Kodi magazi a mtima wanu asinthidwa? Tiyeni tiphunzire za PAPVR (Partial Anomalous Pulmonary Venous Return)!

Kodi nthawi zina mumamva kutopa? Kodi mumavutika kupuma mukakwera masitepe? Kapena mumakayikira pang'ono za kukula kwa mwana wanu? Pakhoza kukhala zifukwa zingapo za izi. Koma nthawi zina chifukwa cha izi chingakhale kusintha pang'ono mumtima komwe timabadwa nako. Lero tikambirana za vuto lotere, lokhudzana ndi kuyenda kwa magazi mumtima, koma si lofala kwambiri. Izi zimatchedwa PAPVR, zomwe zikutanthauza (Partial Anomalous Pulmonary Venous Return).

Kodi mukudziwa kuti PAPVR (Partial Anomalous Pulmonary Venous Return) ndi chiyani?

Mwachidule, PAPVR ndi matenda a mtima obadwa nawo . Chomwe chimachitika pamenepa ndi chakuti pali vuto laling'ono ndi momwe magazi oyera, okhala ndi mpweya wochokera m'mapapo athu amabwerera kumtima. Kawirikawiri, magazi onse okhala ndi mpweyawu amapita kumanzere kwa mtima. Kenako, mbali yakumanzere ya mtima imapopera magazi amenewo kupita ku thupi lonse.

Koma kwa munthu amene ali ndi PAPVR, magazi ochepa okha omwe ali ndi mpweya wochokera m'mapapo amapita kumanja kwa mtima . Mukudziwa, mbali yakumanja ya mtima nthawi zambiri imalandira magazi omwe agwiritsidwa ntchito ndi thupi, omwe ali ndi mpweya wochepa. Choncho pamene magazi ena omwe ali ndi mpweya apita molakwika, kuchuluka kwa magazi omwe amabwera kumanja kwa mtima kumawonjezeka. Ndiye chimachitika ndi chiyani? Mbali yakumanja ya mtima iyenera kugwira ntchito ndi magazi owonjezerawa, zomwe zikutanthauza kuti iyenera kugwira ntchito molimbika . Katundu wowonjezerawu ukhoza kukulirakulira pamtima pakapita nthawi, ndipo ungakhudze thanzi lathu lonse.

Koma PAPVR siikhudza aliyense mofanana. Zimatengera kuchuluka kwa magazi omwe achotsedwa. Anthu ena akhoza kukhala ndi vuto lochepa kwambiri, ndipo sangakumane ndi zizindikiro zilizonse kwa moyo wawo wonse. Koma ngati zizindikiro zichitika kapena mavuto ena abuka, madokotala athu amatha kuthana ndi vutoli bwino. Nthawi zambiri, opaleshoni imatha kuchiza PAPVR bwino ndikukuthandizani kukhala ndi moyo wautali komanso wathanzi.

Umu ndi momwe magazi amayendera mumtima mwathu, komanso momwe amasinthira tikakhala ndi PAPVR.

Kuti timvetse momwe PAPVR imakhudzira kuyenda kwa magazi, choyamba tiyeni tiwone momwe magazi amayendera pakati pa mtima ndi mapapo athu. Taganizirani ngati ulendo waung'ono.

1. Choyamba, magazi ogwiritsidwa ntchito m'thupi, omwe atha mpweya, amadutsa m'mitsempha ikuluikulu iwiri (vena cava yapamwamba ndi vena cava yapansi) ndikulowa m'chipinda chapamwamba (atrium yakumanja) kumbali yakumanja ya mtima.

2. Kenako, magazi amenewa omwe alibe mpweya wabwino amasuntha kuchokera ku chipinda chakumanja chapamwamba kupita ku chipinda chakumanja chapansi (`(ventricle yakumanja)`).

3. Magazi awa amapopedwa kuchokera ku chipinda chakumanja chapansi kupita ku mapapo , zomwe zimathandizidwa ndi mitsempha ya m'mapapo. M'mapapo, magazi awa amabwezeretsedwa mpweya, ngati kuti apatsidwa moyo watsopano.

4. Magazi atsopano, okhala ndi mpweya tsopano amabwerera kumtima kudzera m'mitsempha ingapo (mitsempha ya m'mapapo) kuchokera m'mapapo, molunjika kupita ku chipinda chakumanzere chakumtunda kwa mtima.(`(atrium yakumanzere)`).

