I-Gastroschisis

I-Gastroschisis sisiphene sokuzalwa apho amathumbu wosana angaphandle komzimba ngenxa yomngxunya eludongeni lwesisu.

Iintsana ezine-gastroschisis zizalwa zinomngxunya eludongeni lwesisu. Amathumbu omntwana ahlala enamathele ngaphandle (ukuphuma) emngxunyeni.

Imeko ijongeka ngokufana ne-omphalocele. I-omphalocele, nangona kunjalo, sisiphene sokuzalwa apho amathumbu osana okanye amanye amalungu esisu aphuma emngxunyeni kwindawo yesisu kwaye agqunywe ngenwebu. Nge-gastroschisis, akukho lwanwe lokugquma.

Iziphene zodonga lwesisu zikhula njengoko umntwana ekhula ngaphakathi kwisibeleko sikanina. Ngexesha lokukhula, amathumbu kunye namanye amalungu (isibindi, isinyi, isisu, kunye namaqanda, okanye iimvavanyo) zikhula ngaphandle komzimba ekuqaleni kwaye zihlala zibuyela ngaphakathi. Kwiintsana ezine-gastroschisis, amathumbu (kwaye ngamanye amaxesha isisu) ahlala ngaphandle kodonga lwesisu, ngaphandle kwembumba ewambozayo. Oyena nobangela weziphene zodonga lwesisu awaziwa.

Oomama abalandelayo banokuba semngciphekweni omkhulu wokuba neentsana ezine-gastroschisis:

• Ubudala obutsha
• Zimbalwa izibonelelo
• Ukungondleki ngexesha lokukhulelwa
• Sebenzisa icuba, icocaine, okanye imethamphetamines
• Ukuvezwa kweNitrosamine (imichiza efumaneka kukutya okuthile, izinto zokuthambisa, icuba)
• Ukusetyenziswa kweasprini, ibuprofen, iacetaminophen
• Ukusetyenziswa kwezinto zokuthambisa ezinekhemikhali pseudoephedrine okanye phenylpropanolamine

Iintsana ezine-gastroschisis zihlala zingenazo ezinye iziphene ezinxulumene nokuzalwa.

I-gastroschisis ihlala ibonwa ngexesha lokukhulelwa kokubeleka. Ingabonakala xa umntwana ezalwa. Kukho umngxuma kudonga lwesisu. Amathumbu amancinci ahlala engaphandle kwesisu kufutshane nentambo. Amanye amalungu anokubonakala amathumbu amakhulu, isisu, okanye inyongo.

Ngokwesiqhelo amathumbu ayacatshukiswa kukuvezwa lulwelo lwe-amniotic. Usana lunokuba neengxaki ekufuneni ukutya.

Ukukhulelwa kwe-prenatal kuhlala kuchonga iintsana ezine-gastroschisis ngaphambi kokuzalwa, zihlala ziiveki ezingama-20 zokukhulelwa.

Ukuba i-gastroschisis ifunyenwe ngaphambi kokuzalwa, umama uya kufuna ukubeka iliso ngokukodwa ukuqinisekisa ukuba umntwana wakhe ongekazalwa uhlala esempilweni.

Unyango lwe-gastroschisis lubandakanya utyando. Ngokwesiqhelo isisu somntwana esiswini sincinci kakhulu ukuba amathumbu angaphinde abuyele ekuzalweni. Ke ingxowa enemingxunya ithungwe ijikeleze imida yesiphene kwaye imiphetho yesiphene iyatsalwa inyuswe. Ingxowa ibizwa ngokuba yisilo. Kwiveki ezayo okanye ezimbini, amathumbu abuyela kwisisu esiswini kwaye isiphene sinokuvalwa.

Ubushushu bomntwana kufuneka bulawulwe ngononophelo, kuba ithumbu elivelileyo livumela ubushushu bomzimba obuninzi ukuba bubaleke. Ngenxa yoxinzelelo olubandakanyekayo ekubuyiseleni amathumbu esiswini, usana lusenokufuna inkxaso yokuphefumla ngomatshini wokuphefumla. Olunye unyango kunyana lubandakanya izakha-mzimba nge-IV kunye namayeza okuthintela usulelo. Nasemva kokuba isiphene sivaliwe, ukutya okunesondlo IV kuya kuqhubeka njengoko ukondla ubisi kufuneka kwenziwe kancinci.

