Chii chinonzi Congenital Diaphragmatic Hernia? Zviratidzo, Zvinokonzera, & Kurapa

Congenital diaphragmatic hernia (CDH), chirwere chinoitika panguva yekuzvarwa, chinoitika apo pane gomba mudiaphragm, tsandanyama inokubatsira kufema. Gomba iri rinobvumira kuti zvikamu zvemudumbu zvipinde mukati mechidziro, izvo zvinogona kuita kuti kufema kuve kwakaoma kune vacheche.

Fungidzira diaphragm yako semadziro akasimba anoparadzanisa chifuva nemuviri. Kana madziro aya aine gomba, zvikamu zvakaita sestomach kana matumbo zvinogona kupinda munzvimbo kwaifanira kuva mapapu. Chirwere ichi chinotapura anenge 1 kubva pa2,500 kusvika ku3,000 vacheche vanozvarwa.

Zviratidzo zveCongenital Diaphragmatic Hernia ndeapi?

Vacheche vakawanda vane CDH vanoratidza matambudziko ekufemera pashure pekuzvarwa. Zviratidzo zvinogona kubva pazvishoma kusvika pazvakanyanya, zvichienderana nekuti zvikamu zvakafambiswa zvinotora nzvimbo yakakura sei muchifuva.

Aya ndiwo maratidziro makuru aunogona kuona:

• Kufema kukurumidza, kwakaoma kana kunetseka kubata mweya
• Ruvara rweganda rwebhuruu kana grey, kunyanya kutenderera miromo neminwe
• Kutemwa kwemoyo kwakanyanya kukurumidza
• Chifuva chakaita sechigaba chinoita sekati chakapoterera
• Mudumbu unoita sekati wakadzika kana wakakombama
• Inzwi rekufema rakadzikira kurutivi rumwe rwechifuva

Vamwe vacheche vanogonawo kuva nematambudziko ekudyisa kana kuti vanoratidza kusagadzikana. Muzviitiko zvisingawanzoitika, CDH isina kukomba inogona kusaratidza zviratidzo zvinonyatsoonekwa kusvika gare gare muhudiki, apo mwana anogona kusangana nemarwadzo ekufemera kana matambudziko emudumbu.

Marudzi eCongenital Diaphragmatic Hernia ndeapi?

CDH ine marudzi akasiyana, zvichienderana nekuti gomba riri kupi mudiaphragm. Rudzi runowanzoitika rinonzi Bochdalek hernia, rinoitika kumashure nekurutivi rwe diaphragm.

Marudzi makuru anosanganisira:

• Bochdalek hernia: Inoumba anenge 85-90% yezviitiko, kazhinji inoitika kurutivi rwekere
• Morgagni hernia: Inoitika pamberi pe diaphragm, isingawanzoitika asi kazhinji isina kukomba
• Central diaphragmatic hernia: Isingawanzoitika, inoitika pakati pe diaphragm
• Eventration: Tsandanyama ye diaphragm inoshaya simba uye yakasimba pane kuva negomba

Hernias dziri kurutivi rwekere dzinoonekwa dzine ngozi kupfuura dzimwe nekuti kazhinji dzinosanganisira zvikamu zvakawanda zvichipinda muchifuva. Hernias dziri kurutivi rwerudyi hadziwanzoitika asi dzinogona kukonzera matambudziko makuru ekufemera.

Chii chinokonzera Congenital Diaphragmatic Hernia?

CDH inoitika apo diaphragm haina kuumbwa zvizere panguva yekuzvitakura. Izvi zvinoitika pakati pevhiki re8 ne12 rekuzvitakura, apo zvikamu zvemwana zvichiri kukura.

Chikonzero chaicho hachizivikanwi zvizere, asi vatsvakurudzi vanofunga kuti zvinogona kunge zviri musanganiswa wezvinhu zvemagariro ne zvekuzvarwa. Muzviitiko zvakawanda, hapana chikonzero chakajeka chekuti nei zvichiitika, uye haisi chinhu vabereki vakaita kana vasina kuita.

Zvimwe zvinhu zvinogona kuita kuti zviitike zvinosanganisira:

• Kuchinja kwemajini kana mutations anokanganisa kukura kwe diaphragm
• Chromosomal abnormalities senge trisomy 18 kana 13
• Nhoroondo yemhuri yeCDH, kunyange izvi zvisingawanzoitika
• Mishonga yakatorwa panguva yekuzvitakura
• Chirwere cheshuga cheamai kana mamwe mamiriro ezveutano

Zvakakosha kuziva kuti CDH inoitika zvisingatarisirwi muzviitiko zvakawanda. Kunyangwe kana uine mwana mumwe chete ane CDH, mukana wekuva nemwana mumwe ane chirwere chimwe chete uchiri wakaderera kwazvo.

Rini unofanira kuona chiremba nekuda kweCongenital Diaphragmatic Hernia?

