Ese umwana wawe afite ikibazo nk'iki cy'umutima? Reka twige ku ndwara y'umutima ifata umugongo!

Iyo umwana wawe avutse, uhangayikishwa cyane n'ibintu byose bimureba, si byo se? Hari igihe abana bato bashobora kugira ibibazo by'umutima bavukanye. Kimwe muri ibyo, nubwo ari ikibazo gikomeye, cy'umutima, ni ingenzi cyane kumenya ni icyitwa Endocardial Cushion Defect (ECD) . Izina rishobora kumvikana nk'aho riteye ubwoba gato, ariko ntugahangayike. Reka tubiganireho mu buryo bworoshye, mu buryo ushobora kumva, si byo se?

Iyi ndwara y'umutima ni iyihe?

Mu magambo make, iki ni inenge iri mu mitima y'abana bacu bato, ikaba ari indwara bavukana , ni ukuvuga inenge iba bakiri mu nda ya nyina. Tekereza ku mutima wacu nk'inzu ifite ibyumba bine. Hari ibyumba bibiri ku igorofa ryo hejuru (twita atria), n'ibyumba bibiri ku igorofa ryo hasi (ari byo byitwa ventricles). Ibi byumba bitandukanyijwe n'inkuta (septums). Kubera izi nkuta, amaraso atembera mu buryo bunoze, mu cyerekezo kimwe gusa.

Nanone, hari uturindantoki tumeze nk'irembo hagati y'utwo twumba dufasha amaraso gutembera mu cyerekezo kimwe gusa. By'umwihariko, uturindantoki twa tricuspid na uturindantoki twa mitral, biri hagati y'uturindantoki two hejuru (atria) n'uturindantoki two hasi (mitral ), bigomba kuba byaremwe neza.

Ariko, ku mwana ufite ubu burwayi bw'umusemburo w'umutima (ECD), ibice by'umutima byitwa imisemburo y'umutima - ingingo y'ibanze ikora izi nkuta n'imisemburo - ntibikura neza. Kubera iyo mpamvu, inkuta zitandukanya ibyumba by'umutima zishobora kudakura neza, cyangwa zikaba zitaraboneka burundu. Imisemburo ibiri y'ingenzi twavuze (tricuspid na mitral) nayo ishobora kudakura neza.

Noneho tekereza, bigenda bite iyo ibi bice biri mu mutima, izi nkuta, bidakora neza, kandi imiyoboro y'amaraso, nk'amarembo, idakora neza? Uburyo amaraso atembera mu mutima burahungabanywa.

• Amaraso menshi arenze asanzwe anyura mu bihaha by'umwana , bigatera umuvuduko w'amaraso uri hejuru mu mitsi iri mu bihaha (umuvuduko w'amaraso uri hejuru mu bihaha).
• Kubera uyu muvuduko mwinshi mu bihaha, amaraso atangira gutembera mu cyerekezo kitari cyo. Hanyuma , amaraso akungahaye kuri ogisijeni, asukuye n'amaraso yanduye adafite ogisijeni atangira kwivanga .
• Umutima ugomba gukora cyane kugira ngo upompe amaraso bitewe n'iyi ndwara y'amaraso itembera nabi. Ni nko kuzamuka umusozi. Uko igihe kigenda gihita, ibi bishobora gutuma imitsi y'umutima w'umwana icika intege.

Ese hari ubwoko butandukanye bw'ubumuga bw'umusego w'umutima (ECD)?

Yego, hari ubwoko butandukanye bw'iyi ndwara, bitewe n'ingano y'ibyangiritse. Hari abana bashobora kugira ibibazo ku rukuta ruri hagati y'ibyumba byo hejuru by'umutima (atria) gusa. Abandi bashobora kugira ibibazo ku rukuta ruri hagati y'ibyumba byo hasi (ventricles). Hari igihe ibibazo byombi bishobora kubaho hamwe. Nanone, inenge ziri mu mitsi ya mitral na tricuspid zishobora gutandukana.

Iyi ndwara, yitwa defect ya endocardial cushion (ECD), izwi kandi nka atrioventricular septal defect (AVSD) cyangwa atrioventricular canal defect .

Iyi ndwara rimwe na rimwe ishobora kujyana n'izindi ndwara z'umutima zavukanye. Urugero:

• Tetralogiya y'ibinyoma
• Inkondo y'iburyo isohoka kabiri
• Guhindura imitsi minini (guhindura imitsi ibiri minini y'amaraso ahantu hadakwiye)
• Patent ductus arteriosus
• Umuvuduko umwe (ventricle imwe)

Iyi ndwara ikunze kugaragara gute?

