Ukuhlaziywa kweCerebral Spinal Fluid (CSF)

-Delile

• Athathwa kanjani amasampula e-CSF
• Izinqubo ezihambisanayo
• Izingozi zokubhoboza i-lumbar
• Kungani isivivinyo siyaliwe
• Izifo ezitholwe ukuhlaziywa kwe-CSF
• Izifo ezithathelwanayo
• Ukopha kakhulu
• Izinkinga zokuphendula komzimba
• Izimila
• Ukuhlaziywa kwe-CSF kanye ne-multiple sclerosis
• Ukuhlolwa kweLab nokuhlaziywa kwe-CSF
• Ukuhumusha imiphumela yakho yokuhlolwa
• Ukulandela ngemuva kokuhlaziywa kwe-CSF

Kuyini ukuhlaziywa kweCSF?

Ukuhlaziywa kweCerebrospinal fluid (CSF) kuyindlela yokubheka izimo ezithinta ubuchopho bakho nomgogodla wakho. Kuchungechunge lwezivivinyo zaselebhu ezenziwe kusampula ye-CSF. I-CSF iwuketshezi olucacile oludonsa futhi luhambise izakhi kuhlelo lwakho lwezinzwa oluphakathi (CNS). I-CNS iqukethe ubuchopho nomgogodla.

I-CSF ikhiqizwa yi-plexus ye-choroid ebuchosheni bese iphinda ifakwa egazini lakho. Uketshezi kushintshwa ngokuphelele njalo emahoreni ambalwa. Ngaphezu kokuletha izakhamzimba, i-CSF igeleza izungeze ubuchopho bakho nekholomu lomgogodla, inikela ngokuvikelwa futhi ithathe imfucuza.

Isampula le-CSF livame ukuqoqwa ngokwenza isibhobo se-lumbar, esaziwa nangokuthi umpompi womgogodla. Ukuhlaziywa kwesampula kufaka ukukalwa nokuhlolwa kwe:

• ingcindezi ketshezi
• amaprotheni
• ushukela
• amangqamuzana abomvu egazi
• amaseli egazi amhlophe
• amakhemikhali
• amagciwane
• amagciwane
• ezinye izinto eziphilayo noma izinto zangaphandle

Ukuhlaziywa kungafaka:

• ukulinganiswa kwezimpawu zomzimba nokubukeka kwe-CSF
• ukuhlolwa kwamakhemikhali ezintweni ezitholakala ku-fluid yakho yomgogodla noma ukuqhathanisa namazinga ezinto ezifanayo ezitholakala egazini lakho
• ukubalwa kwamaseli nokuthayipha kwanoma yimaphi amaseli atholakala ku-CSF yakho
• ukuhlonza noma yiziphi izinto ezincane ezingadala izifo ezithathelwanayo

I-CSF ixhumana ngqo nobuchopho bakho nomgogodla wakho. Ngakho-ke ukuhlaziywa kwe-CSF kusebenza kakhulu kunokuhlolwa kwegazi ukuqonda izimpawu ze-CNS. Kodwa-ke, kunzima kakhulu ukuthola isampula yomgogodla kunesampula segazi. Ukufaka umsele womgogodla ngenaliti kudinga ulwazi lochwepheshe nge-anatomy yomgogodla kanye nokuqonda okucacile kwanoma yibuphi ubuchopho obuyimbangela noma izimo zomgogodla ezingakhuphula ubungozi bezinkinga kusuka enkambisweni.

Athathwa kanjani amasampula e-CSF

Ukubhoboza i-lumbar ngokuvamile kuthatha imizuzu engaphansi kwengu-30. Kwenziwa ngudokotela oqeqeshwe ngokukhethekile ukuqoqa i-CSF.

I-CSF imvamisa ithathwa endaweni yakho engezansi emuva, noma emgogodleni we-lumbar. Kubaluleke kakhulu ukuhlala unganyakazi ngokuphelele ngesikhathi senqubo. Ngale ndlela ugwema ukubekwa kwenaliti okungalungile noma ukuhlukumezeka umgogodla wakho.

Ungahlala phansi bese ucelwa ukuthi uncike ukuze umgogodla wakho ugobeke phambili.Noma udokotela wakho kungenzeka ukuthi ulele ohlangothini lwakho umgogodla wakho ugobile namadolo akho adonsela esifubeni. Ukuguqula umgogodla wakho kwenza isikhala phakathi kwamathambo akho emhlane ongezansi.

