Spina Bifida

I-Spina bifida yisimo esenzeka lapho umgogodla nomgogodla womgogodla ungakhiwa kahle khona. Luhlobo oluthile lokusilela komgudu we-neural. Umgudu we-neural yisakhiwo esikhulayo embonini elikhula elikhula libe yingqondo yengane nomgogodla womgogodla kanye nezinsimbi eziwabekela. Ngokuvamile, umgudu we-neural uqala ekuqaleni kokukhulelwa futhi uvala ngosuku lwe-28 ngemuva kokutholakala. Ezinganeni ezine-spina bifida, ingxenye yomgudu we-neural ayivalwa ngokuphelele. Lokhu kuchaphazela umgogodla womgogodla namagagasi omgogodla. I-Spina bifida ingaba ukusuka kokulula kuya ekubeni yizimbangela zokukhubazeka okukhulu. Izimpawu ziyahluka kuye ukuthi ukuvulwa kusekuphi emgogodleni nobukhulu bayo. Izimpawu ziphinde ziyehluke kuye ukuthi umgogodla womgogodla nezinzwa zihilelekile yini. Uma kunesidingo, ukwelashwa kwasekuqaleni kwe-spina bifida kuhilela ukuhlinzwa. Noma kunjalo, ukuhlinzwa akuhlali kuphinda kubeka kahle umsebenzi olahlekile. I-Spina bifida ivela ngezinhlobo ezahlukene: i-spina bifida occulta, i-myelomeningocele (my-uh-lo-muh-NING-go-seel) noma uhlobo oluyimfihlo kakhulu, i-meningocele (muh-NING-go-seel). I-Occulta isho ukufihla. I-Spina bifida occulta yilona uhlobo oluthambile kakhulu futhi oluvamile. Lolu hlobo lwe-spina bifida lubangela ukwahlukana okuncane noma isikhala esisodwa noma ngaphezulu kwamagagasi omgogodla, okuthiwa yi-vertebrae. Abantu abaningi abane-spina bifida occulta abazi ukuthi bayinawo. Kungatholakala ngesikhathi sokuhlolwa kwezithombe njengoba i-X-ray yenziwa ngenye isizathu. I-Myelomeningocele yilona uhlobo olukhulu kunazo zonke. Kuyaziwa nangokuthi yi-spina bifida evulekile. Umgudu womgogodla uvulekile emagagasini amaningana emuva ophansi noma ophakathi. Ingxenye yomgogodla womgogodla, kufaka phakathi ukumbozwa okuvikelayo komgogodla womgogodla nezinzwa zomgogodla, cindezela ngalolu vulwa lapho izalwa, yakha isikhwama emuva lengane. Izicubu nezinzwa ngokuvamile zivelile. Lokhu kwenza ingane ibe sengozini yokutheleleka okubi. Lolu hlobo lungabangela ukulahleka kokunyakaza ezinyaweni, kanye nokusebenza okungalungile kwesisu nomgudu. Lolu uhlobo oluyimfihlo lwe-spina bifida. Kulolu hlobo, isikhwama se-spinal fluid siphuma ngokuphuma emgogodleni. Azikho izinzwa ezihilelekile futhi umgogodla womgogodla awukho esikhwama se-fluid. Izingane ezine-meningocele zingaba nezinye izinkinga ezincane ngokusebenza, kufaka phakathi isisu nomgudu.

Izimpawu ze-spina bifida ziyahlukahluka ngohlobo nangomuntu ngamunye. I-Spina bifida occulta. Ngokuvamile, azikho izimpawu ze-spina bifida occulta ngoba amandla omgogodla awathinteki. Kodwa ngezinye izikhathi ungabona izimpawu ezikhulekeni yengane esanda kuzalwa ngaphezu kwesikhala esincane emgogodleni. Ungabona iqoqo lenwele, i-dimple encane noma uphawu lokuzalwa. Ngezinye izikhathi, lezi zimpawu zesikhumba zingaba yizimpawu zenkinga yomgogodla ongafunyanwa nge-MRI noma i-ultrasound yomgogodla kwingane esanda kuzalwa. I-Meningocele. Lolu hlobo lungathinta umsebenzi we-bladder kanye newe-bowel. I-Myelomeningocele. Kulolu hlobo olukhulu kunawo wonke lwe-spina bifida, umgogodla uhlala uvulekile emadolweni ambalwa ngasemva. Imembranesi nengxenye yomgogodla noma amandla aphuma lapho kuzalwa, kwakha isikhwama. Izicubu namandla ngokuvamile aveziwe, nakuba ngezinye izikhathi isikhumba sihlanganisa isikhwama. Izingane ezinolu hlobo lwe-spina bifida zingaba nezinselele ngomsebenzi we-bladder kanye newe-bowel. Zingase futhi zibhekane nobuthakathaka noma ukungabi khona kokunyakaza ezinyaweni. Izingane zingaba nokubunjwa koketshezi ebuchosheni okuthiwa yi-hydrocephalus okungase kubeka uxinzelelo ezicutini zobuchopho. Ngokuvamile, i-myelomeningocele ibonakala ngaphambi noma ngemuva nje kokuzalwa, lapho kunokunakekelwa kwezokwelapha. Izingane ezitholakala zine-spina bifida kufanele zilandelelwe yiqembu elikhethekile labachwepheshe bezempilo ekuphileni kwazo konke. Imindeni ingafundiswa ngezinkinga ezahlukene okumele iziqaphele. Izingane ezine-spina bifida occulta ngokuvamile azinazimpawu noma izinkinga. Kulezi zingane, ngokuvamile kunakekelwa okwejwayelekile kwezingane kuphela okudingekayo.

