Haɓakar diaphragmatic hernia gyara

Gyaran diaphragmatic hernia (CDH) gyarawa shine tiyata don gyara buɗewa ko sarari a cikin diaphragm na jariri. Ana kiran wannan buɗewar hernia. Nau'i ne na rashin haihuwa. Na haihuwa yana nufin matsalar tana nan lokacin haihuwa.

Kafin ayi aikin, kusan dukkan jarirai suna buƙatar na'urar numfashi don inganta matakan oxygen.

Ana yin aikin tiyatar yayin da yaronku yana cikin ƙwayar rigakafi (barci kuma ba zai iya jin zafi ba). Likita yana yawan yankewa (ciki) a cikin ciki a ƙashin haƙarƙarin sama. Wannan yana bada damar kaiwa ga gabobin dake yankin. Likita ya jawo wadannan gabobin a hankali zuwa cikin wurin ta hanyar budewar a cikin diaphragm din da kuma cikin ramin ciki.

A cikin ƙananan yanayi, ana iya yin tiyatar ta amfani da ƙananan rauni a cikin kirji. Ana sanya ƙaramar kyamarar bidiyo da ake kira thoracoscope ta ɗaya daga cikin wuraren da aka harba. Wannan yana bawa likita damar duba cikin kirji. Ana sanya kayan aikin gyara ramin a cikin diaphragm ta sauran wuraren da aka zana.

A kowane irin aikin, likitan ya gyara ramin a cikin diaphragm. Idan ramin karami ne, za'a iya gyara shi da dinki. Ko kuma, ana amfani da wani facin filastik don rufe ramin.

Diaphragm tsoka ce. Yana da mahimmanci ga numfashi. Yana raba ramin kirji (inda zuciya da huhu suke) daga yankin ciki.

A cikin yaron da ke da CDH, ba a kafa tsokar diaphragm gaba ɗaya. Buɗewar CDH yana bawa gabobi daga ciki (ciki, kumburi, hanta, da hanji) damar zuwa cikin ramin kirji inda huhu yake. Huhu ba sa girma yadda ya kamata kuma suna zama ƙanana da jarirai za su iya numfashi da kansu lokacin da aka haife su. Hakanan jijiyoyin jini a cikin huhu suna haɓaka mara kyau. Wannan yana haifar da isasshen iskar oxygen cikin jikin jariri.

Cutar herphragmatic hernia na iya zama barazanar rai kuma yawancin jarirai masu CDH suna rashin lafiya sosai. Yin aikin tiyata don gyara CDH dole ne a yi shi da wuri-wuri bayan haihuwar jariri.

Hadarin ga wannan tiyatar sun hada da:

• Matsalar numfashi, wanda ƙila zai iya zama mai tsanani
• Zuban jini
• Huhu ya tarwatse
• Matsalar huhu da basa tafiya
• Kamuwa da cuta
• Amsawa ga magunguna

Yaran da aka haifa tare da CDH an shigar da su cikin sashen kulawa mai kulawa da jarirai (NICU). Yana iya zama kwanaki ko makonni kafin jaririn ya sami isasshen aikin tiyata. Saboda yanayin yana barazanar rai kuma safarar jariri mara lafiya yana da haɗari, jariran da aka sani suna da CDH ya kamata a isar da su a cikin cibiyar tare da likitocin yara da likitocin neonatologist.

• A cikin NICU, jaririnku mai yiwuwa yana buƙatar injin numfashi (mai amfani da iska) kafin aikin tiyata. Wannan yana taimaka wa jariri numfashi.
• Idan yaronka yana da ciwo sosai, ana iya buƙatar inji mai kewaye zuciya (huhun iskar oxygen, ko ECMO) don yin aikin zuciya da huhu.
• Kafin ayi tiyata, jaririnka zaiyi gwajin x-ray da kuma gwajin jini akai-akai don ganin yadda huhu ke aiki. An saka firikwensin haske (wanda ake kira pulse oximeter) a fatar jariri don saka idanu kan yanayin iskar oxygen a cikin jini.
• Ana iya ba jaririn ku magunguna don kula da hawan jini kuma ku kasance cikin kwanciyar hankali.

