Ingaba uxinzelelo olungaphakathi kwentloko yakho luphezulu kakhulu? (Uxinzelelo oluKhulu lwe-Intracranial - ICP) Masiqaphele oku!

Ngaba ngamanye amaxesha uziva ngathi ufuna ukuhlanza ngenxa yentloko ebuhlungu? Okanye uziva ngathi umbono wakho awubonakali kakuhle? Nangona ezi ziimpawu esingazinaki kangako ngamanye amaxesha, zinokubonisa ukuba uxinzelelo olungaphakathi kwentloko yethu, oko kukuthi, ngaphakathi komngxuma wentloko, lunyukile (Uxinzelelo Olunyukileyo Lwe-Intracranial - ICP) . Eli libali elinzulu, ngoko masithethe ngalo ngokweenkcukacha namhlanje.

Yintoni le inyukileyo ingcinezelo engaphakathi kwentloko?

Ngamafutshane, uxinzelelo oluphezulu lwe-Intracranial Pressure (ICP) kuxa uxinzelelo olungaphakathi kwentloko yakho, okanye i-cranial vault, luphezulu kunesiqhelo. Cinga ngentloko yethu njengebhokisi eqinileyo. Ngaphakathi kweli bhokisi kukho izinto ezintathu eziphambili:

• Ingqondo yethu
• Ulwelo lweCerebrospinal (CSF) : Olu lulwelo olujikeleze ingqondo yethu kunye nomqolo kwaye luyikhusela. Lufana nomqamelo.
• Igazi : Ligazi elithwala izondlo kunye neoksijini efunekayo engqondweni.

Ngoku, indawo engaphakathi kweli bhokisi incinci. Ngoko ke zonke ezi zinto zintathu—ingqondo, ulwelo lwe-cerebrospinal, kunye negazi—kufuneka zibe kwibhalansi ethile. Kodwa ukuba ngesizathu esithile umthamo wenye yezi zintathu uyanda, indawo ekhoyo kwezinye iyancipha, kwaye uxinzelelo olupheleleyo ngaphakathi kwentloko luyanda. Olu nyuko loxinzelelo lunokuba ngequbuliso (ngokukhawulezileyo), okanye lunokukhula kancinci kancinci ngokuhamba kwexesha (olungapheliyo).

Xa uxinzelelo olungaphakathi entlokweni lusanda ngale ndlela, inani legazi eliya ebuchotsheni linokwehla. Okanye, iindawo ezithile zengqondo zinokutyhalelwa ngaphandle kwendawo yazo. Oku sikubiza ngokuba yi-brain herniation . Zombini ezi zizifo eziyingozi kakhulu, ezisongela ubomi. Uyayazi?

Zithini iimpawu zoxinzelelo oluphezulu ngaphakathi entloko?

Ngoku makhe sibone ukuba zeziphi iimpawu eziboniswayo kule meko ye-ICP. Ezi mpawu zinokwahluka kancinci kubantu abadala, abantwana abancinci, kunye neentsana.

Iimpawu ezibonakalayo phakathi kwabantu abadala nabantwana abancinci:

• Intloko ebuhlungu: Olu luphawu oluphambili. Ihlala imbi kakhulu kusasa, okanye inokuba mbi ngakumbi xa ulele. Abanye abantu bathi kuvakala ngathi "intloko iza kuqhuma ngaphakathi."
• Isicaphucaphu nokuhlanza: Le meko ixhaphake kakhulu kusasa. Ngamanye amaxesha ukuhlanza kwenzeka ngequbuliso kwaye kungekho sizathu sicacileyo.
• Utshintsho kwimeko yengqondo: Oku kunokusukela ekozeleni ukuya ekungazini (coma) . Umntu unokucaphuka, adideke, aze atshintshe nendlela athetha ngayo.
• Utshintsho lombono: Umbono ofipheleyo, umbono ophindwe kabini , ukwanda kovakalelo ekukhanyeni, oko kukuthi, ukungakwazi ukujonga ukukhanya (photophobia) kunokwenzeka.
• Ubunzima bokuhamba kwamehlo: Usenokungakwazi ukulawula amehlo akho ngokufanelekileyo, kwaye kunokuba nzima ukuwajika aye kwelinye icala.
• Ubuthathaka bemisipha: Imilenze yakho isenokubonakala ngathi ayinamandla okanye ayinabomi.
• Ukuba ndindisholo.
• Ukuxhuzula: Kunokwenzeka ukuxhuzula ngequbuliso.

