Ngaba kukho unxibelelwano olungaqhelekanga phakathi kombhobho wokutya womntwana wakho kunye nombhobho womoya? Masifunde yonke into malunga (ne-Tracheoesophageal Fistula)!

Ngaba umntwana wakho omncinci ukhwehlela ngequbuliso emva kokusela ubisi okanye ukutya ukutya? Ngaba ubonakala enobunzima bokuphefumla okanye ejika abe luhlaza okwesibhakabhaka? Kuqhelekile kuwe njengomzali ukuziva usoyika kwaye ukhathazekile. Ngamanye amaxesha, emva kwezi mpawu, kunokubakho imeko enzima kancinci, kodwa enokunyangeka esiza kuthetha ngayo namhlanje. Leyo yiTracheoesophageal Fistula , okanye iTEF ngamafutshane, kunye nemeko enxulumene nayo iEsophageal Atresia , okanye i-EA. Ungakhathazeki, masiyigcine ilula.

Yintoni iTracheoesophageal Fistula (TEF)? Masiyiqonde ngokulula!

Kulungile, ngoku masibone ukuba yintoni le TEF. Ngamafutshane, ityhubhu ethwala ukutya ukusuka emqaleni ukuya esiswini ibizwa ngokuba yi "esophagus". Ngokufanayo, ityhubhu ethwala umoya ukuya emiphungeni yethu xa siphefumla ibizwa ngokuba yi "trachea". Ngokwesiqhelo, kumntu ophilileyo, ezi tyhubhu zimbini, i-esophagus kunye ne-trachea, zibekwe ngokwahlukeneyo, ngaphandle kokunxibelelana. Kufana neendlela ezimbini, enye yokutya kunye nenye yokuphefumla.

Nangona kunjalo, kumntu onesifo esibizwa ngokuba yiTracheoesophageal Fistula (TEF) , ingakumbi umntwana omncinci, kukho unxibelelwano olungaqhelekanga, okanye umngxuma (i-fistula) phakathi kombhobho wokutya (umlomo) kunye nombhobho womoya (i-trachea). Cinga ngayo njengokuvuza okuncinci phakathi kwemibhobho emibini yamanzi. Kwenzeka ntoni ngenxa yoku? Endaweni yokuhla kumbhobho wokutya uye esiswini, ukutya kunye nolwelo olutyiwayo noluselwa ngumntwana luqala ukuhamba ngaloo nxibelelwano lungaqhelekanga luye kumbhobho womoya kwaye ukusuka apho luye emiphungeni. Oku sikubiza ngokuba yi- "aspiration" . Oku kuyingozi kancinci, kuba ukuba ukutya kungena emiphungeni, izifo zinokwenzeka.

Rhoqo, le meko ye-TEF ibonakala kunye nenye imeko. Oko kukuthi i-Esophageal Atresia (EA) . I-EA yimeko apho i-esophagus (umbhobho wokutya) ingakhekanga ngokupheleleyo, ingadibani nesisu, kwaye ima phakathi. Ngamanye amaxesha i-esophagus yahlulwe yangamacandelo amabini, kwaye iziphelo zala macandelo omabini zivaliwe (iingxowa ezingaboniyo). Njengombhobho oqhekekileyo phakathi.

Ngubani ochaphazeleka kakhulu yile meko?

I-Tracheoesophageal fistula (TEF) idla ngokuba "yimeko yokuzalwa." Oku kuthetha ukuba abantwana bazalwa benale meko. Ibangelwa lutshintsho oluncinci ekukhuleni komntwana ongekazalwa xa esesesibelekweni. Ngenxa yoko, uninzi lweemeko ze-TEF ziyafunyaniswa kwaye zinyangwa ixesha elide emva kokuba umntwana ezelwe, ngexesha lobuntwana.

Nangona kunjalo, nangona kunqabile kakhulu, abantu abadala banokuba nale meko ye-TEF kamva ebomini. Ibizwa ngokuba yi- "Acquired Tracheoesophageal Fistula" . Oku kunokubangelwa ngumhlaza womqala, umhlaza wemiphunga, usulelo olunzima olufana nesifo sephepha, okanye ingozi ngexesha lenkqubo yezonyango.

