Ventriculoperitoneal shunting

Ventriculoperitoneal shunting kuvhiya kurapa yakawandisa cerebrospinal fluid (CSF) mumatanda (ventricles) europi (hydrocephalus).

Maitiro aya anoitwa mukamuri yekuvhiya pasi peanesthesia. Zvinotora anenge 1 1/2 maawa. Chubhu (catheter) inopfuudzwa ichibva mumakomba emusoro ichienda padumbu kubvisa iyo yakawanda cerebrospinal fluid (CSF). Vhavha yekumanikidza uye mudziyo unorwisa-siphon unoita chokwadi chekuti huwandu hwakaringana hwemvura hwadirwa.

Maitiro acho anoitwa seinotevera:

• Nzvimbo yebvudzi mumusoro yakaveurwa. Izvi zvinogona kunge zviri kuseri kwenzeve kana kumusoro kana kumashure kwemusoro.
• Chiremba anovhiya anogadzira ganda kuseri kwenzeve. Kumwe kucheka kwekuvhiya kunoitwa mudumbu.
• Buri diki rinocherwa mudehenya. Mumwe mugumo wekateti unopfuudzwa mu ventricle yeuropi. Izvi zvinogona kuitwa kana kana pasina komputa segwara. Izvo zvinogona zvakare kuitwa ne endoscope iyo inobvumidza chiremba wechiremba kuona mukati meiyo ventricle.
• Catheter yechipiri inoiswa pasi peganda kuseri kwenzeve. Inotumirwa pasi mutsipa nechipfuva, uye kazhinji munzvimbo yedumbu. Dzimwe nguva, inomira panzvimbo yechifuva. Mudumbu, iyo catheter inowanzoiswa pachishandiswa endoscope. Chiremba anogona zvakare kugadzira mashoma mashoma, senge mumutsipa kana padyo nekorara, kubatsira kupfuudza catheter pasi peganda.
• Valve inoiswa pasi peganda, kazhinji kuseri kwenzeve. Iyo vharuvhu yakabatana kune ese maviri maketani. Kana imwe yekumanikidza ikawedzera kutenderedza uropi, iyo vharuvhu inovhura, uye yakawandisa mvura inodonha kuburikidza necatheter kupinda mudumbu kana muchipfuva nzvimbo. Izvi zvinobatsira kudzikisira kusagadzikana kumanikidza. Reservoir pane vharafu inobvumidza priming (kupomba) yevhavha uye yekuunganidza CSF kana zvichidikanwa.
• Munhu wacho anoendeswa kunzvimbo yekudzoreredza obva aendeswa kuimba yemuchipatara.

Kuvhiya uku kunoitwa kana paine zvakawandisa cerebrospinal fluid (CSF) muuropi uye musana. Izvi zvinonzi hydrocephalus. Izvo zvinokonzeresa zvakakwirira kupfuura zvakajairika kumanikidza pauropi. Inogona kukonzera kukuvara kwehuropi.

Vana vanogona kuzvarwa vaine hydrocephalus. Izvo zvinogona kuitika nehumwe hurema hwekuzvara kwepamuviri mbiru kana huropi. Hydrocephalus inogona zvakare kuitika kune vakura vakuru.

Shunt kuvhiyiwa kunofanirwa kuitwa nekukurumidza apo hydrocephalus inowanikwa. Dzimwe nzira dzekuvhiya dzinogona kukurudzirwa. Chiremba wako anogona kukuudza zvakawanda nezve idzi sarudzo.

Ngozi dzeanesthesia uye kuvhiyiwa kazhinji ndezvi:

• Reaction kumishonga kana matambudziko ekufema
• Kubuda ropa, kugwamba kweropa, kana hutachiona

Ngozi dze ventriculoperitoneal shunt kuiswa ndeye:

• Ropa rakavhara kana kubuda ropa muuropi
• Kuzvimba kwehuropi
• Hole mumatumbo (ura perforation), iyo inogona kuitika mushure mekuvhiyiwa
• Kuvuza kweCSF fluid pasi peganda
• Kubatwa kweiyo shunt, huropi, kana mudumbu
• Kukuvadza kune huropi tishu
• Kufenda

Shunt inogona kumira kushanda. Kana izvi zvikaitika, mvura inozotanga kuvaka muuropi zvakare. Sezvo mwana paanokura, iyo shunt inogona kuda kuiswazve.

Kana maitiro asiri ekukurumidzira (kwakarongwa kuvhiya):

• Udza mupi wezvehutano kuti ndeapi mishonga, zvinowedzerwa, mavitamini, kana miriwo inotorwa nemunhu.
• Tora chero mushonga uyo mupi waanoti tora nekumwe kuseva kwemvura.

Kumbira mupiki nezve kudzikisira kudya uye kunwa usati wavhiyiwa.

Tevera chero mimwe mirairo pamusoro pekugadzirira kumba. Izvi zvinogona kusanganisira kugeza nesipo yakakosha.

Munhu wacho angangoda kunyepa zvakaringana kwemaawa makumi maviri nemana kekutanga nguva iyo shunt yakaiswa.

Inguva yakareba sei kugara muchipatara kunoenderana nechikonzero shunt inodiwa. Boka rezvehutano rinoongorora zvakanyanya munhu. IV mvura, mishonga inorwisa mabhakitiriya, nemishonga yekurwadziwa ichapihwa kana zvichidikanwa.

Tevedza rairo yemupi wemupi nezve maitiro ekuchengeta shunt kumba. Izvi zvinogona kusanganisira kutora mushonga kudzivirira hutachiona hwe shunt.

Shunt kuisirwa kunowanzo kubudirira mukuderedza kumanikidza muuropi. Asi kana hydrocephalus yakabatana nemamwe mamiriro, senge spina bifida, bundu rehuropi, meningitis, encephalitis, kana kubuda ropa, aya mamiriro anogona kukanganisa kufungidzira. Iyo yakaoma sei hydrocephalus iri pamberi pekuvhiyiwa zvakare inokanganisa mhedzisiro.

Shunt - ventriculoperitoneal; VP shunt; Shunt kudzokorora

• Kuchengeta ronda rekuvhiya - rakavhurika
• Ventriculoperitoneal shunt - kubuda

• Ventricles europi
• Craniotomy yehuropi shunt
• Ventriculoperitoneal shunt - akateedzana

Badhiwala JH, Kulkarni AV. Ventricular shunting maitiro. Mune: Winn HR, ed. Youmans uye Winn Neurological Kuvhiya. 7th ed. Philadelphia, PA: Elsevier; 2017: chits.

Rosenberg GA. Brain edema uye kusagadzikana kwecerebrospinal fluid kutenderera. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits 88.