So ehu kaa wo bere a meka kyerɛɛ wo sɛ yi nsu mfi w’akyi berɛmo mu no? (Lumbar Puncture / Spinal Tap) Momma yɛnhwehwɛ nea eyi yɛ ankasa!

So woate ‘akyi berɛmo mu tap’ ho asɛm pɛn? Ebia wobɛdwene sɛ, "Wow, ɛbɛyɛ sɛ eyi yɛ ade kɛse a ɛyɛ hu." Ntease wom sɛ wobɛbɔ basaa kakra bere a wote din no. Nanso ɛyɛ sɔhwɛ a ɛnyɛ den koraa a ebetumi aboa nnuruyɛfo ma wɔahu tebea horow a ɛfa w’amemene, wo ntini, ne w’akyi berɛmo ho. Enti, momma yɛnka saa ‘lumbar puncture’ yi ho asɛm nnɛ, wɔ adamfofa kwan so a obiara reka ho asɛm, wɔ Sinhala kasa mu, okay?

Dɛn nti na wɔyɛ eyi (Lumbar Puncture)? Dɛn na ɛrehwehwɛ?

Sɛ yɛbɛka no tiawa a, nea ɛka sɔhwɛ yi ho ne sɛ wobɛfa nsu a atwa w’akyi berɛmo ho ahyia, wɔ w’akyi berɛmo mu no kakraa bi. Wɔfrɛ saa nsu yi amemene mu nsu (CSF). Ɛte sɛ cushion a ɛbɔ w’amemene ne w’akyi berɛmo ho ban na ɛma aduannuru. Enti, nnuruyɛfo betumi asua nneɛma pii denam CSF yi nhwɛsode bi a wɔbɛhwehwɛ mu no so.

Afei momma yɛnhwɛ tebea horow a nnuruyɛfo kamfo kyerɛ sɛ wɔnyɛ ``Lumbar Puncture'':

• Sɛ wususuw sɛ mogya retu wɔ amemene no mu (Intracranial Hemorrhage): Ɛtɔ mmere bi a eyi betumi asi bere a wɔabɔ wo ti akyi.
• Tebea horow a ɛte sɛ adwenemhaw: Hwehwɛ nyarewa a ɛma obi kae ade nkakrankakra.
• Hwɛ sɛ CSF nsu a ɛboro so wɔ amemene no mu anaa.
• Hwɛ sɛ amemene no mu ntini ahonhon na ɛho ayɛ hyew (`(Encephalitis)`).
• Kokoram tebea horow te sɛ mogya mu kokoram: Kokoram nkwammoaa bi nso betumi atrɛw akɔ CSF no mu.
• Amemene mu nyarewa te sɛ meningitis: Eyi yɛ asɛm a egye ntɛmpɛ. Nsɛnkyerɛnne no betumi ayɛ atiridiinini, tiyɛ, ne kɔn a ɛyɛ den.
• Nyarewa a nipadua no tumi ko tia nyarewa te sɛ multiple sclerosis: Eyinom yɛ nyarewa a yɛn ankasa nipadua mu tumi a ɛko tia nyarewa no yɛ adwuma tia nipadua no.
• Tebea horow te sɛ akyi berɛmo mu ɔfe (`(Myelitis)`).

Ɛnyɛ eyi nko, na mmom wɔde Lumbar Puncture di dwuma esiane nneɛma afoforo pii nti:

• Ma aduru a ɛma obi dwensɔ na ama ɛyaw no so atew: Ebia woate epidural ho asɛm. Ɛyɛ aduru bi a wɔde kum akyi berɛmo nso. Wɔde regional anesthesia di dwuma de tew ɛyaw a ɛba bere a wɔreyɛ oprehyɛn ne awo no so.
• Ma wɔnyɛ X-ray sɔhwɛ titiriw (`(Myelogram)`): Wɔ eyi mu no, wɔde nsu titiriw bi (aduru) gu akyi berɛmo no mu na wɔyɛ X-ray.
• Fa nnuru a ekum kokoram anaa nnuru a ɛma ntini mu dwo ma kɔ akyi berɛmo mu nsu no mu tẽẽ.
• Tew nhyɛso kɛse a ɛwɔ amemene no mu so (`(Intracranial Pressure)`): Wobetumi atew saa nhyɛso yi so denam CSF nsu no bi a wobeyi afi hɔ no so.

Kae sɛ ɛnyɛ tebea horow yi nyinaa na ɛhwehwɛ sɛ wɔtow akyi berɛmo mu. Wo duruyɛfo bɛkyerɛkyerɛ mu pɛpɛɛpɛ sɛ ebia wuhia nhwehwɛmu yi ne nea enti a ɛte saa.

Ɔkwan bɛn so na ɛsɛ sɛ misiesie me ho ma sɔhwɛ yi?

