Okuqukethwe
I-congenital pathology yezindebe, lapho izicubu ezithambile zingakhuli ndawonye, ibizwa nge-colloquially ngokuthi "cleft lip". Leli gama liqanjwe ngoba konogwaja udebe olungaphezulu luqukethe izingxenye ezimbili ezingahlanganiswanga.
Imvelo yesici iyafana naleyo "yolwanga oluqhekekile". Kodwa esimweni sokugcina, akuzona kuphela izicubu ezithambile ezingahlanganisi, kodwa futhi namathambo olwanga. Engxenyeni yamacala, izicubu zobuso azithinteki, futhi asikho isici sezimonyo. Kulokhu, kuyoba kuphela "umlomo wempisi".
Ulwanga oludabukile nezindebe zibizwa ngokwesayensi ngokuthi i-cheiloschisis. Le pathology yokuzalwa ivela esibelethweni, ngokuvamile ku-trimester yokuqala yokukhulelwa. Ngaphansi kwethonya lezici eziyingozi, ukuthuthukiswa komlomo, ulwanga kanye nenqubo ye-alveolar kuyaphazamiseka.
Izingane ezinodebe oluqhekekile azikwazi nje ukuba neziphambeko zangaphandle kuphela, kodwa futhi nokukhubazeka okukhulu kwamathambo ogebhezi. Ngenxa yalokhu, kukhona ubunzima ngokudla, inkulumo. Kodwa i-pathology ibangela izinkinga zomzimba kuphela - ukuhlakanipha kanye nengqondo yezingane ezinjalo zihlelekile.
Udebe oluvulekile olungadabukeki luyinkinga ethambile, njengoba kuthinteka izicubu ezithambile kuphela namathambo awakhubazekile.
Yini i-cleft lip
Ulwanga oluvulekile nezindebe zivela enganeni ezinyangeni zokuqala zokukhula. Kulapho-ke kwakheka khona umhlathi nobuso. Ngokujwayelekile, ngeviki le-11, amathambo olwanga ku-fetus akhula ndawonye, bese kwakheka ulwanga oluthambile. Ngenyanga yesi-2 kuya kweyesi-3, udebe olungenhla lubuye lwakhiwe, lapho izinqubo zomhlathi ongenhla kanye nenqubo ye-nasal median ekugcineni zihlanganiswa.
Izinyanga zokuqala zokukhulelwa zibaluleke kakhulu ekwakhiweni kwe-anatomy efanele yengane. Uma phakathi nalesi sikhathi izici ezingezinhle ezivela ngaphandle zithonya umbungu, ukwehluleka ekwakhekeni kwamathambo nezicubu ezithambile kungase kwenzeke, futhi udebe oluqhekekile lwenzeka. Izici zofuzo nazo zinendima.
Izimbangela zokuqhekeka kwezindebe ezinganeni
Udebe oluqhekekile lukhula ngaphansi kwethonya lezimbangela "zangaphakathi" kanye "nangaphandle". Isici sofuzo, ubuphansi bamangqamuzana amagciwane, ukukhipha isisu kusenesikhathi kungathinta ukukhula kombungu.
Azikho izifo eziyingozi lapho owesifazane eqala ukukhulelwa.
Amakhemikhali, imisebe, ukusebenzisa kukamama izidakamizwa, utshwala noma ukubhema kuba nomthelela omubi ekukhuleni kwe-intrauterine. Ukudla okunomsoco, i-beriberi, amakhaza nokushisa, ukuhlukumezeka kwesisu, i-fetus hypoxia nayo ithinta ukwakheka kwe-fetus.
Izimbangela ze-pathology zisacutshungulwa. Eziyinhloko zibalwe ngenhla, kodwa ezimweni ezingavamile, udebe oluqhekekile luba khona ngemva kokuzalwa. Ngemuva kokulimala, izifo, ukususwa kwezimila, ulwanga nezindebe kungalimala.
Izimpawu zokuqhekeka kwezindebe ezinganeni
Udebe oluqhekekile lwengane luvame ukutholwa ngisho nangaphambi kokuzalwa, ku-ultrasound scan ngemva kwamasonto angu-12 ekhulelwe. Ngeshwa, ngisho nalokhu kutholwa kusenesikhathi, akukho okungenziwa ngaphambi kokuba umntwana azalwe.
