Mwana wako anofanira kuitiswa Norwood Procedure here? Ngatitaurei nezvazvo zviri nyore.

Waitya uye wakashamisika zvakadini apo vanachiremba vakakuudza kuti mwana wako mudiki ane chirwere chemwoyo chakaoma chawakazvarwa nacho? Pavakakuudza kuti unofanira kuitwa 'Norwood Procedure', pamwe hauna kana kunzwisisa izwi racho. Zvakajairika. Panguva yakaita seiyi, mibvunzo chiuru inouya mupfungwa dzako. Usanetseke, tichataura nezvazvo zviri nyore, nenzira yaunogona kunzwisisa.

Chii chinonzi Norwood Procedure?

Zvichitaurwa zviri nyore, nzira yeNorwood ndiyo yekutanga uye yakakura kwazvo yekuvhiya inoitirwa kuponesa hupenyu hwevana vanozvarwa vaine chirwere chemwoyo chakaoma. Tinodaidza chirwere chemwoyo ichi kuti Hypoplastic Left Heart Syndrome (HLHS) .

Zvino tarisai, moyo une hutano une makamuri makuru mana. Rutivi rwerudyi ndirwo rune basa rekutumira ropa remuviri risina oxygen kumapapu. Ropa rine oxygen kubva mumapapu rinouya kuruboshwe rwemoyo. Rutivi rweruboshwe ndirwo rune basa rekutumira ropa iri rakazara oxygen kumuviri wese.

Zvisinei, rutivi rwekuruboshwe rwemoyo wemwana ane HLHS haruna kukura zvakakwana. Izvi zvinoreva kuti chikamu chikuru chinopomba ropa rakachena mumuviri hachishande. Saka zvakaoma kuti mwana akadaro ararame.

Apa ndipo panoita vanachiremba nzira yeNorwood. Nzira iyi inobvumira divi rekurudyi remoyo wemwana, iro rave kutoshanda zvakanaka, kuti riite basa rinofanira kuitwa nedivi rekuruboshwe. Kureva kuti, kufamba kweropa remoyo kunochinjwa kuitira kuti ventricle yekurudyi ipombe ropa kuenda kumapapu, ukuwo ichipomba ropa rine oxygen mumuviri wese.

Ndiani anoda kuvhiyiwa uku?

Kuvhiyiwa uku kunonyanya kudiwa kuvana vane chirwere cheHLHS chatakambotaura nezvacho. Vana ava vanoda kuvhiyiwa uku mukati memavhiki maviri ekutanga ekuzvarwa.

Fungidzira, kana mwana ari mudumbu, kusasimba uku kwemoyo hakusi dambudziko nekuti kunogamuchira okisijeni kubva murukuvhute. Kunyangwe mushure mekuzvarwa, kwemazuva mashoma ekutanga, chikamu chidiki chemwoyo chakaita sechubhu pakati petsinga huru dzeropa (aorta nepulmonary artery) (patent ductus arteriosus) chinoramba chakavhurika. Izvi zvinoita kuti ropa riyerere mumuviri.

Zvisinei, chubhu iyi inovharika mumazuva mashoma. Ndipo panotanga kuoma kufema, uye hupenyu hwake huri panjodzi huru. Saka, vanachiremba vanomupa mushonga wakakosha wekudzivirira chubhu kuti isavhare. Panguva iyi, mwana anenge agadzirira kuvhiyiwa uku kweNorwood.

Dzimwe nguva, kune vacheche vanozvarwa nguva isati yakwana, vane huremu hushoma, kana vane mamwe matambudziko makuru ehutano, kuvhiyiwa uku kungasakwanisika panguva imwe chete. Muzviitiko zvakadaro, vanachiremba vanogona kushandisa dzimwe nzira dzenguva pfupi.

Chii chinoitika panguva yekuvhiyiwa?

Uku kuvhiyiwa kwakaoma zvikuru kunotora maawa akati wandei, dzimwe nguva kunyange zuva. Hezvino zvinoitwa nachiremba nemashoko akareruka:

1. Kukudza buri riri pakati pemakamuri epamusoro (atria) emwoyo: Izvi zvinobatsira ropa rine mweya kubva mumapapu kuti rifambe zviri nyore kuenda kurudyi rwemoyo.

2. Kugadziriswazve kwetsinga huru yeropa (aorta): Aorta diki yemwana isina kukura zvakanaka yakabatana netsinga yemapapu, tsinga inotakura ropa kuenda kumapapu, uye patch yakakosha inoiswa kuti pave netsinga imwe chete, hombe, yakasimba yeropa.

3. Kubatanidza tsinga itsva ne ventricle yekurudyi: Iye zvino iyi aorta hombe itsva yakabatana ne ventricle yekurudyi, iyo chete chikamu chinoshanda chemoyo. Iye zvino divi rekurudyi rinogona kupomba ropa kumuviri wese.

4. Kuisa shunt yekutumira ropa kumapapu: Sezvo ropa rese rava kupfuura nemu aorta itsva kuenda kumuviri, nzira yakasiyana inofanira kugadzirwa yekutumira ropa kumapapu. Izvi zvinoitwa uchishandisa chubhu diki inonzi shunt. Izvi zvakabatana kubva ku aorta itsva kuenda ku pulmonary arteries (Blalock-Taussig kana BT shunt) kana kubva ku right ventricle kuenda ku pulmonary arteries (Sano shunt).