Ngokuvamile, i-myelomeningocele ihlonishwa ngaphambi kokubeleka noma ngokushesha ngemva kokubeleka, uma kunesikhathi sokufumana ukunakekelwa kwezokwelapha. Abantwana abatholakale benalesimo kufanele balandelelwe yiqembu elikhethekile labachwepheshe bezempilo ekuphileni kwabo konke. Imindeni ingafundiswa ngezinkinga ezahlukene okumele zibhekwe. Abantwana abane-spina bifida occulta ngokuvamile abanawo ubuhlungu noma izinkinga. Kulababantwana, ngokuvamile kunakekelwa okwejwayelekile kwezingane kuphela okudingekayo.

Imbangela ye-spina bifida ayaziwa. Kucatshangelwa ukuthi ukuxubana kwezinto eziyingozi ezivela kubuchwepheshe, ukudla nokusingqongileyo kubangela le meko. Lokhu kuhlanganisa ukuba nomlando womndeni weziphene ze-neural tube nokufumana i-folate encane kakhulu, eyaziwa nangokuthi yi-vitamin B-9, ngesikhathi sokukhulelwa.

I-Spina bifida ivame kakhulu kubantu baseHispanic kanye nabantu abamhlope. Futhi, izingane ezingemantombazane zithinteka kakhulu kunabantwana abayizilwane. Nakuba ochwepheshe bezempilo nabacwaningi abazi ukuthi kungani i-spina bifida ivela, baye baqaphela ezinye izimbangela ezingozi:

• Ukuncane kwe-folate emzimbeni womuntu okhulelwe. I-folate, uhlobo oluvamile lwe-vitamin B-9, kubalulekile ekukhuleni kwengane enempilo. I-folic acid uhlobo oluyimishini olutholakala ekudleni okunamandla. Uma amazinga e-folate ephansi kakhulu, kwaaziwa njengokuntuleka. Ukuntuleka kwe-folate kukhuphula ingozi ye-spina bifida nezinye izimo ezithinta i-neural tube.
• Umlando womndeni we-neural tube defects. Ukuba nengane eyodwa enesimo esithinta i-neural tube kukhuphula kancane amathuba okuba nengane enye enesimo esifanayo. Ingozi ikhuphuka nakakhulu uma abantwana ababili bangaphambili bethonyeke yilesimo.

Futhi, ukuzalwa une-neural tube defect kukhuphula amathuba okubeletha ingane enespin bifida. Noma kunjalo, izingane eziningi ezinespina bifida zizalwa kubazali abangenayo imlando yomndeni yalesimo.

• Eminye imithi. Ukuthatha imithi yokulwa nokuhlwitha njenge-valproic acid ngesikhathi sokukhulelwa kukhuphula ingozi yokuba nengane enespin bifida. Lokhu kungenzeka ngoba imithi iphazamisa ikhono lomzimba lokusebenzisa i-folate ne-folic acid.
• Ukuhlushwa yi-Diabetes. Ukuba ne-diabetes engalawulwa kahle ngaphambi kokukhulelwa kukhuphula ingozi yokuba nengane enespin bifida.
• Ukukhuluphala. Ukukhuluphala ngesikhathi sokukhulelwa futhi kuhlotshaniswa nengozi eyenyuke kakhulu ye-spina bifida.
• Ukushisa komzimba okuphezulu. Ezinye izibonakaliso zikhomba ukuthi ukushisa komzimba okuphezulu emasontweni okuqala okukhulelwa kungase kukhuphule ingozi ye-spina bifida. Ukushisa komzimba okuphezulu kungabangelwa yisifo sikashukela noma ngokusebenzisa i-sauna noma i-hot tub.

Umlando womndeni we-neural tube defects. Ukuba nengane eyodwa enesimo esithinta i-neural tube kukhuphula kancane amathuba okuba nengane enye enesimo esifanayo. Ingozi ikhuphuka nakakhulu uma abantwana ababili bangaphambili bethonyeke yilesimo.

Futhi, ukuzalwa une-neural tube defect kukhuphula amathuba okubeletha ingane enespin bifida. Noma kunjalo, izingane eziningi ezinespina bifida zizalwa kubazali abangenayo imlando yomndeni yalesimo.

Uma unazo izimbangela ezingozi ze-spina bifida, xoxa nochwepheshe wakho wezempilo. Ungadinga umthamo omkhulu noma umthamo we-folic acid, ngisho nangaphambi kokukhulelwa.

Futhi tshela uchwepheshe wakho wezempilo mayelana nayo yonke imithi oyithathayo. Uma uhlela kusengaphambili, eminye imithi ingalungiswa ukuze iphansi ingozi engozi ye-spina bifida.

