Ese umwana wawe afite ikibazo cyo guhumeka nk'iki? Reka tuvuge kuri "Double Aortic Arch"!

Ese umwana wawe rimwe na rimwe yumva afite ikibazo cyo guhumeka? Ese arumira mu gihe agaburira cyangwa yonsa? Cyangwa se avuza urusaku rudasanzwe mu gihe ahumeka? Nubwo izi zishobora kuba indwara zisanzwe mu bwana, hashobora kubaho indi ndwara ikomeye cyane, ariko ishobora kuvurwa. Imwe muri izo ndwara zidasanzwe ariko z'ingenzi ugomba kumenya ni "Double Aortic Arch." Reka tubiganireho birambuye uyu munsi.

Mu magambo make, umuyoboro w'amaraso munini utwara amaraso ava mu mutima w'umwana wawe akayajyana mu gice cyose cy'umubiri we ni aorta . Akenshi ni umuyoboro umwe munini. Igice cy'uyu muyoboro kiri hejuru y'umutima cyitwa aorta arch .

Ariko, ku mwana ufite "Double Aortic Arch", iyi "aortic arch" ikorwamo kabiri. Ni ukuvuga ko hari undi muyoboro w'amaraso uhujwe n'iyi "aortic arch" nyamukuru, igakora indi arch. Iyi arch ebyiri zirahura, zigakora impeta ikikije umuyoboro w'umwuka w'umwana (trachea) n'umuyoboro w'ibiribwa (esophagus) . Tekereza, bigenda bite iyo iyi mpeta ifunze? Ni bwo umwana atangira kugira ibimenyetso bikomeye nko kugorwa no guhumeka, gukora urusaku mu gihe ahumeka, no kugorwa no kumira ibiryo.

Iyi "aortic arch" ibaho mu ntangiriro cyane zo gutwita, hagati y'ibyumweru bibiri na birindwi. Muri iki gihe, umutima n'imiyoboro y'amaraso bikura mu buryo bugoye cyane. Hari ibice bimwe bibaho, kandi nyuma y'igihe runaka ntibiba bigikenewe kandi birashira. "Aortic arch double" ibaho kubera ikintu nk'iki. Ahagana mu cyumweru cya gatanu cyo gutwita, umuyoboro w'amaraso wagombaga kuba warazimye, ku mpamvu itazwi, ntushira maze iyi "aortic arch double" ibaho. Iki ni ikibazo cy'umutima wavutse , bivuze ko umwana avukana na cyo.

Iyi ndwara, yitwa "double aortic arch," ikomoka ku itsinda ry'ubumuga bw'umutima buvukanwa bwitwa "impeta z'imitsi." Ibi bituma imiyoboro y'umwuka n'umuyoboro w'amaraso by'umwana bikandagira.

Izi "mpeta z'imitsi" ni izihe?

"Impeta z'imitsi", nkuko nabivuze mbere, ni indwara aho "umuyoboro w'amaraso" utera ku buryo budasanzwe, bishobora gutuma imiyoboro y'umwuka (trachea), imiyoboro y'ibiribwa (esophagus), cyangwa byombi bikandagira. Ibi ni indwara zidakunze kugaragara ku mutima . Tekereza nawe, hafi umwana umwe mu bana 100 avuka afite ubwoko runaka bw'ubumuga bw'umutima. Ariko "impeta y'imitsi" igira ingaruka ku mwana umwe gusa mu bana 10.000. Ni gake cyane.

Ni ubuhe bwoko bw'ingenzi bwa "Impeta z'imitsi"?

Hari ubwoko bwinshi bw'ingenzi bw'izi "mpeta z'imitsi". Reka turebe ibyo ari byo:

