Isivivinyo Esingaba Ukuphila-Ukulondoloza
Izinsophezelo akuzona njalo izifo eziyinhloko, njenge-headache ye-migraine noma uhlobo lwezinkinga, kodwa kunezinkomba ukuthi kukhona okunye okuqhubekayo emzimbeni. Ngokwesibonelo, ezinye izinhlungu ezinzima ziyimpawu ezibonakalayo zenqubo eyingozi eyenzeka ohlelweni lwezinzwa. Izibonelo zifaka:
- I-Meningitis
- Ukwanda komfutho wegazi ophezulu
- Ukumiswa kwesimiso esinqunyiwe
Uma udokotela wakho ekhathazekile ukuthi ikhanda lakho liyisinye sezimo ezingenhla, angenza ukukhishwa kwe-lumbar noma akuthumele ekamelweni eliphuthumayo elinye.
Sibutsetelo
Ukukhishwa kwe-lumbar kuyinkqubo yezinzwa eyenziwa ukufinyelela emgodini ongasemgogodleni lapho i- cerebrospinal fluid (CSF) igeleza khona. I-punctures ye-Lumbar yenzelwe izinhloso zokuxilonga noma zokwelapha. Isibonelo, ukukhishwa kwe-lumbar kuyasetshenziswa ekwenzeni ukuxilongwa kwe-meningitis, okudinga ukuhlaziywa kwe-cerebrospinal fluid. Ukukhishwa kwe-lumbar kusetshenziselwa ukuphatha i-chemotherapy ngesiguli nomdlavuza noma i-anesthetics kumuntu osebenzayo.
Yeka ukuthi ukukhishwa kwe-Lumbar kwenziwa kanjani
Okokuqala, udokotela wakho uzokubeka ngokucophelela, ngoba lokhu kubalulekile ekufinyeleleni i-CSF ngokuphepha nangempumelelo. Uzokucela ukuba uhlale emaphethelweni ombhede wakho futhi "u-arch afane nekati," noma akucele ukuthi ulale eceleni kwakho endaweni yokugcina ingane, eyaziwa ngokuthi isikhundla se-lateral. Udokotela wakho uzobe ehlanza isikhumba ngemuva kwakho bese ejoza ummeli we-numbing. Lona yingxenye evame ukushaya kakhulu.
Ngemuva kokuba i-agent engenayo ijojowe, udokotela wakho uzofaka inaliti yomgogodla phakathi kwama-vertebrae amabili emhlane wakho ophansi.
Uma isalana somgogodla ifinyelela endaweni efanele, i-CSF izogeleza kumathebhu weqoqo. Kodwa okokuqala, uma ulele endaweni yokuxoshwa kamuva (eceleni kwakho), udokotela wakho angathatha ingcindezi yokuvula nge-manometer. Ukubona ingcindezi yokuvulwa kuyasiza kakhulu ekutholeni izimo zezokwelapha ezifana ne- idiopathic ingemuva ye-hypertension noma i-bacteria meningitis (izimo ezimbili ezenza ukucindezela okuphezulu okungahambi kahle).
Uma iqoqwe, i-CSF ihlaziywa ngokucophelela ukusiza udokotela wakho ekwenzeni ukuxilongwa. Isibonelo, uma udokotela wakho esolisa i-meningitis, uzohlehlisa i-gram stain kanye namasiko we-CSF, kanye neprotheyini ye-CSF ne-glucose.
Izinkinga ezingenzeka
Ukuhlukunyezwa okuvame kakhulu kokukhishwa kwe-lumbar kuyinhloko ekhanda, eyenzeka ngamaphesenti angaba ngu-36. Isizathu sekhanda siwukuvuza kwe-CSF ngokusebenzisa isayithi ngemuva kwakho lapho inaliti efakwe khona (ebizwa ngokuthi indawo yokuphumula). Ikhono le-complication linciphisa udokotela wakho usebenzisa inaliti encane yomgogodla.
Uma kwenzeka udokotela wekhanda lomgogodla, udokotela wakho angase akhombise ukulala phansi, uketshezi olunamanzi, i-caffeine, noma ngisho ne-blood patch, okuyinto inqubo lapho igazi lakho lijova khona endaweni yokuqothula ukucindezela umgodi, ukuvimbela noma yikuphi ukuqhubeka komgogodla ukuvuza okuketshezi.
Ubunzima bokubheka ubuchopho buyinto engathà sina (kodwa engavamile kakhulu) yokukhishwa kwe-lumbar. Ngezinye izikhathi udokotela wakho uzokusiza ukuba uhlole i-CT yakho ebuchosheni ngaphambi kokuba ube nesibindi sokusiza ekuboneni noma yikuphi ukucindezela okuphakama ebuchosheni bakho, okwakwandisa amathuba okuba u-herniation.
Ukukhipha isitshalo endaweni yokugqekeza kungase kwenzeke, nakuba kungavamile.
Udokotela wakho uzosebenzisa ukuhlakanipha kwakhe uma enza i-lumbar ukukhishwa uma usegazini elincane.
Ezinye izinkinga ezingavamile ezingabonakali zifaka ukutheleleka endaweni yokuphumula, ubuhlungu obuphansi emuva, nokubunjwa kwe-cyst okuthiwa i-subarachnoid epidermal cyst.
Ingabe I-Lumbar Punctures Hurt?
Lo ngumbuzo omuhle futhi uhluka ngempela umuntu. Ngokuvamile ingxenye engathandeki kakhulu yenqubo yi-agent engenayo eyayijova esikhumbeni, ngaphambi kokubekwa kwenaliti yomgogodla. Lokhu uzizwa njenge-bee sting. Khona-ke, uma udokotela ebeka inaliti empilweni yakho, uzozizwa unjengezizwa ezinjenge-pressure, okukhululwa lapho inaliti isusiwe.
Ngokuvamile, inqubo ngokuvamile ivunyelwe kahle, futhi ngenkathi ingase ibe ukukhathazeka-okwenzayo, iyashesha futhi ngaphandle kokungazizwa kahle.
Izwi elivela
Ukukhishwa kwe-Lumbar kusebenza njengefasitela kwisistimu yethu yezinzwa futhi kunganikeza ulwazi olubucayi lokuxilonga nezinqubo zokwelapha. Uma uzothola ukukhishwa kwe-lumbar futhi ube nokukhathazeka, sicela ukhulume nodokotela wakho kusengaphambili ukuze uzizwe ulungele futhi ukhululekile.
Imithombo:
U-Ellenby MS, iTegtmeyer K, Lai S, i-Braner DAV. I-Lumbar Ukuvala. I-New England Journal of Medicine. 2006; 355: e12.
> Klein AM, i-Loder E. Postpartum ekhanda. Int J Obstet Anesth. 2010 Oct; 19 (4): 422-30. doi: 10.1016 / j.ijoa.2010.07.009.
I-DA ye-Seehusen, i-Reeves MM, i- Fomin DA. Ucwaningo lwe-Cerebrospinal Fluid . I-American Family Physician. 2003; 68 (6): 1103-1109.