Sezvo shoko iri richienda: Nguva dzinoshevedza dzinodana zviyero zvakashata, uye muenzaniso wekupedzisira uhu hunhu hwehutano hwehuduku . Kune vana nevechiri kuyaruka vanofanirwa neboka rekurema kwakanyanya , kurapwa kwekusarudzwa kwekupedzisira kuri kuwedzera kuongororwa: Bariatric chirurgic.
Kurasikirwa-kurasikirwa kwekurasikirwa iko zvino kunofanirwa kubatsiririra kwakakodzera kune vakwegura zvakanyanya vari kuyaruka vari kutambura nemigumisiro yehutano-yakabatana uye vakaedza dzimwe nzira kuti vaderedze uremu kwemwedzi inopfuura mitanhatu-asi vasina kubudirira.
Uchapupu hunoti kuvhiyiwa kunogona kubatsira vana ava kudzivisa zvinetso zvehutano zvakadai sechirwere cheshuga, kuvhiringidza kubata kwepabonde, uye kuwedzera kwehutano. Kutsvakurudza kubva kuSaudi Arabia kwakawana kuti vana vakaderera, vane makore 5 kusvika ku21, avo vakazovhiyiwa nevanaatric vakarashika 62 muzana yehuwandu hwavo hwakapfuura mushure memakore maviri-uye vazhinji vavo vakagadzirisa cholesterol yavo isingaori, kukwirira kweropa, zvirwere zvekurara zvepabonde, uye chirwere cheshuga.
Asi, pasinei nezvikomborero izvi zvinobudirira, kushandiswa kwekuvhiyiwa kwevanaatric pakati pevechiri kuyaruka kwave kwakazara kubva muna 2003 muU.S., maererano nekudzidza kwe2013. Mari uye kuwanika kwekutarisira zvinogona kuva zvikonzero zvinokosha muku "kushandiswa kwakanyanya kwechiitiko ichi chinogona kuchinja mararamiro muvechiri kuyaruka nevanasikana vemamiriro ekudzikira kwehupfumi hwevanhu," vakatsvakurudza vakapedzisa.
Nzira dzakasiyana-siyana dzevana vakasiyana
Kune maitiro akasiyana-siyana akasiyana-siyana ekuroredzwa kwebhaatric uye iyo ndiyo yakanakisisa yevana kana yevechidiki haina kutarirwa.
Ne Roux-en-Y gastric inpass surgery, chiremba anovhiya anoita chikwama chiduku pamusoro pemudumbu, achishandisa zvigadzirwa zvokuvhiya, uye anosungira chikwama ichocho pakati nepakati petumbu. Ichi chikwata chinogona kubata chikamu chiduku chezvokudya izvo chirwere chinowanzogara chiripo, saka inomanikidza munhu kudya zvokudya zvishomanana.
Uyezve, nokuti zvokudya zvinopedzwa nepakati pechikamu chikuru chemuviri uye nechomukati memukati, mashoma emakoriya anotorwa kubva pakudya.
Ne chirwere chekugadzira mabhande, chirongwa chinoshandiswa chesilicone band rinowanikwa chakakomberedza chikamu chepamusoro chemuviri kuti igadzire chikwama chiduku; iyi inogumira kuwanda kwezvokudya izvo munhu anogona kudya uye kunobatsira kunzwa kwekuzara zvakakurumidza. Ndiyo nzira isingasviki yekuvhiya, uye haina kupindira nehuwandu hwekudya nenzira iyo gastric inopfuura kuvhiyiwa inoita. Bhenu inogona kugadziriswa, ichiita kuti iwedzere kana yakasununguka, kuti igare nemunhu anoshandiswa kuchinja kuora kwezvinodiwa, uye inogona kubviswa, kana zvichidikanwa.
Kugadziriswa kwemapapirosikodhi kunokonesa ukuru hwemudumbu ne75 muzana, zvichisiya "sleeve" shoma kana kuti tube mukati mawo; iyi ndiyo miganhu yezvokudya zvakadini izvo munhu angadya panguva imwechete. Nemhaka yokuti haifaniri kudarika ura, hutachiona hahuvhiringidzi nehuwandu hwemiti-asi hunogona kuderedza huwandu hweghrelin, hormone inzara, iyo inobudiswa nemudumbu, zvichidaro zvichiita kuti kuve nekurema kwemazuva akawanda. Sezvakaita chirwere chepamusoro chekuvhiya, chirongwa chacho hachigadziriswi.
Zvidzidzo zvepakutanga zvakawana maitiro aya ariatric kuti ave akachengeteka uye anoshanda pakati pevechiri kuyaruka, nemigumisiro yenguva pfupi yakafanana neyevamwe vanhu vakuru.
