Yeka ukuthi inhloko ye-Post-Dural Puncture Puncture Is Why and Why It Happens
Amakhanda omgogodla awumphumela ovame kakhulu ohlangothini lwe- punctures lumbar (obizwa nangokuthi amathinta omgogodla). Noma ubani angabhekana nesinye. Kodwa-ke, kubonakala sengathi kungenzeka kakhulu uma ungowesifazana, phakathi kweminyaka engu-31 no-50, futhi unomlando wezinsizwa ngemuva kwamathinta omgogodla. Izindaba ezinhle ukuthi iningi lalezi zinhlobo zamakhanda omgogodla unomoya omnene futhi zingaphathwa kahle.
Kuyini Ukuphathwa Kwekhanda Lokuthunyelwa Kwesimo Sezulu?
Ikhanda elivela ekugqibeni lumbar, okubizwa ngokuthi i-post-dural puncture headache, kwenzeka ezinsukwini ezinhlanu zenqubo. Ubuhlungu buhluke kakhulu kulokho okubi nakakhulu uma uhlezi noma umile futhi unciphisa lapho ulele phansi. Indawo yobuhlungu ingahluka, nakuba ngokuvamile ikhona ngaphambili kwekhanda (ngokuvamile ngokuqondile ngemuva kwamehlo) noma ngemuva kwekhanda.
Ezinye izimpawu ezikhathini ezithile ezihlotshaniswa nalolu hlobo lwekhanda lomunwe luhlanganisa:
- Ukukhala ezindlebeni
- Ukuzwa izinkinga
- Ukuqina kwentamo
- I-nausea
- Isizungu
- Izinkinga zembono
Ukuchofoza phansi Isizathu
Kungase kusimangaze ukuthi ochwepheshe abazi ukuthi yini ebangela ukukhishwa kwamakhanda okuthunjelwa emadodeni. Kodwa kunezinkolelo ezithile.
Uma kukhishwa isilwane, udokotela kufanele agqame ukuhlala, isibhande esiqukethe ubuchopho nentambo yomgogodla, kanye ne- cerebrospinal fluid (CSF) lapho imiswe okwesikhashana.
Enye inkolelo ukuthi uma kukhona ukuqhuma okuqhubekayo kokuswakama kwe-cerebrospinal, akukwazi ukugcwaliswa ngokushesha ngokwanele. Lokhu kubangela ubuchopho ukuba "buke" endaweni, ukwelula izakhiwo ezibuhlungu. Esinye isizathu esingahle singase sibe ukuhlenga (ukukhulisa) kwemithangu ebuchosheni ngemuva kwenqubo.
Ngokuthakazelisayo, ngokusho kokucwaninga kwe- JAMA Neurology , ukususa umthamo ophezulu we-CSF (ngaphezu kwe-30 mL) kwaholela engozini enkulu yesiguli esakha ikhanda ngemuva kokuba inqubo kodwa engakhulisa ingozi yekhanda ngehora eli-24 Landelela.
Lokhu kusikisela ukuthi i-biology ngemuva kwekhanda ingase ihluke kuye ngokuthi iqala nini (ngemuva nje kwenqubo ngokulandela usuku oluzayo).
Ukuvimbela Inkinga
Ucwaningo oluthile luye lwabonisa ukuthi ukusebenzisa izinaliti ezincane (kunokuba zikhudlwana-zinezilinganiso) noma izinaliti "ze-atraumatic" (kunokuba zibe nezinaliti "zokusika" ezijwayelekile) imiphumela engezansi kakhulu yekhanda lokukhwabanisa ngemuva . Okuwukuphela kwezinto ezingase zibe khona ezinaliti ezincane noma izinaliti ze-atraumatic ukuthi zingadinga ubuchwepheshe obukhulu bokufaka, okusho ukuthi kungase kudingeke kube neminye imizamo yokuthola ngempumelelo isampula.
