Kodi septostomy ndi chiyani? N’chifukwa chiyani ndi yofunika kwa makanda omwe ali ndi matenda a mtima obadwa nawo?

N'zovuta kufotokoza momwe mayi kapena bambo amamvera akadziwa kuti mwana wawo wakhanda ali ndi vuto lalikulu la mtima. Koma masiku ano, mankhwala apita patsogolo kwambiri. Nthawi zina, pali mankhwala ang'onoang'ono koma ofunikira kwambiri omwe angathandize kuti mwana akhale ndi moyo mpaka opaleshoni yayikulu itachitika. Lero, tikulankhula za mankhwala opulumutsa moyo. Izi zimatchedwa septostomy.

Mwachidule, kodi septostomy ndi chiyani?

Septostomy ndi njira yopulumutsa moyo yomwe imathandiza makanda omwe ali ndi vuto la mtima wobadwa nawo kuti akhale ndi moyo mpaka atachitidwa opaleshoni yayikulu kuti akonze mtima wawo. Imatchedwanso 'balloon atrial septostomy'.

Iyi si opaleshoni yotsegula mtima. Chomwe chimachitika apa ndi chakuti dokotala amalowetsa singano yaying'ono pakhungu la mwana ndikulowetsa chubu chopyapyala kwambiri (catheter) kupita nayo kumtima. Kumapeto kwa chubu ichi pali buluni yaying'ono. Baluni iyi imagwiritsidwa ntchito kukulitsa dzenje laling'ono lomwe limapezeka mwachibadwa mumtima mwa mwana.

Bowo ili limalola magazi okhala ndi mpweya wochuluka ndi magazi opanda mpweya wokwanira kusakanikirana . Kenako, magazi ena okhala ndi mpweya wochuluka amazungulira thupi lonse la mwana. Ngati chithandizochi sichichitika, magazi ochepa kwambiri okha ndi omwe amazungulira thupi la mwana. Izi ndizoopsa kwambiri pa moyo wa mwana.

Ndi mwana wamtundu wanji amene akufunikira chithandizochi?

Ana ena omwe ali ndi matenda a mtima obadwa nawo amakhala ndi mtundu wabuluu pakhungu lawo. M'mawu azachipatala, izi zimatchedwa cyanosis . Izi zimachitika chifukwa thupi sililandira mpweya wokwanira kuchokera m'magazi. Izi zikutanthauza kuti magazi omwe alibe mpweya wabwino amapita mwachindunji m'mapapo ndipo sayeretsedwa, koma m'malo mwake amayenda m'thupi lonse. Vutoli ndi loopsa kwambiri ndipo limafuna chithandizo chadzidzidzi .

Septostomy nthawi zambiri imafunika kwa makanda omwe ali ndi matenda a mtima otchedwa cyanotic. Pali matenda awiri akuluakulu a mtima omwe amagwiritsidwa ntchito kwambiri pochiza matendawa.

Kodi nkhani ya dzenje laling'ono ili lotchedwa Foramen Ovale ndi yotani?

Kuti timvetse izi, tiyenera kubwerera m'mbuyo pang'ono ku nthawi imene mwana anali m'mimba mwa mayi ake.

Mwana akakhala m'mimba, mapapo a mwana sagwira ntchito. Mwanayo amalandira mpweya womwe amafunikira kuchokera kwa mayi kudzera mu umbilical cord. Chifukwa chake, magazi opangidwa ndi mpweyawu amatumizidwa mwachindunji ku thupi popanda kupita ku mapapo, ndipo foramen ovale iyi ndi kabowo kakang'ono kachilengedwe mumtima. Izi zili pakhoma pakati pa zipinda ziwiri zapamwamba (atria) za mtima.

Mwana akabadwa, mapapo amayamba kugwira ntchito. Kenako, popeza kampata kakang'ono aka sikafunikanso, nthawi zambiri kamatseka kokha.

Nanga n’chifukwa chiyani dzenje ili ndi lofunika pa chithandizo cha septostomy?

Kwa ana omwe ali ndi matenda a mtima omwe tidakambirana kale, omwe amasanduka abuluu, dzenje ili lotchedwa foramen ovale limawathandiza kukhala ndi moyo kwa masiku angapo atabadwa. Kudzera mmenemo, magazi ena okhala ndi mpweya wambiri amasakanikirana ndi magazi omwe alibe mpweya wabwino ndipo amalowa m'thupi.

Komabe, dzenje ili likayamba kutseka lokha, dzenjelo limatseka. Kenako moyo wa mwana umakhala woopsa kwambiri. Pamenepo ndi pamene chithandizo cha septostomy chimakhala chofunikira. Zimene madokotala amachita ndikugwiritsa ntchito buluniyo kupanga dzenje mu foramen ovale lomwe latsala pang'ono kutseka pang'ono ndikulisunga lotseguka . Kenako mwanayo akhoza kukhalabe ndi moyo mpaka opaleshoni yayikulu itachitika.

Nthawi zina, ngati dzenje ili latsekeka kwathunthu, madokotala amatha kugwiritsa ntchito chubu chapadera chokhala ndi masamba kuti apange dzenje latsopano. Zingamveke zachilendo kuganiza zopanga dzenje mumtima, koma mwina ndiyo njira yokhayo yopulumutsira miyoyo ya makanda ngati awa.

Kodi chithandizo cha septostomy ichi chimachitidwa bwanji?

Chithandizochi chimachitidwa mu labotale yapadera (catheterization lab) mu chipinda cha mtima cha chipatalacho kapena mu chipinda chosamalira odwala omwe ali ndi matenda aakulu (Neonatal ICU). Chimachitika ndi dokotala wa mtima yemwe waphunzitsidwa mwapadera pa izi.

