Spinal tap hnuah lu na nasa tak i nei tawh em, emaw, i naute hrin nan epidural i nei tawh em? He lu na, i ding emaw, ding emaw hian a tibuai hle a, mahse i mut laiin a tlahniam a, a tithinur hle a ni lawm ni? Vawiin hian natna tidamtu pangngai atanga hahdamna a awm loh laia doctor-te’n an rawt thin enkawlna bik kan sawi dawn a ni. Chu chu enkawl dan Epidural Blood Patch an tih chu a ni.
Epidural blood patch tih hi eng nge ni?
A awlsam zawngin, hei hian nangmah thisen thenkhat lak a, i ruhro chhehvel hmun ‘epidural space’ an tihah inject a ngai a ni. Tunah chuan, "Engvangin nge keimah ngeiin ka thisen ka inject leh?"
Hei hi a ni. Kan sawi tawh ang khan lumbar puncture emaw epidural emaw i neih chuan dura mater (spinal cord vel membrane) ah hian khur te tak te a lo awm thei a. Hei hian a chhunga tui hlu tak tak thenkhat, cerebrospinal fluid (CSF) an tih chu a leak chhuak thei a ni. He tui hi a tlakchham chuan lu na nasa tak i nei thei a, chu chuan i lu chu dinglam hawia vawn a harsat phah thei a ni.
Chuvangin he thisen chhuahna hian thil pawimawh pahnih a ti a:
1. Leak a titawp: I thisen chu epidural space-ah i inject hnuah thisen chu a clot a, a khur te tak te chu a seal thin. Band-aid bun ang mai a ni. Hei hian CSF fluid a chhuah loh nan a titawp a ni.
2. Pressure a lo let leh: A hmuna thisen engemaw zat dah belh a nih chuan a chhunga pressure hloh chu eng emaw chen a lo awm leh a, lu na chu a reh thuai thin.
Hei hi elective procedure a ni a, doctor rawtna anga tih a ni a, i duh angin i thlang thei bawk.
Engtikah nge he enkawlna hi a tul?
Standard treatment hmanga reh lo, spinal headache na tak i neih chuan i doctor chuan he thisen patch hi a rawn rawt thei ang. A tlangpuiin, thil tum hmasa ber chu:
- Khumah awm la, a theih ang anga chawlh hahdam rawh.
- Tui leh tui tam tak in la (IV tui, i.e. saline pawh pek theih a ni mai thei).
- Damdawi, natna tidamtu (NSAID) ang chi hman.
- Caffeine awmna in tur, coffee ang chi te in thin ang che.
Mahse heng enkawlnate hian lu na a ti reh lo a nih chuan, emaw, khumah i awm thei lo a nih chuan (entir nan, nu thar nausen nei emaw, hnathawhna hmuna kal vat ngai mi emaw) thisen zam hi a solution tha tak a ni.
Spinal headache hi a bik takin hetiang dinhmunah hian a awm thin:
- Spinal atanga tui lak hnuah (Spinal tap / Lumbar Puncture).
- Nau neih emaw, operation emaw laia natna tihziaawmna atana pek thin epidural hnuah.
- Back surgery emaw accident emaw avanga spinal cord (dura) khuhtu membrane a chhiat chuan.
Engtin nge enkawl hmain i inbuatsaih thin?
Ngaihtuah buai suh, i doctor chuan a tih dan tur, a thatna leh that lohna te, a hnathawh dan te a hrilhfiah ang che. I tih hma darkar 8 vel ei leh in loh tur a ni. Tin, i doctor hnenah a hnuaia mi hi hrilh ngei ang che :
- Thisen tithianghlimtu (anticoagulants) ang chi thil i ei a nih chuan.
- Zunthlum i vei a, insulin i hman chuan.
- Damdawi eng pawh allergy i neih chuan, a bik takin anesthetics i neih chuan.
- Naupai i nih chuan.
