Ese umwana wawe afite HLHS? Reka twige ku bijyanye n'uburyo bwa Norwood Procedure mu magambo make

Nk'umubyeyi, ndumva ukuntu umerewe nabi kandi ukagira ubwoba iyo muganga akubwira ko umwana wawe uvutse afite ikibazo cy'umutima cyitwa Hypoplastic Left Heart Syndrome (HLHS). Byari bimeze nk'aho isi yawe yose yaguye mu buryo butunguranye. Ariko ntugahangayike. Uyu munsi, siyansi y'ubuvuzi yateye imbere cyane. Uburyo bwa Norwood ni intambwe ya mbere y'ingenzi mu guha ubuzima abana nk'abo. Uyu munsi, tuzaganira kuri ibi mu buryo bworoshye ushobora gusobanukirwa, kugira ngo ugabanye ubwoba bwawe.

Uburyo bwa Norwood bwo kuvura indwara ni ubuhe?

Muri make, uburyo bwa Norwood bwo kubaga umutima bukorerwa abana bafite ikibazo cy’umutima bavukanye (bavutse bafite) cyitwa Hypoplastic Left Heart Syndrome (HLHS) .

Tekereza nk'inzu nto ifite ibyumba bine. Ifite ibice bibiri, uruhande rw'iburyo n'uruhande rw'ibumoso. Ubusanzwe, uruhande rw'ibumoso rw'umutima rutanga amaraso meza kandi akungahaye kuri ogisijeni ku mubiri wose. Uruhande rw'iburyo rutanga amaraso yakuwe mu mubiri ajyanwa mu bihaha kugira ngo anyuzwemo ogisijeni.

Ariko, uruhande rw'ibumoso rw'umutima w'umwana ufite HLHS ntirukura neza . Ibyo bivuze ko urwo ruhande ari ruto cyane kandi rufite intege nke. Bityo urwo ruhande ntirushobora kohereza amaraso mu mubiri. Iki ni cyo kibazo gikomeye.

Uburyo bwa Norwood bukora ikintu gitangaje. Abaganga bahanga inzira nshya amaraso atembera mu mutima. Ni ukuvuga ko bayobora akazi uruhande rw'ibumoso rw'umutima rugomba gukora ku ruhande rw'iburyo, ibyo bikaba bikora neza . Nyuma yo kubagwa, ventricle y'iburyo y'umwana itangira kohereza amaraso arimo ogisijeni mu mubiri wose, ndetse no kohereza amaraso mu bihaha.

Ni nde ukeneye ubu buvuzi?

Ubu buryo bwo kubaga bukenewe cyane cyane ku bana bafite indwara ya Hypoplastic Left Heart Syndrome (HLHS) . Bagomba kubagwa mu byumweru bibiri bya mbere bavutse.

Mu gihe cyo kuvuka, buri mwana aba afite isano nto hagati y’imitsi ibiri y’ingenzi y’amaraso mu mutima (aorta n’imitsi y’ibihaha). Ibi byitwa `patent ductus arteriosus`. Ibi bituma umwana ufite HLHS ashobora kugeza amaraso mu mubiri we mu minsi mike ya mbere. Ariko, iyi sano izafunga nyuma y’iminsi mike. Ibi nibibaho, umwana nta buryo azaba afite bwo kugeza amaraso mu mubiri we, ibyo bikaba ari akaga gakomeye.

Kubwibyo, ikintu cya mbere abaganga bakora ni ugutanga umuti wihariye (witwa `Prostaglandin`) kugira ngo imitsi y'amaraso idafunga. Ariko ibyo ni iby'igihe gito. Kubaga Norwood bikorwa nk'igisubizo kirambye.

Hari igihe ubu buryo bwo kubaga bushobora kudashoboka ku bana bavutse igihe kitageze, bavutse bafite ibiro bike, cyangwa bafite izindi ngorane. Muri ibyo bihe, abaganga bakoresha ubundi buryo, nko guterura imitsi y'ibihaha.

Ni iki kibaho mu gihe cyo kubagwa na nyuma yaho?

Mbere no mu gihe cyo kubagwa

Mbere yo kubagwa, umwana aba ari mu cyumba cy’indembe (ICU). Nkuko byavuzwe mbere, bazakomeza gutanga imiti yo gutuma umutsi wihariye w’amaraso uguma ufunguye. Bishobora kandi kuba ngombwa kwagura umwobo uri hagati y’ibyumba bibiri byo hejuru by’umutima (`septostomy`).

