Ingqokelela yeCerebrospinal fluid (CSF)

Ingqokelela yeCerebrospinal fluid (CSF) luvavanyo lokujonga ulwelo olujikeleze ingqondo kunye nentambo yomqolo.

I-CSF isebenza njengomqamelo, ikhusela ingqondo kunye nomqolo ekonzakaleni. Ulwelo ludla ngokucaca. Inokungqinelana okufanayo namanzi. Uvavanyo lukwasetyenziselwa ukulinganisa uxinzelelo kulwelo lomqolo.

Kukho iindlela ezahlukeneyo zokufumana isampulu ye-CSF. Ukugqobhoza iLumbar (impompo yomqolo) yeyona ndlela ixhaphakileyo.

Ukufumana uvavanyo:

• Uya kulala ngecala ngamadolo akho unyuse usiya esifubeni, kwaye isilevu sijolise ezantsi. Ngamanye amaxesha uvavanyo lwenziwa luhleli, kodwa lubheke phambili.
• Emva kokuba ucocekile umqolo, umboneleli wezempilo uya kutofa iyeza lendawo elibulalayo (i-anesthetic) kumqolo ongezantsi.
• Kuza kufakwa inaliti yomqolo.
• Uxinzelelo lokuvula ngamanye amaxesha luyathathwa. Uxinzelelo olungaqhelekanga lunokubonisa usulelo okanye enye ingxaki.
  
• Nje ukuba inaliti ibesendaweni, uxinzelelo lwe-CSF luyalinganiswa kwaye isampulu ye-1 ukuya kwi-10 milliliters (mL) ye-CSF iqokelelwa kwiibhotile ezi-4.
• Inaliti iyasuswa, indawo iyacocwa, kwaye ibhandeji ibekwe ngaphezulu kwendawo yenaliti. Unokucelwa ukuba uhlale ulala phantsi okwexeshana emva kovavanyo.

Kwezinye iimeko, ii-ray ezikhethekileyo zisetyenziselwa ukunceda ukukhokela inaliti kwindawo. Oku kubizwa ngokuba yi-fluoroscopy.

Ukugqobhoza i-Lumbar ngokuqokelelwa kolwelo kunokuba yinxalenye yezinye iinkqubo ezinje nge-x-ray okanye i-CT scan emva kokuba idayi ifakwe kwi-CSF.

Rhoqo, ezinye iindlela zokuqokelela i-CSF zinokusetyenziswa.

• Ukugqobhoza ilitye kusetyenziswa inaliti ebekwe ezantsi kwethambo le-occipital (ngasemva kokhakhayi). Inokuba yingozi kuba isondele kakhulu kwisiqu sobuchopho. Ihlala isenziwa ngefluoroscopy.
• Ukuhlatywa kwe-Ventricular kunokucetyiswa kubantu abanokubakho kwengqondo. Le ndlela kunqabile ukuba isetyenziswe. Oku kwenziwa rhoqo kwigumbi lokusebenza. Kubethwa umngxuma kukhakhayi, kuze kufakwe inaliti ngqo kwenye yeentsimbi zengqondo.

I-CSF inokuqokelelwa nakwityhubhu esele ibekwe kulwelo, njenge-shunt okanye i-ventricular drain.

Kuya kufuneka unike iqela lokhathalelo lwempilo imvume yakho phambi kovavanyo. Xelela umboneleli wakho ukuba unayo nayiphi na iasprini okanye naliphi na iyeza elinciphisa igazi.

Emva kwenkqubo, kuya kufuneka ucwangcise ukuphumla iiyure ezininzi, nokuba uziva uphilile. Oku kukuthintela ukuba ulwelo luvuze kwindawo ejikelezayo. Awuyi kufuna ukulala phantsi emhlane wakho lonke ixesha. Ukuba uphathwa yintloko, kunokuba luncedo ukusela iziselo ezinecafini ezifana nekofu, iti okanye isoda.

Kungangonwabi ukuhlala kwindawo yovavanyo. Ukuhlala kubalulekile kubalulekile kuba intshukumo ingakhokelela ekonzakaleni kwethambo lomqolo.

Unokuxelelwa ukuba ulungise indawo yakho kancinci emva kokuba inaliti ikho. Oku kukunceda ukulinganisa uxinzelelo lwe-CSF.

