Ingabe ingcindezi engaphakathi kwekhanda lakho iphakeme kakhulu? (Ukucindezela Okukhuphukile Kwangaphakathi Kwekhanda - ICP) Masiqaphele lokhu!

Ingabe ngezinye izikhathi uzizwa sengathi uhlanza ngenxa yekhanda elibuhlungu? Noma uzizwa sengathi umbono wakho awucacile? Nakuba lezi kuyizimpawu esingazinaki kakhulu ngezinye izikhathi, zingabonisa ukuthi ingcindezi engaphakathi kwekhanda lethu, okungukuthi, ngaphakathi komgodi wobuchopho, inyukile (Increased Intracranial Pressure - ICP) . Lena indaba engathi sína, ngakho ake sixoxe ngayo ngokuningiliziwe namuhla.

Iyini le ngcindezi ekhulayo yangaphakathi kwekhanda?

Kalula nje, umfutho wegazi ophakeme (i-ICP) uwukuthi ingcindezi engaphakathi kwekhanda lakho, noma indawo engaphansi kwekhanda, iphakeme kunokuvamile. Cabanga ngekhanda lethu njengebhokisi eliqinile. Ngaphakathi kwaleli bhokisi kunezinto ezintathu eziyinhloko:

• Ubuchopho bethu
• Uketshezi lwe-Cerebrospinal (CSF) : Lolu uketshezi oluzungeze ubuchopho bethu kanye nomgogodla futhi luwuvikele. Lufana nomcamelo.
• Igazi : Igazi elithwala izakhamzimba nomoya-mpilo odingwa ubuchopho.

Manje, isikhala ngaphakathi kwaleli bhokisi silinganiselwe. Ngakho-ke zonke lezi zinto ezintathu—ubuchopho, uketshezi lomgogodla, kanye negazi—kufanele zibe sesilinganisweni esithile. Kodwa uma ngesizathu esithile umthamo wanoma iyiphi yalezi ezintathu ukhuphuka, isikhala esitholakalayo salezi ezinye siyancipha, futhi ingcindezi iyonke ngaphakathi kwekhanda iyanda. Lokhu kwanda kwengcindezi kungaba ngokuzumayo (okukhulu), noma kungakhula kancane kancane ngokuhamba kwesikhathi (okungapheli).

Uma ingcindezi engaphakathi kwekhanda ikhuphuka ngale ndlela, inani legazi eligeleza liye ebuchosheni lingancipha. Noma, izingxenye zobuchopho zingasuswa endaweni yazo. Lokhu sikubiza ngokuthi i-brain herniation . Zombili lezi zimo ziyingozi kakhulu, zisongela ukuphila. Uyaqonda?

Yiziphi izimpawu zokucindezeleka okukhulu ngaphakathi kwekhanda?

Manje ake sibone ukuthi yiziphi izimpawu eziboniswa kulesi simo se-ICP. Lezi zimpawu zingase zihluke kancane kubantu abadala, izingane ezincane, kanye nezinsana.

Izici ezibonakala phakathi kwabantu abadala nezingane ezincane:

• Ikhanda elibuhlungu: Lesi yisibonakaliso esiyinhloko. Ngokuvamile kuba kubi kakhulu ekuseni, noma kungaba kubi kakhulu uma ulele phansi. Abanye abantu bathi kuzwakala sengathi "ikhanda lizoqhuma ngaphakathi."
• Isicanucanu nokuhlanza: Lesi simo sivame kakhulu ekuseni. Ngezinye izikhathi ukuhlanza kwenzeka ngokuzumayo futhi ngaphandle kwesizathu esibonakalayo.
• Izinguquko esimweni sengqondo: Lokhu kungasukela ekozeleni nje kuya ekungazini (coma) . Umuntu angase athukuthele, adideke, futhi abe nezinguquko enkulumweni.
• Ukushintsha kombono: Ukubona okufiphele, ukubona okuphindwe kabili , ukuzwela okukhulu ekukhanyeni, okungukuthi, ukungakwazi ukubuka ukukhanya (i-photophobia) kungenzeka.
• Ubunzima bokunyakaza kwamehlo: Ungase ungakwazi ukulawula amehlo akho kahle, futhi kungase kube nzima ukuwaphendula eceleni.
• Ubuthakathaka bemisipha: Izitho zakho zingase zizwe zingaphilile noma zingenampilo.
• Ukuba ndikindiki.
• Ukuquleka: Ukuquleka okungazelelwe kungase kwenzeke.