1. Kupeza njira yolowera: Choyamba, dokotala amaika singano yaying'ono mu mtsempha waukulu wamagazi womwe uli m'mimba mwa mwana. Nthawi zina izi zitha kuchitika kudzera mu chingwe cha umbilical.

2. Kuika catheter: Kenako singano imachotsedwa, ndipo chubu chopyapyala (catheter) chokhala ndi baluni chimalowetsedwa kudzera m'bowo kupita mumtsempha wamagazi.

3. Kusuntha kupita kumtima: Dokotala amatsogolera mosamala chubu ichi kudzera m'mitsempha yamagazi kupita kumtima pamene akuyang'ana zithunzi pa echocardiogram .

4. Kukula kwa dzenje: Chubu chikafika ku atrium yakumanja ya mtima, chimadutsa mu foramen ovale kupita ku atrium yakumanzere. Kenako, baluni kumapeto kwa chubu imadzazidwa ndi madzi ndikukokedwa kumbali yakumanja. Kukoka kumeneku kumakulitsa dzenje laling'ono.

5. Kutha kwa chithandizo: Bowo likakula mokwanira, baluni imatuluka madzi ndipo chubucho chimachotsedwa mosamala.

Njira yonseyi imachitika popatsa mwana mankhwala oletsa ululu komanso oletsa ululu, komanso kuyang'anira mwanayo mosamala.

Kodi madokotala amatsimikiza bwanji ngati chithandizocho chayenda bwino?

Madokotala amafufuza zinthu zingapo kuti adziwe ngati chithandizocho chapambana.

• Amafufuza ngati mpweya m'magazi a mwana wawonjezeka ndi osachepera 10% .
• Amafufuza ngati dzenje lomwe lapangidwa mumtima lakula ndi 33% kuposa kale.
• Timafufuza ngati pali kusiyana kwakukulu pakati pa kuthamanga kwa magazi pakati pa atriums yakumanja ndi yakumanzere ya mtima.

Ngati chimodzi mwa zinthu izi zakwaniritsidwa, chithandizocho chimaonedwa kuti chapambana.

Kodi ubwino ndi zoopsa zake ndi ziti?

Ubwino

Ubwino waukulu wa chithandizochi ndi wakuti chingapulumutse moyo wa mwana . Mwana amene alibe mpweya chifukwa cha vuto la mtima angapatsidwe mpweya mwachangu ndikupatsidwa mwayi wokhala ndi moyo mpaka atachitidwa opaleshoni yaikulu.

Zoopsa

Monga momwe zimakhalira ndi chithandizo chilichonse chamankhwala, pali zoopsa. Chithandizo chilichonse cha makanda omwe ali ndi matenda aakulu a mtima chimakhala ndi zoopsa. Kafukufuku wina wasonyeza kuti chithandizochi chingayambitse sitiroko. Komabe, sizikudziwika bwino ngati izi zikuchitika chifukwa cha chithandizocho kapena kusowa kwa mpweya m'thupi chifukwa cha matenda a mtima.

Kodi tsogolo la mwana lidzakhala bwanji atatha kulandira chithandizo?

Makanda 94% okha omwe amachitidwa opaleshoni ya septostomy amapulumuka . Kenako amafunika kuchitidwa opaleshoni yayikulu kuti akonze vuto la mtima wawo.

Mwachitsanzo, makanda omwe ali ndi d-TGA amachitidwa opaleshoni yotchedwa Arterial Switch Operation (ASO) atangobadwa kumene. Izi zimaphatikizapo kudula mitsempha iwiri yamagazi yosinthidwa ndikuyilumikizanso bwino. Pakati pa 97% ndi 98% ya makanda amachira bwino atatha opaleshoniyi.

Pambuyo pa opaleshoni yayikulu ngati iyi, mwana wanu adzafunika chithandizo chamankhwala chopitilira. Izi zikutanthauza kuti muyenera kuonana ndi dokotala nthawi ndi nthawi, kuyesedwa, komanso kusamalira bwino mwana wanu. Popeza mwana aliyense ndi wosiyana, dokotala wanu angakupatseni chidziwitso chabwino kwambiri chokhudza tsogolo la mwana wanu.

Zinthu zomwe muyenera kudziwa monga kholo

Ndizachibadwa kuchita mantha, kuda nkhawa, komanso kukhala ndi mafunso ambiri mukazindikira kuti mwana wanu ali ndi vuto lalikulu. N'kovutanso kwambiri kukhala kutali ndi mwana wanu ali kuchipatala. Ogwira ntchito zachipatala amamvetsetsa momwe mukumvera.

• Musaope kufunsa mafunso: Funsani dokotala kapena namwino mafunso aliwonse omwe muli nawo okhudza mankhwala omwe mwana wanu akupatsidwa, chithandizo chake, kapena zomwe zichitike pambuyo pake. Ngati simukumvetsa, afunseni kuti akufotokozereninso mosavuta.
• Funani thandizo: Kulankhula ndi makolo ena omwe adakumanapo ndi zomwezo kungakhale kolimbikitsa kwambiri. Funsani dokotala wanu za magulu othandizira.

Matenda a mtima amtunduwu angakhale osowa, koma simuli nokha. Septostomy ikhoza kukhala gawo loyamba komanso lofunika kwambiri pa moyo wa mwana wanu. Ndi chithandizo choyenera chamankhwala komanso chikondi ndi chisamaliro chanu, mutha kutsimikizira kuti mwana wanu adzakhala ndi tsogolo labwino.