Mwana wako mudiki akazvarwa aine dambudziko remwoyo rakaoma here? Dzimwe nguva vanachiremba vanogona kunge vakakuudza kuti moyo wemwana wako une pombi huru imwe chete, ventricle. Kuvhiyiwa kwakakosha kunokurudzirwa navanachiremba muzviitiko zvakadaro kunonzi 'Fontan procedure'. Zvakajairika kuti unzwe kutya uye kusaziva paunonzwa zita iri. Asi kana tichiziva izvi zvizere, uchawana simba guru uye simba rekufamba rwendo urwu. Tingataura nezvazvo zviri nyore here?
Chii chinonzi Fontan Procedure nenzira iri nyore?
Kuti tinzwisise izvi, ngatitangei tatarisa mashandiro anoita moyo une hutano. Mwoyo une hutano une makamuri makuru mana. Maviri ari pamusoro (atria) uye maviri ari pasi (ventricles). Makamuri maviri aya ndiwo mapombi makuru maviri emwoyo. Rimwe rinotumira ropa risina oxygen uye risina kuchena kumapapu kuti ritore oxygen. Rimwe rinopomba ropa rakazara neoxygen uye rakachena kumuviri wese.
Zvisinei, vamwe vacheche vanozvarwa nerimwe remasero maviri aya risina kuumbwa zvakanaka. Zvadaro sero rimwe chete rinoita basa rinofanira kuita mabasa ese aya. Fungidzira kuti zvinonetesa sei kuti munhu mumwe chete aite mabasa maviri. Saizvozvo, sero rimwe chete iri rinogona kuneta nekukurumidza nekuti rinofanira kupomba ropa kuenda kumapapu nemuviri.
Zvinoitwa neFontan kuderedza basa remusero mumwe chete. Zvakafanana nekupa mumwe munhu kuti akubatsire kushanda nesimba.
Mukuita uku, vanachiremba vanobatanidza ropa risina oxygen kubva mumuviri wepazasi kuenda kutsinga dzemapapu, vachipfuura mwoyo. Izvi zvakafanana nekugadzira 'shortcut' itsva. Kazhinji, usati waita izvi, imwe nzira inonzi Glenn procedure inoitwa kutungamira ropa risina oxygen kubva mumuviri wepamusoro kuenda kumapapu. Maitiro eFontan ndiyo nhanho yekupedzisira mune aya maitirwo.
Kana nzira itsva dzagadzirwa nenzira iyi, basa rega rega resero iroro nderekupomba ropa rakachena, rine oxygen mumuviri wese. Izvi zvinozorodza mwoyo mudiki uyu.
Ndiani anoda kuvhiyiwa uku uye nei?
Kuvhiyiwa uku kunonyanya kuitwa pavana vanozvarwa vaine ventricle imwe chete. Kunowanzoitwa pakati pemakore maviri nemashanu .
Asi kuvhiyiwa uku hakusi kwemunhu wese. Chiremba achanyatsoongorora mwana wako kuti aone kana akakodzera kuita izvi. Semuenzaniso:
- Sero remwana rinoshanda rinofanira kunge rakasimba zvikuru.
- Mapapu anofanira kunge aine hutano hwakakwana kuti awane ropa rinouya zvakananga mumapapu.
Tafura iri pazasi inoratidza mamwe ematambudziko makuru emwoyo anorapwa nekuvhiyiwa uku.
| Mamiriro | Tsananguro iri nyore |
|---|---|
| Hypoplastic Left Heart Syndrome (HLHS) | Rutivi rwekuruboshwe rwemoyo (kusanganisira ventricle yekuruboshwe) harukure zvakanaka. (Ichi ndicho chikonzero chinowanzoitwa nekuvhiyiwa kweFontan) |
| Tricuspid Atresia | Vharuvhu yetricuspid iri kurudyi rwemoyo haikure zvakanaka. |
| Kupera kweMapupa | Kuvharika kwevharuvhu yemapapu inotakura ropa kuenda kumapapu. |
| Ventricle Yekuruboshwe Inopinda Kaviri | Mitsipa mikuru miviri yeropa inopinda mumoyo inobatana ne ventricle yekuruboshwe. |
Chii chinoitika usati wavhiyiwa uye panguva yekuvhiyiwa?
Mushure mekusarudza kuti mwana wenyu akakodzera kuvhiyiwa, chiremba achaita bvunzo dzinoverengeka.
- Transthoracic Echocardiogram (TTE): Iyi iultrasound scan yemoyo. Inopa mufananidzo wakanaka wechimiro chemoyo, mavharuvhu, uye mashandiro awo.
- Electrocardiogram (EKG): Inoyera mashandiro emagetsi emwoyo.
- Kugadziriswa kweCatheterization yeMoyo: Chubhu diki (catheter) inopfuudzwa nemutsinga yeropa ichipinda mumoyo kuti ione kumanikidzwa uye mwero weokisijeni mukati memoyo.
- Kuongororwa kweCT kana MRI: Mune zvimwe zviitiko, izvi zvinodiwa kuti pave nemifananidzo yemoyo netsinga dzeropa dzakapoteredza.
