Mwana wenyu mudiki ane dambudziko rekufema rakadai here? Ngatikurukurei nezve "Double Aortic Arch"!

Mwana wako mudiki dzimwe nguva anonzwa sekuti ari kunetseka kufema here? Anozvimbirwa here paanenge achiyamwisa kana kuyamwisa? Kana kuti anoita ruzha rusinganzwisisike paanenge achifema? Kunyange zvazvo izvi zvingave zvirwere zvevana zvakajairika, panogona kunge paine chirwere chakakomba, asi chinorapika, chiri shure kweizvi. Chimwe chezvirwere zvisingawanzoitiki asi zvakakosha zvekuziva chinonzi "Double Aortic Arch." Ngatitaurei nezvazvo zvakadzama nhasi.

Zvichitaurwa zviri nyore, tsinga huru yeropa inotakura ropa kubva pamwoyo wemwana wako kuenda kumuviri wake wese iaorta . Kazhinji itsinga imwe chete, hombe. Chikamu chakakombama chetsinga iyi pamusoro pemoyo chinonzi aortic arch .

Zvisinei, mumwana ane "Double Aortic Arch", "aortic arch" iyi inoumbwa muzvikamu zviviri. Kureva kuti, imwe tsinga yeropa yakabatana ne "aortic arch" iyi huru, ichiumba arch yechipiri. Aya ma arch maviri anosangana, achigadzira denderedzwa rakatenderedza paipi yemhepo yemwana (trachea) nepaipi yekudya (esophagus) . Fungidzira, chii chinoitika kana denderedzwa iri rikavharika? Ndipo mwana paanotanga kuva nezviratidzo zvakakomba zvakaita sekuoma kufema, kuita ruzha paanenge achifema, uye kunetseka kumedza chikafu.

Iyi "aortic arch" inoumbwa pakutanga kwepamuviri, pakati pemavhiki maviri neanomwe. Munguva iyi, moyo netsinga dzeropa zvinokura nenzira yakaoma zvikuru. Zvimwe zvikamu zvinoumbwa, uye mushure mechinguva hazvichadiwi uye zvinonyangarika. "Double aortic arch" inoumbwa nekuda kwechinhu chakadai. Pakupera kwevhiki yechishanu yekuzvitakura, tsinga yeropa yaifanira kunge yanyangarika, nekuda kwechikonzero chisingazivikanwe, hainyangarike uye iyi "double aortic arch" inoumbwa. Uku kukanganisa kwemoyo kwakaberekwa nako , zvinoreva kuti mwana anozvarwa nayo.

Dambudziko iri, rinonzi "double aortic arch," rinobva muboka rezvirwere zvemwoyo zvekuzvarwa nazvo zvinonzi "vascular rings." Izvi zvinokonzera kuti paipi yemhepo negurokuro yemwana zviome.

"Mhete dzeropa" idzi chii?

Zvakanaka, "Vascular Rings", sezvandambotaura, mamiriro ezvinhu apo "aortic arch" inokura zvisina kujairika, izvo zvinogona kukonzera kuti pave nemhepo yemwana (trachea), pombi yekudya (esophagus), kana zvese zviri zviviri zviome. Izvi hazviwanzoitika. Funga nezvazvo, anenge mwana mumwe chete pavana 100 anozvarwa aine imwe mhando yechirwere chemwoyo chekuzvarwa nacho. Asi "vascular ring" inongobata mumwe chete pavana 10,000. Hazviwanzoitika.

Ndedzipi mhando huru dze "Vascular Rings"?

