Ukulungiswa kwe-Omphalocele

Ukulungiswa kwe-Omphalocele inqubo eyenziwe enganeni ukulungisa iphutha lokuzalwa odongeni lwesisu (esiswini) lapho konke noma ingxenye yamathumbu, mhlawumbe isibindi nezinye izitho zinamathela ngaphandle kwenkinobho yesisu (inkaba) zincane isikhwama.

Okunye ukukhubazeka kokuzalwa nakho kungaba khona.

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 kuvame ukwenziwa nge-omphalocele encane.

• Ngemuva nje kokuzalwa, isaka elinezitho ezingaphandle kwesisu limbozwe ngokugqoka okuyinyumba ukulivikela.
• Lapho odokotela benquma ukuthi umntwana wakho osanda kuzalwa unamandla anele okuhlinzwa, ingane yakho ikulungele ukuhlinzwa.
• Ingane yakho ithola i-anesthesia ejwayelekile. Lo ngumuthi ovumela ingane yakho ukuba ilale futhi ingabi nezinhlungu ngesikhathi sokuhlinzwa.
• Udokotela ohlinzayo usika (ukusika) ukususa isaka elizungeze izitho.
• Izitho zihlolwa ngokucophelela ukuthola izimpawu zomonakalo noma ezinye izinkinga zokuzalwa. Izingxenye ezingenampilo ziyasuswa. Amaphethelo enempilo ahlanganiswa ndawonye.
• Izitho zibuyiselwa esiswini.
  
• Imbobo esesiswini iyalungiswa.

Ukulungiswa okuhleliwe kwenziwa lapho ingane yakho ingazinzile ngokwanele ukuba ilungiswe ngokuyinhloko. Noma, kwenziwa uma i-omphalocele inkulu kakhulu futhi izitho azikwazi ukungena esiswini sengane. Ukulungiswa kwenziwa ngale ndlela elandelayo:

• Ngemuva nje kokuzalwa, isikhwama sepulasitiki (esibizwa nge-silo) noma uhlobo oluthile lwemishini sisetshenziselwa ukuqukethe i-omphalocele. Isikhwama noma i-mesh bese sinamathiselwa esiswini somntwana.
• Njalo ezinsukwini ezi-2 kuya kwezi-3, udokotela uqinisa ngobumnene isikhwama noma imeshini ukusunduza amathumbu angene esiswini.
• Kungathatha kuze kube amasonto ama-2 noma ngaphezulu ukuthi zonke izitho zibuyele ngaphakathi esiswini. Isikhwama noma imeshini kuyasuswa. Imbobo esiswini iyalungiswa.

I-Omphalocele 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-omphalocele yilezi:

• Izinkinga zokuphefumula. Ingane ingadinga ishubhu lokuphefumula nomshini wokuphefumula izinsuku ezimbalwa noma amasonto ngemuva kokuhlinzwa.
• Ukuvuvukala kwezicubu okugcwala udonga lwesisu futhi kumboze izitho zesisu.
• Ukulimala komzimba.
• Izinkinga ngokugaya nokufaka izakhamzimba ekudleni, uma ingane inomonakalo omningi emathunjini amancane.

I-Omphalocele ivame ukubonwa kwi-ultrasound ngaphambi kokuzalwa kwengane. Ngemuva kokutholakala, 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 ezinama-omphalocele amakhulu zilethwa nge-cesarean section (C-section).

Ngemuva kokuhlinzwa, ingane yakho izothola ukunakekelwa ku-NICU. Ingane yakho izobekwa embhedeni okhethekile ukugcina 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:

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

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.

Ukuthi ingane yakho ihlala isikhathi esingakanani esibhedlela kuya ngokuthi ngabe kukhona yini okunye ukukhubazeka kokuzalwa kanye nezinkinga. 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, ukuhlinzwa kungalungisa i-omphalocele. Ukuthi ingane yakho yenza kahle kangakanani kuya ngokuthi kungakanani ukulimala noma ukulahleka kwamathumbu, nokuthi ingane yakho inezinye izinkinga zokuzalwa.

Ezinye izingane zine-reflux yesisu ngemuva kokuhlinzwa. Lesi simo senza ukuthi ukudla noma isisu esiswini kubuye kuphume esiswini kungene emphinjeni.

Ezinye izingane ezinama-omphaloceles amakhulu nazo zingaba namaphaphu amancane futhi zingadinga ukusebenzisa umshini wokuphefumula.

Zonke izingane ezizalwe nge-omphalocele kufanele zihlolwe i-chromosome. Lokhu kuzosiza abazali baqonde ubungozi balesi sifo ekukhulelweni okuzayo.

Ukulungiswa kodonga lwesisu esiswini - omphalocele; Ukulungiswa kwe-Exomphalos

• Ukuletha ingane yakho ukuthi ivakashele ingane yakini egula kakhulu
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile

• Ukulungiswa kwe-Omphalocele - uchungechunge

UChung DH. Ukuhlinzwa kwezingane. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa: Isisekelo Sebhayoloji Sokuzijwayeza Kwamanje Kokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; I-2017: isahluko 66.

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.

UWalther AE, uNathan JD. Amaphutha odonga esiswini olusanda kuzalwa. Ku: Wyllie R, Hyams JS, Kay M, eds. Izifo Zamathumbu Emathunjini Nesibindi. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2016: isahluko 58.