Ganda remwana wako achangoberekwa nemiromo zvinotaridzika sebhuruu here? Anoita seari kunetseka kufema here? Kana kuti anonyanya kudikitira paanonwa mukaka? Usangozviti izvi zvinongoitikawo. Dzimwe nguva izvi zvinogona kuva zviratidzo zvechirwere chemwoyo chinoberekwa mwana wako. Nhasi tiri kutaura nezvechirwere chemwoyo chisingawanzoitiki chaunofanira kuziva, semubereki. Ndiyo Double Outlet Right Ventricle, kana kuti DORV muchidimbu.
Zvichitaurwa zviri nyore, chii chinonzi Double Outlet Right Ventricle (DORV)?
Kuti tinzwisise izvi, ngatitangei tafunga nezvekushanda kwemoyo une hutano. Mwoyo wedu wakaita seimba diki ine makamuri mana. Makamuri maviri epamusoro nemakamuri maviri epasi. Makamuri maviri makuru, akasimba ari pasi anonzi maventricle. Rimwe riri kurudyi (Right Ventricle), uye rimwe riri kuruboshwe (Left Ventricle).
Izvi ndizvo zvinowanzoitika:
- Tsinga huru yeropa inotakura ropa "rakasviba" risina okisijeni kuenda kumapapu, tsinga yemapapu, inotangira mu ventricle yekurudyi .
- Tsinga huru yeropa, aorta, inotangira kubva kuruboshwe, ichitakura ropa "rakachena" rakaiswa okisijeni kubva mumapapu mumuviri wese.
Yakanaka kwazvo, handiti? Chubhu imwe chete hombe mukamuri rega rega.
Zvino, kana ari mwana ane DORV, kurongeka uku kunokanganiswa. Mumwana ane DORV, mitsipa mikuru yeropa yatataura, Pulmonary Artery neAorta, zvakabatana zvizere kana kuti zvishoma neRight Ventricle. Zvadaro, Left Ventricle haibatanidzwi netsinga huru yeropa, kana kuti chikamu chidiki chete ndicho chakabatana.
Zvichitaurwa zviri nyore, aorta, inotakura ropa rine oxygen mumuviri wese, uye tsinga yemapapu, inotakura ropa risina oxygen kuenda kumapapu, zvose zvinobva panzvimbo imwe chete, right ventricle. Ichi chirwere chemwoyo chekuzvarwa nacho.
Izvi zvinomutsa mibvunzo miviri:
1. Ropa rakachena, rine oxygen yakawanda rinoda kufamba kuenda kune dzimwe nhengo dzemuviri rinosanganiswa neropa risina oxygen yakawanda uye risina kuchena.
2. Ropa rakawanda riri kupombwa nemumapapu kupfuura zvinodiwa. Izvi zvinoisa mutoro mukuru pamwoyo nemapapu. Nekufamba kwenguva, nhengo idzi dzinogona kukuvara.
Ndezvipi zvimwe zvinetso zvinogona kuonekwa neDORV?
Vacheche vane DORV dzimwe nguva vanosangana nemamwe matambudziko ekuzvarwa. Mamwe acho anosanganisira:
- Kusashanda zvakanaka kwetsinga dzemudumbu: Matambudziko nekushanda kwezvikamu zvidiki zvakaita sebvudzi zvemunzira yekufema yemwana.
- Heterotaxy:Nhengo dzemwana dziri muchipfuva nemudumbu dziri panzvimbo isiri padzinowanzova.
- Kukanganisika kwedumbu: Kukombama kwedumbu remwana zvisina kujairika.
- Kuoma kwetsinga dzemapapu: Kutetepa kana kutetepa kwevharuvhu iri pakati pe ventricle yekurudyi ne pulmonary artery.
- Kusashanda zvakanaka kwemoyo: Kamuri rimwe chete kana ese ari maviri emoyo madiki pane zvakajairika.
Kune mhando dzakasiyana dzeDORV here? Idzi dzingasiyaniswa sei?