Kune mhando dzakawanda huru dze "vascular rings" idzi. Ngationei kuti ndedzipi:

• Double Aortic Arch: Munyaya iyi, "aortic arches" mbiri (kuruboshwe nekurudyi) dzakakomberedza trachea negurokuro. Iyi ndiyo nyaya huru yatiri kutaura nezvayo.
• Chivharo cheaortic chekurudyi chine tsinga yeruboshwe yesubclavian isina kujairika uye ligamentum yeruboshwe: Pane chivharo chimwe chete cheaortic pano, asi chiri kurudyi rwetrachea (kazhinji kuruboshwe). Muchiitiko ichi, tsinga yeruboshwe yesubclavian, iyo inopa ropa mumaoko emwana, inotangira paaorta yopfuura neshure kwetrachea negurokuro. Mhete iyi yeropa inopedzwa nekubatana neleft ligamentum arteriosus, yasara yetsinga yeropa yaivepo panguva yehupenyu hwemwana asati aberekwa uye yobva yanyangarika.
• Chivharo cheaorta yekuruboshwe chine tsinga yesubclavian yekurudyi isina kujairika: Pano, tsinga yesubclavian yekurudyi inopfuura neseri kwetrachea negurokuro, ichizvidzvanya.
• Kudzvanywa kwetsinga dzisina kusimba: Tsinga isina kusimba (brachiocephalic) ibazi reaorta. Panyaya iyi, inotangira kuruboshwe rwetrachea, yozopfuura nepamberi petrachea kurudyi. Izvi zvinoisa kumanikidzwa patrachea.
• Kusling kwetsinga dzemapapu: Tsinga dzemapapu dzekuruboshwe dzinotanga kubva kutsinga dzemapapu dzerudyi dzopfuura nepakati petrachea negurokuro.

Chinoitika mune zvese izvi ndechekuti nzira yekufema kana yegurokuro inokanganiswa neimwe nzira.

Kune mhando dze "Double Aortic Arch" here?

Ehe, kune mhando nhatu huru dze "double aortic arch." Idzi dzinosiyaniswa nekuti arch ipi yakakura, uye kana arch iyoyo yakakura iri kurudyi kana kuruboshwe rwetrachea.

• Chigadziko chekurudyi chine chidimbu chidiki chekuruboshwe: Iyi ndiyo mhando inonyanya kuwanikwa, inowanikwa muzvikamu zvinosvika 80 muzana zvezviitiko.
• Chigadziko chekuruboshwe chine chidimbu chidiki chekurudyi: Izvi zvinoonekwa muzviitiko zvinenge gumi muzana.
• Makumbo akaenzana: Izvi zvinoonekwawo muzviitiko zvinenge gumi muzana.

Rudzii rwe "vascular ring" runonyanya kuonekwa?

Vanachiremba vaimbofunga kuti "double aortic arch" ndiyo yainyanya kushandiswa pakurapa "vascular ring." Asi tsvakurudzo itsva yakawana kuti "right aortic arch" ndiyo yakajairika.

Asi pane chimwe chinhu. Vacheche vane "right aortic arch" vane mukana wekuva nezvimwe zvirwere zvemwoyo zvekuzvarwa nazvo kupfuura vana vane "double aortic arch." Zvisinei, havawanzoonekwa pakuzvarwa. Izvi zvinodaro nekuti "right aortic arch" ingasakonzera zviratidzo pakutanga. Saka, kuvhiyiwa kwedambudziko iri kunogona kudiwa pakati pemwedzi 6 ne18 yekuberekwa.

Chirwere chinonzi ``Double Aortic Arch'' ndicho chinonyanya kuwanikwa mutsinga dzeropa. Saka, chiremba wemwana wako anogona kuona dambudziko racho nekukurumidza. Zvichienzaniswa nevana vane mamwe marudzi etsinga dzeropa, vana vane ``Double Aortic Arch'' vanogona kuvhiyiwa nguva pfupi mushure mekuzvarwa.

Ndezvipi zviratidzo zve "Double Aortic Arch"?

Zviratidzo zve "double aortic arch" zvinowanzoonekwa kana panopinda mweya wemwana, gurokuro, kana zvese zviri zviviri zvamanikidzwa. Kudzvanywa uku kunogona kukanganisa kufema kwemwana, kudya, kana kushanda kwemoyo.

Kazhinji, zviratidzo izvi zvinoonekwa muhudiki (kunyanya kana chirwere chacho chakanyanya), asi dzimwe nguva zvinogona kuonekwa pazera remakore matatu, kana kutotanga kuyaruka.

