Cleft di ncauj nyob rau hauv cov me nyuam

Congenital pathology ntawm daim di ncauj, nyob rau hauv uas cov ntaub so ntswg mos tsis loj hlob ua ke, yog colloquially hu ua "cleft di ncauj". Lub npe no yog muab vim hais tias nyob rau hauv hares lub sab sauv di ncauj muaj ob halves uas tsis fused ua ke.

Qhov xwm ntawm qhov tsis xws luag yog tib yam li ntawm "cleft palate". Tab sis nyob rau hauv rooj plaub tom kawg, tsis tsuas yog cov ntaub so ntswg mos tsis fuse, tab sis kuj cov pob txha ntawm palate. Hauv ib nrab ntawm cov xwm txheej, cov ntaub so ntswg ntawm lub ntsej muag tsis cuam tshuam, thiab tsis muaj qhov tsis xws luag. Hauv qhov no, nws tsuas yog "hma lub qhov ncauj".

Lub cleft palate thiab daim di ncauj yog scientifically hu ua cheiloschisis. Qhov no congenital pathology tshwm sim nyob rau hauv lub tsev menyuam, feem ntau nyob rau hauv thawj peb lub hlis twg ntawm cev xeeb tub. Raws li kev cuam tshuam ntawm cov teeb meem tsis zoo, kev txhim kho ntawm daim di ncauj, palate thiab alveolar txheej txheem cuam tshuam.

Cov menyuam yaus uas muaj daim di ncauj cleft tuaj yeem tsis tsuas yog muaj qhov tsis xws luag, tab sis kuj tseem muaj qhov cuam tshuam loj ntawm cov pob txha taub hau. Vim li no, muaj teeb meem nrog kev noj haus, kev hais lus. Tab sis pathology tsuas yog ua rau muaj teeb meem ntawm lub cev - kev txawj ntse thiab lub siab lub ntsws ntawm cov me nyuam mos yog nyob rau hauv kev txiav txim zoo.

Cleft di ncauj tsis muaj cleft palate yog ib qho mob me me, vim tias tsuas yog cov ntaub so ntswg raug cuam tshuam thiab cov pob txha tsis deformed.

Dab tsi yog cleft di ncauj

Cleft palate thiab di ncauj tshwm nyob rau hauv tus me nyuam nyob rau hauv thawj lub hlis ntawm kev loj hlob. Nws yog tom qab ntawd lub puab tsaig thiab lub ntsej muag raug tsim. Feem ntau, los ntawm 11 lub lis piam, cov pob txha ntawm lub palate nyob rau hauv lub fetus loj hlob ua ke, thiab tom qab ntawd cov palate yog tsim. Nyob rau lub hli thib 2 txog 3, daim di ncauj sab sauv kuj tsim, thaum cov txheej txheem ntawm lub puab tsaig sab sauv thiab cov txheej txheem qhov ntswg nruab nrab yog thaum kawg fused.

Thawj lub hlis ntawm cev xeeb tub yog qhov tseem ceeb tshaj plaws rau kev tsim lub cev ntawm tus menyuam kom raug. Yog hais tias lub sij hawm no lub sij hawm tsis zoo los ntawm sab nraud cuam tshuam lub embryo, ib tug tsis ua hauj lwm nyob rau hauv lub tsim ntawm cov pob txha thiab cov ntaub so ntswg mos yuav tshwm sim, thiab ib tug cleft di ncauj tshwm sim. Cov yam ntxwv ntawm caj ces kuj ua lub luag haujlwm.

Ua rau ntawm daim di ncauj cleft nyob rau hauv cov me nyuam

Daim di ncauj cleft tsim nyob rau hauv kev cuam tshuam ntawm "sab hauv" thiab "sab nraud" ua rau. Ib qho laj thawj, kev ua tsis zoo ntawm cov kab mob, kev rho menyuam ntxov tuaj yeem cuam tshuam rau kev loj hlob ntawm tus menyuam hauv plab.

Tsis muaj kev phom sij tsawg dua uas tus poj niam raug kev txom nyem thaum cev xeeb tub.

Tshuaj, hluav taws xob, leej niam noj tshuaj, cawv lossis haus luam yeeb ua rau muaj kev cuam tshuam rau kev loj hlob ntawm lub cev. Kev noj zaub mov tsis zoo, beriberi, txias thiab cua sov, mob plab, fetal hypoxia kuj cuam tshuam rau kev tsim ntawm fetus.

Cov laj thawj ntawm pathology tseem tab tom kawm. Cov tseem ceeb tau teev saum toj no, tab sis muaj tsawg zaus, daim di ncauj cleft tsim tom qab yug me nyuam. Tom qab raug mob, kis kab mob, tshem tawm cov qog, lub palate thiab daim di ncauj tuaj yeem puas.

Cov tsos mob ntawm daim di ncauj cleft nyob rau hauv cov me nyuam

Tus me nyuam daim di ncauj cleft feem ntau pom txawm tias ua ntej yug los, ntawm kev kuaj ultrasound tom qab 12 lub lis piam ntawm cev xeeb tub. Hmoov tsis zoo, txawm tias qhov kev tshawb pom ntxov no, tsis muaj dab tsi ua tau ua ntej tus menyuam yug los.

