Utyando lwe-anti-reflux-abantwana

Utyando oluchasene ne-reflux lutyando lokuqinisa izihlunu emazantsi esophagus (ityhubhu ehambisa ukutya ukusuka emlonyeni ukuya esiswini). Iingxaki ngezi zihlunu zingakhokelela kwisifo se-reflux sesifo se-gastroesophageal (GERD).

Olu tyando lunokwenziwa kwakhona ngexesha lokulungiswa kwe-hernia yokulungisa.

Eli nqaku lixoxa ngokulungiswa kotyando lwe-reflux kubantwana.

Uhlobo oluqhelekileyo lotyando lwe-anti-reflux lubizwa ngokuba yi-fundoplication. Olu tyando luhlala luthabatha iiyure ezi-2 ukuya kwezi-3.

Umntwana wakho uya kunikwa i-anesthesia ngokubanzi ngaphambi kotyando. Oko kuthetha ukuba umntwana uya kulala kwaye akakwazi kuva iintlungu ngexesha lenkqubo.

Ugqirha uya kusebenzisa imithungo ukusongela indawo ephezulu yesisu somntwana wakho malunga nokuphela komqala. Oku kunceda ukukhusela i-asidi esiswini kunye nokutya ekuphumeni kwakhona.

Ityhubhu ye-gastrostomy (g-ityhubhu) inokufakwa ukuba umntwana wakho uginye okanye ondle iingxaki. Le tyhubhu inceda ekondleni kwaye ikhuphe umoya esiswini somntwana wakho.

Olunye utyando, olubizwa ngokuba yi-pyloroplasty lunokwenziwa. Olu tyando lwandisa ukuvulwa phakathi kwesisu kunye namathumbu amancinci ukuze isisu sikwazi ukukhupha ngokukhawuleza.

Olu tyando lunokwenziwa ngeendlela ezininzi, kubandakanya:

• Ukulungiswa okuvulekileyo - Ugqirha uya kwenza ukusikwa okukhulu kwindawo yesisu somntwana (isisu).
• Ukulungiswa kwe-Laparoscopic-Ugqirha uya kwenza i-3 ukuya kwi-5 ukusika okuncinci esiswini. Ityhubhu ecekeceke, enemingxuma enekhamera encinci esiphelweni (i-laparoscope) ibekwa kwenye yezi zinto zisikayo. Ezinye izixhobo zigqitywa kwezinye izinto ezisikiweyo zotyando.

Ugqirha kusenokufuneka atshintshele kwinkqubo evulekileyo ukuba kukho ukopha, izicwili ezininzi ezibomvu ezivela kutyando lwangaphambili, okanye ukuba umntwana utyebe kakhulu.

I-Endoluminal fundoplication iyafana nokulungiswa kwe-laparoscopic, kodwa ugqirha ugqirha ufikelela kwisisu ngokungena ngomlomo. Iziqeshana ezincinci zisetyenziselwa ukuqinisa unxibelelwano phakathi kwesisu kunye nomqala.

Utyando oluchasene ne-reflux luhlala lusenziwa ukunyanga i-GERD ebantwaneni kuphela emva kokuba amayeza engakhange asebenze okanye iingxaki zikhule. Umboneleli wakho wokhathalelo lwempilo unokucebisa ngo-anti-reflux utyando xa:

• Umntwana wakho uneempawu zokuba nesilonda esiba ngcono ngamayeza, kodwa awufuni ukuba umntwana wakho aqhubeke nokusela la mayeza.
• Iimpawu zokutshiswa sisilonda ziyatsha esiswini, emqaleni, okanye esifubeni, ukugqabhuka okanye amaqamza erhasi, okanye iingxaki zokuginya ukutya okanye ulwelo.
• Inxalenye yesisu somntwana wakho siyabambeka esifubeni okanye siyaziguqula.
• Umntwana wakho une-esophagus (ebizwa ngokuba ngqongqo) okanye ukopha kwi-esophagus.
• Umntwana wakho akakhuli kakuhle okanye akaphumeleli.
• Umntwana wakho unesifo semiphunga esibangelwa kukuphefumla kwesisu kwimiphunga (ebizwa ngokuba yi-aspiration pneumonia).
• I-GERD ibangela ukhohlokhohlo olungapheliyo okanye urhawuzelele kumntwana wakho.

Iingozi zalo naluphi na utyando zibandakanya:

• Ukopha
• Usulelo

Iingozi zeanesthesia zibandakanya:

• Impendulo kumayeza
• Iingxaki zokuphefumla, kubandakanya inyumoniya
• Iingxaki zentliziyo

Umngcipheko wotyando lwe-anti-reflux ubandakanya:

• Ukonakala kwesisu, umqala, isibindi, okanye amathumbu amancinci. Oku kunqabile kakhulu.
• Irhasi kunye nokudumba okwenza ukuba kubenzima ukugqabhuka okanye ukuphosa. Uninzi lwexesha, ezi mpawu zihamba kancinci.
• Ukuhlikihla.
• Kubuhlungu, kunzima ukugwinya, okubizwa ngokuba yi-dysphagia. Kubantwana abaninzi, oku kuyaphela kwiinyanga ezintathu zokuqala emva kotyando.
• Rhoqo, iingxaki zokuphefumla okanye zemiphunga, ezinjengomphunga owileyo.

