Ese ni iki kibazo cya icterus ku bana bato? Ibimenyetso, Intandaro, & Ubuvuzi

Icterus ku bana bato ni ikibazo gisanzwe aho uruhu rw’umwana wawe n’amaso y’umweru bihinduka umuhondo. Ibi bibaho iyo hari umunyu mwinshi wa bilirubine mu maraso y’umwana wawe - ikintu cy’umuhondo gikora iyo itisela zitukura zashaje zisenyuka. Icterus ya benshi mu bana bavutse ni isanzwe kandi ikagenda yonyine mu byumweru bike.

Abana bagera kuri 6 kuri 10 bagira icterus runaka mu cyumweru cyabo cya mbere cy’ubuzima. Nubwo bishobora kugaragara nk’iby’akaga ku babyeyi bashya, umubare munini w’ibibazo nta cyo bibangamira kandi ni igice cy’uburyo umwana wawe yigenga hanze y’inda.

Ese ni iki kibazo cya icterus ku bana bato?

Icterus ku bana bato ibaho iyo bilirubine yiyongera vuba kurusha uko umwijima w’umwana wawe ushobora kuyitunganya. Tekereza kuri bilirubine nk’ikintu gisanzwe cyangiza gikora iyo itisela zitukura zuzuza imirimo yazo kandi zisenyuka. Ku bakuru, umwijima utunganya uyu murimo neza, ariko imwijima y’abana bavutse iracyiga uburyo bwo gukora akazi kayo neza.

Umubiri w’umwana wawe utanga bilirubine nyinshi kurusha umubiri w’umuntu mukuru kuko abana bavutse bafite itisela zitukura nyinshi zisaba gusimburwa kenshi. Muri icyo gihe, umwijima wabo uracyategura ubushobozi bwo gukura bilirubine mu maraso. Ubu busemburwa bw’igihe gito butuma habaho ibara ry’umuhondo ubona mu bana bafite icterus.

Icterus ya benshi mu bana bato igaragara hagati y’umunsi wa kabiri n’uwa kane nyuma yo kuvuka. Umuhondo ugaragara mbere ku maso y’umwana wawe, cyane cyane hafi y’izuru n’uruhande rw’umutwe. Ibara ry’umuhondo rigaragara cyane mu mucyo w’izuba ugereranyije n’umucyo w’amatara.

Ese ni ibihe bimenyetso bya icterus ku bana bato?

Ikimenyetso nyamukuru cya icterus ku bana bato ni ibara ry’umuhondo ry’uruhu rw’umwana wawe n’amaso. Ubusanzwe uzabona uyu muhondo mbere ku maso y’umwana wawe, cyane cyane hafi y’izuru n’uruhande rw’umutwe. Ibara ry’umuhondo rigaragara cyane mu mucyo w’izuba ugereranyije n’umucyo w’amatara.

Dore ibimenyetso by’ingenzi byo kwitondera:

• Ibara ry’umuhondo ku ruhu, ritangirira mu maso rikamanuka
• Ibara ry’umuhondo ku mboni z’amaso
• Ibara ry’umuhondo mu kanwa cyangwa ku menyo
• Umusambi ufite ibara ry’umuhondo cyangwa umuhondo-umutuku (umusambi w’uruhinja rusanzwe akenshi aba adafite ibara cyangwa afite ibara ry’umuhondo koroheye)
• Umusambi ufite ibara ryera cyangwa nk’igitaka (umusambi w’uruhinja rusanzwe akenshi aba ufite ibara ry’umuhondo cyangwa iry’icyatsi)

Abana benshi bafite ibara ry’umuhondo rike bakomeza konsa neza, bagakomeza kuba maso iyo bamenye, kandi bagasinzira nk’uko bisanzwe. Ibi ni ibimenyetso bidutera icyizere ko ibara ry’umuhondo rishobora kuba ari iryo rusanzwe, ritagira ikibazo.

Ariko kandi, hari ibimenyetso bisaba ubuvuzi bw’ihutirwa. Niba umwana wawe arushye cyane, agira ikibazo cyo konsa, agasa n’uwaguye cyangwa adafite imbaraga, agira uburyo bwo kurira bwinshi, cyangwa niba ibara ry’umuhondo rikwirakwira mu kuboko no mu birenge, hamagara umuganga wawe ako kanya. Ibi bimenyetso bishobora kugaragaza ko urwego rwa bilirubine ruri hejuru cyane.

Ni ayahe moko y’ibara ry’umuhondo ku bana?

Hari ubwoko butandukanye bw’ibara ry’umuhondo ku bana, buri bwoko bufite igihe cyabwo n’imiterere yabwo. Gusobanukirwa ubwo bwoko bushobora kugufasha kumenya icyo witeze kandi igihe ukwiye gushaka ubuvuzi.