Iimpawu ezibonakala kwiintsana:

Xa oku kusenzeka kwiintsana ezincinci, azikwazi ukuziveza. Yiyo loo nto iimpawu ezizibonakalisayo zahlukile kancinci. Abazali kufuneka balumke kakhulu ngale nto.

• Ukulala: Ukuba umntwana uhlala elele, akanamdla wokudlala, okanye kunzima ukuvuka.
• I-fontanelle evuvukileyo: Uphawu lwendawo ethambileyo yomntwana entlokweni yakhe ebonakala ivuvukile okanye idumbile lolunye uphawu. Isenokuvakala inzima xa uyichukumisa.
• Ukuhlanza: Ukuhlanza rhoqo, ngamanye amaxesha okuphindaphindiweyo. Abanye abantwana banokuhlanza kwangoko emva kokusela ubisi.

Eyona nto ibalulekileyo kukuba olu xinzelelo luphezulu ngaphakathi entlokweni lungxamiseko lwezonyango. Ukuba wena okanye umntwana wakho ninezi mpawu, kufuneka niye esibhedlele esikufutshane ngoko nangoko. Musa ukuchitha ixesha.

Iimpawu ezifike emva kwexesha:

Ngamanye amaxesha, xa le ICP iba ​​qatha kakhulu, oko kuthetha ukuba i-brain herniation isondele, kukho iimpawu ezithile ezibonakala. Oku sikubiza ngokuba yi-'Cushing's reflex' . Kule nto, iimpawu ezintathu eziphambili zinokubonwa kunye:

• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu).
• Isantya sentliziyo esicothayo: ngaphantsi kwe-60 beats ngomzuzu (bradycardia) .
• Ukuphefumla okungaqhelekanga: Ubunzima bokuphefumla, ingakumbi xa uphefumla kakhulu, njengokuphefumla umoya obandayo (ukuphefumla okungapheliyo) .

Ukuba kukho zonke ezi mpawu zintathu, oko kuthetha ukuba imeko iyingozi kakhulu, kwaye ukonakala kwengqondo kusondele. Ngoko ke, kufuneka uye kwigumbi likaxakeka ngokukhawuleza.

Kutheni uxinzelelo olungaphakathi entlokweni lusanda ngolu hlobo? Zithini izizathu?

Ngoku usenokuba uzibuza, 'Kutheni oku kusenzeka apha emhlabeni?' Kukho izizathu ezininzi zoku. Njengoko besitshilo ngaphambili, indawo engaphakathi kwekhakayi incinci. Ngokwesiqhelo, uxinzelelo olungaphakathi kwekhakayi lomntu ophilileyo lungaphantsi kweemilimitha ezingama-20 zemercury (20 mm Hg) .

Ukuba umthamo wenye yezinto ezintathu—izicubu zobuchopho, ulwelo lwe-cerebrospinal (CSF), kunye negazi engqondweni—uyanda, indawo ekhoyo kwezinye ezimbini iyancipha, kwaye uxinzelelo lulonke luyanda. Iingxaki zivela xa olu lungelelwaniso luphazamisekile. Oogqirha bahlula ezi zizathu ngokusekelwe kwinxalenye ebangela uxinzelelo ukuba lunyuke.