Iyo urebye imibare yo mu bihugu nka Leta Zunze Ubumwe za Amerika, umwana umwe ku bana 1.800 bavuka buri mwaka ashobora kugira iyi ndwara yo mu mutima (ECD). Ikindi kintu cy'ingenzi ni uko abantu bagera kuri 20% bafite iyi ndwara ya Down syndrome bafite iyi ndwara ya ECD.

Ni gute ECD igira ingaruka ku mubiri w'umwana wanjye?

Iyo iki kibazo cya ECD kidafashwe neza, gishobora kwiyongera cyane kandi kigatera ibibazo bikomeye.

• Kwangirika kw'ibihaha: Nkuko twabiganiriyeho mbere, gutembera cyane kw'amaraso mu bihaha, kwiyongera k'umuvuduko w'amaraso, ndetse n'igihe kirekire, bishobora kwangiza ibihaha burundu.
• Imikorere y'umutima idasanzwe: Imikorere y'amashanyarazi y'umutima irahungabana, kandi umutima ushobora kuba utari umeze neza.
• Kunanirwa k'umutima mu gihe cy'ihungabana: Indwara aho umutima ucika intege kandi ntushobore kuvoma amaraso ahagije mu mubiri.
• Eisenmenger syndrome: Iyi ni indwara ikomeye cyane. Umuvuduko w'amaraso mu bihaha wiyongera cyane, bigatuma amaraso atembera burundu, bigatuma amaraso adakora neza bitewe n'umwuka wa ogisijeni azenguruka mu mubiri wose.

Mu bihe bimwe na bimwe bikomeye, iyi ndwara ishobora no gushyira ubuzima mu kaga .

Nanone, nubwo ikibazo cyakosowe no kubagwa, umwana wawe ashobora kuba afite ibyago byo kurwara indwara y'umutima yitwa endocarditis . Kubwibyo, abaganga bashobora kukugira inama yo gufata imiti yica udukoko mbere yo kubagwa amenyo.

Ni ibihe bimenyetso by'iyi ndwara?

Hari igihe abana bafite ikibazo cy’umusemburo w’umutima bashobora kutagaragaza ibimenyetso kugeza bakiri bato cyane. Ariko, abana bafite ikibazo cy’umusemburo w’umutima (ECD yuzuye) bashobora kugaragaza ibimenyetso mu byumweru bike nyuma yo kuvuka. Ni ngombwa kwitondera ibi bimenyetso:

• Umutima wihuta cyane
• Uruhu rwerurutse cyangwa rw'ubururu:Reba ibara ry'ubururu, cyane cyane iminwa, ururimi, n'intoki. Ibi byitwa cyanosis.
• Kurya nabi no kwiyongera ibiro: Reba niba umwana wawe arya cyane, abira ibyuya nyuma yo kunywa amata, cyangwa niba atariyongera ibiro neza.
• Kubura imbaraga: Ese umwana wawe ahora asinzira kandi ntashishikazwe no gukina?
• Guhumeka vuba cyangwa bigoye: Reba niba igituza cy'umwana gisa n'aho gifunze, gihumeka vuba, cyangwa niba igituza kijya imbere iyo ahumeka.
• Kwandura indwara zikunze kugaragara: Menya neza indwara zikunze kugaragara, cyane cyane indwara z'ubuhumekero.

Ni iki gitera ubu busembwa bw'umusego w'umutima?

Impamvu nyayo itera indwara y’umutima (ECD) ntiramenyekana. Ariko, byagaragaye ko ifitanye isano rikomeye na Down syndrome . Iyi ndwara ibaho mu ntangiriro z’imikurire y’umwana uri mu nda. Ikibazo nyamukuru ni uko ingingo yitwa endocardial cushion twavuze mbere idakura neza. Izi ni inkuta n’utubati bitandukanya ibyumba by’umutima nyuma.

Ni gute abaganga basuzuma iyi ndwara?

Muganga w'umwana wawe azabanza apime umwana wawe umubiri wose . Hanyuma, niba ijwi ridasanzwe (umutima uvuza urusaku) ryumvikana iyo urimo kumva umutima ukoresheje stethoscope, bishobora kuba ikimenyetso cy'iyi ndwara.

