Kawirikawiri Matenda Omwe Amapweteka Kwambiri Amakhala Ovuta Kuchitira
Arachnoiditis ndi vuto losasinthasintha lachilendo lomwe lingakhoze kuchitika pamene opaleshoni yatsopano-mwachitsanzo-yachitidwa pamphuno. Ndizoti, chifukwa cha arachnoiditis sichikugwiritsidwa ntchito ku opaleshoni ya kumbuyo.
Mwachitsanzo, kuphulika kwa matenda a mitsempha m'chaka cha 2012 chifukwa cha jekeseni woipa wa steroid kunayambitsa ma 720 ndi anthu 48 akufa. CDC inanena kuti arachnoiditis, komanso matenda opatsirana, achitika pa malo opangira injection kwa odwala ena.
Kodi Arachinoiditis N'chiyani?
Arachnoiditis ndi kutupa kapena kukwiya kwa ululu wa arachnoid wa meninges. Pofuna kukuthandizani kumvetsetsa zomwe zikutanthawuza, phunziro lachidule la anatomy likuyenera:
Maninge ndi mapaundi atatu a mitsempha yophimba msana ndi ubongo. Pamodzi, ubongo ndi msana zimapanga dongosolo loyamba la mitsempha. Mbali ya arachnoid ndi chigawo chapakati cha chophimba ichi. Mzere wosanjikiza, womwe umatchedwa kuti mayi wachisanu - chomwe chimatanthauza "mayi wolimba" - ndilo, kutanthauza dzina lake, minofu yamphamvu yotetezedwa ku mphamvu zomwe zimagwira chingwe kuchokera kunja. Zomwe zimayambira, zomwe zimakhala zozama kwambiri, zimakhala zovuta kwambiri ndi mitsempha yambiri yamagazi yomwe imalowa mkati mwake. Mbali ya arachnoid imakhala ndi mitsempha ya magazi, ndipo zonsezi ndi arachnoid zili ndi cerebrospinal fluid , njira ina yotetezera dongosolo la pakatikati la mitsempha. Mbalameyi imakhala pansi pa nsanamira ya arachnoid, yomwe ili pansi pa zokhazokha.
Mwa kuyankhula kwina, ndizomwezo ndizowonjezera pafupi kwambiri ndi chingwe cha msana.
Monga momwe zimakhalira zovuta kwambiri, pamene arachnoid nembanemba imakwiyitsa, iyo ikhoza kuyambitsa kupweteka. Zimenezi zimatha kuchitika pamene chingwe cha msana chikugwedezeka, kaya chovulala kapena njira ya msana.
Mu arachnoiditis, kutupa kumabweretsa minofu yowonongeka. Minofu yazing'ono, inanso, ingayambitse mitsempha ya m'mphepete mwachisawawa. Njira imodzi yoganizira arachnoiditis ndi nthiti za mitsempha yomwe ili mkati mwa ngalande ya msana.
"Ngati mungathe kulingalira kuti mitsempha ngati nsonga za spaghetti zomwe zimagwirizana, ndiye kuti arachnoiditis ili ngati," akutero Dr. Anand Gandhi, yemwe amagwiritsa ntchito thupi. Gandhi ndi dokotala wodziwa njira zowonongeka. Iye amachita chizolowezi ku Laser Spine Institute ku Tampa, Florida.
Kuphulika kumayamba kuchitika kumadera ena mumtsinje wa msana . Izi zimagwirizana ndi dera lomwe lili mkati mwake (lomwe limatchedwa "medial to") mizu ya mitsempha ya msana , Gandhi akuti. Mukhoza kumvetsetsa kuti malo amtunduwu ndi otani pa malo omwe amayamba kutsogolo ndikuyamba kukhala mitsempha yambiri. Mitsempha ya m'mimba ndiyo mitsempha yomwe imachokera ku chingwe kupita ku thupi lanu lonse; Mitsempha iyi imakupatsani inu kumverera, kuyankha ndi kusuntha.
Zifukwa za Arachnoiditis
Arachnoiditis kawirikawiri ndi chifukwa cha mtundu wina wa kuvulala kapena kusokonezeka kwa msana. Kaŵirikaŵiri zimachitika ngati zotsatira za chinachake chimene chachitidwa msana.
Malingana ndi Dr. Gandhi, zifukwa zitatu za arachnoiditis, mwazimenezi, ndizo: Kuchita opaleshoni, makamaka mtundu wosagwira ntchito, matenda a msana (izi zingakhale mabakiteriya, mavairasi, kapena onse) ndi zoopsa. Zifukwa zina, akuti, ndi zotupa ndi myelograms za CT , zomwe nthawi zina amapatsidwa kuti azindikire zilonda mu malo omwe ali pansi pa arachnoid. Dera la subarachnoid limatchedwanso malo osokonekera .
