Ingaba imiphunga yomntwana wakho ayikhuli kakuhle? (Pulmonary Hypoplasia) Masifunde ngayo!

Uvuyo oluvayo xa ujonge usana olusandul’ ukuzalwa alunakuchazwa, akunjalo? Kodwa ngamanye amaxesha, kunye nolo vuyo, uloyiko oluncinci lufika engqondweni, ingakumbi ukuba ubona ukuba umntwana unengxaki yokuphefumla. Ngamaxesha anjalo, omnye wemibuzo ephakamayo ezingqondweni zabazali ngulo, "Ngaba kukho into engalunganga ngomntwana wam?". Namhlanje siza kuthetha ngemeko enzima kangaka, kodwa ebaluleke kakhulu ekufuneka siyiqaphele. Oko kukuthi, imiphunga yomntwana ayikhuli kakuhle, imeko esiyibiza ngokuba yi-`(Pulmonary Hypoplasia)` ngokwezonyango.

Yintoni i-`(Pulmonary Hypoplasia)`? Masiyiqonde ngokulula.

Ngamafutshane, i-Pulmonary Hypoplasia kuxa imiphunga yomntwana wakho ingaphuhli njengoko bekulindelwe ngelixa esesibelekweni. Le yimeko yokuzalwa , oko kuthetha ukuba ikhona xa ezalwa. Ihlala ibangelwa yenye imeko yempilo engaphantsi. Oko kukuthi, imiphunga ayinandawo yaneleyo yokukhula esibelekweni. Ngamanye amaxesha, oogqirha bayayifumanisa le meko ngaphambi kokuba umntwana azalwe, ngexesha lokukhulelwa, ngee-ultrasound scans. Ngamanye amaxesha, ifunyanwa emva nje kokuba umntwana ezelwe okanye kwiintsuku ezimbalwa emva koko.

Ngoku khangela, ngaphakathi emiphungeni yethu kukho iingxowa zomoya ezincinci ezibizwa ngokuba yi-alveoli. Ezi zezo zongeza ioksijini esiyingenisayo egazini. Igazi lithwala le oksijini liye kwiithishu zomzimba wonke. Ngoko ke, ukuba imiphunga ayikhuliswanga kakuhle, ezi ngxowa zomoya nazo zincinci ngenani. Kwenzeka ntoni ke ngoko? Amanye amalungu kunye nezicubu zomzimba azifumani oksijini eyaneleyo. Oku kubangela ukuba intliziyo isebenze nzima, kwaye uxinzelelo lwegazi emiphungeni lunokwanda (i-pulmonary hypertension). Cinga ngayo, njengokuba isityalo esincinci singenakukhula kakuhle ukuba asinamanzi, indawo, kunye nesondlo.

Zeziphi iimpawu ezibonakaliswa ngumntwana?

Ukuba umntwana osandul’ ukuzalwa une-Pulmonary Hypoplasia, unokubonisa iimpawu ezifana nezi:

• Umbala oluhlaza okwesibhakabhaka kulusu, imilebe, okanye iinzipho (`(cyanosis)`) . Oku kwenzeka xa izicubu zomzimba zingafumani ioksijini eyaneleyo. Ngokukodwa, lo mbala oluhlaza okwesibhakabhaka wenzeka xa kukho ioksijini encinci egazini.
• Iimpumlo ezivuthuzayo . Oku kuthetha ukuba umntwana uzama ngamandla ukuphefumla kuba kunzima. Njengaxa sibaleka size siwa, siyakhupha iimpumlo zethu size siphefumle.
• Ubunzima bokuphefumla. Umntwana unokwenza isandi sokuphefumla okanye sokufutha xa ephefumla.
• Ukwanda kwesantya sokuphefumla (i-tachypnea) . Ukuba umntwana uphefumla ngokukhawuleza kunesiqhelo, oko kukwaluphawu.

Ukuba umntwana wakho unenye okanye ngaphezulu kwezi mpawu, kungcono ukubona ugqirha ngoko nangoko. Ezi zinokuba ziimpawu zezinye izifo zokuphefumla, ngoko ke kubalulekile ukufumana uxilongo olufanelekileyo ngokukhawuleza.

