Cerebral Spinal Fluid (CSF) Nānā

Anter

• Pehea e lawe ʻia ai nā laʻana CSF
• Nā hana e pili ana
• Nā pilikia o ka lumbar puncture
• No ke aha e kauoha ʻia ai ka hoʻāʻo
• Nā maʻi i ʻike ʻia e ka loiloi CSF
• Nā maʻi lele
• Hemorrhaging
• Nā maʻi kūlohelohe
• Nā Tumors
• Nānā CSF a me nā sclerosis he nui
• ʻO ka hoʻowalewale hoʻokolohua ʻana a me ka hoʻokau ʻana o CSF
• Unuhi i kāu hopena hopena
• Ke ukali nei ma hope o ka hoʻoponopono CSF

He aha ka loiloi CSF?

ʻO ke kālailai Cerebrospinal fluid (CSF) kahi ala e ʻimi ai i nā kūlana e hoʻopili i kou lolo a me kou kuamoʻo. He maʻa o nā hoʻokolohua hoʻokolohua i hana ʻia ma kahi laʻana o CSF. ʻO CSF ka wai akāka e hoʻoweliweli a hāʻawi i nā meaʻai i kāu ʻōnaehana waena (CNS). Aia ka CNS i ka lolo a me ka iwi kuamoo.

Hana ʻia ʻo CSF ​​e ka choroid plexus i ka lolo a laila hoʻopili hou ʻia i loko o kou kahe koko. Hoʻololi piha ʻia ka wai i kēlā me kēia hola. Ma waho o ka hāʻawi ʻana i nā mea momona, kahe ʻo CSF ​​a puni kou lolo a me ka kolamu o ka iwi, e hāʻawi ana i ka pale a me ka lawe ʻana i nā ʻōpala.

Hōʻiliʻili maʻamau ʻia kahi laʻana CSF e ka hana ʻana i kahi lumbar puncture, kahi i ʻike ʻia ʻo ke kuʻikuʻi. ʻO ke anamanaʻo o ka laʻana e pili ana i ke ana a me ka ninaninau ʻana no:

• puʻe kaomi
• nā polokina
• glucose
• ʻulaʻula koko
• ʻili koko keʻokeʻo
• kemika
• koʻohune
• nā mea hoʻomaʻi
• nā meaola hoʻouka ʻē aʻe a i ʻole nā ​​mea haole

Hiki i ke kālailai ke hoʻopili:

• ana o nā ʻano kino a me ka hiʻona o CSF
• nā hoʻāʻo kemika i nā mea i loaʻa i loko o kāu wai o ka iwi kuʻuna a i ʻole hoʻohālikelike i nā pae o nā mea like i loaʻa i kou koko
• helu a me ke kikokiko ʻana o nā pūnaewele i loaʻa i kāu CSF
• ʻike o nā microorganism e hiki ai ke hōʻeha i nā maʻi maʻi

Hoʻopili pololei ʻo CSF ​​me kou lolo a me kou kuamoʻo. No laila, ʻoi aku ka maikaʻi o ka hoʻopili ʻana o CSF ​​ma mua o kahi hoʻokolohua koko no ka hoʻomaopopo ʻana i nā ʻōuli CNS.Eia naʻe, ʻoi aku ka paʻakikī o ka loaʻa ʻana o kahi laʻana wai ʻōiwi ma mua o kahi hāpana koko. Ke komo nei i ke kuamoʻo ʻōiwi me kahi nila e koi ai i ka ʻike loea o ka anatomy o ka iwi kuamoo a me ka ʻike maopopo o nā lolo āpau a i ʻole nā ​​ʻano spinal e hoʻonui i ka makaʻu o nā pilikia mai ke kaʻina hana.

Pehea e lawe ʻia ai nā laʻana CSF

Lawe ʻia kahi lumbar puncture ma lalo o 30 mau minuke. Hana ʻia e ke kauka i hoʻomaʻamaʻa kūikawā e hōʻiliʻili iā CSF.

Lawe pinepine ʻia ʻo CSF ​​mai kāu ʻaoʻao haʻahaʻa, a i ʻole ka iwi kuamoo. He mea nui loa ia e noho paʻa mau i ka wā o ke kaʻina hana. Pēlā ʻoe e pale ai i ke kau ʻana o ka nila ʻole a i ʻole trauma i kāu iwikuamoʻo.

Noho paha ʻoe a noi ʻia ʻoe e hilinaʻi i mua e ʻōwili ai i kou iwi kuamoʻo. A i ʻole hiki i kāu kauka ke moe paha ʻoe ma kou ʻaoʻao me kou iwi kuamoʻo a huki ʻia kou mau kuli i ka umauma. ʻO ke kaʻe ʻana i kou iwi kuamoʻo e hana i kahi ma waena o kou mau iwi ma ka ʻaoʻao haʻahaʻa.

