Opaleshoni ya anti-reflux - ana

Opaleshoni ya anti-reflux ndi opaleshoni yolimbitsa minofu pansi pamimba (chubu chomwe chimanyamula chakudya kuchokera mkamwa kupita mmimba). Mavuto ndi minofu imeneyi amatha kubweretsa matenda a reflux a gastroesophageal (GERD).

Kuchita opaleshoniyi kumatha kuchitidwanso pakukonzanso nthenda yobereka.

Nkhaniyi ikufotokoza kukonzanso kwa ma anti-reflux kwa ana.

Mtundu wofala kwambiri wa anti-reflux opaleshoni umatchedwa fundoplication. Kuchita opaleshoniyi nthawi zambiri kumatenga maola awiri kapena atatu.

Mwana wanu adzapatsidwa mankhwala oletsa ululu asanayambe opaleshoni. Izi zikutanthauza kuti mwanayo adzagona ndipo sangathe kumva kupweteka panthawiyi.

Dokotalayo amagwiritsa ntchito zoluka kukulunga kumtunda kwa m'mimba kwa mwana wanu kumapeto kwa kummero. Izi zimathandiza kupewa asidi wam'mimba komanso chakudya kuti chisabwerenso.

Thumba la gastrostomy (g-chubu) limatha kukhazikitsidwa ngati mwana wanu wameza kapena akudya. Izi chubu zimathandizira kudyetsa ndikutulutsa mpweya m'mimba mwa mwana wanu.

Opaleshoni ina, yotchedwa pyloroplasty itha kuchitidwanso. Kuchita opaleshoniyi kumakulitsa kutseguka pakati pamimba ndi matumbo ang'onoang'ono kuti m'mimba muzitha kutuluka mwachangu.

Kuchita opaleshoniyi kumatha kuchitidwa m'njira zingapo, kuphatikiza:

• Kutsegula kotseguka - Dokotalayo adzadula kwambiri pamimba pamimba (pamimba).
• Kukonza ma laparoscopic - Dotoloyu amapanga mabala atatu mpaka asanu m'mimba. Thubhu yopyapyala, yopanda kabowo yokhala ndi kamera yaying'ono kumapeto (laparoscope) imayikidwa kudzera mwa kudulako. Zida zina zimadutsamo mabala ena opaleshoni.

Dokotalayo angafunikire kusinthana ndi njira yotseguka ngati pali magazi, zilonda zambiri zoyambilira zochitidwa maopaleshoni am'mbuyomu, kapena ngati mwanayo ndi wonenepa kwambiri.

Endoluminal fundoplication ndi yofanana ndi kukonzanso kwa laparoscopic, koma dokotalayo amafika m'mimba podutsa pakamwa. Tizigawo tating'ono timagwiritsidwa ntchito kulimbitsa kulumikizana pakati pamimba ndi kholingo.

Opaleshoni ya anti-reflux nthawi zambiri imachitidwa pofuna kuchiza GERD mwa ana pokhapokha mankhwala asanagwire ntchito kapena zovuta zitayamba. Wothandizira zaumoyo wa mwana wanu atha kupereka malingaliro othandizira opatsirana pogonana pamene:

• Mwana wanu ali ndi zizindikiro za kutentha pa chifuwa zomwe zimakhala bwino ndi mankhwala, koma simukufuna kuti mwana wanu apitilize kumwa mankhwalawa.
• Zizindikiro za kutentha pa chifuwa zikuyaka m'mimba, mmero, kapena pachifuwa, kuphulika kapena thovu lamafuta, kapena mavuto akumeza chakudya kapena madzi.
• Gawo lina la m'mimba la mwana wanu limakanirira pachifuwa kapena likudziyendetsa lokha.
• Mwana wanu ali ndi kuchepa kwa m'mimba (kotchedwa solidure) kapena kutuluka magazi.
• Mwana wanu sakukula bwino kapena akulephera kukula bwino.
• Mwana wanu ali ndi matenda am'mapapo omwe amayamba chifukwa cha kupuma m'mimba m'mapapu (otchedwa aspiration pneumonia).
• GERD imayambitsa chifuwa chachikulu kapena kuwuma kwa mwana wanu.

Zowopsa za opaleshoni iliyonse ndi monga:

• Magazi
• Matenda

Zowopsa za anesthesia ndi izi:

• Zomwe zimachitika ndi mankhwala
• Mavuto akupuma, kuphatikizapo chibayo
• Mavuto amtima

Zowopsa za ma anti-reflux ndizo:

• Kuwonongeka kwa m'mimba, kum'mero, chiwindi, kapena m'matumbo ang'ono. Izi ndizosowa kwambiri.
• Gasi ndi zotupa zomwe zimapangitsa kuti zikhale zovuta kubowola kapena kutaya. Nthawi zambiri, zizindikirazi zimayamba bwino pang'onopang'ono.
• Kudzudzula.
• Kupweteka, kumeza kovuta, kotchedwa dysphagia. Kwa ana ambiri, izi zimatha miyezi itatu yoyambirira atachitidwa opaleshoni.
• Nthawi zambiri, kupuma kapena mavuto am'mapapu, monga mapapu omwe agwa.

