Kodi mwana wanu ali ndi mavuto anayi ovuta a mtima awa? (Tetralogy of Fallot) - Tiyeni tikambirane za izi!

Tetralogy of Fallot, kapena ToF mwachidule, ndi vuto lomwe zinthu zinayi zosayembekezereka zimachitika pamodzi mumtima mwa mwana wanu akangobadwa. Mavutowa amachititsa kuti mtima wa mwana ukhale wovuta kupopera magazi okwanira okosijeni ku thupi lonse. Mukudziwa kufunika kwa mpweya kuti chilichonse m'thupi lathu chigwire ntchito bwino. Ndizachibadwa kuchita mantha mukamva za vutoli, koma tiyeni tikambirane mwatsatanetsatane kuti mumvetse bwino.

N’chifukwa chiyani `(Tetralogy of Fallot)` iyi ndi yapadera kwambiri? N’chiyani chimachitika mumtima?

Mwachidule, mumtima wathanzi, magazi amayenda m'njira inayake. Izi zikutanthauza kuti, magazi opanda mpweya amapita m'mapapo, amatenga mpweya, kenako amabwerera kumtima kuti agawidwe m'thupi lonse. Koma chifukwa cha mavuto anayi awa omwe ali mumtima mwa mwana yemwe ali ndi ``Tetralogy of Fallot``, magazi ena opanda mpweya amapita mwachindunji ku thupi m'malo mopita m'mapapo. Ili ndiye vuto lalikulu.

Tsopano tiyeni tiwone mavuto anayi a mtima awa:

1. Ventricular Septal Defect (VSD) : Tangoganizani kuti mtima wanu uli ndi zipinda ziwiri zazikulu, chimodzi kumanja ndi china kumanzere. Pamene VSD ichitika pakhoma pakati pa ziwirizi, magazi opanda mpweya (magazi abuluu) mu ventricle yakumanja amasakanikirana ndi magazi okhala ndi mpweya (magazi ofiira) mu ventricle yakumanzere. Izi sizabwino, chifukwa thupi limafuna magazi oyera, okhala ndi mpweya.

2. Kutsekeka kwa Mitsempha ya M'mapapo : Mtsempha waukulu wamagazi womwe umanyamula magazi opanda mpweya kuchokera ku ventricle yakumanja ya mtima kupita ku mapapo (mtsempha wa m'mapapo) ndipo valavu yake (valavu) imachepa. Zili ngati chitoliro chamadzi chomwe chimatsekeka. Izi zimachepetsa kuchuluka kwa magazi omwe angapite ku mapapo ndi kugunda kulikonse kwa mtima. Izi zimachepetsa kuchuluka kwa mpweya womwe ungawonjezedwe m'magazi.

3. Mtsempha waukulu wamagazi womwe umanyamula magazi kupita ku thupi uli pamalo olakwika (`Overriding Aorta`) : `(Aorta)` ndiye mtsempha waukulu kwambiri wamagazi womwe umanyamula magazi okhala ndi mpweya m'thupi lonse. Nthawi zambiri, izi zimalumikizidwa ndi chipinda chakumanzere chakumunsi cha mtima. Koma ndi `(VSD)`, `(Aorta)` iyi imakhala pamwamba pa zipinda zonse ziwiri, ndikutsegulira zonse ziwiri. Chifukwa cha izi, magazi opanda mpweya komanso magazi okhala ndi mpweya wambiri amayamba kuyenda kudzera mu `(Aorta)` iyi kupita ku thupi. Kunena mosapita m'mbali, magazi ena omwe ayenera kupita ku mapapo kuti atenge mpweya amapita mwachindunji ku thupi.

4. Kukula kwa khoma la chipinda chakumanja chapansi pa mtima (`Ventricular Hypertrophy`) : Chifukwa cha mavuto onse omwe atchulidwa pamwambapa, makamaka kuchepa kwa mtsempha wamagazi womwe umatumiza magazi m'mapapo, chipinda chakumunsi cha mtima (`(Right Ventricle)`) chiyenera kugwira ntchito molimbika kuti chipope magazi. Monga momwe minofu imakulira mukanyamula katundu, minofu yomwe ili pakhoma la chipinda ichi imakulanso pakapita nthawi. Izi zitha kusokoneza kwambiri magwiridwe antchito a mtima.