Izizathu Zokwanda Komthamo Wengqondo:

Ukudumba kwengqondo (i-cerebral edema) kunokubangela uxinzelelo oluphezulu ngaphakathi kwentloko. Oku kunokubangelwa zezi zinto zilandelayo:

• Ukonzakala kwengqondo okubangela ingozi:Ukuba ingqondo yonakaliswe yinto efana nokuwa, ukungqubana, okanye ingozi yemoto.
• Ukuncipha kokuhamba kwegazi ukuya ebuchotsheni (ischemia): Xa ingqondo ingafumani gazi laneleyo, umzekelo emva kokuhlaselwa yintliziyo.
• Ukwanda kwamanqanaba e-ammonia egazini (hyperammonemia): Oku kunokwenzeka kubantu abanesifo sesibindi.
• Ukungasebenzi kakuhle kwezintso kubangela ukuqokelelana kweetyhefu egazini, nto leyo ekhokelela ekuncipheni kokusebenza kwengqondo (uremic encephalopathy).
• Amanqanaba aphantsi esodium egazini (hyponatremia): Oku kukwangunobangela wokudumba kwengqondo.

Ukongeza, ukudumba kunokwenzeka kwiindawo ezithile zobuchopho. Umzekelo:

• Ii-hematomas ze-Intracerebral okanye ze-subdural: Ezi zii-blood clots ezenza ngaphakathi kwengqondo okanye phakathi kweengubo zobuchopho. Abantu abanoxinzelelo lwegazi oluphezulu kunye nabo bathatha amayeza okunciphisa igazi basengozini enkulu.
• Ithumba lobuchopho.
• Ithumba lobuchopho elibangelwa kusulelo lwebhaktheriya engqondweni.
• Istroke.

Izizathu zokwanda kolwelo lwe-cerebrospinal (CSF):

I-ICP inokwanda ngenxa yokwanda kobuninzi bolwelo lwe-cerebrospinal engqondweni. Izizathu zoku:

• I-Hydrocephalus: Le yimeko apho ulwelo lwe-CSF luqokelelana khona kumagumbi obuchopho. Oku kunokwenzeka ukuba ukuhamba kwe-CSF kuthintelwe, ukuba imveliso ye-CSF iyanda, okanye ukuba ukufunxwa kuyancipha.
• Ithumba le-Choroid plexus: Eli lithumba elingaqhelekanga elivela apho kwenziwa khona i-CSF.
• I-Meningitis: Usulelo lwe-membranes egqume ubuchopho. Oku kunokuthintela ukuhamba kwe-CSF.
• Iigranulomas kwi-meninges yakho.

Izizathu zokwanda komthamo wegazi lobuchopho:

Ukwanda komthamo wegazi engqondweni nako kunokunyusa uxinzelelo. Imizekelo:

• Ukuqhuma kwe-aneurysm yobuchopho okanye ukunyuka kwamanqanaba e-carbon dioxide egazini (i-hypercapnia).
• Ukuqhekeka kwegazi kwimithambo yobuchopho (i-Cerebral venous sinus thrombosis).
• Ukumelwa yintliziyo.

Ezinye izizathu:

Ukongeza koku, kunokubakho nezinye izizathu:

• Uxinzelelo oluphezulu ngaphakathi entloko ngaphandle kwesizathu esicacileyo (i-Benign okanye idiopathic intracranial hypertension): Oku kubonakala kakhulu kubasetyhini abancinci nabatyebileyo.
• Ukukhubazeka kwesikhumba sentloko, umzekelo, imeko ebizwa ngokuba yi -craniosynostosis (ukudibana kwamathambo esikhumba ngaphambi kwexesha).
• Ubuninzi bevithamini A emzimbeni.
• Ukusetyenziswa kwe-antibiotic ye-tetracycline.

Ifunyaniswa njani le meko? (Ukuxilongwa)

Ukuba ukrokrela ukuba une-ICP, ugqirha uza kumamela ngononophelo iimpawu zakho aze abhale imbali yezonyango. Emva koko baza kwenza uvavanyo lomzimba kunye novavanyo lwemithambo-luvo.

