He aha ka Lumbar Puncture (Spinal Tap)? Ke Kumu, ke Kaʻina Hana & nā Hōʻike

ʻO ka lumbar puncture, i kapa ʻia he spinal tap, he hana lapaʻau kahi e hoʻokomo ai kāu kauka i kahi nila lahilahi i kou kua lalo e hōʻiliʻili i ka wai cerebrospinal (CSF) no ka hoʻāʻo ʻana. Hoʻopuni kēia wai maʻemaʻe i kou lolo a me ke kuamoʻo, e hana ana e like me ka uluna pale. ʻOiai ʻo ka manaʻo o kahi nila kokoke i kou kuamoʻo e manaʻo paha he mea weliweli, palekana maʻamau kēia kaʻina hana a hiki ke hāʻawi i ka ʻike koʻikoʻi e pili ana i kou olakino ʻaʻole hiki i nā hoʻokolohua ʻē aʻe ke hōʻike.

He aha ka lumbar puncture?

ʻO ka lumbar puncture e pili ana i ka hoʻokomo pono ʻana i kahi nila kūikawā ma waena o nā iwi o kou kuamoʻo lalo e hiki ai i ka wahi i loaʻa ka wai cerebrospinal. Hana ʻia ke kaʻina hana ma kou ʻāpana lumbar, ʻo ia ke kumu i kapa ʻia ai he

• He maʻi lolo a me ke kuamoʻo i manaʻo ʻia (nā maʻi o ka lolo a me ke kuamoʻo)
• Nā maʻi sclerosis lehulehu a i ʻole nā maʻi neurological autoimmune ʻē aʻe
• Ke kahe ʻana o ke koko a puni ka lolo (subarachnoid hemorrhage)
• Nā ʻano maʻi ʻaʻai e pili ana i ka ʻōnaehana nerve
• Guillain-Barré syndrome (he maʻi nerve laha ʻole)
• Nā hōʻailona neurological i wehewehe ʻole ʻia e like me ke poʻo nui a i ʻole ka huikau

I kekahi manawa, hiki i kāu kauka ke hoʻohana i kēia kaʻina hana e hāʻawi pololei i nā lāʻau lapaʻau i kou wahi kuamoʻo, e like me nā lāʻau chemotherapy a i ʻole nā anesthetics no kekahi mau ʻoki. Hiki i kēia ala i manaʻo ʻia ke ʻoi aku ka maikaʻi ma mua o ka lawe ʻana i ka lāʻau lapaʻau ma ka waha a i ʻole ma o ka IV.

He aha ke kaʻina hana no ka lumbar puncture?

ʻO ka lumbar puncture kaʻina hana maʻamau e lawe ma kahi o 30 a 45 mau minuke a hana ʻia i loko o ka haukapila a i ʻole ka hale lapaʻau outpatient. E hoʻonoho ʻia ʻoe e moe ana ma kou ʻaoʻao me kou mau kuli i huki ʻia i kou umauma, a i ʻole e noho ana a e hilinaʻi ana i mua ma luna o kahi papa. Kōkua kēia mau kūlana i ka wehe ʻana i nā wahi ma waena o kou vertebrae.

E hoʻomaʻemaʻe kāu kauka i kou kua lalo me ka hopena antiseptic a e hoʻokomo i ka anesthetic kūloko e hoʻopōpō i ka wahi. E ʻike ʻoe i kahi ʻuʻuku mai kēia injection, akā e ʻoluʻolu ke koena o ke kaʻina hana. Ke ʻeha ʻole ka wahi, e hoʻokomo pono kāu kauka i ka nila spinal ma waena o ʻelua vertebrae i kou kua lalo.

