Kuvamile ukuzizwa ukwesaba okukhulu nokukhathazeka lapho udokotela wakho ekutshela ukuthi ingane yakho encane idinga ukuhlinzwa kwenhliziyo. Ikakhulukazi uma kukhulunywa 'ngeNqubo kaGlenn,' kungenzeka ukuthi awukaze ucabange ukuthi kuzoba njani ngisho nangemva kokuzwa igama layo. Kodwa ungakhathazeki. Sizoxoxa ngalokhu kuhlinzwa, ukuthi kwenziwani, nokuthi kwenzekani ngemva kwalokho ngendlela elula kakhulu ongayiqonda.
Kalula nje, iyini inqubo kaGlenn?
Cabanga nje, kukhona umthambo omkhulu oqoqa igazi 'elingcolile' elingenawo umoya-mpilo, elivela ezingxenyeni ezingaphezulu zomzimba wethu (ikhanda, intamo, izingalo) bese uliletha enhliziyweni. Lokhu sikubiza ngokuthi 'i-Superior Vena Cava' . Ngokuvamile, enhliziyweni enempilo, leli gazi lidlula emakamelweni enhliziyo bese liphonswa emaphashini, lapho 'lihlanzwa' khona ngokuthatha umoya-mpilo.
Kodwa ezinye izingane ezinezifo zenhliziyo ezizalwa nazo azikwazi ukuhamba kahle kulolu hambo ngenxa yezinkinga ngesakhiwo sezinhliziyo zazo. Mhlawumbe uhlangothi olulodwa lwenhliziyo alukhuliswanga kahle, noma kungase kube nenkinga nge-valve.
Inqubo kaGlenn idlula le ngxenye yenhliziyo enenkinga futhi ixhumanisa igazi 'elingcolile' elivela phezulu ngqo emithanjeni yamaphaphu. Ngamanye amazwi, idala umzila omfushane (ukudlula) oyisa igazi ngqo emaphashini esikhundleni sokudlula ekuvinjweni kwenhliziyo. Lokhu kuvumela igazi elingenawo umoya-mpilo ukuthi liye emaphashini ngaphandle kwesithiyo.
Kukuziphi izinhlobo zezimo zenhliziyo lapho lokhu kuhlinzwa kudingeka kwenziwe khona?
Inqubo yeGlenn iyindlela yokwelapha izifo eziningana zenhliziyo ezingavamile kakhulu neziyinkimbinkimbi. Odokotela bavame ukuncoma le nqubo ezinganeni ezinezimo ezilandelayo:
| Isifo senhliziyo (Isimo Sezokwelapha) | Kalula nje... |
|---|---|
| I-Hypoplastic Left Heart Syndrome | Uhlangothi lwesobunxele lwenhliziyo (ingxenye eyinhloko epompa igazi) alukhuli kahle lapho kuzalwa. |
| I-Tricuspid Atresia | Ivalvu ye-tricuspid ohlangothini lwesokudla lwenhliziyo ayakheki kahle. |
| I-Pulmonary Atresia | Ivalvu yamaphaphu, ethwala igazi lisuka enhliziyweni liye emaphashini, ayivuli kahle. |
| I-Ventricle Ephindwe Kabili Yesobunxele noma Yesokudla | Igazi ligeleza lisuka emakamelweni amabili aphezulu enhliziyo liye ekamelweni elilodwa elingezansi (i-ventricle). |
| Amaphutha Emisele Ye-Atrioventricular Angalingani | Ukuba khona kweziphambeko eziyinkimbinkimbi ezindongeni nasemavalvini phakathi kwamakamelo enhliziyo. |
Ukuhlinzwa kuzokwenziwa nini futhi kuzokwenzekani ngaphambi kwako?
Ukuhlinzwa kukaGlenn kuvame ukwenziwa lapho umntwana ephakathi kwezinyanga ezi-3 nezi-6 ubudala . Ezimweni eziningi, lokhu kungukuhlinzwa kwesibili. Kubantwana abanalolu hlobo lwesifo senhliziyo, ukuhlinzwa kokuqala (njenge-Blalock-Taussig (BT) shunt) kwenziwa lapho kuzalwa ukuze kuthuthukiswe ukugeleza kwegazi. Bese kuthi, lapho umntwana esekhulile kancane, ukuhlinzwa kukaGlenn kwenziwe njengesinyathelo esilandelayo.
Ngaphambi kokuhlinzwa
Ngaphambi kokunquma usuku lokuhlinzwa, odokotela kudingeka bathole isithombe esicacile senhliziyo yomntwana. Ukuze benze lokhu, benza izivivinyo ezifana nalezi:
- I-Catheterization Yenhliziyo: Ukuhlolwa lapho ithubhu elincane lidluliselwa khona ngemithambo esemlenzeni noma engalweni liye enhliziyweni, kulinganiswa ingcindezi engaphakathi kwenhliziyo futhi kubhekwe kahle isakhiwo sayo.
- I-MRI Yenhliziyo: Lokhu kusiza ukuhlela ukuhlinzwa ngokuthola izithombe ezinemininingwane ezintathu (3D) zenhliziyo.
- Kufanele utshele udokotela ngayo yonke imithi ethathwa yingane yakho (kufaka phakathi amavithamini kanye nezithasiselo) .
Kwenzekani ngesikhathi sokuhlinzwa nangemva kwalokho?
