Phunzirani zofunikira zokhudzana ndi kukhala ndi phokoso la msana
Kuwombera kwapopu, kapena phokoso la m'mphepete , ndi njira yamba yomwe imachotsera kaperesi yamadzimadzi (CSF) kuchokera kumtsinje wamtsempha kotero dokotala amakhoza kuphunzira madziwo bwinobwino. Ngakhale kuti mapulogalamu a m'maganizo amachititsa kawirikawiri mayesowa, lingaliro la kuponyedwa kwa lumbar kumapangitsa anthu ambiri mantha.
Chifukwa Chake Kutha Kwambiri Kumakhala Kofunika
Mankhwala a Lumbar amachitidwa pofuna kuyesa mayesero opatsirana pamtsempha.
Izi zimathandiza dokotala kuti:
- Kupeza bwino matenda
- Mvetserani momwe matenda omwe ali kale amakhudzira munthu
Cerebrospinal madzi akhoza kuyesedwa kwa matenda opatsirana monga matenda a meningitis , matenda opweteka monga multiple sclerosis , ndi khansa zina. Kuonjezerapo, kuponderezedwa kwa madzi mkati mwa ngalande ya msana kungayesedwe kuti ayesetse kuvutika monga pseudotumor cerebri. Kuti ayese kuchulukira kulikonse, opaleshoni ya m'mitsempha imatha kugwiritsa ntchito chidziwitso chotchedwa manometer panthawiyi.
Chimene Chimachitika Panthawiyi
Ndondomeko yowotula nthawi zambiri imatenga pafupifupi mphindi 45 mpaka ola limodzi. Mudzachita izi:
- Mudzagona pambali panu pamatumbo anu ndi mawondo anu pafupi ndi chifuwa chanu. Mwinanso, mungapemphedwe kuti mukhale mozemba ndi msana wanu kwa katswiri wa zamagetsi.
- Kumbuyo kwanu kumbuyo kudzatsukidwa ndi wothandizira kwambiri monga ayodini, ndipo mankhwala am'deralo monga lidocaine adzalowetsedwa pakhungu kuti agwedeze dera. Jekeseni wa mankhwala opweteka angayambitse pang'ono kuyamwa.
- Pambuyo pake, mitsempha yodwala matenda a ubongo idzagwedeza singano yopanda pakati pakati pa nsana ziwiri zam'mbuyo zam'mbuyo mumtsinje wa thecal, umene uli ndi CSF. Nthawi zina singano imayenera kuikidwa m'malo kuti ipeze malo abwino.
- Pomwe singano ilipo, katswiri wa zamagetsi akhoza kuyesa kuponderezedwa pogwiritsa ntchito manometer.
- Madzi amadziwombera kenako amasonkhanitsidwa m'mayipi omwe amayesa kutumizidwa ku labu.
- Mukamasonkhanitsa madontho, singano imachotsedwa.
- Bandage nthawi zambiri imayikidwa pa tsamba la malo omwe amapezeka.
- Webusaitiyi ikhoza kukhala yowawa kwa tsiku limodzi kapena awiri mutatha.
Kodi Ziwalo Zowonongeka N'zotheka Kuchokera Kumphepete Zamphepete?
Palibenso mwayi uliwonse wa kuwonongeka kwa chingwe kapena kufooka chifukwa singano imayikidwa pamunsi pomwe chingwe cha msana chimatha. Mtambo wa msana umatha masentimita angapo pamwamba pa malo omwe singano imayikidwa. Mitsempha yomwe imagwera pamtunda wa msana imangoyendayenda mosasuntha kupyolera mu theka sac yomwe imatchedwa "cauda equina" ("mchira wa kavalo").
Zovuta Zilipo
Nthawi zina, singano ikhoza kumenyana ndi imodzi mwa mitsempha ku cauda equina , koma izi zimangowononga pafupifupi 1 pa anthu 1,000 ndipo nthawi zambiri zimachiza nthawi. Kawirikawiri mumamva ngati magetsi omwe amagwera pansi.
Pa pakati pa 10 mpaka 30 peresenti ya anthu omwe amapeza kupatsidwa lumbar pambuyo pake adzakula mutu . Ngakhale kuti pali kutsutsana pa momwe mungapewere kupweteka kwa mutu, madokotala ambiri amalimbikitsa bwino hydration ndi kugona pansi kwa ola limodzi pamapeto pake. Caffeine ingathandizenso ngati mutu ukuyamba. Nthawi zina mutu umapitirira kwa masiku angapo pambuyo pake.