Byongeye kandi, hari ibindi bizamini byinshi bishobora gukorwa:

• Electrocardiogram (EKG/ECG): Iyi electrocardiogram ipima imikorere y'amashanyarazi y'umutima.
• Echocardiogram: Iki ni cyo kizamini cy'ingenzi cyane. Gikoresha amajwi kugira ngo gifate ishusho y'umutima. Gishobora kubona neza ibintu byose kuva ku miterere y'umutima, kugeza ku myobo iri mu nkuta zawo n'uko imiyoboro y'amaraso ikora.
• X-ray yo mu gituza: Ibi bishobora kugenzura ingano y'umutima n'imiterere y'ibihaha.
• MRI y'umutima: Hari igihe iki kizamini gikorwa iyo hakenewe ibisobanuro birambuye.
• Gukoresha catheter y'umutima: Muri ubu buryo, umuyoboro muto (catheter) unyura mu mitsi y'amaraso ujya mu mutima kugira ngo upime umuvuduko uri mu mutima no gufata ibizamini by'amaraso. Ibi bishobora kuba ngombwa mbere yo kubagwa.

Igikuru ni ugukomeza kubonana na muganga wawe mu gihe utwite no gupimwa hakoreshejwe ultrasound.Kubikora neza. Hari igihe, ECD ishobora kumenyekana mbere yuko umwana avuka, binyuze mu gupima umwana akiri mu nda ya nyina (echocardiogram y'umwana uri mu nda). Iyo ibi bimenyekanye hakiri kare, birashoboka gutegura uburyo bwo kuvura umwana akimara kuvuka.

Ibi bivurwa bite?

Uburyo bw'ingenzi kandi bwiza bwo kuvura iki kibazo cyo mu nda y'umutima (ECD) ni ukubagwa. Ariko, kugeza igihe abaganga bakorewe, hari imiti imwe n'imwe ishobora gutangwa kugira ngo umwana akomere kandi agire ibiro byinshi. Urugero, imiti igabanya amazi mu mubiri (izwi kandi nka 'ibinini by'amazi') igabanya amazi menshi mu mubiri na digoxin (Cardoxin® cyangwa Lanoxin®) ifasha kunoza imikorere y'umutima ku rugero runaka.

Ni iki kibaho nyuma yo kubagwa?

Mu gihe cyo kubaga, abaganga b'umutima baziba imyobo ituma amaraso ava hagati y'ibyumba by'umutima. Bakoresha agace kabigenewe kugira ngo babikore. Nanone, iyo umwana afite valve imwe gusa, bazayikoramo valve ebyiri zitandukanye za mitral na tricuspid. Hari igihe, iyo valve ya mitral y'umwana iva, ishobora no gusanwa cyangwa gusimburwa bibaye ngombwa.

Ubu buryo bwo kubaga bushobora gukorerwa umwana uri hagati y'amezi 3 na 6. Ariko, niba umwana wawe afite ikibazo cy'umusego w'umutima, ni ngombwa ko umubagwa ukorwa mbere y'uko umwana agira umwaka umwe . Ubu ni bwo buryo bwonyine bwo kwirinda kwangirika burundu kw'ibihaha.

Hari igihe umwana ashobora kurwara cyane cyangwa akaba afite ibiro bike ku buryo atabasha kubagwa byuzuye. Muri icyo gihe, abaganga babanza gukora ubundi buryo bworoshye bwo kubaga kugira ngo bagabanye amaraso ajya mu bihaha by'umwana. Ibi byitwa gufunga imitsi yo mu bihaha . Ibi bishobora gufasha kugenzura ibimenyetso kugeza umwana akomereye kandi akagira ibiro byinshi. Hanyuma, mu gihe gikwiye, gusana byuzuye bishobora gukorwa.

Ese hari ingorane ziri mu kuvura?

Kimwe no kubagwa kose, hari ingorane zimwe na zimwe zishobora kubaho nyuma yo kubagwa ECD. Ariko, akenshi, izi ngorane zishobora gukemurwa.

• Valve ya mitral iva: Hari igihe nyuma yo kubagwa, valve ya mitral ishobora kudafunga neza kandi amaraso amwe ashobora kuva inyuma.
• Imivuduko y'umutima idasanzwe: Hari aho umutima utera nabi.

Ibi bibazo rimwe na rimwe bishobora kuvuka iyo umwana akuze gato, ndetse no mu bwana bwe. Niyo mpamvu kwisuzumisha kwa muganga buri gihe ari ingenzi.

Ese iki kibazo gishobora kwirindwa?

Kubera ko impamvu nyayo ya ECD itazwi, biragoye kuvuga uburyo bwo kuyirinda burundu. Ariko, niba hari umuntu wo mu muryango wawe wagize ubwo bwoko bw'indwara y'umutima (ECD) cyangwa ibindi bibazo by'uturemangingo, byaba byiza ugiye kugisha inama ku bijyanye n'uturemangingo mbere yo gutwita.

