Hapana chinofadza kupfuura kuona mwana achangoberekwa. Asi dzimwe nguva, kana mwana iyeye akatanga kuchema achiyamwa mukaka, uye paanongoerekana achinja kuita bhuruu, amai nababa vese vanotya. Nhasi tichataura nezvechirwere chemwoyo chisingawanzoitiki asi chakakomba chinowanikwa pakuzvarwa, chinoratidza zviratidzo zvakadaro. Mukurapa, tinodana izvi kuti Pulmonary Atresia . Usatya kana ukanzwa zita iri. Nekurapa kwazvino kuripo nhasi, chirwere ichi chinogona kugadziriswa zvinobudirira. Ngatinzwisise izvi kubva pakutanga.
Zvichitaurwa zviri nyore, chii chinonzi Pulmonary Atresia?
Kuti tinzwisise izvi, ngatitangei kurangarira mashandiro anoita mwoyo wedu. Mwoyo wedu une makamuri makuru mana. Kamuri rezasi riri kurudyi (ventricle yekurudyi) rinopomba ropa risina oxygen uye risina kuchena kuenda kumapapu kuti ritore oxygen. Tsinga huru yeropa inotakura ropa iri kuenda kumapapu itsinga yemapapu.
Fungidzira, pane chikamu chakaita segedhi pakati pe ventricle yekurudyi yemoyo netsinga iyi yemapapu. Tinoti iyi ivharuvhu yemapapu. Vharuvhu iyi inovhurika uye inovhara kuti ropa riendeswe kumapapu.
Kupera kweropa mumapapu chirwere chinokonzerwa nekuti vharuvhu yemapapu haikure zvakanaka mwana achiri mudumbu. Dzimwe nguva, vharuvhu iyi inogona kuvharwa zvachose neganda gobvu. Izvi zvinoreva kuti nzira huru yekuti ropa ribude kubva ku right ventricle kuenda kumapapu inenge yakavharwa zvachose.
Saka chii chinoitika ipapo? Ropa harigone kusvika kumapapu kuti riwane okisijeni. Nekuda kweizvozvo, ropa rebhuruu risina okisijeni rinotenderera mumuviri wese. Ichi ndicho chikonzero chikuru chinoita kuti miromo yemwana, minwe, uye dzimwe nguva muviri wese utaridzike sebhuruu. Tinoti chirwere ichi chinonzi cyanosis.
"Dzimwe nzira" dzemwoyo uye mhando dzechirwere ichi
Kana mugwagwa mukuru uyu wakavharwa, mapapu anofanira kuwana ropa kuti ararame. Nerombo rakanaka, mimwe migwagwa "yenguva pfupi" iri mumoyo panguva yekuzvitakura inoshanda semuponesi panguva ino.
- Foramen Ovale: Buri diki riri pakati pemakamuri maviri epamusoro emwoyo. Izvi zvinoita kuti ropa risina mweya unodiwa kuti riyerere kubva kurudyi kuenda kuruboshwe.
- Ductus Arteriosus: Kubatana kudiki pakati petsinga huru inotakura ropa kuenda kumuviri (aorta) netsinga inotakura ropa kuenda kumapapu (pulmonary artery). Kuburikidza neizvi, ropa diki rinobva mumuviri rinodzokera kumapapu.
Zvakajairika kuti nzira idzi dzekufamba kwenguva pfupi dzivharwe mukati memazuva mashoma mushure mekuzvarwa. Zvisinei, mwana ane Pulmonary Atresia anogona kungorarama chero bedzi nzira idzi dzichiramba dzakavhurika. Saka, kana mwana angozvarwa, vanachiremba vanopa mwana mushonga wekuti nzira idzi dzirambe dzakavhurika (kunyanya Ductus Arteriosus).
Tinogona kuona mamiriro ePulmonary Atresia nenzira mbiri huru.
1. Kuputika kweMapumha neIntact Ventricular Septum (IVS): Pano, madziro ari pakati pemakamuri maviri epasi emwoyo (septum) apera. Hapana maburi. Zvisinei, nekuda kweizvi, ventricle yekurudyi haina nzvimbo yekupomba ropa, uye kazhinji haikure zvakanaka uye idiki.
