Mwana wenyu mudiki ane dambudziko remwoyo iri here? Ngatidzidzei nezvePulmonary Artery Stenosis!

Mwana wako dzimwe nguva anonzwa kushaya mweya here? Kana kuti anokurumidza kuneta kunyangwe mushure mekutamba kwenguva yakati? Vamwe vana vadiki vanogona kuva nezvirwere zvemwoyo zvekuzvarwa nazvo. Nhasi tichataura nezvechimwe chirwere chemwoyo chakadai, chisingawanzoitiki, asi chakakosha kuziva nezvacho. Tinochidana kuti `(Pulmonary Artery Stenosis)`. Zvichitaurwa zviri nyore, kuvharika kwetsinga huru inotakura ropa kuenda kumapapu.

Chii chinonzi Pulmonary Artery Stenosis?

Zvichitaurwa zviri nyore, kune tsinga huru yeropa inotakura ropa kubva kurudyi rwemwoyo wedu (yatinodaidza kuti ``right ventricle``) kuenda kumapapu. Izvi zvinonzi ``pulmonary artery``. Kana yasvika kumapapu, ropa iri rinoiswa oxygen, uye ropa iroro rine oxygen rinotakurwa mumuviri wese.

Zvino, muchirwere ichi chinonzi `(Pulmonary Artery Stenosis)`, tsinga yeropa inotakura ropa kuenda kumapapu inovharika kana kutetepa pane imwe nzvimbo kana pane rimwe rematavi ayo. Zvinoita sepombi yemvura iri kuvharika pakati. Chii chinoitika ipapo? Zvinova zvakaoma kuti ropa riyerere kumapapu. Kana ropa rikasayerera zvakanaka, muviri hauwani huwandu hweokisijeni hwaunoda. Nekuda kweizvi, moyo wemwana nemuviri wese hazvigone kushanda zvakanaka.

Kuvharika uku kunogona kuitika mutsinga huru yemapapu (`(main pulmonary artery)`), kana mumatavi ayo ekuruboshwe kana kurudyi (`(left or right branches)`). Kana kuvharika uku kwaitika, divi rekurudyi remoyo (`(right ventricle)`) rinofanira kushanda nesimba kuti ripfuure kuvharika kwacho. Zvakafanana nekushandisa simba rakawanda kusunda mvura nepaipi yakavharika. Nekufamba kwenguva, kuramba uchiedza uku kunogona kukuvadza tsandanyama yemoyo.

Ndezvipi zvinetso zvinogona kuitika kubva muchirwere ichi?

Kana izvi zvikasarapwa zvakanaka, nekufamba kwenguva rutivi rwerudyi rwemoyo runogona kutadza kushanda zvakanaka. Kureva kuti, pane mukana wekuva nechirwere chinonzi "Right-sided heart failure". Saka, zvakakosha zvikuru kutarisira izvi.

Ndiani anonyanya kukanganiswa nemamiriro ezvinhu aya?

Dambudziko iri rinonzi `(Pulmonary Artery Stenosis)` hariwanzoitiki . Izvi zvinoreva kuti hariitiki kune wese munhu. Vamwe vana vanogona kuribata pamwe chete nezvimwe zvirwere zvemwoyo (`(congenital heart disease)` - kureva, zvirwere zvemwoyo zviripo pakuzvarwa). Dzimwe nguva rinogona kunge riri iro rega risina mamwe matambudziko emwoyo. Zvakare, dambudziko iri rinogona kuitika mushure mekuvhiyiwa kwemoyo.

Ndezvipi zviratidzo zveizvi? Tarisa kana mwana wako aine izviwo.

Zviratidzo izvi zvinoenderana nekuti chubhu yacho yakamanikana zvakadii. Dzimwe nguva, kana stenosis iri diki (`mild stenosis`), panogona kunge pasina zviratidzo zvachose . Asi sezvo stenosis ichiramba ichiipa, mwana wako anogona kuratidza zvinhu zvakaita se:

