Ukulungiswa kwe-Gastroschisis

Ukulungiswa kwe-Gastroschisis inqubo eyenziwe enganeni ukulungisa iphutha lokuzalwa elibangela ukuvuleka esikhunjeni nasemisipha emboze isisu (udonga lwesisu). Ukuvuleka kuvumela amathumbu futhi kwesinye isikhathi ezinye izitho zikwazi ukuphuma ngaphandle kwesisu.

Inhloso yenqubo ukubuyisela izitho esiswini somntwana nokulungisa isici. Ukulungisa kungenziwa ngemuva nje kokuzalwa kwengane. Lokhu kubizwa ngokuthi ukulungiswa okuyisisekelo. Noma, ukulungiswa kwenziwa ngezigaba. Lokhu kubizwa ngokuthi ukulungiswa kwesiteji. Ukuhlinzwa ngokulungiswa okuyisisekelo kwenziwa ngale ndlela elandelayo:

• Uma kunokwenzeka, ukuhlinzwa kwenziwa ngosuku lokuzalwa kwengane yakho. Lokhu kuhlinzwa kwenziwa lapho kukhona inani elincane lamathumbu ngaphandle kwesisu futhi ithumbu alivuvukile kakhulu.
• Ngemuva nje kokuzalwa, amathumbu angaphandle kwesisu afakwa esikhwameni esikhethekile noma embozwe ngepulasitiki ukuze asivikele.
• Ingane yakho ibe isilungele ukuhlinzwa.
• Ingane yakho ithola i-anesthesia ejwayelekile. Lo ngumuthi ovumela ingane yakho ukuba ilale futhi ingabi nezinhlungu ngesikhathi sokuhlinzwa.
• Udokotela ohlinzayo uhlola amathumbu engane yakho (amathumbu) eduze ukuze athole izimpawu zokulimala noma ezinye izinkinga zokuzalwa. Izingxenye ezingenampilo ziyasuswa. Amaphethelo enempilo ahlanganiswa ndawonye.
• Amathumbu abuyiselwa esiswini.
• Imbobo esesiswini iyalungiswa.

Ukulungiswa okuhleliwe kwenziwa lapho ingane yakho ingazinzile ngokwanele ukuba ilungiswe ngokuyinhloko. Kungenziwa futhi uma amathumbu engane evuvukele kakhulu noma kunenani elikhulu lamathumbu ngaphandle komzimba. Noma, kwenziwa lapho isisu somntwana singenele ngokwanele ukuqukatha wonke amathumbu. Ukulungiswa kwenziwa ngale ndlela elandelayo:

• Ngemuva nje kokuzalwa, amathumbu engane nanoma yiziphi ezinye izitho ezingaphandle kwesisu zifakwa esikhwameni sepulasitiki eside. Lesi sikhwama sibizwa ngokuthi yisilo. Isilo bese sinamathiselwa esiswini sengane.
• Omunye umkhawulo wesilo ulenga ngaphezu kwengane. Lokhu kuvumela amandla adonsela phansi ukusiza amathumbu ukuthi angene esiswini. Usuku ngalunye, umhlinzeki wezokunakekelwa kwempilo ubuye aqinise ngobumnene isilo ukuze acindezele amathumbu angene esiswini.
• Kungathatha kuze kube amasonto ama-2 ukuthi wonke amathumbu nezinye izitho zibuyele ngaphakathi esiswini. Isilo siyabe sisuswa. Imbobo esiswini iyalungiswa.

Ukuhlinzwa okuningi kungadingeka esikhathini esizayo ukulungisa imisipha esiswini somntanakho.

I-Gastroschisis yisimo esisongela impilo. Kudinga ukwelashwa ngokushesha ngemuva kokuzalwa ukuze izitho zomntwana zikhule futhi zivikeleke esiswini.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukungezwani komzimba nemithi
• Izinkinga zokuphefumula
• Ukopha
• Ukutheleleka

Izingozi zokulungiswa kwe-gastroschisis yilezi:

• Izinkinga zokuphefumula uma indawo yesisu yengane (isikhala sesisu) incane kunokujwayelekile. Ingane ingadinga ishubhu lokuphefumula nomshini wokuphefumula izinsuku ezimbalwa noma amasonto ngemuva kokuhlinzwa.
• Ukuvuvukala kwezicubu eziqonde odongeni lwesisu futhi zimboze izitho zesisu.
• Ukulimala komzimba.
• Izinkinga ngokugaya nokufaka izakhamzimba ekudleni, uma ingane inomonakalo omningi emathunjini amancane.
• Ukukhubazeka kwesikhashana (imisipha iyeke ukuhamba) yamathumbu amancane.
• Udonga lwesisu i-hernia.
  
