Kuqhelekile ukuba noloyiko olukhulu kunye nexhala xa ugqirha wakho ekuxelela ukuba umntwana wakho omncinci udinga utyando lwentliziyo. Ingakumbi xa kufikwa kwi-'Glenn Procedure,' usenokuba awuzange ucinge ukuba iza kuba njani na emva kokuva igama layo. Kodwa ungakhathazeki. Siza kuthetha ngolu tyando, isizathu sokuba lwenziwe, kunye nokuba kwenzeka ntoni emva koko ngendlela elula kakhulu onokuyiqonda.
Ngamafutshane, yintoni iNkqubo kaGlenn?
Khawuthelekelele, kukho umthambo omkhulu oqokelela igazi 'elingcolileyo' elingenaoksijini, eliphuma kwiindawo eziphezulu zomzimba wethu (entloko, entanyeni, ezingalweni) uze ulizise entliziyweni. Oku sikubiza ngokuba yi -'Superior Vena Cava' . Ngokwesiqhelo, entliziyweni ephilileyo, eli gazi lidlula kwiigumbi zentliziyo lize lipompelwe emiphungeni, apho 'licocwa' ngokuthatha ioksijini.
Kodwa ezinye iintsana ezinezifo zentliziyo ezizalwa nazo azikwazi ukuhamba kakuhle kolu hambo ngenxa yeengxaki zesakhiwo seentliziyo zazo. Mhlawumbi elinye icala lentliziyo alikhuliswanga kakuhle, okanye kunokubakho ingxaki ngevalvu.
Inkqubo kaGlenn idlula le nxalenye yentliziyo enengxaki kwaye iqhagamshela igazi 'elingcolileyo' elivela phezulu ngqo kwimithambo yemiphunga. Ngamanye amazwi, idala indlela emfutshane (idlula) ethatha igazi ngqo liye emiphungeni endaweni yokudlula ekuvalekeni kwentliziyo. Oku kuvumela igazi elingenaoksijini ukuba liye emiphungeni ngaphandle kokuphazamiseka.
Olu tyando kufuneka lwenziwe phantsi kweziphi iintlobo zezifo zentliziyo?
Inkqubo yeGlenn yonyango lweengxaki ezininzi zentliziyo ezingaqhelekanga nezintsonkothileyo. Oogqirha badla ngokucebisa le nkqubo kwiintsana ezinezi meko zilandelayo:
| Isifo sentliziyo (Imeko yezonyango) | Kalula nje... |
|---|---|
| Isifo sentliziyo sasekhohlo esingenaplastiki | Icala lasekhohlo lentliziyo (inxalenye ephambili epompa igazi) alikhuli kakuhle ekuzalweni. |
| I-Tricuspid Atresia | Ivalvu ye-tricuspid kwicala lasekunene lentliziyo ayenziwanga kakuhle. |
| I-Pulmonary Atresia | Ivalvu yemiphunga, ethwala igazi lisuka entliziyweni ukuya emiphungeni, ayivuli kakuhle. |
| I-Ventricle ephindwe kabini ekhohlo okanye ekunene | Igazi liphuma kumagumbi amabini aphezulu entliziyo liye kwigumbi elinye elingaphantsi (i-ventricle). |
| Iziphene zeCanal zeAtrioventricular ezingalinganiyo | Ubukho beziphene ezinzima kwiindonga nakwiivalvu phakathi kwamagumbi entliziyo. |
Luza kwenziwa nini utyando kwaye kuza kwenzeka ntoni ngaphambi kwalo?
Utyando lukaGlenn ludla ngokwenziwa xa umntwana ephakathi kweenyanga ezi-3 nezi-6 ubudala . Kwiimeko ezininzi, olu lutyando lwesibini. Kwiintsana ezinesifo sentliziyo esinjalo, utyando lokuqala (olufana ne-Blalock-Taussig (BT) shunt) lwenziwa ekuzalweni ukuze kuphuculwe ukuhamba kwegazi. Emva koko, xa umntwana emdala kancinci, utyando lukaGlenn lwenziwa njengenyathelo elilandelayo.
Ngaphambi kotyando
Ngaphambi kokuba bagqibe ngomhla wotyando, oogqirha kufuneka bafumane umfanekiso ocacileyo wentliziyo yomntwana. Ukuze benze oku, benza iimvavanyo ezifana nezi:
- Ukufakwa kweCatheterization yentliziyo: Uvavanyo apho ityhubhu encinci idluliselwa ngemithambo esemlenzeni okanye engalweni ukuya entliziyweni, ilinganisa uxinzelelo olungaphakathi entliziyweni kwaye ijonge ngokusondeleyo ulwakhiwo lwayo.
- I-MRI yentliziyo: Oku kunceda ekucwangciseni utyando ngokufumana imifanekiso eneenkcukacha ezinemilinganiselo emithathu (3D) yentliziyo.
- Ufanele uxelele ugqirha ngazo zonke amayeza umntwana wakho awasebenzisayo (kuquka iivithamini kunye nezongezo) .
Kwenzeka ntoni ngexesha nasemva kotyando?
