Wolumala msana - ndichiyani? Aakulu kuvutika msana

Malformation msana, kumene limodzi ndi matenda a chingwe msana, - wolumala msana. N'chiyani chimene milandu uka, ena chisokonezo thupi ungabweretse - mayankho a mafunso amenewa amapezeka m'nkhani. Komabe, mokwana za chithunzi matenda a matenda ndi kofunika kumvetsa mfundo ya anthu chapakati mantha dongosolo, dongosolo anatomical a msana ndi ntchito msana.

Lingaliro la chapakati mantha dongosolo

Chapakati mantha dongosolo - mbali yaikulu ya mantha dongosolo anthu. Iwo ukufanizidwa ndi ubongo ndi msana ndi wapangidwa manyuroni ndi njira zawo. CNS anapanga magulu atatu: m'munsi, sing'anga ndi apamwamba. Pakuti m'munsi ndi pakati ndi chingwe msana, ndi medulla oblongata, ndi midbrain, ndi midbrain ndi cerebellum. zigawo izi zonse ntchito ziwalo munthu, kukhazikitsa kugwirizana therebetween, kuonetsetsa umphumphu wa chamoyo ntchito. Apamwamba CNS anapambulwa ankaimira hemispheres oziziritsa ndi zimagwirira ntchito amapereka mogwirizana ndi chilengedwe.

Ntchito yaikulu ya chapakati mantha dongosolo - kukhazikitsa zochita yosavuta zovuta - bongo. Chapakati mantha dongosolo aumbike mwa milungu yoyambirira ya mimba chifukwa cha dongosolo wapadera - ndi ectoderm. Ngati gulu cholakwika ndi chitukuko maselo mitsempha ukapezeka ndi ubongo chubu chilema, amene kenako kumabweretsa chitukuko cha pathologies msana.

Msana - mantha dongosolo limba ili mu ngalande msana. Notional malire pakati pa chingwe msana ndi ubongo unachitikira ku malo interleaving ulusi pyramidal. Ndipo mutu ndi msana zimayambira envelopu, wopangidwa mwa zigawo zitatu: olimba, kangaude ndi mtima. Zisaonongeke kunja ubongo amateteza Chigaza, ndi msana - msana.

Kapangidwe ka ndime vertebral

Msana - maziko a mafupa la munthu lili ndi vertebrae, pakati limene intervertebral mbale - chichereŵechereŵe wosanjikiza. Zimagwirira ntchito, abulusa amatipatsa kusinthasintha msana. 33-34 mu linkawonongeka munthu, salembedwa ophatikizana m'zigawo: khomo lachiberekero, thoracic, lumbar, sacral, coccyx.

Aliyense linkawonongeka aumbike thupi Arc ndi njira. Thupi ndi Arc zimapanga peresenti kutsegula njira vertebrae chikugwirizana ndi mzake ndi kuchita ntchito ya ubwenzi minofu. Mu thupi lathanzi munthu vertebrae mabowo kuphatikiza mu umodzi vertebral ngalande, chimenenso, ndi malo a msana malo. Koma pali zinthu pathological limene pali kusiyana mu fupa - ". Wolumala msana" zodabwitsazi amatchedwa

Chingwe msana amapereka kulankhulana a ubongo ndi mantha dongosolo zotumphukira. Chapakati njira - ndi M'mimbamo mu chingwe msana. Msana, komanso mutu, ali ndi atatu wosanjikiza Kakhungu pakati pa zigawo munali madzimadzi cerebrospinal. Fupa la vertebrae ndi chipolopolo kunja kwa chingwe msana kupanga pakati pa iwo ndi danga epidural wodzazidwa ndi mafuta minofu ndi mauna venous.

Wolumala msana: ndichiyani?

Wolumala msana - ichi alibe a msana (wolumala msana), zimene zimachizidwa kapena kulimbikitsa ndi kudwala ndi - hypoplasia wa chingwe msana. chilema umenewu umayamba kuonekera mu magawo oyambirira mimba ndipo anakagumula mu mapangidwe chubu ubongo. Chubu ubongo - kapangidwe ka amene ali masiteji ina ya mimba Ndisanaumbidwe aumbike chapakati mantha dongosolo - ubongo ndi msana. Nkhani zambirimbiri za odwala matenda wolumala msana kupereka zifukwa m'kagulu mitundu ina ya kudwala pa malinga ndi kukula kwa malformations:

• mitundu salembedwa wofatsa: zobisika wolumala msana, meningocele, lipomeningotsele;
• akulu: myelomeningocele; myelomeningocele, hydrocephalus kobvuta.

Wolumala msana ndi wapezeka pa kulingalira maginito kumveka kapena nejrosonografii.

