Ese umwana wawe afite ibi bibazo bine bikomeye by'umutima? (Tetralogy of Fallot) - Reka tubiganireho!

Tetralogy of Fallot, cyangwa ToF mu magambo ahinnye, ni indwara aho ibintu bine bidasanzwe biba mu mutima w'umwana wawe akivuka. Ibi bibazo bituma umutima w'umwana udashobora kohereza amaraso ahagije arimo ogisijeni mu mubiri wose. Uzi akamaro ka ogisijeni kugira ngo ibintu byose biri mu mubiri wacu bikora neza. Ni ibisanzwe kugira ubwoba iyo wumvise iby'iyi ndwara, ariko reka tubiganireho birambuye kugira ngo ubisobanukirwe neza.

Kuki iyi '(Tetralogiya y'ibinyoma)' ari idasanzwe? Ni iki kiba mu mutima?

Mu magambo make, mu mutima muzima, amaraso agenda mu nzira runaka. Ni ukuvuga ko amaraso yakuwemo umwuka ajya mu bihaha, agafata ogisijeni, hanyuma akagaruka mu mutima kugira ngo akwirakwizwe mu mubiri wose. Ariko kubera ibi bibazo bine by’imiterere y’umutima w’umwana ufite "Tetralogy of Fallot", amwe mu maraso yakuwemo umwuka ajya mu mubiri aho kujya mu bihaha. Iki ni cyo kibazo nyamukuru.

Noneho reka turebe ibyo bibazo bine by'umutima:

1. Indwara y'imitsi yo mu mitsi (VSD) : Tekereza ko umutima wawe ufite ibyumba bibiri by'ingenzi, kimwe iburyo ikindi ibumoso. Iyo VSD igaragaye mu rukuta ruri hagati y'ibyo byombi, amaraso yakuwemo umwuka (amaraso y'ubururu) mu mitsi yo ...

2. Stenose y'imitsi y'ibihaha : Umutsi mukuru w'amaraso utwara amaraso adahumeka neza uva mu gice cy'iburyo cy'umutima ujya mu bihaha (imitsi y'ibihaha) maze umutsi wayo (umutsi w'ibihaha) ugafunga. Ni nk'umuyoboro w'amazi ufunga. Ibi bigabanya ingano y'amaraso ashobora kujya mu bihaha buri gutera k'umutima. Ibi bigabanya ingano y'umwuka ushobora kongerwa mu maraso.

3. Umutsi mukuru w'amaraso ujyana amaraso mu mubiri uba uri ahantu hadakwiye (`Overriding Aorta`) : `(Aorta)` ni wo mutsi munini w'amaraso utwara amaraso arimo ogisijeni mu mubiri wacu wose. Ubusanzwe, uyu mutsi uhuzwa n'icyumba cyo hasi ibumoso cy'umutima. Ariko hamwe na `(VSD)`, uyu mutsi (Aorta)` uba hejuru y'ibyumba byombi, ukingukira kuri byombi. Kubera iyo mpamvu, amaraso adafite ogisijeni n'amaraso akungahaye kuri ogisijeni atangira gutembera muri uyu mutsi (Aorta)` ujya mu mubiri. Mu magambo make, amwe mu maraso agomba kujya mu bihaha kugira ngo ajyane ogisijeni ajya mu mubiri ako kanya.

4. Kwaguka k'urukuta rw'icyumba cyo hasi cy'iburyo cy'umutima (`Ventricular Hypertrophy`) : Kubera ibibazo byose byavuzwe haruguru, cyane cyane kugabanuka k'imitsi y'amaraso yohereza amaraso mu bihaha, icyumba cyo hasi cy'umutima (`(Right Ventricle)`) kigomba gukora cyane kugira ngo gipompe amaraso. Nk'uko imitsi ikura iyo uteruye ikintu, urwego rw'imitsi mu rukuta rw'iki cyumba narwo rurushaho kuba runini uko igihe kigenda gihita. Ibi bishobora kubangamira imikorere y'umutima.

Iyo ibi bibazo bine bihuye, habaho ikibazo kizwi nka "Tetralogy of Fallot".