Ixhaphake kangakanani iTracheoesophageal Fistula (TEF)?

Ngokwezibalo ezivela eMelika, kuqikelelwa ukuba i-TEF ichaphazela malunga nenye kwiintsana ezingama-3,000 ukuya kuma-5,000 ezizalwayo. Ukongeza, malunga nama-50% eentsana ezine-TEF okanye i-EA zinokuba nenye imeko yokuzalwa. Oku kuthetha ukuba kunokubakho iingxaki kwezinye iindawo, njengezintso, intliziyo, okanye inkqubo yamathambo.

"I-Acquired TEF" eyenzeka xa umntu emdala ayiqhelekanga kangako. Kwakhona, kunqabile kakhulu, abanye abantu abadala banokuzalwa bene-TEF kwaye babe neempawu ezibonakala kamva ebomini. Oku kuthetha ukuba banale meko xa bezalwa, kodwa iimpawu zibonakala kamva.

Ziziphi iintlobo eziphambili zeTracheoesophageal Fistula (TEF)?

Ngoku makhe sijonge iintlobo eziphambili zale meko ye-TEF. Oogqirha badla ngokuyihlulahlula ibe ziintlobo ezintlanu. Oku kuneenkcukacha kancinci, kodwa masizame ukuqonda. Khawucinge ukuba i-esophagus (E) yityhubhu enye, kwaye i-trachea (T) yityhubhu enye.

• Uhlobo A: Le yi-TEF, oko kuthetha ukuba akukho nxibelelwano lungaqhelekanga. Kodwa kukho i-EA (Esophageal Atresia) . Oku kuthetha ukuba i-esophagus yahlulwe yangamacandelo amabini, kwaye zombini iziphelo eziphezulu nezisezantsi zala macandelo omabini zivaliwe (iipokotshi ezingaboniyo). Ifana nombhobho oqhekekileyo embindini kwaye iziphelo ezimbini zeziqwenga eziqhekekileyo zivaliwe. Oku kukwabizwa ngokuba yi-"Pure Esophageal Atresia". Malunga ne-8% yazo zonke izigulane ze-TEF/EA zilolu hlobo.

• Uhlobo B: Oku kunqabile kakhulu, kuchaphazeleka kuphela yi-2% yazo zonke izigulana. Apha, inxalenye ephezulu ye-esophagus iqhagamshelwe kwi-trachea (kukho i-TEF), kodwa inxalenye esezantsi ye-esophagus iphela ngesiphelo esivaliweyo (isikhwama esingaboniyo).

• Uhlobo C: Olu lolona hlobo luxhaphakileyo. Malunga nama-85% eemeko awela kolu didi. Okwenzekayo apha kukuba inxalenye ephezulu ye-esophagus iphela ngesiphelo esivaliweyo (isikhwama esingaboniyo), kodwa inxalenye esezantsi ye-esophagus iqhagamshelwe kwi-trachea (TEF). Oku kuthetha ukuba inxalenye ye-esophagus ekufuneka iqhagamshelwe esiswini iqhagamshelwe kwi-trachea.

• Uhlobo D: Olu lolona hlobo lungaqhelekanga, oluvela ngaphantsi kwe-1% yeemeko. Apha, iindawo eziphezulu nezisezantsi ze-esophagus zidibene ne-trachea ngokwahlukeneyo (kukho ii-TEF ezimbini).

• Uhlobo E: Kolu hlobo, i-esophagus yakheke ngokupheleleyo kwaye idibene nesisu. Oku kuthetha ukuba i-EA ayikho. Nangona kunjalo, kukho unxibelelwano olungaqhelekanga (TEF) phakathi kwe-esophagus kunye ne-trachea. Oku ngamanye amaxesha kuthiwa yi-H-type fistula, kuba unxibelelwano lunokubunjwa njengonobumba "H". Malunga ne-4% yazo zonke izigulana ziwela kolu hlobo.

Nangona olu hlobo lolwahlulo lusenokubonakala lunzima kancinci, kubaluleke kakhulu ukuba oogqirha bacebe unyango.

