Odokotela Abahlinza I-CHOP Bahlukanise Amawele Ahlangene AseKhaya Manje

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Ngemva cishe konyaka ekunakekelweni okujulile eSibhedlela Sezingane SasePhiladelphia (CHOP), amawele anezinyanga eziyishumi ubudala u-Addison (Addy) noLilianna (Lily) Altobelli ahlukaniswa ngempumelelo ngodokotela abahlinzayo be-CHOP ngo-Okthoba 10, 13. Manje sebesekhaya eChicago, amantombazane azalwa exhumene esiswini nasesifubeni, isimo esaziwa ngokuthi amawele e-thoraco-omphalopagus, okusho ukuthi ahlanganyela isibindi, i-diaphragm, isifuba nodonga lwesisu.

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Ithimba labahlinzayo elihilela ochwepheshe abangaphezu kweshumi nambili, okuhlanganisa odokotela abahlinzayo abavamile, odokotela ababulala izinzwa, odokotela be-radiothoracic, udokotela ohlinzayo wenhliziyo, nodokotela abahlinzayo, bachitha cishe amahora angu-10 behlukanisa amantombazane. Lapho amawele esehlukene, ithimba labahlinzayo lahlukana kabili futhi lakha kabusha isifuba nodonga lwesisu sentombazane ngayinye, lisebenzisa izingqimba zenetha nezindlela zokuhlinza usana ngalunye.

"Ukuhlukanisa amawele ahlangene kuhlale kuyinselele ngoba iqoqo ngalinye lamawele lihlukile, futhi wonke anezinselele ezahlukene kanye nokucatshangelwa kwe-anatomic," kusho udokotela ohlinzayo oholayo u-Holly L. Hedrick, MD, udokotela ohlinzayo wezingane kanye ne-fetus ku-Division of Pediatric General. , Ukuhlinzwa Kwesifuba Nesibeletho Esibhedlela Sezingane sase-Philadelphia. “Indlela iqembu lethu elisebenzisana ngayo, iyamangalisa ngempela futhi ikhethekile, njengoba abantu abaningi behlangana ndawonye ukuze basebenzele ukufeza umgomo ofanayo. U-Addy noLily baqhuba kahle, futhi sithemba ukuthi bazophila ukuphila okugcwele okujabulisayo.”

Ukusuka Ekuxilongeni kuya Ekulethweni

Uhambo luka-Addy no-Lily lwaqala lapho betholwa bekhulelwe ngesikhathi sabo se-ultrasound samasonto angama-20. Ngaphambi kwalokho, abazali uMaggie no-Dom Altobelli babecabange ukuthi banengane eyodwa, kodwa isithombe se-ultrasound sabonisa ukuthi uMaggie wayephethe imibungu emibili kuphela kodwa futhi wayenanyathiselwe esiswini.

Amawele ahlangene ayivelakancane, ayenzeka cishe ekuzalweni okukodwa kwezingu-1. Laba bashadikazi badluliselwe kwa-CHOP ukuze baqhubeke nokuhlolwa, njengoba isibhedlela singesinye sezimbalwa kuleli esinolwazi lokuhlukanisa amawele ahlangene. Bangaphezu kuka-50,000 amawele ahlangene ahlukene e-CHOP kusukela ngo-28, okuyisibalo esikhulu kunazo zonke izibhedlela ezweni.

Umbhangqwana wahlangana nochwepheshe be-CHOP's Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment, lapho uMaggie ahlolwa kakhulu ngaphambi kokubeletha ukuze anqume ukuthi kungenzeka yini ukuhlukanisa amawele, ngokusekelwe ekuxhumekeni kwawo kanye nokwabelana kwe-anatomy. Odokotela bathola ukuthi nakuba la mantombazane ehlanganyela isifuba nodonga lwesisu, i-diaphragm nesibindi, amawele ayenezinhliziyo ezihlukene, ezinempilo. Isibindi sabo esabelwe nabo sasisikhulu ngokwanele ukuba sihlukanise phakathi kwabo, okubenza babe abantu abahle kakhulu ukuze bahlinzwe ngokuhlukana.

