Icyo Kiyita Congenital Diaphragmatic Hernia (CDH) Ari Cyo, Ibimenyetso, Intandaro n'Uko kivurwa

Congenital diaphragmatic hernia (CDH) ni uburwayi umwana avukana buterwa n'uko hari agatobo mu gice cy'umubiri kitwa diaphragm, gikora nk'inkuta ikomeye itandukanya igituza n'inda. Iki gitobo gitera ingingo ziri mu nda kujya mu gituza, bigatuma umwana agira ikibazo cyo guhumeka.

Tekereza kuri diaphragm yawe nk'inkuta ikomeye itandukanya igituza n'inda. Iyo iyi nkuta ifite agatobo, ingingo nka mu nda cyangwa amara zishobora kujya mu gice aho ibihaha bigomba kuba. Iki kibazo kibasira abana bagera kuri 1 kuri buri 2,500 kugeza kuri 3,000 bavutse.

Ibimenyetso bya Congenital Diaphragmatic Hernia ni ibihe?

Abana benshi bafite CDH bagaragaza ibibazo byo guhumeka nyuma yo kuvuka. Ibimenyetso bishobora kuba bike cyangwa byinshi, bitewe n'aho ingingo ziri mu gituza zifata umwanya munini.

Dore ibimenyetso ushobora kubona:

• Guhumeka cyane, bigoye cyangwa kugira ikibazo cyo gufata umwuka
• Uruhu rw'ibara ry'ubururu cyangwa icyatsi, cyane cyane ku minwa no ku misumari
• Umutima ukubita cyane
• Igituba gifite ishusho nk'iy'ibintu byuzuye
• Inda isa n'iyamanutse cyangwa yoroheje
• Kumva amajwi make yo guhumeka ku ruhande rumwe rw'igituza

Bamwe mu bana bashobora kugira ibibazo byo konsa cyangwa bagasa n'abarakaye cyane. Mu bihe bitoroshye, CDH yoroheje ishobora kutagaragaza ibimenyetso bigaragara kugeza mu bwana, aho umwana ashobora kugira pneumonia isubira cyangwa ibibazo by'igogorwa.

Ubwoko bwa Congenital Diaphragmatic Hernia ni ubuhe?

CDH ifite ubwoko butandukanye, bitewe n'aho agatobo kaba kuri diaphragm. Ubwoko busanzwe ni Bochdalek hernia, iba inyuma no ku ruhande rwa diaphragm.

Ubwoko nyamukuru burimo:

• Bochdalek hernia: Igize 85-90% by'ibibazo, ikunda kuba ku ruhande rw'ibumoso
• Morgagni hernia: Iba imbere ya diaphragm, si yo isanzwe ariko ikunda kuba yoroheje
• Central diaphragmatic hernia: Ihorana, iba hagati ya diaphragm
• Eventration: Iyo umusuli wa diaphragm uba ucyeye kandi udashoboye aho kuba ufite agatobo

Hernias zo ku ruhande rw'ibumoso zikunda kuba zikomeye kuko zikunda kuba zirimo ingingo nyinshi zijya mu gituza. Hernias zo ku ruhande rw'iburyo ntizikunda kubaho ariko zishobora gutera ibibazo bikomeye byo guhumeka.

Icyateye Congenital Diaphragmatic Hernia ni iki?

CDH ibaho iyo diaphragm idakora neza mu gihe cy'inda. Ibi bibaho hagati y'icyumweru cya 8 na 12 cy'inda, igihe ingingo z'umwana zikira ziri gutera imbere.

Intandaro nyakuri ntiyumvikana neza, ariko abashakashatsi bemeza ko bishobora kuba iterambere ry'imiterere y'umubiri n'ibindi bintu. Mu bihe byinshi, nta mpamvu isobanutse y'uko bibaho, kandi si ikintu ababyeyi bakoze cyangwa batakoze.

Bimwe mu bintu bishobora gutera CDH birimo:

• Impinduka mu miterere y'umubiri cyangwa ibindi bintu bigira ingaruka ku iterambere rya diaphragm
• Ibibazo by'imiterere y'umubiri nk'uko trisomy 18 cyangwa 13
• Amateka y'umuryango wa CDH, nubwo ibi bidafite akamaro
• Imiti imwe ifatwa mu gihe cy'inda
• Ibibazo by'ubuzima by'umubyeyi nk'umunaniro

Ni ngombwa kumenya ko CDH ibaho mu buryo butunguranye mu bihe byinshi. Nubwo ufite umwana umwe ufite CDH, amahirwe yo kubyara undi mwana ufite icyo kibazo aguma ari make cyane.

