Ese umwana wawe afite ikibazo nk'iki cy'umutima? (Gusubira mu mitsi y'amaraso mu gifu - TAPVR) Reka tubiganireho!

Iyo umwana wawe avutse, hari igihe yumva bigoye guhumeka? Hari igihe uruhu rusa n'aho ruhinduka ubururu? Ni ibisanzwe kumva ufite ubwoba bwinshi iyo ubonye ikintu nk'icyo. Uyu munsi tugiye kuvuga ku ndwara y'umutima ivukanwa igaragaza ibi bimenyetso. Iyi yitwa TAPVR (Total Anomalous Pulmonary Venous Return) . Nubwo izina rishobora gusa n'aho rigoye, reka tubisobanukirwe mu buryo bworoshye.

TAPVR ni iki? Mu magambo make...

Tekereza nawe, imibiri yacu ibona umwuka uvuye mu bihaha, si byo se? Rero, muri ibi bihaha, amaraso arimo umwuka uvuye mu mwuka (tubyite "amaraso meza") azanwa mu mutima n'imitsi , ubwoko bw'imitsi itwara amaraso. Ubusanzwe, aya "maraso meza" agomba kuza mu gice cy'ibumoso cy'umutima. Kuva aho, amaraso atangwa kugira ngo atange umwuka uvuye mu mubiri wose.

Ariko, ku mwana ufite TAPVR, aho kugira ngo ihuze n'atriyumu y'ibumoso y'umutima, uyu mutsi w'ibihaha uhuza n'ahantu hadakwiye, ari ho atriyumu y'iburyo . Atriyumu y'iburyo isanzwe yakira "amaraso mabi" yakoreshejwe n'umubiri, ari na ogisijeni nkeya. Noneho "amaraso meza" yuzuye ogisijeni yivanga n'aya "maraso mabi." Bigenda bite se? Ingano ya ogisijeni mu maraso igomba kujya mu mubiri wose iragabanuka. Iyi ni indwara iteje akaga cyane kandi ishobora gushyira ubuzima bw'umwana mu kaga . Iyi ni indwara y'umutima yavukanye .

Abana hafi ya bose bafite TAPVR bafite umwobo muto (Atrial Septal Defect - ASD) hagati y’ibyumba bibiri by’umutima wabo, atrium y’iburyo n’atrium y’ibumoso. Uyu mwobo utuma amaraso amwe arimo ogisijeni atembera ibumoso bw’umutima hanyuma akagera ku gice cyose cy’umubiri. Bitabaye ibyo, iyo ndwara yashoboraga kuba mbi cyane.

Igikuru ni uko abana bafite TAPVR bakeneye kubagwa. Iyo kubagwa bikozwe hakiri kare, abana benshi bashobora kubaho ubuzima bwiza kugeza bakuze. Ariko, rimwe na rimwe, ibintu nko kugabanya imitsi mu gihe cy'ubuzima bishobora gusaba ubundi buryo bwo kubagwa cyangwa ubundi buryo bwo kuvurwa. Kubwibyo, ndetse na nyuma yo kubagwa TAPVR, uzakenera gukurikiranwa na muganga w'indwara z'umutima ubuzima bwawe bwose.

Hari igihe abaganga bayita iyi ndwara TAPVC (Total Anomalous Pulmonary Venous Connection). Zombi ni indwara imwe.

Ese hari ubwoko butandukanye bwa TAPVR?

Yego, hari ubwoko bwinshi bw'ingenzi bwa TAPVR. Ubu bwoko bushyirwa mu byiciro hakurikijwe uburyo "amaraso meza" ava mu bihaha ahujwe nabi n'atriyumu y'iburyo.

