Izinyembezi zasemadolobheni ziyinkimbinkimbi yokuhlinza umgogodla lapho ukumbozwa okuncane komgogodla (okubizwa ngokuthi i-dura mater) kungathathwa yinto yokuhlinza.
I-Dural sac izinyembezi ayiyona into yokuzulazula nazo. Esifundweni sabo sango-2017, abacwaningi baseShayina bathi izidakamizwa zasemadolobheni ezidabukisayo zingabangela ukuvuza okuketshezi olumanzi, i-meningitis, izinkinga zemisipha kanye nezimo ezingathí sina nakakhulu.
Iyiphi Inhlobo Yezokwelapha Zezinambuzane Ebangelwa Isikhwama Sezidakamizwa?
Impendulo ukuthi, kuncike. Abalobi baseShayina baveza izinqubo ezihlukahlukene njengezimbangela ezikhona.
Kodwa-ke, ngokuvamile, izinyembezi zasemakhaya zivama ukuba zenzeke ngokuphindaphindiwe ngokuhlinzwa okuhlinzekwa umgogodla. Ukuhlinzekwa kwezigxobo ezingaphezu kwezinga elilandelayo kuleso hlu, kulandelwa ukuhlanganiswa komgogodla, futhi ekugcineni ukuchithwa kwezinga eliphezulu (for spinal stenosis).
Ukuhlinza nge-Disc kanye nokuhlinzekwa kwezinga elilodwa lokunciphisa izinga lokuvama kuvame ukuholela enombolweni encane kunazo zonke izinyembezi zasemakhaya, ukukhuluma ngokulinganayo.
Ukubheka amarekhodi esiguli eshicilelwe encwadini ka-March 2016 i- Clinical Neurology ne-Neurosurgery ithole ukuthi izinyembezi zasemakhaya zazizitholela kaningi kubantu ababhekana nemiphumela empofu evela ekuhlinzeni umgogodla lapho i- cyst synovial isusiwe khona. Ezimweni eziningi ezifana nalezi, ngokusho kwabalobi bokucwaninga, kunjengokuthi izinyembezi zasemakhaya zazifanekisela imiphumela yokuhlinzwa empofu.
I- Clinical Neurology ne-Neurosurgery abalobi bathi futhi izinyembezi zasemakhaya zivame ukwenzeka kaningi ezingeni L5 / S1.
Bathi futhi ukuthi uma kuphela ingxenye ye-cyst isusiwe, isiguli asengozini yezinyembezi zasemakhaya.
Ukugwema Izinyembezi Zomdabu - Inselelo Yophoyiyoni Nezimo Zakho Zengozi
Ngisho nodokotela ohlinzayo onezandla zomlingo, kunzima ukuthi ungadli isikhwama esinezintambo zomgogodla. I-membrane ehlanganisa umthambo womgogodla awunamandla njengethambo, isikhumba noma imisipha, uDkt. Joshua D.
I-Auerbach, oyiNtloko Yezokwelapha Kwezinhlanzi e-Bronx-Lebanon Hospital Centre eNew York City, uyangitshela. "Kuyinkimbinkimbi futhi idabukile kalula."
Ngenkathi inqubo yodokotela wakho nge-scalpel (noma enye ithuluzi) kungaba yilapho ekugcineni idala izinyembezi, izimo ezikhona ngaphambili kanye / noma ukukhubazeka kungandisa ingozi yakho. Isibonelo, ukusebenzisa i-steroids, isifo sikashukela, noma ukubhema konke kwandisa ingozi yakho. Okufanayo uma unenkinga ethile yomgogodla, okungukuthi: i-spondylolisthesis, i- stenosis , i-scoliosis, noma i- kyphosis .
Izibhedlela Akuthandi Ukubika Izindleko Zomzimba Izinkokhelo Amanani
Izinyembezi zasemuva ngenye yezinkinga ezivame kakhulu zokuhlinzwa kwangemuva. Kodwa izibhedlela eziningi zibonakala ziphuza ukubika izinyembezi ezenzeka ezikhungweni zabo. Ngenxa yalokhu futhi mhlawumbe nezinye izizathu, izibalo zezinyembezi zasemadolobheni zingase zibekwe phansi.
Njengoba kunjalo, amanani omphumela abikiwe ekucwaningweni kocwaningo ahlukahluka kakhulu. Izinto eziningana zingase zilandele ukungezwani: isizathu sokuhlinzwa (isifo se-stenosis, i-herniated disc, i-scoliosis, i-synovial cysts njll), kungakhathaliseki ukuthi ukuhlinzeka kwaba yisiguli sokuqala, sesibili, sesi-3, njll nezinye iziguli.
Ohlangothini oluphansi, isifundo seJanuwari 2011 esanyatheliswa ku- Neurosurgery ehlola iziguli ezingaphezu kuka-108,000 ezihlinzekwa izimpumputhe ezathola ukuthi u-1.6% wazo zathola izinyembezi zasemakhaya.