Kukho iimvavanyo ezininzi ezinokunceda ukuqinisekisa le meko nokufumanisa unobangela oyintloko:

• I-Brain CT scan okanye i-MRI scan: Olu vavanyo lwemifanekiso lunokukhangela izinto ezinje ngokudumba kobuchopho, ii-ventricles ezandisiweyo, kunye nokuhluma kobuchopho. Zinokunceda ekufumaneni unobangela we-ICP. Khawuthelekelele, uKamal wethu ngequbuliso waba nentloko ebuhlungu, ukuhlanza, kwaye amehlo akhe avaleka ngequbuliso. Akufika esibhedlele, oogqirha bakhawuleza benza i -CT scan ukuze babone ukuba yintoni engalunganga.
• Uvavanyo lweFunduscopic: Olu luvavanyo lwamehlo olukhethekileyo. Lunokujonga ukudumba (i-papilledema) kwi-optic disc engaphakathi kweliso lakho. Olu luphawu oluhle lwe-ICP.
• Ukubhoboza i-Lumbar (i-spinal tap): Oku kuquka ukuthatha inani elincinci le-cerebrospinal fluid (CSF) kumqolo wakho nakwi-spinal cord uze ulinganise uxinzelelo lwayo. Kunokunceda ekufumaneni ezinye zeemeko ezibangela i-ICP. Nangona kunjalo, olu vavanyo alwenziwanga kubo bonke abantu abane-ICP, njengoko ngamanye amaxesha lunokwenza imeko ibe mandundu. Ugqirha wakho uya kugqiba ukuba akwenze oku okanye akwenzeki.

Ngamanye amaxesha, ugqirha unokulinganisa uxinzelelo lwe-CSF ngokuthe ngqo ngokwenza umngxuma omncinci ekhayeni lakho aze afake isixhobo esikhethekileyo, okanye ityhubhu (i-catheter) , entlokweni yakho. Oku kudla ngokwenziwa kwigumbi lonyango oluphezulu (ICU) .

Luluphi unyango lwale nto?

Ukuba ukhe wahlaselwa yi-ICP ngequbuliso, uza kunyangwa kwiYunithi yoKhathalelo oluNzulu (ICU) yesibhedlele. Apho, iqela lezonyango liza kujonga ngokusondeleyo inkqubo yakho yemithambo-luvo kunye neempawu ezibalulekileyo.

Unyango luxhomekeke kubukhulu bemeko kunye nesizathu esiyintloko. Oku kungabandakanya:

• Ukuphakama kwentloko yebhedi: Intloko yebhedi iphakanyisiwe malunga nama-30 degrees. Oku kunceda igazi kunye ne-CSF ziphume ngokulula engqondweni, nto leyo enciphisa uxinzelelo.
• Ukususwa kolwelo lwe-cerebrospinal (CSF): Ngamanye amaxesha ityhubhu (i-ventricular drain) ifakwa kwi-ventricles yengqondo ukuze kususwe i-CSF engaphezulu kwaye kuncitshiswe uxinzelelo.
• Inkxaso yokuphefumla: Abanye abantu banokufuna ukufakwa kwetyhubhu (intubation) baze baqhagamshelwe kwi-mechanical ventilator ukuze ibancede baphefumle. Oku kuqinisekisa ukuba ingqondo ifumana ioksijini eyaneleyo kwaye kunceda ukulawula amanqanaba e-carbon dioxide egazini kunye nokunciphisa i-ICP.
• Amayeza anciphisa ukudumba kwengqondo: umzekelo , ii-barbituratesAmayeza anjenge -mannitol okanye i-hypertonic saline angasetyenziselwa ukunciphisa ukudumba kwengqondo.
• Amayeza okuthintela ukuxhuzula: Ekubeni i-ICP inokuba mandundu xa kuvela ukuxhuzula okubangelwa kukuxhuzula, kunikwa amayeza okuthintela ukuxhuzula.
• Utyando lwe-decompressive craniectomy: Eli linyathelo lokugqibela. Ukuba zonke ezinye iindlela zonyango azikwazi ukulawula uxinzelelo, inxalenye yentloko iyasuswa okwethutyana ukuze ingqondo idumbe. Oku kuthintela ingqondo ekucinezelekeni. Kamva, xa ukudumba kuphelile, inxalenye yentloko esusiweyo iyaxhunyelelwa kwakhona.

