Ukulungiswa kwePectus excavatum

Ukulungiswa kwe-Pectus excavatum lutyando ukulungisa i-pectus excavatum. Olu luzalo (olukhoyo ekuzalweni) ukukhubazeka ngaphambili kodonga lwesifuba olubangela ithambo lesifuba elitshonileyo (sternum) kunye neembambo.

I-Pectus excavatum ibizwa ngokuba yi-funnel okanye isifuba esitshonileyo. Inokuba mandundu ngakumbi ngexesha lokufikisa.

Zimbini iintlobo zoqhaqho ukulungisa le meko - utyando oluvulekileyo kunye notyando oluvaliweyo (oluncinci). Nokuba kwenzeka utyando ngelixa umntwana elele ubuthongo obunzulu kwaye engenazintlungu kwi-anesthesia ngokubanzi.

Utyando oluvulekileyo luqhelekile. Olu tyando lwenziwa ngale ndlela ilandelayo:

• Ugqirha usika (ukusika) ngaphambili kwinxalenye yesifuba.
• I-cartilage ekhubazekileyo isuswe kwaye ubambo lwembambo lushiyekile endaweni. Oku kuyakuvumela intlala ukuba ikhule kwakhona ngokuchanekileyo.
• Kwenziwa ukusikwa kwethambo lesifuba, elihanjiswa liye kwindawo echanekileyo. Ugqirha unokusebenzisa intambo yesinyithi (isiqwenga senkxaso) ukubamba ithambo lesifuba kule ndawo yesiqhelo lide liphilise. Ukuphilisa kuthatha iinyanga ezi-3 ukuya kwezi-12.
• Ugqirha unokubeka ityhubhu yokucoca ulwelo olwakha kwindawo yokulungisa.
• Ekupheleni kotyando, ukusikwa kuvaliwe.
• Imicu yentsimbi iyasuswa kwiinyanga ezi-6 ukuya kwezi-12 ngokusikwa kancinci kolusu phantsi kwengalo. Le nkqubo ihlala isenziwa ngaphandle.

Uhlobo lwesibini lotyando yindlela evaliweyo. Isetyenziswa ikakhulu ebantwaneni. Akukho ntlala okanye ithambo lisuswe. Olu tyando lwenziwa ngale ndlela ilandelayo:

• Ugqirha wenza ukusika okuncinci, elinye kwicala lesifuba.
• Ikhamera encinci yevidiyo ebizwa ngokuba yi-thoracoscope ibekwe kwesinye seziqwenga. Oku kuvumela ugqirha ukuba abone ngaphakathi kwesifuba.
• Ibha yentsimbi egobile eyenziwe ukuba ilingane umntwana ifakwa phakathi kusiko kwaye ibekwe phantsi kwethambo lesifuba. Injongo yebha kukuphakamisa ithambo lesifuba. Ibha ishiyeke endaweni iminyaka emi-2 ubuncinci. Oku kunceda ithambo lesifuba ukuba likhule ngokufanelekileyo.
• Ekupheleni kotyando, umda uyasuswa kwaye ukusikwa kuvaliwe.

Ugqirha lunokuthatha iiyure ezi-1 ukuya kwezi-4, kuxhomekeke kwinkqubo.

Isizathu esiqhelekileyo sokulungiswa kwe-pectus excavatum kukuphucula ukubonakala kwodonga lwesifuba.

Ngamanye amaxesha ukukhubazeka kubanzima kangangokuba kubangele iintlungu esifubeni kwaye kuchaphazele nokuphefumla, ikakhulu kubantu abadala.

Ugqirha lwenziwa ikakhulu kubantwana abaneminyaka eli-12 ukuya kweli-16 ubudala, kodwa hayi ngaphambi kweminyaka yobudala engama-6. Ingenziwa nakubantu abadala abakwiminyaka yabo yama-20.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Impendulo kumayeza
• Iingxaki zokuphefumla
• Ukopha, amahlwili egazi, okanye usulelo

Iingozi zolu tyando zezi:

• Ukwenzakala entliziyweni
• Ukuwa kwemiphunga
• Intlungu
• Ukubuya kokukhubazeka

Uvavanyo olupheleleyo lwezonyango kunye neemvavanyo zonyango ziyafuneka ngaphambi kotyando. Ugqirha uya kuyalela oku kulandelayo:

• I-electrocardiogram (ECG) kunye ne-echocardiogram ebonisa indlela esebenza ngayo intliziyo
• Uvavanyo lomsebenzi wePulmonary ukukhangela iingxaki zokuphefumla
• I-CT scan okanye iMRI yesifuba

Xelela ugqirha okanye umongikazi malunga:

• Amayeza asetyenziswa ngumntwana wakho. Faka amayeza, amayeza, iivithamini, okanye ezinye izongezo ozithengileyo ngaphandle kommiselo.
• Izinto ezithile emzimbeni umntwana wakho kusenokufuneka amayeza, i-latex, iteyiphu, okanye isicoci solusu.

