Okuleeta omwana eyaakazaalibwa awaka mukolo gwa ssanyu eri amaka. Naye mu kiseera kye kimu, era kiyinza okuleeta okutya okutono mu bazadde. "Omwana akola bulungi?", "Omwana assa bulungi?", "Lwaki akaaba nnyo?" Oyinza okuba nga walina ebibuuzo nga bino. Wadde ng’ebiseera ebisinga bino biba bya bulijjo, oluusi wabaawo embeera ezitatera kubaawo ezitwetaagisa okwegendereza katono. Olwaleero tugenda kwogera ku mbeera y’omutima etali ya bulijjo ennyo eyinza okubaawo mu baana abaakazaalibwa, naye nga yeetaaga okujjanjabibwa mu bwangu. Oyo ye Interrupted Aortic Arch, oba IAA mu bufunze.
Mu ngeri ennyangu, Interrupted Aortic Arch (IAA) kye ki?
Kino okukitegeera, ka tusooke tulabe engeri omutima gwaffe gye gukola. Teebereza omutima gwo ppampu y’amazzi enkulu ey’ebisenge bina.
- Ebisenge ebibiri ebya waggulu (Atria): Omusaayi "ogwa bbululu" ogutaliimu oxygen okuva mu mubiri guyingira mu kisenge ekimu, ate omusaayi "emmyufu" ogutaliimu oxygen okuva mu mawuggwe ne guyingira mu kirala.
- Ebisenge ebibiri ebya wansi (ventricles): Bino bye bisenge ebikulu ebipampagira. Ku ludda olumu, zisindika omusaayi ogutaliimu mukka gwa oxygen mu mawuggwe okugusitula. Ku ludda olulala, zipampagira omusaayi omumyufu ogulimu omukka gwa oxygen okusaasaanyizibwa mu mubiri gwonna.
Omusuwa omukulu ogutambuza omusaayi ogulimu omukka gwa oxygen mu mubiri gwonna guyitibwa Aorta . Ebiseera ebisinga kibeera ng’omuggo, oba ekikondo.
Kati, mu mbeera ya Interrupted Aortic Arch (IAA) , ekisenge ky’omusuwa ekiyitibwa aorta tekijjuvu. Kiringa payipu enkulu etambuza amazzi okuva mu ttanka y'amazzi okutuuka mu nnyumba yonna ekutuse ebitundu bibiri . Olw’ensonga eno, omutima ne bwe gukuba amaanyi gutya, tegusobola kusindika musaayi ogulimu omukka gwa oxygen mu bitundu by’omubiri ebya wansi. Eno mbeera ya maanyi nnyo, eyinza okutta omuntu . Kubanga ebitundu by’omubiri ssinga tebifuna musaayi, ebitundu ebyo bisobola okulemererwa ne biba mu bulabe obw’amaanyi eri omwana.
Embeera eno tetera kubaawo nnyo. Bukwata abaana nga babiri ku buli 100,000 abazaalibwa mu Sri Lanka. Kale wadde nga kikulu okukimanya kino, tosattira mu ngeri eteetaagisa.
Omanya otya nti omwana wo alina embeera eno? Obubonero bwe buliwa?
Omwana alina IAA atera okulaga obubonero mu nnaku ezisooka oluvannyuma lw’okuzaalibwa. Kino kiri bwe kityo kubanga omwana nga tannazaalibwa, omutima gw’omwana guba gufuna omukka gwa oxygen okuva mu mubiri gwa maama, ekitali kizibu, naye oluvannyuma lw’okuzaalibwa omutima gw’omwana gulina okwekolera. Awo we wava ekizibu kino.
Olina okwegendereza ennyo obubonero buno wammanga.