Uburyo bwa Norwood bukorwa mu gihe cy'amasaha menshi bugoye cyane (ubusanzwe amasaha 8-10). Itsinda ry'abaganga rikora ibi bikurikira neza:

• Umwobo ucukurwa hagati y’ibyumba bibiri byo hejuru (atria) by’umutima kugira ngo amaraso atembera.
• Umuyoboro muto w’amaraso uhujwe n’imitsi minini y’ibihaha, kandi hashyirwamo agace kadasanzwe kugira ngo hakorwe umuyoboro mushya kandi munini w’amaraso.
• Iyi aorta nshya ihujwe na ventilateur y'iburyo ikora.
• Hanyuma, hashyirwamo 'shunt' , umuyoboro muto w'ubukorano, kugira ngo wohereze amaraso mu bihaha. Ibi bishobora kuva kuri aorta kugera mu bihaha (Blalock-Taussig shunt) cyangwa kuva kuri ventilateur y'iburyo kugera mu bihaha (Sano shunt).

Muri iki gikorwa cyo kubaga, umwana aba ahujwe n'imashini ikoresha umutima n'ibihaha . Ibi bivuze ko umutima n'ibihaha by'umwana biba birimo gukoreshwa by'agateganyo n'iyi mashini.

Nyuma yo kubagwa

Nyuma yo kubagwa, umwana asubizwa mu cyumba cy’indembe (ICU). Iyo ugiye kureba umwana, uzabona imiyoboro myinshi, insinga, n’imashini. Ntugatinye iyo ubibonye. Byose biriho kugira ngo umwana agire ubuzima bwiza, bifashe umwana . Uzabona igitambaro gipfutse igikomere cyo kubagwa kiri hagati mu gituza.

Ndetse na nyuma y'uku kubagwa, uruhu rw'umwana rushobora kugira ibara ry'ubururu gato (cyanosis) . Ibi biterwa nuko amaraso amwe yakuwemo ogisijeni n'amaraso yakuwemo ogisijeni bikiri kwivanga mu mutima. Ibi ni ibisanzwe muri iki cyiciro.

Nyuma y'icyumweru kimwe mu cyumba cy'indembe, umwana azimurirwa mu cyumba gisanzwe. Uzakenera kumara ibyumweru 2-3 mu bitaro kugira ngo akire neza. Nyuma yo gutaha, abaganga n'abaforomo bazaguha amabwiriza arambuye y'uburyo bwo kwita ku mwana, uburyo bwo kumuha imiti, n'uburyo bwo kugenzura urugero rw'umwuka we wa ogisijeni.

Urukurikirane rw'ibikorwa byo kubaga HLHS

HLHS ntigarukira mu kubagwa rimwe gusa. Ni urukurikirane rw'ibyiciro bitatu by'ukubaga . Norwood ni icyiciro cya mbere gusa.

Ni izihe nyungu n'ingaruka byagira?

Ibyiza

Icyiza gikomeye kandi cyonyine cy’ibi ni uko umwana agira amahirwe yo kubaho . Mbere y’imyaka ya 1980, nta buvuzi bwari buhari ku bana bavukanye HLHS. Ariko kuva aho uburyo bwa Norwood buvumburiwe, aba bana bagize amahirwe yo kubaho kugeza mu bwana no mu bwangavu.

Ingaruka n'ingorane

Kimwe n'ubundi buryo bwose bwo kubaga bunini, hari ingaruka zishobora kubaho. Ni ngombwa kubimenya.

• Kuziba cyangwa kudakora neza kw'imitsi: Umuyoboro muto ujyana amaraso mu bihaha ushobora kuziba.
• Kugabanuka kw'imitsi y'amaraso (Stenose): Aorta cyangwa imitsi y'amaraso ijya mu bihaha ishobora kuba mito.
• Ugutera k'umutima (Arrhythmia): Imitere y'umutima ishobora kuba idahuye.
• Kugabanuka k'imikorere y'umutima: Uko ventricle y'iburyo igomba gutwara uburemere bwinshi, imikorere yayo ishobora gucika intege.
• Gutinda mu mikurire y'ubwonko: Hari aho gutinda mu mikurire y'ubwonko n'imitsi bishobora kubaho. Ingaruka zabyo ni uko bamwe mu bana bashobora gukenera ubufasha bwihariye mu bintu nko kuvuga no kugenda.

Igipimo cyo kubaho mu bitaro nyuma yo kubagwa kwa Norwood kiri hejuru cyane kigera kuri 90%. Ariko, hari aho abana bamwe batagera mu kubagwa kwa kabiri.

Ni ryari ukwiye kujya kwa muganga wawe?

Ugomba kwita cyane ku mwana wawe umaze kugera mu rugo. Niba ufite ikibazo, hamagara muganga wawe ako kanya.Witondere cyane ibi bintu:

• Niba ufite ikibazo icyo ari cyo cyose kijyanye no kwita ku mwana wawe mu rugo.
• Niba umwana atari kwiyongera ibiro neza.
• Niba urugero rwa ogisijeni rw'umwana ruri hasi ugereranije n'ibyo muganga yavuze ko biteganijwe.
• Iyo umwana adakira neza imiti yahawe.
• Iyo umwana asinzira cyane kurusha uko bisanzwe cyangwa akaba yaragabanije amashereka.