I-Spina bifida lingabangela izimpawu ezincane noma ingabangela izimo zempilo ezingathi sína. Izimpawu zithinteka yi:

• Ubukhulu nendawo yokuvuleka emgogodleni.
• Uma isikhumba sihlanganisa indawo ethintekayo.
• Yiziphi izinzwa zomgogodla eziphuma endaweni ethintekayo yomgogodla.

Inani lezingxaki lingathinta abantwana abane-spina bifida. Kodwa-ke akuwona wonke abantwana abatholakala nazo zonke lezi zingxaki. Izinkinga eziningi zingaphathwa.

• Izinkinga zokuhamba nokuhamba. Izinzwa eziqondisa imisipha yemilenze azisebenzi kahle ngaphansi kwendawo yomgogodla ethintekayo. Lokhu kungabangela ubuthakathaka bemisipha yemilenze. Ngezinye izikhathi kungabangela ukulahleka kokunyakaza, okwaziwa ngokuthi i-paralysis. Uma ingane ingahamba yixhomeke endaweni yomgogodla ethintekayo nobukhulu bokuvula emgqeni we-neural. Ikhono lokuhamba liphinde lixhomeke ekunakekelweni okwamukelwayo ngaphambi nangemva kokuzalwa.
• Ukuhlupheka kwe-Orthopedic. Abantwana abane-myelomeningocele bangaba nezingxaki eziningi ezinyaweni nasemgogodleni ngenxa yemisipha ebuthakathaka. Izingxaki zixhomeke endaweni yomgogodla ethintekayo. Izingxaki ze-orthopedic ezingase zibe khona zingafaka:
  • Umgogodla oqondile, owaziwa ngokuthi i-scoliosis.
  • Izinguquko ezingavamile, njengenyawu ebheke ngaphakathi, eyaziwa ngokuthi i-clubfoot.
  • Ukukhishwa kwe-hip.
  • Isimo sethambo nezinhlangothi.
  • Imisipha emifushane, eqinile, eyaziwa ngokuthi i-muscle contractures.
• Umgogodla oqondile, owaziwa ngokuthi i-scoliosis.
• Izinguquko ezingavamile, njengenyawu ebheke ngaphakathi, eyaziwa ngokuthi i-clubfoot.
• Ukukhishwa kwe-hip.
• Isimo sethambo nezinhlangothi.
• Imisipha emifushane, eqinile, eyaziwa ngokuthi i-muscle contractures.
• Izimpawu ze-Bowel ne-bladder. Izinzwa ezinikeza i-bladder ne-bowel ngokuvamile azisebenzi kahle kubantwana abane-myelomeningocele. Ngenxa yalokho, abakwazi ukulawula i-bowel noma i-bladder. Lokhu kungenxa yokuthi izinzwa ezinikeza i-bowel ne-bladder zivela ezingeni eliphansi lomgogodla.
• Ukubunjwa kwe-fluid ebuchosheni, okwaziwa ngokuthi i-hydrocephalus. Izingane ezizalwa ne-myelomeningocele ngokuvamile ziba nokuqongelela kwe-fluid ebuchosheni. Lesi simo siwaziwa ngokuthi i-hydrocephalus.
• Ukuphazamiseka kwe-shunt. I-shunts ebekwe ebuchosheni ukuze ikhiphe i-hydrocephalus ingase iyeke ukusebenza noma ibe nokutheleleka. Izimpawu zokuqapha zingase zihluke. Ezinye zezimpawu zokuqapha ze-shunt engasebenzi kahle zifaka:
  • Izinhlungu zikhanda.
  • Ukugabha.
  • Ubuthakathaka.
  • Ukucasuka.
  • Ukukhula noma ubomvu eceleni kwe-shunt.
  • Ukuphazamiseka.
  • Izinguquko emehlweni, njengokubuka phansi okuqondile.
  • Ukuphazamiseka kokudla.
  • Ukubamba.
• Izinhlungu zikhanda.
• Ukugabha.
• Ubuthakathaka.
• Ukucasuka.
• Ukukhula noma ubomvu eceleni kwe-shunt.
• Ukuphazamiseka.
• Izinguquko emehlweni, njengokubuka phansi okuqondile.
• Ukuphazamiseka kokudla.
• Ukubamba.
• Ukutheleleka emathinini awokuzungezile ubuchopho, okwaziwa ngokuthi i-meningitis. Ezinye izingane ezine-myelomeningocele zingase zithole ukutheleleka emathinini awokuzungezile ubuchopho. Lokhu kutheleleka okunga yingozi kungabangela ukulimala kobuchopho.
• Umgogodla oqoshwe. Umgogodla oqoshwe yilapho izinzwa zomgogodla zibopha kuma-tissue futhi zolule. Lokhu kungenzeka nge-scar tissue ephuma ekuhlinzweni. Uma umgogodla uqoshwe, awukwazi ukukhula njengoba ingane ikhula. Kungabangela ukulahleka komsebenzi wemisipha ezinyaweni, i-bowel noma i-bladder. Ukuhlinzwa kunganciphisa izinga lokukhubazeka.
• Ukuphumula okuphazamisekileyo kokuphefumula. I-sleep apnea noma ezinye izimo zokulala zingathinta kokubili abantwana nabantu abadala abane-spina bifida, ikakhulu labo abane-myelomeningocele. Kungase kudingeke bahlolwe ukuze babone ukuthi bayeka ukuphefumula okwesikhashana izikhathi eziningi ngesikhathi sokulala, okwaziwa ngokuthi i-sleep apnea. Ukuthola ukwelashwa kungathuthukisa impilo kanye nekwalithi yokuphila.
• Izinkinga zesikhumba. Abantwana abane-spina bifida bane-feeling encane ezingxenyeni ezithile zemizimba yabo futhi bangase bathole amanxeba ezinyaweni, emilenzeni, emathangeni noma emikhakheni. Ama-blisters noma ama-sores angaguquka abe yizilonda ezijulile noma ukutheleleka kwenyawo okunzima ukuyiphatha. Abantwana abane-myelomeningocele banengozi enkulu yokuthuthukisa izilonda ezikhishini.
• Ukutheleleka kwe-Latex. Abantwana abane-spina bifida banengozi enkulu yokuthola ukusabela okungafani nemikhiqizo ye-rubber noma ye-latex. Ukutheleleka kwe-latex kungabangela isihlungu, ukuthimula, ukukhahlela, amehlo amanzi nekhala. Kungabangela nesimo esinga yingozi lapho ubuso nezinhlangothi ziqhuma futhi kwenze kube nzima ukuphefumula, okwaziwa ngokuthi i-anaphylaxis. Kungcono ukusebenzisa i-latex-free gloves nama-equipment ngesikhathi sokubeletha futhi lapho unakekela ingane ene-spina bifida.
• Umgogodla oqondile, owaziwa ngokuthi i-scoliosis.
• Izinguquko ezingavamile, njengenyawu ebheke ngaphakathi, eyaziwa ngokuthi i-clubfoot.
• Ukukhishwa kwe-hip.
• Isimo sethambo nezinhlangothi.
• Imisipha emifushane, eqinile, eyaziwa ngokuthi i-muscle contractures.
• Izinhlungu zikhanda.
• Ukugabha.
• Ubuthakathaka.
• Ukucasuka.
• Ukukhula noma ubomvu eceleni kwe-shunt.
• Ukuphazamiseka.
• Izinguquko emehlweni, njengokubuka phansi okuqondile.
• Ukuphazamiseka kokudla.
• Ukubamba.

