Ingaba umntwana wakho osandul’ ukuzalwa unengxaki yokuginya ubisi? Isenokuba yi-Esophageal Atresia.

Ngaba umntwana wakho osandul’ ukuzalwa uqala ukukhohlela nokukrwitshwa ngequbuliso xa umnika ubisi? Ngaba ukhupha igwebu emlonyeni? Njengomama okanye utata, kufuneka woyike kakhulu xa ubona ezi zinto. Ngamanye amaxesha ezi mpawu zinokubangelwa yimeko yokuzalwa ebizwa ngokuba yi-Esophageal Atresia. Ungakhathazeki. Masithethe ngale nto ngokulula namhlanje size siqonde yonke into.

Ngamafutshane, yintoni i-Esophageal Atresia (EA)?

I-Esophageal Atresia (ebizwa ngokuba yi-"esophagus") sisiphene sokuzalwa. Ukuchaneka, yingxaki yomqala womntwana. Umbhobho othwala ukutya ukusuka emlonyeni ukuya esiswini xa siginya. Igama elithi "atresia" lithetha ukuba indlela emzimbeni ivaliwe okanye ivaliwe. Ngoko ke, kwimeko ye-esophageal atresia, umqala womntwana awukhuli usuka apho ufanele udibane khona nesisu, kodwa uyema phakathi kwaye uvalwe. Ufana nombhobho wamanzi oqhekekileyo kubini. Ngenxa yesi sizathu, umntwana akanakusela ubisi okanye ukuginya ukutya ngokuqhelekileyo. Enye ingxaki enkulu enokubonwa ngale meko yi -tracheoesophageal fistula (TEF) . Kule meko, endaweni yokudibanisa umqala nesisu, iqhagamshela kwi-trachea yomntwana, eyipayipi yokuphefumla. Oku kuyingozi kakhulu, kuba izinto ezifana nobisi kunye namathe umntwana awaginyayo zinokungena ngqo emiphungeni.

Ngaba kukho iintlobo ezahlukeneyo zale meko?

Ewe, ezi meko ze-Esophageal Atresia kunye ne-Tracheoesophageal Fistula (TEF) zahlulwe zibe ziintlobo ezininzi eziphambili kuxhomekeke kwindlela ezenzeka ngayo kunye okanye ngokwahlukeneyo. Ugqirha wakho uza kucwangcisa unyango lwakho ngokusekelwe kuhlobo oluchanekileyo.

Uyazi njani ukuba umntwana wakho unale meko? Zithini iimpawu?

Oogqirha nabahlengikazi banika ingqalelo engakumbi kwezi mpawu xa behlola usana olusandul’ ukuzalwa. Ngokukodwa, banika ingqalelo kwiimpawu ezintathu eziphambili.

• Ukukhwehlela: Ingakumbi xa uzama ukusela ubisi.
• Ukuminxa : Ukuminxa kwenzeka kuba ubisi okanye amathe awakwazi ukuginywa.
• I-Cyanosis: Ulusu kunye nemilebe zijika zibe luhlaza okwesibhakabhaka ngenxa yokunqongophala kweoksijini emzimbeni.

Nazi ezo mpawu zongezelelweyo:

• Ukuphuma komfinya onamagwebu emlonyeni.
• Ukuvuza amathe kakhulu.
• Ukugabha okanye ukukrwitshwa xa uzama ukuncancisa.
• Ubunzima bokuphefumla kunye nokuphefumla ngokukhawuleza.

Ngokwesiqhelo, ezinye izifo ezibangela ubunzima bokuginya azibangeli ubunzima bokuphefumla. Nangona kunjalo, ukuba ubunzima bokuginya kunye nobunzima bokuphefumla zenzeka kunye , kusenokwenzeka ukuba kungenxa yemeko ebizwa ngokuba yi-Esophageal Atresia ene-Tracheoesophageal Fistula (TEF).

Kutheni oku kusenzeka kwiintsana? Yintoni esona sizathu siphambili?