Kutheni oku kusenzeka? Zithini izizathu eziphambili ze-`(Pulmonary Hypoplasia)`?

I-Pulmonary Hypoplasia idla ngokubangelwa zezinye iimeko zempilo ezithintela imiphunga ukuba ingakhuli kakuhle kwimveku. Ezi meko zishiya imiphunga ingenasithuba esifunekayo ukuze ikhule. Ezi meko zilandelayo zezona zixhaphakileyo:

• Ulwelo oluphantsi lwe-amniotic (oligohydramnios) : Xa kukho ulwelo oluncinci lwe-amniotic olujikeleze umntwana, lunokufaka uxinzelelo emaphashini luze lubangele ukuba akhule kakubi. Olu lwelo lusebenza njengomqamelo womntwana kwaye lunceda amaphaphu akhule.
• I-Congenital Diaphragmatic Hernia (CDH) : I-diaphragm sisihlunu esahlula isifuba nesisu. Ukuba kukho umngxuma kuyo kwaye ezinye zezitho zesisu (ezifana namathumbu nesibindi) ziphuma esifubeni, akukho ndawo ingako yemiphunga. Emva koko imiphunga ayikwazi ukufutha nokukhula kakuhle.
• I-Omphalocele : Kule meko, amanye amalungu omntwana aphuma ngentambo yesisu, egqunywe yi-membrane. Oku kunokutshintsha uxinzelelo ngaphakathi kwesibeleko somntwana kwaye kuchaphazele ukukhula kwemiphunga.
• Ukuqhekeka Kwama-Membranes Ngaphambi Kokuzalwa (i-PROM) Okude : Xa i-amniotic sac igqabhuka ngaphambi kokuba umntwana azalwe, eyaziwa ngokuba yi-PROM, amanqanaba olwelo anokwehla aze achaphazele uphuhliso lwamaphaphu.
• Isifo semiphunga esibizwa ngokuba yi-cystic lung disease : Ezi zi-tumors ezingezizo ezomhlaza ezithatha indawo emiphungeni kwaye ziphazamise ukukhula kwezicubu zemiphunga eziqhelekileyo.
• Ukwanda kwentliziyo ngenxa yeengxaki zentliziyo : Umzekelo, xa intliziyo ikhula ngenxa yezifo zentliziyo zokuzalwa ezifana ne-"tricuspid atresia" okanye i-"Ebstein's anomaly", inokubangela uxinzelelo kwimiphunga.
• I-diaphragm engaqhelekanga okanye engasebenziyo : I-diaphragm sisihlunu esibalulekileyo ukuze imiphunga isebenze kakuhle. Ukuba kukho ingxaki ngomsebenzi wayo, inokuchaphazela nophuhliso lwemiphunga.

Nangona kunjalo, ngamanye amaxesha oogqirha abakwazi ukufumana unobangela othile we-"Pulmonary Hypoplasia." Siyibiza ngokuba yi -primary pulmonary hypoplasia . Oku kwenzeka malunga ne-10% ukuya kwi-15% yamatyala.

Ngubani osengozini enkulu yokuba nale meko?

Ezinye iimeko ngexesha lokukhulelwa zinokubeka umntwana ongekazalwa emngciphekweni omkhulu we-pulmonary hypoplasia, njenge-oligohydramnios kunye nokukhulelwa ngaphambi kwexesha. Ezi ziquka:

• Izifo : Izifo ezidluliselwa ngesondo (ii-STI) okanye izifo ezibangelwa ziintsholongwane ezifana ne-bacterial vaginosis zinokubangela ukuba amanzi akho aqhekeke ngaphambi kwexesha.
• Ubude obufutshane bomlomo wesibeleko . Oku kungaba yimbangela yokuzalwa ngaphambi kwexesha kunye ne-PROM.
• Ukulindela ukuzala okuphindaphindeneyo, okufana namawele okanye amawele amathathu . Oku kunokubangela iingxaki ezifana nokungabikho kwesithuba esincinci esibelekweni kunye namanqanaba aphantsi olwelo.
• I-Amniocentesis : Olu luvavanyo olwenziwa ngexesha lokukhulelwa. Nangona kunjalo, kunqabile kakhulu, ingxowa yamanzi inokonakala kwaye ulwelo lunokuvuza.
• Uxinzelelo lwegazi oluphezulu okanye i-preeclampsia ngexesha lokukhulelwa. Ezi zinto zinokuchaphazela ukusebenza kwe-placenta, zinciphise isondlo somntwana kunye ne-oxygen, kwaye zinokubangela ukulahleka kolwelo.
• Isifo seswekile : Ukuba umama unesifo seswekile, sinokubangela iingxaki ezithile.
• Ukuphelelwa ngamanzi emzimbeni : Ukuba umama akaseli manzi aneleyo, inqanaba lolwelo lwe-amniotic linokwehla.