Njalo qinisekisa ukuba iqela lokhathalelo lwempilo lomntwana wakho liyazi malunga nawo onke amayeza kunye nezinto ezincedisayo ezithathwa ngumntwana wakho, kubandakanya nezo uzithengileyo ngaphandle kommiselo.

Kwiveki phambi kotyando, unokucelwa ukuba uyeke ukunika umntwana wakho iimveliso ezichaphazela ukujiya kwegazi. Oku kunokubandakanya i-aspirin, ibuprofen (Advil, Motrin), ivithamin E, kunye ne-warfarin (Coumadin).

Uzakuxelelwa ukuba ufike nini esibhedlele.

• Umntwana akufuneki atye okanye asele nantoni na emva kobusuku bobusuku ngaphambi kotyando.
• Umntwana wakho unokuhlamba okanye ahlambe kubusuku obungaphambi okanye kusasa kwenkqubo yotyando.
• Ngomhla woqhaqho, umntwana kufuneka athathe naliphi na iyeza athe umboneleli makalithathe ngesiphuzo esincinci samanzi.

Umntwana wakho uhlala ixesha elingakanani esibhedlele kuxhomekeke kwindlela olwenziwe ngayo utyando.

• Abantwana abane-laparoscopic anti-reflux yotyando bahlala esibhedlele kangangeentsuku ezi-2 ukuya kwezi-3.
• Abantwana abanotyando oluvulekileyo banokuchitha iintsuku ezi-2 ukuya kwezi-6 esibhedlele.

Umntwana wakho unokuqala ukutya kwakhona malunga neentsuku ezi-1 ukuya kwezi-2 emva kotyando. Ulwelo luhlala lunikwa kuqala.

Abanye abantwana bane-g-tube ebekwe ngexesha lotyando. Le tyhubhu inokusetyenziselwa ukutyisa ulwelo, okanye ukukhupha igesi esiswini.

Ukuba umntwana wakho ebengenayo ityhubhu ye-g, ityhubhu inokufakwa ngempumlo iye esiswini ukunceda ukukhupha irhasi. Le mibhobho iyasuswa xa umntwana wakho eqala ukutya kwakhona.

Umntwana wakho uya kuba nakho ukugoduka xa sele esitya ukutya, ebenentshukumo yamathumbu kwaye eziva engcono.

Isitshisa kunye neempawu ezinxulumene noko kufuneka ziphuculwe emva kotyando lwe-anti-reflux. Nangona kunjalo, umntwana wakho usenokufuna ukuthatha amayeza okuba nesitshisa emva kotyando.

Abanye abantwana baya kufuna olunye utyando kwixesha elizayo ukunyanga iimpawu ezintsha ze-reflux okanye ukuginya iingxaki. Oku kunokwenzeka ukuba isisu sisongelwe ngokuqinileyo okanye sikhulule.

Utyando alunakuphumelela ukuba ukulungiswa kwakukhululekile.

Ukuxhasa ngemali - abantwana; Inkxaso-mali yeNissen - abantwana; Inkxaso-mali yeBelsey (uMark IV) - abantwana; Inkxaso mali yeqela - abantwana; Thal fundoplication - abantwana; Ukulungiswa kweHernatal hernia - abantwana; Endoluminal fundoplication - abantwana

• Utyando lwe-anti-reflux-abantwana-ukukhutshwa
• Utyando lwe-anti-reflux-ukukhutshwa
• I-reflux ye-Gastroesophageal-ukukhutshwa
• Isitshisa - yintoni ekufuneka uyibuze kugqirha

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UKhan S, uMatta SKR. Isifo se-reflux sesifo se-Gastroesophageal. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahl. 349.

UKane TD, uBrown MF, uChen MK; Amalungu eKomiti eNtsha yeTekhnoloji ye-APSA. Indawo yokubeka iphepha kwimisebenzi ye-laparoscopic antireflux kwiintsana nabantwana kwisifo se-reflux sesifo se-gastroesophageal. Umbutho woNyango lwabantwana waseMelika. J Ukunyanga abagulayo. Ngo-2009; 44 (5): 1034-1040. IINKCUKACHA: I-19433194 www.ncbi.nlm.nih.gov/pubmed/19433194.

IYates RB, iOelschlager BK, iPellegrini CA. Isifo se-Gastroesophageal Reflux kunye ne-hernia ye-hiatal. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 42.