Mwana wako ane dambudziko pakati pechipfuva chake nedumbu here? Ngatikurukurei nezve (Congenital Diaphragmatic Hernia - CDH)!

Kana uri amai vanozobereka kana kuti uchitarisira kuti mumwe munhu mutsva auye kumhuri yako, nyaya iyi ichave yakakosha kwauri. Dzimwe nguva vana vedu vanogona kuuya munyika ino vaine hurema hwekuzvarwa nahwo hwatisati tambonzwa nezvahwo. Ndiyo imwe yemamiriro ezvinhu atichataura nezvawo nhasi, akaoma zvishoma, asi akakosha kuziva.

Chii chinonzi CDH? Ngatinzwisise zviri nyore.

Zvakanaka, ngationei kuti iyi `(Congenital Diaphragmatic Hernia)` kana `(CDH)` chii muchidimbu. Zvichitaurwa zviri nyore, iyi inyaya inoitika pakuzvarwa. Izvi zvinoitika mwana achiri mudumbu. Kune tsandanyama inoparadzanisa chipfuva chedu nedumbu, yatinodaidza kuti `Diaphragm` . Yakafanana nemadziro anoparadzanisa makamuri maviri. Kana diaphragm iyi isina kusimba zvakakwana, kana paine buri mairi, nhengo dziri mudumbu - kureva dumbu, ura, chiropa, nezvimwewo - dzinogona kupinda muchipfuva. Ndizvo zvatinodaidza kuti `(Hernia)`, kana kuti hernia.

Zvino fungidzira kuti chii chingaitika kana chimwe chinhu chakadai chikaitika mwana achiri kukura mudumbu. Kana nhengo dziri mudumbu dzichipinda muchipfuva, hapana nzvimbo yakakwana, handiti? Dambudziko guru nderekuti mapapu haana nzvimbo yakakwana yekukura zvakanaka. Kana mapapu ari madiki, ndiko kuti, kana chirwere chinonzi `(Pulmonary Hypoplasia)` chikaitika, mwana anonetseka kufema mushure mekuzvarwa, uye ropa hariwani oxygen yakakwana. Kwete izvozvo chete, asi BP mumapapu inogonawo kuwedzera. Izvi zvinoisawo kumanikidzwa kwakanyanya pamoyo. Saka, mwana ane `(CDH)` anoda kurapwa kwakakosha mushure mekuzvarwa.

Ndezvipi zviratidzo zvemwana ane CDH?

Kana mwana wako achinetseka zvakanyanya kufema mushure mekuzvarwa, zvinogona kuva chiratidzo chikuru chechirwere ichi (CDH). Pamusoro pezvo, unogona kuonawo zvinhu zvakaita se:

• Kurova kwemoyo kunokurumidza (Tachycardia).
• Cyanosis iruvara rwebhuruu rweganda runokonzerwa nekushaikwa kweokisijeni.
• Kufema kwakaderera zvikuru (kunyanya kune rumwe rutivi).
• Kunzwa ruzha rwematumbu paunoisa nzeve yako pachipfuva.
• Chipfuva chinobuda uye chinoita sechirongo, ukuwo dumbu richiratidzika kunge riri kunyura mukati.

Kana mwana wako aine chimwe chezviratidzo izvi kana kupfuura, zvakanaka kuti uone chiremba nekukasika.

Sei chirwere ichi chichikura? Ndezvipi zvinokonzera?

Zvakaoma kuti vanachiremba vataure kuti chii chaizvo chinokonzera chirwere ichi chinonzi "(CDH)``. Zvisinei, tsvakurudzo yakawana kuti zvinhu zvinotevera zvinogona kunge zvichibatanidzwa:

• Zvinhu zvinoumba majini: Kureva kuti, zvimwe zvinhu zvinopfuudzwa nezvizvarwa.
• Kusangana nezvinhu zvinokuvadza panguva yekuzvitakura: Zvinhu zvakaita semamwe makemikari nefodya.
• Kusadya kwakakwana kwemwana ari mudumbu: Mwana anowana kudya kwake kubva muchikafu chinodyiwa naamai.