Blood Patch siam dan step by step
Hetianga enkawl dan hi a awlsam hle. Step khat hnu step khatin eng nge thleng tih i lo en ang u.
| Rahbi | Eng Nge Thleng Tawh |
|---|---|
| 1. A dinhmun (posture) a ni | I sir lam hawi la, mu emaw, thu emaw turin an ti ang che. A pawimawh ber chu he hun chhung hian ngawi renga awm hi a ni. |
| 2. Thianghlimna | Hnung lama needle dahna hmun leh kut chhunga thisen lakna hmun chu disinfectant hmangin uluk takin silfai thin a ni. |
| 3. Numbness tih hi a ni | Natna tihziaawmna turin local anesthetic chu needle dahna hmunah an inject a. |
| 4. Thisen lakkhawm | I kut vein pakhatah cannula (IV catheter) dahin i thisen milliliter 15-20 vel lak a ni. |
| 5. Needle dah luh | Anesthesiologist emaw radiologist emaw chuan hnungzang epidural space-ah hian needle bik a dah a, a châng chuan ultrasound hmangin a hmun dik tak chu a kaihruai ṭhin. |
| 6. Thisen chhuah | Kut atanga thisen lak chhuah chu second 30-60 chhungin hnungzang ah zawi zawiin an inject thin. Hetih lai hian i hnungzang na deuh emaw, tightness emaw i nei thei. I rilru put hmang chu doctor hnenah i hrilh nghal tur a ni. |
| 7. Khar a ni | A zung chu la chhuakin a hmunah bandage an vuah a. Chu chu a ni. |
Enkawl hnuah eng nge thleng?
Mi tam tak chuan he enkawlna an neih hnuah hian lu na atang hian hahdamna an nei nghal a ni. Chu chu he enkawlna hlawkna lian ber chu a ni.
Inenkawl zawhah recovery room-ah hun engemaw chen chawlh hahdam turin an hruai ang che. Chumi hnuah chuan i haw thei tawh ang. Doctor chuan thil hahthlak tak tak, thil rit chawi, leh darkar 24 chhung ben loh turin a fuih ang che . Chumi hnuah chuan i thil tih dan pangngaiah i kir leh thei tawh ang.
Hei hian mumang a siam tir che em?
A tlangpuiin he enkawlna chhung hian puitlingte chu an thlamuang kim lo. Hei hi a chhan chu i hnungzang chhunga thisen an inject huna i rilru put hmang doctor hnenah i hrilh a ngai a ni. Mahse, a natna chu i hriat loh nan injection site chauh chu a numbed a ni. Mahse, hemi chungchangah hian ngaihtuahna emaw, lungkhamna emaw i neih chuan doctor hnenah hrilh ngei ang che. He enkawlna chhung hian naupang te te chu sedated an ni thei bawk.
Blood Patch hlawkna leh harsatna awm thei te
Damdawi enkawlna dang ang bawkin, a hlawkna bakah hlauhawmna tenau thenkhat a awm bawk.
| Hlawkpuina | Side Effects & Complication awm thei te |
|---|---|
| Relief rang leh rei tak awm thei. Lu natna nasa tak, kar hnih thleng awm thei atanga chhanchhuahna a pe nghal. Painkiller ang chi temporary solution aiin a hlawk zawk hle. |
|
Zirna atanga a lan dan chuan he enkawlna hi mi 100 zinga 85 (85%) ah a hlawhtling a ni. A vawi khatna a hlawhchham chuan thisen pahnihna pek hian 90% hlawhtlinna a nei a ni.
Engtikah nge doctor ka biak nghal ang?
I enkawl hnua natna kai chhinchhiahna i neih chuan i doctor i pan nghal tur a ni . Heng chhinchhiahnate hi lo thlir reng ang che:
- Injection na hmuna sen, rawng danglam, natna, leh hnim hring .
- Khawsik .
- Chau lutuk tih hriatna .
Hetiang thil i hmuh chuan tihkhawtlai suh. Damdawi lam thurawn zawng nghal rawh.
Take-Home Thuchah a ni
- "Spinal headache" tih hi lu na pangngai a ni lo. He natna hi Epidural Blood Patch hi a tha hle a, i ding chhuak chuan a na zawk.
- Hetah hian nangmah thisen tlem tal chu ruhroah i inject a ni. Chuvangin hlauh tur a awm lo. Hei hi enkawlna him tak anga ngaih a ni.
- Enkawlna hi 85% velin a hlawhtling a ni. Mahse engkim ang bawkin risk tlemte a awm. I doctor nen inhawng takin sawi la, zawhna i neih apiang zawt rawh.
- Enkawlna i neih hnua thil eng emaw i hmuh chuan, injection na hmuna khawsik, hliam, sen, a nih loh leh zun (pus) te hi doctor thurawn zawng nghal rawh .
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