Ngaba umntwana wakho omncinci uneCerebral Palsy? Umele ukuba uqaphele ukuba izihlunu ezikwimilenze, ingakumbi imilenze, yabantwana abanjalo ziqinile kwaye ziqinile ngokungeyomfuneko. Ngokwezonyango, oku sikubiza ngokuba yi-'spasticity'. Ngenxa yolu qina, kunzima kakhulu kumntwana ukuba angahambi nje kuphela, abaleke, atsibe, kodwa enze nemisebenzi yemihla ngemihla. Ngoko ke namhlanje siza kuthetha ngotyando olukhethekileyo olwenziwa njengesisombululo esisisigxina sale ngxaki. Olu lutyando lwe-Selective Dorsal Rhizotomy, okanye utyando lwe-SDR ngamafutshane.
Ngamafutshane, yintoni utyando lwe-SDR?
I-Selective Dorsal Rhizotomy (SDR) yinkqubo yotyando enciphisa ukuqina kwemisipha ngokusisigxina (i-spasticity) kubantwana abane-cerebral palsy. Nangona iyinkqubo enzima kakhulu, ngokufutshane, ibandakanya ukusika nokususa ezinye zeentambo zemithambo-luvo ezikwinxalenye esezantsi yomqolo womntwana ezibangela ukuqina kwemisipha emilenzeni.
Eyona nto ibalulekileyo kukuba olu tyando alubangeli ukushwabana kwamalungu omzimba omntwana. Kwakhona aluchaphazeli ngqo intshukumo yemilenze. Lukhulula kuphela izihlunu eziqinileyo ngokungeyomfuneko.
Kodwa into enye ekufuneka uyikhumbule kukuba ukuze umntwana afumane iziphumo ezilungileyo kolu tyando, kufuneka afumane unyango olunzulu lokubuyisela impilo yakhe emzimbeni emva kotyando. Kwakhona, ayingabo bonke abantwana abaneCerebral Palsy abafanelekileyo kolu tyando.
Ngubani omele enze olu tyando? Ingaba lufanelekile kubo bonke abantwana?
Utyando lwe-SDR lwenziwa ikakhulu njengonyango lokuqina kwemisipha (i-spasticity) ebangelwa yi-cerebral palsy.
Njengoko usazi, i-cerebral palsy (CP) yimeko echaphazela amandla omntwana okulawula iintshukumo zomzimba wakhe. Ibangelwa kukonakala kweendawo zengqondo ezilawula intshukumo kunye nokulungelelaniswa. Abantwana abaninzi abane-CP banemeko ebizwa ngokuba yi-'spasticity'. Oku kuthetha ukuba ezinye izihlunu ziyancipha ngequbuliso xa umntwana ezama ukushukuma okanye emi nje. Oku kunokwenza kube nzima kumntwana ukuhamba, ukwenza imisebenzi yemihla ngemihla, kwaye ngamanye amaxesha kubangele neentlungu.
Utyando lwe-SDR lujolise ngokukodwa:
- I-Spastic diplegic cerebral palsy: Oku kubhekisa kubantwana abanokuqina kwemisipha okuchaphazela kakhulu imilenze.
- I-Severe spastic quadriplegic cerebral palsy: Oku kubhekisa kubantwana abanokuqina kwemisipha okunzima okuchaphazela onke amalungu omane.
Kulungile, olu tyando lunciphisa njani ukuqina kwemisipha?
Ukuze sikuqonde oku, makhe sicinge ngenkqubo yethu yemithambo-luvo okomzuzwana. Ithoni eqhelekileyo yemisipha yemizimba yethu ilawulwa ngumsebenzi wenkqubo yemithambo-luvo ekwintambo yomqolo.
Khawuthelekelele ukuba umzimba wethu unenkqubo yemithambo-luvo efana nefowuni.
