Rutivi rwekuruboshwe rwemwana wako rwakaneta here? Ngatikurukurei nezveHypoplastic Left Heart Syndrome (HLHS)

Zvakaoma kutsanangura manzwiro aunoita kana chiremba wako akakuudza kuti mwana wako achangoberekwa ane chirwere chemwoyo chakakomba. Pamwe chete nekutya, kushamisika, uye kusuruvara, mubvunzo wekuti "Chii chichaitika kumwana wedu?" unouya mupfungwa dzako. Inguva yakaoma zvikuru. Asi chinhu chakakosha panguva yakaita seiyi ndechekuziva zvizere nezvechirwere ichi. Nhasi tichataura nezveHypoplastic Left Heart Syndrome (HLHS), chirwere chemwoyo chakakomba uye chisingawanzoitiki chinokonzerwa nekuzvarwa. Muchinyorwa chino, tichataura nezvazvo zviri nyore, nenzira yaunogona kunzwisisa.

Chii chinonzi Hypoplastic Left Heart Syndrome (HLHS)?

Zvichitaurwa zviri nyore, Hypoplastic Left Heart Syndrome (HLHS) chirwere chinoitika kana divi rekuruboshwe remoyo risingakure zvakanaka mwana achiri kukura mudumbu. Ichi chirwere chemwoyo chekuzvarwa nacho. Izwi rekuti "hypoplastic" rinoreva "kusakura zvakanaka."

Mwoyo wedu wakaita seimba diki ine makamuri mana. Makamuri maviri kumusoro uye makamuri maviri pasi. Zvikamu zverutivi rwekuruboshwe rwemwoyo wemwana ane HLHS, kunyanya:

• Ventricle yekuruboshwe: Iyi ndiyo nzvimbo huru yekupomba yemoyo. Inopomba ropa rakachena, rine okisijeni kumuviri wese. MuHLHS, idiki kwazvo uye haina kukura zvakanaka.
• Aorta: Mutsinga mukuru weropa unotakura ropa kubva kuventricle yekuruboshwe kuenda kune imwe nhengo yemuviri. Uyu unowanzova mutete uye mudiki.
• Mavharuvhu eMitral neaortic: Aya akafanana nemagonhi. Anobvumira ropa kuti riyerere nenzira imwe chete. MuHLHS, mavharuvhu aya anogona kusakura zvakanaka kana kuti anogona kuvharwa zvachose.

Nekuti zvikamu zvikuru izvi hazvikure zvakanaka, rutivi rwekuruboshwe rwemoyo harugone kupomba ropa rakakwana rine oxygen kumuviri wese. Ichi chirwere chakakomba zvikuru. Dzimwe nguva, panogona kuva neburi diki pamadziro pakati pemakamuri maviri epamusoro emoyo, rinonzi atrial septal defect .

Chii chakasiyana pakati peizvi nemoyo une hutano?

Mumoyo une hutano, mativi ese erudyi nekuruboshwe anoshanda pamwe chete. Fungidzira kuti divi rekurudyi rinotora ropa risina oxygen mumuviri roritumira kumapapu kuti riwane oxygen. Ropa rine oxygen yakawanda kubva mumapapu rinodzokera kuruboshwe rwemoyo. Ipapo pombi ine simba iri kuruboshwe (ventricle yekuruboshwe) inopomba ropa iroro kune muviri wese.

Asi mumwana ane HLHS, rutivi rwekuruboshwe rwemoyo haruna simba. Saka harukwanise kuita basa iroro. Saka chii chinoitika? Rutivi rwerudyi rwemoyo runofanira kuita mabasa ese ari maviri ega . Izvi zvinoreva kuti ventricle yekurudyi inofanira kupomba ropa kuenda kumapapu, ukuwo ichipomba ropa kuenda kumuviri wese.

Izvi zvinoitika sei? Kana mwana ari mudumbu, panenge paine kubatana kwenguva pfupi pakati petsinga mbiri huru dzeropa dziri mumoyo. Inonzi ductus arteriosus.Zvakafanana ne 'shortcut'. 'Shortcut' iyi inokosha kuti mwana ane HLHS ararame mushure mekuzvarwa. Nekuti ropa rinoyerera nemuchubhu iyi kuenda mumuviri. Kazhinji, chubhu iyi inovhara mazuva mashoma mushure mekuzvarwa kwemwana. Asi kana chubhu iyi ikavhara mumwana ane HLHS, hapana nzira yekuti ropa riyerere mumuviri. Saka, kana chirwere ichi chisina kurapwa, mwana anongova nemazuva mashoma ekurarama.

Unoziva sei kana mwana wako aine chirwere ichi? Ndezvipi zviratidzo zvacho?

