Kumelwe ukuba wesaba kakhulu lapho udokotela ekutshela ukuthi umzimba womntwana wakho uphenduka ophuzi futhi isizathu siwukuvinjelwa kwemisele yenyongo esibindini, isimo esibizwa ngokuthi i-Biliary Atresia. Manje udokotela cishe ukhuluma ngokuhlinzwa okubizwa ngokuthi 'iKasai'. Kuyini ngempela lokhu kuhlinzwa? Ingabe kuzolunga enganeni? Kumelwe ukuba unemibuzo eminingi ekhanda lakho. Ungakhathazeki. Ake sixoxe ngakho kalula, ngendlela ongayiqonda.
Iyini inqubo yeKasai?
Kalula nje, lokhu ukuhlinzwa okukhethekile okwenziwa ukwelapha isimo esibizwa ngokuthi i-Biliary Atresia . Isibindi sethu sikhiqiza uketshezi olubizwa ngokuthi 'i-bile'. Le nyongo yiyo esiza umzimba ukugaya amafutha kanye namavithamini athile ekudleni esikudlayo futhi uwamunce. Kumntwana one-Biliary Atresia, amapayipi amancane (amapayipi enyongo) athwala inyongo esuka esibindini aye emathunjini ayavalwa noma awakhiwanga lapho ezalwa.
Ngakho-ke kule nqubo yaseKasai, udokotela ohlinzayo ususa la mapayipi enyongo avimbekile, angasebenzi kahle. Bese, bathatha ingxenye yamathumbu amancane omntwana bese beyixhuma ngqo esibindini, badale indlela entsha yokuthi inyongo igeleze ngayo. Kufana nokususa ipayipi elivimbekile elivimbela amanzi ukuthi ageleze bese kufakwa elisha.
Kungani ingane idinga lokhu kuhlinzwa?
Cabanga nje, kwenzekani lapho inyongo evela esibindini ingenandlela yokuphuma? Yonke leyo nyongo eqoqwayo ngaphakathi kwesibindi. Le nyongo eqoqwe kancane kancane iqala ukulimaza amangqamuzana esibindi. Ngokuhamba kwesikhathi, isibindi siyalimala, siqine, futhi singakwazi ukusebenza. Lokhu sikubiza ngokuthi i-cirrhosis .
Uma ingelashwa, i-biliary atresia ingaholela ekuhlulekeni kwesibindi ngokuphelele zingakapheli izinyanga ezimbalwa. Lokhu kusongela ukuphila.
Lokhu kuhlinzwa kweKasai kumisa noma kunciphise umonakalo wesibindi. Lokhu kunikeza ithuba elikhulu lokusindisa impilo yengane.
Kwenzekani ngaphambi nangesikhathi sokuhlinzwa?
Ngaphambi kokuhlinzwa, odokotela bazonika umntwana uketshezi lwe-IV ukuze amgcine emanzi futhi bamnike ama-antibiotic ukuze banciphise ingozi yokutheleleka.
Ngaphambi kokuqala ukuhlinzwa, udokotela ohlinzayo kudingeka aqiniseke ngokuphelele ukuthi umntwana une-Biliary Atresia. Lokhu kuhilela ukwenza ukuhlolwa okubizwa ngokuthi 'i-Cholangiogram' . Kulokhu, kwenziwa ukusika okuncane esiswini somntwana, kufakwe ipayipi elincane enyongweni, bese kufakwa umuthi okhethekile ongabonakala ku-X-ray. Lokhu kuvumela udokotela ukuthi abone ngokucacile ukuthi i-bile duct ivaliwe noma cha.
Uma i-biliary atresia iqinisekisiwe, udokotela uzoqhubeka nokuhlinzwa. Inyongo yomntwana kanye nemisele yenyongo evalekile kuzosuswa, bese kuhlanganiswa okusha nesibindi kusetshenziswa ingxenye yamathumbu amancane (i-jejunum). Lokhu kuhlinzwa kungathatha amahora amaningana.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, umntwana ugcinwa egunjini lokunakekelwa okujulile (ICU) cishe izinsuku ezi-5 kuya kweziyi-10 futhi unakekelwa ngokucophelela.
