Ingabe amaphaphu engane yakho awakhuli kahle? (Pulmonary Hypoplasia) Ake sifunde ngakho!

Injabulo oyizwayo uma ubheka umntwana osanda kuzalwa ayichazeki, akunjalo? Kodwa ngezinye izikhathi, kanye naleyo njabulo, kufika ukwesaba okuncane engqondweni, ikakhulukazi uma ubona ukuthi umntwana unobunzima bokuphefumula. Ngezikhathi ezinjalo, omunye wemibuzo ephakama ezingqondweni zabazali uthi, "Ingabe kukhona okungahambi kahle ngomntwana wami?". Namuhla sizokhuluma ngesimo esibucayi kangaka, kodwa esibaluleke kakhulu okufanele siqaphele. Okusho ukuthi, amaphaphu engane awakhuli kahle, isimo esisibiza ngokuthi `(Pulmonary Hypoplasia)` ngokwezokwelapha.

Kuyini `(Pulmonary Hypoplasia)`? Ake sikuqonde kalula.

Kalula nje, i-Pulmonary Hypoplasia yilapho amaphaphu engane yakho engakhuli njengoba kulindelekile ngesikhathi isesibelethweni. Lesi yisimo sokuzalwa , okusho ukuthi akhona lapho ezalwa. Ngokuvamile, sibangelwa esinye isimo sempilo esiyisisekelo. Okusho ukuthi, amaphaphu awanandawo eyanele yokukhula esibelethweni. Ngezinye izikhathi, odokotela bathola lesi simo ngaphambi kokuba ingane izalwe, ngesikhathi sokukhulelwa, ngokusebenzisa ama-ultrasound scans. Ngezinye izikhathi, sitholakala ngokushesha ngemva kokuzalwa kwengane noma ezinsukwini ezimbalwa ngemva kwalokho.

Manje bheka, ngaphakathi kwamaphaphu ethu kunezikhwama zomoya ezincane ezibizwa ngokuthi i-alveoli. Lezi yizo ezifaka umoya-mpilo esiwuthatha egazini. Igazi libe selithwala lo moya-mpilo liye ezicutshini zomzimba wonke. Ngakho-ke, uma amaphaphu engakhuliswanga kahle, lezi zikhwama zomoya nazo zincane ngenani. Kwenzekani-ke? Ezinye izitho zomzimba nezicubu azitholi umoya-mpilo owanele. Lokhu kubangela inhliziyo ukuthi isebenze kanzima, futhi umfutho wegazi emaphashini ungakhula ngisho (umfutho wegazi ophezulu wamaphaphu). Cabanga ngakho, njengoba nje isitshalo esincane singakwazi ukukhula kahle uma singenawo amanzi, isikhala, kanye nokudla okunempilo.

Yiziphi izimpawu eziboniswa yingane?

Uma umntwana osanda kuzalwa ene-Pulmonary Hypoplasia, angabonisa izimpawu ezifana nalezi:

• Umbala oluhlaza okwesibhakabhaka esikhumbeni, ezindebeni, noma ezinzipho (`(cyanosis)`) . Lokhu kwenzeka lapho izicubu zomzimba zingatholi umoya-mpilo owanele. Ngokukhethekile, lo mbala oluhlaza okwesibhakabhaka uvela lapho kunomoya-mpilo omncane egazini.
• Amakhala aqhumayo . Lokhu kusho ukuthi umntwana uzama kanzima ukuphefumula ngoba kunzima. Njengoba nje sigijima futhi siwe, sikhipha amakhala ethu bese siphefumula.
• Ubunzima bokuphefumula. Ingane ingase yenze umsindo wokuphefumula noma wokuphefumula lapho iphefumula.
• Ukwanda kwesilinganiso sokuphefumula (i-tachypnea) . Uma ingane iphefumula ngokushesha kunokujwayelekile, lokho nakho kuyisibonakaliso.

Uma ingane yakho inesinye noma ngaphezulu salezi zimpawu, kungcono ukubona udokotela ngokushesha. Lezi zingaba futhi izimpawu zezinye izifo zokuphefumula, ngakho-ke kubalulekile ukuthola ukuxilongwa okufanele ngokushesha.

