Ingabe usana lwakho olusanda kuzalwa lunenkinga yokugwinya ubisi? Kungaba yi-Esophageal Atresia.

Ingabe ingane yakho esanda kuzalwa iqala ukukhwehlela nokuklinywa ngokuzumayo uma uyinika ubisi? Ingabe ikhipha igwebu emlonyeni? Njengomama noma ubaba, kumelwe wesabe kakhulu uma ubona lezi zinto. Ngezinye izikhathi lezi zimpawu zingabangelwa yisimo sokuzalwa esibizwa ngokuthi i-Esophageal Atresia. Ungakhathazeki. Ake sixoxe ngalokhu ngamazwi alula namuhla futhi siqonde konke.

Kalula nje, iyini i-Esophageal Atresia (EA)?

I-Esophageal Atresia (ebizwa ngokuthi "i-esophagus") iyisici sokuzalwa. Uma sikhuluma iqiniso, iyinkinga ngomhubhe womntwana. Ipayipi elithwala ukudla kusuka emlonyeni kuya esiswini lapho sigwinya. Igama elithi "atresia" lisho ukuthi indlela emzimbeni ivaliwe noma ivaliwe. Ngakho-ke, esimweni se-atresia yomlomo, umhubhe womntwana awukhuli phansi lapho kufanele uxhumeke khona esiswini, kodwa uyama phakathi bese uvalekile. Kufana nepayipi lamanzi eliqhekekile phakathi. Ngenxa yalokhu, umntwana akakwazi ukuphuza ubisi noma ukugwinya ukudla ngendlela evamile. Enye inkinga enkulu engabonakala ngalesi simo yi- tracheoesophageal fistula (TEF) . Kulesi simo, esikhundleni sokuxhuma umhubhe nesisu, uxhumeka ku-trachea yomntwana, okuyipayipi lokuphefumula. Lokhu kuyingozi kakhulu, ngoba izinto ezifana nobisi namathe umntwana agwinyayo zingangena ngqo emaphashini.

Ingabe kunezinhlobo ezahlukene zalesi simo?

Yebo, lezi zimo ze-Esophageal Atresia kanye ne-Tracheoesophageal Fistula (TEF) zihlukaniswe ngezinhlobo eziningana eziyinhloko kuye ngokuthi zenzeka kanjani ndawonye noma ngokwehlukana. Udokotela wakho uzohlela ukwelashwa kwakho ngokusekelwe ohlotsheni oluqondile.

Wazi kanjani ukuthi ingane yakho inalesi simo? Ziyini izimpawu?

Odokotela nabahlengikazi banaka kakhulu lezi zimpawu lapho behlola umntwana osanda kuzalwa. Ikakhulukazi, banaka izimpawu ezintathu eziyinhloko.

• Ukukhwehlela: Ikakhulukazi uma uzama ukuphuza ubisi.
• Ukuminyana : Ukuminyana kwenzeka ngoba ubisi noma amathe awakwazi ukugwinywa.
• I-Cyanosis: Isikhumba nezindebe ziphenduka zibe luhlaza okwesibhakabhaka ngenxa yokuntuleka komoya-mpilo emzimbeni.

Lezi yizo lezo zici ezengeziwe:

• Ukuphuma kolwelwesi olunegwebu emlonyeni.
• Ukuqunjelwa kwamathe ngokweqile.
• Ukuhlanza noma ukuminyana lapho uzama ukuncelisa.
• Ubunzima bokuphefumula kanye nokuphefumula okusheshayo.

Ngokuvamile, ezinye izifo ezibangela ubunzima bokugwinya azibangeli ubunzima bokuphefumula. Kodwa-ke, uma kokubili ubunzima bokugwinya nokuphefumula kwenzeka kanyekanye , kungenzeka kakhulu ukuthi kungenxa ye-Esophageal Atresia ene-Tracheoesophageal Fistula (TEF).

Kungani lokhu kwenzeka ezinganeni? Iyini imbangela eyinhloko?