Le yimeko yokuzalwa. Oko kukuthi, yenzeka ngelixa umntwana ekhula esibelekweni. Ngokwesiqhelo, kwizigaba zokuqala zomntwana ongekazalwa, i-esophagus kunye ne-trachea zingumbhobho omnye. Kusemva kwexesha apho le nxalenye yahlukana ibe ngamacandelo amabini, okwenza i-esophagus kunye ne-trachea. Kwimeko ye-esophageal atresia , le nkqubo yokwahlukana ayigqitywanga ngokupheleleyo. Abaphandi abakakwazi ukufumana ngokuchanekileyo ukuba yintoni ebangela ukuba le nkqubo ime phakathi. Kodwa bakholelwa ukuba indibaniselwano yezinto zemfuza kunye neemeko ezingqongileyo inokudlala indima.

Oogqirha bayixilonga njani le sifo?

Ngamanye amaxesha iiskeni zokukhulelwa zinganika izikhokelo, kodwa uninzi lwezifo lufunyaniswa emva kokuba umntwana ezelwe.

Ukuxilongwa Kwangaphambi Kokubeleka

Ngamanye amaxesha imiqondiso malunga noku inokubonwa ngexesha lokuhlolwa kwe-anomaly, okwenziwa malunga neeveki ezingama-20 zokukhulelwa.

• IiPolyhydramnios: Ukuba kukho ulwelo oluninzi kakhulu olujikeleze umntwana. Oku kungenxa yokuba umntwana uhlala eginya olu lwelo. Ulwelo luyaqokelelana kuba umntwana akakwazi ukuginya.
• Iqamza lesisu elincinci okanye elingabonakaliyo: Ukuba isisu somntwana asizaliswanga lulwelo ngexesha lokuhlolwa .

Ukuba ubona into efana nale, ugqirha wakho unokucebisa uvavanyo olongezelelweyo, olufana ne-MRI yosana olungekazalwa.

Emva kokuba umntwana ezelwe (Ukuxilongwa emva kokubeleka)

Oogqirha bayayikrokrela le meko xa umntwana ebonisa ezi mpawu zingasentla ekuzalweni. Uvavanyo oluphambili lokuqinisekisa oku kuzama ukufaka ityhubhu encinci (ityhubhu ye-nasogastric) ngempumlo ize ingene esiswini. Ukuba ityhubhu ivaliwe, ityhubhu ima phakathi ingangeni esiswini. Emva koko kwenziwa i-X-ray ukuze kubonwe ukuba ityhubhu ivaliwe phi, nokuba idibene ne-trachea, nokuba ulwelo lungene na emiphungeni. Ukuba esi sifo siqinisekisiwe, oogqirha bajonga nezinye iziphene ezinxulumene nokuzalwa.

Ngaba le meko inganyangeka ngokupheleleyo ngotyando?

Ewe. Kwiimeko ezininzi, kunokwenzeka. Nje ukuba imeko ifunyaniswe, imeko yomntwana iyazinza kwaye ingxaki isonjululwe ngotyando ngokukhawuleza. Nangona kunjalo, ezinye iintsana zisenokufuna ukuhlala esibhedlele okwethutyana ngaphambi kotyando.

• De iintsana ezizelwe ngaphambi kwexesha zityebe kancinci.
• Ukuba umsantsa phakathi kwamacandelo amabini e-esophagus mkhulu kakhulu (i-Long-gap esophageal atresia - LGEA). Kwiimeko ezinjalo, kuya kufuneka ulinde de la macandelo mabini akhule kancinci aze asondele.
• Ukuba kukho ezinye iingxaki ezisongela ubomi, ezifana neengxaki ezinkulu zentliziyo, ezo kufuneka zinyangwe kuqala.

Ngeli xesha, umntwana ufumana lonke unyango olufunekayo phantsi kweliso loogqirha abangochwephesha kunye nabongikazi kwiYunithi yoKhathalelo oluNzulu lweZifo eziSandulelayo (i-NICU) . Umntwana unikwa isondlo esifunekayo ngetyhubhu (isondlo sangaphakathi) okanye ngemithambo (isondlo sangaphakathi). Ngoko ke akufuneki ukhathazeke ngokuba umntwana akakwazi ukutya.

Unyango kunye notyando lwenziwa njani?

Kukho iinjongo eziphambili ezininzi kunyango: ukuzinzisa ukuphefumla komntwana, ukubonelela ngesondlo esikhuselekileyo, kwaye ekugqibeleni kulungiswe imeko ngotyando.