Kungani lokhu kwenzeka? Yiziphi izimbangela eziyinhloko ze-`(Pulmonary Hypoplasia)`?

I-Pulmonary Hypoplasia ivame ukubangelwa ezinye izimo zempilo ezivimbela amaphaphu ukuthi akhule kahle embungwini. Lezi zimo zishiya amaphaphu engenasikhala asidingayo ukuze akhule. Lezi zimo ezilandelayo yizona ezivame kakhulu:

• Uketshezi oluphansi lwe-amniotic (oligohydramnios) : Uma kunoketshezi oluncane lwe-amniotic oluzungeze umntwana, lungacindezela amaphaphu futhi lubangele ukuba akhule kabi. Lolu ketshezi lusebenza njengesivikelo somntwana futhi lusize amaphaphu akhule.
• I-Congenital Diaphragmatic Hernia (CDH) : I-diaphragm iyisicubu esihlukanisa isifuba nesisu. Uma kukhona imbobo kuyo futhi ezinye zezitho zesisu (njengamathumbu nesibindi) ziphuma esifubeni, kuba nendawo encane yamaphaphu. Khona-ke amaphaphu awakwazi ukufutha nokukhula kahle.
• I-Omphalocele : Kulesi simo, ezinye zezitho zomntwana ziphuma ngentambo yesisu, embozwe ulwelwesi. Lokhu kungashintsha nokucindezela ngaphakathi kwesibeletho somntwana futhi kuthinte ukukhula kwamaphaphu.
• Ukuqhuma Kwezinhlayiya Ezincane Ngaphambi Kokukhulelwa (i-PROM) : Lapho isikhwama se-amniotic siqhuma ngaphambi kokuzalwa komntwana, okwaziwa ngokuthi i-PROM, amazinga oketshezi angancipha futhi athinte ukukhula kwamaphaphu.
• Isifo samaphaphu esibizwa ngokuthi yi-cystic : Lezi yizimila ezingezona ezomdlavuza ezithatha indawo emaphashini futhi ziphazamise ukukhula kwezicubu zamaphaphu ezivamile.
• Ukukhula kwenhliziyo ngenxa yezinkinga zenhliziyo : Isibonelo, lapho inhliziyo ikhula ngenxa yezifo zenhliziyo ezizalwa nazo njenge-"tricuspid atresia" noma i-"Ebstein's anomaly", kungacindezela amaphaphu.
• I-diaphragm engavamile noma engasebenzi : I-diaphragm iyisicubu esibalulekile ukuze amaphaphu asebenze kahle. Uma kunenkinga ngomsebenzi wayo, ingathinta nokukhula kwamaphaphu.

Kodwa-ke, ngezinye izikhathi odokotela abakwazi ukuthola imbangela ethile ye-"Pulmonary Hypoplasia." Siyibiza ngokuthi i-primary pulmonary hypoplasia . Lokhu kwenzeka cishe ku-10% kuya ku-15% wamacala.

Ubani osengozini enkulu yalesi simo?

Izimo ezithile ngesikhathi sokukhulelwa zingafaka ingane engozini enkulu yokuntuleka kwe-pulmonary hypoplasia, njenge-oligohydramnios kanye nokukhulelwa ngaphambi kwesikhathi. Lokhu kufaka phakathi:

• Izifo : Izifo ezithathelwana ngocansi (ama-STI) noma izifo ezibangelwa amagciwane njenge-bacterial vaginosis zingabangela ukuthi amanzi akho aqhume ngaphambi kwesikhathi.
• Ubude bomlomo wesibeletho obufushane . Lokhu kungaba yimbangela yokuzalwa ngaphambi kwesikhathi kanye ne-PROM.
• Ukulindela ukuzala okuningi, njengamawele noma amawele amathathu . Lokhu kungabangela izinkinga ezifana nokuntuleka kwesikhala esibelethweni kanye namazinga aphansi oketshezi.
• I-Amniocentesis : Lokhu ukuhlolwa okwenziwa ngesikhathi sokukhulelwa. Kodwa-ke, akuvamile kakhulu, isikhwama samanzi singalimala futhi uketshezi lungavuza.
• Umfutho wegazi ophakeme noma i-preeclampsia ngesikhathi sokukhulelwa. Lokhu kungathinta ukusebenza kwe-placenta, kunciphise ukudla okunomsoco kanye nomoya-mpilo wengane, futhi kungabangela nokulahlekelwa uketshezi.
• Isifo Sikashukela : Uma umama enesifo sikashukela, singadala nezinkinga ezithile.
• Ukuphelelwa amanzi emzimbeni : Uma umama engaphuzi amanzi anele, izinga loketshezi lwe-amniotic lingase lehle.

