Ventriculoperitoneal shunting

I-Ventriculoperitoneal shunting lunyango lokunyanga i-cerebrospinal fluid (CSF) egqithileyo kwimingxunya (ye-ventricles) yengqondo (i-hydrocephalus).

Le nkqubo yenziwa kwigumbi lokusebenza phantsi kwe-anesthesia ngokubanzi. Ithatha malunga 1 1/2 yeeyure. Umbhobho (i-catheter) udluliswa ukusuka kwimingxunya yentloko ukuya esiswini ukukhupha ulwelo olugqithisileyo lwe-cerebrospinal fluid (CSF). Ivalve yoxinzelelo kunye nesixhobo sokulwa nesiphon siqinisekisa ukuba umyinge olungileyo wolwelo uyatsalwa.

Inkqubo yenziwa ngolu hlobo lulandelayo:

• Indawo eneenwele entloko ichetyiwe. Oku kunokuba semva kwendlebe okanye kumphezulu okanye ngasemva kwentloko.
• Ugqirha wenza isikhumba esisikiweyo emva kwendlebe. Olunye usiko oluncinci lotyando lwenziwa esiswini.
• Umngxunya omncinci ukrwelwe lukakayi. Isiphelo esinye se-catheter sidluliselwa kwi-ventricle yengqondo. Oku kunokwenziwa kunye okanye ngaphandle kwekhompyuter njengesikhokelo. Inokwenziwa kwakhona nge-endoscope evumela ugqirha ukuba abone ngaphakathi kwe-ventricle.
• I-catheter yesibini ibekwa phantsi kwesikhumba emva kwendlebe. Ithunyelwa entanyeni nasesifubeni, kwaye ihlala isisu. Ngamanye amaxesha, iyema kwindawo yesifuba. Kwisisu, i-catheter ihlala ibekwa kusetyenziswa i-endoscope. Ugqirha usenokwenza kwakhona ukusika okuncinci okuncinci, umzekelo entanyeni okanye kufutshane nekhola, ukunceda ukudlulisa i-catheter phantsi kolusu.
• Ivalufa ibekwa ngaphantsi kwesikhumba, ihlala ingemva kwendlebe. Ivalve idityaniswe kuzo zombini iicatheters. Xa uxinzelelo olongezelelekileyo lukhula lujikeleze ingqondo, ivalve iyavula, kwaye ulwelo olugqithisileyo ludlula nge-catheter iye esiswini okanye kwindawo yesifuba. Oku kunceda ukunciphisa uxinzelelo lwangaphakathi. Isigcina amanzi esivelini sivumela ukuprinta (ukumpompa) ivelufa kunye nokuqokelela i-CSF ukuba iyafuneka.
• Umntu usiwa kwindawo yokubuyisela emva emva koko asiwe kwigumbi lasesibhedlele.

Olu tyando lwenziwa xa kukho ulwelo oluninzi lwe-cerebrospinal fluid (CSF) kwingqondo nakwintambo yomqolo. Oku kubizwa ngokuba yihydrocephalus. Kubangela ngaphezulu koxinzelelo oluqhelekileyo kwingqondo. Ingabangela ukonakala kwengqondo.

Abantwana banokuzalwa benayo ihydrocephalus. Inokwenzeka nezinye iziphene zokuzalwa zekholamu yomqolo okanye ingqondo. IHydrocephalus inokwenzeka nakwabadala.

Utyando lwe-Shunt kufuneka lwenziwe kwakamsinya nje ukuba kufunyaniswe i-hydrocephalus. Olunye utyando lunokucetyiswa. Ugqirha wakho unokukuxelela ngakumbi ngezi ndlela unokukhetha kuzo.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

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

Umngcipheko wokubekwa kwindawo ye-ventriculoperitoneal shunt yile:

• Ukuqhaqha kwegazi okanye ukopha kwingqondo
• Ukudumba kobuchopho
• Umngxunya emathunjini (ukungcola kwamathumbu), okunokwenzeka kamva emva kotyando
• Ukuvuza kwe-CSF fluid phantsi kwesikhumba
• Usulelo lwe-shunt, ingqondo, okanye isisu
• Umonakalo kwizihlunu zobuchopho
• Ukuxhuzula

Ukuyeka kungayeka ukusebenza. Ukuba oku kuyenzeka, ulwelo luya kuqala ukwakha kwingqondo kwakhona. Njengoko umntwana ekhula, i-shunt inokufuna ukubekwa kwakhona.

Ukuba inkqubo ayisiyongxamiseko (kucetywa ukuba kwenziwe utyando):

• Xelela umboneleli wezempilo ukuba ngawaphi amayeza, izongezo, iivithamini, okanye imifuno ethathwa ngumntu.
• Thatha naliphi na iyeza umboneleli athi makalithathe ngamanzi amancinci.

Buza umboneleli malunga nokunciphisa ukutya nokusela ngaphambi kotyando.

Landela nayiphi na enye imiyalelo malunga nokulungiselela ekhaya. Oku kunokubandakanya ukuhlamba ngesepha ekhethekileyo.

Umntu unokufuna ukulala caba iiyure ezingama-24 okokuqala kufakwa i-shunt.

Ukuhlala ixesha elingakanani esibhedlele kuxhomekeke kwisizathu sokuba kufuneke ukuba shunt. Iqela lokhathalelo lwempilo liya kumbeka esweni lo mntu. Amanzi e-IV, amayeza okubulala iintsholongwane, kunye namayeza eentlungu aya kunikwa xa kufuneka njalo.

Landela imiyalelo yomboneleli malunga nendlela yokunyamekela i-shunt ekhaya. Oku kunokubandakanya ukuthatha iyeza ukuthintela usulelo shunt.

Ukubekwa kwe-Shunt kuhlala kuyimpumelelo ekunciphiseni uxinzelelo kwingqondo. Kodwa ukuba i-hydrocephalus inxulumene nezinye iimeko, ezinje nge-spina bifida, ithumba lobuchopho, i-meningitis, i-encephalitis, okanye i-hemorrhage, ezi meko zinokuchaphazela isifo. Ingakanani i-hydrocephalus ngaphambi kokuba utyando luchaphazele iziphumo.

Shunt - ventriculoperitoneal; VP shunt; Ukuhlaziywa kweShunt

• Unonophelo lwenxeba lotyando - luvulekile
• I-Ventriculoperitoneal shunt - ukukhutshwa

• Iimpawu zengqondo
• I-Craniotomy yeswekile yobuchopho
• Ventriculoperitoneal shunt - uthotho

IBadhiwala JH, Kulkarni AV. Iinkqubo zokucima umoya Ku: Winn HR, ed. Ugqirha we-Youmans kunye no-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 201.

IRosenberg GA. I-edema yobuchopho kunye nokuphazamiseka kokujikeleza kolwelo lwe-cerebrospinal. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahl 88.