Umgogodla Wekhanda

Abantu abaningi baye babhekana nekhanda elivamile, kodwa ikhanda lomgogodla limelela isimo sezokwelapha esihlukile futhi esivame ukungaqondakali esidinga ukunakwa okukhethekile. Lezi zinhlungu zekhanda ngokuvamile zenzeka ngemva kwezinqubo ezithile zezokwelapha futhi zingaba nomthelela omkhulu emisebenzini yansuku zonke. Lesi sihloko esibanzi sihlola izici ezibalulekile zalezi zinhlungu zekhanda ezinzima, kuhlanganise nezimpawu zabo, izimbangela, izindlela zokuvimbela, kanye nokwelapha ikhanda lomgogodla. 

Ziyini Izinhlungu Zekhanda Lomgogodla?

Ikhanda lomgogodla liqala lapho kuncipha inani le-cerebrospinal fluid (CSF) ezungeze ubuchopho. Lolu ketshezi olukhethekile ludlala indima ebalulekile ekuvikeleni nasekondleni ubuchopho futhi lusebenze njengomcamelo omelene nokunyakaza okungazelelwe.

Lesi simo ngokuvamile senzeka lapho i-CSF ivuza ngokubhoboza okuncane kulwelwesi oluvikelayo (olubizwa ngokuthi ama-meninges) oluzungeza umgogodla. Lokhu kuvuza kungenzeka ngokulandela izinqubo ezithile zezokwelapha, ikakhulukazi ngemva kompompi womgogodla noma i-epidural anesthesia.

Odokotela babona lesi simo ngamagama amaningana:

• Izinhlungu zekhanda lokubhoboza ngemva kwesikhathi eside
• Amakhanda e-epidural
• Izinhlungu zekhanda ezinomfutho ophansi
• Ukuqonda Iqhaza Le-CSF: Uketshezi lwe-cerebrospinal lusebenza imisebenzi eminingi ebalulekile:
• Inikeza umsoco ebuchosheni
• Idala umcamelo ovikelayo ozungeze ubuchopho nomgogodla
• Isekela ubuchopho ngesikhathi sokunyakaza
• Igcina ingcindezi efanele kugebhezi lwekhanda

Izimpawu Zekhanda Lomgogodla

Okulandelayo kunezimpawu ezimbalwa ezihlukile zekhanda lomgogodla:

• Ubuhlungu obukhulu obuthuntubezayo noma obuhlabayo obuthinta ingaphambili noma ngemuva kwekhanda
• Ubuhlungu obunzima kakhulu lapho uhlezi noma umile
• Ubukhulu bekhanda elibuhlungu elikhuphuka ngokukhwehlela, ukuthimula, noma ukuzikhandla
• Isicanucanu nesiyezi
• Ubuhlungu bentamo noma ukuqina
• Ukushintsha kokubona kanye nokuzwela okukhulu ekukhanyeni
• ukuquleka

Okwenza ubuhlungu bekhanda lomgogodla buhluke kakhulu isimo sabo sokuma - ubuhlungu ngokuvamile buyaba ngcono lapho umuntu elele phansi. Lesi sici sisiza odokotela ukuba bahlukanise ubuhlungu bekhanda lomgogodla kwezinye izinhlobo zekhanda.

Ukubonakaliswa Okuncane Okujwayelekile: Ezinye iziguli zingase zibe nezimpawu ezengeziwe, ezingavamile:

• I-tinnitus (ukukhala ezindlebeni)
• Ukulahlekelwa kwezindlebe zesikhashana
• Ukuluma noma ukuba ndikindiki ezingalweni (izimpawu ze-radiculopathy)

Umgogodla Wekhanda Izimbangela

Imbangela eyinhloko yekhanda lomgogodla isukela ekubhobhozweni ngengozi kwe-dura mater, ulwelwesi oluvikelayo oluzungeze umgogodla kanye nobuchopho. Lokhu kuvame ukwenzeka phakathi nezinqubo zokwelapha ezivamile ezifana nemijovo ye-epidural, ukubhoboza i-lumbar, noma izinhlobo ezithile zokwelashwa. ukuhlinzwa komgogodla. Noma kunjalo izidakamizwa ze-epidural zijovwa ngaphandle kolwelwesi oluzungeze umgogodla, ukubhobozwa ngengozi kwalolo lwelwesi kungase kubangele ubuhlungu bekhanda lomgogodla.

