Ng’omuzadde, ntegedde omutima gwo bwe gulina okuwulira nga guzitowa ng’omusawo akugamba nti omwana wo omuto alina ekizibu ky’omutima kye yazaalibwa. Okuwulira ebigambo ebyo oyinza okuwulira ng’ensi yo yonna ezze ng’egwa wansi. Naye teweeraliikiriranga. Ka twogere ku mbeera eno eyitibwa Tricuspid Atresia mu ngeri ennyangu era mu ngeri entegeerekeka. Ojja kuwulira obuweerero bungi ng’otegedde ddala kye kiri, lwaki kibaawo, n’ekiyinza okukolebwa.
Mu ngeri ennyangu, Tricuspid Atresia kye ki?
Lowooza ku mutima gwaffe ng’ennyumba entono erimu ebisenge bina. Waggulu waliwo ebisenge bibiri ate wansi waliwo ebisenge bibiri. Waliwo enzigi omusaayi okukulukuta wakati w’ebisenge bino. Tricuspid Atresia bulwadde obuzaalibwa mu Tricuspid Valve, nga eno ye valve wakati w’ekisenge ekya waggulu (Right Atrium) n’ekisenge ekya wansi (Right Ventricle) ku ludda olwa ddyo olw’omutima.
Mu kifo ky’oluggi luno, waliwo ekisenge ekikoleddwa mu bitundu ebinene. Kiringa omuntu eyazimba bbugwe nga wandibaddewo oluggi. Kale omusaayi ogutaliimu mukka gwa oxygen oguva mu kisenge ekya waggulu ku ddyo tegulina ngeri gye guyinza kutuuka mu kisenge ekya wansi. Omusaayi guno gulina okugenda mu kisenge ekya wansi ne gusindikibwa mu mawuggwe okusobola okufuna omukka gwa oxygen.
Kale, oluguudo luno okuggalwa ddala kireeta ebizibu bibiri ebinene:
1. Ekisenge ekya wansi kikendeera: Ekisenge ekya wansi ku ludda olwa ddyo (Right Ventricle) tekikula bulungi kubanga omusaayi tegukituukako. Ebiseera ebisinga kifuuka kitono era kinafu.
2. Omusaayi tegukulukuta mu mawuggwe: Omuwendo gw’omusaayi ogwetaaga okugenda mu mawuggwe okufuna omukka gwa oxygen gukendeera nnyo. Kino kivaamu omukka gwa oxygen ogumala okutuusibwa mu mubiri gwonna.
Tricuspid atresia bulwadde bwa mutima obutatera kulabika era bwa maanyi obuzaalibwa nabwo, naye busobola okuddukanyizibwa obulungi ng’ofunye obujjanjabi obutuufu n’okulongoosebwa.
Embeera eno etiisa obulamu?
Yee. Abasawo batwala Tricuspid Atresia ng'obulwadde bw'omutima obw'amaanyi . Amangu ddala ng’omwana alina embeera eno azaaliddwa, beetaaga okulabirirwa mu kifo ekijjanjaba abalwadde abayi (ICU) ekikuguse mu kujjanjaba abaana abalina embeera z’omutima enzibu. Emirundi mingi, omwana ajja kwetaaga okulongoosebwa omutima mu bwangu nga tannadda waka. Singa embeera eno temanyiddwa era n’ejjanjabibwa, eyinza okutta omuntu. N’olwekyo, kyetaagisa okugenda mu ddwaaliro mu bwangu.
Waliwo ebika ebikulu ebya Tricuspid Atresia?