Unganciphisa kakhulu ingozi yokuba nezingane ezine-spina bifida noma ezinye izifo ze-neural tube ngokuthatha izithasiselo ze-folic acid. Qala ukuthatha izithasiselo okungenani inyanga ngaphambi kokukhulelwa bese uqhubeka uzithatha kuze kube sekupheleni kwekota yokuqala yokukhulelwa. Ukuba ne-folic acid eyanele emzimbeni wakho ekuqaleni kwamasonto okukhulelwa kubalulekile ukuvimbela i-spina bifida. Kodwa abantu abaningi abakwazi ukuthi bakhulelwe kuze kube yileso sikhathi. Ngenxa yalesi sizathu, ochwepheshe bayaluleka ukuthi bonke abantu abaseminyakeni yokuzala bathathe isithasi selanga le-400 micrograms (mcg) le-folic acid. Kusiza futhi ukudla ukudla okune-folate noma okune-folic acid eyongezwe kuwo, okuyaziwa ngokuthi ukunamathisela. Ukudla okunamathiselwe i-folic acid kufaka phakathi:

• Isinkwa esicebile.
• I-Pasta.
• Urayisi.
• Ezinye izitsha zokudla zokudla kwasekuseni. i-Folic acid ingabhalwa kumapakethi okudla njenge-folate, okuyifomu yemvelo ye-folic acid etholakala ekudleni. Abantu abadala abaqondisa ukukhulelwa noma abangase bakhulelwe badinga ukuthola i-400 kuya ku-800 mcg ye-folic acid ngosuku. Umzimba awuyithathi kalula i-folate njengoba uthola i-folic acid, futhi abantu abaningi abayitholi inani le-folate eliyisibonelo ngokudla kuphela. Izithasiselo zevithamini eziqukethe i-folic acid kuyadingeka ukuvimbela i-spina bifida. Kungenzeka futhi ukuthi i-folic acid ingasiza ekuphuculeni ingozi yezinye izimo ezingase zibe khona ngesikhathi sokuzalwa. Lezi zimo zihlanganisa i-cleft lip, i-cleft palate nezinye izimo zenhliziyo. Kuyinto enhle futhi ukudla ukudla okunempilo okuhlanganisa ukudla okunengiwe nge-folate noma okunamathiselwe i-folic acid. Le vithamini ikhona ngokwemvelo ezindlini eziningi zokudla, kufaka phakathi:
• Amabhinca nama-pea.
• Izithelo ze-citrus namajusi.
• Ama-yolk amaqanda.
• Ubisi lwenkomo.
• Ama-Avocados.
• Imifino eluhlaza okwesibhakabhaka, njenge-broccoli ne-spinach. Uma une-spina bifida noma uma uke wazala ingane ene-spina bifida, udinga i-folic acid eyengeziwe ngaphambi kokuba ukhulelwe. Uma uthatha imithi yokuthambisa ukuhlwitha noma une-diabetes, ungase uzuze ngenani elikhulu lale vithamini B. Xhumana nochwepheshe wakho wezokunakekelwa kwezempilo ngaphambi kokuthatha izithasiselo ze-folic acid ezengeziwe.

