Ukuxilongwa, ukuChengwa nokuPhinda
I-epigastric hernia iyenzeka xa ubuthathaka kwisisu esiswini buvumela izicubu zesisu ukuba ziqhube nge-muscle. Ngokuqhelekileyo zikhona xa zizalwa kwaye zifana ne- hernia , ngaphandle kohlobo lwe-hernia olujikelezayo lujikeleze inkomfa yesisu kunye ne-epigastric hernia ngokuqhelekileyo phakathi kweqhosha lesisu nesifuba.
I-epigastric hernia iyancinci ngokwaneleyo ukuba kuphela i-peritoneum, okanye i-lining of the stomity cavity, iqhutywe ngodonga lwe-muscle .
Kwiimeko ezincinci, umba unokuthi ufumaneke ngexesha le-CT scan okanye olunye uvavanyo olwenziwe ngohlobo oluhluke ngokupheleleyo, kwaye aluze lubangele iimpawu. Enyanisweni, ezininzi ze-epigastric hernias zifunyaniswa kubantu abadala, kunokuba kubantwana. Kwiimeko ezinzima, iinxalenye zesigqeba zingadlulela emgodini kwimisipha.
Ngubani osemngciphekweni
I-epigastric hernias ngokuqhelekileyo ikhona ekuzalweni kwaye ibonakala ngathi iyavela kwaye iyabonakala, ebizwa ngokuba "yincinci" ye-hernia. I-hernia ingabonakali ngaphandle kokuba isigulane sikhala, sinyanzelise ukuba nentshukumo, okanye omnye umsebenzi owenza uxinzelelo lwesisu. Ukubonakala kwe-hernia kwenza kube lula ukuxilongwa, ngokufuna ukuba akukho vavanyo ngaphandle kovavanyo lomzimba ngugqirha.
Unyango kubantwana
I-epernastrian hernia ayiyi kuphulukisa ngokwayo kwaye idinga ukuhlinzwa ukuba ilungiswe. Nangona kunjalo, ngaphandle kokuba i-hernia isongela ukuba yimeko engxamisekileyo, utyando lunokuhlehliswa de kube umntwana ekhulile.
Abancinci bavame ukunyamezela utyando olungcono kunabantwana abatsha, ngoko kuya kunceda ukulinda ngaphambi kokuhlinzwa.
Unyango kubantu abadala
Akuqhelekanga ukuba umntu omdala afunyanwe ene-hernia ye-epigastric ayengazi ngaphambili ngaphambili ebomini. Kwakhona kunokwenzeka ukuba i-hernia eyaziwa ukuba ikhona kwiminyaka emininzi ukuba ibe ngumcimbi njengeminyaka yobudala.
Kwabaninzi, i-hernia ayibangeli iimpawu kude kube kamva ebomini ngenxa yobuthakathaka, ubuthathaka obuthathaka, okanye ubunzima kwi-wall muscular yesisu. Kule meko, ukulungiswa kocwangco kunokuba kuyimfuneko ukuba i-hernia ibangela intlungu okanye isongela ukuba idibene.
Xa liphuthumayo
I-hernia ebambelela kwi-"out" isikhundla ibhekiselwa ekubeni yindawo yokuboshwa. Nangona i-hernia eboshiweyo engekho yongxamiseko, kufuneka iqwalaselwe, kwaye kufuneka ilondolozwe unyango. I-hernia yokuvalelwa entolongweni yimeko engxamisekileyo xa iba "yindoda ekhethiweyo," apho izicubu ezinobunzima obungaphandle kwimizimba zibulawa yindlala yegazi. Oku kunokubangela ukufa kwezicubu ezigqithiselayo kwi-hernia.
I-hernia ecacileyo ingabonwa ngumbala obomvu obomvu okanye obomvu weethambo ezinobumba. Inokuhamba kunye nentlungu enzima, kodwa ayisoloko ibuhlungu. Ukuxuba, ukuhlanza, isifo sohudo kunye nokuvuvuka kwesisu kuya kubakho.