Ibara ry’umuhondo risanzwe ni ryo rikunda kugaragara, rigaragara ku bana bamaze amezi icyenda mu nda ku kigero cya 60% n’abana bavutse batararangiza amezi icyenda ku kigero cya 80%. Ibi bibaho gusa kubera ko umwijima w’umwana akeneye igihe kugira ngo ukure kandi ugerane n’umusaruro wa bilirubine w’umubiri. Akenshi bigaragara ku munsi wa 2 cyangwa wa 3 w’ubuzima, bikagera ku rwego rwo hejuru ku munsi wa 5, hanyuma bigakendera kugeza imperuka y’icyumweru cya kabiri.

Ibara ry’umuhondo rikomoka ku konsa rishobora kugaragara mu cyumweru cya mbere cy’ubuzima iyo abana badafata amata ahagije ya nyina. Ibi bishobora kubaho niba konsa itaratangira neza, cyangwa niba amata yawe akiri make. Igisubizo akenshi kiba ari ukonsa kenshi kandi kwita ku buryo bwo konsa neza.

Ihumana ry’umwijima rikomoka ku mata ya nyina ritandukanye n’ihumana ry’umwijima rikomoka ku kunywa amata ya nyina, kandi rigaragara nyuma y’icyumweru cya mbere cy’ubuzima. Ibinyabutabire bimwe biri mu mata ya nyina bamwe bishobora kugabanya umuvuduko w’imikorere y’umwijima mu gukuraho bilirubine. Ubwo bwoko ntabwo buri mbi kandi bushobora kumara ibyumweru byinshi cyangwa amezi, ariko ntibisaba guhagarika konsa.

Ubwoko butari bwo busanzwe burimo ihumana ry’umwijima iterwa no kudahuza kw’amaraso hagati ya nyina n’umwana, indwara zandura, cyangwa ibibazo by’ubuzima. Ubwo bwoko busanzwe buhita bugaragara cyangwa bukamara igihe kirekire kurusha ihumana risanzwe ry’umwijima kandi bisaba gukurikiranwa hafi na muganga.

Ese ihumana ry’umwijima ku bana rikomoka he?

Ihumana ry’umwijima ku bana rigaragara iyo umubiri w’umwana utunganya bilirubine vuba kurusha uko umwijima ushobora kuyikuraho. Ubu busumbane buva mu mpamvu nyinshi zisanzwe zijyanye no guhinduka kuva mu buzima mu nda ku buzima hanze.

Mu gihe cyo gutwita, umuraba wawe wakuraga bilirubine mu maraso y’umwana wawe. Nyuma yo kuvuka, umwijima w’umwana wawe ugomba gufata akazi neza. Kubera ko imwijima y’abana bavutse iheruka gutera imbere ubushobozi bwayo bwuzuye, ntibashobora guhora bakurikirana umusaruro wa bilirubine muri ibyo bihe byambere n’ibyumweru.

Dore ibintu by’ingenzi bigira uruhare mu ihumana ry’umwijima ku bana:

• Imikorere y’umwijima itaratera imbere igera ku byumweru bike byambere by’ubuzima
• Ubwinshi bw’utubuto tw’amaraso y’umutuku mu bana bavutse, bigatuma umusaruro wa bilirubine wiyongera
• Igihe gito cy’ubuzima bw’utubuto tw’amaraso y’umutuku tw’umwana ugereranije n’utubuto tw’amaraso y’umutuku tw’abantu bakuru
• Kugabanyuka kw’ifunguro mu minsi mike ya mbere, bigatuma gukuraho bilirubine binyuze mu guhita bigabanuka
• Gusubira kwakira bilirubine kuva mu mara mu maraso

Bamwe mu bana bahura n’ibibazo byiyongereye bishobora kuba byongera ihumana ry’umwijima. Abana bavutse bataratera imbere bafite imikorere y’umwijima itaratera imbere cyane kandi bashobora gukeneye ubufasha bwiyongereye. Abana bagize ibibazo mu gihe cyo kubyara bashobora kugira ibintu byinshi byangirika by’utubuto tw’amaraso y’umutuku bitewe n’ibikomere cyangwa kuva amaraso.

Ukutabyina kw’amaraso hagati y’umubyeyi n’umwana bishobora kandi gutera ihahamuka rikomeye. Ibi bibaho iyo imiti y’umubyeyi igabwe ku maraso y’umwana, bigatuma asenyuka vuba kurusha uko bisanzwe. Nubwo bitakunda kuboneka muri iki gihe kubera ubuvuzi bwo gukumira mu gihe cyo gutwita, ibi bibazo bisaba gukurikiranwa n’abaganga hafi.

Ryari ukwiye kujya kwa muganga kubera ihahamuka ry’uruhinja?

Wagomba kuvugana n’umuganga wawe niba ihahamuka rigaragaye mu masaha 24 ya mbere nyuma yo kuvuka, kuko gutangira hakiri kare bishobora kugaragaza ikibazo gikomeye kiri inyuma. Ihahamuka risanzwe rya fiziyoloji ntabwo rigaragara mbere y’umunsi wa 2 cyangwa wa 3, bityo kugaragara hakiri kare bisaba isuzuma ry’abaganga.

