Thaum tus kws kho mob hais rau koj tias koj tus me nyuam yuav tsum tau ua qhov kev phais 'Glenn' vim muaj teeb meem plawv, koj yuav tsum tau ntshai thiab poob siab heev. Koj yuav tsum muaj ntau lo lus nug hauv koj lub siab, xws li 'Glenn Procedure' yog dab tsi, nws muaj dab tsi, thiab vim li cas nws thiaj ua. Tsis txhob txhawj. Cov kev xav ntawd yog qhov ib txwm muaj. Cia peb tham txog txhua yam no yooj yim, hauv txoj kev uas koj tuaj yeem nkag siab.
Glenn Txheej Txheem yog dab tsi, hais yooj yim xwb?
Xav txog nws, peb lub plawv yog lub cev uas tso ntshav thoob plaws lub cev. Nws muaj plaub ntu (plaub chav). Qee tus menyuam yug los nrog ib qho ntawm cov chav no tsis loj hlob tag nrho lossis me heev. Hauv qhov no, lub plawv tsis tuaj yeem tso ntshav tau zoo.
Hais yooj yim xwb, tus txheej txheem Glenn yog ib qho txheej txheem 'bypass' uas pab lub plawv tsis muaj zog zoo li no.
Ntawm no, cov kws phais txuas cov hlab ntsha tseem ceeb (superior vena cava), uas nqa cov ntshav tsis muaj oxygen, tsis huv los ntawm lub cev sab saud ntawm tus menyuam, ncaj qha mus rau cov hlab ntsha hauv lub ntsws, es tsis txhob xa mus rau lub plawv.
Qhov no zoo li kev tsim ib txoj kev tshiab, yooj yim dua rau kev siv uas hla txoj kev uas muaj neeg coob coob. Qhov no tso cai rau cov ntshav uas xav tau oxygen kom hla dhau qhov teeb meem ntawm lub plawv thiab mus ncaj qha rau lub ntsws.
Feem ntau qhov no yog qhov kev phais thib ob uas tus menyuam mos tau ua. Ob peb xyoos tom qab ntawd, yuav muaj kev phais ntxiv kom daws tau qhov teeb meem no mus tas li.
Qhov kev phais no ua rau cov menyuam yaus hom twg?
Glenn txoj kev phais feem ntau yog ua rau cov menyuam yaus uas muaj teeb meem plawv txij thaum yug los. Nws yog qhov tsim nyog tshwj xeeb rau cov menyuam yaus me me, lossis rau cov neeg uas ib qho ntawm ob lub chav loj (ventricles) ntawm lub plawv uas tso ntshav tsis ua haujlwm zoo. Qhov mob no hu ua 'single ventricle defect'.
Hauv qab no yog qee qhov mob plawv tseem ceeb uas yuav tsum tau phais Glenn.
| Lub npe ntawm tus kab mob plawv (Medical Mob) | Ib qho lus piav qhia yooj yim |
|---|---|
| Kab mob plawv sab laug Hypoplastic | Sab laug ntawm lub plawv (sab laug ventricle, cov valve) tsis loj hlob zoo. |
| Tricuspid Atresia | Lub tricuspid valve, nyob nruab nrab ntawm cov chav ntawm sab xis ntawm lub plawv, tsis tau tsim kom zoo. |
| Kev puas tsuaj ntawm lub ntsws | Lub qhov ntswg ntawm lub ntsws uas nqa ntshav mus rau lub ntsws raug thaiv. |
| Ob Chav Inlet Sab laug lossis Sab xis Ventricle | Ob lub chav sab saud ntawm lub plawv (atria) txuas nrog ib lub chav sab hauv qab (ventricle). |
Feem ntau yuav phais Glenn thaum twg?
Feem ntau cov kws kho mob pom zoo kom ua qhov kev phais no thaum tus menyuam muaj hnub nyoog ntawm 3 thiab 6 lub hlis . Feem ntau nws yog ua raws li kev phais zaum ob, tom qab tus menyuam tau phais thawj zaug los txhim kho kev ncig ntshav (xws li Blalock-Taussig (BT) shunt) tom qab yug los.
Ua ntej thiab thaum lub sijhawm phais mob muaj dab tsi tshwm sim?
Ua ntej phais
Ua ntej phais, koj tus kws kho mob yuav ua ntau qhov kev kuaj mob kom paub tseeb tias koj tus menyuam lub plawv zoo li cas.
- Kev Siv Catheter Rau Lub Plawv: Qhov kev kuaj no yog ua los ntsuas qhov siab thiab cov pa oxygen hauv lub plawv thiab saib cov qauv ntawm lub plawv.
- MRI ntawm lub plawv: Qhov no pab kom tau txais cov duab peb-seem ntawm lub plawv.
- Nws yog ib qho tseem ceeb heev uas yuav tsum qhia rau tus kws kho mob txog txhua yam tshuaj (xws li cov vitamins thiab cov tshuaj ntxiv) uas koj tus menyuam noj .
Thaum lub sijhawm phais
Feem ntau kev phais mob plab yuav siv sijhawm li plaub teev , tab sis lub sijhawm no yuav txawv nyob ntawm tus menyuam lub mob.
