Yini i-Lumbar Puncture (Spinal Tap)? Inhloso, Inqubo & Nemiphumela

I-lumbar puncture, evame ukubizwa ngokuthi i-spinal tap, iyinqubo yezokwelapha lapho udokotela wakho efaka khona inaliti encane emhlane wakho ongezansi ukuze aqoqe uketshezi lwe-cerebrospinal (CSF) ukuze luhlaziywe. Lolu ketshezi olucacile luzungeza ubuchopho bakho nomgogodla, lusebenza njengomcamelo wokuvikela. Ngenkathi umcabango wenaliti eduze komgogodla wakho ungase uzizwe usabisa, le nqubo ngokuvamile iphephile futhi inganikeza imininingwane ebalulekile ngempilo yakho okungenzeka ukuthi ezinye izivivinyo azikwazi ukuyiveza.

Yini i-lumbar puncture?

I-lumbar puncture ihlanganisa ukufaka ngokucophelela inaliti ekhethekile phakathi kwamathambo omgogodla wakho ongezansi ukuze kufinyelelwe esikhaleni esiqukethe uketshezi lwe-cerebrospinal. Le nqubo yenzeka esifundeni sakho se-lumbar, yingakho ibizwa ngokuthi i-“lumbar” puncture. Udokotela wakho wenza le test ukuze aqoqe uketshezi ukuze luhlaziywe noma ngezinye izikhathi ukuletha imithi ngqo endaweni yakho yomgogodla.

Uketshezi lwe-cerebrospinal oluqoqwe lulandisa indaba ebalulekile ngalokho okwenzekayo ohlelweni lwakho lwezinzwa. Cabanga ngayo njengewindi empilweni yakho yobuchopho nomgogodla. Lolu ketshezi lungadalula izifo, ukopha, ukuvuvukala, noma ezinye izimo ezingase zithinte ukusebenza kwakho kwe-neurological.

Kungani kwenziwa i-lumbar puncture?

Udokotela wakho angase ancome i-lumbar puncture lapho kudingeka ukuthi baphenye izimpawu ezingase zibonise izinkinga ngobuchopho bakho, umgogodla, noma uhlelo lwakho lwezinzwa. Isizathu esivame kakhulu ukuhlola izifo ezinjengemeningitis noma i-encephalitis, ezingase zibe yingozi ekuphileni uma zingatholwanga futhi zangelashwa ngokushesha.

Ngaphandle kwezifo, le nqubo isiza ukuxilonga ezinye izimo eziningi ezibalulekile. Nazi izizathu eziyinhloko ezingenza udokotela wakho asikisela i-spinal tap:

• Ukucatshangelwa kwe-meningitis noma i-encephalitis (izifo zobuchopho nomgogodla)
• I-Multiple sclerosis noma ezinye izimo ze-autoimmune neurological
• Ukuphuma igazi eduze kobuchopho (i-subarachnoid hemorrhage)
• Ezinye izinhlobo zomdlavuza ezithinta uhlelo lwezinzwa
• I-Guillain-Barré syndrome (isifo esingavamile sezinzwa)
• Izimpawu ezingachazeki ze-neurological ezifana nekhanda elibuhlungu noma ukudideka

Ngezinye izikhathi, udokotela wakho angase futhi asebenzise le nqubo ukuletha imithi ngqo endaweni yakho yomgogodla, njengemithi ye-chemotherapy noma ama-anesthetics okuhlinzwa okuthile. Le ndlela eqondiwe ingasebenza kahle kakhulu kunokuthatha imithi ngomlomo noma nge-IV.

Yini inqubo ye-lumbar puncture?

Inqubo ye-lumbar puncture ngokuvamile ithatha imizuzu engaba ngu-30 kuya ku-45 futhi yenziwa esibhedlela noma emtholampilo wabangaphandle. Uzobekwa ulele ohlangothini lwakho ngamadolo akho adonselwe esifubeni sakho, noma uhlezi ukhothame phambili phezu kwetafula. Lezi zikhundla zisiza ukuvula izikhala phakathi kwama-vertebrae akho.