Hamagara muganga wawe ako kanya niba ubona ibimenyetso ibi bikurikira:

• Ihahamuka rigaragara mu masaha 24 ya mbere y’ubuzima
• Ibara ry’umuhondo cyangwa umutuku cyane ku ruhu
• Umuhondo ugera ku kuboko n’ibirenge by’uruhinja
• Umwana wawe arushaho gusinzira cyangwa bigoye kumukangurira
• Kurya nabi cyangwa kwanga kurya
• Gutaka bidasanzwe cyangwa gutaka cyane
• Umuriro urenze 38°C
• Ibimenyetso byo gukama nk’akanwa kari kumeze nabi cyangwa udupfukamunwa duke

Ndetse n’iyo umwana wawe asa neza, gukurikirana bisanzwe ni ingenzi mu gukurikirana urwego rw’ihahamuka. Umuganga wawe ashobora gushaka kubona umwana wawe mu minsi 3-5 nyuma yo kuva mu bitaro kugira ngo arebe uko ihahamuka riri kugenda.

Gira icyizere imyumvire yawe nk’umubyeyi. Niba hari ikintu kidasanzwe ku isura cyangwa imyitwarire y’uruhinja rwawe, nubwo utazi neza icyo ari cyo, ntutinde kuvugana n’itsinda ry’ubuvuzi. Bahari kugufasha kandi bakwishimira gusuzuma umwana wawe ubusa kurusha kwibagirwa ikintu gikomeye.

Ni ibihe bintu byongera ihahamuka ry’uruhinja?

Ibintu byinshi bishobora kongera ibyago by’umwana wawe byo kurwara icterus cyangwa kugira icterus ikomeye isaba ubuvuzi. Gusobanukirwa ibyo bintu bigufasha wowe n’itsinda ry’abaganga bawe kuba maso ku bimenyetso bya mbere no gufata ingamba zo kwirinda igihe bishoboka.

Kuzalirwa imburagihe ni kimwe mu bintu bikomeye byongera ibyago kuko abana bavutse mbere y’ibyumweru 37 bafite imikorere y’umwijima itaratera. Amwijima yabo akeneye igihe cyinshi kugira ngo aterembere ubushobozi bwo gutunganya bilirubine neza. Byongeye kandi, abana bavutse imburagihe bakunze kugira ibibazo byo konsa, bishobora kugabanya gukuraho bilirubine binyuze mu guhita.

Dore ibyago by’ingenzi bishobora kongera amahirwe y’umwana wawe yo kurwara icterus ikomeye:

• Kuzalirwa imburagihe (imbere y’ibyumweru 37 byo gutwita)
• Umuvune ukomeye cyangwa kuva amaraso mu gihe cyo kubyara
• Ubudahuje ubwoko bw’amaraso hagati y’umubyeyi n’umwana (ABO cyangwa Rh incompatibility)
• Amateka y’umuryango y’icterus ikomeye mu bavandimwe
• Kuba ufite inkomoko yo muri Aziya y’iburasirazuba cyangwa Mediterane
• Konsa gusa hamwe n’ibibazo byo konsa
• Gutakaza ibiro byinshi nyuma yo kubyara (kurenza 10% by’ibiro byavukiyeho)
• Kuba umuhungu (abahungu barwara icterus kenshi kurusha abakobwa)

Ibintu bimwe na bimwe by’umubyeyi mu gihe cyo gutwita bishobora kandi kugira ingaruka ku kaga k’icterus. Ibyo birimo diyabete y’umubyeyi, imiti imwe n’imwe ifatwa mu gihe cyo gutwita, n’indwara zishobora kugira ingaruka ku mwana. Itsinda ry’abaganga bawe rizaba rizirikana ibyo bintu mu gutegura kwita ku mwana wawe nyuma yo kubyara.

Kugira ibyago ntibisobanura ko umwana wawe azahita arwara icterus ikomeye, ariko bisobanura ko itsinda ry’abaganga bawe rizajya rikurikirana hafi. Kumenya hakiri kare no gufata ingamba bishobora gukumira ingaruka mbi kandi bikaguha amahoro mu byumweru bya mbere by’ingenzi uri kumwe n’umwana wawe mushya.

Ni iki gishobora kuba ingaruka mbi z’icterus ku bana?

Nubwo umwijima uboneka ku bana bato benshi utari ubwoko bw’indwara kandi ukagenda ukizira ukwacyo, rimwe na rimwe urwego rwo hejuru cyane rwa bilirubine rushobora gutera ingaruka zikomeye. Inkuru nziza ni uko, hakoreshejwe ubugenzuzi n’ubuvuzi bikwiye, izi ngaruka ziba nke cyane mu bihugu biteye imbere bifite ubuvuzi bw’abana bato buhagije.

