Ubunzima Bokhanda Olubangelwa Yiphutha Lomqondo: Izimpawu, Izimbangela, Nokwelashwa

Ubunzima bokhanda olubangelwa yiphutha lomqondo luhlobo oluthile lobunzima bokhanda oluvela lapho i-cerebrospinal fluid iphuma ekhanaleni lakho lomqondo, ngokuvamile ngemva kwesinqumo sokuwelapha. Lokhu kudala ukwehla kokucindezela eduze nobuchopho bakho nomqondo wakho, okuholela ebuhlungwini obukhulu lapho uhlala phansi noma ukuma.

Izindaba ezinhle ukuthi ubunzima bokhanda olubangelwa yiphutha lomqondo buyaphatheka futhi ngokuvamile buyaphela ngokwalo ngokunakekelwa okuqondile. Nakuba kungase kuzwakale kunzima futhi kukukhathaze, ukuqonda ukuthi kwenzekani emzimbeni wakho kungakusiza uphathe ukungakhululeki futhi wazi ukuthi nini kufanele ufuna usizo olwengeziwe.

Yini ubunzima bokhanda olubangelwa yiphutha lomqondo?

Ubunzima bokhanda olubangelwa yiphutha lomqondo buvela lapho i-cerebrospinal fluid iphuma ngesikhala esincane esivikela isikhumba esizungezile umqondo wakho. Leli fluid ngokuvamile livikela ubuchopho bakho nomqondo wakho, ligcina ukucindezela okuzinzile ohlelweni lwakho lwezinzwa.

Lapho leli fluid liphuma, ukucindezela kwehla kakhulu. Ubuchopho bakho ngokuyisisekelo bulahlekelwa ngokusekelwa okuthile okuvikelayo, okuqalisa ubuhlungu bokhanda obuqondene nalolu hlobo. Igama lezokwelapha lalesi simo yi- "post-dural puncture headache" ngoba ngokuvamile kwenzeka ngemva kokuba i-dura mater (isikhumba sangaphandle esiqinile) siqotshiwe.

Lolu hlobo lobunzima bokhanda lunephethini ehlukile kakhulu. Luthuthuka kakhulu lapho ulele phansi futhi lubi kakhulu lapho uhlala noma ukuma. Lesi shintsho esihlobene nesimo yiyona nto ebalulekile esiza odokotela ukuthi baqonde ubunzima bokhanda olubangelwa yiphutha lomqondo.

Ziyini izimpawu zokhanda olubangelwa yiphutha lomqondo?

Isimpawu esiyinhloko yobunzima bokhanda olubangelwa yiphutha lomqondo yibuhlungu elibuhlungu kakhulu elishintsha ngokukhulu ngesimo sakho. Lapho ulele, ungase uzizwe uphilile ngokuphelele noma ube nokungakhululeki okuncane.

Nawa ama-symptom aphambili ongawabhekana nawo:

• Ubunzima bokhanda obukhulu obukhulu noma obuhlungu obukhulu obukhulu obubi ngemizuzu embalwa yokulala noma ukuma
• Ubuhlungu obuthuthuka kakhulu lapho ulele ngemuva
• Ubunzima bokhanda obuvame ukubamba emuva nasebusweni bekhanda lakho
• Ubuhlungu bomhlane nokuqina okungase kuqhubekele emagxeni akho
• Ukuphefumula nokugabha, ikakhulukazi lapho uqondile
• Ukukhathazeka noma ukukhanya lapho ukuma
• Ukukhanya nokukhanya komculo
• Ukukhala ezindlebeni zakho (tinnitus)

Abanye abantu nabo babhekana nezimpawu ezingavamile njengokubona okungacaci, ukushintsha kokuzwa, noma imizwa yokugcwalisa ezindlebeni. Ubukhulu bungase bube ukungakhululeki kuya ekubeni nzima, okwenza kube nzima ukwenza imisebenzi evamile ngenkathi uqondile.

Yini ebangela ubunzima bokhanda olubangelwa yiphutha lomqondo?

Ubunzima bokhanda olubangelwa yiphutha lomqondo buvela lapho kukhona ukukhishwa noma isikhala kwi-dura mater, okuvumela i-cerebrospinal fluid ukuthi iphume. Lokhu ngokuvamile kwenzeka ngesikhathi sezinqumo zokwelapha ezibandakanya ukufaka isicabha ekhanaleni lakho lomqondo.