Iyi ndwara ikunze kugaragara gute? Ni nde ufite amahirwe menshi yo kuyirwara?

Tetralogy of Fallot mu by'ukuri ni indwara idakunze kugaragara.. Dukurikije imibare y’Abanyamerika, ibi bibaho ku mwana umwe mu bana 2.000 bavutse. Ariko, mu ndwara z’umutima bavukanye (`(Congenital Heart Disorders)`), iyi ni indwara ikunze kugaragara cyane. Iyi ndwara ikunze kugaragara ku bana b’abahungu. Nanone, abaganga babonye ko `(ToF)` ishobora no kugaragara ku bana bafite izindi ngorane za chromosome nka `(Down Syndrome)`.

Ni gake cyane, iyo hari abantu batavuwe bakiri abana, ibi bishobora guteza ibibazo ndetse no mu gihe cy'ubukure.

Ni gute abaganga bapima Tetralogy of Fallot?

Muganga wawe ashobora kumenya iyi ndwara mu gihe utwite cyangwa nyuma yuko umwana avutse . Akenshi, irasuzumwa mu byumweru bike cyangwa amezi make ya mbere umwana avutse.

Ibizamini by'igihe cyo kubyara

Iyo isuzuma rya ultrasound risanzwe mu gihe cyo gutwita rigaragaje ko hari ikibazo mu mutima, muganga ashobora gukora isuzuma ryihariye ryitwa echocardiogram y'umwana . Ibi bishobora gukorwa hagati y'ibyumweru 18 na 22 byo gutwita kugira ngo harebwe neza imiterere y'umutima w'umwana no kumenya niba hari ikibazo.

Ibizamini nyuma yo kuvuka k'umwana

Nyuma y'uko umwana avutse, iyo muganga asuzumye umwana kandi akumva umutima, ijwi ridasanzwe (`Heart Murmur`) rishobora kumvikana. Iki ni ikimenyetso gikunze kugaragara ku bana bafite `(ToF)`.

Byongeye kandi, hari n'ibindi bizamini byinshi birimo gukorwa kugira ngo byemezwe iki kibazo:

• Pulse Oximetry : Iki ni ikizamini cyoroshye cyane kandi kidatera ububabare. Mbere yo kujyana umwana wawe mu rugo, hashyirwa agakoresho gato ko gupima urugero rwa ogisijeni mu maraso y'umwana wawe. Urugero rwa ogisijeni nke rushobora kuba ikimenyetso cy'indwara yitwa (ToF).
• Echocardiogram (izwi kandi nka echo) : Ibi ni nk'isuzuma. Ikoresha imiraba y'amajwi kugira ngo ibone neza imiterere y'umutima w'umwana, harimo n'imiyoboro yawo n'uko amaraso atembera.
• Gupima X-ray yo mu gituza cyangwa Cardiac CT Scan : Ibi rimwe na rimwe bishobora kugaragaza imiterere idasanzwe y'umutima "imeze nk'iy'inkweto". Iyi ni kamere ya ToF.
• Electrocardiogram (EKG cyangwa ECG) : Iyi electrocardiogram ipima imikorere y'amashanyarazi y'umutima. Ishobora kumenya ibitagenda neza mu mikorere y'umutima cyangwa niba icyumba cy'umutima gikora cyane.
• Gupima umutima : Iki ni ikizamini kigoye gato. Gikorwa gusa iyo bibaye ngombwa. Umuyoboro muto (catheter) unyura mu mitsi y'amaraso iri ku kuguru cyangwa ku kuboko ujya mu mutima kugira ngo upime umuvuduko uri mu mutima, ufate ibizamini by'amaraso, kandi urebe neza imiterere yawo.

Mu gusuzuma iyi ndwara ku muntu mukuru cyangwa umwana ukuriye gato, ibizamini byavuzwe haruguru, nka `(EKG)` na `(Catheterization y'umutima),` birashobora gukoreshwa.

Iyi ndwara `(Tetralogy of Fallot)` ivurwa ite?