2. Kuputika kweMapumha neVentricular Septal Defect (VSD): Pano, pamusoro pevharuvhu yemapapu yakavharwa, pane buri riri pakati pemakamuri maviri epasi emwoyo (Ventricular Septal Defect - VSD). Buri iri rinobvumira ropa kuti riyerere kubva mukamuri rekurudyi kuenda kuruboshwe, saka kamuri rekurudyi rinogona kunge rakakura zvishoma pane zvakajairika.
Nzira dzekurapa dzinoonekwa zvichienderana nekuti ndedzipi mhando mbiri idzi dzine mwana.
Ndezvipi zviratidzo zvinogona kutariswa nevabereki?
Zviratidzo izvi zvinowanzoonekwa mumaawa mashoma ekutanga kana mazuva mushure mekuzvarwa kwemwana. Kunyangwe vanachiremba vachinyatsoteerera izvi muchipatara, zvakakosha kuti uzive izvi kana wasvika kumba.
| Chiratidzo | Izvi zvinorevei? |
|---|---|
| Kuchinja kweruvara rwebhuruu rwemuviri (Cyanosis) | Miromo, rurimi, zvigunwe zvemaoko, uye pasi penzara zvinoshanduka kuita bhuruu kana pepuru. Izvi zvinogona kuwedzera kana mwana achichema kana kunwa mukaka. Izvi zvinokonzerwa nekushaikwa kweokisijeni muropa. |
| Kufema nekukurumidza kana kuoma | Kunyangwe mwana akangogara, anofema nekukurumidza, chipfuva chake chinoita sechiri kupinda mukati, uye anofema. Uku kuyedza kuwana mweya waanoda mumuviri wake. |
| Kusvina mukaka uchinwa | Anoyamwa mukaka, ousvipa, omira, obva asveta zvakare. Dzimwe nguva anorara achinwa. Zvakaoma kuramba uchinwa semwana mudiki. |
| Hope dzisinganzwisisike uye kuneta | Mwana anogara akarara. Haana chido chekutamba kana kufambisa nhengo dzake. Anonzwa asina hupenyu. |
| Ganda rinotonhora, rinotonhora | Maoko netsoka dzemwana zvinogona kunzwa kutonhora kana zvikabatwa. Dzimwe nguva zvinogona kunge zvichinamira, zvichiratidza kudikitira. |
Sei izvi zvakaitika kumwana wangu? Ndezvipi zvinhu zvinokonzera njodzi?
Mubvunzo uyu unouya mupfungwa dzemubereki wese. "Ndakaita chimwe chinhu chisina kunaka here?" Ungashamisika. Chekutanga, chikonzero chaicho cheizvi hachisati chazivikanwa. Haisi mhosva yako. Inokonzerwa nekusashanda zvakanaka kwemoyo wemwana mumavhiki masere ekutanga epamuviri.
Zvisinei, zvinhu zvakati wandei zvakaonekwa zvinowedzera mukana, kana kuti njodzi, yekuti chirwere ichi chiitike.
- Zvinhu zvinokonzerwa nemajini: Njodzi yacho inokwira zvishoma kana mumwe munhu mumhuri (amai, baba) aine chirwere chemwoyo chaakaberekwa nacho. Chinogonawo kusanganiswa nezvimwe zvirwere zvemajini, zvakaita seDiGeorge's syndrome.
- Hutano hwaamai panguva yekuzvitakura: Amai vaive nechirwere cheshuga chisingadzoreki panguva yekuzvitakura.
- Mimwe mishonga inotorwa panguva yekuzvitakura: Kushandiswa kwemimwe mishonga kunogona kukanganisa mwana ari mudumbu (teratogenic). Ndosaka zvichikurudzirwa kuti usatore chero mushonga panguva yekuzvitakura usina kurairwa nachiremba.
- Kusvuta: Kusvuta kwaamai panguva yekuzvitakura kana kuti vasati vazvitakura.
- Zera raamai: Njodzi yekuremara kwemhando idzi pakuzvarwa inogona kuwedzera zvishoma sezvo zera raamai richiwedzera.
Chinhu chakakosha ndechekuti havasi vese vane zvinhu izvi zvinogona kukonzera njodzi vachava nechirwere ichi. Zvakare, kunyangwe munhu asina chimwe chezvinhu izvi zvinogona kukonzera njodzi anogona kuva nechirwere ichi.
