Ukulungiswa kweGastroschisis

Ukulungiswa kwe-Gastroschisis yinkqubo eyenziweyo kusana ukulungisa isiphene sokuzalwa esenza ukuba kuvuleke kulusu kunye nezihlunu ezigubungele isisu (eludongeni lwesisu). Ukuvulwa kuvumela amathumbu kwaye ngamanye amaxesha amanye amalungu ukuba aphume ngaphandle kwesisu.

Injongo yenkqubo kukubeka amalungu kwakhona kwisisu somntwana kwaye alungise isiphene. Ukulungiswa kunokwenziwa kanye emva kokuba umntwana ezelwe. Oku kubizwa ngokuba lulungiso lokuqala. Okanye, ukulungiswa kwenziwa ngokwamanqanaba. Oku kubizwa ngokuba kukulungiswa ngokwamanqanaba. Utyando lolungiso lokuqala lwenziwa ngale ndlela ilandelayo:

• Ukuba kunokwenzeka, utyando lwenziwa ngomhla wokuzalwa komntwana wakho. Olu tyando lwenziwa xa kukho isixa esincinci samathumbu ngaphandle kwesisu kwaye ithumbu alidumbanga kakhulu.
• Kanye emva kokuzalwa, amathumbu angaphandle kwesisu abekwa engxoweni ekhethekileyo okanye agqunywe ngeplastiki ukuyikhusela.
• Usana lwakho emva koko lulungiselelwe utyando.
• Usana lwakho lufumana ianesthesia ngokubanzi. Eli yeza livumela umntwana wakho ukuba alale kwaye angabinazintlungu ngexesha lotyando.
• Ugqirha uhlola amathumbu omntwana wakho (amathumbu) ngokusondeleyo kwiimpawu zomonakalo okanye ezinye iziphene zokuzalwa. Amalungu angenampilo ayasuswa. Imiphetho esempilweni ithungiwe kunye.
• Amathumbu abuyiselwe emva esiswini.
• Umngxunya eludongeni lwesisu uyalungiswa.

Ukulungiswa okucwangcisiweyo kwenziwa xa umntwana wakho engazinzanga ngokwaneleyo ukulungiswa kokuqala. Inokwenziwa kwakhona ukuba amathumbu wosana adumbile kakhulu okanye kukho isixa esikhulu samathumbu ngaphandle komzimba. Okanye, kwenziwa xa isisu somntwana singekho ngokwaneleyo ukuba singaqulatha onke amathumbu. Ukulungiswa kwenziwa ngale ndlela ilandelayo:

• Kanye emva kokuzalwa, amathumbu omntwana kunye nawaphi na amanye amalungu angaphandle kwesisu abekwa kwisingxobo seplastiki eside. Le ngxowa ibizwa ngokuba yisilo. Isisele emva koko siqhotyoshelwe kwisisu somntwana.
• Elinye icala lesisele lixhonywe ngaphezulu kosana. Oku kuvumela amandla omxhuzulane ukunceda amathumbu ukuba atyibilike esiswini. Yonke imihla, umboneleli ngononophelo lwempilo uqinisa ngobunono isilo ukuze atyhale amathumbu esiswini.
• Kungathatha ukuya kwiiveki ezi-2 ukuba onke amathumbu abuyele ngaphakathi esiswini. Isilo siyasuswa. Umngxuma esiswini uyalungiswa.

Ukuhlinzwa okungakumbi kunokufuneka ngexesha elizayo ukulungisa izihlunu esiswini somntwana wakho.

I-Gastroschisis yimeko esongela ubomi. Kufuneka inyangwe kwakamsinya emva kokuzalwa ukuze amalungu omntwana akwazi ukukhula kwaye akhuselwe esiswini.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Ukunyanga kwamayeza kunyango
• Iingxaki zokuphefumla
• Ukopha
• Usulelo

Iingozi zokulungiswa kwe-gastroschisis zezi:

• Iingxaki zokuphefumla ukuba indawo yesisu somntwana (indawo esiswini) incinci kunesiqhelo. Usana lusenokufuna umbhobho wokuphefumla nomatshini wokuphefumla iintsuku ezimbalwa okanye iiveki emva kotyando.
• Ukudumba kwezicubu ezihambelana nodonga lwesisu kwaye zigubungele amalungu esisu.
• Ukwenzakala komzimba.
• Iingxaki ngokugaya kunye nokufunxa izondlo ekutyeni, ukuba umntwana unomonakalo omkhulu kwithumbu elincinci.
• Ukukhubazeka okwethutyana (izihlunu ziyeke ukuhamba) kwamathumbu amancinci.
• Isisu eseludongeni ihernia.
  