5. Magazi olemera mpweya ochokera ku chipinda chapamwamba kumanzere amapita ku chipinda chapansi kumanzere (`(ventricle yakumanzere)`).

6. Pomaliza, magazi olemera mpweya ochokera m'chipinda chapansi kumanzere amafalikira m'thupi lonse kudzera m'mitsempha yayikulu kwambiri yamagazi (aorta).

Mukuona, nthawi zambiri magazi omwe ali ndi mpweya wochepa amakhala m'zipinda zomwe zili kumanja, ndipo magazi omwe ali ndi mpweya wochuluka amakhala m'zipinda zomwe zili kumanzere. Sizimasokonezeka.

Koma ndi PAPVR, njira iyi sigwira ntchito bwino. PAPVR imayambitsa kayendedwe ka magazi kosazolowereka mkati mwa mtima, kotchedwa cardiac shunt yochokera kumanzere kupita kumanja. "Pang'ono anomalous" zikutanthauza kuti gawo limodzi lokha la magazi okhala ndi mpweya wochokera m'mapapo silikufika pamtima mwanjira yachibadwa.

Izi zili choncho chifukwa chakuti mitsempha yanu imodzi kapena zingapo za m'mapapo zimapopera magazi okhala ndi mpweya kupita ku chipinda chapamwamba chakumanja, m'malo mopita ku chipinda chapamwamba chakumanzere. Ndiye chimachitika ndi chiyani? Magazi opanda mpweya m'chipinda chanu chapamwamba chakumanja amasakanikirana ndi magazi okhala ndi mpweya wambiri. Chifukwa chake, magazi osakanikirana awa amapopera ku chipinda chapansi chakumanja, kupita m'mapapo.

Izi zili ndi zotsatirapo ziwiri:

• Choyamba n’chakuti magazi ena okhala ndi mpweya wambiri amabwerera mosafunikira monga momwe anabwerera, kutanthauza kuti, m’mapapo.
• Chachiwiri, kuchuluka kwa magazi omwe chipinda chanu chakumanja chapansi chiyenera kupopera m'mapapu anu kumawonjezeka . Ntchito yowonjezerayi ingayambitse kupsinjika kwa mtima wanu pakapita nthawi.

Kodi matenda ena a mtima angachitike ndi PAPVR?

Anthu ena akhoza kukhala ndi PAPVR okha, popanda matenda ena aliwonse a mtima. Izi zimatchedwa "isolated PAPVR". Komabe, anthu ambiri omwe ali ndi PAPVR angakhalenso ndi zovuta zina, monga dzenje pakati pa zipinda ziwiri zapamwamba za mtima . Izi zimatchedwa Atrial Septal Defect (ASD).

Kawirikawiri, PAPVR imatha kugwirizanitsidwa ndi vuto la mapapo akumanja ndi mtsempha womwe umanyamula magazi kupita nawo ku mapapo (`(Scimitar syndrome)`).

Kodi PAPVR ndi yosowa bwanji?

Ofufuza akuyerekeza kuti pafupifupi anthu 4 mpaka 7 mwa anthu 1,000 aliwonse ali ndi PAPVR. Komabe, chiwerengerochi chikhoza kukhala chokwera kwambiri, chifukwa anthu ena sangakumane ndi zizindikiro zilizonse ndipo sangadziwike kuti ali ndi vutoli.

Kodi zizindikiro za PAPVR ndi ziti?

Ngati kuchuluka kwa magazi kupita kumbali yolakwika (kotchedwa `shunting`) kuli kochepa, PAPVR si nthawi zonse imayambitsa zizindikiro. Komabe, pamene `shunting` iyi ikuwonjezeka, mungazindikire zizindikiro. Ana aang'ono akhoza kukhala ndi zizindikiro ngati ali ndi vutoli limodzi ndi matenda ena a mtima. Komabe, anthu ambiri omwe ali ndi PAPVR amayamba kukhala ndi zizindikiro ali ndi zaka za m'ma 20 kapena 30 .

Zizindikiro mwa ana aang'ono:

• Kuchedwa kwa chitukuko.
• Kutopa mwachangu mukuchita masewera olimbitsa thupi kapena kusewera.
• Matenda opatsirana pafupipafupi a kupuma (monga kutsekeka pachifuwa).
• Kupuma movutikira.
• Kuvuta kunenepa.