Vamwe vana vanogona kuonekwa zvisirizvo sevanhu vane asthma nekuti zviratidzo zvacho zvakafanana. Dambudziko iri rinongoonekwa chete kana kurapwa kweasthma kwakundikana uye kuongororwa kwakawedzerwa kwaitwa.

Zviratidzo zvekufema

Vanenge 91 muzana yevacheche nevana vane "double aortic arch" vanowana zviratidzo izvi zvine chekuita nekufema. Izvi ndeizvi:

• Ruzha rusinganzwisisike kana uchifema (ruzha rwakakwirira runonzi `stridor` kana ruzha rwekufemera runonzi `heezing`) .
• Kukosora kunonzwika sekunge "kugomera kwechisimbiso." Izvi zvakafanana nekukosora kunoitika panguva yechirwere chinonzi "croup."
• Utachiona hwepazasi hwekufema hunowanzo itika .

Zviratidzo zvemudumbu

Vanenge 40 muzana yevacheche nevana vane "double aortic arch" vanonzwa zviratidzo izvi zvekugaya. Zvinosanganisira:

• Kudzipwa uchiyamwisa kana kudyisa mwana.
• Kuoma kwekumedza (dysphagia) . Izvi zvinowanzoonekwa kana mwana atanga kudya chikafu chakasimba.
• Kuomerwa nekuwedzera uremu .
• Chikafu chinodzokera muhuro (`Regurgitation/reflux`) .

Zviratidzo zvemwoyo

Vanenge makumi matatu muzana vevacheche nevana vane "double aortic arch" vanowana zviratidzo zvine chekuita nemoyo. Izvi zvinosanganisira:

• Kurwadziwa kwechipfuva .
• Ruzha rwemwoyo rusina kujairika ('Heart murmur') .
• Ganda rebhuruu (cyanosis) .

Chii chinokonzera "Double Aortic Arch"?

Chikonzero chaicho che "double otic arch" hachisati chawanikwa . Kunyangwe chirwere ichi chichiwanzoonekwa muvana vanoberekwa kuburikidza ne "in-vitro fertilization" (IVF) , chikonzero chaicho hachizivikanwe.

Double aortic arch inogonawo kusanganiswa nedzimwe zvirwere. Vanenge 12 muzana yevana vane double aortic arch vane chimwe chirwere chemwoyo chekuzvarwa nacho, chakadai se ventricular septal defect (VSD) uye tetralogy of Fallot . Pamusoro pezvo, vanenge 20 muzana yevana vane double aortic arch vane zvirwere zvemajini zvakaita se chromosome 22q11 deletion uye trisomy 21 (Down syndrome) .

Nzira yekuziva sei "Double Aortic Arch"?

Double aortic arch inoonekwa netsaona kana zviratidzo pazvinotanga. Dzimwe nguva, inowanikwa netsaona panguva yekuzvitakura, mushure mekuzvarwa, kana panguva yekuongororwa kwemifananidzo kunoitwa nechimwe chikonzero. Kubva muna 2004, huwandu hwevanhu vanoonekwa vaine chirwere ichi kuburikidza nekuongororwa panguva yekuzvitakura hwakawedzera. Izvi zvinobatsira zvikuru, sezvo kurapwa kuchigona kurongwa mwana achangozvarwa.

Kana kuti, inogona kuonekwa kana zviratidzo zvaonekwa mushure mekunge mwana aberekwa. Chiremba wemwana wako achataura newe nezvezviratidzo uye obva aita mimwe miedzo.

Miedzo yekuongorora "Double Aortic Arch"

Miedzo mikuru inoshandiswa kuongorora chirwere ichi ndeiyi:

• X-ray yechipfuva: Iyi ndiyo bvunzo yekutanga inotorwa kazhinji .
• Kuongororwa kweCT.
• Kuongororwa kweEchocardiogram (Echo): Izvi zvinobatsira zvikuru pakuona kana paine zvimwe zvirwere zvemwoyo.
• Kuongororwa kweMRI (MRI).

