Fentula ya congenital ya mimba ya ana

Fistula ya congenital ingakhale yopatulidwa kapena yogwirizanitsidwa, nthawi zambiri kuphatikizapo atresia ya phokoso. Mafistula ndi zingwe zomwe zimagwirizanitsa lumen ya mimba kapena anastomosis ndi mpweya wotentha (trachea, bronchi) kapena malo akunja kudzera mu dzenje la khungu (kunja kwa fistula). Kutalikirana kwa fistula komwe kumakhala kofalikira kwapakati kumatchulidwa kuti ndizosachitika kawirikawiri za ziphuphu za gawo ili la kapangidwe ka zakudya. Ophunzira kwambiri komanso odziwika bwino ndi omwe amadziwika bwino kwambiri komanso amadziwika bwino kwambiri, ndipo amakhala ndi mitundu yosiyanasiyana ya mthempha yomwe ili ndi mphepo. Mafistula amaloledwa, monga lamulo, pa mlingo wa 1-2 thoracic vertebrae. Kufufuza mwatsatanetsatane ka fostula morphology kunaperekedwa ku ntchito ya AP Biesin (1964), GA Bairov, NS Mankina (1977).

Fistula ya congenital ya mthempha imayamba chifukwa cha kusagwirizana kosatha kwa matumbo oyambirira m'mimba pamatope ndi trachea.

Zizindikiro za kuchipatala

Zizindikiro za kuchipatala zimaonekera patangotha ​​maola angapo mwana atabadwa pakudya koyambirira. Iwo amatsimikiziridwa ndi zosiyana za zofooka zamatenda. Panthawi ya khoma lofanana la mitsempha ndi trachea, komanso kafupipafupi komanso kochepa kwambiri pakangopita kagawo ka chakudya, chomwe chimayambitsa matenda aakulu, sequentially, ndi hypoxia. Cyanosis ikuwonekera. Pambuyo pake pali kusala kwa chakudya ndi chibayo chimayamba. Chifuwa cha pooxysmal sichidziwika pochepa podyetsa kupyolera mu kafukufuku. Panthawi imodzimodziyo, chakudya sichingathe kupeza njira zowonongeka.

Mu nthawi yautali ndi yopapatiza yopanda nzeru kwa ana a masabata oyambirira a moyo, akukakamira ngakhale akuwoneka, koma amalephera kufotokoza. Kufuula ndizochepa. Komabe, kumapeto kwa mapeto, ngakhale zakudya zing'onozing'ono zimagwera m'mapapo opuma, chifukwa chifuwa chimakhala cholemera kwambiri, kupweteka kwa kupuma kumawonjezeka, ndipo chimapewa chibayo.

Chinthu chodziwitsa kwambiri kuti matenda a fistula amatha kukhala oophagoscopy ndi itraheobronchoscopy. Mothandizidwa ndi esophagoscopy, munthu amatha kuona pakhomo la oviposition ndi maonekedwe a mpweya m'mphepete mwa dzenje, komanso ntchentche. Mothandizidwa ndi tracheobronchoscopy, kumeza (kupweteka) kudzera mu fistula mumatenda ochepa a chakudya, amawotchera mitsempha ya trachea kapena bronchus pa malo otuluka fistula. Njira yowonongeka imagwiritsidwanso ntchito kuti azindikire kuyankhulana kwa mphuno ndi kupuma kudzera mwa fistulous course. Kuti muchite izi, sungani madzi omwe akugwiritsidwa ntchito ndi mwana kuti amwe mowa, methylene buluu. Kuwonekera kwa utoto mu tsamba lopuma limatsimikizira kukhalapo kwa fistula.

Zojambula ziwiri ndi tracheobronchoscopy zimagwiritsidwa ntchito pansi pa anesthesia.

Ponena za matenda opatsirana pogonana a fostula ochepa, ali ndi chidziwitso chodziŵika bwino. Choyamba, chifukwa kuphunzira pogwiritsa ntchito mankhwala osiyana kumayambitsa matendawa, kenaka kumalowa mu fistula kudzera mu kutsekemera, kumabweretsa chitukuko chachikulu cha chibayo (pamaso pa chibayo, kuyesedwa kosiyana kumatsutsana). Chachiwiri, phunzirolo lopanda osiyana ndilo limawulula fistula. Pali njira yeniyeni yodziwira kuti matendawa amatha kupweteka kwambiri, zomwe zikufaniziranso zizindikiro za matenda opuma kupuma komanso boma la mapapo. Kuti muchite izi, X-ray kufufuza mapapo. Pomwe palibe zizindikiro za kusintha kwa kutupa m'mapapo a m'mapapo ngati chifuwa, kukula kwa kupuma kwa ana aang'ono, munthu akhoza kuganiza za kukhalapo kwa fostula. Ngati mwanayo wayamba kale kukhala ndi chifuwa cha chibayo, ndiye kuti njira iyi yothandizila siikuthandizani. Choncho, kuyesera kwa X-ray kuyenera kuchitidwa mosamala, kukumbukira zomwe zili pamwambapa.

Chithandizo

Mankhwalawa ndi opaleshoni. Chithandizo chochipatala cha panthawi yake chimachiritsa wodwalayo. Potsatira mankhwala opatsirana, malingalirowa amatsimikiziridwa ndi khalidwe ndi nthawi ya mavuto a bronchopulmonary.

Khalani wathanzi!