  

I-Gastroschisis ivame ukubonwa kwi-ultrasound ngaphambi kokuzalwa kwengane. I-ultrasound ingabonisa izihibe zamathumbu ezintanta ngokukhululekile ngaphandle kwesisu sengane.

Ngemuva kokutholwa kwe-gastroschisis, ingane yakho izolandelwa eduze kakhulu ukuqinisekisa ukuthi iyakhula.

Ingane yakho kufanele ibelethwe esibhedlela esineyunithi yokunakekelwa kwezibhedlela ezisanda kuzalwa (NICU) kanye nodokotela ohlinzayo wezingane. I-NICU isethelwe ukuphatha izimo eziphuthumayo ezenzeka lapho kuzalwa. Udokotela ohlinzayo wezingane unokuqeqeshwa okukhethekile ekuhlinzweni kwezingane nezingane. Iningi lezingane ezine-gastroschisis zilethwe ngesigaba sokuhlinzwa (isigaba se-C).

Ngemuva kokuhlinzwa, ingane yakho izothola ukunakekelwa ku-NICU. Ingane izobekwa embhedeni okhethekile wokugcina ingane yakho ifudumele.

Ingane yakho ingadinga ukuba semshinini wokuphefumula kuze kube yilapho ukuvuvukala komzimba kunciphile nobukhulu bendawo yesisu bukhuphukile.

Ezinye izindlela ingane yakho engazidinga ngemuva kokuhlinzwa yilezi:

• Ishubhu le-nasogastric (NG) elifakwa emakhaleni ukukhipha isisu nokusigcina singenalutho.
• Imithi elwa namagciwane.
• Uketshezi nezakhi zomzimba okunikezwa ngomthambo.
• Oxygen.
• Imithi yezinhlungu.

Ukuphakelwa kuqalwa ngepayipi le-NG ngokushesha nje lapho amathumbu engane yakho eqala ukusebenza ngemuva kokuhlinzwa. Ukuphakelwa ngomlomo kuzoqala kancane kakhulu. Ingane yakho ingadla kancane futhi ingadinga ukwelashwa ngokondla, ukukhuthazwa okuningi, nesikhathi sokululama ngemuva kokuphakelwa.

Isilinganiso sokuhlala esibhedlela amasonto ambalwa kuze kube izinyanga ezimbalwa. Ungakwazi ukuthatha ingane yakho uyise ekhaya lapho isiqale ukuthatha konke ukudla ngomlomo futhi isisindo.

Ngemuva kokuya ekhaya, ingane yakho ingaqala ukuvinjelwa emathunjini (ukuvinjelwa kwamathumbu) ngenxa yekink noma isibazi emathunjini. Udokotela angakutshela ukuthi lokhu kuzolashwa kanjani.

Isikhathi esiningi, i-gastroschisis ingalungiswa ngokuhlinzwa okukodwa noma okubili. Ukuthi ingane yakho yenza kahle kangakanani kuzoya ngokuthi ungakanani umonakalo obekhona emathunjini.

Ngemuva kokululama ekuhlinzweni, izingane eziningi ezine-gastroschisis zenza kahle kakhulu futhi ziphila impilo ejwayelekile. Iningi lezingane ezizalwa zine-gastroschisis azinazo ezinye izinkinga.

Ukulungiswa kodonga lwesisu esiswini - i-gastroschisis

• Ukulungiswa kwe-Gastroschisis - uchungechunge
• ISilo

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I-Islam S. Ukukhubazeka kodonga lwesisu esiswini. Ku: Holcomb GW, Murphy JP, Ostlie DJ, abahleli. Ukuhlinzwa Kwezingane ze-Ashcraft. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2014: isahluko 48.

ULedbetter DJ, uChabra S, uJavid PJ. Izinkinga zodonga lwesisu. Ku: Gleason CA, Juul SE, ama-eds. Izifo zika-Avery Zomntwana osanda kuzalwa. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2018: isahluko 73.