Uburyo bw'ingenzi bwo kuvura umwana ufite `(ToF)` ni imiti no kubagwa . Intambwe ya mbere, abaganga bashobora guha umwana imiti nka `(Beta-blockers)` kugira ngo bagenzure ibimenyetso by'umwana no kunoza amaraso atembera neza. Bashobora kandi gutanga ogisijeni yiyongereye.

Kubaga kugira ngo hakosorwe ibi bibazo bine by'umutima akenshi bikorwa hagati y'amezi atatu n'atandatu umwana avutse. Nyuma y'uku kubagwa, uburyo amaraso atembera mu mutima busubira kumera neza.

Ni ubuhe buryo bwo kubaga?

Uburyo bwo kuvura bushobora gutandukana bitewe n'uko umwana ameze. Hari igihe, iyo umwana ari muto cyane cyangwa afite intege nke cyane, bishobora kugorana kumukorera igikorwa gikomeye icyarimwe. Muri ibyo bihe, kubagwa byoroshye (`(Palliative Surgery)`) bishobora gukorwa kugira ngo hagenzurwe ibimenyetso by'agateganyo kugeza igihe umwana akuze gato kandi akomeye. Icyo gihe ni bwo `(Gusana Byuzuye)` bishobora gukorwa.

Hari uburyo bwinshi bw'ingenzi bwo kubaga:

• Gusana burundu : Muri ubu buryo, umuganga ubaga yagura umuyoboro muto n'inzira ijyana amaraso mu bihaha. Nanone, umwobo uri hagati y'ibyumba bibiri byo hasi by'umutima (VSD) ufungwa hakoreshejwe agace.
• Uburyo bwo Gukoresha BTT Shunt : Ubu ni uburyo bwo kubaga bw'agateganyo bwavuzwe haruguru. Umuyoboro muto (Shunt) ushyirwa hagati y'imitsi yo mu kuboko k'umwana (Subclavian Artery) n'imitsi yo mu bihaha (Pulmonary Artery). Ibi bituma amaraso menshi atembera mu bihaha.
• Uburyo bwo gukoresha catheter : Hari igihe stent ishobora gushyirwa mu mutima binyuze muri catheter nta kubagwa kugira ngo ventricle y'iburyo ikomeze gufungura. Ishobora kandi gukoreshwa mu kurinda ductus arteriosus y'umwana (umuyoboro uhuza imitsi y'ibihaha na aorta) kudafunga.

Kubaga abantu bakuru

Ni gake cyane, hari abantu bashobora kubaho mu bwana bwabo batabanje kubagwa, bakagera mu bwana. Impuguke zigira inama abantu nk'abo kubagwa burundu kugira ngo birinde ingorane zizaza kandi bigabanye ibyago byo gupfa mu buryo butunguranye.

Muri ubu buryo, umuganga w’inzobere mu kuvura indwara z’umutima zavukanye ku bantu bakuru (VSD) afunga icyo kibazo akoresheje agace gato, agafungura atrium y’iburyo, agasana cyangwa agasimbuza valve y’ibihaha. Umutsi w’ibihaha, utanga amaraso ku bihaha byombi, uragurwa. Hari igihe umuyoboro ushyirwa hagati y’atrium y’iburyo n’umutsi w’ibihaha kugira ngo amaraso atembera neza.

Abantu bakuru benshi bakira indwara y'umutima (ToF) ntibazakenera ubundi buvuzi, ariko bagomba gukomeza kubonana n'umuganga w'indwara z'umutima w'umuntu mukuru bavukanye kugira ngo bamukurikirane buri gihe.

Ni izihe ngorane zishobora kubaho nyuma yo kubagwa?

Nyuma yo kubagwa Tetralogy of Fallot, rimwe na rimwe (rimwe na rimwe ndetse na nyuma y'igihe runaka), hari ingorane zishobora kuvuka. Ariko ntugahangayike, abaganga bahora babyitayeho.

