Kev Kho Craniosynostosis

Txoj kev kho Craniosynostosis yog kev phais kho kho qhov teeb meem uas ua rau tus pob txha ntawm tus menyuam pob txha taub hau loj hlob ua ke (fuse) ntxov dhau.

Qhov kev phais no tau ua nyob hauv chav ua haujlwm nyob hauv ib qho kev ua kom loog. Qhov no txhais tau tias koj tus menyuam yuav tsaug zog thiab nws yuav tsis hnov ​​mob. Qee lossis tag nrho cov plaub hau yuav tau chais.

Cov txheej txheem phais mob hu ua qhib kho. Nws suav nrog cov kauj ruam no:

• Feem ntau qhov chaw rau kev phais mob yuav tsum tau ua yog hla lub taub hau, txij li saum ib lub pob ntseg mus rau sab saum toj pob ntseg. Qhov txiav yog feem ntau laim ntoom. Qhov twg txiav yog ua raws li cov teeb meem tshwj xeeb.
• Ib qho nrov ntawm cov tawv nqaij, cov nqaij thiab cov leeg hauv qab daim tawv nqaij, thiab cov nqaij npog lub pob txha yuav xoob thiab tsa ceg kom tus kws phais yuav pom lub pob txha.
• Ib txoj hlua pob txha pob txha feem ntau yog muab tshem tawm thaum ob lub sutures yog fused. Qhov no yog hu ua sawb craniectomy. Qee zaum, cov pob txha loj yuav tsum tau muab tshem tawm thiab. Qhov no hu ua synostectomy. Qee qhov ntawm cov pob txha no tuaj yeem hloov lossis rov kho dua thaum lawv tshem. Tom qab ntawv, lawv muab tso rov qab. Lwm lub sijhawm, lawv tsis yog.
• Qee zaum, cov pob txha uas tseem nyob hauv qhov chaw xav tau txav los yog tsiv.
• Qee zaum, cov pob txha ncig lub qhov muag raug txiav thiab rov kho dua.
• Cov pob txha tau nrawm nrog siv cov phiaj me me nrog screws uas mus rau hauv pob txha taub hau. Cov paib thiab cov ntsia hlau tuaj yeem yog cov hlau lossis cov khoom siv dua tshiab (ploj dhau sijhawm). Cov phiaj yuav loj tuaj thaum lub pob txha pob txha loj tuaj.

Kev phais feem ntau siv 3 txog 7 teev. Koj tus menyuam tej zaum yuav tau txhaj ntshav thaum lub sijhawm lossis tom qab phais tas es hloov cov ntshav uas ploj thaum txoj kev phais mob.

Kev phais tshiab uas zoo dua yog siv rau qee tus menyuam. Hom no feem ntau ua rau cov menyuam yaus hnub nyoog qis dua 3 mus rau 6 hli.

• Tus kws phais yuav txiav ib lossis ob qhov me me txiav rau saum tawv taub hau. Feem ntau cov sij hawm txiav tawm no txhua tus tsuas yog 1 nti (2.5 centimeters) ntev. Cov kev txiav no yog ua rau saum thaj chaw uas yuav tsum tau ua pob txha.
• Ib txoj hlab siv (endoscope) dhau los ntawm kev txiav me me. Txoj kev tso cai ua rau tus kws phais neeg tuaj yeem saib thaj chaw uas tau ua haujlwm. Cov cuab yeej siv kho mob tshwj xeeb thiab lub koob yees duab tau dhau los ntawm qhov endoscope. Siv cov cuab yeej no, cov kws phais mob tshem tawm ntawm cov pob txha los ntawm kev txiav.
• Qhov kev phais no ib txwm siv li 1 teev. Muaj ntau ntau txo cov ntshav uas nrog hom kev phais ntshav.
• Feem ntau cov menyuam yaus yuav tsum tau ntoo kaus mom tshwj xeeb los tiv thaiv lawv lub taub hau ib ntus tom qab phais tas.

Cov menyuam yaus ua tau zoo tshaj plaws thaum lawv muaj qhov phais mob no thaum lawv muaj 3 hlis. Qhov phais yuav tsum tau ua ua ntej tus menyuam muaj 6 lub hlis.

