Oludda lw’omwana wo olwa kkono olw’omutima munafu? Ka twogere ku bulwadde bwa Hypoplastic Left Heart Syndrome (HLHS) .

Kizibu okunnyonnyola engeri gy’owulira ng’omusawo akugamba nti omwana wo eyaakazaalibwa alina obulwadde bw’omutima obw’amaanyi. Ng'oggyeeko okutya, okuwuniikirira, n'ennaku, ekibuuzo "Kiki ekigenda okutuuka ku mwana waffe?" ewuuma mu birowoozo byo. Ekiseera kizibu nnyo. Naye ekisinga obukulu mu kiseera nga kino kwe kumanya mu bujjuvu embeera eno. Leero tugenda kwogera ku bulwadde bwa Hypoplastic Left Heart Syndrome (HLHS), obulwadde bw’omutima obw’amaanyi era obutatera kulabika nga buva ku kuzaalibwa. Mu kitundu kino, tujja kwogera ku nsonga eno mu ngeri ennyangu, mu ngeri gy’osobola okutegeera.

Ddala obulwadde bw’omutima gwa kkono obuyitibwa Hypoplastic Left Heart Syndrome (HLHS) kye ki?

Mu ngeri ennyangu, obulwadde bwa Hypoplastic Left Heart Syndrome (HLHS) mbeera ebaawo ng’oludda olwa kkono olw’omutima terukula bulungi ng’omwana akula mu lubuto. Buno bulwadde bwa mutima obuzaalibwa nabwo. Ekigambo "hypoplastic" kitegeeza "ekitakula."

Omutima gwaffe gulinga akayumba akatono akalimu ebisenge bina. Ebisenge bibiri waggulu ate bibiri wansi. Ebitundu by’oludda olwa kkono olw’omutima gw’omwana alina HLHS, naddala:

• Left ventricle: Kino kye kisenge ekikulu eky’okupampagira omutima. Kipampa omusaayi omuyonjo ogulimu omukka gwa oxygen ne gugenda mu mubiri gwonna. Mu HLHS, ntono nnyo era tekulaakulana.
• Aorta: Omusuwa omukulu ogutwala omusaayi okuva mu kisenge kya kkono okutuuka mu mubiri gwonna. Kino nakyo kitera okuba ekifunda ate nga kitono.
• Mitral ne aortic valves: Zino ziringa enzigi. Zisobozesa omusaayi okukulukuta mu ludda lumu lwokka. Mu HLHS, vvaalu zino ziyinza obutakula bulungi oba ziyinza okuggalwa ddala.

Olw’okuba ebitundu bino ebikulu tebikula bulungi, oludda olwa kkono olw’omutima terusobola kussa musaayi gumala ogulimu omukka gwa oxygen okutuuka mu mubiri gwonna. Eno mbeera ya maanyi nnyo. Oluusi, wayinza okubaawo ekituli ekitono mu bbugwe wakati w’ebisenge bibiri eby’okungulu eby’omutima, ekiyitibwa atrial septal defect .

Njawulo ki eriwo wakati wa kino n’omutima omulamu obulungi?

Mu mutima omulamu obulungi, enjuyi zombi eza ddyo ne kkono zikolagana. Kuba akafaananyi ng’oludda olwa ddyo luggya omusaayi ogutaliimu mukka gwa oxygen mu mubiri ne gugusindika mu mawuggwe okufuna omukka gwa oxygen. Omusaayi ogulimu omukka gwa oxygen oguva mu mawuggwe gudda ku ludda olwa kkono olw’omutima. Olwo ppampu ey’amaanyi eri ku ludda olwa kkono (omusuwa ogwa kkono) n’ekuba omusaayi ogwo okutuuka ku mubiri gwonna.

Naye mu mwana alina HLHS, oludda olwa kkono olw’omutima lunafu nnyo. Kale tesobola kukola mulimu ogwo. Kale kiki ekibaawo? Oludda olwa ddyo olw'omutima lulina okukola emirimu gyombi ku lwalwo . Ekyo kitegeeza nti ventricle eya ddyo erina okukuba omusaayi mu mawuggwe, ate nga n’omusaayi gugenda mu mubiri gwonna.

Kino kibaawo kitya? Omwana bw’aba mu lubuto, wabaawo akakwate ak’ekiseera wakati w’emisuwa emikulu ebiri mu mutima. Kiyitibwa ekitundu ekiyitibwa ductus arteriosus.Kiringa 'ekkubo ennyimpi'. ‘Shortcut’ eno yeetaagibwa nnyo omwana alina HLHS okuwangaala oluvannyuma lw’okuzaalibwa. Kubanga omusaayi guyita mu ttanka eno okutuuka mu mubiri. Mu budde obwabulijjo, ttanka eno eggalawo nga wayise ennaku ntono ng’omwana amaze okuzaalibwa. Naye singa tube eno eggalwa mu mwana alina HLHS, tewali ngeri musaayi gye guyitamu kugenda mu mubiri. N’olwekyo, singa embeera eno tejjanjabibwa, omwana ajja kuba n’ennaku ntono zokka okuwangaala.

