Nyaya dzenyaya

Zhang Yuqing

Gender: Mukadzi

Zera: 5 makore nemwedzi 9

Ruzivo rwekugamuchira:

Murwere akagamuchirwa nekuda kwecerebral palsy kweanopfuura makore matatu. Pazera remakore maviri, akawanikwa asingakwanisi kugara kana kufamba akazvimiririra uye akazoonekwa kuti ane cerebral palsy paTai'an Maternal and Child Health Hospital, kunyange zvazvo asina kuwana kurapwa kwakakosha. Anga achirapwa kune imwe nzvimbo yeko rehabilitation institution kubva ipapo. Parizvino, murwere anoratidza kukanganisa kwenjere, kutaura kusina kujeka ne5-6 syllables, uye kudonha. Ane hurombo hwakanaka hwemotokari mumawoko maviri, nekufamba zvishoma nezvishoma. Kune kuwedzera kwetsandanyama mumakumbo maviri ezasi, kunyanya kudivi rekurudyi, kunoda rubatsiro rwekufamba. Kudzora ura nedundira zvinotenderwa, asi anoda rubatsiro pakudyisa. Mupfungwa, akajeka uye ane mweya wakanaka, asi kutaura kwake hakuna kujeka, uye kungwara kwake uye maitiro ari pasi pevezera rake. Vana vakaenzana, denderedzwa, uye reactive kuchiedza, nehupamhi hunosvika 3mm. Mafambiro eziso akajairika, uye kunzwa kwakasimba. Pharyngeal reflex iripo. Hapana rurimi runyoro kana kudedera, uye zvimiro zvechiso zvine symmetrical. Murwere anogona kuchinjana kusimudza makumbo ake kubva pamubhedha. Iko hakuna edema mumakumbo ezasi. Iyo yekuvhiya incision yakachena pasina kutsvuka, kuzvimba, kana kubuda. Nhasi, ari kunzi akakodzera kuburitswa.

Admission Diagnosis:

Cerebral Palsy

Kurapa Maitiro:

Murwere Zhang Yuqing, mukadzi, ane makore 5 nemwedzi 9, akavhiyiwa robhoti-akabatsirwa stereotactic brain for cerebral palsy under general anesthesia musi waFebruary 27, 2023, na8:00 mangwanani. Kuvhiya kwacho kwaisanganisira kuisa zvicherechedzo zvemusoro post-anesthesia, zvichiteverwa nemusoro CT scan uye kupinza data scan murobhoti yeRemebot. Kuvhiyiwa kwakanangana nekuruboshwe kwechinguva chidiki, kunowanikwa kuburikidza nekuruboshwe kumberi nzvimbo, ine yakanyatsorongwa yekuvhiya trajectory. Murwere akaiswa supine nepillow yakaumbwa kuti musoro ugadzikane. Mushure menguva dzose kuuraya utachiona, ganda remusoro raigezwa munharaunda, buri rebhonzo rakaboorwa, uye tsono inopinza yakabaya dura. Pakutanga, tsono ye electrode yakashandiswa kuyera kusagadzikana kwehuropi, ichiteverwa nekuiswa kwehuropi magetsi ekuongorora maelectrode. Mushure mekuona nzvimbo yepfari panzvimbo yainongedzerwa, tsono yeradiofrequency yakashandiswa kubvisa, kubvisa pfungwa yepfari. Neuroregulatory treatment ine mild magetsi stimulation yakabva yaiswa panzvimbo yaitarisirwa kupedza kuvhiya kuruboshwe. Pashure pacho, chikamu chepamusoro chepamusoro chemukati capsule chakasarudzwa sechinangwa, uye kurapa kwakafanana neuroregulatory kwakaitwa pachishandiswa tsono yeradiofrequency. Iyo nzira yakafamba zvakanaka nekurasikirwa neropa kwe3ml. Mushure mekuvhiyiwa, tsono yakabviswa, uye ganda rakapoteredza jira rakashongedzwa uye rakapfekedzwa. Musoro wepashure weCT scan wakaratidza kusabuda ropa kwakakosha, zvichisimbisa kuvhiya kwakaringana. Murwere akadzokera muwadhi zvakachengetedzeka uye akagashira zvinwiwa zvemutsinga, kurapwa kweokisijeni, uye kutariswa kwemoyo. Vashandi vezvokurapa vanonyatsoongorora zviratidzo zvake zvinokosha uye nokukurumidza kugadzirisa chero nyaya sezvinodiwa. Mhuri yemurwere yakaudzwa nezvenyaya yekuvhiya.

