Stroke, ib qho mob hnyav uas tshwm sim los ntawm kev txo qis ntawm cov ntshav mus rau cov ntaub so ntswg ntawm lub hlwb vim hemorrhagic lossis ischemic pathology, yog qhov thib ob ua rau tuag thoob ntiaj teb thiab thib peb ua rau muaj kev tsis taus. Ob hom kev mob stroke tseem ceeb yog ischemic stroke (suav txog 68%) thiab hemorrhagic stroke (32%). Txawm hais tias lawv qhov sib txawv pathophysiology nyob rau theem pib, ob qho tib si thaum kawg ua rau txo qis hauv cov ntshav thiab tom qab cerebral ischemia thaum lub sij hawm subacute thiab ntev.
Ischemic Stroke
Ischemic stroke (AIS) yog cim los ntawm qhov tshwm sim tam sim ntawm cov hlab ntsha, ua rau muaj kev puas tsuaj rau cov cheeb tsam cuam tshuam. Nyob rau theem mob hnyav, qhov chaw ua haujlwm hypoxic no ua rau muaj kev cuam tshuam ntawm excitotoxicity, oxidative kev nyuaj siab, thiab ua kom muaj microglia, ua rau muaj kev tuag ntau ntawm neuronal. Thaum lub sijhawm subacute, kev tso tawm ntawm cytokines, chemokines, thiab matrix metalloproteinases (MMPs) tuaj yeem ua rau muaj kev mob ntshav qab zib. Qhov tseem ceeb, qib siab ntawm MMPs nce permeability ntawm cov ntshav-hlwb barrier (BBB), tso cai rau leukocyte tsiv teb tsaws mus rau hauv cheeb tsam infarcted, exacerbating inflammatory kev ua.
Kev kho tam sim no rau Ischemic Stroke
Cov kev kho mob tseem ceeb rau AIS suav nrog thrombolysis thiab thrombectomy. Intravenous thrombolysis tuaj yeem muaj txiaj ntsig zoo rau cov neeg mob hauv 4.5 teev, qhov kev kho mob thaum ntxov txhais tau tias muaj txiaj ntsig zoo dua. Piv nrog rau thrombolysis, mechanical thrombectomy muaj lub qhov rais kho dav dua. Tsis tas li ntawd, cov kev kho mob uas tsis yog tshuaj kho mob, uas tsis yog-invasive xws likev kho mob oxygen, acupuncture, thiab hluav taws xob stimulation tau txais traction raws li kev kho mob ntxiv rau cov qauv siv.
Lub hauv paus ntawm Hyperbaric Oxygen Therapy (HBOT)
Ntawm hiav txwv theem siab (1 ATA = 101.3 kPa), huab cua peb ua pa muaj kwv yees li 21% oxygen. Nyob rau hauv cov xwm txheej ntawm lub cev, qhov kev faib ua feem ntawm cov pa oxygen hauv plasma yog qhov tsawg, tsuas yog li 0.29 mL (0.3%) ib 100 mL ntawm cov ntshav. Nyob rau hauv cov xwm txheej hyperbaric, nqus tau 100% oxygen nce qib oxygen hauv cov ntshav hauv cov ntshav loj heev - mus txog 3.26% ntawm 1.5 ATA thiab 5.6% ntawm 2.5 ATA. Yog li, HBOT lub hom phiaj los txhim kho qhov no ntawm cov pa oxygen yaj, ua tau zoonce cov ntaub so ntswg oxygen concentration hauv cov cheeb tsam ischemic. Ntawm qhov siab dua, oxygen diffuses nkag mus rau hauv cov ntaub so ntswg hypoxic, ncav cuag qhov sib txawv ntev dua piv rau cov huab cua hauv huab cua.
Txog niaj hnub no, HBOT tau pom ntau daim ntawv thov rau ob qho tib si ischemic thiab hemorrhagic strokes. Cov kev tshawb fawb qhia tias HBOT muab cov teebmeem neuroprotective los ntawm ntau yam molecular complex, biochemical, thiab hemodynamic mechanisms, suav nrog:
1. Ua kom cov hlab ntsha oxygen ib nrab siab, txhim kho oxygen xa mus rau cov ntaub so ntswg hlwb.
2. Stabilization ntawm BBB, txo lub hlwb edema.
3. Txhim kho lub paj hlwbmicrocirculation, txhim kho lub hlwb metabolism thiab lub zog tsim khoom thaum tswj hwm cellular ion homeostasis.
4. Kev tswj cov ntshav cerebral kom txo qis intracranial siab thiab txo lub hlwb o.
5. Attenuation ntawm neuroinflamation tom qab mob stroke.
6. Tiv thaiv apoptosis thiab necrosistom qab mob stroke.
7. Alleviation ntawm oxidative kev nyuaj siab thiab inhibition ntawm reperfusion raug mob, tseem ceeb nyob rau hauv mob stroke pathophysiology.
8. Kev tshawb fawb qhia tias HBOT tuaj yeem txo cov vasospasm tom qab aneurysmal subarachnoid hemorrhage (SAH).
9. Cov pov thawj tseem txhawb nqa qhov txiaj ntsig ntawm HBOT hauv kev txhawb nqa neurogenesis thiab angiogenesis.
Xaus
Hyperbaric oxygen therapy nthuav qhia txoj kev pheej hmoo rau kev kho mob stroke. Raws li peb txuas ntxiv mus daws cov teeb meem ntawm kev mob stroke rov qab, kev tshawb nrhiav ntxiv yuav yog qhov tseem ceeb los kho peb txoj kev nkag siab ntawm lub sijhawm, ntau npaum li cas, thiab cov txheej txheem ntawm HBOT.
Hauv cov ntsiab lus, raws li peb tshawb nrhiav cov txiaj ntsig ntawm kev kho mob hyperbaric oxygen rau mob stroke, nws pom tseeb tias kev siv cov kev kho mob no muaj peev xwm los hloov kho txoj hauv kev uas peb tswj ischemic strokes, xa kev cia siab rau cov neeg cuam tshuam los ntawm lub neej hloov pauv.
Yog tias koj txaus siab tshawb nrhiav kev kho mob hyperbaric oxygen raws li kev kho mob rau kev mob stroke rov qab, peb caw koj tuaj xyuas peb lub vev xaib kom paub ntau ntxiv txog peb cov qib siab hyperbaric oxygen chambers. Nrog rau ntau yam qauv tsim los rau kev siv hauv tsev thiab kev tshaj lij, MACY-PAN muaj cov kev daws teeb meem uas xa cov pa oxygen zoo, tsom rau kev kho mob los pab txhawb koj txoj kev noj qab haus huv thiab rov qab los.
Tshawb nrhiav peb cov khoom thiab seb lawv tuaj yeem txhim kho koj txoj kev noj qab haus huv li caswww.hbotmacypan.com.
Lub sij hawm xa tuaj: Feb-18-2025