Funda okuyisisekelo mayelana nokuphepha komgogodla
Ukukhishwa kwe-lumbar, noma iphepheni lomgogodla , inqubo evamile ye-neurological evimbela uketshezi lwe-cerebrospinal (CSF) kusuka emgodini ongena emgogodini ukuze udokotela angacwaninga ngokucophelela uketshezi. Nakuba izazi ze-neurologists zenza lokhu kuvivinywa njalo, umqondo wokuqedwa kwe-lumbar wenza abantu abaningi besabe.
Kungani Kungenzeka Kudingeka Ukutholakala Kwesikhwama Se-Lumbar
I-punctures yama-Lumbar ivame ukuqhutshwa ukuhlola izivivinyo zokuhlunga emthonjeni wamagogasi.
Lokhu kusiza udokotela ukuthi:
- Ukuthola kangcono isifo
- Qonda ukuthi isifo esivele sitholiwe sithinta umuntu
I-cerebrospinal fluid ingahlolwa izifo ezithathelwanayo njenge- meningitis , izifo ezivuthayo ezifana ne- multiple sclerosis , namanye amagciwane. Ngaphezu kwalokho, ingcindezi yomswakama ngaphakathi emgodini womgogodla ingalinganiswa ukuze ihlolwe ngezinkinga ezifana ne-pseudotumor cerebri. Ukukala nganoma yikuphi ukunyuka kwengcindezi, izazi zezinzwa zingasebenzisa i-gauge eyaziwa ngokuthi i-manometer ngesikhathi senqubo.
Kwenzekani Ngenkathi Inqubo
Inqubo yokukhishwa kwesibindi ngokuvamile ithatha cishe imizuzu engama-45 kuya ehoreni. Uzohamba ngezinyathelo ezilandelayo:
- Uzobeka eceleni kwakho endaweni yesisu ngokuguqa ngamadolo eduze kwesifuba sakho. Ngaphandle kwalokho, ungacelwa ukuthi uhlale endaweni ezingeliwe ngokubuyela emuva ku-neurologist.
- Umhlane wakho ophansi uzohlanzwa nge-agent esebenza ngenzalo njenge-iodine, futhi ukuhlinzekwa kwezinzwa zendawo okufana ne-lidocaine kuzojova esikhumbeni ukuze kuphazamise indawo. Umjovo wemithi ephazamisayo ingabangela ukuzwa okuncane okuvuthayo.
- Uma umhlane wakho uphazamisekile, i-neurologist izodonsa isaliti esingenalutho emkhatsini we-backbase amabili emgqonyeni we-thecal, okuyinto isikhala esine-CSF. Ngezinye izikhathi inaliti kufanele ihlelwe kabusha ukuze ithole indawo efanele.
- Lapho inaliti isendaweni, i-neurologist ingalinganisa ukucindezela kusetshenziswa i-manometer.
- Umswakama uvele uphumele futhi uqoqwe kuma-tubes wokuhlola ukuze uthunyelwe ebhodini.
- Uma nje uketshezi luqoqwe, inaliti isusiwe.
- I-bandage ivame ukufakwa phezu kwesayithi le-lumbar puncture.
- Isayithi ingaba nesifo usuku noma ezimbili emva kwenqubo.
Ingabe Ukukhubazeka Kungenzeka Emgodini Womgogodla?
Akukho cishe ukulimala kwentambo noma ukukhubazeka ngoba inaliti ifakwe ngaphansi ngezansi lapho umgogodla uphela khona. Umgogodla uphela amasentimitha ambalwa ngaphezu kwendawo lapho inaliti ifakiwe khona. Amagundane aqhamuka emthonjeni we-umgogodla awela phansi ngokungahambisani nesikhwama se-thecal esibizwa ngokuthi i-cauda equina ("umsila wehhashi").
Izinkinga ezingenzeka
Ngezinye izikhathi, inaliti ingase iqhubekele ngokumelene nesinye sezinzwa kule -cauda equina , kodwa lokhu kubangele ukulimala kubantu abangaba ngu-1 kwabangu-1 000 futhi kuvame ukuphilisa isikhathi. Ngokuvamile ungase uzizwe i-twinge encane kagesi ewela phansi umlenze wakho.
Phakathi kwamaphesenti angama-10 kuya kwangu-30 abantu abathola ukukhishwa kwe-lumbar ngokuhamba kwesikhathi bazokwakhiwa ikhanda . Ngenkathi kunokukhona ukuphikisana mayelana nokuthi kungcono kanjani ukugwema lezi zinsizwa, odokotela abaningi bayotusa ama-hydration amahle bese belala phansi isikhathi esingangehora ngemva kokugqunywa kwe-lumbar. I-caffeine ingase isize futhi uma ikhanda liqala. Ngezinye izikhathi ikhanda liyaqhubeka izinsuku ezimbalwa emva kokukhishwa kwe-lumbar.
