Utyando lwe-Scoliosis ebantwaneni

Utyando lwe-Scoliosis lulungisa ukujika okungaqhelekanga komqolo (scoliosis). Injongo kukukhusela ngokukhuselekileyo umgudu womntwana wakho kwaye ulungelelanise amahlombe omntwana wakho kunye neentsimbi ukulungisa ingxaki yomqolo womntwana wakho.

Ngaphambi kotyando, umntwana wakho uya kufumana i-anesthesia ngokubanzi. La ngamayeza alalisa umntwana wakho kubuthongo obunzulu kwaye amenza angakwazi ukuziva iintlungu ngexesha lotyando.

Ngexesha lotyando, ugqirha womntwana wakho uya kusebenzisa izinto ezifakwayo, ezinjengeentonga zentsimbi, iihuku, izikrufu, okanye ezinye izixhobo zentsimbi ukulungisa umqolo womntwana wakho kunye nokuxhasa amathambo omqolo. Ukufakelwa kwamathambo kubekwe ukubamba umqolo kwindawo echanekileyo kwaye ugcine ukugoba kwakhona.

Ugqirha wotyando uya kwenza ubuncinci ukusikwa kotyando (ukusikwa) ukuya kumqolo womntwana wakho. Oku kunqunyulwa kunokuba kumqolo, esifubeni, okanye kuzo zombini iindawo. Ugqirha usenokwenza nenkqubo esebenzisa ikhamera ekhethekileyo yevidiyo.

• Ukusikwa kotyando ngasemva kubizwa ngokuba yindlela yangasemva. Olu tyando ludla ngokuthatha iiyure ezininzi.
• Ukusika udonga lwesifuba kuthiwa yi-thoracotomy. Ugqirha usika esifubeni somntwana wakho, uphungula imiphunga, kwaye uhlala esusa ubambo. Ukubuyiselwa emva kolu tyando kuhlala kukhawuleza.
• Abanye abagqirha benza zozibini ezi ndlela kunye. Lo ngumsebenzi omde kwaye unzima ngakumbi.
• Uncedo lwevidiyo yokuncedisa utyando lwe-thoracoscopic (VATS) yenye indlela. Isetyenziselwa iintlobo ezithile zemijelo yomqolo. Kuthatha ubuchule obuninzi, kwaye ayingabo bonke abagqirha abaqeqeshiweyo ukuba bayenze. Umntwana kufuneka anxibe izihlangu zezilima ezidityaniswe ngentsinjana / ngeplangana kwiinyanga ezintathu emva kwale nkqubo.

Ngexesha lotyando:

• Ugqirha uya kususa izihlunu ecaleni emva kokusika.
• Amalungu phakathi kwe-vertebrae eyahlukeneyo (amathambo omqolo) aya kukhutshwa.
• Ukufakelwa kwamathambo kuhlala kufakwa endaweni yawo.
• Izixhobo zensimbi, ezinje ngeentonga, izikrufu, iihaksi, okanye iingcingo ziya kufakwa nazo ukunceda ukubamba umqolo kunye de kufakelelwe amathambo kunye nokuphilisa.

Ugqirha unokufumana ithambo lokumiliselwa kwezi ndlela:

• Ugqirha wotyando usenokuthatha ithambo kwelinye ilungu lomzimba womntwana wakho. Oku kubizwa ngokuba yi-autograft. Ithambo elithatyathwa emzimbeni womntu lelona lihle.
• Ithambo linokuthathwa kwibhanki yethambo, kakhulu njengebhanki yegazi. Oku kubizwa ngokuba yi-allograft. Ezi zifomathi azihlali ziphumelele njengezixhobo ezizenzekelayo.
• Manmade (synthetic) ithambo elinokusetyenziswa linokusetyenziswa.

Utyando olwahlukeneyo lusebenzisa iintlobo ezahlukeneyo zezixhobo zesinyithi. Oku kuhlala kushiyeka emzimbeni emva kokuba ithambo lidibene kunye.

Iindidi ezintsha zotyando lwe-scoliosis azidingi fusion. Endaweni yoko, utyando lusebenzisa ukufakelwa ukulawula ukukhula komqolo.

Ngexesha lotyando lwe-scoliosis, ugqirha wotyando uya kusebenzisa izixhobo ezizodwa ukugcina iliso kwimithambo-luvo evela emqolo ukuqinisekisa ukuba ayonakalanga.

Utyando lwe-Scoliosis ludla ngokuthatha iiyure ezi-4 ukuya kwezi-6.