Izimo eziningana zezokwelapha zingase futhi zibangele ukuvuza koketshezi lomgogodla, okuhlanganisa:

• I-cyst ephukile emthonjeni womgogodla
• Ukudabuka emgogodleni we-meninges
• Ukulimala ekhanda noma ebusweni, ikakhulukazi izingebhezi eziphukile

Izingozi Zezingozi 

Amathuba okuthuthukisa ikhanda lomgogodla akhuphuka ngezici ezithile zobungozi:

• Abantu abaphakathi kweminyaka engama-20 no-40 ubudala
• Ukukhulelwa
• Ukuphelelwa amanzi emzimbeni
• Izifo zesistimu ezithinta wonke umzimba
• Umlando wangaphambilini wekhanda elibuhlungu
• I-Low body mass index (BMI)
• Ukwenza izinqubo ezibandakanya ukubhoboza okukhulu noma ukusika izinaliti zomgogodla

Izinkinga Zekhanda Lomgogodla

Ezimweni ezimbi kakhulu, ikakhulukazi uma zingalashwa, ikhanda lomgogodla lingakhula libe yizimo ezimbi kakhulu:

• I-cerebral venous sinus thrombosis (amahlule egazi emithanjeni yobuchopho)
• I-Subdural hematoma (ukopha kugebhezi)
• ukuquleka
• I-Brain herniation (ingcindezi eyandayo ebangela ukufuduka kwezicubu zobuchopho)
• I-Hypopituitarism (ukwehla kokukhiqizwa kwama-hormone)
• I-Syringomyelia (i-cyst egcwele uketshezi emthonjeni womgogodla)

Sifo

Ezigulini ezitholwe ngompompi womgogodla ezinsukwini eziyi-14 ezedlule, ukuxilonga ngokuvamile kuqondile futhi ngokuvamile akudingi ukuhlolwa okwengeziwe.
Izindlela zokuxilonga zihlanganisa:

• Ukuhlolwa okuningiliziwe komzimba
• Ukuhlolwa kwamaphethini obuhlungu nokulinganiselwa kokunyakaza
• Ukuhlolwa kwezimpawu ezihambisanayo njengesiyezi nesicanucanu
• Ukubuyekezwa kwezinqubo zezokwelapha zakamuva
• I-Magnetic resonance imaging (MRI) uma kunesidingo

Ukwelashwa Kwekhanda Lomgogodla

Odokotela bavamise ukuqala ngezindlela ezingavamisile kakhulu ngaphambi kokucabangela izindlela zokwelapha ezinolaka.

• Izindlela zokwelashwa kwe-Conservative: Uhlelo lokuqala lokwelapha lugxile ezindleleni ezilula, ezingahlaseli iziguli ezingazisebenzisa ekhaya. Odokotela batusa amasu amaningana abalulekile:
  • Ukugcina indawo elele phansi okungenani amahora angama-24-48
  • Ukwandisa umthamo wamanzi kakhulu
  • Ukusebenzisa iziphuzo ezine-caffeine
  • Ukuthatha ama-over-the-counter relievers
• Izindlela Zokwelapha Ezihlaselayo: 
  • Odokotela bangase batuse ukungenelela okuqondiwe okwengeziwe uma lezi zinyathelo zokuvikela zinganikezi ukukhululeka phakathi namahora angu-24. Ukwelashwa okuphumelelayo kakhulu kwekhanda lomgogodla eliqhubekayo yi-epidural patch yegazi. 
  • Ezimweni ezingavamile lapho i-epidural patch yegazi ibonakala ingasebenzi, ukungenelela kokuhlinzwa kungase kudingeke ukuze kuvalwe ukuvuza koketshezi lomgogodla. 

Uzoyibona Nini Udokotela

• Iziguli kufanele zithole ukwelashwa okuphuthumayo uma:
• Izwa ubunzima bokuchama
• Balahlekelwa ukuzwa emhlane noma emilenzeni
• Kuvele ikhanda elibuhlungu kungazelelwe, elinzima nokuqina kwentamo
• Qaphela noma yibuphi ubuthakathaka kunoma iyiphi ingxenye yomzimba
• Uphethwe yikhanda elihambisana imfiva, isicanucanu, noma ukuhlanza

Izimpawu Zesexwayiso Ezengeziwe: Ukuhlolwa kodokotela nakho kuyadingeka uma iziguli zibona:

• Ikhanda elibuhlungu eliqhubeka izinsuku noma amasonto
• Izinguquko emaphethini ekhanda
• Amakhanda amabili noma ngaphezulu ngesonto
• Ubuhlungu bekhanda obuqhubekayo kubantu abangaphezu kweminyaka engama-50 ababengenalo ikhanda

Prevention

Isilinganiso sokuvimbela esiphumelela kakhulu sisezandleni zodokotela abenza izinqubo zomgogodla.