Izimbangela ezivame kakhulu zihlanganisa:

• Ukunciphisa ubuhlungu ngesikhathi sokubeletha (kwenzeka cishe ku-1-2% yezimangalo)
• Ukunciphisa ubuhlungu ngesikhathi sokuhlinzwa
• Ukwenza i-lumbar puncture (spinal tap) ukuhlola
• I-Myelography (ukubona umqondo nge-contrast dye)
• Ukugcoba umqondo ukulawula ubuhlungu

Akukuvamile, ubunzima bokhanda olubangelwa yiphutha lomqondo bungase buvele ngokungalindelekile ngaphandle kwanoma iyiphi inqubo yokwelapha. Lokhu kungase kwenzeke ngenxa yokucindezela okungazelelwe, ukukhokha okukhulu, noma ngisho nokulimala okuncane okwenza ukucindezela okwanele ukukrazula i-dura mater.

Ezimweni ezingavamile, izifo ezithile zezicubu ezihlanganisiwe noma izinkinga zokugqwala kwegazi zingenza umuntu abe semngciphekweni wokopha okungazelelwe kwe-spinal fluid. Kodwa-ke, iningi lobunzima bokhanda olubangelwa yiphutha lomqondo luhlobene ngokuqondile nezinqubo zokwelapha.

Nini kufanele ubona udokotela ngenxa yobunzima bokhanda olubangelwa yiphutha lomqondo?

Kufanele uxhumane nodokotela wakho uma uthola ubunzima bokhanda obukhulu obuhlobene nesimo sakho ezinsukwini ezimbalwa ngemva kokuba uthole inqubo yomqondo. Ungazami ukukuthwala, njengoba ukwelashwa okusheshayo kungavimbela izinkinga futhi kunikeze impumuzo enkulu.

Funani usizo lwezokwelapha ngokushesha uma ubhekana nanoma yiziphi izimpawu zezixwayiso:

• Ukuqhuma kanye nobunzima bokhanda
• Ukuqina okukhulu komhlane
• Ukuphazamiseka noma ukukhuluphala
• Ukushintsha kokubona noma ukubona okubili
• Ubuthakathaka ezandleni noma ezinyaweni
• Ukuhlinzwa
• Izimpawu zokutheleleka endaweni yenqubo

Ngisho nangaphandle kwalezi zimpawu ezinkulu, kufanele ubizela udokotela wakho uma ubunzima bokhanda bakho bukhulu kangangokuba buphazamisa ukudla, ukuphuza, noma imisebenzi eyisisekelo. Ukwelashwa okusheshayo ngokuvamile kuholela ekuphileni okusheshayo nemiphumela emihle.

Ziyini izimbangela zengozi zokhanda olubangelwa yiphutha lomqondo?

Izici eziningi zingandisa amathuba akho okuba nobunzima bokhanda olubangelwa yiphutha lomqondo ngemva kwenqubo. Ukuqonda lezi zici zengozi kungakusiza wena neqembu lakho lokunakekelwa kwezempilo ukuthi nithathe izinyathelo ezifanele.

Izici eziyinhloko zengozi zihlanganisa:

• Ukuba owesifazane (abesifazane banethuba elingu-2-3 lokuthola ubunzima bokhanda olubangelwa yiphutha lomqondo)
• Ubudala obuphansi, ikakhulukazi phakathi kweminyaka engu-18-40
• Umbhalo wangaphambili wobunzima bokhanda olubangelwa yiphutha lomqondo
• I-Body mass index ephansi
• Umbhalo wobunzima bokhanda obuhlala njalo noma i-migraine
• Ukusetshenziswa kwama-needle amakhulu ngesikhathi sezinqubo
• Izinzondo eziningi ngesikhathi sezinqubo zomqondo
• Izinhlobo ezithile ze-needle nezindlela zokufaka

Ukukhulelwa ngokwalo akwandisi ingozi, kodwa izenzo ezivamile ezisetshenziswa ngesikhathi sokubeletha zenza.

Ziyini izinkinga ezingase zenzeke ngenxa yobunzima bokhanda olubangelwa yiphutha lomqondo?

Nakuba iningi lobunzima bokhanda olubangelwa yiphutha lomqondo luphela ngaphandle kwezinkinga ezihlala njalo, ukulisela kungase kube yimbangela yezinkinga ezinkulu. Izindaba ezinhle ukuthi lezi zinkinga azivamile lapho kunikezwa ukwelashwa okuqondile.

