Kuyang'anitsitsa kupanikizika kwapakati

Kuwunika kwa intracranial pressure (ICP) kumagwiritsa ntchito chida choyikidwa mkati mwa mutu. Chowunikiracho chimazindikira kupsinjika mkati mwa chigaza ndikutumiza zoyerekeza ku chojambulira.

Pali njira zitatu zowunikira ICP. ICP ndiyopanikizika mu chigaza.

CATHETER WOSANGALALA

Catheter ya intraventricular ndiyo njira yolondola kwambiri yowunikira.

Kuti muike katemera wa mkati mwa intraventricular, dzenje limabooleredwa ndi chigaza. Catheter imalowetsedwa kudzera muubongo mu ventricle yotsatira. Mbali iyi yaubongo ili ndi cerebrospinal fluid (CSF). CSF ndi madzi omwe amateteza ubongo ndi msana.

Catheter ya intraventricular itha kugwiritsidwanso ntchito kutulutsa madzi kudzera mu catheter.

Catheter ikhoza kukhala yovuta kulowa m'malo pomwe kupsinjika kwamphamvu kumakhala kwakukulu.

SUBDURAL SCREW (BOLT)

Njirayi imagwiritsidwa ntchito ngati kuwunika kuyenera kuchitidwa nthawi yomweyo. Chowotcha chabowo chimalowetsedwa kudzera mu dzenje lokuboola chigaza. Amayikidwa kudzera mu nembanemba yomwe imateteza ubongo ndi msana (dura mater). Izi zimalola sensa kuti ijambule kuchokera mkati mwa danga laling'ono.

ZOKHUDZA KWAMBIRI

Chojambulira cha epidural chimayikidwa pakati pa chigaza ndi minofu yakumaso. Chojambulira cha epidural chimayikidwa kudzera mu dzenje lokuboola chigaza. Njirayi ndi yovuta kwambiri kuposa njira zina, koma siyingachotse CSF yochulukirapo.

Lidocaine kapena mankhwala ena oletsa ululu adzabayidwa pamalo omwe adzadulidwe. Mutha kupeza mankhwala okuthandizani kupumula.

• Poyamba malowa amametedwa ndikutsukidwa ndi mankhwala opha tizilombo.
• Dera likakhala louma, amadulidwa. Khungu limakokedwa kumbuyo mpaka chigaza chiwoneka.
• Kenako paboola amagwiritsidwa ntchito kudula fupa.

Nthawi zambiri, njirayi imachitika munthu akakhala mchipatala. Ngati muli maso ndipo mukudziwa, wothandizira zaumoyo wanu akufotokozerani njira ndi kuopsa kwake. Muyenera kusaina fomu yovomerezeka.

Ngati ndondomekoyi ikugwiritsidwa ntchito pogwiritsa ntchito anesthesia, mudzakhala mukugona komanso osamva ululu. Mukadzuka, mudzamva zotsatira zoyipa za anesthesia. Mudzakhalanso osasangalala chifukwa chodulidwa pachigoba.

Ngati njirayi yachitika pansi pa dzanzi, mudzakhala ogalamuka. Mankhwala osungitsa ukadaulo adzalowetsedwa m'malo omwe ayenera kudula. Izi zimvekera ngati koboola pamutu panu, ngati mbola yoluma. Mutha kumva kukoka ngati khungu limadulidwa ndikubwezeretsedwanso. Mukumva kubowola pamene kumadula chigaza. Nthawi yomwe izi zimatengera zimatengera mtundu wa kubowola komwe kumagwiritsidwa ntchito. Mudzamvanso kukoka pamene dokotalayo amalumikiza khungu kumbuyo pambuyo poti achitepo.

Wothandizira anu akhoza kukupatsani mankhwala ochepetsa kupweteka kuti musavutike. Simudzalandira mankhwala opweteka kwambiri, chifukwa omwe amakupatsani adzafuna kudziwa ngati ubongo ukugwira ntchito.

Mayesowa amachitika nthawi zambiri kuti athe kuyeza ICP. Zitha kuchitika ngati pali kuvulala kwamutu kwakukulu kapena matenda am'mitsempha / yamanjenje. Zitha kuchitidwanso pambuyo pochitidwa opaleshoni kuti achotse chotupa kapena kukonza kuwonongeka kwa mtsempha wamagazi ngati dotoloyo akuda nkhawa ndi kutupa kwa ubongo.

Mkulu ICP itha kuchiritsidwa ndikutulutsa CSF kudzera mu catheter. Itha kuthandizidwanso ndi:

• Kusintha makina opumira kwa anthu omwe ali ndi makina opumira
• Kupereka mankhwala ena kudzera mumitsempha (kudzera m'mitsempha)

Nthawi zambiri, ICP imakhala kuyambira 1 mpaka 20 mm Hg.

Lankhulani ndi omwe akukuthandizani za tanthauzo la zotsatira zanu zoyeserera.

Mkulu ICP amatanthauza kuti zonse zamanjenje ndi zotengera zamagazi zimapanikizika. Ngati sanalandire chithandizo, izi zitha kubweretsa kuwonongeka kwamuyaya. Nthawi zina, zitha kukhala zowopsa.

Zowopsa panjira iyi zingaphatikizepo:

• Magazi
• Kuchepetsa ubongo kapena kuvulala chifukwa chakuwonjezereka
• Kuwonongeka kwa minofu yaubongo
• Kulephera kupeza ventricle ndikuyika catheter
• Matenda
• Kuopsa kwa anesthesia wamba

Kuwunika kwa ICP; Kuwunika kwa CSF

• Kuyang'anitsitsa kupanikizika kwapakati

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Oddo M, Vincent JL. Kuyang'anitsitsa kupanikizika kwapakati. Mu: Vincent JL, Abraham E, Moore FA, Prime Minister wa Kochanek, MP wa Fink, eds. Buku Lopereka Chithandizo Chachikulu. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu E20.

Rabinstein AA, Wothawira JE. Mfundo zothandiza kusamalira ana. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 55.

Robba C. Kuyang'anira kukakamiza kuchitapo kanthu. Mu: Prabhakar H, mkonzi. Njira za Neuromonitoring. 1 ed. Philadelphia, PA: Elsevier; 2018: mutu 1.