Uma ususesikhundleni, umhlane wakho uhlanzwa ngesixazululo esiyinyumba. Iodine ivame kusetjentiselwa kuhlanta. Indawo eyinyumba igcinwa kuyo yonke inqubo. Lokhu kunciphisa ubungozi bokutheleleka.

Ukhilimu noma isifutho esikindayo sifakwa esikhunjeni sakho. Udokotela wakho ube esejova izinzwa. Lapho isiza sesikindiki ngokuphelele, udokotela wakho ufaka inaliti yomgogodla omncane phakathi kwama-vertebrae amabili. Uhlobo olukhethekile lwe-X-ray olubizwa nge-fluoroscopy kwesinye isikhathi lusetshenziselwa ukuqondisa inaliti.

Okokuqala, ingcindezi engaphakathi kogebhezi ilinganiswa kusetshenziswa i-manometer. Kokubili ingcindezi ephezulu nephansi ye-CSF ingaba yizimpawu zezimo ezithile.

Amasampula we-fluid athathwa ngenaliti. Lapho ukuqoqwa koketshezi kuqediwe, inaliti iyasuswa. Indawo yokubhoboza ihlanzwa futhi. Kusetshenziswa ibhandishi.

Uzocelwa ukuthi uhlale ulele cishe ihora elilodwa. Lokhu kunciphisa ubungozi bekhanda, okuwumphumela ohlangothini ovamile wenqubo.

Izinqubo ezihambisanayo

Kwesinye isikhathi umuntu akakwazi ukuba nesibhobo semilenze ngenxa yokukhubazeka emuva, ukutheleleka, noma ukuhluma kobuchopho okungenzeka. Kulezi zimo, indlela esetshenziswayo yokuqoqa i-CSF edinga ukulaliswa esibhedlela ingasetshenziswa, njengokukodwa kokulandelayo:

• Ngesikhathi sokubhoboza i-ventricular, udokotela wakho ubhoboza imbobo kugebhezi lwakho bese efaka inaliti ngqo kwesinye sezingibe zobuchopho bakho.
• Ngesikhathi sokubhoboza umthombo, udokotela wakho ufaka inaliti ngemuva kogebhezi lwakho.
• I-ventricular shunt noma idreyini ingaqoqa i-CSF kubhubhu udokotela wakho akubeka ebuchosheni bakho. Lokhu kwenziwa ukukhipha ingcindezi ephezulu yoketshezi.

Iqoqo le-CSF livame ukuhlanganiswa nezinye izinqubo. Isibonelo, udayi ungafakwa ku-CSF yakho ukuze uthole i-myelogram. Lokhu ukuskena kwe-X-ray noma kwe-CT kobuchopho bakho nomgogodla wakho.

Izingozi zokubhoboza i-lumbar

Lokhu kuhlolwa kudinga ukukhishwa okusayiniwe okusho ukuthi uyabuqonda ubungozi benqubo.

Izingozi eziyinhloko ezihambisana nokubhoboza i-lumbar zifaka:

• ukopha endaweni yokubhoboza kungena kolwelwesi lomgogodla, olubizwa ngompompi obuhlungu
• ukungakhululeki ngesikhathi nangemva kwenqubo
• ukusabela okweqile ku-anesthetic
• ukutheleleka endaweni yokubhoboza
• ikhanda ngemuva kokuhlolwa

Abantu abathatha izinciphisi zegazi basengozini enkulu yokopha. Ukubhoboza i-lumbar kuyingozi enkulu kubantu abanezinkinga ezijiyisayo ezifana nenani eliphansi leplatelet, elibizwa nge-thrombocytopenia.

Kukhona ezinye izingozi ezinkulu uma unesisindo sobuchopho, isimila noma ithumba. Lezi zimo zifaka ingcindezi esiqwini sobuchopho bakho. Ukubhoboza i-lumbar kungadala ukuthi i-herniation yobuchopho yenzeke. Lokhu kungaholela ekulimaleni kwengqondo noma ngisho nasekufeni.

I-Brain herniation ukuguqulwa kwezakhiwo zobuchopho. Imvamisa kuhambisana nengcindezi ephezulu yokungena ngaphakathi. Isimo sigcina sinqamule ukunikezwa kwegazi ebuchosheni bakho. Lokhu kudala umonakalo ongalungiseki. Ukuhlolwa ngeke kwenziwe uma kusolwa isisindo sobuchopho.

