Mwana wako mudiki ane dambudziko remwoyo rakadai here? (Total Anomalous Pulmonary Venous Return - TAPVR) Ngatikurukurei nezvazvo!

Kana mwana wako aberekwa, dzimwe nguva anonzwa sekunge zvakaoma kufema here? Dzimwe nguva ganda rinoita serinoshanduka kuita bhuruu here? Zvakajairika kuti unzwe kutya zvikuru paunoona chimwe chinhu chakadai. Nhasi tichataura nezvechirwere chemwoyo chinoratidzwa nezviratidzo izvi. Izvi zvinonzi TAPVR (Total Anomalous Pulmonary Venous Return) . Kunyangwe zita racho ringaita serakaoma, ngatirinzwisisei zviri nyore.

Chii chinonzi TAPVR? Zvichitaurwa zviri nyore...

Funga nezvazvo, miviri yedu inowana okisijeni kubva mumapapu, handiti? Saka, kubva mumapapu aya, ropa rine okisijeni (ngatitii "ropa rakanaka") rinounzwa kumoyo netsinga , rudzi rwetsinga yeropa. Kazhinji, "ropa rakanaka" iri rinofanira kuuya kuruboshwe rweatrium kuruboshwe rwemoyo. Kubva ipapo, ropa rinopombwa kuti ripe okisijeni kumuviri wese.

Zvisinei, mumwana ane TAPVR, pachinzvimbo chekubatana neatrium yekuruboshwe yemoyo, tsinga iyi yemapapu inobatana nenzvimbo isiriyo, inova atrium yekurudyi . Atrium yekurudyi inowanzo gamuchira "ropa rakaipa" rakashandiswa nemuviri, iro rine oxygen shoma. Iye zvino "ropa rakanaka" rakazara oxygen rinosanganiswa ne "ropa rakaipa" iri. Chii chinoitika ipapo? Huwandu hweoxygen muropa hunofanirwa kuenda kumuviri wese hunoderera. Ichi chirwere chine njodzi uye chinotyisidzira hupenyu hwemwana. Ichi chirwere chemwoyo chekuzvarwa nacho .

Vacheche vanenge vese vane TAPVR vane buri diki (Atrial Septal Defect - ASD) pakati pemakamuri maviri emwoyo wavo, atrium yekurudyi neatrium yekuruboshwe. Buri iri rinobvumira ropa rine oxygen kuti riyerere kuruboshwe rwemoyo uye rozoenda kune mumwe muviri wese. Dai zvisina kudaro, dambudziko iri ringadai rakatoipisisa.

Chinhu chinonyanya kukosha ndechekuti vacheche vane TAPVR vanofanira kuvhiyiwa zvechokwadi. Kana kuvhiyiwa kukaitwa nekukurumidza, vana vazhinji vanogona kurarama hupenyu hwakanaka kusvika vakura. Zvisinei, dzimwe nguva, zvinhu zvakaita sekutetepa kwetsinga dzeropa mushure menguva yakareba zvinogona kuda kuvhiyiwa kumwe kana kumwe kurapwa. Saka, kunyangwe mushure mekuvhiyiwa kweTAPVR, uchafanirwa kutariswa nachiremba wemwoyo kweupenyu hwako hwese.

Dzimwe nguva vanachiremba vanodanawo chirwere ichi kuti TAPVC (Total Anomalous Pulmonary Venous Connection). Zvose zviri zviviri zvakafanana.

Kune mhando dzakasiyana dzeTAPVR here?

Ehe, kune mhando dzakawanda dzeTAPVR. Idzi dzinopatsanurwa zvichienderana nekuti "ropa rakanaka" rinobva mumapapu rakabatana sei zvisina kunaka neatrium yekurudyi.

