Ese umwana wawe afite ikibazo cyo kurwara ubwonko? Reka twige kuri ubu buryo bwo kubaga SDR (Selective Dorsal Rhizotomy)

Nk'umubyeyi cyangwa se, wumva ubabaye ute iyo ubonye umwana wawe arwaye indwara yo mu bwonko , agorana kugenda, kwiruka, gusimbuka no gukora imirimo ya buri munsi? Biragoye cyane kureba umwana ababara cyane mu maguru, ni ukuvuga imitsi igoramye (spasticity), si byo se? Uyu munsi turimo kuvuga ku kubagwa kwihariye gushobora gufasha bene abo bana.

Gupima amenyo y'umugongo (Selective Dorsal Rhizotomy) (SDR) ni iki?

Muri make, Selective Dorsal Rhizotomy (SDR) ni uburyo bwo kubaga bukorwa kugira ngo bugabanye burundu imitsi igoramye (spasticity) ku bana bafite cerebral palsy.

Ibi bikubiyemo gukata no gukuraho imitsi imwe n'imwe y'imitsi ifata amaguru mu gice cyo hasi cy'umugongo itera amaguru gukomera. Ariko ntugahangayike, ubu buryo bwo kubaga ntabwo buzagabanya amaguru y'umwana. Ntabwo kandi buzagira ingaruka ku kuntu amaguru agenda.

Ariko ikintu kimwe ugomba kuzirikana: Kugira ngo ubone ibisubizo byiza muri ubu buvuzi, ugomba gukora ubuvuzi bw'umubiri buhanitse no gukora gahunda zo kuvura indwara nyuma yo kubagwa. Nanone, ubu buvuzi ntibukwiriye abana bose bafite ubumuga bwo mu bwonko.

Ni izihe ndwara zivurwa hakoreshejwe uburyo bwa SDR?

Abaganga bakoresha ubu buryo bwo kubaga bwa SDR kugira ngo bavure imitsi idakomera (spasticity) ku bana bafite ubumuga bwo mu bwonko.

Indwara yo mu bwonko ( CP ) ni indwara igira ingaruka ku bushobozi bw'umwana bwo kugenzura imitsi ye. Iterwa no kwangirika kw'ibice by'ubwonko bigenzura ingendo n'imikorere y'umubiri. Abana benshi bafite CP bafite ikibazo cyitwa spasticity . Ibi bivuze ko iyo umwana agerageje kwimuka, cyangwa rimwe na rimwe agahagarara gusa, imwe mu mitsi ihita yifata igakomera. Ibi bishobora gutuma ibintu nko kugenda bigorana, bigatera ububabare, kandi bikabangamira imirimo ya buri munsi .

Kubaga SDR bikorerwa ahanini abana bafite indwara ya Spastic Diplegic Cerebral Palsy, ifata amaguru abiri gusa, na Spastic Quadriplegic Cerebral Palsy, ifata cyane amaguru ane yose.

Uku kubagwa bikora gute?

Tekereza, uburyo imitsi ifatana mu mubiri wacu igenzurwa n'imikorere y'imitsi mu ruti rw'umugongo. Muri ibi, imitsi ifatana izana amakuru ava mu mitsi ijya mu ruti rw'umugongo, hanyuma umutsi ugenda usubira muri iyo mitsi ugatuma ifungana.

Ubusanzwe, iyi gahunda igenzurwa n'ubutumwa buturuka mu bwonko bwacu. Ibyo bivuze ko dushobora kugenzura imitsi yacu uko tubyifuza. Ariko, mu ndwara yo mu bwonko itera indwara yo mu bwonko, ubushobozi bw'ubwonko bwo kuyigenzura buragabanuka. Kubera iyo mpamvu, imitsi imwe ihora ifunganye kandi igakomera.

Kubaga SDR bishobora gukuraho ubu bukomere bukabije (spasticity). Umuganga ubaga ahitamo kandi agakata gusa imizi y'imitsi idasanzwe ituma ubwo bukomere butera ubu bukomere. Niyo mpamvu bishoboka kugabanya ubukomere butibagiwe n'izindi ngaruka. Mu gihe cyo kubaga, iyo mitsi yose irapimwa kugira ngo hamenyekane neza imitsi ikora neza n'iyo ari yo mitsi ifite ikibazo.

Iyo ubu bukomere bushize, imitsi yo munsi ishobora gutangira gukora neza. Icyo gihe, kugenda k'umwana, nko kugenda, bizarushaho kuba byiza. Nanone, iyo ubu bukomere bukomeje, ibyago byo gucika kw'imitsi no kugorama kw'ingingo n'amagufwa bishobora kwirindwa muri ubu buvuzi.

Ni gute wategura umwana kubagwa SDR?

Kubera ko kubagwa kwa SDR bidakwiye buri mwana, umwana wawe azakorerwa isuzuma ryihariye kugira ngo barebe niba bizamugirira akamaro. Kugira ngo ibi bigerweho, abaganga benshi b'inzobere bazasuzuma umwana.

