Ingabe ingane yakho ine-Cerebral Palsy? Ake sifunde ngalokhu kuhlinzwa kwe-SDR (Selective Dorsal Rhizotomy)

Njengomzali, uzizwa udabuke kangakanani uma ubona ingane yakho ihlushwa yi -Cerebral Palsy, inenkinga yokuhamba, ukugijima, ukugxuma, nokwenza imisebenzi yansuku zonke? Kunzima kakhulu ukubuka ingane ihlushwa ukuqina okukhulu emilenzeni, okungukuthi, ukuqina kwemisipha (spasticity), akunjalo? Namuhla sikhuluma ngokuhlinzwa okukhethekile okungasiza izingane ezinjalo.

Kuyini i-Selective Dorsal Rhizotomy (SDR)?

Kalula nje, i-Selective Dorsal Rhizotomy (SDR) inqubo yokuhlinzwa eyenziwa ukuze kuncishiswe ukuqina kwemisipha unomphela (ukuqaqamba kwemisipha) ezinganeni ezine-Cerebral Palsy.

Lokhu kuhilela ukusika nokususa ngokukhetha ezinye zezintambo zemizwa ezizwayo emgogodleni ongezansi ezibangela ukuqina kwemilenze yengane. Kodwa ungakhathazeki, lokhu kuhlinzwa ngeke kukhubaze imilenze yengane. Ngeke futhi kuthinte ukunyakaza kwemilenze.

Kodwa into eyodwa okufanele uyikhumbule: Ukuze uthole imiphumela emihle kakhulu kulokhu kuhlinzwa, udinga ukwenza ukwelashwa okujulile ngokomzimba kanye nezinhlelo zokuvuselelwa ngemva kokuhlinzwa. Futhi, lokhu kuhlinzwa akufaneleki kubo bonke abantwana abane-cerebral palsy.

Yiziphi izimo eziphathwa ngokuhlinzwa kwe-SDR?

Odokotela basebenzisa lolu hlinzeko lwe-SDR ukwelapha ukuqina kwemisipha (ukuqaqamba kwemisipha) ezinganeni ezine-cerebral palsy.

I-Cerebral palsy ( CP ) yisimo esithinta ikhono lengane lokulawula imisipha yayo. Sibangelwa ukulimala kwezingxenye zobuchopho ezilawula ukunyakaza nokuxhumana. Izingane eziningi ezine-CP zinesifo esibizwa ngokuthi i-spasticity . Lokhu kusho ukuthi lapho ingane izama ukunyakaza, noma ngezinye izikhathi ngisho nokuma nje, eminye yemisipha iyafinyela ngokuzumayo futhi iqine. Lokhu kungenza izinto ezifana nokuhamba kube nzima, kubangele ubuhlungu, futhi kuphazamise imisebenzi yansuku zonke .

Ukuhlinzwa kwe-SDR kwenziwa kakhulu ezinganeni ezine-Spastic Diplegic Cerebral Palsy, ethinta imilenze emibili kuphela, kanye ne-Spastic Quadriplegic Cerebral Palsy, ethinta kakhulu wonke amalungu amane.

Lokhu kuhlinzwa kusebenza kanjani?

Cabanga nje, ukuqina okuvamile kwemisipha emzimbeni wethu kulawulwa inqubo ohlelweni lwezinzwa emgogodleni. Kulokhu, inzwa yezinzwa iletha ulwazi oluvela emgogodleni iye emgogodleni, bese inzwa yokunyakaza ibuyela kulowo msipha bese ibangela ukuba unciphe.

Ngokuvamile, le nqubo ilawulwa yimiyalezo evela ebuchosheni bethu. Lokho kusho ukuthi singalawula imisipha yethu ngendlela esiyifunayo. Kodwa-ke, ku-cerebral palsy, ikhono lobuchopho lokulawula lokhu liyancishiswa. Ngenxa yalokho, eminye imisipha ihlala ifinyela futhi iqine.

