Izingozi Nezifo Zokwelashwa Kwekhanda Lokusakaza Umgogodla
Kungakhathaliseki ukuthi une-lumbar puncture (eyaziwa nangokuthi umgogodla) ngesikhathi sokubeletha noma ukuxilongwa noma ukwelashwa kwesimo sezokwelapha, awuyedwa uma uhlakulele ikhanda-isenzakalo esivamile (kodwa ungakhathazeki, cishe njalo iyahamba yedwa).
Iyini i-Post-Lumbar Ukukhanda Kwekhanda?
Ukukhishwa kwe-lumbar kuyinkqubo eyenziwa ngezizathu eziningana, kufaka phakathi ukuhlola uketshezi lwama- cerebrospinal (umthamo ogeza futhi ophazamisa ubuchopho bakho nomgogodla) ngokutheleleka noma ukuvuvukala, njengokungathi u-meningitis osolayo noma multiple sclerosis.
Ama-punctures e-Lumbar nawo ayenziwa ukuze ahlinzekwe imithi ku-cerebrospinal fluid (CSF), njenge-antibiotics, i-chemotherapy, i-steroids, noma i-anesthetics. Ngokwesibonelo, ngesikhathi sokubeletha, kuvamile ukuba owesifazane abe nesifo sokuphumula ngenxa yobuhlungu. Kule nqubo, i-anesthetic ijojowe endaweni ye-epidural lapho i-CSF igeleza khona ukuba ibambezele endaweni engaphansi kwesinqe sesifazane. I-Lumbar punctures ingenziwa futhi ukukala ukucindezelwa kwe-CSF, njengokwe- hypertension ye-idiopathic engenawo umfutho wegazi ophezulu -isimo esibangela ukuphathwa ikhanda nokubukwa kombono.
Cishe ingxenye yesithathu yeziguli zakha ikhanda ngemuva kokukhishwa kwe-lumbar (ngokuvamile kungakapheli izinsuku ezingu-5) ngenxa yokungena emgodini womgogodla, lapho i-CSF iphuma khona. Uma i-CSF iphuma, ingabangela ukuphathwa ikhanda okubi kakhulu uma uhlezi uqinile noma umile. Lokhu kusho ukuthi ubuhlungu bekhanda buyanciphisa uma umuntu elala phansi ngokuphelele, kodwa abuya (ngokushesha kakhulu) lapho bephakamisa ikhanda lakhe (njengoba ngaphezulu i-CSF iphuma ngenxa yemandla adonsela phansi).
Indlela ecacile yokuthi indlela ikhanda lokushaya ikhanda elizoqala ngayo elibonakalayo liqala ngokucacile. Abanye ochwepheshe bakholelwa ukuthi ukuvuza kwe-CSF kubangela ukwehla kwevolumu nokucindezela kwe-CSF ebuchosheni, ukuvimbela ubuchopho ukuthi bubekwe yi-skull. Uma umuntu elele, umkhuhlane ungadlulela emuva ebuchosheni (amandla adonsela phansi) avumele ukuthi uphinde uvuselelwe futhi ngaleyo ndlela ukhulule ikhanda.
Abanye bakholelwa ukuthi inani eliphansi le-CSF livuselela ama-receptors athile ebuchosheni obangela ukuhlukumeza kwemibhobho yobuchopho, okuholela ekuhloleni ikhanda.
Abantu abathile basengozini enkulu yokuthuthukisa ikhanda lokukhishwa kwesikhumba. Lezi zici zengozi zihlanganisa:
- ngokuba owesifazane
- phakathi kweminyaka engu-31 no-50 ubudala
- umlando wangaphambilini wekhanda lokukhanda ikhanda lokuthutha
- indlela yokwenza izinqubo kanye nobukhulu benaliti esetshenziselwa ukufakwa esikhwameni se-thecal (esine-CSF)
Ukukhulelwa nokugcoba kungakhuphula ingozi yomuntu yokuthuthukisa ikhanda lokukhanda ikhanda.
Kuyini Ukuthandwa Kwamathambo Okuthunyelwe Kwe-Post-Lumbar?
Ngaphezu kokubuhlungu ezinhlangothini zombili zekhanda okungezansi-kuncishiswe lapho uqamba amanga kakhulu futhi kubangelwa uma umile noma uhlezi phezulu-ikhanda lokukhanda ikhanda lingase lihambisane nezinye izimpawu ezinjengalezi:
- ukuqina kwentamo
- ukukhala ezindlebeni
- ukushintsha kokuzwa
- ukuzwela ukukhanya
- isiyaluyalu
Ukwelashwa kwe-Post-Lumbar Ukukhanda Kwekhanda
I-head-lumbar ekhanda ukukhanda ikhanda ngokuvamile ixazulula yedwa phakathi nesonto kodwa ingathatha amasonto amabili. Izindaba ezinhle ukuthi abaningi bayahamba bebodwa. Ngokuvamile izinyathelo ezilula ezifana nokudla oketshezi, kanye nokuphulukisa ubuhlungu (njenge- opioids ) kungasiza.
Abanye odokotela basikisela i-caffeine futhi (nakuba kungekho idatha enhle yesayense yokubuyisela lokhu.)
Kodwa uma ikhanda lakho lezinwele liqhubeka, kungadingeka i-epidural blood patch. Lena yinkambiso lapho umgodi wokugoba ogqamile uvalwe ngegazi lakho. Linikeza usizo ngokushesha futhi luvame ukuphumelela, nakuba ngezinye izikhathi kudinga ukuphindwa.
Izwi kusuka
Ukutholwa kwe-lumbar kungamnandi ngokwakho, futhi ikhanda eliphezulu phezu kwalo akuyona into elula. Kodwa ungadangali, njengoba ikhanda lakho lekhanda lomsindo lizohamba noma linye noma ngegazi (okuyinto inqubo enhle kakhulu).
Imithombo:
U-Ahmed, uSV, uJayawarna, C., noJude, E. Ukuthumela ikhanda lokukhanda ikhanda: ukuxilongwa nokuphathwa. I-Medical Journal ye-Postgraduate. 2006, Nov 82 (973): 713-16.
I-Halker, i-RB 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.