Lumbar puncture: he aha ia, he aha ia no, pehea e hana ai a me nā pilikia

Anter

• No ke aha ia
• Pehea e hana ai i ka puncture
• Nā hopena ʻē aʻe
• Nā Contraindications no ka lumbar puncture
• Nā hopena o

ʻO ka lumbar puncture kahi hana e hana maʻamau e ʻohiʻohi i kahi laʻana o ka wai cerebrospinal e holoi i ka lolo a me ka iwi kuamoʻo, ma ka hoʻokomo ʻana i kahi nila ma waena o ʻelua mau lumbar vertebrae a hiki i ka subarachnoid space, kahi kahi ma waena o nā papa e hoʻopili i ka iwi kuamoʻo, kahi e hele ai ka wai.

Hoʻohana ʻia kēia hana e ʻike ai i nā loli neurological, hiki i nā maʻi, e like me ka meningitis a i ʻole encephalitis, a me nā maʻi e like me sclerosis maha a i ʻole hemorrhage subarachnoid i laʻana. Hoʻohui ʻia, hiki ke hoʻohana ʻia e hoʻokomo i nā lāʻau i loko o ka wai cerebrospinal, e like me chemotherapy a i ʻole antibiotics.

No ke aha ia

Loaʻa i nā lumbar puncture kekahi mau hōʻailona, ​​i hoʻopili ʻia:

• Nānā Laboratory o cerebrospinal loli, e ʻike a loiloi i nā maʻi;
• Ka ana o ke kahe wai cerebrospinal;
• Hoʻohaʻahaʻa Spinal;
• ʻO ka hoʻokomo ʻana i nā lāʻau e like me antibiotics a me chemotherapy;
• Ke hoʻonohonoho a mālama ʻana paha i nā leukemias a me nā lymphomas;
• Ka hoʻopili ʻana o ka ʻokoʻa a i ʻole nā ​​mea radioactive e hana i nā radiographs.

Hoʻolālā ʻia ka loiloi Laboratory e ʻike i ke ola o nā loli i ke kikowaena pūnaewele, e like me ka maʻi bacteria, viral a fungal paha e like me meningitis, encephalitis a syphilis paha, e laʻa ai, e ʻike ai i ke kahe ʻana o ke kanesa, ka maʻi ʻaʻai a i ʻole ke kuhi o kekahi ʻano hoʻouluhua a hōʻino paha ka ʻōnaehana ʻōnaehana, e like me nā sclerosis he nui, ka maʻi ʻo Alzheimer a i ʻole Guillain-Barré Syndrome.

Pehea e hana ai i ka puncture

Ma mua o ke kaʻina hana, ʻaʻole koi ʻia kahi hoʻomākaukau kūikawā, ke ʻole ka pilikia me ka coagulation a i ʻole ka hoʻohana ʻana i kekahi lāʻau e hoʻopilikia i ka hana, e like me ka hihia me nā anticoagulants.

Hiki i ke kanaka ke waiho iā ia iho i kekahi o nā kūlana ʻelua, a i ʻole moe i kona ʻaoʻao me nā kuli a me ke poʻo kokoke i ka umauma, i kapa ʻia ke kūlana fetal, a i ʻole noho me ke poʻo a me ka iwi kuamoʻo i mua a me nā lima i keʻa.

A laila, hoʻopili ke kauka i kahi hopena antiseptic i ka lumbar wahi a nānā i ka hakahaka ma waena o ka L3 a me ka L4 a me ka L4 a me ka L5 vertebrae, i hiki ai ke hoʻokomo i kahi lāʻau anesthetic i kēia wahi. A laila hoʻokomo koke ʻia kahi nila maikaʻi a ma waena o ka vertebrae, a hiki i ka subarachnoid space, mai kahi e kahe ai ka wai a kulu ma waena o ka nila, e ʻohiʻohi ʻia ana i kahi paipu hoʻowali.

ʻO ka hope, hemo ka nila a pili ka lole i ka pūnaewele nahu. Lōʻihi nō kēia kaʻina hana i kekahi mau minuke, akā ʻaʻole hiki i ke kauka ke kiʻi i ka laʻana wai cerebrospinal pono i ka wā e hoʻokomo ana i ka nila, a he mea pono paha e hoʻopili i ke ʻaoʻao o ka nila.

Nā hopena ʻē aʻe

Palekana kēia kaʻina hana maʻamau, me nā manawa liʻiliʻi o ka hōʻike ʻana i nā pilikia a i ʻole nā ​​pilikia no ke kanaka. ʻO ka hopena maikaʻi ʻole e hiki ke hana ma hope o ke kuʻi ʻana o ka lumbar he ʻeha kuikawa ia ma muli o ka emi ʻana o ka wai o ka cerebrospinal i nā aʻa pili, a aia nō paha ka nausea a me ka luaʻi e hiki ke hōʻalo ʻia inā e moe ana ke kanaka no kekahi manawa ma hope o ka hoʻāʻo.

Hiki paha i ka ʻeha a me ka hōʻoluʻolu ʻole o ke kua i lalo ke hiki ke hoʻopau ʻia me nā painkillers i kuhikuhi ʻia e ke kauka, a ʻoiai he kākaʻikahi, hiki i ka maʻi a i ʻole ke kahe ʻana.

Nā Contraindications no ka lumbar puncture

Kūpono ʻia ka lumbar puncture i ke alo o ka hypertension intracranial, e like me ka mea i hoʻokumu ʻia e ka nui o ka lolo, no ka pilikia o ka neʻe o ka lolo a me ka herniation. ʻAʻole pono e hana ʻia i ka poʻe i loaʻa ka ʻili i ka ʻili e hou ʻia a i ʻole he abscess ka lolo.

Eia hou, pono mau ʻoe e hoʻomaopopo i ke kauka e pili ana i ka lāʻau a lākou e lawe nei, keu hoʻi inā e lawe ana ke kanaka i nā anticoagulants e like me warfarin a i ʻole clopidogrel, no ka makaʻu o ke kahe.

Nā hopena o

Hoʻouna ʻia nā laʻana wai cerebrospinal i ka hale hana no ke kālailai ʻana i nā palena like ʻole e like me ka helehelena, aniani moakaka a kala ʻole. Inā he melemele a ʻulaʻula paha a ʻano ʻōpua paha ia, hōʻike paha ia i ka maʻi, a me ke alo o nā microorganism e like me bacteria, nā mea hoʻomaʻi a i ʻole fungi.

Hoʻohui ʻia, loiloi ʻia hoʻi nā huina protein a me nā nui o nā hunaola keokeo, inā kiʻekiʻe, hiki ke hōʻike i ka maʻi a i ʻole kekahi ʻano inflammatory, glucose, inā haʻahaʻa, he hōʻailona ia o ka maʻi a i ʻole nā ​​maʻi ʻē aʻe, a me ke alo pū kekahi. o nā hunaola ʻē aʻe e hōʻike i kekahi ʻano o ka maʻi ʻaʻai.