1. Iimvakalelo: Ezi zithwala ulwazi oluvela kwimisipha ukuya kwintambo yomqolo.
2. IiMotor Neves: Ezi zithumela imiyalelo esuka kumqolo ibuyele kwimisipha ukuze "ifinyele ngolu hlobo."
Ngokwesiqhelo, ingqondo yethu ilawula ukuhamba kakuhle komyalezo. Oko kuthetha ukuba singalawula izihlunu zethu ngendlela esifuna ngayo. Kodwa kwi-Cerebral Palsy, amandla engqondo okulawula ezi mithambo-luvo ayancipha. Okwenzekayo ke kukuba ezinye iimithambo-luvo zisebenza kakhulu kwaye ziqhubeka zithumela imiqondiso engalunganga kwimisipha, zisithi "qinisa, qinisa."
Nantsi into eyenzekayo ngexesha lotyando lwe-SDR:
Ugqirha ukhetha aze asike kuphela iingcambu zemithambo-luvo ezibangela ukuqina kwemisipha kwaye zivuselelwa ngokungeyomfuneko. Uvavanyo olukhethekileyo (EMG) lusetyenziselwa ukufumanisa ukuba zeziphi imithambo-luvo esebenza kakuhle kwaye zeziphi imithambo-luvo ethumela imiqondiso engalunganga. Oku kuvumela ukuqina kwemisipha kuphela ukuba kuncitshiswe ngaphandle kokuchaphazela eminye imisebenzi.
Ngale ndlela, xa ukuqina kwemisipha kuncitshisiwe, izihlunu ezingaphantsi zinokuqala ukusebenza ngendlela eqhelekileyo. Oku kuphucula ukuhamba nokusebenza komntwana. Kukwanceda ekuthinteleni ukukhubazeka kwamathambo kunye namalungu okunokwenzeka ngenxa yokuqina kwemisipha ixesha elide.
Uzilungiselela njani ngaphambi kotyando?
Ekubeni utyando lwe-SDR lungafanelekanga kubo bonke abantwana, umntwana wakho uya kuvavanywa liqela leengcali ukuze kuqinisekiswe ukuba luya kubanceda na. Ezi ngcali zilandelayo zihlala zibandakanyeka kule nkqubo:
| Ugqirha oyingcali | Indima yabo |
|---|---|
| Ugqirha weengqondo zabantwana | Ingcali enamava kutyando lwe-SDR iza kuhlola imilenze kunye nezihlunu zomntwana ukuze ibone ukuba zifanelekile na utyando. |
| Ugqirha wamathambo wabantwana | Ukuba kukho iingxaki ezinje ngokukhubazeka kwamathambo okanye ukugoba kwemisipha, baya kuhlolwa ukuba ngaba badinga olunye utyando. |
| Ingcali yoNyango lomzimba | Amandla emisipha kunye nomsebenzi wemilenze yomntwana kuyalinganiswa. |
| Ingcali yoNyango loMsebenzi | Ubuchule bokwenza imisebenzi yemihla ngemihla efana nokuhamba, ukutya, kunye nokunxiba buyavavanywa. |
Bonke aba bantu bayamhlola umntwana baze badibane njengeqela ukuze benze isigqibo sokugqibela sokuba utyando lwe-SDR luya kumzuzisa na umntwana.
Ukongeza, kunokufuneka wenze ezinye iimvavanyo ezininzi ngaphambi kotyando:
- Iingcali zonyango lomzimba nezemisebenzi zenza uvavanyo olunzulu ukuze zivavanye ngokupheleleyo amandla omzimba omntwana. Zirekhoda iintshukumo zomntwana ngevidiyo kwaye zicwangcise naluphi na unyango olufunekayo emva kotyando.
- I-MRI scan yobuchopho ukuqinisekisa ukuba akukho ezinye iingxaki zemithambo-luvo.
- Ukuba unezinye iingxaki zemithambo-luvo, bonana nogqirha wezifo zengqondo zabantwana .
- Dibana nogqirha wezifo zengqondo kwakhona ukuze nithethe ngeengozi zotyando kunye nexesha lokuchacha.
- Ndwendwela ingcali yokubulala iintlungu ukuqinisekisa ukuba kukhuselekile ukuba umntwana wakho anikwe i-anesthesia.