Dzimwe nguva bronchoscopy inogona kuitwa kuti paonekwe windpipe yemwana. Izvi zvinogona kuitwa kuti pave nematambudziko ekufema asati aonekwa kuti ane double aortic arch. Kana kuti, zvinogona kuitwa vasati vavhiyiwa kuti chiremba anzwisise zviri kuitika.

Kuongororwa kwemajini kunobatsira kuona zvirwere zvemajini.

Nzira yekurapa "Double Aortic Arch"?

Kuvhiyiwa kunodiwa kugadzirisa mamiriro e "double aortic arch." Kunyangwe kune vacheche vasina zviratidzo, kuvhiyiwa kunoitwa zviri nani pakati pemwedzi 6 ne9 yekuberekwa. Vacheche vane zviratidzo, kunyanya kana zviratidzo zvakanyanya, vangada kuvhiyiwa kare.

Chimbofungai, chirwere chinonzi "double aortic arch" chakatanga kuzivikanwa muna 1737. Kuvhiyiwa kwekutanga kwacho kwakaitwa muna 1947. Tasvika kure zvakadii kubva ipapo! Vacheche vane chirwere ichi chekuzvarwa nacho vakakwanisa kurarama hupenyu hurefu, hune hutano nekuda kwekuvhiyiwa.

Kuvhiyiwa kwe "Double Aortic Arch"

Kuvhiyiwa kwe "Double Aortic Arch" kwakachengeteka zvikuru, uye mhedzisiro yacho inobudirira zvikuru . Mwana wako haazodi kubatanidzwa ne "cardiopulmonary bypass" (muchina wemwoyo nemapapu) .

Kuvhiyiwa uku kunoitwa uchishandisa nzira inonzi "lateral thoracotomy." Izvi zvinoreva kuti chiremba anochekwa parutivi rumwe rwechipfuva chemwana, pakati pembabvu mbiri. Izvi zvinowanzoitwa kuruboshwe, nekuti ndipo panowanikwa vacheche vazhinji "vane" mbabvu diki. Kuongororwa kwemifananidzo kunoitwa vasati vavhiyiwa kunobvumira chiremba kuti anyatsoona mukati memuviri wemwana uye kuronga kuvhiyiwa kwacho zvinoenderana nazvo.

Chiremba anoshandisa nzira ye "kusunga nekuparadzanisa" . Izvi zvinoreva kuti denderedzwa diki rinosungirirwa kuti ropa risabude. Zvadaro rinochekwa uye rinosungirirwa. Maitiro aya anodzokororwa kusvika denderedzwa rapatsanurwa zvachose uye kumanikidzwa kwepaipi yemhepo nepagurokuro kwabviswa.

Mwana wako achagara muchipatara kweinenge vhiki, ozopora odzoka kumba.

Kurapa kwe "Kommerell diverticulum" (`Kommerell diverticulum - KD`)

Kashoma, vamwe vacheche vane "double aortic arch" vanogonawo kuva nechimwe chinhu chinonzi "Kommerell diverticulum (KD)." Izvi zvinowanzoitika kuvacheche vane "right aortic arch," asi hazviwanzoitikiwo kana paine "double aortic arch".

Iyi `KD` i`aneurysm`, tsinga yeropa inokura mu`aorta` inodzika pedyo ne`aortic arch`. Kuzvimba uku kunogona kutora nzvimbo uye kudzvanya papombi yemhepo yemwana nepaipi yekudya. Hazvingakonzere matambudziko ipapo ipapo. Zvisinei, vanachiremba vanovhiya vanofarira kubvisa izvi zvakare pavanenge vachigadzira `double aortic arch` kudzivirira matambudziko gare gare.

Kurapa kwezvimwe zvikanganiso zvemwoyo

Kana mwana wako aine zvimwe zvirwere zvemwoyo zvinoda kuvhiyiwa, anogona kurapwa panguva imwe chete nedouble aortic arch. Izvi zvingada nzira inonzi ``median sternotomy'' , iyo inosanganisira kugadzira chibooreso pakati pechipfuva. Chiremba wemwana wako achakurukura nezvesarudzo yakanakira iwe, zvichienderana nematambudziko anofanirwa kurapwa.

Ndezvipi zvinetso zvinogona kuitika kana munhu avhiyiwa?

