Kuongorora uye Kurapa kweDuodenal Atresia
Duodenal atresia inoshaya kuberekwa kwekudya kana chirwere chemuviri (GI) inowanikwa kakawanda mumucheche ane Down syndrome . Pane imwe nzvimbo pakati pe5 kubva muzana uye 7 muzana yevana vane Down syndrome vachazvarwa ne duodenal atresia, kana vachienzanisa nevana chete mu10 000 vacheche vasina Down syndrome.
Hapana anoziva chikonzero nei izvi zvichiitika, asi zvinozivikanwa kuti zvinoitika pakutanga kwekuberekwa kwepabonde asati aberekwa, zvisati zvaitika kwevhiki gumi neimwe.
Iva nechokwadi chokuti kana mwana wako ane duodenal atresia, hapana chawakaita kuti chiite icho kana kuti chingave chaita kuti chidzivirire. Vana vakawanda vane dambudziko iri vanoita zvakanaka mushure mekuvhiyiwa.
Chii Chinonzi Duodenal Atresia?
Duodenal atresia inzvimbo iyo chikamu chemukoko muduku (we duodenum) haisi kuumba zvakanaka. Iyo duodenum ipfundo duku-sechigadziro chinoita kuti nyama inodyiwa kubva mudumbu ipinde muchidiki. Pane imwe nguva, duodenum haina kuumba zvakanaka uye inogona kuvharwa (duodenal atresia) kana kuti yakawanda kudukusa (deodenal stenosis).
Kurapa Kwepabonde kweDuodenal Atresia
Duodenal atresia inowanzoongororwa panguva yekubata panguva ye ultrasound. Kana zviripo, kune mukana we30% wekuti mwana achava neA Down syndrome. Zvichiitika, nzira chete dzekuziva kuti Down syndrome mumutsara wechipiri kana wechitatu ndeyekuongorora amniocentesis kana kuongorora kwePUBS (percutaneous umbilical blood sampling).
Iyo ultrasound icharatidza izvo zvinonzi "kaviri bubble" chiratidzo. Chiratidzo chechipiri chinokonzerwa nekuwedzera kwemvura mu duodenum uye mudumbu, izvo zvinokonzera kuti vauye. Sezvo iine iri pedo kune imwe neimwe uye yakaparadzana nekodzero yakazaruka yokuzarura, idzi zvivako zviviri zvakafanana ne "kaviri bubble" kana mabhiri maviri kurutivi, kana ichionekwa ne ultrasound.
Duodenal atresia inogona kuonekwa ne ultrasound pamasvondo 18 kusvika ku20 ekudzivirira, asi inowanzoonekwa pashure pemasvondo makumi maviri nemaviri. Chimwe chiratidzo che duodenal atresia pakuberekwa inowedzera amniotic fluid. Mikana yemukamu yechipfuva inogona kuwedzerwawo nekuda kwehuwandu hwemvura inenge mudumbu. Izvi zvinowanzoitika zvisati zvaitika kusvikira musvondo makumi maviri nemana.
Kuongororwa kweDuodenal Atresia paKuberekwa
Zviitiko zvakawanda zve duodenal atresia zvinoratidzwa panguva yekuzvitakura kana nguva pfupi kuberekwa.
Kana mwana wako akawanikwa iwe paunenge uine pamuviri, iwe uchatumirwa kune perinatologist (chiremba wezvipembenene anotarisana nehutachiona hwepamusoro) kuti ukurukure kutarisira zvose zvekuzvitora kwako. Iwe unogonawo kutaurirwa kune mazita ekupa mazita, kuti ukurukure kusarudzwa kwekuedzwa kwepabonde, uye chiremba wechiremba, kuti ukurukure kugadziriswa kwechinetso ichi mushure mokuberekwa.
Vacheche vaine duodenal atresia vanogona kunge vane chero zviratidzo izvi zvinotevera, zvinogona kuita kuti vaongorore:
- Dzorera mudumbu rekumusoro
- Kurasira zvakanyanya, kunyange pasina kudya kana kurutsira kwemavara (bile)
- Kusava nekudhonza
- Kutadza kusanganisa mhombho shure kwezvishoma zvishoma maseconium zvigaro
Kamwe kuongororwa kwe duodenal atresia kunofungidzirwa, chiremba acharaira x-ray yemudumbu.
Kana chirwere ichi chiri duodenal atresia, x-ray icharatidza mhepo mudumbu uye chikamu chokutanga che duodenum, asi hapana mhepo shure kweiyo inoratidza kubviswa.
Kurapa kweDuodenal Atresia
Kurapa chete kwe duodenal atresia kunovhiyiwa, iyo inowanzoitwa nguva pfupi mushure mekuberekwa. Vasati vavhiyiwa, chirwere chinonzi nasogastric (NG) chichaiswa mudumbu recheche kuti chibudise utsi hwakanyanya uye mhepo yakawana, uye mwana achawana IV kuitira kuti agone kugamuchira mvura inogona kudzivirira kupera simba. Chiremba wevana vako uye chiremba wechiremba achakurukura kuronga kwevana vako neurongwa hwekuchengeta newe iwe musati wapera chirwere.
Vacheche vane mamwe matambudziko ekuberekwa kana mamwe maitiro akaoma haagoni kuita pamwe nechecheche dzinongova neododal atresia chete. Vazhinji vacheche vanoita zvakanaka kwazvo mushure mekuvhiyiwa uye vanopora zvachose kubva mukukanganisa uku kuberekwa.
Sources:
Cassidy, Suzanne B., Allanson, Judith E., (2001) Kutungamirirwa kweGenetic Syndromes. 1st ed. New York, NY; 2001.
Karrer, F., Duodenal Atresia, Emedicine , 2009
Newberger, D., Down Syndrome: Kutarisana kweKuberekwa Kwepabonde uye Kuongororwa. American Family Physician. 2001.