Izinkinga ezingase zenzeke zihlanganisa:

• Ubunzima bokhanda bemihla ngemihla obuhlala amasonto noma izinyanga
• I-Subdural hematoma (ukopha phakathi kwamazinga ebuchopho ngenxa yokucindezela okuphansi)
• Ubuchopho obukhulu noma ukuqhuma ezimweni ezinkulu
• Ukuhlinzwa ngenxa yokushintsha kokucindezela ebuchopho
• Ukulahlekelwa ukuzwa noma ukukhala okuhlala njalo ezindlebeni
• Izinkinga ze-cranial nerve ezithinta ukubona noma imizwa yobuso

Lezi zinkinga ezinkulu azivamile, ikakhulukazi ngokunakekelwa kwezokwelapha okusheshayo. Abantu abaningi abamukela ukwelashwa okuqondile baphila ngokuphelele phakathi kwezinsuku ezimbalwa kuya emaviki ngaphandle kwanoma yimiphi imiphumela ende.

Ubunzima bokhanda olubangelwa yiphutha lomqondo butholakala kanjani?

Ukuthola ubunzima bokhanda olubangelwa yiphutha lomqondo kuncike kakhulu ezimpawu zakho nasesimweni sakho sezokwelapha, ikakhulukazi uma usanda kuba nenqubo yomqondo. Udokotela wakho uzokubuza imibuzo eminingi mayelana nokuthi ubunzima bokhanda beqale nini nokuthi buphendula kanjani ekushintsheni kwesimo.

Ukutholakala kuvame ukuba kulula lapho unephethini evamile yobunzima bokhanda obukhulu obuthuthuka lapho ulele futhi obukhulu lapho uqondile. Umhlinzeki wakho wezokunakekelwa kwezempilo uzoqhuba nokuhlolwa komzimba ukuhlola ukuqina komhlane, izimpawu zezinzwa, nezibonakaliso zezinkinga.

Kwezinye izimo, ukuhlolwa okwengeziwe kungase kudingeke, ikakhulukazi uma ukutholakala kungacaci noma kukhona izinkinga ezithathwe njengokukhathazeka. Lokhu kungase kuhlanganise i-MRI scans ukubona ubuchopho nomqondo, noma ukubona okukhethekile ukuthola ukopha kwe-spinal fluid.

Yini ukwelashwa kobunzima bokhanda olubangelwa yiphutha lomqondo?

Ukwelashwa kobunzima bokhanda olubangelwa yiphutha lomqondo kugxile ekubambeni ukopha nokuphatha ubuhlungu bakho ngenkathi umzimba wakho uyahlanza. Indlela ethathiwe iyancika ebukhulu bezimpawu zakho nokuthi uzitholile isikhathi esingakanani.

Izinketho zokwelashwa ezilula zihlanganisa:

• Ukuphumula embhedeni esimweni esiqondile amahora angu-24-48
• Ukukhuluphala kokudla ukuze kusize ukufaka i-spinal fluid elahlekile
• I-Caffeine (ngomlomo noma nge-intravenous) ukuze kusize ukunciphisa imithambo yegazi
• Imithi yobun

Uma ukwelashwa okulula kungakuniki impumuzo phakathi kwamahora angu-24-48, udokotela wakho angase akukhuthaze i-epidural blood patch. Le nqubo ibandakanya ukugcoba inani elincane legazi lakho eduze nendawo yokopha, eliqina futhi livala isikhala.

I-blood patch isebenza kakhulu, inikeza impumuzo cishe ku-90% yezimangalo. Kwezinye izimo lapho i-blood patches eminingi ingasebenzi, ukulungisa ngokuhlinzwa kungase kudingeke, nakuba lokhu kungavamile kakhulu.

Ungaphatha kanjani ubunzima bokhanda olubangelwa yiphutha lomqondo ekhaya?

Nakuba ukwelashwa kwezokwelapha kuvame ukudingeka, kunezinto eziningi ongazenza ekhaya ukuze usize uphathe izimpawu zakho futhi usekele ukuphulukisa kwakho. Lezi zinyathelo zisebenza kangcono kanye, hhayi esikhundleni, sokunakekelwa kwezokwelapha.

Nawa ongawenza ukuze uzizwe ukhulu:

• Hlala ulele phansi ngangokunokwenzeka, uvuka kuphela lapho kudingeka ngempela
• Phuza amanzi amaningi, kuhlanganise neziphuzo ezinuka i-caffeine njengokofi noma i-cola
• Thatha imithi yobun

Ubunzima bokhanda olubangelwa yiphutha lomqondo bungavikeleka kanjani?