Eia ka mea e hana ʻia i ka wā o ke kaʻina hana:

1. Huli kāu kauka i kahi kūpono me ka hoʻohana ʻana i nā hōʻailona anatomical
2. Hoʻomau mālie ʻia ka nila a hiki i ka wahi wai cerebrospinal
3. He liʻiliʻi ka wai (maʻamau 1-4 teaspoon) i hōʻiliʻili ʻia i loko o nā paipu sterile
4. Wehe ʻia ka nila a hoʻopili ʻia kahi bandage liʻiliʻi
5. E noi ʻia ʻoe e moe palahalaha no 30 mau minuke a i hoʻokahi hola ma hope

I ka wā e hōʻiliʻili ʻia ai ka wai, e ʻike paha ʻoe i ke kaomi a i ʻole ka manaʻo pōkole e iho ana i kou wāwae. He mea maʻamau kēia a hana ʻia no ka mea kokoke ka nila i nā aʻa o nā aʻa. ʻO ka hapa nui o nā kānaka e wehewehe i ka ʻoluʻolu ma lalo o kā lākou i manaʻo ai.

Pehea e hoʻomākaukau ai no kāu lumbar puncture?

He maʻalahi ka hoʻomākaukau ʻana no ka lumbar puncture, a e hāʻawi kāu hui mālama ola iā ʻoe i nā ʻōlelo kikoʻī. Ma keʻano maʻamau, hiki iā ʻoe ke ʻai a inu maʻamau ma mua o ke kaʻina hana ke ʻole kāu kauka e haʻi iā ʻoe i nā mea ʻē aʻe. He mea nui e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau a pau āu e lawe nei, ʻoiai nā mea hoʻokahe koko.

Pono paha ʻoe e hooki i kekahi mau lāʻau lapaʻau ma mua o ke kaʻina hana, ʻoiai nā mea e pili ana i ka hoʻopaʻa ʻana i ke koko. E hāʻawi kāu kauka iā ʻoe i ke alakaʻi maopopo e pili ana i nā lāʻau lapaʻau e hoʻomaha ai a no ka lōʻihi. Mai hooki i nā lāʻau lapaʻau i kauoha ʻia me ka ʻole o ka ʻae ʻana o kāu kauka.

I ka lā o kāu kaʻina hana, e ʻaʻahu i nā lole ʻoluʻolu, nā lole ʻoluʻolu e hiki ai ke komo maʻalahi i kou kua. E noʻonoʻo e lawe mai i kekahi e hoʻokele iā ʻoe i ka home, no ka mea, pono ʻoe e hoʻomaha no kekahi mau hola ma hope. Manaʻo kekahi poʻe i ka luhi a i ʻole ke poʻo liʻiliʻi ma hope o ke kaʻina hana.

Pehea e heluhelu ai i kāu mau hopena lumbar puncture?

E hōʻike ana kāu mau hopena wai cerebrospinal i kekahi mau ana nui e kōkua i kāu kauka e hoʻomaopopo i ka mea e hana nei i loko o kāu ʻōnaehana nerve. He maopopo a me ka ʻole o ke kala ka CSF maʻamau, e like me ka wai. Hiki i nā loli i ka helehelena, ke kala, a i ʻole ka haku ʻana ke hōʻike i nā kūlana kikoʻī.

E nānā kāu kauka i nā ʻano like ʻole o kāu laʻana wai. ʻO nā ana nui e pili ana i ka helu cell, nā pae protein, nā pae glucose, a me nā helu kaomi. ʻO nā hopena maʻamau ke manaʻo nei e hana maikaʻi ana kāu ʻōnaehana nerve a ʻaʻohe hōʻike o ka maʻi a i ʻole nā pilikia koʻikoʻi.

Eia ka mea e hōʻike ai nā mea i loaʻa:

• Ka helu kiʻekiʻe o nā keʻena koko keʻokeʻo: He maʻi a i ʻole mumū paha
• Nā keʻena koko ʻulaʻula i loaʻa: He kahe koko paha a i ʻole kahi paʻi ʻeha
• Nā pae protein kiʻekiʻe: Hiki ke hōʻike i ka maʻi, mumū, a i ʻole nā ​​kūlana ʻē aʻe
• Nā pae glucose haʻahaʻa: Hōʻike pinepine i ka maʻi bacteria
• He wai ao a i ʻole ke kala: Hōʻailona maʻamau i ka maʻi a i ʻole ke kahe koko
• Nā helu kaomi maʻamau ʻole: Hiki ke hōʻike i nā kūlana neurological like ʻole

E wehewehe kāu kauka i kāu mau hopena kikoʻī a me ke ʻano o lākou no kou olakino. I kekahi manawa, pono paha nā hoʻokolohua hou aʻe ma ka laʻana wai e kiʻi i kahi kiʻi piha. E hoʻomanaʻo pono e wehewehe ʻia nā hopena i ka pōʻaiapili o kāu mau hōʻailona a me nā ʻike olakino ʻē aʻe.

