Ventriculoperitoneal shunting

I-Ventriculoperitoneal shunting ukuhlinzwa ukwelapha uketshezi oluningi lwe-cerebrospinal fluid (CSF) emigodini (ama-ventricles) obuchopho (i-hydrocephalus).

Le nqubo yenziwa egumbini lokusebenza ngaphansi kwe-anesthesia ejwayelekile. Kuthatha cishe 1 1/2 amahora. Ishubhu (ipayipi) lidluliselwa lisuka emigodini yekhanda liye esiswini ukukhipha uketshezi oluningi lwe-cerebrospinal fluid (CSF). I-valve yengcindezi nedivayisi elwa ne-siphon iqinisekisa ukuthi kukhishwa inani elifanele loketshezi kuphela.

Inqubo yenziwa ngale ndlela elandelayo:

• Indawo yezinwele ekhanda igundiwe. Lokhu kungaba ngemuva kwendlebe noma ngaphezulu noma emuva kwekhanda.
• Udokotela ohlinzayo wenza ukusikwa kwesikhumba ngemuva kwendlebe. Okunye ukusika okuncane kokuhlinzwa kwenziwa esiswini.
• Kubhobozwa imbobo encane kugebhezi. Omunye umkhawulo we-catheter udluliselwa ku-ventricle yobuchopho. Lokhu kungenziwa ngekhompuyutha noma ngaphandle kwayo njengesiqondisi. Kungenziwa futhi nge-endoscope evumela udokotela ohlinzayo ukuthi abone ngaphakathi kwe-ventricle.
• Ipayipi lesibili lifakwa ngaphansi kwesikhumba ngemuva kwendlebe. Ithunyelwa phansi entanyeni nasesifubeni, futhi imvamisa ifakwa endaweni yesisu. Kwesinye isikhathi, iyama endaweni yesifuba. Esiswini, i-catheter ivame ukufakwa kusetshenziswa i-endoscope. Udokotela angenza futhi ukusikeka okuncane okuncane, ngokwesibonelo entanyeni noma eduze kokhololo, ukusiza ukudlulisa ipayipi ngaphansi kwesikhumba.
• I-valve ibekwa ngaphansi kwesikhumba, imvamisa ngemuva kwendlebe. I-valve ixhunywe kuwo womabili ama-catheters. Lapho ingcindezi eyengeziwe yakhela nxazonke zobuchopho, i-valve iyavula, bese uketshezi oluningi ludonsa nge-catheter luye esiswini noma endaweni yesifuba. Lokhu kusiza ukwehlisa ingcindezi yokungasebenzi. Isigubhu esisevalvejini sivumela ukuqalwa (kokumpompa) kwe-valve nokuqoqa i-CSF uma kudingeka.
• Umuntu uyiswa endaweni yokutakula abese ethuthelwa egumbini lesibhedlela.

Lokhu kuhlinzwa kwenziwa lapho kune-cerebrospinal fluid (CSF) eningi kakhulu ebuchosheni nasemgogodleni. Lokhu kubizwa nge-hydrocephalus. Kubangela ingcindezi ephakeme kunokujwayelekile ebuchosheni. Kungadala ukulimala kobuchopho.

Izingane zingazalwa zine-hydrocephalus. Kungenzeka nezinye izinkinga zokuzalwa zekholomu lomgogodla noma ubuchopho. I-Hydrocephalus nayo ingenzeka kubantu abadala asebekhulile.

Ukuhlinzwa nge-shunt kufanele kwenziwe ngokushesha lapho kutholakala i-hydrocephalus. Kungaphakanyiswa ukuhlinzwa okunye. Udokotela wakho angakutshela kabanzi ngalezi zinketho.

Izingozi ze-anesthesia nokuhlinzwa ngokujwayelekile yilezi:

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

Izingozi zokubekwa kwe-ventriculoperitoneal shunt yilezi:

• Ukuqina kwegazi noma ukopha ebuchosheni
• Ukuvuvukala kobuchopho
• I-Hole emathunjini (i-perforation yamathumbu), engenzeka ngemuva kokuhlinzwa
• Ukuvuza kwe-CSF fluid ngaphansi kwesikhumba
• Ukutheleleka kwe-shunt, ubuchopho, noma esiswini
• Ukulimala kwezicubu zobuchopho
• Ukuquleka

I-shunt ingayeka ukusebenza. Uma lokhu kwenzeka, uketshezi luzoqala ukwakha ebuchosheni futhi. Njengoba ingane ikhula, i-shunt ingadinga ukubekwa kabusha.

Uma inqubo kungesona isimo esiphuthumayo (kuhlelwe ukuhlinzwa okuhleliwe):

• Tshela umhlinzeki wezempilo ukuthi yimiphi imishanguzo, izithasiselo, amavithamini, noma amakhambi umuntu awasebenzisayo.
• Thatha noma imuphi umuthi umhlinzeki athe awuphuze ngesiphuzo esincane samanzi.

Buza umhlinzeki mayelana nokukhawulela ukudla nokuphuza ngaphambi kokuhlinzwa.

Landela noma imiphi eminye imiyalelo yokulungiselela ekhaya. Lokhu kungafaka ukugeza ngensipho ekhethekile.

Umuntu angadinga ukulala phansi amahora angama-24 okokuqala lapho kufakwa i-shunt.

Ukuhlala isikhathi esingakanani esibhedlela kuncike ekutheni kungani i-shunt idingeka. Ithimba lezokunakekelwa kwezempilo lizomqapha ngeso lokhozi umuntu. Uketshezi lwe-IV, ama-antibiotic, kanye nemithi yezinhlungu kuzonikezwa uma kudingeka.

Landela imiyalo yomhlinzeki mayelana nokuthi uyinakekela kanjani i-shunt ekhaya. Lokhu kungabandakanya ukuthatha umuthi ukuvikela ukutheleleka kwe-shunt.

Ukubekwa kwe-Shunt kuvame ukuphumelela ekwehliseni ingcindezi ebuchosheni. Kepha uma i-hydrocephalus ihlobene nezinye izimo, njenge-spina bifida, isimila sobuchopho, i-meningitis, i-encephalitis, noma ukopha, lezi zimo zingathinta ukubikezela. I-hydrocephalus enamandla kangakanani ngaphambi kokuhlinzwa nayo ithinta umphumela.

Shunt - i-ventriculoperitoneal; VP shunt; Ukubuyekezwa kwe-Shunt

• Ukunakekelwa kwesilonda sokuhlinzwa - kuvulekile
• I-Ventriculoperitoneal shunt - ukukhipha

• Ama-Ventricles obuchopho
• I-Craniotomy ye-cerebral shunt
• I-Ventriculoperitoneal shunt - uchungechunge

IBadhiwala JH, Kulkarni AV. Izinqubo ze-Ventricular shunting. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans neWinn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 201.

IRosenberg GA. I-edema yobuchopho nokuphazamiseka kokujikeleza kwe-cerebrospinal fluid. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 88.