ʻO ka hahau ʻana, kahi maʻi weliweli i hōʻike ʻia e ka emi koke ʻana o ke koko i ka ʻiʻo lolo ma muli o ka pathology hemorrhagic a ischemic paha, ʻo ia ke kumu lua o ka make ma ka honua holoʻokoʻa a me ke kolu o ke kumu nui o ke kīnā. ʻO nā ʻano nui ʻelua o ka hahau ʻana, ʻo ia ka hahau ischemic (68%) a me ka hahau hemorrhagic (32%). ʻOiai ko lākou pathophysiology ʻokoʻa i nā pae mua, ʻo ka hopena, alakaʻi nā mea ʻelua i ka emi ʻana o ke koko a me ka ischemia cerebral ma hope i nā pae subacute a me nā pae maʻi.
Hahau Ischemic
ʻO ka hahau ischemic (AIS) i hōʻailona ʻia e ka pani koke ʻana o kahi kīʻaha koko, e hopena ana i ka hōʻino ischemic i ka wahi i hoʻopilikia ʻia. I ka wā ʻoi loa, hoʻoulu kēia ʻano hypoxic mua i kahi cascade o ka excitotoxicity, oxidative stress, a me ka hoʻoulu ʻana o microglia, e alakaʻi ana i ka make neuronal ākea. I ka wā subacute, hiki i ka hoʻokuʻu ʻia ʻana o nā cytokines, chemokines, a me nā matrix metalloproteinases (MMPs) ke kōkua i ka neuroinflammation. ʻO ka mea nui, ʻo nā pae kiʻekiʻe o MMPs e hoʻonui i ka permeability o ka pale koko-lolo (BBB), e ʻae ana i ka neʻe ʻana o ka leukocyte i loko o ka ʻāpana infarcted, e hoʻonui ana i ka hana mumū.
Nā Lapaʻau o kēia manawa no ka Stroke Ischemic
ʻO nā lāʻau lapaʻau mua loa no AIS e komo pū me ka thrombolysis a me ka thrombectomy. Hiki i ka intravenous thrombolysis ke pōmaikaʻi i nā mea maʻi i loko o 4.5 mau hola, kahi e unuhi ʻia ai ka lāʻau lapaʻau mua i nā pono nui aʻe. Ke hoʻohālikelike ʻia me ka thrombolysis, loaʻa i ka mechanical thrombectomy kahi puka makani lapaʻau ākea. Eia kekahi, ʻo nā lāʻau lapaʻau non-pharmacological, non-invasive e like melāʻau lapaʻau oxygen, ke loaʻa nei ka acupuncture, a me ka hoʻoulu ʻana i ka uila ma ke ʻano he mau lāʻau lapaʻau hou i nā ʻano hana maʻamau.
Nā Kumu o ka Hyperbaric Oxygen Therapy (HBOT)
Ma ke kaomi o ka ʻilikai (1 ATA = 101.3 kPa), ʻo ka ea a mākou e hanu ai he 21% oxygen. Ma lalo o nā kūlana physiological, ʻo ka hapa o ka oxygen i hoʻoheheʻe ʻia i loko o ka plasma he mea liʻiliʻi wale nō, ma kahi o 0.29 mL (0.3%) no 100 mL o ke koko. Ma lalo o nā kūlana hyperbaric, ʻo ka hanu ʻana i ka 100% oxygen e hoʻonui nui i nā pae oxygen i hoʻoheheʻe ʻia i loko o ka plasma—a hiki i ka 3.26% ma 1.5 ATA a me 5.6% ma 2.5 ATA. No laila, manaʻo ʻo HBOT e hoʻonui i kēia ʻāpana o ka oxygen i hoʻoheheʻe ʻia, me ka maikaʻi.ke hoʻonui nei i ka nui o ka oxygen o nā ʻiʻo ma nā wahi ischemic. Ma nā kaomi kiʻekiʻe, hoʻolaha maʻalahi ka oxygen i loko o nā ʻiʻo hypoxic, e hōʻea ana i nā mamao hoʻolaha lōʻihi i hoʻohālikelike ʻia me ke kaomi lewa maʻamau.