Ingaruka ikomeye ishobora kubaho ni kernicterus, ubwoko bwa ubwonko buke butari bwo, ariko bukomeye, bushobora kubaho iyo urwego rwa bilirubine rugeze hejuru cyane. Ibi bibaho iyo bilirubine yarenze mu mubiri w’ubwonko ikangiza uturemangingo tw’imiterere y’ubwonko. Kernicterus irashobora kwirindwa hakoreshejwe ubuvuzi n’ubugenzuzi bikwiye.

Dore ingaruka zishobora kubaho abaganga baharanira gukumira:

• Acute bilirubin encephalopathy - ibimenyetso bya mbere byo guhungabana kw’ubwonko biterwa na bilirubine nyinshi
• Kernicterus - ikangirika ry’ubwonko ridashira rigira ingaruka ku mikorere y’umubiri, kumva, no gutera imbere
• Kubura kumva kuva ku kiciriritse kugeza ku kutakumva na gato
• Cerebral palsy igira ingaruka ku mikorere y’imitsi n’imyanya y’umubiri
• Ubumuga bwo mu mutwe cyangwa gutinda gutera imbere
• Ibibazo byo guhindura amaso n’ubuhumyi
• Ibibazo by’amenyo bigira ingaruka ku iterambere ry’enamel y’amenyo

Ibimenyetso by’umubiri by’ibanze byerekana ko urwego rwa bilirubine rushobora kuba rugera ku rwego rw’akaga harimo uburwayi bukabije, kudya nabi, intege nke z’imitsi, n’imikorere idasanzwe yo kurira. Ibi bimenyetso bisaba ubuvuzi bw’ihutirwa kandi bikunze gutera ubuvuzi bwa phototherapy cyangwa ibindi bivugurura.

Ni ngombwa kwibuka ko izi ngaruka zikomeye zibaho gusa iyo umwijima ukabije utabonye ubuvuzi. Kwitabwaho n’abaganga b’abana, harimo gusura inshuro zateganijwe nyuma y’ivuka, bigenewe cyane cyane gufata no kuvura umwijima mbere y’uko ugera ku rwego rw’akaga. Itsinda ryanyu ry’ubuvuzi rifite ibikoresho byiza byo kugenzura no gucunga umwijima mu buryo buzewe.

Uko umwijima ku bana bato wakwirindwa?

Nta buryo bwo kwirinda burundu ihahamuka ry’umubiri kuko ari kimwe mu bintu bisanzwe bibaho ku bana benshi mu gihe bahindura ubuzima bwo mu nda, ariko hari intambwe ushobora gutera kugira ngo ugabanye ibyago byo kurwara ihahamuka rikabije kandi ufashe umwana wawe guhinduka neza.

Kugaburira umwana bihagije ni kimwe mu bintu by’ingenzi byo kwirinda. Kugaburira kenshi bituma umwana wawe akuramo bilirubine binyuze mu guhita, kandi bikarinda kukama, bishobora kongera ihahamuka. Uko waba ugaburira umwana amata ya nyina cyangwa amata y’ifu, gerageza kugaburira inshuro 8-12 mu masaha 24 mu cyumweru cya mbere cy’ubuzima bwe.

Dore ingamba nyamukuru zishobora kugufasha kwirinda ihahamuka rikabije:

• Gaburira umwana wawe kenshi (buri saha 2-3) kugira ngo ate umunani kenshi
• Kora uburyo bwiza bwo konsa, umwana akaba afite isano ryiza kandi amata akamugeraho
• Kureba ibiro by’umwana wawe kugira ngo umenye ko ahabwa indyo ihagije
• Kwitabira ibizamini byose by’abaganga byateganijwe kugira ngo harebwe ihahamuka
• Kureba ibimenyetso bya mbere by’ihahamuka no kubimenyesha vuba
• Kwitaho neza inda kugira ngo hakemurwe ibibazo by’ubwoko bw’amaraso butanyuranye

Niba ukoresha amata ya nyina, gukorana n’umujyanama w’ubukoresha bw’amata mu minsi mike ya mbere bishobora kugufasha gushyiraho uburyo bwiza bwo kugaburira. Uburyo bwiza bwo konsa butuma umwana wawe abona indyo ihagije kandi bufasha gutuma ate umunani kenshi, bikakuramo bilirubine mu mubiri.

Ku babyeyi bafite ubwoko bw’amaraso butanyuranye, kwitabwaho neza mu gihe cy’inda no kuvurwa nka inshinge za RhoGAM bishobora kwirinda ubwoko bumwe bw’ihahamuka rikabije. Itsinda ry’abaganga bazamenya ibyago muri iyo nda kandi bagafata ingamba zo kwirinda igihe bibaye ngombwa.

Ihahamuka ry’uruhinja rimenyekana gute?

Abaganga bamenya ihahamuka ry’uruhinja binyuze mu isuzuma ry’amaso hamwe n’ibizamini byihariye byo gupima urwego rwa bilirubine mu maraso y’umwana wawe. Uburyo bwo kubimenya ni bworoheje kandi bufasha kumenya niba hakenewe kuvurwa.

