Ukuxilongwa, Ukuhlinzwa nokubuyiswa
I- hernia ye- epigastric iyenzeka lapho ubuthakathaka emisipha yomzimba kuvumela izicubu zesisu ukuba ziqhubekele ngaphakathi kwemisipha. Ngokuvamile kutholakala lapho ezalwa futhi kufana ne- hernia embilical , ngaphandle kwe-hernia embilical ihamba ngokuzungeze inkinobho yesisu futhi i-hernia epigastric ngokuvamile iphakathi kwe-inkinobho yesisu nesifuba.
I-hernia ye-epigastric ngokuvamile isincane ngokwanele ukuthi i-peritoneum kuphela, noma i-lining of the stomaid cavity, iqhubekela phambili edongeni lomzimba .
Ezimweni ezincane, le nkinga ingase itholakale ngesikhathi se-CT scan noma enye yokuhlolwa kwenkinga ehluke ngokuphelele, futhi ingase ingabangeli izimpawu. Eqinisweni, eziningi ze-epigastric hernias zitholwa kubantu abadala, kunokuba zibheke ezinganeni. Ezimweni ezimbi, izingxenye zelungu zingadlulela emgodini emisipha.
Ubani engozini
Ama-hernias e-epigastric ajwayelekile lapho ezalwa futhi angase abonakale avela futhi aphele, okubhekwa ngokuthi "i-hernia" yokunciphisa. I-hernia ingase ingabonakali ngaphandle kokuthi isiguli sikhala, sigijimela ukuba sibe nokunyakaza kwesisu, noma omunye umsebenzi owenza ukucindezelwa kwesisu. Ukubonakala kwe-hernia kwenza kube lula ukuxilongwa, ngokuvamile okudinga ukuhlolwa ngaphandle kokuhlolwa komzimba odokotela.
Ukwelashwa Kwezingane
I-hernia ye-epigastric ngeke ikwazi ukuphulukisa ngokwayo futhi idinga ukuthi ukuhlinzwa kulungiswe. Kodwa-ke, ngaphandle uma i-hernia isongela ukuthi ibe yiphuthumayo, ukuhlinzeka kungase kuhlehliswe kuze kube yilapho ingane ikhulile.
Izingane zivame ukubekezelela ukuhlinzeka kangcono kunezingane ezisanda kuzalwa, ngakho-ke kungase kuzuze ukulinda ngaphambi kokuhlinzwa.
Ukwelashwa kwabadala
Akuvamile ukuba umuntu omdala atholakale ene-hernia ye-epigastric ukuthi ayengazi ngaphambili kokuphila. Kungenzeka futhi ukuthi i-hernia eyaziwa ukuthi ikhona iminyaka eminingi ukuze ibe yinkinga njengeminyaka yobudala.
Kwabaningi, i-hernia ayibangeli izimpawu kuze kube kamuva ekuphileni ngenxa yokukhuluphala, ubuthakathaka obuthakathaka, noma ubunzima emdongeni wamasipha wesisu. Kulezi zimo, ukulungiswa kokuhlinzwa kungahle kudingeke uma i-hernia ibangela ubuhlungu noma isongela ukuba ilingiswe.
Uma Kuyisimo Esiphuthumayo
I-hernia ephoqelelwe endaweni "ngaphandle" ibhekiselwa njengenkosikazi yakhe eboshiwe. Ngenkathi i-hernia eboshiwe engeyona ephuthumayo, kufanele iqondiswe, futhi kufanele kutholakale ukunakekelwa kwezokwelapha. I-hernia eboshiwe yinto ephuthumayo uma iba "i-hernia ecacisiwe," lapho izicubu ezinama-bulges ngaphandle kwemisipha zibulawa yigazi layo. Lokhu kungabangela ukufa kwezicubu ezikhukhulayo phakathi kwe-hernia.
I-hernia ekhonjisiwe ingabonakala ngombala obomvu obomvu noma obomvu wezicubu ezinamandla. Kungase kuhambisane nobuhlungu obunzima, kodwa akusiyo njalo ubuhlungu. Ukudabuka, ukuhlanza, isifo sohudo, nokuvuvukala kwesisu kungaba khona.
