Mwana wako anowanzova nematambudziko emudumbu akaita semanyoka here? Hazvinei kuti unomupa chikafu chakawanda sei, haanyanyi kudya zvakakwana, uye haawedzere uremu? Kana kuti zviratidzo izvi zvakaonekwa here mushure mekuvhiyiwa kwemudumbu? Saamai kana baba, zvakajairika kuti unzwe kutya uye kunetseka zvakanyanya paunoona zvinhu zvakaita seizvi. Nhasi tichataura nezveShort Bowel Syndrome (SBS), chirwere chinogona kukonzera zviratidzo izvi, asi hachinyanyo taurwa nezvacho.
Zvichitaurwa zviri nyore, chii chinonzi Short Bowel Syndrome (SBS)?
Chirwere che "Short Bowel Syndrome" (SBS) chirwere chinoita kuti muviri wemwana wako usakwanise kupinza zvinovaka muviri zvakakwana nemvura. Izvi zvinokonzerwa nekuti chikamu cheura hudiki hwemwana hachina kana kuti hachishande zvakanaka.
Dambudziko iri rinogona kuvapo kubva pakuzvarwa. Dzimwe nguva SBS inogona kuitika mushure mekunge chikamu chikuru cheura diki chabviswa nekuvhiyiwa nekuda kwechimwe chirwere. Izvi zvinonziwo "Short gut syndrome".
Saka, basa reura hudiki uhwu nderei?
Kuti tinzwisise izvi zviri nani, ngatitangei tadzidza zvishoma nezveura hudiki, gamba regadziriro yedu yekugaya. Funga nezveura hudiki sebhandi refu rinoendesa zvinhu mufekitori. Chikafu chatinodya chinoshanduka kuita mvura mudumbu uye chobva chafamba nebhandi iri. Munzira, madziro eura, anoshanda sevashandi vefekitori, anoparadzanisa zvinhu zvese zvakanaka zviri muchikafu ichocho - kureva, zvinovaka muviri zvakakosha zvakaita semapuroteni, makabhohaidhiretsi, mafuta, mavhitamini, iron, calcium, uye mvura - uye zvinowedzerwa muropa. Zvimwe zvese, zvisingabatsire muviri, zvinoenda kuura hukuru uye zvinoburitswa setsvina.
Ura hudiki hune zvikamu zvikuru zvitatu:
- Duodenum: Iyi ndiyo chikamu chipfupi kupfuura dumbu.
- Jejunum: Ichi chikamu chepakati.
- Ileum: Iyi ndiyo chikamu chakarebesa. Chinogumira paura hukuru.
SBS inokanganisa sei ura hudiki?
Zvino fungidzira, chii chingaitika kana tikabvisa chidimbu chikuru kubva mubhandi rekufambisa zvinhu mufekitori yatataura? Zvinhu (kureva chikafu) zvaizopera nekukurumidza mubhandi rekufambisa zvinhu. Vashandi (madziro eura) havazove nenguva yakakwana yekuparadzanisa zvinhu zvakanaka (kudya) nezvinhu. Chinhu chimwe chete chinoitika muSBS.
Kazhinji, mwana anozvarwa aine ura hwakareba zvishoma pane hwakajairika. Zvakafanana nechikamu chekuwedzera. Kunyangwe chikamu chidiki cheduodenum nejejunum chikabviswa panguva yekuvhiyiwa, ileum inogona kutora basa rezvikamu zvese uye kudzikamisa kunwa kwezvinovaka muviri.
Zvisinei, chikamu chikuru chejejunum kana ileumKana chikabviswa nekuvhiyiwa, zvinova zvakaoma kuti muviri uwane chikafu chakakwana. Nekuti chikafu chinofamba daro diki, nguva yachinofanira kugayiwa nekunwiwa nemuviri ishoma zvikuru.
Kana chirwere ichi chikasarapwa, mwana anogona kuva nematambudziko akakomba akadai sekushaya chikafu chakakwana uye kutoisa upenyu panjodzi.
Unoziva sei kana mwana ane SBS? Ndezvipi zviratidzo?