Izimpawu ezibonakala ezinganeni:

Uma lokhu kwenzeka ezinganeni ezincane, azikwazi ukuziveza. Yingakho izimpawu ezizibonisayo zihlukile kancane. Abazali kufanele baqaphele kakhulu ngalokhu.

• Ukulala: Uma ingane ilala njalo, ingenasithakazelo sokudlala, noma kunzima ukuvuka.
• I-fontanelle evuvukele: Uphawu lwendawo ethambile yengane ekhanda layo ebonakala ivuvukele noma ivuvukele luyisibonakaliso esinye. Kungase futhi kuzwakale kunzima uma uyithinta.
• Ukuhlanza: Ukuhlanza okuvamile, ngezinye izikhathi okuphindaphindiwe. Ezinye izingane zingase zihlanze ngokushesha ngemva kokuphuza ubisi.

Into ebaluleke kakhulu ukuthi lokhu kucindezela okwandayo ngaphakathi kwekhanda kuyisimo esiphuthumayo sezokwelapha. Uma wena noma ingane yakho ninalezi zimpawu, kufanele niye esibhedlela esiseduze ngokushesha. Ungachithi isikhathi.

Izimpawu Zokuphela Kwesikhathi:

Ngezinye izikhathi, lapho le ICP iba ​​nzima kakhulu, okusho ukuthi ukuqhuma kobuchopho sekuseduze, kuba khona izimpawu ezithile ezivelelayo. Lokhu sikubiza ngokuthi 'i-Cushing's reflex' . Kulokhu, izimpawu ezintathu eziyinhloko zingabonakala ndawonye:

• Umfutho wegazi ophezulu (umfutho wegazi ophakeme).
• Isilinganiso senhliziyo esihamba kancane: ngaphansi kwama-beats angu-60 ngomzuzu (bradycardia) .
• Ukuphefumula okungajwayelekile: Ubunzima bokuphefumula, ikakhulukazi uma uphefumula kakhulu, njengokuphefumula umoya obandayo (ukuphefumula okungapheli) .

Uma zonke lezi zimpawu ezintathu zikhona, kusho ukuthi isimo siyingozi kakhulu, futhi ukulimala kobuchopho kuseduze. Ngakho-ke, kufanele uye ekamelweni eliphuthumayo ngokushesha.

Kungani ingcindezi engaphakathi kwekhanda ikhuphuka kanje? Ziyini izimbangela?

Manje ungase uzibuze, 'Kungani lokhu kwenzeka emhlabeni?' Empeleni kunezizathu eziningana zalokhu. Njengoba sixoxile ngaphambili, isikhala esingaphakathi kwekhanda silinganiselwe. Ngokuvamile, ingcindezi engaphakathi kwekhanda lomuntu ophilile ingaphansi kwamamilimitha angu-20 e-mercury (20 mm Hg) .

Uma umthamo wanoma iyiphi yalezi zingxenye ezintathu—izicubu zobuchopho, uketshezi lomgogodla (i-CSF), kanye negazi ebuchosheni—ukhuphuka, isikhala esitholakalayo salezi ezinye ezimbili siyancipha, futhi ingcindezi iyonke iyanda. Izinkinga ziyavela lapho lokhu kulinganisela kuphazamiseka. Odokotela bahlukanisa lezi zimbangela ngokusekelwe kulokho okudala ingcindezi ukuthi ikhuphuke.

