Ngaba umntwana wakho kufuneka enziwe iNorwood Procedure? Makhe sithethe ngayo ngokulula.

Umele ukuba woyika kwaye wothuka kangakanani xa oogqirha bekuxelela ukuba umntwana wakho omncinci unesifo sentliziyo esiyinkimbinkimbi sokuzalwa? Xa bekuxelela ukuba kufuneka wenze 'iNorwood Procedure', mhlawumbi awuzange uyiqonde negama elo. Liqhelekile kakhulu. Ngexesha elinje, kufika imibuzo eliwaka engqondweni. Ungakhathazeki, siza kuthetha ngale nto ngokulula, ngendlela onokuyiqonda.

Iyintoni iNkqubo yaseNorwood?

Ngamafutshane, inkqubo yaseNorwood lolona tyando lokuqala nolukhulu olwenziwayo ukusindisa ubomi beentsana ezizelwe zinesiphene sentliziyo esintsonkothileyo. Esi sibizwa ngokuba yiHypoplastic Left Heart Syndrome (HLHS) .

Jonga ngoku, intliziyo ephilileyo ineegumbi ezine eziphambili. Icala lasekunene linoxanduva lokuthumela igazi lomzimba elingenaoksijini emaphashini. Igazi elinooksijini elivela emaphashini liza kwicala lasekhohlo lentliziyo. Icala lasekhohlo linoxanduva lokupompa eli gazi licocekileyo nelinooksijini emzimbeni wonke.

Nangona kunjalo, icala lasekhohlo lentliziyo yomntwana one-HLHS alikakhuli ngokupheleleyo. Oku kuthetha ukuba inxalenye ephambili epompa igazi elicocekileyo emzimbeni ayisebenzi. Ngoko ke kunzima ukuba umntwana onjalo aphile.

Kulapho oogqirha benza khona inkqubo yeNorwood. Le nkqubo ivumela icala lasekunene lentliziyo yomntwana, esele isebenza kakuhle, ukuba lenze umsebenzi omele wenziwe licala lasekhohlo. Oko kukuthi, ukuhamba kwegazi lentliziyo kuyatshintshwa ukuze i-ventricle yasekunene ipompe igazi liye emiphungeni, ngelixa kwangaxeshanye ipompe igazi elineoksijini liye emzimbeni wonke.

Ngubani odinga olu tyando?

Olu tyando lufuneka kakhulu kwiintsana ezinemeko ye-HLHS esithethe ngayo ngaphambili. Ezi ntsana zidinga olu tyando kwiiveki ezimbini zokuqala zokuzalwa.

Khawucinge nje, xa umntwana esesibelekweni, obu buthathaka bentliziyo abuyongxaki kuba bufumana ioksijini kwintambo yomlomo. Kwanasemva kokuzalwa, kwiintsuku ezimbalwa zokuqala, inxalenye encinci yentliziyo efana nombhobho phakathi kwemithambo yegazi ephambili (i-aorta kunye nomthambo we-pulmonary) (i-patent ductus arteriosus) ihlala ivulekile. Oku kuvumela igazi elithile ukuba lihambe liye emzimbeni.

Nangona kunjalo, le tube ivaleka ngokwemvelo kwiintsuku ezimbalwa. Kulapho umntwana enengxaki yokuphefumla, kwaye ubomi bakhe busemngciphekweni omkhulu. Ngenxa yoko, oogqirha bamnika amayeza akhethekileyo okuthintela le tube ukuba ingavali. Okwangoku, umntwana ulungele olu tyando lwaseNorwood.

Ngamanye amaxesha, kwiintsana ezizelwe ngaphambi kwexesha, ezinobunzima obuphantsi, okanye ezinezinye iingxaki zempilo ezinzulu, olu tyando lusenokungenzeki ngaxeshanye. Kwiimeko ezinjalo, oogqirha banokusebenzisa ezinye iindlela zexeshana.

Kwenzeka ntoni ngexesha lotyando?

Olu lutyando oluntsonkothileyo kakhulu oluthatha iiyure ezininzi, ngamanye amaxesha kwanosuku. Nantsi into eyenziwa ngugqirha ngamazwi alula:

1. Ukwandisa umngxuma phakathi kwamagumbi aphezulu (i-atria) entliziyo: Oku kunceda igazi elineoksijini elivela emiphungeni ukuba lihambe lula liye kwicala lasekunene lentliziyo.

2. Ukwakhiwa kwakhona komthambo oyintloko (i-aorta): I-aorta encinci yomntwana engakhulanga kakuhle iqhagamshelwe kumthambo wemiphunga, umthambo othwala igazi ukuya emiphungeni, kwaye kufakwa i-patch ekhethekileyo ukwenza umthambo wegazi omnye, omkhulu, noqinileyo.

3. Ukudibanisa umthambo omtsha kwi-ventricle yasekunene: Ngoku le aorta inkulu esandula ukwenziwa iqhagamshelwe kwi-ventricle yasekunene, eyona ndawo isebenzayo yentliziyo. Ngoku icala lasekunene linokupompa igazi liye emzimbeni wonke.

4. Ukubeka i-shunt ukuthumela igazi emiphungeni: Ekubeni lonke igazi ngoku lidlula kwi-aorta entsha ukuya emzimbeni, kufuneka kwenziwe indlela eyahlukileyo yokuthumela igazi emiphungeni. Oku kwenziwa kusetyenziswa ityhubhu encinci ebizwa ngokuba yi-shunt. Oku kuqhagamshelwe kwi-aorta entsha ukuya kwimithambo yemiphunga (iBlalock-Taussig okanye i-BT shunt) okanye ukusuka kwi-ventricle yasekunene ukuya kwimithambo yemiphunga (iSano shunt).

