Ngesikhathi udokotela ekutshela ukuthi ingane yakho encane idinga ukuhlinzwa 'kweGlenn' ngenxa yenkinga yenhliziyo, kumelwe ukuthi wazizwa wesaba kakhulu futhi wethukile. Kufanele ukuthi unemibuzo eminingi engqondweni yakho, njengokuthi iyini 'inqubo yeGlenn', ihilelani, nokuthi kungani yenziwa. Ungakhathazeki. Leyo mizwa ivamile kakhulu. Ake sixoxe ngakho konke lokhu kalula, ngendlela ongayiqonda.
Iyini inqubo kaGlenn, uma siyibeka kalula?
Cabanga ngakho, inhliziyo yethu iyinjini epompa igazi emzimbeni wonke. Inezingxenye ezine (amakamelo amane). Ezinye izingane zizalwa zinenye yalezi zindawo engakakhuli ngokugcwele noma incane kakhulu. Kulesi simo, inhliziyo ayikwazi ukupompa igazi kahle.
Kalula nje, inqubo kaGlenn iyindlela 'yokudlula' esiza inhliziyo ebuthakathaka njengale.
Lapha, odokotela abahlinzayo baxhuma umthambo wegazi oyinhloko (i-vena cava ephezulu), othwala igazi elingcolile elingenawo umoya-mpilo lisuka emzimbeni ongaphezulu womntwana, ngqo emthanjeni wamaphaphu, esikhundleni sokulithumela enhliziyweni.
Lokhu kufana nokwakha umgwaqo omusha, olula ukuwusebenzisa odlula umgwaqo omatasa. Lokhu kuvumela igazi elidinga ukuthola umoya-mpilo ukuthi lidlule ingxenye yenhliziyo enenkinga bese liqonda ngqo emaphashini.
Lokhu kuvame ukuba ukuhlinzwa kwesibili umntwana akwenzayo. Okunye ukuhlinzwa kwenziwa eminyakeni embalwa kamuva ukuze kutholakale ikhambi elihlala njalo kulesi simo.
Lolu hlobo lokuhlinzwa lwenziwa kubantwana abanjani?
Ukuhlinzwa kukaGlenn kwenziwa kakhulu ezinganeni ezinezinkinga zenhliziyo ezizalwa nazo. Kudingeka kakhulu ezinganeni ezincane kakhulu, noma kulabo lapho elinye lamakamelo amabili amakhulu (ama-ventricle) enhliziyo eliphampa igazi lingasebenzi kahle. Lesi simo sibizwa ngokuthi 'i-single ventricle defect'.
Ngezansi kunezinye zezinkinga zenhliziyo eziyinhloko ezidinga ukuhlinzwa kukaGlenn.
| Igama lesifo senhliziyo (Isimo Sezokwelapha) | Incazelo elula |
|---|---|
| I-Hypoplastic Left Heart Syndrome | Uhlangothi lwesobunxele lwenhliziyo (i-ventricle yesobunxele, ama-valve) alukhuli kahle. |
| I-Tricuspid Atresia | Ivalvu ye-tricuspid, etholakala phakathi kwamakamelo ohlangothini lwesokudla lwenhliziyo, ayakheki kahle. |
| I-Pulmonary Atresia | Ivalvu yamaphaphu ethwala igazi emaphashini ivaliwe. |
| I-Ventricle Ephindwe Kabili Yesobunxele noma Yesokudla | Amakamelo amabili aphezulu enhliziyo (i-atria) axhumeka ekamelweni elilodwa eliphansi (i-ventricle). |
Ukuhlinzwa kukaGlenn kuvame ukwenziwa nini?
Odokotela bavame ukuncoma lokhu kuhlinzwa lapho umntwana ephakathi kwezinyanga ezintathu neziyisithupha ubudala . Kuvame ukwenziwa njengokuhlinzwa kwesibili, ngemva kokuba umntwana ehlinzwe okokuqala ukuze kuthuthukiswe ukujikeleza kwegazi (njenge-Blalock-Taussig (BT) shunt) ngemva kokuzalwa.
Kwenzekani ngaphambi nangesikhathi sokuhlinzwa?
Ngaphambi kokuhlinzwa
Ngaphambi kokuhlinzwa, udokotela wakho uzokwenza izivivinyo eziningana ukuze ahlole kangcono isimo senhliziyo yengane yakho.
- Ukuhlolwa kwe-Catheterization Yenhliziyo: Lokhu kuhlolwa kwenziwa ukuze kulinganiswe ukucindezela kanye namazinga omoya-mpilo ngaphakathi kwenhliziyo kanye nokubheka isakhiwo senhliziyo.
- I-MRI Yenhliziyo: Lokhu kusiza ukuthola izithombe ezinemininingwane zenhliziyo ezinobukhulu obuthathu.
- Kubaluleke kakhulu ukwazisa udokotela ngayo yonke imithi (kufaka phakathi amavithamini kanye nezithasiselo) ingane yakho eyithathayo .