Mavuto anayiwa akabwera pamodzi, vuto lotchedwa ``Tetralogy of Fallot'' limachitika.

Kodi vutoli ndi lofala bwanji? Ndani amene ali ndi mwayi waukulu wolitenga?

Tetralogy of Fallot ndi vuto losowa kwambiri.Malinga ndi ziwerengero zaku America, izi zimachitika pafupifupi mwana m'modzi mwa ana 2,000 obadwa. Komabe, pakati pa matenda a mtima obadwa nawo (`(Congenital Heart Disorders)`), iyi ndi vuto lofala kwambiri. Vutoli ndi lofala pang'ono pakati pa makanda aamuna. Komanso, madokotala awona kuti `(ToF)` ingathenso kuwoneka pakati pa makanda omwe ali ndi mavuto ena a chromosome monga `(Down Syndrome)`.

Kawirikawiri, ngati anthu ena salandira chithandizo ali ana, izi zingayambitse mavuto ngakhale atakula.

Kodi madokotala amazindikira bwanji Tetralogy of Fallot?

Dokotala wanu angazindikire vutoli panthawi ya mimba kapena mwana akabadwa . Nthawi zambiri, matendawa amapezeka mkati mwa milungu kapena miyezi ingapo yoyambirira mwana akabadwa.

Mayeso a mwana asanabadwe

Ngati ultrasound yochitidwa nthawi zonse panthawi ya mimba ikuwonetsa zolakwika zilizonse mumtima, dokotala angachite ultrasound yapadera yotchedwa fetal echocardiogram . Izi zitha kuchitika pakati pa milungu 18 ndi 22 ya mimba kuti aone bwino kapangidwe ka mtima wa mwana ndikuwona ngati pali mavuto aliwonse.

Mayeso a mwana atabadwa

Mwana akabadwa, dokotala akamamufufuza mwanayo ndikumvetsera mtima, mawu osazolowereka (`Heart Murmur`) angamveke. Ichi ndi chizindikiro chofala chomwe chimapezeka mwa makanda omwe ali ndi `(ToF)`.

Kuphatikiza apo, mayeso ena angapo akuchitidwa kuti atsimikizire izi:

• Pulse Oximetry : Iyi ndi njira yosavuta komanso yopanda ululu. Musanatenge mwana wanu kupita naye kunyumba, kachipangizo kakang'ono kamayikidwa pa mkono kapena mwendo wa mwana wanu kuti ayesere kuchuluka kwa mpweya m'magazi mwake. Kuchepa kwa mpweya m'magazi kungakhale chizindikiro cha matenda otchedwa (ToF).
• Echocardiogram (yomwe imadziwikanso kuti echo) : Izi zili ngati scan. Imagwiritsa ntchito mafunde a phokoso kuti ione bwino kapangidwe ka mtima wa mwana, kuphatikizapo ma valve ake ndi kayendedwe ka magazi.
• Kujambula X-ray pachifuwa kapena Cardiac CT Scan : Izi nthawi zina zingasonyeze mawonekedwe osazolowereka a mtima "ofanana ndi nsapato". Ichi ndi chizindikiro cha ToF.
• Electrocardiogram (EKG kapena ECG) : Iyi imayesa ntchito yamagetsi ya mtima. Imatha kuzindikira zolakwika zilizonse mu kayimbidwe ka mtima kapena ngati zipinda zamtima zikugwira ntchito molimbika kwambiri.
• Kuyeza kwa Catheter ya Mtima : Iyi ndi njira yovuta pang'ono yoyezera. Imachitika pokhapokha ngati pakufunika kutero. Chubu chaching'ono (catheter) chimadutsa m'mitsempha yamagazi yomwe ili m'mwendo kapena mkono kupita kumtima kuti chiyese kuthamanga kwa magazi mkati mwa mtima, kutenga zitsanzo za magazi, ndikuwona bwino kapangidwe kake.

Pozindikira vutoli kwa munthu wamkulu kapena mwana wokulirapo pang'ono, mayeso omwe atchulidwa pamwambapa, monga `(EKG)` ndi `(Cardiac Catheterization),` angagwiritsidwe ntchito.