Ngelixa besenza olu nyango, iqela lezonyango liza kukhangela unobangela we-ICP kwaye liyinyange. Umzekelo, ukuba yithumba lobuchopho, kunokufuneka utyando ukuze lisuswe, okanye ukuba yintsholongwane, kunokunikwa amayeza okubulala iintsholongwane.

Zithini amathuba okuchacha kule meko? (Ingqikelelo)

Imbono yomntu one-ICP ixhomekeke kwizinto ezininzi:

• Ubunzima bemeko.
• Unobangela oyintloko kunye nomlinganiselo onokunyangwa ngawo.
• Indlela okhawuleze ngayo ukufumana unyango.
• Nokuba i-ICP ivele ngequbuliso (ngokukhawulezileyo) okanye iphuhla kancinci kancinci (ihlala ixesha elide).

I-ICP ngequbuliso idla ngokuba yingozi ebomini. Okukhona ufumana unyango ngokukhawuleza, kokukhona amathuba akho okuchacha aphezulu. Nangona kunjalo, ukuba uxinzelelo luyanda kwaye lutyhala iindawo ezibalulekileyo zengqondo kunye nemithambo yegazi, inokubangela umonakalo ongunaphakade engqondweni okanye nokufa.

Iimeko ezingapheliyo ezifana ne -idiopathic intracranial hypertension (ICP) azisoloko zimbi kakhulu, kodwa ukuba azinyangwa, zinokukhokelela ekubeni ube yimfama. Ke ngoko, nokuba loluphi uhlobo lwe-ICP, unyango olukhawulezileyo lubalulekile.

Yintoni uphawu lokuqala loxinzelelo oluphezulu ngaphakathi entloko?

Amaxesha amaninzi, uphawu lokuqala loxinzelelo oluphezulu ngaphakathi entlokweni yintloko ebuhlungu kakhulu kusasa okanye xa ulele phantsi. Olu lolona phawu luqhelekileyo lwe-ICP. Kodwa khumbula, ayizizo zonke iintloko ezibangelwa yi-ICP. Nangona kunjalo, ukuba oku kunye nezinye iimpawu (ezifana nokuhlanza, utshintsho embonweni), ngokuqinisekileyo kufuneka ufune ingcebiso kagqirha.

Okokugqibela, eyona nto ibalulekileyo (Umyalezo Wokuya Ekhaya)

Ingqondo yethu sisitho esibaluleke kakhulu nesintsonkothileyo emzimbeni wethu. Senza izinto ezininzi! Ngoko ke ukuba kukho into eyonakeleyo kule ngqondo, inokubangela iingxaki ezinkulu. Yiyo loo nto kubalulekile ukufuna uncedo lwezonyango ngokukhawuleza kwiimeko ezifana noxinzelelo oluphezulu lwe-Intracranial Pressure (ICP) .

Ukuba wena okanye umntwana wakho ufumana iimpawu ezifana nentloko ebuhlungu, ukuhlanza, okanye utshintsho lombono, ungaze uyityeshele loo nto. Yiya esibhedlele ungacingi kabini. Ukunyanga i-ICP kwangethuba kunokukhokelela kwiziphumo ezingcono kakhulu. Khumbula, impilo yakho yeyona nto ibalulekileyo!

ICP , Uxinzelelo oluphezulu lwe-Intracranial, uxinzelelo entloko, uxinzelelo engqondweni, uxinzelelo ekhakhayini, i-CSF, ukudumba engqondweni, intloko ebuhlungu, ukuhlanza, umbono ofipheleyo