Qhov kev xyiv fab uas koj hnov thaum koj saib koj tus menyuam mos yog qhov tsis muaj peev xwm piav tau, puas yog? Tib lub sijhawm, muaj lub luag haujlwm loj hauv koj lub siab rau lub neej me me ntawd. Qee zaum nws yog ib qho ib txwm muaj uas yuav ntshai thiab txhawj xeeb heev thaum koj hnov txog qee yam kab mob uas cov menyuam yaus raug kev txom nyem. Niaj hnub no, peb tab tom tham txog kab mob plawv loj heev uas tuaj yeem tshwm sim rau cov menyuam mos, tab sis tsis tshua muaj, thiab xav tau kev kho mob tam sim ntawd. Tus mob no hu ua Interrupted Aortic Arch, lossis (IAA) luv.
Hais yooj yim xwb, Interrupted Aortic Arch (IAA) yog dab tsi?
Yuav kom nkag siab qhov no, cia peb xub saib seb peb lub plawv ua haujlwm li cas. Xav txog peb lub plawv zoo li lub twj tso dej. Lub twj tso dej no muaj plaub lub chav tseem ceeb. Ob lub rau sab saud thiab ob lub rau hauv qab. Cov ntshav, uas lub cev tau siv thiab muaj cov pa oxygen tsawg, uas yog xim xiav me ntsis, nkag mus rau hauv chav sab xis sab saud. Los ntawm qhov ntawd, nws mus rau chav qis dua thiab raug nqus mus rau lub ntsws. Hauv lub ntsws, cov ntshav no muaj oxygen zoo thiab muaj xim liab zoo nkauj.
Tam sim no cov ntshav liab uas muaj oxygen no nkag mus rau hauv chav sab laug sab saud ntawm lub plawv. Los ntawm qhov ntawd, nws mus rau chav sab laug sab qis thiab raug nqus mus thoob plaws lub cev los ntawm cov hlab ntsha loj tshaj plaws thiab tseem ceeb tshaj plaws hauv peb lub cev, lub aorta . Lub aorta no zoo li lub raj xa dej tseem ceeb uas nqa dej los ntawm peb lub tank dej mus rau tag nrho lub tsev. Nws zoo li ib tug pas nrig qab zib.
Yog li, qhov tshwm sim rau ib tug me nyuam uas muaj mob hu ua Interrupted Aortic Arch (IAA) yog tias cov hlab ntsha tseem ceeb, aorta, tsis tiav. Muaj ib qho kev thaiv qhov twg hauv nws, zoo li qhov sib txawv uas tawg. Hais yooj yim, cov yeeb nkab dej tseem ceeb tawg hauv nruab nrab. Vim li no, txawm tias lub plawv nqus zog npaum li cas los xij, cov ntshav zoo uas muaj oxygen ntau tsis mus rau qhov qis ntawm lub cev.
Qhov no yog ib qho mob hnyav heev, uas yuav ua rau tuag taus vim tias yog tias lub cev cov kab mob tsis tau txais oxygen, lawv yuav pib kaw. Hauv kev kho mob, peb hu qhov no ua 'kev poob siab'.
Koj yuav paub li cas yog tias koj tus menyuam muaj tus mob no? Cov tsos mob yog dab tsi?
Cov menyuam mos uas muaj IAA feem ntau pib muaj cov tsos mob hauv ob peb teev lossis ob peb hnub tom qab yug los. Ua niam txiv, nws yog ib qho tseem ceeb heev rau koj kom paub txog qhov no.
| Cov tsos mob | Ib qho lus piav qhia yooj yim |
|---|---|
| Tsis kam haus mis thiab qaug zog | Tus me nyuam yuav nkees tom qab haus mis, yuav haus me ntsis thiab tom qab ntawd tsaus muag, lossis yuav tsaug zog tas li. |
| Ua pa sai | Tus me nyuam yuav ua pa thiab ua pa sai dua li qub. Qhov no yog vim lub plawv yuav tsum ua haujlwm hnyav dua. |
| Lub plawv dhia ceev ceev | Thaum koj muab koj txhais tes tso rau ntawm tus menyuam lub hauv siab, koj yuav hnov tias lub plawv dhia ceev heev. |
| Tsis muaj zog thiab tsaug zog tsis zoo | Tus me nyuam yuav xav tias tsis muaj sia nyob, pw tsaug zog tas li, thiab nyuaj rau sawv. |
| Kev hloov xim ntawm daim tawv nqaij | Tus me nyuam ob txhais ceg, taw, thiab lub cev qis, tshwj xeeb tshaj yog vim lawv tsis muaj ntshav, yuav zoo li xim grey lossis xiav. Qhov txawv no tuaj yeem pom thaum tes thiab lub ntsej muag feem ntau yog xim liab. |
Yog koj pom ib lossis ntau yam ntawm cov tsos mob no hauv koj tus menyuam, koj yuav tsum mus ntsib kws kho mob tam sim ntawd lossis coj koj tus menyuam mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) ntawm tsev kho mob yam tsis muaj kev ncua .