Tom qab yug me nyuam, tus me nyuam qhia tau hais tias deformed daim di ncauj, qhov ntswg, thiab tej zaum ib tug cleft palate. Daim ntawv thiab qib ntawm pathology yog sib txawv heev - crevices yog ua tau txawm nyob rau ob sab. Tab sis unilateral cleft palate thiab daim di ncauj yog ntau dua.

Tus menyuam mos uas muaj qhov tsis xws luag yuav siv lub mis tsis zoo, feem ntau chokes, thiab ua pa qis. Nws yog nquag mus rau kab mob ntawm nasopharynx thiab pob ntseg vim nquag reflux ntawm cov zaub mov los ntawm lub cleft nyob rau hauv cov cheeb tsam no.

Kev kho ntawm daim di ncauj cleft nyob rau hauv cov me nyuam

Nws yog ib qho tseem ceeb kom nkag siab tias daim di ncauj cleft feem ntau tsis yog ib qho teeb meem ntawm lub ntsej muag xwb. Txawm li cas los xij, nws yuav tsum tau kho, thiab thaum muaj hnub nyoog ntxov heev. Txwv tsis pub, tus me nyuam yuav tsis muaj peev xwm nqus tau, nqos cov zaub mov kom raug, qee zaum txawm tias yuav tsum pub noj los ntawm lub raj.

Yog tsis muaj kev kho mob ntawm qhov tsis xws luag, qhov tom yog tsim tsis raug, kev hais lus cuam tshuam. Kev sib cais ntawm lub palate cuam tshuam lub suab ntawm lub suab, cov menyuam yaus tsis hais suab zoo thiab hais "los ntawm lub qhov ntswg". Txawm tias ib qho cleft nkaus xwb nyob rau hauv cov ntaub so ntswg mos yuav cuam tshuam nrog kev tsim cov lus. Nquag o nyob rau hauv lub qhov ntswg kab noj hniav thiab pob ntseg vim reflux ntawm cov zaub mov ua rau tsis hnov ​​lus.

Tom qab kev kuaj mob, kev txiav txim siab raug txiav txim siab ntawm kev phais - tsis muaj lwm txoj hauv kev los pab tus menyuam. Lub hnub nyoog ntawm tus me nyuam yuav ua haujlwm yog txiav txim los ntawm tus kws kho mob. Yog tias qhov tsis xws luag yog qhov txaus ntshai heev, thawj qhov kev ua haujlwm yog ua tau hauv thawj lub hlis ntawm lub neej. Feem ntau nws yog ncua mus txog 5 - 6 lub hlis.

Kev kho mob muaj ntau theem, yog li ib qho kev phais yuav tsis ua haujlwm. Txawm tias ua ntej hnub nyoog 3 xyoos, tus me nyuam yuav tau mus txog 2 mus rau 6 txoj haujlwm. Tab sis raws li qhov tshwm sim, tsuas yog ib qho tsis tshua pom qhov caws pliav thiab tej zaum yuav muaj me ntsis asymmetry ntawm daim di ncauj yuav nyob twj ywm. Tag nrho lwm yam teeb meem yuav nyob tom qab.

diagnostics

Thawj qhov kev kuaj mob ntawm daim di ncauj cleft yog nqa tawm txawm nyob rau hauv lub tsev menyuam siv ultrasound. Tom qab yug me nyuam xws li ib tug me nyuam, tus kws kho mob soj ntsuam qhov hnyav ntawm pathology. Nws txiav txim siab npaum li cas qhov tsis xws luag tiv thaiv tus menyuam noj, txawm tias muaj teeb meem ua pa.

Lawv mus rau kev pab los ntawm lwm tus kws tshaj lij: tus kws kho mob otolaryngologist, kws kho hniav, tus kws kho mob tshwj xeeb. Tsis tas li ntawd, kev kuaj ntshav thiab zis, ntshav biochemistry, x-rays ntawm cheeb tsam maxillofacial raug sau tseg. Cov tshuaj tiv thaiv ntawm tus menyuam rau lub suab thiab hnov ​​tsw yog kuaj - qhov no yog qhov kev hnov ​​​​lus thiab hnov ​​​​tsw, ntsuas lub ntsej muag.

Kev kho mob niaj hnub

Txhawm rau tshem tawm qhov tsis xws luag ntawm daim di ncauj cleft, kev phais yas yog siv. Cov kws kho mob ntawm ntau yam profiles yuav koom nrog kev kho mob ntau theem. Ua ntej kev phais, tus me nyuam feem ntau hnav obturator - ib qho cuab yeej uas ua rau lub qhov ntswg thiab qhov ncauj. Qhov no tiv thaiv reflux ntawm cov zaub mov, pab ua pa thiab tham ib txwm.

