Cerebrospinal fluid (CSF) kuunganidzwa

Cerebrospinal fluid (CSF) muunganidzwa muyedzo wekutarisa mvura inenge yakatenderedza uropi nemuzongoza.

CSF inoshanda seyako, inodzivirira uropi uye musana kubva mukukuvara. Mvura yacho inowanzojeka. Iine kuenzana kumwe chete nemvura. Muedzo unoshandiswa zvakare kuyera kumanikidza mune musana mvura.

Kune nzira dzakasiyana dzekutora muyenzaniso weCSF. Lumbar puncture (musana tap) ndiyo nzira yakajairika.

Kuve nemuedzo:

• Iwe ucharara parutivi rwako nemabvi ako akasimudzwa akananga kuchipfuva, uye chin chakanamatira pasi. Dzimwe nguva muyedzo unoitwa wakagara, asi wakakotamira kumberi.
• Mushure mokunge musana wacheneswa, mupi wezvehutano anozobaya mushonga wekunoita chiveve (anesthetic) mumuzasi wezasi.
• Tsono yemusana ichaiswa.
• Kumanikidza kwekuvhura dzimwe nguva kunotorwa. Dzvinyiriro isina kujairika inogona kuratidza hutachiona kana rimwe dambudziko.
  
• Kana iyo tsono ichinge yakamira, iyo CSF ​​kumanikidzwa inoyerwa uye muyenzaniso we1 kusvika 10 milliliters (mL) yeCSF inounganidzwa mumabhodhoro mana.
• Tsono inobviswa, nzvimbo inocheneswa, uye bhandeji rinoiswa pamusoro penzvimbo yenzano. Iwe unogona kukumbirwa kuti ugare wakarara pasi kwenguva pfupi mushure mekuedzwa.

Mune zvimwe zviitiko, akakosha x-ray anoshandiswa kubatsira kutungamira iyo tsono munzvimbo. Izvi zvinonzi fluoroscopy.

Lumbar kubaya pamwe nekuunganidzwa kwemvura kunogona zvakare kuve chikamu cheimwe nzira senge x-ray kana CT scan mushure mekunge dhayi yaiswa mu CSF.

Kazhinji, dzimwe nzira dze CSF muunganidzwa dzinogona kushandiswa.

• Kubaya gomba kunoshandisa tsono yakaiswa pasi peiyo occipital bone (kumashure kwedehenya). Inogona kuve nenjodzi nekuti iri padyo padyo nepfungwa yehuropi. Inogara ichiitwa ne fluoroscopy.
• Ventricular puncture inogona kukurudzirwa kune vanhu vane mukana wehuropi herniation. Iyi inzira isinganyanyo shandiswa. Inowanzoitwa mukamuri yekuvhiya. Buri rinocherwa mudehenya, uye tsono inopinzwa yakananga mune imwe yemhepo yeuropi.

CSF inogona zvakare kuunganidzwa kubva kune chubhu iyo yatove yakaiswa mukati memvura, senge shunt kana ventricular drain.

Iwe unozofanirwa kupa timu yehutano mvumo yako usati waedzwa. Udza mupi wako kana iwe uri pane chero asipurini kana chero mimwe mishonga yekuchera ropa.

Mushure mekuita, iwe unofanirwa kuronga kuzorora kwemaawa akati wandei, kunyangwe iwe uchinzwa zvakanaka. Izvi ndezvekudzivirira hura kubva mukudonha kwakatenderedza saiti yekubaya. Iwe haufanire kurara zvakati sandarara kumusana kwako nguva yese. Kana iwe ukava nemusoro, zvinogona kubatsira kunwa zvine caffeine senge kofi, tii kana soda.

Zvinogona kunge zvisina kugadzikana kugara munzvimbo yekuyedzwa. Kuramba wakamira kwakakosha nekuti kufamba kunogona kukonzera kukuvara kwemuzongoza.

Iwe unogona kuudzwa kutwasanudza chinzvimbo chako zvishoma mushure mekunge tsono yave panzvimbo. Izvi ndezvekubatsira kuyera iyo CSF ​​kumanikidza.