Izimbangela Zokwanda Komthamo Wobuchopho:

Ukuvuvukala kobuchopho (i-cerebral edema) kungabangela ingcindezi eyengeziwe ngaphakathi kwekhanda. Lokhu kungabangelwa yi:

• Ukulimala kobuchopho okubuhlungu:Uma ubuchopho bonakaliswe yinto efana nokuwa, ukushayisana, noma ingozi yemoto.
• Ukwehla kokugeleza kwegazi kuya ebuchosheni (ischemia): Lapho ubuchopho bungatholi igazi elanele, isibonelo ngemva kokuhlaselwa yinhliziyo.
• Ukwanda kwamazinga e-ammonia egazini (hyperammonemia): Lokhu kungenzeka kubantu abanesifo sesibindi.
• Ukwehla kokusebenza kwezinso kubangela ukunqwabelana kobuthi egazini, okuholela ekunciphiseni ukusebenza kobuchopho (uremic encephalopathy).
• Amazinga aphansi e-sodium egazini (i-hyponatremia): Lokhu futhi kuyimbangela yokuvuvukala kobuchopho.

Ngaphezu kwalokho, ukuvuvukala kungenzeka ezindaweni ezithile zobuchopho. Isibonelo:

• Ama-hematoma angaphakathi kobuchopho noma angaphansi kobuchopho: Lawa amahlule egazi akha ngaphakathi kobuchopho noma phakathi kwezembozo zobuchopho. Abantu abanomfutho wegazi ophezulu kanye nalabo abathatha imithi yokunciphisa igazi basengozini enkulu.
• Isimila sobuchopho.
• Ithumba lobuchopho elibangelwa ukutheleleka ngamagciwane ebuchosheni.
• Isifo sohlangothi.

Izimbangela Zokwanda Koketshezi Lomgogodla (CSF):

I-ICP inganda futhi ngenxa yokwanda kwenani loketshezi lomgogodla ebuchosheni. Izizathu zalokhu:

• I-Hydrocephalus: Lesi yisimo lapho uketshezi lwe-CSF luqongelela khona emakamelweni obuchopho. Lokhu kungenzeka uma ukugeleza kwe-CSF kuvimbekile, uma ukukhiqizwa kwe-CSF kwanda, noma uma ukumuncwa kwehla.
• Isimila se-Choroid plexus: Lesi isimila esingavamile esikhula lapho kwenziwa khona i-CSF.
• I-Meningitis: Ukutheleleka kwezicubu ezimboze ubuchopho. Lokhu kungavimbela nokugeleza kwe-CSF.
• Ama-granuloma kuma-meninges akho.

Izimbangela Zokwanda Komthamo Wegazi Lobuchopho:

Ukwanda komthamo wegazi ebuchosheni nakho kungandisa ukucindezeleka. Izibonelo:

• Ukuqhuma kwe-aneurysm yobuchopho noma amazinga e-carbon dioxide akhuphukile egazini (i-hypercapnia).
• Ukugoba kwegazi emithanjeni yobuchopho (i-cerebral venous sinus thrombosis).
• Ukwehluleka kwenhliziyo.

Ezinye Izimbangela:

Ngaphezu kwalokhu, kungase kube nezinye izizathu:

• Ukwanda kwengcindezi ngaphakathi kwekhanda ngaphandle kwesizathu esibonakalayo (i-Benign noma idiopathic intracranial hypertension): Lokhu kuvame ukubonwa kwabesifazane abasebasha, abakhuluphele.
• Ukukhubazeka kwekhanda, isibonelo, isimo esibizwa ngokuthi i-craniosynostosis (ukuhlangana kwamathambo ekhanda ngaphambi kwesikhathi).
• Inani elikhulu levithamini A emzimbeni.
• Ukusetshenziswa kwe-antibiotic ye-tetracycline.

Lesi simo sitholakala kanjani? (Ukuxilongwa)

Uma usola ukuthi une-ICP, udokotela uzolalela ngokucophelela izimpawu zakho futhi athathe umlando wezokwelapha. Ngemuva kwalokho bazokwenza ukuhlolwa ngokomzimba kanye nokuhlolwa kwezinzwa.