Ehe, kune mhando dzakasiyana dzeDORV. Kupatsanurwa uku kunobva pane chimwe chinhu chakakosha zvikuru. Kureva kuti, mwana wese ane DORV anewo buri riri pakati pemakamuri maviri emoyo (Ventricular Septal Defect - VSD). Buri iri rinodzivirira ropa kuti risayerere richidzokera shure pakati pemakamuri maviri aya.
Vanachiremba vanoisa DORV muzvikamu zvichienderana nekuti VSD, kana kuti gomba, riri kupi.
| Rudzi rweDORV | Tsananguro iri nyore |
|---|---|
| DORV ine subaortic VSD | Buri riri mumoyo (VSD) riri pasi peaorta. |
| DORV ine subpulmonary VSD (Taussig-Bing) | Buri riri mumoyo riri pasi petsinga yemapapu. Izvi zvinonziwo chirwere cheTaussig-Bing. |
| DORV ine VSD yakapetwa kaviri | Buri iri riri pasi petsinga mbiri huru dzeropa (Aorta nePulmonary Artery). |
| DORV ine VSD isina kuzvipira (iri kure) | Buri iri riri kure netsinga mbiri idzi huru dzeropa, panzvimbo isina kubatana. |
Kuziva kuti rudzii rwechirwere ichi kwakakosha zvikuru pakuronga kurapwa.
Amai naBaba, zivai zviratidzo izvi!
Zviratidzo zveDORV zvinowanzoonekwa mukati memazuva mashoma ekutanga kana mavhiki mushure mekuzvarwa. Unofanira kungwarira zvikuru nezveizvi.
| Chiratidzo | Izvi zvinorevei? |
|---|---|
| Kusviba kwebhuruu (Cyanosis) | Ganda remwana, miromo, kana nzara zvinogona kuita bhuruu kana pepuru. Izvi zvinokonzerwa nekushaikwa kweokisijeni muropa. |
| Kuoma kufema | Kufema zvinonzwika, nekukurumidza (tachypnea) kana kunzwa kushaya mweya. |
| Kuomerwa nekudya/kunwa | Kusada kunwa mukaka, uye kunyangwe ukanwa zvishoma, unozorega mushure mechinguva. Izvi zvinogonawo kukonzera kuti uremu husanyanye kuderera. |
| Kugunun'una kwemoyo | Kana chiremba achiongorora moyo ne stethoscope, anonzwa ruzha rwakasiyana pamusoro pekurova kwemoyo. |
| Kurova kwemoyo nekukurumidza (Tachycardia) | Kurova kwemoyo kunokurumidza kupfuura kurova zana paminiti. |
| Kudikitira zvakanyanya | Mwana anodikitira zvakanyanya, kunyanya kana achiyamwisa. |
| Hope dzisinganzwisisike | Mwana anogara akarara uye asina hupenyu. |
Chii chinokonzera chirwere ichi? Ndezvipi zvinetso zvinogona kuitika?
Kutaura zvazviri, vaongorori havasati vawana chikonzero chaicho cheDORV. Zvisinei, zvakaonekwa kuti vanenge 50% vevana vane chirwere ichi vane shanduko mumachromosome avo, zvikamu zveruzivo rwemajini edu (DNA).
Asi yeuka izvi. Iyi haisi mhosva yako, haisi mhosva yako. Saka usambozvifunga wozvipa mhosva.
Kana DORV ikasarapwa zvakanaka, matambudziko anogona kukura nekufamba kwenguva.
- Kusarongeka kwekurova kwemoyo (Arrhythmias)
- Matambudziko evharuvhu yemoyo
- Kukundikana kwemoyo
- Kukwira kweropa zvakanyanya mumapapu
- Kutapukira kwemukati memwoyo (Endocarditis)
Vanachiremba vanoongorora sei mamiriro eDORV?
Dzimwe nguva, rudzi urwu rwechirwere chemwoyo runogona kuonekwa kunyangwe mwana asati aberekwa, panguva yekuongororwa kweropa panguva yekuzvitakura. Kuongororwa kwakakosha kunoshandiswa pakuongorora uku kunonzi ``Fetal Echocardiogram''.