He aha nā mea pilikia no nā pilikia mai ka lumbar puncture?

ʻOiai palekana ka lumbar puncture, hiki i kekahi mau mea ke hoʻonui i kou pilikia o nā pilikia. He maʻalahi ka hapa nui o nā kaʻina hana, akā he mea nui e hoʻomaopopo i ka mea e paʻakikī ai ke kaʻina hana a i ʻole e hoʻonui i kou pilikia o nā hopena ʻaoʻao.

E loiloi pono kāu kauka i kou kūlana pilikino ma mua o ka ʻōlelo ʻana i ke kaʻina hana. ʻO kekahi mau mea e hoʻonui ai i nā pilikia e pili ana i nā maʻi kahe koko, kekahi mau lāʻau lapaʻau, a i ʻole nā ​​ʻano anatomical i kou iwi kuamoʻo. Hiki i ka poʻe me ka arthritis koʻikoʻi a i ʻole ke ʻoki ʻana i ke kua ma mua ke kū i nā pilikia hou.

ʻO nā mea pilikia e noʻonoʻo ai kāu kauka e pili ana:

• Ke lawe nei i nā lāʻau lahilahi koko
• He maʻi kahe koko a i ʻole ka helu platelet haʻahaʻa
• ʻO ka arthritis spinal koʻikoʻi a i ʻole ka deformity
• ʻO ka ʻoki ʻana i ke kua ma mua me nā lako
• Hoʻonui ʻia ke kaomi i ka lolo
• Maʻi ʻili ma ke kahua puncture
• Nā kūlana neurological

E nānā kāu hui mālama ola i kāu mōʻaukala olakino a me nā lāʻau lapaʻau o kēia manawa e hōʻemi i nā pilikia. Hiki iā lākou ke kauoha i nā hoʻokolohua koko e nānā i kāu hana ʻana i ke koko a i ʻole nā haʻawina kiʻi e loiloi i kou anatomy iwi kuamoʻo ma mua o ke kaʻina hana.

He aha nā pilikia hiki ke loaʻa i ka lumbar puncture?

ʻAʻole nui ka poʻe e ʻike i nā pilikia koʻikoʻi mai ka lumbar puncture, akā he mea nui e ʻike i ka mea e nānā ai. ʻO ka hopena ʻaoʻao maʻamau he ʻehaʻeha e ulu ana i loko o 24 a 48 mau hola ma hope o ke kaʻina hana. Hana ʻia kēia ma kahi o 10-15% o nā kānaka a he maʻalahi a he manawa pōkole.

Hana ʻia ka ʻehaʻeha ma muli o nā loli manawa i ke kaomi wai cerebrospinal ma hope o ke kaʻina hana. ʻOi aku ka maikaʻi o ka manaʻo ke noho ʻoe a i ʻole ke kū ʻana a hoʻomaikaʻi ke moe ʻoe. Hoʻoponopono ka hapa nui o nā ʻehaʻeha iā lākou iho i loko o kekahi mau lā me ka hoʻomaha a me ka inu wai kūpono.

