Zomwe muyenera kudziwa zokhudza dzenje mumtima (Atrial Septal Defect - ASD)

Muyenera kuti munachita mantha kwambiri dokotala atakuuzani kuti mwana wanu ali ndi kamvekedwe kakang'ono mumtima mwake, 'kung'ung'udza kwa mtima'. Kapena, kodi muli ndi zaka 40 ndipo mukupumabe movutikira komanso mukutopa nthawi zonse, ngakhale mukuchita masewera olimbitsa thupi pang'ono? Mwina chifukwa cha zonsezi ndi kabowo kakang'ono mumtima. M'mawu azachipatala, timatcha izi 'Atrial Septal Defect' kapena ASD. Musachite mantha mukamva dzinali. Ili ndi vuto la mtima lobadwa nalo lofala kwambiri. Tiyeni tikambirane zonsezi mosavuta komanso mwaubwenzi lero.

Mwachidule, kodi dzenje ili mumtima (ASD) ndi chiyani?

Chabwino, kuti timvetse izi, tiyeni tiganizire za mtima wathu ngati nyumba yokhala ndi zipinda zinayi. Nyumba iyi ili ndi zipinda ziwiri pamwamba ndi zipinda ziwiri pansi. Mu zamankhwala, timatcha zipinda ziwiri pamwamba atria . Ndiko kuti, atrium yakumanja ndi atrium yakumanzere. Pali khoma pakati pa zipinda ziwiri zapamwambazi. Timatcha khoma ili septum ya atria .

Chomwe chimachitika nthawi zambiri ndichakuti magazi odetsedwa a m'thupi omwe alibe mpweya wabwino amalowa mu atrium yakumanja, amapita m'mapapo, amayeretsedwa (okhala ndi mpweya), kenako amabwerera ku atrium yakumanzere. Kenako magazi oyera komanso odzaza ndi mpweya wabwino amapopedwa m'thupi lonse.

Tangoganizani, chikanachitika n’chiyani ngati pakanakhala kabowo kakang’ono pakhoma (septum) komwe kamalekanitsa zipinda ziwiri zapamwamba? Kenako, magazi ena abwino ochokera kuchipinda chakumanzere omwe ali ndi mpweya wambiri angadutse kudzera mubowo ili kupita kuchipinda chakumanja. Kenako, magazi abwinowa angasakanizike ndi magazi odetsedwa ochokera kumanja. Zotsatira zake, magazi ambiri osafunikira angasonkhanitsidwe kumbali yakumanja, ndipo mbali yakumanja ya mtima iyenera kugwira ntchito molimbika kuti ipompe magazi owonjezerawo kubwerera ku mapapo. Ndicho chimene ASD ili.

Kodi pali mitundu ikuluikulu ya ASD?

Inde, pali mitundu inayi ikuluikulu ya atrial fibrillation, kutengera komwe dzenje lili pakhoma la mtima. Izi ndizofunikira kudziwa, chifukwa njira zina zochiritsira nthawi zina zimadalira mtundu wake.

Kodi zizindikiro za vutoli ndi ziti?

Chodabwitsa n'chakuti, ngakhale kuti ASD ndi matenda obadwa nawo, anthu ambiri samakhala ndi zizindikiro zilizonse mpaka patapita zaka zambiri, mwina mpaka kufika pa msinkhu wapakati. Ngati dzenjelo ndi laling'ono kwambiri (losakwana mamilimita 5), ​​silingakhale ndi zotsatirapo zazikulu pa mtima kapena mapapo, kotero sipangakhale zizindikiro zilizonse.

Zizindikiro mwa ana aang'ono

Kawirikawiri, chizindikiro choyamba chakuti mwana wamng'ono ali ndi ASD ndi phokoso la mtima losazolowereka (kung'ung'udza kwa mtima) komwe dokotala amamva akamamufufuza ndi stethoscope. Ichi ndi chizindikiro chofala kwambiri.

