Isimo Esibuhlungu Sokugulisa Isifo Esijwayelekile Esiyinkimbinkimbi Kunzima Ukuphatha
I-Arachnoiditis yisimo esibuhlungu esingavamile esingokomzwelo esingase senzeke lapho ukuhlinzeka okuthile emuva, isibonelo-kwenziwa emgodini wakho. Ngalokho kusho, imbangela ye-arachnoiditis ayikhawulelwanga ekuhlinzekeni emuva.
Isibonelo, i-fungal meningitis ehlaselwa ngo-2012 ngenxa yokujola kwe-steroid eyonakele yabangela amacala angu-720 nama-48 ukufa. I-CDC ibike ukuthi i-arachnoiditis, kanye nezifo ezitholakala endaweni, zenzeke endaweni yokujova kwezinye iziguli.
Iyini i-Arachnoiditis?
U-Arachnoiditis ukuvuvukala noma ukucasuka kwekhanda elibhekene ne-arachnoid lama-meninges. Ukukusiza ukuthi uqonde ukuthi kusho ukuthini lokhu, isifundo esifushane se-anatomy sihlelekile:
I-meninges yizingxenye ezintathu zezicubu ezimboza intambo yomgogodla nobuchopho. Ngokubili, ubuchopho nomgogodla wakha uhlelo oluyisisekelo senzwa. I-membrane ye-arachnoid iyisendlalelo esiphakathi kwalokhu okumboziwe. Ingqimba ephezulu, ebizwa ngokuthi i-dura mater - okusho ukuthi "umama onzima" -, njengoba igama libonisa, izicubu ezinamandla ezihloselwe ukuhlinzeka ukuvikelwa emandleni asebenza ngentambo evela ngaphandle. I-too mater, okuyizingqimba ezijulile zamadoda, iyisisindo esibucayi esinemizila eminingi yegazi efakwe kuwo. I-membrane ye-arachnoid nayo iqukethe imithwalo yegazi, futhi kokubili i-arachnoid ne-arachnoid iqukethe i- cerebrospinal fluid , enye indlela yokuzivikela yesistimu ye-central central. I-mater efanayo nayo ikhona ngaphansi kwebhubhane le-arachnoid, elitholakala phansi kwe-mater.
Ngamanye amazwi, i-too mater yilapho isendlalelo eseduze kakhulu nomgogodla ngokwawo.
Njengemibandela eminingi yokuvuvukala, lapho ilwelwesi le-arachnoid licasuka, lingabangela ubuhlungu. Lokhu kuthukuthela kungase kwenzeke lapho intambo yomgogodla igxilile, kungakhathaliseki ukulimala noma inqubo yomgogodla.
Ngo-arachnoiditis, ukuvuvukala kuholela ekwakheni izicubu zomzimba. Izicubu zesikhumba, nazo, zingabangela izinzwa zomgogodla ukunamathela ngokungafaneleki. Enye indlela yokucabanga nge-arachnoiditis iyi-gob yezinzwa ezitholakala ngaphakathi komgudu wamagogasi.
"Uma ungacabanga ukuthi izinzwa ziyizintambo ze-spaghetti ezihlanganisa ndawonye, yilokho okushiwo u-arachnoiditis," kusho uDkt. Anand Gandhi, ochwepheshe bokungenelela. UGandhi ungudokotela onguchwepheshe ezinqubo ezincane ezingenasidingo. Ugcina umkhuba eLazer Spine Institute eTampa, eFlorida.
I-clumping ivame ukuba khona endaweni ethile emgodini ongasemgogodini . Lokhu kufana nendawo ngaphakathi ngaphakathi (okuthiwa ngokuthi "ophakathi" kuya kuthi) " izimpande zesisu somgogodla ," kusho uGandhi. Ungase uqonde indawo ye-clumping njengendawo endaweni yentambo ngaphambi nje kokuba iqala ukuphuma futhi ithuthuke ibe yizinzwa zomzimba. Izinzwa zomzimba ziyisifo somuntu ngamunye esivela entanyeni kuya emzimbeni wakho wonke; lezi zinzwa zenza ukwazi ukuzizwa, uphendule futhi uhambe.
Izimbangela ze-Arachnoiditis
I-Arachnoiditis ivame ngenxa yokulimala noma ukuphazamiseka emgodini. Ngokuvamile kwenzeka njengomphumela wento eyenziwe emthonjeni.
Ngokusho kukaDkt. Gandhi, izimbangela eziphezulu ezintathu ze-arachnoiditis, ngokulandelana, ziwukuthi: Ukuhlinzekwa ngesikhala, ikakhulukazi uhlobo olungapheli oluthile, izifo zomgogodla (lokhu kungaba yi-bacterial, viral, noma kokubili) nokuhlukunyezwa. Eminye imbangela, uthi, yizicubu kanye ne- CT myelograms , ngezinye izikhathi ezinikezwa ukuxilonga izilonda esikhaleni se-sub-arachnoid. Isikhala esinqunyiwe se-subarachnoid siphinde sabizwa ngokuthi isikhala se-intrathecal .