Ukuhlinzwa kwe-SDR kungaqeda lokhu kuqina ngokweqile (ukungaqini). Udokotela ohlinzayo ukhetha futhi asike kuphela izimpande zemizwa ezingavamile ezibangela lokhu kuqina. Yingakho kungenzeka ukunciphisa ukuqina ngaphandle kokuthinta eminye imisebenzi. Ngesikhathi sokuhlinzwa, yonke le mizwa iyahlolwa ukuze kutholakale ukuthi yimiphi imizwa esebenza kahle nokuthi yimiphi imizwa eyinkinga.

Uma lokhu kuqina sekuphelile, imisipha engaphansi ingaqala ukusebenza ngendlela evamile. Ngemuva kwalokho, ukunyakaza kwengane, njengokuhamba, kuzothuthuka. Futhi, uma lokhu kuqina kuqhubeka, amathuba okuba nezibazi zemisipha kanye nokukhubazeka kwamalunga namathambo (ukugoba) kungavinjelwa ngalokhu kuhlinzwa.

Ungayilungiselela kanjani ingane ukuhlinzwa kwe-SDR?

Njengoba ukuhlinzwa kwe-SDR kungafaneleki kuwo wonke umntwana, ingane yakho izohlolwa ngokukhethekile ukuze kubonakale ukuthi kuzoyizuzisa yini. Ngenxa yalokhu, odokotela abaningana abangochwepheshe bazohlola ingane.

Bonke laba bantu bahlola ingane futhi basebenzisane njengeqembu ukuze banqume ukuthi ukuhlinzwa kwe-SDR kulungile yini enganeni. Ngaphezu kwalokho, kungenziwa ezinye izivivinyo eziningana:

• Ukuze bahlele ukwelashwa ngemva kokuhlinzwa, abelaphi bomzimba kanye nabezomsebenzi baqopha ngevidiyo ukunyakaza nemisebenzi yengane.
• I-MRI yobuchopho ukuqinisekisa ukuthi azikho ezinye izimo zezinzwa.
• Hlangana nodokotela ohlinza izinzwa ukuze uchaze izingozi zokuhlinzwa kanye nenqubo yokululama.
• Hlangana nodokotela wezinzwa ukuze uqiniseke ukuthi i-anesthesia iphephile enganeni.

Kwenzekani ngesikhathi sokuhlinzwa?

Lezi yizinyathelo ezivame ukwenzeka ngesikhathi sokuhlinzwa kwe-SDR.

1. I-Anesthesia: Udokotela we-anesthesia unikeza ingane i-anesthesia. Lokhu kwenza ingane ilale futhi ingabi nobuhlungu ngesikhathi sokuhlinzwa.

2. Ukusikwa: Udokotela ohlinzayo wezinzwa wenza ukusikwa okuncane phakathi nomhlane wengane ongezansi.

3. Ukuvezwa kwemizwa: Ngaleyo mbobo, kwenziwa "ifasitela" elincane phakathi kwamathambo omgogodla kanye ne-membrane (dura) emboza intambo yomgogodla, bese imicu yemizwa engaphansi kwayo ivezwa.

4. Ukuhlukaniswa kwemizwa: Okulandelayo, imizwa yemisipha kanye nemizwa yezinzwa kuyahlukaniswa. Imizwa yemisipha ivikelwe ukuvimbela umonakalo.

5. Ukuhlolwa kwemizwa: Kusetshenziswa ama-electrode, inqubo ebizwa ngokuthi i-electromyography (EMG) isetshenziswa ukuvuselela imizwa yezinzwa. Lokhu kungasiza ekutholeni ukuthi yimiphi imizwa engajwayelekile ebangela ukuqaqamba kwemizwa nokuthi yimiphi imizwa evamile.

6. Ukusikwa kwemizwa:Bese kuba nephesenti elithile lezinzwa ezingavamile ezitholakalayo ezisikwayo. Inani lezinzwa ezisikiwe liyahlukahluka kuye ngengane.