Ukuhlinzwa
Utyando lwe-epigastric hernia luqhutshwa ngokusetyenziswa kwe-anesthesia jikelele kwaye lunokwenziwa kwisifo sengqondo okanye isiguli . Ukuba isiguli singumntwana, kufuneka kuthathelwe ingqalelo ekhethekileyo ukulungiselela abantwana ngokwaneleyo ukuhlinzwa .
Olu uphando luyenziwa ngugqirha oqhelekileyo okanye ugqirha we- colon-rectal , ukuba isigulane ngumntwana ogqirha ogqirha kwizonyango ngokuqhelekileyo uqhuba inkqubo.
Xa kunikwe i-anesthesia, utyando luqala ngokuchotshiswa kwinqanaba le-hernia. I- laparoscope ifakwe kwisicatshulwa esisodwa, kwaye esinye isicatshulwa sisetyenziselwa izixhobo zokuphanda ezongezelelweyo. Ugqirha ke uhlukanisa isahlulo sesinxibe esiswini esichukumisa nge-muscle. Lezi zicubu zibizwa ngokuba yi "hernia sac." Ugqirha uya kubuya esikhwameni sakhe se-hernia kwisikhundla sakhe esifanelekileyo, ngoko uqala ukulungisa isiphako semisipha.
Ukuba isiphene kwisisipha sincinci, sinokuthi sutured ivaliwe. I-sutures izakuhlala kwindawo ngokusisigxina, ukukhusela i-hernia ukuba ibuye. Ngenxa yeziphene ezinkulu, ugqirha unokuvakalelwa kukuba ukukhwabanisa akukwanele.
Kule meko, i-graft graft izakusetyenziswa ukumboza umgodi. I-mesh isigxina kwaye inqanda ukuba i-hernia ibuyele, nangona isiphako sihlala sivulekile.
Ukuba i-suture indlela isetyenzisiwe kunye neziphene ezininzi (malunga nobukhulu bekota okanye ngaphezulu), ithuba lokuphindaphinda landa. Ukusetyenziswa kweendwangu kwi-hernias emikhulu ngumgangatho wonyango, kodwa kungenakufaneleka ukuba isigulane sinomlando wokugatya iziphene zokugqithisa okanye imeko evimbela ukusetyenziswa kwemfono.
Emva kokuba i-mesh isendaweni okanye i-muscle ixhunyiwe, i-laparoscope isuswe kwaye ukuvalwa kungavalwa. Isibhengezo singavalwa ngeendlela eziliqela. Ingavalwa kunye ne-sutures esuswe ekuhambeni kokulandelelana kunye nodokotela ogqirha, uhlobo olukhethekileyo lweglue elisetyenziselwa ukubamba isibopho esivaliwe ngaphandle kwe-sutures, okanye amabhinti amancinci amancinci abizwa ngokuthi i-ster-strips.
Ukubuyisela
Uninzi lwezigulane ze-hernia ziyakwazi ukubuyela emsebenzini wazo eziqhelekileyo kwiiveki ezimbini ukuya kwezine. Izigulane eziguga zithatha ixesha elide. Isisu siya kuba nethenda, ngakumbi kwiveki yokuqala. Ngeli xesha, ukukhutshwa kufuneka kukhuselwe ngexesha lomsebenzi okwandisa ingcinezelo esiswini ngokusebenzisa isinyanzelo kodwa uxinzelelo oluncinci kwi- incision line .
Imisebenzi ngexesha lokukhutshwa kufuneka likhuselwe libandakanya:
- Ukuhamba ukusuka kwindawo yokulala ukuya kwindawo ehleliyo, okanye ukusuka kwindawo ehleliyo ukuma
- Ukukrazula
- Ukuhlahlela
- Ukukhala, ngakumbi xa umntwana ephenduka obomvu ebusweni kumzamo
- Ukunyameka ngexesha lokunyakaza kwebilini
- Ukuvutha
Umthombo:
> Lang B, u-Lau H, u-Lee F. I-epistastric hernia kunye ne-etiology yayo. Hernia 2002; 6: 148.