• Supracardiac TAPVR: Muri ibi, imitsi y'ibihaha ihurira kandi igahuza n'umutsi munini uri hejuru y'umutima (witwa vena cava iruta iyindi , ari wo mutsi munini utwara amaraso ava mu bice byo hejuru by'umubiri ujya iburyo bw'umutima).
• Indwara y'umutima: Aha ngaha, imitsi y'ibihaha itembera neza mu gice cy'umutima kiri iburyo bw'umutima.Ihuza. Uyu mutsi w'amaraso utera umutima ni ahantu amaraso adafite umwuka wa ogisijeni asanzwe ahurira mu mitsi y'umutima.
• Infracardiac TAPVR: Muri ubu bwoko, imitsi y'ibihaha inyura munsi y'umutima, ikanyura mu mwijima, igahuza n'umutsi munini ( vena cava iri hasi ) utwara amaraso ava mu bice byo hasi by'umubiri akayajyana iburyo bw'umutima.
• TAPVR ivanze: Iyi ni yo bwoko budasanzwe kandi bugoye cyane gusana. Aha, imitsi irenze imwe iva mu bihaha ishobora guhuzwa, mu buryo bumwe cyangwa bwinshi muri ubwo bwoko bwavuzwe haruguru.

Uku gushyira mu byiciro ni ingenzi ku baganga kugira ngo bategure kubaga no kugena uburyo bwo kuvura.

TAPVR ikunze kugaragara gute?

TAPVR ni indwara y'umutima ikunze kugaragara cyane . Ndetse no mu gihugu nka Amerika, iyi ndwara yibasira umwana umwe gusa mu bana 7.500 bavutse. Nanone ni gake muri Sri Lanka.

Ni ibihe bimenyetso bya TAPVR?

Ibimenyetso bya TAPVR bikunze kugaragara umwana akivuka , cyane cyane iyo imitsi y'ibihaha igabanutse aho ihurira n'umutima. Ariko, hari abana bashobora kutagaragaza ibimenyetso mu gihe cy'ibyumweru byinshi.

Ibimenyetso by'ingenzi ni ibi bikurikira:

• Cyanosis: Guhinduka kw'uruhu, inzara n'iminwa nk'umukara cyangwa ibara ry'umukara (ku bana bafite uruhu rwijimye). Ibi biterwa no kubura umwuka wa ogisijeni mu maraso.
• Kugorana konka: Umwana agira ikibazo cyo konka kandi ananirwa nyuma yo kunywa gato.
• Umunaniro n'ubunebwe: Umwana ahora ananiwe kandi asa n'unaniwe.
• Umutima uvuza urusaku: Iyo muganga yumvise umutima w'umwana (akoresheje stethoscope), ijwi ridasanzwe ryumvikanye.
• Guhumeka nabi (dyspnea): Umwana arimo guhumeka vuba kandi asa n'aho afite ikibazo cyo guhumeka.
• Gukura nabi no kwiyongera ibiro: Umwana ntabyibuha neza kandi arabyibuha.

Niba umwana wawe afite kimwe cyangwa byinshi muri ibi bimenyetso, ugomba guhita ugisha inama kwa muganga .

Ni iki gitera TAPVR?

Mu by’ukuri, abaganga ntibaramenya impamvu nyayo ya TAPVR. Iterwa n’inenge mu mutima no mu mitsi y’amaraso mu gihe umwana akura .

Ntabwo akenshi bifatwa nk'indwara ikomoka ku murage. Ariko, hari raporo z'uko abavukana bo mu muryango umwe banduye iyi ndwara. Ubushakashatsi bumwe bwagaragaje ko hashobora kuba hari isano hagati y'abana bafite indwara zimwe na zimwe no guhura n'imiti ikuraho irangi, imiti yica udukoko, n'uburozi bw'ibishingwe mu gihe batwite. Ariko, ibi ntibiragaragazwa.

Ni izihe ngorane zishobora guterwa na TAPVR?

Umwana urwaye TAPVR afite ikibazo cy'umutima n'umuvuduko ukabije w'amaraso mu bihaha.Ndetse na nyuma yo kubagwa, hari igihe umutima utari mwiza cyangwa imitsi y'ibihaha ishobora kuziba. Niyo mpamvu gukomeza gusuzumwa na muganga ari ingenzi.

TAPVR ipimwa ite?

Hari igihe, iyo ndwara ishobora kumenyekana mbere yuko umwana avuka, hakoreshejwe echocardiogram (isuzuma ry'umutima) mu gihe atwite. Ariko, akenshi isuzuma rikorwa nyuma y'ibyumweru bike cyangwa amezi make umwana avutse.

Iyo umwana avutse, muganga azasuzuma umubiri we kandi atege amatwi umutima w'umwana. Agakoresho gato kitwa pulse oximeter (agace gafata ku mano manini y'umwana) gashobora gukoreshwa mu gupima urugero rwa ogisijeni mu maraso.