Yee, abasawo embeera eno bagigabanya mu bika ebikulu ebiwerako. Ensonga lwaki kino kibaawo eri nti enkola z’obujjanjabi zaawukana okusinziira ku buzibu obulala obw’omutima obubeerawo n’obulwadde buno.
| Okuwandiika | Ennyinyonnyola ennyangu |
|---|---|
| Ekika kya I | Kino kye kika ekisinga okubeerawo. Emisuwa emikulu egiva mu mutima (omusuwa gw’amawuggwe ne aorta) giri mu bifo ebituufu. Wabula wayinza okubaawo ekituli mu bbugwe wakati w’ebisenge ebya wansi eby’omutima (ventricular septal defect) oba obuzibu ku vvaalu y’amawuggwe. |
| Ekika kya II | Wano, emisuwa emikulu ebiri gikyusibwakyusibwa. Kwe kugamba, omu w’alina okubeera omulala. Waliwo n’ekituli mu bbugwe wakati w’ebisenge ebya wansi (Ventricular Septal Defect). |
| Ekika kya III | Kino kika kya bulwadde bwa mutima obutatera kulabika. Kizingiramu ebizibu ebizibu okugatta awamu ebizingiramu emisuwa eminene n’ebisenge by’omutima. |
Abasawo bajja kukubuulira ddala ekika ky’omwana wo ky’alina oluvannyuma lw’okukeberebwa echocardiogram.
Bubonero ki bw’osobola okulaba ng’omuzadde?
Ebiseera ebisinga obubonero buno butandika okulabika mu wiiki esooka ng’omwana amaze okuzaalibwa.
- Olususu n’emimwa gya bbululu (Cyanosis): Olususu lw’omwana, emimwa, ne wansi w’enjala bifuuka bbululu kubanga omubiri tegufuna mukka gwa oxygen gumala. Kano ke kabonero akakulu era akasinga okweyoleka.
- Okukaluubirirwa okussa n’okussa amangu: Omwana ayinza okukaluubirirwa okussa oba okulabika ng’assa mangu, ng’alinga assa omukka.
- Okukaluubirirwa okunywa n’okukoowa amangu: Omwana ayinza okukoowa oluvannyuma lw’okunywa amata amatono. N’olwekyo, lekera awo okunywa ekitundu, oba ayinza okutuuyana ng’anywa.
- Okugejja: Omwana okugejja n’okukula bigenda mpola nnyo olw’obutaba na mmere ezeetaagisa n’omukka gwa oxygen.
- Okwemulugunya kw’omutima: Omusawo bw’akebera omutima n’ekyuma ekiwuliriza, ayinza okuwulira eddoboozi ly’omutima eritali lya bulijjo.
Bw’olaba obubonero buno bwonna, laba omusawo mu bwangu awatali kulwa.
Lwaki kino kituuka ku balongo?
Y'ensonga lwakiEkituufu ekivaako kino tekinnamanyika. Obulema buno obw’okuzaalibwa bubaawo nga bukyali mu kukula kw’omwana mu lubuto naddala mu wiiki 6-8 ezisooka ng’ali lubuto ng’omutima gukola. Wabula ensonga eziwerako zizuuliddwa ezongera obulabe bw’embeera eno.
Ensonga ezireeta akabi
Embeera ezimu maama z’ayolekagana nazo ng’ali lubuto ziyinza okukosa kino:
- Obulwadde bw’akawuka: Okufuna obulwadde bw’akawuka ng’oli lubuto naddala ng’omusujja gw’ensiri ogw’e Girimaani.
- Ssukaali: Maama alina ssukaali era tafugibwa bulungi ng’ali lubuto.
- Okukozesa omwenge: Okunywa omwenge ng’oli lubuto.
- Eddagala erimu: Okukozesa eddagala erimu eriwonya okukonziba oba embalabe.
- Ebivaako obuzaale: Omu ku bazadde alina obulwadde bw’omutima obuzaalibwa oba omwana alina embeera y’obuzaale nga Down syndrome.
Abasawo bazuula batya obulwadde buno?
Obulwadde bwa Tricuspid atresia busobola okuzuulibwa nga tonnazaalibwa oba oluvannyuma lw’okuzaalibwa.