Ulawulo olukhawulezileyo

Nje ukuba umntwana afunyaniswe enale meko, kwenziwa ezi zinto zilandelayo ngelixa elungiselela utyando:

• I-mucus kunye namathe aqokelelana emqaleni nasemlonyeni asuswa ngokufunxwa.
• Kufakwa ityhubhu yokuphefumla ukukhusela indlela yomoya.
• Ityhubhu yokutya okanye umgca we-IV usetyenziselwa ukubonelela ngesondlo kunye nolwelo.
• Ii-antibiotics zinikwa ukuthintela usulelo lwemiphunga (i-pneumonia).

Utyando (Ukulungiswa kotyando)

Xa iqela lezonyango ligqibe kwelokuba umntwana ulungele utyando, utyando luyenziwa. Iinjongo eziphambili zezi: 1. Ukudibanisa kwakhona iindawo ezimbini ezahluliweyo ze-esophagus (anastomosis). 2. Ukuvala i-fistula (unxibelelwano phakathi kwe-esophagus kunye nombhobho womoya), ukuba ikhona. Kule mihla, nanini na xa kunokwenzeka, oogqirha benza olu tyando besebenzisa utyando olungenabungozi kangako . Oku kuthetha ukuba endaweni yokwenza utyando olukhulu esifubeni, kufakwa ikhamera (thoracoscope) kunye nezixhobo ezithambileyo ngokusebenzisa utyando oluncinci oluninzi. Oku kuvumela umntwana ukuba aphile ngokukhawuleza.

Ukubuyiselwa emva kotyando

Emva kotyando, umntwana ubuyiselwa kwi-NICU. Emva kweentsuku ezimbalwa, kwenziwa i-X-ray ekhethekileyo ebizwa ngokuba yi-esophagram ukujonga ukuba inxeba lipholile kakuhle na kwaye kukho ukuvuza. Nje ukuba yonke into iqinisekiswe ukuba ilungile, umntwana uqaliswa kancinci kancinci ukuncancisa phantsi kweliso likagqirha. Oku kuthatha ixesha ukuba umntwana aqhele.

Buza kuba njani ubomi bomntwana emva konyango?

Uninzi lwabantwana luyachacha kakuhle kwaye luphila ubomi obuqhelekileyo. Nangona kunjalo, abanye abantwana banokuba neengxaki zexesha elide ngenxa yesi simo kunye notyando. Ezi ngxaki zihlala ziphucuka ngokuhamba kwexesha, kodwa zinokufuna ulwalathiso lwezonyango kangangeminyaka eliqela.

• I-Tracheomalacia: Le yimeko apho i-cartilage kwi-trachea iba buthathaka, nto leyo ebangela ukuba i-trachea inciphe kancinci xa iphefumla. Oku kunokubangela ukuphefumla nzima , ubunzima bokuphefumla xa ulele, kunye nosulelo lwesifuba rhoqo (i-pneumonia, i-bronchitis).
• Ubunzima bokuginya: Abanye abantwana banokuba nobunzima bokuginya ngenxa yokungasebenzi kakuhle komphimbo. Le ngxaki inokubakho ngakumbi xa kwaziswa ukutya okuqinileyo. Oku kunokulawulwa ngokusika ukutya kube ziingceba ezincinci uze ukunike ulwelo.
• Isifo seGastroesophageal Reflux (GERD):Kulapho i-asidi yesisu iphuma khona kwi-esophagus (efana ne-gastritis). Le meko yenzeka malunga nesiqingatha sabantwana abaphathwa nge-EA. Kubalulekile ukunyanga oku njengoko ugqirha eyalela.

Ukuba umntwana wakho uneengxaki ezinjalo, thetha nogqirha wakho rhoqo ngazo. Ungacela uncedo kwiingcali ezifana neengcali zezifo zolwimi lokuthetha kunye neengcali zezondlo ukuze zinike umntwana wakho inkxaso ayidingayo. I-Esophageal atresia, ukuvaleka kwe-esophageal, i-tracheoesophageal fistula, iziphene zokuzalwa, iintsana ezisandul' ukuzalwa, ukukrwitshwa kosana, utyando lweentsana ezisandul' ukuzalwa, i-esophagus