Udokotela wakho uzohlanza umhlane wakho ongezansi ngesisombululo se-antiseptic bese ejova i-anesthetic yendawo ukuze numba indawo. Uzozwa ukugwaza okuncane kulokhu kujova, kodwa kwenza yonke inqubo ibe ntofontofo kakhulu. Uma indawo isinumbile, udokotela wakho uzofaka ngokucophelela inaliti yomgogodla phakathi kwama-vertebrae amabili emhlane wakho ongezansi.

Nakhu okwenzekayo ngesikhathi senqubo:

1. Udokotela wakho uthola indawo efanele esebenzisa izimpawu ze-anatomical
2. Inaliti iqhubekela phambili kancane kancane ize ifinyelele endaweni ye-cerebrospinal fluid
3. Inani elincane lolwelo (ngokuvamile amathisipuni angu-1-4) liqoqwa emashubhu ahlanzekile
4. Inaliti iyasuswa futhi kufakwa ibhandishi elincane
5. Uzocelwa ukuba ulale phansi imizuzu engama-30 kuya ehoreni elilodwa ngemva kwalokho

Ngesikhathi sokuqoqwa koketshezi, ungase uzwe ukucindezela okuthile noma umuzwa omfushane wokudubula ngomlenze wakho. Lokhu kujwayelekile futhi kwenzeka ngoba inaliti iseduze nezimpande zemizwa. Abantu abaningi bachaza ukungakhululeki njengokuncane kunalokho ababekulindele.

Ungalungiselela kanjani ukubhobozwa kwakho kwe-lumbar?

Ukulungiselela ukubhobozwa kwe-lumbar kuqondile, futhi ithimba lakho lezempilo lizokunikeza imiyalelo ethile. Ngokuvamile, ungafunda futhi uphuze ngokujwayelekile ngaphambi kwenqubo ngaphandle uma udokotela wakho ekutshela ngenye indlela. Kubalulekile ukutshela udokotela wakho ngayo yonke imithi oyithathayo, ikakhulukazi ama-blood thinners.

Ungase udinge ukuyeka imithi ethile ngaphambi kwenqubo, ikakhulukazi lezo ezithinta ukujiya kwegazi. Udokotela wakho uzokunikeza isiqondiso esicacile mayelana nokuthi imiphi imithi okufanele uyimise nokuthi isikhathi esingakanani. Ungalokothi uyeke imithi ebekiwe ngaphandle kwemvume kadokotela wakho.

Ngosuku lwenqubo yakho, gqoka izingubo ezikhululekile, ezivulekile ezivumela ukufinyelela kalula emhlane wakho. Cabanga ngokuletha umuntu ozokuqhuba ekhaya, njengoba uzodinga ukuphumula amahora ambalwa ngemva kwalokho. Abanye abantu bazizwa bekhathele noma benekhanda elibuhlungu elincane ngemva kwenqubo.

Ungawafunda kanjani imiphumela yakho yokubhobozwa kwe-lumbar?

Imiphumela yakho yoketshezi lwe-cerebrospinal izokhombisa izilinganiso eziningana ezibalulekile ezisiza udokotela wakho ukuthi aqonde ukuthi kwenzekani ohlelweni lwakho lwezinzwa. I-CSF ejwayelekile icacile njengekristalu futhi ayinambala, njengamanzi. Noma yiziphi izinguquko ekubukekeni, umbala, noma ukwakheka kungabonisa izimo ezithile.

Udokotela wakho uzobheka izici eziningi zesampula lakho loketshezi. Izilinganiso ezibalulekile zihlanganisa ukubalwa kwamaseli, amazinga amaprotheni, amazinga e-glucose, kanye nokufundwa kwengcindezi. Imiphumela ejwayelekile ngokuvamile isho ukuthi uhlelo lwakho lwezinzwa lusebenza kahle futhi akukho bufakazi bokutheleleka noma ezinye izinkinga ezinkulu.

