Ingabe ingane yakho ine-HLHS? Ake sifunde ngeNqubo yeNorwood ngamagama alula

Njengomzali, ngiyaqonda ukuthi uzizwa unzima futhi wesaba kangakanani lapho udokotela wakho ekutshela ukuthi ingane yakho esanda kuzalwa inesici senhliziyo esibizwa ngokuthi i-Hypoplastic Left Heart Syndrome (HLHS). Kumelwe ukuba kwakuzwakala sengathi umhlaba wakho wonke uwile ngokuzumayo. Kodwa ungakhathazeki. Namuhla, isayensi yezokwelapha isithuthuke kakhulu. Inqubo yeNorwood iyisinyathelo sokuqala esibaluleke kakhulu ekunikezeni impilo ezinganeni ezinjalo. Namuhla, sizoxoxa ngalokhu ngendlela elula ongayiqonda, ukuze unciphise ukwesaba kwakho.

Iyini inqubo yeNorwood?

Kalula nje, inqubo yeNorwood iwukuhlinzwa kwenhliziyo okukhethekile okwenziwa ezinganeni ezinesifo senhliziyo esizalwa naso (esizalwa naso) esibizwa ngokuthi i-Hypoplastic Left Heart Syndrome (HLHS) .

Cabanga ngayo njengendlu encane enamakamelo amane. Inezingxenye ezimbili, uhlangothi lwesokudla nohlangothi lwesobunxele. Ngokuvamile, uhlangothi lwesobunxele lwenhliziyo lupompa igazi elihlanzekile, elinomoya-mpilo emzimbeni wonke. Uhlangothi lwesokudla lupompa igazi elingenawo umoya-mpilo lisuka emzimbeni libuyele emaphashini ukuze liyofakwa umoya-mpilo.

Kodwa-ke, uhlangothi lwesobunxele lwenhliziyo yengane ene-HLHS alukhuli kahle . Lokho kusho ukuthi lolo hlangothi luncane kakhulu futhi lubuthakathaka. Ngakho lolo hlangothi alukwazi ukupompa igazi emzimbeni. Lena inkinga enkulu kunazo zonke.

Inqubo yaseNorwood yenza into emangalisayo. Odokotela bakha izindlela ezintsha zokuthi igazi ligeleze enhliziyweni. Okusho ukuthi, baqondisa umsebenzi okufanele wenziwe ohlangothini lwesobunxele lwenhliziyo uye ohlangothini lwesokudla, olusebenza kahle . Ngemva kokuhlinzwa, i-ventricle yesokudla yomntwana iqala ukupompa igazi elinomoya-mpilo liye kuwo wonke umzimba, kanye nokuthumela igazi emaphashini.

Ubani odinga lokhu kuhlinzwa?

Lokhu kuhlinzwa kuyadingeka kakhulu ezinganeni ezine -Hypoplastic Left Heart Syndrome (HLHS) . Kudingeka zenze lokhu kuhlinzwa zingakapheli amasonto amabili okuqala zizelwe.

Ekuzalweni, ingane ngayinye inokuxhumana okuncane phakathi kwemithambo yegazi emibili eyinhloko enhliziyweni (i-aorta kanye nomthambo wamaphaphu). Lokhu kubizwa ngokuthi 'i-patent ductus arteriosus'. Lokhu kuvumela ingane ene-HLHS ukuthi ithole igazi emzimbeni wayo ezinsukwini ezimbalwa zokuqala. Kodwa-ke, lokhu kuxhumana kuzovaleka ngokwemvelo ngemva kwezinsuku ezimbalwa. Uma lokhu kwenzeka, ingane ngeke ibe nendlela yokuletha igazi emzimbeni wayo, okuyingozi kakhulu.

Ngakho-ke, into yokuqala odokotela abayenzayo ukunikeza umuthi okhethekile (obizwa ngokuthi 'i-Prostaglandin') ukuze kuvinjwe umthambo wegazi. Kodwa lokho kungokwesikhashana. Ukuhlinzwa kweNorwood kwenziwa njengesixazululo esihlala njalo.

Ngezinye izikhathi, lokhu kuhlinzwa kungase kungenzeki ezinganeni ezizalwa ngaphambi kwesikhathi, ezinesisindo esiphansi, noma ezinezinye izinkinga. Ezimweni ezinjalo, odokotela basebenzisa ezinye izindlela, njengezinsimbi zemithambo yegazi yamaphaphu.

Kwenzekani ngesikhathi sokuhlinzwa nangemva kwalokho?

Ngaphambi nangesikhathi sokuhlinzwa

Ngaphambi kokuhlinzwa, umntwana usegumbini lokunakekelwa okujulile (ICU). Njengoba kushiwo ngaphambili, bazoqhubeka nokunikeza imithi yokugcina umthambo wegazi okhethekile uvulekile. Kungadingeka futhi ukwandisa imbobo phakathi kwamakamelo amabili aphezulu enhliziyo (i-'septostomy').