Iyo anesthetic inozobaya kana kupisa painotanga kujowa. Pachave nekuoma kwekumanikidza kwekunzwa kana tsono yaiswa. Kazhinji, panove nekurwadziwa kupfupi apo tsono inopinda nemukati mechipfuva chakakomberedza musana. Uku kurwadziwa kunofanira kumira mumasekondi mashoma.

Muzviitiko zvakawanda, maitiro anotora maminetsi makumi matatu. Izvo chaizvo zviyero zvekumanikidza uye kuunganidzwa kwe CSF zvinongotora maminetsi mashoma.

Bvunzo iyi inoitwa kuyera kumanikidza mukati meiyo CSF ​​uye kuunganidza sampu yemvura kuti iwedzere kuyedzwa.

CSF ongororo inogona kushandiswa kuongorora kumwe kusagadzikana kwetsinga. Izvi zvinogona kusanganisira hutachiona (senge meningitis) uye huropi kana musana tambo kukuvara. Iyo pombi yemuzongoza inogona zvakare kuitwa kuti umisike kuongororwa kweyakajairika kumanikidza hydrocephalus.

Maitiro akajairwa anowanzo kuve anotevera:

• Kumanikidza: 70 kusvika 180 mm H₂O
• Chitarisiko: yakajeka, isina ruvara
• CSF yakazara mapuroteni: 15 kusvika 60 mg / 100 mL
• Gamma globulin: 3% kusvika 12% yeiyo yakazara protein
• CSF glucose: 50 kusvika 80 mg / 100 mL (kana yakakura kupfuura zvikamu zviviri kubva muzvitatu zveshuga yeropa)
• CSF cell kuverenga: 0 kusvika ku5 maseru machena eropa (ese mononuclear), uye hapana masero matsvuku eropa
• Chloride: 110 kusvika 125 mEq / L

Zvakajairika kukosha masenduru anogona kusiyana zvishoma pakati pemarabhoritari akasiyana. Taura nemupi wako nezve zvinorehwa nemimwe miedzo yako.

Iyi mienzaniso iripamusoro inoratidza zviyero zvakajairika zvemhedzisiro yeiyi bvunzo. Mamwe marabhoritari anoshandisa zviyero zvakasiyana kana anogona kuyedza mienzaniso dzakasiyana.

Kana iyo CSF ​​ichitaridzika kuva nemakore, zvinogona kureva kuti pane hutachiona kana kuwanda kwemasero machena eropa kana protein.

Kana iyo CSF ​​ichitaridzika kunge ine ropa kana tsvuku, inogona kunge iri chiratidzo chekubuda ropa kana musana wemusana. Kana iri shava, orenji, kana yero, inogona kunge iri chiratidzo cheakawedzera CSF protein kana kubuda kweropa kwakapfuura (anopfuura mazuva matatu apfuura). Panogona kunge paine ropa mumuenzaniso wakabva mupombi yemuzongoza pachawo. Izvi zvinoita kuti zvive zvakaoma kududzira zvawanikwa.

CSF KUFANIRA

• Kuwedzera kweCFF kumanikidzwa kunogona kunge kuri nekuda kwekuwedzera kwekumanikidza kushushikana (kumanikidza mukati mehenya.
• Yakadzikira CSF kumanikidza kunogona kunge kuri nekuda kwepelinha block, kupera mvura, kupera simba, kana CSF kuvuza.

CSF PROTEIN

• Kuwedzera kweCFF protein kunogona kunge kuri nekuda kweropa muCSF, chirwere cheshuga, polyneuritis, bundu, kukuvara, kana chero mamiriro ekuputira kana kutapukira.
• Kuderedza mapuroteni chiratidzo chekukurumidza kugadzirwa kweCSF.

CSF GLUCOSE

• Kuwedzera CSF glucose chiratidzo cheshuga yakakwira muropa.
• Yakadzikira CSF glucose inogona kunge yakakonzerwa ne hypoglycemia (yakaderera ropa shuga), hutachiona kana fungal hutachiona (senge meningitis), tibhii, kana mamwewo marudzi ehurombo.