I-anesthetic iya kubetha okanye itshise xa ijojowe kuqala. Kuya kubakho uxinzelelo olunzima xa inaliti ifakiwe. Rhoqo, kubakho iintlungu ezimfutshane xa inaliti idlula kwithishu ejikeleze intambo yomqolo. Le ntlungu kufuneka iyeke kwimizuzwana embalwa.

Kwiimeko ezininzi, inkqubo ithatha malunga nemizuzu engama-30. Olona nyathelo loxinzelelo kunye nokuqokelelwa kwe-CSF kuthatha imizuzu embalwa.

Olu vavanyo lwenziwa ukulinganisa uxinzelelo ngaphakathi kwe-CSF kunye nokuqokelela isampulu yolwelo ukuze iphinde ivavanywe.

Uhlalutyo lwe-CSF lunokusetyenziselwa ukufumanisa isifo esithile se-neurologic. Oku kunokubandakanya usulelo (njenge-meningitis) kunye nengqondo okanye umonakalo wentambo yomqolo. Impompo yomqolo ingenziwa kwakhona ukufumanisa isifo koxinzelelo lwehydrocephalus.

Amaxabiso aqhelekileyo ahluka ngolu hlobo lulandelayo:

• Uxinzelelo: 70 ukuya kwi-180 mm H₂O
• Inkangeleko: icacile, ayinambala
• I-protein ye-CSF iyonke: 15 ukuya kwi-60 mg / 100 mL
• I-Gamma globulin: 3% ukuya kwi-12% yeeprotein zizonke
• I-CSF glucose: 50 ukuya kuma-80 mg / 100 ml (okanye ngaphezulu kwesibini kwisithathu senqanaba leswekile yegazi)
• Inani leeseli ze-CSF: 0 ukuya kwi-5 iiseli ezimhlophe zegazi (yonke inyukliya), kwaye akukho maseli abomvu egazi
• I-Chloride: 110 ukuya kwi-125 mEq / L

Amaxabiso esiqhelo ahluka kancinci phakathi kweelebhu ezahlukeneyo. Thetha nomboneleli wakho malunga nentsingiselo yeziphumo zakho zovavanyo.

Imizekelo engentla ibonisa imilinganiselo eqhelekileyo yeziphumo zolu vavanyo. Ezinye iilabhoratri zisebenzisa imilinganiselo eyahlukeneyo okanye zinokuvavanya iisampulu ezahlukeneyo.

Ukuba i-CSF ijongeka ngathi inamafu, oko kunokuthetha ukuba kukho usulelo okanye inqwaba yeeseli ezimhlophe zegazi okanye iprotheni.

Ukuba i-CSF ijongeka inegazi okanye ibomvu, inokuba luphawu lokopha okanye ukuvala kwethambo lomqolo. Ukuba imdaka, orenji, okanye tyheli, inokuba luphawu lokunyuka kweprotein ye-CSF okanye ukopha kwangaphambili (ngaphezulu kweentsuku ezi-3 ezidlulileyo). Kunokubakho igazi kwisampulu evela kwimpompo yomqolo uqobo. Oku kwenza ukuba kube nzima ukutolika iziphumo zovavanyo.

Uxinzelelo lwe-CSF

• Ukonyuka koxinzelelo lwe-CSF kunokubangelwa kukunyuka koxinzelelo lwangaphakathi (uxinzelelo ngaphakathi kolukakayi).
• Ukwehla koxinzelelo lwe-CSF kunokuba ngenxa yebhloko yomqolo, ukuphelelwa ngamanzi emzimbeni, ukuphelelwa ngamandla, okanye ukuvuza kwe-CSF.

IINKCUKACHA ZE-CSF

• Ukonyuka kweprotein ye-CSF kunokuba ngenxa yegazi kwi-CSF, isifo seswekile, i-polyneuritis, ithumba, ukwenzakala, okanye nayiphi na imeko etshisayo okanye eyosulelayo.
• Ukuncipha kweprotein luphawu lokuvelisa ngokukhawuleza kwe-CSF.

ICSF GLUCOSE

• Ukonyuka kwe-CSF glucose luphawu lweswekile ephezulu yegazi.
• Ukuncipha kweglucose ye-CSF kunokubangelwa yi-hypoglycemia (iswekile esezantsi yegazi), usulelo lwebhaktiriya okanye lokungunda (njenge-meningitis), isifo sephepha, okanye ezinye iintlobo ze-meningitis.

