Amawuggwe g’omwana wo tegakula bulungi? (Pulmonary Hypoplasia) Ka tuyige ku nsonga eno!

Essanyu ly’owulira ng’otunuulira omwana eyaakazaalibwa teriyinza kwogerwako, nedda? Naye oluusi, awamu n’essanyu eryo, okutya okutono kujja mu birowoozo naddala bw’olaba ng’omwana afuna obuzibu okussa. Mu biseera ng'ebyo, ekimu ku bibuuzo ebijja mu birowoozo by'abazadde kiri nti, "Waliwo ekikyamu ku mwana wange?". Leero tugenda kwogera ku mbeera ey’amaanyi bwetyo, naye nga nkulu nnyo gy’olina okumanya. Kwe kugamba, amawuggwe g’omwana tegakula bulungi, embeera gye tuyita mu by’obujjanjabi `(Pulmonary Hypoplasia)`.

`(Obulwadde bw'amawuggwe)` kye ki? Ka tukitegeere mu ngeri ennyangu.

Mu ngeri ennyangu, Pulmonary Hypoplasia ye mawuggwe g’omwana wo bwe gatakula nga bwe kisuubirwa ng’ali mu lubuto. This is a congenital condition , ekitegeeza nti baliwo nga bazaalibwa. Ebiseera ebisinga, kiva ku mbeera endala ey’obulamu. Kwe kugamba, amawuggwe tegalina kifo kimala kukula mu lubuto. Oluusi, abasawo bazuula embeera eno nga omwana tannazaalibwa, ng’ali lubuto, nga bayita mu ‘ultrasound scans’. Oluusi, kizuulibwa amangu ddala ng’omwana amaze okuzaalibwa oba nga wayise ennaku ntono.

Kati laba, munda mu mawuggwe gaffe mulimu obusawo obutonotono obw’empewo obuyitibwa alveoli. Zino ze zongera omukka gwa oxygen gwe tuyingiza mu musaayi. Olwo omusaayi ne gutwala omukka guno mu bitundu by’omubiri mu mubiri gwonna. Kale, singa amawuggwe tegakula bulungi, ensawo zino ez’empewo nazo ziba ntono mu muwendo. Kiki ekibaawo olwo? Ebitundu by’omubiri ebirala n’ebitundu by’omubiri tebifuna mukka gwa oxygen gumala. Kino kireetera omutima okukola ennyo, era puleesa mu mawuggwe esobola n’okweyongera (pulmonary hypertension). Lowooza ku kino, ng’ekimera ekitono bwe kitasobola kukula bulungi singa kiba tekirina mazzi, kifo, n’emmere.

Bubonero ki omwana bw’alaga?

Singa omwana omuwere alina obulwadde bwa Pulmonary Hypoplasia, ayinza okulaga obubonero nga:

• Langi ya bbululu eri olususu, emimwa oba enjala (`(cyanosis)`) . Kino kibaawo ng’ebitundu by’omubiri tebifuna mukka gwa oxygen gumala. Okusingira ddala, langi eno eya bbululu ebaawo nga omukka gwa oxygen mutono mu musaayi.
• Ennyindo ezikutte omuliro . Kino kitegeeza nti omwana afuba nnyo okussa kubanga kizibu. Nga bwe tudduka ne tugwa, tufuuwa ennyindo ne tussa.
• Okukaluubirirwa okussa. Omwana ayinza okukola eddoboozi ery’okuwunya oba okuwuuma ng’assa.
• Okweyongera kw’omutindo gw’okussa (tachypnea) . Omwana bw’aba assa mangu okusinga ku bulijjo, ekyo nakyo kabonero.

Omwana wo bw’aba alina obubonero buno obumu oba obusingawo, kirungi n’ogenda ew’omusawo amangu ago. Bino era biyinza okuba obubonero bw’endwadde endala ez’okussa, n’olwekyo kikulu okuzuula amangu obulwadde obutuufu.

Lwaki kino kibaawo? Biki ebikulu ebivaako `(Pulmonary Hypoplasia)`?

