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თიაქარი ბავშვებში

თარიღი: 13 ოქტომბერი, 2022

თიაქარი ბავშვებში ერთ-ერთი ყველაზე გავრცელებული დაავადებაა, რომლის დროსაც გამოხატულია ადვილად შესამჩნევი გამობერილობა მუცლის წინა კედელზე, საზარდულის მიდამოში ან სათესლე პარკში. მისი გამომწვევი მიზეზი უხშირესად თანდაყოლილია. იშვიათად, შედარებით მოზრდილ ასაკში გვხვდება შეძენილი თიაქარი, რომელიც ძირითადად ფიზიკური დატვირთვის შედეგია. დაავადება ორივე სქესის ბავშვებში გვხვდება, თუმცა შედარებით ხშირია ბიჭებში.

განასხვავებენ ჭიპის, თეთრი ხაზის ანუ მუცლის წინა კედლის და საზარდულის თიაქრებს. უკანასკნელი ყველაზე გავრცელებულია ფორმაა.

საზარდულის ირიბი თიაქარი - ნაწლავის მარყუჟი, ბადექონი ან საკვეცხე (გოგონებში) იჭრება საზარდულის არხში და ზოგჯერ ჩამოდის სათესლე პარკშიც (ბიჭების შემთხვევაში). იგი ყოველთვის თანდაყოლილია და მისი მიზეზი ბუდობრივი მორჩის შეუხორცებლობაა.

საზარდულის თიაქარი (ირიბი) ბავშვებში ყველაზე გავრცელებული დაავადებაა, შესაბამისად ხშირია ოპერაციული ჩარევაც. აღინიშნება მცირე ზომის გამობერილობა, რომელიც იწყება საზარდულის მიდამოში და ზოგჯერ აღწევს სათესლე პარკამდეც. იგი უმეტესად დიაგნოსტირდება წლამდე ასაკში. თუ ჩვილი ხშირად ტირის და ჭირვეულობს, ტირილის სხვა მიზეზებთან ერთად უნდა გამოირიცხოს თიაქრის ჩაჭედვაც. ვინაიდან საზარდულის თიაქარი შეიცავს ჩაჭედვის მაღალ რისკს მისი შემდგომი გართულებებით, თანამედროვე მიდგომით მისი ოპერაციული მკურნალობა უნდა მოხდეს დიაგნოზის დასმის თანავე, მიუხედავად ბავშვის ასაკისა.

თიაქრის ჩაჭედვის დროს გასათვალისწინებელია შემდეგი რეკომენდაციები:თბილი აბაზანა, საზარდულის მიდამოზე თბილის სათბურის დადება. უმოკლეს დროში ბავშვის გადაყვანა შესაბამისი პროფილის სამკურნალო დაწესებულებაში.

ჭიპის თიაქარი – წარმოადგენს გამობერილობას ჭიპის მიდამოში. ჭიპის თიაქარი ბავშვებში პერიოდულად ტკივილსა და დისკომფორტს იწვევს. მასზე უარყოფითად მოქმედებს შეკრულობა, მეტეორიზმი, ტირილი, ხველა. იგი დაბადებისას ბევრ ახალშობილს აქვს, მაგრამ ზრდის პროცესში, სამ-ოთხ წლამდე, უფრო ხშირად კი ერთ წლამდე ხდება ჭიპის რგოლის დახურვა და თვით განკურნება.

ჭიპის თიაქარი სხვადასხვა ზომის შეიძლება იყოს. მის ზომას ექიმი განსაზღვრავს პალპატორული გასინჯვისას. თიაქარი მეტად შესამჩნევია ტირილის, ხველის დროს, ფეხზე წამოდგომისას, რაც მუცლის ღრუში წნევის მატებას უკავშირდება.

ჭიპის თიაქარი, ჩვეულებრივ, სამედიცინო ჩარევას არ საჭიროებს. მშობლებმა ყურადღება უნდა მიაქციონ შებერილობას, რომელიც ასაკთან ერთად უნდა შემცირდეს, რეგულარულად შეამოწმონ მისი მდგომარეობა, განსაკუთრებით - დაბანისას. ის არ უნდა იზრდებოდეს და მაგრდებოდეს. არ არის რეკომენდირებული ჭიპის გადაკვრა და სხვადახვა საგნების (მაგ. ხურდა ფული) გადაწეპება, რაც არაეფექტურია და იწვევს ჭიპისა და მიმდებარე კანის გაღიზიანება - ინფიცირებას.

იმ შემთხვევაში, თუ თიაქარი ბავშვს სამ-ოთხ წლამდე არ დაეხურა, საჭიროა ოპერაციული ჩარევა.

თეთრი ხაზის თიაქარი - თეთრი ხაზი არის მუცლის წინა კედელზე კუნთების მყესებისგან შექმნილი მკვრივი ზონარი. ჭიპის ზევით ჩნდება გამობერილობა, რომელიც, ჭიპის თიაქარისგან განსხვავებით, თავისთავად არ ხორცდება.

თეთრი ხაზის თიაქარი უმეტესად 2 -3 წლის ასაკში ყალიბდება, მიიჩნევა, რომ იგი შეძენილია, თუმცა არ გამოვრიცხავთ, საქმე გვქონდეს თანდაყოლილი დეფექტის მოგვიანებით გამოვლენასთან.

ჭიპისა და თეთრი ხაზის თიაქრების ოპერაციული მკურნალობა გულისხმობს წინა კედელზე არსებული აპონევროზული დეფექტის დახურვას, მის გაკერვას.

როგორი მომზადებაა საჭირო ოპერაციისთვის?
ბავშვებში ყველა ამ ტიპის ოპერაცია ზოგადი ანესთეზიით ტარდება, შესაბამისად ოპერაციისთვის მომზადება ნარკოზისთვის მომზადებას გულისხმობს. ოპერაციამდე 10-14 დღის განმავლობაში ბავშვს არ უნდა ჰქონდეს გადატანილი ინფექციური დაავადება, სისხლის და შარდის საერთო ანალიზების პასუხი უნდა აკმაყოფილებდეს ნორმებს.

როგორია ოპერაციის შემდგომი რეკომენდაციები?
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