Kev coj ib tug menyuam mos los tsev yog ib lub sijhawm zoo siab rau ib tsev neeg. Tab sis tib lub sijhawm, nws kuj tuaj yeem ua rau cov niam txiv ntshai me ntsis. "Tus menyuam puas zoo?", "Tus menyuam puas ua pa zoo?", "Vim li cas nws thiaj quaj ntau ua luaj?" Tej zaum koj yuav muaj cov lus nug zoo li no. Txawm hais tias feem ntau cov no yog cov khoom ib txwm muaj, qee zaum muaj cov xwm txheej tsis tshua muaj uas yuav tsum tau peb ceev faj ntxiv me ntsis. Hnub no peb yuav tham txog ib qho mob plawv tsis tshua muaj uas tuaj yeem tshwm sim rau cov menyuam mos, tab sis uas yuav tsum tau kho tam sim ntawd. Qhov ntawd yog Interrupted Aortic Arch, lossis luv luv IAA.
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 tias koj lub plawv yog lub twj tso dej loj plaub chav.
- Ob lub chav sab saud (Atria): Cov ntshav "xiav" uas tsis muaj pa oxygen los ntawm lub cev nkag mus rau hauv ib lub chav, thiab cov ntshav "liab" uas muaj pa oxygen los ntawm lub ntsws nkag mus rau lwm lub.
- Ob lub qhov hauv qab (ventricles): Cov no yog cov qhov tseem ceeb uas nqus cov ntshav. Ib sab, lawv xa cov ntshav uas tsis muaj oxygen mus rau lub ntsws kom khaws nws. Sab tod, lawv nqus cov ntshav liab uas muaj oxygen ntau kom faib thoob plaws lub cev.
Lub hlab ntsha tseem ceeb uas nqa cov ntshav uas muaj oxygen thoob plaws lub cev hu ua Aorta . Feem ntau nws zoo li ib tug pas nrig, lossis ib lub arch.
Tam sim no, nyob rau hauv rooj plaub ntawm Interrupted Aortic Arch (IAA) , lub arch ntawm aorta tsis tiav. Nws zoo li lub yeeb nkab tseem ceeb uas nqa dej los ntawm lub tank dej mus rau tag nrho lub tsev tau tawg ua ob ntu . Vim li no, txawm tias lub plawv nqus zog npaum li cas los xij, nws tsis tuaj yeem xa cov ntshav uas muaj oxygen mus rau qhov qis dua ntawm lub cev. Qhov no yog ib qho mob hnyav heev, txaus ntshai rau lub neej . Vim tias yog tias qee qhov ntawm lub cev tsis tau txais ntshav, cov kab mob ntawd tuaj yeem ua tsis tiav thiab ua rau muaj kev phom sij loj rau tus menyuam.
Tus mob no tsis tshua muaj. Nws cuam tshuam rau kwv yees li ob ntawm txhua 100,000 tus menyuam mos uas yug hauv Sri Lanka. Yog li thaum nws tseem ceeb kom paub txog qhov no, tsis txhob ntshai tsis tsim nyog.
Koj yuav paub li cas yog tias koj tus menyuam muaj tus mob no? Cov tsos mob yog dab tsi?
Feem ntau tus menyuam uas muaj IAA yuav pom cov tsos mob hauv ob peb hnub tom qab yug los. Qhov no yog vim ua ntej yug los, tus menyuam lub plawv tau txais cov pa oxygen los ntawm niam lub cev, uas tsis yog teeb meem, tab sis tom qab yug los, tus menyuam lub plawv yuav tsum ua haujlwm ntawm nws tus kheej. Yog thaum ntawd qhov teeb meem no tshwm sim.
Koj yuav tsum ceev faj heev txog cov tsos mob hauv qab no.
| Cov tsos mob | Piav qhia yooj yim xwb |
|---|---|
| Nyuaj siab thaum pub niam mis thiab qaug zog heev | Txawm tias thaum ib tug me nyuam haus me ntsis mis los, nws zoo li muaj teeb meem, tawm hws, thiab ua haujlwm hnyav heev. Vim tias txawm tias txoj haujlwm me me ntawd los kuj xav tau kev siv zog ntau los ntawm lub siab. |
| Ua pa sai | Vim tias lub cev tsis tau txais oxygen txaus, tus menyuam yuav pib ua pa sai sai los kho qhov teeb meem no. Lub hauv siab yuav zoo li mob heev. |
| Lub plawv dhia ceev ceev | Vim tias lub plawv yuav tsum ua haujlwm hnyav dua los tso ntshav mus thoob plaws lub cev, lub plawv pib dhia nrawm dua. |
| Tawv nqaij tig xim grey los yog xiav | Qhov tshwj xeeb tshaj yog vim cov ntshav uas muaj oxygen ntau tsis ntws mus rau qhov qis ntawm tus menyuam lub cev, xws li ob txhais ceg thiab taw, daim tawv nqaij ntawm cov chaw ntawd yuav tig xim grey lossis tu siab. |
| Kev tsaug zog tsis zoo thiab tsis muaj zog | Yog tias koj tus menyuam yaus pheej tsaug zog thiab qaug zog, tej zaum nws yog vim lawv lub cev tsis tau txais lub zog uas nws xav tau. |
Yog koj pom ib qho ntawm cov tsos mob no, mus ntsib kws kho mob tam sim ntawd yam tsis muaj kev ncua. Yog tias tsim nyog, coj koj tus menyuam mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) ze tshaj plaws hauv tsev kho mob.