Nthawi zonse onetsetsani kuti gulu lazachipatala la mwana wanu limadziwa zamankhwala onse ndi zowonjezera zomwe mwana wanu amatenga, kuphatikiza omwe mudagula popanda mankhwala.

Sabata imodzi musanachite opareshoni, mwina mungafunsidwe kuti musiye kupatsa mwana wanu zinthu zomwe zimakhudza magazi. Izi zingaphatikizepo aspirin, ibuprofen (Advil, Motrin), vitamini E, ndi warfarin (Coumadin).

Mudzauzidwa nthawi yobwera kuchipatala.

• Mwanayo sayenera kudya kapena kumwa chilichonse pakati pausiku asanachite opareshoni.
• Mwana wanu mutha kusamba kapena kusamba usiku watha kapena m'mawa wa opareshoni.
• Patsiku la opareshoni, mwanayo ayenera kumwa mankhwala aliwonse omwe woperekayo akuti amwe ndikumwa pang'ono madzi.

Kuti mwana wanu azikhala mchipatala nthawi yayitali zimadalira momwe opaleshoniyi idachitikira.

• Ana omwe ali ndi laparoscopic anti-reflux opareshoni nthawi zambiri amakhala mchipatala masiku awiri kapena atatu.
• Ana omwe achita opaleshoni yotseguka amatha masiku awiri kapena asanu ndi awiri ali mchipatala.

Mwana wanu amatha kuyambiranso kudya pakadutsa masiku awiri kapena awiri atachitidwa opaleshoni. Zamadzimadzi zimaperekedwa koyamba.

Ana ena amaikidwa g-chubu panthawi yochita opareshoni. Chubu ichi chitha kugwiritsidwa ntchito podyetsa madzi, kapena kutulutsa mpweya m'mimba.

Ngati mwana wanu analibe g-chubu yoyikidwa, chubu imatha kulowetsedwa kudzera pamphuno mpaka m'mimba kuti athandize kutulutsa mpweya. Izi chubu amachotsa mwana wanu akayambiranso kudya.

Mwana wanu azitha kupita kwawo akudya chakudya, atakhala ndi matumbo ndipo akumva bwino.

Kutentha pa chifuwa ndi zina zokhudzana nazo zimayenera kusintha pambuyo poti achite opaleshoni ya anti-reflux. Komabe, mwana wanu angafunikirebe kumwa mankhwala a kutentha kwa chifuwa pambuyo pochitidwa opaleshoni.

Ana ena adzafunika kuchitidwanso opaleshoni mtsogolo kuti athe kuchiza matenda atsopano okhudzana ndi Reflux kapena mavuto akumeza. Izi zitha kuchitika ngati mimba idakulungidwa pamimbayo mwamphamvu kapena imamasuka.

Kuchita opareshoniyo sikungakhale kopambana ngati kukonzanso kunali kotayirira kwambiri.

Kuphunzitsa ndalama - ana; Kuphatikiza ndalama kwa Nissen - ana; Belsey (Mark IV) kugwiritsa ntchito ndalama - ana; Toupet fundoplication - ana; Thal fundoplication - ana; Hiatal hernia kukonza - ana; Endoluminal fundoplication - ana

• Opaleshoni ya anti-reflux - ana - kutulutsa
• Opaleshoni ya anti-reflux - kutulutsa
• Reflux ya gastroesophageal - kutulutsa
• Kutentha pa chifuwa - zomwe mungafunse dokotala wanu

Chun R, Noel RJ. Matenda a Reflux a Laryngopharyngeal ndi gastroesophageal ndi eosinophilic esophagitis. Mu: Lesperance MM, Flint PW, ma eds. Cummings Dokotala Otolaryngology. Philadelphia, PA: Elsevier Saunders; 2015: mutu 29.

Khan S, Matta SKR. Matenda a reflux am'mimba. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 349.

Kane TD, Brown MF, Chen MK; Mamembala a APSA New Technology Committee. Maudindo papepala la laparoscopic antireflux m'makanda ndi ana a gastroesophageal Reflux matenda. Mgwirizano wa Achinyamata Opaleshoni ya ku America. J Odwala Opaleshoni. 2009; 44 (5): 1034-1040. PMID: 19433194 www.ncbi.nlm.nih.gov/pubmed/19433194. (Adasankhidwa)

Yates RB, Oelschlager BK, Pellegrini CA. (Adasankhidwa) Matenda a reflux a gastroesophageal ndi hernia wobereka. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Buku Lopanga Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: mutu 42.