Zizindikiro mwa akuluakulu:

• Kuvuta kupuma.
• Kumva kutopa nthawi zonse (`(Kutopa)`).
• Kumva kugunda kwa mtima kosazolowereka (`(Kugunda kwa mtima)`).
• Kupweteka pachifuwa (`(Kupweteka pachifuwa)`).
• Kugunda kwa mtima kumawonjezeka.
• Matenda opatsirana pafupipafupi.

Nchifukwa chiyani PAPVR iyi imachitika?

Monga matenda ena obadwa nawo a mtima, PAPVR imachitika pamene mtima sukupanga bwino panthawi yomwe mwana wosabadwayo akukula . Kawirikawiri, m'masabata oyamba a mimba, mitsempha inayi ya m'mapapo imapangidwa kuchokera ku mtsempha wamba wa m'mapapo. Mitsempha iyi imalumikizana ndi chipinda chakumanzere chapamwamba cha mtima wa mwana wosabadwayo. Komabe, ngati pali kusintha kulikonse mu njirayi, mtsempha wa m'mapapo ukhoza kulumikizana ndi chipinda chakumanja chapamwamba m'malo mwa chipinda chakumanzere chapamwamba, kapena ku mitsempha ina yapafupi (monga vena cava yapamwamba kapena mtsempha wakumanzere wa brachiocephalic). Apa ndi pamene PAPVR imachitika.

Kodi ndi mavuto ati omwe angayambitse PAPVR?

Ma shunt ochokera kumanzere kupita kumanja omwe sanachiritsidwe kwa nthawi yayitali amatha kubwerera m'mbuyo ndikuyambitsa matenda oopsa otchedwa Eisenmenger syndrome. Chifukwa chake, ndikofunikira kufunafuna upangiri wachipatala nthawi yomweyo ngati muli ndi zizindikiro.

Kodi mungadziwe bwanji ngati muli ndi PAPVR?

Madokotala amazindikira PAPVR ndi mayeso akuthupi ndi mayeso ena apadera . Dokotala wanu akamakufufuzani, adzamvetsera mtima wanu ndi stethoscope. Anthu ena omwe ali ndi PAPVR angamve phokoso la mtima losazolowereka (kung'ung'udza kwa mtima). Ngati izi zikukayikiridwa, dokotala wanu adzalamula mayeso ena.

Zaka zomwe PAPVR imapezekera zimasiyana malinga ndi munthu. Imatha kupezeka isanakwane, kapena ingathe kupezeka isanakwane kukula. Mutha kukhala ndi PAPVR, koma osawonetsa zizindikiro zilizonse, kotero simungadziwe kwa moyo wanu wonse. Nthawi zina, vutoli limapezeka mwangozi panthawi yoyezetsa chinthu china.

Ndi mayeso ati omwe amachitidwa?

Mayeso omwe amathandiza kuzindikira PAPVR ndi awa:

• Echocardiogram (Echocardiogram) - makamaka transesophageal echocardiogram (TEE). Izi zimatenga chithunzi cha mtima pogwiritsa ntchito ultrasound.
• MRI ya Mtima (MRI ya Mtima).
• Kujambula kwa mtima kopangidwa ndi kompyuta (CT).

Kodi PAPVR imafuna opaleshoni?

Ana ndi akuluakulu ena amafunika kuchitidwa opaleshoni yokonza PAPVR kuti akonze njira yoyendetsera magazi mumtima. Ana omwe apezeka ndi PAPVR nthawi zambiri amafunika opaleshoni kuposa akuluakulu. Izi zili choncho chifukwa nthawi zambiri amakhala ndi PAPVR limodzi ndi matenda ena a mtima omwe amafunika opaleshoni.

Madokotala amalimbikitsa opaleshoni.Pokhapokha ngati pakufunikadi kuthetsa zizindikiro kapena kupewa mavuto amtsogolo. Inu kapena mwana wanu mungafunike opaleshoni ngati PAPVR ikuyambitsa kusuntha kwakukulu kuchokera kumanzere kupita kumanja. Izi zikutanthauza kuti magazi ambiri omwe ayenera kupita m'thupi akubwerera kumanja kwa mtima ndi mapapo. Izi zingayambitse zizindikiro zosasangalatsa komanso zovuta monga kuthamanga kwa magazi m'mapapo (PAH) kapena kulephera kwa mtima. Dokotala wanu adzagwiritsa ntchito mayeso ojambulira kuti adziwe kukula kwa kusuntha kumeneku.

