Ukulungiswa kwe-Pectus excavatum

Ukulungiswa kwe-Pectus excavatum ukuhlinzwa ukulungisa i-pectus excavatum. Lokhu kungukuzalwa (okukhona lapho kuzalwa) ukukhubazeka ngaphambili kodonga lwesifuba okubanga ithambo lesifuba elicwilile (sternum) nezimbambo.

I-Pectus excavatum ibizwa nangokuthi i-funnel noma isifuba esishonile. Kungase kube nzima phakathi neminyaka yobusha.

Kunezinhlobo ezimbili zokuhlinzwa ukulungisa lesi simo - ukuhlinzwa okuvulekile nokuhlinzwa okuvaliwe (okungahlaseli kakhulu). Kuphela ukuhlinzwa kwenziwa ngenkathi ingane ilele ubuthongo obukhulu futhi ingenabuhlungu ku-anesthesia ejwayelekile.

Ukuhlinzwa okuvulekile kungokwesiko ngokwengeziwe. Ukuhlinzwa kwenziwa ngale ndlela elandelayo:

• Udokotela ohlinzayo usika (ukusika) engxenyeni engaphambili yesifuba.
• Uqwanga olukhubazekile luyasuswa futhi ulwelwesi lobambo lusele endaweni. Lokhu kuzovumela uqwanga ukuthi lukhule lubuye ngendlela efanele.
• Ngemuva kwalokho kusikwa ithambo lesifuba, elihanjiswa liyiswe endaweni efanele. Udokotela ohlinzayo angasebenzisa umucu wensimbi (isiqeshana sokweseka) ukubamba ithambo lesifuba kule ndawo ejwayelekile lize liphole. Ukwelapha kuthatha izinyanga ezi-3 ukuya kweziyi-12.
• Udokotela ohlinzayo angafaka ithubhu lokukhipha uketshezi olwakha endaweni yokulungisa.
• Ekupheleni kokuhlinzwa, imbobo ivaliwe.
• Imichilo yensimbi isuswa ezinyangeni eziyisithupha kuye kweziyishumi nambili ngokusikwa okuncane esikhunjeni ngaphansi kwengalo. Le nqubo ivame ukwenziwa ngokuya esibhedlela.

Uhlobo lwesibili lokuhlinzwa luyindlela evaliwe. Isetshenziswa kakhulu ezinganeni. Akukho uqwanga noma ithambo elikhishwayo. Ukuhlinzwa kwenziwa ngale ndlela elandelayo:

• Udokotela ohlinzayo wenza ukusikeka okuncane okubili, okukodwa ohlangothini lwesifuba.
• Ikhamera encane yevidiyo ebizwa nge-thoracoscope ifakwa kwesinye sezinto ezisikiwe. Lokhu kuvumela udokotela ohlinzayo ukuthi abuke ngaphakathi kwesifuba.
• Umgoqo wensimbi ogobile owakhelwe ukulingana ingane ufakwa phakathi kokuqhekeka bese ufakwa ngaphansi kwethambo lesifuba. Inhloso yebha ukuphakamisa ithambo lesifuba. Ibha ishiywe endaweni okungenani iminyaka emi-2. Lokhu kusiza ithambo lesifuba ukuba likhule kahle.
• Ekupheleni kokuhlinzwa, ubukhulu buyasuswa futhi ukusikeka kuvaliwe.

Ukuhlinzwa kungathatha ihora eli-1 kuye kwele-4, kuya ngenqubo.

Isizathu esivame kakhulu sokulungiswa kwe-pectus excavatum ukuthuthukisa ukubonakala kodonga lwesifuba.

Kwesinye isikhathi ukukhubazeka kubanzima kangangokuba kubangele ubuhlungu besifuba futhi kuthinte ukuphefumula, ikakhulu kubantu abadala.

Ukuhlinzwa kwenziwa kakhulu ezinganeni ezineminyaka engu-12 kuya kwengu-16 ubudala, kodwa hhayi ngaphambi kweminyaka yobudala engama-6. Kungenziwa nakubantu abadala abaseminyakeni yabo engama-20 ubudala.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

• Ukusabela emithini
• Izinkinga zokuphefumula
• Ukopha, amahlule egazi, noma ukutheleleka

Izingozi zalokhu kuhlinzwa yilezi:

• Ukulimala enhliziyweni
• Ukuwa kwamaphaphu
• Ubuhlungu
• Ukubuyiselwa kokukhubazeka

Kudingeka ukuhlolwa okuphelele kwezokwelapha nokuhlolwa kwezokwelapha ngaphambi kokuhlinzwa. Udokotela ohlinzayo uzo-oda okulandelayo:

• I-electrocardiogram (ECG) futhi mhlawumbe ne-echocardiogram ekhombisa ukuthi inhliziyo isebenza kanjani
• Ukuhlolwa komsebenzi wePulmonary ukuhlola izinkinga zokuphefumula
• I-CT scan noma i-MRI yesifuba

Tshela udokotela ohlinzayo noma umhlengikazi ngalokhu:

• Imithi ethathwa ingane yakho. Faka phakathi izidakamizwa, amakhambi, amavithamini, noma ezinye izithako ozithengile ngaphandle kwemithi kadokotela.
• Ukungezwani komzimba nengane yakho kungadingeka ukuthi iye emithini, i-latex, i-tape, noma umhlanzi wezikhumba.