Kana uchifungidzira kuti mwana wako ane chirwere ichi, chenjerera zviratidzo izvi. Kana uine chimwe chezviratidzo izvi zvakatevedzana, enda kuna chiremba nekukasika.
| Chiratidzo | Tsananguro iri nyore |
|---|---|
| Manyoka | Manyoka anobuda mvura nguva nenguva. Ichi ndicho chiratidzo chikuru uye chinowanzoonekwa cheSBS. |
| Kuzvimba | Kunzwa sekuti dumbu rako rakazara nemhepo, dumbu rako rinoita serakazvimba. |
| Gasi rakawandisa | Mhepo yakawanda kupfuura yakajairika. |
| Chituru chinonhuwa | Mafuta asina kugayiwa anokonzera kunhuhwirira kwakasimba mutsvina. |
| Kuneta | Mwana anowanzonzwa kuneta uye hope nekuda kwekushaya chikafu chakakwana. |
| Kukura kusina kunaka | Kusawedzera huremu nekukwirira zvinoenderana nezera. |
Sei vana vaine chirwere ichi?
Sezvinotaurwa nezita racho, chikonzero chikuru cheizvi kuvharika kwematumbu. Kune mapoka maviri makuru ezvikonzero zvinokonzera izvi:
1. Matambudziko ekuzvarwa nawo: Vamwe vana vanoberekwa vaine zvimwe zvirwere zvemudumbu.
- Kudzikira kwehurefu hweura hwekuzvarwa nahwo.
- Kuzvarwa usina chikamu cheura.
- Matumbu atresia izwi rezvekurapa rinoreva kutadza kukura kweura zvachose mudumbu.
2. Semhedzisiro yekuvhiyiwa: Mamwe matambudziko akakomba anoda kubviswa kwechikamu cheura hudiki hwemwana. SBS inogonawo kuitika.
Ndezvipi zvirwere zvinoda kubviswa chikamu cheura neoparesheni?
- Kukonzera chirwere cheEnteritis: Izvi zvinoitika kana ropa richiyerera richidzika kumadziro emudumbu, zvichiita kuti zvikamu zvemudumbu zvife. Dambudziko iri rinowanzoitika muvana vacheche vasati vasvika nguva.
- Gastroschisis: Apa ndipo apo ura hunobuda kunze kwemuviri mwana achiri kukura mudumbu.
- Volvulus: Kutenderedza ura. Izvi zvinogona kumisa kufamba kweropa uye kukanganisa nzvimbo iyoyo.
- Chirwere cheCrohn: Chirwere chisingaperi chekuzvimba kwemudumbu.
- Kupinda mukati medumbu: Chikamu chimwe cheura chinovharirwa mukati mechimwe chikamu.
Ndezvipi zvinetso zvinogona kuitika nekuda kweSBS?
Kana SBS ikasarapwa zvakanaka, mwana anogona kuva nematambudziko akasiyana-siyana, mamwe acho anogona kunge akakomba zvikuru.
- Kushaya mvura mumuviri: Kugara uchichengeta mvura mumuviri nekuti muviri haugone kunwisa mvura inodiwa.
- Kushaya chikafu: Kudzikira kwehuremu uye kutadza kuwedzera uremu nekuda kwekusapinza zvakanaka zvinovaka muviri mumuviri.
- Kushaikwa kwemavhitamini nemaminerari: Kushaikwa kwemavhitamini akakosha (A, D, E, K, B12) nemaminerari (calcium, magnesium, zinc) mumuviri.
- Mapundu emudumbu: Kutsamwiswa kweganda zvakanyanya kunokonzerwa nekufamba-famba kwemudumbu nguva nenguva uye tsvina ine acid yakawanda.
- Chirwere chechiropa: Kukuvara kwechiropa kunokonzerwa nekudya kwenguva refu kwemuviri pamwe nezvimwe zvikonzero.
- Matombo eitsvo: Nekuda kwekusaenzana mukupinza calcium neoxalate mumuviri.
- Kukura kwebhakitiriya: Kukura kwebhakitiriya inokuvadza muura hudiki.