Pulmonary Hypoplasia etera okuva ku mbeera endala ez’obulamu eziremesa amawuggwe okukula obulungi mu mwana ali mu lubuto. Embeera zino zireka amawuggwe nga tegalina kifo kye geetaaga okukula. Embeera zino wammanga ze zisinga okubeerawo:

• Amazzi g’omu lubuto amatono (oligohydramnios) : Bwe wabaawo amazzi g’omu lubuto matono okwetooloola omwana, gasobola okussa puleesa ku mawuggwe ne galeetera okukula obubi. Amazzi gano gakola ng’omutto eri omwana era gayamba amawuggwe okukula.
• Congenital Diaphragmatic Hernia (CDH) : Ensigo y’omubiri (diaphragm) kinywa ekyawula ekifuba n’olubuto. Singa wabaawo ekituli mu yo era ebimu ku bitundu by’olubuto (nga ebyenda n’ekibumba) ne bifuluma mu kifuba, ekifo amawuggwe kiba kitono. Olwo amawuggwe tegasobola kufuuwa n’okukula obulungi.
• Omphalocele : Mu mbeera eno, ebimu ku bitundu by’omwana bifuluma nga biyita mu nnabaana, nga bibikkiddwa oluwuzi. Kino era kiyinza okukyusa puleesa eri munda mu lubuto lw’omwana n’okukosa enkula y’amawuggwe.
• Prolonged Premature Rupture of Membranes (PROM) : Ensawo y’omu lubuto bw’ekutuka ng’omwana tannazaalibwa, ekimanyiddwa nga PROM, amazzi gayinza okukendeera, ekikosa enkula y’amawuggwe.
• Obulwadde bw’amawuggwe obuyitibwa Cystic lung disease : Bino bizimba ebitali bya kookolo ebitwala ekifo mu mawuggwe ne bitaataaganya okukula kw’ebitundu by’amawuggwe ebya bulijjo.
• Okugaziwa kw'omutima olw'obuzibu bw'omutima : Okugeza, omutima bwe gukula olw'endwadde z'omutima ezizaalibwa nga ``tricuspid atresia'' oba ``Ebstein's anomaly'', kiyinza okussa akazito ku mawuggwe.
• Omusuwa ogutali gwa bulijjo oba ogutakola : Omusuwa kinywa kyetaagisa nnyo amawuggwe okukola obulungi. Singa wabaawo obuzibu mu nkola yaayo, era kiyinza okukosa enkula y’amawuggwe.

Wabula oluusi abasawo tebasobola kuzuula kivaako kituufu ekivaako ``Pulmonary Hypoplasia.`` Tukiyita primary pulmonary hypoplasia . Kino kibaawo mu bitundu nga 10% ku 15% ku balwadde.

Ani asinga okubeera mu bulabe bw’embeera eno?

Embeera ezimu mu kiseera ky’olubuto ziyinza okuteeka omwana mu lubuto mu bulabe obw’amaanyi obw’okulwala obulwadde bw’amawuggwe, gamba nga oligohydramnios n’okuzaalibwa nga tannatuuka. Mu bino mulimu:

• Yinfekisoni : Obulwadde bw’ekikaba (STIs) oba obuwuka obuleeta endwadde nga bacterial vaginosis busobola okuviirako amazzi go okukutuka nga tebunnatuuka.
• Obuwanvu bw'omumwa gwa nnabaana obumpi . Kino era kiyinza okuba ekivaako okuzaala nga tebanneetuuka ne `(PROM)`.
• Okusuubira emirundi mingi, gamba ng’abalongo oba abaana basatu . Kino kiyinza okuleeta obuzibu ng’ekifo ekitono mu lubuto n’amazzi amatono.
• Amniocentesis : Kino kigezo ekikolebwa ng’oli lubuto. Wabula si bulijjo nnyo, ensawo y’amazzi eyinza okwonooneka n’amazzi ne gakulukuta.
• Puleesa oba preeclampsia ng’oli lubuto. Bino bisobola okukosa enkola y’enkwaso, ne bikendeeza ku mmere y’omwana n’omukka gwa oxygen, era bisobola n’okufiirwa amazzi.
• Ssukaali : Maama bw’aba n’obulwadde bwa sukaali, era ayinza okuvaako ebizibu ebimu.
• Okubulwa amazzi mu mubiri : Singa maama tanywa mazzi gamala, amazzi g’omu lubuto gayinza okukendeera.