• Udukingirizo tubiri tw’imitsi: Muri iki gice, "imitsi ibiri y’imitsi" (ibumoso n’iburyo) ikikije trachea n’umuyoboro w’amaraso. Iyi ni yo ngingo nyamukuru tuvugaho.
• Umuyoboro w'iburyo w'amaraso ufite umuyoboro w'ibumoso w'amaraso udasanzwe hamwe n'umuyoboro w'ibumoso w'amaraso: Hari umuyoboro umwe w'amaraso hano, ariko uri iburyo bwa trachea (ubusanzwe ibumoso). Muri iki gihe, umuyoboro w'ibumoso w'amaraso, utanga amaraso mu maboko y'umwana, utangirira kuri aorta ukanyura inyuma ya trachea na epoopho. Iyi mpeta y'imitsi irangira ihujwe n'umuyoboro w'ibumoso w'amaraso, igice cy'umuyoboro w'amaraso wari uhari mu gihe cy'ubuzima bw'umwana hanyuma ukabura.
• Umugongo w'ibumoso w'umutima ufite umutsi w'iburyo udasanzwe: Aha, umutsi w'iburyo w'umutima unyura inyuma y'umuyoboro w'amaraso n'umuyoboro w'amaraso, ukabikanda.
• Gukanda imitsi y'amaraso itagaragara: Imitsi y'amaraso itagaragara (brachiocephalic) ni ishami rya aorta. Muri iki gihe, itangirira ibumoso bwa trachea, hanyuma inyura imbere ya trachea iburyo. Ibi bishyira igitutu kuri trachea.
• Imitsi y'ibihaha ikoreshwa mu gufunga imitsi: Imitsi y'ibihaha y'ibumoso ihera mu mitsi y'ibihaha y'iburyo ikanyura hagati y'imitsi yo mu gifu n'umuyoboro w'amaraso.

Ikibaho muri ibi byose ni uko inzira z'ubuhumekero cyangwa umwobo bigira ingaruka ku buryo runaka.

Ese hari ubwoko bwa "Double Aortic Arch"?

Yego, hari ubwoko butatu bw'ingenzi bwa "double aortic arch." Ubu bwoko butandukanywa n'agace kanini, n'uko ako gace kanini kari iburyo cyangwa ibumoso bw'agace ka trachea.

• Umugongo w'iburyo ukomeye ufite umugongo muto w'ibumoso: Ubu ni bwo bwoko bukunze kugaragara cyane, buboneka hafi 80% by'abarwayi.
• Agace k'ibumoso gakomeye gafite agace gato k'iburyo: Ibi bigaragara mu bantu bagera kuri 10 ku ijana.
• Imirongo iringaniye: Ibi binagaragara mu manza zigera kuri 10%.

Ni ubuhe bwoko bwa "impeta y'imitsi" ikunze kugaragara cyane?

Abaganga batekerezaga ko "agace k'imitsi ibiri" ari bwo bwoko bukunze kugaragara cyane bwa "impeta y'imitsi." Ariko ubushakashatsi bushya bwagaragaje ko "agace k'imitsi yo mu buryo bw'iburyo" mu by'ukuri gakunze kugaragara cyane.

Ariko hari ikindi kintu. Abana bafite "right aortic arch" baba bafite amahirwe menshi yo kugira izindi ndwara z'umutima bavukanye kurusha abana bafite "double aortic arch". Ariko, ntibakunze kumenyekana mu gihe cyo kuvuka. Ibi biterwa nuko "right aortic arch" ishobora kutagira ibimenyetso mu ntangiriro. Bityo rero, kubagwa iki kibazo bishobora kuba ngombwa hagati y'amezi 6 na 18.

Indwara yitwa "Double Aortic Arch" ni yo ikunze kugaragara cyane mu mitsi. Kubwibyo, muganga w'umwana wawe ashobora kumenya ikibazo hakiri kare. Ugereranyije n'abana bafite ubundi bwoko bw'impeta z'imitsi, abana bafite "Double Aortic Arch" bashobora gukenera kubagwa nyuma gato yo kuvuka.

Ni ibihe bimenyetso by'indwara ya "Double Aortic Arch"?

Ibimenyetso bya "double aortic arch" bikunze kubaho iyo umuyoboro w'umwuka w'umwana, umwobo w'amaraso, cyangwa byombi bikandamijwe. Uku gukandamizwa gushobora kugira ingaruka ku mikorere y'umwana yo guhumeka, kugaburira, cyangwa ku mikorere y'umutima.

Akenshi, ibi bimenyetso bigaragara mu bwana (cyane cyane iyo indwara ikomeye), ariko rimwe na rimwe bishobora kugaragara mu myaka itatu y'amavuko, cyangwa no mu bwana.

