Ukulimala kwe-plexus ye-Brachial kwiintsana

I-plexus ye-brachial liqela leemvakalelo ezijikeleze igxalaba. Ukuphulukana nentshukumo okanye ubuthathaka bengalo kunokwenzeka ukuba ezi luvo zonakele. Oku kwenzakala kubizwa ngokuba yi-neonatal brachial plexus palsy (NBPP).

Iimbilini ze-plexus ye-brachial inokuchaphazeleka ngokucinezeleka ngaphakathi kwesibeleko sikamama okanye ngexesha lokuhanjiswa nzima. Ukwenzakala kunokubangelwa:

• Intloko yosana nentamo itsala ecaleni njengoko amagxa edlula kumjelo wokuzalwa
• Ukolulwa kwamagxa osana ngexesha lokuhanjiswa kwentloko yokuqala
• Uxinzelelo kwiingalo zomntwana eziphakanyisiweyo ngexesha lokubeleka (iinyawo zokuqala) ukuhanjiswa

Kukho iindlela ezahlukeneyo zeNBPP. Uhlobo luxhomekeke kwinani lokukhubazeka kwengalo:

• I-brachial plexus palsy ihlala ichaphazela kuphela ingalo ephezulu. Ikwabizwa ngokuba yi-Duchenne-Erb okanye i-Erb-Duchenne ukukhubazeka.
• Ukukhubazeka kweKlumpke kuchaphazela ingalo esezantsi nesandla. Oku akuqhelekanga.

Ezi zinto zilandelayo zonyusa umngcipheko we-NBPP:

• Ukuhanjiswa kweBreech
• Ukutyeba kakhulu koomama
• Umntwana osandul 'ukuzalwa (njengomntwana womama wesifo sikashukela)
• Kunzima ukuhambisa igxalaba lomntwana emva kokuba intloko sele iphumile (ibizwa ngokuba yi-shoulder dystocia)

I-NBPP ayiqhelekanga kunangaphambili. Ukuhanjiswa kwe-cearean kusetyenziswa rhoqo xa kukho iinkxalabo malunga nokuhanjiswa okunzima. Nangona iC-section inciphisa umngcipheko wokulimala, ayikuthinteli. Icandelo le-C likwathatha eminye ingozi.

I-NBPP inokudideka kwimeko ebizwa ngokuba yi-pseudoparalysis. Oku kubonakala xa usana lunokwaphuka kwaye lungashukumisi ingalo ngenxa yeentlungu, kodwa akukho monakalo wenzwa.

Iimpawu zinokubonwa kwangoko okanye kwakamsinya emva kokuzalwa. Banokubandakanya:

• Akukho ntshukumo kwingalo ephezulu okanye esezantsi yosana olusandul 'ukuzalwa
• Moro reflex engekhoyo kwicala elichaphazelekayo
• Ingalo yolulwe (nkqo) engqinibeni kwaye ibanjwe emzimbeni
• Ukunciphisa ukubamba kwicala elichaphazelekayo (kuxhomekeke kwindawo yokulimala)

Uvavanyo lomzimba luhlala lubonisa ukuba usana alushukumisi ingalo ephezulu okanye esezantsi okanye isandla. Ingalo echaphazelekayo inokubhabha xa usana luqengqelwe ngapha nangapha.

I-Moro reflex ayikho kwicala lokulimala.

Umboneleli wezempilo uya kuvavanya ikhola yekhola ukukhangela ukwaphuka. Usana lusenokufuna ukuba kuthathwe i-x-ray yekolarbone.

Kwiimeko ezinobulali, umboneleli uya kuphakamisa:

• Ukuthanjiswa ngobumnene kwengalo
• Ukuzilolonga kwendlela yokuhamba

Usana lusenokufuna ukubonwa ziingcali ukuba ngaba umonakalo mkhulu okanye imeko ayiphucukanga kwiiveki zokuqala ezimbalwa.

Ugqirha lunokuqwalaselwa ukuba amandla awaphuculanga ngeenyanga ezi-3 ukuya kwezi-9 ubudala.

Uninzi lweentsana luya kuphila ngokupheleleyo kwiinyanga ezi-3 ukuya kwezi-4. Abo bangacholiyo ngeli xesha banesimo sengqondo esibi. Kule meko, kunokubakho ukwahlulwa kwengcambu yengcambu kumqolo womqolo (ukuvuswa).

Akucaci ukuba utyando ukulungisa ingxaki yemithambo-luvo lunokunceda. Utyando lunokubandakanya ukufakelwa kwemithambo-luvo okanye ukuhanjiswa kwemithambo luvo. Kungathatha iminyaka emininzi ukuba unyango lwenzeke.

Kwiimeko ze-pseudoparalysis, umntwana uya kuqala ukusebenzisa ingalo echaphazelekayo njengoko kuphulukana nokwaphuka. Ukuqhekeka kweentsana kuphilisa ngokukhawuleza kwaye ngokulula kwiimeko ezininzi.

Iingxaki zibandakanya:

• Izihlunu ezingaqhelekanga (izivumelwano) okanye ukuqiniswa kwezihlunu. Oku kunokuba sisigxina.
• Ukulahleka okungapheliyo, okupheleleyo, okanye okupheleleyo komsebenzi wee-nerves ezichaphazelekayo, ezibangela ukukhubazeka kwengalo okanye ubuthathaka bengalo.

Fowunela umnikezeli wakho ukuba usana lwakho olusandul 'ukuzalwa lubonisa ukungahambi kakuhle kwengalo.

Kunzima ukuthintela i-NBPP. Ukuthatha amanyathelo okuthintela ukuhanjiswa okunzima, xa kunokwenzeka, kunciphisa umngcipheko.

Klumpke ukukhubazeka; Erb-Duchenne ukukhubazeka; Ukukhubazeka kuka-Erb; Ukukhubazeka kweBrachial; Plexopathy Brachial; Ukuthintela i-plexus plexus; I-plexus plexus palsy enxulumene nokuzalwa; I-plexus plexus palsus ebusayo; I-NBPP

Isishwankathelo soLawulo: I-plexus plexus palsus ebeleka Ingxelo yeAmerican College of Obstetricians and Gynecologists 'Task Force kwi-plexus palsus palsus ebelekayo. IGynecol ebambekayo. Ngo-2014; 123 (4): 902-904. IINKCUKACHA: 24785634 pubmed.ncbi.nlm.nih.gov/24785634/.

Ipaki TS, Ranalli NJ. Ukuzalwa kwenzakalo ye-plexus. Ku: Winn HR, ed. Ugqirha we-Youmans kunye no-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 228.

Iprazad PA, iRajpal MN, iMangurten HH, iPuppala BL. Ukulimala kokuzalwa. Ku: RJ, Fanaroff AA, Walsh MC, ii-eds. UFanaroff kunye noMartin's Neonatal-Perinatal Medicine. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 29.