Yingakho kubaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo nokuya emitholampilo ngesikhathi ngesikhathi sokukhulelwa. Ukunakekela impilo yakho kuthinta ngqo impilo yengane yakho.

Yiziphi ezinye izinkinga ezingabangelwa yilokhu?

Iqiniso lokuthi amaphaphu awakhuli kahle lingabangela izinkinga kwezinye izingxenye zomzimba womntwana. Lokhu okulandelayo yizinkinga ezingase zenzeke ngenxa ye-`(Pulmonary Hypoplasia):`

• Amazinga aphansi omoya-mpilo egazini (i-hypoxemia) : Lena yinkinga eyinhloko. Ingalimaza ubuchopho nezinye izitho zomzimba.
• Umfutho wegazi ophezulu emaphashini engane (umfutho wegazi ophezulu wamaphaphu) : Imithambo yegazi emaphashini iyancipha, okufaka ingcindezi eyengeziwe enhliziyweni.
• Ukukhula okubuthakathaka noma okungafanele kwe-trachea (i-tracheomalacia) : Lokhu kungabangela ukuthi i-trachea ivaleke lapho uphefumula.
• I-Pneumothorax : Umoya uyavuza emaphashini, uqoqana eduze kwamaphaphu, bese iphaphu liyawa.
• Izinkinga zokuphefumula : Isibonelo, i-bronchopulmonary dysplasia. Lokhu kungenzeka kamuva, ikakhulukazi ezinganeni ezizalwa ngaphambi kwesikhathi, lapho zixhunywe kumshini wokuphefumula.
• Ezinye izinkinga ezingase zivele ngenxa yesimo esiyisisekelo esibangele i-pulmonary hypoplasia. Isibonelo, ubunzima bokudla, ukukhubazeka kokuzwa, kanye nokubambezeleka kokukhula .

"Ungase uzizwe wesaba uma uzwa konke lokhu. Kodwa khumbula, ukwaziswa kuyisinyathelo esingcono kakhulu sokubhekana nesimo esinjengalesi. Khuluma nodokotela bakho bese ubuza yonke imibuzo onayo."

Odokotela bakuthola kanjani lesi simo?

Ngokuvamile, udokotela uxilonga i-Pulmonary Hypoplasia ngesikhathi sokuhlolwa kwe-ultrasound okuvamile ngesikhathi sokukhulelwa. Ukuhlolwa kulinganisa ubukhulu bamaphaphu engane kanye nobubanzi besifuba. Ukuhlolwa kwe-MRI (magnetic resonance imaging) nakho kungenziwa ukuqinisekisa ukuxilongwa. I-MRI inganikeza isithombe esicacile somthamo wamaphaphu.

Ngezinye izikhathi, udokotela uzoxilonga lesi simo lapho ezalwa noma ezinsukwini ezimbalwa ngemva kokuzalwa. Uma ingane yakho inenkinga yokuphefumula, udokotela uzokwenza i-X-ray yesifuba ukuze ahlole i-pulmonary hypoplasia noma esinye isimo samaphaphu. I-X-ray ingabonisa ubukhulu nesimo samaphaphu.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kwe-Pulmonary Hypoplasia kuncike embangela, ubukhali besimo, nokuthi ngabe sitholakale ngesikhathi sokukhulelwa noma ngemva kokuzalwa. Umgomo oyinhloko wokwelashwa ukunikeza ingane umoya-mpilo ewudingayo ukuze iphile nokusiza amaphaphu ayo akhule ngangokunokwenzeka. Uma ingane yakho izalwa ne-Pulmonary Hypoplasia, kuzodingeka uyisize iphefumule kuze kube yilapho amaphaphu ayo ekhula ngokwanele ukuba iphefumule yodwa, noma kuze kube yilapho odokotela bekwazi ukunikeza ukwelashwa okwengeziwe.

