Kusungunuka kwa magazi mwachangu kumadalira kwambiri chithandizo cha mankhwala. Nthawi zina, opaleshoni yochotsa magazi m'magazi imagwiritsidwanso ntchito.

Chiyambi chatsatanetsatane ndi ichi:

1 Kutsekeka kwa magazi m'thupi pogwiritsa ntchito mankhwala

1.1 Mankhwala ogwiritsidwa ntchito kwambiri

Urokinase: enzyme yachilengedwe yochokera mu mkodzo wa munthu kapena yopangidwa ndi maselo a impso. Imatha kugwira ntchito mwachindunji pa dongosolo la fibrinolytic la endogen, kuyambitsa plasminogen kukhala plasmin, motero kusungunula magazi oundana.

Streptokinase: puloteni yotengedwa kuchokera ku madzi opangidwa kuchokera ku hemolytic streptococci. Imatha kumangirira ku plasminogen kuti ipange chophatikizana, kupititsa patsogolo kusintha kwa plasminogen kukhala plasmin, kenako kusungunula magazi oundana.

Choyambitsa plasminogen cha minofu yolumikizana (rt-PA): glycoprotein yomwe imatha kuyambitsa plasminogen ndipo imakhala ndi mphamvu yayikulu pa fibrin. Imatha kugwira ntchito mosankha pa fibrin m'magazi oundana kuti iwonongeke ndikukwaniritsa cholinga chosungunula magazi oundana. Poyerekeza ndi urokinase ndi streptokinase, rt-PA ili ndi mphamvu yayikulu yotulutsa magazi ndipo imakhala ndi zovuta zochepa zotuluka magazi.

1.2 Nthawi yochizira

Pa matenda monga acute myocardial infarction ndi cerebral infarction, nthawi yoti chithandizo cha thrombolytic chikhale chofunikira kwambiri. Kawirikawiri, odwala omwe ali ndi acute myocardial infarction ayenera kulandira chithandizo cha thrombolytic mkati mwa maola 12 atayamba, makamaka mkati mwa maola 3-6; odwala omwe ali ndi acute cerebral infarction ali mu nthawi yabwino kwambiri ya thrombolysis mkati mwa maola 4.5-6 atayamba.

2 Kuchotsa thrombectomy ndi opaleshoni

2.1 Kuchotsa thrombectomy yokhudza opaleshoni

Motsogozedwa ndi digito yochotsera angiography (DSA), chipangizo chochotsera thrombectomy chimatumizidwa kumalo ochotsera thrombus kudzera mu catheter kuti chichotse thrombus mwachindunji. Njirayi ili ndi ubwino wochepa chifukwa cha kuvulala kochepa komanso kuchira mwachangu, ndipo ndi yoyenera kwa odwala ena omwe sangathe kulekerera thrombolysis ya mankhwala kapena omwe ali ndi zotsatira zoyipa za thrombolysis ya mankhwala.

2.2 Kuchotsa thrombectomy pa opaleshoni

Dulani mitsempha yamagazi mwachindunji kudzera mu opaleshoni kuti muchotse thrombus. Njirayi imagwiritsidwa ntchito nthawi zambiri pazochitika zadzidzidzi pomwe thrombolysis ya mankhwala ndi thrombectomy yolowererapo singathe kuchitika kapena zotsatira zake sizili bwino, monga embolism ya mitsempha ya m'munsi. Kuchotsa thrombectomy yochitidwa opaleshoni kumatha kubwezeretsa magazi mwachangu, koma kuvulala kwa opaleshoni ndi kwakukulu ndipo pali zovuta zina pambuyo pa opaleshoni.

Kaya njira yosankhidwa ndi iti, chithandizo chapadera chimafunika motsogozedwa ndi dokotala kutengera momwe wodwalayo alili, monga malo, kukula, nthawi yopangira thrombus, komanso momwe wodwalayo alili. Nthawi yomweyo, pambuyo pa thrombolysis kapena thrombectomy, mankhwala oletsa magazi kuundana, antiplatelet ndi mankhwala ena amafunika kuti aletse kupangikanso kwa thrombus.