Eno y’ensonga lwaki kikulu nnyo okugoberera ddala ebiragiro by’omusawo n’okugenda mu malwaliro mu budde ng’oli lubuto. Okufaayo ku bulamu bwo kikosa butereevu obulamu bw’omwana wo.

Bizibu ki ebirala bino bye biyinza okuleeta?

Eky’amawuggwe obutakula bulungi kiyinza okuleeta obuzibu mu bitundu by’omubiri gw’omwana ebirala. Bino wammanga bye bizibu ebiyinza okuva ku `(Pulmonary Hypoplasia):`

• Omukka gwa oxygen omutono mu musaayi (hypoxemia) : Kino kye kizibu ekisinga. Kiyinza okwonoona obwongo n’ebitundu ebirala.
• Puleesa mu mawuggwe g’omwana (pulmonary hypertension) : Emisuwa mu mawuggwe gifunda, ne giteeka puleesa ey’enjawulo ku mutima.
• Okunafuwa oba okukula obubi mu nnyindo (tracheomalacia) : Kino kiyinza okuvaako omukka okuzibikira ng’ossa.
• Pneumothorax : Empewo ekulukuta okuva mu mawuggwe, n’ekuŋŋaana okwetooloola amawuggwe, amawuggwe ne gagwa.
• Obuzibu mu kussa : Okugeza, obulwadde bw’amawuggwe obuyitibwa bronchopulmonary dysplasia. Bino bisobola okubaawo oluvannyuma naddala mu baana abazaalibwa nga tebanneetuuka, nga bayungiddwa ku kyuma ekissa.
• Ebizibu ebirala ebiyinza okubaawo olw’embeera eyaliwo eyavaako okukendeera kw’amawuggwe. Ng’ekyokulabirako, obuzibu mu kuliisa, obutawulira bulungi, n’okulwawo okukula .

"Oyinza okuwulira ng'otya bw'owulira bino byonna. Naye jjukira nti okutegeezebwa lye ddaala erisinga obulungi okusobola okwolekagana n'embeera ng'eno. Yogerako n'abasawo bo era obuuze ebibuuzo byonna by'olina."

Abasawo bazuula batya embeera eno?

Ebiseera ebisinga, omusawo azuula obulwadde bwa Pulmonary Hypoplasia mu kiseera ky’okukebera amaloboozi aga bulijjo ng’ali lubuto. Sikaani eno epima obunene bw’amawuggwe g’omwana n’okwetooloola ekifuba. MRI (magnetic resonance imaging) scan nayo eyinza okukolebwa okukakasa nti omuntu azuuliddwa. MRI esobola okuwa ekifaananyi ekitegeerekeka obulungi ku bunene bw’amawuggwe.

Oluusi, omusawo ajja kuzuula embeera eno ng’azaalibwa oba nga wayise ennaku ntono ng’azaalibwa. Singa omwana afuna obuzibu mu kussa, omusawo ajja kukola X-ray y’ekifuba okukebera oba alina obulwadde bw’amawuggwe oba embeera endala ey’amawuggwe. X-ray esobola okulaga obunene n’embeera y’amawuggwe.

Bujjanjabi ki obukolebwa ku kino?

Obujjanjabi bw’obulwadde bwa Pulmonary Hypoplasia businziira ku kivaako, obuzibu bw’embeera eno, n’okumanya oba yazuulibwa ng’oli lubuto oba oluvannyuma lw’okuzaalibwa. Ekigendererwa ekikulu eky’obujjanjabi kwe kuwa omwana omukka gwa oxygen gwe yeetaaga okusobola okuwangaala n’okuyamba amawuggwe ge okukula nga bwe kisoboka. Singa omwana wo azaalibwa n’obulwadde bwa Pulmonary Hypoplasia, ojja kwetaaga okumuyamba okussa okutuusa ng’amawuggwe ge gakula ekimala okussa ku lulwe, oba okutuusa ng’abasawo basobodde okumuwa obujjanjabi obw’enjawulo.