Discharge Summary:

Chimiro chendangariro chomurwere chakanaka, nokurara kwenguva dzose, kudya, kushanda kwoura uye dundira, uye zviratidzo zvinokosha zvakatsiga. Kuongororwa kwemuviri kunoratidza kurira kwakajeka kwemapapu, kurova kwemoyo kwakajairwa uye mutinhimira pasina kugunun'una, vana vakaenzana uye vanobata-bata, kufamba kwemaziso uye kunzwa, uye simba retsandanyama rakajairika mumakumbo. Ikoko hakuna edema mumakumbo ezasi, uye kuvhiyiwa kucheneswa kwakachena pasina zviratidzo zvehutachiona kana kubuda ropa. Kutevera kuongororwa, murwere anoburitswa nhasi.

Discharge Mirayiridzo:

1, Chengetedza ronda rakaoma mushure mokubuda uye bvisa matinji mushure memazuva mashanu.

2, Zorora zvakanaka, dzivirira kufamba kwemusoro kwakasimba, uye simbisa matanho ekudzivirira.

3, Tevedzera kudzidziswa kwekudzoreredza zvinoenderana nemamiriro emwana mushure mekubuda.

4、Tsvaka rubatsiro rwekuchipatara nekukasika kana paine kusanzwanana.

Kubvuma Kuongororwa: Cerebral underdevelopment, Autism

Kurapa Maitiro

Murwere Wang Zhiqiang, murume, parizvino ane makore gumi nemwedzi mina, akavhiyiwa robhoti-akabatsirwa frameless stereotactic yecerebral underdevelopment uye autism under general anesthesia musi waApril 10, 2023, na3:00 PM. Kuvhiyiwa kwakatanga nekuisa zvibodzwa mumusoro nekuita CT scan yemusoro. Iyo scan data yakabva yapinzwa muRemebot robhoti. Iyo yekuruboshwe basal ganglia yakasarudzwa sechinangwa chekuvhiya, uye nzira yekuvhiya yakamiswa kuburikidza nekuruboshwe kumberi nharaunda. Murwere akaiswa panzvimbo yepamusoro ane piro yakaumbwa yekugadzirisa musoro. Mushure mekuuraya utachiona, pakachekwa ganda remusoro kuti riboore buri redehenya rimwe chete. Electrode yetsono yaishandiswa kuyera hurwere hwehuropi, ichiteverwa nekunyorovesa kwemagetsi stimulation therapy uchishandisa radiofrequency tsono painongedzerwa tsinga modulation. Kuvhiya kwekuruboshwe kwakanangana kwakapedzwa zvinobudirira. Maitirwo mamwe chetewo akabva aitwa parudyi rwemberi senzvimbo yaivavarirwa. Kuvhiyiwa kwacho kwakaenderera mberi zvakanaka neanenge 3 ml yekurasikirwa neropa. Mushure mekuvhiyiwa, tsono yakabviswa, uye ganda rakaiswa sutured uye rakapfekedzwa nekumanikidza. Musoro wepashure weCT scan wakaratidza kusabuda ropa kwakakosha, zvichisimbisa kutariswa chaiko kwenzvimbo dzinodiwa. Murwere akadzoserwa muwadhi zvakachengeteka uye akagashira zvinwiwa zvemutsinga, kurapwa kweokisijeni, uye kutariswa kwemoyo. Zviratidzo zvakakosha zvakatariswa zvakanyanya nekutonga nekukurumidza kwechero nyaya dziri kubuda. Nzira yekuvhiya uye zvakabuda zvakaziviswa kumhuri yemurwere.

Discharge Summary:

Mamiriro ekubuda kwemurwere akanaka: mamiriro acho akadzikama asina kunyanya kunetseka, uye mamiriro ezvinhu akanaka. Kurara nekudya zvakajairwa, uye ura nedundira zvinogara zvichiitwa pasina kukanganisa. Kuongororwa kwemuviri kunoratidza zviratidzo zvakakosha zvakagadzikana, chimiro chepfungwa chakajeka, uye mamiriro akanaka epfungwa. Vana vakaenzana, denderedzwa, uye reactive kuchiedza. Lung auscultation hairatidze ruzha rusina kujairika, uye rhythm yemoyo ndeyenguva dzose pasina kugunun'una. Babinski chiratidzo chisina kunaka. Iyo yekuvhiya incision haina hutachiona uye inopora zvakanaka, saka kuburitsa kunokurudzirwa.

Discharge Mirayiridzo:

1, Chengetedza ronda rakaoma mushure mokubuda uye bvisa matinji mushure memazuva mashanu.

2, Zorora zvakanaka, dzivirira kufamba kwemusoro kwakasimba, uye simbisa matanho ekudzivirira.

3, Tevedzera kudzidziswa kwekudzoreredza zvinoenderana nemamiriro emwana mushure mekubuda.

4、Tsvaka rubatsiro rwekuchipatara nekukasika kana paine kusanzwanana.