  

I-Gastroschisis ihlala ibonwa kwi-ultrasound ngaphambi kokuba umntwana azalwe. I-ultrasound ingabonisa ii-loops zamathumbu zihamba ngokukhululekileyo ngaphandle kwesisu somntwana.

Emva kokuba ifunyenwe i-gastroschisis, umntwana wakho uya kulandelwa kufutshane kakhulu ukuqinisekisa ukuba bayakhula.

Umntwana wakho kufuneka aziswe esibhedlele esineyunithi yokunyamekela ye-neonatal (NICU) kunye nogqirha wotyando. I-NICU isetyenziswe ukujongana neengxamiseko ezenzeka ngexesha lokuzalwa. Ugqirha wabantwana uqeqesho olukhethekileyo kuqhaqho lweentsana nabantwana. Uninzi lweentsana ezine-gastroschisis zihanjiswa ngecandelo le-cesarean (icandelo le-C).

Emva kotyando, umntwana wakho uya kufumana inkathalo kwi-NICU. Usana luya kubekwa ebhedini ekhethekileyo ukuze umntwana wakho afudumale.

Usana lwakho lusenokufuna ukuba kumatshini wokuphefumla de kube ukudumba kwamalungu kuyehla kunye nobukhulu bendawo yesisu inyukile.

Olunye unyango umntwana wakho oya kulufuna emva kotyando zezi:

• Ityhubhu ye-nasogastric (NG) ebekwe ngempumlo ukukhupha isisu kunye nokusigcina singenanto.
• Amayeza okubulala iintsholongwane.
• Ulwelo kunye nezondlo ezinikezwa ngomthambo.
• Ioksijini.
• Amayeza entlungu.

Ukondla kuqalwa nge-NG ityhubhu kwangoko xa amathumbu omntwana wakho eqala ukusebenza emva kotyando. Ukutyisa ngomlomo kuya kuqala kancinci. Umntwana wakho unokutya kancinci kwaye unokufuna unyango lokondla, inkuthazo eninzi kunye nexesha lokuchacha emva kokondla.

Umndilili wokuhlala esibhedlele ziiveki ezimbalwa ukuya kwiinyanga ezimbalwa. Unokwazi ukuthatha usana lwakho ekhaya xa sele beqalisile ukuthatha konke ukutya ngomlomo kunye nokuzuza ubunzima.

Emva kokuba uye ekhaya, umntwana wakho unokukhula ekuvalelweni kwamathumbu (isisu) ngenxa yekink okanye inxeba emathunjini. Ugqirha angakuxelela ukuba inyangwa njani.

Uninzi lwexesha, i-gastroschisis inokulungiswa ngoqhaqho olunye okanye ezimbini. Ukusebenza kakuhle komntwana wakho kuya kuxhomekeka kumonakalo ongakanani obukho emathunjini.

Emva kokuchacha kutyando, uninzi lwabantwana abane-gastroschisis bahlala kakuhle kwaye bahlala ubomi obuqhelekileyo. Uninzi lweentsana ezizalwa zine-gastroschisis azinazo naziphi na ezinye iziphene zokuzalwa.

Ukulungiswa kwesiphene kwodonga lwesisu - i-gastroschisis

• Ukulungiswa kweGastroschisis-uthotho
• Isililo

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I-Islam S. Iziphene zodonga lwesisu esiswini. Ku: Holcomb GW, Murphy JP, Ostlie DJ, ii-eds. Utyando lwabantwana luka-Ashcraft. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; I-2014: isahluko 48.

UDedbetter DJ, uChabra S, uJavid PJ. Iziphene zodonga lwesisu. Ku: Gleason CA, Juul SE, ii-eds. Izifo zika-Avery Zomntwana osandul 'ukuzalwa. Ngomhla we-10. IPhiladelphia, PA: Elsevier; I-2018: isahluko 73.