Yingakho kubaluleke kakhulu ukulandela imiyalelo kagqirha wakho ngokuchanekileyo nokuya kwiikliniki ngexesha elifanelekileyo ngexesha lokukhulelwa. Ukunyamekela impilo yakho kuchaphazela ngqo impilo yomntwana wakho.

Zeziphi ezinye iingxaki ezinokubangela oku?

Inyani yokuba imiphunga ayikhuliswanga kakuhle inokubangela iingxaki kwezinye iindawo zomzimba womntwana. Ezi zilandelayo ziingxaki ezinokubakho ngenxa ye-`(Pulmonary Hypoplasia):`

• Amanqanaba aphantsi eoksijini egazini (i-hypoxemia) : Le yeyona ngxaki iphambili. Ingonakalisa ingqondo kunye nezinye izitho zomzimba.
• Uxinzelelo lwegazi oluphezulu kwimiphunga yomntwana (i-pulmonary hypertension) : Imithambo yegazi kwimiphunga iyancipha, nto leyo ebeka uxinzelelo olongezelelekileyo entliziyweni.
• Ukukhula okubuthathaka okanye okungafanelekanga kwe-trachea (tracheomalacia) : Oku kunokubangela ukuba i-trachea ivalwe xa uphefumla.
• I-Pneumothorax : Umoya uvuza emiphungeni, uqokelelana ujikeleze imiphunga, uze umphunga udilike.
• Iingxaki zokuphefumla : Umzekelo, i-bronchopulmonary dysplasia. Ezi zinokwenzeka kamva, ingakumbi kwiintsana ezizelwe ngaphambi kwexesha, xa ziqhagamshelwe kwi-ventilator.
• Ezinye iingxaki ezinokubakho ngenxa yemeko ebangela i-pulmonary hypoplasia. Umzekelo, ubunzima bokutya, ukungasebenzi kakuhle kokuva, kunye nokulibaziseka kokukhula .

"Ungaziva usoyika xa usiva konke oku. Kodwa khumbula, ukwaziswa lelona nyathelo lilungileyo lokujongana nemeko efana nale. Thetha noogqirha bakho kwaye ubuze yonke imibuzo onayo."

Oogqirha bayixilonga njani le meko?

Amaxesha amaninzi, ugqirha uxilonga i-Pulmonary Hypoplasia ngexesha lokuhlolwa kwe-ultrasound rhoqo ngexesha lokukhulelwa. Olu xilonga lulinganisa ubungakanani bemiphunga yomntwana kunye nobubanzi besifuba sakhe. Uxilonga lwe-MRI (magnetic resonance imaging) lunokwenziwa ukuqinisekisa uxilongo. I-MRI inokubonelela ngomfanekiso ocacileyo womthamo wemiphunga.

Ngamanye amaxesha, ugqirha uya kuyixilonga le meko xa ezalwa okanye kwiintsuku ezimbalwa emva kokuzalwa. Ukuba umntwana wakho unengxaki yokuphefumla, ugqirha uya kwenza i-X-ray yesifuba ukujonga ukuba akanayo na i-pulmonary hypoplasia okanye enye imeko yemiphunga. I-X-ray ingabonisa ubungakanani kunye nemeko yemiphunga.

Zithini iindlela zonyango zoku?