• Kunzwa sekunge zvakaoma kufema (`(Kushaya mweya)`).
• Kunzwa kuneta nguva dzese (`(Kuneta)`).
• Zvinoita sekunge uri kufema nekukurumidza , kana kuti pamwe uri kufema zvine ruzha.Zvinoita seizvi here? (`(Kufema zvakanyanya kana nekukurumidza)`).
• Ko kurova kwemoyo wako kunonzwa sekunge kuri kurova nekukurumidza here? (Kurova kwemoyo nekukurumidza).
• Pane kuzvimba here mumakumbo ako, muzvitsitsinho, kumeso, mumaziso, kana mudumbu? (`(Kuzvimba)`).
• Dzimwe nguva unonzwa dzungu here kana kuti kufenda ? (`(Dzungu kana kufenda)`).
• Miromo yako, minwe, nezvigunwe zvinoshanduka kuita bhuruu here ? Izvi ndizvo zvatinodaidza kuti "Cyanosis" mukurapa.
• Unokurumidza kuneta here kana uchitamba nevamwe vana? Haugone kumhanya nekusvetuka zvakanaka sevamwe vana here? (`(Kusakwanisa kurovedza muviri kwakaderera)`).

Yeuka kuti kungova nechimwe kana zviviri zvezviratidzo izvi hazvirevi kuti une chirwere ichi. Asi kana mwana wako aine chimwe chezvinhu izvi, zvakanaka kutsvaga rubatsiro kubva kuna chiremba.

Sei tsinga iyi yemapapu ichivharika? Ndezvipi zvinokonzera?

Vamwe vana vanozvarwa vaine chirwere ichi (Pulmonary Artery Stenosis), uye vanogonawo kuva nematambudziko nemavharuvhu, madziro, kana zvimwe zvikamu zvemoyo. Vamwe vanogona kuzvarwa vaine chirwere ichi asi vasina mamwe matambudziko emwoyo. Pamusoro pezvo, chirwere ichi chinogona kuitika mushure mekuvhiyiwa kwemoyo kana nekuda kwemamwe mamiriro ezvinhu asingawanzoitiki.

Zvikonzero zvekuzvarwa nazvo

Kazhinji, vanhu vanosvika 40% vanozvarwa vaine chirwere ichi (Pulmonary Artery Stenosis), asi havana mamwe matambudziko emwoyo.

Zvisinei, pakati pe2% ne3% yevanhu vane zvimwe zvirwere zvemwoyo zvekuzvarwa nazvo vanogonawo kuva nechirwere ichi (Pulmonary Artery Stenosis). Heano mamwe ematambudziko emwoyo anowanzoitika:

• (Tetralogy of Fallot): Muizvi, mwana ane matambudziko mana emwoyo, ayo anokanganisa kufamba kweropa.
• (Pulmonary atresia): Muizvi, vharuvhu (pulmonary valve) iri pakati pe ventricle yekurudyi yemoyo ne pulmonary artery (pulmonary artery) haiumbwe. Nokudaro, ropa hariende kumapapu.
• (Truncus arteriosus): Mutsinga mumwe chete mukuru weropa panzvimbo pemiviri yakajairika. Izvi zvinoita kuti ropa rine okisijeni risanganiswe neropa risina okisijeni.
• Kuoma kwetsinga yeropa: Dambudziko revharuvhu iri mutsinga huru inotakura ropa kubva pamoyo kuenda mumuviri, izvo zvinoderedza huwandu hweropa rinoyerera richienda mumuviri.
• Kukanganisika kweropa muchikamu chemwoyo: Buri riri pakati pemakamuri maviri epamusoro emoyo (atria). Izvi zvinobvumira ropa rine okisijeni neropa risina okisijeni kusanganisana.
• Kukanganisika kwetsinga dzemumapapu: Buri riri pamadziro rinoparadzanisa makamuri maviri epazasi (maventricles) emwoyo. Izvi zvinogona kukonzera ropa rakawanda kuti ribude mumapapu.
• (Kuchinja kwetsinga huru): Tsinga mbiri huru dzinotakura ropa kubva pamoyo dzakadzoserwa kumashure. Izvi zvinokanganisa kufamba kweropa kwakajairika uye zvinoderedza huwandu hweokisijeni hunosvika mumasero emuviri.
• (Patent ductus arteriosus):Uku kubatana kuripo pakati petsinga yemapapu yemwana netsinga huru inotakura ropa kuenda mumuviri (aorta). Izvi zvinofanira kuvhara mushure mekuzvarwa, asi kana zvikasadaro, ropa rakawanda richayerera richienda kumapapu.