Niba umwana wanjye afite ECD, ni iki nakwitega?

Iki ni cyo kibazo gikomeye ababyeyi benshi bibaza. Inkuru nziza ni uko nyuma yo kubagwa kugira ngo hakosorwe ECD, abana benshi bakomeza kubaho ubuzima busanzwe kandi bufite ubuzima bwiza. Ariko, ubuzima bw'umwana mu gihe kizaza bushingira ku bintu nk'uburemere bwa ECD ye, niba ibihaha bye byarangiritse, ndetse n'ubuzima bwe muri rusange.

Imibare igaragaza ko amahirwe yo kubaho mu mwaka wa mbere nyuma yo kubagwa ari hafi 80%. Amahirwe yo kubaho mu yindi myaka 10 ni hafi 75%, naho amahirwe yo kubaho mu myaka 20 ni hafi 65%.

Ndetse na nyuma yo kubagwa, bamwe mu bana bashobora kugira ibibazo nyuma. Ikibazo gikunze kugaragara ni uko valve ya mitral idafunga neza kandi amaraso akava. Ibi bibaye, hashobora gukorwa ubundi buvuzi kugira ngo bukosorwe .

Ese ECD imara igihe kingana iki?

Ibi ni ingenzi cyane. Indwara yo mu mutima (ECD) si indwara izakira ubwayo. Ikibazo kizagumaho kugeza igihe umuganga w’umutima azabaga kugira ngo akosore iyo ndwara. Iyo hatabayeho kubagwa, abana benshi ntibazaramba barengeje imyaka 2 cyangwa 3. Niyo mpamvu kubagwa ku gihe ari ngombwa.

Ni gute nakwita ku mwana wanjye?

Nyuma yuko umwana wawe asanzwe afite ECD, ndetse na nyuma yo kubagwa, umwana wawe azakenera gusuzumwa buri gihe na muganga w’indwara z’umutima . Izi gahunda zo gukurikirana zishobora kuba rimwe cyangwa kabiri mu mwaka. Izi gahunda zizakomeza mu bwana bw’umwana wawe kugeza akuze. Ibi bituma muganga akurikirana uko umwana amerewe, akareba niba nta kibazo kiri mu gikoresho cyangwa agace k’amaraso gafite, nko kuva amaraso, kandi akamufasha hakiri kare bibaye ngombwa.

Ni ryari nkwiye kujyana umwana wanjye kwa muganga?

Niba umwana wawe agaragaje kimwe muri ibi bikurikira, hita ubonana na muganga:

• Kugorwa no guhumeka
• Kunanirwa nta mbaraga nyinshi nyuma yo kwiruka no gukina igihe gito
• Kudakura cyangwa kongera ibiro nkuko byari byitezwe
• Kugira uruhu rw'ubururu

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Ni ingenzi cyane gukuraho gushidikanya kose ushobora kuba ufite. Ntutinye kubaza muganga wawe ibibazo nk'ibi:

• "Muganga, umwana wanjye afite ikibazo cy'umusego w'umutima cyangwa igice cyawo?"
• "Ni iyihe gahunda yo kuvura umwana wanjye?"
• "Muganga, ni bangahe wabazwe ECD nk'iyi?"
• "Ni ibihe bintu byihariye ngomba kwitaho nyuma yo kubagwa?"

Ibintu by'ingenzi cyane ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Ushobora kuba utarigera urota kubagwa umwana wawe. Ariko, kubagwa ni bwo buryo bwiza kandi bwiza bwo gukosora ikibazo cy'umusego w'umutima (ECD). Iki kibazo ntikizakemuka ubwacyo. Rero, niba hari ikintu udasobanukiwe, saba muganga wawe kugira ngo agusobanurire.

Igikuru ni uko utari wenyine. Abaganga, abaforomo, n'itsinda ryose ry'abaganga bariho kugira ngo bagufashe kandi bagukomeze muri uru rugendo. Ndetse na nyuma yo kubagwa, ntucikwe n'ivuriro ry'umwana wawe kandi ukurikize amabwiriza ya muganga nk'uko byategetswe. Muri ubwo buryo, wowe n'umwana wawe muzashobora kumenya ibibazo byose bishobora kuvuka mu gihe kizaza no kubikemura neza. Komera!

` Indwara y'umutima, AVSD, indwara z'umutima, ubumuga bwo kuvukana, indwara z'umutima z'abana, kubagwa umutima, Down syndrome, indwara z'umutima zo mu muryango, indwara z'umutima z'abana