Nazi ezinye zezindlela zokwelapha ezisetshenziswa udokotela wezifo zabesifazane noma udokotela wezinsana:

• Ukufakwa kwe-Amnio : Uma kunezinga eliphansi loketshezi lwe-amniotic ngesikhathi sokukhulelwa, le nqubo ifaka uketshezi ngokwenziwa. Lokhu kungasiza ekunciphiseni ingcindezi emaphashini futhi kusize ekukhuleni.
• Ukuhlinzwa noma ukuhlinzwa kwengane ngemuva kokuzalwa : Isibonelo, uma kukhona isimo esibizwa ngokuthi i-CDH, ukuhlinzwa kungenziwa ukuze kulungiswe. Ngezinye izikhathi lokhu kuhlinzwa kwenziwa ingane isesesibelethweni.
• Ukwelashwa nge-oxygen : I-oxygen inikezwa ingane nge-cannula yamakhala noma i-mask ebekwa ebusweni.
• Umoya wokungenisa umoya ngomshini : Lokhu kuhilela ukuxhuma umshini wokungenisa umoya emshinini nokusiza ukuphefumula ngokwenziwa. Lokhu kwenziwa ngokufaka ipayipi epayipini lomoya.
• Ukuphefumula Nge-Oxygenation Ye-Extracorporeal Membrane (ECMO) : Lokhu kuyindlela yokwelapha ekhethekile kakhulu neyinkimbinkimbi. Umshini unezela umoya-mpilo egazini futhi ususa i-carbon dioxide ngenkathi unikeza amaphaphu nenhliziyo yengane ukuphumula. Usetshenziswa ezimweni ezinzima kakhulu lapho zonke ezinye izindlela zokwelapha zehlulekile.

Kwenzekani uma ingane yakho izalwa ine-Pulmonary Hypoplasia?

Uma ingane yakho izalwa inamaphaphu angakakhuli kahle, izohlolwa ngudokotela wezinsana (udokotela ogxile ezinsaneni ezisanda kuzalwa) kanye nethimba labanye ochwepheshe. Kuye ngokuthi isimo sibucayi kangakanani kanye nezinye izitho ezithintekile, ithimba lezokwelapha lingafaka:

• Ochwepheshe Bezinso (Odokotela Bezinso)
• Odokotela bezifo zokuphefumula (ochwepheshe bezifo zokuphefumula)
• Odokotela abahlinzayo benhliziyo (odokotela abahlinzayo benhliziyo)
• Odokotela bezifo zesisu (ochwepheshe ohlelweni lokugaya ukudla)

Izingane ezine-``(Pulmonary Hypoplasia)`` zivame ukwelashwa nge-` ...Eyunithi yokunakekelwa okujulile kwezinsana (i-NICU), izingane zithola ukunakekelwa okukhethekile kanye nokuqashwa njalo. Zivame ukuba nezinkinga zamaphaphu zesikhathi eside kanye nezinye izimo zempilo. Lokhu kufaka phakathi izifo zokuphefumula ezivame ukwenzeka, izimo ezifana ne-asthma, kanye nokubambezeleka kokukhula. Kodwa-ke, ezinye izingane ezine-Pulmonary Hypoplasia zingase zingabi nesimo esibi njengoba zikhula, futhi amaphaphu azo angaqhubeka nokukhula futhi izimpawu zawo zingase zithuthuke.

Kungenzeka kanjani ukuphila nalesi simo?

Kuyiqiniso ukuthi izingane ezinamaphaphu angakakhuli kahle zingasinda. Kodwa isimo somuntu ngamunye sihlukile. Amandla okusinda ne-Pulmonary Hypoplasia ancike kulezi zici:

• Ubunzima besimo. Ukuthi amaphaphu asekhule kangakanani.
• Imbangela eyisisekelo. Yisiphi isifo esiyisisekelo esibangele i-`(Pulmonary Hypoplasia)` nokuthi sibi kangakanani.
• Kungakhathaliseki ukuthi kutholakale ngesikhathi sokukhulelwa noma ngemva kokubeletha. Uma kutholakale kusenesikhathi, ngezinye izikhathi ukungenelela kusenesikhathi kungenzeka.
• Ingabe zikhona ezinye izinkinga?