Zvimwe zvikonzero

Kunze kweizvi, panogona kunge paine zvimwe zvikonzero zvakawanda:

• Rubella syndrome: Kana ukabatwa nerubella panguva yekuzvitakura, mwana wako anogona kunge aine matambudziko emwoyo nezvimwe zvirwere.
• (Williams syndrome): Izvi zvinokonzera kusarongeka kwakasiyana-siyana mumoyo wemwana nedzimwe nhengo dzemuviri.
• (Alagille syndrome): Izvi zvinokonzera matambudziko echiropa nezvirwere zvemwoyo.
• Arteritis yaTakayasu: Uku kuzvimba kunokuvadza mitsipa mikuru yeropa.
• Zvimwe zvinonetsa nemafambiro anoita tsinga dzemapapu dzemwana.

Zvikonzero zvekuvhiyiwa

Vamwe vanhu vanogona kuva nechirwere ichi mushure mekuvhiyiwa. Semuenzaniso:

• Kuisirwa mapapu.
• Kuvhiyiwa kugadzirisa dambudziko remwoyo rekuzvarwa naro mumwana, kana kuti kuvandudza kufamba kweropa mumoyo.
• Kuvhiyiwa kunonzi "Pulmonary artery banding". Mukuita izvi, tsinga inoderedzwa nemaune kuti ropa riende kumapapu rideredzwe.

Nzira yekuziva sei chirwere ichi?

Kana mwana wako akaongororwa nachiremba, anogona kunzwa ruzha rwemwoyo rusina kujairika ("kunyunyuta"). Kana zvakadaro, vacharaira mimwe miedzo yakati wandei. Mimwe yacho inosanganisira:

• Electrocardiogram - ECG kana EKG: Iyi inorekodha shanduko dzemagetsi dzinoitika kana moyo uchirova. Inogona kuona kurova kwemoyo kusina kurongeka (arrhythmias) uye kushushikana kwetsandanyama yemoyo.
• X-ray yechipfuva: Izvi zvinogona kuratidza saizi uye chimiro chemwoyo, mapapu, uye tsinga dzemapapu.
• Echocardiogram: Izvi zvakafanana nemufananidzo unofamba wemoyo. Inoshandisa mafungu eruzha kutarisa tsandanyama dzemwoyo nemavharuvhu.
• Kufungidzira kwemoyo nemagnetic resonance (MRI): Iyi inzira yekufungidzira ine mativi matatu (3D) inogona kuona kuti ropa rinoyerera sei mumoyo wemwana wako netsinga dzeropa.
• (CT scan): Iyi bvunzo ye `(X-ray)` zvakare. Kombiyuta inoshandisa mifananidzo ye `(X-ray)` yemoyo wemwana kuti igadzire maonero akasiyana-siyana. Dhayi yakakosha (`(IV contrast)`) inopinzwa mumoyo kuti ione chimiro uye kuyerera kweropa remwoyo.
• Kuisa catheter mumoyo: Mukuita uku, chubhu yakatetepa (catheter) inopinzwa mutsinga kana mutsinga yeropa yoendeswa kumoyo. Izvi zvinobvumira chiremba kutarisa mwero weokisijeni, kuchinja kwekumanikidzwa, uye kutora maX-ray emoyo.
• Angiography yemapapu: X-ray yetsinga dzemapapu netsinga dzemwoyo inotorwa uchishandisa dhayi.
• (Kuskena kweropa): Mukuita izvi, panopinda zvinhu zvishoma zvine mwaranzi. Zvadaro, muchina wakakosha unoshandiswa kutarisa kuti ropa riri kufamba zvakanaka sei mumapapu ese.

Kana chiremba wenyu akaona kuti mwana wenyu ane chirwere chePulmonary Artery Stenosis, vachakutumirai kuna chiremba wemwoyo akaberekerwa naye. Vanachiremba verudzi urwu vane hunyanzvi nekudzidziswa kwekuongorora dambudziko remwoyo remwana wenyu nemazvo, kuita bvunzo dzinodiwa, kupa kurapwa, kuita oparesheni yemwoyo, uye kuita bvunzo dzekutevera . Vanogonawo kuita bvunzo dzakawanda kana zvichidikanwa.

