubwonko.
5. Kwiyongera kwa neuroinflammation nyuma yubwonko.
6. Kurwanya apoptose na necrosisgukurikira inkorora.
7. Kugabanya imihangayiko ya okiside no kubuza gukomeretsa kwa reperfusion, ingenzi muri stroke pathophysiology.
8. Ubushakashatsi bwerekana ko HBOT ishobora kugabanya vasospasm nyuma yo kuva amaraso ya aneurysmal subarachnoid (SAH).
9. Ibimenyetso kandi bishyigikira inyungu za HBOT mugutezimbere neurogenezi na angiogenez.
Umwanzuro
Hyperbaric ogisijeni ivura yerekana inzira itanga uburyo bwo kuvura indwara yubwonko. Mugihe dukomeje gutahura ingorane zo gukira indwara yubwonko, irindi perereza rizakenerwa kugirango tunonosore imyumvire yigihe, dosiye, nuburyo bwa HBOT.
Muri make, mugihe dushakisha ibyiza byo kuvura hyperbaric okisijene ivura indwara yubwonko, biragaragara ko gukoresha ubu buvuzi bifite ubushobozi bwo guhindura uburyo bwo gucunga imitsi ya ischemic, bigatanga ibyiringiro kubarebwa niyi miterere ihindura ubuzima.
Niba ushishikajwe no gushakisha uburyo bwo kuvura hyperbaric ogisijeni nk'ubuvuzi bushobora kuvura indwara yo mu bwonko, turagutumiye gusura urubuga rwacu kugira ngo umenye byinshi ku byumba byacu byateye imbere bya hyperbaric. Hamwe nurugero rwicyitegererezo cyagenewe gukoreshwa murugo no mu mwuga, MACY-PAN itanga ibisubizo bitanga ubuvuzi bwiza, bufite intego yo kuvura ogisijeni igamije gufasha ubuzima bwawe no gukira.
Menya ibicuruzwa byacu nuburyo bishobora kuzamura imibereho yawe kuriwww.hbotmacypan.com.
Igihe cyo kohereza: Gashyantare-18-2025