Za a sanya jaririn ku tubes:

• Daga bakin ko hanci zuwa ciki don barin iska daga cikin
• A cikin jijiyoyin don saka idanu kan karfin jini
• A cikin jijiya don isar da abinci da magunguna

Jaririn zai kasance a kan na'urar shan iska bayan tiyatar kuma zai kasance a asibiti na tsawon makonni. Da zarar an cire na'urar numfashi, jaririn na iya buƙatar oxygen da magunguna na ɗan lokaci.

Ciyarwa zata fara bayan hanjin jaririn ya fara aiki. Yawancin lokaci ana ba da abinci ta ƙaramin bututu mai taushi daga baki ko hanci zuwa ciki ko ƙaramin hanji har sai jaririnku ya sha madara da baki.

Kusan dukkan jarirai masu CDH suna da narkewa idan sun ci abinci. Wannan yana nufin abinci ko acid a cikin cikinsu yana motsawa zuwa cikin hancinsu, bututun da ke kaiwa daga maƙogwaro zuwa ciki. Wannan na iya zama mara dadi. Hakanan yana haifar da yawan tofawa da amai, wanda ke sa ciyarwar ta zama mai wahala da zarar jaririnka yana shan abinci ta bakinsa. Reflux yana ƙara haɗarin cutar huhu idan jarirai shaƙar madara a huhunsu. Hakanan yana iya zama ƙalubale ga jarirai su ɗauki isasshen adadin kuzari don girma.

Ma’aikatan jinya da kwararru masu ciyarwa zasu koya muku hanyoyin da zaku bi ku ciyar da jaririn ku don hana yaduwar cutar. Wasu jariran suna buƙatar kasancewa akan bututun ciyarwa na dogon lokaci don taimaka musu samun isasshen adadin kuzari don girma.

Sakamakon wannan tiyatar ya dogara da yadda huhun jaririnku ya ci gaba. Wasu jariran suna da wasu matsalolin kiwon lafiya, musamman tare da zuciya, kwakwalwa, tsokoki, da haɗin gwiwa, wanda yawanci yakan shafi yadda jaririn yake da kyau.

Yawancin lokaci hangen nesa yana da kyau ga jarirai waɗanda ke da ƙwaƙƙwarar ƙwayoyin huhu kuma babu wasu matsaloli. Ko da hakane, yawancin jariran da aka haifa da herphphragmatic hernia suna rashin lafiya sosai kuma zasu zauna a asibiti na dogon lokaci. Tare da ci gaba a fannin magani, hangen nesa ga waɗannan jarirai yana inganta.

Duk jariran da suka yi gyare-gyare na CDH za su buƙaci a sa musu ido sosai don tabbatar ramin da ke cikin diaphragm ɗin bai sake buɗewa yayin da suke girma.

Yaran da ke da babban buɗewa ko nakasa a cikin diaphragm, ko kuma waɗanda suka sami matsala game da huhunsu bayan haihuwa, na iya samun cutar huhu bayan sun bar asibiti. Suna iya buƙatar oxygen, magunguna, da bututun ciyarwa na tsawon watanni ko shekaru.

Wasu jariran zasu sami matsaloli na rarrafe, tafiya, magana, da cin abinci. Suna buƙatar ganin likitocin jiki ko na aiki don taimaka musu haɓaka tsokoki da ƙarfi.

Diaphragmatic hernia - tiyata

• Kawowa yaronka ziyara dan uwansa mara lafiya
• Kula da rauni na tiyata - a buɗe

• Diaphragmatic hernia gyara - jerin

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Hollinger LE, Harting MT, Lally KP. Biyan lokaci mai tsawo na cututtukan diaphragmatic na haihuwa Semin Pediatr Surg. 2017; 26 (3): 178-184. PMID: 28641757 www.ncbi.nlm.nih.gov/pubmed/28641757.

Keller BA, Hirose S, Farmer DL. Rashin lafiyar tiyata na kirji da hanyoyin iska. A cikin: Gleason CA, Juul SE, eds. Cututtukan Avery na Jariri. 10 ed. Philadelphia, PA: Elsevier; 2018: babi na 49.

Tsao KJ, Lally KP. Hanyar diaphragmatic hernia da taron. A cikin: Holcomb GW, Murphy JP, Ostlie DJ, eds. Yin aikin tiyata na yara na Ashcraft. Na 6 ed. Philadelphia, PA: Elsevier Saunders; 2014: babi na 24.