Mphanga mlomo ndipo m'kamwa: chifukwa ndi chilangizo

Kubadwa kwa mwana - ndi nthawi yaitali mphindi ambiri. Koma pali nthawi zina pamene uthenga wabwino akutsatiridwa ndi zochitika zimene makolo sanakonzekere pasadakhale. zinthu zimenezi ndi kobadwa nako anomalies ndi zilema kuti mdima maonekedwe a kubadwa kwa mwana.

Mphanga mlomo ndipo m'kamwa - ambiri kubadwa chilema munthu. Anthu anomaly amatchedwa "zaychey mlomo" (mphanga mlomo) ndi "abadwe" (abadwe). mapangidwe awo chikuchitika mu trimester mimba, kuchokera 5 sabata 11 chitukuko embryonic.

etiology

"Zaychey mlomo" akutchedwa anomaly, amene amakhala ndi kusapezeka tsankho kapena wathunthu wa adhesions wa zimakhala za mlomo chapamwamba. Amatha ngati boma palokha, ndipo akhoza pamodzi ndi vuto.

"Abadwe" - kusiyana, abadwe mu chapakati kapena mbali gawo. Mwina inali mu makamaka dera (zapambuyo fupa kapena zofewa minofu zapambuyo m'kamwa), kapena kuwonjezera utali wonse.

Pa thupi la mayi ali woyembekezera akhoza linapuwalanso ndi zinthu zingapo, chifukwa mu maonekedwe a anomalies monga mphanga mlomo ndipo m'kamwa. Zimayambitsa wa pathologies zotsatirazi:

1. Cholowa chimene chingawapangitse kukhala zidakwa - munthu amene anabadwa ndi mphanga, pali kuthekera kusamutsa chikhalidwe ichi tinatengera mwana wake mu 7-10% ya milandu.
2. Disease chiyambi tizilombo, anasamutsira mayi ake trimester mimba (chikuku, cytomegalovirus, matenda nsungu HIV, toxoplasmosis).
3. Umalemera mmene chilengedwe ndi cheza m'dera la akazi moyo pa nthawi ya adanyamula mwana.
4. matenda aakulu ndi utsogoleli wa mankhwala ndi teratogenic mu moyo wawo.
5. oipa mayi (mowa, kusuta fodya, kugwiritsa ntchito mankhwala chomwa mankhwalawa).

Gulu la mphanga mlomo ndipo m'kamwa

Pa chifukwa cha maonekedwe anatomical ndi thupi la gulu la m'mapanga wakhala otukuka. Pakuti mayiko, ife azipereka mfundo tebulo.

gulu	subgroups	Features subgroups
Wakutali mphanga mlomo	submucous	C 1 mbali 2 mbali
	Chosakwanira (s mphuno mapindikidwe kapena popanda)	C 1 mbali 2 mbali
	zonse	C 1 mbali 2 mbali
Wakutali abadwe	Amene bwanji okha dera m'kamwa zofewa	Submucous, chosakwanira, wathunthu
	Anthu amene amakhudza dera la m'kamwa zofewa ndi zovuta	Submucous, chosakwanira, wathunthu
Complete abadwe ndi alveolar fupa	C 1 mbali 2 mbali
Mphanga ya gawo zapambuyo wa m'kamwa zofewa, chapamwamba mlomo ndipo alveolar fupa	C 1 mbali 2 mbali
Looping mphanga zokhudza mlomo chapamwamba, alveolar ndondomeko, zovuta ndi yofewa m'kamwa	C 1 mbali	Kumanja chimanjamanja, wamanzere
	C 2 mbali
Mphanga mlomo ndipo m'kamwa (chithunzi m'munsimu), atypical chikhalidwe

diagnostics

Kudwala akufotokozera nthawi ya mimba. Kobadwa nako mphanga mlomo ndipo m'kamwa kale visualized pa sabata 16-20 chitukuko embryonic. Ngati zonse 3 lalikulu ultrasound kumupima mwana akasiya unit kachipangizo kuti n'ngoonekeratu dongosolo akhale onama chifukwa kafukufuku.

Reviews makolo, amene pambuyo pake ana ndi anomalies kobadwa nako, kutsimikizira kuti n'zotheka positives wabodza, ndi malangizo onse. Ena amanena kuti mwana wabadwa odwala, ndi chifukwa mwanayo palibe kusiyana ndi anzawo. Kapena M'malo mwake, makolo sankakayikira thanzi wamphamvu mwana, ndipo iye anabadwa ndi matenda.