Okay, ma yɛnka sɛ woasi gyinae sɛ wobɛto wo akyi berɛmo mu. Ansa na ɛno bɛba no, oduruyɛfo no bebisa wo nsɛm bi na wahwɛ w’akwahosan ho abakɔsɛm. Ebia ɔbɛka akyerɛ wo nso sɛ yɛ nneɛma te sɛ:

• Nya CT scan (`(CT scan)`) anaa MRI scan (`(MRI)`): Eyi betumi ama woanya akyi berɛmo no ne mmeae a atwa ho ahyia no mfonini pa.
• Yɛ mogya mu nhwehwɛmu: Hwɛ nneɛma te sɛ sɛnea wo mogya tumi tu.
• Ka wo nnuru ho asɛm kyerɛ wo duruyɛfo: Sɛ worenom nnuru a ɛma mogya yɛ mmerɛw te sɛ Warfarin anaa Aspirin a, akyinnye biara nni ho sɛ ɛsɛ sɛ woka kyerɛ wo duruyɛfo . Ebia ɔbɛka akyerɛ wo sɛ gyae nnuru yi bi nom anaasɛ sesa dodow no nna kakraa bi ansa na wɔayɛ nhwehwɛmu no. Nanso kae sɛ, nnyae anaa nnsesa wo nnuru no biara kosi sɛ wo duruyɛfo bɛka akyerɛ wo sɛ, ɛyɛ?

Saa ahosiesie ahorow yi bɛboa oduruyɛfo a ɔreyɛ nhwehwɛmu no ma wate wo tebea no ase yiye, ayɛ nhwehwɛmu no dwoodwoo, na asiw nsɛnnennen a ɛho nhia ano. Wo duruyɛfo nso bɛkyerɛ wo sɛ ɔwɔ akwankyerɛ titiriw bi ma wo a.

Dɛn na ɛba bere a wɔayɛ me Lumbar Puncture no? So ɛbɛyɛ yaw?

Eyi ne baabi a nnipa pii suro. Nanso wonte ɛyaw biara nka ankasa . Ebia wobɛte nhyɛso kakra nka, worepia wo kakra, nanso ɛnyɛ yaw.

Nea ɛba ni:

1. Gyinabea: Wɔbɛdan wo akɔ wo benkum so wɔ mpa bi so na wɔaka akyerɛ wo sɛ da fam. Afei, wɔbɛtwe wo nkotodwe abɛn wo moma so sɛnea wobetumi, te sɛ bɔɔl ketewaa bi. Anaasɛ, ɛtɔ da bi a, wɔbɛka akyerɛ wo sɛ tena nkongua so, kotow w’anim wɔ pon bi so, na fa wo ti ne wo nsa to pon no so. Ebia gyinabea yi bɛte nka sɛ ɛnyɛ dɛ kakra, nanso ɛho hia sɛ wotra hɔ dinn sɛnea wubetumi . Ebia wɔbɛka akyerɛ wo sɛ sesa wo gyinabea kakra wɔ sɔhwɛ no mu.

. Sɛ wɔde aduru a ɛma obi dwensɔ no gu wo mu a , wobɛte nka sɛ wo ho hyehye wo kakra wɔ sikani kakraa bi mu , te sɛ ntɛtea a ɔwe. Ɛno ne no. Afei beae no bɛyɛ mmerɛw koraa.

3. Ade a wode bɛhyɛ mu: Sɛ beae no ayɛ mmerɛw a, oduruyɛfo no de ade a ɛyɛ fɛ yiye a ɛyɛ tokuru hyɛ w’akyi ase wɔ akyi berɛmo abien ntam (mpɛn pii no, akyi berɛmo a ɛto so abiɛsa ne anan, anaa akyi berɛmo a ɛto so anan ne anum). Eyi wɔ w’asen atifi pɛɛ. Wɔde ade no hyɛ baabi (subarachnoid space) a ɛda ntini a ɛbɔ ho ban (meninges) a atwa akyi berɛmo no ho ahyia na CSF ahyɛ mu ma no ntam. Ɛtɔ mmere bi a, wobetumi de X-ray afiri titiriw bi a wɔfrɛ no fluoroscopy adi dwuma de ahwɛ ahu sɛ ade no wɔ baabi a ɛfata.

4. CSF nsu a wɔnom:Sɛ ade no si baabi a ɛfata pɛ a, oduruyɛfo no di kan susuw CSF nsu no nhyɛso. Afei, wɔboaboa nhwɛsode ketewaa bi (mililita kakraa bi) ano. Eyi gye simma kakraa bi.

5. Nea wɔde wie: Sɛ wɔfa nhwɛsode no wie a, oduruyɛfo no yi ade no na ɔde plaster ketewaa bi anaasɛ aduru a wɔde kyekyere nneɛma ho gu beae no.