Kunezivivinyo eziningana ezingasiza ukuqinisekisa lesi simo nokuthola imbangela eyisisekelo:

• I-Brain CT scan noma i-MRI scan: Lezi zivivinyo ze-imaging zingabheka izinto ezifana nokuvuvukala kobuchopho, ama-ventricle akhulisiwe, kanye nokuhluma kobuchopho. Zingasiza futhi ekutholeni imbangela ye-ICP. Cabanga nje, uKamal wethu wavele waba nekhanda elibuhlungu, wahlanza, futhi amehlo akhe avaleka ngokuzumayo. Lapho efika esibhedlela, odokotela bashesha benza i -CT scan ukuze babone ukuthi yini engalungile.
• Ukuhlolwa kwe-Funduscopic: Lokhu ukuhlolwa kwamehlo okukhethekile. Kungahlola ukuvuvukala (i-papilledema) ku-optic disc engaphakathi kweso lakho. Lokhu kuyisibonakaliso esihle se-ICP.
• Ukubhoboza i-Lumbar (umpompi womgogodla): Lokhu kuhilela ukuthatha inani elincane loketshezi lwe-cerebrospinal (CSF) emgogodleni wakho nasemgogodleni bese ulinganisa ukucindezeleka kwalo. Kungasiza futhi ekuxilongeni ezinye zezimo ezibangela i-ICP. Kodwa-ke, lokhu kuhlolwa akwenziwa yiwo wonke umuntu one-ICP, njengoba ngezinye izikhathi kungenza isimo sibe sibi kakhulu. Udokotela wakho uzonquma ukuthi akwenze lokhu noma cha.

Ngezinye izikhathi, udokotela angalinganisa ingcindezi ye-CSF ngqo ngokwenza imbobo encane ekhanda lakho bese efaka ithuluzi elikhethekile, noma ithubhu (i-catheter) , ekhanda lakho. Lokhu kuvame ukwenziwa egunjini lokunakekelwa okujulile (ICU) .

Iyini indlela yokwelapha lokhu?

Uma uhlaselwa yi-ICP ngokuzumayo, uzolashwa e-Intensive Care Unit (ICU) yesibhedlela. Lapho, ithimba lezokwelapha lizoqapha ngokucophelela uhlelo lwakho lwezinzwa kanye nezimpawu zokuphila.

Ukwelashwa kuncike ebunzimeni besimo kanye nembangela eyinhloko. Lokhu kungafaka:

• Ukuphakama kwekhanda lombhede: Ikhanda lombhede liphakeme cishe ngama-degree angu-30. Lokhu kusiza igazi kanye ne-CSF ukuthi kuphume kalula ebuchosheni, kunciphisa ukucindezeleka.
• Ukususwa koketshezi lwe-cerebrospinal (CSF): Ngezinye izikhathi ipayipi (i-ventricular drain) lifakwa kuma-ventricles obuchopho ukuze kususwe ingxenye ye-CSF eningi futhi kuncishiswe ingcindezi.
• Ukusekelwa kokuphefumula: Abanye abantu kungadingeka bafakwe ipayipi (intubation) bese bexhunywa kumshini wokuphefumula ukuze ubasize baphefumule. Lokhu kuqinisekisa ukuthi ubuchopho buthola umoya-mpilo owanele futhi kusiza ukulawula amazinga e-carbon dioxide egazini kanye nokunciphisa i-ICP.
• Imithi enciphisa ukuvuvukala kobuchopho: isibonelo , ama-barbituratesImithi efana ne -mannitol noma i-hypertonic saline ingasetshenziswa ukunciphisa ukuvuvukala kobuchopho.
• Imithi yokuvimbela ukuquleka: Njengoba i-ICP ingaba yimbi kakhulu uma kuvela ukuquleka kwesifo sokuwa, kunikezwa imithi yokuvimbela.
• Ukuhlinzwa kwe-craniectomy okudambisa ukucindezeleka: Lena yindlela yokugcina. Uma zonke ezinye izindlela zokwelapha zihluleka ukulawula ingcindezi, ingxenye yogebhezi isuswa okwesikhashana ukuze ubuchopho buvuvuke. Lokhu kuvimbela ubuchopho ekucindezelweni. Kamuva, lapho ukuvuvukala sekuphelile, ingxenye yogebhezi esusiwe iyaxhunywa kabusha.