• Ihungabana ry'amashanyarazi: Agace gafunga VSD gashobora rimwe na rimwe kubangamira ibimenyetso by'amashanyarazi biva mu byumba byo hejuru by'umutima (Atria) bijya mu byumba byo hasi (Ventricles). Ibi bishobora gukosorwa n'icyuma gipima umutima. Iyo ukoresheje ToF yavuguruwe, hari ibyago byo kurwara arrhythmias (umutima utera ubudasa) haba mu byumba byo hejuru n'ibyo hasi by'umutima. Niba ufite ikibazo cya syncopal episode, ugomba kugenzurwa ibi.
• Indwara ya Septal isigaye mu miyoboro y'amaraso : Hari igihe hashobora kubaho akantu gato gatwikira agace gakoreshwa mu gufunga VSD.
• Aneurysm : Agace gakoreshwa mu gusana valve gashobora gutuma ahantu hadakomeye muri valve habyimba hagahinduka aneurysm (umubyimba umeze nk'ibendera mu mitsi y'amaraso). Hari kandi ibyago byinshi byo kugira aneurysm mu muyoboro w'amaraso uzamuka.
• Ibibazo byo Gufunga : Bitewe n'umugozi ushyirwa mu gihe cyo kubagwa by'agateganyo, ibibazo nko kugabanuka (stenosis), umuvuduko ukabije w'amaraso mu mitsi yo mu bihaha, no guhangayika cyane ibumoso bw'umutima bishobora kubaho.
• Valves zisohoka : Amaraso ashobora kuva inyuma anyuze mu miyoboro iri mu bihaha byawe, mu muyoboro w'amaraso, cyangwa mu ruhande rw'iburyo rw'umutima wawe (Tricuspid). Hari igihe biba ngombwa ko habaho valves zisohoka mu bihaha (Valves Replacement).

Ni iki wakwitega mu gihe ubana n'iki kibazo?

Nubwo amaraso mu mutima asubira kumera neza nyuma yo kubagwa Tetralogy of Fallot, hari ibintu bike wowe cyangwa umwana wawe mugomba kumenya:

• Ingaruka zo kwandura amenyo : Ingaruka zo kurwara indwara ya endocarditis ziri hejuru gato. Kubwibyo, ugomba kwitondera cyane ubuzima bw'amenyo yawe. Muganga wawe ashobora kukugira inama yo gufata imiti yica udukoko kugira ngo wirinde kwandura amenyo mu gihe cyo kuyavura.
• Imikurire Itinze : Abana bafite Tetralogy of Fallot bashobora gukura buhoro no kwiyongera ibiro. Bashobora gukenera kuvurwa mu buryo bw'umubiri, mu mivugire cyangwa mu kazi.
• Ingaruka zo gutwita : Abagore bakuze bagomba kwisuzumisha umutima wabo mbere yo gutwita. Ingaruka zo gutwita zishobora kuba nyinshi gato ugereranyije n'ibisanzwe.
• Ibibujijwe ku miti : Umaze gukura, ushobora gusabwa gukoresha imiti imwe n'imwe n'uburyo bwo kuboneza urubyaro gusa bitewe n'indwara y'umutima wawe.

Ni iki kizakurikiraho mu gihe kizaza cya `(ToF)`?

Bitewe n’iterambere ry’ubumenyi bw’ubuvuzi, ahazaza h’abana bafite `(Tetralogy of Fallot)` ni heza cyane kurusha mbere. Ubuvuzi bwo kubaga bugira ingaruka nziza cyane mu gukosora inenge mu miterere y’umutima n’amaraso atembera. Igipimo cyo kubaga abantu bakuru gitangwa n’inzobere mu kubaga umutima nacyo kiri hejuru cyane.

Muri iki gihe, abana benshi babagwa kugira ngo bakosore Tetralogy of Fallot babaho ubuzima busanzwe. Ariko, hashobora kubaho imbogamizi zimwe na zimwe ku bikorwa bitoroshye, nko gukina siporo yo guhiganwa. Igipimo cy'ubuzima bw'igihe kirekire nyuma yo kubagwa ToF ni cyiza cyane. Abantu benshi babagwa babaho kugeza ku myaka 30. Ariko, niba badakozwe, umuntu umwe muri batatu bafite Tetralogy of Fallot ni we uzakomeza kubaho imyaka 10.