Izivivinyo ngaphambi kokuzalwa kwengane, ezibizwa ngokuthi ukucubungula ngaphambi kokuzalwa, zingahlola i-spina bifida nezinye izimo. Izivivinyo aziphelele. Abanye abantu abanezivivinyo zegazi ezizwakalayo banezingane ezingenayo i-spina bifida. Ngisho noma imiphumela ingalungile, kusasekhona ithuba elincane lokuthi i-spina bifida ikhona. Xoxa nodokotela wakho mayelana nokuhlolwa ngaphambi kokuzalwa, ingozi yalo nokuthi imiphumela isho ukuthini. Izivivinyo zegazi I-spina bifida ingahlolwa ngezivivinyo zegazi ngesikhathi sokukhulelwa, kodwa ngokuvamile ukuxilongwa kwenziwa ngokuhlolwa kwe-ultrasound. Ukuhlolwa kwe-Maternal serum alpha-fetoprotein (MSAFP). Ekwenzeni ukuhlolwa kwe-MSAFP, isampula legazi lithathiwe futhi lihlolwe i-alpha-fetoprotein (AFP). Lena iprotheni eyenziwa yingane. Kuvamile ukuthi inani elincane le-AFP liwele endaweni yokuhlukanisa futhi liye egazini lomzali okhulelwe. Kepha amazinga aphezulu e-AFP aphakamisa ukuthi ingane ingaba nokuphazamiseka komchamo we-neural njenge-spina bifida. Noma kunjalo, amazinga aphezulu e-AFP awenziwa njalo yi-spina bifida. Ukuhlolwa ukuqinisekisa amazinga aphezulu e-AFP. Amazinga ahlukahlukene e-AFP angabangelwa ezinye izinto ezifana nokulinganisela okungalungile kobukhulu bengane engakazalwa noma ukuba khona kwezingane eziningi. Ungase udinga ukuhlolwa kwegazi okulandelayo ukuqinisekisa imiphumela. Uma amazinga e-AFP esaphezulu, udinga ukuhlolwa okuqhubekayo, kufaka phakathi ukuhlolwa kwe-ultrasound. Ezinye izivivinyo zegazi. Udokotela wakho angenza ukuhlolwa kwe-MSAFP ngezinye izivivinyo ezimbili noma ezintathu. Lezi zivivinyo ziqapha ezinye izimo, ezifana ne-trisomy 21 syndrome, eyaziwa nangokuthi i-Down syndrome. Zivame ukwenziwa ngokuhlolwa kwe-MSAFP. I-Ultrasound I-ultrasound iyindlela enembile kunazo zonke yokuxilonga i-spina bifida engwaneni yakho ngaphambi kokubeletha. Ngesikhathi sokukhulelwa, i-ultrasound ingenziwa emasontweni angu-11 kuya kwangu-14 okuqala kokukhulelwa, okuyaziwa ngokuthi i-trimester yokuqala. Noma ingenziwa emasontweni angu-18 kuya kwangu-22, okuyaziwa ngokuthi i-trimester yesibili. I-spina bifida ingaxilongwa ngokunembile ngesikhathi sokwenziwa kokuhlolwa kwe-ultrasound kwe-trimester yesibili. Lokhu kuhlolwa kubalulekile ekuqondeni nasekuqedeni izimo ezingase zibe khona ngesikhathi sokuzalwa. I-ultrasound ephambili ingathola izimpawu ze-spina bifida, njengokuvuleka komgogodla noma izici ebuchosheni bengane. Ngezinye izikhathi i-ultrasound ingasiza nodokotela wakho ukubona ukuthi i-spina bifida iyingozi kangakanani. I-Amniocentesis Uma i-ultrasound ngaphambi kokuzalwa iqinisekisa ukuxilongwa kwe-spina bifida, udokotela wakho angacela ukuhlolwa okuthiwa yi-amniocentesis. Ngesikhathi salo mvivinyo, inhlanzi isebenzisa ukususa isampula yephunga elivela esikhwameni se-amniotic esizungezile ingane. Lokhu kuhlolwa kungase kubaluleke ekuphepheni izifo ze-genetic. Xoxa nodokotela wakho mayelana nezingozi ezingase zibe khona ze-amniocentesis. Kukhona ingozi encane yokulahlekelwa ukukhulelwa. Ukunakekelwa eMayo Clinic Iqembu lethu lochwepheshe beMayo Clinic elinakekelayo lingakusiza ngezinkinga zakho zempilo ezihlobene ne-spina bifida Qala Lapha Ulwazi Olwengeziwe Ukunakekelwa kwe-spina bifida eMayo Clinic I-Amniocentesis I-Ultrasound

Ukwelapha i-spina bifida kuncike ekuthini isimo sibuhlungu kangakanani engwaneni yakho. I-spina bifida occulta ngokuvamile ayidingi ukwelashwa nhlobo, kodwa ezinye izinhlobo ze-spina bifida ziyadingeka.

