Mpweya

Gastroschisis ndi vuto lobadwa kumene matumbo a khanda ali kunja kwa thupi chifukwa cha bowo pakhoma pamimba.

Ana omwe ali ndi gastroschisis amabadwa ali ndi bowo kukhoma lam'mimba. Matumbo a mwana nthawi zambiri amatuluka (kutuluka) kudzera pabowo.

Chikhalidwe chikuwoneka chofanana ndi omphalocele. Omphalocele, komabe, ndi vuto lobadwa kumene matumbo a khanda kapena ziwalo zina zam'mimba zimatuluka kudzera mu dzenje lam'mimba ndipo zimakutidwa ndi nembanemba. Ndi gastroschisis, palibe chotchinga chophimba.

Kupindika kwa khoma m'mimba kumakula pamene mwana amakula m'mimba mwa mayi. Pakukula, matumbo ndi ziwalo zina (chiwindi, chikhodzodzo, m'mimba, ndi thumba losunga mazira, kapena ma testes) zimatulukira kunja kwa thupi poyamba ndipo nthawi zambiri zimabwerera mkati. Kwa ana omwe ali ndi gastroschisis, matumbo (ndipo nthawi zina m'mimba) amakhalabe kunja kwa khoma la m'mimba, opanda nembanemba. Zomwe zimayambitsa zolakwika zam'mimba sizikudziwika.

Amayi omwe ali ndi zotsatirazi atha kukhala pachiwopsezo chachikulu chokhala ndi ana omwe ali ndi gastroschisis:

• Achinyamata
• Zothandizira zochepa
• Zakudya zoperewera panthawi yoyembekezera
• Gwiritsani ntchito fodya, cocaine, kapena methamphetamines
• Nitrosamine exposure (mankhwala omwe amapezeka mu zakudya zina, zodzoladzola, ndudu)
• Kugwiritsa ntchito aspirin, ibuprofen, acetaminophen
• Kugwiritsa ntchito ma decongestant omwe ali ndi mankhwala pseudoephedrine kapena phenylpropanolamine

Ana omwe ali ndi gastroschisis nthawi zambiri samakhala ndi zovuta zina zobadwa nazo.

Gastroschisis nthawi zambiri imawoneka pa nthawi ya prenatal ultrasound. Zitha kuwonekeranso pamene mwana wabadwa. Pali bowo pakhoma pamimba. Matumbo ang'onoang'ono nthawi zambiri amakhala kunja kwa pamimba pafupi ndi umbilical. Ziwalo zina zomwe zimawonedwanso ndi matumbo akulu, m'mimba, kapena ndulu.

Nthawi zambiri matumbo amakwiya chifukwa chokhudzidwa ndi amniotic fluid. Mwana amatha kukhala ndi vuto loyamwa chakudya.

Ma ultrasound omwe amapezeka asanabadwe nthawi zambiri amadziwika kuti ana ali ndi gastroschisis asanabadwe, nthawi zambiri pamasabata 20 obadwa.

Ngati gastroschisis imapezeka asanabadwe, mayi adzafunika kuyang'aniridwa mwapadera kuti atsimikizire kuti mwana wosabadwayo amakhala wathanzi.

Chithandizo cha gastroschisis chimaphatikizapo opaleshoni. Nthawi zambiri matumbo a khanda amakhala ochepa kwambiri kuti matumbo abwererenso pobadwa. Kotero thumba la thumba limasokedwa mozungulira malire a chilemacho ndipo m'mbali mwake mwaulemalo mumakwezedwa. Thumba limatchedwa silo. Pakadutsa sabata limodzi kapena awiri, matumbo amabwerera m'mimbamo ndipo chilema chimatsekedwa.