Hari abana bashobora gufatwa nk'abafite asima nabi kuko ibimenyetso bisa. Iyi ndwara imenyekana gusa iyo ubuvuzi bwa asima bwananiranye hanyuma hagakorwa ibizamini birambuye.

Ibimenyetso by'ubuhumekero

Hafi 91 ku ijana by'impinja n'abana bafite "double aortic arch" bagaragaza ibimenyetso bijyanye no guhumeka. Ni ibi bikurikira:

• Ijwi ridasanzwe iyo uhumeka (ijwi rirenga ryitwa `stridor` cyangwa ijwi ryo guhumeka ryitwa `humira`) .
• Inkorora isa n'aho "ipfutse mu gifu." Ibi bisa n'inkorora ibaho mu gihe cy'indwara yitwa "croup".
• Indwara zikunze kugaragara mu myanya y'ubuhumekero yo hasi .

Ibimenyetso by'igifu

Hafi 40 ku ijana by'impinja n'abana bafite "double aortic arch" bahura n'ibi bimenyetso by'igogora. Muri byo harimo:

• Kumirwa mu gihe cyo konsa cyangwa cyonsa.
• Kugorwa no kumira (dysphagia) . Ibi bikunze kugaragara nyuma y'uko umwana atangiye kurya ibiryo bikomeye.
• Kugorwa no kongera ibiro .
• Ibiryo bigaruka mu muhogo (`Regurgitation/Reflux`) .

Ibimenyetso by'umutima

Hafi 30 ku ijana by'impinja n'abana bafite "double aortic arch" bagaragaza ibimenyetso by'umutima. Ibi birimo:

• Kubabara mu gituza .
• Ijwi ridasanzwe ry'umutima ('Umutima uvuza induru') .
• Uruhu rw'ubururu (cyanose) .

Ni iki gitera "Double Aortic Arch"?

Impamvu nyayo ya "double otic arch" ntiramenyekana . Nubwo iyi ndwara ikunze kugaragara ku bana batwite binyuze mu "gutera inda mu buryo bwa "in-vitro fertilization" (IVF) , impamvu nyayo ntabwo izwi.

Udupira tw’imitsi duto dushobora kandi kujyana n’izindi ndwara. Abana bagera kuri 12 ku ijana bafite utwo dupira tw’imitsi duto bafite ubundi busembwa bw’umutima bavukanye, nka ventricular septal defect (VSD) na tetralogy of Fallot . Byongeye kandi, abana bagera kuri 20 ku ijana bafite utwo dupira tw’imitsi duto bafite indwara za genetiki nka chromosome 22q11 deletion na trisomy 21 (Down syndrome) .

Ni gute wamenya "Double Aortic Arch"?

Indwara y’imitsi ibiri ivurwa ku bw’amahirwe cyangwa iyo ibimenyetso bitangiye. Hari igihe ivumburwa ku buryo butunguranye mu gihe cyo gutwita, nyuma yo kubyara, cyangwa mu gihe cyo gupima amashusho ku yindi mpamvu. Kuva mu 2004, umubare w’abantu basuzumwa iyi ndwara binyuze mu gupima mu gihe cyo gutwita wariyongereye. Ibi ni ingirakamaro cyane, kuko ubuvuzi bushobora gutegurwa umwana akimara kuvuka.

Cyangwa, bishobora kumenyekana iyo ibimenyetso bigaragaye nyuma yuko umwana avutse. Muganga w'umwana wawe azakubwira ibimenyetso hanyuma agukorere ibizamini.

Ibizamini byo gusuzuma "Double Aortic Arch"

Ibipimo by'ingenzi byakoreshejwe mu gusuzuma iyi ndwara ni ibi bikurikira:

• X-ray yo mu gituza: Iki ni cyo kizamini cya mbere gikorerwa.
• Isuzuma rya CT.
• Ikizamini cya Echocardiogram (Echo): Ibi birafasha cyane mu kumenya niba hari izindi ndwara z'umutima.
• Ikizamini cya MRI (MRI).