Pakutaura nezvechirwere ichi, chiremba wako anogona kuchitumidza kuti Type I, II, III, kana IV. Uku kupatsanurwa kunoenderana nekuti ndeapi mativi etsinga akavharika uye kuti akawanda sei.

Ndeapi marapirwo eizvi? (Kurapwa)

Kurapwa kwakanakisisa kunoenderana nezviratidzo zvemwana wako nezvimwe zvinhu. Kana paine kutetepa kuri pakati nepakati kwebazi rimwe kana kupfuura retsinga yemapapu, kurapwa kungasave kwakakosha . Zvisinei, kana kutetepa kwakanyanya, kurapwa kunodiwa .

Mishonga ye `(Pulmonary Artery Stenosis)` ndeiyi:

Kukura kwebharumu / Angioplasty

Muchiitiko ichi, chiremba anoita:

• Katheta yakaita sebharumu (katheta yekutambanudza bharumu) inopinzwa mumugero wakavharika.
• Zvadaro, nokungwarira kukuru, bharumu rinofuridzirwa kubva pakumanikidzwa kwakaderera kusvika pakumanikidzwa kwakakwira.
• Ipapo mugero wakavharika unowedzera kukura.
• Ipapo mweya unobviswa kubva mubharumu woburitswa.

Kukura kwemabharumu uye kuisa stent (izvi zvinowanzoitwa)

Muchiitiko ichi, chiremba anoita:

• Stent inowedzerwa nebharumu (stent ichubhu diki ine mesh) inoshandiswa kuvhura tsinga yakavharika.
• Iyi stent inoiswa pamusoro pecatheter yebharumu ye angioplasty yovharwa ne sheath.
• Stent iri kutamiswa kuenda kunzvimbo chaiyo.
• Chifukidziro chiri pabharumu restent chinobviswa.
• Zvadaro bharumu rinofuridzirwa kusvika pakumanikidzwa kwakakodzera, zvichiita kuti stent iwedzere uye zvichiita kuti irambe yakanamatira ipapo.

Bharuni rakakosha rinonzi ``(The Cutting Balloon™)``

Bharumu iri rakangofanana nebharumu renguva dzose. Zvisinei, rine mapanga madiki akati wandei pakureba kwaro. Kana chiremba afuridza bharumu, mapanga aya anovhura uye anocheka nzvimbo yakavharika. Izvi zvinoita kuti zvive nyore kuwedzera chubhu, zvichiita kuti pave nekuvhurika kukuru.

Vanhu vazhinji vasina zvimwe zvirwere zvemwoyo zvekuzvarwa nazvo vanowana mhedzisiro yakanaka nekuita izvi. Zvisinei, vanhu vanosvika 21% vanogona kuvharwa tsinga dzavo dzeropa mushure memwedzi mishoma.

Kuvhiya

Vanachiremba vanoshandisa nzira dzakasiyana-siyana kurapa stenosis yetsinga dzemapapu. Sarudzo yacho inoenderana nemhando yetsinga dzakavharika, mitsipa yeropa yakapoteredza, nezvimwe zvimiro.

Pane matambudziko aripo here pakurapwa?

Kukura kwemabharumu kunoderedza kuvharika kweropa muvanhu vazhinji. Zvisinei, nekufamba kwenguva, tsinga dzeropa dzinogona kuvharika zvakare ne15% kusvika 20%, uye maitiro acho anofanira kudzokororwa. Vaongorori vari kuongorora mhando dzakasiyana dzemabharumu dzinogona kupa mhedzisiro iri nani uye inogara kwenguva refu.

Matambudziko angangoitika panguva yekuvhurwa kwebharumu:

• Aneurysm yetsinga dzemapapu.
• Kubviswa kwetsinga dzemapapu (Kubviswa kwetsinga dzemapapu).
• Kuputika kwetsinga dzemapapu (`(Kuputika kwetsinga dzemapapu)`).
• Kuzvimba kwemapapu (`(Kuzvimba kwemapapu)`).
• Kashoma, panogona kuva nerufu.

Matambudziko angangoitika pakushandisa stent:

• Kugwamba kweropa.
• Kusarongeka kwemutinhimira wemoyo (`(Ventricular arrhythmias)`).
• Stent inogona kunge yakasiyiwa kana kubviswa panzvimbo yayo.
• Kufanira kuwedzera tsinga zvakare (izvi hazviwanzoitika).

