Iingxelo zeCase
Gong Junyao
Isini: Ibhinqa
Ubudala: iminyaka emi-3 kunye neenyanga ezi-7
Imeko yokwamkelwa:
Isigulana samkelwa malunga neminyaka emibini edlulileyo sineminyaka emalunga ne-1 kunye nesiqingatha ubudala xa abazali baqaphela ukunqongophala kobuchule bolwimi. Ufumene ukuxilongwa kunye nonyango lokubuyisela kwisibhedlele sasekhaya ngenxa ye-autism kunye nokulibaziseka kophuhliso. Okwangoku, isigulana sisangakwazi ukuthetha ulwimi, sinemiqobo yokunxibelelana, kwaye sibonisa ukusabela okulinganiselweyo kwizinto zangaphandle. Ukongeza, izakhono zakhe zokuqonda kunye nokuqonda zihlwempuzekile, okwenza kube nzima ukugqiba izenzo zomyalelo. Isigulana sibonisa ukuxakeka kakhulu, ulawulo olulambathayo lweemvakalelo, kwaye sithanda ukukhwaza kakhulu kodwa asibonakalisi ndlongondlongo okanye indlela yokuzenzakalisa. Umgangatho wokulala uphantsi kwaye kunzima ukulala. Isigulana sinokuzondla ngokwaso kodwa asizazi iimfuno zaso zangasese. Ukushukuma kwamalungu kuqhelekile. Ukuqhubela phambili ukuxilonga kunye nokunyanga imeko yakhe, kucwangciswe ukudlulisela isigulane kwisibhedlele sethu sonyango lotyando. Ukususela ekuqaleni kokugula, isigulane siye sahlala siqaphele, sinokuqonda okucacileyo, ukutya okuqhelekileyo kunye nemikhwa yamathumbu, kunye nobunzima obuzinzile ngaphandle kweenguqu ezinkulu.
Ukuxilongwa kokwamkelwa: I-Cerebral dysplasia, i-autism, i-epilepsy
Inkqubo yoNyango
Isigulana uGong Junyao, obhinqileyo, iminyaka emi-3 kunye neenyanga ezi-7 ubudala, wenziwa utyando lwengqondo oluncediswa yirobhothi nge-15 kaJanuwari, ngo-2023, ngo-14:30 ngenxa ye-cerebral dysplasia, Autism, kunye nokukhubazeka kwengqondo. Utyando lwenziwa phantsi kwe-anesthesia jikelele kwaye lwaqhubeka kakuhle. Emva kwe-anesthesia eyimpumelelo, intloko yaphawulwa, ilandelwa yi-CT scan kunye nokungenisa idatha kwi-robot ye-Remebot. Ilobe yethutyana yasekhohlo yakhethwa njengendawo ekujoliswe kuyo, kwaye indlela yotyando yamiselwa kwindawo engaphambili yasekhohlo. Isigulana sibekwe kwindawo ye-supine kunye nentloko ehleliweyo, kwaye i-scalp yendawo ye-scalp yenziwa ukugrumba umngxuma we-cranial kwaye ingene kwi-dura mater. Emva koko, ukufunyanwa kwenaliti ye-electrode kunye nokufakelwa kwee-electrode zokubeka iliso zengqondo kwenziwa. Emva kokuchonga i-epileptic lesion, i-radiofrequency ablation yenziwa, ilandelwa ngokuphinda kufakwe i-electrodes yokubeka iliso ukuqinisekisa ukunyamalala kwesilonda.
Ekugqibeleni, ukuvuselela umbane othambileyo kwasetyenziswa unyango lwe-neuroregulation kwindawo ekujoliswe kuyo kwicala lasekhohlo. Utyando kwindawo ekujoliswe kuyo ekhohlo lugqitywe ngempumelelo ngevolumu yokopha kwe-3ml. Emva kokuhlinzwa, ulusu lwaluxutywe kwaye lucinezelwe, kwaye isigulane sabuyiselwa ngokukhuselekileyo kwiwadi. I-intravenous fluids yesiqhelo, i-oxygen inhalation, kunye nokubeka iliso kwintliziyo yanikezelwa, ngokuqwalaselwa ngokusondeleyo kweempawu ezibalulekileyo kunye nonyango olukhawulezileyo lwako nakuphi na ukungahambi kakuhle. Iinkcukacha zotyando ziye zacaciswa ngokucokisekileyo kwintsapho yomguli.
Isishwankathelo sokukhupha:
Imeko yangoku yesigulana izinzile kwaye akukho ntloko, isicaphucaphu, okanye ukugabha. Ukuthanda ukutya kulungile, kwaye akukho zimpawu zokopha okanye ukudumba kwindawo yotyando. Ukusebenza kwamathumbu kunye nesinyi kuqhelekile, kwaye uyatya kwaye ulala kakuhle. Uvavanyo lomzimba lubonisa iimpawu ezibalulekileyo ezizinzileyo, ukuqonda okucacileyo, kunye nesimo esihle sengqondo. Isigulana asinanto ingaqhelekanga kulwimi, ubukrelekrele okanye uqhelaniso. Abafundi bayalingana ngobukhulu kwaye bangqukuva, malunga ne-3mm ububanzi, kunye ne-reflexes yokukhanya engaguqukiyo kunye neentshukumo eziqhelekileyo zamehlo. Ukuva kuqhelekile, kwaye kukho i-reflexes yomqala. Akukho zimpawu ze-atrophy yezihlunu zolwimi okanye ukungcangcazela, kwaye iimpawu zobuso ziyalingana. Amalungu esigulane anamandla aqhelekileyo emisipha (ibakala V), ithoni yemisipha eqhelekileyo, kunye ne-tendon reflexes eqhelekileyo. Akukho kunyakaza okuzenzekelayo, kwaye akasebenzisani novavanyo lwempumlo yomnwe, uvavanyo lwesithende-edolo-shin, okanye uphawu lukaRomberg. Uphawu lwe-Bilateral Babinski alukho, kwaye iimpawu zokucaphuka kwe-meningeal ezifana ne-Kernig's sign azikho. Akukho i-edema ebonwayo kumalungu angaphantsi, kwaye ukuhamba kuqhelekileyo.
Imiyalelo yokukhupha: