Kodi mwana wanu ali ndi vuto la mtima lotere? Tiyeni tiphunzire za vuto la Endocardial Cushion Defect!

Mwana wanu akabadwa, mumadandaula kwambiri ndi chilichonse chokhudza iye, sichoncho? Nthawi zina ana aang'ono amakhala ndi vuto la mtima lobadwa nalo. Limodzi mwa mavuto amenewa, ngakhale kuti ndi lovuta pang'ono, la mtima lomwe ndi lofunika kwambiri kulidziwa limatchedwa Endocardial Cushion Defect (ECD) . Dzinalo lingamveke ngati loopsa pang'ono, koma musadandaule. Tiyeni tikambirane za izi mwachidule, m'njira yomwe mungamvetse, chabwino?

Kodi vuto la Endocardial Cushion Defect limeneli ndi chiyani?

Mwachidule, ichi ndi chilema m'mitima ya ana athu aang'ono, chomwe ndi chobadwa nacho , kutanthauza kuti, chilema chomwe chimachitika akadali m'mimba mwa mayi. Taganizirani za mtima wathu ngati nyumba yokhala ndi zipinda zinayi. Pali zipinda ziwiri pamwamba (zomwe timatcha atria), ndi zipinda ziwiri pansi (zomwe ndi ma ventricles). Zipindazi zimalekanitsidwa ndi makoma (septums). Chifukwa cha makoma awa, magazi amayenda mwadongosolo, mbali imodzi yokha.

Komanso, pali ma valve ofanana ndi chipata pakati pa zipinda izi omwe amathandiza kuti magazi aziyenda mbali imodzi yokha. Makamaka, valavu ya tricuspid ndi valavu ya mitral, zomwe zili pakati pa zipinda zapamwamba (atria) ndi zipinda zapansi (mitral ), ziyenera kupangidwa bwino kwambiri.

Komabe, mwa mwana amene ali ndi vuto la endocardial cushion (ECD), ziwalo za mtima zotchedwa endocardial cushions - minofu yoyambira yomwe imapanga makoma ndi ma valve awa - sizikukula bwino. Zotsatira zake, makoma omwe amalekanitsa zipinda za mtima sangakule bwino, kapena sangakule konse. Ma valve awiri ofunikira omwe tawatchulawa (tricuspid ndi mitral) nawonso sangakule bwino.

Tsopano tangoganizani, chimachitika ndi chiyani pamene kugawanika kumeneku mumtima, makoma awa, sikukugwira ntchito bwino, ndipo ma valve, monga zipata, sakugwira ntchito bwino? Dongosolo lomwe magazi amayendera mkati mwa mtima limasokonekera.

• Magazi ambiri kuposa masiku onse amalowa m'mapapo a mwana , zomwe zimapangitsa kuti magazi azithamanga kwambiri m'mitsempha yamagazi mkati mwa mapapo (pulmonary high blood pressure).
• Chifukwa cha kuthamanga kwa magazi m'mapapo, magazi amayamba kuyenda molakwika. Kenako , magazi odzaza ndi mpweya, oyera komanso odetsedwa amayamba kusakanikirana .
• Mtima uyenera kugwira ntchito molimbika kuti upompe magazi ndi vuto la kuyenda kwa magazi. Zili ngati kukwera phiri. Pakapita nthawi, izi zitha kufooketsa minofu ya mtima wa mwana.

Kodi pali mitundu yosiyanasiyana ya vuto la endocardial cushion defect (ECD)?

Inde, pali mitundu ingapo ya vutoli, kutengera kukula kwa kuwonongeka. Ana ena amatha kukhala ndi mavuto ndi khoma pakati pa zipinda zapamwamba za mtima (atria) zokha. Ena amatha kukhala ndi mavuto ndi khoma pakati pa zipinda zapansi (ventricles). Nthawi zina mavuto onse awiri amatha kuchitika limodzi. Komanso, zolakwika mu ma valve a mitral ndi tricuspid zimatha kusiyana.

Vutoli, lotchedwa endocardial cushion defect (ECD), limadziwikanso kuti atrioventricular septal defect (AVSD) kapena atrioventricular canal defect .

Vutoli nthawi zina limatha kugwirizanitsidwa ndi matenda ena a mtima obadwa nawo. Mwachitsanzo:

• Tetralogy ya Fallot
• Ventricular yakumanja yotuluka kawiri
• Kusintha kwa mitsempha yayikulu (kusintha kwa mitsempha ikuluikulu iwiri yamagazi m'malo olakwika)
• Patent ductus arteriosus
• Ventricular imodzi (ventricle imodzi)

Kodi vutoli ndi lofala bwanji?