Ngexesha lotyando
Utyando lukaGlenn ludla ngokuthatha malunga neeyure ezi-4 . Nangona kunjalo, ixesha linokwahluka ngokuxhomekeke kwimeko yomntwana. Ngalo lonke eli xesha, umntwana uphantsi kwe-anesthesia jikelele. Oku kuthetha ukuba akaziva nto, ulele ngokupheleleyo.
Abanye abantwana banokufuna umatshini we-cardiopulmonary bypass ukuze balawule okwethutyana ukusebenza kwentliziyo nemiphunga yabo ngexesha lotyando. Ugqirha uza kusebenzisa iintsalela zotyando lwangaphambili ukudibanisa i-vena cava ephezulu nomthambo othwala igazi ukuya emiphungeni.
Emva kotyando
Ukubona umntwana wakho emva kotyando kunokuba yinto eyoyikisayo. Uza kuxhonywa kuthotho lweetyhubhu kunye neemonitha ezibonisa izinga lokubetha kwentliziyo yakhe kunye namanqanaba eoksijini. Kodwa konke oku kujongwa imeko yomntwana ngokusondeleyo. Umntwana uza kugcinwa kwiYunithi yoKhathalelo oluPhezulu (ICU) malunga neentsuku ezi-3 kwaye uza kuhlolwa ngokusondeleyo. Emva koko, uza kudluliselwa kwigumbi eliqhelekileyo kwaye uza kukwazi ukuya ekhaya kwiintsuku ezimbalwa ezizayo.
Into ebalulekileyo kukuba inkqubo yeGlenn idla ngokuba linyathelo lesibini kwisisombululo esipheleleyo. Xa umntwana emdala kancinci kwaye eqala ukuhamba (ngesiqhelo phakathi kweminyaka emi-2-4 ubudala), kufuneka olunye utyando olubizwa ngokuba yi-'Fontan procedure'. Ugqirha wakho uza kukuchazela oku.
Ziziphi iingenelo kunye neengxaki ezinokubakho zenkqubo yeGlenn?
Njengalo naluphi na utyando, inkqubo kaGlenn ineenzuzo zayo kunye neengozi ezithile. Kubalulekile ukuzazi ezi zinto.
| Iingenelo | Iingozi/Iingxaki ezinokubakho |
|---|---|
| Iyanciphisa umthwalo kwigumbi lokusebenza lodwa lentliziyo (i-ventricle). | Ukwehla kwamanqanaba eoksijini egazini. |
| Ithintela intliziyo ukuba ingabi nkulu ngenxa yokusebenza kakhulu. | Igazi elonyukayo. |
| Kwenza utyando olulandelayo lweFontan lube lula. | Ukuphuma kwegazi kwi-Pleural. |
| Yandisa amathuba okusinda komntwana. | Ukulungela ukutya ngetyhubhu ngenxa yobunzima bokusela ubisi. |
| Utyando lweFontan lubonelela ngenye indlela kwabo bangayifuniyo okanye abangayifuniyo. | Kufuneka ndiphinde ndityandwe. |
Izinga lempumelelo yolu tyando liphezulu kakhulu, malunga ne-99% . Ngoko ke ungakhathazeki. Oogqirha bayazi kakuhle le mingcipheko kwaye baqeqeshwe kakuhle ukuyilawula.
Hlala ujonge oku emva kokuba ufikile ekhaya!
Emva kokuba ufikile ekhaya uvela esibhedlele, kufuneka ulumke kakhulu ngemeko yomntwana wakho. Ukuba ubona naziphi na kwezi mpawu zilandelayo, kufuneka ufowunele ugqirha wakho ngoko nangoko .
- Ifiva.
- Ukopha igazi elivela kwinxeba lotyando okanye olunye ulwelo.
- Ubunzima bokusela ubisi okanye ukwala ukusela ubisi.
- Usana alutyebi kakuhle.
- Ubunzima bokuphefumla okanye imilebe/izinzipho zomntwana zijika zibe luhlaza okwesibhakabhaka.
Ngaphambi kokuba uphume esibhedlele, uza kunikwa umhla wokudibana nogqirha wentliziyo. Qiniseka ukuba uza nomntwana wakho ngaloo mihla.
Umyalezo Wokuya Ekhaya
- Inkqubo yeGlenn yindlela esindisa ubomi kwiintsana ezinesifo sentliziyo esintsonkothileyo. Iphucula ukujikeleza kwegazi.
- Oku kudla ngokwenziwa xa umntwana ephakathi kweenyanga ezi-3 ukuya kwezi-6 ubudala. Ngokuqhelekileyo, eli linyathelo lesibini kuthotho lweenkqubo zotyando.
- Izinga lempumelelo yotyando liphezulu kakhulu (malunga ne-99%). Nangona kunjalo, qonda ukuba njengakuzo zonke iintlobo zotyando, kukho iingozi ezithile.
- Emva kotyando, umntwana kufuneka aqhubeke nokuba phantsi kweliso likagqirha. Landela imiyalelo kagqirha ngokuchanekileyo.
- Ukuba unemibuzo, iinkxalabo, okanye amathandabuzo malunga noku, ungathandabuzi ukuxoxa ngayo nogqirha wakho. Kubaluleke kakhulu ukwazi ukuba yintoni na ekucingayo.
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