Nakhu okungase kukhombe imiphumela ehlukene:

• Inani eliphezulu lamaseli amhlophe egazi: Kungenzeka ukuthi kunomkhuhlane noma ukuvuvukala
• Amaseli abomvu egazi akhona: Ukopha okungenzeka noma ukuthinta okubuhlungu
• Amazinga amaprotheni aphakeme: Kungase kusikisela ukutheleleka, ukuvuvukala, noma ezinye izimo
• Amazinga e-glucose aphansi: Ngokuvamile kubonisa ukutheleleka ngamagciwane
• Uketshezi olunamafu noma olunombala: Ngokuvamile kubonisa ukutheleleka noma ukopha
• Ukufundwa kwengcindezi okungajwayelekile: Kungase kubonise izimo ezihlukahlukene ze-neurological

Udokotela wakho uzochaza imiphumela yakho ethile nokuthi isho ukuthini empilweni yakho. Ngezinye izikhathi, izivivinyo ezengeziwe esampulini yoketshezi zingase zidingeke ukuze uthole isithombe esiphelele. Khumbula ukuthi imiphumela idinga ukuhunyushwa ngokuya ngezimpawu zakho nolunye ulwazi lwezokwelapha.

Ziyini izici eziyingozi zezinkinga ezivela ekubhobozweni kwe-lumbar?

Ngenkathi ukubhobozwa kwe-lumbar kuvamile ukuthi kuphephile, ezinye izici zingakhuphula ingozi yakho yezinkinga. Iningi lezinqubo zihamba kahle, kodwa kubalulekile ukuqonda ukuthi yini engenza inqubo ibe yinselele noma ikhuphule ingozi yakho yemiphumela emibi.

Udokotela wakho uzoqaphela ngokucophelela isimo sakho ngaphambi kokuncoma inqubo. Ezinye izici ezingase zikhuphule izinkinga zihlanganisa izifo zokopha, imithi ethile, noma ukuhlukahluka kwe-anatomical emgogodleni wakho. Abantu abane-arthritis enzima noma ukuhlinzwa kwangaphambili emhlane bangase babhekane nezinselelo ezengeziwe.

Izici eziyingozi udokotela wakho azozicabangela zihlanganisa:

• Ukuphuza imithi yokunciphisa igazi
• Ukuba nesifo sokopha noma inani eliphansi lama-platelet
• I-arthritis yomgogodla enzima noma ukukhubazeka
• Ukuhlinzwa kwangaphambili emhlane ngamathuluzi
• Ingcindezi eyengeziwe ebuchosheni
• Ukutheleleka kwesikhumba endaweni yokubhoboza
• Ezinye izimo ze-neurological

Iqembu lakho lezempilo lizobukeza umlando wakho wezokwelapha nemithi yamanje ukuze kuncishiswe noma yiziphi izingozi. Bangase bayalele ukuhlolwa kwegazi ukuze kuhlolwe ukusebenza kwegazi noma izifundo zokuthwebula izithombe ukuze kuhlolwe i-anatomy yomgogodla wakho ngaphambi kwenqubo.

Ziyini izinkinga ezingase zibe khona ze-lumbar puncture?

Abantu abaningi ababi nazinkinga ezinkulu ezivela ku-lumbar puncture, kodwa kubalulekile ukwazi ukuthi yini okufanele uyibheke. Umphumela ovamile kakhulu ukuba nekhanda elibangelwa phakathi kwama-24 kuya kuma-48 amahora ngemuva kwenqubo. Lokhu kwenzeka cishe kuma-10-15% abantu futhi kuvamile ukuba kube lula futhi okwesikhashana.