Chizindikiro cha Arachnoiditis
Kuwopsa kwa ululu wammbuyo wokhudzana ndi arachnoiditis ukhoza kukhala wofatsa mpaka wovuta, Gandhi akuti. Akuti zizindikiro zikhoza kuphatikizapo mitsempha yokhudzana ndi kupweteka komanso kutentha kumbuyo komanso kumapazi.
Amanena kuti arachnoiditis nthawi zina amaphatikizidwa ndi paresthesia (mwachitsanzo, kugwedeza, kumverera kwa mapepala ndi singano, ndi / kapena kutaya mkono kapena mwendo). Kupweteka kumeneku ndi paresthesia nthawi zambiri zimachitika m'malo ovuta omwe sali okhudzana ndi kufalitsa kwadzidzidzi , akuti. Kugawanika kwa magazi kumangotanthauza thupi lomwe likutanthauza kuti "moto" wa mitsempha.
Zizindikiro zingaphatikizeponso kuwonongeka kwa minofu, kuphulika, kapena kupuma. Arachnoiditis ingakhudze chikhodzodzo, chifuwa, ndi kugonana, ndipo pakakhala zovuta kwambiri, zingayambitse ziwalo za m'munsi, Gandhi akuti.
Arachnoiditis Treatment
Arachnoiditis ndi matenda aakulu omwe amachititsa kuti, ambiri, asamayankhe mankhwala omwe alipo. Pamwamba pa izo, zizindikiro zake zimakhala zovuta chifukwa cha kusowa kwa zizindikilo zodziwika.
Gandhi amavomereza kuti arachnoiditis ingakhale yovuta kuchiza. Izi ziri choncho, akuti chifukwa mankhwala ndi zotsatira za mankhwalawa nthawi zambiri zimakhala zofanana. Kufikira malo a arachnoid popanda kupweteketsa mwapadera kumapangitsa mankhwala osokoneza bongo kukhala ovuta. Osati kokha, koma mankhwala oopsa angapangitse minofu yowonjezereka m'mlengalenga. Ndicho chinthu chomaliza chomwe mukufuna mu nthawi ya arachnoiditis (komanso zina zamtsempha). Tiyeni tiwone zofooka ziwiri imodzi pa nthawi kuti tiwone bwino chifukwa chake mankhwala a arachnoiditis siwongolunjika nthawi zonse:
- Malo ochizira: Lingaliro la mankhwala a arachnoiditis ndikuthetsa kupanikizika (mu malo osungirako mankhwala) omwe amayamba chifukwa cha "spaghetti yachitsulo," Gandhi akuti. "Koma malo a sub-arachnoid akhoza kukhala ovuta kuti afike popanda kupitiliza kukwiyitsa malo ovutawo," akuwonjezera. Mwatsoka, izi zimakhala zovuta kwa madokotala amene amachiza matendawa.
- Zosakaniza Zozizira Zozizira Zozizira: Ngakhale kuti pali njira zambiri zomwe madokotala amatha kuchizira minofu yowopsya , zambiri zimayambitsa minofu yambiri mu arachnoid malo. Kutembenuzidwa: Mankhwala a minofu yofiira yomwe imayikidwa mu sub-arachnoid malo amachititsa kuti chiwopsezo chanu chiwonjezere kuchuluka kwa "spaghetti yakufa" mu msana wako.
Nanga ndi chithandizo chotani cha arachnoiditis? Izi zikhoza kudalira momwe zimafooketsa, Gandhi akuti. Komanso, palibe chitsimikizo kuti chithandizo chilichonse chidzathandiza kuthetsa zizindikiro.
"Arachnoiditis ndi ovuta ndi mankhwala ochepa. Palibe wina wa golidi wothandizira, "akutero. "Ngati muli ndi arachnoiditis, kambiranani ndi dokotala wanu zomwe mungachite."
National Institutes of Health amati mankhwala ambiri okhudza arachnoiditis amayang'ana pa kupweteka kwa kupweteka ndi kusintha kwa zizindikiro - kukuthandizani kuti muzigwira ntchito bwino mu moyo wanu wa tsiku ndi tsiku. Amanenanso kuti opaleshoni ndi yotsutsana, makamaka chifukwa chabwino, mpumulo ndi waifupi.