Thaum lub sijhawm phais, tus menyuam yuav tau txais tshuaj loog, yog li tus menyuam yuav tsis hnov mob. Tus menyuam pw tsaug zog tob. Ib txhia menyuam yaus yuav txuas nrog lub tshuab tshwj xeeb uas yuav ua haujlwm ntawm lub plawv thiab lub ntsws ib ntus thaum lub sijhawm phais. Qhov no hu ua lub tshuab cardiopulmonary bypass . Tom qab ntawd, raws li tau hais ua ntej, tus kws phais yuav ua qhov kev txuas cov hlab ntsha thiab kho lwm yam kev kho plawv yog tias tsim nyog.
Cov txiaj ntsig thiab tej yam yuav ua rau muaj kev phais mob
Ib yam li lwm yam kev phais mob, txoj kev phais mob Glenn muaj ob qho txiaj ntsig thiab kev pheej hmoo. Nws yog ib qho tseem ceeb rau cov niam txiv kom paub txog cov no.
| Cov txiaj ntsig | Tej yam txaus ntshai/tej teeb meem uas yuav muaj tau |
|---|---|
| Txo qhov hnyav ntawm lub plawv ua haujlwm nkaus xwb (ventricle). | Cov pa oxygen hauv cov ntshav txo qis. |
| Tiv thaiv kom lub plawv tsis txhob loj vim yog ua haujlwm ntau dhau. | Ntshav siab. |
| Qhov kev phais mob Fontan uas yuav los txog no yuav yooj yim dua. | Cov kua dej hauv lub pleural. |
| Muaj feem ntau dua los cawm tus menyuam txoj sia tom qab phais Fontan. | Yuav tsum tau pub mis los ntawm lub raj vim nyuaj rau noj mov. |
| Ua lwm txoj hauv kev rau cov menyuam yaus uas tsis xav tau lossis tsis tuaj yeem phais Fontan. | Yuav tsum tau phais dua lwm zaus. |
Qhov tseem ceeb tshaj plaws yog tias tus menyuam muaj sia nyob tom qab phais Glenn siab heev. Nws yog kwv yees li 99% . Qhov no yog kev phais mob zoo heev.
Tom qab phais tas, muaj dab tsi tshwm sim?
Tom qab phais tas, tus me nyuam yuav raug xa mus rau chav saib xyuas mob hnyav (ICU). Tej zaum koj yuav ntshai thaum koj pom cov raj thiab cov khoom siv uas txuas rau tus me nyuam lub cev. Tab sis qhov ntawd yog ib txwm muaj. Pawg kws kho mob yuav saib xyuas tus me nyuam ze heev.
Tus me nyuam yuav nyob hauv chav saib xyuas mob hnyav li peb hnub, tom qab ntawd yuav raug xa mus rau chav kho mob ib txwm. Tej zaum yuav siv sijhawm ob peb lub lis piam rau tus me nyuam kom rov zoo thiab mus tsev.
Muaj ntau tus menyuam yaus, ob peb xyoos tom qab Glenn txoj kev kho mob, thaum lawv pib taug kev, yuav tsum tau ua qhov kauj ruam tom ntej, ib txoj kev kho mob Fontan , uas muab kev daws teeb meem ruaj khov dua rau lub plawv txoj kev ncig ntshav.
Thaum twg koj yuav tsum mus ntsib kws kho mob tom qab koj mus tsev lawm?
Nws yog ib qho tseem ceeb heev uas yuav tsum tau saib xyuas koj tus menyuam tom qab koj mus tsev. Yog tias koj pom ib qho ntawm cov tsos mob hauv qab no , hu rau koj tus kws kho mob tam sim ntawd.
- Yog tias tus menyuam muaj mob kub taub hau.
- Yog tias ntshav lossis lwm yam kua dej tawm ntawm qhov txhab phais.
- Yog koj muaj teeb meem haus mis nyuj.
- Yog koj muaj teeb meem nrog qhov hnyav nce.
Koj tus menyuam yuav tau mus rau lub tsev kho mob plawv thiab noj tshuaj ntev heev. Qhov ntawd yog ib feem ntawm txoj kev taug kev no.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Txoj Kev Kho Mob Glenn yog ib txoj kev phais mob theem ob uas tau npaj tseg rau cov menyuam mos uas muaj kab mob plawv txij thaum yug los.
- Qhov no txhais tau tias cov ntshav uas tsis muaj oxygen txaus raug xa ncaj qha mus rau lub ntsws, hla lub plawv, txo qhov kev ua haujlwm ntawm lub plawv.
- Qhov kev phais no muaj kev vam meej ntau heev (kwv yees li 99%). Yog li ntawd, tsis txhob ntshai.
- Tom qab phais lawm, tus me nyuam yuav xav tau kev saib xyuas mob ntev thiab noj tshuaj, yog li nws tseem ceeb heev uas yuav tsum ua raws li tus kws kho mob cov lus qhia.
- Tham nrog koj tus kws kho mob txog tej lus nug lossis kev ntshai uas koj muaj. Lawv yeej npaj txhij los pab koj.
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