Zithini iimpawu zeTracheoesophageal Fistula (TEF)?

Iimpawu ze-TEF zixhomekeke ekubeni i-EA (Esophageal Atresia) ikhona na kwaye ixhomekeke kuhlobo lwe-TEF.

Iintsana ezine-TEF kuphela (umzekelo, uHlobo E) ezingenayo i-EA zisenokungabonakalisi zimpawu xa zizalwa. Nangona kunjalo, ngokuhamba kwexesha, zinokubona izinto ezifana nezi:

• Usulelo oluqhelekileyo lwemiphunga luvela kuba amasuntswana okutya anamathela kwimibhobho yomoya.
• Xa bencancisa okanye bencancisa, bayaphefumla baze bazive ngathi bayakrwitshwa.

Iintsana ezine-Esophageal Atresia (EA) kunye ne-Tracheoesophageal Fistula (TEF) (ezifana nohlobo oluqhelekileyo, i-Type C) zihlala zibonisa iimpawu kwiiyure ezimbalwa emva kokuzalwa. Iimpawu eziqhelekileyo zezi:

• Ukukhohlela rhoqo, ingakumbi xa uzama ukuncancisa.
• Ukuminxeka xa uzama ukuginya.
• Iingxaki zokuphefumla.
• Ukuphuma kwe-mucous okugqithisileyo emlonyeni.
• Ukudumba kwesisu (ingakumbi kwi-Type C, njengoko umoya ophefumliweyo udlula kwi-TEF uye esiswini).
• Usana lujika lube luhlaza okwesibhakabhaka (i-cyanosis) ngelixa luncancisa.

Khawucinge nje, kukho usana olusandul’ ukuzalwa. Kwakamsinya nje xa umama ezama ukuncancisa ubisi, umntwana uqala ukukhohlela rhoqo, abonakale ngathi uyakrwitshwa, kwaye ngamanye amaxesha ujika abe luhlaza okwesibhakabhaka emlonyeni. Kukho incindi eninzi ephuma emlonyeni. Ukuba ubona into efana nale, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngoko nangoko.

Yintoni ebangela iTracheoesophageal Fistula (TEF)?

Oku kwenzeka rhoqo ngexesha lokukhula komntwana ongekazalwa, apho umntwana ekhula esibelekweni. Ngokwesiqhelo, phakathi kweeveki ezine ukuya kwezisibhozo emva kokukhulelwa, udonga lwenzeka phakathi komqala kunye nombhobho womoya, oqala ekuqaleni njengombhobho omnye. Xa olu donga lungakheki kakuhle, okanye ukwahlukana kungaphelelanga, olu nxibelelwano lungaqhelekanga olubizwa ngokuba yiTracheoesophageal Fistula (TEF) luyenzeka. Isizathu esichanekileyo sale meko asikaziwa okwangoku, kodwa kucingelwa ukuba sibangelwa zizinto zemfuza kunye neemeko ezingqongileyo.

Oogqirha bayixilonga njani i-TEF?

Kunqabile kakhulu, ugqirha unokurhanela ukuba umntwana une-TEF ngenxa yezinto ezingaqhelekanga ezibonwe kwi-ultrasound scan ngaphambi kokuba umntwana azalwe. Umzekelo, ukuba kukho ulwelo oluninzi lwe-amniotic olujikeleze umntwana (i-polyhydramnios), okanye ukuba isisu somntwana asibonakali ngokucacileyo, ugqirha unokurhanela.

Nangona kunjalo, amaxesha amaninzi, ukurhanelwa kwe-TEF kuvela kwiiyure ezimbalwa emva kokuzalwa, xa umntwana eqala ukubonisa ezi mpawu zikhankanyiweyo apha ngasentla (ukubila okugqithisileyo, ubunzima bokuphefumla, ukungakwazi ukuginya).