Kodi vuto limeneli `(Tetralogy of Fallot)` limachiritsidwa bwanji?

Mankhwala akuluakulu a mwana amene ali ndi `(ToF)` ndi mankhwala ndi opaleshoni . Choyamba, madokotala angapatse mwana mankhwala monga `(Beta-blockers)` kuti achepetse zizindikiro za mwana ndikuwonjezera kuyenda kwa magazi. Angaperekenso mpweya wowonjezera.

Opaleshoni yokonza mavuto onse anayi a mtima nthawi zambiri imachitika pakati pa miyezi itatu ndi isanu ndi umodzi mwana atabadwa. Pambuyo pa opaleshoniyi, momwe magazi amayendera mumtima zimabwerera mwakale.

Kodi njira zochitira opaleshoni ndi ziti?

Njira zochiritsira zingasiyane malinga ndi momwe mwana alili. Nthawi zina, ngati mwana ali wamng'ono kwambiri kapena wofooka kwambiri, zingakhale zovuta kuchita opaleshoni yayikulu nthawi imodzi. Pazochitika zotere, opaleshoni yosavuta (`(Palliative Surgery)`) ikhoza kuchitidwa kuti ithetse zizindikiro kwakanthawi mpaka mwanayo atakula pang'ono komanso ali ndi mphamvu. Pokhapokha `(Kukonza Konse)` kungachitike.

Pali njira zingapo zazikulu zochitira opaleshoni:

• Kukonza Konse : Mu njirayi, dokotala wa opaleshoni amakulitsa valavu yopapatiza ndi njira yopitira magazi kupita ku mapapo. Komanso, dzenje pakati pa zipinda ziwiri zapansi pa mtima (VSD) limatsekedwa ndi chigamba.
• Njira Yogwiritsira Ntchito BTT Shunt : Iyi ndi opaleshoni yakanthawi yomwe yatchulidwa kale. Kachubu kakang'ono (Shunt) kamayikidwa pakati pa mtsempha wa m'manja wa mwana (Subclavian Artery) ndi mtsempha wa m'mapapo (Pulmonary Artery). Izi zimathandiza kuti magazi ambiri ayende kupita ku mapapo.
• Njira Yogwiritsira Ntchito Catheter : Nthawi zina, stent imatha kulowetsedwa mumtima kudzera mu catheter popanda opaleshoni kuti ventricle yakumanja ikhale yotseguka. Ingagwiritsidwenso ntchito kuteteza ductus arteriosus ya mwana (chubu chomwe chimalumikiza mtsempha wa m'mapapo ndi aorta) kuti isatseke.

Maopaleshoni a akuluakulu

Kawirikawiri, anthu ena amatha kupulumuka ubwana wawo popanda opaleshoni iliyonse n’kufika paukulu. Akatswiri amalangiza anthu otere kuti achite opaleshoni yonse kuti apewe mavuto amtsogolo ndikuchepetsa chiopsezo cha imfa yadzidzidzi.

Mu njira imeneyi, dokotala wochita opaleshoni yemwe ndi katswiri wa matenda a mtima obadwa nawo kwa akuluakulu (VSD) amatseka vutolo ndi chigamba, kutsegula atrium yakumanja, ndikukonza kapena kusintha valavu ya m'mapapo. Mtsempha wa m'mapapo, womwe umapatsa magazi m'mapapo onse awiri, umakulitsidwa. Nthawi zina chubu chimayikidwa pakati pa atrium yakumanja ndi mtsempha wa m'mapapo kuti magazi aziyenda bwino.

Akuluakulu ambiri omwe akuchira chifukwa cha vuto la mtima (ToF) sadzafunika chithandizo china cha opaleshoni, koma ayenera kupitiriza kuonana ndi dokotala wamkulu wa mtima wobadwa nawo kuti akawunikidwe nthawi zonse.

Kodi ndi mavuto otani omwe angachitike mutachita opaleshoni?

Pambuyo pa opaleshoni ya Tetralogy of Fallot, nthawi zina (ndipo nthawi zina pakapita nthawi), mavuto ena angabuke. Koma musadandaule, madokotala nthawi zonse amasamala za izi.

