Kunezinhlobo ezimbili eziyinhloko zokukhubazeka: i-gastroschisis (ivela kancane kancane) futhi i-hernia yomzimba (evamile kakhulu). Ngombili kokukhubazeka okuthuthukayo, iziphuzo zamathumbu (ngezinye izikhathi kanye nesibindi nezinye izitho) ziphuma odongeni lwesisu ngaphandle, okudinga ukulungiswa okuhlinzekwayo.
Ukunakekela ingane esanda kuzalwa
Uma isici sodonga lwesisu sitholakale ngaphambi kokuzalwa kwengane, ngesikhathi sokuzalwa kwayo, iqembu lokuhlinza izingane kufanele lilungele. Uma iphutha litholakala ngemuva kokubeletha, ingane kufanele ithunyelwe ngokushesha esikhungweni esikhethekile. I-Gastroschisis yindlala yamathumbu kusukela emgodini wesisu ngokusebenzisa umgodi ohlangothini lwezintambo (ngokuvamile kwesokudla). Ubuningi bomgodi odongeni lwesisu, njengokubusa, u-2-3 cm. Iphutha lingabonakala ngesikhathi sokuqala lokuthuthukiswa kwe-intrauterine futhi ngokuvamile liwumphumela "wengozi" lapho insimu yomzimba iqhuma khona kunokuba nephutha lokuzalwa. Ngokuvamile, intombazane encane nengxenye yekoloni iyawa. Okungavamile, isibindi, isilwane kanye nengxenye yesisu kungawela emgodini wesisu. Mhlawumbe ukutholakala ketshezi enamahloni okunamathela emathunjini awile futhi kuwukhuni kakhulu. Ngenxa yalokhu, kungase kube nzima ukuthola i-concomitant atresia (ukutheleleka) komathumbu omncane. Ngokungafani ne-hernia embilical, ne-gastroschisis ejikeleze isici sodonga lwamathumbu ayikho isikhwama esimboza izitho, futhi kungenzeka ukuthi umntwana osanda kubhekana nanoma yikuphi ukuphazamiseka okuhambisanayo kuphansi.
Ukwelapha
Ingane ene-gastroschisis ilahlekelwa ukushisa futhi isetshenziswe ngamanzi ngokusebenzisa izitho eziwa. Ukuvimbela lokhu, izitho kufanele zihlanganiswe kwifilimu. Umgomo oyinhloko ukugcina impilo yengane esanda kuzalwa ngesikhathi ehamba eya emnyangweni wokuhlinza. Ukuze igcine amathumbu ahlanzekile, ithubhu ye-nasogastric ingafakwa, futhi isisombululo se-glucose singasungulwa ngokusebenzisa i-dropper. Kunezinhlobo ezimbili zokwelashwa eziyinhloko zokwelapha. Uma kunokwenzeka, ukuvuselelwa okusheshayo kwenziwa, kodwa uma kungenakwenzeka, izitho zifakwa esikhwameni sokufakelwa, esinciphisa usayizi ngezinsuku ezizayo ezingu-7-10, zixoshe izitho zangena emgodini wesisu. Khona-ke odokotela abahlinzayo bakhonsa isikhumba endaweni yecala. I-hernia ye-umbilical iyinhloko yakhe yokuzalwa yomthamo we-umbilical, obangelwa ukulimala okuthuthukisayo. Iphutha lingase libe lincane noma likhulu futhi livame ukuhlanganiswa nokungajwayelekile kwe-chromosomal. Kulesi simo, ukungenelela kokuhlinzwa kuyadingeka. I-hernia yombilical (eyaziwa nangokuthi i-omphalocele) ingumphumela wokuvalwa okwanele kodonga lwesisu esiswini lomntwana ngesikhathi se-embryonic development, okuholela ekulahlekelweni kwezitho zangaphakathi ngokusebenzisa ukuvula emgqeni womlomo. Nokho, ngokungafani ne-gastroschisis, izitho zangaphakathi zangaphakathi ze-hernia zizungezwe yi-peritoneum. I-hernia ye-umbilical ayidlangalaleni - ibonakala ku-1 kwabangu-5 000 abasanda kuzalwa.
