Yisiphi isikhokelo seNtloko-seDural Circture Isihloko kunye nesizathu sokuba kwenzeke
Izikhwebu zomsila ziyimpembelelo yecala eliqhelekileyo yeplomtures lumbar (ekwabizwa ngokuba yi-tapinal taps). Nabani na onokubandezeleka omnye. Nangona kunjalo, kubonakala kunokwenzeka ukuba ungumfazi, phakathi kweminyaka engama-31 no-50, kwaye unembali yeentloko emva kweempompo zomgcini. Iindaba ezilungileyo kukuba ezininzi zeentlobo zeentloko zomzimba zincinci kwaye zinokuphathwa kakuhle.
Ziyintoni i-Post-Dural Puncture headache?
Intloko ephuma kwi-lumbar puncture, ebizwa ngokuba yintloko yesicathulo sokuphulwa komzimba, ivela kwiintsuku ezintlanu zenkqubo. Intlungu ihluke ngokucacileyo kuba kukubi kakhulu xa uhleli okanye umile kwaye ulula xa ulala. Indawo yintlungu iyahluka, nangona ivela ngaphambili kwintloko (ngokuqhelekileyo ikhangele ngqo emehlweni) okanye ngasemva kwentloko.
Ezinye iimpawu eziye zidibaniswa nale hlobo lomlenze womlenze ziquka:
- Ukubetha ezindlebeni
- Ukuva iingxaki
- Ukhuni lukhuni
- I sizathu
- Utywala
- Ingxaki zo mbono
Ukucima iCause
Inokumangalisa ukuba iingcali azizi ukuba yintoni ebangela ukuba iisifo zentloko zisetyenziswe. Kodwa kukho ezinye iingcamango.
Xa kugqitywa i-lumbar puncture, ugqirha kufuneka agqitywe i-dura, i-membrane equlethe ingqondo kunye nomthambo womgudu, kunye ne- cerebrospinal fluid (CSF) apho ixinyiwe khona.
Enye inyelelo kukuba ukuba kukho ukuvuza okuqhubekayo kohlobo lwe-cerebrospinal, ayikwazi ukuzaliswa ngokukhawuleza. Oku kubangela ukuba ubuchopho "buqhube" kwindawo, ulwebise izakhiwo ezibuhlungu. Esinye isizathu esinokubakho sinokuhluthwa (ukwandisa) kweemvini engqondweni emva kwenkqubo.
Kuyathakazelisa, ngokutsho kwesifundo kwiJAMA Neurology , ukususa umthamo ophezulu we-CSF (ngaphezu kwe-30 mL) kukhokelela umngcipheko omkhulu wesigulane ophuhlisa intloko emva kokuba yenze inkqubo kodwa engenakwandisa umngcipheko weentloko ngeeyure ezingama-24 ukulandelisa.
Oku kuphakamisa ukuba i-biology emva kweentloko ziyahlukahluka kuxhomekeke xa ikhula (emva kokulandela inkqubo emva komhla kamva).
Ukuthintela ingxaki
Izifundo ezimbalwa zibonise ukuba kusetyenziswa inaliti ezincinci (kunokuba zikhusele iinaliti) okanye iindile ze "atraumatic" (kunokuba zidibanise "inkunkuma" zesalathisi) ziphumo kwiziganeko ezincinci zentloko yomzimba . Ukuphela kwezinto ezinokuthi zifumaneke kwiinaliti ezincinci okanye iinaliti ze-atraumatic kukuba zifuna ubuchule obunzulu bokufakela, oku kuthetha ukuba kunokufuna ukuzama ukufumana isampuli.
Kubalulekile ukuba uqaphele ukuba ixesha elide, kunconywa ukuba abantu bahlale embhedeni ixesha elilandela ukutshitshiswa kwendawo yokulala, belele phantsi emacaleni abo. Ukuphononongwa kwezifundo eziliqela kubonise ukuba oku kubonakala kungenayo impembelelo kuzo zonke kwaye izigulane ezivuka ngokukhawulezileyo azikwazi ukuba nekhanda lomlenze kunabo bahlala embhedeni.