- Omwana nga tannazaalibwa: Singa wabaawo ekintu ekitali kya bulijjo ku mutima gw’omwana mu kiseera ky’okukebera eddoboozi ery’omwana ng’ali lubuto, abasawo bajja kukola sikaani ey’enjawulo eyitibwa fetal echocardiogram. Kino kisobozesa ensengekera y’omutima n’entambula y’omusaayi okulabibwa obulungi ennyo.
- Oluvannyuma lw’okuzaalibwa omwana: Mu kukeberebwa okusooka ng’omwana amaze okuzaalibwa, omusawo ayinza okuwulira eddoboozi ly’omutima eritali lya bulijjo (a `heart murmur`). Era, singa omwana aba bbululu, okukebera okwangu okuyitibwa `pulse oximetry` kujja kukozesebwa okupima omuwendo gwa oxygen mu musaayi. Singa bino bireeta okubuusabuusa, okukebera kwa `echocardiogram` (echo) kujja kukolebwa okuzuula obulwadde buno mu ngeri enkakafu.
Okugezesebwa kwa `Echo` kuyinza okulaga bulungi nti vvaalu ya tricuspid ebula, ventricle eya ddyo ntono, era oba waliwo ebituli ebirala mu mutima (`atrial septal defect` oba `ventricular septal defect`).
Obujjanjabi bwe buruwa?
Embeera eno tesobola kuwona ddala. Naye obujjanjabi bugenderera okukuuma omulimu gw’omutima ku mutindo ogusinga obulungi n’okulongoosa entambula y’omusaayi omubiri gusobole okufuna omukka gwa oxygen gwe gwetaaga. Enkola z’obujjanjabi zisobola okwawulwamu ebika bibiri: eddagala n’okulongoosa.
Obujjanjabi bw’eddagala
Nga tannalongoosebwa, omwana bamuwa eddagala okutebenkeza embeera. Eddagala erisinga ddagala eriyitibwa `Alprostadil`. Kino kikuuma omusuwa omutono (`ductus arteriosus`) mu mutima gw’omwana, ogutera okuggalwa ng’azaalibwa, nga guggule. Kino kireeta ekkubo eppya omusaayi okukulukuta okutuuka mu mawuggwe okumala akaseera.
Okulongoosa
Okulongoosebwa kyetaagisa nnyo omwana alina obulwadde bwa Tricuspid Atresia okusobola okuwangaala. Kino ebiseera ebisinga tekikolebwa mu kulongoosa kumu. Okusinziira ku myaka gy’omwana, kyetaagisa okulongoosebwa emirundi egiwerako mu mitendera egiwerako.
| Erinnya ly’okulongoosebwa | Ekyo ekimala okubaawo |
|---|---|
| BTT Shunt y’emmotoka | Kino kitera okukolebwa ng’okulongoosa okusooka. Mu nkola eno, akatundu akatono (shunt) kaggyibwa mu musuwa omukulu ogutwala omusaayi mu mubiri ne kayungibwa ku musuwa ogutwala omusaayi mu mawuggwe. Kino kyongera okutambula kw’omusaayi mu mawuggwe. |
| Enkola ya Glenn | Okulongoosa kuno kukolebwa ng’omwana awezezza emyezi nga 4-6. Mu nkola eno, omusaayi ogutaliimu mukka gwa oxygen oguva mu mubiri ogwa waggulu gukyusibwa butereevu ne gugenda mu mawuggwe, ne guyita ku mutima. |
| Enkola ya Fontan | Guno gwe mutendera ogusembayo mu kulongoosa. Kikolebwa ng’omwana ali wakati w’emyaka 2-4. Wano, omusaayi ogutaliimu mukka gwa oxygen oguva mu kitundu eky’okunsi eky’omubiri guyungibwa butereevu ku mawuggwe. Oluvannyuma lw’okulongoosebwa kuno, okutabula omusaayi ogulimu omukka gwa oxygen n’omusaayi ogutaliimu mukka gwa oxygen kumpi kukoma ddala. |
Oluvannyuma lw’okulongoosebwa kuno, omwana ajja kuba alina okumala wiiki emu oba bbiri mu ddwaaliro. Okusooka mu kisenge ky’abalwadde abayi, oluvannyuma n’akyusibwa n’atwalibwa mu waadi eya bulijjo. Singa okulongoosa kuno tekugenda bulungi oba singa omutima gunafuwa okumala ekiseera, kiyinza okulowoozebwako okukyusa omutima.