Ikhanda livela ngenxa yezinguquko zesikhashana ekucindezelweni kwamanzi e-cerebrospinal ngemuva kwenqubo. Ngokuvamile kuzwakala kubi kakhulu uma uhlezi noma umi futhi kuthuthuka uma ulele phansi. Amakhanda amaningi alulama ngokwawo phakathi nezinsuku ezimbalwa ngokuphumula nokuphuza uketshezi olwanele.

Ezinye izinkinga ezingase zibe khona zihlanganisa:

• Ikhanda elibangelwa ngemuva kwe-lumbar puncture (elivame kakhulu)
• Ubuhlungu bomhlane noma ubuhlungu endaweni yokubhoboza
• Ukuba ndikindiki kwemilenze okwesikhashana noma ukuzwa ukuluma
• Ukuphuma igazi okuncane endaweni yokubhoboza
• Okungavamile: ukutheleleka endaweni yokubhoboza
• Okungavamile kakhulu: ukulimala kwemizwa noma ukuvuza okuqhubekayo kwamanzi omgogodla
• Okungavamile kakhulu: i-brain herniation (ezimweni zokwanda kwengcindezi yobuchopho)

Izinkinga ezinzima azivamile kakhulu uma inqubo yenziwa abahlinzeki bezempilo abanolwazi. Ithimba lakho lezokwelapha lizokuqapha ngokucophelela futhi linikeze imiyalelo ecacile mayelana nokuthi kufanele ufune nini ukwelashwa uma uhlangabezana nanoma yiziphi izimpawu ezikhathazayo.

Kufanele ngibone nini udokotela ngemuva kwe-lumbar puncture?

Kufanele uthinte udokotela wakho uma uba nezimpawu ezithile ngemuva kwe-lumbar puncture yakho. Ngenkathi abantu abaningi belulama ngaphandle kwezinkinga, kubalulekile ukwazi ukuthi izimpawu zingabonisa nini inkinga edinga ukwelashwa.

Ubuhlungu bekhanda obukhulu obungathuthuki ngokuphumula nokulala phansi, noma obuba sibi ngokuhamba kwesikhathi, kufanele ushayele udokotela wakho. Ngokufanayo, uma uba nomkhuhlane, ukuqina kwentamo, noma izimpawu zokutheleleka endaweni yokubhoboza, kufanele ufune ukwelashwa ngokushesha.

Xhumana nomhlinzeki wakho wezempilo uma uhlangabezana nalokhu okulandelayo:

• Ubuhlungu bekhanda obukhulu obuba sibi noma obungathuthuki ngemva kwamahora angama-48
• Umkhuhlane ongaphezu kuka-101°F (38.3°C)
• Ukuqina kwentamo noma ubuhlungu obukhulu bentamo
• Isicanucanu esiqhubekayo nokuhlanza
• Ububomvu, ukuvuvukala, noma ukukhipha amanzi endaweni yokubhoboza
• Ubuhlungu obukhulu emhlane obuya ngokuya buba sibi
• Ukuqaqamba noma ubuthakathaka emilenzeni yakho obungathuthuki

Izimpawu eziningi ezivela ngemva kokubhoboza umgogodla zithambile futhi zesikhashana. Kodwa-ke, unganqikazi ukuxhumana nethimba lakho lezempilo uma ukhathazekile nganoma yiziphi izimpawu oziphilayo. Bangakunikeza isiqondiso nokuthula kwengqondo.

Imibuzo evame ukubuzwa mayelana nokubhoboza umgogodla

Umbuzo 1: Ingabe ukuhlolwa kokubhoboza umgogodla kubuhlungu?

Abantu abaningi bathola ukubhoboza umgogodla kungabuhlungu kangako kunalokho ababekulindele. Ukujova komuthi wokubulala izinzwa wendawo kubangela ukucindezela okufushane, kodwa ngemva kwalokho, kufanele uzwe kuphela ukucindezela noma ukungakhululeki okuncane. Abanye abantu bazwa umuzwa omfushane wokudubula emlenzeni wabo lapho inaliti ifinyelela endaweni yezinzwa, kodwa lokhu kudlula ngokushesha.