Vanachiremba vanozviwana sei izvi?
Neruzivo rwemazuva ano, chirwere ichi chinogona kuonekwa mwana asati aberekwa, kureva kuti, panguva yekuzvitakura .
- Munguva yekuzvitakura: Kana kuongororwa kweultrasound nguva dzose kuchiratidza kusarongeka kwemoyo wemwana wako, chiremba wako anogona kukutumira kune scan yakakosha inonzi fetal echocardiogram . Izvi zvinokutendera kuti uone chimiro uye mashandiro emoyo wemwana wako zvakajeka.
Mushure mekunge mwana azvarwa, kana chiremba akanzwa kurira kwemoyo kusingawanzoitiki kana kuona ruvara rwebhuruu (cyanosis) pavanenge vachiongorora mwana, vachamuita bvunzo dzakawanda kuti vasimbise chirwere ichi.
- Pulse Oximetry: Iyi bvunzo iri nyore kwazvo, isingarwadzi. Muchina mudiki wakaita seclip unosungirirwa pagunwe guru remwana uye unoyera huwandu hweoxygen muropa. Kana huwandu hweoxygen huri pasi, chiratidzo chedambudziko remwoyo.
- X-ray yechipfuva: X-ray yechipfuva inogona kupa pfungwa isina kujeka yehukuru, chimiro, uye kuyerera kweropa kuenda kumapapu.
- Electrocardiogram (ECG/EKG): Muedzo unonyora mashandiro emagetsi emwoyo. Izvi zvinogona kutarisa kana paine kushushikana kwetsandanyama yemoyo uye chero shanduko mumutinhimira wekurova kwemoyo.
- Echocardiogram ('Echo' scan): Iyi ndiyo bvunzo inonyanya kukosha uye yakananga. Yakafanana neultrasound scan. Inokwanisa kuona zvese zviri mumoyo, kusanganisira makamuri, mavharuvhu, mitsipa yeropa, uye kuti ropa rinoyerera sei. Pulmonary Atresia inoonekwa nemazvo nebvunzo iyi.
Ndezvipi zvirongwa zvekurapa mwana?
Kunyange hazvo chirwere ichi chisingarapike zvachose, kuvhiyiwa nedzimwe nzira dzekurapa zvinogona kuvandudza kufamba kweropa mumoyo wemwana, zvichimubvumira kurarama hupenyu hwakajairika. Hurongwa hwekurapa hunosiyana kubva pamwana mumwe kusvika mumwe.
Danho Rokutanga: Kudzikamisa Mwana
Mwana paanongozvarwa, chinangwa chekutanga ndechekuchengetedza tsinga yeropa inoponesa hupenyu inonzi Ductus Arteriosus yakavhurika uye kudzivirira kuti isavhare.
- Mushonga: Mushonga unonzi alprostadil unopihwa nguva dzose kuburikidza netsinga (IV). Izvi zvinodzivirira tsinga yeropa yenguva pfupi kuti isavhare. Izvi zvinogadzira imwe nzira yekuti ropa riende kumapapu.
- Dzimwe nzira: Dzimwe nguva, vanachiremba vemwoyo vanoshandisa chubhu yakatetepa (catheter) inopinda nemutsinga yeropa iri mugumbo ichienda kumoyo yoisa chidimbu chidiki chakaita semesh (stent) mukati meDuctus Arteriosus kuti irambe yakavhurika.
Danho Rechipiri: Maitiro Ekuvhiya
Kazhinji, mwana ane Pulmonary Atresia anofanira kuvhiyiwa kakawanda mumakore mashoma ekutanga ehupenyu hwake. Kuvhiyiwa uku hakugone kuitwa panguva imwe chete, asi kunoitwa muzvikamu nezvikamu mwana paanokura.
Kuvhiyiwa uku kwakafanana nekugadzira "pombi" itsva yekuyerera kweropa mumoyo. Zvese izvi zvinosarudzwa nechikwata chevanachiremba vemwoyo nevanachiremba vanorapa mwana wako.