7. Ukuthungela i-incision: Ngemva kokuthi ukusika kwemizwa sekuqediwe, i-incision ithungwa emuva ivaliwe ungqimba ngengqimba.

8. Igumbi lokululama: Ngemva kokuhlinzwa, ingane igcinwa iqashwe eYunithi Yokunakekelwa Okujulile (ICU).

Lokhu kuhlinzwa kuvame ukuthatha cishe amahora amane noma amahlanu.

Kwenzekani ngemva kokuhlinzwa? Futhi yiziphi izinzuzo?

Ngemva kokuhlinzwa, ingane kuzodingeka ihlale esibhedlela cishe izinsuku ezinhlanu. Phakathi namahora okuqala angu-24-48, ingane kuzodingeka ihlale embhedeni. Ukwelashwa ngokomzimba kuzoqala zingakapheli izinsuku ezimbalwa.

Izinzuzo zezingane ezine-CP (Spastic Diplegic CP) ezithinta imilenze kuphela:

• Ukuhamba okuthuthukisiwe kanye nokuhamba kahle.
• Ukuqina okukhulu.
• Ukuwa okunciphile kanye nokulinganisela okuthuthukisiwe.
• Ukuma okuhle kokuhlala nokuma.
• Ukunciphisa ubuhlungu obubangelwa yi-spasticity.

Izinzuzo zezingane ezine-Spastic Quadriplegic CP:

• Ikhono lokuhlala ngokukhululeka isikhathi eside.
• Ukukwazi ukusebenzisa isihlalo esinomshini wokuwasha.
• Ikhono lokusebenzisa isihlalo sabakhubazekile ngokuzimela.

Futhi, ngenxa yokuthi imisipha ayiqini kakhulu, kuba lula ngabanakekeli ukushintsha inabukeni lomntwana bese bemnika ukudla.

Ziyini izingozi zalokhu kuhlinzwa?

Njenganoma yikuphi ukuhlinzwa, ama-SDR anezingozi ezincane.

Izinkinga zesikhashana:

• Ukutheleleka
• Ukopha
• Ukuvuza koketshezi lomgogodla (CSF)

Izinkinga ezihlala njalo (ezingavamile kakhulu):

• Ukuzwela okukhulu ekuthinteni (i-hyperesthesia), ngezinye izikhathi kuhambisana nobuhlungu.
• Ukulahlekelwa ukulawula umchamo (ukungakwazi ukuzibamba komchamo).
• Ukulahlekelwa ukulawula amathumbu (ukungakwazi ukuzibamba).
• Ubuthakathaka noma ukulahlekelwa ikhono lokuhamba langaphambilini.

Ungakhathazeki, ithimba lezokwelapha lengane yakho lizokuchazela kahle zonke lezi zingozi ngaphambi kokuhlinzwa.

Isikhathi sokululama kanye nokubaluleka kokwelashwa ngokomzimba

Ukwelashwa ngokomzimba kanye nokwelashwa ngokomsebenzi kubaluleke kakhulu ngemva kokuhlinzwa. Lolu hlelo lokuvuselela umzimba lubalulekile ukuze kufezwe imiphumela yokuhlinzwa.

Udokotela wezokwelapha ngokomzimba uzokwenza izivivinyo zokuqinisa, ukwelula, nokuthuthukisa imisipha yengane. Udokotela wezokwelapha ngokomzimba uzosiza ingane ukuba izimele kakhudlwana ekhaya nasesikoleni.

Ngaphambi kokuba ingane yakho iphume esibhedlela, abelaphi bazokunikeza incazelo ecacile yezivivinyo kanye nokwelashwa okudingeka ukwenze ekhaya. Kuzodingeka wenze lokhu kwelashwa izinsuku eziningana ngesonto izinyanga ezi-3-6.

Uma ubona noma yiziphi izimpawu zenkinga ngemva kokuhlinzwa kwengane yakho, njengokutheleleka kwenxeba noma ukulahlekelwa ukulawula umchamo, shayela udokotela wakho ngokushesha.