IISELI ZEGAZI KWI-CSF

• Ukonyuka kweeseli ezimhlophe zegazi kwi-CSF kunokuba luphawu lwe-meningitis, usulelo olubi, ukuqala kwesifo sexesha elide (esinganyangekiyo), ithumba, ithumba, okanye isifo sokuphelisa isifo (njenge-multiple sclerosis).
• Iiseli ezibomvu zegazi kwisampulu ye-CSF inokuba luphawu lokuphuma kwegazi kulusu lomqolo okanye sisiphumo sokuhlatywa okumbi okwenzekileyo.

EZINYE IZIPHUMO ZE-CSF

• Ukonyuka kwamanqanaba e-CSF gamma globulin kunokubangelwa zizifo ezinjenge-multiple sclerosis, i-neurosyphilis, okanye i-Guillain-Barré syndrome.

Iimeko ezongezelelweyo apho uvavanyo lunokwenziwa khona:

• I-polyneuropathy engapheliyo yokuvuvukala
• Isifo sengqondo esixhalabisayo ngenxa yoonobangela bokubanga umzimba
• I-Encephalitis
• Isathuthwane
• Ukubanjwa kwefebrile (abantwana)
• Ukubanjwa ngokubanzi kweetoni-clonic
• IHydrocephalus
• Ukuphefumla i-anthrax
• Uxinzelelo oluqhelekileyo lwehydrocephalus (NPH)
• Ithumba lelungu lobufazi
• Isifo seReye

Iingozi zokuhlatywa empontshwa zibandakanya:

• Ukopha kumjelo womqolo okanye ujikeleze ingqondo (hematomas engaphantsi).
• Ukuphazamiseka ngexesha lovavanyo.
• Intloko ebuhlungu emva kovavanyo olunokuhlala iiyure ezimbalwa okanye iintsuku. Kunokuba luncedo ukusela iziselo ezine-caffeine ezifana nekofu, iti okanye isoda ukunceda ekunciphiseni intloko. Ukuba iintloko zihlala ngaphezulu kweentsuku ezimbalwa (ngakumbi xa uhleli, yima okanye uhambe) unokuba nokuvuza kwe-CSF. Kuya kufuneka uthethe nogqirha wakho ukuba oku kuyenzeka.
• Impendulo ye-Hypersensitivity (i-allergen) kwi-anesthetic.
• Usulelo olwenziwe ngenaliti ludlula kulusu.

I-Brain herniation inokwenzeka ukuba olu vavanyo lwenziwa kumntu onobunzima kwingqondo (njengethumba okanye ithumba). Oku kunokubangela ukonakala kwengqondo okanye ukufa. Olu vavanyo alwenziwa ukuba uvavanyo okanye uvavanyo lubonisa iimpawu zobunzima bengqondo.

Ukonakala kwimithambo-luvo kwintambo yomqolo kunokwenzeka, ngakumbi ukuba umntu uyahamba ngexesha lovavanyo.

Ukugqobhoza amanzi emthonjeni okanye ukugqobhoza i-ventricular kuthwala umngcipheko owongezelelweyo wobuchopho okanye umonakalo wentambo yomqolo kunye nokuphuma kwegazi ngaphakathi kwengqondo.

Olu vavanyo luyingozi kakhulu kubantu abane:

• Ithumba ngasemva kwengqondo elicinezela ezantsi kwinkqubo yobuchopho
• Iingxaki zokunqanda igazi
• Inani eliphantsi leplatelet (thrombocytopenia)
• Abantu abathatha i-thinner yegazi, i-aspirin, i-clopidogrel, okanye ezinye iziyobisi ezifanayo ukunciphisa ukwakheka kwamahlwili egazi.

Impompo yomqolo; Ukubhoboza umoya; Ukugqobhoza empontshwa; Ukugqojozwa; Inkcubeko yeCerebrospinal fluid

• I-CSF chemistry
• I-vertebrae yeLumbar

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I-Euerle BD. Ukuhlanjwa komqolo kunye novavanyo lwe-cerebrospinal fluid. Ku: Roberts JR, Custalow CB, Thomsen TW, ii-eds. Iinkqubo zeKlinikhi zikaRoberts kunye neHedges kwiNyango kaXakeka kunye noKhathalelo oluQhelekileyo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2019: isahluko 60.

IRosenberg GA. I-edema yobuchopho kunye nokuphazamiseka kokujikeleza kolwelo lwe-cerebrospinal. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahl 88.