Aba bantu bose basuzuma umwana bagafatanya nk'ikipe kugira ngo barebe niba kubaga SDR bikwiriye umwana. Byongeye kandi, hari n'ibindi bizamini byinshi bishobora gukorwa:

• Kugira ngo bategure uburyo bwo kuvura nyuma yo kubagwa, abaganga b'imitsi n'abakora akazi kabo bafatira amashusho y'ingendo n'ibikorwa by'umwana.
• MRI y'ubwonko kugira ngo harebwe neza ko nta zindi ndwara z'imitsi.
• Hurira n'umuganga w'imitsi kugira ngo umusobanurire ingaruka zo kubagwa n'inzira yo gukira.
• Hurira n'inzobere mu gutera ikinya kugira ngo urebe neza ko gutera ikinya ari nta kibazo ku mwana.

Ni iki kibaho mu gihe cyo kubagwa?

Izi ni intambwe zikunze kubaho mu gihe cyo kubaga SDR.

1. Anesthesia: Umuganga w’inzobere mu by’imiti atera anesthesia umwana. Ibi bituma umwana asinzira kandi ntagire ububabare mu gihe cyo kubagwa.

2. Gukata: Umuganga w’imitsi akora akantu gato hagati mu mugongo wo hasi w’umwana.

3. Guhura n'imitsi: Binyuze muri iyo mvune, hakorwa "idirishya" rito hagati y'amagufwa y'umugongo n'agace k'umugongo (dura) gatwikira umugongo, maze imitsi yo munsi igaragara.

4. Gutandukanya imitsi: Hanyuma, imitsi ijyana n'imyakura ...

5. Gupima imitsi: Hakoreshejwe electrodes, uburyo bwitwa electromyography (EMG) bukoreshwa mu gukangura imitsi ikoresha ibyuma. Ibi bishobora gufasha kumenya imitsi idasanzwe itera spasticity n'imitsi isanzwe.

6. Guca imitsi:Hanyuma, ijanisha runaka ry'imitsi idasanzwe iboneka iracibwa. Ingano y'imitsi icibwa iratandukana bitewe n'umwana.

7. Gukata inshinge: Nyuma yo gukata imitsi, inshinge zishyirwa inyuma zifunze neza.

8. Icyumba cyo gukira: Nyuma yo kubagwa, umwana akurikiranwa mu cyumba cy’indembe (ICU).

Ubusanzwe ubu buvuzi bumara amasaha ane cyangwa atanu.

Ni iki kibaho nyuma yo kubagwa? Kandi ni izihe nyungu?

Nyuma yo kubagwa, umwana azakenera kuguma mu bitaro iminsi itanu. Mu masaha 24-48 ya mbere, umwana azakenera kuguma mu buriri. Ubuvuzi bw'umubiri buzatangira mu minsi mike.

Ibyiza ku bana bafite CP bigira ingaruka ku maguru gusa (Spastic Diplegic CP):

• Gutembera neza no kugenda neza.
• Kongera imbaraga.
• Kugabanuka kw'igabanuka no kunoza uburinganire.
• Kwicara neza no guhagarara neza.
• Kugabanya ububabare buterwa no gucika intege.

Ibyiza ku bana barwaye Spastic Quadriplegic CP:

• Ubushobozi bwo kwicara neza igihe kirekire.
• Kuba ushobora gukoresha intebe yo mu gikoni.
• Ubushobozi bwo gukoresha intebe y'abamugaye ku giti cyabo.

Nanone, kubera ko imitsi idakomera cyane, biroroha ku barera umwana guhindura ipantaro ye no kumugaburira.

Ni izihe ngaruka mbi zishobora guterwa n'ubu buvuzi?

Nk’uko bigenda mu kubaga kose, imiti igabanya ubukana bw’indwara zo mu mutwe (SDRs) ifite ingaruka nto.

Ingorane z'igihe gito:

• Kwandura
• Kuva amaraso
• Kuva kw'amazi yo mu bwonko (CSF)

Ingorane zidashira (zidakunze kubaho cyane):

• Kumva umuntu akozeho cyane (hyperesthesia), rimwe na rimwe bigana n'ububabare.
• Kubura uburyo bwo kugenzura inkari (kunanirwa kwihagarika inkari).
• Kubura uburyo bwo kugenzura amara (kunanirwa kwifata).
• Intege nke cyangwa gutakaza ubushobozi bwo kugenda mbere.

Ntugahangayike, itsinda ry’abaganga b’umwana wawe rizagusobanurira neza izi ngaruka zose mbere yo kubagwa.

Igihe cyo gukira n'akamaro ko kuvura umubiri

Ubuvuzi bw'umubiri n'ubuvuzi bw'akazi ni ingenzi cyane nyuma yo kubagwa. Iyi gahunda yo kuvura indwara ni ingenzi kugira ngo hagerwe ku musaruro w'ubuvuzi.

Umuganga w’imitsi azakora imyitozo ngororamubiri kugira ngo akomeze, agorore, kandi arusheho kunoza imitsi y’umwana. Umuganga w’imitsi azafasha umwana kwigenga mu rugo no ku ishuri.

Mbere yuko umwana wawe ava mu bitaro, abaganga bazagusobanurira neza imyitozo n'uburyo bwo kuvura ugomba gukorera mu rugo. Uzakenera gukora ubu buryo iminsi myinshi mu cyumweru mu gihe cy'amezi 3-6.

Niba ubonye ibimenyetso by'ingorane nyuma yo kubagwa k'umwana wawe, nko kwandura igikomere cyangwa kubura uburyo bwo kugenzura inkari, hamagara muganga wawe vuba.