Omanya otya nti omwana wo alina embeera eno? Obubonero bwe buliwa?

Singa omwana eyaakazaalibwa aba n’obulwadde bwa HLHS, oluusi obubonero tebusooka kulabika. Naye obubonero buno busobola okulabika mu ssaawa oba ennaku ntono. Kino kikulu nnyo abazadde okukimanya.

Lwaki kino kituuka ku balongo? Ensonga eri etya?

Ekibuuzo kino kiri ku birowoozo bya buli muzadde. Kya bulijjo okwebuuza nti, "Lwaki kino kyatuuka ku mwana waffe? Twakola ekikyamu?"

Naye ekituufu kiri nti, emirundi egisinga, tewali nsonga ntongole ereeta HLHS . Kwe kugamba, si kintu ekiva ku maama oba taata. Oluusi, ensonga z’obuzaale zisobola okukola kinene. Kwe kugamba, enkyukakyuka ezimu mu buzaale mu maka ziyinza okwongera ku bulabe. Abalongo abalina embeera endala ez’obuzaale, gamba nga Turner syndrome oba trisomy 18, nabo bali mu bulabe bw’okulwala HLHS.

Abasawo bazuula batya mu butuufu obulwadde buno?

Ekirungi, olw’okukozesa tekinologiya ow’omulembe ow’ennaku zino, obulwadde buno busobola okuzuulibwa nga omwana tannazaalibwa, kwe kugamba, ng’ali lubuto . Singa wasangibwawo ekintu ekitali kya bulijjo mu mutima mu kiseera ky’okukebera eddoboozi erya bulijjo nga tonnazaala, omusawo wo ajja kukusindika ew’omusawo omukugu n’akusaba okukeberebwa echocardiogram y’omwana ali mu lubuto . Kino kikusobozesa okulaba obulungi ennyo ensengeka n’enkola y’omutima gw’omwana.

Okuzuula embeera eno ng’omwana amaze okuzaalibwa, omusawo ajja kutunuulira obubonero bw’omwana n’awuliriza ekifuba ng’akozesa ekyuma ekiwuliriza okulaba oba waliwo eddoboozi ly’omutima eritali lya bulijjo (heart murmur). Olwo, okukebera okuwerako kujja kukolebwa okukakasa embeera eno, gamba nga:

• X-ray y’ekifuba: X-ray y’ekifuba esobola okukebera obunene n’enkula y’omutima n’amawuggwe.
• Echocardiogram: Kino kye kigezo ekisinga obukulu. Kiringa vidiyo scan y'omutima. Ebisenge by’omutima, obusuwa, n’emisuwa byonna birabika bulungi. Kino kye kikakasa okubeerawo kwa HLHS.
• Electrocardiogram (EKG): Okukebera okupima amasannyalaze g’omutima.
• Pulse oximetry screening: Akasimu akatono akalinga aka clip kateekebwa ku ngalo oba ku kutu kw’omwana okupima obungi bwa oxygen mu musaayi. Omuwendo guno mutono mu baana abalina HLHS.

Waliwo obujjanjabi bw’embeera eno? Omwana asobola okulokolebwa?

Yee, eno embeera ya maanyi nnyo, naye waliwo obujjanjabi. Naye buno si bulwadde obusobola okuwonyezebwa n’eddagala. Okusobola okutaasa obulamu bw’omwana, kulina okulongoosebwa mu ngeri enzibu ennyo nga kuliko emitendera egiwerako .

Omutendera ogusooka: Okutebenkeza Omwana

Nga tannalongoosebwa, omwana yeetaaga okutebenkera. Omutendera ogusooka kwe kukuuma ductus arteriosus , omusuwa gw’omusaayi ‘ogw’omumpi’ gwe twayogeddeko, nga guggule. Eddagala eriyitibwa prostaglandin liweebwa mu misuwa. Eddagala eddala nalyo liyinza okukozesebwa okuyamba omutima gw’omwana okukuba, n’ekyuma ekiyamba omwana okussa.

Omutendera ogwokubiri: Omuddirirwa gw’okulongoosa ogw’emitendera esatu

Ekigendererwa ekikulu eky’okulongoosa kuno kwe kuyita ddala ku ludda olwa kkono olunafu n’okuwa oludda olwa ddyo olw’omutima olunywevu (omusuwa ogwa ddyo) omulimu gw’okupampagira omusaayi mu mubiri gwonna. Kiba ng’okukyusa okutambula kw’omusaayi mu kkubo ery’enjawulo ddala.

1. Enkola ya Norwood: Kino kikolebwa mu wiiki bbiri ezisooka ng’omwana azaaliddwa. Kuno kulongoosa kuzibu nnyo, kwa maanyi. Wano, abasawo abalongoosa:

• Omusuwa ogutakula bulungi guddamu okuzimbibwa.
• Tubu ey’enjawulo (shunt) eyingizibwa okusindika omusaayi okuva mu ventricle eya ddyo butereevu mu mawuggwe.
• Mu ngeri eno, "enkola ya tubular" y'omutima ekyusibwa olwo ventricle eya ddyo esobole okusindika omusaayi mu mubiri gwonna n'amawuggwe.