Ke kū nei ʻoe i kahi kūlana, hoʻomaʻemaʻe ʻia kou kua me kahi hopena sterile. Hoʻohana pinepine ʻia ka iodine no ka hoʻomaʻemaʻe. Mālama ʻia kahi ākea ma nā kaʻina hana. Hoʻoemi kēia i ka makaʻu o ka maʻi.

Hoʻopili ʻia kahi kalima numbing a ʻehu paha i kou ʻili. Hoʻokomo kāu kauka i ka anesthetic. Ke pau ka namu o ka pūnaewele, hoʻokomo kāu kauka i kahi kui kuʻikuʻi lahilahi ma waena o ʻelua vertebrae. Hoʻohana ʻia kekahi ʻano kūikawā o ka X-ray i kapa ʻia ʻo fluoroscopy e alakaʻi i ka nila.

ʻO ka mea mua, ana ʻia ke kaomi o loko o ka iwi poʻo me ka hoʻohana ʻana i ka manometa. Hiki i nā kaomi CSF kiʻekiʻe a haʻahaʻa hoʻi ke hōʻailona o kekahi mau ʻano.

Lawe ʻia nā laʻana wai ma o ka nila. Ke pau ka hōʻiliʻili wai, hemo ka nila. Hoʻomaʻemaʻe hou ʻia ka pūnaewele puncture. Hoʻopili ʻia kahi kaula.

E noi ʻia ʻoe e moe i lalo no hoʻokahi hola. Hoʻoemi kēia i ka makaʻu o ka ʻeha poʻo, kahi hopena ʻaoʻao maʻamau o ke kaʻina hana.

Nā hana e pili ana

I kekahi manawa ʻaʻole hiki i kahi kanaka ke loaʻa kahi lumbar puncture no ka hemahema o ke kua, ka maʻi, a me ka herniation lolo hiki paha. I kēia mau hihia, hiki ke hoʻohana ʻia kahi ʻano hōʻiliʻili CSF ʻoi aku koi e pono ai ka hoʻokipa ʻana i ka haukapila, e like me kekahi o kēia:

• I ka wā o ka puncture ventricular, kōkola kāu kauka i kahi lua i kou iwi poʻo a hoʻokomo pono i kahi nila i loko o kekahi o nā ventricle o kou lolo.
• I ka wā o kahi cisternal puncture, hoʻokomo kāu kauka i kahi nila i hope o kou iwi poʻo.
• Hiki i kahi shunt ventricular a i ʻole ke kahe ke hōʻiliʻili iā CSF mai kahi paipu i kau ʻia e kāu kauka i kou lolo. Hana ʻia kēia e hoʻokuʻu i ke kaomi wai kiʻekiʻe.

Hoʻohui pinepine ʻia ka hōʻiliʻili CSF me nā kaʻina hana ʻē aʻe. ʻO kahi laʻana, e hoʻokomo ʻia ka kala i kāu CSF no kahi myelogram. ʻO kēia kahi X-ray a i ʻole CT scan o kou lolo a me kou iwi kuamoo.

Nā pilikia o ka lumbar puncture

Pono kēia hōʻike i kahi hoʻokuʻu i kau inoa ʻia e ʻōlelo ai maopopo iā ʻoe ka makaʻu o ke kaʻina hana.

ʻO nā pilikia mua e pili pū ana me ka lumbar puncture:

• kahe kahe mai ka pūnaewele puncture i loko o ka wai o ka iwi kuamoʻo, kahi i kapa ʻia he tap traumatic
• hōʻoluʻolu i ka wā a ma hope o ke kaʻina hana
• kahi hopena maʻi ʻaʻano i ka anesthetic
• he maʻi maʻi ma ka pūnaewele puncture
• ʻeha poʻo ma hope o ka hoʻāʻo

ʻO ka poʻe e lawe i ka lahilahi o ke koko i ka nui o ka makaʻu o ke kahe ʻana. He mea weliweli loa ka lumbar puncture no ka poʻe i loaʻa nā pilikia o ke kāpili ʻana e like me ka helu platelet haʻahaʻa, i kapa ʻia ʻo thrombositopenia.

Aia kekahi pilikia ʻino inā loaʻa iā ʻoe ka nui o ka lolo, ka tumo, a i ʻole ke abscess. Kau kēia mau kūlana i ke kaomi ma luna o ka lolo o kou lolo. Hiki i kahi lumbar puncture ke hana i ka herniation o ka lolo. Hiki i kēia ke hopena i ka hōʻino o ka lolo a i ʻole ka make.