Muganga wawe azabanza gukora isuzuma ry’umubiri, arebe ibara ry’uruhu rw’umwana wawe mu mucyo uhagije. Azakanda buhoro buhoro uruhu rw’umwana wawe kugira ngo arebe uburyo ibara ry’umuhondo rigaragara vuba iyo igitutu cyakujijwe. Ibi bifasha mu gupima uburemere bw’indwara y’umuhondo, nubwo urwego nyaryo rwa bilirubine rusaba isuzuma ry’amaraso.

Ibikoresho by’ingenzi byo gupima birimo:

• Gusuzuma ibara ry’uruhu n’amaso
• Ikimagiriro cya transcutaneous bilirubinometer (igikoresho gikoreshwa urumuri gishyirwa ku ruhu)
• Isuzuma ry’amaraso rya serum bilirubin kugira ngo hamenyekane urwego nyaryo
• Isuzuma ry’amaraso ryuzuye kugira ngo harebwe uburwayi buri inyuma
• Isuzuma ry’amaraso ry’umubyeyi n’umwana
• Isuzuma rya antikorali (Coombs test) niba hakekwa ikibazo cy’amaraso

Ikimagiriro cya transcutaneous bilirubinometer ni igikoresho cyo gupima kidakomeretsa gikoresha urumuri mu gupima urwego rwa bilirubine binyuze ku ruhu. Niba iri suzuma ryerekana urwego rwo hejuru, muganga wawe azategeka isuzuma ry’amaraso kugira ngo hamenyekane urwego nyaryo. Isuzuma ry’amaraso ririmo gufata igice gito cy’amaraso mu rutugu rw’umwana wawe cyangwa mu kuboko.

Itsinda ry’abaganga bazaba banareba imyaka y’umwana wawe, ibyago, n’ubuzima bwe muri rusange mu gihe basobanura urwego rwa bilirubine. Icyitwa gisanzwe gitandukanye bitewe n’amasaha cyangwa iminsi umwana wawe amaze avutse, niba yavutse imburagihe, n’ibindi bintu byihariye.

Bishingiye kuri ibi bisubizo, muganga wawe ashobora kumenya niba umuhondo uri mu rwego rusanzwe, ukeneye gukurikiranwa, cyangwa ukeneye kuvurwa. Ubu buryo burambuye bwo gusuzuma bufasha guha ubufasha abana babukeneye vuba kandi birinda kuvura abana bafite umuhondo utagira ikibazo.

Ubuvuzi bw’umuhondo ku bana bato ni bwoki?

Ubuvuzi bw’umwijima ku mwana ukiri muto bushingiye ku rugero rw’umwijima (bilirubine) uri mu mwana wawe, imyaka ye, n’ubuzima bwe muri rusange. Imyinshi mu mibare y’umwijima muke ntabwo isaba ubuvuzi uretse gukurikiranwa neza, mu gihe umwijima ukabije ushobora gusaba ubutabazi bwihariye bwa muganga kugira ngo hirindwe ingaruka.

Ukwifashisha umucyo (Photothérapie) ni bwo buvuzi busanzwe kandi bugira akamaro mu kuvura umwijima uciriritse cyangwa ukabije. Ibi bisobanura gushyira umwana wawe munsi y’amatara yihariye y’ubururu afasha gusenya umwijima (bilirubine) uri ku ruhu kugira ngo ubone uburyo bworoshye bwo kuwukuraho. Ubuvuzi bw’umucyo ntabwo bubabaza kandi bushobora gukorwa mugihe ukomeje gufata no konsa umwana wawe.

Dore amahitamo y’ubuvuzi nyamukuru itsinda ryawe ry’ubuvuzi rishobora kugutekerezaho:

• Kongera kenshi konsa kugira ngo habeho gukuraho umwijima (bilirubine) binyuze mu guhita
• Ukwifashisha umucyo (Photothérapie) gakondo hakoreshejwe amatara y’ubururu yo hejuru mu bitaro
• Ukwifashisha umucyo (Photothérapie) ukoresha fibre optique hamwe n’igitambara cyihariye cyo gukoreshwa mu rugo mu bihe bimwe na bimwe
• Imunoglobuline yinjizwa mu mitsi (IVIG) ku mwijima uterwa no kudahuza amaraso
• Gusimbuza amaraso ku bihe bikomeye (gusimbuza amaraso y’umwana amaraso y’umutanga)
• Kuvura indwara ziri inyuma nka za ndwara niba zihari

Mu gihe cyo kwifashisha umucyo (Photothérapie), umwana wawe azambara agapfukamunwa gusa n’ibikoresho byo kurinda amaso mugihe aryamye munsi y’amatara. Ushobora gufata ibiruhuko kugira ngo umuhe amabere kandi umukumbure, kandi ibitaro byinshi ubu bifite ibikoresho byemerera kwifashisha umucyo (Photothérapie) gukomeza muri ibi bihe byo kunga ubumwe. Abana benshi bakenera kwifashisha umucyo (Photothérapie) iminsi 1-2 mbere yuko urugero rw’umwijima (bilirubine) rugabanuka bihagije.