Bino bye bimu ku bujjanjabi omusawo w’abazaalisa-abakyala oba omusawo w’abaana abato by’akozesa:

• Amnioinfusion : Singa wabaawo amazzi g’omu lubuto amatono, enkola eno eyingiza amazzi ago mu ngeri ey’ekikugu. Kino kiyinza okuyamba okukendeeza ku puleesa ku mawuggwe n’okuyamba okukula.
• Okulongoosa omwana ali mu lubuto oba okulongoosebwa oluvannyuma lw’okuzaalibwa : Okugeza, singa wabaawo embeera eyitibwa CDH, okulongoosa kuyinza okukolebwa okugitereeza. Oluusi okulongoosa kuno kukolebwa ng’omwana akyali mu lubuto.
• Obujjanjabi bwa oxygen : Oxygen aweebwa omwana oba ng’ayita mu kanyula mu nnyindo oba masiki eteekebwa ku maaso.
• Okuyingiza empewo mu byuma : Kino kizingiramu okuyunga ekyuma ekissa ku kyuma n’okuyamba okussa mu ngeri ey’ekikugu. Kino kikolebwa nga bateekamu ttanka mu payipu y’empewo.
• Extracorporeal Membrane Oxygenation (ECMO) : Buno bujjanjabi bwa njawulo nnyo, obuzibu. Ekyuma kyongera omukka gwa oxygen mu musaayi ne kiggyamu kaboni dayokisayidi ate nga kiwa amawuggwe n’omutima gw’omwana ekiwummulo. Kikozesebwa mu mbeera ez’amaanyi ennyo ng’obujjanjabi obulala bwonna bulemye.

Kiki ekibaawo singa omwana wo azaalibwa n’obulwadde bwa Pulmonary Hypoplasia?

Omwana wo bw’aba azaalibwa ng’amawuggwe tegakula, ajja kwekebejjebwa omusawo w’abaana abazaalibwa (omusawo mukugu mu baana abazaalibwa) ne ttiimu y’abakugu abalala. Okusinziira ku buzibu bw’embeera n’ebitundu ebirala ebikoseddwa, ttiimu y’abasawo eyinza okuli:

• Abakugu mu kibumba (Nephrologists) .
• Abasawo b’amawuggwe (abakugu mu by’okussa) .
• Abasawo abalongoosa omutima (Abalongoosa omutima) .
• Abakugu mu by’omu lubuto (abakugu mu nkola y’okugaaya emmere) .

Abalongo abalina ``(Pulmonary Hypoplasia)`` batera okujjanjabibwa neMu kifo ekirabirira abalongo (NICU), abalongo bafuna obujjanjabi obw’enjawulo n’okulondoola buli kiseera. Batera okuba n’ebizibu by’amawuggwe ebiwangaala n’embeera endala ez’obulamu. Kuno kw’ogatta okukwatibwa endwadde z’okussa enfunda eziwera, embeera nga asima, n’okulwawo okukula. Wabula abalongo abamu abalina obulwadde bwa Pulmonary Hypoplasia bayinza obutaba na mbeera ya maanyi nga bwe bakaddiwa, era amawuggwe gaabwe gayinza okweyongera okukula n’obubonero bwabwe ne butereera.

Kisoboka kitya okubeera n’embeera eno?

Kituufu abalongo abalina amawuggwe agatakula basobola okuwangaala. Naye embeera ya buli muntu ya njawulo. Obusobozi bw'okuwangaala ne `(Pulmonary Hypoplasia)` businziira ku nsonga zino:

• Obuzibu bw’embeera eno. Amawuggwe gakuze wala.
• Ekivaako ensonga enkulu. Obulwadde ki obusibukako obwaleeta `(Pulmonary Hypoplasia)` era bwe buba obw'amaanyi.
• Oba kyazuulibwa ng’ali lubuto oba oluvannyuma lw’okuzaala. Singa kizuulibwa nga bukyali, oluusi okuyingira mu nsonga nga bukyali kisoboka.
• Waliwo ebizibu ebirala ebiyinza okuvaamu?

