Mafi yawan abin da ya fi damuwa da yin amfani da fibrillation shine ya bugun jini . A cikin filastillation da ke tattare da kwayar cutar, ƙwararrun zuciya ba ta doke komai yadda ya kamata, wanda ya ba da jini ya "zama" a cikin wadannan ɗakunan.
A sakamakon haka, wani ɓangaren tarkon (blood clot) zai iya zamawa. A ƙarshe, ma'anar thrombus mai cin gashin kanta na iya yin amfani da ita - wato, yana iya karyawa da tafiya ta wurin arteries.
Duk sau da yawa, wannan alamar zai zama a cikin kwakwalwa, kuma sakamakon haka shi ne bugun jini.
Don haka idan kana da kwarewa, dole ne likitanku ya yi kimantaccen kimanin ku na hadarin bugun jini, kuma idan wannan hadarin ya isa, ya kamata a sanya shi a kan maganin don hana yaduwar jini daga kafa, don haka, don hana cutar bugun jini.
Bayyana Yanayinka
Yin la'akari da hadarin da ke fama da cutar bugun jini idan kana da fibrillation na bukatar yin la'akari da shekarunka, jima'i, da kuma wasu yanayin kiwon lafiya da ka samu. Na farko, idan kuna da wasu cututtuka na zuciya mai banƙyama a cikin ƙananan ƙwayoyin cuta, za ku buƙaci farfado don hana yaduwar jini, tun da yake haɗarin cutar shan jini ya karu.
Idan ba ku da wata cuta ta bawul din zuciya, likitanku zai yi amfani da lissafi mai hadari, wanda ake kira CHA2DS2-VASc, don kimanta yiwuwar hadarin bugun jini. A cikin mutanen da ke da alamar fitarwa, wanda ya fi girma a kan k'wallar CHA2DS2-VASc, mafi girman haɗarin bugun jini.
Sakamakon CHA2DS2-VASc ya kasance daga zero zuwa maki tara kuma ana lissafta kamar haka:
- Zuciyar zuciya ta zuciya = aya ɗaya
- Hawan hawan jini = aya ɗaya
- Shekaru 75 ko mafi girma = maki biyu
- Ciwon sukari = aya ɗaya
- Na farko bugun jini ko TIA = maki biyu
- Cututtukan maganin ƙwaƙwalwar ƙwayar cuta = aya ɗaya
- Shekaru tsakanin 64 zuwa 74 = aya daya
- Mace jima'i = daya aya
Mafi girman samfurin CHA2DS2-VASc, mafi girma yawan haɗari na shekara-shekara na bugun jini. Don haka, idan cikewarku ba kome ba ne, hadarin ciwon kwari yana da kashi 0.2 a kowace shekara, wanda ba shi da kyau. Idan cibiyar ku biyu ne, halayen shekara-shekara yana da kashi 2.2 cikin dari, kuma yakan tashi daga nan. Sakamakon kashi tara daga cikin tara yana haifar da annobar shekara-shekara na kashi 12.2. (Ta hanyar kwatanta, ga kowane mutum 100 da ke da shekaru 65 ba tare da wani filaye ba, game da guda daya a kowace shekara zai sami bugun jini.)
Rage Rashin Cutar
Yin amfani da magungunan ƙwayoyin cuta zai iya rage haɗarin cewa wani asali daga hagu na hagu zai haifar da bugun jini a cikin mutane tare da fibrillation. Duk da haka, wadannan kwayoyi suna iya kawo hadari na samar da babban zubar da jini, ciki har da ciwon jini (jini a cikin kwakwalwa). An kiyasta cewa yawan kwayar cutar da cutar ta haifar ta kai kashi 0.4 bisa dari.
Abin da ake nufi shine yin amfani da kwayoyi masu amfani da kwayoyin halitta yana da hankali yayin da hadari na fashewa daga fibrillation mai tsanani ya fi girma fiye da hadarin bugun jini daga miyagun ƙwayoyi. Doctors yarda, a mafi yawan, cewa a cikin marasa lafiya tare da nonvalvular atrial fibrillation wanda CHA2DS2-VASc score ne ba kome, antioagulation ba za a yi amfani da. Don yawancin biyu ko mafi girma, dole ne a yi amfani da magungunan ƙwayoyin cuta gaba daya.
Kuma saboda yawancin daya, magani yana buƙatar zama mutum ɗaya ga kowane mai haƙuri.
A baya, likitoci sun zaci cewa idan sun ci nasara wajen yin amfani da " farfadowa na kula da kwayar cutar " don neman filastillation (wato, magani don dakatar da fibrillation da kuma rike da zuciya ta jiki), hadarin bugun jini zai sauke. Duk da haka, shaidun asibiti a yanzu sun kasa nuna cewa tsarin farfadowa na rudani ya rage hadarin bugun jini. Don haka ko da idan kai da likitanka sun fita don maganin kwance, ya kamata a bi da ku don hana fashewa idan kodin ku CHA2DS2-VASc ya isa.
Wace Dokokin Za a Yi Amfani?
Magunguna da suke da tasiri wajen rage hadarin bugun jini a cikin filastillation kwayar cutar sune kwayoyi masu tsauraran kwayoyi.
Wadannan kwayoyi ne da ke hana jini daga jini , kuma hakan zai hana ginin jini. A cikin marasa lafiya tare da fibrillation, wanda ya rage kashi biyu cikin uku na hadarin bugun jini.