Komanso, ana ena angasonyeze zizindikiro monga:

• Kuchepetsa thupi koyenera msinkhu komanso kuchedwa kukula.
• Matenda opatsirana pafupipafupi (monga chimfine, chibayo).
• Kutopa mwachangu mukusewera.
• Kuvuta kupuma.
• Kusakhazikika kwa kugunda kwa mtima (arrhythmias) - koma izi sizichitika kawirikawiri mwa ana.

Zizindikiro mwa akuluakulu

Ngati muli ndi dzenje lalikulu lomwe silinazindikirike muli ana, zizindikiro zingayambe kuonekera pafupifupi zaka 40. Izi zili choncho chifukwa mbali yakumanja ya mtima ndi mapapo yakhala ikugwira ntchito molimbika kwa zaka zambiri ndipo yatopa.

Akuluakulu akhoza kukhala ndi zizindikiro monga:

• Kutopa kwambiri popanda chifukwa.
• Kuvuta kupuma, monga poyenda mtunda waufupi kapena kukwera masitepe.
• Kumva kugunda kwa mtima kosazolowereka (kugunda kwa mtima).
• Kugunda kwa mtima mwachangu (tachycardia).
• Kutupa (edema) kwa miyendo, akakolo, ndi manja.
• Nthawi zina milomo ndi khungu zimakhala zabuluu (cyanosis).

N’chifukwa chiyani vutoli limachitika?

Chifukwa chenicheni cha izi sichinadziwikebe. Komabe, zambiri mwa zolakwika zobadwa nazozi zimachitika chifukwa cha kusintha kwa majini komwe kumachitika panthawi yomwe mwana akukula m'mimba. Kusintha kwa majini monga NKX2.5/CSX, GATA4, ndi TBX5 kwapezeka kuti kumagwirizana ndi ASD.

Komanso, nthawi zina makanda omwe ali ndi ASD amatha kukhala ndi zilema zina za mtima kapena matenda ena a majini, monga Down syndrome.

Zinthu zomwe zimawonjezera chiopsezo panthawi ya mimba

Ngati mayi wapakati ali ndi matenda enaake, mwana akhoza kukhala ndi chiopsezo chowonjezeka cha matenda a mtima obadwa nawo.

• Mayiyo anali ndi matenda a shuga asanayambe kutenga mimba.
• Kudwala matenda opatsirana ndi mavairasi monga chimfine panthawi ya mimba.
• Kugwiritsa ntchito mowa ndi fodya.
• Kugwiritsa ntchito mankhwala ena popanda upangiri wa dokotala.
• Kugwiritsa ntchito mankhwala osokoneza bongo monga cocaine.

Ndi mavuto otani omwe angachitike ngati sanachiritsidwe?

Dzenje laling'ono silingawononge kwambiri. Komabe, ngati dzenje lalikulu silinachiritsidwe kwa nthawi yayitali, lingayambitse mavuto aakulu azaumoyo. Izi zili choncho chifukwa mbali yakumanja ya mtima ndi mapapo nthawi zonse zimagwira ntchito molimbika, zomwe zimawawononga.

• Kukulitsa mtima kumanja: Ngati izi zipitirira, zingayambitse kulephera kwa mtima.
• Matenda a mtima (Arrhythmia): Pafupifupi theka la anthu omwe ali ndi ASD azaka zopitilira 40 amakhala ndi matenda a mtima (monga atrial fibrillation).
• Stroke: Nthawi zina, magazi ang'onoang'ono omwe amaundana mumtima amatha kudutsa m'bowo ili ndikulowa muubongo, zomwe zimayambitsa sitiroko.
• Kuthamanga kwa magazi m'mapapo: Kuthamanga kwa magazi m'mitsempha yamagazi yomwe imanyamula magazi kupita ku mapapo. Imeneyi ndi vuto loopsa.
• Matenda a Eisenmenger:Vuto lalikulu lomwe limachitika pamene ASD ikupezeka ndi kuthamanga kwa magazi m'mapapo.

