Pectus Excavatum

Zamkati

• Zizindikiro za pectus excavatum
• Njira zopangira opaleshoni
• Njira ya Ravitch
• Njira ya Nuss
• Zovuta za pectus excavatum opaleshoni
• Kutsogoloku

Pectus excavatum ndi mawu achi Latin omwe amatanthauza "chifuwa chopindika." Anthu omwe ali ndi vuto lobadwa nalo ali ndi chifuwa chowonekera bwino. Concave sternum, kapena fupa la chifuwa, limatha kukhalapo pakubadwa. Ikhozanso kukula pambuyo pake, makamaka nthawi yaunyamata. Mayina ena odziwika a matendawa ndi awa: chifuwa cha wolobera, chifuwa, ndi chifuwa chomira.

Pafupifupi 37 peresenti ya anthu omwe ali ndi pectus excavatum amakhalanso ndi achibale omwe ali ndi vutoli. Izi zikusonyeza kuti ukhoza kukhala cholowa. Pectus excavatum ndiye khoma lofala kwambiri pachifuwa pakati pa ana.

Zikakhala zovuta, zimatha kusokoneza kugwira ntchito kwa mtima ndi mapapo. Pazofatsa, zimatha kubweretsa mavuto pazithunzi. Odwala ena omwe ali ndi vutoli nthawi zambiri amapewa zinthu monga kusambira zomwe zimapangitsa kuti kubisala kukhale kovuta.

Zizindikiro za pectus excavatum

Odwala omwe ali ndi vuto lalikulu la pectus excavatum amatha kupuma movutikira komanso kupweteka pachifuwa. Kuchita opaleshoni kungakhale kofunikira kuti muchepetse kusapeza bwino ndikupewa kupindika kwamtima ndi kupuma.

Madokotala amagwiritsa ntchito ma X-rays pachifuwa kapena makina a CT kupanga zithunzi zamkati mwa chifuwa. Izi zimathandizira kuyeza kukula kwa kupindika. Mndandanda wa Haller ndi muyeso wokhazikika womwe umagwiritsidwa ntchito powerengera kukula kwa vutoli.

Mndandanda wa Haller umawerengedwa pogawa m'lifupi mwa nthitiyo mtunda kuchokera ku sternum mpaka msana. Mndandanda wabwinobwino ndi pafupifupi 2.5.Chizindikiro choposa 3.25 chimawerengedwa kuti ndi cholimba mokwanira kuti chipangitsidwe kukonza opaleshoni. Odwala ali ndi mwayi wosachita chilichonse ngati kupindika kuli kofatsa.

Njira zopangira opaleshoni

Kuchita opaleshoni kumatha kukhala kovuta kapena kowopsa pang'ono, ndipo kumatha kukhala ndi njira zotsatirazi.

Njira ya Ravitch

Njira ya Ravitch ndi njira yovuta yochitira opaleshoni yomwe idachita upainiya kumapeto kwa ma 1940. Njirayi imaphatikizapo kutsegula pachifuwa ndi mawonekedwe osakanikirana. Zigawo zazing'ono zazingwe zazingwe zimachotsedwa ndipo sternum ndiyofewa.

Mikwingwirima, kapena mipiringidzo yachitsulo, itha kupangika kuti ikasunge khungu ndi mafupa m'malo mwake. Ngalande zimayikidwa mbali zonse ziwiri, ndipo chekecho chimalumikizananso. Mikwingwirima imatha kuchotsedwa, koma amayenera kuti azikhalabe mpaka kalekale. Zovuta nthawi zambiri zimakhala zochepa, ndipo kuchipatala kumakhala kosakwana sabata kumakhala kofala.

Njira ya Nuss

Njira ya Nuss idapangidwa m'ma 1980. Ndi njira yocheperako. Zimaphatikizapo kudula mabala awiri mbali zonse za chifuwa, pang'ono pamunsi pamabele. Chodulira chachitatu chaching'ono chimalola ochita opaleshoni kuyika kamera yaying'ono, yomwe imagwiritsidwa ntchito kuwongolera kulowetsa chitsulo chokhota pang'ono. Chipindacho chimazungulira kotero chimakhotera panja chikakhala kuti chikhala pansi pa mafupa ndi katemera wa nthiti yakumtunda. Izi zimapangitsa sternum kunja.

Bala yachiwiri imatha kulumikizidwa mozungulira yoyamba kuthandizira bala yopindika. Zomwe zimapangidwazo zimatsekedwa ndi zoluka, ndipo ngalande zazing'ono zimayikidwa pafupi kapena pafupi ndi malo omwe amathandizira. Njira imeneyi sikufuna kudula kapena kuchotsa khungu kapena fupa.

Zitsulo zachitsulo zimachotsedwa nthawi yochizira odwala pafupifupi zaka ziwiri kuchokera kuchitidwa opaleshoni yoyamba kwa odwala achichepere. Pakadali pano, kuwongolera kumayembekezeredwa kukhala kosatha. Zitsulozo sizingachotsedwe kwa zaka zitatu kapena zisanu kapena zitha kusungidwa m'malo mwa akulu. Njirayi idzagwira ntchito bwino kwa ana, omwe mafupa awo ndi mafupa awo akukula.

Zovuta za pectus excavatum opaleshoni

Kuwongolera opareshoni kumachita bwino kwambiri. Njira iliyonse yochita opaleshoni imayambitsa zoopsa, kuphatikizapo:

• ululu
• chiopsezo chotenga matenda
• kuthekera kuti kuwongolera sikungakhale kothandiza kuposa momwe amayembekezera

Zipsera ndizosapeweka, koma ndizochepa kwambiri ndi njira ya Nuss.

Pali chiopsezo cha matenda amtundu wa thoracic ndi njira ya Ravitch, yomwe imatha kubweretsa zovuta kupuma kwambiri. Pofuna kuchepetsa chiopsezo, opaleshoni nthawi zambiri imachedwa mpaka atakwanitsa zaka 8.

Zovuta sizachilendo pakuchita opaleshoni, koma kuopsa kwake komanso kuchepa kwamavuto kumakhala kofanana kwa onse awiri.

Kutsogoloku

Madokotala akuyesa njira yatsopano: njira yamaginito yosunthira. Njira yoyeserayi imaphatikizapo kuyika maginito mwamphamvu mkati mwa chifuwa. Maginito achiwiri amamangiriridwa kunja kwa chifuwa. Maginito amapanga mphamvu zokwanira pang'onopang'ono kukonzanso sternum ndi nthiti, ndikuwakakamiza kunjaku. Maginito akunja amavala ngati cholimba kwa maola angapo patsiku.