Ukuqinisekisa olu rhanelwa, iqela lezonyango lingenza iimvavanyo ezifana nezi:

• Ii-X-reyi zesifuba nezesisu: Ezi zinokujonga imeko yomqala, imiphunga, kunye nokuba kukho umoya na esiswini. Umzekelo, umbhobho omncinci (ityhubhu ye-nasogastric) ebekwe kumqala womntwana one-EA unokuma phakathi kwi-X-reyi ngaphandle kokufikelela esiswini.
• I-Endoscopy okanye iBronchoscopy: Kwezi mvavanyo, ityhubhu encinci enekhamera eqhotyoshelweyo ifakwa ngomlomo okanye empumlweni ize ijonge ngqo ngaphakathi kwi-esophagus (endoscopy) okanye kwi-windpipe (bronchoscopy). Oku kunokunceda ekufumaneni indawo echanekileyo yoqhagamshelwano olungaqhelekanga (i-fistula).

Xa umntwana efunyenwe ene-TEF okanye i-EA, ugqirha uya kuyalela iimvavanyo ezongezelelweyo ukuze kuhlolwe ezinye iziphene zokuzalwa, njengoko bekutshiwo ngaphambili. Umzekelo, kunokwenziwa iskeni yentliziyo (echocardiogram) kunye neskeni yezintso.

Iphathwa njani iTracheoesophageal Fistula (TEF)?

Unyango olusebenzayo kuphela lwe-TEF lutyando. Kolu tyando, ugqirha ususa unxibelelwano olungaqhelekanga phakathi komqala womntwana kunye ne-trachea aze avale umngxuma. Emva koko, ukuba i-EA nayo ikhona, iindawo ezimbini eziphukileyo ze-esophagus zidityaniswa ukuze kube nokwenzeka ukuba ukutya kudlule.

Olu tyando lungenziwa njengotyando oluvulekileyo lwendabuko okanye njengotyando olungenasithintelo kangako (utyando lwe-thoracoscopic) kusetyenziswa imingxunya embalwa emincinci. Indlela esetyenziswayo ixhomekeke kwizinto ezifana nemeko yosana, uhlobo lwe-TEF, kunye namava kagqirha otyando.

Ngaba kukho naziphi na iingozi kolu tyando?

Njengakwezinye iindlela zotyando, utyando lokulungisa i-TEF lunokuba neengxaki ezithile. Ezi ziquka:

• Ukuvuza kwe-Anastomotic: Oku kubhekisa ekuphumeni kolwelo oluvela kwi-anastomosis (uqhagamshelo) lwetyhubhu yokondla.
• Ukuqina komlomo wesibeleko: Le yimeko apho unxibelelwano nombhobho wokutya luncipha ngokuhamba kwexesha. Oku kunokwenza kube nzima kumntwana ukuginya.
• Ukonakala kwemithambo-luvo yelaryngeal: Oku kunokuchaphazela ilizwi lomntwana.
• Ukuphinda kwe-fistula: Kwanasemva kotyando, unxibelelwano olungaqhelekanga alunakuphinda luvele. Oku kwenzeka malunga ne-3% ukuya kwi-14% yamatyala.
• Iintsholongwane.
• Isifo seGastroesophageal Reflux (GERD): Oku kwenzeka xa i-asidi yesisu ibuyela kwi-esophagus. Oku kuqhelekile emva kotyando lwe-TEF.

Iqela lezonyango liza kuthetha nawe ngale mingcipheko. Ungakhathazeki, oogqirha bakulungele konke oku.

Kuthatha ixesha elingakanani ukuchacha emva konyango lwe-TEF?

Ixesha lokuchacha linokwahluka kusana nosana. Kuxhomekeke kubukhali bemeko yosana, uhlobo lotyando, kunye nendlela umntwana asabela ngayo kunyango. Kwiimeko ezininzi, kunokuthatha malunga neeveki ezili-12, okanye malunga neenyanga ezintathu, ukuba aphile ngokupheleleyo. Ngeli xesha, umntwana unokondliwa ngetyhubhu ekhethekileyo yokondla, okanye angeniswe kancinci kancinci ekutyeni ngomlomo. Oogqirha kunye nabasebenzi bomongikazi baya kukuchazela konke oku.

Ngaba i-Tracheoesophageal Fistula (TEF) ingathintelwa?