Phakathi nezinsuku ngaphambi kokuhlinzwa:

• Cishe izinsuku eziyi-7 ngaphambi kokuhlinzwa, ingane yakho ingacelwa ukuthi iyeke ukuthatha i-aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), warfarin (Coumadin), nanoma iziphi ezinye izidakamizwa zokuncipha kwegazi.
• Buza udokotela wakho ohlinzayo noma umhlengikazi ukuthi yimiphi imithi ingane yakho okufanele ayithathe ngosuku lokuhlinzwa.

Ngosuku lokuhlinzwa:

• Ingane yakho kungenzeka icelwe ukuthi ingaphuzi noma idle noma yini ngemuva kwamabili ebusuku ngaphambi kokuhlinzwa.
• Nikeza ingane yakho noma imiphi imishanguzo udokotela ohlinzayo akutshele yona ukuthi uyinikeze ngesiphuzo esincane samanzi.
• Fika esibhedlela ngesikhathi.
• Udokotela ohlinzayo uzoqinisekisa ukuthi ingane yakho ayinazo izimpawu zokugula ngaphambi kokuhlinzwa. Uma ingane yakho igula, ukuhlinzwa kungahlehliswa.

Kuvamile ukuthi izingane zihlale esibhedlela izinsuku ezintathu kuya kwezi-7. Ukuthi ingane yakho ihlala isikhathi esingakanani kuya ngokuthi ukutakula kuhamba kanjani.

Ubuhlungu buvamile ngemuva kokuhlinzwa. Ezinsukwini ezimbalwa zokuqala, ingane yakho ingathola umuthi onobuhlungu oqinile emthanjeni (nge-IV) noma nge-catheter ebekwe emgogodleni (i-epidural). Ngemuva kwalokho, izinhlungu zivame ukuphathwa ngemithi ethathwe ngomlomo.

Ingane yakho ingaba namashubhu esifubeni ezungeze ukusikeka kokuhlinzwa. La mashubhu akhipha uketshezi oluthe xaxa oluqoqa kusuka enqubeni. Amashubhu azohlala endaweni aze ayeke ukukhipha, imvamisa ngemuva kwezinsuku ezimbalwa. Amashubhu abese esuswa.

Ngosuku olulandelayo ngemuva kokuhlinzwa, ingane yakho izokhuthazeka ukuthi ihlale phansi, iphefumule kakhulu, futhi ivuke embhedeni ihambe. Le misebenzi izosiza ukwelashwa.

Ekuqaleni, ingane yakho ngeke ikwazi ukugoba, ukusonta, noma ukugoqa ukusuka kolunye uhlangothi. Imisebenzi izokwandiswa kancane kancane.

Lapho ingane yakho ikwazi ukuhamba ngaphandle kosizo, cishe ilungele ukuya ekhaya. Ngaphambi kokuphuma esibhedlela, uzothola incwadi kadokotela wezinhlungu.

Ekhaya, landela noma imiphi imiyalo yokunakekela ingane yakho.

Ukuhlinzwa kuvame ukuholela ekuthuthukiseni ukubukeka, ukuphefumula, kanye nokukwazi ukuzivocavoca umzimba.

Ukulungiswa kwesifuba somsele; Ukulungiswa kwesifuba; Ukulungiswa kwesifuba esidakiwe; Ukulungiswa kwesifuba sikaCobbler; Ukulungiswa kweNuss; Ukulungiswa kwe-Ravitch

• I-Pectus excavatum - ukukhishwa
• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile

• I-Pectus excavatum
• Ukulungiswa kwe-Pectus excavatum - uchungechunge

UNuss D, uKelly RE. Ukukhubazeka kodonga lwesifuba sokuzalwa. Ku: Holcomb GW, Murphy JP, Ostlie DJ, abahleli. Ukuhlinzwa Kwezingane ze-Ashcraft. Umhlaka 6. IPhiladelphia, PA: Elsevier Saunders; 2014: isahluko 20.

UPutnam JB. Amaphaphu, udonga lwesifuba, i-pleura, ne-mediastinum. 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; 2017: isahluko 57.