Ku mwijima ukabije udasubiza kwifashisha umucyo (Photothérapie), gusimbuza amaraso bishobora kuba ngombwa. Ubu buryo burimo gukuraho buhoro buhoro ibice bito by’amaraso y’umwana wawe no kubusimbuza amaraso y’umutanga kugira ngo hagabanyuke vuba urugero rw’umwijima (bilirubine). Nubwo ibi bishobora kuba bigoye, ni uburyo buzwi neza kandi butekanye mugihe bukorwa n’amakipe y’abaganga bafite ubunararibonye.

Itsinda ry’abaganga bazakurikirana urwego rw’umunyu wa bilirubine mu mwana wawe buri gihe mu gihe cyo kuvurwa kugira ngo bakurikirane uko ibintu bigenda kandi bamenye igihe kuvurwa bishobora guhagarara. Abana benshi bagaragaza impinduka nziza mu gihe cyo kuvurwa kandi bashobora gutaha igihe urwego rw’umunyu wa bilirubine rwaba ruringaniye mu rwego rukwiye.

Uko witwara mu rugo mu gihe umwana afite igihagararo?

Kwita ku mwana mu rugo mu gihe afite igihagararo bigamije gushyigikira uburyo bw’umubiri we bwo gukira binyuze mu guha amabere neza, gukurikirana, no guha umutekano. Abana benshi bafite igihagararo gito bashobora kwitabwaho mu rugo bakurikiranwa n’abaganga kugira ngo harebwe niba urwego rw’umunyu wa bilirubine rugabanuka uko bikwiye.

Guha amabere kenshi ni inkingi y’ibanze mu kwita ku mwana mu rugo afite igihagararo. Guha amabere buri saha 2-3 bifasha mu kugira ko umwana akora umubiri kenshi, ari na ko umubiri we uvanaho umunyu wa bilirubine. Ntukabe umerewe nabi niba umwana wawe asa n’urushye kurusha uko bisanzwe kubera igihagararo – ushobora kumuhagurukira kugira ngo umuhe amabere.

Dore ingamba z’ingenzi zo kwita ku mwana mu rugo:

• Ha amabere umwana wawe inshuro 8-12 ku munsi, umuhagurutse niba ari ngombwa
• Kora isuzuma ry’ibimenyetso by’umubiri – gerageza kugira nibura ibendera 6 by’amazi n’ibyondo 3-4 ku munsi
• Komeza kwandika igihe cyo guha amabere n’ingano niba umuha amabere mu icupa
• Suzuma ibara ry’uruhu rw’umwana wawe mu mucyo w’izuba buri munsi
• Kora isuzuma ry’impinduka mu bwenge, mu kurira, cyangwa mu kurya
• Komeza gukurikiza gahunda yose y’ibitaro uganira na muganga wawe
• Komeza kwandika ibintu byoroshye byo guha amabere no guhindura ibendera kugira ngo ubisangize muganga wawe

Niba uha umwana wawe amabere, ntukongeremo amazi cyangwa amazi asukari keretse ubaye wabwirijwe n’abaganga. Ibyo bintu bishobora kubangamira uburyo bwo konsa kandi ntibifasha mu gukuraho umunyu wa bilirubine. Ahubwo, shyira imbaraga mu guha amabere kenshi kandi ube maso ko umwana wawe afata neza amabere kandi ahabwa amata uko bikwiye.

Bamwe mu babyeyi bahangayikishwa no kwerekana umwana wabo ufite igihagararo izuba, ariko ibi ntibyemerwa nk'ubuvuzi. Nubwo izuba rifite umucyo ushobora gusenya bilirubine, ntabwo ari umuti ukwiye cyangwa ufite akamaro mu kuvura igihagararo kandi bishobora gutera umwana gucana cyangwa gushyuha cyane.

Ishyire icyizere mu byiyumvo byawe kandi ntutinye kuvugana n'abaganga bawe niba ubona impinduka iyo ari yo yose ku mubiri w'umwana wawe. Kugira umwana ufite igihagararo iruhande rwawe bishobora kuguhagarara, ariko ufite ubufasha bukwiye no kugenzura, abana benshi barakira neza mu byumweru bike.

Wategura gute uruzinduko kwa muganga?

Gutegura uruzinduko kwa muganga bishobora kugufasha kugira ngo ubone isuzuma ryiza rya igihagararo cy'umwana wawe n'amabwiriza meza yo kumwitaho. Kuzana amakuru akwiye no kubaza ibibazo byiza bizafasha itsinda ry'abaganga bawe gutanga ubufasha bwiza cyane ku mwana wawe.

Mbere y'uruzinduko rwawe, irinde umwanya wo kureba ibara ry'uruhu rw'umwana wawe mu mucyo w'izuba, kuko amatara y'ikoranabuhanga bishobora kubagora gusuzuma igihagararo neza. Andika impinduka zose wabonye kuva igihagararo cyagaragaye bwa mbere, harimo niba bigaragara ko birimo gukira, bigenda biba bibi, cyangwa bikomeza kumera kimwe.