Ɛno ara ne nea ɛba. Sɔhwɛ no nyinaa gye simma 15 kosi 30. Nanso ade no wɔ w’akyi simma kakraa bi pɛ.

Ɛhe na wɔyɛ sɔhwɛ yi? So ɛbɛma m’adwene atu afra?

Ɛtɔ da bi a wobetumi ayɛ saa `(Lumbar Puncture)` yi wɔ ayaresabea sɛ `Outpatient Procedure`. Eyi kyerɛ sɛ wubetumi akɔ fie da koro no ara. Anaasɛ, sɛ woyɛ ayaresabea tenafo a, wobetumi ayɛ wɔ ward no so. Sɛ wɔyɛ no sɛ ɔyarefo a wɔda ayaresabea a, ɛho behia sɛ obi wɔ hɔ de wo bɛkɔ fie bere a wɔayɛ nhwehwɛmu no awie no.

Afei nso, worennya adwenem naayɛ koraa wɔ sɔhwɛ yi mu. Wɔbɛma wo aduru a ɛma wo ho tɔ wo kɛkɛ. Enti wobɛte nka, nanso worente ɛyaw biara.

Dɛn na ɛsɛ sɛ meyɛ wɔ sɔhwɛ no akyi?

Sɛ wowie sɔhwɛ no a, oduruyɛfo anaa ɔyarehwɛfo no bɛma wo akwankyerɛ bi. Ɛho hia paa sɛ yedi wɔn akyi. Wɔtaa ka nsɛm te sɛ eyi:

• Mfa kar anaasɛ mfa mfiri a emu yɛ duru nni dwuma nnɔnhwerew 24.
• Da mpa so (wɔ w’afã anaa w’akyi) dɔnhwerew biako anaa abien, ebia akyɛ sen saa. Eyi betumi aboa ma tiyɛ no so atew.
• Mma nnyɛ biribiara a ɛyɛ den, te sɛ apɔw-mu-teɛteɛ, nnɔnhwerew 24 kosi 48.
• Gye w’ahome yiye.
• Nom nsu ne nsu pii na amma wo ho atɔ wo.

Sɛ wo duruyɛfo ma wo kwan a, ebia wubetumi asan afi wo dwumadi ahorow a woyɛ daa no ase da koro no ara anaa da a edi hɔ wɔ nhwehwɛmu no akyi.

So ɛyɛ ade a ɛfata sɛ obi ti yɛ wo yaw bere a wɔato wo akyi berɛmo mu awie no?

Yiw, ebia nnipa binom benya tiyɛ wɔ sɔhwɛ yi akyi. Yɛfrɛ no `(Spinal Headache)`. Ɛnyɛ obiara na onya, bɛyɛ nnipa 10% na wonya eyi .

Nea ɛba wɔ asɛm yi mu ne sɛ wo ti yɛ wo yaw kɛse bere a wote ase anaa wugyina hɔ no. Ɛkɔ bere a woada fam no. Eyi betumi afi ase wɔ nnɔnhwerew kakraa bi anaa nna kakraa bi wɔ sɔhwɛ no akyi. Mpɛn pii no, ɛno nkutoo na ɛyɛ yiye wɔ nnansa anaa nnansa mu. Nanso nnipa binom fam no, etumi di akosi dapɛn biako.

Saa `(Spinal Headache)` yi betumi de nsɛnkyerɛnne afoforo te sɛ:

• Koma a ɛbɔ kɛse (Tachycardia) .
• Mogya mmoroso a ɛba fam (`(Hypotension)`) .
• Abofono

Nea ɛbɛboa eyi no, ɛyaw nnuru a wɔtɔn, nsu pii a wobɛkɔ so anya denam nsu pii a wobɛnom so, ne anonne bi a caffeine wom te sɛ kɔfe a wobɛnom no betumi aboa. Wo duruyɛfo nso bɛtu wo fo.

So nsunsuanso bɔne foforo bi wɔ hɔ? So ɛbɛsɛe akyi berɛmo no?

Nneɛma bɔne a anibere wom a efi sɔhwɛ yi mu ba no ntaa mma. Nanso, wɔ nsɛm a ɛntaa nsi koraa mu no, nea edidi so yi betumi aba:

• Nyarewa a ɛwɔ baabi a wɔde ade no gu no
• Ɛno ne swelling a ɛte saa.
• Mogya a ɛretu
• Akyi ase yaw

Kae eyi: Sɛ wobɔ w’akyi berɛmo a, ɛrempira w’akyi berɛmo. Nea enti a ɛte saa ne sɛ wɔde ade no hyɛ mu a ɛba fam koraa sen sɛnea akyi berɛmo no te. Enti nsuro.

Dɛn ne nea efi mu ba a minya? Dɛn na wɔka?