Unyango lwe-Pulmonary Hypoplasia luxhomekeke kwisizathu, ubukhali bemeko, nokuba yafunyaniswa na ngexesha lokukhulelwa okanye emva kokuzalwa. Injongo ephambili yonyango kukubonelela umntwana ngeoksijini ayidingayo ukuze aphile kunye nokunceda imiphunga yakhe ikhule kangangoko kunokwenzeka. Ukuba umntwana wakho uzelwe ene-Pulmonary Hypoplasia, kuya kufuneka umncede aphefumle de imiphunga yakhe ikhule ngokwaneleyo ukuba aphefumle yedwa, okanye de oogqirha bakwazi ukunika unyango olongezelelweyo.

Nazi ezinye zeendlela zonyango ezisetyenziswa yingcali yokubelekisa-ingcali yezifo zabesifazane okanye ingcali yezifo ezisandul’ ukuzalwa:

• Ukufakwa kwe-Amnioinfusion : Ukuba kukho inqanaba eliphantsi lolwelo lwe-amniotic ngexesha lokukhulelwa, le nkqubo ifaka ulwelo ngendlela yokwenziwa. Oku kunokunceda ukunciphisa uxinzelelo emaphaphu kwaye kuncede ekukhuleni.
• Utyando okanye utyando losana olusandul’ ukuzalwa : Umzekelo, ukuba kukho imeko ebizwa ngokuba yi-CDH, utyando lunokwenziwa ukuze lulungiswe. Ngamanye amaxesha olu tyando lwenziwa ngelixa umntwana esesesibelekweni.
• Unyango lweoksijini : Umntwana unikwa ioksijini nge-cannula yempumlo okanye imaski ebekwe ebusweni.
• Umoya womoya : Oku kuquka ukudibanisa i-ventilator kumatshini kunye nokunceda ukuphefumla ngendlela yokwenziwa. Oku kwenziwa ngokufaka ityhubhu kumbhobho womoya.
• I-Extracorporeal Membrane Oxygenation (ECMO) : Olu lunyango olukhethekileyo nolunzima. Umatshini wongeza ioksijini egazini kwaye ususa i-carbon dioxide ngelixa unika ukuphumla kwemiphunga nentliziyo yomntwana. Isetyenziswa kwiimeko ezinzima kakhulu xa zonke ezinye iindlela zonyango zingaphumelelanga.

Kuthekani ukuba umntwana wakho uzalwa ene-Pulmonary Hypoplasia?

Ukuba umntwana wakho uzelwe enemiphunga engakhulanga kakuhle, uza kuhlolwa yingcali yeentsana ezisandul’ ukuzalwa (ugqirha ogxile kwiintsana ezisandul’ ukuzalwa) kunye neqela lezinye iingcali. Ngokuxhomekeke kubukhali bemeko kunye namanye amalungu omzimba achaphazelekileyo, iqela lezonyango lingabandakanya:

• Iingcali zezintso (iingcali ze-Nephrology)
• Iingcali zePulmonologists (iingcali zokuphefumla)
• Oogqirha bentliziyo (iingcali zentliziyo)
• Iingcali zeGastroenterologists (iingcali kwinkqubo yokwetyisa)

Iintsana ezine-``(Pulmonary Hypoplasia)`` zihlala zinyangwa ngeKwiyunithi yokhathalelo oluphezulu lweentsana ezisandul’ ukuzalwa (i-NICU), iintsana zifumana unyango olukhethekileyo kunye nokubekwa esweni rhoqo. Zihlala zineengxaki zemiphunga ezihlala ixesha elide kunye nezinye iimeko zempilo. Oku kuquka usulelo oluqhelekileyo lokuphefumla, iimeko ezifana ne-asthma, kunye nokulibaziseka kokukhula. Nangona kunjalo, ezinye iintsana ezine-Pulmonary Hypoplasia zisenokungabi naso isifo esinzima njengoko zikhula, kwaye imiphunga yazo inokuqhubeka nokukhula kwaye iimpawu zazo zinokuphucuka.

Kunokwenzeka njani ukuphila nale meko?

Liyinyaniso elokuba iintsana ezinemiphunga engakhulanga kakuhle zinokuphila. Kodwa imeko yomntu wonke yahlukile. Ukukwazi ukusinda nge-`(Pulmonary Hypoplasia)` kuxhomekeke kwezi zinto:

• Ubunzima bemeko. Indlela imiphunga ekhule ngayo.
• Unobangela oyintloko. Sisiphi isifo esibangele i-`(Pulmonary Hypoplasia)` kwaye sibi kangakanani.
• Nokuba ifunyenwe ngexesha lokukhulelwa okanye emva kokuzalwa. Ukuba ifunyenwe kwangethuba, ngamanye amaxesha ukungenelela kwangethuba kunokwenzeka.
• Ngaba kukho ezinye iingxaki?

