Dendaase Hirschsprung - nzira yekugadzirisa sei chirwere?

Kana kukwidziridzwa kwekuberekwa kusina kukanganisa, fetus inokanganisa muhutano hwehumukati. Chimwe chezvinhu izvi zvinochinja ndeyeHirschsprung syndrome (megacolon kana aganglion). Ichi chirwere chinoitika mune imwe yevana 5000, kunyanya varume.

Chirwere cheHirschsprung - chii ichocho?

Utumbo hwomukati uye kushandiswa kwenguva nenguva kwezvipfeko zvinotungamirirwa nemasero akaoma emasero. Congenital megacolon inoratidzirwa nekushaiwa kwavo kana kushayikwa, nekuda kwekuti kusunungurwa kwezvipfeko zvinoremekedzwa zvikuru. Somugumisiro, huwandu hwakawanda hwehutu hunoungana mumatumbo makuru. Izvi zvinotungamirira pakuwedzera nekuwedzerwa kwechirongwa.

Chirwere cheHirschsprung muvana - zviratidzo

Chimiro chemakiriniki chinonyanya kutaridzika pane nzvimbo uye chiyero chekusachengetwa kwemukati. Chirwere cheHirschsprung mucheche chinoratidzwa nenzira yezviratidzo zvinotevera:

• kusavapo kwezvisikwa zvepakutanga (meconium);
• mark gassing;
• flatulence ;
• kurutsa, dzimwe nguva bile;
• kuramba kwenguva refu;
• kuchinja mumamiriro emimba;
• inverted or low positioned umbilicus;
• kazhinji kuora.

Dendaase Hirschsprung muvana vakwegura inofambiswa nezvimwe zviratidzo:

• kusabvirika kwemuviri wemafudzi pasina enema;
• kurwadziwa kwepamuviri;
• kudhakwa kwomuviri;
• rakasununguka pakukura muviri;
• partial heterochromy;
• kuvapo kwemvura yakaoma ("matumbo emukati");
• anemia ;
• kududzirwa kwebhokisi;
• hypotrophy;
• enterocolitis;
• kuwedzera kwemuviri wakakura;
• chinangwa chekuwedzera bronchitis uye pneumonia;
• kurutsa uye chirwere shure kwekuvharwa kwenguva refu.

Dendaase Hirschsprung muvana - kuongororwa

Kuti aratidze kusafungirwa kwezvakatsanangurwa chirwere, chiremba anotanga kunyatsoongorora murwere muduku. Chirwere cheHirschsprung muzvitsva zvinogona kuve zvakaratidzwa kunyange kurpation, kunzwa musikana munzvimbo yemukumbo mukuru. Basa rinokosha rinowedzerwa nekubvunzwa kwevabereki kwemwana. Kana mhuri yaive nemhosva yekusakatika mune mubvunzo, mukana wekuitika kwayo mumwana yakanyanya kuwedzerwa (nhaka inowanikwa).

Kuongorora kwakaitwa mwana neHirschsprung chirwere

Nzira huru yekuongororwa kwechirwere ichi chiratidzo chekuona uye chemukati che rectum (sigmoidoscopy). Chirwere cheHirschsprung chinoperekedzwa nezwi rakakwirira re sphincter pamwe nenzvimbo isina chinhu pamberi pekuzarura kwemazamu, kunyange kana kubudisa kusina kuitika kwemazuva mashoma. Kuti uwane mamwe mashoko, tsvakurudzo yehutori inopiwa. Dendaase Hirschsprung - Kuongororwa:

• Irrigoscopy nekuiswa kwesanganiswa yeabrium;
• colonoscopy;
• anorectal manometry;
• biopsy uye inotevera kuongorora kwake.

Chirwere cheHirschsprung - X-ray

Chimwe chikonzero chekuongororwa mukuongororwa kwechirevo chinorondedzerwa chirwere ndechekuita kwekuongorora. Dhiyabhorosi inobatsira kuziva zvakajeka kuti megacolon (chirwere cheHirschsprung) chinowanikwa panzvimbo ipi, kuti uwane huwandu hwekuoma kwehutachiona. Kuti uongorore hutano hwemubumbo motility, zvinokurudzirwa kuisa mutauro wepakati uye kuwedzera ultrasound.

Kurapa kweHirschsprung zvirwere muvana

Iyo chete nzira inobatsira yekurapa iyo inoratidzika isingaiti chirwere chinopindira. Nzira yekuchengetedza inotarisirwa chete pamusi wekushanda. Inobatsira kuderedza uye kuderedza chirwere cheHirschsprung - kurapwa kunosanganisira kubvisa zviratidzo zvehutachiona, kuratidza kuvhiringidza kwezvakawanda zvechirwere nekudzorera mucheche musikana. Mushure mokurapa kurapwa zvakakosha kuvimbisa mwana kutarisira kwakanaka uye kutevera kubatisisa kune kudya kwakakosha.