ʻO ka herniation Brain kahi hoʻololi o nā hanana o ka lolo. Hoʻohui pinepine ʻia me ke kaomi intracranial kiʻekiʻe. ʻO ke ʻano ʻoki loa i ka hāʻawi koko i kou lolo. Kēia ke kumu irreparable poino. ʻAʻole e hana ʻia ka hōʻike inā manaʻo ʻia kahi nui o ka lolo.

Lawe nā ʻano puncture cisternal a me nā ventricular i nā pilikia hou aʻe. ʻO kēia mau pilikia me:

• poino i kou iwi kuamoʻo a i ʻole lolo
• e kahe ana ke koko i loko o kou lolo
• haunaele o ka pale ā-lolo

No ke aha e kauoha ʻia ai ka hoʻāʻo

Kauoha ʻia paha ka loiloi CSF inā loaʻa iā ʻoe ka trauma CNS. Hiki ke hoʻohana ʻia inā loaʻa ʻoe i ka maʻi ʻaʻai a makemake kāu kauka e ʻike inā ua pālahalaha ka maʻi ʻaʻai i ka CNS.

Hoʻohui ʻia, kauoha ʻia paha ke kālailai ʻana o CSF ​​inā loaʻa iā ʻoe i hoʻokahi a ʻoi paha o nā hōʻailona aʻe:

• ʻehaʻeha, ʻāʻī poʻo ʻole
• ʻāʻī ʻoʻoleʻa
• hallucination, huikau, a dementia paha
• ka hopu ʻana
• flu-like hōʻailona e hoʻomau a hoʻoikaika paha
• luhi, lethargy, a nāwaliwali o nā mākala
• hoʻololi i ka ʻike
• nausea nui
• fiva a pehu paha
• ʻālohilohi kukui
• ʻōlohelohe a haʻalulu paha
• ʻūpā
• nā pilikia ʻōlelo
• pilikia i ka hele wāwae a i ʻole ke kūlike maikaʻi ʻole
• ʻoliʻoli loa ke ʻano
• kaumaha kaumaha hiki ʻole

Nā maʻi i ʻike ʻia e ka loiloi CSF

Hiki i ka anamanaʻo CSF ​​ke hoʻokaʻawale pono ma waena o kahi ākea o nā maʻi CNS i hiki i ka paʻakikī ke kuhikuhi. Loaʻa nā ʻano i loaʻa e ka hōʻiliʻili CSF:

Nā maʻi lele

Hiki i nā virus, bacteria, fungi, a me nā parasites ke hoʻopili i ka CNS. Hiki ke ʻike ʻia kekahi mau maʻi e ka CSF analysis. ʻO nā maʻi CNS maʻamau ka:

• meningitis
• encephalitis
• maʻi puʻu
• nā maʻi lele
• Virus Nile Komohana
• maʻi hoʻoilina encephalitis hikina hikina (EEEV)

Hemorrhaging

Hiki ke ʻike ʻia ke kahe intracranial e ka ʻikepili CSF. Eia nō naʻe, hoʻokaʻawale i ke kumu kikoʻī o ke kahe e koi ai i kahi scan hou a i ʻole nā ​​hoʻokolohua. ʻO nā kumu maʻamau e pili ana i ke kiʻekiʻe o ke koko, hahau, a i ʻole aneurysm.

Nā maʻi kūlohelohe

Hiki i ke anamanaʻo CSF ​​ke ʻike i nā maʻi pale pale. Hiki i ka ʻōnaehana pale ʻole ke hoʻopōʻino i ka CNS ma o ka mumū, ka luku ʻana i ka uhi myelin e pili ana i nā aʻa, a me ka hana antibody.

ʻO nā maʻi maʻamau o kēia ʻano:

• ʻO Guillain-Barré Syndrome
• sarcoidosis
• neurosyphilis
• sclerosis maha

Nā Tumors

Hiki i ke anamanaʻo CSF ​​ke ʻike i nā tumors mua i ka lolo a i ʻole ka iwi kuamoʻo. Hiki iā ia ke ʻike i nā maʻi maʻi metastatic i pāhola ʻia i kāu CNS mai nā ʻāpana kino ʻē aʻe.

Nānā CSF a me nā sclerosis he nui

Hiki ke hoʻohana ʻia ka anamanaʻo CSF ​​e kōkua i ke kuhi ʻana i mau sclerosis (MS). ʻO MS kahi kūlana hoʻomau kahi e luku ai kāu ʻōnaehana pale i ka uhi pale o kou aʻa, i kapa ʻia ʻo myelin. Loaʻa paha i ka poʻe me MS nā ʻano ʻōuli like ʻole e hoʻomau a hele mai paha. Hoʻopili lākou i ka helu a i ʻole ʻeha ma ko lākou mau lima a me nā wāwae, nā pilikia ʻike, a me nā pilikia e hele wāwae ana.