Ngokubanzi, izinga lokufa ngenxa ye-Pulmonary Hypoplasia kuthiwa lingaphezulu kwe-55%. Ngokuqhelekileyo kunzima ukuhlala neemeko ezinzima ze-Pulmonary Hypoplasia. Kuyadabukisa ukutsho oku, kodwa kubalulekile ukwazi inyani. Nangona kunjalo, ngokuhambela phambili kwesayensi yezonyango, iindlela zokunceda iintsana ezinjalo ziphucuke kakhulu namhlanje.

Ngaba kukho into esinokuyenza ukuthintela oku?

Akukho ndlela inye yokuthintela i-Pulmonary Hypoplasia, njengoko idla ngokuba yimiphumo yenye imeko. Nangona kunjalo, eyona ndlela ilungileyo yokunciphisa umngcipheko weengxaki zempilo xa umntwana wakho ezalwa kukulandela icebiso likagqirha wakho wokukhulelwa okunempilo. Ungazinyamekela ngokuthi:

• Lawula izifo zakho ezingapheliyo, ezifana nesifo seswekile kunye noxinzelelo lwegazi oluphezulu.
• Yiya kugqirha wakho yonke imihla ngexesha lokukhulelwa kwakho. Ngale ndlela, ukuba kukho naziphi na iingxaki, unokuzibona kwangethuba.
• Kuphephe ukutshaya nokusela utywala ngokupheleleyo. Oku kunefuthe elibi ngqo ekukhuleni komntwana.
• Sela amanzi amaninzi. Kubaluleke kakhulu ukusela ubuncinane iilitha ezi-2-3 zamanzi ngosuku.
• Zikhusele kwizifo ezidluliselwa ngesondo (ii-STI) kunye nezinye izifo ezisulelayo.

Ukuhlolwa rhoqo ngugqirha wakho wotyando kunye nogqirha wezifo zabesifazane kunokunceda ekuchongeni iingxaki ezinokubakho kwangethuba. Ngamanye amaxesha, oogqirha banokunyanga unobangela we-Pulmonary Hypoplasia ngexesha lokukhulelwa. Oku kunokunceda ukuthintela umntwana wakho ukuba azalwe enemiphunga engakhulanga kakuhle.

Ekugqibeleni, kufuneka uthi...

Ukuba umntwana wakho uzelwe ene-Pulmonary Hypoplasia, iqela loogqirha liya kuba nawe kuyo yonke inyathelo. Baza kuchaza ubunzulu bemeko, iindlela zakho zonyango, kunye nokuba ikamva liza kuba njani. Musa ukuthandabuza ukubuza nayiphi na imibuzo onokuba nayo ukuze ukwazi ukwenza izigqibo ezinolwazi malunga nokhathalelo lomntwana wakho - okanye impilo yakho.

"Ukuba kunokwenzeka, dala iqela lakho lenkxaso labantu obathembayo nabathandayo. Oko kuthetha ukuba abantu abafana nomyeni wakho, umama, utata, abantakwenu, kunye nabahlobo bakho abasenyongweni. Inkxaso yabo iya kuba ngamandla amakhulu okujongana nayo nayiphi na imingeni eza kuwe. Kubaluleke kakhulu ukuhlala uqinile. Musa ukuphelelwa lithemba."

Siyathemba ukuba olu lwazi luza kukunceda. Khumbula, soloko uqhagamshelana nogqirha ofanelekileyo ukuze ufumane ingcebiso kwezonyango. Eli nqaku lelolwazi ngokubanzi kuphela.

I- Pulmonary Hypoplasia, uphuhliso olungaphelelanga lwemiphunga, iintsana ezisandul' ukuzalwa, iingxaki zokuphefumla, iimeko zokuzalwa, i-NICU, impilo yeentsana, iingxaki zokukhulelwa