Ukulungiswa kwe-Omphalocele

Ukulungiswa kwe-Omphalocele yinkqubo eyenziweyo kusana ukulungisa isiphako sokuzalwa eludongeni lwesisu (esiswini) apho onke okanye inxenye yesisu, mhlawumbi isibindi kunye namanye amalungu angena ngaphandle kwesisu (inkaba) ebhityile. ingxowa.

Ezinye iziphene zokuzalwa zinokubakho.

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 oluphambili luhlala lusenziwa nge-omphalocele encinci.

• Kanye emva kokuzalwa, ingxowa enamalungu angaphandle kwesisu igutyungelwe ngendlela engenazintsholongwane ukuyikhusela.
• Xa oogqirha befumanisa ukuba umntwana wakho osanda kuzalwa womelele ngokwaneleyo ukuba angatyandwa, umntwana wakho ukulungele ukwenza utyando.
• Usana lwakho lufumana ianesthesia ngokubanzi. Eli yeza livumela umntwana wakho ukuba alale kwaye angabinazintlungu ngexesha lotyando.
• Ugqirha usika (ukusika) ukususa isaka ejikeleze amalungu.
• Amalungu avavanywa ngokusondeleyo ukuze abonakalise iimpawu zomonakalo okanye ezinye iziphene zokuzalwa. Amalungu angenampilo ayasuswa. Imiphetho esempilweni ithungiwe kunye.
• Amalungu abuyiselwa emva esiswini.
  
• Umngxunya eludongeni lwesisu uyalungiswa.

Ukulungiswa okucwangcisiweyo kwenziwa xa umntwana wakho engazinzanga ngokwaneleyo ukulungiswa kokuqala. Okanye, kuyenziwa ukuba i-omphalocele inkulu kakhulu kwaye izitho azinakulunga esiswini somntwana. Ukulungiswa kwenziwa ngale ndlela ilandelayo:

• Kanye emva kokuzalwa, isingxobo seplastiki (esibizwa ngokuba sisisele) okanye uhlobo lwemathiriyeli esisetyenziselwa ukuqulatha i-omphalocele. Ingxowa okanye umnatha emva koko uncamathele kwisisu somntwana.
• Zonke iintsuku ezi-2 ukuya kwezi-3, ugqirha uqinisa ngobunono isikhwama okanye umnatha ukutyhala amathumbu esiswini.
• Ingathatha ukuya kwiiveki ezi-2 okanye nangaphezulu ukuba onke amalungu abuyele ngaphakathi esiswini. Ingxowa okanye umnatha uyasuswa. Umngxuma esiswini uyalungiswa.

I-Omphalocele 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

Umngcipheko wokulungiswa kwe-omphalocele zezi:

• Iingxaki zokuphefumla. Usana lusenokufuna umbhobho wokuphefumla nomatshini wokuphefumla iintsuku ezimbalwa okanye iiveki emva kotyando.
• Ukudumba kwethishu eligcina udonga lwesisu kwaye ligubungele amalungu esisu.
• Ukwenzakala komzimba.
• Iingxaki ngokugaya kunye nokufunxa izondlo ekutyeni, ukuba umntwana unomonakalo omkhulu kwithumbu elincinci.

I-Omphalocele ihlala ibonwa kwi-ultrasound ngaphambi kokuba umntwana azalwe. Emva kokuba ifunyenwe, 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 ezinee-omphalocele ezinkulu zihanjiswa ngecandelo le-cesarean (C-icandelo).

Emva kotyando, umntwana wakho uya kufumana inkathalo kwi-NICU. Usana lwakho 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:

• Amayeza okubulala iintsholongwane
• Ulwelo kunye nezondlo ezinikezwa ngomthambo
• Ioksijini
• Amayeza entlungu
• Umbhobho we-nasogastric (NG) obekwe ngempumlo ungene esiswini ukukhupha isisu kwaye usigcine singenanto

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

Umntwana wakho uhlala ixesha elingakanani esibhedlele kuxhomekeke ekubeni kukho ezinye iziphene zokuzalwa kunye neengxaki. 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, utyando lunokulungisa i-omphalocele. Ukusebenza kakuhle komntwana wakho kuxhomekeke kumonakalo okanye ilahleko yamathumbu, nokuba umntwana wakho unazo ezinye iziphene zokuzalwa.

Abanye abantwana bane-gastroesophageal reflux emva kotyando. Le meko ibangela ukutya okanye isisu esisisu ukuba sibuye kwakhona sisuka kwisisu siye kwi-esophagus.

Abanye abantwana abanee-omphaloceles ezinkulu banokuba nemiphunga emincinci kwaye banokufuna ukusebenzisa umatshini wokuphefumla.

Zonke iintsana ezizalwe nge-omphalocele kufuneka zenze uvavanyo lwe-chromosome. Oku kuya kunceda abazali baqonde umngcipheko wale ngxaki ekukhulelweni okuzayo.

Ukulungiswa kwesiphene eludongeni esiswini - i-omphalocele; Ukulungiswa kwe-Exomphalos

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

• Ukulungiswa kwe-Omphalocele-uthotho

UChung DH. Utyando lwabantwana. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango: Isiseko sebhayiloji yoQeqesho lwangoku. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 66.

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.

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.