Kafukufuku amasonyeza kuti pali matenda makanda 1-2 mu 1000. The kudwala ndi chibadwa, chifukwa mpaka 8% ya kubadwa mobwerezabwereza malekezero anapezeka ndi wolumala msana. Madokotala amanena kuti nthawi zambiri zimachitika Ana akazi azaka. Komabe, 95% makanda ndi matenda wolumala msana kuoneka makolo Olimba sazunzika ku matenda ofanana.

mitundu ofatsa a wolumala msana

Chobisika wolumala msana (occulta) - mawonekedwe ambiri ofatsa a matenda, limene underdevelopment, kusiyana yaing'ono vertebrae lapansi. Nthawi zambiri kumachitika mu lumbar kapena sacral msana. kudwala chino chikulongosola yekha msana fupa minofu ndi sikumangotikhudza kapangidwe msana. Matendawa amtengo lofotokozedwa, ndipo kawirikawiri sakhala kuonekera mwa zizindikiro kuti imasokoneza munthu. odwala ambiri ndi matenda ndipo sadziwa za matenda awo. zizindikiro zowoneka noticeable matenda a ana akhanda akhoza kukhala gulu la tsitsi, kawirikawiri amakhala aang'ono; mafuta thumba; maganizo kapena birthmark mu malo kudwala.

Only mu zina (1 kunja milandu 1,000 ndi ananamizira mawonekedwe wolumala msana) chosayenerera zimabweretsa chisokonezo zinchito mu kapepala mkodzo, matumbo, minofu kufooka kwa miyendo m'munsi, ku kupindika msana. nambala makamaka a vertebrae msana nthawi anasonyeza kuti nkhani za mankhwala a wodwalayo, zimene panali kudwala. Mwachitsanzo, kulowa "wolumala msana zapambuyo S1" limasonyeza mavuto a woyamba linkawonongeka sacral msana.

Meningocele - zosiyanasiyana wolumala msana, imene Kuwonjezera alibe la mafupa m'chimake zoteteza kumachititsa munthu lofufuma kwambiri mbali imodzi kapena makapisozi mwa kagawo alipo. Nthawi zambiri msana ndi mitsempha njira popanda pathologies kapena kupunduka pang'ono. Nthawi zambiri, kapisozi aphimbidwa ndi khungu, amene conventionally amateteza nkhani zake. Komabe, ngakhale izi chilema wamng'ono amafunika chithandizo opaleshoni kuti vuto zodzikongoletsera.

Lipomeningotsele

Lipomeningotsele - mawonekedwe wolumala msana, amene ankaona zolimbitsa kudwala. Mu mankhwala, kuphwanya kwa zimagawidwa monga kudalirana anapanga hernias msana ndi lipomas - chosaopsa zotupa. kusokonezeka izi mu mapangidwe ubongo chubu zidzachitika choyamba masiku 20 mimba. Lipomeningotsele chilema zomwe zingachititse chitukuko cha pathologies ubongo ndi kumayambitsa matenda aakulu a dongosolo genitourinary, matumbo - adipose minofu umalimbikitsa pa chingwe msana. Popeza mbiri ya odwala matenda lipomeningotsele, akhoza salembedwa m'magulu anayi maonekedwe pathological matendawa:

• popanda matenda a ubongo, m'chiuno ndi mafupa;
• wofatsa paresis wa miyendo, mapazi mapindikidwe;
• kwambiri chakhungu galimoto ntchito, kupindika msana, m'chiuno pansi matenda;
• nthambi deformities, aakulu m'chiuno kudwala.

Choncho yekha ndi mankhwala abwino koposa matenda ankaona kuti mwamsanga oyambirira alowererepo pa opaleshoni. Mogwirizana ndi opaleshoni kuti achotse matumba mafuta akhoza kuchitika pulasitiki chophukacho chipata.

Myelomeningocele - chaukali mawonekedwe wolumala msana

The aakulu mawonekedwe a matenda, lomwe limapezeka mu 75% milandu onse alibe wa vertebrae wa - myelomeningocele (Cystica wolumala msana). Ndi chiyani icho? Encephalocele - chinthu chingwe chimene mutuluka kudzera chilema msana. Nthawi zina kapisozi pa chingwe msana zimatetezedwa ndi khungu, nthawi zina ubongo minofu ndi zikumera mitsempha kutuluka. Mu mawonekedwe a matenda mosalephera ubongo matenda. Mlingo wa matendawa kudzayesedwa kuopsa kwa chilema cha chingwe msana ndi gawo msana, imene kuphwanya inkachitika. Ngati matendawa amakhudza mapeto a chingwe msana, mavuto zokhudza dongosolo genitourinary ndi matumbo, m'munsi nthambi ziwalo amapezeka.

