Ukulungiswa kwe-Craniosynostosis

Ukulungiswa kwe-Craniosynostosis ukuhlinzwa ukulungisa inkinga edala ukuthi amathambo ogebhezi lwengane akhule ndawonye (fuse) kusenesikhathi.

Lokhu kuhlinzwa kwenziwa egumbini lokuhlinza ngaphansi kwe-anesthesia ejwayelekile. Lokhu kusho ukuthi ingane yakho izobe ilele futhi ngeke ibuzwe ubuhlungu. Ezinye noma zonke izinwele zizogundwa.

Ukuhlinzwa okujwayelekile kubizwa ngokuthi ukulungiswa okuvulekile. Kufaka lezi zinyathelo:

• Indawo ejwayeleke kakhulu yokusika okuhlinzekwayo ingaphezulu kwekhanda, kusuka ngenhla kwendlebe eyodwa kuye ngaphezulu kwenye indlebe. Ukusika kuvame uku-wavy. Lapho ukusikwa kwenziwa khona kuncike enkingeni ethile.
• Isicubu sesikhumba, izicubu, nemisipha ngaphansi kwesikhumba, nezicubu ezivale ithambo ziyakhululwa futhi zikhuphuke ukuze udokotela ohlinzayo abone ithambo.
• Umugqa wethambo uvame ukususwa lapho kufakwa khona ama-suture amabili. Lokhu kubizwa ngokuthi i-strip craniectomy. Kwesinye isikhathi, izingcezu ezinkulu zethambo kufanele futhi zisuswe. Lokhu kubizwa nge-synostectomy. Izingxenye zala mathambo zingashintshwa noma zakhiwe kabusha lapho zisuswa. Ngemuva kwalokho, zibuyiselwa emuva. Ngezinye izikhathi, akunjalo.
• Kwesinye isikhathi, amathambo asele endaweni adinga ukuhanjiswa noma ukuhanjiswa.
• Kwesinye isikhathi, amathambo azungeze amehlo ayasikwa futhi abunjwe kabusha.
• Amathambo aboshelwa kusetshenziswa amapuleti amancane anezikulufu ezingena kugebhezi. Amapuleti nezikulufu kungaba yinsimbi noma into ekwazi ukuhleleka kabusha (inyamalala ngokuhamba kwesikhathi). Amapuleti angakhula njengoba ugebhezi lukhula.

Ukuhlinzwa kuvame ukuthatha amahora amathathu kuya kwayisi-7. Ingane yakho mhlawumbe izodinga ukumpontshelwa igazi ngesikhathi noma ngemuva kokuhlinzwa ukuze ithathe indawo yegazi elilahlekile ngesikhathi sokuhlinzwa.

Uhlobo olusha lokuhlinzwa lusetshenziselwa ezinye izingane. Lolu hlobo luvame ukwenzelwa izingane ezingaphansi kwezinyanga ezintathu kuya kwezi-6 ubudala.

• Udokotela ohlinzayo usika okukodwa noma okubili okuncane ekhanda. Izikhathi eziningi, lokhu kusikeka kukodwa kungamayintshi ama-intshi (2.5 amasentimitha) ubude. Lokhu kusikwa kwenziwa ngenhla kwendawo lapho ithambo lidinga ukususwa khona.
• Ishubhu (endoscope) idluliswa ngokusikeka okuncane. Ububanzi buvumela udokotela ohlinzayo ukuthi abuke indawo okuhlinzwa kuyo. Imishini ekhethekile yezokwelapha nekhamera kudluliswa nge-endoscope. Esebenzisa le mishini, udokotela ohlinzayo ususa izingxenye zamathambo ngokusikeka.
• Lokhu kuhlinzwa kuvame ukuthatha cishe ihora elilodwa. Kukhona ukulahleka kwegazi okuncane kakhulu ngalolu hlobo lokuhlinzwa.
• Iningi lezingane lidinga ukugqoka isigqoko sokuzivikela esikhethekile ukuvikela ikhanda laso isikhathi esithile ngemuva kokuhlinzwa.

