Ukujongwa koxinzelelo lwangaphakathi

Uvavanyo lwe-Intracranial uxinzelelo (ICP) lusebenzisa isixhobo esibekwe ngaphakathi kwentloko. Imonitha iyaluva uxinzelelo ngaphakathi kolukakayi kwaye ithumela imilinganiselo kwisixhobo sokurekhoda.

Zintathu iindlela zokubeka iliso kwi-ICP. I-ICP luxinzelelo kwikrele.

IKATHETERI YANGAPHAKATHI

I-catheter ye-intraventricular yeyona ndlela ichanekileyo yokujonga.

Ukufaka i-catheter ye-intraventricular, umngxunya ugqobhoziwe ngokakayi. I-catheter ifakwa ngengqondo kwi-ventricle yecala. Lo mmandla wengqondo uqulethe i-cerebrospinal fluid (CSF). I-CSF lulwelo olukhusela ingqondo kunye nomqolo.

I-catheter ye-intraventricular inokusetyenziselwa ukukhupha ulwelo ngaphandle kwe-catheter.

I-catheter inokuba nzima ukungena endaweni xa uxinzelelo lwe-intracranial luphezulu.

ISIKHOKELO SEZIKO (IBHOLI)

Le ndlela isetyenziselwa ukuba ukubeka esweni kufuneka kwenziwe kwangoko. Isikrufu esingenamngxuma sifakwa emngxunyeni owombiwe ukakayi. Ibekwe kwi-membrane ekhusela ubuchopho kunye nentambo yomqolo (ukuhlala ixesha elide). Oku kuvumela inzwa ukuba irekhode ngaphakathi kwisithuba esingaphantsi komhlaba.

Inzwa yengqondo

Inzwa yesifo sifakwa phakathi kolukakayi kunye nethishu yangaphakathi. Isivamvo se-epidural sibekwa emngxunyeni ogrunjiweyo kulukakayi. Le nkqubo ayinakuncipha kunezinye iindlela, kodwa ayinakususa i-CSF engaphezulu.

I-Lidocaine okanye enye i-anesthetic yendawo iya kufakwa kwindawo apho kuya kwenziwa khona ukusikwa. Ngokuqinisekileyo uya kufumana i-sedative ukukunceda uphumle.

• Kuqala indawo ichetyiwe kwaye icocwe nge-antiseptic.
• Emva kokuba loo ndawo yomile, kusikwa utyando. Ulusu lutsaliwe umva de kubonakale ukakayi.
• Emva koko kusetyenziswa i-drill ukusika ithambo.

Amaxesha amaninzi, le nkqubo yenziwa xa umntu ekwigumbi labagula kakhulu esibhedlele. Ukuba uvukile kwaye uyazi, umboneleli wakho wezempilo uya kuchaza inkqubo kunye nemingcipheko. Kuya kufuneka usayine ifom yemvume.

Ukuba inkqubo yenziwe ngokusebenzisa i-anesthesia ngokubanzi, uya kulala kwaye ungenazintlungu. Xa uvuka, uya kuziva iziphumo ebezingalindelekanga eziqhelekileyo zeanesthesia. Kananjalo uya kufumana ukungonwabi kwisikhewu esenziwe kukhakhayi lwakho.

Ukuba inkqubo yenziwa phantsi kwe-anesthesia yendawo, uya kuvuka. Iyeza lokugcina amanani liya kufakwa kwindawo apho kuya kwenziwa khona ukusikwa. Oku kuyakuvakala ngathi kukuhlaba entlokweni yakho, njengokuhlatywa yinyosi. Unokuziva utsala njengoko ulusu lunqunyiwe kwaye lubuyiswe umva. Uya kuva isandi sokuprinta njengoko usika ngokakayi. Ixesha elithathwayo eli liya kuxhomekeka kuhlobo lokupraktha olusetyenziswayo. Uyakuziva ukurhuqa njengoko ugqirha ehambisa isikhumba kwakhona emva kwenkqubo.

Umboneleli wakho unokukunika amayeza entlungu athambileyo ukuze unciphise ukungonwabi kwakho. Awuyi kufumana amayeza eentlungu, kuba umboneleli wakho uya kufuna ukukhangela imiqondiso yokusebenza kwengqondo.

Olu vavanyo luhlala lwenziwa ukulinganisa i-ICP. Inokwenziwa xa kukho ukonzakala entloko okanye isifo sobuchopho / inkqubo yovalo. Kananjalo kunokwenziwa emva kotyando ukususa ithumba okanye ukulungisa umonakalo kwisitya segazi ukuba ugqirha ukhathazekile ngokudumba kwengqondo.

I-ICP ephezulu inokunyangwa ngokukhupha i-CSF nge-catheter. Inokunyangwa kwakhona:

• Ukutshintsha iisetingi zokuphefumla zabantu abakumatshini wokuphefumla
• Ukunika amayeza athile ngomthambo (ngaphakathi)

Ngokwesiqhelo, i-ICP isusela kwi-1 ukuya kwi-20 mm Hg.

Thetha nomboneleli wakho malunga nentsingiselo yeziphumo zakho zovavanyo.

Ukuphakama kwe-ICP kuthetha ukuba zombini iisistim zemithambo-luvo kunye nezicubu zemithambo yegazi ziphantsi koxinzelelo. Ukuba ayinyangwa, oku kungakhokelela kumonakalo osisigxina. Kwezinye iimeko, kunokusongela ubomi.

Iingozi ezivela kwinkqubo zinokubandakanya:

• Ukopha
• Ubunzima beBongo okanye ukonzakala kuxinzelelo olonyukayo
• Ukonakala kwizihlunu zobuchopho
• Ukungakwazi ukufumana i-ventricle kunye nendawo yokubeka i-catheter
• Usulelo
• Umngcipheko weanesthesia ngokubanzi

Ukubeka iliso kwi-ICP; Ukujonga uxinzelelo lwe-CSF

• Ukujongwa koxinzelelo lwangaphakathi

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U-Oddo M, uVincent JL. Ukujongwa koxinzelelo lwangaphakathi. Ku: Vincent JL, Abraham E, Moore FA, PM Kochanek, Fink MP, ii-eds. Incwadi yesikhokelo soKhathalelo oluBalulekileyo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahlulo E20.

IRabinstein AA, iFugate JE. Imigaqo yokhathalelo lwe-neurointensive. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 55.

URobba C. Ukuvavanywa koxinzelelo lwangaphakathi. Ku: Prabhakar H, ed. Iindlela zeNeuromonitoring. Umhla woku-1. IPhiladelphia, PA: Elsevier; I-2018: isahluko 1.