Pectus excavatum kukonza

Pectus excavatum kukonza ndi opaleshoni kukonza pectus excavatum. Uku ndikubadwa nako (komwe kumakhalapo pakubadwa) kofooka kutsogolo kwa khoma lachifuwa komwe kumayambitsa chifuwa cha chifuwa (sternum) ndi nthiti.

Pectus excavatum amatchedwanso faneli kapena chifuwa cholowa. Zitha kukulirakulira pazaka zaunyamata.

Pali mitundu iwiri ya opareshoni yokonza vutoli - opaleshoni yotseguka komanso opaleshoni yotseka (yocheperako). Opaleshoni iliyonse imachitika mwana ali mtulo tofa nato ndipo samva kuwawa ku anesthesia wamba.

Opaleshoni yotseguka ndichikhalidwe. Kuchita opaleshoni kumachitika motere:

• Dokotalayo amadula (cheka) mbali yakutsogolo ya chifuwa.
• Matenda opunduka amachotsedwa ndipo nthiti ya nthiti yatsala m'malo mwake. Izi zidzalola kuti karotiyo ibwerere molondola.
• Kenako amadulidwa m'chifuwa, chomwe chimasunthidwira pamalo oyenera. Dokotalayo amatha kugwiritsa ntchito chingwe chachitsulo (chothandizira) kuti agwirizane ndi chifuwa cha bere mpaka atachira. Kuchiritsa kumatenga miyezi 3 mpaka 12.
• Dokotalayo akhoza kuyika chubu chothira madzi omwe amadzikonzera.
• Pamapeto pa opaleshoni, incision imatsekedwa.
• Zingwe zazitsulo zimachotsedwa m'miyezi 6 mpaka 12 kudzera pakucheka pang'ono pakhungu pansi pa mkono. Njirayi imachitika nthawi zambiri kuchipatala.

Mtundu wachiwiri wa opaleshoni ndi njira yotsekedwa. Amagwiritsidwa ntchito makamaka kwa ana. Palibe chichereŵechereŵe kapena mafupa amene amachotsedwa. Kuchita opaleshoni kumachitika motere:

• Dokotalayo amatenga timatumba ting'onoting'ono kawiri, mbali imodzi pachifuwa.
• Kamera yaying'ono yamakanema yotchedwa thoracoscope imayikidwa kudzera pachimodzi mwazinthuzi. Izi zimathandiza dokotalayo kuti aone mkati mwa chifuwa.
• Chitsulo chokhotakhota chomwe chakonzedwa kuti chikwaniritse mwanayo chimalowetsedwa kudzera m'matumba ndikuyika pansi pa chifuwa. Cholinga cha bala ndikutukula fupa la m'mawere. Bala limasiyidwa m'malo osachepera zaka 2. Izi zimathandiza kuti chifuwa cha m'mawere chikule bwino.
• Pamapeto pa opareshoni, kuchuluka kumachotsedwa ndipo mawonekedwe adatsekedwa.

Opaleshoni imatha kutenga maola 1 kapena 4, kutengera ndondomekoyi.

Chifukwa chofala kwambiri chokonzekera pectus excavatum ndikutulutsa mawonekedwe a khoma pachifuwa.

Nthawi zina kupundako kumakhala kovuta kwambiri komwe kumayambitsa kupweteka pachifuwa komanso kumakhudza kupuma, makamaka kwa akulu.

Opaleshoni imachitika makamaka kwa ana omwe ali ndi zaka 12 mpaka 16, koma osakwanitsa zaka 6. Zitha kuchitidwanso kwa achikulire omwe ali ndi zaka zoyambirira za 20.

Zowopsa za anesthesia ndi opaleshoni yonse ndi izi:

• Zomwe zimachitika ndi mankhwala
• Mavuto opumira
• Kukhetsa magazi, magazi kuundana, kapena matenda

Zowopsa za opaleshoniyi ndi izi:

• Kuvulaza mtima
• Mapapo kugwa
• Ululu
• Kubwerera kwa kupundako

Kuyezetsa kwathunthu kwamankhwala ndi mayeso azachipatala amafunikira asanachite opareshoni. Dokotalayo amalamula zotsatirazi:

• An electrocardiogram (ECG) ndipo mwina echocardiogram yomwe imawonetsa momwe mtima ukugwirira ntchito
• Ntchito ya m'mapapo mwanga kuyesa kuyesa kupuma
• CT scan kapena MRI ya chifuwa

Uzani dokotala kapena namwino za:

• Mankhwala omwe mwana wanu amamwa. Phatikizani mankhwala, zitsamba, mavitamini, kapena zowonjezera zilizonse zomwe mudagula popanda mankhwala.
• Matenda a mwana wanu angafunikire kumwa mankhwala, latex, tepi, kapena kuyeretsa khungu.