Ngemva kokuzalwa, umntwana ubonisa izindebe ezikhubazekile, ikhala, futhi mhlawumbe nolwanga oluqhekekile. Ifomu nezinga le-pathology linobunzima obuhlukahlukene - imifantu ingenzeka ngisho nhlangothi zombili. Kodwa ulwanga olunezinhlangothi ezihlukene nezindebe kuvame kakhulu.
Usana olunesici esinjalo aliliphathi kahle ibele, livame ukuklinywa, futhi liphefumule kancane. Ijwayele ukungenwa izifo ze-nasopharynx nendlebe ngenxa yokuguquguquka njalo kokudla ngomfantu kule ndawo.
Ukwelashwa kokuqhekeka kwezindebe ezinganeni
Kubalulekile ukuqonda ukuthi udebe oluhlukene ngokuvamile aluyona nje inkinga yezimonyo. Kuzofanele elashwe noma kunjalo, futhi esemncane kakhulu. Uma kungenjalo, ingane ngeke ikwazi ukuncela, ukugwinya ukudla ngendlela efanele, ngezinye izikhathi ukondla ngeshubhu kuyadingeka ngisho.
Ngaphandle kokwelashwa kwesici, ukulunywa kwakhiwa ngokungalungile, inkulumo iphazamiseka. Ukuhlukaniswa kwe-palate kuphazamisa i-timbre yezwi, izingane azikhulumi kahle futhi zikhulume "ngekhala". Ngisho nokuqhekeka kwezicubu ezithambile kuphela kuzophazamisa ukukhiqizwa kwenkulumo. Ukuvuvukala okuvamisile emakhaleni nasezindlebeni ngenxa ye-reflux yokudla kuholela ekulahlekelweni kokuzwa.
Ngemva kokuxilongwa, kwenziwa isinqumo ngokuhlinzwa kokuhlinzwa - azikho ezinye izindlela zokusiza ingane. Iminyaka umntwana ezohlinzwa ngayo inqunywa udokotela. Uma iphutha liyingozi kakhulu, ukusebenza kokuqala kungenzeka ngenyanga yokuqala yokuphila. Ngokuvamile kuhlehliswa kuze kube yizinyanga ezi-5 - 6.
Ukwelashwa kuqukethe izigaba eziningana, ngakho ukungenelela okukodwa kokuhlinzwa ngeke kusebenze. Ngisho nangaphambi kokuba ibe neminyaka emi-3, ingane kuyodingeka ihlinzwe izikhathi ezimbili kuya kweziyisi-2. Kodwa ngenxa yalokho, kuphela isibazi esingabonakali futhi mhlawumbe i-asymmetry encane yezindebe izosala. Zonke ezinye izinkinga zizoba ngemuva.
Diagnostics
Ukuxilongwa kokuqala kodebe oluqhekekile kwenziwa ngisho nangaphakathi esibelethweni kusetshenziswa i-ultrasound. Ngemva kokuzalwa kwengane enjalo, udokotela uhlola ubunzima be-pathology. Inquma ukuthi ukukhubazeka kuyivimbela kangakanani ingane ekudleni, kungakhathaliseki ukuthi kukhona ukuphazamiseka kokuphefumula.
Baphendukela osizweni lwabanye ochwepheshe: i-otolaryngologist, udokotela wamazinyo, uchwepheshe wezifo ezithathelwanayo. Ngaphezu kwalokho, ukuhlolwa kwegazi nomchamo okuvamile, i-biochemistry yegazi, i-x-ray yesifunda se-maxillofacial kunqunywa. Ukusabela kwengane emisindweni namaphunga kuyahlolwa - yilena ndlela ukuzwa nokuhogela, isimo sobuso kuhlolwa ngayo.
Ukwelashwa kwesimanje
Ukuze kuqedwe iphutha le-cleft lip, kusetshenziswa ukuhlinzwa kwepulasitiki. Odokotela bamaphrofayili ahlukahlukene bazobandakanyeka ekwelashweni kwezigaba eziningi. Ngaphambi kokuhlinzwa, ingane ivame ukugqoka i-obturator - idivayisi esebenza njengesithiyo phakathi kwemigodi yamakhala neyomlomo. Lokhu kuvimbela ukugeleza kokudla, kusiza ukuphefumula nokukhuluma ngendlela evamile.