Sekukonke, izinga lokufa ngenxa ye-Pulmonary Hypoplasia kuthiwa lingaphezu kuka-55%. Ngokuvamile kunzima ukuphila nezimo ezimbi kakhulu ze-Pulmonary Hypoplasia. Kuyadabukisa ukusho lokhu, kodwa kubalulekile ukwazi iqiniso. Kodwa-ke, ngokuthuthuka kwesayensi yezokwelapha, izindlela zokusiza izingane ezinjalo zithuthuke kakhulu namuhla.

Ingabe kukhona esingakwenza ukuvimbela lokhu?

Ayikho indlela eyodwa yokuvimbela i-Pulmonary Hypoplasia, njengoba ivame ukuba umphumela wesinye isimo. Kodwa-ke, indlela engcono kakhulu yokunciphisa ingozi yezinkinga zempilo lapho ingane yakho izalwa ukulandela iseluleko sikadokotela wakho wokubeletha ukuze ukhulelwe kahle. Ungazinakekela ngokuthi:

• Lawula izimo zakho ezingamahlalakhona, njengesifo sikashukela kanye nomfutho wegazi ophakeme.
• Yiya kudokotela wakho nsuku zonke ngesikhathi sokukhulelwa kwakho. Ngaleyo ndlela, uma kukhona izinkinga, ungazibona kusenesikhathi.
• Gwema ukubhema nokuphuza utshwala ngokuphelele. Lokhu kunomthelela omubi ngqo ekukhuleni komntwana.
• Phuza amanzi amaningi. Kubaluleke kakhulu ukuphuza okungenani amalitha angu-2-3 amanzi ngosuku.
• Zivikele ezifweni ezithathelwana ngocansi (STI) kanye nezinye izifo ezithelelanayo.

Ukuhlolwa njalo nodokotela wakho wezifo zabesifazane kanye nodokotela wezifo zabesifazane kungasiza ekutholeni izinkinga ezingaba khona kusenesikhathi. Ngezinye izikhathi, odokotela bangelapha imbangela eyinhloko ye-Pulmonary Hypoplasia ngesikhathi sokukhulelwa. Lokhu kungasiza ekuvimbeleni ingane yakho ukuthi izalwe inamaphaphu angakakhuli kahle.

Ekugcineni, kufanele uthi...

Uma ingane yakho izalwa ine-Pulmonary Hypoplasia, ithimba lodokotela lizoba nawe kuzo zonke izinyathelo. Bazochaza ubucayi besimo, izinketho zakho zokwelashwa, kanye nokuthi ikusasa liphetheni. Unganqikazi ukubuza noma yimiphi imibuzo ongase ube nayo ukuze ukwazi ukwenza izinqumo ezinolwazi mayelana nokunakekelwa kwengane yakho - noma impilo yakho.

"Uma kungenzeka, dala iqembu lakho lokusekela labantu obathembayo futhi obathandayo. Lokho kusho ukuthi abantu abafana nomyeni wakho, umama, ubaba, izingane zakini, kanye nabangane bakho abakhulu. Ukusekela kwabo kuzoba amandla amakhulu okubhekana nanoma yiziphi izinselele eziza kuwe. Kubaluleke kakhulu ukuhlala uqinile. Ungalilahli ithemba."

Sithemba ukuthi lolu lwazi luzokusiza. Khumbula, njalo xhumana nodokotela ofanelekayo ukuze uthole iseluleko sezokwelapha. Lesi sihloko singesolwazi olujwayelekile kuphela.

I- Pulmonary Hypoplasia, ukungakhuli kahle kwamaphaphu, izinsana ezisanda kuzalwa, ukucindezeleka kokuphefumula, izimo zokuzalwa, i-NICU, impilo yezingane, izinkinga zokukhulelwa