Izingane zenza kahle kakhulu lapho zithola lokhu kuhlinzwa lapho zinezinyanga ezintathu ubudala. Ukuhlinzwa kufanele kwenziwe ngaphambi kokuba ingane ibe nezinyanga eziyisithupha ubudala.

Ikhanda lengane, noma ugebhezi, lwakhiwa ngamathambo ahlukene ayisishiyagalombili. Ukuxhumana phakathi kwala mathambo kubizwa ngokuthi ama-sutures. Lapho ingane izalwa, kujwayelekile ukuthi la ma-suture avuleke kancane. Uma nje ama-suture evulekile, i-skull yengane nengqondo kungakhula.

I-Craniosynostosis yisimo esenza ukuthi ama-suture wengane eyodwa noma amaningi avale kusenesikhathi. Lokhu kungadala ukwakheka kwekhanda lengane yakho ukuthi kwehluke kunokujwayelekile. Ngezinye izikhathi kunganciphisa ukuthi ubuchopho bungakhula kangakanani.

I-x-ray noma i-computed tomography (CT) scan ingasetshenziselwa ukuxilonga i-craniosynostosis. Ukuhlinzwa kuvame ukudingeka ukukulungisa.

Ukuhlinzwa kukhulula ama-suture ahlanganisiwe. Iphinde ibumbe kabusha ibunzi, amasokhethi wamehlo, nogebhezi lapho kudingeka. Izinhloso zokuhlinzwa yilezi:

• Ukwehlisa ingcindezi ebuchosheni bengane
• Ukuqinisekisa ukuthi kunendawo eyanele kugebhezi ukuvumela ubuchopho ukuthi bukhule kahle
• Ukwenza ngcono ukubonakala kwekhanda lengane
• Ukuvimbela izingqinamba zesikhathi eside ze-neurocognitive

Izingozi zanoma yikuphi ukuhlinzwa yilezi:

• Izinkinga zokuphefumula
• Ukutheleleka, kufaka phakathi amaphaphu kanye nomgudu womchamo
• Ukwehla kwegazi (izingane ezilungiswa kahle zingadinga ukumpontshelwa okukodwa noma ngaphezulu)
• Ukusabela emithini

Izingozi zalokhu kuhlinzwa yilezi:

• Ukutheleleka ebuchosheni
• Amathambo ahlangana futhi, futhi kudingeka ukuhlinzwa okwengeziwe
• Ukuvuvukala kobuchopho
• Ukulimala kwezicubu zobuchopho

Uma ukuhlinzwa kuhlelwe, kuzodingeka uthathe izinyathelo ezilandelayo:

Phakathi nezinsuku ngaphambi kokuhlinzwa:

• Tshela umhlinzeki wakho wezempilo ukuthi yimiphi imithi, amavithamini, noma amakhambi owanikeza ingane yakho. Lokhu kufaka noma yini oyithengile ngaphandle kwemithi kadokotela. Ungacelwa ukuthi uyeke ukunika ingane yakho eminye yale mithi ezinsukwini ezandulela ukuhlinzwa.
• Buza umhlinzeki ukuthi imiphi imithi ingane yakho okufanele ayithathe ngosuku lokuhlinzwa.

Ngosuku lokuhlinzwa:

• Nikeza ingane yakho amanzi amancane ngamanzi nganoma imiphi imithi umhlinzeki wakho akutshele yona ukuthi uyinike ingane yakho.
• Umhlinzeki wengane yakho uzokutshela ukuthi uzofika nini ezohlinzwa.

Buza umhlinzeki wakho ukuthi ingane yakho ingadla noma iphuze ngaphambi kokuhlinzwa. Ngenjwayelo:

• Izingane ezindala akufanele zidle noma ziphuze noma yiluphi ubisi ngemuva kwamabili ngaphambi kokuhlinzwa. Bangaba nejusi ecacile, amanzi, nobisi lwebele kuze kufike emahoreni amane ngaphambi kokuhlinzwa.
• Izinsana ezingaphansi kwezinyanga eziyi-12 ngokuvamile zingadla ifomula, okusanhlamvu, noma ukudla kwezingane kuze kube cishe amahora ayisithupha ngaphambi kokuhlinzwa. Bangaba noketshezi olucacile nobisi lwebele kuze kube amahora amane ngaphambi kokuhlinzwa.