Izvi ndizvo zvikonzero zviripo pari zvino, asi tsvakiridzo iri kuitwa pamusoro peizvi.

Ndezvipi zvinetso zvinogona kuitika nekuda kweCDH?

Sezvatakambotaura, vacheche vazhinji vane CDH vane mapapu asina kukura zvakanaka (Pulmonary Hypoplasia). Izvi zvinogona kukonzera matambudziko akasiyana-siyana:

• Mwero weokisijeni muropa (Hypoxemia): Izvi zvinokanganisa nhengo dzese dzemwana, kunyanya uropi nemoyo. Kana chirwere ichi chakanyanya kana kuti chikaramba chiripo, chinogona kukonzera kukuvara kwenguva refu.
• Kukwira kweropa mutsinga dzemapapu (Pulmonary Hypertension): Izvi zvinoisa simba rakawanda kurudyi rwemoyo uye zvinogona kutokonzera kutadza kushanda kwemoyo.
• Utachiona hweMapapu: Mapapu asina kukura zvakanaka anogona kutanga kutapurirana utachiona hwakadai sepneumonia. Kunyangwe kana hernia yagadziriswa nekuvhiyiwa, njodzi yekutapurirana uku inogona kuramba iripo kweupenyu hwese.

Pamusoro peizvi, vacheche vane `(CDH)` vangangove nemamwe matambudziko:

• Matambudziko ekudya: Izvi zvinogona kukonzerwa nekumanikidzwa kwenhengo dzemudumbu kana nekuda kwekurapwa kwakawanda panguva yekuzvarwa. Vamwe vacheche vangada kupihwa machubhu kwenguva yakareba, uye vanogonawo kuona kusakura zvakanaka.
• Kunonoka Kukura: Vamwe vacheche vangada kurapwa nemuviri, kutaura kana basa kwenguva yakati nekuda kwekushaya mweya wekufema.
• Kurasikirwa Nekunzwa Kwetsinga: Vamwe vacheche vane CDH vanorasikirwa nekunzwa kwavo zvishoma nezvishoma. Masayendisiti haasati ava nechokwadi kana izvi zvichikonzerwa nechirwere chacho, kurapwa kwacho, kana zvese zviri zviviri.

Fungidzira kuti amai kana baba vanofanira kunzwa mutoro wakakura sei pavanonzwa chinhu chakadai. Asi yeuka, sainzi yezvekurapa yafambira mberi zvikuru ikozvino.

Vanachiremba vanoongorora sei chirwere cheCDH?

Kazhinji, vanachiremba vanogona kuona chirwere ichi panguva yekuongororwa kweultrasound kwemwana asati aberekwa panguva yekuzvitakura. Kana zvaonekwa, vanozoita mimwe miedzo. Semuenzaniso, vanozoita MRI yemwana asati aberekwa kuti vaone hernia yacho zvakajeka. Vachaitawo echocardiogram yemwana asati aberekwa kuti vaone kana moyo wemwana asati aberekwa wakakanganiswa.

Dzimwe nguva, vanachiremba vanogona kusaona CDH kusvika mwana azvarwa. Mushure mekunge mwana azvarwa, timu yezvekurapa inogona kufungidzira kana vakaona zvinhu zvakaita sekuoma kwekufema, septum yakatsauka, kana chipfuva chakazvimba. Vanobva vaita X-ray yechipfuva uye echocardiogram . Vanogonawo kutora sampuro yeropa kuti vatarise huwandu hweokisijeni muropa remwana uye kuti vatarise zvimwe zvirwere zvemajini .

Kashoma, vacheche vane CDH vanogona kusaratidza zviratidzo zvikuru pakuzvarwa. Kana hernia iri diki kwazvo, inogona kusaonekwa pahudiki, kana kunyange pakukura.

Ndezvipi zvirongwa zvekurapa chirwere cheCDH?