Tus menyuam mos lub taub hau, lossis pob txha taub hau yog ua los ntawm yim pob txha txawv. Cov kev sib txuas ntawm cov pob txha no yog hu ua sutures. Thaum ib tus menyuam yug los, nws yog qhov ib txwm rau cov sutures qhib me ntsis. Tsuav ntev qhov sutures qhib, tus menyuam lub pob txha taub hau thiab lub paj hlwb yuav loj tuaj.

Craniosynostosis yog ib yam mob uas ua rau ib lossis ntau tshaj ntawm cov menyuam yaus kaw cia kom ntxov dhau. Qhov no tuaj yeem ua rau koj tus menyuam lub taub hau txawv dua li ib txwm. Nws tuaj yeem qee qhov kev txwv tias lub hlwb muaj ntau npaum li cas.

Kev siv duab xoo hluav taws xob lossis xoo tomography (CT) tuaj yeem siv los kuaj mob craniosynostosis. Kev phais feem ntau xav tau kho nws.

Kev phais mob txhaws kev rau yav tom ntej uas fused. Nws tseem rov kho lub pob tw, lub qhov muag thiab pob txha taub hau raws li xav tau. Lub hom phiaj ntawm kev phais mob yog:

• Txo kom lub siab ntawm tus menyuam lub hlwb
• Txhawm rau kom muaj chaw txaus hauv lub pob txha taub hau kom cia lub hlwb kom zoo
• Txhawm rau txhim kho cov ntsej muag ntawm tus me nyuam lub taub hau
• Txhawm rau tiv thaiv cov teeb meem neurocognitive ntev

Kev phom sij rau kev phais mob yog:

• Cov teeb meem ua pa
• Kev kis mob, suav nrog hauv lub ntsws thiab lub plab
• Ntshav poob (menyuam muaj qhib kho yuav xav tau ib lossis ntau dua ntshav)
• Kev tshuaj tiv thaiv

Kev phom sij rau qhov kev phais mob no yog:

• Kab mob hauv lub hlwb
• Cov pob txha txuas txuas ua ke dua, thiab xav tau kev phais mob ntxiv
• Lub hlwb o
• Kev puas tsuaj rau cov ntaub so ntswg hlwb

Yog tias qhov kev phais mob tau npaj tseg, koj yuav tsum ua raws li cov theem hauv qab no:

Thaum lub hnub ua ntej kev phais mob:

• Qhia koj tus kws kho mob tias yam tshuaj twg, cov vitamins, lossis tshuaj ntsuab uas koj muab rau koj tus menyuam. Qhov no suav nrog txhua yam uas koj yuav yam uas tsis tas sau ntawv yuav tshuaj. Koj yuav tau hais kom tsum tsis txhob muab tshuaj rau koj tus menyuam hnub ua ntej kev phais mob.
• Nug tus kws khomob uas koj tus menyuam yuav siv cov tshuaj hnub twg los phais.

Hnub ntawm kev phais:

• Muab dej me me haus nrog rau cov tshuaj uas koj tus kws kho mob tau hais kom koj muab rau koj tus menyuam.
• Koj tus kws kho mob yuav qhia koj thaum yuav txog qhov phais mob.

Nug koj tus kws kho mob yog tias koj tus menyuam tuaj yeem noj lossis haus ua ntej kev phais mob. Feem ntau:

• Cov menyuam hlob dua yuav tsum tsis txhob noj zaub mov lossis haus ib qho mis tom qab ib tag hmo ua ntej kev ua haujlwm. Lawv tuaj yeem muaj kua txiv ntshiab, dej, thiab niam mis txog 4 teev ua ntej kev phais mob.
• Cov menyuam mos uas yau dua 12 lub hlis feem ntau tuaj yeem noj mis nyuj, mis nyuj, lossis zaub mov menyuam mos kom txog 6 teev ua ntej kev phais mob. Lawv yuav muaj kua ntshiab thiab haus kua mis txog 4 teev ua ntej phais.