Ngati muyang'ana ziwerengero m'maiko ngati United States, pafupifupi mwana m'modzi mwa 1,800 wobadwa chaka chilichonse akhoza kukhala ndi vuto la endocardial cushion defect (ECD). Chinthu china chofunikira ndichakuti pafupifupi 20% ya anthu omwe ali ndi Down syndrome ali ndi vuto la ECD.

Kodi ECD imakhudza bwanji thupi la mwana wanga?

Ngati vuto la ECD silikusamalidwa bwino, likhoza kukulirakulira ndi kuyambitsa mavuto aakulu.

• Kuwonongeka kwa mapapo: Monga tafotokozera kale, kuyenda kwa magazi mopitirira muyeso kupita ku mapapo, kupanikizika kwambiri, komanso pakapita nthawi, kungayambitse kuwonongeka kosatha kwa mapapo.
• Kugunda kwa mtima kosazolowereka: Ntchito yamagetsi ya mtima imasokonekera, ndipo kugunda kwa mtima kumatha kusakhazikika.
• Kulephera kwa mtima: Mtima umafooka ndipo sungathe kupopera magazi okwanira m'thupi.
• Matenda a Eisenmenger: Uwu ndi vuto lalikulu kwambiri. Kupanikizika m'mapapo kumawonjezeka kwambiri, zomwe zimapangitsa kuti magazi abwerere m'mbuyo, zomwe zimapangitsa kuti magazi omwe alibe mpweya wabwino aziyenda m'thupi lonse.

Muzochitika zina zoopsa, vutoli likhoza kukhala loopsa ngakhale moyo .

Komanso, ngakhale vutolo litakonzedwa ndi opaleshoni, mwana wanu akhoza kukhala pachiwopsezo chotenga matenda a mtima otchedwa endocarditis . Chifukwa chake, madokotala angakulangizeni kumwa mankhwala opha maantibayotiki musanachite opaleshoni ya mano.

Kodi zizindikiro za vutoli ndi ziti?

Nthawi zina, makanda omwe ali ndi vuto la endocardial cushion sangawonetse zizindikiro zilizonse mpaka ali aang'ono kwambiri. Komabe, makanda omwe ali ndi vuto la endocardial cushion (ECD) amatha kukhala ndi zizindikiro mkati mwa milungu ingapo kuchokera pamene anabadwa. Ndikofunikira kuyang'anira zizindikiro izi:

• Kugunda kwa mtima mwachangu
• Khungu lotumbululuka kapena labuluu:Yang'anani mtundu wa buluu, makamaka milomo, lilime, ndi zala. Izi zimatchedwa cyanosis.
• Kuvutika kudya ndi kunenepa: Onani ngati mwana wanu akuvutika, akutuluka thukuta atamwa mkaka, kapena sakulemera bwino.
• Kusowa mphamvu: Kodi mwana wanu nthawi zonse amakhala ndi tulo ndipo sakonda kusewera?
• Kupuma mofulumira kapena kovuta: Yang'anani ngati chifuwa cha mwana chikuoneka cholimba, chikupuma mofulumira, kapena ngati chifuwacho chimalowa mkati akamapuma.
• Matenda opatsirana pafupipafupi: Dziwani matenda opatsirana pafupipafupi, makamaka matenda opatsirana popuma.

Kodi n’chiyani chimayambitsa vuto la endocardial cushion?

Chifukwa chenicheni cha vuto la endocardial cushion defect (ECD) sichinadziwikebe. Komabe, zapezeka kuti chikugwirizana kwambiri ndi Down syndrome . Vutoli limachitika mwana akangoyamba kukula m'mimba. Vuto lalikulu ndilakuti minofu yotchedwa endocardial cushion yomwe tidakambirana kale siikula bwino. Izi ndi makoma ndi ma valve omwe pambuyo pake amalekanitsa zipinda za mtima.

Kodi madokotala amazindikira bwanji vutoli?

Dokotala wa mwana wanu adzayamba kaye amuyeza mwana wanu thupi lonse . Kenako, ngati phokoso losazolowereka (kung'ung'udza kwa mtima) limveka pomvetsera mtima pogwiritsa ntchito stethoscope, izi zitha kukhala chizindikiro cha vutoli.

