Papiso ea litekanyo tsa Prehospital bakeng sa ho bolela esale pele ho Koaheloa ha Sejana se Seholo sa Anterior Sebakeng sa Ambulense

By Cristiano Antonino On Nov 21, 2021

ambulense ho tšoaroa pelo tlaleho ea nyeoe lekaleng la bongaka mooki Tlhahlobo pholosa sekwahelo koetliso ea

Mekhahlelo ea Prehospital le molemo oa bona ho li ambulense, phuputso e phatlalalitsoeng ho Jama e qala ka potso ena: ke litekanyetso life tsa ts'ebetso le ho khoneha ha litekanyo tsa ho bolela esale pele bakeng sa ho koaloa ha sekepe se seholo sa ka pele ha se tiisitsoe ka ntle 'me se bapisoa le hlooho ho ea boemong ba lits'ebeletso tsa meriana ea tšohanyetso?

Thutong ena ea bakuli ba fumaneng likhoutu tse matla tsa stroke, litekanyo tse 7 tsa ho bolela esale pele tsa prehospital lia hlahlojoa.

Thutong ena ea sehlopha sa bakuli ba 2007 ba fumaneng likhoutu tse matla tsa stroke, litekanyo tse 7 tsa ho bolela esale pele li bonts'itse lintlha tse nepahetseng, tse phahameng haholo, le kutlo e tlase, ho latela lipalo ho rata Los Angeles Motor Scale le Sekala sa Rapid Arterial Occlusion Evaluation.

Litefiso tsa ho khonahala li ne li rata sekala sa Prehospital Acute Stroke Severity.

Liphello tsa hona joale li fana ka maikutlo a hore liphapang tse nyenyane empa tse nang le lipalo-palo tse nepahetseng li bonahala li na le moelelo oa kliniki ho baahi ba bangata bakeng sa ho fokotsa tieho ea phekolo, ka liphello tse ntlafetseng tsa kliniki tse latelang, le hore ho khoneha ho lokela ho nahanoa pele ho sebelisoa sekala.

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Bohlokoa ba sekala sa pele ho sepetlele ka liambulense

Katleho ea endovascular thrombectomy (EVT) bakeng sa matšoao a maholo a ka hare ho sekepe occlusion (sLAVO) e fokotseha haholo ha nako e ntse e tsamaea.

Hobane EVT e lekanyelitsoe litsing tse felletseng tsa stroke, prehospital triage ea bakuli ba nang le li-code tse matla tsa stroke bakeng sa sLAVO ke tsa bohlokoa, 'me le hoja litekanyo tse' maloa tsa ho bolela esale pele li se li ntse li sebelisoa, ho netefatsa ka ntle, ho bapisoa ha hlooho le hlooho, le lintlha tsa ho khoneha li haella.

Sepheo: Ho etsa bonnete ba ka ntle le ho bapisa lihlooho tsa 7 sLAVO ho bolela esale pele litekanyo boemong ba ts'ebeletso ea meriana ea tšohanyetso (EMS) le ho hlahloba ho khoneha ha tekanyo ke baoki ba liphallelo tsa EMS.

Boithuto bona ba sehlopha se lebelletsoeng bo entsoe lipakeng tsa Phupu 2018 le Mphalane 2019 setsing se seholo sa litoropo Netherlands se nang le baahi ba ka bang limilione tse 2 mme se kenyelelitse li-EMS tse peli, litsi tse 2 tse felletseng tsa stroke, le litsi tse 3 tsa mantlha tsa stroke.

Barupeluoa e ne e le bakuli ba latellanang ba lilemo li 18 kapa ho feta bao khoutu ea EMS e qalileng e ile ea etsoa.

Har'a li-code tsa 2812 tse matla tsa stroke, 805 (28.6%) li ne li sa kenyelletsoa, hobane ha ho kopo e sebelisitsoeng kapa ha ho na lintlha tsa kliniki tse fumanehang, ho siea bakuli ba 2007 ba kenyelletsoeng litlhahlobong.

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Litekanyo tsa ho bolela esale pele tsa prehospital li hlahlobiloe

Likōpo tse nang le litlhaloso tsa kliniki tse tlatsitsoeng ke baoki ba liphallelo tsa EMS bakeng sa khoutu e 'ngoe le e' ngoe e matla ea stroke e nolofalletsang ho tsosolosoa ha litekanyo tse latelang tsa 7: Los Angeles Motor Scale (LAMS); Tlhahlobo e Potlako ea ho Koaheloa ha Metsi (RACE); Sesebelisoa sa Tekolo sa Tekolo ea Leqeba la Cincinnati; Prehospital Acute Stroke Severity (PASS); sheba-sefahleho-sephaka-nako-ea-puo; Tekolo ea Tšimo ea Leqeba bakeng sa Sebaka sa Tšohanyetso; le tebello, asymmetry ea sefahleho, boemo ba kelello, ho fela / ho se tsotelle.

Liphetho tse reriloeng tsa mantlha le tsa bobeli e ne e le sLAVO le litefiso tsa ho khonahala (ke hore, karolo ea likhoutu tse matla tsa stroke tseo sekala sa prehospital se ka nchafatsoang).

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Mehato ea ts'ebetso e boletsoeng esale pele e ne e kenyelletsa ho nepahala, kutloelo-bohloko, ho hlaka, index ea Youden, le litekanyetso tsa ho bolela esale pele.

Ho bakuli ba 2007 ba ileng ba fumana li-code tse matla tsa stroke (bolemo [SD] lilemo, 71.1 [14.9] lilemo; 1021 [50.9%] banna), 158 (7.9%) ba ne ba e-na le sLAVO.

Ho nepahala ha sekala ho ne ho tloha ho 0.79 ho ea ho 0.89, 'me litekanyo tsa LAMS le RACE li fana ka lintlha tse phahameng ka ho fetisisa.

Boikutlo ba sekala bo ne bo tloha ho 38% ho isa ho 62%, le ho khetheha ho tloha 80% ho ea ho 93%.

Litefiso tsa ho khonahala ho tloha ho 78% ho isa ho 88%, ka sekhahla se phahameng ka ho fetisisa sa sekala sa PASS.

Phuputso ena e fumane hore litekanyo tsohle tsa 7 tsa ho bolela esale pele li ne li e-na le ho nepahala ho hotle, ho khetheha ho phahameng, le kutloisiso e tlaase, le LAMS le RACE e le litekanyo tse phahameng ka ho fetisisa tsa lintlha.

Litefiso tsa ho khonahala li ne li le lipakeng tsa 78% le 88% 'me li lokela ho eloa hloko pele ho kengoa sekala.

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