Kutentha kwa mwana kuyenera kuyang'aniridwa mosamala, chifukwa matumbo owonekera amalola kutentha kwa thupi kuthawa. Chifukwa cha kukakamizidwa kubwezera matumbo m'mimba, mwana angafunike kuthandizidwa kuti apume ndi mpweya wabwino. Njira zina zochizira khanda zimaphatikizira michere ya IV komanso maantibayotiki kupewa matenda. Ngakhale chilepheretsocho chitatsekedwa, zakudya za IV zidzapitilirabe popeza kuyamwa mkaka kuyenera kuyambitsidwa pang'onopang'ono.

Mwanayo ali ndi mwayi wochira ngati palibe zovuta zina komanso ngati m'mimba mwake ndikokwanira. Kamimba kakang'ono kwambiri m'mimba kangayambitse zovuta zomwe zimafunikira maopaleshoni ochulukirapo.

Ndondomeko ziyenera kupangidwa pobereka mosamala ndikuwongolera msanga vutoli atabadwa. Mwanayo ayenera kuperekedwa kuchipatala chomwe ndi luso lokonza zolakwika zam'mimba. Ana atha kuchita bwino ngati sakufunika kupita nawo kumalo ena kukalandira chithandizo china.

Chifukwa cha kupezeka kwa amniotic fluid, matumbo a ana sangagwire bwino ntchito ngakhale ziwalozo zibwezeretsedwenso mkati mwa m'mimba. Ana omwe ali ndi gastroschisis amafunikira nthawi kuti matumbo awo achire ndikuzolowera kudya.

Chiwerengero chochepa cha ana omwe ali ndi gastroschisis (pafupifupi 10-20%) atha kukhala ndi m'mimba atresia (ziwalo zamatumbo zomwe sizinakule m'mimba). Ana awa amafunika kuchitidwa maopaleshoni enanso kuti athetse mavuto.

Kuwonjezeka kwa kuthamanga kuchokera m'mimba kolakwika kumatha kuchepetsa magazi kupita m'matumbo ndi impso. Zingapangitsenso kuti zikhale zovuta kuti mwana akweze mapapu, zomwe zimabweretsa mavuto kupuma.

Vuto lina lomwe lingachitike ndi matenda am'mimba necrosis. Izi zimachitika minofu yamatumbo ikafa chifukwa chotsika magazi kapena matenda. Izi zitha kuchepetsedwa mwa makanda omwe amalandira mkaka wa m'mawere osati mkaka wa m'mawere.

Matendawa amawonekera pobadwa ndipo amawonekera kuchipatala pakubereka ngati sanawonekere pamayeso azowoneka a fetus nthawi yapakati. Ngati mwaberekera kunyumba ndipo mwana wanu akuwoneka kuti ali ndi vuto ili, itanani nambala yadzidzidzi yakomweko (monga 911) nthawi yomweyo.

Vutoli limapezeka ndikuchiritsidwa mchipatala atabadwa. Mukabwerera kunyumba, itanani wothandizira zaumoyo wanu ngati mwana wanu ali ndi izi:

• Kuchepetsa matumbo
• Mavuto akudya
• Malungo
• Masanzi obiriwira obiriwira kapena achikasu
• Malo otupa amimba
• Kusanza (mosiyana ndi kulavuliridwa kwa mwana)
• Kusintha kwamakhalidwe oyipa

Kubadwa chilema - gastroschisis; M'mimba khoma chilema - khanda; M'mimba khoma chilema - akhanda; M'mimba khoma chilema - wakhanda

• Khanda la m'mimba la khanda (gastroschisis)
• Kukonzekera kwa Gastroschisis - mndandanda
• Silo

Islam S. Kubadwa kwam'mimba zolakwika: gastroschisis ndi omphalocele. Mu: Holcomb GW, Murphy P, St. Peter SD, eds. Opaleshoni ya Ana ya Holcomb ndi Ashcraft. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2020: chap 48.

Walther AE, Nathan JD. Khanda lobadwa m'mimba lobadwa kumene. Mu: Wyllie R, Hyams JS, Kay M, olemba., Eds. Matenda a m'mimba ndi Matenda a Chiwindi. 5th ed. Philadelphia, PA: Elsevier; 2016: chap 58.