Oku kutyunjwa kunomnye igama - i-lumbar, kwiimeko ezininzi ezisetyenziswe kwi-neurology ekumisweni kwesifo sokugqibela ngokuthatha i-cerebrospinal fluid nokuyihlalutya. Inqubo inezibonakaliso zayo, ukuchasana kunye neempawu.
Ukugqitywa kweLumbar - izibonakaliso
Ukuba isigulane sinikezelwa ukuhlanjululwa komgudu, izibonakaliso kule nto zinokuba zipheleleyo kwaye zihambelana. Okokuthi, ukuqhuba ukunyanzeliswa kuyimfuneko okanye unokwenza ngaphandle kwayo (kulo mzekelo ugqirha oya kwixesha eliya kuthatha isigqibo). Ngokuphathelele izifo, izibonakaliso ezipheleleyo zilandelayo:
- izifo ezithathelwanayo zesistim somhlaba;
- neoplasms ezimbi;
- ukubola.
Izibonakaliso ezihambelanayo:
- multiple sclerosis;
- polyneuropathy ;
- ukuthungqwa kweempahla;
- umkhuhlane wesimo esingaziwayo kubantwana abangaphantsi kweminyaka emi-2;
- lupus erythematosus .
Izibonakaliso zenkqubo zibandakanya:
- i-anesthesia yomgulane ngaphambi kokuhlinzwa;
- i-anesthesia yokubeleka;
- ukulinganiselwa kwengcinezelo kwi-cerebrospinal fluid (cerebrospinal fluid);
- ukufakwa kwamachiza.
Yiyiphi ingozi yokuguqula umgudu?
Ukugqithiswa kwe-cerebrospinal fluid ngenye yeendlela ezinzima kakhulu zokuxilonga ezifanele zenziwe ngutitshala oqeqeshekileyo kwaye mhlawumbi esibhedlele. Ingozi ebalulekileyo yintsholongwane yomgca womgca kunye nomonakalo wayo. Ngokudlulileyo, xa kuqhutywe i-lumbar puncture, intambo yomgudu ngokwawo ayinakuchaphazeleka.
I-Lumbar yokutshitshisa - ngaba kubuhlungu?
Ukugqitywa kwe-Lumbar kwenziwa nge-aneshesia yangaphambili ye-lidocaine. Iimvakalelo emva kokusungulwa kwesi sixhobo sokuhlaziywa kwama-anesthetic sivalelwa malunga nomntu wonke: sinyanisekile, sifana nokunyanga kwamazinyo. Ngenxa ye-anesthesia, ijojo ngokwayo ayinabuhlungu. Ukuba umonakalo wegulane unomonakalo, isigulane sinokuziva igalaji efana nokutshitshiswa kwamanje. Izikhalazo malunga nentloko ziqhelekile.
Nantsi indlela yokunciphisa iimpawu zokugqithisa umlenze:
- Ukususela ekuqaleni, emva kokunyanzelisa, isigulane simiselwe ukuphumla kwebhedlele ngokupheleleyo ubuncinane kwiiyure ezingama-18. Ngamanye amaxesha, ukuba kuyimfuneko, iyanwezelwa kwiintsuku ezi-3.
- Ubunzima (intloko kunye nesayithi lokuqhawula) lusekwe unyango lwe-analgesic ngendlela ye-NSAID.
- Kwakhona, isigulane sinconywa isiselo esifudumele. Ukuba kuyimfuneko, iinguqu ze-plasma ziyaziswa.
Ukutshatyalaliswa kokutshatyalaliswa kwesikhala
Oku kutyunjwa kweengcali akunzima kakhulu. Kodwa ekubeni kukho imiphumo emibi, kukho ukuchasene. Iinjongo zokuxilonga zithatha kuphela i-5 ml ye-CSF, kwaye usuku lusekwe malunga ne-700 ml. Xa ujoza i-arhente ehlukileyo kwi-inaliti, malunga ne-10 ml ye-fluid ingena kwindawo yomgcini. Kuyakwazi ukufumana iintsholongwane ngokusebenzisa inaliti, kunye nezitya ezilinzakeleyo. Ukuqhubeka ukusuka ngasentla, le nkqubo ayifanele kwenziwe:
- kunye ne-hematoma engasebenzi, ukuphulwa kobuchopho, i-edema, i-abscess, i-absumric form and other changes of the brain;
- ukutshitshiswa kakubi;
- kunye nesilonda esikhulu samathambo kunye nezilonda zoxinzelelo kwiindawo apho kukhishwa khona;
- nge-diathesis ephazamisayo;
- kunye neentsholongwane zomgudu womgogodla kunye nokuphazamiseka komjikelezo we-cerebrospinal fluid;
- kunye ne-occlusal ifom ye-hydrocephalus.
