Ingabe ingane yakho encane ine-Cerebral Palsy? Kumelwe ukuthi uqaphele ukuthi imisipha emilenzeni, ikakhulukazi imilenze, yabantwana abanjalo iqinile futhi iqinile ngokungadingekile. Ngokwezokwelapha, lokhu sikubiza ngokuthi 'i-spasticity'. Ngenxa yalokhu kuqina, kunzima kakhulu ukuthi ingane ingagcini nje ngokuhamba, ukugijima, ukugxuma, kodwa futhi nokwenza imisebenzi yansuku zonke. Ngakho-ke namuhla sizokhuluma ngokuhlinzwa okukhethekile okwenziwa njengesixazululo esihlala njalo sale nkinga. Lokho yi-Selective Dorsal Rhizotomy, noma ukuhlinzwa kwe-SDR ngamafuphi.
Kalula nje, kuyini ukuhlinzwa kwe-SDR?
I-Selective Dorsal Rhizotomy (SDR) inqubo yokuhlinzwa enciphisa unomphela ukuqina kwemisipha (spasticity) ezinganeni ezine-cerebral palsy. Nakuba kuyinqubo eyinkimbinkimbi kakhulu, ngamafuphi, ihilela ukusika nokususa ngokukhetha eminye yemicu yezinzwa engxenyeni engezansi yomgogodla wengane ebangela ukuqina kwemisipha emilenzeni.
Into ebaluleke kakhulu ukuthi lokhu kuhlinzwa akubanga ukukhubazeka kwezitho zomzimba zengane. Futhi akukuthinti ngqo ukunyakaza kwemilenze. Kukhulula kuphela imisipha eqine ngokungadingekile.
Kodwa into eyodwa okufanele uyikhumbule ukuthi ukuze uthole imiphumela emihle kakhulu kulokhu kuhlinzwa, ingane kumele ithole ukwelashwa okujulile kanye nokwelashwa ngokomzimba ngemva kokuhlinzwa. Futhi, akuzona zonke izingane ezine-Cerebral Palsy ezifanelekela lokhu kuhlinzwa.
Ubani okufanele ahlinzwe? Ingabe kufanelekile kubo bonke abantwana?
Ukuhlinzwa kwe-SDR kwenziwa ikakhulukazi njengokwelashwa kokuqina kwemisipha (i-spasticity) okubangelwa yi-cerebral palsy.
Njengoba wazi, i-cerebral palsy (CP) yisimo esithinta ikhono lengane lokulawula ukunyakaza kwemizimba yayo. Sibangelwa ukulimala kwezingxenye zobuchopho ezilawula ukunyakaza nokuxhumana. Izingane eziningi ezine-CP zinesifo esibizwa ngokuthi 'i-spasticity'. Lokhu kusho ukuthi eminye imisipha ifinyela ngamandla ngokuzumayo lapho ingane izama ukunyakaza noma imile nje. Lokhu kungenza kube nzima ngengane ukuhamba, ukwenza imisebenzi yansuku zonke, futhi ngezinye izikhathi ngisho nokubangela ubuhlungu.
Ukuhlinzwa kwe-SDR kuhlose ngqo:
- I-Spastic diplegic cerebral palsy: Lokhu kubhekisela ezinganeni ezinokuqina kwemisipha okuthinta kakhulu imilenze.
- I-Severe spastic quadriplegic cerebral palsy: Lokhu kubhekisela ezinganeni ezinokuqina okukhulu kwemisipha okuthinta wonke amalungu amane.
Kulungile, lokhu kuhlinzwa kunciphisa kanjani ukuqina kwemisipha?
Ukuze siqonde lokhu, ake sicabange ngesimiso sethu sezinzwa okwesikhashana. Ithoni evamile yemisipha yemisipha yomzimba wethu ilawulwa umsebenzi wesimiso sezinzwa esitholakala emgogodleni.
Cabanga nje ukuthi umzimba wethu unesimiso sezinzwa esifana nefoni.