Izimpawu ze-Arachnoiditis
Ubukhulu bezinhlungu zasemuva ezihambisana nokuhlaselwa kwe-arachnoiditis kungahle kube phakathi komnene kuze kube mkhulu, kusho uGandhi. Uthi izimpawu zingase zihlanganise ukunzwa kwezinzwa ezinjengokugxuma nokushisa phansi nasemilenzeni.
Uphawula ukuthi i-arachnoiditis ngezinye izikhathi ihambisana ne-paresthesia (okungukuthi, ukugubha, ukuzwa kwezikhonkwane nezinaliti, kanye / noma ukuphazamisa phansi ingalo noma umlenze). Lokhu ubuhlungu kanye ne-paresthesia kuvame ukuvela ezindaweni ezingenayo okungahambisani nokusabalalisa kwe- dermatomal , uthi. Ukusatshalaliswa kwe-Dermatomal kumane kubhekisela kumaphethini kulo lonke umzimba lapho izibilini "zomlilo".
Izimpawu zingase zibandakanye izidakamizwa ezincibilikisa imisipha, ama-twitches, noma ama-spasms. I-Arachnoiditis ingathinta isisindo, isilonda, kanye nesenzo socansi, futhi ezimweni ezinzima, kungabangela ukukhubazeka kwamalungu angaphansi, kusho uGandhi.
I-Arachnoiditis Treatment
I-Arachnoiditis yimizwa yokuhlunguphazeka okungapheliyo, engxenyeni enkulu, engaphenduli ngempela empilweni okwamanje etholakalayo. Ngaphezu kwalokhu, ukubikezelwa kwayo kuvame ukulukhuni ngokuntuleka kwezimpawu ezibonakalayo.
UGandhi uyavuma ukuthi i-arachnoiditis ingaba nzima ukuyiphatha. Lokhu kungukuthi, uthi ngoba ukwelashwa nemiphumela emibi ekwelashweni kuvame ukufana. Ukufinyelela isikhala sokuhlaselwa ngaphandle kokwenza umonakalo owengeziwe kuso kwenza ukwelashwa kohlobo olungavamile kungavamile. Akukhona lokho kuphela, kodwa ukwelapha okungahambi kahle kungabangela ukubunjwa kwamathambo amaningi endaweni. Yilokho okugcina oyifunayo ezimweni ze-arachnoiditis (kanye nezinye izimo zomgogodla). Ake sibheke lezi zilinganiso ezimbili ngesikhathi esisodwa ukuze sithole ukuthi kungani ukwelashwa kwe-arachnoiditis akuhlali njalo ngokuqondile:
- Indawo yokwelapha: Umqondo wekhambi lokwelapha ukubulala i-arachnoiditis ukukhulula ukucindezelwa (esikhaleni esingaphansi komhlaba) esibangelwa "i-spaghetti ehlanganisiwe," kusho uGandhi. "Kodwa isikhala se-sub-arachnoid singaba nzima kakhulu ukufinyelela ngaphandle kokucasula leyo ndawo encane," esho. Ngeshwa, lokhu kubangela ukukhathazeka odokotela abaphatha lesi simo.
- Isikhwama Sesikhumba Sihlaba Izicubu Zesiqhwa: Nakuba kunezindlela eziningi odokotela abangakwazi ukuphatha ngazo izicubu ezibomvu, iningi lenza izicubu ezinzima kakhulu endaweni ye-arachnoid. Kuhunyushwe: Ukwelashwa kwezicubu ezilahla ezigxilwe esikhaleni se-sub-arachnoid kuvame ukuphakamisa ingozi yakho yokwandisa inani "le-spaghetti ehlanganisiwe" entanjeni yakho yomgogodla.
Ngakho-ke yimuphi ukwelashwa okuphumelela kakhulu kwe-arachnoiditis? Lokho kungase kuxhomeke ekutheni kunzima kangakanani, uGandhi uthi. Futhi, akukho isiqinisekiso sokuthi noma yimuphi ukwelashwa kuzosebenza ngempumelelo ekunciphiseni izimpawu.
"I-Arachnoiditis yinkinga enemithi embalwa. Akekho izinga legolide lokuliphatha, "usho kanje. "Uma une-arachnoiditis, khuluma nodokotela wakho mayelana nezinketho zakho."
I-Institutes of Health kazwelonke ithi izinhlobo eziningi zokwelashwa zibhekene nokukhululeka kobuhlungu nokuthuthukisa izimpawu - ukuze ukwazi ukusebenza kangcono ekuphileni kwakho kwansuku zonke. Bathi futhi ukuhlinzeka kuyinkimbinkimbi, ikakhulukazi ngenxa yokuthi okungcono, ukukhululeka kuyisikhathi esifushane.