Hana ʻia paha ka anamanaʻo CSF ​​e kāpae i nā kūlana olakino ʻē aʻe i loaʻa nā hōʻailona e like me MS. Hōʻike paha ka wai i nā hōʻailona ʻaʻole e holo maʻamau kāu ʻōnaehana pale. Hiki i kēia ke hoʻopili i nā pae kiʻekiʻe o IgG (kahi ʻano antibody) a me ke alo o kekahi mau protein i hana ke wā i wāwahi ai ka myelin. Ma kahi o 85 a 90 paha pākēneka o ka poʻe me MS i loaʻa i kēia mau ʻano ʻē i loko o kā lākou cerebral spinal fluid.

Ke holo wikiwiki nei kekahi ʻano o MS a hiki ke hoʻoweliweli i ke ola i loko o nā pule a i ʻole mau mahina. Ke nānā nei i nā protein i CSF hiki i nā kauka ke hoʻomohala i nā "kī" i kapa ʻia biomarkers. Hiki i nā biomarkers ke kōkua e ʻike i ke ʻano o MS āu i loaʻa ai ma mua a maʻalahi hoʻi. Hiki i ka diagnose mua ke ʻae iā ʻoe e loaʻa i ka lāʻau e hiki ai ke hoʻolōʻihi i kou ola inā loaʻa iā ʻoe kahi ʻano o MS e holomua nei i mua.

ʻO ka hoʻowalewale hoʻokolohua ʻana a me ka hoʻokau ʻana o CSF

Ua ana pinepine ʻia kēia mau mea i ka anamanaʻo CSF:

• helu keʻokeʻo koko keʻokeʻo
• helu ʻulaʻula koko
• kolikola
• glucose, a i ʻole kō kō
• glutamine
• lactate dehydrogenase, ʻo ia ke koko enzyme
• koʻohune
• nā antigens, a i ʻole nā ​​mea hoʻopōʻino i hana ʻia e ka hoʻouka kaua ʻana i nā microorganism
• huina protein
• nā kaula oligoclonal, nā protein ponoʻī
• nā hunaola maʻi ʻaʻai
• DNA ākea
• nā pale ʻea e kūʻē i nā virus

Unuhi i kāu hopena hopena

ʻO nā hopena maʻamau ke kumu o ka loaʻa ʻole o kahi mea ʻino i loko o ka wai spinal. Loaʻa nā pae ana a pau o nā ʻāpana CSF i loko o ka pae maʻamau.

Hoʻokumu ʻia paha nā hopena maʻamau e kekahi o kēia mau mea:

• he tumo
• maʻi ʻaʻai metastatic
• hemorrhaging
• encephalitis, kahi pehu o ka lolo
• he maʻi maʻi
• pehu
• ʻO Reye's Syndrome, kahi ʻano laha ʻole ia, pinepine i nā maʻi make e pili ana i nā keiki e pili ana i nā maʻi viral a me ka lawe ʻana i ka aspirin
• meningitis, hiki iā ʻoe ke loaʻa mai nā fungi, ka maʻi pehu, nā mea hoʻomaʻi, a me nā koʻohune
• nā mea ʻino e like me West Nile a i ʻole Equine hikina
• ʻO Guillain-Barré Syndrome, kahi ʻano autoimmune e hiki ai i ka paralysis a kū ma hope o ka hopena o ka viral
• sarcoidosis, ʻo ia kahi kūlana granulomatous o ke kumu i ʻike ʻole ʻia e pili ana i nā ʻāpana he nui (ʻo ka māmā, nā hono, a me nā ʻili)
• neurosyphilis, kahi e hiki ai ke hoʻopili ʻia kahi maʻi me syphilis i kou lolo
• sclerosis nunui, ʻo ia kahi maʻi autoimmune e hoʻopili i kou lolo a me ka iwi maha

Ke ukali nei ma hope o ka hoʻoponopono CSF

E pili ana kāu ukali a me kāu kuana i ka mea i kūpono ʻole ai kāu hōʻike CNS. E koi ʻia paha kahi hoʻokolohua hou aku i mea e loaʻa ai kahi hōʻailona paʻa. E loli ka mālama ʻana a me nā hopena.

Hoʻokumu ʻia ka meneningitis e kahi maʻi bacteria a i ʻole parasitic kahi maʻi kūpilikiʻi. Ua like nā hōʻailona me ka meningitis viral. Eia naʻe, ʻoi aku ka hoʻoweliweli o ka meningitis viral i ke ola.

Loaʻa i ka poʻe me ka meningitis bacteria i nā antibiotic ākea ākea a hiki i ka hoʻoholo ʻana o ke kumu o ka maʻi. Pono ka mālama koke ʻana e mālama i kou ola. Hiki iā ia ke pale i ka hōʻino loa o ka CNS.