Izi zikutanthauza kuti singano yasiya dzenje mu theg sac, ndipo madzi akuthabe. Pachifukwa ichi, njira yomwe imatchedwa magazi "chigamba" -pamene magazi anu amalowetsamo mu theka sac-ikhoza kuthetsa mutu.
Odwala omwe ali mu ubongo monga abscess kapena chotupa, mavuto omwe amayamba chifukwa chochotsa madzi a m'mimba amatha kusintha kusintha kwa ubongo. Chithunzi cha CT kapena MRI cha ubongo musanayambe ndondomekoyi chikhoza kutulutsa mtundu uliwonsewo. Zovuta zina zotere zimaphatikizapo matenda kapena magazi. Zovuta zonsezi si zachilendo kupatsidwa kukonzekera kokwanira.
Mmene Mungakonzekere Mphepete Yam'madzi
Palibe mapangidwe apadera omwe akufunikira asanayambe kugwiritsira ntchito matepi. Ndondomekoyi ikhoza kuchitidwa ku ofesi kapena kuchipatala. Komabe, ngati mutenga mankhwala ochepetsa magazi , akhoza kuimitsa musanayambe njira yothandizira kuchepetsa kuika magazi. Komanso nkofunika kuonetsetsa kuti dokotala wayankha mafunso anu onse musanachitike. Izi zingakuthandizeni kuthetsa nkhawa iliyonse yomwe muli nayo yowonjezereka.
Kodi Kupweteka Kwambiri Kwambiri Kumakhala Kovuta?
Chisokonezo chomwe chimagwirizanitsidwa ndi kuponyedwa kwa lumbar kumawoneka mosiyanasiyana kuyambira odwala mpaka opirira. Palibe amene anganene kuti matepi a msana ndi omasuka, koma kawirikawiri sikumvetsa kupweteka kuposa momwe amaganizira. Nthawi zina gawo loipitsitsa ndichitsulo chimamveka ndi jekeseni wa mankhwala opweteka. Pamene nsalu yowonjezera imayikidwa kuti imve madzi, anthu ambiri amalongosola zambiri za kuthamanga kwakukulu, ndipo nthawi zina kumamva magetsi kumbuyo kapena kusuntha pansi. Zomwe zimagwiritsanso ntchito mankhwala amadzimadzi amtunduwu amafunika kuthana ndi ululu.
Njira Zina Zopangira Zambiri Zamtundu wa Cerebrospinal
Kwa anthu omwe ali ndi mavuto monga a scoliosis , nyamakazi , kapena kunenepa kwambiri , zingakhale zovuta kwambiri kwa katswiri wa zamagetsi kuti atenge CSF pambali pa bedi. Muzochitika izi, kupuma kwapadera kungapangidwe pansi pa chitsogozo cha fluoroscopic mothandizidwa ndi a radiologist. Komabe, nthawi zambiri, izi ndi zosavuta komanso zosafunika.
Mawu Ochokera
Kuwombera kosavuta, komabe kusasangalatsa, sikuli koipa monga momwe odwala ambiri amawopa. Ngakhale mavuto angakhoze kuchitika, iwo amakhala ochepa kwambiri. Phindu la kupeza madzi akuyesera kawirikawiri limaposa zoopsa komanso zovuta. Kuti mudziwe zambiri, onetsetsani kuti mafunso anu onse akuyankhidwa ndi dokotala wanu.
Zotsatira:
> Silberstein SD. Kutsika Kwambiri Kumutu. Baibulo la Merck Manual Consumer Version. Chiwongola dzanja
> Robbins E, Hauser EL, "Chaputala E32. Njira Yopambitsira Lumbar Puncture" (Chaputala). Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J: Harrison's Principles of Internal Medicine, 19 : 2015. McGraw-Hill Maphunziro.
> Ropper AH, MA Samuels, "Chaputala 2. Njira Zapadera za Kufufuza kwa Neurologic" (Chaputala). Ropper AH, Samuels MA: Adams ndi Victor's Principles of Neurology, 10 : 2014. McGraw-Hill Education.