Lesi yisimo sokuzalwa. Okusho ukuthi, kwenzeka ngesikhathi umntwana ekhula esibelethweni. Ngokuvamile, ezigabeni zokuqala zengane, i-esophagus kanye ne-trachea kuyipayipi elilodwa. Kungemva kwesikhathi kuphela lapho le ngxenye ihlukana khona ibe izingxenye ezimbili, yakha i-esophagus kanye ne-trachea. Endabeni ye-esophageal atresia , le nqubo yokuhlukana ayiqedi ngokuphelele. Abacwaningi abakakwazi ukuthola ukuthi yini ngempela ebangela ukuthi le nqubo ime phakathi. Kodwa bakholelwa ukuthi inhlanganisela yezici zofuzo kanye nezemvelo ingadlala indima.

Odokotela basithola kanjani lesi sifo?

Ngezinye izikhathi ukuskena kwangaphambi kokubeletha kunganikeza izinkomba, kodwa ngokuvamile lesi sifo sitholakala ngemva kokuzalwa komntwana.

Ukuxilongwa Kwangaphambi Kokubeletha

Ngezinye izikhathi izinkomba ngalokhu zingabonakala ngesikhathi sokuhlolwa kwe-anomaly, okwenziwa cishe emavikini angama-20 okukhulelwa.

• Ama-Polyhydramnios: Uma kunoketshezi oluningi kakhulu oluzungeze umntwana. Lokhu kungenxa yokuthi umntwana uvame ukugwinya lolu ketshezi. Uketshezi luyanqwabelana ngoba umntwana akakwazi ukugwinya.
• Ibhamuza lesisu elincane noma elingabonakali: Uma isisu somntwana singagcwele uketshezi ngesikhathi sokuhlolwa .

Uma ubona into efana nale, udokotela wakho angase akuncomele ukuhlolwa okwengeziwe, njenge-MRI yengane esanda kuzalwa.

Ngemva kokuzalwa komntwana (Ukuxilongwa Kwangemva Kokubeletha)

Odokotela basola lesi simo lapho umntwana ebonisa izimpawu ezingenhla ekuzalweni. Ukuhlolwa okuyinhloko kokuqinisekisa lokhu ukuzama ukufaka ithubhu elincane (ithubhu le-nasogastric) ngekhala bese lingena esiswini. Uma i-esophagus ivalekile, ithubhu ima phakathi nendawo ngaphandle kokungena esiswini. Ngemuva kwalokho kwenziwa i-X-ray ukuze kubonakale ukuthi i-esophagus ivalekile kuphi, ukuthi ixhunywe yini ku-trachea, nokuthi uketshezi lungene yini emaphashini. Uma lesi sifo siqinisekiswa, odokotela bahlola nezinye izinkinga zokuzalwa ezihlobene.

Ingabe lesi simo singalapheka ngokuphelele ngokuhlinzwa?

Yebo. Ezimweni eziningi, kungenzeka. Uma isimo sesitholakele, isimo somntwana siyaqina futhi inkinga ixazululwa ngokuhlinzwa ngokushesha okukhulu. Kodwa-ke, ezinye izingane kungadingeka zihlale esibhedlela isikhashana ngaphambi kokuhlinzwa.

• Kuze kube yilapho izingane ezizalwa ngaphambi kwesikhathi zithola isisindo.
• Uma igebe phakathi kwezingxenye ezimbili zomthambo likhulu kakhulu (i-Long-gap esophageal atresia - LGEA). Ezimweni ezinjalo, kuzodingeka ulinde kuze kube yilapho izingxenye ezimbili zikhula kancane bese zisondela.
• Uma kunezinye izinkinga ezisongela ukuphila, njengezinkinga ezinkulu zenhliziyo, lezo zidinga ukwelashwa kuqala.

Phakathi nalesi sikhathi, umntwana uthola lonke ukunakekelwa okudingekayo ngaphansi kokuqondisa kodokotela nabahlengikazi abangochwepheshe e-Neonatal Intensive Care Unit (NICU) . Umntwana unikezwa ukudla okunomsoco okudingekayo ngepayipi (i-enteral nutrition) noma nge-intravenous (i-parenteral nutrition). Ngakho-ke akudingeki ukhathazeke ngokuthi umntwana akakwazi ukudla.

Ukwelashwa nokuhlinzwa kwenziwa kanjani?

Kunemigomo eminingana eyinhloko yokwelashwa: ukuzinzisa ukuphefumula kwengane, ukuhlinzeka ngokudla okuphephile, kanye nokulungisa isimo ngokuhlinzwa.