CDH kazhinji inoonekwa usati wazvarwa panguva yekutarisa kwemazuva ose kwekuzvitakura, kazhinji anenge mavhiki 18-20. Chiremba wako anogona kuona kuti zvikamu zviri munzvimbo isiriyo kana kuti mapapu emwana achiita madiki pane zvakaonekwa.

Kuongororwa kunogona kusanganisira:

• Ultrasound yakadzama kuona nzvimbo yezvikamu
• Fetal MRI yemafomu akajeka
• Amniocentesis kuongorora mamiriro ejini
• Chest X-ray pashure pekuzvarwa kusimbisa chirwere
• Echocardiogram kuongorora kushanda kwemoyo
• Kuongororwa kweropa kuona mazinga okisijeni

Dzimwe nguva CDH haionekwi kusvika pashure pekuzvarwa, kunyanya muzviitiko zvisina kukomba. Timu yako yezvokurapa icha shandisa Chest X-rays nemamwe bvunzo dzekuongorora kuti iisimbisise chirwere uye kuronga kurapwa.

Zvinhu zvinogona kukonzera matambudziko muCongenital Diaphragmatic Hernia ndeapi?

Kunetseka kukuru neCDH ndekwekuti inogona kukanganisa kukura nekuita kwemapapu. Kana zvikamu zvemudumbu zvichitora nzvimbo muchifuva, mapapu anogona kusakurira zvakakwana kana kuti anogona kumanikidzwa.

Matambudziko anowanzoitika anosanganisira:

• Pulmonary hypoplasia (mapapu asina kukura zvakakwana)
• Persistent pulmonary hypertension (kumanikidzwa kwakanyanya kweropa mutsinga dzemapapu)
• Gastroesophageal reflux (asidhi yemudumbu ichidzoka)
• Matambudziko ekudyisa nekukura kwakaderera
• Kurasikirwa nekunzwa nekuda kwekutsigirwa kwenguva refu kweoksijeni
• Kukura kwakaderera muzviitiko zvakanyanya

Matambudziko asingawanzoitika asi ane ngozi anosanganisira matambudziko emoyo, itsvo, kana matambudziko eneurological. Nekudaro, nekurapwa kwakakodzera nekutarisa, vana vakawanda vane CDH vanokura vachirarama hupenyu hune hutano, hunoshanda.

Kurapwa kweCongenital Diaphragmatic Hernia ndekupi?

Kurapwa kweCDH kazhinji kunosanganisira kuvhiya kugadzirisa diaphragm, asi nguva inoenderana nemiriro yemwana wako. Timu yezvokurapa ichakutanga nekugadzirisa kufema nekutsigira mapapu usati wavhiya.

Matanho ekutanga ekurapa anosanganisira:

• Kutsigirwa kwekufema neventilator
• Mishonga inobatsira kumanikidzwa kweropa nekushanda kwemoyo
• Kudya kweIV sezvo kudya kunogona kuva kwakaoma
• Kutarisa munzvimbo yakasarudzika yekurapa vacheche

Kuvhiya kazhinji kunoitika kana mwana wako akagadzikana, kazhinji mukati memazuva mashoma kusvika mavhiki ekutanga ehupenyu. Chiremba achafambisa zvikamu zvakafambiswa kudzokera kumudumbu uye kugadzirisa gomba mu diaphragm. Dzimwe nguva patch inodiwa kana gomba rakakura.

Kupora kunoenderana nehukomba hwechirwere. Vamwe vacheche vanogona kuda kutsigirwa kwekufema, nepo vamwe vachipora nekukurumidza. Timu yako yezvokurapa icha shanda newe pedyo kuti utarise kufambira mberi uye kugadzirisa kurapwa sezvinodiwa.

Nzira yekupa hanya kumba panguva yekupora kweCongenital Diaphragmatic Hernia?

Vacheche vakawanda vane CDH vanopedza mavhiki kana mwedzi yakati wandei muchipatara vasati vadzokera kumba. Kana wadzokera kumba, unofanira kuramba uchipa hanya yakasarudzika kuti utsigire kupora kwemwana wako nekukura.

Kutarisa kumba kazhinji kunosanganisira:

• Kutevera maitiro ekudyisa nekutarisa kukura
• Kupa mishonga sezvakanyorwa
• Kutarisa maitiro ekufemera nemazinga okisijeni kana zvichidiwa
• Kuenda kune zvekutarisa nguva dzose
• Kutarisa zviratidzo zvematambudziko senge kunetseka kufema kana matambudziko ekudyisa
• Kuita kuti vakure zvakanaka nekurapa kwemuviri sezvakakurudzirwa

Timu yako yehutano icha kupa mirairo yakadzama nezvinhu zvekutsigira. Usanetseka kufona kana ukaona chero kuchinja mukufema kwemwana wako, kudya, kana mamiriro ose.

Ungagadzirira sei kuenda kuchiremba?