Hari igihe hashobora gukorwa isuzuma rya bronchoscopy kugira ngo hasuzumwe imiyoboro y'umwuka y'umwana. Ibi bishobora gukorwa mu rwego rwo gusubiza ibibazo byo guhumeka mbere yuko hamenyekana icyuma cy'imiyoboro ibiri y'amaraso gifata imiyoboro y'amaraso. Cyangwa, bishobora gukorwa mbere yo kubagwa kugira ngo bifashe umuganga kubaga gusobanukirwa neza ibiri kuba.

Gupima imiterere y'uturemangingo bifasha kumenya indwara z'uturemangingo.

Ni gute wavura "Double Aortic Arch"?

Kubagwa birakenewe kugira ngo hakosorwe ikibazo cya "double aortic arch." Ndetse no ku bana badafite ibimenyetso, kubagwa ni byiza gukorwa hagati y'amezi 6 na 9. Abana bafite ibimenyetso, cyane cyane iyo ibimenyetso bikomeye, bashobora gukenera kubagwa mbere y'igihe.

Tekereza gato, indwara "double aortic arch" yamenyekanye bwa mbere mu 1737. Kubagwa kwa mbere kwakozwe mu 1947. Kuva icyo gihe tugeze kure! Abana bafite ubu busembwa bavutse bashoboye kubaho igihe kirekire kandi bafite ubuzima bwiza bitewe n'ubuvuzi bwo kubagwa.

Kubaga "Double Aortic Arch"

Kubaga "Double Aortic Arch" ni byiza cyane, kandi ibisubizo biratanga umusaruro mwiza cyane . Umwana wawe ntazakenera gushyirwa ku "mashini ikoresha umutima n'ibihaha" (imashini ikoresha umutima n'ibihaha) .

Kubaga bikorwa hakoreshejwe uburyo bwitwa "lateral thoracotomy." Ibi bivuze ko umuganga atema uruhande rumwe rw'igituza cy'umwana, hagati y'imbavu ebyiri. Ibi bikunze gukorwa ibumoso, kuko ariho abana benshi baba bafite "inyongera" y'imbavu nto. Ibizamini by'amashusho byakozwe mbere yo kubagwa bituma umuganga areba neza imbere mu mubiri w'umwana no gutegura uburyo bwo kubaga.

Umuganga ubaga akoresha uburyo bwo "gushyira no kugabanya" . Ibi bivuze ko agace gato kaboshywe kugira ngo kahagarike kuva amaraso muri ako gace. Hanyuma karacibwa kakanasukwa. Iki gikorwa gisubirwamo kugeza igihe agace katandukanijwe burundu kandi igitutu ku muyoboro w'amazi n'umuyoboro w'amaraso kikavaho.

Umwana wawe azamara icyumweru kimwe mu bitaro, hanyuma akire agaruke mu rugo.

Umuti wa "Kommerell diverticulum" (`Kommerell diverticulum - KD`)

Ni gake cyane, bamwe mu bana bafite "double aortic arch" bashobora kugira ikintu cyitwa "Kommerell diverticulum (KD)." Ibi bikunze kugaragara ku bana bafite "right aortic arch," ariko nanone ni gake cyane iyo bafite "double aortic arch".

Iyi 'KD' ni 'aneurysm', umuyoboro w'amaraso utera mu 'aorta' imanuka hafi ya 'aortike'. Iyi mvune ishobora gufata umwanya igakanda ku muyoboro w'umwuka w'umwana n'umuyoboro w'ibiribwa. Ishobora kutagira ibibazo byihutirwa. Ariko, abaganga b'inzobere bakunda kuyikuraho iyo bakora 'aortike' ebyiri kugira ngo birinde ibibazo nyuma.

Kuvura izindi ndwara z'umutima

Niba umwana wawe afite izindi ndwara z'umutima zisaba kubagwa, ashobora kuvurwa icyarimwe n'umuyoboro w'amaraso ufata imiyoboro ibiri. Ibi bishobora gusaba uburyo bwitwa "median sternotomy" , bukubiyemo gukata igice hagati mu gituza. Umuganga w'umwana wawe azakubwira uburyo bwiza kuri wewe, bitewe n'ibibazo bigomba kuvurwa.