- Kusawirirana nechikafu: Semuenzaniso, kusakwanisa kugaya zvigadzirwa zvemukaka zvine lactose.
Saka, zvakakosha zvikuru kutsvaga rubatsiro rwechiremba nekukasika kana mwana wako aine zviratidzo zveSBS, kunyanya mushure mekuvhiyiwa kwemudumbu.
Vanachiremba vanoongorora sei chirwere ichi?
Paunoendesa mwana wako kuna chiremba, iye achatanga nekubvunza nezvezviratidzo zvemwana uye nhoroondo yezveutano hwemhuri. Zvadaro, mwana achaongororwa. Miedzo yakati wandei inogona kuitwa kuti asimbise chirwere ichi uye kuwana chikonzero chaicho:
- Kuongororwa kweropa: Tarisa ropa remwana kuti uone kana paine zvinhu zvakaita sehuwandu hwemavhitamini nemaminerari, uye anemia.
- Kuongororwa kwemafuta etsvina: Kunoongorora kuti mafuta akawanda sei asina kugayiwa ari mutsvina.
- X-ray: Kuti utarise mamiriro eura. Unogona kupihwa mvura yakakosha, yakaita sebarium, uye X-ray inogona kutorwa.
- Kuongororwa kweCT: Wana mufananidzo wakajeka weura nedzimwe nhengo dzemudumbu.
Ndezvipi zvirongwa zvekurapa SBS?
Pane zvinangwa zvikuru zviviri pakurapa mwana ane SBS. Chimwe ndechekupa mwana chikafu chaanoda kuti akure. Chimwe ndechekudzora zviratidzo zvakaita semanyoka. Nzira dzakasiyana-siyana dzekurapa dzinoshandiswa pamwe chete kuti izvi zviitike.
1. Kuchinja kwezvekudya
Ichi ndicho chikamu chakakosha. Zvichienderana nemamiriro emwana, vanachiremba nenyanzvi dzezvekudya vanoshanda pamwe chete kugadzira hurongwa hwakakodzera hwekudya kwemwana.
- Kuchinja kwekudya: Kana mwana wako achikwanisa kudya nemuromo, chiremba wako anogona kukurudzira kumupa chikafu chidiki kakawanda pazuva . Vanogona kukurudzira kuderedza chikafu chine mafuta akawanda, shuga, uye fiber uye panzvimbo pezvo kumupa chikafu chine macalorie akawanda chakapfuma mumacarbohydrate nemapuroteni.
- Kudya Kwese Kwevabereki (TPN): Izvi zvinosanganisira kupa zvinovaka muviri zvese (mvura, shuga, mapuroteni, mafuta, mavhitamini) zvakananga mutsinga semvura, zvichiita kuti mwana asapinda mudumbu zvachose. Nzira iyi inowanzo shandiswa mushure mekuvhiyiwa kwemudumbu kana kana mwana asingakwanise kutora chikafu nemuromo.
- Kudya Kwemukati: Muizvi, chubhu inochinjika inopinzwa nemhino kana zvakananga mudumbu kana muura hudiki, uye kudya kwemvura kunopihwa kuburikidza nayo. Nzira iyi inobatsira kupa kudya kwakawanda pamusoro pehuwandu hwechikafu chinodyiwa nemuromo.
2. Mishonga
Mishonga yakasiyana-siyana inoshandiswa kudzora zviratidzo uye kuvandudza kunwa kwekudya kunovaka muviri.
- Mishonga inorwisa mabhakitiriya: Dzivisa kukura kwemabhakitiriya mudumbu.
- Mishonga inoderedza acid mudumbu (proton pump inhibitors, H2 blockers): Inoderedza matambudziko anokonzerwa neacid mudumbu.
- Mishonga yekudzivirira manyoka: Inoderedza kumhanya kwekufamba kwechikafu nemudumbu, zvichiita kuti chikafu chiwane nguva yakawanda yekunyudzwa kwezvinovaka muviri.
- Mahormone ekukura: Kuvandudza kupinza kwezvinovaka muviri mudumbu.