Wɔde CSF nhwɛsoɔ a wɔagye afiri wo hɔ no bɛkɔ lab na wɔasɔ ahwɛ wɔ deɛ ɛdidi soɔ yi ho:

• So mmoawa (`(Bacteria)`), fungi (`(Fungi)`), anaa nkwammoaa a ɛnyɛ ne kwan so (te sɛ kokoram nkwammoaa) wɔ hɔ?
• Wo asikre (`(Glucose)`) dodow te dɛn?
• Protein ahorow ne dodow a ɛwɔ mu no te dɛn?
• Mogya mu nkwammoaa fitaa ahorow ne dodow bɛn na ɛwɔ hɔ? (Eyinom betumi aka ɔyare mmoawa ho asɛm) .

Saa nneɛma a efi mu ba yi ne nea ɛma wo duruyɛfo tumi si aduruyɛ mu tebea horow so dua anaasɛ ɔpow.

Bere tenten ahe na egye ansa na wɔahu nea efi mu ba?

Egyina nea enti a wɔyɛ sɔhwɛ no so. Mpɛn pii no, wonya nea efi mu ba no wɔ nna abien kosi abiɛsa mu. Nanso, sɛ wɔyɛ de hwɛ sɛ mogya atɔ amemene mu anaa tebea bi a egye ntɛmpɛ te sɛ meningitis a, ebia nea ebefi mu aba no betumi aba ntɛm koraa, wɔ nnɔnhwerew kakraa bi mpo mu.

Sɛ nea efi mu ba no nyɛ nea ɛfata a, dɛn na ɛsɛ sɛ woyɛ akyi?

Esiane sɛ akyi berɛmo a wɔtow no tumi hu nyarewa pii a ɛfa amemene, ntini, ne akyi berɛmo ho nti, nea efi mu ba no betumi ayɛ soronko. Sɛ nhwɛso no, sɛ wo CSF ​​no mogya mu nkwammoaa fitaa dodow dɔɔso a, ebetumi akyerɛ sɛ woanya ɔyare mmoawa. Sɛ ɛba saa a, wubetumi de nnuru a ekum ɔyare mmoawa asa ɔyare no.

Wo duruyɛfo bɛkyerɛkyerɛ nea nea afi mu aba no kyerɛ mu, na ɔbɛkyerɛ wo ayaresa a ehia sɛnea ɛfata, ne nea ɛsɛ sɛ woyɛ akyi.

Bere bɛn na ɛsɛ sɛ mesan kɔ oduruyɛfo nkyɛn bio?

Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi wɔ nhwehwɛmu no akyi a, hwɛ hu sɛ wobɛbɔ wo duruyɛfo amanneɛ:

• Sɛ tiyɛ no kyɛ bɛboro nna kakraa bi na emu yɛ den yiye a.
• Sɛ mogya anaa nsu foforo bi retu afi baabi a wɔde ade no retu a.
• Sɛ sɛnkyerɛnne ahorow bi wɔ hɔ a ɛkyerɛ sɛ obi anya ɔyare no (a ɛho ayɛ kurukuruwa, ne ho ayɛ kɔkɔɔ, atiridiinini).

Awiei koraa no, kae eyi... (Take-Home Message)

Enti, `(Lumbar Puncture)` anaa `(Spinal Tap)` a yɛkaa ho asɛm no nyɛ biribi a ɛsɛ sɛ yesuro. Yiw, ɛyɛ ade a ɛfata sɛ wobɛte ahodwiriw ne ehu nka kakra nka bere a wɔde ade bi ahyɛ w’akyi berɛmo mu no. Nanso, worente ɛyaw a wuntumi nnyina ano mfi eyi mu. Ebia ɛbɛyɛ te sɛ nea wɔrepiapia no kakra.

Eyi yɛ sɔhwɛ a ahobammɔ nnim koraa a ebetumi aboa ma wɔahu aduruyɛ mu tebea horow pii. Ɛnsɛe akyi berɛmo no.

Sɛ wowɔ nsɛmmisa anaa nsɛm foforo bi a ɛhaw wo wɔ eyi ho a, wo ne wo duruyɛfo nsusuw ho ansa na woayɛ nhwehwɛmu no. Saa kwan no so no, wobɛte nka sɛ wo ho adwo wo kɛse. Sɛ wo ti yɛ wo yaw wɔ nhwehwɛmu no akyi a, ebia wo duruyɛfo bɛkyerɛ wo ɔkwan a wobɛfa so ayi afi hɔ. Enti, susuw eyi ho kɛkɛ sɛ sɔhwɛ foforo a ɛho hia wɔ aduruyɛ mu!

` lumbar puncture, akyi berɛmo mu tap, akyi berɛmo mu tap, amemene mu nsuo, amemene mu nsuo, CSF, amemene mu yareɛ, ntini mu yareɛ, akyi berɛmo, diagnosis, tiyɛ