Ni ryari ukwiye kujya kwa muganga kubera Congenital Diaphragmatic Hernia?

CDH ikunda kuvumburwa mu gihe cy'inda hakoreshejwe ibizamini bya ultrasound, akenshi hagati y'icyumweru cya 18 na 20. Muganga wawe ashobora kubona ko ingingo ziri ahantu hatariho cyangwa ko ibihaha by'umwana bigaragara bito ugereranyije n'uko bigomba kuba.

Ibimenyetso byihutirwa bikeneye ubufasha bwa muganga byihuse birimo:

• Ikibazo gikomeye cyo guhumeka cyangwa guhumeka cyane
• Uruhu rw'ibara ry'ubururu cyangwa icyatsi, ku minwa cyangwa ku misumari
• Kurakara cyane cyangwa kugira ubunebwe
• Kudashishoza cyangwa kudafata ibiryo
• Umutima ukubita cyane cyangwa imikorere y'ubuhumeka idasanzwe

Ku bana bakuru bafite CDH yoroheje itari kuvumburwa igihe cy'amavuko, banza kureba indwara z'ubuhumeka zisubira, inkorora idashira, cyangwa ibibazo by'igogorwa. Ibi bimenyetso, nubwo bitari byihutirwa, bigomba gusuzumwa na muganga.

Ibyago bya Congenital Diaphragmatic Hernia ni ibihe?

Ibihe byinshi bya CDH bibaho nta kintu na kimwe kizwi cyabyateye, bigatuma bigoye kubiteganya. Ariko, hari ibintu bimwe bishobora kongera amahirwe y'iki kibazo.

Ibintu bishobora gutera CDH birimo:

• Uburwayi bw'umubyeyi (imbere y'imyaka 35)
• Umubyeyi arwaye diyabete cyangwa ibindi bibazo by'imikorere y'umubiri
• Kugira ikibazo cy'imiti cyangwa ibindi bintu mu gihe cy'inda
• Amateka y'umuryango w'uburwayi bwo kuvuka
• Ibibazo by'imiterere y'umubiri bigira ingaruka ku iterambere
• Umubyeyi kunywa itabi cyangwa inzoga mu gihe cy'inda

Wibuke ko kugira ibyago ntibisobanura ko CDH izabaho. Abana benshi bafite ibi byago bavuka bafite ubuzima bwiza, naho abandi badafite ibyago bashobora kugira CDH.

Ingaruka zishoboka za Congenital Diaphragmatic Hernia ni izihe?

Ikibazo gikomeye kuri CDH ni uko gishobora kugira ingaruka ku iterambere n'imikorere y'ibihaha. Iyo ingingo ziri mu nda zifata umwanya mu gituza, ibihaha bishobora kudakura neza cyangwa bishobora gukomera.

Ingaruka zisanzwe zirimo:

• Pulmonary hypoplasia (ibihaha bidahagije)
• Persistent pulmonary hypertension (umuvuduko ukabije w'amaraso mu mitsi y'ibihaha)
• Gastroesophageal reflux (amazi y'inda asubira inyuma)
• Ibibazo byo konsa no kudakura neza
• Kubura kumva kubera inkunga y'umwuka igihe kirekire
• Gutinda gutera imbere mu bihe bikomeye

Ingaruka zikomeye ariko zidafite akamaro zishobora kuba harimo ibibazo by'umutima, ibibazo by'impyiko, cyangwa ibibazo by'ubwonko. Ariko, hakoreshejwe ubufasha bwa muganga no kugenzura, abana benshi bafite CDH bakura neza, bagira ubuzima bwiza.

Uko Congenital Diaphragmatic Hernia imenyekana

CDH ikunda kuvumburwa mu gihe cy'inda hakoreshejwe ibizamini bya ultrasound, akenshi hagati y'icyumweru cya 18 na 20. Muganga wawe ashobora kubona ko ingingo ziri ahantu hatariho cyangwa ko ibihaha by'umwana bigaragara bito ugereranyije n'uko bigomba kuba.