• Kusokonezeka kwa Magetsi: Chigamba chomwe chimatseka VSD nthawi zina chingasokoneze zizindikiro zamagetsi kuchokera ku zipinda zapamwamba za mtima (Atria) kupita ku zipinda zapansi (Ventricles). Izi zitha kukonzedwa ndi pacemaker. Ndi ToF yokonzedwa, pali chiopsezo cha arrhythmias (kugunda kwa mtima kosakhazikika) m'zipinda zapamwamba komanso zapansi za mtima. Ngati muli ndi vuto la syncopal episode, muyenera kufufuzidwa izi.
• Chilema cha Septal Chotsalira cha Ventricular : Nthawi zina pangakhale kutuluka pang'ono mozungulira chigamba chomwe chimagwiritsidwa ntchito kutseka VSD.
• Aneurysm : Chigamba chomwe chimagwiritsidwa ntchito pokonza valavu chingayambitse malo ofooka mu valavu kuti atuluke ndikupanga aneurysm (kutupa kofanana ndi baluni mumtsempha wamagazi). Palinso chiopsezo chachikulu cha kukhala ndi aneurysm mu aorta yokwezeka.
• Mavuto a Shunt : Chifukwa cha shunt yomwe imayikidwa pa opaleshoni yoyamba yakanthawi, mavuto monga kuchepa kwa minofu (stenosis), kuthamanga kwa magazi m'mitsempha ya m'mapapo, komanso kupsinjika kwambiri kumbali yakumanzere ya mtima kumatha kuchitika.
• Ma Valves Otuluka : Magazi amatha kutuluka m'mbuyo kudzera m'ma valves m'mapapu anu, mtsempha wamagazi, kapena mbali yakumanja ya mtima wanu (Tricuspid). Nthawi zina, valavu ya m'mapapo (Valves Replacement) ingafunike.

Kodi mungayembekezere chiyani mukakhala ndi vutoli?

Ngakhale kuti magazi m'mtima amabwerera mwakale pambuyo pa opaleshoni ya Tetralogy of Fallot, pali zinthu zingapo zomwe inu kapena mwana wanu muyenera kudziwa:

• Kuopsa kwa Matenda a Mtima : Kuopsa kwa matenda a endocarditis n'kokwera pang'ono. Chifukwa chake, muyenera kusamala kwambiri za thanzi la mano anu. Dokotala wanu angakulangizeni kuti mumwe mankhwala opha tizilombo toyambitsa matenda kuti mupewe matenda mukamalandira chithandizo cha mano.
• Kukula Kochepa : Makanda omwe ali ndi Tetralogy of Fallot akhoza kukula pang'onopang'ono komanso kunenepa pang'onopang'ono. Angafunike chithandizo cha thupi, kulankhula, kapena ntchito.
• Zoopsa za Mimba : Azimayi okalamba ayenera kuyesedwa mtima mwapadera asanayambe kutenga mimba. Chiwopsezo cha kutaya mimba chingakhale chachikulu pang'ono kuposa masiku onse.
• Zoletsa Mankhwala : Mukakula, mungafunike kugwiritsa ntchito mankhwala enaake ndi njira zolerera kubereka zokha ndi vuto la mtima wanu.

Kodi tsogolo la udindo wa `(ToF)` ndi lotani?

Ndi kupita patsogolo kwa sayansi ya zamankhwala, tsogolo la makanda omwe ali ndi `(Tetralogy of Fallot)` lili bwino kwambiri kuposa kale. Chithandizo cha opaleshoni chimathandiza kwambiri kukonza zolakwika mu kapangidwe ka mtima ndi kayendedwe ka magazi. Kupambana kwa opaleshoni ya mtima mwa akuluakulu ndi dokotala wodziwa bwino ntchito yobereka nako kulinso kwakukulu kwambiri.

Masiku ano, makanda ambiri omwe amachitidwa opaleshoni kuti akonze Tetralogy of Fallot amakhala ndi moyo wokangalika. Komabe, pakhoza kukhala zoletsa zina pa zochita zolimbitsa thupi, monga masewera ampikisano. Chiŵerengero cha moyo wautali pambuyo pa opaleshoni ya ToF ndi chabwino kwambiri. Anthu ambiri omwe amachitidwa opaleshoni amakhala ndi moyo mpaka zaka 30. Komabe, ngati opaleshoni siichitika, munthu m'modzi mwa atatu okha ndi omwe ali ndi Tetralogy of Fallot ndiye amene amakhala ndi moyo kwa zaka 10.