Usana lunethuba elihle lokuchacha ukuba azikho ezinye iingxaki kwaye ukuba isisu sikhulu ngokwaneleyo. Isisu esincinci esiswini kunokubangela iingxaki ezifuna utyando olungakumbi.

Kufuneka kwenziwe izicwangciso zokuhanjiswa ngononophelo kunye nokulawulwa kwangoko kwengxaki emva kokuzalwa. Usana kufuneka luziswe kwiziko lonyango elinobuchule ekulungiseni iziphene zodonga lwesisu. Iintsana kunokwenzeka ukuba zenze ngcono ukuba akukho mfuneko yokuba zisiwe kwelinye iziko ukuze zifumane unyango olungaphezulu.

Ngenxa yokuba sesichengeni se-amniotic fluid, amathumbu abantwana anokungasebenzi ngesiqhelo nasemva kokuba amalungu ebuyiselwe ngaphakathi kwisisu. Iintsana ezinegastroschisis zifuna ixesha lokuba amathumbu azo achache kwaye aqhelane nokuthatha ukutya.

Inani elincinci leentsana ezine-gastroschisis (malunga ne-10-20%) zinokuba ne-intestinal atresia (iinxalenye zamathumbu ezingakhange zikhule esibelekweni). Ezi ntsana zifuna olunye utyando ukuze kuthintelwe ukuphazamiseka.

Uxinzelelo olonyukayo oluvela kwindawo engalunganga yesisu lunokunciphisa ukuhamba kwegazi ukuya emathunjini nasezintso. Inokwenza nokuba kube nzima emntwaneni ukwandisa imiphunga, kukhokelela kwiingxaki zokuphefumla.

Enye into enokubakho kukufa kwamathumbu necrosis. Oku kwenzeka xa izicubu zamathumbu zisifa ngenxa yokuhamba kwegazi okuphantsi okanye usulelo. Lo mngcipheko unokuncitshiswa kwiintsana ezifumana ubisi lwebele endaweni yefomula.

Le meko ibonakala ekuzalweni kwaye iya kufunyanwa esibhedlele xa kuziswa ukuba ibingakhange ibonwe kwiimviwo zesiqhelo ze-fetal ultrasound ngexesha lokukhulelwa. Ukuba ubelekele ekhaya kwaye umntwana wakho ubonakala enale ngxaki, tsalela umnxeba kwindawo yongxamiseko yendawo (enje nge-911) kwangoko.

Le ngxaki ifunyaniswa kwaye inyangwa esibhedlele ngexesha lokuzalwa. Emva kokubuyela ekhaya, biza umboneleli wakho wezempilo ukuba umntwana wakho uvelisa naziphi na kwezi mpawu:

• Ukwehla kwamathumbu
• Iingxaki zokondla
• Ifiva
• Umhlanzo oluhlaza okanye otyheli
• Indawo yesisu edumbileyo
• Ukuphalaza (ngokwahlukileyo kunesiqhelo sokutshica umntwana)
• Utshintsho kwindlela yokuziphatha

Isiphene sokuzalwa - isisu esiswini; Isiphene eludongeni lwesisu - usana; Isiphene sodonga lwesisu - umntwana osandul 'ukuzalwa; Isiphene sodonga lwesisu - usana olusandul 'ukuzalwa

• Iintsana esiswini esiswini (gastroschisis)
• Ukulungiswa kweGastroschisis-uthotho
• Isililo

I-Islam S. Iziphako zodonga lwesisu esiswini: i-gastroschisis kunye ne-omphalocele. Ku: Holcomb GW, Murphy P, St. Peter SD, ii-eds. Uqhaqho lwabantwana lweHolcomb kunye neAshcraft. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 48.

UWalther AE, uNathan JD. Usana olusanda kuzalwa oluneziphene. Ku: Wyllie R, Hyams JS, Kay M, ii-eds. Izifo zesisu esiswini kunye nezifo zesibindi. Umhla we-5. IPhiladelphia, PA: Elsevier; 2016: isahluko 58.