Nānā kaomi Intracranial

Hoʻomaʻamaʻa kaomi Intracranial (ICP) i kahi mea hana i kau ʻia i loko o ke poʻo. ʻIke ka mea nānā i ke kaomi i loko o ka iwi poʻo a hoʻouna i nā ana i kahi hāmeʻa hoʻopaʻa leo.

ʻEkolu ala e nānā ai iā ICP. ʻO ICP ke kaomi o ka iwi poʻo.

PAHAKAHA LOA

ʻO ka catheter intraventricular ke ʻano o ka mālama pono ʻana.

E hoʻokomo i kahi catheter intraventricular, ʻeli ʻia kahi puka ma ka iwi poʻo. Hoʻokomo ʻia ka catheter ma o ka lolo i loko o ka ventricle ʻaoʻao. Loaʻa kēia ʻāpana o ka lolo i ka wai cerebrospinal (CSF). He wai ʻo CSF ​​i pale i ka lolo a me ka iwi kuamoo.

Hiki ke hoʻohana pū ʻia ka catheter intraventricular e hoʻokahe i ka wai ma o ka catheter.

He paʻakikī paha ka catheter e komo i kahi ke kiʻekiʻe ka intracranial pressure.

SCREW LOA (BOLT)

Hoʻohana ʻia kēia ala inā pono ke nānā koke ʻia. Hoʻokomo ʻia kahi ʻāha hollow ma o kahi puka i hū ʻia i ka iwi poʻo. Hoʻokomo ʻia ia ma o ka membrane e pale ai i ka lolo a me ka iwi maha (dura mater). ʻAe kēia i ka mea ʻike e hoʻopaʻa mai loko o ka wahi subdural.

ʻO EPIDURAL SENSOR

Hoʻokomo ʻia kahi mea hoʻopili epidural ma waena o ka iwi poʻo iwi a me ka iwi. Hoʻokomo ʻia ka mea ʻikepili epidural ma o kahi lua i hū ʻia i ka iwi poʻo. ʻOi aku ka liʻiliʻi o kēia hana ma mua o nā ʻano ʻē aʻe, akā ʻaʻole hiki ke hemo iā CSF keu.

Lidocaine a i ʻole kahi anesthetic kūloko e hoʻopili ʻia ma ka pūnaewele kahi e ʻokiʻoki ai. E loaʻa paha iā ʻoe kahi lāʻau hoʻonanea e kōkua ai iā ʻoe e hoʻomaha.

• ʻO ka mea i kahi ʻia a hoʻomaʻemaʻe ʻia me ka antiseptic.
• Ma hope o ka maloʻo o kahi, hana ʻia kahi ʻoki kino. Huki ʻia ka ʻili i hope a ʻike ʻia ka iwi poʻo.
• Hoʻohana ʻia kahi drill e ʻoki i ka iwi.

ʻO ka hapanui o ka manawa, hana ʻia kēia kaʻina hana inā aia ke kanaka i ka haukapila mālama maʻi nui. Inā ala ʻoe a makaʻala, e wehewehe kāu mea mālama ola i ke kaʻina hana a me nā pilikia. E kau inoa ʻoe i kahi palapala ʻae.

Inā hana ʻia nā kaʻina hana me ka hoʻohana ʻana i ka anesthesia ākea, e hiamoe ʻoe a ʻaʻohe ʻeha. Ke ala ʻoe, e ʻike ʻoe i nā hopena maʻamau o ka anesthesia. E loaʻa nō iā ʻoe kekahi pilikia o ka ʻoki i hana ʻia i kou poʻo poʻo.

Inā hana ʻia ke kaʻina hana ma lalo o ka anesthesia kūloko, e ala ana ʻoe. E hoʻokomo ʻia ka lāʻau nū i kahi e hana ʻia ai ka ʻoki. E like kēia me he mea ʻūlū lā i kou poʻo, e like me ka nī pi. ʻIke paha ʻoe i kahi leʻaleʻa ke ʻoki ʻia ka ʻili a huki ʻia i hope. E lohe ʻoe i kahi kani drill i kona ʻoki ʻana i ka iwi poʻo. Pili ka nui o ka manawa i ke ʻano o ka drill i hoʻohana ʻia. E ʻike pū ʻoe i ka ʻūlū ʻana i ke kau ʻana o ke kauka i ka ʻili ma hope o ke kaʻina hana.

Hāʻawi paha kāu mea hāʻawi iā ʻoe i nā lāʻau ʻeha ʻoluʻolu e hōʻoluʻolu ai i kou pilikia. ʻAʻole ʻoe e loaʻa i nā lāʻau ʻehaʻeha, no ka mea e makemake ana kāu mea nāna e nānā i nā hōʻailona o ka hana o ka lolo.

Hana pinepine ʻia kēia hōʻike e ana iā ICP. Hiki ke hana ʻia ke loaʻa ka ʻeha poʻo poʻo a i ʻole ka maʻi lolo / ʻōnaehana. Hana ʻia ia paha ma hope o ke kaha ʻana e wehe i kahi tumo a hoʻoponopono i nā mea i hōʻino ʻia i kahi kīʻaha koko inā hopohopo ka mea lapaʻau e pili ana i ka pehu ʻana o ka lolo.

Hiki ke mālama ʻia ka ICP kiʻekiʻe ma ka hoʻokahe ʻana iā CSF ma o ka catheter. Hiki ke mālama ʻia e:

• Ke hoʻololi nei i nā hoʻonohonoho ventilator no ka poʻe ma ka respirator
• Ke hāʻawi nei i kekahi mau lāʻau i loko o kahi aa (intravenously)

ʻO ka maʻamau, ʻo ka ICP mai 1 a 20 mm Hg.

E kamaʻilio i kāu mea hāʻawi e pili ana i ke ʻano o kāu mau hopena hōʻike.

ʻO ke kiʻekiʻe o ka ICP ʻo ia hoʻi ke kaomi ʻia nā ʻōnaehana hopohopo a me nā aʻa koko. Inā mālama ʻole ʻia, hiki i kēia ke alakaʻi i ka pōʻino mau loa. I kekahi mau hihia, hiki ke hoʻoweliweli i ke ola.

Pākuʻi ʻia paha nā pōpilikia mai ke kaʻina hana:

• Kahena
• ʻO ka herniation a i ʻole ka ʻeha mai ka hoʻonui kaomi
• Poino i kaʻiʻo lolo
• Hiki ʻole ke loaʻa ka ventricle a kau i ka catheter
• Maʻi kīnā
• Nā pilikia o ka anesthesia ākea

Ka nānā ʻana iā ICP; Nānā kaomi CSF

• Nānā kaomi Intracranial

Huang MC, Wang VY, Manley GT. Nānā kaomi Intracranial. I: Winn HR, hoʻoponopono. ʻO Youmans a me Winn Neurological Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap15.

ʻO Oddo M, ʻo Vincent J-L. Nānā kaomi Intracranial. I: ʻO Vincent J-L, ʻo Abraham E, Moore FA, Kochanek PM, Fink MP, eds. Puke aʻo o ka mālama koʻikoʻi. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap E20.

Rabinstein AA, Fugate JE. Nā loina o ka mālama neurointensive. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 55.

ʻO Robba C. Intracranial pressure pressure monitoring. I: Prabhakar H, hoʻoponopono. Nā Hana Neuromonitoring. 1st ed. Piladelapia, PA: Elsevier; 2018: chap 1.