Izindlela zokubhoboza emgodini nezingaphakathi emgodini zinobungozi obengeziwe. Lezi zingozi zifaka:

• ukulimala komgogodla noma ubuchopho bakho
• ukopha ngaphakathi kwengqondo yakho
• ukuphazamiseka kwesithiyo segazi nobuchopho

Kungani isivivinyo siyaliwe

Ukuhlaziywa kwe-CSF kunga-odwa uma ngabe ube nokuhlukumezeka kwe-CNS. Kungasetshenziswa futhi uma unomdlavuza futhi udokotela wakho efuna ukubona ukuthi umdlavuza ususabalele ku-CNS.

Ngaphezu kwalokho, ukuhlaziywa kwe-CSF kungahle ku-odwe uma unezimpawu ezilandelayo noma ngaphezulu:

• ikhanda elibi, elingapheli
• intamo elukhuni
• ukusangana, ukudideka, noma ukuwohloka komqondo
• isithuthwane
• izimpawu ezinjengomkhuhlane eziqhubekayo noma eziqinisa
• ukukhathala, ukukhathala, noma ubuthakathaka bemisipha
• ushintsho olwazini
• isicanucanu esinzima
• umkhuhlane noma ukuqubuka
• ukuzwela ukukhanya
• ukuba ndikindiki noma ukuthuthumela
• isiyezi
• ubunzima bokukhuluma
• ukuhamba kanzima noma ukungahambisani kahle
• ukushintsha kwemizwelo okukhulu
• ukucindezeleka komtholampilo okungalapheki

Izifo ezitholwe ukuhlaziywa kwe-CSF

Ukuhlaziywa kwe-CSF kungahlukanisa ngokunembile phakathi kwezifo ezahlukahlukene ze-CNS okungaba nzima ukuzithola. Izimo ezitholwe ukuhlaziywa kwe-CSF zifaka:

Izifo ezithathelwanayo

Amagciwane, amabhaktheriya, isikhunta nezinambuzane konke kungathelela i-CNS. Ukutheleleka okuthile kungatholakala ngokuhlaziywa kwe-CSF. Ukutheleleka okuvamile kwe-CNS kufaka:

• meningitis
• i-encephalitis
• isifo sofuba
• izifo zokukhunta
• Igciwane le-West Nile
• igciwane lase-eastern equine encephalitis (EEEV)

Ukopha kakhulu

Ukuphuma kwegazi ngaphakathi kungatholwa ngokuhlaziywa kwe-CSF. Kodwa-ke, ukuhlukanisa imbangela ngqo yokopha kungadinga ukuskena noma ukuhlolwa okwengeziwe. Izimbangela ezivamile zifaka umfutho wegazi ophakeme, isifo sohlangothi, noma i-aneurysm.

Izinkinga zokuphendula komzimba

Ukuhlaziywa kwe-CSF kungathola ukuphazamiseka kokuphendula komzimba. Amasosha omzimba angadala ukulimala ku-CNS ngokuvuvukala, ukucekelwa phansi kwe-myelin sheath ezungeze izinzwa, nokukhiqizwa kwama-antibody.

Izifo ezivamile zalolu hlobo zifaka:

• Isifo se-Guillain-Barré
• sarcoidosis
• i-neurosyphilis
• i-multiple sclerosis

Izimila

Ukuhlaziywa kwe-CSF kungathola izicubu eziyinhloko ebuchosheni noma emgogodleni. Ingathola futhi umdlavuza we-metastatic osabalalele ku-CNS yakho kusuka kwezinye izitho zomzimba.

Ukuhlaziywa kwe-CSF kanye ne-multiple sclerosis

Ukuhlaziywa kwe-CSF kungasetshenziselwa ukusiza ukuxilonga i-multiple sclerosis (MS). I-MS yisimo esingelapheki lapho amasosha akho omzimba ecekela phansi isivikelo semizwa yakho, esibizwa nge-myelin. Abantu abane-MS bangaba nezimpawu ezahlukahlukene ezihlala njalo noma eza futhi zihambe. Kubandakanya ukuba ndikindiki noma ubuhlungu ezingalweni nasemilenzeni, izinkinga zokubona, nenkinga yokuhamba.