Kana izvozvo zvisingakwanisike, vanachiremba vanozongofungidzira izvi chete kana zviratidzo zvatataura nezvazvo zvaonekwa mushure mekunge mwana azvarwa. Ipapo vanozoongorora mwana.
- Tarisa kuti ganda remwana riri kuchinja kuita bhuruu here.
- Moyo unoteererwa ne stethoscope kuti utarise kana paine ruzha rusina kujairika (kunyunyuta).
- Pulse Oximetry inzira yekuyera huwandu hweokisijeni muropa remwana nekuisa chinhu chidiki chakaita seclip pamunwe kana nzeve yemwana. Iyi inzira iri nyore yekuyedza isingakuvadze mwana.
Mushure mekuongororwa kwekutanga uku, mimwe miedzo yakati wandei inogona kuitwa kusimbisa chirwere ichi.
- Kuongororwa kwemifananidzo kusingapindi muropa: Kuongororwa kweCT, MRI, uye X-ray zvinoitwa kunze kwemuviri wemwana.
- Electrocardiogram (ECG kana EKG): Kuongororwa kwemoyo kusingarwadzi kunoyera mashandiro emagetsi emwoyo.
- Echocardiogram (echo): Izvi zvakafanana nekuongororwa kwemoyo. Inoshandisa mafungu eruzha kuti ione zvakajeka zvese nezvemoyo, kusanganisira chimiro chawo, mashandiro awo, uye kuti mitsipa yeropa yakabatana sei.
- Kuisa catheter mumoyo: Muizvi, chubhu yakatetepa (catheter) inopinzwa mumoyo kuburikidza netsinga yeropa iri muhudyu kana muruoko rwemwana kuti iwane ruzivo rwakarurama nezve pressure yemoyo, oxygen levels, uye chimiro.
Usazvidya moyo, pane mushonga weizvi! - Ngatidzidzei nezvekuvhiyiwa
Mwana wese ane DORV achada kuvhiyiwa mwoyo mukati megore rekutanga rehupenyu hwake. Izvi zvinganzwika sekutyisa kwauri. Izvozvo zvakajairika. Asi yeuka, nehunyanzvi hwekurapa hwemazuva ano, kuvhiyiwa uku kunogona kuitwa zvinobudirira zvikuru.
Chiremba wako uye chiremba wemwoyo vachafunga nezvezvinhu zvakati wandei pavanenge vachiita sarudzo nezvekuvhiyiwa.
- Rudzii rweDORV rwemwana?
- Kana paine mamwe matambudziko pamoyo wemwana kana dzimwe nhengo dzemuviri.
- Hutano hwese hwemwana.
Kune mhando dzakasiyana-siyana dzekuvhiya dzinowanzoitwa.
- Kugadziriswa kwemukati memoyo: Mukuita uku, chiremba anogadzira mugero unopfuura nepakati peVSD, kana buri riri mumoyo, achishandisa chigamba chakakosha. Mugero uyu unogadzira nzira yekuti ropa riyerere kubva kuruboshwe kuenda kuaorta.
- Kugadziriswa kweBiventricular kana arterial switch: Kana maventricle ese ari maviri emwana ari mumamiriro akanaka uye DORV iri subpulmonary VSD (Taussig-Bing), chiremba anogona kuita oparesheni yekubvisa aorta uye kuibatanidza neleft ventricle.
- Kugadziriswa kweUniventricular (Kuvhiyiwa kweFontan): Kana DORV yakaoma zvikuru, chiremba anogona kukurudzira kuvhiyiwa uku. Izvi zvinosanganisira kutungamira ropa risina oxygen kubva pasi pemuviri zvakananga kumapapu. Uku kuvhiyiwa kwakaoma kunosanganisira matanho akati wandei.
Kune njodzi dzinosanganisirwa nekuvhiyiwa kwemoyo chero kupi zvako. Izvi zvinosanganisira kubuda ropa, kuvharika kweropa, hutachiona, uye matambudziko ekushandisa mushonga wekutindivadza. Asi vanachiremba vanoita zvese zvavanogona kuderedza njodzi idzi.
