Hernias na Diaphragmatic Congenital: Bincike, Tiyata da Saukewa

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Mene ne Ma'anar Cikin Gida (Bochdalek) Hernia?

Wani halayen dan adam wanda ke da alamunta, ko kuma Bochdalek hernia, ya faru a cikin mahaifa kuma an gano shi a lokacin daukar ciki ko a jariri. Yana faruwa a lokacin da wani rauni a cikin diaphragm, tsoka wanda ke raba katangar daga cikin rami na ciki. Baya ga rabu da gabobin kirji daga gabobin ciki, diaphragm yana taimakawa ga huhu da ke cika da oxygen. (A motsi na ciki ciki da ka gani lokacin da kake numfashi shine motsi na diaphragm.)

Kyakkyawan hernia mai tsanani zai iya ba da izini ga dukan kwayoyin halitta ko gabobin jiki don jingina cikin kirji, ta hanyar rami ko lahani. A mafi yawancin lokuta, halayen diaphragmatic yana gaggawa ne, yana buƙatar samun magani na gaggawa. Wannan shi ne saboda zuciya da huhu suna da wahala a cika da kuma samar da jiki tare da iskar oxygen saboda mahaɗin katako. Yarinya da irin wannan hernia na iya samun lebe wanda ya nuna rashin haske, saboda rashin isashshen oxygen.

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Dalili da Dalili Dama

Dalili na Hernia

Babu wani dalilin da aka sani game da hernia . Rashin rauni a cikin tsoka yana a lokacin haihuwar, kuma ana kiranta "lalacewa ta jiki." Babu wata hanyar da za ta iya hana halayen diaphragmatic, kamar yadda suke cikin utero, kafin a haifi jariri.

Wane ne ke da haɗari don Hannun Harshen Diaphragmatic?

Harshen diaphragmatic na faruwa a cikin 1 daga kowace 2,000 zuwa 5,000 haihuwa. Akwai alamar haɗin gwiwar da ta haɗa da wannan nau'in hernia, yayin da jaririn zai iya samun haɗari mai yawa na samun irin wannan danna idan dan uwan ​​ko iyaye yana da yanayin. Yaran yara suna da haɗari fiye da 'yan mata.

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Sanin asali

Kyakkyawan hernia ba su da kamannin kamuwa da su a karkashin fata kamar yawancin hernias. A lokuta da yawa, babu alamun da ke gani cewa jaririn yana da irin wannan hernia. Za a bincikar da shi tare da duban dan tayi kafin a haifi jariri, ko kuma bayan haihuwar lokacin da ciki ta ji "ba zato ba" a lokacin da aka yi nazari na jiki. A wasu lokuta, ana iya gano hernia yayin da likitoci ke neman bayani game da wahalar numfashi wanda jaririn yake fuskanta.

Hanyoyin da ke cikin layi na faruwa ne a kan hagu na hagu, ya sa ya zama mabambanci don ciki ya ɓacewa. A lokuta masu sauƙi, inda kawai ciki yake ciki, jaririn zai iya nuna alamun bayyanar wahalar wahala da ciyawa.

Za a iya gwada gwaje-gwaje don sanin abin da matsalar ta shafi kwayoyin. Za'a iya umurni da saƙo don yin nazarin aikin zuciya; za a iya amfani da x-ray kirji, CT scan ko MRI don kimanta ƙarin gabobin. Za a iya yin gwaje-gwajen jini don ƙayyade yawancin oxygen da ke kai jinin baya ga aikin aiki na kwarai.

Alamun Hernia Diaphragmatic

• Zuciyar zuciya (zuciyar da ke ƙoƙarin samun oxygen ga jiki)
• Rawan numfashi na numfashi (kwayoyin huhu suna ƙoƙari don samun oxygen ga jiki)
• Cyanosis (launi mai laushi da gadaje)
• Matsalar numfashi marasa lafiya, marasa lafiya
• Sakamakon ganewar asali na ruwa mai haɗari a lokacin daukar ciki
• Sakamakon ganewar asali ne wanda ya rushe turun
• Daya gefen kirji ya fi girma fiye da sauran
• Matsaloli mai tsanani da cin abinci ko kiyaye abinci
• Zane-zane na kirji yana nuna mahaukaci a cikin kirji

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Yayin da Hernia ya zama gaggawa?

Hanyoyin da ke cikin harshe na iya zama gaggawa saboda dalilan da yawa. Mai jariri yana da matukar wahalar numfashi, kamar yadda karin ƙwayoyin a cikin kirji yana da wuyar ƙwayar huhu. Wannan ma gaskiya ne ga zuciya; zai iya zama da wuyar zuciya don cike da jini saboda cika cika kirji.

Bugu da ƙari, akwai hadarin strangulation na kwayoyin da ke matsawa cikin kirji, ma'ana cewa kwayoyin da suka shiga cikin kirji suna hana jini. Wannan na iya haifar da mutuwar nama da kuma gabobin da suke bullawa ta hanyar hernia.

Baban da aka haifa tare da hernias na yau da kullum ana kulawa da su a cikin kulawa mai kulawa mai tsanani saboda matsalolin da suke da wuya. Duk da cewa jariran da aka haifa tare da halayen diaphragmatic suna da rashin lafiya, ba a iya jinkirta aikin tiyata har sai aikin yajin aiki, saboda wannan zai iya inganta sauƙin rayuwa ta tiyata.