1. Izinzwa Zemizwa: Lezi zithwala ulwazi oluvela emisipheni luye emgogodleni.
2. Izinzwa Zomzimba: Lezi zithumela imiyalo esuka emgogodleni iye emisipheni ukuze "ifinyele kanje."
Ngokuvamile, ubuchopho bethu bulawula kahle ukugeleza kwalo myalezo. Lokho kusho ukuthi singalawula imisipha yethu ngendlela esifuna ngayo. Kodwa ku-Cerebral Palsy, ikhono lobuchopho lokulawula le mizwa liyancishiswa. Okwenzekayo-ke ukuthi eminye imizwa iyasebenza ngokweqile futhi iqhubeka nokuthumela izimpawu ezingalungile emisipheni, izitshela ukuthi "qinisa, qinisa."
Nakhu okwenzekayo ngesikhathi sokuhlinzwa kwe-SDR:
Udokotela ohlinzayo ukhetha futhi asike kuphela izimpande zemizwa ezibangela ukuqina kwemisipha futhi ezivuselelwa ngokungadingekile. Ukuhlolwa okukhethekile (i-EMG) kusetshenziswa ukuthola ukuthi yimiphi imizwa esebenza kahle nokuthi yimiphi imizwa ethumela izimpawu ezingalungile. Lokhu kuvumela ukuqina kwemisipha kuphela ukuthi kuncishiswe ngaphandle kokuthinta eminye imisebenzi.
Ngale ndlela, lapho ukuqina kwemisipha kukhululeka, imisipha engaphansi ingaqala ukusebenza ngendlela evamile. Lokhu kuthuthukisa ukuhamba nokusebenza kwengane. Kuphinde kusize ekuvimbeleni ukukhubazeka emathanjeni nasemalungeni okungenzeka ngenxa yokuqina kwemisipha isikhathi eside.
Uzilungiselela kanjani ngaphambi kokuhlinzwa?
Njengoba ukuhlinzwa kwe-SDR kungafaneleki kuwo wonke umntwana, ingane yakho izohlolwa yithimba lochwepheshe ukuze kutholakale ukuthi kuzoyizuzisa yini. Ochwepheshe abalandelayo bavame ukuba yingxenye yale nqubo:
| Udokotela ochwepheshe | Indima yabo |
|---|---|
| Udokotela Wezinzwa Wezingane | Uchwepheshe onolwazi ekuhlinzeni i-SDR uzohlola imilenze nemisipha yengane ukuze anqume ukuthi ifanelekile yini ukuhlinzwa. |
| Udokotela Wezitho Zezingane | Uma kunezinkinga ezifana nokukhubazeka kwamathambo noma ukugoba kwemisipha, bazohlolwa ukuze kubonakale ukuthi badinga yini okunye ukuhlinzwa. |
| Udokotela Wezokwelapha Umzimba | Amandla emisipha kanye nomsebenzi emilenzeni yengane kuyalinganiswa. |
| Uchwepheshe Wezokwelapha Emsebenzini | Ikhono lokwenza imisebenzi yansuku zonke njengokuhamba, ukudla, nokugqoka liyahlolwa. |
Bonke laba bantu bahlola ingane bese behlangana njengeqembu ukuze benze isinqumo sokugcina sokuthi ukuhlinzwa kwe-SDR kuzoyizuzisa yini ingane.
Ngaphezu kwalokho, kungadingeka ukuthi wenze ezinye izivivinyo eziningana ngaphambi kokuhlinzwa:
- Abelaphi bezomzimba kanye nabezomsebenzi benza ukuhlolwa okujulile ukuze bahlole ngokugcwele amakhono omzimba engane. Baqopha ngevidiyo ukunyakaza kwengane futhi bahlele noma yikuphi ukwelashwa okudingekayo ngemva kokuhlinzwa.
- Ukuhlolwa kobuchopho nge-MRI ukuqinisekisa ukuthi azikho ezinye izifo zezinzwa.
- Uma unezinye izinkinga zezinzwa, bheka udokotela wezinzwa wezingane .
- Hlangana nodokotela wezinzwa futhi ukuze nixoxe ngezingozi zokuhlinzwa kanye nesikhathi sokululama.
- Vakashela udokotela wezinzwa ukuze uqiniseke ukuthi kuphephile ukuthi ingane yakho inikezwe izinzwa.