Kuphatikiza apo, mayeso ena angapo akhoza kuchitidwa:

• Electrocardiogram (EKG/ECG): Izi zimayesa momwe magetsi a mtima amagwirira ntchito.
• Echocardiogram: Iyi ndi njira yofunika kwambiri yoyezera. Imagwiritsa ntchito mafunde a phokoso kujambula mtima. Imatha kuwona bwino chilichonse kuyambira mawonekedwe a mtima, mpaka mabowo omwe ali m'makoma ake komanso momwe ma valve akugwirira ntchito.
• X-ray ya pachifuwa: Izi zitha kuwona kukula kwa mtima ndi momwe mapapo alili.
• MRI ya Mtima: Nthawi zina mayesowa amachitika ngati pakufunika zina zambiri.
• Kutsegula m'mimba mwa mtima: Mu njira imeneyi, chubu chaching'ono (catheter) chimadutsa mumtsempha wamagazi kupita mumtima kuti chiyeze kuthamanga kwa magazi mkati mwa mtima ndikuyesa magazi. Izi zingafunike opaleshoni isanachitike.

Chofunika kwambiri ndi kupitiriza kuonana ndi dokotala wanu panthawi yomwe muli ndi pakati komanso kuyesedwa ndi ultrasound.Kuchita bwino. Nthawi zina, ECD imatha kuzindikirika mwana asanabadwe, kudzera mu scan yomwe imachitika mwana akadali m'mimba (fetal echocardiogram). Izi zikadziwika msanga, n'zotheka kukonzekera kuti chithandizo chofunikira chiyambe mwana akangobadwa.

Kodi izi zimachiritsidwa bwanji?

Chithandizo chachikulu komanso chabwino kwambiri cha vuto la endocardial cushion defect (ECD) ndi opaleshoni. Komabe, mpaka opaleshoniyo itatha, mankhwala ena angaperekedwe kuti athandize mwana kukhala wamphamvu komanso wonenepa. Mwachitsanzo, mankhwala ochepetsa madzi m'thupi (omwe amatchedwanso 'mapiritsi amadzi') omwe amachepetsa madzi ochulukirapo m'thupi ndi digoxin (Cardoxin® kapena Lanoxin®) omwe amathandiza kukonza magwiridwe antchito a mtima pang'ono.

Kodi chimachitika ndi chiyani pambuyo pa opaleshoni?

Pa opaleshoni, madokotala a mtima amatseka mabowo omwe akuchititsa kuti magazi atuluke pakati pa zipinda za mtima. Amagwiritsa ntchito chigamba chapadera pochita izi. Komanso, ngati mwana ali ndi valavu imodzi yokha, amapanga mavalavu awiri osiyana a mitral ndi tricuspid kuchokera pamenepo. Nthawi zina, ngati valavu ya mitral ya mwana ikutuluka, imatha kukonzedwanso kapena kusinthidwa ngati pakufunika kutero.

Opaleshoni iyi nthawi zambiri imatha kuchitidwa pa mwana wa miyezi yapakati pa 3 ndi 6. Komabe, ngati mwana wanu ali ndi vuto la endocardial cushion, ndikofunikira kuti opaleshoniyo ichitike mwana asanakwanitse chaka chimodzi . Iyi ndiyo njira yokhayo yopewera kuwonongeka kwa mapapo kosatha.

Nthawi zina mwana akhoza kukhala wodwala kwambiri kapena wochepa thupi moti sangamuchite opaleshoni yonse. Zikatero, madokotala adzachita kaye opaleshoni ina yosavuta kuti achepetse magazi omwe amapita ku mapapo a mwana. Izi zimatchedwa pulmonary artery banding . Izi zingathandize kuwongolera zizindikiro mpaka mwanayo atakula ndikukula. Kenako, panthawi yoyenera, kukonza kwathunthu kungachitike.

Kodi pali zovuta zilizonse pa chithandizochi?

Monga opaleshoni iliyonse, pali mavuto ena omwe angachitike pambuyo pa opaleshoni ya ECD. Komabe, nthawi zambiri, mavutowa amatha kuthetsedwa.

• Valavu ya mitral yomwe imatuluka: Nthawi zina pambuyo pa opaleshoni, valavu ya mitral singatseke bwino ndipo magazi ena amatha kutuluka chammbuyo.
• Kugunda kwa mtima kosazolowereka: Kugunda kwa mtima kungachitike molakwika.

Mavuto amenewa nthawi zina angabuke mwana akakula pang'ono, ngakhale ali wachinyamata. Ichi ndichifukwa chake kufufuza nthawi zonse kwa dokotala n'kofunika.

Kodi vutoli lingapewedwe?

Popeza chifukwa chenicheni cha ECD sichikudziwika, n'zovuta kunena momwe mungapewere kwathunthu. Komabe, ngati wina m'banja mwanu wakhala ndi vuto la mtima (ECD) kapena mavuto ena a majini, kungakhale bwino kupeza upangiri wa majini musanayambe kutenga mimba.

Ngati mwana wanga ali ndi ECD, ndiyenera kuyembekezera chiyani?