• Supracardiac TAPVR: Muizvi, tsinga dzemapapu dzinobatana uye dzinobatana netsinga huru iri pamusoro pemoyo (inonzi superior vena cava , inova tsinga huru inotakura ropa kubva kumativi ekumusoro emuviri kuenda kurudyi kwemoyo).
• Mwoyo weTAPVR: Pano, tsinga dzemapapu dzinoyerera zvakananga mumoyo wemoyo uri kurudyi rwemoyo.Inobatanidza. Iyi tsinga yemoyo inzvimbo iyo ropa risina oxygen rinowanzo ungana kubva mutsandanyama yemwoyo.
• Infracardiac TAPVR: Murudzi urwu, tsinga yemapapu inopfuura nepasi pemoyo, nemuchiropa, uye inobatanidzwa kune tsinga huru ( inferior vena cava ) inotakura ropa kubva pasi pemuviri kuenda kurudyi rwemoyo.
• TAPVR Yakasanganiswa: Iyi ndiyo mhando isingawanzoonekwi uye yakaoma kugadzirisa. Pano, mitsipa inopfuura imwe chete inobva mumapapu inogona kunge yakabatana, musanganiswa weimwe kana kupfuura yemhando dzataurwa pamusoro apa.

Kurongwa uku kwakakosha kuti vanachiremba varonge kuvhiyiwa uye vasarudze nzira dzekurapa nadzo.

TAPVR yakajairika zvakadii?

TAPVR chirwere chemwoyo chisingawanzoitiki . Kunyangwe munyika yakaita seAmerica, chirwere ichi chinobata mwana mumwe chete pavana 7,500 vachangoberekwa. Hazviwanzoitikiwo muSri Lanka.

Ndezvipi zviratidzo zveTAPVR?

Zviratidzo zveTAPVR zvinowanzoonekwa pakuzvarwa , kunyanya kana paine kutetepa kwetsinga dzemapapu padzinosangana nemoyo. Zvisinei, vamwe vacheche vanogona kusaratidza zviratidzo kwemavhiki akati wandei.

Zviratidzo zvikuru ndeizvi:

• Cyanosis: Kuchinja kweruvara rwebhuruu kana grey kweganda, nzara, nemiromo (muvana vacheche vane ganda dema). Izvi zvinokonzerwa nekushaikwa kweokisijeni muropa.
• Kuoma kwekuyamwa: Mwana anonetseka nekuyamwa uye anoneta mushure mekunwa zvishoma.
• Kuneta uye kuneta: Mwana anogara aneta uye anoita seaneta.
• Kugunun'una kwemoyo: Kana chiremba akateerera moyo wemwana (ne stethoscope), ruzha rusina kujairika runonzwika.
• Kushaya mweya wekufema (dyspnea): Mwana ari kufema nekukurumidza uye anoita seari kunetseka kufema.
• Kukura kusina kunaka uye kuwedzera huremu: Mwana haasi kuwedzera huremu zvakanaka uye haasati akura zvakanaka.

Kana mwana wako aine chimwe chezviratidzo izvi kana kupfuura, unofanira kutsvaga rubatsiro rwechiremba nekukasika .

Chii chinokonzera TAPVR?

Kutaura zvazviri, vanachiremba havasati vaziva chikonzero chaicho cheTAPVR. Inokonzerwa nekusashanda zvakanaka kwemoyo netsinga dzeropa panguva yekukura kwemwana ari mudumbu .

Hazviwanzoonekwa sechirwere chinogara nhaka. Zvisinei, kwave nemishumo yekuti kune nyaya dzinoitika muhama dziri mumhuri imwe chete. Dzimwe ongororo dzakaratidza kuti panogona kunge paine hukama pakati pevana vane mamwe masyndromes uye kusangana nemishonga inobvisa pendi, mishonga yekuuraya zvipembenene, uye mutobvu panguva yekuzvitakura. Zvisinei, izvi hazvisati zvaratidzwa.

Ndezvipi zvinetso zvinogona kuitika nekuda kweTAPVR?

Mwana ane TAPVR ane chirwere chemwoyo uye BP yemapapu.Kunyangwe mushure mekuvhiyiwa, dzimwe nguva mwoyo inomira zvisina kujairika kana kuti kuvharika kwetsinga dzemapapu kunogona kuitika. Ndosaka kuramba uchiongororwa nachiremba kuchikosha.

TAPVR inoonekwa sei?

Dzimwe nguva, chirwere ichi chinogona kuonekwa mwana asati aberekwa, ne echocardiogram (kuongororwa kwemoyo) panguva yekuzvitakura. Zvisinei, kazhinji kuongororwa kunoitwa mavhiki mashoma kana mwedzi mushure mekuzvarwa kwemwana.