Ndezvipi zvakanakira kurapwa?

Vanachiremba vanosarudza kuisa ma stents ePulmonary Artery Stenosis nekuda kwezvikonzero izvi:

• Vanoshanda ne96% ipapo ipapo .
• Zvinotora nguva yakareba kuti tsinga irambe yakavhurika.
• Nzvimbo yakamanikana inogona kuwedzerwa kaviri .
• Hazvidhuri uye zvinoshanda kupfuura kungoisa mabharumu kana kuita oparesheni.
• Kubudirira kupfuura bharuni angioplasty.

Vanachiremba vanogona kusarudza bharuni angioplasty pachinzvimbo chestent muzviitiko zvinotevera:

• Kana chirwere chemwana chakanyanya kuipa .
• Kana chimiro chemukati chemuviri wemwana chakaoma (`(complex anatomy)`).
• Kana mwana ari mudiki kwazvo .

Chii chinoitika mushure mekuvhiyiwa?

Kana mwana wako aine stent, achafanira kunwa mishonga inorwisa mabhakitiriya pamwe nemishonga inodzikisa ropa kwenguva yakati. Mishonga iyi inopihwa kudzivirira hutachiona uye kumisa kuumbwa kweropa.

Mwana achazonzwa zviri nani kwenguva yakareba sei mushure mekurapwa?

Maitiro ekuwedzera tsinga dzemapapu emwana wako anoshanda pakarepo. Izvi zvinoreva kuti zvinova nyore kuti mwana wako aise ropa mumapapu ake uye awane oxygen.

Kana mwana wangu aine chirwere ichi, ramangwana rake richange rakaita sei? (Kufungidzira)

Nekurapa kwazvino uno, vanhu vazhinji vane chirwere ichi vanorarama kusvika vakura. Zvisinei, vanhu vane zvirwere zvakaita se "Williams syndrome" uye "Alagille syndrome" vangasada kurapwa zvakanaka.

Unofanira kuenda nemwana wako kuna chiremba rini?

Uchafanira kuenda nemwana wako kunoongororwa nguva nenguva kuti uone kuti ari sei. Uchafanirawo kuongororwa moyo nguva nenguva kuti uone kana tsinga yeropa ichida kuvhurwa zvakare mune ramangwana.

Chii chandinofanira kubvunza chiremba?

Unogona kubvunza chiremba mibvunzo yakaita seiyi:

• Sei mwana wangu akabatwa nechirwere che "Pulmonary Artery Stenosis"?
• Ndeipi nzira yakanakisisa yekurapa mwana wangu?
• Mikana ipi iripo yekuti mwana wangu achazoda kurapwa zvakare nekuda kweizvi?

Kana mwana wako achida kurapwa chirwere chePulmonary Artery Stenosis, chiremba achafunga nezvekurapa kwakanakira chirwere chemwana wako. Usazeza kubvunza mibvunzo nezvechero chausinganzwisisi nezvemaitiro emwana wako.

Mharidzo Yekuenda Nayo Kumba

Kana zvasvika pachirwere ichi chinonzi `(Pulmonary Artery Stenosis)`, chinhu chakakosha kuziva zviratidzo nekukurumidza uye kutsvaga mazano echiremba . Zvakakosha kutsvaga mazano kubva kuna `(nyanzvi yemwoyo inoberekwa nayo)`, kunyanya kana vana vaine chirwere ichi.

Usazvidya moyo, kune nzira dzekurapa izvi . Dambudziko iri rinogona kudzorwa nezvinhu zvakaita sekuwedzerwa kwebharuni, kuiswa kwestent, uye, kana zvichidikanwa, kuvhiyiwa. Kunyangwe mushure mekurapwa, zvakakosha kuti hutano hwemwana huende kunoongororwa nachiremba nguva dzose uye kutevedzera mirairo yachiremba . Taura nachiremba nezvemibvunzo kana zvinokunetsa zvaungave nazvo.

` Pulmonary Artery Stenosis, Chirwere chemwoyo chevana, Zvirwere zvemoyo zvekuzvarwa nazvo, Kuoma kwekufema, Kuvhiyiwa kwemoyo, Stent