Udokotela wakho angakucela ukuthi ugeze ingane yakho ngensipho ekhethekile ekuseni yokuhlinzwa. Hlanza ingane yakho kahle.

Ngemuva kokuhlinzwa, ingane yakho izoyiswa egumbini labagula kakhulu (i-ICU). Ingane yakho izoyiswa egumbini lesibhedlela elijwayelekile ngemuva kosuku noma ezimbili. Ingane yakho izohlala esibhedlela izinsuku ezintathu kuya kwezi-7.

• Ingane yakho izoba nebhandeshi elikhulu elisongwe ekhanda. Kuzobakhona neshubhu elizongena emthanjeni. Lokhu kubizwa nge-IV.
• Abahlengikazi bazogada ingane yakho eduze.
• Kuzokwenziwa izivivinyo zokubheka ukuthi ingabe ingane yakho ilahlekelwe igazi eliningi ngesikhathi sokuhlinzwa. Ukumpontshelwa igazi kuzonikezwa, uma kudingeka.
• Ingane yakho iyoba nokuvuvukala nokulimala eduze kwamehlo nasebusweni. Kwesinye isikhathi, amehlo angavuvukala avaleke. Lokhu kuvame ukuba kubi kakhulu ezinsukwini ezintathu zokuqala ngemuva kokuhlinzwa. Kufanele kube ngcono ngosuku 7.
• Ingane yakho kufanele ihlale embhedeni izinsuku ezimbalwa zokuqala. Inhloko yombhede wengane yakho izovuswa. Lokhu kusiza ukugcina ukuvuvukala phansi.

Ukukhuluma, ukucula, ukudlala umculo nokuxoxa izindaba kungasiza ekudambiseni ingane yakho. I-Acetaminophen (iTylenol) isetshenziselwa ubuhlungu. Udokotela wakho angakunikeza eminye imithi yezinhlungu uma ingane yakho iyidinga.

Iningi lezingane ezihlinzwa i-endoscopic zingaya emakhaya ngemuva kokuhlala esibhedlela ubusuku obubodwa.

Landela imiyalo oyinikezwe ngokunakekela ingane yakho ekhaya.

Isikhathi esiningi, umphumela wokulungiswa kwe-craniosynostosis muhle.

I-craniectomy - ingane; I-Synostectomy; Umugqa we-craniectomy; I-endoscopy esizwa i-craniectomy; I-Sagittal craniectomy; Intuthuko engaphambili yomzimba; FOA

• Ukuletha ingane yakho ukuthi ivakashele ingane yakini egula kakhulu
• Ukuvimbela ukulimala ekhanda ezinganeni

UDemke JC, Tatum SA. Ukuhlinzwa kwe-Craniofacial kokukhubazeka kokuzalwa nokuzalwa. Ku: IFlint PW, uFrancis HW, uHaughey BH, et al, eds. I-Cummings Otolaryngology: Ukuhlinzwa Kwekhanda Nentamo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2021: isahluko 187.

UGabrick KS, Wu RT, Singh A, Persing JA, Alperovich M. Radiographic solidity of metopic craniosynostosis correlates nemiphumela yesikhathi eside ye-neurocognitive. Ukuhlinzwa kabusha kwePlast. 2020; 145 (5): 1241-1248. I-PMID: 32332546 pubmed.ncbi.nlm.nih.gov/32332546/.

ULin KY, uPersing JA, uJane JA noJane JA. I-Nonsyndromic craniosynostosis: isingeniso kanye ne-single-suture synostosis. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans ne-Winn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 193.

Proctor MR. Ukulungiswa kwe-endoscopic craniosynostosis. Humusha i-Pediatr. 2014; 3 (3): 247-258. I-PMID: 26835342 pubmed.ncbi.nlm.nih.gov/26835342/.