Okwangoku akukho ndlela yokuthintela i-TEF yokuzalwa, eyi-TEF ekhoyo ekuzalweni. Oku kungenxa yokuba yenzeka ngexesha lokukhulelwa. Kwakhona, ekubeni i-TEF efunyenweyo, eyenzeka xa umntu emdala, idla ngokubangelwa ngumhlaza okanye usulelo oluqatha, akukho ndlela ithile yokuyithintela. Nangona kunjalo, ukulandela indlela yokuphila enempilo kunokunceda ukukhusela umhlaza kunye nosulelo.

Yintoni endimele ndiyilindele ukuba umntwana wam une-TEF?

Ukuba umntwana wakho ufunyaniswe ene-TEF, iqela lezonyango liya kucebisa ukuba atyandwe ngoko nangoko. Le inokuba yimeko esongela ubomi, ngoko ke kubalulekile ukufumana unyango ngokukhawuleza. Uhlobo lotyando luxhomekeke kuhlobo lwe-TEF.

Ukuba umntwana ufumana naziphi na iingxaki emva kotyando, iqela lezonyango liza kumgcina umntwana esibhedlele iintsuku ezimbalwa kwaye lijonge imeko yakhe ngokusondeleyo. Iintsana ezifumana iingxaki kwangethuba emva kotyando zinamathuba amaninzi okuba ne-TEF ephinde ivele kwakhona kamva. Ke ngoko, ukuba iingxaki ezinjalo ziyenzeka, ugqirha uza kuqhubeka nokujonga umntwana (ukulandelela).

Ngexesha elinje, njengabazali, nisenokuziva nixinezelekile engqondweni. Nisenokuziva nisoyika. Yinto eqhelekileyo leyo. Buza oogqirha kunye nabahlengikazi imibuzo yakho kwaye ucime amathandabuzo akho. Baza kukunceda.

Ngaba i-Tracheoesophageal Fistula (TEF) inganyangeka ngokupheleleyo?

Ewe! I-Tracheoesophageal fistula (TEF) inokunyangeka ngokupheleleyo ngotyando. Eyona nto ibalulekileyo kukuyiqaphela kwangethuba kwaye uqale unyango ngoko nangoko, njengoko inokuba yimeko esongela ubomi. Ukwenza njalo kunokulungisa unxibelelwano olungaqhelekanga phakathi komqala womntwana kunye nombhobho womoya, kuthintele ukutya ekungeneni emiphungeni (aspiration), kwaye kunike umntwana ithuba lokuphila ubomi obusempilweni.

Okokugqibela, khumbula oku (Umyalezo Wokuya Ekhaya)

Kuqhelekile ukuziva uxinezelekile xa ufumanisa ukuba umntwana wakho omncinci une-Tracheoesophageal Fistula (TEF). Kodwa khumbula, le yimeko enokunyangeka.

• Ukufunyanwa kwangoko kunye nonyango olukhawulezileyo zezona zinto zibalulekileyo. Ukuba umntwana wakho uhlala ekhala ngelixa encancisa okanye esitya, ubonakala enengxaki yokuphefumla, okanye ejika abe luhlaza okwesibhakabhaka, funa uncedo lwezonyango ngokukhawuleza.
• Utyando lolona nyango luphambili loku.Oogqirha baza kunika unyango olufanelekileyo kumntwana wakho.
• Nokuba emva kotyando, kubaluleke kakhulu ukulandela imiyalelo yoogqirha nokuthatha umntwana aye kulandelelwa ngexesha.
• Awuwedwa. Inkxaso yeqela lakho lezonyango, usapho, kunye nabahlobo ibaluleke kakhulu ngeli xesha. Ungathandabuzi ukwabelana ngeemvakalelo zakho kwaye ucele uncedo.

Siyathemba ukuba olu lwazi luza kukunceda uqonde le meko inzima. Sinqwenela umntwana wakho aphile ngokukhawuleza!

i- tracheoesophageal fistula, i-esophageal atresia, imeko yokuzalwa, isiphene sokuzalwa, impilo yomntwana, utyando lwabantwana, ukufunxwa