Nthawi zambiri, hernias msana zimachitika msana lumbosacral. Nthawi pamene kudwala akufotokozera pa mlingo wa thoracic kapena khomo lachiberekero msana, Komabe, anakumana mu yochizira matenda. Mwatsoka, ubongo chubu chilema zambiri limodzi ndi kuphwanya wina - hydrocephalus kapena Chiari anomaly chifukwa cha kuswa mapangidwe cavities mkati chigaza mowa.

Hydrocephalus ndi Chiari anomaly

Hydrocephalus (madzi pa ubongo) - ndi kudwala chifukwa kudzikundikira madzimadzi cerebrospinal mu ventricles ubongo. Cerebrospinal madzimadzi - mowa - ndi mosalekeza akufalitsa mu dongosolo yamitsempha yamagazi.

Buku chofunika wa madzimadzi cerebrospinal zikhoza kukhazikitsidwa m'njira ziwiri:

• maselo glandular opangidwa ziwiya mu ventricles ubongo;
• propotevanie anapanga chifukwa cha madzi a m'magazi khoma mtima.

Cerebrospinal madzimadzi amazungulira ku ventricles kuti ubongo ndi msana subarachnoid danga la ubongo. Intracranial ndi msana mowa malo mu thupi wathanzi ndi Integrated. Pamene lumbar herniated, anapanga kulankhulana hydrocephalus. kudzikundikira kumam'phunzitsa madzimadzi kwa kuthamanga intracranial, imbaenda utachepa masomphenya, pakutchulidwa a khunyu, strabismus, kufooka kwa minofu ya m'makona chapamwamba ndipo m'munsi. msokonezo koteroko matenda aakulu ubongo, imfa ya maluso luntha, imfa.

Anomaly Arnold Chiari - ndi kudwala imene amygdala adatchithisira pansi kwa mlingo wa loyamba ndi lachiwiri vertebrae khomo lachiberekero, potero kutsekereza makope madzimadzi cerebrospinal.

Opaleshoni chithandizo cha myelomeningocele

Kuopsa kwambiri moyo wa makanda ndi myelomeningocele kusiyana chophukacho sac ndi matenda kupeza mkati nkhani zake. zosokonezeka opatsirana, decompensation hydrocephalus - chifukwa chachikulu cha imfa mkulu khanda, anapezeka ndi wolumala msana. Kamodzi wapezeka liquorrhea - kwa madzimadzi cerebrospinal - ikuchitika opaleshoni mwadzidzidzi kuchotsa chophukacho msana.

Pakali pano, njira mulingo woyenera kuthetsa pathologies awa akhala akugwiritsidwa ntchito bwino padziko lonse, ndi kuchita kuti akalandire chithandizo kuchotsa chophukacho msana. Sunanene za phukusi opaleshoni kumathandiza chitukuko cha hydrocephalus ndi Chiari anomaly odwala wamng'ono; kupewa mavuto aakulu ndi moyo pachiswe, komanso wotsatira opaleshoni kulambalala. The mpheto pamwamba kupereka mwayi mwana kwa kambiri chitukuko ndi khalidwe la moyo.

Ngati yake yoopsa opaleshoni chifukwa ena zaperekedwa, ankayesetsa shunt opaleshoni yomwe normalizes kuchuluka kwa madzimadzi cerebrospinal. Kawirikawiri, ntchito imeneyi ikuchitika mu magawo awiri. Msana Clinic - mankhwala bungwe yopapatiza cholinga, zomwe kawirikawiri kuthandiza kuthetsa mavuto ambiri kugwirizana ndi pathologies msana.

diagnostics

Mu mankhwala amakono, wolumala msana amawapeza mu magawo oyambirira mimba. Choncho, makolo oyembekezera ndi nthawi matenda ndi kuzindikira kukonzekera maganizo azikhala mbali. Komano, iwonso nthawi ndi mwayi kusankha sanali kusamala mwana wosabadwayo.

Pa mimba (masabata 16-18), amayi oyembekezera kukumana ndi mayesero mosamala, zochokera magazi. njira tichipeza mu poona ndende ya mapuloteni embryonic, imene Inde yachibadwa mimba zipatso mu pang'ono. Pamaso pa chapakati mantha dongosolo chilema AFP ndende kuchuluka. Pali mbali pa mayeso. Chifukwa pakutchulidwa zotheka zolakwa pamene akutanthauzira zotsatira za kuwunika kuti litsatidwe kuti ena mwa malamulo:

• kukhazikitsa mimba zolondola kwambiri;
• ngati mimba ndi wakhama, izo ziyenera anapezeka mu nthawi.