Ukusebenza kwama-nerve ezinganeni ezine-spina bifida kungaba sibi uma kungelaphiwe. Ukuhlinzwa kwangaphambi kokubeletha kwe-spina bifida, okwaziwa nangokuthi ukwelapha kwesisu, kwenzeka ngaphambi kwamasonto angu-26 okukhulelwa. Odokotela abenza ukuhlinzwa bavula isisu somuntu okhulelwe bese bevula isibeletho, esaziwa nangokuthi i-uterus. I-spinal cord yengane engakazalwa ilulungiswa. Khona-ke udokotela ohlinzayo uvala i-uterus nesisu. Ngezinye izikhathi le nqubo ingenziwa ngendlela engathinti kakhulu ngesixhobo sokuhlinzwa esikhethekile esibizwa nge-fetoscope. Izixhobo zifakwa e-uterus ngezikhala ezincane ukuze kwenziwe ukuhlinzwa engwaneni engakazalwa.

Ucwaningo lubonisa ukuthi izingane ezine-spina bifida ezinokuhlinzwa kwesisu zingaba nakukhubazeka okuncane futhi kungenzeka zingadingi izinti noma ezinye izinto zokuhamba. Ukuhlinzwa kwesisu kunganciphisa nezingozi ze-hydrocephalus. Buza ochwepheshe bakho bezempilo ukuthi le nqubo ingaba yilungele wena yini. Buza ngezinzuzo ezingaba khona. Buza futhi ngezingozi kuwe nengane yakho, njengokubeletha kwangaphambi kwesikhathi nezinye izinkinga.

Kubalulekile ukuba nokulingwa okubanzi ukuze kunqunywe ukuthi ukwelapha kwesisu kungenziwa yini. Lokhu kuhlinzwa okukhethekile kufanele kwenziwe kuphela esikhungweni sezempilo esinaochwepheshe abanolwazi lokuhlinzwa kwesisu, iqembu lemithamo eminingi nokunakekelwa okuqine kakhulu kwengane. Ngokuvamile, iqembu lihlanganisa udokotela ohlinzayo, udokotela we-neurosurgeon wezingane, ochwepheshe bezokwelapha abakhulelwe, udokotela we-fetal cardiologist no-neonatologist.

Izingane eziningi ezine-myelomeningocele zivame ukuba sesimweni sokuqala ngezinyawo, okwaziwa ngokuthi i-breech. Ukubeletha ngoCesarean kungaba yindlela ephephile yokubeletha uma ingane yakho i-breech noma inecyst enkulu noma isikhwama.

I-Myelomeningocele idinga ukuhlinzwa ukuze kuvalwe ukuvulwa emuva kwengane phakathi kwamahora angu-72 ngemva kokuzalwa. Ukuhlinzwa okusheshayo kungasiza ekuqedeni ingozi yokutheleleka ehlobene nama-nerve avuliwe. Kungasiza futhi ekuvikeleni i-spinal cord ekulimala okwengeziwe.

Phakathi nenqubo, udokotela we-neurosurgeon ubeka i-spinal cord nezinye izicubu ezivuliwe emzimbeni wengane bese ezivala ngemisipha nokwesikhumba. Ngesikhathi esifanayo, udokotela we-neurosurgeon angafaka i-shunt ebuchosheni bengane ukuze alawule i-hydrocephalus.

Ezinganeni ezine-myelomeningocele, ukonakala kwama-nerve okungenakulungiswa kungenzeka sekwenzeke e-uterus. Ukunakekelwa okuqhubekayo yiqembu lemithamo eminingi labahlinzayo, odokotela nabaphathi bevame ukudingeka. Izingane ezine-myelomeningocele zingadinga ukuhlinzwa okwengeziwe ngenxa yezinhlungu. Izinhlungu zingabandakanya imilenze ebuthakathaka, izinkinga zesibindi nesisu, noma i-hydrocephalus. Ukwelashwa ngokuvamile kuqala ngokushesha ngemva kokuzalwa.

Izindlela zokwelapha zingabandakanya:

• Izinto zokuhamba nokuhamba. Ezinye izingane zingaqala ukuzivocavoca ukuze zilungiselele imilenze yazo ukuhamba ngama-brace noma izinti lapho izingane zikhulu. Ezinye izingane zingadinga ama-walkers noma i-wheelchair. Izinto zokuhamba, kanye ne-physical therapy ejwayelekile, zingasiza ingane ibe yiyona. Ngisho nezingane ezidinga i-wheelchair zingafunda ukusebenza kahle futhi zibe ngezizimele.
• Ukuphathwa kwesisu nesibindi. Ukulingwa okujwayelekile nokuphathwa kwesisu nesibindi kusiza ekuqedeni ingozi yokonakala kwamalungu nomkhuhlane. Ukulingwa kubandakanya i-X-rays, ukuskena kwamalunga, i-ultrasounds, ukuhlolwa kwegazi nokufunda ukusebenza kwesisu. Lezi zilingo zivame kakhulu eminyakeni embalwa yokuqala yokuphila futhi zenziwa kancane njengoba izingane zikhula. Ochwepheshe bezokwelapha i-urology yezingane abanokuhlangenwe nakho ekwenzeni ukuhlinzwa ezinganeni ezine-spina bifida bangase banikeze izinketho zokuphatha ezisebenzayo kakhulu.