Vim li cas qhov no thiaj tshwm sim rau cov menyuam mos?
Thaum koj hnov ib yam dab tsi zoo li no, lo lus nug thawj zaug uas los rau hauv koj lub siab ua ib tug niam txiv yog, "Vim li cas qhov no thiaj tshwm sim rau peb tus menyuam? Peb puas tau ua qee yam tsis ncaj ncees lawm?"
Thawj qhov uas yuav tsum nco ntsoov yog qhov no tsis yog vim niam txiv muaj qhov txhaum . IAA yog ib qho mob caj ces .
Hais yooj yim xwb, qhov mob no tshwm sim thaum tus menyuam loj hlob hauv plab, vim yog poob ib feem me me ntawm cov chromosome uas cuam tshuam rau kev tsim ntawm lub plawv thiab cov hlab ntsha loj.
Cov menyuam mos uas muaj IAA feem ntau muaj DiGeorge syndrome.Nws tuaj yeem tshwm sim nrog lwm yam mob caj ces hu ua DiGeorge syndrome. Qhov no yog tshwm sim los ntawm kev poob ib feem ntawm tib lub chromosome raws li tau hais los saum toj no. Cov menyuam yaus uas muaj DiGeorge syndrome yuav muaj kev kis kab mob ntau zaus thiab tej zaum yuav muaj qee qhov kev hloov pauv ntawm lub ntsej muag (xws li daim di ncauj tawg).
Lwm yam teeb meem plawv uas nrog IAA
Cov menyuam mos uas muaj IAA feem ntau muaj ib lossis ntau qhov teeb meem ntawm lub plawv. Ib qho ntawm cov teeb meem feem ntau yog Ventricular Septal Defect (VSD).
- Qhov Tsis Zoo ntawm Lub Plawv Hauv Plawv (VSD): Hais yooj yim xwb, qhov no yog lub qhov hauv phab ntsa (septum) ntawm ob lub plawv loj uas nqus tau cov ntshav. Txawm hais tias qhov no feem ntau yog qhov tsis zoo, VSD tuaj yeem yog ib qho kev cawm siav ib ntus rau tus menyuam uas muaj IAA. Xav txog tias thaum cov ntshav tsis tuaj yeem ntws mus rau hauv lub plawv aorta, qee cov ntshav uas muaj oxygen nyob rau sab laug ntawm lub plawv aorta tuaj yeem ntws los ntawm lub qhov no mus rau sab xis, qhov chaw uas nws tuaj yeem ntws mus rau lub ntsws kom muab qee cov ntshav rau cov qis dua ntawm lub cev. Nws zoo li muaj ib txoj kev hla me me thaum txoj kev loj raug thaiv. Tab sis qhov no tsuas yog ib qho kev daws teeb meem ib ntus xwb.
Cov kev kuaj mob thiab kev kho mob yog dab tsi?
Nws yog ib qho tseem ceeb kom paub thiab kho qhov mob no sai li sai tau.
Kev kuaj mob
Feem ntau, tus mob no raug kuaj pom los ntawm kev siv Echocardiogram . Peb hu nws ua 'Echo test'. Qhov no zoo li kev luam theej lub plawv. Qhov kev kuaj mob no tsis mob heev tuaj yeem pom meej meej txog cov duab thiab kev ua haujlwm ntawm lub plawv lub plawv, cov qhov dej, thiab cov hlab ntsha. Qee zaum, tus mob no tuaj yeem kuaj pom thaum ntxov nrog kev luam theej thaum tus menyuam tseem nyob hauv plab.