Okutwalira awamu, omuwendo gw’abafa olw’obulwadde bwa Pulmonary Hypoplasia kigambibwa nti gusukka ebitundu 55%. Okutwalira awamu kizibu okubeera n’abalwadde abasinga okuba ab’amaanyi aba Pulmonary Hypoplasia. Kinaku okwogera bino, naye kikulu okumanya amazima. Kyokka, olw’okukulaakulana kwa ssaayansi w’obusawo, enkola ez’okuyamba abalongo ng’abo ziteredde nnyo leero.

Ekintu kyonna kye tuyinza okukola okuziyiza kino?

Tewali ngeri emu ey’okuziyiza Pulmonary Hypoplasia, kubanga etera okuva ku mbeera endala. Wabula engeri esinga okukendeeza ku buzibu bw’ebyobulamu ng’omwana azaaliddwa kwe kugoberera amagezi g’omusawo w’okuzaalisa ng’afuna olubuto olulamu. Osobola okwerabirira ng’okozesa:

• Dukanya embeera zo ezitawona, gamba nga ssukaali ne puleesa.
• Genda ew’omusawo buli lunaku ng’oli lubuto. Mu ngeri eyo, bwe wabaawo ebizibu byonna, osobola okubizuula nga bukyali.
• Weewale ddala okunywa sigala n’okunywa omwenge. Bino birina akakwate akabi obutereevu ku nkula y’omwana.
• Nywa amazzi mangi. Kikulu nnyo okunywa waakiri liita z’amazzi 2-3 olunaku.
• Weekuume okuva ku ndwadde z’ekikaba (STIs) n’endwadde endala ezisiigibwa.

Okwekebeza buli kiseera n’omusawo w’abazaalisa n’omusawo w’abakyala kiyinza okuyamba okuzuula ebizibu ebiyinza okubaawo nga bukyali. Oluusi, abasawo basobola okujjanjaba ekivaako obulwadde bwa Pulmonary Hypoplasia ng’oli lubuto. Kino kiyinza okuyamba omwana wo obutazaalibwa n’amawuggwe agatakula.

N’ekisembayo, olina okugamba nti...

Singa omwana wo azaalibwa n’obulwadde bwa Pulmonary Hypoplasia, ttiimu y’abasawo ejja kuba naawe buli ddaala ly’ogenda. Bajja kunnyonnyola obuzibu bw’embeera eyo, obujjanjabi bw’oyinza okukozesa, n’ebiseera eby’omu maaso. Tolwawo kubuuza bibuuzo byonna by’oyinza okuba nabyo osobole okusalawo mu ngeri ey’amagezi ku ndabirira y’omwana wo – oba obulamu bwo.

"Bwe kiba kisoboka, tonda ekibiina kyo eky'obuwagizi obw'obuntu obw'abantu be weesiga era b'oyagala. Ekyo kitegeeza abantu nga balo nga balo, maama, taata, baganda bo, n'emikwano egy'oku lusegere. Obuwagizi bwabwe bujja kuba maanyi manene okwolekagana n'okusoomoozebwa kwonna okujja mu kkubo lyo. Kikulu nnyo okusigala ng'oli mugumu. Toggwaamu ssuubi."

Tusuubira nti amawulire gano gakuyamba. Jjukira nti bulijjo weebuuze ku musawo alina ebisaanyizo akuwe amagezi mu by’obujjanjabi. Ekitundu kino kya mawulire ga bulijjo gokka.

` Pulmonary Hypoplasia, okukula obubi kw’amawuggwe, abalongo, obuzibu mu kussa, embeera z’obuzaale, NICU, obulamu bw’abaana abawere, ebizibu by’olubuto