Ukuphathwa okusheshayo

Uma ingane isitholakale inalesi simo, kwenziwa izinto ezilandelayo ngesikhathi ilungiselela ukuhlinzwa:

• Amathe namathe aqongelela emphinjeni nasemlonyeni asuswa ngokumunca.
• Kufakwa ipayipi lokuphefumula ukuze kuvikelwe indlela yokuphefumula.
• Ipayipi lokudla noma umugqa we-IV usetshenziselwa ukunikeza ukudla okunomsoco kanye noketshezi.
• Ama-antibiotic anikezwa ukuvimbela ukutheleleka kwamaphaphu (i-pneumonia).

Ukuhlinzwa (Ukulungiswa Kokuhlinzwa)

Uma ithimba lezokwelapha selinqume ukuthi umntwana usekulungele ukuhlinzwa, ukuhlinzwa kuyakwenziwa. Imigomo eyinhloko yile: 1. Ukuxhumanisa kabusha izingxenye ezimbili ezihlukene ze-esophagus (anastomosis). 2. Ukuvala i-fistula (uxhumano phakathi kwe-esophagus nomphimbo), uma ikhona. Namuhla, noma nini lapho kungenzeka, odokotela abahlinzayo benza lokhu kuhlinzwa besebenzisa ukuhlinzwa okungangenisi kakhulu . Lokhu kusho ukuthi esikhundleni sokwenza ukusika okukhulu esifubeni, kufakwa ikhamera (i-thoracoscope) kanye nezinsimbi ezibucayi ngokusebenzisa ukusika okuncane okuningana. Lokhu kuvumela umntwana ukuba alulame ngokushesha.

Ukululama ngemva kokuhlinzwa

Ngemva kokuhlinzwa, umntwana ubuyiselwa e-NICU. Ezinsukwini ezimbalwa kamuva, kwenziwa i-X-ray ekhethekile ebizwa ngokuthi i-esophagram ukuhlola ukuthi ngabe ukusikwa kupholile kahle yini nokuthi kukhona yini ukuvuza. Uma konke sekuqinisekisiwe ukuthi kulungile, umntwana uqala kancane kancane ukuncelisa ngaphansi kokuqondisa kukadokotela. Lokhu kuthatha isikhathi ukuba umntwana ajwayele.

Impilo yengane izoba njani ngemva kokwelashwa?

Iningi lezingane liyalulama kahle futhi liphile impilo evamile. Kodwa-ke, ezinye izingane zingase zibe nezinkinga zesikhathi eside ngenxa yalesi simo kanye nokuhlinzwa. Lezi zivame ukuthuthuka ngokuhamba kwesikhathi, kodwa zingadinga ukubhekwa kwezokwelapha iminyaka eminingana.

• I-Tracheomalacia: Lesi yisimo lapho i-cartilage ku-trachea iba buthakathaka, okubangela ukuthi i-trachea inciphe kancane lapho iphefumula. Lokhu kungabangela ukuphefumula kanzima , ubunzima bokuphefumula ngesikhathi sokulala, kanye nokutheleleka njalo esifubeni (i-pneumonia, i-bronchitis).
• Ubunzima bokugwinya: Ezinye izingane zingase zibe nobunzima bokugwinya ngenxa yokungasebenzi kahle komgudu wokugaya ukudla. Le nkinga ingavela ikakhulukazi lapho uletha ukudla okuqinile. Lokhu kungalawulwa ngokusika ukudla kube yizicucu ezincane bese kunikezwa uketshezi.
• Isifo Sokuphindezela Kwesisu Esisuka Emzimbeni (GERD):Yilapho kuvela khona i-asidi yesisu e-esophagus (efana ne-gastritis). Lesi simo senzeka cishe kwengxenye yezingane ezelashwa nge-EA. Kubalulekile ukwelapha lokhu njengoba kuqondiswe udokotela.

Uma ingane yakho inanoma yiluphi lwalezi zinkinga, khuluma nodokotela wakho ngakho njalo. Ungacela usizo kochwepheshe abanjengodokotela bezifo zolimi lokukhuluma kanye nochwepheshe bezokudla ukuze bakunikeze ukwesekwa okudingwa yingane yakho. I-Esophageal atresia, ukuvaleka komphimbo, i-tracheoesophageal fistula, ukukhubazeka kokuzalwa, izinsana ezisanda kuzalwa, ukuminyana kwengane, ukuhlinzwa kwezingane ezisanda kuzalwa, i-esophagus