Xa ugqirha ekuxelela ukuba umntwana wakho omncinci kufuneka enziwe utyando lwe-'Glenn' ngenxa yengxaki yentliziyo, umele ukuba waziva usoyika kakhulu kwaye wothuka. Umele ukuba unemibuzo emininzi engqondweni yakho, efana nokuba yintoni i-'Glenn Procedure', ibandakanya ntoni, kwaye kutheni yenziwa. Ungakhathazeki. Ezo mvakalelo ziqhelekile. Masithethe ngazo zonke ezi zinto ngokulula, ngendlela onokuyiqonda.
Ithini iNkqubo kaGlenn, ngokufutshane?
Cinga nje, intliziyo yethu yinjini epompa igazi emzimbeni wonke. Inamacandelo amane (amagumbi amane). Abanye abantwana bazalwa elinye lala magumbi lingakhulanga ngokupheleleyo okanye lincinci kakhulu. Kwimeko enjalo, intliziyo ayikwazi ukupompa igazi ngokufanelekileyo.
Ngamafutshane, inkqubo kaGlenn yinkqubo 'yokudlula' enceda intliziyo ebuthathaka ngolu hlobo.
Apha, oogqirha botyando badibanisa umthambo wegazi oyintloko (i-vena cava ephezulu), ethwala igazi elingcolileyo nelingenawo umoya-mpilo ukusuka emzimbeni ongaphezulu womntwana, ngqo kwi-pulmonary artery, endaweni yokulithumela entliziyweni.
Oku kufana nokwakha indlela entsha, elula ukuyisebenzisa edlula indlela exakekileyo. Oku kuvumela igazi elifuna ukufumana ioksijini ukuba lidlule inxalenye yentliziyo enengxaki lize liye ngqo emiphungeni.
Olu lutyando lwesibini oluye lwenziwe ngumntwana. Olunye utyando lwenziwa emva kweminyaka embalwa ukuze kufumaneke isisombululo esihlala sihleli kule meko.
Olu tyando lwenziwa kubantwana abanjani?
Utyando lukaGlenn lwenziwa ikakhulu kubantwana abaneziphene zentliziyo abazalwa nazo. Luyimfuneko kakhulu kubantwana abancinci kakhulu, okanye kwabo bangenazo ii-ventricles ezimbini eziphambili zentliziyo ezimpompa igazi. Le meko ibizwa ngokuba yi-'single ventricle defect'.
Ngezantsi kukho ezinye zeengxaki eziphambili zentliziyo ezifuna utyando lukaGlenn.
| Igama lesifo sentliziyo (Imeko yezonyango) | Ingcaciso elula |
|---|---|
| Isifo sentliziyo sasekhohlo esingenaplastiki | Icala lasekhohlo lentliziyo (i-ventricle yasekhohlo, ii-valve) aliphuhli kakuhle. |
| I-Tricuspid Atresia | Ivalvu ye-tricuspid, ephakathi kwamagumbi asekunene kwentliziyo, ayenziwanga kakuhle. |
| I-Pulmonary Atresia | Ivalvu yemiphunga ethwala igazi ukuya emiphungeni ivaliwe. |
| I-Ventricle ephindwe kabini ekhohlo okanye ekunene | Amagumbi amabini aphezulu entliziyo (i-atria) adibana negumbi elinye elingaphantsi (i-ventricle). |
Utyando lukaGlenn ludla ngokwenziwa nini?
Oogqirha badla ngokucebisa olu tyando xa umntwana ephakathi kweenyanga ezi-3 nezi-6 ubudala . Ludla ngokwenziwa njengotyando lwesibini, emva kokuba umntwana etyandwe okokuqala ukuphucula ukujikeleza kwegazi (njenge-Blalock-Taussig (BT) shunt) emva kokuzalwa.
Kwenzeka ntoni ngaphambi nangexesha lotyando?
Ngaphambi kotyando
Ngaphambi kotyando, ugqirha wakho uza kwenza uvavanyo oluninzi ukuze ahlole ngcono imeko yentliziyo yomntwana wakho.
- Ukulungiswa kwentliziyo: Olu vavanyo lwenzelwa ukulinganisa uxinzelelo kunye namanqanaba eoksijini ngaphakathi kwentliziyo kunye nokujonga ulwakhiwo lwentliziyo.
- I-MRI yentliziyo: Oku kunceda ukufumana imifanekiso eneenkcukacha zentliziyo enamacala amathathu.
- Kubaluleke kakhulu ukwazisa ugqirha malunga nawo onke amayeza (kuquka iivithamini kunye nezongezo) umntwana wakho awasebenzisayo .
Ngexesha lotyando
Utyando lwe-c-section ludla ngokuthatha malunga neeyure ezine , kodwa eli xesha linokwahluka ngokuxhomekeke kwimeko yomntwana.