Opaleshoni nthawi zambiri imatha kuchiza PAPVR bwino. Ndikofunikira kulankhula ndi dokotala wanu za tsatanetsatane wa opaleshoni yanu ndi zomwe mungayembekezere.

Njira yochitira opaleshoni ingasiyane malinga ndi mawonekedwe a mtima wanu ndi mitsempha ya m'mapapo. Kawirikawiri, madokotala ochita opaleshoni amayesetsa kusintha njira yoyendera magazi kuti magazi okhala ndi mpweya aziyenda m'zipinda zakumanzere za mtima.

Komabe, anthu ambiri sadzafunika opaleshoni . Ngati PAPVR yanu ndi yofatsa, dokotala wanu adzayang'anira vuto lanu. Ngati mukupeza zizindikiro kapena kusonyeza zizindikiro za mavuto, dokotala wanu angakulangizeni opaleshoni panthawiyo.

Kodi PAPVR ingapewedwe?

Mwatsoka, palibe njira yopewera PAPVR. Ndi chinthu chomwe timabadwa nacho. Komabe, ngati mukukonzekera kutenga pakati, lankhulani ndi dokotala wanu za njira zochepetsera chiopsezo chanu chokhala ndi mwana wokhala ndi vuto la mtima lobadwa nalo. Nazi malangizo ena:

• Pewani mowa, mankhwala osokoneza bongo, fodya, ndi utsi wa fodya.
• Pitani kukaonana ndi dokotala nthawi zonse za mimba.
• Gwirani ntchito ndi dokotala wanu kuti muthane ndi matenda ena aliwonse omwe mungakhale nawo (monga matenda a shuga, kuthamanga kwa magazi).

Kodi munthu amene ali ndi PAPVR angachite bwino kukhala ndi moyo wabwinobwino?

Ndizotheka kukhala ndi moyo wautali komanso wathanzi ndi PAPVR. Anthu ambiri amakhala zaka zambiri popanda zizindikiro kapena zovuta zilizonse. Ngakhale omwe amafunika opaleshoni nthawi zambiri amakhala ndi zotsatira zabwino. Komabe, zotsatira zake zimatha kusiyana malinga ndi matenda ena amtima kapena matenda omwe munthu ali nawo. Chifukwa chake ndi bwino kulankhula ndi dokotala wanu za zomwe mungayembekezere kutengera momwe mulili.

Ngati muli ndi PAPVR, mumadzisamalira bwanji? / Kodi mumasamalira bwanji mwana wanu?

Kukhala ndi vuto la mtima lobadwa nalo nthawi zina kungakhale kovuta. Ndikofunikira kukumbukira kuchita zinthu tsiku ndi tsiku. Nazi malangizo ena omwe mungatsatire:

• Pezani chithandizo kuchokera kwa dokotala wa mtima yemwe ndi katswiri wa matenda a mtima obadwa nawo kwa akuluakulu. Iye adzayang'anira vuto lanu mwa kukuyang'anirani nthawi zonse.
• Funsani dokotala wanu mitundu ya masewera olimbitsa thupi yomwe ili yoyenera kwa inu. Pamodzi, mutha kupanga dongosolo lochita masewera olimbitsa thupi.
• Tsatirani zakudya zopatsa thanzi la mtima (monga zakudya za ku Mediterranean).
• Imwani mankhwala onse monga momwe dokotala wanu wanenera.
• Pewani kusuta fodya ndi zinthu zonse zopangidwa ndi fodya. Funsani dokotala wanu ngati mukufuna thandizo kuti musiye kusuta fodya.

Ngati mwana wanu ali ndi PAPVR, funsani dokotala wake momwe angamusamalire bwino. Mwana wanu angafunike kutsatira malangizo apadera okhudza masewera olimbitsa thupi kapena zochita zina, makamaka ngati ali ndi matenda ena obadwa nawo a mtima.

Kodi muyenera kupita kwa dokotala liti?

Pitani kwa dokotala wanu monga momwe mwakonzera. Kukumana ndi dokotala nthawi zonse komanso kuyezetsa zithunzi ndikofunikira kuti muwone momwe PAPVR yanu ilili komanso kuthana ndi mavuto.

