Pali mitundu iwiri ikuluikulu ya vuto: gastroschisis (imachitika kawirikawiri) ndi umbilical hernia (yowonjezereka). Ndi ziwalo ziwiri zolepheretsa, matumbo a m'mimba (nthawi zina pamodzi ndi chiwindi ndi ziwalo zina) amatha kupyola mu khomo la m'mimba kunja, zomwe zimafuna kukonzekera opaleshoni.
Kusamalira mwana wakhanda
Ngati vuto la mimba ya m'mimba lidawonekere mwana asanabadwe, panthawi yomwe wabadwa, timu ya opaleshoni ya ana iyenera kukhala yokonzeka. Ngati kachilombo kamapezeka atabereka, mwanayo ayenera kutumizidwa ku malo apadera. Gastroschisis ndi kupweteka kwa m'mimba m'mimba mwa mimba mwa dzenje lomwe lili kumbali ya umbilical (nthawi zambiri kumanja). Pakatikati mwa khoma la m'mimba muli chigawo cha 2-3 masentimita. Chilakolako chikhoza kuoneka pachiyambi cha intrauterine chitukuko ndipo nthawi zambiri chimakhala chifukwa cha "ngozi" imene mzerewu umatha kupitilirapo kusiyana ndi kubereka kovuta. Kawirikawiri, utumbo wawung'ono ndi gawo la coloni zimagwa. Kawirikawiri, chiwindi, nthenda ndi gawo la m'mimba zimatha kutuluka m'mimba. Mwinamwake kupezeka kwa madzi owopsa omwe amamatira kumatumbo akugwa ndipo mochuluka kumawatsitsa iwo. Chifukwa cha izi, zingakhale zovuta kupeza concomitant atresia (matenda) a m'matumbo aang'ono. Mosiyana ndi chombo cha umbilical, ndi gastroschisis pafupi ndi vuto la khoma la m'mimba mulibe thumba lophimba ziwalo, ndipo mwinamwake kuti mwana wakhanda akusowa ndi zolakwika zirizonse ziri zochepa.
Chithandizo
Mwana yemwe ali ndi gastroschisis amatha kutaya kutentha ndi madzi mwa ziwalo zogwa. Pofuna kupewa izi, ziwalo ziyenera kutsekedwa mu filimu. Cholinga chachikulu ndicho kukhalabe ndi moyo wa mwana wakhanda paulendo wake wopita kuchipatala. Pofuna kuteteza m'matumbo, tizilombo toyambitsa matenda timatha kuikapo, ndipo tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Pali njira ziwiri zamakono zopangira opaleshoni. Ngati n'kotheka, kuchipatala mwamsanga kumene kumachitidwa, koma ngati izi sizingatheke, ziwalo zimayikidwa mu thumba lakumanga, zomwe zimachepetsa kukula kwa masiku 7-10 otsatira, ndikukankhira ziwalo kubwerera m'mimba. Kenaka opaleshoniyo amawombera khungu m'malo mwa chilema. Mphuno ya umbilical ndi nthenda yobadwa nayo ya umbilical chingwe, yochitidwa ndi malformation akukula. Vutoli likhoza kukhala laling'ono kapena lalikulu ndipo nthawi zambiri limakhala limodzi ndi vuto la chromosomal. Pachikhalidwe ichi, opaleshoni yopanga opaleshoni ndi yofunikira. Mphuno ya umbilical (yomwe imatchedwanso omphalocele) ndi chifukwa cha kutsekedwa kosakwanira kwa khoma la m'mimba mwa fetus pa kukula kwa emmoni, zomwe zimayambitsa kutaya kwa ziwalo za mkati kupyolera mu chitseko cha umbilical. Komabe, mosiyana ndi gastroschisis, ziwalo zogonana za umbilical zizunguliridwa ndi peritoneum. Nthenda ya umbilical ndi yosavomerezeka - imapezeka m'modzi mwa ana asanu ndi anayi okwana 5,000.
Kukonzekera kwa hernial sac
Kawirikawiri, thumba lachiberekero pa kubadwa sichiwonongeke. Komabe, ikhoza kutha nthawi zonse komanso nthawi yobereka. Choncho, ndikofunika kuti dokotala ayang'anire mosamala kupezeka kwa thumba la chikwama chodzudzulidwa kuti apewe zolakwitsa komanso kuti asasokoneze nthata ndi gastroschisis (momwe mulibe thumba lophimba ziwalo zamkati).
Yaikulu ndi yaing'ono yambilical hernia
Chomera cha umbilical chingakhale chachikulu kapena chaching'ono. Ndi kamtundu kakang'ono kamene kameneka kameneka, kamimba kamimba kamene kali ndi kachilombo kakang'ono kuposa masentimita 4, palibe chiwindi mu thumba. Chomera chachikulucho chimakhala ndi dzenje lalikulu la masentimita 4, ndi chiwindi ndi zosiyana za matumbo m'mimba mkati mwa thumba.
Zolakwika zosagwirizana
Matendawa nthawi zambiri amatsatiridwa ndi zilema zina, zomwe zimaphatikizapo malingaliro a mtima, impso ndi colon. Muzinthu zogonana ndi umbilical hernia, zovuta zowonongeka zimakhalanso zachilendo (pafupifupi 50%). Chofunika kwambiri ndi matenda a Beckwith-Wiedemann. Ana omwe ali ndi matendawa amakula kwambiri chifukwa cha matenda a intrauterine, omwe amachititsa kudwala kwambiri kwa shuga. Izi ndizoopsa kwambiri, chifukwa zingayambitse ubongo wosasinthika; ndikofunika kuti mwamsanga muthe kutsanulira mu njira ya shuga. Powapatsa wodwalayo ndi vuto la umbilical, ndikofunikira kudziwa ngati ali ndi zizindikiro za matenda a Beckwith-Wiedemann, omwe amachititsa kuti thupi likhale ndi hypoglycemia yowonongeka chifukwa cha kuwonjezeka kwa makoswe. Nthawi zonse amadzimadzi amadzimadzi amadziwika nthawi yoyamba, ndipo milandu yokhala ndi vuto lopweteka kwambiri nthawi zambiri imabweretsa mavuto olakwika chifukwa cha imfa ya intrauterine kapena zifukwa zina. Ana obadwa kumene asanabadwe amafunika chithandizo chamadzimadzi, kudziwitsidwa ndi kutsimikiziridwa kwa zolakwika zosagwirizana, komanso kuyezetsa magazi kwa shuga kuti asatengere hypoglycemia. Zitatha izi, dokotala wa opaleshoni amatsegula molunjika. Ngati nthawi yomweyo kuchira sikulephera, ndiye kumapangidwira pang'onopang'ono pogwiritsa ntchito thumba lachangu (monga gastroschisis).
Kupanda opaleshoni
Chithandizo chodziletsa chimasonyezedwa kwa odwala omwe ali ndi vuto lovuta la mankhwala omwe sangathe kudwala opaleshoni. Chikwamacho chimachiritsidwa ndi yankho la mankhwala ophera tizilombo toyambitsa matenda kapena mowa kuti apange chilonda chopanda kanthu. Pang'onopang'ono izi zimabweretsa chikopa pakhungu. M'tsogolomu nkofunika kubwezeretsa minofu ya m'mimba.