Nkhani za Case

Zhang Yuqing

Jenda: Mkazi

Zaka: zaka 5 ndi miyezi 9

Zambiri Zovomerezeka:

Wodwalayo adaloledwa chifukwa cha matenda a ubongo kwa zaka zoposa 3. Ali ndi zaka 2, adapezeka kuti sangathe kukhala kapena kuyenda payekha ndipo pambuyo pake adapezeka ndi matenda a ubongo ku chipatala cha Tai'an Maternal and Child Health Hospital, ngakhale kuti sanalandire chithandizo chapadera. Kuyambira nthawi imeneyo, wakhala akulandira chithandizo chamankhwala kuchipatala chothandizira anthu otsitsirako. Pakalipano, wodwalayo akuwonetsa kuwonongeka kwaluntha, kulankhula momveka bwino ndi mawu a 5-6, ndi kumeza. Ali ndi luso losayenda bwino m'manja onse awiri, ndikuyenda pang'onopang'ono. Pali kuwonjezereka kwa minofu m'miyendo yonse yapansi, makamaka kumanja, komwe kumafunikira thandizo loyenda. Kuletsa matumbo ndi chikhodzodzo ndikovomerezeka, koma amafunikira chithandizo chakudya. M'maganizo, iye ndi womveka bwino komanso wabwino, koma zolankhula zake sizimveka bwino, ndipo nzeru zake ndi malingaliro ake zili pansi pa anzake. Ana ndi ofanana, ozungulira, ndipo amasunthika ku kuwala, ndi m'mimba mwake pafupifupi 3mm. Kuyenda kwa maso n’kwachibadwa, ndipo kumva kumakhala bwino. Pharyngeal reflex ilipo. Palibe lilime kapena kunjenjemera, ndipo mawonekedwe a nkhope amafanana. Wodwala akhoza kusinthana kukweza miyendo yake pabedi. Palibe edema m'miyendo yapansi. Opanga opaleshoniyo ndi oyera popanda kufiira, kutupa, kapena kutulutsa. Masiku ano, akuonedwa kuti ndi woyenera kutulutsidwa.

Kuzindikira Kuloledwa:

Cerebral Palsy

Njira Yochizira:

Wodwala Zhang Yuqing, wamkazi, wazaka 5 ndi miyezi 9, anachitidwa opaleshoni yaubongo yothandizidwa ndi loboti ya cerebral palsy pansi pa anesthesia wamba pa February 27, 2023, nthawi ya 8:00 m'mawa. Opaleshoniyo inkaphatikizapo kuyika zolembera zam'mutu pambuyo pa opaleshoni, kutsatiridwa ndi mutu wa CT scan ndikulowetsa deta mu robot ya Remebot. Opaleshoniyo inalunjika kumanzere kwa temporal lobe, yomwe imalowa kumanzere chakumanzere, ndi njira yopangira opaleshoni yokonzedwa bwino. Wodwalayo adayikidwa pamwamba ndi pilo wopangidwa kuti akhazikitse mutu. Atatha kupha tizilombo toyambitsa matenda, ankametedwa m’mutu, kubowola fupa, ndipo singano yakuthwa inaboola fupalo. Poyamba, singano ya electrode inkagwiritsidwa ntchito kuyeza kulimba kwa minofu ya muubongo, ndikutsatiridwa ndi kuyika kwa ma elekitirodi owunika magetsi muubongo. Pambuyo pozindikira khunyu pamalo omwe akufuna, singano ya radiofrequency idagwiritsidwa ntchito pochotsa, kuthetsa khunyu. Kuchiza kwa Neuroregulatory ndi kusonkhezera kwamagetsi pang'ono kunagwiritsidwa ntchito pamalo omwe mukufuna kuti amalize opaleshoniyo kumanzere. Pambuyo pake, mbali yoyenera ya kapisozi wamkati inasankhidwa kukhala chandamale, ndipo chithandizo chofanana cha neuroregulatory chinachitidwa pogwiritsa ntchito singano ya radiofrequency. Njirayo idayenda bwino ndikutaya magazi kwa 3ml. Pambuyo pa opaleshoniyo, singanoyo idachotsedwa, ndipo khungu lozungulira pobowola lidadulidwa ndikuvekedwa. Kujambula kwa mutu wa postoperative CT scan sikunawonetse magazi ambiri, kutsimikizira kulunjika kolondola kwa opaleshoni. Wodwalayo anabwerera m’chipindamo bwinobwino n’kulandira madzi a m’mitsempha, kupatsidwa mpweya wabwino, ndiponso kuwunika mtima. Ogwira ntchito zachipatala adzayang'anitsitsa zizindikiro zake zofunika kwambiri ndipo mwamsanga athetse vuto lililonse ngati likufunikira. Banja la wodwalayo ladziwitsidwa zatsatanetsatane wa opaleshoni.