Ukuphathwa kwesisu kungabandakanya imithi yomlomo, ama-suppositories, ama-enemas, ukuhlinzwa noma ukuhlanganiswa kwalezi zindlela. Ukuphathwa kwesisu kungabandakanya imithi, ama-catheters okuvala isisu, ukuhlinzwa noma ukuhlanganiswa kokwelashwa.

• Ukuhlinzwa kwe-hydrocephalus. Izingane eziningi ezine-myelomeningocele zidinga ukuhlinzwa ukuze kubeke i-tube evumela uketshezi ebuchosheni ukuze ligeleze kwenye ingxenye yomzimba. I-tube ibizwa nge-ventricular shunt. Ingafakwa ngokushesha ngemva kokuzalwa, ngesikhathi sokuhlinzwa ukuze kuvalwe isikhwama emuva. Noma ingafakwa kamuva njengoba uketshezi lukhula.

Inqubo engathinti kakhulu ebizwa nge-endoscopic third ventriculostomy iyinketho kwabanye abantwana. Kodwa kufanele kuhlangatshezwe izindinganiso ezithile ngaphambi kokuba le nqubo yenziwe. Udokotela ohlinzayo usebenzisa ikhamera encane yevidiyo ukuze abone ngaphakathi ebuchosheni. Udokotela ohlinzayo bese enza umgodi ezansi noma phakathi kwamakhamera ebuchosheni. Lokhu kuvumela uketshezi lwe-cerebrospinal fluid ukuthi ligeleze ebuchosheni.

• Ukuphathwa nokulawulwa kwezinye izinkinga. Imishini ekhethekile efana nama-bath chairs, ama-commode chairs nama-standing frames angasiza ekusebenzeni kwansuku zonke. Izinkinga eziningi ze-spina bifida zingaphathwa noma zilawulwe ukuze kuthuthukiswe ikhwalithi yokuphila. Lokhu kubandakanya izinkinga ze-orthopedic, i-tethered spinal cord, izinkinga ze-GI, izimo zesikhumba nezinye izinkinga.

Ukuphathwa kwesisu nesibindi. Ukulingwa okujwayelekile nokuphathwa kwesisu nesibindi kusiza ekuqedeni ingozi yokonakala kwamalungu nomkhuhlane. Ukulingwa kubandakanya i-X-rays, ukuskena kwamalunga, i-ultrasounds, ukuhlolwa kwegazi nokufunda ukusebenza kwesisu. Lezi zilingo zivame kakhulu eminyakeni embalwa yokuqala yokuphila futhi zenziwa kancane njengoba izingane zikhula. Ochwepheshe bezokwelapha i-urology yezingane abanokuhlangenwe nakho ekwenzeni ukuhlinzwa ezinganeni ezine-spina bifida bangase banikeze izinketho zokuphatha ezisebenzayo kakhulu.

Ukuphathwa kwesisu kungabandakanya imithi yomlomo, ama-suppositories, ama-enemas, ukuhlinzwa noma ukuhlanganiswa kwalezi zindlela. Ukuphathwa kwesisu kungabandakanya imithi, ama-catheters okuvala isisu, ukuhlinzwa noma ukuhlanganiswa kokwelashwa.

Ukuhlinzwa kwe-hydrocephalus. Izingane eziningi ezine-myelomeningocele zidinga ukuhlinzwa ukuze kubeke i-tube evumela uketshezi ebuchosheni ukuze ligeleze kwenye ingxenye yomzimba. I-tube ibizwa nge-ventricular shunt. Ingafakwa ngokushesha ngemva kokuzalwa, ngesikhathi sokuhlinzwa ukuze kuvalwe isikhwama emuva. Noma ingafakwa kamuva njengoba uketshezi lukhula.

A nqubo engathinti kakhulu ebizwa nge-endoscopic third ventriculostomy iyinketho kwabanye abantwana. Kodwa kufanele kuhlangatshezwe izindinganiso ezithile ngaphambi kokuba le nqubo yenziwe. Udokotela ohlinzayo usebenzisa ikhamera encane yevidiyo ukuze abone ngaphakathi ebuchosheni. Udokotela ohlinzayo bese enza umgodi ezansi noma phakathi kwamakhamera ebuchosheni. Lokhu kuvumela uketshezi lwe-cerebrospinal fluid ukuthi ligeleze ebuchosheni.

Izingane ezine-spina bifida zidinga ukunakekelwa okuqhubekayo nokuqapha. Ochwepheshe bezempilo babo bahlola ukukhula kwabo, isidingo se-vaccinations nezinkinga zezokwelapha ezijwayelekile. Ukunakekelwa kwezokwelapha kuhlanganiswe phakathi kwabachwepheshe.

Izingane ezine-spina bifida zivame ukudinga ukwelashwa nokunakekelwa okuqhubekayo ochwepheshe bezempilo abanokuqonda:

• Ukwelashwa komzimba nokulungiswa.
• I-Neurology.
• I-Neurosurgery.
• I-Urology.
• I-Orthopedics.
• I-Physical therapy.
• I-Occupational therapy.
• Imfundo ekhethekile.
• Umsebenzi womphakathi.
• Ukudla.

