Kukho iintlobo ezimbini eziphambili zesiphene: i-gastroschisis (ivela ngaphantsi kwexesha) kunye ne-hernia ye-herbia (eqhelekileyo). Ngesiphene sokuphuhlisa, izibilini zamathumbu (ngamanye amaxesha kunye kunye nesibindi kunye nezinye izitho) ziphuma ngaphakathi kwidonga lomzimba ngaphandle, olufuna ukulungiswa kokucoca.
Ukunyamekela usana olutsha
Ukuba isalathisi sodonga lwesisu sasifumene ngaphambi kokuzalwa komntwana, ngexesha lokuzalwa kwakhe, iqela lokupasa lezingane kufuneka lilungele. Ukuba isiphako sifumaneka emva kokuzalwa, umntwana kufuneka athatyathwe ngokukhawuleza kwiziko elizodwa. I-Gastrostisis yindlala yesisu esisuka kwisisu esiswini esisemkhatsini ongasecaleni lomkhonto wecala (ngokuqhelekileyo ngakwesokudla). Ubuninzi bomgodi eludongeni lwesisu, ngokomthetho, u-2-3 cm. Isiphako singabonakala kwinqanaba eliphambili lokuphuhliswa kwe-intrauterine kwaye lidla ngokuba ngumphumo "wengozi" apho intambo yomgca iqhutywe khona kunokuba ihlaselwe yintlungu yokuzalwa. Ngokuqhelekileyo, intlungu encinane kunye nenxalenye yekholoni iyawa. Okungaqhelekanga, isibindi, i-spleen kunye nenxalenye yesisu ingawa ngaphandle kwesigxina esiswini. Mhlawumbi ubukho bombane obuthakathaka obambelela emathunjini awileyo kwaye lukhulu kakhulu. Ngenxa yoko, kunokuba nzima ukufumanisa i-atresia edibeneyo (intsholongwane) yesisu esincinci. Ngokungafani ne-hernia embilical, kunye ne-gastroschisis ejikeleze isiphako sodonga lwesisu akukho sikhwama esigubungela iziko, kunye nokuba kungenzeka ukuba usana olusandul 'ukuzalwa lunalo naluphi na umonakalo oluhambelanayo.
Unyango
Umntwana one-gastroschisis ngokukhawuleza ulahlekelwa ngumshushu kunye nomlambo ngokusebenzisa izitho eziwa. Ukuthintela oku, izitho kufuneka zifakwe kwifilimu. Injongo ephambili kukugcina ubomi bentsana ngexesha lokuthutha kwisebe elikhuphayo. Ukuze ugcine amathambo ahlambulukile, ithubhu ye-nasogastric ingeniswa, kwaye isisombululo se-glucose sinokungeniswa kwi-dropper. Kukho iindlela ezimbini zokupakraza eziphambili. Ukuba kunokwenzeka, ukubuyiswa kokukhawuleza kwangoko kwenziwa, kodwa ukuba oko akunakwenzeka, izitho zifakwa esikhwameni sokufakelwa, esinciphisa ubuninzi beentsuku ezi-7-10 ezalandelayo, ukunyusa izitho kwakhona kwisisu esiswini. Emva koko oogqirha banqumla isikhumba kwindawo yecala. I-hernia ye-umbilical yintambo yokuzalwa ebomvu, kubangelwa ukuphuhliswa kwe-malformation. Isiphene sinokuba sincinci okanye sikhulu kwaye idla ngokudibanisa ne-chromosomal engafanelekanga. Kule meko, inyango yokungenelela iyimfuneko. I-herbilical hernia (eyaziwa nangokuthi i-omphalocele) yimbangela yokuvalwa okwaneleyo kwodonga lwesisu lomntwana ngexesha lokuphuhliswa kwamamori, okuphumela ekulahlekelweni kwamalungu angaphakathi ngokuvulwa kwintambo yomlomo. Nangona kunjalo, ngokungafani ne-gastrostisis, izitho zangaphakathi ze-hernia zijikelezwe yi-peritoneum. I-herbilical hernia ayinqabile - iyabonwa malunga ne-1 kwi-5,000 iintsana.
Ukuguqulwa kwesigxobo se-hernial
Kwiimeko ezininzi, isikhwama sokubeleka ekuzalweni asonakali. Nangona kunjalo, iyakwazi ukuphula phambi kokubili nangesikhathi sokubeletha. Ngoko ke, kubalulekile ukuba ugqirha uqaphelisise ubukho beengxowa zesikhwama esiqwengileyo ukuze uphephe iimpazamo kwaye ungadibanisi i-hernia kunye ne-gastrostisis (apho kungekho sikhwama esinezitho zangaphakathi).
I-hernia enkulu kunye encinane
I-herbilical hernia ingaba enkulu okanye encinci. Ngomnxeba omncinci womzimba, isalathisi sesidumbu sesisu sesingaphantsi kwamasentimitha angama-4 ububanzi, akukho sibindi esikhwameni. I-hernia enkulu, ngokuchaseneyo, ibonakaliswe ngophahla lwamanzi angaphezu kwama-4 centimeters, ngesibindi kunye nemali ehlukeneyo yamathumbu emathumbu ngaphakathi kwesikhwama.
Izikhalazo ezihambelanayo
Esi sifo sisoloko sihamba kunye nezinye iziphoso zokuzalwa, eziquka intliziyo, izintso kunye neentlungu. Kwiindawo ezinobunzima be-hernia, i-chromosomal ine-normal (ye-50% yamatyala). Okubaluleke ngakumbi ukuxilongwa ngokufanelekileyo ngexesha lika-Beckwith-Wiedemann syndrome. Abantwana abaneli syndrome bahlakulela inani elincinci lokukhula kwe-insulin ngexesha lophuhliso lwe-intrauterine, olukhokelela kwi-hypoglycemia enamandla (izinga eliphantsi le-ushukela wegazi). Oku kuyingozi kakhulu, kuba ingabangela ukulimala kwengqondo engapheliyo; kubalulekile ukuba uqale ukuthulula kwisicombululo seglucose. Xa ulawula isigulane nge-hernia embilical, kubalulekile ukuba uqaphele ukuba unempawu ze-Beckwith-Wiedemann syndrome, ezibandakanya u-hypoglycemia obalulekileyo obangelwe ukwanda kweepancreas. Ngokuqhelekileyo i-hernias ihlale ifunyenwe kwinqanaba lokuqala, kwaye iziganeko ezinokukhubazeka okuphuculweyo zivame ukuphazamiseka kwezinto ezibangelwa ukufa kwangaphakathi okanye ezinye izizathu. Iintsana ezisandul 'ukuzalwa zifuna iintsholongwane, ukuchongwa kunye nokuqinisekiswa kwezimo eziphazamisayo, kunye nokuhlolwa kwegazi kwi-glucose ukukhuphela i-hypoglycemia. Emva kokuba kwenziwe oko, ugqirha ugqirha ngokukhawuleza. Ukuba ukuphulukana ngokukhawuleza kwehluleka, ngoko kuqhutyelwa ngezigaba usebenzisa isikhwama sokufakelwa (njengegastroschisis).
Unyango olungaphelelanga
Unyango olulondolozo lwentliziyo luboniswa kwizigulane ezinomnxeba obunzima obunokuthi angabandakanyeki ngoncedo olunyango. Isikhwama siphathwa ngesisombululo se-antiseptic okanye utywala ukuze wenze utywala obunobumba. Oku kuqhubela phambili ekufubeni isiphene ngesikhumba. Kwixesha elizayo kuyimfuneko ukubuyisela izihlunu zodonga lwesisu.