Lokacin da mutum yana fama da bugun jini, magani mafi kyau (duka lafiya, da farfado don hana wani bugun jini) ya dogara da abin da ya haifar da bugun jini . Saboda haka yana da mahimmanci ga likitoci suyi la'akari da ainihin dalilin kowace fashewa.
Abin takaici, har zuwa kashi 40 cikin dari na Amirkawa da ke fama da bugun jini sun ƙare tare da rarrabuwa na annobar cryptogenic , wanda ke nufin cewa ko da bayan an gwada lafiyar likita ba tare da saninsa ba.
Ba tare da sanin dalilin ba, hanyar kulawa mafi kyau ga fashewar su kawai za a iya dogara ne akan zanewa.
Domin shekaru masu yawa masu bincike sunyi ƙoƙari su gane abin da yanayin kiwon lafiya zai iya haifar da ciwon bugun jini ba tare da barin wata matsala ba, wato, wanda yanayin kiwon lafiya zai iya haifar da bugun jini na cryptogenic. Masu laifi biyu da suka kware mafi yawan hankali sune oval mai suna (PFO) da kuma fibrillation . Yin la'akari da cewa PFO yana iya haifar da kullun cryptogenic ya tabbatar da wahala da rikici.
Rashin jayayya shi ne haɗari da ke tattare da fibrillation. Rashin jini, mafi yawan abin da ya fi damuwa da yin amfani da fibrillation, yana da yawa a cikin marasa lafiya wanda ke da wannan arrhythmia. Kuma a yanzu ya bayyana cewa filastillation na shari'a zai iya kasancewa mafi mahimmanci na annobar cryptogenic fiye da yadda muka gane a baya.
Atrial Fibrillation & Cryptogenic Stroke
Yayinda yake shawo kan magungunan cututtuka (kamar ƙyatarwa da hasken wuta), zangon samfurin filastillation zai iya faruwa ba tare da samar da wata alama ba. A cikin waɗannan lokuta, ba mai haƙuri ko likita na iya samun wani ra'ayi cewa samfurin da ake yi wa dan adam yana faruwa. Yanzu yana ƙara fahimtar cewa irin waɗannan nauyin "subclinical" (wato, wanda ba a san shi ba) fibrillation ne mai mahimmanci na cututtuka na cryptogenic.
Nazarin binciken CRYSTAL-AF, wanda yayi ƙoƙari ya auna yadda sau da yawa shawoɗɗen shari'ar da aka yi a cikin kullun zai iya daukar alhakin shawoɗun cryptogenic, ya dubi mutane 414 da suka kasance da shanyewar annobar cryptogenic. Masu bincike sun kirkiro wani ƙananan ƙwayar zuciya - mai bayyanawa (Medtronic, Inc.) - a cikinsu wanda zai iya saka idanu zuciyar mutum har zuwa shekaru uku.
A ƙarshen binciken, kashi 30 cikin dari na marasa lafiya tare da masu saka ido na kwakwalwa da aka kafa sun kasance sun kasance suna da alamun dabarar da aka fi sani da fibrillation. Ya bambanta, a cikin rukuni mai kula da marasa lafiya 220 wadanda aka gwada bugun ƙwayoyin cututtuka ba tare da irin wannan kulawa na tsawon lokaci ba, an gano jigilar fibrillation a cikin kasa da kashi biyu.
Wannan yana nuna wasu abubuwa biyu game da fibrillation da cryptogenic stroke. Na farko, magungunan ƙaddamar da ƙaddamarwa na ƙetare mai yiwuwa yana da alhakin mafi yawan ƙananan cututtuka na cryptogenic fiye da yadda muka sani. Kuma na biyu, mai kula da ƙwaƙwalwar ƙwayar cuta na tsawon lokaci zai zama dole don gano marasa lafiya da suke da wannan matsala. (Lokacin da aka saka idanu wanda ba a iya gani ba a cikin wannan binciken kafin a fara binciken fibrillation shine kwanaki 84).
Wannan binciken ba lallai ya tabbatar da cewa cin zarafin da ake yi ba yana da alhakin cututtuka na cryptogenic a cikin wadannan marasa lafiya, kuma ba ya tabbatar da cewa amfani da kwayoyin cutar shanko zai inganta sakamakon su.
Yawancin gwaje-gwaje na ƙarshe ba za a iya gwada waɗannan abubuwa ba. Amma mun san cewa mutanen da ke fama da ƙwayar cryptogenic suna da mummunar haɗari na fashewar ƙwayar cuta, da cewa fibrillation mai tsanani ya ƙara haɗarin cutar shan ƙwaƙwalwa, kuma cewa maganin cutar shan-jini yana da yawa ya rage hadarin bugun jini a cikin fibrillation. Tare da wadannan gaskiyar, kashi 97 cikin 100 na marasa lafiya a binciken da aka yi a CRYSTAL-AF waɗanda aka gano suna da ciwon maganganu da ke dauke da kwayoyin cutar ta hanyar magance cutar shan magani ta likitoci.
Zuciya Tsuntsauran Zuciya
Bisa ga abin da muka sani a yau, dogon lokaci mai kulawa na zuciya ya kamata a kalla a cikin marasa lafiya waɗanda suka yi bugun jini, musamman idan likitocin su canza shawarar maganin su dangane da sakamakon wannan saka idanu.
Kwanan ƙwaƙwalwar ƙwaƙwalwa na tsawon lokaci yana iya yiwuwa a cikin aikin likita. Za a iya amfani da masu kula da kwakwalwa na zuciya a yanzu har zuwa kwanaki 30, tsawon lokacin saka idanu wanda aka nuna don gano adadin yawan marasa lafiya da ƙaddarar ƙirar ƙira. Kuma masu lura da kwakwalwar zuciya na dindindin na zamani-waɗanda suke amfani da su a cikin binciken CRYSTAL-AF da kuma ƙananan samfurin "tsara na gaba" - suna samuwa don amfani da asibiti.
Idan kai ko wanda kake ƙauna yana da ƙwayar cututtuka, kuma idan likitanku zai canza farjin ku dangane da ko wane ne ko a'a ba a bincikar fibrillation ba, to, ya kamata kuyi magana da likita game da yiwuwar kulawa ta zuciya mai tsawo.
Sources:
Sakamakon binciken CRYSTAL-AF. Ƙungiyar Harkokin Kasa ta Duniya (ISC) 2014. Abubuwa LB11. An gabatar da Fabrairu 14, 2014.
Liao J, Khalid Z, Scallan C, et al. Gudanar da ƙwaƙwalwar zuciya na zuciya don gano ƙwayar cuta mai ƙin ƙetare ko ƙwayar cuta bayan ƙaddarar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa. Cutar da 2007; 38: 2935.
Hylek EM, Go AS, Chang Y, et al. Halin ƙarfin maganganu na maganganu a kan cutar kutsawa da kuma mace-mace a cikin fibrillation. N Engl J Med 2003; 349: 1019.