Gastroschisis

Gastroschisis hurema hwekuzvara umo ura hwemucheche huri kunze kwemuviri nekuda kwegomba mumadziro emudumbu.

Vacheche vane gastroschisis vanozvarwa vaine gomba mudumbu remadziro. Ura hwomwana hunowanzonamira kunze (kubuda) nepaburi.

Mamiriro acho anotaridzika akafanana neomphalocele. Omphalocele, zvisinei, hurema hwekuzvarwa umo ura hwemucheche kana dzimwe nhengo dzemudumbu dzinobuda nepaburi munzvimbo yedumbu uye rakafukidzwa ne membrane. Ne gastroschisis, hapana chekuvhara membrane.

Dumbu remadziro kutadza kunokura sekukura kwemwana mudumbu raamai. Munguva yekusimudzira, ura uye dzimwe nhengo (chiropa, dundira, mudumbu, uye maovari, kana testes) zvinokura kunze kwemuviri pakutanga uye kazhinji zvinodzokera mukati. Muvacheche vane gastroschisis, ura (uye dzimwe nguva dumbu) hunogara kunze kwemadziro emudumbu, pasina membrane inovafukidza. Icho chaicho chikonzero chedumbu remadziro kuremara hachizivikanwe.

Vanamai vane zvinotevera vanogona kunge vari panjodzi yakakura yekuve nevacheche vane gastroschisis:

• Vechidiki zera
• Zvishoma zviwanikwa
• Chikafu chisina kunaka panguva yekuzvitakura
• Shandisa fodya, cocaine, kana methamphetamines
• Nitrosamine exposure (kemikari inowanikwa mune zvimwe zvekudya, zvipoda, fodya)
• Kushandisa aspirin, ibuprofen, acetaminophen
• Kushandiswa kwema decongestants ane kemikari pseudoephedrine kana phenylpropanolamine

Vacheche vane gastroschisis kazhinji havana zvimwe zvinokanganisa kuberekwa.

Gastroschisis inowanzoonekwa panguva yekuberekwa kwe ultrasound. Inogona zvakare kuonekwa kana mwana achinge azvarwa. Kune buri mumadziro emudumbu. Ura hudiki hunowanzo kuve kunze kwedumbu padhuze nemutambo. Dzimwe nhengo dzinogona zvakare kuonekwa ndiwo ura hwakakura, mudumbu, kana nduru.

Kazhinji ura hunotsamwiswa nekuratidzwa kune amniotic fluid.Mwana anogona kunge aine matambudziko ekupinza chikafu.

Prenatal ultrasound inowanzozivisa vacheche vane gastroschisis vasati vaberekwa, kazhinji nemavhiki makumi maviri epamuviri.

Kana gastroschisis ikawanikwa asati aberekwa, amai vanozoda kuongororwa kwakasarudzika kuti vaone kuti mwana wavo asati azvarwa arambe aine hutano.

Kurapa kwegastroschisis kunosanganisira kuvhiyiwa. Kazhinji dumbu remucheche mudumbu rakanyanya kushomeka kuti ura rigone kudzokerazve pakuzvarwa. Saka mesh saga rakasonerwa rakatenderedza pamiganhu yehurema uye micheto yehurema inodhonzwa. Chisaga chiya chinonzi silo. Kupfuura svondo rinotevera kana maviri, ura hunodzokera mudumbu uye hurema hunogona kuzovharwa.

Iyo tembiricha yemwana inofanira kunyatso kudzorwa, nekuti ura hwakafumurwa hunobvumira yakawanda yemuviri kupisa kuti itize. Nekuda kwesimba rinowanikwa mukudzosera ura mudumbu, mwana angangoda rutsigiro kufema nemhepo inofema. Kumwe kurapwa kwemwana kunosanganisira zvinovaka muviri neIV uye mishonga yekudzivirira hutachiona. Kunyangwe mushure mekunge hurema hwapfigwa, IV chikafu chinoenderera mberi sezvo kudyiswa kwemukaka kunofanirwa kuunzwa zvishoma nezvishoma.