Top Treatments
Uninzi lweentloko zomlenze olandela i-punctures lumbar zinyamekile kwaye zithatha ukuzixazulula zodwa. Kodwa ezi zindlela eziqhelekileyo zonyango.
- Iipilisi: Ziyakuthi ziphendule kakuhle kwi-painkillers, kuquka i- opioids , ukuba kuyimfuneko.
- Imida ehlukeneyo: Ezinye iziyobisi zingaluncedo njenge-anticonvulsant Neurontin (gabapentin), i-hydrocortisone (uhlobo lwe-steroid), kunye nemithi yemiphunga ebizwa ngokuthi i -ophylline.
- I-caffeine: Kucatshangelwa ukuba i-cafeine okanye i-oral caffeine iyasebenza ngokubangela ukuba i-vascular system inengqondo ibe namandla. Le ndlela ibonakala ibe nemiphumo embalwa yecala kunye nangaphezulu ekuphatheni intloko yesigxina, kunokukunceda ukunqanda.
- I-Epidural Blood Patch: Oku kunokuzama ukuba ubuhlungu bentloko yesisu buhlala ngaphezu kweeyure ezingama-24 kwaye kunzima kangangokuthi i-painkillers ayinikezeli uncedo. Kuboniswe ukuba uphumelele kwi-98 yeepesenti zezigulane, nangona kufuneka ngezinye iinkhathi kufuneka kwenziwe kabini. Inkqubo ilula kwaye yenziwa ngugqirha. Igazi likhutshwa ngaphandle kwentshebe kwaye lijojowe kwindawo yakho yepidural (isikhala ngaphandle kwexesha elide). Ixabiso elincinci le-anesthesia lendawo liya kusetyenziswa kwaye uya kucelwa ukuba uphumle malunga nemizuzu engama-30, uze ume. Okubalulekileyo, le nqubo isebenza ngokuthi "ukuxhoma ukuvuza" kwindawo yakho yokuhlala.
ILizwi
Nangona uninzi lwale ntloko zentloko zentloko zincinci, ezinye ziyakunzima kakhulu. Ngethamsanqa, ininzi iya kuphendula ngokukhawuleza kwiipilisi okanye ngokwazo (nangona inokuthatha iintsuku eziliqela).
Kwiimeko ezinqabileyo kakhulu, intloko yesigxina esisemva kwesigxina sibonisa ukuba into ebaluleke ngakumbi eqhubekayo kwingqondo efana negazi okanye isifo. Yingakho kubalulekile ukuba uqaphele ugqirha wakho ukuba unesihlunu esinjalo.
> Imithombo:
> Basurto Ona X, Osorio D, I-Bonfill Cosp X. Ugqirha unyango lo kunyanga emva kwentloko. Cochrane Database Syst Rev. 2015 Jul 15; (7): CD007887.
> Halker RB, iDemaerschalk BM, Wellik KE, i-Wingerchuk DM, i-Rubin DI, i-Crum BA, i-Dodick DW. I-caffeine yokuthintela kunye nokunyangwa kobunzima beentloko zangasemva kwesikhumba: debunking inkolelo. Neurologist. 2007 Sep; 13 (5): 323-7.
> Ikomidi lokuBamba iintloko zeMatyala eManyeneyo. Ukwahlulelwa kwaMazwe ngamazwe kweengxaki zeNtloko: I-3 Edition (i-beta version) ". I-Cephalalgia 2013; 33 (9): 629-808.
> Monserrate AE et al. Izinto ezinxulumene nokuqala nokuphikelela kwintloko yesicathulo sokuphulukana nesigxina. JAMA Neurol . 2015 uMar; 72 (3): 325-32.