Kodi madokotala amapeza bwanji izi?

Adzakufunsani za zizindikiro zanu, adzakuyesani thupi, kenako adzakuyesani mayeso angapo kuti awone momwe mtima wanu umagwirira ntchito komanso kapangidwe kake.

Nthawi zina, ma scan a CT kapena MRI angafunikenso.

Kodi mankhwala ochizira izi ndi otani?

Ngakhale mankhwala angaperekedwe kuti athetse zizindikiro zina za ASD, sangatseke dzenjelo. Pali njira ziwiri zotsekera dzenjelo: opaleshoni kapena kutseka dzenje popanda opaleshoni (percutaneous repair).

• Matenda a ASD Ang'onoang'ono:Mabowo ang'onoang'ono kwambiri, makamaka mwa ana, mwina angatseke okha. Ngati sichoncho, ndipo sakuvulaza, dokotala angakulimbikitseni "kudikira mosamala," zomwe zikutanthauza kuti musachite chilichonse koma kuyang'ana pafupipafupi.

• Matenda Aakulu a ASD: Ngati dzenje ndi lalikulu, ndi bwino kulitseka, ngakhale palibe zizindikiro. Izi zitha kupewa mavuto akuluakulu omwe angachitike mtsogolo. Nthawi zambiri, ngati mbali yakumanja ya mtima yakula, kapena ngati magazi ambiri akutuluka m'dzenjemo, chithandizo chimalimbikitsidwa.

Njira zochizira

1. Kutseka Chipangizo Chozungulira: Iyi ndiyo njira yomwe imagwiritsidwa ntchito kwambiri masiku ano. Chubu chaching'ono (catheter) chimayikidwa kudzera mu mtsempha waukulu womwe uli mu mwendo, ndikutsogoleredwa kumtima, ndipo chipangizo chaching'ono (chipangizo) monga ambulera chimayikidwa kuti chitseke dzenjelo. Izi sizimafuna kudula kwakukulu. Kugona kuchipatala kumatenga tsiku limodzi kapena awiri okha. Njirayi siipezeka pa mitundu yonse ya ASD.

2. Opaleshoni Yotsegula Mtima: Opaleshoni iyi imachitika pa mabowo omwe sangatsekedwe ndi njira zomwe zili pamwambapa kapena pa mabowo omwe ali ndi vuto lina la mtima. Apa, chifuwa chimatsegulidwa ndipo bowo la mtima limatsekedwa ndi zosokera kapena chigamba. Iyi tsopano ndi opaleshoni yotetezeka kwambiri komanso yopambana.

Pambuyo pa chithandizo, dokotala wanu adzakuuzani kuti mumwe mankhwala ochepetsa magazi ndi maantibayotiki kuti mupewe matenda a mtima kwa miyezi pafupifupi 6.

Kodi moyo uli bwanji ndi ASD?

Ndizachibadwa kuchita mantha inu kapena mwana wanu mukamva kuti ali ndi ASD. Koma nkhani yabwino ndi yakuti ndi sayansi ya zamankhwala ya masiku ano, vutoli lingathe kuchiritsidwa bwino ndipo anthu akhoza kukhala ndi moyo wathanzi komanso wabwinobwino .

Mwana amene watsekedwa dzenje adzatha kusewera, kuthamanga, ndi kusewera masewera monga ana ena akachira. Ngakhale atakula, amatha kupitiriza ntchito zawo zachizolowezi akalandira chithandizo.

Chofunika kwambiri ndikutsatira malangizo a dokotala wanu molondola ndikupita kuzipatala kuti mukayezedwe nthawi yake. Makamaka, kuyang'aniridwa ndi katswiri wa matenda a mtima wobadwa nawo ngati uyu ndikofunikira kwambiri pa thanzi lanu.