Indlela ukuhlinzwa okwenziwa ngayo isinyathelo ngesinyathelo
Nansi indlela ukuhlinzwa kwe-SDR okwenzeka ngayo:
1. I-Anesthesia: Okokuqala, udokotela wezinzwa unikeza ingane i-anesthesia ejwayelekile. Ngakho ingane ilala kahle ngesikhathi sokuhlinzwa futhi ayizizwa ubuhlungu.
2. Ukusikwa: Udokotela ohlinzayo wezinzwa wenza ukusikwa okuncane phakathi nomhlane wengane ongezansi.
3. Ukuvezwa kwemizwa: Ngalesi simbozo, i-dura emboze intambo yomgogodla iyavuleka, idlule emisipheni nasemathanjeni, bese imicu yemizwa engaphansi ivezwa.
4. Ukuhlukaniswa Kwezinzwa: Okulandelayo, udokotela ohlinzayo uhlukanisa izinzwa zemisipha kanye nezinzwa. Izinzwa zemisipha zivikelwe kunoma yimuphi umonakalo.
5. Ukuhlonza izinzwa ezingalungile: Ama-electrode manje anamathele ezimpandeni zezinzwa, bese kwenziwa i-electromyography (EMG).Ukuvuselelwa kukagesi kunikezwa kusetshenziswa umshini obizwa ngokuthi i-stimulator. Lokhu kusenza sikwazi ukubona ukuthi yimiphi imizwa ebangela ukuqina kwemisipha, ethumela izimpawu ezingalungile, kanye nokuthi yimiphi imizwa esebenza kahle.
6. Ukusikwa kwemizwa: Ngokucophelela okukhulu, iphesenti elithile lemizwa engavamile etholakele liyasikwa. Yimiphi imizwa nokuthi ingakanani esikwayo iyahlukahluka kuye ngengane.
7. Ukuvala i-incision: Uma ukusika kwemizwa sekuqediwe, i-incision ithungwa ndawonye ungqimba ngengqimba.
8. Ukululama: Ngemva kokuhlinzwa, ingane idluliselwa egunjini lokunakekelwa okujulile (ICU) noma ekamelweni elikhethekile lokululama futhi iqashwe ngokucophelela yithimba lezokwelapha.
Lokhu kuhlinzwa kuvame ukuthatha cishe amahora amane noma amahlanu.
Kwenzekani ngemva kokuhlinzwa?
Izingane kuzodingeka zihlale esibhedlela cishe izinsuku ezinhlanu ngemva kokuhlinzwa. Emahoreni okuqala angu-24-48, ingane kuzodingeka ihlale embhedeni. Ukwelashwa ngokomzimba kuzoqala zingakapheli izinsuku ezimbalwa ngemuva kokuhlinzwa.
Ziyini izinzuzo zalokhu kuhlinzwa?
Imiphumela yokuhlinzwa kwe-SDR ingahluka kuye ngesimo sengane. Futhi, impumelelo yokuhlinzwa incike ngokuphelele ekwelashweni okujulile kokwelashwa ngokomzimba okwenziwa ngemva kokuhlinzwa.
| Isimo sengane | Izinzuzo ezingaba khona |
|---|---|
| I-Spastic Diplegic CP (izingane ezinemilenze ethinteke kakhulu) |
|
| I-Spastic Quadriplegic CP (izingane ezinemilenze emine ethintekile) |
|
Njenganoma yikuphi ukuhlinzwa, ingabe zikhona izingozi?
Yebo, njenganoma yikuphi ukuhlinzwa, ukuhlinzwa kwe-SDR kunezingozi ezithile, kodwa izinkinga ezihlala njalo azivamile.
| Uhlobo lwengozi | Kungaba yini |
|---|---|
| Izinkinga zesikhashana | |
| Ukutheleleka | Ukutheleleka ngokuhlinzwa kokusika. |
| Ukopha | Ukopha ngokweqile ngesikhathi sokuhlinzwa noma ngemva kokuhlinzwa. |
| Ukuvuza koketshezi lwe-CSF | Ukuvuza koketshezi lomgogodla (CSF) oluzungeze intambo yomgogodla. |
| Izinkinga ezihlala njalo (kodwa ezingavamile kakhulu) | |
| I-Hyperesthesia | Ukuzwela okukhulu ekuthinteni nasebuhlungu. |
| Ukulahlekelwa ukulawula umchamo | Ukungakwazi ukulawula ukuchama. |
| Ukulahlekelwa ukulawula amathumbu | Ukungakwazi ukulawula ukuhamba kwamathumbu. |
| Ubuthakathaka | Ubuthakathaka noma ukulahlekelwa ikhono lokuhamba langaphambilini. |
Ithimba lezokwelapha lengane yakho lizoxoxa nawe ngazo zonke lezi zingozi ngokuningiliziwe ngaphambi kokuhlinzwa.
