ʻO shunting Ventriculoperitoneal

ʻO ke aniani ʻo Ventriculoperitoneal shunting e mālama i ka nui o ka wai cerebrospinal (CSF) i nā lua (ventricle) o ka lolo (hydrocephalus).

Hana ʻia kēia hana i ke keʻena hana ma lalo o ka anesthesia ākea. Ma kahi o 1 1/2 mau hola. Hāʻawi ʻia kahi ʻōmole (catheter) mai nā hakahaka o ke poʻo i ka ʻōpū e hoʻokahe i ka wai o ka cerebrospinal (CSF). ʻO kahi kiwikā a me kahi mea anti-siphon e hōʻoia i ka hoʻokahe ʻia o ka wai o ka wai kūpono.

Hana ʻia ke ʻano hana penei:

• Ua kahi ʻia kahi ʻāpana o ka lauoho i ke poʻo. Ma hope paha o ka pepeiao a i ʻole ma luna a i hope paha o ke poʻo.
• Hana ke kauka i ka ʻoki o ka ʻili ma hope o ka pepeiao. Hana ʻia kekahi ʻoki ʻoki liʻiliʻi i loko o ka ʻōpū.
• Hoʻomoʻu ʻia kahi lua liʻiliʻi i ka iwi poʻo. Hoʻohui ʻia kahi wēlau o ka catheter i loko o ka ventricle o ka lolo. Hiki i kēia ke hana me ka ʻole a me kahi kamepiula ma ke ʻano he alakaʻi. Hiki iā ia ke hana ʻia me kahi endoscope e hiki ai i ke kaukipō ke ʻike i loko o ka ventricle.
• Hoʻokomo ʻia ka lua o ka catheter ma lalo o ka ʻili ma hope o ka pepeiao. Hoʻouna ʻia i lalo o ka ʻāʻī a me ka umauma, a maʻa mau i loko o ka ʻōpū. I kekahi manawa, kū ma ka wahi o ka umauma. I loko o ka ʻōpū, hoʻonoho pinepine ʻia ka catheter me ka hoʻohana ʻana i ka endoscope. Hiki paha i ke kauka ke hana i kekahi mau ʻoki liʻiliʻi hou aku, no ka laʻana i ka ʻāʻī a i ʻole ke kokoke i ka iwi iwi, e kōkua ai i ka lawe ʻana i ka catheter ma lalo o ka ʻili.
• Hoʻokomo ʻia kahi kiwikā ma lalo o ka ʻili, ma hope o ka pepeiao. Pili ka paipu i nā catheters ʻelua. Ke kūkulu ʻia ke kaomi hou a puni ka lolo, wehe ka kiwikā, a hoʻokahe kahe o ka wai ma o ka catheter i loko o ka ʻōpū a i ʻole ka pahu. Kōkua kēia i ka hoʻohaʻahaʻa intracranial pressure. Hāʻawi kahi waihona i ke kiwikā i ka priming (pumping) o ka valve a no ka hōʻiliʻili ʻana i ka CSF inā pono.
• Lawe ʻia kēlā kanaka i kahi wahi hoʻōla a laila neʻe i kahi lumi haukapila.

Hana ʻia kēia ʻoki ke nui ka wai o ka cerebrospinal (CSF) i ka lolo a me ka iwi kuamoʻo. Kapa ʻia kēia ʻo hydrocephalus. Hoʻonui ia i ke kiʻekiʻe ma mua o ka kaomi maʻamau ma ka lolo. Hiki iā ia ke hōʻino i ka lolo.

Hānau ʻia paha nā keiki me ka hydrocephalus. Hiki iā ia ke hana me nā kīnā hānau ʻē aʻe o ka koluma a i ʻole ka lolo. Hiki i ka Hydrocephalus ke hana i nā mākua makua.

Pono e hana i ke kahakaha Shunt ke ʻike ʻia ʻo hydrocephalus. Hāʻawi ʻia nā ʻoki ʻoki ʻē aʻe. Hiki i kāu kauka ke haʻi hou aku iā ʻoe e pili ana i kēia mau koho.