MASERU eropa mu CSF

• Kuwedzera kwemasero machena eropa muCSF kunogona kunge kuri chiratidzo chengonda, chirwere chakakomba, kutanga kwechirwere chenguva refu (chisingaperi), bundu, abscess, kana chirwere chinoparadzanisa (senge multiple sclerosis).
• Masero matsvuku eropa mumuenzaniso weCSF anogona kunge ari chiratidzo chekubuda ropa mukati memvura yepelinha kana mhedzisiro yekutambudzika kwechiuno.

MIMWE CSF ZVINOGONESESA

• Kuwedzera kweCSF gamma globulin mazinga anogona kunge ari nekuda kwezvirwere zvakaita se multiple sclerosis, neurosyphilis, kana Guillain-Barré syndrome.

Zvimwe zvinowedzerwa mamiriro anogona kuitiswa iyo bvunzo:

• Chisingaperi chinokonzera kupisa polyneuropathy
• Dementia nekuda kwezvikonzero zvemagetsi
• Encephalitis
• Pfari
• Kukanganiswa kwepabrile (vana)
• Generalized tonic-clonic kubatwa
• Hydrocephalus
• Kufema chigwadara
• Kazhinji kumanikidzwa hydrocephalus (NPH)
• Pituitary bundu
• Reye chirwere

Ngozi dzekuputika kwechiuno dzinosanganisira:

• Kuyerera mukati memupendero wepelinha kana kutenderedza huropi (subdural hematomas).
• Kusagadzikana panguva yekuyedzwa.
• Kutemwa nemusoro mushure mekuyedzwa kunogona kutora maawa mashoma kana mazuva. Zvinogona kubatsira kunwa zvinwiwa zvine caffeine senge kofi, tii kana soda kubatsira kubvisa musoro. Kana kutemwa nemusoro kuchipfuura mazuva mashoma (kunyanya kana iwe ugere, mira kana kufamba) unogona kunge uine CSF-inodonha. Iwe unofanirwa kutaura nachiremba wako kana izvi zvikaitika.
• Hypersensitivity (sema) maitiro kune anesthetic.
• Utachiona hunounzwa netsono inopfuura nepaganda.

Brain herniation inogona kuitika kana bvunzo iyi ikaitwa pamunhu ane hura muuropi (senge bundu kana bundu). Izvi zvinogona kukonzera kukuvara kwehuropi kana kufa. Muedzo uyu hauitwe kana bvunzo kana bvunzo zvaratidza zviratidzo zvehukuru hwehuropi.

Kukuvadza kumitsipa iri mumuzongoza kunogona kuitika, kunyanya kana munhu achifamba panguva yekuedzwa.

Kuburitswa kwetangi kana kuburitsa ventricular kune dzimwe njodzi dzehuropi kana musana wekukuvara uye kubuda ropa mukati mehuropi.

Uyu muedzo une njodzi kune vanhu vane:

• Bundu riri kumashure kwehuropi iro riri kutsikirira pasi pane brainstem
• Matambudziko ekuvhara ropa
• Yakadzika platelet kuverenga (thrombocytopenia)
• Ivo vanhu vanotora vatete veropa, asipurini, clopidogrel, kana mimwe mishonga yakafanana kudzikisira kuumbwa kweropa.

Musana pombi; Kupinza mukati; Lumbar kubaya; Kubaya gomba; Cerebrospinal fluid tsika

• CSF kemisitiri
• Lumbar vertebrae

Deluca GC, Griggs RC. Kusvika kumurwere ane chirwere chetsinga. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 368.

Euerle BD. Spinal kubaya uye cerebrospinal fluid kuongorora. Mune: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts uye Hedges 'Clinical Maitiro muEmergency Medicine uye Acute Kuchengeta. 7th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 60.

Rosenberg GA. Brain edema uye kusagadzikana kwecerebrospinal fluid kutenderera. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits 88.