Kudyetsa mwana ndi chosayenerera ndi

Chisanafike kuti vutolo, muyenera kuthetsa nkhani ndi mwana mphamvu zoyendera. Kudyetsa ana ndi mphanga mlomo ndipo m'kamwa ndi osiyana, kotero amayi ayenera kutsatira malamulo, amene ikhoza kusintha kutengera mawonekedwe a kudwala.

Ngati mwana ali anomaly yekha mu kapangidwe ka milomo, mavuto ndi adani a nipple ndi woyamwa milomo yake iye sadzatero. Mphanga mlomo ndipo m'kamwa kapena kumwamba kokha kumafuna ena zosintha chakudya kudya mwana kuyambira kutsegula pakati pa m'mphuno ndi m'kamwa M'mimbamo akhoza kuyenda mu mkaka, ndipo palibe kuthamanga wofunikila woyamwa ndondomeko.

Kodi mkaka umalowa mu m'mphuno, ndi mpweya chimodzimodzi amalowa pakamwa ndi moyenera, mmimba. Ana amafunika nthawi yaitali yopingasa malo atatha kudya ndi thovu owonjezera mpweya kunja. Miyezi ya moyo limodzi ndi colic pafupipafupi, regurgitation, angafikire ngakhale kuti kusanza.

kudyetsa malamulo:

1. Gwiritsani ntchito kapena kuyamwitsa, kapena mwa mabotolo kudya (kuchokera ku chikho kapena supuni Sikuti kudyetsa).
2. Massaging mawere pamaso kudyetsa. Izi kuwonjezera kuchuluka kwa mkaka kuchita reflexively, ndi mwana alibe khama khama.
3. Kusunga malamulo a pa ankafuna kudya. Nthawi zambiri kuika mwana bere.
4. Kuchititsa chala kufinya kwa areola, amene amalola kuonjezera protrusion wa nipple lapansi. Ngati ndi kotheka, ntchito ziyangoyango wapadera, kusankha kukula kwa mkamwa mwanayo.
5. Ngati mwakumana ndi zatsalira unsaturated mwana mkaka kusonkhanitsa chifuwa mpope ndi kudya zapadera ku botolo. nipple nayenso anasankha payekha, kutenga nkhani mbali anatomical.

Malangizo chithandizo

Ana ndi mphanga mlomo ndipo m'kamwa akufunikira opaleshoni. Izi ndi zofunika osati kuchotsa zopindika zodzikongoletsera, komanso kubwezeretsa ntchito ya thirakiti m'mimba ndi dongosolo kupuma.

Masiku a ntchito, chiwerengero chawo, kuchuluka kwa alowererepo imalongosola yokha opaleshoni. Mphanga mlomo ndipo m'kamwa atachotsedwa njira zotsatirazi:

• chiloplasty;
• rinoheyloplastika;
• rinoheylognatoplastika;
• veloplastika;
• palatoplastika;
• fupa kumezetsanitsa.

zikunena zonsezi chachikulu mphanga opaleshoni. M'tsogolo kungafune ntchito yachiwiri yomwe ndi mbali ya malangizo maonekedwe ndi zotsatira yotsalira.

Rinoheyloplastika

opaleshoni Izi kubwezeretsa anatomical ndi thupi makhalidwe a mphuno ndi chapamwamba mlomo. Mphanga mlomo ndipo m'kamwa si kunatha alowererepo zimenezi, koma kuti tikonzedwe "milomo zaychey" rinoheyloplastika ankaona ndondomeko wosankha.

Ntchito madokotala:

• Kubwezeredwa kwa dongosolo minofu ya Mlomo chapamwamba;
• Kudzudzulidwa wofiira malire;
• mapangidwe wamuyezo buccal M'mimbamo;
• kubwezeretsa pamalo olondola a mphuno;
• ndi chosokonekera wa uphunguwo;
• kupanga pansi pa ndime m'mphuno.