Kana mwana achangoberekwa aine HLHS, dzimwe nguva zviratidzo hazvionekwe pakutanga. Asi zviratidzo izvi zvinogona kuonekwa mukati memaawa mashoma kana mazuva. Zvakakosha kuti vabereki vazive izvi.

Sei izvi zvichiitika kuvana vacheche? Chikonzero chacho ndechei?

Mubvunzo uyu uri mupfungwa dzemubereki wese. Zvakajairika kuzvibvunza kuti, "Sei izvi zvakaitika kumwana wedu? Pane chatakaita chisina kunaka here?"

Asi chokwadi ndechekuti, kazhinji, hapana chikonzero chaicho cheHLHS . Kureva kuti, hachisi chinhu chinokonzerwa naamai kana baba. Dzimwe nguva, zvinhu zvemajini zvinogona kuita basa. Kureva kuti, shanduko dzemajini mumhuri dzinogona kuwedzera njodzi. Vacheche vane mamwe mamiriro emajini, akadai seTurner syndrome kana trisomy 18, variwo panjodzi yeHLHS.

Vanachiremba vanoongorora sei chirwere ichi nemazvo?

Nerombo rakanaka, neruzivo rwemazuva ano rwekuvandudza hunyanzvi, chirwere ichi chinogona kuonekwa mwana asati aberekwa, kureva panguva yekuzvitakura . Kana paine chinhu chisina kujairika mumoyo panguva yekuongorora kwe prenatal ultrasound, chiremba wako achakutumira kuna nyanzvi uye okukumbira kuti uite fetal echocardiogram . Izvi zvinokutendera kuti uone chimiro uye mashandiro emoyo wemwana zvakajeka.

Kuti vaongorore chirwere ichi mushure mekunge mwana azvarwa, chiremba achatarisa zviratidzo zvemwana uye oteerera chipfuva ne stethoscope kuti aone kana paine ruzha rwemwoyo rusina kujairika (heart murmur). Zvadaro, bvunzo dzinoverengeka dzichaitwa kuti dzisimbise chirwere chacho, dzakadai se:

• X-ray yechipfuva: X-ray yechipfuva inogona kutarisa saizi uye chimiro chemwoyo nemapapu.
• Echocardiogram: Iyi ndiyo bvunzo inonyanya kukosha. Yakafanana nekuongororwa kwevhidhiyo kwemoyo. Makamuri emoyo, mavharuvhu, netsinga dzeropa zvese zvinoonekwa zvakajeka. Izvi ndizvo zvinosimbisa kuvapo kweHLHS.
• Electrocardiogram (EKG): Muedzo unoyera mashandiro emagetsi emwoyo.
• Kuongorora pulse oximetry: Muchina mudiki wakaita seclip unoiswa pamunwe kana nzeve yemwana kuti upime huwandu hweoxygen muropa. Kukosha uku kwakaderera kuvana vane HLHS.

Pane mushonga wechirwere ichi here? Mwana anogona kuponeswa here?

Ehe, chirwere ichi chakakomba zvikuru, asi kune mishonga. Asi ichi hachisi chirwere chinogona kurapwa nemishonga. Kuti mwana aponeswe, kuvhiyiwa kwakaomarara kunosanganisira matanho akati wandei kunofanira kuitwa.

Danho Rokutanga: Kudzikamisa Mwana

Mwana asati avhiyiwa, anofanira kugadzikana. Danho rekutanga nderekuchengetedza ductus arteriosus , iyo 'nzira pfupi' yeropa yatakataura nezvayo, yakavhurika. Mushonga unonzi prostaglandin unopihwa netsinga. Mimwe mishonga inogona kushandiswawo kubatsira kurova kwemoyo wemwana, uye mudziyo wekufema unogona kushandiswa kubatsira mwana kufema.

Danho Rechipiri: Nhevedzano Yekuvhiya Yematanho Matatu

Chinangwa chikuru chekuvhiyiwa uku ndechekudzivisa zvachose divi rekuruboshwe risina simba uye kupa divi rerudyi rakasimba remoyo (ventricle yekurudyi) basa rekupomba ropa kumuviri wese. Zvakafanana nekutungamira ropa munzira yakasiyana zvachose.

1. Maitiro ekuvhiya eNorwood: Izvi zvinoitwa mukati memavhiki maviri ekutanga ekuzvarwa kwemwana. Uku kuvhiya kwakaoma uye kwakakomba. Pano, vanachiremba:

• Mwoyo usina kukura zvakanaka unogadzirwazve.
• Chubhu yakakosha (shunt) inoiswa kuti ropa ritumirwe kubva ku ventricle yekurudyi zvakananga kumapapu.
• Nenzira iyi, "tubular system" yemoyo inogadziriswa kuitira kuti ventricle yekurudyi igone kupomba ropa mumuviri wese nemapapu.

