Ukulungiswa kwe-hernia yokuzalwa kwe-diaphragmatic

Ukulungiswa kwe-hernia ye-diaphragmatic hernia (CDH) yokulungisa lutyando ukulungisa ukuvulwa okanye indawo kwidayaphragm yomntwana. Olu kuvulwa kuthiwa yi-hernia. Luhlobo olunqabileyo lokuzalwa kwesiphene. Ukuzalwa kuthetha ukuba ingxaki ikhona xa uzalwa.

Ngaphambi kokuba utyando lwenziwe, phantse zonke iintsana zifuna isixhobo sokuphefumla ukuphucula amanqanaba eoksijini.

Utyando lwenziwa ngelixa umntwana wakho ephantsi kwe-anesthesia ngokubanzi (elele kwaye engakwazi ukuziva iintlungu). Ugqirha uhlala esika (isisiko) esiswini phantsi kweembambo ezingaphezulu. Oku kuvumela amalungu kummandla ukuba afikeleleke. Ugqirha utsalela la malungu kwindawo yawo ngokuvula kwidayaphragm nakwisisu esiswini.

Kwiimeko ezingaphantsi kakhulu, utyando lunokwenziwa kusetyenziswa ukubonwa okuncinci esifubeni. Ikhamera encinci yevidiyo ebizwa ngokuba yi-thoracoscope ibekwe kwesinye seziqwenga. Oku kuvumela ugqirha ukuba abone ngaphakathi kwesifuba. Izixhobo zokulungisa umngxunya kwidayaphragm zibekwe kwezinye iindlela.

Ngalo naluphi na uhlobo lokusebenza, ugqirha ulungisa umngxunya kwidayaphragm. Ukuba umngxunya mncinci, unokulungiswa ngemithungo. Okanye, isiqwenga seplastiki sisetyenziselwa ukugquma umngxunya.

Isithambisi sisihlunu. Kubalulekile ukuphefumla. Yahlulahlula isifuba (apho intliziyo nemiphunga ikhoyo) kwindawo yesisu.

Kumntwana one-CDH, umsipha we-diaphragm awubunjwanga ngokupheleleyo. Ukuvulwa kwe-CDH kuvumela amalungu asuka esiswini (isisu, udakada, isibindi kunye namathumbu) ukuba aye kwisifuba apho kukho imiphunga. Imiphunga ayikhuli ngokwesiqhelo kwaye ihlala incinci kakhulu ukuba iintsana zikwazi ukuziphefumlela xa zizelwe. Imithambo yegazi emiphungeni ikhula ngokungaqhelekanga. Oku kubangela ukuba ioksijini engonelanga ingene emzimbeni wosana.

I-hernia ene-diaphragmatic isenokubusongela ubomi kwaye uninzi lweentsana ezine-CDH zigula kakhulu. Ugqirha lokulungisa i-CDH kufuneka lwenziwe kwangoko emva kokuba umntwana ezelwe.

Iingozi zolu tyando zibandakanya:

• Iingxaki zokuphefumla, ezinokuba nzima
• Ukopha
• Umphunga owileyo
• Iingxaki zemiphunga ezingapheliyo
• Usulelo
• Impendulo kumayeza

Iintsana ezizalwe zine-CDH zamkelwe kwicandelo lokhathalelo olunzulu lweentsana (i-NICU). Kungaba ziintsuku okanye iiveki ngaphambi kokuba umntwana azinze ngokwaneleyo ukuba angatyandwa. Kuba le meko isongela ubomi kwaye ukuhambisa usana olusandula ukuzalwa kuyingozi, iintsana ezaziwa ngokuba zine-CDH kufuneka zisiwe kwiziko elinabagqirha babantwana kunye neonatologists.

• Kwi-NICU, umntwana wakho uya kufuna umatshini wokuphefumla (umatshini wokuphefumla ngomatshini) ngaphambi kotyando. Oku kunceda umntwana aphefumle.
• Ukuba umntwana wakho ugula kakhulu, umatshini we-heart-lung bypass (i-membrane yangaphandle yeoksijini, okanye i-ECMO) inokufuneka ukwenza umsebenzi wentliziyo kunye nemiphunga.
• Phambi kotyando, usana lwakho luya kuba ne-x-reyi kunye novavanyo lwegazi rhoqo ukubona ukuba imiphunga isebenza njani. Inzwa yokukhanya (ebizwa ngokuba yi-pulse oximeter) ifakwa kulusu lomntwana ukujonga inqanaba leoksijini egazini.
• Usana lwakho lunokunikwa amayeza okulawula uxinzelelo lwegazi kwaye uhlale ukhululekile.