Inqubo yeNorwood iyinkimbinkimbi kakhulu, ithatha amahora amaningi (ngokuvamile amahora angu-8-10). Ithimba lodokotela lenza lokhu okulandelayo ngokucophelela:

• Kwenziwa imbobo phakathi kwamakamelo amabili aphezulu (i-atria) yenhliziyo ukuze kuvunyelwe igazi ukuthi ligeleze.
• I-aorta encane ixhunywe emthanjeni omkhulu wamaphaphu, bese kufakwa i-patch ekhethekile ukuze kudalwe i-aorta entsha, enkulu.
• Le aorta entsha ixhunywe kwi-ventricle yesokudla esebenzayo.
• Okulandelayo, kufakwa 'i-shunt' , ipayipi elincane lokwenziwa, ukuze kuthunyelwe igazi emaphashini. Lokhu kungaba kusukela ku-aorta kuya emaphashini (i-Blalock-Taussig shunt) noma kusukela ku-ventricle yesokudla kuya emaphashini (i-Sano shunt).

Phakathi nalolu hlinzo, umntwana uxhunywe emshinini we-cardiopulmonary bypass . Lokhu kusho ukuthi inhliziyo namaphaphu engane kusetshenziswa okwesikhashana yilo mshini.

Ngemva kokuhlinzwa

Ngemva kokuhlinzwa, umntwana ubuyiselwa egunjini lokunakekelwa okujulile (ICU). Uma uya ukuyobona umntwana, uzobona amapayipi amaningi, izintambo, nemishini. Ungesabi uma uzibona. Zonke zikhona ukuze kusizwe umntwana, ukuze kusizwe umntwana . Uzobona ibhandishi elimboza inxeba lokuhlinzwa phakathi kwesifuba.

Ngisho nangemva kwalokhu kuhlinzwa, isikhumba somntwana singase sibe nombala oluhlaza okwesibhakabhaka (i-cyanosis) . Lokhu kungenxa yokuthi igazi elithile elingenawo umoya-mpilo kanye negazi elinomoya-mpilo kusahlangana ngaphakathi kwenhliziyo. Lokhu kuvamile kulesi sigaba.

Ngemva kwesonto elilodwa egunjini lokunakekelwa okujulile, umntwana uzodluliselwa egunjini elivamile. Kuzodingeka uhlale esibhedlela cishe amasonto amabili kuya kwamathathu ukuze ululame ngokugcwele. Ngemva kokubuyela ekhaya, odokotela nabahlengikazi bazokunikeza imiyalelo eningiliziwe yokuthi ungayinakekela kanjani ingane, ungayinika kanjani imithi, nokuthi ungahlola kanjani amazinga ayo e-oxygen.

Uchungechunge lwezindlela zokuhlinzwa ze-HLHS

I-HLHS ayigcini ngokuhlinzwa okukodwa nje. Luwuchungechunge lwezigaba ezintathu zokuhlinzwa . I-Norwood iyisigaba sokuqala nje.

Yiziphi izinzuzo nezingozi?

Izinzuzo

Inzuzo enkulu neyodwa yalokhu ukuthi umntwana unethuba lokusinda . Ngaphambi kweminyaka yama-1980, kwakungekho ukwelashwa kwezingane ezizalwa zine-HLHS. Kodwa selokhu kwasungulwa inqubo yeNorwood, lezi zingane ziye zaba nethuba lokusinda zize zibe yizingane kanye nentsha.

Izingozi Nezinkinga

Njenganoma yikuphi ukuhlinzwa okukhulu, kunezingozi ezihilelekile. Kubalulekile ukuzazi lezi.

• Ukuvaleka noma ukungasebenzi kahle kwe-shunt: Ithubhu elincane elithwala igazi liye emaphashini lingavaleka.
• Ukuncishiswa kwemithambo yegazi (i-Stenosis): I-aorta ekhishwe ngokuhlinzwa noma imithambo yegazi eholela emaphashini ingase ibe mincane.
• Ukungasebenzi kahle kwenhliziyo (i-Arrhythmia): Isigqi sokushaya kwenhliziyo singase singabi ngendlela evamile.
• Ubuthakathaka bokusebenza kwenhliziyo: Njengoba i-ventricle yesokudla kufanele ithwale isisindo esengeziwe, ukusebenza kwayo kungase kube buthaka.
• Ukulibaziseka kokukhula kwemizwa: Kungaba khona ukubambezeleka okuthile ekukhuleni kobuchopho kanye nesimiso sezinzwa. Ngenxa yalokho, ezinye izingane zingadinga usizo olukhethekile ngezinto ezifana nokukhuluma nokuhamba.

Izinga lokusinda esibhedlela ngemuva kwenqubo yaseNorwood liphezulu ngamaphesenti angama-90. Kodwa-ke, kunezimo lapho ezinye izingane zingafiki khona ekuhlinzweni kwesibili.

Kufanele ubonane nini nodokotela wakho?

Kufanele unake kakhulu ingane yakho uma usufikile ekhaya. Uma usola ukuthi kunenkinga, shayela udokotela wakho ngokushesha.Qaphela kakhulu ngalezi zinto:

• Uma unemibuzo mayelana nokunakekela ingane yakho ekhaya.
• Uma ingane ingakhuli kahle.
• Uma izinga lomoya-mpilo lomntwana liphansi kunalokho udokotela akushilo ukuthi akulindele.
• Uma ingane ingasabeli kahle emithini enikezwe udokotela.
• Uma ingane ilele kakhulu kunokujwayelekile noma iphuza ubisi olunciphile.