| Obubonero | Nga kinnyonnyoddwa mu ngeri ennyangu |
|---|---|
| Okukaluubirirwa okuyonsa n’okukoowa ennyo | Omwana ne bw’ayonka amata amatono, alabika ng’alwana, atuuyana era ng’akola nnyo. Kubanga n’omulimu ogwo omutono gwetaaga okufuba ennyo okuva ku mutima. |
| Okussa amangu | Olw’okuba omubiri tegufuna mukka gwa oxygen gumala, omwana atandika okussa amangu okusobola okuliyirira. Ekifuba kiyinza okulabika ng’ekikuba. |
| Omutima okukuba amangu | Olw’okuba omutima gulina okukola ennyo okusobola okusiba omusaayi mu mubiri gwonna, omutima gutandika okukuba amangu. |
| Olususu okufuuka enzirugavu oba bbululu | Naddala olw’okuba omusaayi ogulimu omukka gwa oxygen tegutambula bulungi mu bitundu bya wansi eby’omubiri gw’omwana, gamba ng’amagulu n’ebigere, olususu mu bitundu ebyo luyinza okufuuka enzirugavu oba okunakuwala. |
| Otulo n’obunafu obutali bwa bulijjo | Omwana wo bw’aba yeebase buli kiseera n’okukoowa, kiyinza okuba nga kiva ku mubiri gwe tegufuna maanyi ge gwetaaga. |
Bw’olaba obubonero buno bwonna, laba omusawo mu bwangu awatali kulwa. Bwe kiba kyetaagisa, twala omwana wo mu ddwaaliro erikuli okumpi erya Emergency Treatment Unit (ETU).
Obulema bw’omutima obulala obuyinza okubaawo n’embeera eno
Abalongo abalina IAA bayinza okuba n’obulema obulala obuwerako ku mutima mu kiseera kye kimu.
- Ventricular Septal Defect (VSD): Kino kinnya mu bbugwe wakati w’ebisenge bibiri ebya wansi ebipampagira (ventricles) eby’omutima. Ekyewuunyisa, okubeera ne VSD oluusi kiyinza okuyamba okumala akaseera mu mbeera za IAA, kubanga kisobozesa omusaayi ogumu ogulimu omukka gwa oxygen okuyita mu kinnya okutuuka ku mubiri.
- Atrial Septal Defect (ASD): Kino kinnya mu bbugwe wakati w’ebisenge bibiri ebya waggulu eby’omutima.
- Truncus Arteriosus: Wano emisuwa emikulu ebiri egiva mu mutima (omusuwa omunene n’omusuwa gw’amawuggwe) we gugatta ne gukola gumu.
Lwaki kino kituuka ku balongo? Ensonga eri etya?
Ng'abazadde, ekibuuzo ekisooka okujja mu birowoozo byammwe nga muwulira bino kiri nti, "Guno musango gwaffe?" Kya lwatu nti si bwe kiri.
Interrupted Aortic Arch (IAA) mbeera ereetebwa obuzibu mu buzaale . Mu ngeri ennyangu, chromosomes zaffe kye ‘kitabo’ ekirimu ebiragiro byonna ebikwata ku ngeri emibiri gyaffe gye gizimbibwamu. Mu mbeera eno, akatundu akatono ennyo aka chromosome akalimu ebiragiro ku ngeri omutima n’emisuwa gye bizimbibwamu bibulamu. Kino kireetera omusuwa gw’omusaayi obutakola bulungi.
Emirundi mingi, abalongo abalina IAA nabo baba n’embeera endala ey’obuzaale eyitibwa DiGeorge syndrome . Kino nakyo kiva ku kitundu kya chromosome y’emu ekibula. Abaana abalina obulwadde bwa DiGeorge syndrome bayinza okufuna yinfekisoni enfunda eziwera n’enkyukakyuka ezimu mu maaso (nga emimwa egyakutuse).
Kino abasawo bakizuula batya ddala?
Bw’otwala omwana mu ddwaaliro, singa abasawo bakebera omwana ne bateebereza nti alina embeera y’omutima nga eno, okukeberebwa okukulu okumukakasa kwe kukebera omutima .
Echocardiogram eringa okulaba vidiyo y’omutima gw’omwana. Tekirina bulumi. Ekozesa amayengo agayitibwa ultrasound waves okulaba obulungi ebisenge by’omutima, valve, n’emisuwa gy’omusaayi. Mu mbeera ya IAA, esobola okulaga bulungi okuzibikira mu aorta.
Oluusi, obuzibu ku mutima nga buno busobola okuzuulibwa mu kiseera kya anomaly scan (ultrasound scan) ekolebwa ng’omwana akyali mu lubuto.
Bujjanjabi ki obukolebwa ku kino? Omwana asobola okuwona?
Yee, ddala. Wadde nga eno mbeera ya maanyi, esobola okuwona ddala ng’olongooseddwa . Enkola y’obujjanjabi esobola okwawulwamu ebitundu bibiri ebikulu.