Ngexesha lonke lotyando, intliziyo nemiphunga yomntwana zisebenza okwethutyana ngomatshini okhethekileyo obizwa ngokuba yi-cardiopulmonary bypass .

Kwenzeka ntoni emva kotyando?

Emva kotyando, umntwana wakho uza kungeniswa kwiYunithi yoKhathalelo oluNzulu (ICU) , apho oogqirha nabahlengikazi abaqeqeshwe ngokukodwa baza kunyamekela umntwana wakho iiyure ezingama-24 ngosuku.

Uza kubona ukuba kukho iityhubhu ezininzi kunye neengcingo ezidityaniswe emzimbeni womntwana. Zisetyenziselwa ukunika umntwana amayeza afunekayo, ioksijini, ukutya, kwaye zilinganisa rhoqo imisebenzi yomzimba. Ungoyiki ukuzibona , zonke zilapho ngenxa yempilo-ntle yomntwana.

Nasemva kotyando, njengoko besitshilo ngaphambili, ulusu kunye nemilebe yomntwana zinokuba nombala oluhlaza okwesibhakabhaka ngenxa yokuxubana kwegazi elineoksijini ephezulu kunye negazi elineoksijini ephantsi. Oku kuqhelekile ngeli xesha.

Emva kweveki ekwigumbi lokunyamekela abagula kakhulu, xa imeko yomntwana iphucukile, uza kudluliselwa kwigumbi eliqhelekileyo. Ngaphambi kokuba ubuyele ekhaya, oogqirha kunye nabongikazi baza kukunika ingcaciso epheleleyo malunga nendlela yokunyamekela umntwana wakho, indlela yokumnika amayeza, kunye neempawu ekufuneka uziqaphele.

Gqibezela uthotho lotyando lwemeko ye-HLHS

Inkqubo yaseNorwood linyathelo lokuqala nje kolu hambo. Ukuze umntwana one-HLHS abe nobomi obuqhelekileyo, kufuneka enziwe utyando oluthathu.

Ziziphi iingozi kunye neengxaki ezinokubakho?

Njengakwezinye iintlobo zotyando olukhulu, inkqubo yaseNorwood ineengozi ezithile. Ugqirha wakho uza kukuchazela ezi zinto. Iingxaki eziphambili ezinokubakho zezi:

• Ukuncitshiswa kwemithambo yegazi: Emva kotyando, i-aorta eyakhiwe ngokutsha okanye umthambo othwala igazi ukuya emiphungeni unokuba mxinwa (stenosis).
• Iingxaki ze-shunt: I-shunt ethumela igazi emiphungeni isenokuvaleka okanye ingasebenzi kakuhle.
• Ukubetha kwentliziyo okungaqhelekanga: Isingqisho sentliziyo sinokutshintsha (arrhythmia).
• Ukusebenza kwentliziyo okubuthathaka: Amandla okupompa kwentliziyo okanye ukusebenza kweevalvu zayo kusenokuphazamiseka.
• Ukulibaziseka kophuhliso lwe-neurodevelopment: Kukho ithuba elincinci lokuba uphuhliso lwengqondo luya kuchaphazeleka, nto leyo ekhokelela kwiingxaki zokufunda okanye zokuziphatha (ukulibaziseka kophuhliso lwe-Neurodevelopmental).

Zinjani iziphumo kunye nokusinda?

Lo ngumbuzo omkhulu abazali bonke abanawo. Inyaniso kukuba, ngaphambi kokuba olu tyando lufunyanwe ngeminyaka yoo-1980, bekungekho nyango lweentsana ezizelwe zine-HLHS. Inkqubo yaseNorwood lithuba lokuba ezi ntsana ziphile.

Ngokwezibalo, amathuba okusinda esibhedlele emva kolu tyando yi-90%.Izinga lokusinda kweminyaka emihlanu emva kotyando liphakathi kwama-60% nama-75%. Abanye abantwana, ngelishwa, bafa ngequbuliso ngaphambi kokufikelela kwinqanaba lotyando lwesibini.

Nangona kunjalo, ukuba zonke ezi ntlobo zotyando zintathu ziyaphumelela, aba bantwana banokukhula babe ngabantu abadala abancinci. Baza kuba nethuba lokuya esikolweni, badlale, kwaye baphile ubomi obuqhelekileyo.

Ndifanele ndimbone nini ugqirha?

Emva kokuzisa umntwana wakho ekhaya, unoxanduva olukhulu. Kufuneka ulumke kakhulu ngezi zinto zilandelayo. Ukuba ubona into efana nale, fowunela ugqirha wakho ngokukhawuleza.

• Ukuba umntwana akatyebi kakuhle.
• Ukuba inqanaba le-oksijini yomntwana wakho lehla ngaphantsi kwenqanaba elichazwe ngugqirha wakho (uya kuba unikwe isixhobo sokulinganisa i-oksijini ekhaya).
• Ukuba umntwana akasabeli kakuhle kumayeza anikwe ngugqirha.
• Ukuba unemibuzo okanye amathandabuzo malunga nendlela yokunyamekela umntwana wakho.

Ngenxa yokuba i-HLHS yimeko engaqhelekanga, kubaluleke kakhulu ukukhetha ugqirha onamava kunye nesibhedlele esenza olu hlobo lotyando rhoqo. Musa ukoyika okanye ube neentloni ukubuza ugqirha wakho ngokuphindaphindiweyo ngayo nantoni na ongayiqondiyo.