Nā pilikia no ka anesthesia a me ke kahakaha ʻana ma:

• Nā hopena i nā lāʻau a i ʻole nā ​​pilikia hanu
• Kahe ʻana o ke kahe, ke koko koko, a i ʻole ka maʻi

Nā pilikia no ke kau ʻana o shunt ventriculoperitoneal:

• Koko koko a hoʻokahe paha i ka lolo
• Huʻi lolo
• Hole i loko o nā ʻōpū (bowel perforation), hiki ke loaʻa ma hope ma hope o ke kaha ʻana
• Kulu o ka wai CSF ma lalo o ka ʻili
• ʻO ka maʻi o ka shunt, lolo, a i ʻole i loko o ka ʻōpū
• Poino i ka lolo lolo
• Ka hopu ʻana i nā maʻi

Kū paha ka shunt i ka hana. Inā kū kēia, e hoʻomaka hou ke kahe i ka lolo. Ke ulu a keiki, pono paha ke reposition i ka shunt.

Inā ʻaʻole kahi ʻōnaehana kahi pilikia (hoʻolālā ʻia ia i ke ʻoki kino):

• E haʻi i ka mea mālama ola i nā lāʻau, nā mea hoʻopili, nā wikamina, a me nā mea kanu a ke kanaka e lawe ai.
• E lawe i nā lāʻau a ka mea hāʻawi i ʻōlelo ai e lawe me kahi wai liʻiliʻi.

E noi i ka mea hāʻawi e pili ana i ka palena ʻana i ka ʻai a me ka inu ma mua o ke kaha

E hāhai i nā ʻōkuhi ʻē aʻe e pili ana i ka hoʻomākaukau ʻana ma ka home. Pākuʻi paha kēia i ka ʻauʻau ʻana me ke kopa kūikawā.

Pono paha e moe ke kanaka no 24 mau hola i ka manawa mua i hoʻokau ʻia kahi shunt.

ʻO ka lōʻihi o ka noho ʻana o ka haukapila e pili ana i ke kumu e pono ai ka shunt. E nānā pono ke kime mālama ola i ke kanaka. E hāʻawi ʻia nā wai IV, antibiotic, a me nā lāʻau ʻeha inā pono.

E hāhai i nā ʻōkuhi a ka mea hāʻawi e pili ana i ka mālama ʻana i ka shunt ma ka home. Hoʻopili paha kēia i ka lawe ʻana i ka lāʻau e pale ai i ka maʻi o ka shunt.

Kūleʻa ke kau ʻana ʻo Shunt i ka hōʻemi ʻana i ke kaomi i ka lolo. Akā inā pili ka hydrocephalus i nā kūlana ʻē aʻe, e like me spina bifida, tumo lolo, meningitis, encephalitis, a i ʻole hemorrhage, hiki i kēia mau ʻano ke hoʻopili i ka wānana. Pehea ka nui o ka hydrocephalus ma mua o ke ʻoki ʻana i ka hopena.

Shunt - ventriculoperitoneal; VP shunt; Hoʻololi Shunt

• Mālama ʻeha ʻeha - wehe
• Shunt Ventriculoperitoneal - hoʻokuʻu

• Ventricles o ka lolo
• ʻO Craniotomy no ka cerebral shunt
• Shunt ʻo Ventriculoperitoneal - moʻo

Badhiwala JH, Kulkarni AV. Nā ʻōnaehana shunting Ventricular. I: Winn HR, hoʻoponopono. ʻO Youmans a me Winn Neurological Surgery. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 201.

ʻO Rosenberg GA. ʻO ka edema lolo a me nā maʻi o ka holo ʻana o ka wai cerebrospinal. I: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. ʻO Bradley's Neurology i ka hana lapaʻau. ʻEpekema 7 Piladelapia, PA: Elsevier; 2016: chap 88.