Chidule Chachidule:

Mkhalidwe wamaganizo wa wodwalayo ndi wabwino, ndi kugona bwino, zakudya, matumbo ndi chikhodzodzo, ndi zizindikiro zokhazikika. Kupenda thupi kumavumbula phokoso lomveka bwino la m'mapapo, kugunda kwa mtima kwachibadwa ndi kamvekedwe kake popanda kung'ung'udza, ana ofanana ndi achangu, kuyenda kwa maso ndi kumva, ndi mphamvu yachibadwa ya minofu m'miyendo. Palibe edema m'munsi, ndipo opaleshoniyi imakhala yoyera popanda zizindikiro za matenda kapena kutuluka magazi. Pambuyo pakuwunika, wodwalayo amatulutsidwa lero.

Malangizo Ochotsa:

1, Sungani chilondacho chouma mukatha kutulutsa ndikuchotsa nsonga pakatha masiku asanu.

2, Pumulani bwino, pewani kusuntha kwamphamvu kwa mutu, ndikulimbitsa chitetezo.

3, Tsatirani maphunziro okonzanso potengera momwe mwanayo alili pambuyo potuluka.

4、Fufuzani kuchipatala mwamsanga ngati pali zovuta zilizonse.

Kuzindikira Kuvomerezeka: Kukula kwa Cerebral, Autism

Chithandizo Njira

Wodwala Wang Zhiqiang, wamwamuna, yemwe pano ali ndi zaka 10 ndi miyezi inayi, adachitidwa opaleshoni yothandizidwa ndi loboti ya cerebral underdevelopment ndi autism pansi pa anesthesia wamba pa Epulo 10, 2023, 3:00 PM. Opaleshoniyo idayamba ndikuyika zolembera pamutu ndikujambula mutu wa CT scan. Deta ya scan idatumizidwa mu robot ya Remebot. Gulu lakumanzere la basal ganglia linasankhidwa kukhala cholinga cha opaleshoni, ndipo njira ya opaleshoni inakhazikitsidwa kudera lakumanzere lakumanzere. Wodwalayo anayikidwa pampando wapamwamba ndi pilo wopangidwa kuti akonze mutu. Akamaliza kupha tizilombo toyambitsa matenda, ankadula m'mutu kuti abowole bowo limodzi lachigaza. Elekitirodi ya singano idagwiritsidwa ntchito kuyeza kulimba kwa minofu ya muubongo, kutsatiridwa ndi kutsitsimula kwamagetsi mofatsa pogwiritsa ntchito singano ya radiofrequency pamalo omwe mukufuna kusintha minyewa. Opaleshoni yomwe ili kumanzere kwa chandamale idamalizidwa bwino. Mchitidwe womwewo unkachitikanso pa lobe yakumanja yakumanja ngati malo omwe mukufuna. Opaleshoniyo inayenda bwino ndi kutaya magazi pafupifupi 3 ml. Pambuyo pa opaleshoni, singanoyo inachotsedwa, ndipo khungu linali lopangidwa ndi sutured ndi kuvala ndi kuponderezedwa. Kujambula kwa mutu wa postoperative CT scan sikunawonetse magazi ambiri, kutsimikizira kulunjika kolondola kwa malo omwe mukufuna. Wodwalayo adasamutsidwa bwino ku ward ndipo adalandira madzi a m'mitsempha, chithandizo cha oxygen, ndi kuyang'anira mtima. Zizindikiro zofunikira zidayang'aniridwa mosamala ndikuwongolera mwachangu zovuta zilizonse zomwe zidabuka. Njira ya opaleshoni ndi zotsatira zake zadziwitsidwa kwa banja la wodwalayo.

Chidule Chachidule:

Kutuluka kwa wodwalayo kuli bwino: chikhalidwecho chimakhala chokhazikika popanda kusokonezeka kwapadera, ndipo mkhalidwe wamba ndi wabwino. Kugona ndi kudya ndi zabwinobwino, ndipo matumbo ndi chikhodzodzo amakhala nthawi zonse popanda vuto lililonse. Kuwunika kwakuthupi kumawonetsa zizindikiro zokhazikika, malingaliro omveka bwino, komanso malingaliro abwino. Ana ndi ofanana, ozungulira, komanso ochita chidwi ndi kuwala. Mapapo auscultation samawonetsa kumveka kwachilendo, ndipo kugunda kwa mtima kumakhala kokhazikika popanda kung'ung'udza. Chizindikiro cha Babinski ndi choyipa. Opaleshoniyo ilibe matenda komanso imachiritsa bwino, chifukwa chake kutulutsa kumalimbikitsidwa.

Malangizo Ochotsa:

1, Sungani chilondacho chouma mukatha kutulutsa ndikuchotsa nsonga pakatha masiku asanu.

2, Pumulani bwino, pewani kusuntha kwamphamvu kwa mutu, ndikulimbitsa chitetezo.

3, Tsatirani maphunziro okonzanso potengera momwe mwanayo alili pambuyo potuluka.

4、Fufuzani kuchipatala mwamsanga ngati pali zovuta zilizonse.