Ithumba le-Epidural

Ithumba elibangelwa yintsholongwane yingqokelela yobofu (into eyosulelekileyo) kunye neentsholongwane phakathi kwesigqubuthelo esingaphandle kwengqondo kunye nomqolo kunye namathambo okakayi okanye omqolo. Ithumba libangela ukudumba kuloo ndawo.

Ithumba le-Epidural sisifo esinqabileyo esibangelwa kukosuleleka kwindawo phakathi kwamathambo okakayi, okanye umqolo, kunye neembambo ezigubungele ingqondo kunye nentambo yomqolo (meninges). Olu suleleko lubizwa ngokuba yithumba elingaphakathi ngaphakathi ukuba liphakathi kwendawo yokakayi. Ibizwa ngokuba ithumba lomqolo xa lifunyenwe kwindawo yomqolo. Uninzi lubekwe emqolo.

Usulelo lomqolo luhlala lubangelwa ziibhaktheriya kodwa kunokubangelwa ngundo. Isenokuba ngenxa yolunye usulelo emzimbeni (ngakumbi usulelo lomchamo), okanye iintsholongwane ezisasazeka egazini. Kwabanye abantu, nangona kunjalo, awukho omnye umthombo wosulelo ofunyenweyo.

Ithumba ngaphakathi kolukakayi libizwa ngokuba yithumba elingaphakathi kwintsholongwane. Unobangela unokuba kuko oku kulandelayo:

• Izifo ezingapheliyo
• Isinusitis engapheliyo
• Ukwenzakala entloko
• Mastoiditis
• Kutshanje i-neurosurgery

Ithumba lomqolo libizwa ngokuba lithumba lomqolo wesibindi. Inokubonwa kubantu abanoku kulandelayo:

• Ngaba wayenokuhlinzwa ngasemva okanye enye inkqubo engenayo ebandakanya umqolo
• Usulelo lwegazi
• Amathumba, ngakumbi ngasemva okanye entlonzeni
• Ukusuleleka kwamathambo emqolo (i-vertebral osteomyelitis)

Abantu abajova iziyobisi basemngciphekweni owandayo.

I-Spinal epidural abscess inokubangela ezi mpawu:

• Izibilini okanye ukungakwazi ukubamba kwesinyi
• Ubunzima bokuchama (ukugcinwa komchamo)
• Umkhuhlane kunye nentlungu

Itracranial epidural abscess inokubangela ezi mpawu:

• Ifiva
• Intloko ebuhlungu
• Ukuhamba
• Isicaphucaphu nokugabha
• Intlungu kwindawo yotyando lwamva nje iya isiba mandundu (ngakumbi ukuba umkhuhlane ukhona)

Iimpawu zenkqubo yemithambo-luvo zixhomekeke kwindawo enethumba kwaye zinokubandakanya:

• Ukwehla kwamandla okuhambisa naliphi na ilungu lomzimba
• Ukuphulukana nemvakalelo nakweyiphi na indawo yomzimba, okanye utshintsho olungaqhelekanga kwimvakalelo
• Ubuthathaka

Umboneleli wezempilo uya kwenza uvavanyo lomzimba ukukhangela ukulahleka kwemisebenzi, njengokuhamba okanye uvakalelo.

Uvavanyo olunokwenziwa lunokubandakanya:

• Iinkcubeko zegazi ukukhangela intsholongwane egazini
• Gcwalisa ubalo lwegazi (CBC)
• Ukuvavanywa kwe-CT kwentloko okanye umqolo
• Ukutsalwa kwethumba kunye nokuhlolwa kwemathiriyeli
• I-MRI yentloko okanye yomqolo
• Uhlalutyo lomchamo kunye nenkcubeko
  

Injongo yonyango kukunyanga usulelo kunye nokunciphisa umngcipheko wokonakaliswa ngokusisigxina. Unyango luhlala lubandakanya i-antibiotics kunye nokuhlinzwa. Ngamanye amaxesha, kusetyenziswa amayeza okubulala iintsholongwane.

Amayeza okubulala iintsholongwane ahlala enikwa ngomthambo (IV) ubuncinci iiveki ezi-4 ukuya kwezi-6. Abanye abantu kufuneka bazithathe ixesha elide, kuxhomekeka kuhlobo lwebacteria kunye nokuba isifo siqatha kangakanani.

Utyando lunokufuneka ukukhupha okanye ukususa ithumba. Ugqirha luyafuneka kaninzi ukunciphisa uxinzelelo kwithambo lomqolo okanye kwingqondo, ukuba kukho ubuthathaka okanye ukonakala kwimithambo-luvo.

Ukuchongwa kwangoko kunye nonyango kuphucula kakhulu ithuba lesiphumo esihle. Nje ukuba ubuthathaka, ukukhubazeka, okanye ukutshintsha kwemvakalelo kwenzeke, ithuba lokufumana kwakhona umsebenzi elahlekileyo linciphile kakhulu. Umonakalo osisigxina wenkqubo yemithambo-luvo okanye ukufa kusenokwenzeka.

Iingxaki zinokubandakanya:

• Ithumba lobuchopho
• Umonakalo wobuchopho
• Usulelo lwe-Bone (osteomyelitis)
• Ubuhlungu obungapheliyo
• I-Meningitis (usulelo lweembrane ezigubungele ubuchopho kunye nentambo yomqolo)
• Umonakalo wemithambo
• Ukubuya kosulelo
• Ithumba lomqolo ithumba

Ithumba lesifo esingxamisekileyo lingxamiseko lonyango. Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba uneempawu zethambo lomqolo lomqolo.

Unyango lwezifo ezithile, ezifana nosulelo lwendlebe, i-sinusitis, kunye nosulelo lwegazi, lunokunciphisa umngcipheko we-absural abscess. Ukuchongwa kwangoko kunye nonyango kubalulekile ukuthintela iingxaki.

Ithumba - isifo; Ithumba lomqolo

I-Kusuma S, iKlineberg EO. Usulelo lomqolo: ukuxilongwa kunye nokunyangwa kwe-discitis, i-osteomyelitis, kunye ne-epidural abscess. Ku: I-Steinmetz MP, iBenzel EC, ii-eds. Utyando lwe-Spine lweBenzel. Ngomhla we-4. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 122.

Tunkel AR. I-empyema yangaphantsi kwendalo, i-epidural abscess, kunye ne-thrucophlebitis engapheliyo. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. UMandell, uDouglas, kunye neMigaqo yeBennett kunye nokuSebenza kwezifo ezosulelayo, uHlelo oluHlaziyiweyo. Ngomhla we-8. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 93.