Nthawi zambiri, njira imeneyi ntchito, kotero kuti mabala zinkaoneka ngati zazing'ono ngati n'kotheka. N'zoona kusokonezedwa njira osankhidwa, mlingo wa mapindikidwe minofu pulayimale ndi kukonza chichereŵechereŵe ndi choyenera postoperative nyengo - zinthu zimene kudziwa kufunika opaleshoni sekondale pambuyo kuchira kwathunthu kwa mtima.

Unilateral pathological ndondomeko amalola opareshoni kukwaniritsa 3-amwezi mwana ziwiri - patapita miyezi isanu. Pambuyo mapulasitiki mwana kudyetsedwa kaya ndi supuni kapena kudzera chubu nasogastric, malingana ndi chikhalidwe ambiri ndi zaka za wodwalayo. Patapita masiku 3-4, inu mukhoza kubwerera njira kuti ntchito zonse.

Rinoheylognatoplastika

Ana ndi mphanga mlomo ndipo m'kamwa akhoza muchisiye matenda kudzera mwa alowererepo zimenezi. Opaleshoni imeneyi umalimbana kuchotsa anatomical matenda mphuno, chapamwamba mlomo ndipo alveolar fupa. Amalola kudzudzulidwa kudzera zopindika. Amgwirizano mphanga mlomo ndipo m'kamwa - chimodzi mwa zizindikiro kwa rinoheylognatoplastike.

The mulingo woyenera kwambiri nthawi ya opaleshoni ali wakhanda mpaka occlusion okhazikika komabe athanzi ndipo sichinafikebe teething canines chapamwamba.

Veloplastika

Mphanga mlomo ndipo m'kamwa abwezeretsedwa ndi imodzi ntchito njira angapo kugwira ntchito. Akatswiri ndi zinthu ophatikizana heylorinoplastiki veloplastiki (kuwukonza m'kamwa zofewa). alowererepo imachitidwa ndi zolinga izi:

• kubwezeretsa Pomeza ntchito;
• kupuma kudzudzulidwa ndondomeko;
• kubwezeretsa phonation kutukwana.

Ngati mwana angaphunzire kudya, kotero kuti chakudya si kutayikira kuchokera mkamwa mphuno, ndi zida amapilira ndi woipa. kusintha kwenikweni mu kulankhula sangakhale kudziletsa Kukonza. Izi ndi zofunika mu zaka zingapo choyamba, mwana amaphunzira kulankhula ndi kupanga maluso awo (akuimba, pobwereza ndakatulo).

Veloplastika inachitika kuyambira miyezi 8 zakubadwa. Kawirikawiri opaleshoni bwino analekerera, ndipo pakutha masiku 1-2, mwanayo akhoza kudya paokha.

Palatoplastika

Ana ndi mphanga mlomo ndipo m'kamwa (kulemala a ana amenewa ali mu funso) kungafune magawo angapo a opareshoni, yomwe ikuchitika fupipafupi. Ngati chilema kubadwa anakhudzidwa osati Mlomo, alveolar fupa ndi m'kamwa zofewa, komanso m'kamwa molimbika, boma kumasonyeza kuti palatoplastiki.

Pambuyo kukonzedwa kwa thunthu la m'kamwa kusiyana zofewa mu olimba basi mwapang'ono. Ndi zaka 3-4 amakhala choncho wopanikiza mukhoza kubwezeretsa kukhulupirika popanda matenda yaikulu zoopsa. Chotero tsatane awiri kudzudzulidwa Ubwino:

• zinthu oyambirira kuchira pa chitukuko yachibadwa mbali kulankhula;
• kumulepheretsa chisokonezo kukula mu mabacteria la nsagwada chapamwamba.

-Sitepe imodzi pochira zotheka, koma mu nkhani iyi kumaonjezera ngozi ya underdevelopment la nsagwada chapamwamba.

fupa kumezetsanitsa

Opaleshoni imeneyi imagwiridwa ndi dokotala, koma mgwirizano ndi orthodontist lapansi. Ikuchitika pa kusintha kwa nthawi yochepa occlusion okhazikika (zaka 7-9). Pa alowererepo kutenga kumezanitsa ku tibia fupa la wodwalayo, ndi kuziika mu dera mphanga alveolar fupa. The kumezanitsa angathe kubwezeretsa umphumphu wa fupa la nsagwada chapamwamba ndi kulenga zinthu mulingo woyenera kuphulika kwa mano okhazikika.

opaleshoni yachiwiri

Mphanga mlomo ndipo m'kamwa - ndi kobadwa nako anomaly kuti akhoza kusiya kufufuza pa nkhope ya munthu moyo wake wonse. odwala ambiri amafuna kuchita sekondale maopaleshoni pulasitiki, cholinga chimene chiri motere:

• kudzudzulidwa maonekedwe;
• ayambe ntchito mau;
• Kupha aya nthenda pakati cavities awiri (m'mphuno m'kamwa);
• kuyenda ndi olimba a nsagwada chapamwamba.

