Ukuhlinzwa kwe-anti-reflux - izingane

Ukuhlinzwa nge-anti-reflux wukuhlinzwa ukuze kuqiniswe imisipha engezansi kwesisu (ishubhu elithwala ukudla lisuke emlonyeni liye esiswini). Izinkinga ngale misipha zingaholela kwisifo se-reflux se-gastroesophageal (GERD).

Lokhu kuhlinzwa kungenziwa futhi ngesikhathi sokulungiswa kwe-hernia yokulanda.

Lo mbhalo ukhuluma ngokulungiswa kokuhlinzwa kwe-anti-reflux ezinganeni.

Uhlobo oluvame kakhulu lokuhlinzwa kwe-anti-reflux lubizwa ngokuthi yi-fundoplication. Lokhu kuhlinzwa kaningi kuthatha amahora amabili kuya kwamathathu.

Ingane yakho izonikezwa i-anesthesia ejwayelekile ngaphambi kokuhlinzwa. Lokho kusho ukuthi ingane izobe ilele futhi ingakwazi ukuzwa ubuhlungu ngesikhathi senqubo.

Udokotela ohlinzayo uzosebenzisa umthungo ukusonga ingxenye engenhla yesisu sengane yakho ngasekupheleni komphetho. Lokhu kusiza ukuvimbela i-asidi esiswini kanye nokudla ekugelezeni emuva.

Kungafakwa i-gastrostomy tube (g-tube) uma ingane yakho ibinenkinga yokugwinya noma yokondla. Le tube isiza ekondleni futhi ikhiphe umoya esiswini sengane yakho.

Okunye ukuhlinzwa, okubizwa nge-pyloroplasty nakho kungenziwa. Lokhu kuhlinzwa kukhulisa ukuvuleka phakathi kwesisu namathumbu amancane ukuze isisu sikwazi ukukhipha ngokushesha.

Lokhu kuhlinzwa kungenziwa ngezindlela eziningana, kufaka phakathi:

• Ukulungisa okuvulekile - Udokotela ohlinzayo uzosika indawo enkulu esiswini sengane (esiswini).
• Ukulungiswa kwe-Laparoscopic - Udokotela ohlinzayo uzokwenza ukusikeka okuncane okungu-3 kuye ku-5 esiswini. Ishubhu elincane, elingenalutho elinekhamera encane ekugcineni (i-laparoscope) lifakwa kokunye kwalokhu kusikeka. Amanye amathuluzi adluliselwa kokunye ukusikeka kokuhlinzwa.

Udokotela ohlinzayo angadinga ukushintshela enqubweni evulekile uma kuphuma ukopha, izicubu eziningi ezibomvu ezivela ekuhlinzweni kwangaphambili, noma uma ingane ikhuluphele kakhulu.

I-endoluminal fundoplication ifana nokulungiswa kwe-laparoscopic, kepha udokotela ohlinzayo ufinyelela isisu ngokungena ngomlomo. Iziqeshana ezincane zisetshenziselwa ukuqinisa ukuxhumana phakathi kwesisu nomphimbo.

Ukuhlinzwa kwe-anti-reflux kuvame ukwenziwa ukwelapha i-GERD ezinganeni kuphela ngemuva kokuthi imithi ingasebenzi noma izinkinga ziba khona. Umhlinzeki wezokunakekelwa kwempilo yengane yakho angaphakamisa ukuhlinzwa kwe-anti-reflux lapho:

• Ingane yakho inezimpawu zesilungulela eziba ngcono ngemithi, kepha awufuni ukuthi ingane yakho iqhubeke nokuthatha le mithi.
• Izimpawu zesilungulela ziyasha esiswini, emphinjeni, noma esifubeni, kubhoboza noma kumabhamuza egesi, noma izinkinga zokugwinya ukudla noma uketshezi.
• Ingxenye yesisu sengane yakho iyabambeka esifubeni noma iyazisonga.
• Ingane yakho inokuncipha komphimbo (obizwa ngokuthi yi-solidure) noma wopha egazini.
• Ingane yakho ayikhuli kahle noma yehluleka ukukhula.
• Ingane yakho inokutheleleka kwamaphaphu okubangelwa ukuphefumula okuqukethwe yisisu emaphashini (okubizwa ngokuthi i-aspiration pneumonia).
• I-GERD ibanga ukukhwehlela okungapheli noma ukushaqeka enganeni yakho.

Izingozi zanoma yikuphi ukuhlinzwa zifaka:

• Ukopha
• Ukutheleleka

Izingozi ze-anesthesia zifaka:

• Ukusabela emithini
• Izinkinga zokuphefumula, kufaka phakathi i-pneumonia
• Izinkinga zenhliziyo

Izingozi zokuhlinzwa ze-anti-reflux zifaka:

• Ukulimala esiswini, esophagus, isibindi, noma amathumbu amancane. Lokhu akuvamile.
• Igesi nokuqunjelwa okwenza kube nzima ukubhodliza noma ukuphonsa phezulu. Isikhathi esiningi, lezi zimpawu ziba ngcono kancane kancane.
• Ukuvala umlomo.
• Ukugwinya okubuhlungu, okunzima, okubizwa nge-dysphagia. Ezinganeni eziningi, lokhu kuyaphela ezinyangeni ezintathu zokuqala ngemuva kokuhlinzwa.
• Kukaningi, izinkinga zokuphefumula noma zamaphaphu, njengephaphu elibhidlikile.