Gandhi akuti mankhwala ambiri amayamba mwachizolowezi ndipo amapita ku mitundu yambiri ya njira zowonongeka. Pano pali phokoso (mwadongosolo):
- Thandizo la Thupi
- Mankhwala (amlomo) amamva kupweteka kwa mitsempha, mwachitsanzo: Lyrica kapena Neurotonin
- Jekeseni wa Intrathecal steroid mu malo osungirako mankhwala, omwe kwenikweni ndi mankhwala otsutsa-kutupa omwe amatanthauza kuchepetsa kupsa mtima m'danga
- Zomwe zimayambitsa (njira yowonongeka ya msana) yomwe ingathandize kuthandizira zizindikiro zowawa kuti musamawamvere mosavuta
- Thecaloscopy, ndi yatsopano, makamaka njira yopanda chitetezo yomwe imapangidwa pambuyo poti madokotala anayamba kugwiritsa ntchito endoscope kuti adziwe arachnoiditis. Madokotala anazindikira kuti njira yothetsera matendayo ingasinthidwe kukhala opaleshoni yomwe inaletsa kupweteka kumene kunayambitsa "mitsempha ya spaghetti". Pakadali pano, mankhwalawa adayesedwa odwala 23 okha; mwa kuyankhula kwina, palibe kafukufuku wochuluka pa thecaloscopy yachitidwa, choncho palibe mafunso onse okhudzana ndi chitetezo chake ndi kuthandizira kwake tayankhidwa.
Dziwani, sikoyenera kuti aloscapy achite kuti adziwe matenda a arachnoiditis. Thecaloscopy ndi imodzi yokha njira. Ndipotu, Gandhi akunena kuti ndondomeko ya golide yopezera matenda ndi MRI .
Chithandizo chabwino cha arachnoiditis ndi kupewa, Gandhi akuti. Mabwalowa amabwerera ku zifukwa zazikuluzikulu - minofu yopangidwa pambuyo poti chinachake chachitika msana wanu. Lingaliro pano ndi kuchepetsa chiopsezo chanu cha minofu yofiira. Kwa Gandhi uyu akuti ngati mukukonzekera kuchita opaleshoni ya msana, ganizirani njira yowonongeka. Kusankha kupita pang'onopang'ono (kumene kuli kofunikira kwa chikhalidwe chanu) kungachepetse chiopsezo chanu chowombera minofu, choncho kuchepetsa chiopsezo cha arachnoiditis. Monga momwe mungathetsere msana, lankhulani ndi dokotala mukakudziwitsani njira yabwino kwambiri.
Kodi Akuchita Kafukufuku Wotani?
Munda wa mankhwala a arachnoiditis ndi chingwe chomwe ochepa opereka ndi ochita kafukufuku apita kudzaza. Kafukufuku wowonjezereka komanso wodalirika angathe kuchitika ku National Institutes of Health. Choncho, kafukufuku wa arachnoiditis ndi wokongola kwambiri komanso amapezeka pafupipafupi. Ngati mukufuna kupititsa patsogolo njira zamankhwala, kambiranani ndi adokotala za zinthu zomwe tazitchula pamwambapa.
Zotsatira:
Kusonkhanitsa kwa Cerebral Spluid (CSF). Medline Plus. Ndasinthidwa komaliza: June 2011.
Di leva, A., et al. Lumbar Arachnoiditis ndi Thecaloscopy: Ndemanga Yachidule. Cent Eur. Neurosurger 2012.
Gandhi, A., Physiatrist Interactive, Laser Spine Institute, Tampa, Fla. May 2013.
Chidziwitso kwa Odwala: Kuphulika kwa Multistate kwa Fungal Meningitis ndi Matenda Ena. Webusaiti ya CDC.
Meninges of the Brain. Medline Plus. Ndasinthidwa komaliza: Oct. 2012.
NINDS Arachnoiditis Information Page. Tsamba la National Institute Neurological Disorders ndi Stroke. Ndasinthidwa komaliza: Jan. 2011.
Zindikirani kwa Madokotala: Kukhalabe Maso Kulimbikitsidwa kwa Matenda a Fungal pakati pa Odwala Amene Analandira Zosakaniza Zoipa za Steroid. Webusaiti ya CDC.
> Tetsuryu Mitsuyama, Shunji Asamoto, Takakazu Kawamata. Novel Surgical Management of Spinal Adhesive Arachnoiditis ndi Arachnoid Microdissection ndi Ventriculo-Subarachnoid Shunting. Journal of Clinical Neuroscience 18 (2011).