Kana mwana azvarwa, chiremba achaita bvunzo yemuviri uye kuteerera mwoyo wemwana. Muchina mudiki unonzi pulse oximeter (chinokwana pagunwe guru remwana) unogona kushandiswa kuyera huwandu hweokisijeni muropa.

Pamusoro pezvo, bvunzo dzakadai sedzinotevera dzinogona kuitwa kuti paonekwe mamiriro emwoyo netsinga dzeropa:

• X-ray yechipfuva
• CT scan (CT scan - computed tomography)
• MRI yemoyo (magnetic resonance imaging)
• Echocardiogram
• EKG (EKG kana ECG - Electrocardiogram)

Mimwe yemiedzo iyi (yakadai seMRI) ingada kuti mwana arare zvishoma. Asi miedzo iyi yese haipindi mumuviri. Miedzo iyi inobvumira vanachiremba kuwana mifananidzo yakajeka yemwoyo nemapapu emwana, kuona kuti ropa riri kuyerera sei, uye kutsvaga zvisina kunaka.

Dzimwe nguva bvunzo inonzi cardiac catheterization inoshandiswawo kuongorora chirwere chacho. Zvisinei, sezvo ruzivo rwakakosha ruchigona kuwanikwa kubva mumaskeni ataurwa pamusoro apa, mwana haawanzoongororwa zvakanyanya.

TAPVR inorapwa sei?

Vacheche vanenge vese vane TAPVR vanoda kuvhiyiwa kuti vararame. Vanachiremba vanorapa nekuvhiyiwa kwemoyo wese . Kazhinji, kuvhiyiwa uku kunoitwa nekukurumidza mushure mekunge chirwere ichi chaonekwa.

Kunyangwe zvisingawanzoitiki, vamwe vanhu vanoonekwa vaine TAPVR vachiri vakuru vasina kuvhiyiwa vachiri vana. Zvisinei, panguva iyoyo vanogona kunge vaine zvirwere zvakaita seBP yemapapu zvinoita kuti kuvhiyiwa kuve kwakaoma.

Kurapwa usati wavhiyiwa

Paanenge akamirira kuvhiyiwa, mwana angangoda kupiwa okisijeni yakawedzerwa kana kubatanidzwa nemuchina wekufema kuti umubatsire kufema. Unogonawo kupihwa mhando yemushonga unonzi inotrope , unobatsira mwoyo kurova zvakanyanya.

Kuvhiyiwa kunoitwa sei

Mushure mekunge mwana arara zvachose pasi peanesthesia , chiremba achaita zvinotevera:

1. Kuchekwa kwechipfuva nemoyo wemwana kunoitirwa pachipfuva nepamoyo.

2. Tsinga dzemapapu dzinobatanidzwazve panzvimbo chaiyo, kureva, atrium yekuruboshwe yemoyo.

3. Tsinga dzisina kubatana zvisina kujairika dzinovharika.

4. Kana paine kuvharika kwetsinga dzemapapu, zvinobviswa.

5. Kazhinji, buri riri pakati peatria yekuruboshwe nerudyi ( Atrial Septal Defect - ASD ) rinovharwa.

Kunyange zvazvo uku kuvhiyiwa kwakaoma zvikuru, mapoka evanachiremba vane ruzivo vanokuita zvinobudirira.

Matambudziko ekurapwa

Aya ndiwo mamwe ematambudziko anogona kuitika mushure mekuvhiyiwa:

• Kusarongeka kwekurova kwemoyo (Arrhythmias)
• Kukwira kweropa zvakanyanya mumapapu
• Kuvharika kwetsinga dzemapapu
• Dzimwe nguva, mushure mekushandisa muchina wemwoyo nemapapu (muchina wepamusana) panguva yekuvhiyiwa, mwoyo unonetseka kurova wega.

Vanachiremba vanogara vachitarisa zvinhu zvakaita seizvi.

TAPVR inogona kudzivirirwa here?

Zvinosuwisa kuti hapana nzira yekudzivirira chirwere chemwoyo chakadai. Kana mumwe munhu mumhuri yako aine chirwere chemwoyo chawakazvarwa nacho, kana kuti uine TAPVR, zvakanaka kutaura nachiremba wako usati watanga mhuri.

Kana mwana wangu aine TAPVR, chii chandinofanira kutarisira?