Ibizamini byo kuvumbura birimo:

• Ultrasound irambuye kugira ngo urebe aho ingingo ziri
• MRI y'umwana kugira ngo ubone amafoto arambuye
• Amniocentesis kugira ngo urebe ibibazo by'imiterere y'umubiri
• Ibizamini by'igituza nyuma yo kuvuka kugira ngo hemezwe uburwayi
• Echocardiogram kugira ngo urebe imikorere y'umutima
• Ibizamini by'amaraso kugira ngo urebe urwego rw'umwuka

Rimwe na rimwe CDH ntabwo ivumburwa kugeza nyuma yo kuvuka, cyane cyane mu bihe byoroheje. Itsinda ryawe ry'abaganga rizakoresha ibizamini by'igituza n'ibindi bizamini byo kubona amafoto kugira ngo hemezwe uburwayi kandi bategurire uburyo bwo kuvura.

Uburyo bwo kuvura Congenital Diaphragmatic Hernia

Uburyo bwo kuvura CDH busanzwe burimo kubaga kugira ngo hakosorwe diaphragm, ariko igihe cyabyo biterwa n'ubuzima bw'umwana wawe. Itsinda ry'abaganga bazabanza kwibanda ku guha umwuka uhagije no gushyigikira ibihaha mbere yo kubaga.

Intambwe za mbere zo kuvura zirimo:

• Inkunga yo guhumeka ikoresheje imashini
• Imiti ifasha umuvuduko w'amaraso n'imikorere y'umutima
• Ibiryo binyinjijwe mu mubiri kuko konsa bishobora kugorana
• Kuguma mu bitaro byihariye byita ku bana bavutse batarakuze

Kubaga bisanzwe bibaho igihe umwana wawe ameze neza, akenshi mu minsi mike cyangwa mu byumweru bike nyuma yo kuvuka. Umuganga azimurira ingingo ziri mu gituza mu nda kandi akosore agatobo kuri diaphragm. Rimwe na rimwe hasabwa igice cy'umubiri cyuzuza agatobo iyo ari kinini.

Igihe cyo gukira gitandukanye bitewe n'uburemere bw'uburwayi. Bamwe mu bana bashobora gukenera inkunga yo guhumeka, naho abandi bakira vuba. Itsinda ryawe ry'abaganga rizakorana nawe kugira ngo rikurikirane iterambere kandi rihindure uburyo bwo kuvura uko bibaye ngombwa.

Uko witwara mu rugo mu gihe cyo gukira Congenital Diaphragmatic Hernia

Abana benshi bafite CDH bazamara ibyumweru cyangwa amezi mu bitaro mbere yo gutaha. Iyo umwana ataha, ugomba gukomeza kwita ku buzima bwe kugira ngo umufashe gukira no gutera imbere.

Kwita ku buzima bw'umwana mu rugo bisanzwe birimo:

• Kugendera ku gahunda yo konsa no kugenzura uko umwana akura
• Gutanga imiti uko yategetswe
• Kugenzura uburyo bwo guhumeka n'umwuka uko bibaye ngombwa
• Kwitabira ibizamini byo gukurikirana
• Kureba ibimenyetso by'ingaruka nk'ikibazo cyo guhumeka cyangwa konsa
• Gutera inkunga iterambere n'imyitozo ngororamubiri uko byategetswe

Itsinda ryawe ry'abaganga rizakugira inama irambuye n'ubufasha. Ntukabe ikibazo cyo guhamagara iyo ubonye impinduka mu guhumeka, konsa, cyangwa ubuzima bw'umwana wawe muri rusange.

Uko witegura kujya kwa muganga

Kwitoza kujya kwa muganga bishobora kugufasha kubona byinshi mu buvuzi bwawe kandi bikaba byiza kumenya ibibazo byawe byose.

Tegura ibi:

• Urutonde rw'ibimenyetso byose ubu ufite n'igihe byatangiye
• Ibibazo ku buryo bwo kuvura n'icyo witeze
• Amakuru ku mateka y'ubuzima bw'umuryango
• Imiti ufashe ubu n'ingano
• Amakuru y'ubwishingizi n'ibyangombwa byo kwerekezwa
• Umuntu uzagufasha kwibuka amakuru

Ntukagire ikibazo cyo gusaba ibisobanuro iyo amagambo y'ubuvuzi atumvikana. Itsinda ryawe ry'abaganga rishaka ko usobanukiwe neza uburwayi bw'umwana wawe n'uburyo bwo kuvura.