M'masiku asanachitike opareshoni:

• Pafupifupi masiku 7 asanamuchite opaleshoni, mwana wanu angafunsidwe kuti asiye kumwa aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), warfarin (Coumadin), ndi mankhwala ena aliwonse opatulira magazi.
• Funsani dotolo wanu kapena namwino mankhwala omwe mwana wanu ayenera kumwa patsiku la opareshoni.

Patsiku la opareshoni:

• Mwana wanu adzafunsidwa kuti asamwe kapena kudya chilichonse pakati pausiku usiku woti achite opaleshoni.
• Mupatseni mwana wanu mankhwala aliwonse omwe dokotalayo anakuwuzani kuti mumupatse pomwako pang'ono madzi.
• Fikani kuchipatala nthawi yake.
• Dokotalayo adzaonetsetsa kuti mwana wanu alibe matenda aliwonse asanamuchite opaleshoni. Ngati mwana wanu akudwala, opareshoniyo akhoza kuimitsidwa kaye.

Nthawi zambiri ana amakhala mchipatala masiku atatu kapena 7. Mwana wanu amakhala nthawi yayitali bwanji zimatengera momwe akuchira.

Ululu umakhala wofala pambuyo pa opaleshoni. Kwa masiku angapo oyamba, mwana wanu amatha kulandira mankhwala opweteka kwambiri mumtsempha (kudzera mu IV) kapena kudzera mu catheter yoyikidwa mumsana (chotupa). Pambuyo pake, kupweteka kumayendetsedwa ndi mankhwala omwe amamwa pakamwa.

Mwana wanu akhoza kukhala ndi machubu pachifuwa mozungulira kudula kwa opaleshoni. Machubu awa amatulutsa madzi owonjezera omwe amatenga kuchokera ku ndondomekoyi. Machubu amakhalabe mpaka atasiya kukhetsa, nthawi zambiri pakatha masiku angapo. Machubuwo amachotsedwa.

Tsiku lotsatira opaleshoni, mwana wanu adzalimbikitsidwa kukhala tsonga, kupuma mokoka mpweya, ndikudzuka pabedi ndikuyenda. Izi zithandiza kuchira.

Poyamba, mwana wanu sadzatha kupindika, kupotoza, kapena kupindika kuchokera mbali kupita mbali. Ntchito zidzawonjezedwa pang'onopang'ono.

Mwana wanu akamayenda popanda kuthandizidwa, mwina amakhala wokonzeka kupita kwawo. Musanatuluke kuchipatala, mudzalandira mankhwala a ululu wa mwana wanu.

Kunyumba, tsatirani malangizo aliwonse osamalira mwana wanu.

Opaleshoni nthawi zambiri imawongolera kusintha kwa mawonekedwe, kupuma, komanso kuthekera kochita masewera olimbitsa thupi.

Kukonza chifuwa cha fanizo; Kukhazikika pachifuwa; Kukonza pachifuwa chonyamula; Kukonza chifuwa cha Cobbler; Kukonza Nuss; Kukonzanso

• Pectus excavatum - kutulutsa
• Chisamaliro cha bala la opaleshoni - chotseguka

• Pectus excavatum
• Pectus excavatum kukonza - mndandanda

Nuss D, Kelly RE. Matenda obadwa pachifuwa obadwa nawo. Mu: Holcomb GW, Murphy JP, Ostlie DJ, olemba. Opaleshoni ya Ana ya Ashcraft. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2014: mutu 20.

Putnam JB. Mapapu, khoma pachifuwa, pleura, ndi mediastinum. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: Maziko Achilengedwe a Njira Zamakono Zopangira Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 57.