Koj tus kws kho mob yuav hais kom koj ntxuav koj tus menyuam nrog xab npum tshwj xeeb rau thaum sawv ntxov ntawm kev phais mob. Yaug koj tus menyuam kom zoo.

Tom qab phais tas, koj tus menyuam yuav raug coj mus nyob hauv tsev saib xyuas mob nkeeg (ICU). Koj tus menyuam yuav raug hloov mus nyob hauv chav tsev kho mob ib hnub dhau ib hnub lossis ob hnub. Koj tus menyuam yuav tau pw hauv tsev kho mob ntev li 3 txog 7 hnub.

• Koj tus menyuam yuav muaj ntau txoj phuam qhwv ncig ntawm lub taub hau. Kuj tseem yuav muaj ib txoj raj txuas rau hauv txoj hlab ntshav thiab. Qhov no hu ua IV.
• Cov kws tu neeg mob yuav saib xyuas koj tus menyuam kom zoo.
• Yuav kuaj seb koj tus menyuam puas tau ntshav ntau thaum phais mob. Yuav muab ntshav ntxiv rau, yog xav tau.
• Koj tus menyuam yuav o thiab tawv nqaij ncig ntawm lub qhov muag thiab lub ntsej muag. Qee zaum, lub qhov muag yuav o tuaj. Qhov no feem ntau mob heev ntxiv hauv thawj 3 hnub tom qab phais tus mob. Nws yuav tsum zoo dua nyob rau hnub 7.
• Koj tus menyuam yuav tsum tau nyob hauv txaj thawj ob peb hnub. Yuav tsa taub hau ntawm koj tus menyuam lub txaj. Qhov no yuav pab kom qhov o tuaj.

Kev hais lus, hu nkauj, ntaus nkauj, thiab hais dab neeg tej zaum yuav pab ua rau koj tus menyuam nyiam. Acetaminophen (Tylenol) yog siv rau mob. Koj tus kws kho mob tuaj yeem sau tshuaj rau lwm cov tshuaj rau qhov mob yog tias koj tus menyuam xav tau.

Cov menyuam yaus feem ntau uas tau phais qhov mob siab tuaj yeem mus tsev tom qab pw hauv tsev kho mob ib hmos.

Ua raws cov lus qhia muab rau koj txog kev saib xyuas koj tus menyuam nyob hauv tsev.

Feem ntau ntawm cov sij hawm, qhov tshwm sim los ntawm kev kho craniosynostosis yog qhov zoo.

Craniectomy - menyuam; Synostectomy; Sawb craniectomy; Pab tau craniectomy Endoscopy; Sagittal craniectomy; Kev loj hlob ntawm sab nraub qaum-orbital; FOA

• Coj koj tus me nyuam mus xyuas ib tug nus muag sib xws
• Tiv thaiv kev mob taub hau rau menyuam yaus

Demke JC, Tatum SA. Kev txiav txim siab Craniofacial rau kev yug txawv txav thiab tau txais cov deformities. Hauv: Flint PW, Francis HW, Haughey BH, li al, eds. Cummings Otolaryngology: Taub Hau Thiab Caj Dab. 7 tus ed. Philadelphia, PA: Elsevier; 2021: chap 187.

Gabrick KS, Wu RT, Singh A, Persing JA, Alperovich M. Radiographic mob hnyav ntawm cov kabmob craniosynostosis sib txheeb nrog cov txiaj ntsig neurocognitive ntev. Plast Reconstr Surg. 2020; 145 (5): 1241-1248. PMID: 32332546 pubmed.ncbi.nlm.nih.gov/32332546/.

Lin KY, Persing JA, Jane JA, thiab Jane JA. Nonsyndromic craniosynostosis: kev taw qhia thiab ib leeg-suture synostosis. Hauv: Winn HR, ed. Youmans thiab Winn Neurological phais. 7 tus ed. Philadelphia, PA: Elsevier; 2017: chap 193.

Proctor MR. Kev Kho Cov Kab Mob Endoscopic craniosynostosis. Txhais Pediatr. Xyoo 2014; 3 (3): 247-258. PMID: 26835342 pubmed.ncbi.nlm.nih.gov/26835342/.