Maitiro matatu ekuvhiya anowanzoitwa ndeaya:
1. BTT Shunt (Kuvhiyiwa kwekutanga - mumavhiki mashoma ekutanga): Izvi zvinosanganisira kubatanidza chubhu diki yekugadzira (shunt) pakati pebazi retsinga huru yeropa inotakura ropa mumuviri netsinga inotakura ropa kuenda kumapapu. Izvi zvinoita kuti ropa riende kumapapu zvakanaka.
2.Maitiro eGlenn (kuvhiyiwa kwechipiri - mwedzi inenge 4-8): Kana mwana akura zvishoma, shunt yaakamboisa inobviswa. Zvadaro, ropa risina oxygen rinobva pamusoro pemuviri rinobatanidzwa zvakananga netsinga dzemapapu. Izvi zvinoderedza zvikuru basa remoyo.
3. Maitiro eFontan (kuvhiyiwa kwechitatu uye kwekupedzisira - makore angangoita 2-4 ekuberekwa): Mukuita izvi, ropa risina mweya kubva mumuviri wepasi rinobatanidzwawo zvakananga netsinga dzemapapu. Mushure mekuvhiyiwa uku, kufamba kweropa kunogadziriswa kuitira kuti ropa rese risina mweya kubva mumuviri riende zvakananga kumapapu, pane kuenda kurudyi rwemoyo.
Mushure mekuvhiyiwa uku, mwana anofanira kugara muchipatara, muchikamu chevarwere vakanyanya (ICU), kwevhiki imwe kana mbiri.
Upenyu huri sei mushure mekuvhiyiwa?
Mushure mekuvhiyiwa uku, mwana achakwanisa kuenda kuchikoro nekutamba zvakanaka. Zvisinei, ichi chirwere chinoda kutarisirwa nachiremba kwehupenyu hwake hwese.
- Kuongororwa nachiremba nguva dzose: Unofanira kuenda kunoongororwa nachiremba wemwoyo nguva nenguva. Uchafanirwa kuongororwa se echo scan ne ECG kanenge kamwe chete pagore.
- Matambudziko: Nekufamba kwenguva, pane njodzi yematambudziko akadai sekushaya simba kwemoyo, matambudziko echiropa, uye kutadza kushanda kwemoyo. Ndosaka zvichikosha kuti ugare uchiongororwa.
- Kudzivirira kubva kuzvirwere: Vana ava vari panjodzi yakakura yekubatwa nechirwere chemwoyo chinonzi endocarditis, hutachiona hwemukati memwoyo. Saka, unofanira kubvunza chiremba wako kana uchida kutora mishonga inorwisa utachiona kudzivirira hutachiona usati watanga mamwe maitiro ekurapa, akadai sekubviswa kwezino.
- Mabasa: Unofanira kutaura nachiremba wako wosarudza kuti ndeapi maekisesaizi nemitambo izvo mwana wako anogona kuita nezvaasingakwanise kuita.
Mashoko haagone kuratidza kurwadziwa, kutya, uye kuvhunduka kwaunonzwa paunoziva kuti mwana wako ane chirwere ichi. Asi yeuka, hausi wega. Chikwata chikuru chevanachiremba nevanamukoti vane hunyanzvi chakazvipira kupa rubatsiro rwakanakisisa kumwana wako. Taura nachiremba wako nezvemibvunzo kana zvinokunetsa zvaungave nazvo.
Mharidzo Yekuenda Nayo Kumba
- Pulmonary atresia chirwere chemwoyo chakakomba chinokonzerwa nekuzvarwa nacho apo vharuvhu inotakura ropa kuenda kumapapu inovharika.
- Zviratidzo zvikuru kuchinja kweruvara rwebhuruu kwemuviri wemwana, miromo, neminwe (cyanosis), kudzipwa panguva yekuyamwisa, uye kuoma kufema.
- Ichi chirwere chinouraya kana chikasarapwa. Zvisinei, nekufambira mberi kwemishonga yemazuva ano, kuvhiyiwa kwakawanda kunogona kupa mwana hupenyu huri nani.
- Vana ava muhupenyu hwavo hweseKutariswa nachiremba wemwoyo uye kuongororwa nguva dzose nachiremba kwakakosha.
- Sevabereki, musambotya kubvunza chiremba wenyu mibvunzo, kujekesa kusava nechokwadi, uye kuziva zvakawanda nezvehurongwa hwekurapa.
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