I-fistula ebusweni yabantwana

I-fistula yangasese ingabandakanywa okanye idibeneyo, ngokuqhelekileyo inxulumene ne-atresia yesifo. I-Fistula yimixobo engamanzi edibanisa i-lumen ye-esophagus okanye i-anastomosis nge-tube yokuphefumula (i-trachea, i-bronchi) okanye indawo yangaphandle ngokusebenzisa isikhumba sesikhumba (i-fistula yangaphandle ye-esophagus). I-fistula yokuzalwa engama-fentula ebusweni ihlelwe njengento engaqhelekiyo yokungahambi kakuhle kwezi nxalenye zendlela yokugaya. Eyona nto ifundwayo kwaye iyaziwa yi-fostula esophageal-tracheal kunye ne-esophageal-bronchial fistula, eneempawu ezihlukahlukeneyo ze-esophagus esophagus nge-airways: i-esophagus kunye ne-trachea inodonga oluqhelekileyo, inkambo ye-fistulous ide kwaye iminyene, inkambo ye-fistulous ifutshane kwaye ibanzi. I-Fistula yendawo, njengommiselo, kwinqanaba le-vertibrae ye-thoracic. Uphando olunzulu lwe-fostula morphology lunikezelwa kwimisebenzi ye-AP Biesin (1964), GA Bairov, NS Mankina (1977).

I-fistula yokuzalwa yomsongqimba ivela ngenxa yokuqhawula okungaphelelanga kwiphubhu yokuqala yamathumbu e-intestinal and trachea.

Izimpawu zonyango

Izimpawu zonyango zivela emva kweeyure ezimbalwa emva kokuzalwa komntwana ekudleni kokuqala. Zizimisele ngokuhlukahlukana kwephutha lokugcina. Kwimiba yodonga oluqhelekileyo lwesigxina kunye ne-trachea, kunye nekhosi emfutshane kunye neyobubanzi ngokukhawuleza emva kwenyanga nganye yokutya, ebangela ukuphazamiseka okukhulu kokuphefumla, i-sequentially, ne-hypoxia. Cyanosis ivela. Kwixesha elilandelayo kukho ukuzila ukutya kunye ne-pneumonia. Umkhuhlane we-paroxysmal awunakuchazwa xa ungondliwe ngeprobe. Ngexesha elifanayo, ukutya akukwazi ukufikelela kwimimandla ejikelezayo.

Kwiimeko zexesha elide kunye elincinci elincinci kubantwana beeveki zokuqala zokuphila, ukukhwehlela nangona kubonakala, kodwa kubonakaliswe ngokuthe tye. Ukuqhaqhaqhaqhaqhaqheko akuyithandeki Nangona kunjalo, ekupheleni kwesiphelo, kwanokuba inani elincinci lokutya liwela emphefumlweni wokuphefumula, ngenxa yokuba ukuhlaselwa ukukhwehlela kuya kuba nzima, ukungaphumeleli kokuphefumula kwanda, kwaye kusinda imiphunga.

Eyona nto inolwazi yokufumanisa i-fistula ye-esophagus isophagoscopy kunye ne-itraheobronchoscopy. Ngomnxeba we-esophagoscopy, umntu unokubona umgodi wokungena we-oviposition kunye nokubonakala kwamabhulebhu emoyeni kwindawo yokulo mgodi, kunye ne-mucus frothy. Ngomncedisi we-tracheobronchoscopy, ukungena (ukuvuza) nge-fistula kwindawo yokuphefumula kwezinto ezincinci zokutya kufunyenwe, ukucaphukisa kwimbumba ye-trachea okanye i-bronchus kwisiza sokuphuma kwe-fistula. Iindlela ezibalaseleyo zisetyenziselwa ukufumanisa ukuxubusha kwe-esophagus ne-respiratory tract ngokusebenzisa i-fistulous course. Ukwenza oku, tint i-liquide esetyenziswa ngumntwana ukusela, i-methylene eluhlaza okwesibhakabhaka. Ukubonakala kwendeyinti kwiphepha lokuphefumula liqinisekisa ubungqina be-fistula.

Zombili i-esophagoscopy kunye ne-tracheobronchoscopy zenziwa phantsi kwe-anesthesia jikelele.

Ngokuphathelele ukuxilongwa kwe-radiological ye-fostula ye-esophageal, inexabiso lokuxilonga. Okokuqala, ngenxa yokuba isifundo sisebenzisa umlinganiselo ohlukileyo owenziwe kwi-esophagus, bese ungena kwi-fistula ngokusebenzisa inhalation, kukhokelela ekuphuhlisweni kwefuthe eliphambili lepneumonia (phambi kwe-pneumonia, ukuvavanya ukuphikiswa kuyachaswa). Okwesibini, isifundo ngaphandle kwe-ejenti eyahlukileyo ayibonakalisi i-fistula. Kukho indlela engathanga ngqo yokufumanisa i-fostula yokutshatyalaliswa kwe-esophageal-bronchial, ebonisa ukubonakaliswa kweempawu zeklinikhi zokungaphumeleli kokuphefumula kunye nemeko yemiphunga. Ukwenza oku, ukuhlolwa kwe-X-ray yemiphunga. Ukungabikho kwempawu zokutshintsha okuvuthayo kwimizimba yamaphaphu kwimeko yokukhwehlela, ukuphuhliswa kokuphefumula okuphefumulayo kubantwana abancinci, umntu unokucinga ngokufumaneka kwesifo se-fostula. Ukuba umntwana sele sele evelise i-aspiration pneumonia, ngoko, le ndlela yokuxilonga ayinandaba. Ngaloo ndlela, uvavanyo lwe-X-ray kufuneka lwenziwe ngokucophelela, lukhumbule ingentla.

Unyango

Unyango lwe-esophagus uphando. Ukunyanga ngokukhawuleza kunyango kumphilisa. Ngonyango olusenyakanyiswayo, uhlahlo lwabiwo lugqitywa ngumlingiswa kunye nobude beengxaki ze-bronchopulmonary.

Ukhule uphilile!