Ngexesha leentsuku ngaphambi kotyando:

• Malunga neentsuku ezisi-7 ngaphambi kotyando, umntwana wakho angacelwa ukuba ayeke ukuthatha i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), warfarin (Coumadin), kunye nezinye iziyobisi ezicothayo.
• Buza ugqirha wakho okanye umongikazi ukuba zeziphi iziyobisi umntwana wakho afanele ukuzithatha ngosuku lotyando.

Ngomhla wotyando:

• Umntwana wakho uya kucelwa ukuba angaseli okanye atye nantoni na emva kobusuku bobusuku ngaphambi kokuhlinzwa.
• Nika umntwana wakho naziphi na iziyobisi ugqirha akuxelele ukuba uzinike kunye nokusela okuncinci kwamanzi.
• Fika esibhedlele ngexesha.
• Ugqirha uya kuqinisekisa ukuba umntwana wakho akanazimpawu zokugula ngaphambi kotyando. Ukuba umntwana wakho uyagula, utyando lusenokumiswa.

Kuqhelekile ukuba abantwana bahlale esibhedlele iintsuku ezi-3 ukuya kwezi-7. Uhlala ixesha elingakanani umntwana wakho kuxhomekeke kwindlela aqhubeka ngayo nokubuyela kwimeko yesiqhelo.

Ubuhlungu buqhelekile emva kotyando. Kwiintsuku zokuqala ezimbalwa, umntwana wakho unokufumana iyeza lentlungu elomeleleyo emthanjeni (nge-IV) okanye nge-catheter ebekwe emqolo (i-epidural). Emva koko, iintlungu zihlala zilawulwa ngamayeza athathwe ngomlomo.

Umntwana wakho unokuba nemibhobho esifubeni ejikeleze ukusika kotyando. Ezi tyhubhu zikhupha ulwelo olongezelelekileyo oluqokelela kwinkqubo. Iityhubhu ziya kuhlala zide zide ziyeke ukukhupha amanzi, zihlala emva kweentsuku ezimbalwa. Iityhubhu ke ziyasuswa.

Ngomhla emva kotyando, umntwana wakho uya kukhuthazwa ukuba ahlale, aphefumle kakhulu, aphume ebhedini ahambe. Le misebenzi iya kunceda ukuphilisa.

Ekuqaleni, umntwana wakho akasayi kuba nako ukugoba, ukujija, okanye ukuziqengqa ukusuka kwelinye icala ukuya kwelinye. Imisebenzi iya kwandiswa kancinci.

Xa umntwana wakho ekwazi ukuhamba ngaphandle koncedo, mhlawumbi bakulungele ukugoduka. Phambi kokuba uphume esibhedlele, uyakufumana amayeza amayeza eentlungu zomntwana wakho.

Ekhaya, landela nayiphi na imiyalelo yokukhathalela umntwana wakho.

Utyando luhlala lukhokelela kuphuculo kwimbonakalo, ukuphefumla, kunye nokwenza umthambo.

Ukulungiswa kwesifuba somsebenzi; Ukulungiswa kwesifuba; Ukulungiswa kwesifuba se-Sunken; Ukulungiswa kwesifuba sikaCobbler; Ukulungiswa kweNuss; Ukulungiswa kwakhona

• I-Pectus excavatum - ukukhutshwa
• Unonophelo lwenxeba lotyando - luvulekile

• I-Pectus excavatum
• Ukulungiswa kwepectus excavatum - uthotho

UNuss D, uKelly RE. Ukukhubazeka kodonga lwesifuba sokuzalwa. Ku: Holcomb GW, Murphy JP, Ostlie DJ, ii-eds. Utyando lwabantwana luka-Ashcraft. Umhla wesi-6. IPhiladelphia, PA: Elsevier Saunders; 2014: isahluko 20.

U-Putnam JB. Umlenze, udonga lwesifuba, i-pleura, kunye ne-mediastinum. 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 57.