ʻO nā pilikia ʻē aʻe e pili ana:

• ʻEhaʻeha ma hope o ka lumbar puncture (maʻamau)
• ʻEhaʻeha hope a i ʻole ka ʻeha ma kahi o ka puncture
• Ka palaka wāwae manawa a i ʻole ke ʻano
• Ka liʻiliʻi o ke koko ma kahi o ka puncture
• Kākaʻikahi: maʻi ma kahi o ka puncture
• Kākaʻikahi loa: ka pōʻino o ke aʻalolo a i ʻole ka leaka wai spinal mau
• Kākaʻikahi loa: ka herniation lolo (i nā hihia o ka piʻi ʻana o ke kaomi lolo)

ʻAʻole maʻamau nā pilikia koʻikoʻi ke hana ʻia ke kaʻina hana e nā mea mālama ola i ʻike ʻia. E nānā pono kāu hui lapaʻau iā ʻoe a hāʻawi i nā ʻōlelo maopopo e pili ana i ka manawa e ʻimi ai i ka lāʻau lapaʻau inā ʻike ʻoe i nā hōʻailona e pili ana.

I ka manawa hea wau e ʻike ai i ke kauka ma hope o ka lumbar puncture?

Pono ʻoe e hoʻokaʻaʻike i kāu kauka inā loaʻa iā ʻoe kekahi mau hōʻailona ma hope o kāu lumbar puncture. ʻOiai e ola ana ka hapa nui o nā kānaka me ka ʻole o nā pilikia, he mea nui e ʻike i ka wā e hōʻike ai nā hōʻailona i kahi pilikia e pono ai ka lāʻau lapaʻau.

He ʻeha poʻo nui ʻaʻole e hoʻomaikaʻi me ka hoʻomaha a me ka moe ʻana, a i ʻole e ʻoi aku ka ʻino i ka wā, pono e kelepona i kāu kauka. Pēlā nō, inā loaʻa iā ʻoe ke kuni, ka ʻoʻoleʻo o ka ʻāʻī, a i ʻole nā ​​hōʻailona o ka maʻi ma kahi o ka wahi e hou ʻia ai, pono ʻoe e ʻimi koke i ka lāʻau lapaʻau.

E kelepona i kāu mea mālama ola inā ʻike ʻoe i kēia mau mea:

• He ʻeha poʻo nui e ʻoi aku ka ʻino a i ʻole ʻaʻole e hoʻomaikaʻi ma hope o 48 mau hola
• Ke kuni ma luna o 101°F (38.3°C)
• ʻOʻoleʻo o ka ʻāʻī a i ʻole ka ʻeha nui o ka ʻāʻī
• Ka luaʻi mau a me ka luaʻi
• ʻUlaʻula, pehu, a i ʻole ka wai ma kahi o ka wahi e hou ʻia ai
• ʻEha hope nui e ʻoi aku ka ʻino
• ʻOʻoleʻa a i ʻole nāwaliwali i kou mau wāwae ʻaʻole e hoʻomaikaʻi

ʻO ka hapa nui o nā hōʻailona e kū mai ma hope o ka lumbar puncture he maʻalahi a he manawa pōkole. Eia naʻe, mai kānalua e hoʻokaʻaʻike i kāu hui mālama ola inā hopohopo ʻoe e pili ana i nā hōʻailona āu e ʻike nei. Hiki iā lākou ke hāʻawi i ke alakaʻi a me ka maluhia o ka noʻonoʻo.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka lumbar puncture

Q1: He ʻeha anei ka hoʻāʻo lumbar puncture?

ʻIke ka hapa nui o nā kānaka i ka lumbar puncture ʻaʻole ʻeha e like me kā lākou i manaʻo ai. Hoʻokumu ka injection anesthetic kūloko i kahi ʻeha pōkole, akā ma hope o kēlā, pono ʻoe e manaʻo i ke kaomi a i ʻole ka hōʻoluʻolu maʻalahi. ʻIke kekahi poʻe i kahi manaʻo pana pōkole i lalo o ko lākou wāwae i ka wā e hiki ai ka nila i ka wahi nerve, akā hala koke kēia.

Hoʻohālikelike pinepine ʻia ka pae hōʻoluʻolu i ka loaʻa ʻana o kahi lāʻau lapaʻau nui a i ʻole ka lawe ʻana i ke koko mai kahi vein paʻakikī. E hana kāu hui mālama ola e mālama iā ʻoe e like me ka hiki i ka wā o ke kaʻina hana.

Q2: Hiki i ka lumbar puncture ke hōʻino mau?