Mune chidzidzo che2014 chema 345 mumitambo uye vechidiki vakuru, vatsvakurudzi muGermany vakawana kuti nzira dzekuvhiya dzinowanzoitwa kakawanda muhuwandu hwevanhu dzaiva nechechi yekunamatira uye gastric inpass, yakateverwa nejasi rakagadziriswa. Mushure megore, gastric bypass yakanga yakabudisa kukura kwekureruka kwemazuva mashure-kupera, yakateverwa ne-sleeve gastrectomy uye gastric banding-asi zvose zvitatu zvinotungamirira kukonzerwa nekureruka kwekureruka uye zviduku zvinetso.
Chidzidzo che2013 paYunivhesiti yeMiami School of Medicine yakawanawo kuti vana vane makore 10 kusvika ku19 avo vakawana chirwere chepamuviri chepamusoro chaive nekupeta kaviri zvinoreva kurasikirwa kwemashure mushure megore sevaya vakashandura chirwere chegastric band.
Munguva iyi, chidzidzo che2012 pavana National Medical Center muWashington, DC, chakawana kuti vaduku vanorema zvakanyanya vanorasikirwa ne40 muzana yehuwandu hwehutano hwavo nekuda kwechaparoscopic sleeve gastrectomy.
Mufananidzo Mukuru Wokufunganya
Pasinei nehuwandu hwekubudirira kwehuwandu, nguva yakareba yekutevera pakuberekwa kwavanaatric kuvana nevechiri kuyaruka kunoshaikwa. Parizvino, hapana nzira yekuziva chii chinoitika pamusoro pemakore eupenyu kune vana vakambove vaine chirongwa chebheririri sezvo izvi zvisiri izvo zvaisawanika kune chizvarwa chevabereki vavo pavakanga vari vana. Kuwana manzwisisiro kune nguva yakareba kubudirira kwehuwandu, hutano hwekuwedzerwa hutsika, uye marudzi ezvinetso zvinogona kuitika makore akazotevera (shure kwezvose, miviri yevana ichiri kukura) inokosha pakuona uchenjeri hwekushandisa izvi nenzira iyo kune avo vari muduku zvakare kuti vhoti.
Zvakakoshawo kuyeuka kuti chirongwa chebhaatric haisi chirongwa chepakati pekukura kwehuduku. Kufanana nevakuru, kuyerwa-kuora-kurasikirwa muvana vakanyanya kunongova chikamu chemhinduro. Vaya vanoita izvi vanoda kushandisa nzira dzakanaka dzekudya uye kuita basa rekuita muupenyu. Kana zvisina kudaro, vangangodaro vanogona kudzorera zvimwe kana huwandu hwehuremu hwavanenge varasika.
Sources:
Alqahtani AR, Antonisamy B, Alamri H, Elahmedi M, Zimmerman VA. Shanduro yeSaffaroscopic Gastrectomy muna 108 Vana Vose uye Vana Vachiri Kuyaruka vane makore 5 kusvika ku21. Annals of Surgery, August 2012; 256 (2): 266-73.
Kelleher DC, Merrill CT, Cottrell LT, Nadler EP, Burd RS. Munguva pfupi yapfuura National Trends mukushandiswa kwevechiri kuyaruka Inpatient Bariatric Surgery: 2000 kusvika muna 2009. JAMA Pediatrics 2013; 167 (20: 126-132.
Kelly AS, Barlow SE, Rao G, Inge TH, Hayman LL, Steinberger J, Urbina EM, Ewing LJ, Daniels SR. Kuwedzera Kuwanda Kwevana Nevana Vachiri Kuyaruka: Kuzivikanwa, Ngozi Dzakabatana Nehutano, uye Kurapa Mazano AScience Statement Kubva kuAmerica Heart Association Circulation, Nyamavhuvhu 2013 (yakabudiswa paIndaneti kare isati yadhindwa).
Lennerz BS, Wabitsch M, Lippert H, Wolff S, Knoll C, Weiner R, Tanger T, Kiess W, Stroh C. Bariatric Surgery muVechiduku neVaduku Vakuru-Kudzivirirwa uye kubudirira muKohort yevarwere 345. International Journal of Obesity, March 2014; 38 (3): 334-40.
Mesiyo SE, Lopez-Mitnik G, Winegar D, Sherif B, Arheart KL, Reichard KW, Michalsky MP, Lipshultz SE, Miller TL, Livingstone AS, de Cruz-Munoz N. Kuchinja muhutano uye kuwirirana pakati pevechiri kuyaruka vari kusangana neBaratric Kuvhiyiwa: zvibereko zvemakore 1 kubva kuBariatric Outcomes Longitudinal Database. Kuvhiya Kwekuwedzera Uye Zvirwere Zvichienderana, July-August 2013; 9 (4): 503-13.
Nadler EP, Barefoot LC, Qureshi FG. Zvitsva Zvepakutanga Pashure Pemapuranga Anonzi Laparoscopic Gastrectomy muAri Kuyaruka Nechipfuva Chekuwedzera. Kuvhiya, August 2012; 152 (2): 212-7.