- Ukudla Okunomsoco: Akukho ukudla okunikezwayo ezinsukwini ezimbalwa zokuqala, ukuze amanxeba aphole. Ukudla okunomsoco okudingekayo kunikezwa nge-saline. Ngemva kwalokho, ubisi luqalwa ngepayipi le-nasogastric. Kancane kancane, ukuncelisa ngomlomo kuyaqhutshwa.
- Ukuqaphela: Odokotela nabahlengikazi babheke ingane eduze ukuze babone ukuthi kukhona yini ukopha noma ukuthi inyongo iyakhishwa. Indle yomntwana izophenduka ibe phuzi noma ibe luhlaza okotshani ukuze kuboniswe ukuthi inyongo isiqalile ukugeleza.
- Ukuya ekhaya: Uzovunyelwa ukuya ekhaya lapho amanxeba eqala ukuphola, ukusebenza kwesibindi kuthuthuka, futhi umntwana esekwazi ukuncelisa kahle.
Uphumelele kangakanani umsebenzi waseKasai?
Lona umbuzo obaluleke kakhulu. Impumelelo yokuhlinzwa incike ezintweni eziningana:
- Isikhathi: Lokhu kuhlinzwa kungenzeka kakhulu ukuthi kuphumelele uma ingane iphakathi kwamasonto ayi-6 nezinyanga ezi-2 ubudala . Ngakho-ke, kubaluleke kakhulu ukubona udokotela ngokushesha nje lapho ubona izimpawu.
- Isimo sesibindi: Uma umonakalo esibindini uncane ngesikhathi sokuhlinzwa, imiphumela iba mihle.
- Ithimba lezokwelapha: Kubaluleke kakhulu futhi ukuthi ukuhlinzwa kwenziwe udokotela ohlinzayo onekhono kanye nethimba lezokwelapha abanolwazi kulokhu kuhlinzwa.
Ngaphansi kwezimo ezifanele, lokhu kuhlinzwa kunganciphisa izimpawu, okuhlanganisa ne-jaundice, ezinganeni ezingaphezu kuka-60%. Odokotela bacabanga ukuthi ukuhlinzwa kuphumelele uma ingane ingaphinde ibe ne-jaundice zingakapheli izinyanga eziyisithupha kusukela kuhlinzwa.
Kuthiwani uma ukuhlinzwa kungaphumelelanga?
Ngezinye izikhathi, ngisho nangemva kokuhlinzwa eKasai, imisele yenyongo ingase ingaphumi kahle. Uma lokho kwenzeka, umntwana uzodinga ukufakelwa isibindi . Ungakhathazeki ngalokhu. Eqinisweni, cishe ingxenye yezingane ezihlinzwa eKasai zizodinga ukufakelwa isibindi lapho sezineminyaka emibili ubudala. Ukuhlinzwa eKasai kuyindlela yokwelapha isikhathi kuze kudingeke ukufakelwa isibindi.
Unakekela kanjani ingane yakho ngemva kokuyiletha ekhaya?
Kungathatha cishe izinyanga ezi-3-4 ukuthi umntwana alulame ngokugcwele. Udinga ukuqaphela kakhulu ngalezi zinto uma unakekela umntwana ekhaya.
- Nikeza umuthi ngendlela efanele:Phuza imithi yakho njengoba nje udokotela wakho ekuyalele, ngesikhathi esifanele. Ama-antibiotic omlomo ukuvimbela ukutheleleka kungadingeka anikezwe izinyanga eziningana. Imithi yokuthuthukisa ukuhamba kwenyongo ingadinga ukunikezwa iminyaka.
- Nakekela inxeba: Cela udokotela wakho noma umhlengikazi ukuthi akunike imiyalelo ethile yokuthi ungalihlanza kanjani inxeba nokuthi yiziphi izibhandishi okufanele uzisebenzise.