He mea maʻamau loa ka pōʻino mau mai ka lumbar puncture ke hana ʻia e nā mea mālama ola i ʻike ʻia. Hoʻōla ka hapa nui o nā kānaka me ka ʻole o nā hopena mau loa. Hoʻolālā ʻia ke kaʻina hana e pale i ke kaula iwi kuamoʻo, e pau ana ma luna o kou iwi kuamoʻo.

ʻOiai he mea maʻamau nā hopena ʻaoʻao manawa, e like me ke poʻo a i ʻole ka ʻeha o ke kua, ʻo nā pilikia mau loa e like me ka pōʻino o ke aʻalolo a i ʻole ka ʻeha mau loa e hana ʻia ma lalo o 1% o nā kaʻina hana. ʻO nā pōmaikaʻi o ka loaʻa ʻana o kahi hōʻailona pololei e ʻoi aku ka nui o kēia mau pilikia liʻiliʻi.

Q3: Pehea ka lōʻihi o ka hoʻōla ʻana mai ka lumbar puncture?

ʻO ka hapa nui o nā kānaka e manaʻo maʻamau i loko o 24 a 48 mau hola ma hope o ka lumbar puncture. Pono ʻoe e hoʻomaha no nā hola mua ma hope o ke kaʻina hana, e moe ana ma kahi palahalaha no 30 mau minuke a i hoʻokahi hola i loko o ka hale lapaʻau. Nui ka poʻe e hiki ke hoʻi i nā hana māmā i ka lā hoʻokahi.

Pono ʻoe e pale i nā hana ikaika, ka hāpai ʻana i nā mea kaumaha, a i ʻole ka hoʻoikaika kino no 24 a 48 mau hola. ʻIke kekahi poʻe i ka ʻeha o ke kua a i ʻole ka luhi no hoʻokahi a ʻelua paha lā, akā hoʻoponopono pinepine ʻia kēia me ka hoʻomaha a me nā mea hōʻoluʻolu ʻeha ma luna o ka counter inā pono.

Q4: He aha kaʻu e hana ai inā loaʻa iaʻu ke poʻo ma hope o ka lumbar puncture?

Inā loaʻa iā ʻoe ke poʻo ma hope o ka lumbar puncture, e hoʻāʻo e moe palahalaha a inu i ka wai nui. Hoʻomaikaʻi pinepine ke poʻo i ka wā e pae ai ʻoe no ka mea kōkua kēia i ka hoʻoponopono ʻana i ke kaomi i loko o kāu ʻōnaehana wai cerebrospinal.

Hiki i nā mea hōʻoluʻolu ʻeha ma luna o ka counter e like me ka acetaminophen a i ʻole ibuprofen ke kōkua i ka mālama ʻana i ka hōʻoluʻolu ʻole. Inā koʻikoʻi ke poʻo a mau no 48 mau hola, e hoʻokaʻaʻike i kāu mea mālama ola. Hiki iā lākou ke ʻōlelo i nā lāʻau lapaʻau hou a i ʻole makemake e loiloi iā ʻoe no nā pilikia.

Q5: Hiki iaʻu ke kalaiwa ma hope o ka lumbar puncture?

ʻAʻole pono ʻoe e kalaiwa koke ma hope o ka lumbar puncture. Manaʻo ka hapa nui o nā kauka e loaʻa i kekahi e hoʻokele iā ʻoe i ka home mai ke kaʻina hana. Pono ʻoe e hoʻomaha no kekahi mau hola ma hope, a manaʻo kekahi poʻe i ka luhi a i ʻole ke poʻo māmā e hiki ke hoʻopilikia i ko lākou hiki ke kalaiwa palekana.

Hiki i ka hapa nui o nā kānaka ke hoʻi i ka hoʻokele i loko o 24 hola inā maikaʻi lākou a ʻaʻole lākou e ʻike i ke poʻo nui a i ʻole nā hōʻailona ʻē aʻe. E hoʻolohe i kou kino a mai hoʻokele inā ʻoe e ʻike i ka wili, he poʻo nui, a i ʻole ʻaʻole ʻoe e ʻike i ka makaʻala a me ka nānā.