Ngesikhathi sokuhlinzwa
Ukuhlinzwa kukaGlenn kuvame ukuthatha cishe amahora amane . Kodwa-ke, isikhathi singahluka kuye ngesimo somntwana. Phakathi nalesi sikhathi sonke, umntwana ungaphansi kwe-anesthesia ejwayelekile. Lokhu kusho ukuthi akezwa lutho, ulele ngokuphelele.
Ezinye izingane zingadinga umshini wokudlulisa igazi emaphashini ukuze zithathe isikhashana ukusebenza kwenhliziyo namaphaphu azo ngesikhathi sokuhlinzwa. Udokotela ohlinzayo uzosebenzisa izinsalela zokuhlinzwa kwangaphambilini ukuxhuma i-vena cava ephezulu nomthambo othwala igazi emaphashini.
Ngemva kokuhlinzwa
Ukubona ingane yakho ngemva kokuhlinzwa kungaba yinto eyesabekayo. Izoxhunywa ochungechungeni lwamapayipi kanye nezikrini ezibonisa izinga lokushaya kwenhliziyo yayo kanye namazinga omoya-mpilo. Kodwa konke lokhu kuhloswe ukuqapha isimo sengane eduze. Ingane izogcinwa e-Intensive Care Unit (ICU) cishe izinsuku ezintathu futhi izoqashwa eduze. Ngemva kwalokho, izodluliselwa ewadini evamile futhi izokwazi ukuya ekhaya ezinsukwini ezimbalwa ezizayo.
Into ebalulekile ukuthi inqubo yeGlenn ivame ukuba yisinyathelo sesibili kuphela esixazululweni esiphelele. Lapho ingane isikhulile kancane futhi iqala ukuhamba (ngokuvamile iphakathi kweminyaka engu-2-4 ubudala), kudingeka olunye ukuhlinzwa olubizwa ngokuthi 'inqubo yeFontan'. Udokotela wakho uzokuchazela lokhu.
Yiziphi izinzuzo kanye nezinkinga ezingaba khona zenqubo kaGlenn?
Njenganoma yikuphi ukuhlinzwa, inqubo kaGlenn inezinzuzo zayo kanye nezingozi ezithile. Kubalulekile ukuzazi lezi.
| Izinzuzo | Izingozi/Izinkinga Ezingaba Khona |
|---|---|
| Kunciphisa umthwalo ekamelweni lokusebenza elilodwa kuphela lenhliziyo (i-ventricle). | Ukwehla kwamazinga omoya-mpilo egazini. |
| Kuvimbela inhliziyo ukuthi ikhule ngenxa yokusebenza ngokweqile. | Umfutho wegazi ophezulu. |
| Kwenza ukuhlinzwa okulandelayo kweFontan kube lula. | Ukuphuma kwegazi emithanjeni. |
| Kwandisa amathuba okusinda kwengane. | Ukudinga ukudla ngepayipi ngenxa yobunzima bokuphuza ubisi. |
| Ukuhlinzwa kweFontan kunikeza enye indlela kulabo abangafuni noma abangenakukwazi ukuba nakho. | Kudingeka ngiphinde ngihlinzwe. |
Izinga lempumelelo yalokhu kuhlinzwa liphezulu kakhulu, cishe li-99% . Ngakho-ke ungakhathazeki. Odokotela bayazi kahle lezi zingozi futhi baqeqeshwe kahle ukuzilawula.
Qaphela lokhu uma usufikile ekhaya!
Ngemva kokufika ekhaya uvela esibhedlela, kufanele uqaphele kakhulu ngesimo somntwana wakho. Uma ubona noma yiziphi izimpawu ezilandelayo, kufanele ushayele udokotela wakho ucingo ngokushesha .
- Imfiva.
- Ukopha okuvela enxebeni lokuhlinzwa noma olunye uketshezi.
- Ubunzima bokuphuza ubisi noma ukwenqaba ukuphuza ubisi.
- Ingane ayikhuli kahle.
- Ubunzima bokuphefumula noma izindebe/izinzipho zengane ziphenduka zibe luhlaza okwesibhakabhaka.
Ngaphambi kokuba ukhishwe esibhedlela, uzonikezwa usuku lokubonana nodokotela wenhliziyo ngokulandelayo. Qiniseka ukuthi uletha ingane yakho kulezo zinsuku.
Umlayezo Wokuya Nawe Ekhaya
- Inqubo yeGlenn iyindlela esindisa impilo yezingane ezinesifo senhliziyo esiyinkimbinkimbi esizalwa naso. Ithuthukisa ukujikeleza kwegazi.
- Lokhu kuvame ukwenziwa lapho umntwana ephakathi kwezinyanga ezi-3-6 ubudala. Ngokuvamile, lesi yisinyathelo sesibili ochungechungeni lokuhlinzwa.
- Izinga lempumelelo lokuhlinzwa liphezulu kakhulu (cishe ama-99%). Kodwa-ke, qonda ukuthi njengakuzo zonke izinhlobo zokuhlinzwa, kunezingozi ezithile.
- Ngemva kokuhlinzwa, umntwana kufanele aqhubeke nokuba ngaphansi kokuqashwa ngudokotela. Landela imiyalelo kadokotela ngqo.
- Uma unemibuzo, ukukhathazeka, noma ukungabaza ngalokhu, ungangabazi ukuxoxa ngakho nodokotela wakho. Kubaluleke kakhulu ukwazi ukuthi yini esemqondweni wakho.
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