Njodzi yekusangana nematambudziko kubva pakuvhiyiwa kweaorta yeropa kaviri yakaderera zvikuru . Kashoma kuti mwana awane dambudziko rekudya kana kufema nguva dzose. Kana paine matambudziko ekufema nguva dzose, anowanzopera mukati megore mushure mekuvhiyiwa.

Matambudziko ekuvhiyiwa kugadzirisa double aortic arch nezvimwe zvirwere zvemoyo zvinogona kusiyana. Kurukurai njodzi idzi dzose nematambudziko aya nachiremba wemwana wenyu.

"Double Aortic Arch" inogona kudzivirirwa here?

Kwete, chirwere chinonzi "double aortic arch" hachigone kudzivirirwa . Chinhu chinokura pakutanga kwepamuviri uye chinowanikwa pakuzvarwa.

Remangwana revanhu vane "Double Aortic Arch" nderei?

Vacheche nevana vakavhiyiwa "Double Aortic Arch" vane ramangwana rakajeka . Vanogona kurarama nekuita mabasa enguva dzose pasina zvirambidzo.

Mushure mekuvhiyiwa, mwana wako anogona kuramba achifema zvine ruzha kusvika gore. Izvi zvinokonzerwa nekuti paipi yemhepo yemwana haisati yakura zvakakwana nekuda kwe "double aortic arch." Saka, zvinotora nguva kuti paipi yemhepo isimbe.

Kashoma, vacheche nevana vanogona kuramba vaine zviratidzo zvekufema mushure megore rimwe chete mushure mekuvhiyiwa.

Chinhu chinonyanya kukosha ndechekuendesa mwana wako kunoongororwa nguva dzose uye kuudza chiremba wako kana uine zviratidzo zviri kuramba zvichiitika. Kutarisirwa kwenguva refu kwakakosha zvikuru kumwana wese akavhiyiwa mwoyo.

Ndinofanira kufonera chiremba wemwana wangu rini?

Kana mukaona zviratidzo zvitsva, kana kuti zviratidzo zviripo zvichiratidza kunge zviri kuwedzera kuipa, taurai nachiremba wemwana wenyu nekukasika. Vacheche nevana vadiki vanochinja zvakanyanya zvekuti dzimwe nguva zvinogona kuoma kuziva zviri zvakajairika uye zvisina kujairika. Asi kana mwana wenyu aine kukosora kwakadaro "kwakaita sechisimbiso" kana ruzha rwekufemera , taurirai chiremba wenyu nekukasika. Kunogona kunge kuri chirwere chemwana. Asi kashoma, chingave chiratidzo chedambudziko remwoyo riri kukanganisa kugona kwemwana wenyu kufema.

Unofanira kufonera 911 rini (nhamba yekukurumidzira)?

"Double aortic arch" inogona kuisa dambudziko pahuro yemwana wako. Kana ganda remwana wako rikaita sebhuruu (cyanosis) , kana kuti mwana wako ari kunetseka zvakanyanya kufema , fonera 911 nekukasika.

Mibvunzo ipi yandinofanira kubvunza chiremba wemwana wangu?

Kana mwana wako akaonekwa aine "double aortic arch," zvakajairika kuti uve nemibvunzo yakawanda. Zvakakosha kuziva mamiriro emwana wako, kusanganisira nguva yekuvhiyiwa, uye kana mwana wako aine mamwe matambudziko ehutano. Ungangoda kubvunza mibvunzo yakaita seyi:

• Mwana wangu anofanira kuvhiyiwa rini?
• Kuvhiyiwa uku kunoitirwa kupi? Ndiani ari kukuita?
• Ndezvipi zviratidzo zvandinofanira kutarisa kumba?
• Chii chandingaita kuti zvive nyore kuti mwana wangu agare pamba?
• Mwana wangu ane zvimwe zvinetso zvemwoyo here?
• Ndinofanira kuongororwa majini emwana wangu kana kuti mhuri yangu yese here?
• Remangwana remwana wangu richave rakaita sei?