2. Kuvhiyiwa kwaGlenn (Bidirectional Glenn shunt operation): Izvi zvinoitwa kana mwana ari pakati pemwedzi mina netanhatu . Pano:

• Chubhu (shunt) yakaiswa panguva yekuvhiyiwa kwekutanga inobviswa.
• Ropa risingakwanise kuwana okisijeni kubva kuchikamu chepamusoro chemuviri (rinobva mutsinga inonzi superior vena cava) rakabatana zvakananga nemapapu.
• Izvi zvinoderedza zvakanyanya mutoro pa ventricle yekurudyi, nekuti ikozvino haifanirwe kupomba ropa kubva mumuviri wepamusoro, rinoenda zvakananga kumapapu.

3. Maitiro eFontan: Iri ndiro danho rekupedzisira. Rinoitwa pakati pemwedzi gumi nemisere nemakore mana . Pano:

• Ropa risingakwanise kuwana okisijeni kubva pasi pemuviri (rinobva mutsinga inonzi inferior vena cava) rakabatana zvakananga nemapapu.
• Mushure mekuvhiyiwa uku, ropa rese risingade okisijeni rinobva mumuviri rinoenda zvakananga kumapapu. Ventricle yekurudyi yemoyo inongofanira kupomba ropa rakachena, rine okisijeni kubva kumapapu kuenda kumuviri wese.

Mushure mekunge maoparesheni matatu aya apera, hurongwa hweropa hwemwana hunotanga kushanda nenzira itsva zvachose.

Ndezvipi zvinetso zvinokonzereswa nekurapwa?

Kunyange zvazvo kuvhiyiwa uku kuchiponesa hupenyu, kwakaoma zvikuru uye kunogona kuva nenjodzi nematambudziko. Matambudziko anogona kumuka panguva yekuvhiyiwa uye mushure mekuvhiyiwa.

• Ventricular yekurudyi inoshaya simba nekuda kwemutoro unorema wainofanira kutakura.
• Kubuda kweropa kubva mumavharuvhu emwoyo.
• Zvirwere zvechiropa.
• Kurira kwemoyo kusina kujairika.
• Kugwamba kweropa.
• Utachiona.
• Kuomerwa nekudya.
• Kubatwa nepfari.
• Mhedzisiro paitsvo.

Chiremba achakurukura nemi nezvenjodzi idzi zvakadzama. Chikwata chevanachiremba chichange chichinyatso tarisa mwana pavanenge vachifamba rwendo urwu.

Kuisirwa moyo chinhu chakanaka here?

Mune zvimwe zviitiko, kana mamiriro emwoyo wemwana akaomarara kana kuti vanachiremba vachifunga kuti mwana haazorarami nekuvhiyiwa, vanogona kukurudzira kuti aisirwe moyo . Asi vanofanira kumirira kusvika moyo wakakodzera wavapo. Zvakare, mushure mekuisirwa moyo, mwana anofanira kutora mishonga inodzvinyirira immune system kweupenyu hwake hwese.

Kana mwana aine chirwere ichi, isu sevabereki tinofanira kuzivei?

Rwendo urwu rwakaoma, asi nekutarisirwa kwakakodzera kwechiremba nekutarisirwa, vana vane HLHS vanogona kurarama hupenyu hwakanaka.

• Kutarisirwa kwehupenyu hwese kwevanachiremba: Mushure mekuvhiyiwa, mwana anofanira kuenda kuna chiremba wemwoyo kweupenyu hwake hwese. Anofanira kuongororwa kanenge kamwe chete pagore.
• Mishonga: Vana vazhinji vachafanira kutora mishonga yemwoyo muhupenyu hwavo hwese.
• Mishonga inorwisa mabhakitiriya usati wavhiyiwa: Usati wavhiyiwa chero kupi zvako, sekubviswa kwezino, unofanirwa kutora mishonga inorwisa mabhakitiriya kudzivirira hutachiona hwemwoyo (endocarditis).
• Kurovedza muviri: Kurovedza muviri kwemwana wako kungada kuganhurirwa. Mabasa anorema, akadai semitambo yemakwikwi, haawanzokurudzirwa. Bvunza chiremba wako kuti akupe mazano pane izvi.
• Hutano hwepfungwa dzako: Rwendo urwu runonetesa vabereki zvikuru. Runogona kunetsa. Saka, taura nezvemanzwiro ako nemurume/mukadzi wako nemhuri yako. Tsvaga mazano kana zvichidikanwa. Kana wakasimba ndipo chete pauchakwanisa kutarisira mwana wako zvakanaka.