Isikhathi sokululama kanye nokubaluleka kokwelashwa ngokomzimba
Lena yingxenye ebaluleke kakhulu nebalulekile yempumelelo yokuhlinzwa kwe-SDR. Ukuhlinzwa kuyisinyathelo sokuqala nje ohambweni. Ukuvuselelwa kubalulekile ukuze kutholakale imiphumela yangempela.
Ukwelashwa ngokomzimba kanye nokwelashwa ngokomsebenzi kuqala zingakapheli izinsuku ezimbalwa ngemuva kokuhlinzwa. Ingane kufanele iye kulezi zindlela zokwelapha izinsuku eziningana ngesonto izinyanga ezintathu kuya kweziyisithupha ngemva kokuhlinzwa.
- Udokotela Wezokwelapha: Ukuzivocavoca ukuqinisa, ukwelula, nokuthuthukisa ububanzi bokunyakaza emisipheni yengane. Ekuqaleni, udokotela wezokwelapha uzokwenza ukuzivocavoca, futhi njengoba ingane ilulama, ingane izohlanganyela ngenkuthalo ekuzivocavoceni ngokwayo.
- Udokotela Wezokwelapha Emsebenzini: Usiza ingane ukuthi yenze imisebenzi yansuku zonke (isib. ukugqoka, ukudlala) kalula nangokuzimela.
Izinhloso eziyinhloko zalezi zivivinyo yilezi:
- Amandla akhuphukile.
- Ukuthuthukisa ibhalansi kanye nokuma kahle ngesikhathi uhleli futhi umile.
- Ukulungiselela izinyawo ukuma.
- Ukuziqeqesha ukwenza ukunyakaza, njengokuma uhleli, ngokushelela kakhudlwana.
Kuvamile ngabazali ukwesaba lapho bezwa ngokuhlinzwa. Kodwa khumbula, ithimba lezokwelapha lengane yakho lingochwepheshe kulo mkhakha. Bazokulungiselela wena nengane yakho lokhu kuhlinzwa. Unganqikazi ukukhuluma nabo nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.
Kunini lapho udinga ukukhuluma nodokotela?
Uma ubona noma yiziphi izimpawu zezinkinga ngemuva kokuletha ingane yakho ekhaya isuka esibhedlela, shayela udokotela wakho ngokushesha.
- Uma ukuhlinzwa kubomvu, kuvuvukile, noma kuphuma ubomvu (izimpawu zokutheleleka).
- Uma ingane inomkhuhlane omkhulu.
- Uma ulahlekelwa ikhono lokulawula umchamo noma indle yakho.
Uma ubona noma yiziphi izimpawu ezingavamile ezifana nalezi, funa iseluleko sezokwelapha ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- I-SDR iwukuhlinzwa okukhethekile okwenziwa ukunciphisa ukuqina kwemisipha (ukuqaqamba kwemisipha) kwabanye abantwana abane-Cerebral Palsy.
- Lokhu kuhilela ukunquma ngokukhetha imizwa yezinzwa evuselelwa ngokungadingekile. Lokhu kunciphisa ukuqina kwemisipha unomphela.
- Lokhu kuhlinzwa akufaneleki kuwo wonke umntwana. Ingane ikhethelwa lokhu kuphela ngemva kokuhlolwa okuphelele yithimba lodokotela abangochwepheshe.
- Ukuze ukuhlinzwa kuphumelele, ukwelashwa ngokomzimba okujulile nokuqhubekayo kanye nokwelashwa ngokomsebenzi ngemva kokuhlinzwa kubalulekile. Lena yinto ebaluleke kakhulu.
- Ngaphambi kokuhlinzwa, xoxa ngezinzuzo nezingozi nodokotela wakho futhi uziqonde.
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