1. By’olina okukola amangu ddala nga tonnalongoosebwa
Oluvannyuma lw’okuzuulibwa nti omwana alina ekirwadde kino, amangu ago aweebwa ekitanda mu ddwaaliro erijjanjaba abaana abaakazaalibwa (NICU). Ekigendererwa ekikulu kwe kukuuma omusaayi nga gugenda mu mubiri okutuusa ng’omwana yeetegese okulongoosebwa.
Abasawo bakozesa akakodyo akagezigezi okukola kino. Nga buli mwana tannazaalibwa, wabaawo akakwate ak’ekiseera (ductus arteriosus) wakati w’omusuwa omunene n’omusuwa ogutwala omusaayi mu mawuggwe. Kino kiggalawo ku bwakyo mu ssaawa ntono oba ennaku ntono oluvannyuma lw’okuzaalibwa.
Naye mu mbeera ya IAA, abasawo tebajja kuleka kakwate kano ak’ekiseera kuggalawo. Kiringa ‘bypass’ ekozesebwa ng’oluguudo olukulu luggaddwa. Bypass eno gikuume nga nzigule.Eddagala eriyitibwa Prostaglandin E1 liweebwa omwana mu saline. Kino kisobozesa omubiri gw’omwana ogwa wansi okufuna omusaayi okutuusa lw’alongoosebwa.
2. Okulongoosa okutaasa obulamu
Embeera y’omwana bw’emala okutereera, okulongoosa kukolebwa abasawo b’abaana abalongoosa omutima.
- Ekikulu: Ebitundu ebibiri eby’omusuwa gw’omusaayi ebisaliddwako ne byawulwamu biddamu okuyungibwa, ne bikola ekisenge ekijjuvu.
- Ebintu ebirala: Mu kiseera kye kimu, singa omwana aba n’akawuka ka VSD (ekituli mu mutima), naye ajja kuggalwa mu kiseera ky’okulongoosebwa kuno. Bypass (PDA) eyaggulwawo n’eddagala emabegako nayo egenda kuggalwa, kubanga kati ekkubo eddene bwe liwedde, tekyetaagisa.
Kuno kulongoosa kuzibu nnyo, naye abasawo abakugu mu Sri Lanka bakola bulungi okulongoosa ng’okwo.
Ebiseera by’omwana eby’omu maaso binaaba bitya oluvannyuma lw’okulongoosebwa?
Kino kye kintu ekisinga obukulu. Oluvannyuma lw’okulongoosebwa obulungi, abaana abasinga obungi basobola okubeera mu bulamu obwa bulijjo era obulungi . Okusinziira ku bibalo, ne bwe wayise emyaka 10 nga balongooseddwa, abantu abasoba mu 81% bakyali balamu.
Naye ekisinga obukulu okujjukira nti ne bw’omala okulongoosebwa, olina okubeera wansi w’omusawo w’omutima obulamu bwo bwonna . Olina okugenda mu malwaliro mu kiseera ekitegekeddwa n’okukeberebwa nga echocardiogram okulaba oba omutima gwo gukola bulungi. Oluusi, bw’okaddiwa, oyinza okuddamu okwetaaga obujjanjabi. N’olwekyo, kyetaagisa okugoberera ebiragiro by’omusawo.
Kya bulijjo okuwulira ng’ensi yo yonna ezze egwa wansi ng’okizudde nti omwana wo alina embeera eno. Naye jjukira nti ssaayansi w’obusawo akulaakulana nnyo leero. Singa obulwadde buno buzuulibwa nga bukyali ne bujjanjabwa obulungi, omwana wo alina emikisa mingi okubeera essanyu ng’omwana omulala yenna.
Obubaka Obutwala Awaka
- Interrupted Aortic Arch (IAA) bwe buba ng’omusuwa omukulu ogutwala omusaayi okuva ku mutima gw’omwana okutuuka mu mubiri tegujjuvu.
- Eno embeera etali ya bulijjo nnyo, naye nga ya maanyi era nga yeetaaga okujjanjabibwa amangu .
- Weegendereze nnyo obubonero ng’okukaluubirirwa okuyonsa, okussa amangu, n’olususu enzirugavu.
- Kino kiva ku bulema mu buzaale, so si musango gwa bazadde.
- Obujjanjabi buno buba bwa kulongoosa, era oluvannyuma lw’okulongoosebwa obulungi, abaana abasinga obungi basobola okubeera mu bulamu obwa bulijjo .
- Kikulu nnyo okusigala ng’olabirirwa omusawo w’omutima obulamu bwo bwonna, ne bw’omala okulongoosebwa.
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