Ngexesha lotyando, umntwana unikwa i-anesthesia, ukuze umntwana angaziva ntlungu. Umntwana ulele ubuthongo obunzulu. Abanye abantwana baqhagamshelwe kumatshini okhethekileyo othatha okwethutyana umsebenzi wentliziyo nemiphunga ngexesha lotyando. Oku kubizwa ngokuba ngumatshini we-cardiopulmonary bypass . Emva koko, njengoko bekutshiwo ngaphambili, ugqirha wenza ukufakelwa kwakhona kwemithambo yegazi kunye nokulungiswa kwentliziyo ukuba kuyimfuneko.
Iingenelo kunye neengozi ezinokubakho zotyando
Njengalo naluphi na utyando, inkqubo kaGlenn ineengenelo kunye neengozi. Kubalulekile ukuba abazali bazi ngale nto.
| Iingenelo | Iingozi/iingxaki ezinokubakho |
|---|---|
| Ubunzima obunciphileyo begumbi lentliziyo elisebenzayo lodwa (i-ventricle). | Ukwehla kwamanqanaba eoksijini egazini. |
| Ukuthintela intliziyo ukuba ingabi nkulu ngenxa yokusebenza kakhulu. | Igazi elonyukayo. |
| Utyando oluzayo lwaseFontan luza kuba lula. | Ukuphuma kwegazi kwi-Pleural. |
| Amathuba okusindisa ubomi bomntwana emva kotyando lweFontan ayanda. | Ukufuneka utyiswe ngetyhubhu ngenxa yobunzima bokutya. |
| Ukuba yindlela eyahlukileyo yabantwana abangadingi okanye abangenako ukwenziwa utyando lweFontan. | Kufuneka ndiphinde ndityandwe. |
Eyona nto ibalulekileyo kukuba izinga lokusinda komntwana emva kotyando lukaGlenn liphezulu kakhulu. Limalunga ne-99% . Olu lutyando oluphumelele kakhulu.
Kwenzeka ntoni emva kotyando?
Emva kotyando, umntwana uza kungeniswa kwigumbi lokunyamekela abagula kakhulu (ICU). Usenokuziva usoyika xa ubona iityhubhu kunye neemonitha zinamathele emzimbeni womntwana. Kodwa oko kuqhelekile. Iqela lezonyango liza kumjonga umntwana ngokusondeleyo.
Usana luza kuhlala kwigumbi lokhathalelo oluphezulu kangangeentsuku ezintathu, emva koko ludluliselwe kwigumbi eliqhelekileyo. Kungathatha iiveki ezininzi ukuba umntwana aphile ngokupheleleyo aze abuyele ekhaya.
Abantwana abaninzi, emva kweminyaka embalwa emva kokwenziwa kwenkqubo kaGlenn, xa beqala ukuhamba, kuya kufuneka badlule kwinqanaba elilandelayo, inkqubo yeFontan , enika isisombululo esihlala sihleli kwinkqubo yokujikeleza kwegazi entliziyweni.
Udinga nini ukubona ugqirha emva kokuba ubuyele ekhaya?
Kubaluleke kakhulu ukumnyamekela kakuhle umntwana wakho emva kokuba ubuyele ekhaya. Ukuba ubona naziphi na iimpawu ezilandelayo , fowunela ugqirha wakho ngoko nangoko.
- Ukuba umntwana unomkhuhlane.
- Ukuba igazi okanye olunye ulwelo luvuza kwinxeba lotyando.
- Ukuba unengxaki yokusela ubisi.
- Ukuba unengxaki yokutyeba.
Umntwana wakho kuya kufuneka aye kwikliniki kagqirha wentliziyo aze athathe amayeza ixesha elide. Leyo yinxalenye yolu hambo.
Umyalezo Wokuya Ekhaya
- Inkqubo yeGlenn lutyando olucwangcisiweyo, olukwinqanaba lesibini olwenziwa kwiintsana ezinesifo sentliziyo esintsonkothileyo.
- Oku kuthetha ukuba igazi elingenaoksijini lithunyelwa ngqo emiphungeni, lidlula intliziyo, nto leyo enciphisa umthwalo womsebenzi entliziyweni.
- Izinga lempumelelo yolu tyando liphezulu kakhulu (malunga ne-99%). Ngoko ke ungoyiki.
- Emva kotyando, umntwana uya kufuna ulwalathiso lwezonyango oluhlala ixesha elide kunye namayeza, ngoko ke kubaluleke kakhulu ukulandela imiyalelo kagqirha.
- Thetha ngokukhululekileyo nogqirha wakho ngayo nayiphi na imibuzo okanye uloyiko onalo. Bakho ukuze bakuncede.
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