Ngemuva kwezinyanga zokuhlelela ukulethwa okuyingozi kakhulu nge-C-section, eholwa nguJulie S. Moldenhauer, MD, uMqondisi Wezinsizakalo Zokubelethisa, u-Addy no-Lily bazalwa ngoNovemba 18, 2020 eGarbose Family Special Delivery Unit (SDU), Iyunithi yokulethwa kweziguli ezilalisiwe ze-CHOP. Bachitha izinyanga ezine eYunithi Yokunakekelwa Okujulile Kwezingane Ezisanda kuzalwa/Izingane (N/IICU), zalandelwa yizinyanga eziyisithupha ePhikweni Lokunakekelwa Kwabagula Kakhulu (PICU). Udokotela ohlinzayo wepulasitiki we-CHOP uDavid W. Low, MD, wafaka izinwebe zesikhumba ukuze zelule isikhumba samantombazane ukulungiselela ukuhlinzwa ngokuhlukana. Njengamabhaluni amancane agoqekayo, izandisi zesikhumba ziyakhula kancane kancane ngemijovo, zelula isikhumba kancane ngokuhamba kwesikhathi ukuze intombazane ngayinye ibe nesikhumba esanele sokuvala udonga lwesifuba nesisu esivuliwe ngemva kokuhlukana.

Ukuhlinzwa Okuyinkimbinkimbi

Lapho amawele esezinzile futhi kunesikhumba esanele sokuvikeleka okwanele ngemva kokuhlukana, ayeselungele ukuhlinzwa. Inyanga ngaphambi kokuhlinzwa, ithimba labahlinzayo lalihlangana masonto onke, libukeza izithombe ze-ultrasound ngokuphindaphindiwe ukuze lihlole umthamo wegazi esibindini samantombazane, ukuze likwazi ukuhlukanisa ukugeleza kwegazi nalapho imithambo yamantombazane iwela khona. I-CHOP radiologists idale amamodeli e-3D, ahlanganiswe njengezingcezu ze-Lego®, ukuze ithimba labahlinzayo liqonde ubudlelwano bokwakheka komzimba okwabelwanayo kwamantombazane futhi lizilolonge ukuhlinzwa ngokuzivocavoca okuhamba ngezinyawo, njengokuzilolongela izingubo zosuku lokuhlinzwa.

Ngomhla ziyi-13 kuMfumfu, 2021, ngemva kwezinyanga zokuzilungiselela, u-Addy no-Lily bahlinzwa amahora angu-10 futhi bahlukaniswa ngokusemthethweni ngo-2:38 ntambama I-Radiology yayikhona phakathi nokuhlinzwa ukuze kubonakale izakhi ezibalulekile zesibindi nge-ultrasound. Lapho amantombazane esehlukene, iqembu labahlinzayo lahlukana kabili laqala ukusebenza liqinisa intombazane ngayinye futhi livuselela isifuba nodonga lwesisu. UStephanie Fuller, MD, udokotela ohlinza i-cardiothoracic, wahlanganisa i-patent arteriosus yamantombazane futhi waqinisekisa ukuthi izinhliziyo zamantombazane womabili zisesimweni esifanele futhi zisebenza kahle. Odokotela abahlinzayo bepulasitiki babeka izingqimba ezimbili zemeshi - eyodwa yesikhashana, eyodwa unomphela - phezu kwezindonga zesisu nesifuba samawele base beyivala ngesikhumba ebesinwetshiwe izinyanga eziningi ngesikhathi amantombazane ese-PICU. 

Lapho amantombazane ephumile ekuhlinzweni, uMaggie noDom babona amadodakazi abo ehlukana okokuqala ngqa.

"Ukubabona benemizimba yabo - imizimba yabo yayiphelele - kwakumangalisa," kusho uMaggie. “Bekungachazeki nje.”

Ikhaya lamaholide

Ngomhla lu-1 kuZibandlela wezi-2021, abakwa-Altobellis bagcina bendizele ekhaya e-Chicago - iwele elilodwa ngesikhathi, inomzali oyedwa - ngemva kokuhlala e-Philadelphia isikhathi esingaphezu konyaka. La mawele achithe amasonto amabili esibhedlela iLurie Children's ngaphansi kwethimba lodokotela elizoweseka eduze nasekhaya. Amantombazane akhishwe ngesikhathi sikaKhisimusi kanti afika ekhaya athola igceke lawo lihlotshiswe ngomakhelwane. Iholidi balichithe ndawonye ekhaya bengumndeni wabane.

U-Addy no-Lily bobabili basenamashubhu e-tracheostomy kanye nama-ventilators ukusiza ngokuphefumula kwabo, njengoba bazodinga isikhathi sokuthuthukisa imisipha futhi bazijwayeze ukuphefumula ngokwabo. Ngokuhamba kwesikhathi, bazolunyulwa kuma-ventilators.

“Siqala incwadi entsha – akusona ngisho isahluko esisha, yincwadi entsha,” kusho uDom. “Siqale incwadi entsha sha yamantombazane, kukhona nencwadi ka-Addy, kukhona neLily.”

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