Kev Kho Mob
Kev kho mob rau IAA yog phais . Txawm li cas los xij, kom txog thaum tus menyuam npaj txhij rau kev phais, cov kws kho mob yuav ua lwm yam ua ntej los cawm tus menyuam txoj sia.
1. Kauj Ruam Ib - Khaws Lub Qhov Dej Ib Ntus Qhib:
Txhua tus menyuam mos muaj ib txoj kev sib txuas ib ntus ntawm lub plawv, lub aorta, thiab lub raj uas nqa ntshav mus rau lub ntsws hu ua Ductus Arteriosus . Qhov no tseem ceeb heev thaum tus menyuam tseem nyob hauv plab. Lub raj no kaw nws tus kheej hauv ob peb teev tom qab yug los.
Tiam sis rau ib tug me nyuam uas muaj IAA, vim tias cov hlab ntsha aorta raug rhuav, tib txoj kev xaiv rau cov ntshav oxygenated ntws mus rau hauv lub cev yog los ntawm Ductus Arteriosus. Yog li thawj qhov uas cov kws kho mob ua yog muab tshuaj rau tus me nyuam hu ua Prostaglandin E1 , uas ua rau lub raj ib ntus ntawd qhib yam tsis kaw. Qhov no pab tswj cov ntshav mus rau lub cev ntawm tus me nyuam kom txog thaum phais.
2. Kauj ruam thib ob - Kev phais:
Thaum tus me nyuam mob ruaj khov lawm, cov kws phais mob tshwj xeeb yuav ua phais. Qhov no suav nrog:
- Muab ob sab kawg ntawm lub aorta uas tawg lawm thiab txuas lawv ua ke los tsim ib txoj hlab ntshav tiav thiab tsis muaj dab tsi thaiv.
- Kaw qhov Ductus Arteriosus ib ntus uas tau qhib los ntawm kev muab prostaglandin.
- Yog tias muaj VSD (lub qhov hauv phab ntsa plawv), nws kuj yuav raug kaw thaum lub sijhawm phais mob no.
Tus me nyuam yuav xav li cas tom qab phais lawm?
Tsis muaj ib yam dab tsi nyuaj rau cov niam txiv ris tshaj qhov hnov tias lawv tus menyuam mos muaj mob uas yuav ua rau tuag taus. Tab sis los ntawm qhov peb tau tham, koj tuaj yeem pom tias qhov mob no tuaj yeem tswj tau zoo nrog kev kho mob sai.
Cov menyuam yaus tom qab phais IAA muaj kev noj qab haus huv zoo heev . Raws li cov ntaub ntawv txheeb cais, txawm tias 10 xyoo tom qab phais, 81% ntawm cov menyuam yaus tseem muaj sia nyob. Qhov ntawd txhais tau tias tus nqi ua tiav siab heev.
Tiamsis qhov no yog xwm txheej ceev. Thaum twg pom cov tsos mob, tus menyuam yuav tsum tau mus rau hauv chav saib xyuas mob hnyav (ICU) hauv tsev kho mob thiab kev kho mob yuav tsum pib tam sim ntawd. Txawm tias tom qab phais lawm los xij, nws tseem ceeb heev uas yuav tsum coj tus menyuam mus rau chaw kho mob thiab ua qhov kev kuaj mob tsim nyog, raws li cov kws kho mob qhia.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab laug sab hauv lub plawv (IAA) yog kab laug sab hauv lub plawv tawg hauv ib tug menyuam mos. Qhov no yog ib qho mob hnyav heev tab sis tsis tshua muaj.
- Qhov no yog tshwm sim los ntawm kev ua rau caj ces, tsis yog los ntawm kev tsis saib xyuas ntawm niam txiv thaum cev xeeb tub.
- Yog koj pom cov tsos mob xws li nyuaj rau pub niam mis, ua pa sai, tsaug zog ntau dhau, thiab tawv nqaij dawb, nrhiav kev pab kho mob tam sim ntawd .
- Tus mob no kho tau zoo los ntawm kev kuaj mob thaum ntxov thiab phais mob, ua rau tus menyuam muaj lub neej noj qab nyob zoo.
- Yog koj muaj kev txhawj xeeb txog koj tus menyuam txoj kev noj qab haus huv, tsis txhob tsis quav ntsej lawv li teeb meem me me. Ib txwm nrog koj tus kws kho mob tham .
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus