Esophageal atresia

Esophageal atresia ndimatenda am'mimba omwe m'mimba mwake simukula bwino. M'mero ​​ndi chubu chomwe nthawi zambiri chimanyamula chakudya kuchokera mkamwa kupita mmimba.

Esophageal atresia (EA) ndi vuto lobadwa nalo. Izi zikutanthauza kuti zimachitika asanabadwe. Pali mitundu ingapo. Nthawi zambiri, kum'mero ​​kwapamwamba kumatha ndipo sikulumikizana ndi kum'mero ​​kwenikweni ndi m'mimba.

Makanda ambiri omwe ali ndi EA ali ndi vuto lina lotchedwa tracheoesophageal fistula (TEF). Uwu ndi kulumikizana kosazolowereka pakati pammero ndi mphepo (trachea).

Kuphatikiza apo, makanda omwe ali ndi EA / TEF nthawi zambiri amakhala ndi tracheomalacia. Uku ndikofooka komanso kusunthika kwamakoma amphepo, zomwe zimatha kupangitsa kuti kupuma kumveke kaphokoso kwambiri kapena kaphokoso.

Ana ena omwe ali ndi EA / TEF amakhalanso ndi zovuta zina, makamaka zopindika pamtima.

Zizindikiro za EA zitha kuphatikiza:

• Mtundu wabuluu pakhungu (cyanosis) poyesera kudyetsa
• Kutsokomola, kukugugudani, ndikutsamwa poyesera kudyetsa
• Kutsetsereka
• Kudya moperewera

Asanabadwe, ultrasound ya mayi imatha kuwonetsa amniotic fluid yambiri. Izi zitha kukhala chizindikiro cha EA kapena kutsekeka kwina kwa gawo logaya mwana.

Matendawa amawonekera atangobadwa kumene pamene khanda limayesera kudyetsa kenako limatsokomola, kutsamwa, ndikusintha buluu. Ngati EA akukayikiridwa, wothandizira zaumoyo ayesa kuperekera chubu chodyera chaching'ono kudzera mkamwa kapena m'mphuno mwa mwana m'mimba. Ngati chubu lodyetsera silingathe kupita kumimba, khanda limapezeka ndi EA.

X-ray imachitika ndipo iwonetsa izi:

• Chikwama chodzaza mpweya m'mimbamo.
• Mpweya m'mimba ndi m'matumbo.
• Tepu yodyetsera idzawoneka yophimbidwa kumtunda ngati itayikidwa x-ray isanachitike.

EA ndi vuto lazopanga opaleshoni. Kuchita opaleshoni yokonza kum'mero ​​kumachitika mwachangu atabadwa kuti mapapo asawonongeke komanso kuti mwana adyetsedwe.

Asanachite opareshoni, mwana samadyetsedwa pakamwa ndipo amafunikira zakudya zamitsempha (IV). Chisamaliro chimatengedwa kuti chiteteze kuyenda kwa katulutsidwe kamapapu m'mapapu.

Kuzindikira koyambirira kumapereka mpata wabwino wazotsatira.

Khanda limatha kupuma malovu ndi madzi ena m'mapapu, ndikuyambitsa chibayo, kutsamwa, komanso kufa.

Zovuta zina zingaphatikizepo:

• Mavuto akudya
• Reflux (kubweretsanso chakudya kuchokera m'mimba) pambuyo pochitidwa opaleshoni
• Kuchepetsa (kukhwimitsa) kwam'mero ​​chifukwa chakumalizira kochitidwa opaleshoni

Kutha msinkhu kungasokoneze vutoli. Monga tafotokozera pamwambapa, pakhoza kukhala zolakwika m'malo ena amthupi.

Vutoli limapezeka atangobadwa kumene.

Itanani wothandizira mwana wanu nthawi yomweyo ngati mwana akusanza mobwerezabwereza pambuyo poyamwitsa, kapena ngati mwanayo ayamba kupuma movutikira.

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Rothenberg SS. Esophageal atresia ndi zolakwika za tracheoesophageal fistula. Mu: Holcomb GW, Murphy JP, St. Peter SD, olemba. Opaleshoni ya Ana ya Holcomb ndi Ashcraft. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier Saunders; 2020: chap 27.

Nkhandwe RB. Kujambula m'mimba. Mu: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, olemba. Creasy ndi Resnik's Maternal-Fetal Medicine: Mfundo ndi Kuchita. 8th ed. Philadelphia, PA: Elsevier Saunders; 2019: chaputala 26.