Har sai kawai 'yan shekaru da suka gabata, kawai magani mai tsaurin kwayoyin cutar wanda yake samuwa shine warfarin ( Coumadin ), wani magani da ke dauke da bitamin K. (Vitamin K yana da alhakin yin yawancin abubuwan clotting.) Taking Coumadin ba abu ne mai ban mamaki ba sau da yawa wuya, duk da haka. Ana buƙatar lokacin gwajin jini da yawa sau da yawa don auna ma'aunin jini da kuma daidaita yawan kashi na Coumadin. Har ila yau, an hana hane-hane na abinci saboda yawancin abinci zasu iya canza aikin Hussain. Idan ba a gyara sashi ba daidai ko sau da yawa, jinin zai iya zama "ƙaramin bakin ciki" ko kuma bai dace ba, kuma kowane abu zai iya haifar da matsala mai tsanani.
A cikin 'yan shekarun da suka gabata, an kafa sababbin kwayoyi masu kirkirar kwayoyin halitta wadanda basu hana ta hanyar hana bitamin K, amma a maimakon haka ta hanyar kai tsaye wajen hana wasu abubuwa masu rarraba. Wadannan ana kiransu "magungunan kamfanoni", ko NOACs. Aikin da aka amince a yanzu a Amurka sune dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis), da kuma watsar (Savaysa).
Wadannan kwayoyi duk suna da amfani a kan Coumadin. Suna amfani da takardun tsari na yau da kullum, saboda haka an kawar da buƙatar ƙwaƙwalwar jini da gyaran gyare-gyare. Ba su buƙatar kowane ƙuntataccen abinci. Kuma bincike na asibiti sun nuna cewa wadannan kwayoyi masu mahimmanci sun kasance akalla a matsayin tasiri da kuma lafiya a matsayin Coumadin.
Akwai wasu alamu ga NOACs, duk da haka. Sun kasance mafi tsada fiye da Coumadin, kuma ba kamar Coumadin (wanda za'a iya juyawa da sauri ta hanyar samar da bitamin K) yana da wuyar sake juyo da sakamakon su idan an sami babbar matsalar jini. (Banda har yanzu ya kasance Pradaxa, an yarda da maganin wannan miyagun ƙwayoyi a watan Oktobar 2015.)
Yawancin masana yanzu sun fi so su yi amfani da magani na NOAC akan Coumadin a marasa lafiya tare da fibrillation. Duk da haka, akwai mutane wanda Coubalin shine har yanzu zaɓin zaɓi. Abun dacewa yana da kyau idan kana shan Coumadin rigaka kuma an tabbatar da shi a kan miyagun ƙwayoyi ko kuma idan ba za ka dauki kwayoyi sau biyu a rana ba (abin da ake buƙatar da Pradaxa da Eliquis) ko kuma idan ba za ka iya samun kudin da ake yi a yanzu ba. sababbin kwayoyi.
Hanyar aikin
Saboda matsalolin da ke tattare da shan kwayoyi marasa amfani, anyi kokarin ci gaba da maganin magunguna don kokarin hana fashewa a cikin marasa lafiya tare da fibrillation. Wadannan hanyoyi an yi amfani da su wajen rabu da gefen hagu na lissafi (wani "jakar" na hagu na hagu wadda aka rage daga ci gaban tayi). Ya bayyana cewa mafi yawan clots da suke samarwa a cikin hagu na hagu a lokacin da aka yi amfani da fibrillation ne a cikin ƙaddamar da ƙira.
Za'a iya rarraba takardar lissafi na hagu na wurare dabam dabam daga wurare dabam-dabam ta hanyar amfani da ƙwayoyi ko kuma ta saka na'urar ta musamman a cikin kwaskwarima ta hanyar kullun. Duk da yake suna amfani da asibiti, dukkanin wadannan hanyoyi suna da manyan kuskure, kuma a wannan yanayin an adana su ne don lokuta na musamman.
Takaitaccen
Hutun da ya fi damuwa shi ne mafi yawan tsoron, kuma rashin tausayi mafi yawanci, ƙananan ƙaddamar da fibrillation. Saboda haka rage yawan haɗarin ciwon bugun jini shine wani abu da kai da likitanku zasu dauka sosai. Abin farin ciki, idan kai da likitanka sun kusanci matsalar nan gaba-ƙididdige haɗarinka da kuma magance daidai-yadda za a guje wa wannan batu za a inganta sosai.
Sources:
Fuster, V, Ryden, LE, Cannom, DS, et al. ACC / AHA / ESC 2006 Rubuce-rubuce don Gudanar da marasa lafiya tare da hangen nesa Wani rahoto na Cibiyar Harkokin Kasuwancin Amirka da Ƙungiyar Harkokin Kasuwancin Amirka game da Ka'idojin Harkokin Kasuwanci da Ƙungiyar Harkokin Kasuwancin Kasuwancin Kasuwanci (Guidance Guidelines) (Kwamitin Rubuta don Gyara Shawarar 2001 don Gudanar da marasa lafiya tare da Fibrillation na Wajibi). J Am Coll Cardiol 2006; 48: e149.
Fang MC, Go AS, Chang Y, et al. Daidaita tsarin ƙaddamar da hadarin haɗari don hango hasashen thromboembolism a cikin mutane tare da fibrillation. J Am Coll Cardiol 2008; 51: 810.