Lwm yam teeb meem plawv uas yuav tshwm sim nrog tus mob no
Cov menyuam mos uas muaj IAA yuav muaj ntau yam teeb meem plawv tib lub sijhawm.
- Qhov tsis zoo ntawm lub plawv sab hauv (VSD): Qhov no yog lub qhov hauv phab ntsa ntawm ob lub chambers uas nqus cov ntshav hauv qab (ventricles) ntawm lub plawv. Qhov xav tsis thoob yog tias muaj VSD qee zaum tuaj yeem pab tau ib ntus hauv cov xwm txheej ntawm IAA, vim nws tso cai rau qee cov ntshav uas muaj oxygen hla dhau lub qhov mus rau lub cev.
- Atrial Septal Defect (ASD): Qhov no yog lub qhov hauv phab ntsa ntawm ob lub chav sab saud ntawm lub plawv.
- Truncus Arteriosus: Qhov no yog qhov uas ob lub hlab ntsha loj tawm ntawm lub plawv (lub aorta thiab lub pulmonary artery) koom ua ke los ua ib qho.
Vim li cas qhov no thiaj tshwm sim rau cov menyuam mos? Yog vim li cas?
Ua niam txiv, lo lus nug thawj zaug uas los rau hauv koj lub siab thaum koj hnov qhov no yog, "Qhov no puas yog peb qhov txhaum?" Tau kawg tsis yog.
Qhov Aortic Arch uas raug cuam tshuam (IAA) yog ib qho mob uas tshwm sim los ntawm qhov tsis zoo ntawm noob caj noob ces. Hais yooj yim xwb, peb cov chromosomes yog 'phau ntawv' uas muaj tag nrho cov lus qhia txog peb lub cev tsim li cas. Hauv qhov mob no, ib daim me me ntawm chromosome uas muaj cov lus qhia txog lub plawv thiab cov hlab ntsha tsim li cas ploj lawm. Qhov no ua rau aorta tsis tsim tau zoo.
Feem ntau, cov menyuam mos uas muaj IAA kuj muaj lwm yam mob caj ces hu ua DiGeorge syndrome . Qhov no kuj yog los ntawm ib feem ntawm tib lub chromosome uas ploj lawm. Cov menyuam yaus uas muaj DiGeorge syndrome tej zaum yuav muaj kev kis kab mob ntau zaus thiab qee qhov kev hloov pauv ntawm lub ntsej muag (xws li daim di ncauj tawg).
Cov kws kho mob nrhiav tau qhov no li cas?
Thaum koj coj koj tus menyuam mus rau tsev kho mob, yog tias cov kws kho mob kuaj xyuas tus menyuam thiab xav tias muaj mob plawv zoo li no, qhov kev kuaj tseem ceeb los paub meej tias nws yog echocardiogram .
Kev kuaj echocardiogram zoo li saib cov yeeb yaj kiab ntawm lub plawv ntawm tus menyuam mos. Nws tsis mob. Nws siv cov nthwv dej ultrasound los pom tseeb cov chav plawv, cov qhov valve, thiab cov hlab ntsha. Hauv rooj plaub ntawm IAA, nws tuaj yeem qhia meej meej qhov kev thaiv hauv aorta.
Qee zaum, qhov teeb meem plawv zoo li no tuaj yeem pom thaum lub sijhawm kuaj mob anomaly (ultrasound scan) thaum tus menyuam tseem nyob hauv plab.
Yuav kho tus me nyuam no li cas? Puas kho tau?
Yog, yeej muaj tseeb tiag. Txawm hais tias qhov no yog ib qho mob hnyav heev los, nws tuaj yeem kho tau tag nrho los ntawm kev phais . Cov txheej txheem kho mob tuaj yeem muab faib ua ob ntu tseem ceeb.