Munguva yese yekuvhiyiwa uku, moyo nemapapu emwana zvinofambiswa kwenguva pfupi nemuchina wakakosha unonzi cardiopulmonary bypass .

Chii chinoitika mushure mekuvhiyiwa?

Mushure mekuvhiyiwa, mwana wako achaendeswa kuIntensive Care Unit (ICU) , uko vanachiremba nevanamukoti vakadzidziswa zvakanaka vachatarisira mwana wako maawa makumi maviri nemana pazuva.

Uchaona kuti kune machubhu newaya dzakawanda zvakabatana nemuviri wemwana. Zvinoshandiswa kupa mwana mushonga unodiwa, okisijeni, chikafu, uye zvinogara zvichiyera mashandiro emuviri. Usatya kuzviona , zvese zviripo kuti mwana agare zvakanaka.

Kunyangwe mushure mekuvhiyiwa, sezvatakambokurukura, ganda remwana nemiromo zvinogona kunge zviine ruvara rwebhuruu zvishoma nekuda kwekusanganiswa kweropa rine oxygen yakawanda neropa rine oxygen shoma. Izvi zvakajairika panguva ino.

Mushure mevhiki imwe chete muchikamu chevanonyanya kurwara, kana mamiriro emwana ava nani, muchaendeswa kuchipatara chenguva dzose. Usati waenda kumba, vanachiremba nevanamukoti vachakupa tsananguro yakakwana yekuti ungachengeta sei mwana wako, ungamupa sei mishonga, uye zviratidzo zvekuchenjerera.

Nhevedzano yakakwana yekuvhiya yechirwere cheHLHS

Maitiro eNorwood ingori danho rekutanga murwendo urwu. Kuti mwana ane HLHS ararame hupenyu hwakanaka, anofanira kuvhiyiwa katatu.

Ndezvipi njodzi nematambudziko zvinogona kuitika?

Sekunge kune chero kuvhiyiwa kukuru, nzira yeNorwood ine njodzi. Chiremba wako achakutsanangurira izvi. Matambudziko makuru anogona kuitika ndeaya:

• Kutetepa kwetsinga dzeropa: Mushure mekuvhiyiwa, aorta yakagadzirwazve kana tsinga inotakura ropa kuenda kumapapu inogona kutetepa (stenosis).
• Matambudziko ekushanda kwetsinga: Tsinga inotumira ropa kumapapu inogona kuvharika kana kusashanda zvakanaka.
• Kurova kwemoyo kusina kujairika: Kurira kwemoyo kunogona kuchinja (arrhythmia).
• Kushanda kwemoyo usina simba: Kugona kwemoyo kupomba kana kushanda kwemavharuvhu ayo kunogona kunge kusina kunaka.
• Kunonoka kukura kwetsinga: Pane mukana mudiki wekuti kukura kwehuropi kuchakanganiswa, zvichikonzera matambudziko ekudzidza kana maitiro (kunonoka kukura kwetsinga).

Zvakadini nemigumisiro uye kupona?

Uyu ndiwo mubvunzo mukuru unobvunzwa nevabereki vese. Chokwadi ndechekuti, kuvhiyiwa uku kusati kwawanikwa muma1980, pakanga pasina kurapwa kwevana vanozvarwa vaine HLHS. Maitiro eNorwood mukana wekuti vana ava vararame.

Zvichienderana nehuwandu, mukana wekurarama muchipatara mushure mekuvhiyiwa uku i90%.Mwero wekurarama kwemakore mashanu mushure mekuvhiyiwa uri pakati pe60% ne75%. Zvinosuwisa kuti vamwe vacheche vanofa kamwe kamwe vasati vasvika padanho rekuvhiyiwa kwechipiri.

Zvisinei, kana maoparesheni ese matatu akabudirira, vana ava vanogona kukura kusvika vava vechidiki. Vachawana mukana wekuenda kuchikoro, kutamba, uye kurarama hupenyu hwakajairika.

Ndinofanira kuona chiremba rini?

Mushure mekuunza mwana kumba, une basa guru. Unofanira kungwarira zvinhu zvinotevera. Kana ukaona chimwe chinhu chakadai, fonera chiremba wako nekukasika.

• Kana mwana asiri kuwedzera uremu nemazvo.
• Kana mwero weokisijeni wemwana wako ukadonha pasi pemwero wawakaudzwa nachiremba (unenge wapihwa mudziyo wekuyera okisijeni kumba).
• Kana mwana asiri kupindura zvakanaka pamushonga waakapihwa.
• Kana muine mibvunzo kana kusava nechokwadi nezvekuti mungachengeta sei mwana wenyu.

Nekuti chirwere cheHLHS hachiwanzoitiki, zvakakosha kusarudza chiremba ane ruzivo uye chipatara chinoita kuvhiyiwa kwakadai kakawanda. Usatya kana kunyara kubvunza chiremba wako kakawanda nezvechero chausinganzwisisi.