Imbani dokotala wanu nthawi yomweyo ngati inu kapena mwana wanu mukumana ndi zotsatirazi:

• Ngati zizindikiro zatsopano zikuwonekera kapena zizindikiro zomwe zilipo zikusintha.
• Ngati pali zotsatirapo zoyipa kuchokera ku mankhwala.
• Ngati muli ndi mafunso kapena nkhawa zilizonse.

Kodi ndi nthawi ziti pamene muyenera kupita ku Emergency Treatment Unit (ETU) ?

Ngati inu kapena mwana wanu mukuwonetsa zizindikiro izi, imbani 911 kapena nambala yanu yadzidzidzi yapafupi nthawi yomweyo:

• Kugunda kwa mtima komwe kumathamanga kwambiri (kugunda 100-150 pamphindi) ndipo sikuchepetsa liwiro.
• Kutaya chidziwitso ndi kukomoka.
• Kupuma movutikira kwambiri pochita masewera olimbitsa thupi komanso/kapena kusapumula.
• Kupweteka pachifuwa mwadzidzidzi komanso koopsa.
• Mutu wopweteka komanso woopsa mwadzidzidzi.
• Kufooka mwadzidzidzi kapena dzanzi m'manja kapena m'miyendo.

Mafunso ofunikira oti mufunse dokotala wanu

Lankhulani ndi dokotala wanu za vuto lanu ndi zomwe mungayembekezere mtsogolo. Nazi mafunso ena omwe mungafunse:

Ngati muli ndi PAPVR:

• Kodi vuto langa ndi lalikulu bwanji?
• Ndi kusintha kotani kwa moyo komwe ndiyenera kusintha?
• Kodi ndikufunika opaleshoni?
• Kodi ubwino ndi zoopsa za opaleshoni ndi ziti?
• Kodi tsogolo langa lidzakhala bwanji?

Ngati mwana wanu ali ndi PAPVR, funsani dokotala wake:

• Kodi vuto la mwana wanga ndi lalikulu bwanji?
• Kodi mwana wanga ali ndi matenda ena a mtima obadwa nawo?
• Kodi mwana wanga adzafunika opaleshoni kapena chithandizo china?
• Kodi ndingasamalire bwanji mwana wanga kunyumba?
• Kodi ali ndi zoletsa zilizonse pa zochita zake?
• Ndi zinthu ziti zomwe zilipo zothandizira mwana wanga kumvetsetsa izi moyenera msinkhu wake?

Kodi kusiyana pakati pa PAPVR ndi TAPVR ndi kotani?

PAPVR ndi yosiyana ndi matenda otchedwa ``Total Anomalous Pulmonary Venous Return (TAPVR)``. Mwa munthu amene ali ndi TAPVR, mitsempha yonse m'mapapo imalumikizidwa ndi mtima mwanjira yosazolowereka. TAPVR ndi vuto lalikulu kuposa mitundu yambiri ya PAPVR, ndipo nthawi zambiri limafuna chithandizo chadzidzidzi atangobadwa kumene. Komabe, PAPVR ndi TAPVR zonse ndi zofanana chifukwa zimasokoneza njira yachibadwa yoyendera magazi kudzera mumtima.

Pomaliza, kumbukirani zinthu izi:

PAPVR singakhudze moyo wanu konse. Kapena, ingayambitse zizindikiro kapena zovuta zomwe zimafuna chithandizo. Komabe, ndi zachilendo kuti mumve kupsinjika maganizo kapena kuda nkhawa ndi PAPVR. Ngati mwana wanu ali ndi PAPVR, ndi zachilendo kuti mudandaule za thanzi lake. Maganizo amenewa ndi achibadwa, ndipo musawamvere chisoni.

Gawani nkhawa zanu ndi dokotala wanu. Funsani za zinthu zomwe zingakuthandizeni inu ndi banja lanu. Kuphunzira zambiri zokhudza matenda a mtima obadwa nawo - kaya akukhudzani inu, mwana wanu, kapena wokondedwa wanu - kungakuthandizeni kusamalira bwino vuto lanu. Kulankhula ndi mlangizi kungakuthandizeninso kukhala ndi mtendere wamumtima. Paulendowu, musazengereze kufunsa dokotala wanu za mafunso kapena nkhawa zilizonse zomwe mungakhale nazo. Simuli nokha.

PAPVR , matenda a mtima, matenda obadwa nawo, mapapo, kuyenda kwa magazi, opaleshoni ya mtima, matenda obadwa nawo a mtima, mitsempha ya m'mapapo, opaleshoni ya mtima