Ukuhlinzwa
Ukuhlinzekwa kwe-epigastric hernia kwenziwa ngokujwayelekile ngokusebenzisa i- anesthesia ejwayelekile futhi kungenziwa ngesifo sengqondo noma isiguli . Uma isiguli esemncane, kunakekelwa okukhethekile okumele kuthathwe ngokulungiselela izingane ngokufanele ukuhlinzwa .
Lokhu kuhlinzekwa kwenziwa ngudokotela ohlinzayo jikelele noma ochwepheshe bekolon-rectal , uma isiguli ingane engumntwana udokotela ohlinzayo ogxile ekuzileni kwezingane ngokuvamile uqhuba inqubo.
Lapho sekuhlinzekwa i-anesthesia, ukuhlinzwa kuqala ngokuchotshozwa ohlangothini lwe-hernia. I- laparoscope ifakwe ekufakweni okukodwa, kanti enye isichazamazwi isetshenziselwa ezinye izinto zokuhlinzwa. Udokotela ohlinzayo wabe esehlukanisa ingxenye yesigcawu esiswini esiswini. Lezi zicubu zibizwa ngokuthi "i-hernia sac." Udokotela ohlinzayo ubuyela esikhwameni sakhe se-hernia endaweni yaso efanele, bese uqala ukulungisa ukukhubazeka kwesisipha.
Uma i-defect in muscle incane, kungenzeka ukuthi i- sutured ivaliwe. I-sutures izohlala endaweni enomphela, ivimbele ukuthi i-hernia ingabuyeli. Ngenxa yeziphambeko ezinkulu, udokotela ohlinzayo angase abe nomuzwa wokuthi ukukhwabanisa akukwanele.
Kulesi simo, i-graft graft izosetshenziselwa ukumboza umgodi. I-mesh ingunaphakade futhi ivimbela i-hernia ukuba ibuye, nakuba isici sihlala sivulekile.
Uma indlela ye-suture isetshenziselwa ukukhubazeka okukhulu kwemisipha (cishe ubukhulu bekota noma ngaphezulu), ithuba lokuphindaphindiwe landa. Ukusetshenziswa kwemifino emanzini amakhulu kunesidingo sokwelashwa, kodwa kungase kungabi kufanele uma isiguli sinomlando wokwenqaba izimila zokuhlinza noma isimo esivimbela ukusetshenziswa komshini.
Uma isikhunta sisekhona noma isisindo sesithunywe, i-laparoscope isusiwe futhi ukucubungula kungavalwa. Ukuchotshozwa kungavalwa ngenye yezindlela eziningana. Kungavalwa ngama-sutures asusiwe ekuvakashelweni okulandelwayo nodokotela ohlinzayo, uhlobo olukhethekile lweglue elisetshenziselwa ukubamba ukuchotshozwa kuvaliwe ngaphandle kwe-sutures, noma amabhandeki amancane anama-ster-strips.
Ukubuyisela
Iningi le-hernia iziguli liyakwazi ukubuyela emsebenzini walo ojwayelekile ngaphakathi kwamasonto amabili kuya kwamane. Iziguli ezigugile zithatha isikhathi eside. Isisu sizoba nesisa, ikakhulukazi ngesonto lokuqala. Ngalesi sikhathi, ukufakwa komzimba kufanele kuvikelwe ngesikhathi somsebenzi okwandisa ingcindezi yesisu ngokufaka isicelo eqinile kodwa ingcindezi emnene emgqeni wokungena .
Imisebenzi lapho ukufakwa komshini kufanele kuvikelwe kuhlanganisa:
- Ukuhamba esikhundleni sokulala ukuya endaweni ehlezi, noma kusuka endaweni ehlezi ukuma
- Sneezing
- Ukushaya
- Ukukhala, ikakhulukazi uma ingane iphenduka ebomvu ebusweni ngomzamo
- Ukuwa phansi ngesikhathi sokunyakaza kwamathumba
- Ukuvota
Umthombo:
> Lang B, u-Lau H, u-Lee F. U-Epistasty hernia kanye ne-etiology yakhe. Hernia 2002; 6: 148.