Indlela olu tyando lwenziwa ngayo inyathelo ngenyathelo
Nantsi indlela utyando lwe-SDR oluhlala lusenzeka ngayo:
1. I-Anesthesia: Okokuqala, ingcali ye-anesthesia inika umntwana i-anesthesia eqhelekileyo. Ngoko ke umntwana ulala kamnandi ngexesha lotyando kwaye akaziva ntlungu.
2. Ukusika: Ugqirha wemithambo-luvo wenza ukusika okuncinci embindini womqolo womntwana.
3. Ukuvezwa kwemithambo-luvo: Ngale ntambo, i-dura egqume umqolo iyavuleka, idlule kwimisipha namathambo, kwaye imicu yemithambo-luvo engaphantsi iyavezwa.
4. Ukwahlulwa kwemithambo-luvo: Okulandelayo, ugqirha wotyando wahlula imithambo-luvo kunye nemithambo-luvo. Imithambo-luvo ikhuselekile kuyo nayiphi na ingozi.
5. Ukuchonga imithambo-luvo engalunganga: Ii-electrodes ngoku zinamathele kwiingcambu zemithambo-luvo, kwaye kwenziwa i-electromyography (EMG).Ukuvuselelwa kombane kunikezelwa kusetyenziswa umatshini obizwa ngokuba yi-stimulator. Oku kusenza sikwazi ukubona ukuba zeziphi iimithambo-luvo ezibangela ukuxinana kwemisipha, ezithumela imiqondiso engalunganga, kunye nemithambo-luvo esebenza kakuhle.
6. Ukusikwa kwemithambo-luvo: Ngononophelo olukhulu, ipesenti ethile yemithambo-luvo engaqhelekanga echongiweyo iyasikwa. Yeyiphi imithambo-luvo kunye nokuba ingakanani esikwayo iyahluka kumntwana ngamnye.
7. Ukuvala i-incision: Nje ukuba i-nerve cut igqityiwe, i-incision ithungwa ndawonye umaleko ngokulandelelana.
8. Ukuchacha: Emva kotyando, umntwana udluliselwa kwigumbi lokhathalelo olunzulu (ICU) okanye kwigumbi elikhethekileyo lokuchacha kwaye ujongwa ngokusondeleyo liqela lezonyango.
Olu tyando ludla ngokuthatha malunga neeyure ezine okanye ezintlanu.
Kwenzeka ntoni emva kotyando?
Abantwana kuya kufuneka bahlale esibhedlele kangangeentsuku ezintlanu emva kotyando. Kwiiyure zokuqala ezingama-24-48, umntwana kuya kufuneka ahlale ebhedini. Unyango lomzimba luya kuqala kwiintsuku ezimbalwa emva kotyando.
Zithini iingenelo zolu tyando?
Iziphumo zotyando lwe-SDR zinokwahluka ngokuxhomekeke kwimeko yomntwana. Kwakhona, impumelelo yotyando ixhomekeke ngokupheleleyo kunyango olunzulu lomzimba oluqhutywa emva kotyando.
| Imeko yomntwana | Iingenelo ezinokubakho |
|---|---|
| I-Spastic Diplegic CP (abantwana abanemilenze echaphazelekileyo ngakumbi) |
|
| I-Spastic Quadriplegic CP (abantwana abanamalungu amane achaphazelekileyo) |
|
Njengayo yonke into yotyando, ngaba kukho naziphi na iingozi?
Ewe, njengalo naluphi na utyando, utyando lwe-SDR lunemingcipheko ethile, kodwa iingxaki ezihlala zihleli azixhaphakanga.
| Uhlobo lomngcipheko | Yintoni enokuba yiyo |
|---|---|
| Iingxaki zexesha elifutshane | |
| Usulelo | Usulelo lotyando. |
| Ukopha | Ukopha kakhulu ngexesha okanye emva kotyando. |
| Ukuvuza kolwelo lwe-CSF | Ukuvuza kolwelo lwe-cerebrospinal (CSF) olujikeleze umqolo. |
| Iingxaki ezingapheliyo (kodwa ezingaqhelekanga kakhulu) | |
| I-Hyperesthesia | Uvakalelo oluphezulu ekuchukumiseni nasekuveni intlungu. |
| Ukulahlekelwa lulawulo lomchamo | Ukungakwazi ukulawula ukuchama. |
| Ukulahlekelwa kulawulo lwamathumbu | Ukungakwazi ukulawula ukuhamba kwamathumbu. |
| Ubuthathaka | Ukuba buthathaka okanye ukulahleka kwamandla okuhamba ngaphambili. |
Iqela lezonyango lomntwana wakho liza kuxoxa nawe ngazo zonke ezi ngozi ngaphambi kotyando.