Kuve wakagadzirira kuenda kuchiremba kunogona kukubatsira kuti uwane zvakawanda kubva pakushanya kwako uye kuve nechokwadi chekuti zvinetso zvako zvose zvakagadziriswa. Nyora mibvunzo yako usati waenda kuti usakanganwa chinhu chakakosha.

Funga kugadzirira:

• Ruzivo rwezviratidzo zvese zviripo uye nguva zvakatanga
• Mibvunzo nezve nzira dzekurapa uye zvaunofanira kutarisira
• Ruzivo nezve nhoroondo yemhuri yezveutano
• Mishonga iripo nehuwandu
• Ruzivo rweinshurensi nepepa rekutumira
• Munhu anokutsigira kukubatsira kuyeuka ruzivo

Usatya kukumbira kuti zvinhu zvinonzwisisike kana mazwi ezvokurapa akanyanya kuoma. Timu yako yehutano inoda kuve nechokwadi chekuti unonzwisisa zvizere mamiriro emwana wako uye kuronga kurapwa.

Chii chinonyanya kukosha nezveCongenital Diaphragmatic Hernia?

CDH chirwere chakakomba asi chinorapika chinotapura tsandanyama ye diaphragm. Kunyange zvazvo ichida hanya yakasarudzika yezvokurapa nekuvhiya, vana vakawanda vane CDH vanorarama hupenyu hune hutano, hunowanzoitika nekurapwa kwakakodzera.

Chinhu chakakosha chokurangarira ndechekuti kuongororwa nekurapwa kwakakurumidza kunoita musiyano mukuru mumagumisiro. Kana CDH ikaonekwa panguva yekuzvitakura, timu yako yezvokurapa inogona kugadzirira kuberekwa nekutarisirwa kwemangwana. Nekufambira mberi kwetekinoroji yezvokurapa nematekiniki ekurapa, tarisiro yevacheche vane CDH inoramba ichivandudzika.

Rangarira kuti kesi imwe neimwe yakasiyana, uye timu yako yehutano icha shanda newe kuti uite kuronga kwakanakisa kwemwana wako. Gara wakabatana ne timu yako yezvokurapa, bvunza mibvunzo, uye usanetseka kukumbira rubatsiro kana uchida.

Mibvunzo inowanzo bvunzwa nezveCongenital Diaphragmatic Hernia

Congenital Diaphragmatic Hernia inogona kudzivirirwa here?

Parizvino, hapana nzira inozivikanwa yekudzivirira CDH sezvo inoitika panguva yekukura kwemwana. Kutora mavhitamini ekutanga kwekuzvitakura, kudzivisa zvinhu zvinokuvadza panguva yekuzvitakura, nekutarisira zvakanaka kwekuzvitakura zvinokurudzirwa nguva dzose kune hutano hwemwana, asi aya matanho haadziviriri CDH chaizvoizvo.

Chii chinonzi mukana wekupona wevacheche vane CDH?

Mugove wekupona weCDH wakavandudzika zvikuru mumakore achangopfuura uye ikozvino uri pakati pe70-90%, zvichienderana nehukomba hwechirwere. Vacheche vane CDH isina kukomba uye mapapu akakura vane magumisiro akanaka, nepo avo vane zviitiko zvakanyanya kukomba vanogona kusangana nematambudziko akawedzerwa asi vachine mukana wakanaka wekupona nekurapwa kwakakodzera.

Mwana wangu achada kutarisirwa nguva dzose mushure mekuvhiya kweCDH here?

Vana vakawanda vachada kutarisirwa nguva dzose kuti vatarisire basa remapapu, kukura, nekukura. Vamwe vanogona kuda kurapwa kuwedzerwa kwezvinetso senge gastroesophageal reflux kana matambudziko ekunzwa. Nekudaro, vana vakawanda vane CDH vanogona kuita mabasa akajairika sezvo vakakura, kusanganisira mitambo nemamwe mabasa emuviri.

CDH inogona kuitika zvakare mukuzvitakura kwemangwana here?

Ngozi yekuve nemwana mumwe ane CDH yakaderera kwazvo, kazhinji pasi pe2%. Kazhinji zviitiko zveCDH zvinoitika zvisingatarisirwi uye hazvina kuwanikwa. Nekudaro, kana paine zvinhu zvemajini zvinobatanidzwa, chiremba wako anogona kukurudzira mazano ejini kuti akurukure mamiriro ako chaiwo uye chero sarudzo dzekuongorora.

Nguva yakareba sei mushure mekuzvarwa kuvhiya kweCDH kunoitika?

Nguva yekuvhiya inoenderana nemiriro yemwana wako. Vamwe vacheche vanoda kuvhiya mukati memazuva mashoma ekutanga ehupenyu, nepo vamwe vachigona kumirira mavhiki mashoma kusvika vagadzikana. Timu yezvokurapa ichakutanga nekutsigira kufema nehutano hwese usati waenderera mberi nekuvhiya kugadzirisa diaphragm.