3. Kuvhiyiwa
Vamwe vana vangada kuvhiyiwa zvakare kuti vawedzere kushanda zvakanaka kwemudumbu. Izvi zvinosanganisira:
- Kuwedzera hurefu hweura (kuburikidza nenzira dzakakosha dzekuvhiya).
- Kuderedza kumhanya kwekufamba kwechikafu.
- Kubvisa zvinovhara ura.
Muzviitiko zvakakomba, mwana angafanira kuisirwa ura/chiropa.
Tariro ine tariro yekuchinjika muura
Iyi ndiyo tariro huru kuvabereki vane vana vane SBS. Kuchinja-chinja ura inzira iyo chikamu chasara cheura chinovandudza mashandiro acho nekufamba kwenguva mushure mekunge chikamu cheura chabviswa.
Muizvi, rusvingo rwemukati rweura rwasara runokora, uye maumbirwo akaita seminwe anonzi villi anotora zvinovaka muviri anova marefu uye makobvu. Izvi zvinobvumira ura hudiki hwasara kutora zvinovaka muviri zvinobudirira kupfuura kare. Maitiro aya ekugadzirisa anogona kubudirira zvikuru, sezvo ura hwevana vadiki hunoramba huchikura zvechisikigo kusvika vasvika pazera diki.
Mishonga yekudzivirira zvirwere yakaita seteduglutide iri kukurumidza kushandiswa uye iri kubatsira vana kuti varege kudya zvinovaka muviri zvakaita seTPN.
Chii chaunogona kuita semubereki?
Kunyange zvazvo rwendo urwu rwakaoma, hausi wega. Kune timu yakanaka yekukubatsira kugadzirisa hutano hwemwana wako.
- Chiremba wevana
- Chiremba wezvekudya zvevana
- Nyanzvi yezvekudya kwevana
- Chiremba wevana
Basa renyu guru nderekutevera mirairo yakapihwa nechikwata ichi chekurapa nemazvo. Zvakakosha kungwarira zvikuru pakudyisa mwana, kumupa mishonga nenguva, uye kana muri kushandisa mishonga yakaita seTPN, zvakakosha kungwarira zvikuru pakumuchengeta akachena.
Kana muine mibvunzo kana zvinokunetsai, musatya kubvunza chiremba wenyu. Bvunzai mibvunzo yakaita sekuti, "Mushonga uyu ndewei?", "Chikafu ichi chakanaka here kumwana wangu?", "Ndinofanira kutarisira chii chinotevera?" kuti pfungwa dzenyu dzinyaradzwe.
SBS inogona kuva chirwere chehupenyu hwese kune vamwe vana. Zvisinei, kune vamwe vana, chirwere ichi chinovandudzika zvakanyanya nekufamba kwenguva. Nekurapwa kwakakodzera, kudya kwakanaka, uye kutarisirwa nerudo, vazhinji vevana ava vanogona kurarama hupenyu hwakajairika, hunofadza.
Mharidzo Yekuenda Nayo Kumba
- Chirwere che "Short Bowel Syndrome" (SBS) chirwere chinokonzerwa nekushaya simba kwemuviri kana kudya zvinovaka muviri nekuda kwekusashanda zvakanaka kweura hudiki.
- Manyoka anowanzoitika uye kusakura zvakanaka ndizvo zviratidzo zvikuru.
- Chinangwa chikuru chekurapa ndechekupa mwana chikafu chinodiwa. Izvi zvinogona kuitwa kuburikidza nekudya kwakakosha, kupa mwana chikafu chechubhu, kana kudya kwevabereki (TPN).
- Nekufamba kwenguva, chikamu chasara cheura hwemwana chinozochinja zvinoenderana nemamiriro ezvinhu (mudumbu). Ichi chiratidzo chakanaka kwazvo.
- Dambudziko iri rinogoneka kugadziriswa. Nerutsigiro rwechikwata chevanachiremba vane hunyanzvi uye kuzvipira kwevabereki, mwana anogona kupiwa hupenyu hwakanaka.
- Kana mwana wako aine zviratidzo izvi, enda kuna chiremba wevana nekukurumidza.
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