Byongeye kandi, ibizamini nk'ibi bikurikira bishobora gukorwa kugira ngo harebwe uko umutima n'imitsi y'amaraso bimeze:

• X-ray yo mu gituza
• CT scan (CT scan - tomography ya mudasobwa)
• MRI y'umutima (ishusho ya resonance ya magnetic)
• Echocardiogram
• EKG (EKG cyangwa ECG - Electrocardiogram)

Bimwe muri ibi bizamini (nk'ibya MRI) bishobora gusaba ko umwana aryamishwa agasinzira gato. Ariko ibi bizamini byose ntibitera indwara. Ibi bizamini bifasha abaganga kubona amashusho asobanutse y'umutima n'ibihaha by'umwana, kureba uko amaraso atemba, no kureba ibitagenda neza.

Hari igihe ikizamini cyitwa catheterization y'umutima nacyo gikoreshwa mu gusuzuma indwara. Ariko, kubera ko amakuru akenewe ashobora kuboneka muri scan zavuzwe haruguru, umwana ntabwo akunze gukorerwa ibizamini by’indwara.

TAPVR ivurwa ite?

Abana hafi ya bose bafite TAPVR bakeneye kubagwa kugira ngo barokoke. Abaganga bayivura mu kubaga umutima . Akenshi, ubu buvuzi bukorwa vuba bishoboka iyo bumaze gupimwa.

Nubwo ari gake cyane, hari abantu basuzumwa TAPVR bakiri bakuru batabanje kubagwa bakiri abana. Ariko, icyo gihe bashobora kuba bafite indwara nk'umuvuduko ukabije w'amaraso mu bihaha bigatuma kubagwa bigorana cyane.

Kuvura mbere yo kubagwa

Mu gihe utegereje kubagwa, umwana ashobora gukenera guhabwa umwuka wa ogisijeni cyangwa kuwushyira ku cyuma gifasha guhumeka. Ushobora kandi guhabwa ubwoko bw'umuti witwa inotrope , ufasha umutima gutera cyane.

Uburyo bwo kubaga bikorwa

Nyuma yuko umwana asinzira neza akoresheje ikinya rusange , umuganga ubaga azakora ibi bikurikira:

1. Gutemagura umwana mu gituza no mu mutima.

2. Imitsi y'ibihaha ihuzwa n'ahantu heza, ni ukuvuga ku gice cy'ibumoso cy'umutima.

3. Imitsi idafite aho ihuriye irafunze.

4. Iyo hari ikintu cyose cyazibye mu mitsi y'ibihaha, kirakurwaho.

5. Akenshi, umwobo uri hagati y'atrial y'ibumoso n'iburyo ( Atrial Septal Defect - ASD ) urafungwa.

Nubwo ubu buryo ari ukubaga bugoye cyane, abaganga b'inararibonye barabukora neza.

Ingorane zo kuvurwa

Izi ni zimwe mu ngorane zishobora kubaho nyuma yo kubagwa:

• Ugutera kw'umutima nabi (Arrhythmias)
• Umuvuduko ukabije w'amaraso mu bihaha
• Kuziba kw'imitsi y'ibihaha
• Hari igihe, nyuma yo gukoresha imashini ikoresha umutima n'ibihaha (bypass machine) mu gihe cyo kubagwa, umutima ugorwa no kwikubita wonyine.

Abaganga bahora bashakisha ibintu nk'ibi.

Ese TAPVR ishobora kwirindwa?

Ikibabaje ni uko nta buryo bwo kwirinda ubwo bwoko bw'indwara y'umutima yavukanye. Niba hari umuntu wo mu muryango wawe ufite indwara y'umutima yavukanye, cyangwa niba ufite TAPVR, ni byiza kubanza kuvugana na muganga wawe mbere yo gutangiza umuryango.

Niba umwana wanjye afite TAPVR, ni iki nakwitega?

Hatabayeho kubagwa, ubwoko bumwe na bumwe bwa TAPVR bushobora kwica mu byumweru bike nyuma yo kuvuka. Ariko, iyo indwara igaragaye hakiri kare ikavurwa mu buryo bwo kubagwa, icyizere cy'abana barwaye TAPVR ni cyiza cyane. Igipimo cyo kubaho nyuma yo kubagwa ni hafi 97%. Icyo ni igipimo cyo gutsinda kiri hejuru cyane.

