Mwana wako achangoberekwa ari kunetseka here nekumedza mukaka? Inogona kunge iri Esophageal Atresia.

Mwana wako achangoberekwa anotanga kukosora nekukachidzwa paunomupa mukaka here? Anoita furo pamuromo here? Saamai kana baba, unofanira kutya zvikuru paunoona zvinhu izvi. Dzimwe nguva zviratidzo izvi zvinogona kukonzerwa nechirwere chekuzvarwa nacho chinonzi Esophageal Atresia. Usazvidya mwoyo. Ngatitaurei nezvazvo nenzira iri nyore nhasi uye tinzwisise zvese.

Zvichitaurwa zviri nyore, chii chinonzi Esophageal Atresia (EA)?

Esophageal Atresia (inodudzwa kuti "esophagus") idambudziko rekuzvarwa naro. Kutaura chokwadi, idambudziko regurokuro remwana. Chubhu inotakura chikafu kubva mumuromo kuenda mudumbu patinomedza. Izwi rekuti "atresia" rinoreva kuti nzira iri mumuviri yakavharwa kana kuvharika. Saka, kana tichitarisa esophageal atresia, gurokuro remwana harikure kubva parinofanira kubatana nedumbu, asi rinomira pakati uye rinovharika. Rakafanana nepaipi yemvura yakatyoka kuita nepakati. Nekuda kweizvi, mwana haakwanise kunwa mukaka kana kumedza chikafu zvakanaka. Rimwe dambudziko rakakura rinogona kuonekwa nechirwere ichi itracheoesophageal fistula (TEF) . Muchiitiko ichi, pachinzvimbo chekubatanidza gurokuro nedumbu, rinobatanidza netrachea yemwana, inova chubhu yekufema. Izvi zvine njodzi zvikuru, nekuti zvinhu zvakaita semukaka nemate zvinomedzwa nemwana zvinogona kuenda zvakananga mumapapu.

Pane mhando dzakasiyana dzechirwere ichi here?

Ehe, zvirwere izvi zveEsophageal Atresia neTracheoesophageal Fistula (TEF) zvakakamurwa kuita mhando dzakasiyana-siyana zvichienderana nekuti zvinoitika sei pamwe chete kana kuti zvakasiyana. Chiremba wako acharonga kurapwa kwako zvichienderana nerudzi chairwo.

Unoziva sei kana mwana wako aine chirwere ichi? Ndezvipi zviratidzo zvacho?

Vanachiremba nevanamukoti vanonyatsoteerera zviratidzo izvi pavanenge vachiongorora mwana achangoberekwa. Kunyanya, vanoteerera zviratidzo zvikuru zvitatu.

• Kukosora: Kunyanya kana uchiedza kunwa mukaka.
• Kudzipwa : Kudzipwa kunoitika nekuti mukaka kana mate hazvigone kumedzwa.
• Cyanosis: Ganda nemiromo zvinoshanduka kuita bhuruu nekuda kwekushaikwa kweokisijeni mumuviri.

Aya ndiwo mamwe maficha:

• Kubuda kwemvura mumuromo kunenge kune furo.
• Kubuda mate zvakanyanya.
• Kurutsa kana kudzipwa paunenge uchiedza kuyamwisa.
• Kutadza kufema zvakanaka uye kufema nekukurumidza.

Kazhinji, zvimwe zvirwere zvinokonzera kuoma kwekumedza hazvikonzeri kuoma kwekufema. Zvisinei, kana matambudziko ekumedza nekuoma kwekufema zvikaitika pamwe chete , zvinowanzoitika nekuda kwechirwere chinonzi Esophageal Atresia neTracheoesophageal Fistula (TEF).

Sei izvi zvichiitika kuvana vacheche? Chikonzero chikuru ndechei?