Funso lalikulu lomwe makolo ambiri amakhala nalo ndi ili. Nkhani yabwino ndi yakuti pambuyo pa opaleshoni yokonza ECD, makanda ambiri amakhala ndi moyo wabwinobwino komanso wathanzi. Komabe, thanzi la mtsogolo la mwana limadalira zinthu monga kuopsa kwa ECD yake, ngati mapapo ake awonongeka, komanso thanzi lake lonse.

Malinga ndi ziwerengero, mwayi wopulumuka chaka choyamba pambuyo pa opaleshoni ndi pafupifupi 80%. Mwayi wopulumuka kwa zaka zina 10 ndi pafupifupi 75%, ndipo mwayi wopulumuka kwa zaka 20 ndi pafupifupi 65%.

Ngakhale atachitidwa opaleshoni, ana ena amatha kukhala ndi mavuto pambuyo pake. Vuto lofala ndilakuti valavu ya mitral siitseka bwino ndipo magazi amatuluka. Ngati izi zitachitika, opaleshoni ina ingachitike kuti ikonzedwe .

Kodi ECD imatenga nthawi yayitali bwanji?

Izi ndizofunikira kwambiri. Endocardial cushion defect (ECD) si vuto lomwe lingachiritsidwe lokha. Vutoli lidzakhalapobe mpaka dokotala wa opaleshoni ya mtima atachita opaleshoni kuti akonze vutoli. Popanda opaleshoni, makanda ambiri sangapitirire zaka ziwiri kapena zitatu. Ichi ndichifukwa chake opaleshoni yanthawi yake ndi yofunika.

Kodi ndimasamalira bwanji mwana wanga?

Mwana wanu akapezeka ndi ECD, komanso ngakhale atachitidwa opaleshoni, mwana wanu ayenera kukaonana ndi dokotala wa mtima nthawi zonse. Kukumana ndi dokotala wotsatira kumeneku kungakhale kamodzi kapena kawiri pachaka. Kuwona kumeneku kudzapitirira kuyambira ali mwana mpaka atakula. Izi zimathandiza dokotala kuyang'anira momwe mwana wanu alili, kuona ngati pali vuto lililonse ndi chigamba kapena valavu, monga kutuluka kwa madzi, ndikuchitapo kanthu msanga ngati pakufunika kutero.

Kodi ndiyenera kupita ndi mwana wanga kwa dokotala liti?

Ngati mwana wanu akusonyeza zizindikiro zotsatirazi, pitani kwa dokotala nthawi yomweyo:

• Kuvutika kupuma
• Kutopa popanda khama lalikulu mutathamanga ndi kusewera kwakanthawi
• Sikukula kapena kunenepa monga momwe amayembekezera
• Kukhala ndi khungu labuluu

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Ndikofunikira kwambiri kuthetsa kukayikira kulikonse komwe mungakhale nako. Musaope kufunsa dokotala wanu mafunso monga:

• "Dokotala, kodi mwana wanga ali ndi vuto lonse kapena pang'ono la endocardial cushion?"
• "Dokotala akulangiza njira yotani yothandizira mwana wanga?"
• "Dokotala, mwachita opaleshoni ingati ya ECD ngati iyi?"
• "Ndi zinthu ziti zapadera zomwe ndiyenera kusamalira nditachita opaleshoni?"

Zinthu zofunika kwambiri kukumbukira (Uthenga Wopita Nawo Kunyumba)

Mwina simunaganizepo zochitira opaleshoni mwana wanu. Komabe, opaleshoni ndiyo njira yabwino kwambiri komanso yothandiza kwambiri yothetsera vuto la endocardial cushion defect (ECD). Vutoli silidzatha lokha. Choncho, ngati pali chilichonse chomwe simukumvetsa, funsani dokotala wanu kuti akufotokozereni.

Chofunika kwambiri ndichakuti simuli nokha. Madokotala, anamwino, ndi gulu lonse lazachipatala alipo kuti akuthandizeni ndikukulimbitsani paulendowu. Ngakhale mutachita opaleshoni, musaphonye zipatala za mwana wanu ndipo tsatirani malangizo a dokotala monga momwe adanenera. Mwanjira imeneyi, inu ndi mwana wanu mudzatha kuzindikira mavuto aliwonse omwe angabuke mtsogolo ndikulimbana nawo bwino. Khalani olimba mtima!

Chilema cha Endocardial Cushion, AVSD, matenda a mtima, zilema zobadwa nazo, matenda a mtima a ana, opaleshoni ya mtima, Down syndrome, matenda a mtima obadwa nawo, matenda a mtima a ana