Uko umwana wawe akura akagera mu bantu bakuru, agomba kujya kwa muganga w’indwara z’umutima buri gihe . Uku gusuzumwa buri gihe mu buzima bwe bwose bishobora gufasha kumenya no kuvura ibibazo nko kutumvikana kw’umutima no kuziba kw’imitsi y’amaraso. Hari igihe, iyo habayeho kuziba kw’imitsi, bishobora gusaba kubagwa bundi bushya kandi bishobora kugorana kuvura. Niyo mpamvu ari ngombwa gukomeza gukurikiza amabwiriza ya muganga wawe.

Umwana wawe ashobora gukenera gukomeza gufata imiti cyangwa kuvurwa nko gukoresha catheter mu mutima .

Ni gute nakwita ku mwana wanjye?

Abana barwaye TAPVR rimwe na rimwe bashobora kugira ingorane mu iterambere risanzwe, nko gukora neza kw'imitsi. Ushobora gukurikirana iterambere ry'umwana wawe hanyuma ukamwohereza ku muntu ushobora kumufasha guteza imbere ubwo bumenyi nibiba ngombwa.

Vugana na muganga w'umwana wawe niba umwana wawe ashobora kwitabira siporo n'imyitozo ngororamubiri. Ushobora gukenera kugabanya imyitozo ngororamubiri isaba imbaraga nyinshi .

Ni ryari umwana wanjye agomba kujya kwa muganga?

Nyuma yo kubagwa, umwana wawe azagaragara buri mezi 6 kugeza kuri 12.Kwisuzumisha kwa muganga. Ugomba gukomeza kubonana na muganga wawe buri gihe mu buzima bwawe bwose bwo gukura. Muganga w'umwana wawe ashobora gushaka gukora ibizamini nka EKG, ikizamini cy'imihangayiko mu myitozo ngororamubiri, cyangwa echocardiogram .

Ni ryari ugomba kujya mu cyumba cy’ubutabazi bw’ibanze (ETU) ?

Shaka ubuvuzi bwihuse (jya kwa muganga wita ku buzima) niba umwana wawe afite kimwe muri ibi bimenyetso:

• Iyo uruhu, inzara, cyangwa iminwa bihindutse ubururu/imvi.
• Niba ufite ikibazo cyo guhumeka cyangwa kurya/kunywa amata.
• Niba usa n'usinziriye cyane cyangwa udafite ubuzima.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Dore ibibazo by'ingenzi ugomba kubaza muganga w'umwana wawe:

• Ni ubuhe bwoko bwa TAPVR umwana wanjye afite?
• Uratekereza ko umwana wanjye azakenera kubagwa bwa kabiri?
• Ni inshuro zingahe wabazwe kugira ngo usane TAPVR?

Ubutumwa bw'ingenzi bwo kujyana mu rugo

Ushobora kuba warakurikije inama za muganga wawe zo kugumana ubuzima bwiza mu gihe utwite. Ariko rimwe na rimwe, umwana uvutse ashobora kugira ikibazo cy'umutima. Si ikosa ry'umuntu uwo ari we wese. Bitewe n'ubumenyi bw'ubuvuzi bwateye imbere muri iki gihe, umwana wawe ashobora kwitega umusaruro mwiza cyane kurusha abana bo mu bisekuru byashize. Ubuvuzi bwo kubagwa burakora cyane.

Wibuke ko nubwo TAPVR ari indwara ikomeye, iyo isanzwe ipimwa hakiri kare kandi ikabagwa neza, abana bafite amahirwe menshi yo kubaho neza. Nyuma yo kubagwa, ni ngombwa kujyana umwana wawe kwisuzumisha kwa muganga buri gihe. Ibi ni ukugira ngo ubuzima bw'umwana wawe bushobore gukurikiranwa kandi ibibazo byose bishobora kuvuka bivurwe vuba. Ntabwo uri wenyine, abaganga n'abakozi bo mu rwego rw'ubuzima bariho kugira ngo bagufashe wowe n'umwana wawe.

TAPVR , indwara z'umutima, umwana, kubagwa, imitsi y'ibihaha, cyanosis, indwara zo kuvukana