Ichi chirwere chekuzvarwa nacho. Kureva kuti, chinoitika mwana achiri kukura mudumbu. Kazhinji, pakutanga kwemwana ari mudumbu, gumbo negumbo remudumbu zvinongova chubhu imwe chete. Chikamu ichi chinongozopatsanuka kuita zvikamu zviviri, zvichiumba gumbo negumbo remudumbu. Panyaya yegumbo remudumbu , kupatsanurwa uku hakuperi zvachose. Vaongorori havasati vakwanisa kuwana chaicho chinokonzera kuti maitiro aya amire pakati. Asi vanotenda kuti musanganiswa wezvinhu zvemajini nezvakatipoteredza zvinogona kuita basa.

Vanachiremba vanoongorora sei chirwere ichi?

Dzimwe nguva kuongororwa kwemwana asati aberekwa kunogona kuratidza zviratidzo, asi kazhinji chirwere ichi chinowanikwa mushure mekunge mwana aberekwa.

Kuongorora Kuberekwa Kwemwana

Dzimwe nguva zviratidzo zveizvi zvinogona kuonekwa panguva yekuongorora kwemuviri kusina kunaka, uko kunoitwa mavhiki makumi maviri epamuviri.

• Polyhydramnios: Kana mvura yeamniotic yakawandisa yakakomberedza mwana. Izvi zvinokonzerwa nekuti mwana anowanzo medza mvura iyi. Mvura iyi inoungana nekuti mwana haakwanise kumedza.
• Dumbu diki kana risingaonekwe: Kana dumbu remwana risina kuzadzwa nemvura panguva yekuongororwa .

Kana ukaona chimwe chinhu chakadai, chiremba wako anogona kukurudzira kuti uongorore zvimwe zvinhu, zvakaita seMRI yemwana asati aberekwa.

Mushure mekunge mwana azvarwa (Postnatal Diagnosis)

Vanachiremba vanofungidzira kuti chirwere ichi kana mwana akaratidza zviratidzo zvataurwa pamusoro apa pakuzvarwa. Muedzo mukuru wekusimbisa izvi ndewekuyedza kuisa chubhu diki (nasogastric tube) nepamhino uye mudumbu. Kana gumbo rakavharika, chubhu inomira pakati isingapinde mudumbu. Zvadaro X-ray inozoitwa kuti ione kuti gumbo rakavharika papi, kana rakabatana netrachea, uye kana mvura yapinda mumapapu. Kana chirwere ichi chikasimbiswa, vanachiremba vanoongororawo zvimwe zvinetso zvine chekuita nekuzvarwa.

Dambudziko iri rinogona kurapwa zvizere nekuvhiyiwa here?

Ehe. Kazhinji, zvinogoneka. Kana chirwere chacho chaonekwa, mamiriro emwana anogadzikana uye dambudziko racho rinogadziriswa nekuvhiyiwa nekukurumidza. Zvisinei, vamwe vacheche vangangoda kugara muchipatara kwenguva yakati vasati vavhiyiwa.

• Kusvikira vacheche vanozvarwa nguva isati yakwana vawedzera huremu.
• Kana mukaha uri pakati pezvikamu zviviri zvegurokuro wakakura zvakanyanya (Long-gap esophageal atresia - LGEA). Muzviitiko zvakadaro, uchafanira kumirira kusvika zvikamu zviviri zvakura zvishoma woswedera pedyo.
• Kana paine zvimwe zvinetso zvinotyisidzira hupenyu, zvakaita sematambudziko emwoyo akakomba, izvozvo zvinofanirwa kurapwa kutanga.

Munguva iyi, mwana anowana rubatsiro rwese rwakakosha achitarisirwa navanachiremba vane hunyanzvi nevakoti muNeonatal Intensive Care Unit (NICU) . Mwana anopiwa chikafu chinodiwa kuburikidza nechubhu (enteral nutrition) kana netsinga (parenteral nutrition). Saka haufanirwe kunetseka kuti mwana haakwanise kudya.

Kurapwa nekuvhiyiwa kunoitwa sei?

Pane zvinangwa zvikuru zvakati wandei mukurapa: kugadzirisa kufema kwemwana, kupa chikafu chakachengeteka, uye pakupedzisira kugadzirisa dambudziko racho kuburikidza nekuvhiyiwa.