Pasina kuvhiyiwa, mamwe marudzi eTAPVR anogona kuuraya mukati memavhiki ekuzvarwa. Zvisinei, kana chirwere chikaonekwa nekukurumidza uye chikarapwa nekuvhiyiwa, tarisiro yevana vane TAPVR yakanaka kwazvo. Mwero wekurarama mushure mekuvhiyiwa ungangoita 97%. Uyu mwero wekubudirira wakakwira kwazvo.

Mwana wako paanokura uye ava munhu mukuru, anofanira kugara achiona chiremba wemwoyo . Kuongororwa uku kwehupenyu hwese kunogona kubatsira kuona nekurapa matambudziko akadai sekushaya simba kwemoyo uye kuvharika kwetsinga dzeropa. Dzimwe nguva, kana kuvharika kukaitika, kunogona kuda kuvhiyiwa kumwe uye kunogona kuoma kurapa. Ndosaka zvichikosha kuti urambe uchitevera mirairo yachiremba wako.

Mwana wenyu angangoda kuramba achitora mishonga kana kurapwa zvakaita se cardiac catheterization .

Ndingatarisira sei mwana wangu?

Vana vane TAPVR dzimwe nguva vanogona kunetseka nematanho ekukura akajairwa, akadai sekushanda zvakanaka kwemuviri. Unogona kutarisa matanho ekukura kwemwana wako womutumira kune mumwe munhu anogona kumubatsira kukudziridza hunyanzvi ihwohwo kana zvichidikanwa.

Taura nachiremba wemwana wako kana mwana wako achigona kutamba mitambo nemitambo yemuviri. Ungangoda kuderedza kurovedza muviri kunorema .

Mwana wangu anofanira kuona chiremba rini?

Mushure mekuvhiyiwa, mwana wako achaonekwa mwedzi 6 kusvika ku12 yega yega.Kuongororwa nachiremba. Unofanira kuramba uchiona chiremba wako nguva dzose muhupenyu hwako hwese. Chiremba wemwana wako angangoda kuita bvunzo dzakadai seEKG, bvunzo yekumanikidzwa kwemuviri, kana echocardiogram .

Unofanira kuenda kuEmergency Room (ETU) riini?

Tsvaga rubatsiro rwechiremba nekukasika (enda kuchipatara chekurapa) kana mwana wako aine chimwe chezviratidzo izvi:

• Kana ganda, nzara, kana miromo zvikaita bhuruu/grey.
• Kana uchinetseka kufema kana kudya/kunwa mukaka.
• Kana uchiita sewakarara zvakanyanya kana kuti usina hupenyu.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Heano mimwe mibvunzo inokosha yekubvunza chiremba wemwana wako:

• Mwana wangu ane rudzii rweTAPVR?
• Unofunga kuti mwana wangu achada kuvhiyiwa kwechipiri here?
• Mavhiyiwa mangani awakavhiyiwa kuti ugadzirise TAPVR?

Shoko rinokosha rekuenda naro kumba

Ungave wakatevedzera zano rachiremba wako rekuti ugare uine hutano panguva yekuzvitakura. Asi dzimwe nguva, mwana achangoberekwa anogona kuva nechirwere chemwoyo. Hazvisi mhosva yemunhu. Nesainzi yekurapa yanhasi, mwana wako anogona kutarisira mhedzisiro iri nani kupfuura vana vezvizvarwa zvakapfuura. Kurapa kwekuvhiyiwa kunoshanda zvikuru.

Yeukai, kunyange zvazvo TAPVR iri chirwere chakakomba, kana chikaonekwa nekukurumidza uye kurapwa kwakakodzera, vana vane mukana mukuru wekurarama hupenyu hwakanaka. Mushure mekuvhiyiwa, zvakakosha kuti mwana wako aendeswe kunoongororwa nachiremba nguva dzose. Izvi zvinoitirwa kuti hutano hwemwana wako hutariswe uye chero matambudziko angamuka agone kurapwa nekukurumidza. Hausi wega, vanachiremba nevashandi vehutano varipo kuti vakubatsire iwe nemwana wako.

` TAPVR, chirwere chemwoyo, mwana, kuvhiyiwa, mitsipa yemapapu, cyanosis, zvirwere zvekuzvarwa nazvo