Ohlangothini oluphezulu, i- Medscape ibika ukuthi ukutadisha kuka-1989 okushicilelwe ku- Spine kubalwe ukulinganiselwa kwama-17.4% wezinyembezi zasemakhaya endaweni yokucwaninga equkethe abantu abangu-481 abahlinzwa ngokuphindaphindiwe.
Ikomidi le- ICD -CM Coordination and Maintenance (ikomidi elidlala indima ebalulekile ekwenzeni ukuxilongwa kwezibalo) lithole ukuthi ama-57% wezibhedlela azihlolisisile azwakalisa ukukhala kwezinyembezi zasemakhaya. Ikomidi lifakazela ukuthi ama-46% wezibhedlela ezingu-2,446 azibikezeli neze izinyembezi zasemakhaya! Iphinde ithi izibhedlela zibika ukuphatha izinyembezi zasemaphandleni, kodwa azibizi izinyembezi zasemadolobheni ezake zenzeka.
Iya isibalo.
Futhi lapho odokotela benza ukuhlinzekwa kwesihlungu emanzini amaningi kulezi zibhedlela babambe iqhaza kwizifundo zokwenza ucwaningo (ezigcinwa zihluke ekubikweni kwezokuphatha ezenziwe izibhedlela), izimo zezinyembezi zasemadolobheni, ngezinye izikhathi, zazingaphezulu kuka-10%.
Ikomidi le-ICD-CM lilinganisela ukuthi lezi zibhedlela zibika cishe ingxenye yesihlandla sezinyembezi ezisemakhaya ezenzeka ngempela.
Izinyembezi ZaseDural and Cerebrospinal Fluid Leaks - Izimpawu Nezokwelapha
Njengoba ngishilo ekuqaleni kwalesi sihloko, izimpawu zesikhumba esisezindaweni zasemakhaya zihlanganisa ukuvuza okuketshezi (okubizwa nge-CSF ukuvuza). Lokho kubonakala kanjani? Ungatshela kanjani ukuthi wena (ungahle) ube nezinyembezi zasemakhaya?
UDkt. Auerbach uthi uma une-CSF evuza, ungase ubone ukuthi uketshezi olucacile lukhishwa kwilonda lakho lokuhlinzwa. Ungase uzwe nezinhlungu ezihlobene nesikhundla ezimbi nakakhulu uma usukuma futhi ukhululekile uma ulala phansi. Ezinye izimpawu zifaka izinguquko ezibukwayo, isicanucanu, ukuhlanza noma isizungu, i-Auerbach ithi.
Uma ingelashwa ngokushesha futhi ngokufanele, ukuvuza okune-cerebrospinal kwamanzi kungaphazamisa impilo yakho. Ngakho izimpawu ezifana nalezo okukhulunywe ngazo ngenhla zidinga ukunakekelwa ngokushesha.
Konke lokho kusho, inyembezi yasezindaweni ezivame ukubanjwa udokotela wakho ngesikhathi sokuhlinzwa futhi uphathwa khona lapho.
Kodwa izimpawu eziseduze zingenzeka, futhi kulokhu, kuyoba kuwe ukuwabona futhi uthathe isenzo. Uma uhlangabezana nanoma yikuphi noma zonke izimpawu ezibalwe ngenhla, qiniseka ukuxoxa nabo nodokotela wakho ngokushesha.
Ukwelashwa kwezinyembezi zasemakhaya kufaka ukuphumula kombhede, ukudonsa, futhi uma kuqhuma ukuqhuma, ukuhlinzwa. Ukuhlinzekwa kwezinyembezi zasemakhaya kufana nokubhoqa umgodi etsheni. Kusukela ngo-Mashi 2012, ukuhlinzeka kwezinyanga eziningi zasemaphandleni kufaka ama-sutures (stitches), kodwa amasu angenasici manje asethuthukiswa futhi.
Umthombo:
> Fang, Z., Ukwelashwa kwe-cerebrospinal fluid lead emva kokuhlinzwa kwesikhala. I-Chin J Traumatol. Ngo-Ephreli 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5392710/
> Guerin P, et. al., durotomy engokwemvelo ngesikhathi sokuhlinza izimpumputhe: Ingozi, ukuphathwa, nezinkinga. Ukubuyekeza okubukeziwe. Ukulimala. 2011 Jan 18. [Epub ngaphambi kokuphrinta]. http://www.ncbi.nlm.nih.gov/pubmed/21251652
> Klessinger, S. Isimo sezinyembezi zasemuva emva kokuvuselelwa okuphelele kwe-cysts lumbar synovial kanye nokuhlobene nomphumela. I-Clin Neurol Neurosurg. NgoMashi 2016 Mar http://www.ncbi.nlm.nih.gov/pubmed/26945877
> Shaw, J. Okungavamile Ukuhlakulela / Ukuqeda Izinyembezi. Ikomidi le-ICD-9-CM Yokuxhumanisa Neyokugcinwa. NgoMashi 19-20, 2008. Isethulo sePowerpoint.
> Williams, BJ, et. al. Isimo se-durotomy engahlosiwe ekuhlinzekeni komgogodla esekelwe amacala angu-108 478. I-Neurosurgery. Jan 2011. http://www.ncbi.nlm.nih.gov/pubmed/21150757 "