Ngaso sonke isikhathi qiniseka ukuthi iqembu lezokunakekelwa kwempilo yengane yakho liyazi ngayo yonke imithi nezithasiselo ezithathwa yingane yakho, kufaka phakathi lezo ozithenge ngaphandle kwemithi kadokotela.

Isonto ngaphambi kokuhlinzwa, ungacelwa ukuthi uyeke ukunikeza ingane yakho imikhiqizo ethinta ukujiya kwegazi. Lokhu kungafaka i-aspirin, ibuprofen (Advil, Motrin), uvithamini E, ne-warfarin (Coumadin).

Uzotshelwa ukuthi ufika nini esibhedlela.

• Ingane akufanele idle noma iphuze noma yini ngemuva kwamabili ngaphambi kokuhlinzwa.
• Wena mntwana ungageza noma ugeze ubusuku obandulela noma ekuseni yokuhlinzwa.
• Ngosuku lokuhlinzwa, ingane kufanele iphuze noma imuphi umuthi umhlinzeki athe awuphuze ngesiphuzo esincane samanzi.

Ukuthi ingane yakho ihlala isikhathi esingakanani esibhedlela kuya ngokuthi ukuhlinzwa kwenziwe kanjani.

• Izingane ezinokuhlinzwa kwe-laparoscopic anti-reflux zihlala esibhedlela izinsuku ezimbili kuya kwezi-3.
• Izingane ezinokuhlinzwa okuvulekile zingachitha izinsuku ezimbili kuya kweziyisithupha esibhedlela.

Ingane yakho ingaqala ukudla futhi cishe ezinsukwini ezi-1 kuya kwezi-2 ngemuva kokuhlinzwa. Amanzi ngokuvamile anikezwa kuqala.

Ezinye izingane zine-g-tube ebekwe ngesikhathi sokuhlinzwa. Le tube ingasetshenziselwa ukondla oketshezi, noma ukukhipha igesi esiswini.

Uma ingane yakho ingenayo i-g-tube ebekiwe, ithubhu ingafakwa ngamakhala iye esiswini ukusiza ukukhipha igesi. Le tube isuswa lapho ingane yakho iqala ukudla futhi.

Ingane yakho izokwazi ukuya ekhaya uma isidla ukudla, iba nokuhamba kwamathumbu futhi izizwa ingcono.

Isilungulela nezimpawu ezihlobene nazo kufanele zithuthuke ngemuva kokuhlinzwa kwe-anti-reflux. Kodwa-ke, ingane yakho kungenzeka ukuthi isadinga ukuthatha imishanguzo yesilungulela ngemuva kokuhlinzwa.

Ezinye izingane zizodinga okunye ukuhlinzwa esikhathini esizayo ukwelapha izimpawu ezintsha ze-reflux noma izinkinga zokugwinya. Lokhu kungenzeka uma isisu sasigoqwe sasiqiniswa kakhulu noma sithukulula.

Ukuhlinzwa kungenzeka kungaphumeleli uma ukulungiswa bekuxekeke kakhulu.

Ukusetshenziswa kwemali - izingane; Ukuxhaswa kweNissen - izingane; Ukusetshenziswa kwemali kweBelsey (Mark IV) - izingane; I-Toupet fundoplication - izingane; Thal fundoplication - izingane; Ukulungiswa kwe-hernia hernia - izingane; Endoluminal fundoplication - izingane

• Ukuhlinzwa kwe-anti-reflux - izingane - ukukhishwa
• Ukuhlinzwa kwe-anti-reflux - ukukhishwa
• Ukukhishwa kwe-gastroesophageal - ukukhipha
• Isilungulela - okufanele ukubuze kudokotela wakho

UChun R, uNoel RJ. Isifo se-Laryngopharyngeal ne-gastroesophageal reflux kanye ne-eosinophilic esophagitis. Ku: Lesperance MM, Flint PW, eds. I-Cummings Pediatric Otolaryngology. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 29.

UKhan S, uMatta SKR. Isifo se-reflux se-gastroesophageal. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2020: isahluko 349.

UKane TD, uBrown MF, uChen MK; Amalungu eKomidi Lezobuchwepheshe elisha le-APSA. Beka iphepha ekusebenzeni kwe-laparoscopic antireflux ezinganeni nasezinganeni zesifo se-reflux se-gastroesophageal. I-American Pediatric Surgery Association. J Ukuhlinzwa kwezingane. U-2009; 44 (5): 1034-1040. PMID: 19433194 www.ncbi.nlm.nih.gov/pubmed/19433194.

I-Yates RB, i-Oelschlager BK, iPellegrini CA. Isifo se-reflux se-gastroesophageal kanye ne-hernia yokubeletha. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 42.