Kutarisira ipapo ipapo

Kana mwana aonekwa kuti ane chirwere ichi, zvinhu zvinotevera zvinoitwa panguva yekugadzirira kuvhiyiwa:

• Madzihwa nemate zvinoungana pahuro nemuromo zvinobviswa nekusveta.
• Pombi yekufema inoiswa kudzivirira nzira yekufema.
• Chubhu yekudyisa kana kuti IV line inoshandiswa kupa chikafu uye mvura.
• Mishonga inorwisa mabhakitiriya inopiwa kudzivirira hutachiona hwemapapu (pneumonia).

Kuvhiya (Kugadzirisa Kuvhiya)

Kana chikwata chevanachiremba chaona kuti mwana agadzirira kuvhiyiwa, kuvhiyiwa kunoitwa. Zvinangwa zvikuru ndeizvi: 1. Kubatanidza zvakare zvikamu zviviri zvegurokuro (anastomosis). 2. Kuvhara fistula (kubatana pakati pegurokuro nepaipi yemhepo), kana iripo. Mazuva ano, pese pazvinogoneka, vanachiremba vanoita kuvhiyiwa uku vachishandisa kuvhiyiwa kushoma . Izvi zvinoreva kuti pachinzvimbo chekuita kucheka kukuru muchipfuva, kamera (thoracoscope) nemidziyo yakapfava zvinoiswa kuburikidza nekucheka kudiki kwakati wandei. Izvi zvinoita kuti mwana apore nekukurumidza.

Kupora mushure mekuvhiyiwa

Mushure mekuvhiyiwa, mwana anodzoserwa kuNICU. Mushure memazuva mashoma, X-ray chaiyo inonzi esophagram inoitirwa kutarisa kana ganda rakachekwa rapora zvakanaka uye kana paine kubuda kwemvura. Kana zvese zvasimbiswa kuti zvakanaka, mwana anotanga kuyamwisa zvishoma nezvishoma achitarisirwa nachiremba. Izvi zvinotora nguva kuti mwana ajaire.

Hupenyu hwemwana huchava hwakaita sei mushure mekurapwa?

Vana vazhinji vanopora zvakanaka uye vanorarama hupenyu hwemazuva ese. Zvisinei, vamwe vana vanogona kuva nematambudziko kwenguva refu nekuda kwechirwere ichi nekuvhiyiwa. Izvi zvinowanzovandudzika nekufamba kwenguva, asi zvinogona kuda kutarisirwa nachiremba kwemakore akati wandei.

• Tracheomalacia: Ichi chirwere apo shwashwa iri mu trachea inoshaya simba, zvichiita kuti trachea itetepe zvishoma pakufema. Izvi zvinogona kukonzera kufemereka , kuoma kufema panguva yekurara, uye hutachiona hwepachipfuva (pneumonia, bronchitis).
• Matambudziko ekumedza: Vamwe vana vanogona kunetseka nekumedza nekuda kwekusashanda zvakanaka kwegurokuro. Dambudziko iri rinogona kuitika kunyanya kana ukavapa chikafu chakasimba. Izvi zvinogona kugadziriswa nekucheka chikafu kuita zvidimbu zvidiki wochipa mvura.
• Chirwere cheGastroesophageal Reflux (GERD):Apa ndipo panobuda acid mudumbu mugurokuro (sezvakaita gastritis). Dambudziko iri rinoitika muvana vanosvika hafu vanorapwa nechirwere cheEA. Zvakakosha kurapa izvi sekurairwa kwachiremba.

Kana mwana wako aine chero dambudziko iri, taura nachiremba wako nezvazvo nguva nenguva. Unogona kutsvaga rubatsiro kubva kune nyanzvi dzakadai sevanachiremba vemitauro yekutaura nevanoongorora zvekudya kuti vape rubatsiro rwaunoda. Kudzipwa kweropa, kuvharika kwegurokuro, fistula yemudumbu, zvirema zvekuzvarwa, vacheche vachangoberekwa, kudzipwa kwemwana, kuvhiyiwa kwevacheche, gurokurokuro