Kumele uqaphele ukuthi isikhathi eside, kunconywa ukuthi abantu bahlale embhedeni isikhathi esilandelayo ekugqibeleni i-lumbar, belele phansi emhlane. Ukubuyekezwa kwezifundo eziningana kubonise ukuthi lokhu kubonakala kungenalo nhlobo nhlobo nokuthi iziguli ezivuka ngokushesha azikwazi ukuba nomama wekhanda lomgogodla kunabo abahlala embhedeni.
Ukwelapha Okuphezulu
Iningi lamakhanda omgogodla olandela ama-punctures lumbar anomoya omnene futhi athambekele ekuxazululeni eyedwa. Kodwa lezi ezinye zezindlela zokwelashwa ezivamile.
- Ama-Painkillers: Ajwayele ukuphendula kahle kulabo abathintekayo, kuhlanganise nama- opioids , uma kunesidingo.
- Imithi engavamile: Ezinye izidakamizwa zingase zibe usizo njenge-anticonvulsant Neurontin (gabapentin), i-hydrocortisone (uhlobo lwe-steroid), kanye nemithi yamaphaphu okuthiwa i-theophylline.
- I-caffeine: Kucatshangelwa ukuthi i- caffeine engenakucabangela noma eyomlomo isebenza ngokubangela uhlelo lwe-vascular ebuchosheni ukuba lube namandla. Le ndlela ibonakala ibe nemiphumela emibi kakhulu futhi ngaphezu kokwelapha ikhanda le-post-dural, kungasiza futhi ukuvimbela eyodwa.
- I-Epidural Blood Patch: Lokhu kungase kuvivinywe uma ubuhlungu besisu sekhanda lomgogodla buhlala emahoreni angaphezu kwangu-24 futhi bukhulu kangangokuthi abanikazi bezinhlungu abanikezi usizo. Kuboniswe ukuthi uphumelele ezigulini ezingamaphesenti angu-98, nakuba ngezinye izikhathi kudingeka kwenziwe kabili. Inqubo ilula futhi yenziwa udokotela. Igazi likhishwa emthanjeni bese lijova libe yindawo yakho ye-epidural (isikhala esingaphandle kokuhlala). Inani elincane le-anesthesia lendawo lizosetshenziselwa futhi uzocelwa ukuba uphumule imizuzu engaba ngu-30, bese usukuma. Ngokuyinhloko, le nqubo isebenza ngokuthi "ukuxhuma ukuvuza" ekugcineni kwakho.
Izwi elivela
Ngenkathi iningi lala mahlumela asemaphandleni ngemuva kokumisa amancane, amanye angase abe mkhulu kakhulu. Ngenhlanhla, iningi lizophendula ngokushesha kulabo abathintekayo noma bebodwa (nakuba kungathatha izinsuku eziningana).
Ezimweni ezingavamile kakhulu, ikhanda lokuthunjwa kwe-post-dural libonisa ukuthi kukhona okungathí sina okuqhubekayo ebuchosheni njengengculazi noma isifo. Yingakho kubalulekile ukuxwayisa udokotela wakho uma ubhekana nokuphathwa ikhanda elinjalo.
> Imithombo:
> Basurto Ona X, Osorio D, Cosp Bonfill X. Ukwelapha izidakamizwa zokwelapha ngemuva kokudutshulwa kwesikhumba. I-Cochrane Database Syst Rev. 2015 Jul 15; (7): CD007887.
> Halker RB, Demaerschalk BM, Wellik KE, Wingerchuk DM, Rubin DI, Crum BA, Dodick DW. I-caffeine yokuvimbela nokwelashwa kwekhanda lokukhanda ngemuva kwe-postdural: debunking the myth. I-neurologist. 2007 Sep; 13 (5): 323-7.
> Ikomidi Lokuhlukanisa Amakhanda Ye-International Headache Society. "I-International Classification of Headache Disorders: I-3rd Edition (i-beta version)". I-Cephalalgia 2013; 33 (9): 629-808.
> Monserrate AE et al. Izinto ezihlotshaniswa nokuqala nokuphikelela kokukhanda kwekhanda lokuthutha ngemuva. I-JAMA Neurol . 2015 uMar; 72 (3): 325-32.