I-Brace ihlala izanywa kuqala ukugcina ijika ukuba ingabi mandundu. Kodwa, xa bengasasebenzi, umboneleli wokhathalelo lwempilo lomntwana uya kuncoma utyando.

Kukho izizathu ezininzi zokunyanga i-scoliosis:

• Inkangeleko yeyona nto ixhalabisayo.
• I-Scoliosis ihlala ibangela iintlungu zangasemva.
• Ukuba ijika linzima ngokwaneleyo, i-scoliosis ichaphazela ukuphefumla komntwana wakho.

Ukukhethwa kwexesha lotyando kuya kwahluka.

• Emva kokuba amathambo emathambo eyekile ukukhula, ijika kufuneka lingabi libi kakhulu. Ngenxa yoku, ugqirha wotyando unokulinda de amathambo omntwana wakho ayeke ukukhula.
• Umntwana wakho unokufuna utyando ngaphambi koku ukuba ijika lomqolo libuhlungu okanye liya lisanda ngokukhawuleza.

Utyando luhlala lucetyiswa kwaba bantwana balandelayo kunye nolutsha nge-scoliosis yesizathu esingaziwayo (idiopathic scoliosis):

• Lonke ulutsha olunamathambo lukhulile, kwaye lunegophe elingaphezulu kweedigri ezingama-45.
• Ukukhula kwabantwana abagobileyo bayo igqithile kwiidigri ezingama-40. (Ayingabo bonke oogqirha abavumelana malunga nokuba bonke abantwana abanee curve ezingama-40 degrees kufuneka benze utyando.)

Kukho iingxaki kunye nayiphi na inkqubo yokulungisa i-scoliosis.

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

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

Iingozi zotyando lwe-scoliosis zezi:

• Ukuphulukana negazi kufuna ukuba utofelwe igazi.
• Amatye okanye i-pancreatitis (ukudumba kwepancreas)
• Ukuphazamiseka kwamathumbu emathumbu (ukuvaleka).
• Ukulimala kwamathambo kubangela ubuthathaka bemisipha okanye ukukhubazeka (kunqabile kakhulu)
• Iingxaki zemiphunga ukuya kwiveki e-1 emva kotyando. Ukuphefumla akunakubuyela esiqhelweni kude kube ziinyanga ezi-1 ukuya kwezi-2 emva kotyando.

Iingxaki ezinokuthi ziphuhle kwixesha elizayo zibandakanya:

• Fusion ayiphilisi. Oku kungakhokelela kwimeko ebuhlungu apho ilungu elixokayo likhula kwindawo leyo. Oku kubizwa ngokuba yi-pseudarthrosis.
• Iindawo zomqolo ezihlanganisiweyo azisakwazi ukuhamba. Oku kubeka uxinzelelo kwamanye amalungu omqolo. Uxinzelelo olongezelelekileyo lunokubangela iintlungu zangasemva kwaye lwenze ukuba iidiski zonakale (ukonakala kwediski).
• Ikhonkco lesinyithi elibekwe emqolo linokuhamba kancinci. Okanye, intonga yesinyithi inokuzihlikihla kwindawo ebuthathaka. Zombini ezi zinto zinokubangela iintlungu.
• Iingxaki ezintsha zomqolo zinokukhula, ikakhulu kubantwana abenziwe utyando ngaphambi kokuba umqolo uyeke ukukhula.

Xelela umboneleli womntwana wakho ukuba ngawaphi amayeza asetyenziswa ngumntwana wakho. Oku kubandakanya amayeza, izongezo, okanye amayeza owathengileyo ngaphandle kommiselo.

Phambi kotyando:

• Umntwana wakho uya kuvavanywa ngokwasemzimbeni ngugqirha.
• Umntwana wakho uya kufunda malunga notyando kunye nento onokuyilindela.
• Umntwana wakho uya kufunda ukwenza imithambo ekhethekileyo yokuphefumla ukunceda imiphunga ibuye emva kotyando.
• Umntwana wakho uya kufundiswa ngeendlela ezizodwa zokwenza izinto zemihla ngemihla emva kotyando ukukhusela umqolo. Oku kubandakanya ukufunda indlela yokuhamba ngokufanelekileyo, ukutshintsha ukusuka kwindawo enye ukuya kwenye, kunye nokuhlala, ukuma nokuhamba. Umntwana wakho uya kuxelelwa ukuba asebenzise indlela "yokuziqengqa" xa ephuma ebhedini. Oku kuthetha ukuhambisa umzimba wonke ngaxeshanye ukunqanda ukujija umqolo.
• Umboneleli womntwana wakho uya kuthetha nawe malunga nokuba umntwana wakho agcine elinye igazi lakhe malunga nenyanga ngaphambi kotyando. Oku kwenzelwa ukuba igazi lomntwana wakho lisetyenziswe ukuba kufuneka utofelo-gazi ngexesha lotyando.