Ni izihe ngorane zishobora guterwa no kubagwa?

Ingaruka zo kugira ibibazo bivuye mu kubagwa imitsi ibiri y’amaraso ni nke cyane . Ni gake cyane umwana ashobora kugira ibibazo byo kugaburira cyangwa guhumeka bidashira. Iyo hari ibibazo byo guhumeka bidashira, akenshi bishira mu mwaka umwe nyuma yo kubagwa.

Ingorane zo kubagwa kugira ngo hakosorwe imiyoboro ibiri y'amaraso n'izindi ndwara z'umutima zishobora gutandukana. Ganira n'umuganga w'umwana wawe kuri izi ngaruka zose n'ibibazo.

Ese "Double Aortic Arch" ishobora kwirindwa?

Oya, indwara yitwa "double aortic arch" ntishobora kwirindwa . Ni ikintu kivuka mu ntangiriro z'inda kandi kikabaho mu gihe cyo kuvuka.

Ni iki kizaba ku bantu bafite "Double Aortic Arch"?

Impinja n'abana bakorewe "Double Aortic Arch" bafite ahazaza heza cyane . Bashobora kubaho no gukora imirimo isanzwe nta mbogamizi.

Nyuma yo kubagwa, umwana wawe ashobora gukomeza guhumeka mu buryo bw'urusaku mu gihe cy'umwaka. Ibi biterwa nuko imiyoboro y'umwuka y'umwana iba itarakura neza bitewe na "double aortic arch." Bityo, bizafata igihe kugira ngo imiyoboro y'umwuka ikomere.

Ni gake cyane, impinja n'abana bashobora kugira ibimenyetso byo guhumeka nyuma y'umwaka urenga nyuma yo kubagwa.

Igikuru ni ukujyana umwana wawe kwisuzumisha buri gihe no kubibwira muganga wawe niba ufite ibimenyetso bikomeje. Kwitabwaho igihe kirekire ni ingenzi cyane kuri buri mwana wese wabazwe umutima.

Ni ryari nkwiye guhamagara muganga w'umwana wanjye?

Niba ubonye ibimenyetso bishya, cyangwa niba ibimenyetso bihari bisa n'aho birushaho kwiyongera, vugana na muganga w'umwana wawe vuba. Impinja n'abana bato barahinduka cyane ku buryo rimwe na rimwe bishobora kugorana kumenya ibisanzwe n'ibidasanzwe. Ariko niba umwana wawe afite inkorora "imeze nk'ipfundo" cyangwa ijwi rihuha , bwira muganga wawe vuba. Ishobora kuba indwara isanzwe yo mu bwana. Ariko gake cyane, ishobora kuba ikimenyetso cy'ikibazo cy'umutima kigira ingaruka ku bushobozi bw'umwana wawe bwo guhumeka.

Ni ryari ugomba guhamagara 911 (nimero y'ubutabazi bwihutirwa)?

"Umuyoboro w'amaraso ufata imiyoboro ibiri" ushobora gushyira igitutu ku muyoboro w'amazi w'umwana wawe mu kaga . Niba uruhu rw'umwana wawe rusa n'urusaku rw'ubururu (cyanosis) , cyangwa niba umwana wawe afite ikibazo gikomeye cyo guhumeka , hamagara 911 ako kanya.

Ni ibihe bibazo ngomba kubaza muganga w'umwana wanjye?

Niba umwana wawe asanzwe afite "double aortic arch", ni ibisanzwe ko ugira ibibazo byinshi. Ni ngombwa kumenya uko umwana wawe amerewe, harimo n'igihe abagwa, ndetse niba umwana wawe afite ibindi bibazo by'ubuzima. Ushobora kubaza ibibazo nk'ibi:

• Ni ryari umwana wanjye agomba kubagwa?
• Kubagwa bikorerwa he? Ni nde ubikora?
• Ni ibihe bimenyetso ngomba kwitondera mu rugo?
• Ni iki nakora kugira ngo byorohereze umwana wanjye kuguma mu rugo?
• Ese umwana wanjye afite izindi ndwara z'umutima?
• Ese nkwiye gupimwa imiterere y'umubiri w'umwana wanjye cyangwa uw'umuryango wanjye wose?
• Ejo hazaza h'umwana wanjye hazaba hameze hate?