Ngesikhathi sokuhlinzwa
Ukuhlinzwa ngokuhlinzwa ngokuvamile kuthatha cishe amahora amane , kodwa lesi sikhathi singahluka kuye ngesimo somntwana.
Ngesikhathi sokuhlinzwa, umntwana unikezwa i-anesthesia, ukuze umntwana angazizwa ubuhlungu. Umntwana ulele ubuthongo obujulile. Ezinye izingane zixhunywe emshinini okhethekile othatha okwesikhashana umsebenzi wenhliziyo namaphaphu ngesikhathi sokuhlinzwa. Lokhu kubizwa ngokuthi umshini we-cardiopulmonary bypass . Ngemuva kwalokho, njengoba kushiwo ngaphambili, udokotela ohlinzayo wenza ukuxhumanisa imithambo yegazi kanye nokunye ukulungiswa kwenhliziyo uma kudingeka.
Izinzuzo kanye nezingozi ezingaba khona zokuhlinzwa
Njenganoma yikuphi ukuhlinzwa, inqubo kaGlenn inezinzuzo kanye nezingozi. Kubalulekile ukuthi abazali bazi ngalokhu.
| Izinzuzo | Izingozi/izinkinga ezingaba khona |
|---|---|
| Ukwehla kwesisindo segumbi lenhliziyo elisebenzayo kuphela (i-ventricle). | Ukwehla kwamazinga omoya-mpilo egazini. |
| Ukuvimbela inhliziyo ukuthi ingakhuli ngenxa yokusebenza ngokweqile. | Umfutho wegazi ophezulu. |
| Ukuhlinzwa kweFontan okuzayo kuzoba lula. | Ukuphuma kwegazi emithanjeni. |
| Amathuba anda okusindisa impilo yengane ngemva kokuhlinzwa kweFontan. | Ukuthi umuntu anikwe ukudla ngepayipi ngenxa yobunzima bokudla. |
| Ukuba yindlela ehlukile yezingane ezingadingi noma ezingenakukwazi ukuhlinzwa kweFontan. | Kuzodingeka ngiphinde ngihlinzwe. |
Into ebaluleke kakhulu ukuthi izinga lokusinda kwengane ngemva kokuhlinzwa kukaGlenn liphezulu kakhulu. Licishe libe ngu-99% . Lo msebenzi uphumelele kakhulu.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, umntwana uzongeniswa egunjini lokunakekelwa okujulile (ICU). Ungase uzizwe wesaba uma ubona amapayipi nama-monitor exhunywe emzimbeni wengane. Kodwa lokho kuvamile. Ithimba lezokwelapha lizomqapha umntwana eduze kakhulu.
Ingane izohlala egunjini lokunakekelwa okujulile cishe izinsuku ezintathu, bese idluliselwa egunjini elivamile. Kungathatha amasonto amaningana ukuthi ingane ilulame ngokugcwele futhi ibuyele ekhaya.
Izingane eziningi, eminyakeni embalwa ngemva kwenqubo kaGlenn, lapho ziqala ukuhamba, kuzodingeka zidlule esinyathelweni esilandelayo, inqubo kaFontan , enikeza ikhambi elihlala njalo ohlelweni lokujikeleza kwegazi lwenhliziyo.
Kunini lapho udinga ukubonana nodokotela ngemva kokubuyela ekhaya?
Kubaluleke kakhulu ukunakekela ingane yakho kahle ngemva kokubuyela ekhaya. Uma ubona noma yiziphi izimpawu ezilandelayo , shayela udokotela wakho ngokushesha.
- Uma ingane inomkhuhlane.
- Uma igazi noma olunye uketshezi luvuza enxebeni lokuhlinzwa.
- Uma unenkinga yokuphuza ubisi.
- Uma unenkinga yokukhuluphala.
Ingane yakho kuzodingeka iye emtholampilo kadokotela wenhliziyo futhi ithathe imithi isikhathi eside. Lokho kuyingxenye yalolu hambo.
Umlayezo Wokuya Nawe Ekhaya
- Inqubo yeGlenn iwukuhlinzwa okuhleliwe, kwesigaba sesibili okwenziwa ezinganeni ezinesifo senhliziyo esiyinkimbinkimbi sokuzalwa.
- Lokhu kusho ukuthi igazi elingenawo umoya-mpilo lithunyelwa ngqo emaphashini, lidlule inhliziyo, kuncishiswe umthwalo womsebenzi enhliziyweni.
- Izinga lempumelelo yalokhu kuhlinzwa liphezulu kakhulu (cishe ama-99%). Ngakho-ke ungesabi.
- Ngemva kokuhlinzwa, ingane izodinga ukubhekwa isikhathi eside kwezokwelapha kanye nemithi, ngakho-ke kubaluleke kakhulu ukulandela imiyalelo kadokotela.
- Khuluma nodokotela wakho ngokukhululekile nganoma yimiphi imibuzo noma ukwesaba onakho. Bakhona ukukusiza.
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