Ngesikhathi senza lokhu kwelashwa, ithimba lezokwelapha lizobheka imbangela eyisisekelo ye-ICP bese liyelapha. Isibonelo, uma kuyisifo sobuchopho, kungase kudingeke ukuhlinzwa ukuze kususwe, noma uma kuyisifo, kunganikezwa ama-antibiotic.

Yimaphi amathuba okululama kulesi simo? (Isibikezelo)

Umbono womuntu one-ICP uncike ezintweni eziningana:

• Ubunzima besimo.
• Imbangela eyinhloko kanye nezinga engelashwa ngalo.
• Indlela othole ukwelashwa ngokushesha ngayo.
• Kungakhathaliseki ukuthi i-ICP yavela ngokuzumayo (ebukhali) noma yathuthuka kancane kancane (engapheli).

I-ICP engazelelwe ivame ukusongela impilo. Uma uthola ukwelashwa ngokushesha, amathuba akho okululama ayanda. Kodwa-ke, uma ingcindezi ikhuphuka futhi icindezela izingxenye ezibalulekile zobuchopho nemithambo yegazi, ingabangela ukulimala kobuchopho unomphela noma ngisho nokufa.

Izimo ezingamahlalakhona njenge -idiopathic intracranial hypertension (ICP) ngokuvamile azibi kakhulu, kodwa uma zingalashwa, zingaholela ebumpumputheni. Ngakho-ke, kungakhathaliseki uhlobo lwe-ICP, ukwelashwa okusheshayo kubalulekile.

Yisiphi isibonakaliso sokuqala sokucindezela okukhulu ngaphakathi kwekhanda?

Ngokuvamile, uphawu lokuqala lokucindezeleka okukhulu ngaphakathi kwekhanda ikhanda eliba libi kakhulu ekuseni noma lapho ulele phansi. Lolu uphawu oluvame kakhulu lwe-ICP. Kodwa khumbula, akuzona zonke izinhlungu zekhanda ezibangelwa yi-ICP. Kodwa-ke, uma unalokhu kanye nezinye izimpawu (njengokuhlanza, izinguquko embonweni), kufanele nakanjani ufune iseluleko sezokwelapha.

Okokugcina, into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

Ubuchopho bethu buyisitho esibaluleke kakhulu nesiyinkimbinkimbi emzimbeni wethu. Senza izinto eziningi kakhulu! Ngakho-ke uma kukhona okonakalayo kulobu buchopho, kungabangela izinkinga ezinkulu. Yingakho kubalulekile ukufuna usizo lwezokwelapha ngokushesha okukhulu ezimweni ezifana nokwanda kokucindezeleka kwangaphakathi kwekhanda (ICP) .

Uma wena noma ingane yakho nithola izimpawu ezifana nekhanda elibuhlungu, ukuhlanza, noma ukushintsha kombono, ningalokothi nizishaye indiva. Yiya esibhedlela ngaphandle kokucabanga kabili. Ukwelapha i-ICP kusenesikhathi kungaholela emiphumeleni engcono kakhulu. Khumbula, impilo yakho iyona nto ebaluleke kakhulu!

I- ICP, Ukwanda Kokucindezeleka Kwangaphakathi Kwekhanda, ukucindezeleka ekhanda, ukucindezeleka ebuchosheni, ukucindezeleka ekhanda, i-CSF, ukuvuvukala ebuchosheni, ikhanda elibuhlungu, ukuhlanza, ukubona okufiphele