Mwana ane mukana wakanaka wekupora kana pasina mamwe matambudziko uye kana dumbu remukati rakakura zvakakwana. Iyo diki dumbu dumbu inogona kukonzeresa kumatambudziko anoda kuwanda kwakawanda.

Zvirongwa zvinofanirwa kuitwa zvekusvitsa pakuburitsa uye nekukurumidza manejimendi redambudziko mushure mekuzvara. Mwana anofanirwa kuburitswa mune yekurapa nzvimbo ine hunyanzvi hwekugadzirisa dumbu remadziro zvikanganiso. Vacheche vanogona kuita zvirinani kana vasingade kuendeswa kune imwe nzvimbo kunorapwa.

Nekuda kwekuratidzwa neamniotic fluid, ura hwevacheche hunogona kusashanda zvakajairika kunyangwe mushure mekudzoserwa kwenhengo mukati memukati medumbu. Vacheche vane gastroschisis vanoda nguva yekuti ura hwavo huvepo uye kujairira kutora feedings.

Chiverengero chidiki chevacheche vane gastroschisis (ingangoita 10-20%) inogona kunge iine intestinal atresia (zvikamu zvematumbo zvisina kukura mudumbu). Vacheche ava vanoda kumwe kuvhiyiwa kuti vabvise kusagadzikana.

Kuwedzera kwekumanikidza kubva kune zvakasarudzika zvemukati zvemukati kunogona kudzikira kuyerera kweropa kuenda kumatumbu neitsvo. Izvo zvinogona zvakare kuita kuti zviomere kuti mwana awedzere mapapu, zvichitungamira kumatambudziko ekufema.

Chimwe chinogoneka chinetso ndechekuti kufa necrosis. Izvi zvinoitika kana ura hwemukati hwakafa nekuda kwekuyerera kweropa kana hutachiona. Iyi njodzi inogona kuderedzwa muvacheche vanogamuchira mukaka wechipfuva pane fomura.

Aya mamiriro anoonekwa pakuzvarwa uye anozoonekwa muchipatara pakuzvara kana isati yatomboonekwa pane zvakajairwa fetal ultrasound bvunzo panguva yekuzvitakura. Kana iwe wakasununguka pamba uye mwana wako achiratidza kunge ane hurema uhu, fonera iyo yemuno emergency emergency (se911) ipapo ipapo.

Dambudziko iri rinoonekwa nekurapwa muchipatara pakuzvarwa. Mushure mokudzokera kumba, danai mupi wehutano wehutano kana mwana wako achigadzira chero chezviratidzo izvi:

• Kuderedza ura
• Matambudziko ekudyisa
• Kupindwa nechando
• Marutsi girini kana yero
• Dumbu rakazvimba nzvimbo
• Kurutsa (zvakasiyana neakajairwa mwana kupfira)
• Zvinoshungurudza maitiro ekuchinja

Kuremara kwekuzvarwa - gastroschisis; Dumbu remadziro kukanganisa - mucheche; Dumbu remadziro kukanganisa - neonate; Dumbu remadziro kuremara - achangoberekwa

• Mucheche mudumbu hernia (gastroschisis)
• Gastroschisis kugadzirisa - akateedzana
• Silo

Islam S. Kuberekwa kwepamuviri pamadziro kuremara: gastroschisis uye omphalocele. Mune: Holcomb GW, Murphy P, St. Peter SD, eds. Holcomb uye Ashcraft's Pediatric Kuvhiya. 7th ed. Philadelphia, PA: Elsevier; 2020: chitsipa 48.

Walther AE, Nathan JD. Achangozvarwa mudumbu madziro kukanganisa. Mune: Wyllie R, Hyams JS, Kay M, eds. Chiremba Gastrointestinal uye Chirwere Chiropa. 5 ed. Philadelphia, PA: Elsevier; 2016: chits. 58.