Kurapwa kwechirwere ichi, "Congenital Diaphragmatic Hernia", kunotanga kana changoonekwa. Unganzwa kutya paunonzwa nezvekurapa uku, asi yeuka kuti vanachiremba vari kuita zvese zvavanogona kuti vadzivirire mwana wako.

Kurapwa kwemwana asati aberekwa

Kana ukaonekwa uine CDH panguva yekuzvitakura, chiremba wako achakutarisa zvakanyanya. Vachaongorora matambudziko ari munhengo dzemuviri, sezvo dzimwe nguva zvichigona kuva chikamu chechirwere chakaoma. Vachaongororawo kana mwana wako achizoberekwa nguva isati yakwana (premature labor), uye kana zvakadaro, vachasarudza kana vachida kusimudzira kusununguka (induce labor) kuti vabatsire hutano hwemwana.

Mune zvimwe zviitiko zvakakosha, timu yezvekurapa inogona kurapa mwana asati aberekwa. ``Fetoscopic Tracheal Occlusion (FETO)`` ndeimwe yekuvhiya kwemwana asati aberekwa. Inobatsira kuvandudza saizi uye mashandiro emapapu emwana paanokura mudumbu. Izvi zvinoitwa uchishandisa kamera diki inonzi ``Fetoscopy``, kuburikidza nekucheka kudiki kunogadzirwa neganda rako kuenda mudumbu rako.

Mukuita uku kwe `(FETO)`, chiremba anoisa bharumu diki mu`(Trachea)` yemwana ari mudumbu. Zvadaro, `(Amniotic Fluid)` inounganidzwa nemwana kuseri kwebharumu nemukati memapapu, zvichiita kuti mapapu azvimbe. Kuzvimba uku kunovandudza kukura nekushanda kwemapapu, uye kunobatsira kugadzirisa kumwe kukuvara kunokonzerwa ne`(CDH)`.

Kurapa kwevana vacheche

Vana vanozvarwa vaine CDH vanowanzoda rubatsiro rwakanyanya kubva kuchikwata chenyanzvi mushure mekuzvarwa. Kana mapapu emwana asati anyatsokura (Pulmonary Hypoplasia), vanotanga vapihwa rutsigiro rweokisijeni. Kune vamwe vacheche, iyi ingave chubhu yekufema yakabatana nemuchina wekufema .

Vamwe vacheche vangada rutsigiro rwakasimba rwehupenyu. Izvi zvinonzi Extracorporeal Membrane Oxygenation (ECMO) . Izvi zvinosanganisira kunzvenga mapapu emwana asati akura uye dzimwe nguva mwoyo, uye kushandisa muchina kuwedzera oxygen muropa nekuridzosera mumuviri wemwana.

Zvadaro, mwana achada kuvhiyiwa. Mwana achachengetwa muNeonatal Intensive Care Unit (NICU) kusvika mwana agadzikana zvakakwana kuti avhiyiwe. Izvi zvinowanzoreva kusvika BP yakwira mumapapu (pulmonary hypertension) yaderera uye extracorporeal membrane oxygenation (ECMO) isisadiwi.

Pakuvhiyiwa, chiremba wevana anorara mwana achibatsirwa neanesthesia . Zvadaro chiremba wevana anozoita oparesheni yacho.Kuvhiyiwa uku kunosanganisira kufambisa nhengo dzakabviswa pachipfuva dzichidzokera mudumbu uye kugadzirisa dambudziko riri mu diaphragm. Kazhinji, inova hafu yekuvhiyiwa kwese, vanachiremba vanokwanisa kuita kuvhiyiwa kushoma (MIS) kunosanganisira kucheka zvidimbu zvidiki zvemamirimita matatu pachinzvimbo chekucheka kukuru .

Nguva yekupora yakaita sei?

Mwana wako paanopora kubva pakuvhiyiwa, zvishoma nezvishoma uchabviswa okisijeni. Ucharamba uchipiwa chikafu kuburikidza nechubhu kusvika chubhu yekufema yabviswa. Mushure meizvozvo, vanachiremba vekutaura nenyanzvi dzekuyamwisa vachakubatsira iwe nemwana wako kutanga kudya nemuromo. Vamwe vacheche vanotora nguva yakareba kuti varege kupa okisijeni nechubhu kupfuura vamwe. Chikwata chako chekurapa chichakutsigira chero bedzi zvichidikanwa.