A hiki i kēia lā, ua ʻike ʻia ka hoʻohana nui ʻia ʻana o HBOT no nā hahau ischemic a me hemorrhagic. Hōʻike nā haʻawina e hāʻawi ana ʻo HBOT i nā hopena neuroprotective ma o nā ʻano hana molekala, biochemical, a me hemodynamic paʻakikī, me:
1. Hoʻonui ʻia ke kaomi hapa oxygen arterial, e hoʻomaikaʻi ana i ka lawe ʻana o ka oxygen i ka ʻiʻo lolo.
2. Ka hoʻopaʻa ʻana o ka BBB, e hōʻemi ana i ka edema o ka lolo.
3. Hoʻonui ʻia o ka loloka hoʻokele ʻana o ka microcirculation, hoʻomaikaʻi i ka metabolism o ka lolo a me ka hana ʻana o ka ikehu ʻoiai e mālama ana i ka homeostasis ion cellular.
4. Ka hoʻoponopono ʻana i ke kahe koko o ka lolo e hoʻemi i ke kaomi intracranial a hōʻoluʻolu i ka pehu ʻana o ka lolo.
5. Ka hōʻemi ʻana o ka neuroinflammation ma hope o ka hahau ʻana.
6. Ka hoʻopau ʻana i ka apoptosis a me ka necrosisma hope o ka hahau ʻana.
7. Hoʻēmi i ke koʻikoʻi oxidative a me ka pale ʻana i ka hōʻeha reperfusion, he mea koʻikoʻi i ka pathophysiology stroke.
8. Hōʻike ka noiʻi hiki i ka HBOT ke hōʻemi i ka vasospasm ma hope o ka aneurysmal subarachnoid hemorrhage (SAH).
9. Kākoʻo pū nā hōʻike i ka pono o HBOT i ka hoʻolaha ʻana i ka neurogenesis a me ka angiogenesis.
Hopena
Hāʻawi ka lāʻau lapaʻau oxygen hyperbaric i kahi ala hoʻohiki no ka mālama ʻana i ka hahau. I ko mākou hoʻomau ʻana e wehewehe i nā paʻakikī o ka hoʻōla ʻana i ka hahau, he mea nui nā noiʻi hou aʻe e hoʻomaʻemaʻe i ko mākou ʻike i ka manawa, ka nui, a me nā ʻano hana o HBOT.
I ka hōʻuluʻulu manaʻo, i ko mākou ʻimi ʻana i nā pono o ka lāʻau lapaʻau oxygen hyperbaric no ka hahau ʻana, ua maopopo he hiki i ka hoʻohana ʻana i kēia lāʻau ke hoʻololi i ke ʻano o kā mākou mālama ʻana i nā hahau ischemic, e hāʻawi ana i ka manaʻolana i ka poʻe i hoʻopilikia ʻia e kēia kūlana hoʻololi ola.
Inā makemake ʻoe e ʻimi i ka lāʻau lapaʻau oxygen hyperbaric ma ke ʻano he lāʻau lapaʻau kūpono no ka hoʻōla ʻana i ka hahau, ke kono aku nei mākou iā ʻoe e kipa i kā mākou pūnaewele e aʻo hou e pili ana i kā mākou mau keʻena oxygen hyperbaric holomua. Me nā ʻano hoʻohālike i hoʻolālā ʻia no ka hoʻohana ʻana ma ka home a me ka ʻoihana, hāʻawi ʻo MACY-PAN i nā hoʻonā e hāʻawi i ka lāʻau lapaʻau oxygen kiʻekiʻe, i kuhikuhi ʻia e kākoʻo i kāu huakaʻi olakino a me ka hoʻōla ʻana.
E ʻike i kā mākou huahana a pehea e hiki ai iā lākou ke hoʻomaikaʻi i kou olakino mawww.hbotmacypan.com.
Ka manawa hoʻouna: Pepeluali-18-2025