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Hanyar Harkokin Harkokin Harkokin Hanya ta Hanyoyin Hoto

An yi amfani da aikin tiyata na Diaphragmatic ta hanyar yin amfani da cutar ta hanyar rigakafi kuma an yi shi a kan asibiti . Ana iya yin aiki da gaggawa, nan da nan bayan haihuwar yaro, ko kuma da zarar yaro ya sami daidaituwa don jure wa tiyata. A wasu lokuta, akwai yiwuwar yin sulhu na numfashi ko zuciya kafin a yi aikin tiyata. A wasu yanayi da yawa, tiyata a cikin utero za a iya la'akari da shi, hanyar da aka yi wa tayin yayin da mahaifiyar take ciki. An yarda da tayin a ci gaba da cigaba yayin da ciki ya ci gaba, kodayake ciki ya zama babban haɗari.

Tiyata, lokacin da aka yi a jariri, anyi likita ne na likitan yara, amma yana iya buƙatar taimakon likitocin sauran likitoci, irin su likita na cardiothoracic ko kwararre na gyare-gyare a cikin lokuta masu tsanani. Dangane da gabobin da aka shafi, daban-daban ko ƙarin likitocin jinya da fasaha dabam dabam zasu iya shiga aikin.

An yi amfani da tiyata tare da hanyar budewa ta hanyar amfani da daidaitattun daidaituwa a ƙarƙashin gefen haƙarƙari, maimakon ƙananan hanyar laparoscopic . Wannan shi ne saboda mummunan matsalar da aka haɗa tare da ƙananan ƙwayar mai haƙuri.

Tiyata ta fara ne ta hanyar gano lahani a cikin diaphragm da kuma abin da ya tura a cikin akwatin kirji. Da nama da gabobin, idan akwai, an mayar da su cikin ciki. Da zarar an mayar da kyallen takalma zuwa wurin da suke dacewa, toshe rami a diaphragm an rufe. Anyi wannan ne don hana ƙwayar ciki daga ciki zuwa komawa cikin ɓoye. Idan lahani a cikin diaphragm yana da matukar tsanani, za'a iya ƙirƙirar diaphragm daga kayan haɗi.

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Ana dawowa daga Diaphragmatic Hernia Surgery

Yawancin marasa lafiya da ke fama da rashin lafiya suna fama da rashin lafiya a ƙarshen aikin tiyata kuma za a kai su zuwa Ƙungiyar Kulawa ta Hanyar Neonatal (NICU) don farfadowa. Ga marasa lafiya marasa lafiya waɗanda suke iya numfasawa a kan su ba da daɗewa ba bayan tiyata, sa ran wani jariri wanda ba shi da nakasa kuma a wasu lokuta, da wuya a kwantar da hankali.

Idan ƙwayar jaririn ta kasa kunne ko kuma idan matsaloli na numfashi ya ci gaba bayan yin aikin tiyata, mai yiwuwa mai daukar motsi ya zama dole a lokacin dawowa. A wasu lokuta masu tsanani, mai karfin iska bai isa ba don isasshen isasshen oxygen ga jiki. A cikin waɗannan lokuta ana iya amfani da ECLS / ECMO (Extracorporeal Life Support / Extracorporeal Membrane Oxygenation), na'urar da zata taimaka wajen oxygenate jinin lokacin da huhu da zuciya basu iya yin haka. Wannan magani ne kawai ana amfani da shi a cikin marasa lafiya marasa lafiya, wadanda za su mutu ba tare da ƙarin oxygen da aka kai ga jiki.

Tsawon lokacin da jaririn ya yi a cikin ICU ya dogara ne akan yadda mummunar hernia ta kasance mai tsanani, idan akwai wata lalacewa ta jiki kuma yadda yadda sassan jikin suka kasance da kyau.

Abin takaici, wannan yanayin yana da matukar tsanani kuma wasu yara ba su yarda da tiyata ba. Sauran yara suna yin ta ta tiyata, amma haɗuwa da tiyata, ɓangarorin da ba su da tushe ko lalacewar jiki suna haifar da mutuwa. An kiyasta cewa kashi 80 cikin 100 na marasa lafiya suna tsira da tiyata da kuma dawo da su.

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Dalilai na Ƙarshe na Hernias Diaphragmatic

Hanyoyin da ke cikin halayya suna iya haifar da matsaloli kafin a haifi jariri. Laka da kuma zuciyar jaririn bazai iya ci gaba ba, saboda matsin da ƙarin nama ke ciki a cikin kirji. Zane ko gabobin da ke ɓoye zuwa cikin kirji na iya lalace ko kuma kasa yin kyau yadda ya kamata saboda rashin jinin jini. Wannan zai iya haifar da matsalolin motsawa, matsalolin zuciya da abubuwan da ke cikin jiki.

Wadannan marasa lafiya sukan fuskanci jinkirin raya kasa, wanda zai iya rage lokaci. A wasu, rashin gazawar haɓaka ganewar asali yana tare da rashin ƙarfin lokaci don samun isasshen oxygen ga jiki.

Karin Bayani: Duk Game da Hernias

_Sources:

_{Congenital Diaphragmatic Hernia. Jami'ar Michigan Health System. http://surgery.med.umich.edu/pediatric/clinical/physician_content/am/congenital_diaphragmatic.shtml}

_{Hernias na Diaphragmatic. Asibitin Yara da Lucile Packard na yara a Stanford http://www.lpch.org/diseasehealthinfo/healthlibrary/digest/diaphrag.html}