Enye yemiphumo engavumelekanga kwaye isiqhelo esenzeka ngokuqhelekileyo yintloko emva kokugqithisa umlenze. Kudla ngokufumaneka kwizigulane ezahlukeneyo. Njengomthetho, xa usukuma, intlungu ikhula, ngelixa elele kwindawo elele, ngokuchaseneyo, iyancipha. Iinqununu zamancinci amancinane zinciphisa iziganeko zentloko. Ngokuqhelekileyo isibonakaliso sidlula ngokwaso kwaye sihamba ngokukhawuleza. Kwakhona ukuyilahla, ukuphumla kombhede, isiselo esininzi, i-analgesics kunye ne-caffeine.
Hlela umgca wesipelini
Ukusetyenziswa, ukusetyenziswa kwezixhobo, ukulungiselela kunye nezinto ezifunekayo:
- isisombululo se-iodine 5%;
- utywala
- collodion;
- isisombululo se-novocaine 0.5%;
- ii-syringes 5 ne-10 ml;
- iinaliti ezincinci kwiisring;
- inaliti yokutyunjwa kwe-lumbar (iindidi ezilula kakhulu ze-iridium-platinum ezingaphuli kwaye zingabambi);
- isilinganisi samanzi soxinzelelo lokubeka uxinzelelo lwe-cerebrospinal fluid;
- Iibhubhu zokuvavanya ziyinyumba, i-napkins kunye noboya bekoton.
Ukulungiselela ukugqithiswa komgudu
Umlenze (lumbar) ukugqitywa kubandakanya ukuqeqeshwa kwangaphambili. Ukuqala, ugqirha kufuneka afumane oku kulandelayo:
- ngokumalunga nesigulane sesibini, nokuba uyakhulelwa;
- ingaba isigulane sineempembelelo ezichasene neziyobisi kunye ne-anesthetics;
- Ingaba kukho nawaphi na amayeza athatyathwa okwangoku;
- malunga nokuphulwa kwegazi.
Olunye uhlobo lolungiso olunzima alufunanga ukusetyenziswa. Kukho imithetho ethile. Isigulane sifanele sichithwe isisu kunye nesisu sicocekile. Isidlo sokugqibela senziwe ngaphandle kweeyure ezingama-2 phambi kwenkqubo. Kunconywa ukuba uyeke ukutshaya ngomhla wokugqithisa. Zonke ezinye iinkqubo kunye namachiza ziyacinywa.
Ukugqithisa umgca
Ukugqitywa kweLumbar - inkqubo yokuphunyezwa:
- Unyango kunye nesepha ye-antiseptic, ngoko utywala okanye iodode.
- Faka isicelo sokususa i-site yokuhamba.
- Isigulane sithatha isikhundla esifanelekileyo: silele ecaleni, siguqa ngamadolo, sicinezela intloko yakhe kwisifuba okanye sihleli, sigubungela phambili.
- Ukunyangwa kwendawo yokuqhawulwa ngotywala.
- Ukunqunywa kwendawo yokuhlutha (kubantu abadala phakathi kwe-2 ne-3 vertebrae lumbar, kubantwana abaphakathi kwe-4 no-5).
- Ukuqaliswa kwe-anesthetic yendawo (isisombululo se-novocaine okanye i-lidocaine).
- Emva kwemizuzu engama-2-3 elinde isenzo se-anesthetic, inaliti ifakwe kwi-spinal puncture. Ngolawulo oluchanekileyo, ugqirha kunye nesigulane zivakalelwa kukuba ziwela kumlingani ohlalayo.
- Ukususwa kwe-mandrin, kuqala ukuqhuma utywala.
- Umlinganiselo woxinzelelo nge-manometer.
- Faka isicelo kwi-bandage eyinyumba kwi-site.
Imiphumo yesigxina
Ngokuqhelekileyo, iingxaki emva kokuqhutyelwa kwezinto zenzeke ngokukhawuleza, kodwa nangona ukugqitywa kwe-cerebrospinal fluid kwenziwa ngokufanelekileyo, iziphumo zisenokwenzeka. Njengoko kukhankanywe ngasentla, oku kuyintloko, kwaye kwakhona:
- isicefe
- ukuhlanza;
- ukungcola.
Xa ubuchule bokugqithisa umgudu buphukile:
- kuphuma;
- paresis;
- indlela yokuphendula;
- izifo ezithathelwanayo, njl