1. Yuav ua li cas ua ntej phais mob
Tom qab kuaj pom tias muaj mob lawm, tus me nyuam yuav raug xa mus rau chav kho mob menyuam mos (NICU) tam sim ntawd. Lub hom phiaj tseem ceeb yog kom cov ntshav ntws mus rau hauv lub cev kom txog thaum tus me nyuam npaj txhij rau kev phais.
Cov kws kho mob siv ib qho tswv yim ntse los ua qhov no. Ua ntej txhua tus menyuam yug los, muaj ib qho kev sib txuas ib ntus (ductus arteriosus) ntawm aorta thiab cov hlab ntsha uas nqa cov ntshav mus rau lub ntsws. Qhov no kaw nws tus kheej hauv ob peb teev lossis ob peb hnub tom qab yug los.
Tiam sis nyob rau hauv qhov xwm txheej IAA, cov kws kho mob yuav tsis cia qhov kev sib txuas ib ntus no kaw. Nws zoo li 'bypass' siv thaum txoj kev loj raug kaw. Khaws qhov bypass no qhib.Muab tshuaj hu ua Prostaglandin E1 rau tus menyuam hauv cov dej ntsev. Qhov no ua rau tus menyuam lub cev qis tau txais qee cov ntshav kom txog thaum phais.
2. Kev phais mob cawm txoj sia
Thaum tus me nyuam mob ruaj khov lawm, cov kws phais plawv menyuam yaus yuav ua qhov phais.
- Qhov tseem ceeb: Ob feem ntawm lub aorta uas tau raug txiav thiab sib cais tau rov txuas dua, tsim kom muaj lub arch tiav.
- Tej yam ntxiv: Tib lub sijhawm, yog tias tus menyuam muaj VSD (lub qhov hauv lub plawv), nws kuj yuav raug kaw thaum lub sijhawm phais no. Lub bypass (PDA) uas tau qhib nrog tshuaj ua ntej kuj yuav raug kaw, vim tias tam sim no txoj kev loj tau ua tiav lawm, tsis tas yuav muaj nws.
Qhov no yog ib qho kev phais mob nyuaj heev, tab sis cov kws kho mob txawj ntse hauv Sri Lanka ua tiav cov kev phais mob zoo li no.
Tom qab phais tas, tus me nyuam yav tom ntej yuav zoo li cas?
Qhov no yog qhov tseem ceeb tshaj plaws. Tom qab phais tiav lawm, feem ntau cov menyuam yaus tuaj yeem ua neej nyob zoo li qub . Raws li cov ntaub ntawv txheeb cais, txawm tias 10 xyoo tom qab phais, ntau dua 81% ntawm cov neeg tseem muaj sia nyob.
Tiam sis qhov tseem ceeb tshaj plaws uas yuav tsum nco ntsoov yog tias tom qab phais mob, koj yuav tsum tau nyob hauv qab kev saib xyuas ntawm tus kws kho mob plawv mus tas koj lub neej . Koj yuav tsum mus rau cov chaw kho mob raws sijhawm teem tseg thiab muaj kev kuaj mob xws li echocardiogram kom pom tias koj lub plawv puas ua haujlwm zoo. Qee zaum, thaum koj laus zuj zus, koj yuav xav tau kev kho mob dua. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia.
Nws yog ib qho ib txwm muaj uas koj yuav xav tias koj lub ntiaj teb tag nrho tau tawg thaum koj pom tias koj tus menyuam muaj tus mob no. Tab sis nco ntsoov tias, kev tshawb fawb kho mob tau nce qib heev niaj hnub no. Yog tias tus kab mob raug kuaj pom thaum ntxov thiab kho kom zoo, koj tus menyuam muaj lub sijhawm zoo los zoo siab ib yam li lwm tus menyuam.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Qhov Aortic Arch uas raug cuam tshuam (IAA) yog thaum cov hlab ntsha tseem ceeb uas nqa ntshav los ntawm lub plawv ntawm tus menyuam mus rau lub cev tsis tiav.
- Qhov no yog ib qho mob tsis tshua muaj, tab sis mob hnyav uas yuav tsum tau kho mob tam sim ntawd .
- Ua tib zoo xyuam xim rau cov tsos mob xws li nyuaj rau pub niam mis, ua pa sai, thiab tawv nqaij dawb.
- Qhov no yog tshwm sim los ntawm qhov teeb meem caj ces, tsis yog qhov txhaum ntawm niam txiv.
- Kev kho mob yog phais, thiab tom qab phais tiav, feem ntau cov menyuam yaus tuaj yeem ua neej nyob li qub .
- Nws yog ib qho tseem ceeb uas yuav tsum nyob hauv qab kev saib xyuas ntawm tus kws kho mob plawv mus tas koj lub neej, txawm tias tom qab phais lawm los xij.
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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