Dangerous Mechanism Thiab Tag Nrho -Txoj Kev Tiv Thaiv Ntawm Lub Hlwb Hernia Induced Los Ntawm Lumbar Puncture

Ntxiv nrog rau cauda equina paj hlwb compression sequelae, lub paj hlwb hernia yog qhov mob hnyav tshaj plaws ntawm lumbar puncture. Kev ua haujlwm tsis raug ntawmKev Kho Mob Stainless Hlau Spinal Koobthiab qhov tsis tsim nyog tuav ntawm cov tshuaj puncture tuaj yeem ua rau foramen magnum hernia, uas yuav ua rau lub ntsws thiab lub plawv dhia sai sai thiab ua rau tus neeg mob tuag hauv cov mob hnyav. Nkag siab txog cov txheej txheem pathogenic ntawm lub hlwb hernia thiab ua tiav tag nrho - txheej txheem kev tiv thaiv kev ntsuas yog qhov tsim nyog kev paub txog kev siv tshuaj loog thiab cov kws kho mob paj hlwb, thiab tseem yog tus qauv tseem ceeb rau kev txiav txim siab txog kev nyab xeeb ntawm tus txha caj qaum daim ntawv thov kev kho mob.

Lub hauv paus pathogenic mechanism ntawm lub paj hlwb hernia induced los ntawm lumbar puncture yog lub unbalanced intracranial thiab spinal kwj dej siab sib txawv. Rau cov neeg mob uas muaj zog intracranial siab, qhov chaw - nyob rau hauv intracranial lesions thiab unmeasured intracranial siab, dig muag lumbar puncture thiab ceev ceev cerebrospinal kua extraction yuav ua rau kom ceev ceev ntawm tus txha caj qaum kwj dej. Qhov sib txawv ntawm qhov siab ntawm intracranial siab thiab tus txha nraub qaum qis yuav ua rau lub cerebellar tonsils hloov mus rau hauv qab thiab herniate rau hauv lub foramen magnum, compressing lub medulla oblongata qhov chaw ua pa thiab lub plawv dhia, ua rau lub neej - hem thaum muaj xwm txheej ceev.

Kev siv tsis raug ntawm tus txha caj qaum yog ib qho tseem ceeb ua rau muaj teeb meem hauv lub hlwb hernia. Kev xaiv ntawm Kev Kho Mob Tsis Muaj Hlau Ntsig Loj Loj yuav ua rau cov kua cerebrospinal ntau dhau thiab nrawm, ua rau lub siab poob qis hauv tus txha caj qaum. Uncontrolled kua extraction ceev thiab ntau extraction ntim yuav ua rau intracranial thiab spinal siab tsis txaus. Tsis tas li ntawd, tsis yog -kev soj ntsuam ua ntej ua ntej thiab ua tsis tiav los tshuaj xyuas cov tshuaj tiv thaiv xws li intracranial hypertension thiab intracranial qhov chaw- nyob qhov mob yog qhov laj thawj tseem ceeb rau qhov tshwm sim ntawm iatrogenic hlwb hernia.

Sib txawv ntawm cov tsos mob ntawm cov hlab ntsha tsis sib haum xeeb, lub hlwb hernia muaj qhov pib mob hnyav thiab cov neeg tuag siab heev, uas yuav luag tsis muaj lub sijhawm cawm tau zoo tom qab pib. Yog li ntawd, tag nrho - txheej txheem kev tiv thaiv yuav tsum tau ua ua ntej, thaum lub sijhawm thiab tom qab ua haujlwm. Preoperative nruj qhia kev tshuaj ntsuam xyuas yog thawj kab ntawm kev tiv thaiv: lumbar puncture yog txwv tsis pub rau cov neeg mob uas muaj meej intracranial kub siab, intracranial qog thiab cerebral edema. Preoperative intracranial siab nrhiav kom tau thiab imaging kuaj yuav tsum tau tshem tawm siab - tej yam muaj feem yuav.

Intraoperative tus qauv kev lag luam thiab kev xaiv cov khoom tsim nyog yog cov tseem ceeb tiv thaiv kev sib txuas. Raws li tus neeg mob tus mob, xaiv qhov me me thiab nruab nrab- qhov loj me me ntawm tus txha caj qaum kom tswj tau cov kua cerebrospinal tawm nrawm thiab tsis txhob poob siab. Ua kom lub koob ntxig qhov tob kom raug, txo qis kev hloov kho dua, thiab tswj kom ruaj khov ntawm tus txha nqaj qaum. Postoperative standardized kev saib xyuas neeg mob yog qhov kawg guarantee: nruj me ntsis siv hauv ncoo- dawb supine so rau 4-6 teev, zam thaum ntxov sawv thiab dabtsi yog khoov kev ua ub no, tuav ruaj khov intracranial thiab spinal siab tshuav nyiaj li cas, thiab tshem tawm tej yam uas yuav muaj feem xyuam rau ncua sij hawm lub hlwb hernia. Daim ntawv thov cov khoom lag luam thiab kev tswj xyuas kev ua haujlwm tuaj yeem zam kom tsis txhob muaj kev phom sij ntawm lub paj hlwb hernia thiab ua kom muaj kev nyab xeeb tseem ceeb ntawm kev kuaj mob lumbar puncture thiab kho.