Ukuqapha kwengcindezi yangaphakathi

Ukuqapha kwe-Intracranial pressure (ICP) kusebenzisa idivayisi efakwe ngaphakathi kwekhanda. Umqaphi uzwa ingcindezi engaphakathi kogebhezi bese ethumela izilinganiso kudivayisi yokuqopha.

Kunezindlela ezintathu zokuqapha i-ICP. ICP ingcindezi ogebhezini.

IKHATHETUTHI ELIPHAKAMILEYO

I-catheter ye-intraventricular iyindlela enembile kakhulu yokuqapha.

Ukufaka i-catheter ye-intraventricular, imbobo ibhobozwa ngogebhezi. I-catheter ifakwa ebuchosheni ku-ventricle ye-lateral. Le ndawo yobuchopho iqukethe i-cerebrospinal fluid (CSF). I-CSF iwuketshezi oluvikela ubuchopho nomgogodla.

I-catheter ye-intraventricular nayo ingasetshenziselwa ukukhipha uketshezi nge-catheter.

I-catheter ingaba nzima ukungena endaweni lapho ingcindezi yokungasebenzi iphezulu.

ISIKHUMBUZO SENHLANGANO (IBOLOTI)

Le ndlela isetshenziswa uma ukuqapha kudinga ukwenziwa zisuka. Isikulufa esingenalutho sifakwa emgodini oboshwe kugebhezi. Ibekwe kulwelwesi oluvikela ubuchopho nomgogodla (dura mater). Lokhu kuvumela inzwa ukurekhoda ngaphakathi kwesikhala esingaphansi.

Inzwa EPIDURAL

Inzwa ye-epidural ifakwa phakathi kogebhezi nezicubu zasemuva. Inzwa ye-epidural ifakwa emgodini oboshwe kugebhezi. Le nqubo ihlasela kancane kunezinye izindlela, kepha ayikwazi ukususa i-CSF eyeqile.

I-Lidocaine noma omunye umuthi wokubulala izinzwa uzofakwa endaweni lapho kuzosikwa khona. Ngokuqinisekile uzothola isidambisi sokukusiza uphumule.

• Okokuqala indawo igundwe ihlanzwe ngesinqanda magciwane.
• Ngemuva kokuthi indawo isomile, kwenziwa ukusika kokuhlinzwa. Isikhumba sikhishwa emuva kuze kubonakale ugebhezi.
• Kusetshenziswa i-drill ukusika ngethambo.

Isikhathi esiningi, le nqubo yenziwa lapho umuntu esegunjini labagula kakhulu esibhedlela. Uma uvukile futhi wazi, umhlinzeki wakho wezokunakekelwa kwempilo uzokuchazela inqubo kanye nezingozi. Kuzofanele usayine ifomu lokuvuma.

Uma inqubo yenziwa kusetshenziswa i-anesthesia ejwayelekile, uzobe ulele futhi ungenazinhlungu. Lapho uvuka, uzozwa imiphumela emibi ejwayelekile ye-anesthesia. Uzothola ukungakhululeki kusuka ekusikeni okwenziwe kugebhezi lwakho.

Uma inqubo yenziwa ngaphansi kwe-anesthesia yendawo, uzobe uphapheme. Umuthi wokugunyaza uzofakwa endaweni lapho kuzosikwa khona. Lokhu kuzozwakala njengokuhlaba kwesikhumba sakho, njengokulunywa yinyosi. Ungase uzwe ukuhudula umuzwa njengoba isikhumba sinqunywa futhi sidonswa emuva. Uzozwa umsindo we-drill njengoba usika ukhakhayi. Isikhathi esithathwa yilezi sizoya ngohlobo lokubhora olusetshenziswayo. Uzozwa futhi ukudonsa njengoba udokotela ohlinzayo ehlanganisa isikhumba sibuyele emuva ngemuva kwenqubo.

Umhlinzeki wakho angakunika imishanguzo yobuhlungu emnene ukuze unciphise ukungakhululeki kwakho. Ngeke uthole imishanguzo yobuhlungu eqinile, ngoba umhlinzeki wakho uzofuna ukuhlola izimpawu zokusebenza kobuchopho.

Lokhu kuhlolwa kuvame ukwenziwa ukukala i-ICP. Kungenziwa lapho kukhona ukulimala kanzima ekhanda noma isifo sobuchopho / sezinzwa. Futhi kungenziwa ngemuva kokuhlinzwa ukukhipha isimila noma ukulungisa umonakalo esitsheni segazi uma udokotela ohlinzayo ekhathazekile ngokuvuvukala kobuchopho.

I-ICP ephezulu ingalashwa ngokukhipha i-CSF nge-catheter. Ingaphathwa futhi nge:

• Ukushintsha izilungiselelo zokuphefumula zabantu abakumshini wokuphefumula
• Ukunikeza imithi ethile ngomthambo (ngemithambo yegazi)

Imvamisa, i-ICP isukela ku-1 kuye ku-20 mm Hg.

Khuluma nomhlinzeki wakho mayelana nencazelo yemiphumela yakho ethile yokuhlolwa.

I-ICP ephezulu isho ukuthi zombili izinhlelo zezinzwa nezicubu zomthambo wegazi zingaphansi kwengcindezi. Uma ingalashwa, lokhu kungaholela ekulimaleni unomphela. Kwezinye izimo, kungasongela impilo.

Izingozi ezivela kule nqubo zingafaka:

• Ukopha
• Ukuqothula ubuchopho noma ukulimala kusuka kwingcindezi eyandisiwe
• Ukulimala kwezicubu zobuchopho
• Ukungakwazi ukuthola i-ventricle nendawo ye-catheter
• Ukutheleleka
• Izingozi ze-anesthesia ejwayelekile

Ukuqapha kwe-ICP; Ukuqapha kwengcindezi ye-CSF

• Ukuqapha kwengcindezi yangaphakathi

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URabinstein AA, uFugate JE. Izimiso zokunakekelwa kwe-neurointensive. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 55.

Ukuqapha kwengcindezi yangaphakathi kweRobba C. Ku: Prabhakar H, ed. Amasu we-Neuromonitoring. 1st ed. IPhiladelphia, PA: Elsevier; 2018: isahluko 1.