Ixesha lokuchacha kunye nokubaluleka konyango lomzimba
Le yeyona nxalenye ibalulekileyo nebalulekileyo yempumelelo yotyando lwe-SDR. Utyando linyathelo lokuqala nje kuphela kolu hambo. Ukuvuselelwa kubalulekile ukuze kufunyanwe iziphumo zokwenyani.
Unyango lomzimba kunye nonyango lomsebenzi luqala kwiintsuku ezimbalwa emva kotyando. Umntwana kufuneka aye kwezi zonyango iintsuku ezininzi ngeveki kangangeenyanga ezintathu ukuya kwezintandathu emva kotyando.
- Ingcali yoNyango lomzimba: Ukuzilolonga ukuqinisa, ukolula, nokuphucula uluhlu lokushukuma kwezihlunu zomntwana. Ekuqaleni, ingcali yonyango iza kwenza izivivinyo, kwaye njengoko umntwana echacha, umntwana uza kuzibandakanya ngokukhutheleyo kwimithambo ngokwakhe.
- Ingcali yoNyango lweMisebenzi: Inceda umntwana ukuba enze imisebenzi yemihla ngemihla (umz., ukunxiba, ukudlala) ngokulula nangokuzimeleyo.
Iinjongo eziphambili zezi zifundo zezi:
- Amandla anyukileyo.
- Ukwakha ibhalansi kunye nokuma ngendlela efanelekileyo xa uhleli naxa umi.
- Ukulungiselela iinyawo ukuma.
- Ukuziqeqesha ukwenza iintshukumo, njengokuma uhleli, ngokulula.
Kuqhelekile ukuba abazali bazive besoyika xa besiva ngotyando. Kodwa khumbula, iqela lezonyango lomntwana wakho ziingcali kweli candelo. Baza kukulungiselela wena nomntwana wakho olu tyando. Musa ukuthandabuza ukuthetha nabo ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo.
Kufuneka uthethe nini nogqirha?
Ukuba ubona naziphi na iimpawu zeengxaki emva kokuzisa umntwana wakho ekhaya evela esibhedlele, fowunela ugqirha wakho ngoko nangoko.
- Ukuba utyando lubomvu, ludumbile, okanye ubomvu buphuma (iimpawu zosulelo).
- Ukuba umntwana unomkhuhlane ophezulu.
- Ukuba ulahlekelwa ngamandla okulawula umchamo okanye ilindle lakho.
Ukuba ubona naziphi na iimpawu ezingaqhelekanga ezifana nezi, funa ingcebiso kagqirha ngokukhawuleza.
Umyalezo Wokuya Ekhaya
- I-SDR lutyando olukhethekileyo olwenziwayo ukunciphisa ukuqina kwemisipha (ukuqaqamba kwemisipha) kwabanye abantwana abane-Cerebral Palsy.
- Oku kuquka ukunqumla ngokukhetha imithambo-luvo evuselelwayo ngokungeyomfuneko. Oku kunciphisa ukuqina kwemisipha ngokusisigxina.
- Olu tyando alufanelekanga kuwo wonke umntwana. Umntwana ukhethwa kuphela emva kovavanyo olucokisekileyo liqela loogqirha abaziingcali.
- Ukuze utyando luphumelele, unyango lomzimba oluqinileyo noluqhubekayo kunye nonyango lomsebenzi emva kotyando zibalulekile. Le yeyona nto ibalulekileyo.
- Ngaphambi kotyando, xoxa nogqirha wakho ngeenzuzo kunye neengozi kwaye uziqonde.
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