Chirwere cheHirschsprung muvana - kliniki mazano

Kana chirwere ichi chichisimbiswa uye chiremba akagadza zuva rekushanda, zvakakosha kugadzirira nzira. Megacolon muvana inosanganisira zvinotevera kurapa:

1. Kugadziriswa kwemuviri kunodzivirira. Nguva dzose yakaiswa siphon enemas nekuiswa kwechigadziro chinogadziriswa che sodium chloride concentration ye 0.9%.
2. Kudzorerwa kwepamuviri microflora. Mwana wacho anofanira kushandisa zvinodhaka zvinokurudzira basa rinokosha reabhakitiriya anobatsira ( probiotics ).
3. Tsigira hutachiona. Mwana anorayirwa mavitamini - E, C, B6, B12.
4. Kuvandudza marara kubvisa. Kuti kuve nekugadzirisa kubudiswa kwematumbo kunobatsira kupisa mudumbu uye gymnastics.
5. Kudzivirira kubatwa. Kudzivirira kupera kwemazimbe pamwe nekudya kunobatanidzwa ne fiber zvakakanganiswa nekushandiswa kwemvura yakachena.
6. Kudzorerwa kwemagadzirirwo emagetsi. Nezvinetso zvakakomba zvekudya, intravenous electrolyte solutions, glucose uye mapuroteni mazano anokurudzirwa.

Kuvhiya kweHirschsprung chirwere

Kune dzimwe nzira dzakasiyana-siyana dzokugadzirira kupindira kuti ubvise chirwere chiri mubvunzo. Zvose izvi zvinoshandiswa mukunyengedzwa kwezvivako zvakakanganiswa nemutsara wakarurama uye chirwere chechimiro chechimiro uye kugadzika pakati pemishonga ane utano hweAnastomosis. Muhucheche, chirwere cheDuhamel chinonyanya kuitwa muchirwere chaHirschsprung, asi pane mamwe marudzi ehutano hwakanaka uye akachengeteka:

• Rectosigmoidectomy maererano naSvenson-Hyatt-Isakov;
• a deep colorectal anterior anastomosis according to Rebein;
• Operation Soave.

Nzira idzi dzakanyorwa dzakangofanana nenzira yekubudirira, saka kusarudzwa kworudzi rwekupindira kunoparidzirwa neyanyanzvi. Kupa imwe nzira yekutsoropodza, chiremba anotungamirirwa nezera uye chimiro chomurwere muduku, anoongorora kuti nokukurumidza chirwere cheHirschsprung chinowedzera sei. Zvakakosha kuti vabereki vawane chiremba wechiremba anoziva, izvi zvose zvinoshandiswa nenzira yakaoma yekushandiswa.

Dendaase Hirschsprung - kudya

Kuti kuderedza zviratidzo zvehutsananguro hwehutachiona, kudya kwakakosha kunokonzerwa nekudya kunokonzerwa. Chikafu cheHirschsprung chirwere chinosanganisira kushandiswa kwemiti yakagadzirisa chigaro uye inokurudzira mucheche muitiro:

• a decoction ye bran kana dill (kumucheche);
• apricots akaomeswa, prunes, kunyanya compotes pachikonzero chavo;
• pumpkin;
• buckwheat, oats, gorosi peji;
• rimwe zuva kefir;
• beet;
• makungu;
• yoghurt;
• vegetarian soups;
• steam cutlets uye soufflé kubva pakaderera-mafuta kudya nyama;
• miriwo yemafuta;
• mahwendeji matsva, michero nemiriwo.

Kubva pakudya, tinofanira kusiya zvinhu zvose zvinosimbisa uye zvinokonzera maitiro ekuvirisa mumatumbo:

• pears;
• rice, semolina pariji;
• chingwa chitsva nechingwa;
• tsvina;
• bun uye pastry;
• kocoa uye chokoti;
• mbeu;
• kabbage;
• mafuta ane nyama;
• mupfumi nemafuta;
• mbatata (zvishoma nezvishoma);
• pasta;
• cherry;
• sweets nemakrisheni emafuta;
• nyemba;
• mukaka wose.

Chirwere cheHirschsprung muvana - migumisiro

Pasina kukodzera uye kurapa panguva yakakodzera, iyo anomaly inofungidzirwa inogona kuguma zvakashata, kunyanya kana inowanikwa muchechecheche. Muna 80% yezviitiko zvakadaro, chirwere cheHarald Hirschsprung chinotungamirira kurufu rwechecheche. Apo chirwere ichi chakaitwa panguva uye chimiro, huporofita hunovandudzwa zvikuru, vanenge 90% yevaduku vaduku vanodzokera kumatengo anogutsa.

Zvimwe zvinetso zvakajairika zvehosha yeHirschsprung:

• enterocolitis yakaoma;
• anemia;
• matumbo okudzivirira ;
• inxication yakaoma;
• peritonitis;
• fever;
• kubuda mumimba;
• fistula;
• stenosis;
• fecal incontinence.