Nrog rau qhov tsis xws luag, cais cheiloplasty yog siv - daim tawv nqaij, fiber ntau, cov leeg thiab cov mucous txheej ntawm daim di ncauj yog sewn ua ke. Yog tias qhov ntswg raug cuam tshuam, rhinocheiloplasty yog ua, kho cov pob txha mos ntawm lub qhov ntswg. Rhinognatocheiloplasty tsim cov leeg nqaij ntawm lub qhov ncauj.

Cleavage ntawm palate yog tshem tawm los ntawm uranoplasty. Tsis zoo li kev ua haujlwm dhau los, nws tau ua tiav lig - los ntawm 3 lossis 5 xyoos. Kev cuam tshuam thaum ntxov tuaj yeem ua rau lub puab tsaig loj hlob.

Yuav tsum muaj kev phais ntxiv kom tshem tawm cov caws pliav, txhim kho kev hais lus thiab kev zoo nkauj.

Ntxiv nrog rau kev kho mob phais, tus menyuam xav tau kev pab los ntawm tus kws kho hais lus, vim nws nyuaj rau cov menyuam yaus hais suab kom raug dua li lwm tus. Tus kws kho mob otolaryngologist kom paub tseeb tias tus menyuam tsis hnov ​​lus tsis cuam tshuam, thiab ua pa puv. Yog hais tias cov hniav tsis loj hlob zoo, tus kws kho hniav txhim kho braces.

Kev tshaib plab tsis tu ncua ntawm cov pa oxygen vim ua tsis taus pa, qhov hnyav nce thiab nquag kis tau tuaj yeem ua rau mob hnyav, kev loj hlob stunted.

Kev pab ntawm tus kws kho mob hlwb yuav yog qhov tseem ceeb sib npaug, vim tias vim lawv cov yam ntxwv, cov menyuam yaus uas muaj daim di ncauj cleft ntsib teeb meem hauv kev hloov kho. Txawm tias muaj tseeb hais tias lub siab ntawm cov me nyuam no nyob rau hauv zoo meej kev txiav txim, lawv muaj peev xwm tseem lag qab nyob rau hauv kev loj hlob. Vim muaj teeb meem kev puas siab puas ntsws, tsis kam kawm vim kev thab plaub los ntawm cov phooj ywg, muaj teeb meem hauv kev kawm. Nyuaj hauv kev hais lus ntawm cov lus tuaj yeem cuam tshuam rau lub neej ua tiav. Yog li ntawd, nws yog qhov zoo dua los ua kom tiav txhua theem ntawm kev kho mob ua ntej hnub nyoog kawm ntawv.

Kev tiv thaiv ntawm daim di ncauj cleft hauv cov menyuam yaus hauv tsev

Nws yog qhov nyuaj heev kom tsis txhob muaj teeb meem zoo li no. Yog hais tias xws li ib tug pathology tau soj ntsuam nyob rau hauv tsev neeg, koj muaj peev xwm sab laj ib tug kws tshuaj ntsuam geneticist kom paub seb yuav muaj ib tug me nyuam nrog ib tug cleft di ncauj.

Nws yog ib qho tseem ceeb uas yuav tau saib xyuas koj tus kheej tshwj xeeb hauv thawj lub lim tiam ntawm cev xeeb tub - tsis txhob kis kab mob, raug mob, noj kom zoo. Raws li kev tiv thaiv, cov poj niam cev xeeb tub noj folic acid.

Nws yog ib qho tsim nyog kom kuaj xyuas qhov teeb meem sai li sai tau, txawm tias nyob hauv plab. Txij li thaum cleft palate thiab di ncauj tuaj yeem ua rau muaj teeb meem ntxiv thaum yug menyuam, tus kws kho mob yuav tsum paub. Thaum yug me nyuam, qhov kev pheej hmoo ntawm cov kua amniotic nkag mus rau tus menyuam txoj kev ua pa yuav nce.

Tom qab yug me nyuam nrog daim di ncauj cleft, nws yog ib qho tsim nyog yuav tau ua tiav kev kuaj mob, sab laj nrog kws kho mob thiab tshuaj xyuas qhov hnyav ntawm pathology. Yog tias kws kho mob hais kom ua haujlwm ntxov, tus menyuam xav tau tiag tiag.

Thawj lub hlis thiab xyoo ntawm lub neej ntawm tus menyuam yaus no yuav nyuaj, kev pub mis yog qhov nyuaj thiab cov niam txiv yuav tsum tau npaj rau qhov no. Tab sis tsis txhob hnov ​​​​qab tias tom qab txhua theem ntawm kev kho mob, tus me nyuam yuav noj qab nyob zoo thiab qhov teeb meem yuav raug tso tseg.

Nrov lus nug thiab lus teb

Tus kws kho mob tseem yog tus kws kho mob tseem ceeb rau tus menyuam uas muaj daim di ncauj cleft - nws sau cov kev kuaj mob ntxiv, hais txog cov kws kho mob nqaim. Xav paub ntau ntxiv txog qhov no pathology Pediatrician Daria Schukina.