Ngesici esincane, i-cheiloplasty eyodwa isetshenziswa - isikhumba, i-fiber, izicubu zemisipha kanye nezingqimba zezindebe zihlanganiswe ndawonye. Uma ikhala lithintekile, i-rhinocheiloplasty yenziwa, ilungisa ama-cartilages ekhaleni. I-Rhinognatocheiloplasty yakha uhlaka lwemisipha lwendawo yomlomo.
Ukuqhekeka kolwanga kuqedwa yi-uranoplasty. Ngokungafani nokusebenza kwangaphambilini, kwenziwa sekwephuzile kakhulu - ngeminyaka emi-3 noma emi-5. Ukungenelela kusenesikhathi kungalimaza ukukhula komhlathi.
Ukuhlinzwa okwengeziwe okwakha kabusha kuyadingeka ukususa izibazi, ukuthuthukisa inkulumo nobuhle.
Ngaphezu kokwelashwa okuhlinzayo, ingane idinga usizo lomelaphi wokukhuluma, ngoba kunzima kakhulu kubantwana abanjalo ukuphimisa imisindo ngendlela efanele kunakwabanye. I-otolaryngologist iqinisekisa ukuthi ukuzwa kwengane akuthinteki, futhi ukuphefumula kugcwele. Uma amazinyo engakhuli kahle, udokotela wamazinyo ufaka izinsimbi.
Ukulamba komoyampilo njalo ngenxa yokuphefumula okungajulile, ukukhuluphala ngokweqile kanye nokutheleleka ngezifo njalo kungaholela ekubukekeni okugulayo, ukukhula okuqinile.
Usizo lwesazi sokusebenza kwengqondo luzobaluleka ngokulinganayo, ngoba ngenxa yezimpawu zabo, izingane ezinodebe oluqhekekile zithola ubunzima ekuzivumelaniseni nezimo. Naphezu kweqiniso lokuthi ingqondo yezingane ezinjalo ihleleke ngokuphelele, zisengasilela emuva ekukhuleni. Ngenxa yezinkinga zengqondo, ukungafuni ukufunda ngenxa yokuxhashazwa ontanga, kuba nezinkinga ekufundeni. Ubunzima ekubizeni amagama bungaphazamisa ukuphila okwanelisayo. Ngakho-ke, kungcono ukuqeda zonke izigaba zokwelashwa ngaphambi kweminyaka yesikole.
Ukuvimbela ukuqhekeka kwezindebe ezinganeni ekhaya
Kunzima kakhulu ukugwema inkinga enjalo. Uma i-pathology enjalo ibonakala emndenini, ungathintana nesazi sofuzo ukuze uthole ukuthi kungenzeka yini ukuba nomntwana oqhekeke udebe.
Kubalulekile ukuzinakekela ngokukhethekile emasontweni okuqala okukhulelwa - gwema izifo, ukulimala, ukudla kahle. Njengendlela yokuvimbela, abesifazane abakhulelwe bathatha i-folic acid.
Kudingeka ukuhlonza inkinga kusenesikhathi, ngisho nasesibelethweni. Njengoba ulwanga oluqhekekile nezindebe kungabangela izinkinga ezengeziwe ngesikhathi sokubeletha, udokotela kufanele aqaphele. Ngesikhathi sokubeletha, ingozi ye-amniotic fluid ingena emgudwini wokuphefumula wengane iyanda.
Ngemuva kokuzalwa kwengane enodebe oluqhekekile, kuyadingeka ukwenza ukuxilongwa okuphelele, uthintane nochwepheshe futhi uhlole ubukhulu be-pathology. Uma odokotela bephikelela ekuhlinzweni kusenesikhathi, ingane iyakudinga ngempela.
Izinyanga zokuqala neminyaka yokuphila komntwana onjalo kuyoba nzima, ukondla kunzima futhi abazali kudingeka balungiselele lokhu. Kodwa ungakhohlwa ukuthi ngemva kwazo zonke izigaba zokwelashwa, ingane izoba nempilo ephelele futhi inkinga izosala ngemuva.
Imibuzo nezimpendulo ezidumile
Udokotela wezingane uhlala engudokotela oyinhloko wengane ene-cleft lip - ubeka ukuhlolwa okwengeziwe, ubhekisela kochwepheshe emincane. Funda kabanzi ngale pathology udokotela wezingane uDaria Schukina.