U-Gandhi uthi ukwelashwa ngokuvamile kuqala ngokuqhubekayo futhi kuqhubeka nezinqubo ezithile zokuhlasela. Nasi i-rundown (ngokulandelana):
- Ukwelashwa Kwemvelo
- (Imlomo) imithi yokuhlunguphazwa kwezinzwa, isibonelo: Lyrica noma Neurotonin
- Umjovo we-intrathecal steroid endaweni engaphansi kwe-subarachnoid, okungukuthi imithi ephikisana nokuvuvukala okuhloswe ukuvimbela ukucasula endaweni
- Ukutshalaliswa (inqubo encane encane) yokuvuselela intambo yomgogodla engasiza ekusikiseni izimpawu zobuhlungu ukuze ungazizwa kalula
- I-Thecaloscopy, entsha, inqubo encane engavinjelwe engavinjelwe ngemuva kokuba odokotela baqala ukusebenzisa i-endoscope ukuxilonga i-arachnoiditis. Odokotela baqaphela ukuthi inqubo yokuxilonga ingashintshwa ibe yindlela yokuhlinzwa eyenza ukucindezeleka okubangelwa yizinzwa "ze-spaghetti" ezihluthulelwe. Kuze kube manje, lokhu kukwelashwa kuye kwahlolwa kuphela iziguli ezingu-23; ngamanye amazwi, akucwaningi okuningi mayelana ne-thecaloscopy okwenziwayo, ngakho-ke akuwona yonke imibuzo mayelana nokuphepha nokusebenza kwayo iphendulwe.
Khumbula, akudingekile ukuba i-theloscapy yenziwe ukuze uthole ukuxilongwa kwe-arachnoiditis. I-Thecaloscopy yindlela eyodwa kuphela engenzeka. Eqinisweni, uGandhi uthi izinga legolide lokuthola ukuxilongwa yi- MRI .
Ukwelashwa okungcono kakhulu kwe-arachnoiditis kuyisivikelo, kusho uGandhi. Le mibuthano ibuyele embangela oyinhloko yamacala amaningi - ukonakala kwesisindo emva kokuthile okwenziwe emthonjeni wakho. Umqondo lapha ukunciphisa ingozi yokubunjwa kwamathambo. Kulo Gandhi uthi uma uhlela ukuba nokuhlinzwa komgogodla, cabangela inqubo encane yokuhlasela. Ukukhetha ukuhamba kancane (lapho kufanele khona isimo sakho) kunganciphisa ingozi yakho yokwakheka kwesisindo somzimba, futhi ngaleyo ndlela, ukunciphisa ingozi yokulwa ne-arachnoiditis. Njengazo zonke izifo zokwelashwa ezikhona, khuluma nodokotela wakho lapho unquma indlela engcono kakhulu yokwenza ngayo.
Yimuphi Ucwaningo Olwenziwe?
Insimu ye-arachnoiditis imithi iyisiko esincane abahlinzeki nabacwaningi abaye baqala ukugcwalisa. Ucwaningo oluphelele kunazo zonke nolunokwethenjelwa lungenzeka eNational Institutes of Health. Ngakho-ke, ucwaningo lwe-arachnoiditis lubukeka kahle kakhulu kanye nokucwaninga kwezinye izifo zokwelashwa ezingapheli. Uma ufisa ukwandisa izinketho zakho zokwelapha, futhi, khuluma nodokotela wakho mayelana nezinto ezibalwe ngenhla.
Imithombo:
Iqoqo le-Cerebral Spinal Fluid (CSF). I-Medline Plus. Kugcine ukubuyekezwa: Juni 2011.
Di leva, A., et al. I-Lumbar Arachnoiditis neThecaloscopy: Ukubukeza Okufushane. I-Cent Eur. Neurosurg 2012.
UGandhi, A., uPhysicalist Interventional, Laser Spine Institute, iTampa, i-Fla. May 2013.
Ukwaziswa kweziguli: Ukuqhekeka kweMultistate ye-Fungal Meningitis nezinye izifo. Iwebhusayithi ye-CDC.
Izinkulumo zobuchopho. I-Medline Plus. Kugcine ukubuyekezwa: Okthoba 2012.
I-NINDS I-Arachnoiditis Ulwazi Lomkhakha. Ikhasi lewebhu le-National Institute Neurological Disorder and Stroke. Kugcine ukubuyekezwa: Jan. 2011.
Isaziso kwaMitholampilo: Ukuqapha Okuqhubekayo Kukhuthazwa Izifo Zamafungulane Phakathi Kwabagulayo Abaye Bakuthola Ukujola Kwe-Steroid Engcolisiwe. Iwebhusayithi ye-CDC.
> Tetsuryu Mitsuyama, Shunji Asamoto, Takakazu Kawamata. I-Novel Yokuphathwa Okuhlinzekwa Kwe-Spinal Adhesive Arachnoiditis nge-Arachnoid Microdissection ne-Ventriculo-Subarachnoid Shunting. I-Journal ye-Clinical Neuroscience 18 (2011).