Odokotela banganciphisa kakhulu ingozi yekhanda lomgogodla ngokusebenzisa imishini ekhethekile phakathi nezinqubo. Ithuluzi eliyinhloko lokuvimbela inaliti engasikiwe noma inaliti ye-atraumatic, eyenza ukubhoboza okuncane kulwelwesi lomgogodla, okunciphisa amathuba okuvuza kwe-cerebrospinal fluid.

Isiphetho

Ikhanda lomgogodla linikeza izinselele eziyingqayizivele ezibenza bahluke ekhanda elivamile. Isimo sabo sokuma esihlukile - ubuhlungu obunzima lapho behlezi noma bemile - benza kube lula ukuhlonza, nakuba ukuhlolwa okufanele kwezokwelapha kuhlala kubalulekile ukuze kuhlonzwe kahle.

Intuthuko yezokwelapha iye yanciphisa kakhulu ingozi yekhanda lomgogodla ngokusebenzisa imishini ethuthukisiwe kanye namasu. Iziguli eziningi ziphola ngokugcwele emasontweni amabili lapho zithola ukwelashwa okufanele, kungakhathaliseki ukuthi ngokusebenzisa izindlela ezilondolozayo ezifana nokuphumula kombhede kanye ne-hydration noma ukungenelela kwezokwelapha njengama-epidural patches.
Odokotela dlala indima ebalulekile ekuvimbeleni nasekwelapheni ikhanda lomgogodla. Ubuchwepheshe babo busiza ukunciphisa izingozi phakathi nezinqubo zomgogodla futhi kuqinisekisa ukuphathwa okufanele uma izimpawu zikhula. 

Imibuzo Evame Ukubuzwa

1. Zivame kangakanani ubuhlungu bekhanda lomgogodla?

Ucwaningo lubonisa ukuthi ubuhlungu bekhanda lomgogodla lwenzeka cishe ku-10% kuya ku-40% weziguli ezenza izinqubo zokubhoboza i-lumbar. Imvamisa iyahlukahluka kuye ngohlobo lwenaliti esetshenzisiwe kanye nenqubo ethile eyenziwe. Ngamasu nemishini yesimanje, izigameko zehle kakhulu, ikakhulukazi lapho odokotela besebenzisa izinaliti ezikhethekile.

2. Ikhanda lomgogodla lihlala isikhathi esingakanani?

Amakhanda amaningi omgogodla ngokuvamile axazulula phakathi namahora ambalwa kuya ezinsukwini ezimbalwa. Kodwa-ke, odokotela batusa ukufuna usizo lwezokwelapha uma izimpawu ziqhubeka ngaphezu kwamahora angu-24. Kwezinye izimo, lezi zinhlungu zekhanda zingahlala amasonto amabili ngaphandle kokwelashwa okufanele, nakuba lokhu kungavamile.

3. Ikhanda lomgogodla liqala eminyakeni emingaki?

Amakhanda omgogodla ngokuvamile athinta abantu abaphakathi kweminyaka engama-20 nengama-40 ubudala. Leli qembu lobudala lisengozini enkulu, lapho abesifazane abakhulelwe besengozini enkulu ngenxa yokusetshenziswa njalo kwama-epidural ngesikhathi sokubeletha. Lesi simo asivamile kubantu abadala kanye nezingane.

4. Yimuphi udokotela ongabonisana naye ngekhanda lomgogodla?

Iziguli kufanele ziqale zithintane nodokotela wazo oyinhloko, ongazidlulisela kochwepheshe abafanelekile. Ngezinhlungu zomgogodla ezilandela izinqubo zezokwelapha, udokotela owenza le nqubo kufanele athintwe kuqala, njengoba ejwayele umlando wezokwelapha wesiguli.

5. Yiziphi izindlela zokwelapha eziphumelelayo zekhanda lomgogodla ekhaya?

Okulandelayo amakhambi amaningana asekhaya ezimpawu zekhanda lomgogodla:

• Ukugcina indawo elele phansi
• Ukwandisa umthamo wamanzi kakhulu
• Ukusebenzisa iziphuzo ezine-caffeine
• Ukuthatha ama-over-the-counter relievers njengoba kunconyiwe
• Ukugwema imisebenzi eyenza izimpawu zibe zimbi kakhulu

UDkt. Ashish Bagdi

MBBS, MD (Umuthi), DM (Neurology)
Izibhedlela ze-CARE CHL, e-Indore

Ukuze Ubhukhe Isikhathi, shayela:

+91 406 810 6585