Ngexesha leeveki ezi-2 ngaphambi kotyando:

• Ukuba umntwana wakho uyatshaya, kufuneka ayeke. Abantu abane-fusion yomgogodla kwaye baqhubeka nokutshaya abaphili ngokunjalo. Cela uncedo kugqirha.
• Kwiiveki ezimbini ngaphambi kotyando, ugqirha unokukucela ukuba uyeke ukunika umntwana wakho amayeza enza kube nzima ukuba igazi lijiye. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn).
• Buza ugqirha womntwana wakho ukuba ngawaphi amayeza ekufuneka uwanike umntwana wakho ngosuku lotyando.
• Yazisa ugqirha kwangoko xa umntwana wakho enokubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye esinye isifo ngaphambi kotyando.

Ngomhla wotyando:

• Uya kucelwa ukuba ungamniki umntwana wakho nantoni na yokutya okanye yokusela iiyure ezingama-6 ukuya kwezi-12 ngaphambi kwenkqubo.
• Nika umntwana wakho nawaphi na amayeza ugqirha akuxelele ukuba umnike kunye nokusela okuncinci kwamanzi.
• Qiniseka ukuba ufika esibhedlele ngexesha.

Umntwana wakho uya kuhlala esibhedlele malunga neentsuku ezi-3 ukuya kwezi-4 emva kotyando. Umqolo olungisiweyo kufuneka ugcinwe kwindawo efanelekileyo yokugcina ulungelelwaniso. Ukuba utyando lwalubandakanya ukusikwa kotyando esifubeni, umntwana wakho unokuba netyhubhu esifubeni ukukhupha ulwakhiwo lwamanzi. Le tyhubhu ihlala isuswa emva kweeyure ezingama-24 ukuya kwezingama-72.

Icatheter (ityhubhu) inokubekwa kwisinyi kwiintsuku zokuqala ezimbalwa ukunceda umntwana wakho achame.

Isisu somntwana wakho kunye namathumbu asenokungasebenzi kwiintsuku ezimbalwa emva kotyando. Umntwana wakho unokufuna ukufumana ulwelo kunye nesondlo ngokusebenzisa umgca we-intravenous (IV).

Umntwana wakho uya kufumana amayeza entlungu esibhedlele. Ekuqaleni, iyeza linokuhanjiswa nge-catheter ekhethekileyo efakwe kumqolo womntwana wakho. Emva koko, impompo ingasetyenziselwa ukulawula ukuba zingaphi iintlungu ezifunyanwa ngumntwana wakho. Umntwana wakho unokufumana izithonga okanye athathe iipilisi zentlungu.

Umntwana wakho unokuba nomzimba okanye isihlangu somzimba.

Landela nayiphi na imiyalelo oyinikiweyo malunga nokhathalelo lomntwana wakho ekhaya.

Umqolo womntwana wakho kufuneka ujonge kakhulu emva kotyando. Kusaza kubakho igophe. Kuthatha ubuncinci iinyanga ezi-3 ukuze amathambo omqolo adibane kakuhle. Kuya kuthatha i-1 ukuya kwi-2 iminyaka ukuba badibanise ngokupheleleyo.

Fusion iyeka ukukhula emqolo. Oku akusoloko kuxhalabisa kuba ukukhula okuninzi kwenzeka kumathambo omzimba omde, njengamathambo omlenze. Abantwana abanolu tyando banokufumana ukuphakama kokubini kokukhula emilenzeni kunye nokuba nomqolo othe nkqo.

Utyando lwe-curvature yomqolo-umntwana; Utyando lweKyphoscoliosis - umntwana; Unyango lwe-thoracoscopic olwenziwe ngevidiyo-umntwana; I-VATS - umntwana

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IWarner WC, iSawyer JR. Scoliosis kunye ne kyphosis. Ku: Azar FM, Beaty JH, Kanale ST, ii-eds. Umsebenzi weCampbell's Orthopedics. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 44.

Yang S, Andras LM, Redding GJ, Skaggs DL. Ukuqala kwangoko kwe-scoliosis: uphononongo lwembali, unyango lwangoku, kunye nezikhokelo ezizayo. IPediatrics. Ngo-2016; 137 (1): e20150709. IINKCUKACHA: 26644484