Icyo ukwiye kumenya kuri Congenital Diaphragmatic Hernia

CDH ni uburwayi bukomeye ariko bukavurwa bugira ingaruka ku gice cy'umubiri kitwa diaphragm. Nubwo bisaba ubufasha bwa muganga n'ubuganga, abana benshi bafite CDH bakura neza, bagira ubuzima busanzwe hakoreshejwe uburyo bwiza bwo kuvura.

Ikintu cy'ingenzi cyo kwibuka ni uko kuvumbura no kuvura hakiri kare bigira uruhare runini mu musaruro. Iyo CDH ivumburwa mu gihe cy'inda, itsinda ryawe ry'abaganga rishobora kwitegura kubyara no kwita ku mwana hakiri kare. Kubera iterambere ry'ikoranabuhanga mu buvuzi no mu buryo bwo kubaga, amahirwe y'abana bafite CDH akomeza kwiyongera.

Wibuke ko buri kibazo gitandukanye, kandi itsinda ryawe ry'abaganga rizakorana nawe kugira ngo ritegure uburyo bwiza bwo kuvura bukubereye. Komereza gukorana n'itsinda ryawe ry'abaganga, ubaze ibibazo, kandi ntutinye gusaba ubufasha iyo ubukeneye.

Ibibazo byakunda kubaho kuri Congenital Diaphragmatic Hernia

Congenital Diaphragmatic Hernia ishobora kwirindwa?

Ubu, nta buryo buzwi bwo kwirinda CDH kuko ibaho mu gihe cy'iterambere ry'umwana mu nda. Gukoresha intungamubiri, kwirinda ibintu byangiza mu gihe cy'inda, no kugira ubuvuzi bwiza mu gihe cy'inda byose birabujijwe kugira ngo umwana azave mu buzima bwiza, ariko ibi bintu ntibyabuza CDH.

Urwego rw'abana barokoka bafite CDH ni uruhe?

Urwego rw'abana barokoka bafite CDH rwiyongereye cyane mu myaka ishize kandi ubu rugera kuri 70-90%, bitewe n'uburemere bw'uburwayi. Abana bafite CDH yoroheje n'ibihaha byateye imbere neza bagira umusaruro mwiza, naho abafite ibibazo bikomeye bashobora guhura n'ibibazo byiyongereye ariko bagifite amahirwe meza yo kurokoka hakoreshejwe ubufasha bwa muganga.

Umwana wanjye azakenera ubufasha bwa muganga nyuma yo kubagwa kuri CDH?

Abana benshi bazakenera gukurikiranwa kugira ngo hagenzurwe imikorere y'ibihaha, uko bakura, n'iterambere. Bamwe bashobora gukenera kuvurwa ibindi bibazo nk'igogorwa cyangwa kubura kumva. Ariko, abana benshi bafite CDH bashobora gukora ibikorwa bisanzwe uko bakura, harimo imikino n'ibindi bikorwa by'umubiri.

CDH ishobora kongera kubaho mu gihe cy'inda itaha?

Ibyago byo kubyara undi mwana ufite CDH ni bike cyane, akenshi munsi ya 2%. Ibihe byinshi bya CDH bibaho mu buryo butunguranye kandi ntibyarazwe. Ariko, niba hari impamvu z'imiterere y'umubiri, muganga wawe ashobora kugira inama yo kugisha inama ku bibazo by'imiterere y'umubiri kugira ngo aganire ku kibazo cyawe n'ibizamini byose.

Nyuma y'igihe kihe umwana avutse kubagwa kuri CDH bisanzwe bibaho?

Igihe cyo kubaga gitandukanye bitewe n'ubuzima bw'umwana wawe. Bamwe mu bana bakenera kubagwa mu minsi mike nyuma yo kuvuka, naho abandi bashobora gutegereza ibyumweru bike kugeza bameze neza. Itsinda ry'abaganga bazabanza kwibanda ku gushyigikira ubuhumure n'ubuzima muri rusange mbere yo kubaga kugira ngo hakosorwe diaphragm.