Bamwe mu bantu bakuru babazwe Tetralogy of Fallot bakiri abana bashobora kugira ibibazo mu gihe cy'ubukure bisaba imiti, kuvurwa cyangwa kubagwa ubundi buryo. Kubwibyo, ni ngombwa ko abantu bakuru bagisha inama abaganga babo b'indwara z'umutima mbere yo kubagwa ikindi gice cy'umubiri.

Ese hari icyo nakora kugira ngo umwana wanjye arusheho kumererwa neza?

Mu gihe umwana wawe ategereje kubagwa, ushobora kumufasha mu gihe afite "tet spells" (igihe ahindutse ubururu kandi ahumeka nabi). Mu gihe ahumeka nabi, mushyire mu mwanya wo kwicara amavi ye afatanye n'igituza cye . Iyi myanya yongera amaraso ajya mu bihaha, bishobora gufasha umwana wawe kumva amerewe neza.

Nanone, ni ingenzi cyane guha umwana ibinyobwa bihagije byo kunywa no kumurinda gukora cyane.

Ni ryari ngomba kubonana na muganga wanjye?

Niba umwana wawe afite ikibazo gikomeye cya "tet spell", bivuze ko ahinduka ubururu kandi akaba afite ikibazo cyo guhumeka, mujyane vuba mu cyumba cy’ubutabazi bw’ibanze cy’ibitaro biri hafi yawe . Niba uri umuntu mukuru, niba wumva ufite intege nke, uzumva, ufite ikibazo cyo guhumeka, cyangwa ubabara mu gatuza, ugomba no kujya mu cyumba cy’ubutabazi bw’ibanze.

Abantu bakuru babazwe bwa mbere mu gihe cy'ubwana bwabo, bagomba gusuzumwa umutima wose buri mwaka cyangwa ibiri . Ibizamini bitandukanye bishobora gukorwa kugira ngo barebe imikorere y'umutima, urugero:

• `(Holter Monitor)` (Igikoresho gifata `ECG` umunsi wose)
• Isuzuma ry'umutima (Electrocardiogram) (EKG)
• Ikizamini cy'Imihangayiko mu myitozo ngororamubiri
• Echocardiogram (gupima umutima)
• MRI y'umutima

Nanone, umuganga wawe azakurikirana buri gihe ingano n'imikorere y'uruhande rw'iburyo rw'umutima wawe.

Nyuma yo gusana Tetralogy of Fallot, umwana wawe azakenera kwisuzumisha buri gihe kwa muganga w’indwara z’umutima w’abana. Ubu buvuzi busanzwe buzakomeza kugeza akuze.

Ibibazo bimwe na bimwe ushobora kubaza muganga wawe:

• Ese umwana wanjye azagomba kugabanya ibikorwa bye bya siporo nyuma yo kubagwa?
• Ese umwana wanjye azakenera kubagwa byinshi?
• Ni iyihe miti yindi (niba ihari) umwana wanjye yagombye gufata?

Amaherezo, ngomba kuvuga... (Ubutumwa bwo kujyana mu rugo)

Ni ibisanzwe kumva uremerewe kandi ubabaye iyo umenye ko umwana wawe w’uruhinja afite ikibazo cy’umutima. Ariko ibuka ko itsinda ry’abaganga ryafashije abandi babyeyi benshi bahuye n’ibibazo nk’ibyo, kandi nabo bashobora kugufasha. Niba wumva ufite stress yo kwita ku mwana ufite Tetralogy of Fallot, ntutinye kuvugana n’umuganga. Nanone, umuganga ashobora gufasha abana n’urubyiruko bumva ko bari imbere y’abandi mu iterambere ryabo. Izere ko iyo ubuvuzi bukwiye kandi ubwitaho bw’urukundo, abo bana nabo bashobora kugira ubuzima bwiza.

Tetralogy ya Fallot, Indwara z'Umutima z'Abana, Ubusembwa bw'Umutima bw'Abana Bavukanye, Umwobo mu Mutima, Indwara y'Ubururu bw'Abana, Kubagwa k'Umutima, Imiterere y'Umutima