Nakuba ungakwazi ukususa ngokuphelele ingozi yobunzima bokhanda olubangelwa yiphutha lomqondo, ezinye izindlela nezinyathelo zinganciphisa kakhulu amathuba akho okuba nalo. Izindlela eziningi zokuvimbela zigxile ezintweni zobuchwepheshe zezinqubo zomqondo.

Abanakekeli bezempilo banganciphisa ingozi ngokuthi:

• Ukusebenzisa ama-needle amancane lapho kunokwenzeka
• Ukukhetha ama-needle e-pencil-point kunama-needle okusika
• Ukuncipha inani lezinzondo zokufaka
• Ukusebenzisa izindlela ezifanele zokufaka i-needle
• Ukuqinisekisa ukukhuluphala okwanele ngaphambi nangemva kwezinqubo

Uma uhlelwe ukuba nenqubo yomqondo, xoxa ngezici zakho zengozi neqembu lakho lokunakekelwa kwezempilo ngaphambi kwesikhathi. Bangalungisa indlela yabo ngokusekelwe esimweni sakho somuntu siqu futhi bathathe izinyathelo ezengeziwe uma usesengozini enkulu.

Kufanele ulungiselele kanjani i-appointment yakho nodokotela?

Ukulungiselela i-appointment yakho kungasiza ukuqinisekisa ukuthi uthola ukunakekelwa okuphumelelayo kobunzima bakho bokhanda olubangelwa yiphutha lomqondo. Ukuba nolwazi olufanele okulungile kuzosiza udokotela wakho ukuba enze ukutholakala okuqondile nelenqubo yokwelapha.

Ngaphambi kwendwendwelo yakho, buthana nalolu lwazi olubalulekile:

• Izinsuku ezicacile nemininingwane yanoma iyiphi inqubo yomqondo yakamuva
• Lapho ubunzima bokhanda bakho beqale futhi buqhubeke kanjani
• Inkulumo ecacile yokuthi ukushintsha kwesimo kuchaphazela kanjani ubuhlungu bakho
• Uhlu lwemithi yonke oyithatha njengamanje
• Noma yiziphi ezinye izimpawu ozibonile
• Umbhalo wangaphambili wobunzima bokhanda noma izenzo zomqondo

Bhala phansi imibuzo ethile ofuna ukuyibuza, njengokwelashwa, isikhathi esilindelekile sokuphulukisa, nokunciphisa imisebenzi. Ukuba nelungu lomndeni noma umngani ohambisana nawe kungasiza, ikakhulukazi uma ubunzima bokhanda bakho benza kube nzima ukugxila ngesikhathi se-appointment.

Yini into ebalulekile mayelana nobunzima bokhanda olubangelwa yiphutha lomqondo?

Ubunzima bokhanda olubangelwa yiphutha lomqondo yisimo esiphatheka esingase sibe nzima, kodwa ngokuvamile siyaphela ngokunakekelwa kwezokwelapha okuqondile. Iphethini ehlukile yobun

Imibuzo evamile ebuzwa mayelana nobunzima bokhanda olubangelwa yiphutha lomqondo

Ubunzima bokhanda olubangelwa yiphutha lomqondo buhlala isikhathi esingakanani ngaphandle kokwelashwa?

Ubunzima bokhanda olubangelwa yiphutha lomqondo obungelashwanga bungase buhlale kusukela ezinsukwini ezimbalwa kuya emavikini amaningana, nakuba iningi liqala ukuthuthuka phakathi kwezinsuku eziyi-5-7 njengoba ukopha kuyahlanza kancane ngokwalo. Noma kunjalo, ukulinda ukuphulukisa kwemvelo kusho ukukhuthazelela ubuhlungu obukhulu nezinkinga ezingase zenzeke, kungakho ukwelashwa kwezokwelapha kunconywa kakhulu.

Ngingasebenza noma ngisebenze yini ngenkathi nginobunzima bokhanda olubangelwa yiphutha lomqondo?

Imisebenzi yomzimba nomsebenzi ngokuvamile awunconywa ngesikhathi sobunzima bokhanda olubangelwa yiphutha lomqondo, njengoba izimo eziqondile nokuqina kungenza izimpawu zibe zimbi futhi kwenze ukuphulukisa kube sekugcineni. Odokotela abaningi bayaluleka ukuthi uhlale ulele de ubunzima bokhanda buqedwe noma uthole ukwelashwa okuqondile njenge-blood patch.

Kuphephile yini ukuthatha imithi yobun