Chii chinonzi "Aortic Arch Syndrome"? Yakasiyana here ne "Double Aortic Arch"?

Ehe, musavhiringa zvinhu zviviri izvi. "Aortic Arch Syndrome" rudzi rwe "Vasculitis" rusingawanzoitiki. Runozivikanwawo se "Takayasu's arteritis" .

"Vasculitis" kuzvimba kwemadziro etsinga dzeropa. Inogona kuitika mutsinga chero ipi zvayo yeropa, kunyangwe tsinga diki dzeropa, ma capillaries. "Takayasu's arteritis" kuzvimba kwetsinga dzeropa dzepakati nepakati nehombe. Zvinowanzoitika mu "aortic arch" nemapazi ayo makuru. Ndosaka ichinziwo "aortic arch syndrome."

Dambudziko reTakayasu's arteritis (rinozivikanwawo se "aortic arch syndrome") rinowanikwa muvechidiki nevechidiki . Iri idambudziko rakasiyana zvachose ne "double aortic arch" yekuzvarwa nayo yatakakurukura kare, uye kurapwa kunodiwa kwakasiyana.

Kuzvarwa kwemwana kunowanzova nguva yekufara nekupemberera. Zvisinei, kana ukaona kuti mwana wako ane chirwere chemwoyo, kungave panguva yekuzvitakura kana mushure mekusununguka, mufaro iwoyo unotsiviwa nekuzvidya mwoyo uye kusava nechokwadi. Kana uchangobva kuziva kuti mwana wako ane "double aortic arch," ungangove uchishamisika kuti chii chinotevera.

Musazvidya moyo. Chikwata chenyu chezvekurapa chichakubatsirai kuburikidza neizvi zvese nhanho nhanho. Matotora danho rekutanga, iro rekudzidza zvakawanda nezvemamiriro emwana wenyu. Mashoko akanaka ndeekuti kuvhiyiwa kwe double aortic arch kwakachengeteka uye kunobudirira. Kana mwana wenyu aine zvimwe zvirema zvemwoyo kana zvirwere zvemajini, kurapwa kunogona kuoma zvishoma. Zvisinei, nekufambira mberi mukutarisira mwana achangoberekwa, munogona kubatsira mwana wenyu kuwana rubatsiro rwakakodzera rwaanoda, kupora, uye kuva nehupenyu hunofadza hwemwana.

Saka, ndezvipi zvinhu zvakakosha zvekurangarira kubva pane zvatataura nezvazvo? (Mharidzo Yekuenda Kumba)

Zvakanaka, ngatipfupisei zvimwe zvezvinhu zvaunofanira kurangarira kubva pane zvatataura nezvazvo maererano ne "Double Aortic Arch" iyi:

• "Double aortic arch" chirwere chemwoyo chinokonzerwa nekuzvarwa nacho . Aorta yemwana yakakamurwa kuita maarches maviri, zvichikonzera kudzvanywa kwetrachea negurokuro.
• Zviratidzo zvikuru kufema zvakaoma, kufemereka, kuoma kumedza, uye hutachiona hwekufema hunogara huripo .
• Dambudziko iri rinowanikwa kuburikidza nekuongororwa kwakadai se `CT scan`, `MRI`, `Echocardiogram` . Dzimwe nguva rinogona kuonekwa panguva yekuzvitakura.
• Kurapa kwacho ndekwekuvhiya . Kuvhiya uku kwakachengeteka uye kunobudirira.
• Kumwana mushure mekuvhiyiwaUnogona kurarama hupenyu hwakanaka uye hwakajairika.
• Kana mwana wako aine zviratidzo zvakaita sekuoma kufema kana kudzipwa, tsvaga rubatsiro rwechiremba nekukasika .
• Musazvidya moyo . Nekufambira mberi kwemishonga yemazuva ano, chirwere ichi chinogona kurapwa zvinobudirira. Chikwata chenyu chekurapa chichakupai rutsigiro rwamunoda.

` Double Aortic Arch, Congenital Heart Disease, Vascular Rings, Mucheche Asphyxia, Hutano hweVacheche, Kuvhiyiwa kweMwoyo