Izinga lokungakhululeki livame ukuqhathaniswa nokuthola umgomo omkhulu noma ukuhlolwa kwegazi emthanjeni onzima. Ithimba lakho lezempilo lizosebenza ukukugcina ukhululekile ngangokunokwenzeka kuyo yonke inqubo.

Umbuzo 2: Ingabe ukubhoboza umgogodla kungabangela umonakalo unomphela?

Umonakalo unomphela ovela ekubhobozweni komgogodla awavamile uma kwenziwa abahlinzeki bezempilo abanolwazi. Iningi labantu lithola ukuthi lilulama ngokuphelele ngaphandle kwemiphumela ehlala njalo. Le nqubo yenzelwe ukugwema umgogodla, ophela phezulu emgogodleni wakho.

Ngenkathi imiphumela emibi yesikhashana efana nekhanda noma ubuhlungu emhlane ivamile, izinkinga ezingapheli njengokulimala kwemizwa noma ubuhlungu obungapheli zenzeka ngaphansi kuka-1% wezinqubo. Izinzuzo zokuthola ukuxilongwa okunembile ngokuvamile zidlula lezi zingozi ezincane.

Q3: Kuthatha isikhathi esingakanani ukululama emva kokubhoboza umgogodla?

Abantu abaningi bazizwa bejwayelekile phakathi kwamahora angu-24 kuya kwangu-48 emva kokubhoboza umgogodla. Kuzodingeka uphumule emahoreni ambalwa okuqala ngemva kwenqubo, ngokuvamile ulala ngendlela eyisicaba imizuzu engama-30 kuya kwelilodwa emahoreni esikhungweni sezokwelapha. Abantu abaningi bangakwazi ukubuyela emisebenzini elula ngosuku olufanayo.

Kufanele ugweme imisebenzi eqinile, ukuphakamisa izinto ezinzima, noma ukuzivocavoca ngamandla amahora angu-24 kuya kwangu-48. Abanye abantu bazwa ubuhlungu obuncane emhlane noma ukukhathala usuku olulodwa noma ezimbili, kodwa lokhu kuvame ukuxazululwa ngokuphumula kanye nezidambisi zokucasuka ezingathengiswa ngaphandle uma kudingeka.

Q4: Kufanele ngenzeni uma ngithola ikhanda ngemva kokubhoboza umgogodla?

Uma uba nekhanda ngemva kokubhoboza umgogodla, zama ukulala phansi futhi uphuze uketshezi oluningi. Ikhanda livame ukuthuthuka kakhulu uma ulele ngoba lokhu kusiza ukujwayela ingcindezi ohlelweni lwakho loketshezi olusebuchosheni.

Izidambisi zokucasuka ezingathengiswa ngaphandle njenge-acetaminophen noma i-ibuprofen zingasiza ekuphatheni ukungakhululeki. Uma ikhanda libi kakhulu noma liqhubeka ngaphezu kwamahora angu-48, xhumana nomhlinzeki wakho wezempilo. Bangase batusa ukwelashwa okwengeziwe noma bafune ukukuhlola ngezinkinga.

Q5: Ngingashayela ngemva kokubhoboza umgogodla?

Akufanele ushayele ngemva nje kokubhoboza umgogodla. Odokotela abaningi batusa ukuthi omunye umuntu akuqhubele ekhaya emva kwenqubo. Kuzodingeka uphumule amahora ambalwa ngemva kwalokho, futhi abanye abantu bazizwa bekhathele noma benekhanda elincane elingathinta ikhono labo lokushayela ngokuphepha.

Abantu abaningi bangakwazi ukuqhubeka nokushayela kungakapheli amahora angama-24 uma bezizwa kahle futhi bengenazo izinhlungu zekhanda ezinzima noma ezinye izimpawu. Lalela umzimba wakho futhi ungashayeli uma uzizwa unesiyezi, unezinhlungu zekhanda ezinzima, noma ungazizwa uqaphile futhi ugxilile.