Kune miviri miviri mikuru yeremera: gastroschisis (inoitika zvishoma nezvishoma) uye umbilical hernia (inozivikanwa zvikuru). Nezvose zvakakonzera kukura, maronda emukati (dzimwe nguva pamwe pamwe nechiropa nemamwe nhengo) anobuda mukati memadziro emimba panze, izvo zvinoda kururamisa chirwere.
Kutarisira kwechechecheche
Kana chirwere chemuviri chemuviri chikaonekwa musati maberekwa mwana, panguva yekuzvarwa kwayo, boka rekuvhima revana rinofanira kunge rakagadzirira. Kana icho chirema chikawanikwa mushure mokuberekwa, mwana anofanira kuendeswa kune imwe nzvimbo. Gastroschisis inopera mumatumbo kubva mudumbu remuviri kuburikidza nehomwe iri pamucheto wetsvimbo yembilical (kazhinji kurudyi). Iyo yakareba yegomba mumadziro emimba ndeyekuti, sekutonga, 2-3 masikati. Chirema chinogona kuonekwa pachigamba chekutanga chekugadzira intrauterine uye kazhinji kazhinji chikonzero che "ngozi" iyo inonzi umbilical inopinda kuburikidza neyekusangana kwemajeri. Kazhinji, mucheche muduku uye chikamu chetoni chinowira kunze. Kunyanya kazhinji, chiropa, chirwere uye chikamu chemuviri chinogona kubuda kubva mudumbu remuviri. Zvichida kuvapo kwemvura inonyanyisa inonamatira kumutsipa wakawira uye inonyanya kuidzikisa. Nemhaka yeizvi, zvinogona kuva zvakaoma kuona hutachiona hwetresia (utachiona) hwemukati mudumbu. Kusiyana nemumbilical hernia, ne gastroschisis inotarisana nechiremera chemuviri wepamuviri hapana chikwama chiri kuvhara nhengo, uye mukana wekuti mwana achangoberekwa anotambura nemupi upi zvake unopfurikidza nemasinaes akaderera.
Kurapa
Mwana ane gastroschisis anotsvaga kupisa uye kupisa kwemvura kuburikidza nhengo dzinowira. Kuti udzivise izvi, nhengo dzinofanira kuvharwa mufirimu. Chinangwa chikuru ndechekuchengetedza hupenyu hwemucheche paanenge achienda kune dhipatimendi rekuvhiya. Kuti urambe hutumbu hunocheneswa, chironga chinogona kuiswa, uye glucose solution inogona kuiswawo kuburikidza nehotera. Pane nzira mbiri dzekuporesa dzokurapa. Kana zvichibvira, kupora kushanda nokukurumidza kunoitwa, asi kana izvi zvisingaitike, nhengo dzinoiswa muhomwe yekugadzirira, iyo inoderedza hukuru hwemazuva 7-10 anotevera, kusundira nhengo kumashure mumudumbu. Ipapo vanachiremba vanochera ganda panzvimbo yechirema. Umbilical hernia inhengo yehutano hwembilical, yakakonzerwa nehutano hwekukura. Chiremera chacho chingava chiduku kana chikuru uye chinowanzobatanidzwa nechromosomal kusakanganisika. Mumamiriro ezvinhu aya, kupindira kwekuvhiya kunokosha. Umbilical hernia (inozivikanwawo seomphalocele) inokonzerwa nekuvhara kwakakwana kwemuviri mudumbu re fetus panguva yekukura kweumumyori, izvo zvinoguma nekurasikirwa kwemuviri mukati kuburikidza nekuvhura mumutsara wembilical. Zvisinei, kusiyana negastroschisis, nembilical hernia nhengo dzomukati dzakapoteredzwa ne peritoneum. Umbilical hernia haiwanzoviki - inowanikwa mune 1 muvana 5 000 vacheche.
Perforation of the hernial sac
Mune zviitiko zvakawanda, chikafu chinoshandiswa pakuberekwa hachina kuberekwa. Zvisinei, rinogona kuparadzanisa zvose uye nguva yekuberekwa. Nokudaro, zvinokosha kuti chiremba akanyatsocherechedza kuvapo kwezvimedu zvehombodo yakabvamburwa kuti arege kukanganisa uye kwete kukanganisa seni ne gastroschisis (umo pasina bhegi iri kuvhara nhengo dzomukati).
Makuru uye maduku mumbilical hernia
Umbilical hernia inogona kuva yakakura kana duku. Nekamudiki kamumambo wake, chirwere chepamuviri chiremara chiri pasi pe 4 cm masendimita, hapana chiropa muhomwe. Nzvimbo yakakura yakawanda, pane zvinopesana, inoratidzika nehupamhi hwepakati hwemasentimita mana, uye nechiropa uye zvakasiyana-siyana zvepachiviri mukati mehomwe.
Concomitant anomalies
Chirwere ichi chinowanzosangana nemamwe matambudziko ekuberekwa, anosanganisira moyo, tsvete nemakoroni. Muzvinyorwa zvinokonzerwa nembilical hernia, chromosomal zvisiri izvo zvinowanikwawo zvachose (anenge 50% emhosva). Kunyanya kukosha ndezvenguva yakatarwa kuwanikwa kweBkwkwith-Wiedemann syndrome. Vana vane chirwere ichi vanokura kuwandisa kwakanyanya kwe insulini-kufanana nekukura panguva yekukura kwepiruterine, iyo inotungamirira ku hypoglycemia yakasimba (chirwere cheshuga chepasi). Izvi zvinonyanya kuipa, sezvo zvingakonzera kukanganisa kwepfungwa dzisingagoneki; zvakakosha kuti utange kudira muganhu weglucose. Pakupa murwere ane unbilical hernia, zvinokosha kuziva kana ane zviratidzo zveBkwkwith-Wiedemann syndrome, iyo inosanganisira kunyanya hypoglycemia inokonzerwa nekuwedzera kwepascreas. Zvichida nguva dzose umbilical hernias inowanikwa mumatanho ekutanga, uye maitiro ane kukonzera kukura kwemasimba anowanzokonzera kukanganisa kwakakonzerwa nekufa kweprorauterine kana zvimwe zvinokonzera. Vana vasati vaberekwa vacheche vanoda kurapwa, kugadziriswa uye kusimbiswa kwezvinokonzera kusagadzikana, uye kuongororwa ropa kweglucose kusabvisa hypoglycemia. Mushure mekunge izvi zvaitika, chiremba anovhiya anonyatsovhara chirema. Kana kupora nokukurumidza kuchikundikana, zvino inoitwa mumatanho uchishandisa bhagi rekugadzirira (segastroschisis).
Kwete-kurapwa kurapwa
Kuchengetedza kurapa kunoratidzwa nevarwere vane mhando yakasimba yembilical avo vangave vasingatamburi kupindira chirwere. Bhegi inobatwa nemhinduro ye antiseptic kana doro kuitira kuti igadzire ruvara rutsvina. Izvi zvishoma nezvishoma zvinotungamirira kuvhara chirema neganda. Mune ramangwana zvakadii kudzorera masimba emadziro emimba.