Abazali nabanye abanamakhaya bayingxenye ebalulekile yeqembu. Bangafunda ukuthi bangasiza kanjani ekulawuleni isimo sengane nokuthi bangakhuthaza kanjani nokusekela ingane ngokomzwelo nangokomphakathi.

Izindaba zokuthi ingane yakho esanda kuzalwa inesimo njenge-spina bifida zingakubangela ukuzwa imizwa eminingi. Kubalulekile ukwazi ukuthi abantu abane-spina bifida baphila impilo esebenzayo, ezuzisayo nezele - ikakhulukazi ngesikhuthazo nokwesekwa kwabathandekayo. Izingane ezine-spina bifida zingaya ekolishi, zithole imisebenzi futhi zibe nemindeni.

Kungase kudingeke ukulungiswa okukhethekile endleleni. Kodwa khuthaza ingane yakho ukuba izimele ngangokunokwenzeka.

Ukuzimela kokunyakaza kuyigama elibalulekile nelifanele bonke abantwana abane-spina bifida. Lokhu kungasho ukuhamba nge-brace noma ngaphandle kwawo, ukusebenzisa izinto zokuhamba ezifana nama-canes noma izinti, noma ukusebenzisa i-wheelchair. Khuthaza ingane yakho ukuba ihlanganyele emisebenzini nabangane. Abanamakhaya bangasiza ekuhleni imisebenzi ukuze balungele ukukhubazeka komzimba.

Abanamakhaya bezingane ezine-spina bifida bangasiza ekuhleni imisebenzi ukuze balungele ukulinganiselwa komzimba.

Izingane eziningi ezine-spina bifida zihluzekile, kodwa ezinye zingadinga usizo lwezemfundo ngenxa yokukhubazeka kokufunda. Zingaba nezinkinga zokuqaphela, ukugxila noma ulimi oludinga ukwelashwa ochwepheshe abangaphandle kwesikole.

jengoba kunjalo kunanoma yiliphi ingane elinesimo sezempilo esiqhubekayo, izingane ezine-spina bifida zingazuza ngokuhlangana nochwepheshe bezempilo yengqondo. Uchwepheshe wezingane kanye nabanye ochwepheshe bezempilo yengqondo bangasiza ekulungiseni nasekubhekaneni. Izingane eziningi ezine-spina bifida ziqinile futhi zizilungiselela izinselele zazo ngokusekelwa abazali bazo, othisha nabanye abanamakhaya.

Uma ingane yakho ine-spina bifida, ungazuza ngokuthola iqembu lokusekela lababazali abanye ababhekana nesimo. Ukukhuluma nabanye abaqonda izinselele zokuphila ne-spina bifida kungasiza.

Izindaba zokuthi ingane yakho esanda kuzalwa inesimo esinjengoba spina bifida zingakubangela ukuthi uzizwe unemizwelo eminingi. Kubalulekile ukwazi ukuthi abantu abane-spina bifida baphila impilo esebenzayo, ezuzisayo nezele - ikakhulukazi ngesikhuthazo nokwesekwa kwabathandekayo. Izingane ezine-spina bifida zingaya emakolishi, zithole imisebenzi futhi zibe nemindeni. Kungenzeka kube khona ukulungiswa okukhethekile endleleni. Kodwa khuthaza ingane yakho ukuba izimele ngangokunokwenzeka. Ukuzimela kokunyakaza kuyigama elibalulekile nelifanele bonke abantwana abane-spina bifida. Lokhu kungasho ukuhamba ngezinsiza noma ngaphandle kwezibopho, ukusebenzisa izinto zokusiza ekuhambeni njengezikhali noma izinti, noma ukusebenzisa i-wheelchair. Khuthaza ingane yakho ukuba ihlanganyele emisebenzini nabangane bayo. Abanakekeli bangasiza ekuhleni imisebenzi ukuze kulungiswe ubuthakathaka bomzimba. Abanakekeli babantwana abane-spina bifida bangasiza ekuhleni imisebenzi ukuze kulungiswe ukulinganiselwa komzimba. Abantwana abaningi abane-spina bifida banengqondo evamile, kodwa abanye bangadinga usizo lwezemfundo ngezinkinga zokufunda. Bangaba nezinkinga zokuqaphela, ukugxila noma ulimi oludinga ukwelashwa ochwepheshe abangaphandle kwesikole. Ngokuphathelene nanoma yiliphi ingane elinesimo sezempilo esingapheli, abantwana abane-spina bifida bangazuza ngokuhlangana nochwepheshe bezempilo yengqondo. Uchwepheshe wezingane kanye nochwepheshe bezempilo yengqondo bangasiza ekulungiseni nasekuphatheni. Abantwana abaningi abane-spina bifida bayaphila futhi bazivumelanisa nezinselele zabo ngokwesekwa kwabazali babo, othisha nabanye abanakekeli. Uma ingane yakho ine-spina bifida, ungazuza ngokuthola iqembu lokusekela labo abazali abaphathana nesimo. Ukukhuluma nabanye abaqonda izinselele zokuphila ne-spina bifida kungasiza.