"Aortic Arch Syndrome" ni iki? Ese itandukanye na "Double Aortic Arch"?

Yego, ntukivange ibyo byombi. "Aortic Arch Syndrome" ni ubwoko budasanzwe bwa "Vasculitis" . Izwi kandi nka "Takayasu's arteritis" .

"Vasculitis" ni ukubyimba kw'inkuta z'imitsi yawe y'amaraso. Ishobora kubaho mu mitsi iyo ari yo yose y'amaraso, ndetse no mu mitsi mito y'amaraso, imitsi mito cyane. "Takayasu's arteritis" ni ukubyimba kw'imitsi y'amaraso minini n'iminini. Ikunze kugaragara cyane mu "aortic arch" no mu mashami yayo manini. Niyo mpamvu yitwa kandi "aortic arch syndrome."

Indwara ya Takayasu arteritis (izwi kandi nka "syndrome ya aortic arch") igaragara mu rubyiruko no mu rubyiruko . Iki ni ikibazo gitandukanye rwose n'indwara ya "double aortic arch" twavuze mbere, kandi uburyo bwo kuvura busabwa buratandukanye.

Kuvuka k'umwana akenshi ni igihe cy'ibyishimo n'ibirori. Ariko, iyo umenye ko umwana wawe afite ikibazo cy'umutima, haba mu gihe atwite cyangwa nyuma yo kubyara, icyo cyishimo gisimburwa n'imihangayiko no kutizera. Niba umaze kumenya ko umwana wawe afite "double aortic arch", ushobora kuba wibaza ikizakurikiraho.

Wihangayika. Itsinda ry'abaganga bawe rizagufasha muri ibi byose intambwe ku yindi. Wamaze gutera intambwe ya mbere, ariyo kumenya byinshi ku buzima bw'umwana wawe. Inkuru nziza ni uko kubaga umuyoboro w'amaraso ukoresheje aorta ebyiri ari byiza cyane kandi bitanga umusaruro. Niba umwana wawe afite izindi ndwara z'umutima cyangwa indwara z'uturemangingo, ubuvuzi bushobora kugorana gato. Ariko, hamwe n'iterambere mu kwita ku mwana ukiri muto, ushobora gufasha umwana wawe kubona ubuvuzi bukwiye akeneye, gukira no kugira ubwana bwiza.

None se, ni ibihe bintu by'ingenzi ugomba kwibuka mu byo twavuze? (Ubutumwa bwo kujyana mu rugo)

Sawa, reka tuvuge muri make bimwe mu bintu ugomba kuzirikana mu byo twavuze ku bijyanye n'iyi "Double Aortic Arch":

• "Double aortic arch" ni ikibazo cy'umutima givukanwa . Aorta y'umwana igabanyijemo ibice bibiri, bigatera gukandagira trachea na epoopho.
• Ibimenyetso by'ingenzi ni ukugorwa no guhumeka, guhumeka nabi, kugorwa no kumira, ndetse no kwandura indwara z'ubuhumekero kenshi .
• Iyi ndwara ipimwa binyuze mu bipimo nka `CT scan`, `MRI`, `Echocardiogram` . Hari igihe ishobora no gupimwa mu gihe cyo gutwita.
• Ubu buvuzi ni ukubaga . Ubu buvuzi ni bwiza cyane kandi bugira ingaruka nziza.
• Ku mwana nyuma yo kubagwaUshobora kubaho ubuzima busanzwe kandi bufite ubuzima bwiza.
• Niba umwana wawe afite ibimenyetso nko kugorwa no guhumeka cyangwa kubyimbirwa, shaka ubufasha bwa muganga ako kanya .
• Wihangayika . Bitewe n'iterambere ry'ubuvuzi bugezweho, iyi ndwara ishobora kuvurwa neza. Itsinda ry'abaganga bawe rizaguha ubufasha ukeneye.

` Double Aortic Arch, Indwara y'Umutima yavutse, Impeta z'Imitsi, Kubura umwuka mu nda kw'uruhinja, Ubuzima bw'uruhinja, Kubagwa k'Umutima