Wina njira ya matenda ndi kuti akalandire chithandizo ultrasound imachitika pa magawo ena a mimba, kuwapangitsa kudziwa kudwala. Njira imeneyi zimathandiza inu kuti muzione ubongo, msana, ndime vertebral ndi matenda m'njira yake. Komabe, tiyenera kukumbukira kuti ndi zilema zazing'ono (chobisika wolumala msana) chosayenerera sangathe wapezeka.

Amniocentesis - puncture ndi amniotic madzimadzi - njira ina matenda. Iwo umadutsa singano lalikulu ndi mosamalitsa okha m'manja mwa ultrasound. Njira ntchito pamene kusanthula magazi anapeza anthu ambiri owonjezera AFP, ndi matenda a pathologies akupanga sakudziwika. Madzi mwazi, anayesedwa kwa mapuloteni ndende achikalekale, owonjezera zimene zikusonyeza pamaso pa chisokonezo chitukuko cha ndime msana.

kupewa

Ndithudi, palibe katswiri zachipatala angathe akutsimikizira kuti ngati njira zofunika zonse ndiponso kusapezeka kwa zinthu odziwika pangozi makolo wathanzi amabadwa ali mwana wathanzi. Mwatsoka, nthawi zina chikhalidwe disposes ina kuposa munthu amadzisankhira. Koma mphamvu ya amayi tsogolo ndi makolo kuchita pazipita kuti zingachepetse mavuto zotheka kuti osachepera kuchepetsa mosavuta ndi mwana ali wolumala msana kudwala pafupifupi ziro. Tikuyankhula zokhudza njira zodzitetezera.

Imodzi mwa miyeso waukulu kuteteza zikamera matenda wakhanda "wolumala msana" ndi kukonzekera bwino kukhala ndi pakati. Kuti tichite zimenezi, mayi angathe ndi bambo isanafike lingaliro n'kofunika pochitika kufufuza mankhwala kuvomerezedwa kupita mokambilana ndi chibadwa. A mayi ali woyembekezera m'pofunika kukhala moyo wathanzi, kukhala watcheru kulandira anticonvulsants. Koma kupatsidwa folic acid moyenera M'malo mwake, zikusonyezedwa nthawi imeneyi. M'mayiko ambiri olemera, ili ndi mfundo yaikulu ya pulogalamu tikuyivomereza mu mimba Health Organization.

Kumbukirani kuti zinthu chiopsezo cha matenda chibadwa majini; adzanyamula matenda a akazi woyembekezera, monga chikuku; mphamvu ya chilengedwe kunja - dzuwa, mowa, mankhwala.

The mfundozo chachikulu

Choncho kuyankha funso «wolumala msana -? Kodi ichi", mukhoza kusankha mfundo zazikulu. Wolumala msana - ndi kudwala kuti amapezeka utero, pa milungu yoyambirira ya mimba. Njira yokhayo kupewa matenda mwana - akukonza mimba, kukwaniritsa zofunika zonse zofunikira madokotala, mayi woyembekezerayo kukhala moyo wathanzi, kuti apange kupanda kupatsidwa folic acid mu thupi.

Ngati kudwala ukadali anapeza, yobereka wopangidwa yekha ndi gawo la Kaisara kupewa kupweteka kwa msana chingwe pa ndime ya mwana wosabadwayo kudzera m'njira kubadwa.

Matenda, pali njira zosiyanasiyana - magazi mayeso, ultrasound diagnostics, amniocentesis. Koma ngati kulakwila opezeka ndi matenda anapangidwa, m'pofunika kuchita opaleshoni.

Nzeru njira - ndi kuchotsa kudwala intrauterine. Iwo anagwiritsanso opaleshoni atabadwa mwana - mu masiku atatu oyambirira a moyo wake. Mwa njira, ndi achifwamba mu wakhanda wolumala msana zingachititse: msana chophukacho, birthmarks kapena matendawa, pa chimodzi cha ziwalo za khungu, zachilendo tsitsi bun. Kumene, matenda yomaliza anapangidwa pambuyo kuwonjezera maphunziro - CT, Kujambula.

Malinga ndi zomwe zinkakhala msana dera kutanthauzira, komanso matenda okhudzana zinchito, matenda zimagawidwa mu kuwala ndi mitundu zolemera.

mitundu wofatsa wolumala msana samasankha kuyambitsa zilema, odwala matenda izi chikhalidwe kusinthidwa. Mu nkhani ya zopindika aakulu - meningomyelocoele - kupewa chilema simungathe ngakhale opaleshoni wopambana.

Msana Clinic - mtundu wa malo zaumoyo, amene makamaka umoyo asamalire odwala matenda a ziwalo CNS. Choncho, matenda a wolumala msana - si chiweruzo. Iye akhoza ndi kukhala ndi moyo.