Upenyu huchava hwakaita sei mushure mekuvhiyiwa?
Mushure mekuvhiyiwa, mwana anofanira kugara muchipatara kwevhiki imwe chete kana kupfuura. Nguva yekurapwa ichasiyana zvichienderana nerudzi rwekuvhiyiwa kwakaitwa uye mamiriro emwana.
Chinhu chakakosha ndechekuti mushure mekuvhiyiwa, ruzhinji rwevacheche vane DORV vanogona kurarama hupenyu hwakanaka uye hwakajairika hwevanhu vakuru.
Asi chinhu chimwe chete chekurangarira ndechekuti munhu akavhiyiwa DORV anofanira kuramba achitarisirwa nachiremba wemwoyo kweupenyu hwake hwese. Zvakakosha kuenda kunoongororwa panguva yakatarwa uye kuongororwa zvinodiwa.
Vamwe vanhu vanogona kusangana nematambudziko emwoyo asingatarisirwi kana kurova kwemoyo kunyangwe mushure memakore akawanda, saka zvakakosha kugara uchitarisira hutano hwako.
Nguva yekuona chiremba uye nguva yekuenda kuETU
Kunyangwe mushure mekuvhiyiwa, rambai muchitarisa mwana wenyu. Kana zviratidzo zvinotevera zvikaonekwa, zivisai chiremba wenyu nekukasika.
- Kana uchinzwa kurova kwemoyo kusina kujairika, nekukurumidza, kana kurova zvakanyanya.
- Kana uchinzwa kurwadziwa pachipfuva kana kuoma kufema (izvi zvinogona kuva zviratidzo zvechirwere chemwoyo).
Muzviitiko zvinotevera, endesai mwana kuEmergency Treatment Unit (ETU) yechipatara chiri pedyo nekukurumidza.
Kana mwana wako achinetseka zvakanyanya kufema uye/kana nzara dzake, miromo, kana ganda rake rakaita sebhuruu, enda kuETU nekukasika!
Mibvunzo inokosha yekubvunza chiremba wako
Zvakajairika kuva nemibvunzo yakawanda kana ukaona kuti mwana wako ane DORV. Usavanza chero chinhu kwauri. Bvunza chiremba wako zvese wobva watsanangurirwa. Heano mimwe mibvunzo yaunogona kubvunza.
1. Mwana wangu ane chirwere cherudzii cheDORV?
2. Munoda kuvhiyiwa rudzii?
3. Kuvhiyiwa uku kunofanira kuitwa riini?
4. Ngozi dzipi dziripo dzekuvhiyiwa?
5. Ndeipi njodzi dzekusavhiyiwa?
6. Mwana wangu achada kuvhiyiwa zvakare here mushure mekuvhiyiwa uku?
7. Mwana wangu achafanira kutora mishonga kweupenyu hwake hwese here?
Kana ukaziva zvese zvakanaka nekubvunza mibvunzo yakaita seiyi, uchakwanisa kuita sarudzo dzakachenjera pasina kutya.
Mharidzo Yekuenda Nayo Kumba
- Double Outlet Right Ventricle (DORV) chirwere chemwoyo chakakonzerwa nekuzvarwa nacho chakakomba, asi chinorapika.
- Sezvo chikonzero chaicho chechirwere ichi chisingazivikanwi, usambofa wakafungidzira kuti iyi imhosva yako semubereki.
- Kuongororwa kwechirwere nekukasika uye kuvhiyiwa nenguva zvinopa vana mukana wekurarama hupenyu hune hutano uye hurefu.
- Mushure mekuvhiyiwa, zvinosungirwa kuti ugare pasi pekutarisirwa nachiremba wemwoyo kweupenyu hwako hwese.
- Gara wakangwarira zviratidzo zvekukurumidzira zvakaita sekuoma kwekufema uye ganda rebhuruu. Kana zvakadaro, tora mwana uende naye kuEmergency Treatment Unit (ETU) nekukasika.
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