Lokhu kungase kusho ukuthi inaliti ishiye umgodi esikhwameni se-thecal, futhi umthamo wesimanje usaqhubeka. Kulesi simo, inqubo ebizwa ngegazi "i-patch" -ukuthi igazi lakho lijojelwe ku-sac le-thec-kunganciphisa ikhanda.
Ezigulini ezinesisindo ebuchosheni ezifana ne-abscess noma i-tumor, ukuguqulwa kwengcindezi okubangelwa ukususa umkhuhlane we-spinal kungaholela ekuguquleni okwenyuka kwezicubu zobuchopho. Ukuskena kwe- CT noma i-MRI yobuchopho ngaphambi kokuba inqubo ikwazi ukukhipha noma yikuphi ukulingana okunjalo. Ezinye izinkinga ezikhona kungenzeka zifaka ukutheleleka noma ukuphuma. Zonke lezi zinkinga azivamile ukulungiselelwa ngokwanele.
Indlela Yokulungiselela Ithebhu Yomgogodla
Awekho amalungiselelo akhethekile adingekayo ngaphambi kompompi wokugwinya. Inqubo ingenziwa ehhovisi likadokotela noma embhedeni. Kodwa-ke, uma uthatha imishanguzo yegazi , ingabekwa ngaphambi kwenqubo yokunciphisa ingozi yokuphuma kwegazi. Futhi, kubalulekile ukuqinisekisa ukuthi udokotela uphendule yonke imibuzo yakho ngaphambi kwenqubo. Lokhu kungasiza ukukhulula noma yikuphi ukukhathazeka onakho ngokukhishwa kwe-lumbar.
Ingabe Ukulimala Kwe-Lumbar Ukulimaza?
Ukungahambi kahle okuhambisana nokugqama kwe-lumbar kubonakala kuhlukahluka kakhulu kusuka kwesineke kuya kwesineke. Akekho ozosho ukuthi ucingo lomgogodla lukhululekile, kodwa ngokuvamile lubuhlungu kakhulu kunalokho okucatshangwa. Ngezinye izikhathi ingxenye enkulu kunazo zonke yi-pinch ezwayo ngomjovo womuthi wokubulala. Njengoba inaliti ende isetshenziswa ukudweba uketshezi, abantu abaningi bachaza ngaphezulu kokuzwa kwengcindezi ejulile, futhi ngezinye izikhathi inzwa kagesi ngemuva noma ihamba phansi emlenzeni. Akukhona nje ukuthi ukuhlinzekwa kwezidakamizwa zendawo kudingekile ukulawula ubuhlungu.
Ezinye Izindlela Zokuthola I-Cerebrospinal Fluid
Kubantu abanezinkinga ezinjenge- scoliosis ezinzima, i- arthritis , noma ukukhuluphala , kungase kube nzima kakhulu ukuba isazi sezinzwa sokuthola i-CSF embhedeni. Kulezi zimo, ukukhishwa kwe-lumbar kungenziwa ngaphansi komhlahlandlela we-fluoroscopic ngosizo lwe-radiologist. Nokho, ezimweni eziningi, lokhu akudingekile futhi kuyabiza.
Izwi elivela
Ukukhishwa kwe-lumbar, kuyilapho kungakhathazeki, akukubi njengoba iziguli eziningi zesaba. Nakuba izinkinga zingase zenzeke, ziningi kakhulu. Izinzuzo zokuthola uketshezi oluvivinywa ngokuvamile zivelele izingozi nokungahambi kahle kwenqubo. Ukuze uthole olunye ulwazi, qiniseka ukuthi yonke imibuzo yakho iqondiswa udokotela wakho.
Imithombo:
> Silberstein SD. Ukwehla kwekhanda lokucindezeleka okuphansi. I-Merck Manual Consumer Version. https://www.merckmanuals.com/home/brain--spinal-cord,-and-nerve-disorders/headaches/low-pressure-headache.
> Robbins E, Hauser EL, "Isahluko e32. I-Technique ye-Lumbar Puncture" (Isahluko). Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J: Izimiso zikaHarrison zika-Internal Medicine, 19 : 2015. iMcGraw-Hill Education.
> Ropper AH, MA Samuels, "Isahluko 2. Izindlela Ezikhethekile Ze-Neurologic Diagnosis" (Isahluko). Ropper AH, Samuels MA: Adams kanye nemigomo kaVictor ye-Neurology, ngo-10 : 2014. Imfundo ye-McGraw-Hill.