Remangwana revacheche vane CDH rakaita sei?

Mashoko akanaka ndeekuti huwandu hwevanhu vanozvarwa vaine chirwere cheCDH hwavandudzika zvikuru. Pakati pevana vanomwe nepfumbamwe pavana gumi vanorarama. Kunyangwe vana ava vachiberekwa vaine zvirwere zvakakomba, kana vakapfuura nemazuva mashoma ekutanga, mikana yavo yekupona inova nani zvikuru. Vamwe vana vanogona kunge vaine matambudziko kwenguva refu, asi vanogonawo kurarama hupenyu hurefu, hwakazara. Nekufambira mberi mune zvesainzi yezvekurapa, huwandu hwevanhu vanopona kwenguva pfupi uye mhedzisiro yehutano kwenguva refu iri kuwedzera zuva nezuva.

Kufanotaura kwenguva refu kunoenderana nezvinhu zvakati wandei:

• Mwana akazvarwa nguva isati yakwana here?
• Kurwara kwemwana kwaive kwakaipa sei pakuzvarwa kwake.
• Kukura kwehernia.
• Ndeipi nhengo yapinda muchipfuva?
• Pane zvimwe zvinetso zvehutano here?

Vacheche vanoda rubatsiro rwekufema kana rwekudyiswa kwenguva yakareba vari panjodzi huru yekusangana nematambudziko anoramba aripo, akadai sechirwere chemapapu chisingaperi, kutadza kukura zvakanaka, kurasikirwa nekunzwa, uye kunonoka kukura. Chiremba wemwana wenyu achavatarisa zvakanyanya mumakore avo ekutanga.

Kuziva kuti mwana wako ane hernia yekuzvarwa nayo inogona kutyisa uye kunetsa. Mwana wako achaendeswa kuchipatara chevarwere vane chirwere (ICU) mushure mekuzvarwa, uye angatofanira kugara muchipatara kwenguva yakareba. Asi nekufambira mberi mune zvesainzi yezvekurapa, mamiriro echirwere ichi ari nani kupfuura kare. Kunyangwe iyi iri nguva yakaoma, kune timu yevanachiremba nevakoti pano kuti vakubatsire iwe nemwana wako achangoberekwa. Vachakutsigira kubva panguva yekuongororwa chirwere, muhupenyu hwese hwemwana wako.

Zvinhu zvatinofanira kurangarira

Kunyange hazvo chirwere ichi chinonzi `(Congenital Diaphragmatic Hernia - CDH)` chakakomba zvishoma, kana ukachiziva pachine nguva, unogona kutarisana nacho usingatyi.

• CDH chirwere chinoitika pakuzvarwa uye chinoita kuti nhengo dzemudumbu dzifambe dzichienda muchipfuva nekuda kwekusagadzikana kuri mu diaphragm.
• Izvi zvinonyanya kukanganisa kukura kwemapapu.
• Izvi zvinogona kuonekwa kuburikidza nekuskena panguva yekuzvitakura.
• Vanoda kurapwa kwakakosha uye kuvhiyiwa nguva pfupi mushure mekuzvarwa.
• Nekufambira mberi mune zvesainzi yezvekurapa, vazhinji vevacheche ava vanogona kurarama hupenyu hwakanaka.

Kana uine mimwe mibvunzo kana zvinokunetsa nezvenyaya iyi, iva nechokwadi chekutaura nachiremba wako kana nesi. Vanogona kukupa rumwe ruzivo uye kukubatsira kubvisa kushushikana mupfungwa dzako. Yeuka, hausi wega.

` CDH, Congenital Diaphragmatic Hernia, Diaphragmatic hernia, Zvirema zvekuzvarwa, Kukura kwemapapu, Hutano hwemwana, Kuvhiyiwa