2. Okulongoosa Glenn (Bidirectional Glenn shunt operation): Kino kikolebwa ng’omwana ali wakati w’emyezi 4 ne 6 . Wano:

• Tubu (shunt) eyingizibwa mu kulongoosa okusooka eggyibwamu.
• Omusaayi ogutaliimu oxygen okuva mu kitundu eky’okungulu eky’omubiri (okuva mu musuwa oguyitibwa superior vena cava) guyungibwa butereevu ku mawuggwe.
• Kino kikendeeza nnyo ku buzito ku ventricle eya ddyo, kubanga kati tekirina kusiba musaayi okuva mu mubiri ogwa waggulu, gugenda butereevu mu mawuggwe.

3. Enkola ya Fontan: Guno gwe mutendera ogusembayo. Kikolebwa wakati w'emyaka 18 n'emyaka 4 . Wano:

• Omusaayi ogutaliimu mukka gwa oxygen oguva mu kitundu kya wansi eky’omubiri (okuva mu musuwa oguyitibwa inferior vena cava) guyungibwa butereevu ku mawuggwe.
• Oluvannyuma lw’okulongoosebwa kuno, omusaayi gwonna ogutaliimu mukka gwa oxygen oguva mu mubiri gugenda butereevu mu mawuggwe. Ekitundu kya ddyo eky’omutima kirina okupampagira omusaayi omuyonjo ogulimu omukka gwa oxygen okuva mu mawuggwe okutuuka mu mubiri gwonna.

Oluvannyuma lw’okulongoosa kuno okusatu okuggwa, enkola y’omusaayi gw’omwana etandika okukola mu ngeri empya ddala.

Bizibu ki ebiva mu bujjanjabi?

Wadde ng’okulongoosa kuno kutaasa obulamu, kuzibu nnyo era kuyinza okuleeta akabi n’ebizibu. Ebizibu bisobola okuvaayo nga balongooseddwa n’oluvannyuma lw’okulongoosebwa.

• Ventricle eya ddyo efuuka nnafu olw’omugugu omuzito gwe erina okwetikka.
• Omusaayi ogukulukuta okuva mu vvaalu z’omutima.
• Endwadde z’ekibumba.
• Ennyimba z’omutima ezitali za bulijjo.
• Okuzimba omusaayi.
• Yinfekisoni.
• Okukaluubirirwa okulya.
• Okukonziba.
• Ebikosa ensigo.

Omusawo ajja kwogera naawe ku bulabe buno bwonna mu bujjuvu. Ttiimu y’abasawo egenda kulondoola nnyo omwana nga bwe bakola olugendo luno.

Okukyusa Omutima Kirungi?

Mu mbeera ezimu, singa embeera y’omutima gw’omwana eba nzibu nnyo oba ng’abasawo balowooza nti omwana tajja kuwona okulongoosebwa, bayinza okumuwa amagezi okumusimbuliza omutima . Naye balina okulinda okutuusa ng’omutima ogukwatagana gufuusewo. Ate era, oluvannyuma lw’okusimbibwa omutima, omwana ajja kuba alina okumira eddagala eriweweeza ku busimu bw’omubiri obulamu bwe bwonna.

Omwana bw’aba alina embeera eno, kiki ffe ng’abazadde kye tusaanidde okumanya?

Olugendo luno lusoomooza, naye singa abasawo balabiriddwa bulungi n’okulabirira, abaana abalina HLHS basobola okubeera n’obulamu obulungi.

• Okulabirira omusawo obulamu bwe bwonna: Oluvannyuma lw’okulongoosebwa, omwana ajja kwetaaga okugenda ew’omusawo w’omutima obulamu bwe bwonna. Balina okwekebejjebwa waakiri omulundi gumu mu mwaka.
• Eddagala: Abaana bangi bajja kwetaaga okumira eddagala ly’omutima obulamu bwabwe bwonna.
• Eddagala eritta obuwuka nga tonnalongoosa mulala: Nga tonnalongoosa mulala gwonna, gamba ng’okuggyamu amannyo, olina okumira eddagala eritta obuwuka okuziyiza endwadde z’omutima (endocarditis).
• Okukola emirimu gy’omubiri: Omwana wo okukola emirimu gy’omubiri kiyinza okwetaagisa okukoma. Okutwalira awamu emirimu egy’amaanyi, gamba ng’emizannyo egy’okuvuganya, tegisemba. Saba omusawo akuwe amagezi ku nsonga eno.
• Obulamu bwo obw’omutwe: Olugendo luno lukooya nnyo abazadde. Kiyinza okukuleetera situleesi. Kale, yogera ku nneewulira zo n’omwami wo/omukyala wo n’ab’omu maka go. Noonya okubudaabudibwa bwe kiba kyetaagisa. Bw’oba ​​n’amaanyi g’onoosobola okulabirira obulungi omwana wo.