Dore ibyo ugomba gutegura no kuzana mu ruzinduko rwawe:

• Igitabo cyerekana igihe cyo konsa, umunaniro, n'uburyo umwana wawe yakira konsa
• Inyandiko z'impinduka z'udupfukamunwa harimo kenshi uhinduranya udupfukamunwa n' ibara ry'inkari n'amatinyiro
• Inyandiko z'imyitwarire y'umwana wawe yo kuryama n'uburyo yubaha
• Impungenge iyo ari yo yose ku mpinduka mu kurira, konsa, cyangwa imyitwarire
• Ibibazo ku buryo bwo konsa niba ufite ibibazo
• Amakuru yo kuva mu bitaro y'umwana wawe n'ibisubizo by'ibizamini byabanje
• Urutonde rw'imiti cyangwa ibintu byongera imbaraga ufata niba uonsa

Andika ibibazo byawe mbere y’igihe kugira ngo utabyibagirwa ubwo uzaba ugiye kwa muganga. Ibibazo bisanzwe birimo: Umuti w’umwana wanjye ukomeye gute? Tugenekereje ubuvuzi? Nzageraho ryari niba mfite impungenge? Nkwiye konsa umwana wanjye kangahe? Uzongera kutubona ryari?

Mu gihe cy’isuzumwa, muganga wawe arashobora gusuzuma umwana wawe mu mucyo mwiza kandi ashobora gutegeka ibizamini by’amaraso kugira ngo arebe urwego rwa bilirubine. Ntugatangazwe niba ibi bikubiyemo gupima amaraso make mu ntugu - ibi ni ibintu bisanzwe mu gukurikirana indwara y’umwijima kandi bitanga amakuru akomeye yerekeye niba ubuvuzi bukenewe.

Saha amabwiriza yihariye yerekeye ibyo ukwiye kwitondera iwawe no igihe ukwiye guhamagara ibiro. Gusobanukirwa ibimenyetso by’umubabaro no kugira gahunda isobanutse yo gukurikirana ubuvuzi bizaguha icyizere mu kwita ku mwana wawe hagati y’ibindi bisuzumwa.

Ni iki cy’ingenzi cyo kumenya ku bijyanye n’umwijima w’abana?

Umuwijima w’abana ni indwara isanzwe cyane ikora ku bana bavutse bose mu rugero runaka, kandi umubare munini w’imibare ikemuka ubwabyo nta ngaruka zirambye. Nubwo ibara ry’umuhondo rishobora guhangayikisha ababyeyi bashya, gusobanukirwa ko ibi bisanzwe ari igice gisanzwe cyo guhuza umwana wawe n’ubuzima hanze y’inda bishobora gutanga ihumure.

Ikintu cy’ingenzi cyo kwibuka ni uko ubuvuzi bw’ubu bufite ibikoresho byiza cyane byo gukurikirana no kuvura umwijima igihe bibaye ngombwa. Ingaruka zikomeye ni nke kuko abaganga bazi uburyo bwo kumenya abana bakeneye ubuvuzi kandi bafite ingamba zikora. Ibizami byo gukurikirana bya muganga wawe bigenewe cyane gufata umwijima ukeneye kwitabwaho.

Ibanda ku byo ushobora kugenzura: kenshi na kenshi konsa umwana wawe, kujya mu buvuzi bwose bwagenwe, no kwitondera impinduka zose mu mimerere y'umwana wawe. Konsa kenshi ni ingenzi cyane kuko bituma umwana wawe akuramo bilirubine mu buryo bw’umwimerere kandi bikamufasha kugira ubuzima bwiza muri iki gihe cy’impinduka.

Gira icyizere ikipe yawe y’ubuvuzi kandi ntutinye kuvugana na bo ibibazo cyangwa impungenge ufite. Bazi ko kugira umwana ufite igihagararo bishobora gutera ababyeyi umunaniro, kandi bari aho kugira ngo bagufashe wowe n’umwana wawe. Abana benshi bafite igihagararo bakura bagira ubuzima bwiza nta ngaruka z’igihe kirekire ziterwa n’igihagararo cyabo.

Wibuke ko iki gihe ari icy’igihe gito. Ndetse n’abana bakeneye kuvurwa bakira vuba kandi neza. Hamwe no kwitaho neza no kugenzura, ushobora kwizera ko umwana wawe azanyura muri iri huriro risanzwe ry’abana bashya kandi azakomeza gukura neza mu byumweru n’amezi ari imbere.

Ibibazo bikunze kubaho ku gihagararo cy’abana

Nshobora gukomeza konsa umwana wanjye niba afite igihagararo?