Obulamu bw’omwana bunaaba butya oluvannyuma lw’okujjanjabibwa?
Okulongoosa kuno kuyinza okusembereza omwana n’obulamu obwa bulijjo. Kyokka, bajja kwetaaga okubeera wansi w’omusawo w’omutima obulamu bwabwe bwonna.
- Omwana okwekebejjebwa buli kiseera: Emyaka gy’omwana n’omutendera gw’obujjanjabi bye bijja okusalawo emirundi omusawo gy’alina okumulaba. Oluvannyuma lw’okulongoosebwa Fontan, ojja kwetaaga okugenda okwekebejjebwa waakiri omulundi gumu mu mwaka.
- Okulondoola awaka: Oluusi omusawo ayinza okukusaba okulondoola buli kiseera n’okuwandiika ebintu ng’obuzito bw’omwana wo n’omukka gwa oxygen awaka.
- Eddagala eritta obuwuka: Oyinza okwetaaga okumira eddagala eriziyiza obuwuka okuziyiza yinfekisoni nga tonnagenda mu bintu ng’okujjanjaba amannyo.
- Okukola emirimu gy’omubiri:Kiyinza okwetaagisa okussa ekkomo ku mizannyo n’emirimu egy’amaanyi. Yogerako n’omusawo wo ku nsonga eno ofune amagezi.
- Obulemu mu kuyiga: Abaana abamu abalina obulwadde bwa Tricuspid Atresia balina akabi akatono ak‟okufuna obuzibu mu kuyiga oba obuzibu bw‟okufaayo ennyo (ADHD). Kino nakyo kikulu okukuuma eriiso.
Kiki ky’oyinza okwogera ku bulamu bw’abaana bano?
Eno nsonga ya maanyi nnyo. Mu butuufu, singa tebajjanjabwa, abalongo bangi abalina obulwadde bwa Tricuspid Atresia tebajja kutuuka wadde okukuza amazaalibwa gaabwe agasooka.
Kyokka bwe balongoosebwa, embeera eno ekyuka ddala. Olw’okukulaakulana kwa tekinologiya w’obusawo leero, abaana abasinga obungi abalongoosebwa bawangaala okutuusa lwe bakula. Okusinziira ku kunoonyereza okumu, abasinga obungi ku abo abalongoosebwa bawangaala emyaka egisukka mu 20. Kisuubirwa nti omwana eyalongoosebwa `Fontan` asobola okuwangaala emyaka 35-40 oba okusingawo.
Obubaka Obutwala Awaka
- Tricuspid atresia bulwadde bwa mutima obw’amaanyi obuzaalibwa nabwo nga mu bubonero bwa vvaalu ku ludda olwa ddyo olw’omutima tebuliiwo.
- Obubonero obukulu bw’olususu lw’omwana okufuuka bbululu, okukaluubirirwa okussa, n’okukaluubirirwa okuliisa.
- Wadde nga kino kitta obulamu, okulongoosa okw’omulembe okwa leero kuyinza okuwa omwana omukisa okubeera n’obulamu obulungi.
- Obujjanjabi buno butera kubaamu okulongoosa okuddirira okukolebwa mu mitendera egiwerako.
- Oluvannyuma lw’okulongoosebwa, omwana ajja kwetaaga okulondoola obulamu bwe bwonna omusawo w’omutima.
- Ng’omuzadde, tolwawo okukubaganya ebirowoozo n’omusawo wo ku kintu kyonna ekikweraliikiriza oba ky’otya. Gy’okoma okumanyibwa, gy’okoma okusobola okulabirira omwana wo mu ngeri esinga obulungi.
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