Pazuva rekuvhiyiwa, mwana anopiwa mushonga weanesthesia kuti arare. Izvi zvinoreva kuti mwana haazonzwi kurwadziwa. Munguva yekuvhiyiwa, mwana anobatanidzwa nemuchina wakakosha unoita basa remoyo nemapapu kwenguva pfupi (muchina wemwoyo nemapapu) . Muchina uyu uchapa ropa mumuviri kusvika chiremba agadzira kubatana kutsva (kubva kune inferior vena cava kuenda ku pulmonary artery).
Dzimwe nguva chiremba anovhiya anoita buri diki (fenestration) munzira itsva iyi.Izvi zvinoitwa kuderedza kumanikidzwa kwemoyo mushure mekuvhiyiwa. Kuvhiyiwa kwese kunogona kutora maawa angangoita mana kusvika mashanu .
Chii chinoitika mushure mekuvhiyiwa? Pane njodzi here?
Mushure mekuvhiyiwa, mwana anopinzwa mukamuri rekutarisirwa zvakanyanya (ICU) kuti anyatsoongororwa. Mushure memazuva mashoma, anotamisirwa muwadhi yenguva dzose. Avhareji yekugara muchipatara inguva iri pakati pemazuva manomwe negumi nematatu .
Kuvhiyiwa uku kune zvakunobatsira pamwe nenjodzi nematambudziko, uye zvakakosha zvikuru kuziva nezvazvo.
| Rudzi rwenjodzi | Matambudziko anogona kuitika |
|---|---|
| Njodzi dzenguva pfupi (Mushure mekuvhiyiwa) | Kubuda kweropa muropa, matambudziko eitsvo, kutadza kushanda zvakanaka kwemoyo, kurova kwemoyo kusina kujairika, chirwere chechiropa. |
| Njodzi dzenguva refu (nenguva) | Kurasikirwa nemapuroteni mumuviri, kuumbwa kweropa rakaita sethromboembolism, chirwere chechiropa chinokonzerwa neFontan (FALD), uye bronchitis yepurasitiki. |
Nekufamba kwenguva, vamwe varwere vanogona kuona kudzikira kwekushanda kwekuvhiyiwa uku. Izvi zvinonzi 'Fontan yakundikana'. Panguva iyoyo, kuisirwa moyo kunogona kudiwa. Vanachiremba vanoona ichi sechikamu cherwendo.
Mwana anogona kutarisira remangwana rerudzii?
Kare, remangwana remwana anozvarwa nesero rimwe chete raive risina chokwadi. Asi nhasi, nekufambira mberi kwesainzi yezvekurapa, kuvhiyiwa kweFontan kwapa vana ava mukana wekufamba kupfuura hudiki, kupinda muhudiki, uye kusvika pakuva vakuru.
Zvichienderana nehuwandu, kune avo vakambovhiyiwa Fontan:
- Vanenge 90% vanorarama mushure memakore gumi.
- Vanenge 85% vanorarama mushure memakore makumi matatu.
Vanhu vazhinji vava kurarama hupenyu hune hutano hwapfuura makore makumi mashanu. Asi chinonyanya kukosha ndechekuti, vana avaZvakakosha kuti ugare uchitariswa nachiremba wemwoyo muhupenyu hwako hwese. Zvinodiwa kuti ugare uchiongororwa uye uchitariswa nguva nenguva.
Unofanira kuona chiremba rini?
Paunodzokera kumba mushure mekuvhiyiwa, zivisa chiremba wako nekukasika kana uine chimwe chezviratidzo zvinotevera:
- Kana ropa kana chimwe chinhu chiri kubuda kubva paronda rekuvhiyiwa.
- Kana uine fivha kana zvimwe zviratidzo zvehutachiona (kukosora, dzihwa).
Sezvo chirwere chemwana wako chakaoma, usatya kubvunza chiremba nezvechero chausinganzwisisi. Kunzwisisa zvakanaka chirwere chemwana wako kuchakubatsira kuti utarisire mwana wako zvakanaka.
Mharidzo Yekuenda Nayo Kumba
- Maitiro eFontan haasi mushonga wakakwana wechirwere chemwoyo chesero rimwe chete. Inzira yakakosha zvikuru inochinja kufamba kweropa, inoderedza kumanikidzwa kwemoyo, uye inoita kuti hupenyu huve nyore.
- Kuvhiyiwa uku kunoderedza basa remwana musero rimwe chete uye kunowedzera zvakanyanya mwero weokisijeni mumuviri.
- Zvakakosha kuziva matambudziko anoitika kwenguva refu, akadai sechirwere chechiropa, anogona kuitika nekufamba kwenguva.
- Chinonyanya kukosha: Zvakakosha kuona chiremba wemwoyo uye kuongororwa nguva nenguva muhupenyu hwako hwese mushure mekuvhiyiwa.
- Taura pachena nachiremba wako. Kurukura mibvunzo kana zvinokunetsa. Kuziva kwako kwakakosha zvikuru pakugara zvakanaka kwemwana wako.
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