Akuluakulu ena omwe adachitidwa opaleshoni ya Tetralogy of Fallot ali ana akhoza kukhala ndi mavuto akakula omwe amafunika mankhwala, chithandizo chamankhwala, kapena opaleshoni ina. Chifukwa chake, ndikofunikira kuti akuluakulu alankhule ndi dokotala wawo wa mtima asanachite opaleshoni ina ya thupi.

Kodi pali chilichonse chomwe ndingachite kuti mwana wanga amve bwino?

Pamene mwana wanu akuyembekezera opaleshoni, mutha kumuthandiza akamavutika kupuma (akasanduka buluu ndipo akuvutika kupuma). Akamavutika kupuma, muikeni pamalo opumula ndi mawondo ake moyang'anizana ndi chifuwa chake . Malo amenewa amawonjezera kuyenda kwa magazi kupita ku mapapo, zomwe zingathandize mwana wanu kumva bwino.

Komanso, ndikofunikira kwambiri kupatsa mwana madzi okwanira kuti amwe komanso kuti asamadzivutitse kwambiri.

Ndiyenera kupita kwa dokotala liti?

Ngati mwana wanu ali ndi "tet spell" yoopsa, kutanthauza kuti amasintha mtundu ndipo akuvutika kupuma, mutengereni ku chipinda chadzidzidzi chapafupi nthawi yomweyo . Ngati ndinu wamkulu, ngati mukumva kufooka, chizungulire, mukuvutika kupuma, kapena mukuvutika pachifuwa, muyeneranso kupita ku chipinda chadzidzidzi.

Akuluakulu omwe adachitidwa opaleshoni yoyamba ya valve ya mtima (ToF) ali ana ayenera kuyesedwa mtima wonse chaka chilichonse kapena ziwiri . Mayeso osiyanasiyana angachitike kuti awone momwe mtima ukugwira ntchito, mwachitsanzo:

• `(Holter Monitor)` (Chida chomwe chimalemba `ECG` tsiku lonse)
• Electrocardiogram (EKG)
• Mayeso Olimbitsa Thupi
• Echocardiogram (kujambula mtima)
• MRI ya Mtima

Komanso, dokotala wanu nthawi zonse amawunika kukula ndi momwe mbali yakumanja ya mtima wanu imagwirira ntchito.

Pambuyo pokonza Tetralogy of Fallot, mwana wanu adzafunika kukaonana ndi dokotala wa mtima wa ana nthawi zonse. Chisamaliro chachizolowezichi chidzapitirira mpaka atakula.

Mafunso ena omwe mungafunse dokotala wanu:

• Kodi mwana wanga adzayenera kuchepetsa masewera ake atatha opaleshoni?
• Kodi mwana wanga adzafunika opaleshoni ina?
• Ndi mankhwala ena ati (ngati alipo) omwe mwana wanga ayenera kumwa?

Pomaliza, ndiyenera kunena... (Uthenga Wopita Nawo Kunyumba)

Ndizachibadwa kumva chisoni kwambiri mukazindikira kuti mwana wanu wakhanda ali ndi vuto la mtima. Koma kumbukirani, gulu lanu lachipatala lathandiza makolo ena ambiri omwe adakumanapo ndi mavuto ofanana, ndipo angakuthandizeninso. Ngati mukumva kupsinjika maganizo pankhani yosamalira mwana yemwe ali ndi Tetralogy of Fallot, musaope kulankhula ndi katswiri wa zamaganizo. Komanso, katswiri wa zamaganizo angathandize ana ndi achinyamata omwe akumva kuti ali patsogolo pa anzawo omwe akukula. Khulupirirani kuti ndi chithandizo choyenera chamankhwala ndi chisamaliro chachikondi, ana awa akhoza kukhala ndi moyo wabwino.

` Tetralogy of Fallot, Matenda a Mtima a Ana, Zilema za Mtima Wobadwa Nawo, Mabowo mu Mtima, Blue Baby Syndrome, Opaleshoni ya Mtima, Kapangidwe ka Mtima