1. Upper mlomo

Ambiri odwala amene akufuna kugwira kuwukonza mlomo chapamwamba, kuganizira awo pa chakuti pambuyo alowererepo koyamba anali zam'mimba. Chilakolako kuthetsa ndi kumabweretsa dokotala wa. Kumbukirani kuti chilonda kapena chipsera zikhoza kupangidwa osaonekera kuchepa kuchuluka, koma sikutheka kwathunthu muchisiye izo.

kupsyinjika pafupipafupi:

• zobwera kupinda wofiira malire;
• asymmetry;
• kuphwanya ntchito akulu dongosolo;
• nthenda chidzalo.

2. Mphuno

Anomalies wa mlomo chapamwamba pamodzi ndi chilema m'mphuno. mphuno Secondary opaleshoni chofunika pafupifupi odwala onse. Mlingo wa mapindikidwe zimadalira kukula kwa matenda chachikulu. Kukonza asymmetry, maonekedwe zokongoletsa, kubwezeretsa kwa amphuno septum umachitika rhinoplasty.

kusintha Minor kuti amafunika kudzudzulidwa angathe kuchitidwa ana aang'ono. Yaikulu alowererepo analola zaka pokhapokha 16-17, pamene mafupa a nkhope athanzi.

3. m'kamwa zofewa

Chifukwa cha mphako zovuta opaleshoni yaikulu awo velofaringealnaya akhale osakwanira. Ndi chikhalidwe pathological kugwirizana ndi mawu m'mphuno, slurred kulankhula. Opaleshoni njira umalimbana kuchotsa kulankhula chilema.

ntchito amaloledwa pa m'badwo uliwonse, koma patsogolo ndi bwino kufunsa ndikuphunzitsidwa kulankhula, n'kutsimikizira kuti n'zosatheka kulankhula zokhudzana m'njira zina.

Ndi msanga kuti aone chifukwa cha ntchito pa m'kamwa zofewa n'zosatheka, chifukwa dongosolo akulu a dera ndi yovuta kwambiri kusokonezedwa kunja, kutanthauza kuti amamuyambitsa timabala pambuyo opaleshoni yaikulu ndi nthawi yaikulu. Kubwezeretsa zinthu zinchito kuchita mwai izi:

• kukonzanso minofu plasty popanda kapena ndi elongation munthawi yomweyo;
• pulasitiki zofewa m'kamwa ntchito pharyngeal khumudwitsidwa.

Nkhani ina mochedwa nthawi postoperative ndi kuthana ndi aluso logopedist kumva dokotala.

4. Oronazalnye fistula

Izi ndi vuto wamba odwala unathandizira pa mphanga mlomo ndipo m'kamwa. Fistula ndi kutsegula pakati pa cavities awiri. Pafupipafupi kutanthauzira - m'dera la fupa alveolar, m'kamwa molimbika. Ndili wamng'ono, mipata zoterezi chifukwa chotenga chakudya mu mphuno, koma ana kuphunzira kuugwira chikhalidwe. Chifukwa amakhala m'mphuno ndi mawu slurred.

Kuchotsa fistulas oronazalnyh adatengedwa ndi fupa kumezetsanitsa kupanga pansi pa ndime m'mphuno.

Pomaliza

Mphanga mlomo ndipo m'kamwa, imene chilema amakhalabe funso amatanthauza chikhalidwe kobadwa nako. Pankhani ya osakaniza amgwirizano kudwala aakulu ndi anomalies ena angalandire chilema.

Pamaso pa matenda chimodzi palibe okhudzidwa anomalies kobadwa nako khalidwe chokhazikitsidwa chotero, kuti samaletsa munthu payekhapayekha kudzisamalira osati limodzi ndi kuvutika m'madera ena (maganizo, maganizo chipangizo). Zikatero matenda, wodwala safuna kuzindikira yosagwira ntchito.