Yego, ugomba gukomeza konsa umwana wawe niba afite igihagararo. Amata ya nyina atanga intungamubiri z’ingenzi kandi afasha umwana wawe gukuramo bilirubine binyuze mu guhita. Mu by’ukuri, konsa kenshi bisanzwe bifasha gukemura igihagararo vuba binyuze mu guteza imbere imyanda isanzwe no gukumira kukama.

Ndetse niba umwana wawe afite “igihagararo cy’amata ya nyina,” gishobora guterwa n’ibintu biri mu mata ya nyina, ntukeneye guhagarika konsa. Ubwo bwoko bw’igihagararo nta ngaruka mbi bugira kandi buzakira ubwabwo mu gihe umwana wawe ahabwa inyungu zose z’amata ya nyina. Umuganga wawe azagufasha kumenya gahunda nziza yo konsa ikujyanye n’imimerere yawe.

Igihagararo cy’abana gisanzwe mara igihe kingana iki?

Umuti w’umwijima usanzwe ugaragara ku munsi wa 2-3 nyuma yo kuvuka, ukagera ku rwego rwo hejuru ku munsi wa 5, hanyuma ugabanuka buhoro buhoro mu byumweru 2-3. Abana benshi bafata amata ya nyina bashobora kugira umuti w’umwijima muke ukamara igihe kirekire, rimwe na rimwe ukagera ku ndunduro y’ibyumweru 6-8, ariko ibi ntabwo bikunze kuba ikibazo niba umwana anywa amata neza kandi agakura neza.

Abana bavutse batararangira bashobora kugira umuti w’umwijima ukamara igihe kirekire kurusha abana bavutse bararangira kuko imwijima yabo ikeneye igihe kirekire kugira ngo ikure. Umuganga wawe azakurikirana igihe n’uburemere bw’umuti w’umwijima kugira ngo abemeze ko byose bigenda neza kandi asuzume niba hari ubuvuzi bukenewe.

Ese ni byiza kujyana umwana wanjye ufite umuti w’umwijima hanze?

Yego, muri rusange ni byiza kujyana umwana wawe ufite umuti w’umwijima hanze mu gihe gito, ariko ugomba kumurinda izuba ry’akataraboneka nk’uko wakora ku mwana uwo ari we wese wavutse. Nubwo izuba rifite umucyo ushobora gusenya bilirubine, si ubuvuzi bukoreshwa cyangwa butekanye bwo kuvura umuti w’umwijima kandi bishobora gutera umwana gucana cyangwa gushyuha cyane.

Niba ukeneye kujya hanze, komeza umwana wawe mu gicucu, umwambike imyenda ikwiye igihe, kandi ugabanye igihe azamara hanze. Ikintu cy’ingenzi ni ugukomeza kumwonsa kenshi no gukurikiza amabwiriza y’umuganga wawe yo gukurikirana no kuvura aho kwiringira izuba.

Ese umuti w’umwijima uzagira ingaruka ku iterambere ry’umwana wanjye cyangwa ku bwenge bwe?

Umuti w’umwijima usanzwe ku bana ufite ubugenzuzi bukwiye kandi uvuwe igihe bikenewe ntabwo ugira ingaruka ku iterambere ry’umwana wawe, ku bwenge bwe, cyangwa ku buzima bwe bw’igihe kirekire. Benshi mu bana bagira umuti w’umwijima bakura neza nta ngaruka zirambye ziterwa n’umuti w’umwijima bagize mu gihe cy’ubwana.

Ibiribwa bikabije, bitavuwe, bigera ku rugero rwo hejuru cyane rwa bilirubine bishobora gutera ibibazo by’iterambere. Niyo mpamvu gukurikirana umwana n’abaganga buri gihe ari ingenzi cyane - bituma ibibazo byose by’ibiribwa bisaba kuvurwa bimenyekana kandi bigacukumbuzwa mbere yuko byatera ingaruka. Hamwe n’ubuvuzi bukwiye, ushobora kwiringira ko iterambere ry’umwana wawe rizaba risanzwe.

Mbese nakangura umwana wanjye urwaye iribwa aryamye ngo ampe amashereka?

Yego, ugomba gukangura umwana wawe urwaye iribwa ngo ampe amashereka niba aryamye igihe kirekire cyane kurusha amasaha 3-4, cyane cyane mu gihe cy’umunsi. Iribwa rishobora gutuma abana baryama kurusha igihe gisanzwe, ariko guha amabere kenshi ni ingenzi mu gufasha gukuraho bilirubine no gukumira ibura ry’amazi, bishobora kurushaho kubije iribwa.

Gerageza guha amabere inshuro 8-12 mu masaha 24 yose mu cyumweru cya mbere cy’ubuzima. Kangurira umwana wawe witonze umukuramo ibishushanyo, umuvugishe utuje, cyangwa umukore ku itama witonze. Niba umwana wawe asa n’aho bigoye cyane kumukangurira cyangwa agaragaza inyota nke yo kunywa amata, hamagara umuganga wawe kuko bishobora kugaragaza ko urugero rwa bilirubine rugenda rurakomeye.