- Ungaphuthelwa yikliniki: Qiniseka ukuthi uya emtholampilo ngezinsuku ezihleliwe ngemva kokuhlinzwa. Kubaluleke kakhulu ukuthi udokotela aziswe njalo ngenqubo yokululama komntwana.
- Ukuncelisa ibele kubaluleke kakhulu: Uma kungenzeka, ncelisa ingane yakho. Amafutha obisi lwebele amuncwa kalula yisibindi. Uma ukuncelisa ibele kungenzeki, sebenzisa ifomula ekhethekile enconywe udokotela wakho.
- Hlala uhlanzekile: Geza izandla zakho kahle ngaphambi kokuthinta ingane yakho. Gwema ukuthinta ingane yakho uma kukhona emndenini onomkhuhlane noma umkhuhlane.
| Izimpawu zengozi okufanele zibikwe kudokotela ngokushesha | |
|---|---|
| Isibonakaliso Sesexwayiso | Incazelo |
| Imfiva | Umkhuhlane ongama-38 Celsius (100.4 Fahrenheit) noma ngaphezulu. Lokhu kungaba uphawu lokutheleleka. |
| Ukwenqaba ukudla | Uma umntwana enqaba ngokuphelele ukuphuza ubisi. |
| Izinguquko enxebeni | Inxeba lokuhlinzwa liyavuvukala, libe bomvu, noma liphume uketshezi/ubomvu. |
| Ubuhlungu besisu | Ukukhala ngenxa yobuhlungu noma ukuqunjelwa lapho isisu somntwana sithinteka. |
| Ukuphinda kwe-jaundice | Okumhlophe kwamehlo noma isikhumba somntwana kuphenduka kube phuzi futhi noma kube phuzi kakhulu. |
| Umbala wesihlalo | Indle enombala ophuzi noma onjengobumba isho ukuthi ukugeleza kwenyongo sekuphelile. |
| Ukopha | Igazi esitulweni noma ngokuhlanza. |
| Uma ubona noma yiziphi zalezi zimpawu, yazisa udokotela wakho ngokushesha noma uthathe ingane yakho uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze. | |
Ngiyaqonda ukuthi kumelwe ukuba ushaqeka, udabuke, futhi wesaba kangakanani lapho uthola ukuthi ingane yakho idinga ukudlula entweni efana nale. Uma konke kwenzeka ngokushesha kangaka, uzodinga usizo nakanjani. Cela usizo emndenini wakho, kubangani, nakubantu obathandayo. Khumbula, awuwedwa kulolu hambo. Zicabange nawe kulolu hambo. Yiba nethemba, hlala unolwazi, futhi ufune ukwesekwa kulabo abakuzungezile.
Umlayezo Wokuya Nawe Ekhaya
- Inqubo yaseKasai iyindlela eyinhloko yokuhlinzwa kwe-biliary atresia, isifo sesibindi esenzeka ezinganeni.
- Lokhu kuhilela ukususa umsele we-bile ovalekile nokusebenzisa ingxenye yamathumbu ukudala indlela entsha yokugeleza kwe-bile.
- Uma ukuhlinzwa kwenziwa ngokushesha (ngaphambi kokuba umntwana abe nezinyanga ezimbili ubudala), amathuba okuphumelela aba maningi.
- Kubaluleke kakhulu ukunakekela ingane yakho ekhaya ngemva kokuhlinzwa. Landela imiyalelo kadokotela ngqo.
- Uma ukuhlinzwa kungaphumeleli, kungase kudingeke ukufakelwa isibindi, okuyingxenye yenqubo yokwelapha lesi sifo.
- Uma ubona noma yiziphi izimpawu eziyingozi njengomkhuhlane, ukwenqaba ukudla, ukuphinda kwe-jaundice, noma indle emhlophe, yazisa udokotela wakho ngokushesha.
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