Epidural abscess

Chuma chotupa ndi mafinya (matenda opatsirana) ndi majeremusi pakati pa chophimba chakunja chaubongo ndi msana ndi mafupa a chigaza kapena msana. Thumba limayambitsa kutupa m'deralo.

Epidural abscess ndi matenda osowa omwe amayamba chifukwa cha matenda m'dera pakati pa mafupa a chigaza, kapena msana, ndi nembanemba zokuta ubongo ndi msana (meninges). Matendawa amatchedwa abscess intracranial epidural abscess ngati ali mkati mwa chigaza. Amatchedwa abscess epidural abscess ngati amapezeka msana. Ambiri amapezeka mumsana.

Matenda a msana nthawi zambiri amayambitsidwa ndi mabakiteriya koma amayamba chifukwa cha bowa. Zitha kukhala chifukwa cha matenda ena mthupi (makamaka matenda amkodzo), kapena majeremusi omwe amafalikira m'magazi. Kwa anthu ena, palibe njira ina yothandizira.

Chotupa mkati mwa chigaza chimatchedwa chifuwa chosagwedezeka. Chifukwa chake chitha kukhala izi:

• Matenda a khutu osatha
• Matenda a sinusitis
• Kuvulala pamutu
• Mastoiditis
• Ma neurosurgery aposachedwa

Chotupa cha msana chimatchedwa chotupa cha msana. Zitha kuwoneka mwa anthu omwe ali ndi izi:

• Anali ndi opareshoni yam'mbuyo kapena njira ina yovuta yokhudza msana
• Matenda a m'magazi
• Zithupsa, makamaka kumbuyo kapena kumutu
• Matenda a mafupa a msana (vertebral osteomyelitis)

Anthu omwe amabaya mankhwala osokoneza bongo nawonso amakhala pachiwopsezo chachikulu.

Kuphulika kwa msana kumatha kubweretsa izi:

• Kusagwirizana kwa matumbo kapena chikhodzodzo
• Kuvuta kukodza (kusungira mkodzo)
• Malungo ndi kupweteka kwa msana

Kutupa kwamkati kwam'mimba kumatha kubweretsa izi:

• Malungo
• Mutu
• Kukonda
• Nseru ndi kusanza
• Ululu pamalo opareshoni yaposachedwa omwe umakulirakulira (makamaka ngati malungo alipo)

Zizindikiro zamanjenje zimadalira komwe kuli abscess ndipo zingaphatikizepo:

• Kuchepetsa kuthekera kosuntha gawo lililonse la thupi
• Kutaya kwadzidzidzi m'dera lililonse la thupi, kapena kusintha kosazolowereka pakumverera
• Kufooka

Wopereka chithandizo chamankhwala ayesa thupi kuti aone ngati ntchito zatha, monga kuyenda kapena kumva.

Mayeso omwe angachitike ndi awa:

• Zikhalidwe zamagazi kuti muwone ngati mabakiteriya ali m'magazi
• Kuwerengera kwathunthu kwa magazi (CBC)
• Kujambula kwa CT pamutu kapena msana
• Kukhetsa kwa abscess ndikuwunika nkhaniyo
• MRI ya mutu kapena msana
• Kusanthula kwamkodzo ndi chikhalidwe
  

Cholinga cha mankhwalawa ndikuchiza matenda ndikuchepetsa chiopsezo chowonongekeratu. Chithandizochi chimaphatikizapo maantibayotiki ndi opaleshoni. Nthawi zina, maantibayotiki okha amagwiritsidwa ntchito.

Maantibayotiki nthawi zambiri amaperekedwa kudzera mumitsempha (IV) kwa milungu 4 kapena 6. Anthu ena amafunika kuwatenga kwa nthawi yayitali, kutengera mtundu wa mabakiteriya komanso momwe matendawa alili oopsa.

Kuchita opaleshoni kungafunike kukhetsa kapena kuchotsa abscess. Kuchita opaleshoni kumafunikanso kuti muchepetse kuthamanga kwa msana kapena ubongo, ngati pali kufooka kapena kuwonongeka kwa mitsempha.

Kuzindikira koyambirira ndi chithandizo kumathandizira kwambiri mwayi wazotsatira. Kufooka, kufooka, kapena kusintha kwakanthawi kumachitika, mwayi wopezanso ntchito yotayika umachepa kwambiri. Kuwonongeka kwamuyaya kwamanjenje kapena kufa kumatha kuchitika.

Zovuta zingaphatikizepo:

• Kutupa kwa ubongo
• Kuwonongeka kwa ubongo
• Matenda a mafupa (osteomyelitis)
• Ululu wopweteka wammbuyo
• Meninjaitisi (matenda a nembanemba yophimba ubongo ndi msana)
• Kuwonongeka kwa mitsempha
• Kubwereranso kwa matenda
• Msana wa abscess

Kuphulika kwamatenda ndi vuto lazachipatala. Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) ngati muli ndi zizindikilo za abscess ya msana.

Chithandizo cha matenda ena, monga matenda am'makutu, sinusitis, ndi matenda am'magazi, zitha kuchepetsa chiopsezo chotupa chotupa. Kuzindikira koyambirira ndi chithandizo ndikofunikira popewa zovuta.

Abscess - matenda; Msana abscess

Kusuma S, Klineberg EO. Matenda a msana: matenda ndi chithandizo cha discitis, osteomyelitis, ndi epidural abscess. Mu: Steinmetz MP, Benzel EC, olemba. Opaleshoni ya Spine ya Benzel. Wolemba 4. Philadelphia, PA: Elsevier; 2017: mutu 122.

Tunkel AR. Kukula kwachilengedwe, kuphulika kwamatenda, komanso kupwetekedwa mtima kosagwirizana ndi thrombophlebitis. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Mfundo za Bennett ndi Kuchita kwa Matenda Opatsirana, Kusinthidwa. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 93.