Umntwana wakho uya kuba neetyhubhu ezibekiweyo:

• Ukusuka emlonyeni okanye empumlweni ukuya esiswini ukugcina umoya ungangeni esiswini
• Kwithambo lokujonga uxinzelelo lwegazi
• Kwimithambo ukuhambisa izakhamzimba kunye namayeza

Usana lwakho luya kuba kumatshini wokuphefumla emva kotyando kwaye luza kuhlala esibhedlele iiveki ezininzi. Nje ukuba ususwe kumatshini wokuphefumla, umntwana wakho usenokufuna ioksijini kunye namayeza okwethutyana.

Ukondla kuya kuqala emva kokuba amathumbu omntwana wakho eqale ukusebenza. Ukutyiswa kuhlala kunikezelwa ngombhobho omncinci, othambileyo wokutyisa ukusuka emlonyeni okanye empumlweni ungene esiswini okanye emathunjini amancinci de umntwana wakho athathe ubisi ngomlomo.

Phantse zonke iintsana ezine-CDH zine-reflux xa zisitya. Oku kuthetha ukuba ukutya okanye iasidi esiswini sabo inyukela phezulu kummango, ityhubhu ekhokelela emqaleni iye esiswini. Oku kunokuba kubi. Ikwakhokelela ekuphalazeleni nasekugabheni rhoqo, okwenza ukutya kube nzima ngakumbi xa umntwana wakho ethatha ukutya ngomlomo. I-Reflux inyusa umngcipheko we-pneumonia ukuba iintsana zifunxa ubisi kwimiphunga yazo. Ingenza nokuba kube ngumngeni kwiintsana ukuba zithathe iikhalori ezaneleyo ukuze zikhule.

Abongikazi kunye neengcali zokondla baya kukufundisa ngeendlela zokubamba nokondla umntwana wakho ukukhusela i-reflux. Olunye usana kufuneka lube kwityhubhu yokondla ixesha elide ukubanceda ukuba bafumane iikhalori ezaneleyo ukuze zikhule.

Iziphumo zolu tyando zixhomekeke kwindlela ophuke ngayo umntwana wakho. Ezinye iintsana zinezinye iingxaki zonyango, ngakumbi ngentliziyo, ngengqondo, izihlunu, kunye namalungu, ahlala echaphazela impilo yomntwana.

Ngokwesiqhelo imbonakalo ilungile kwiintsana ezinezicubu zemiphunga ezikhule kakuhle kwaye azikho ezinye iingxaki. Nangona kunjalo, uninzi lwabantwana abazalwa benesifo esine-diaphragmatic hernia bagula kakhulu kwaye baya kuhlala esibhedlele ixesha elide. Ngokuhambela phambili kwezonyango, indlela ezijongwa ngayo ezi ntsana iyaphucuka.

Zonke iintsana eziye zalungiswa i-CDH kuya kufuneka zijongwe ngocoselelo ukuqinisekisa ukuba umngxunya kwidayaphragm yayo awuvuleki kwakhona njengoko bekhula.

Iintsana ezazinokuvula okukhulu okanye isiphene kwidayaphragm, okanye ezazineengxaki kwimiphunga yazo emva kokuzalwa, zinokuba nesifo semiphunga emva kokuphuma kwabo esibhedlele. Basenokufuna ioksijini, amayeza, kunye netyhubhu yokondla iinyanga okanye iminyaka.

Ezinye iintsana ziya kuba neengxaki zokukhasa, ukuhamba, ukuthetha nokutya. Kuya kufuneka babone abanyangi ngokwasemzimbeni okanye emsebenzini ukubanceda baphuhlise izihlunu kunye namandla.

I-hernia ye-diaphragmatic-utyando

• Ukuzisa umntwana wakho ukuba atyelele umntakwabo ogula kakhulu
• Unonophelo lwenxeba lotyando - luvulekile

• Ukulungiswa kwe-hernia ye-diaphragmatic-uthotho

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