Ukuguqulwa kwesigxobo se-hernial
Ezimweni eziningi, isikhwama sokubeletha esibelethweni asilimazanga. Kodwa-ke, kungaphula kokubili ngaphambi nangesikhathi sokubeletha. Ngakho-ke, kubalulekile ukuthi udokotela aqaphele ukuba khona kwezinsalela zesigxobo esikhishwe ukuze kugweme amaphutha hhayi ukudidanisa i-hernia ne-gastroschisis (lapho kungekho sikhwama esimboza izitho zangaphakathi).
I-hernia emincane neyincane
I-hernia ye-umbilical ingaba enkulu noma encane. Nge-hernia encane yomzimba, isici sogu lwesisu esisingaphansi kwamasentimitha angu-4 ububanzi, asikho isibindi esikhwameni. I-hernia enkulu, ngokuphambene nalokho, ibonakala ngamangqamuzana angaphezu kwamasentimitha angama-4, nesibindi nesilinganiso esithile sezinsipho zamathumbu ngaphakathi kwesikhwama.
Izinkinga ezihambisanayo
Lesi sifo sivame ukuhambisana nezinye iziphambeko zokuzalwa, ezihlanganisa izinkinga zenhliziyo, izinso kanye ne-colon. Ku-neonates ne-hernia embilical, ukukhubazeka kwe-chromosomal nakho kuvamile (cishe ngamacala angu-50%). Okubaluleke ngokukhethekile ukuxilongwa okufika kwesikhathi kwe-Beckwith-Wiedemann syndrome. Izingane ezine-syndrome zihlakulela inani eliphakeme ngokweqile lokukhula kwe-insulini phakathi nokuthuthukiswa kwe-intrauterine, okuholela ekukhuleni kwe-hypoglycemia eqinile (izinga eliphansi lokushukela kwegazi). Lokhu kuyingozi kakhulu, ngoba kungabangela ukulimala kwengqondo okungapheli; kuyadingeka ukuba uqale ukuthululela isisombululo se-glucose. Uma uhlinzeka isiguli esinomzimba wakhe, kubalulekile ukuthi uqaphele ukuthi unezibonakaliso ze-Beckwith-Wiedemann syndrome, ehlanganisa ne-hypoglycemia ephawulekayo ebangelwa ukwanda kwamaphakethe. Ngokuvamile ama-hernias ombi njalo atholakale ekuqaleni, futhi amacala anezinkinga zokuthuthukiswa okuhambisana nokuvame ukuholela ekutheni ukukhubazeka okubangelwa ukufa kwe-intrauterine noma ezinye izimbangela. Izinsana ezisanda kuzalwa zingadinga ukwelashwa, ukuhlonza nokuqinisekiswa kwezimo ezihlukumezayo, nokuhlolwa kwegazi kwe-glucose ukukhipha u-hypoglycemia. Emva kwalokhu kwenziwa, udokotela ohlinzayo uvala ngokuqondile isici. Uma ukuphumula okusheshayo kwehluleka, khona-ke kwenziwa ngezinyathelo usebenzisa isikhwama sokufakelwa (njengasegastroschisis).
Ukwelashwa okungelapheki
Imithi yokwelapha ikhonjiswe kulabaguli abane-hernia eyinkimbinkimbi enzima okungenzeka bangabi nengozi yokungenela. Isikhwama siphathwa ngesisombululo se-antiseptic noma utshwala ukuze kutholakale ukonakala oyinyumba. Lokhu kancane kancane kuholela ekumbozeni isici ngesikhumba. Esikhathini esizayo kubalulekile ukubuyisela imisipha yodonga lwesisu.