Ukulungiswa kwesinyi esstrophy

Ukulungiswa kwe-bladder exstrophy kukuhlinzwa ukuze kulungiswe isiphene sokuzalwa kwesinyi. Isinyi singaphakathi ngaphandle. Ihlanganiswe nodonga lwesisu kwaye iyavezwa. Amathambo e-pelvic nawo ahlukene.

Ukulungiswa kwe-bladder exstrophy kubandakanya utyando kabini. Utyando lokuqala kukulungisa isinyi. Eyesibini kukuncamathisela amathambo e-pelvic komnye komnye.

Utyando lokuqala lwahlula isinyi eludongeni lwesisu. Isinyi sivalekile. Intamo yesinyi kunye urethra ziyalungiswa. Umbhobho obhetyebhetye, obumbeneyo obizwa ngokuba yi-catheter ubekwa ukuze ukhuphe umchamo kwisinyi. Oku kubekwe ngodonga lwesisu. I-catheter yesibini ishiyekile kwi-urethra yokukhuthaza ukuphilisa.

Utyando lwesibini, utyando lwethambo lomqolo, lunokwenziwa kunye nokulungiswa kwesinyi. Inokulibaziseka kangangeeveki okanye iinyanga.

Utyando lwesithathu lunokufuneka ukuba kukho ingxaki kwisisu okanye naziphi na iingxaki kulungiso lokuqala lokuqala.

Utyando luyacetyiswa kubantwana abazalwa benesinyi esstrophy. Esi siphene senzeka rhoqo kubafana kwaye sihlala sinxulunyaniswa nezinye iziphene zokuzalwa.

Utyando kufuneka:

• Vumela umntwana ukuba akhule ngendlela eqhelekileyo yokulawula umchamo
• Thintela iingxaki zexesha elizayo ngomsebenzi wesondo
• Ukuphucula ukubonakala komntwana ngokwasemzimbeni (amalungu esini aya kujongeka njengesiqhelo)
• Thintela usulelo olunokwenzakalisa izintso

Ngamanye amaxesha, isinyi sincinci kakhulu xa kuzalwa. Kule meko, utyando luya kulibaziseka ide ikhule isinyi. Ezi zintsana zithunyelwa ekhaya kwii-antibiotics. Isinyi, esingaphandle kwesisu, kufuneka sigcinwe sifumile.

Kungathabatha iinyanga ukuba isinyi sikhule siye kubungakanani obuchanekileyo. Usana luya kulandelwa kufutshane neqela lezonyango. Iqela ligqiba ekubeni utyando kufuneka lwenziwe nini.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Impendulo kumayeza
• Iingxaki zokuphefumla
• Ukopha, amahlwili egazi
• Usulelo

Iingozi ngale nkqubo zinokubandakanya:

• Izifo ezingapheliyo zomchamo
• Ukungasebenzi kakuhle ngokwesondo / nge-erectile
• Iingxaki zezintso
• Imfuneko yotyando lwexesha elizayo
• Ulawulo olubi lomchamo (ukungasebenzi)

Uninzi lolungiso lwe-bladder exstrophy lwenziwa xa umntwana wakho eneentsuku nje ezimbalwa ubudala, ngaphambi kokuba aphume esibhedlele. Kule meko, abasebenzi basesibhedlele baya kulungiselela umntwana wakho ukuba enze utyando.

Ukuba utyando aluzange lwenziwe xa umntwana wakho esandul 'ukuzalwa, umntwana wakho unokufuna ezi mvavanyo zilandelayo ngexesha lotyando:

• Uvavanyo lomchamo (inkcubeko yokuchama kunye nokuchama) ukujonga umchamo womntwana wakho ukuba wosulelekile kwaye uvavanye ukusebenza kwezintso
• Uvavanyo lwegazi (ukubala okupheleleyo kwegazi, ii-electrolyte, kunye novavanyo lwezintso)
• Ingxelo yokukhutshwa komchamo
• X-reyi isinqe
• I-Ultrasound yezintso

Soloko uxelela umboneleli wezempilo womntwana wakho ukuba ngawaphi amayeza awathathayo umntwana wakho. Bazise malunga namayeza okanye amayeza owathengileyo ngaphandle kommiselo.

Kwiintsuku ezilishumi ngaphambi kotyando, umntwana wakho angacelwa ukuba ayeke ukuthatha i-aspirin, ibuprofen, warfarin (Coumadin), kunye namanye amayeza. La mayeza enza kube nzima ukuba igazi lijiye. Buza umboneleli ukuba zeziphi iziyobisi umntwana wakho afanele ukuzithatha ngosuku lotyando.

Ngomhla wotyando:

• Umntwana wakho uhlala ecelwa ukuba angaseli okanye atye nantoni na iiyure ezininzi ngaphambi kotyando.
• Nika amayeza umboneleli womntwana wakho akuxelele ukuba unike kunye nokusela okuncinci kwamanzi.
• Umboneleli womntwana wakho uya kukuxelela ukuba uza kufika nini.

Emva kotyando lwethambo lomqolo, umntwana wakho kuya kufuneka abe kumzimba ophantsi okanye isilingi kangangeeveki ezi-4 ukuya kwezi-6. Oku kunceda amathambo aphile.

Emva kotyando lwesinyi, umntwana wakho uya kuba netyhubhu ekhupha isinyi kudonga lwesisu (i-catheter yesuprapubic). Oku kuya kubakhona iiveki ezi-3 ukuya kwezi-4.

Umntwana wakho uya kudinga ulawulo lwentlungu, ukhathalelo lwenxeba kunye neyeza lokubulala iintsholongwane. Umboneleli uya kukufundisa ngezi zinto ngaphambi kokuba uphume esibhedlele.

Ngenxa yomngcipheko omkhulu wosulelo, umntwana wakho kuya kufuneka ukuba abe novavanyo lokuchama kunye nenkcubeko yokuchama kulo lonke utyelelo lwabantwana abalungileyo. Kwimpawu zokuqala zokugula, ezi mvavanyo zinokuphindwa. Abanye abantwana bathatha ii-antibiotics rhoqo ukukhusela usulelo.

Ulawulo lwe-Urinary luhlala lusenzeka emva kokuba intamo yesinyi ilungisiwe. Olu tyando alusoloko luphumelela. Umntwana unokufuna ukuphinda enze utyando kamva.

Ngaphandle kotyando oluphindaphindiweyo, abantwana abambalwa abayi kuba nolawulo kumchamo wabo. Banokufuna i-catheterization.

Ukulungiswa kwesiphene sokuzalwa; Ukulungiswa kwesinyi rhoqo; Ukulungiswa kwesinyi; Ukulungiswa kwesinyi esstrophy

• Unonophelo lwenxeba lotyando - luvulekile

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UGearhart JP, uDi Carlo HN. Ubunzima be-Exstrophy-epispadias. Ku: UPartin AW, uDmochowski RR, uKavoussi LR, uPeter CA, ii-eds. ICampbell-Walsh-Wein Urology. Umhla we-12. IPhiladelphia, PA: Elsevier; 2021: isahluko 31.

I-Weiss DA, i-Canning DA, iBorer JG, uKryger JV, uRoth E, uMitchell ME. Isinyi kunye ne-cloacal exstrophy. Ku: Holcomb GW, Murphy JP, St Peter SD eds. Utyando lwabantwana eHolcomb kunye neAshcraft. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2020: isahluko 58.