Ukuhlaziywa kwe-CSF kungenziwa ukukhipha ezinye izimo zezokwelapha ezinezimpawu ezifana ne-MS. Uketshezi kungakhombisa nezimpawu zokuthi amasosha akho omzimba awasebenzi ngokujwayelekile. Lokhu kungafaka amazinga aphezulu e-IgG (uhlobo lwe-antibody) nokuba khona kwamaprotheni athile akha lapho i-myelin iphuka. Cishe amaphesenti angama-85 kuye kwangama-90 abantu abane-MS banakho lokhu kungahambi kahle ku-cerebral spinal fluid yabo.

Ezinye izinhlobo ze-MS zithuthuka ngokushesha futhi zingasongela impilo kungakapheli amasonto noma izinyanga. Ukubheka amaprotheni akwi-CSF kungenza odokotela bakwazi ukwenza "okhiye" ababizwa ngama-biomarkers. Ama-biomarkers angasiza ukukhomba uhlobo lwe-MS onalo ngaphambili futhi kalula. Ukuxilongwa kusenesikhathi kungakuvumela ukuthi uthole ukwelashwa okunganweba impilo yakho uma unefomu le-MS eliqhubeka ngokushesha.

Ukuhlolwa kweLab nokuhlaziywa kwe-CSF

Okulandelayo kuvame ukukalwa ekuhlaziyweni kwe-CSF:

• ukubalwa kwamangqamuzana egazi amhlophe
• isibalo segazi elibomvu
• i-chloride
• ushukela, noma ushukela wegazi
• i-glutamine
• i-lactate dehydrogenase, eyi-enzyme yegazi
• amagciwane
• ama-antigen, noma izinto eziyingozi ezikhiqizwa amagciwane ahlaselayo
• amaprotheni esewonke
• ama-oligoclonal band, angamaprotheni athile
• amangqamuzana omdlavuza
• i-DNA yegciwane
• amasosha omzimba alwa namagciwane

Ukuhumusha imiphumela yakho yokuhlolwa

Imiphumela ejwayelekile isho ukuthi akukho lutho olungajwayelekile olutholakele ku-fluid fluid. Onke amazinga alinganisiwe wezinto ze-CSF atholakale ephakathi kobubanzi obujwayelekile.

Imiphumela engajwayelekile ingabangelwa kokulandelayo:

• isimila
• umdlavuza we-metastatic
• ukopha
• i-encephalitis, okuwukuvuvukala kobuchopho
• ukutheleleka
• ukuvuvukala
• I-Reye's syndrome, okuyisifo esingajwayelekile, esivame ukubulala esithinta izingane ezihambisana nokutheleleka ngegciwane kanye nokufakwa kwe-aspirin
• i-meningitis, ongayithola ku-fungi, isifo sofuba, amagciwane, noma ama-bacteria
• amagciwane afana ne-West Nile noma i-Eastern equine
• I-Guillain-Barré syndrome, okuyisimo sokuzimela komzimba esidala ukukhubazeka futhi kwenzeka ngemuva kokuvezwa yigciwane
• i-sarcoidosis, okuyisimo se-granulomatous sesizathu esingaziwa esithinta izitho eziningi (ikakhulukazi amaphaphu, amalunga nesikhumba)
• i-neurosyphilis, eyenzeka lapho ukutheleleka nge-syphilis kuhilela ubuchopho bakho
• i-multiple sclerosis, okuyi-autoimmune disorder ethinta ubuchopho bakho nentambo yomgogodla

Ukulandela ngemuva kokuhlaziywa kwe-CSF

Ukulandelela nokubuka kwakho kuzoya ngokuthi yini edale ukuthi ukuhlolwa kwakho kwe-CNS kube okungajwayelekile. Ukuhlolwa okwengeziwe kuzodingeka kakhulu ukuze uthole ukuxilongwa okucacile. Ukwelashwa kanye nemiphumela kuzohluka.

I-Meningitis ebangelwa ukutheleleka ngamagciwane noma i-parasitic yisimo esiphuthumayo sezokwelapha. Izimpawu ziyefana ne-viral meningitis. Kodwa-ke, i-viral meningitis ayisongeli impilo kangako.

Abantu abane-bacterial meningitis bangathola ama-antibiotic abanzi kuze kube yilapho kutholakala imbangela yokutheleleka. Ukwelashwa ngokushesha kubalulekile ukuze usindise impilo yakho. Kungavimbela futhi ukulimala okungapheli kwe-CNS.