Bonke umama notata bayoyika xa bebona usana olusandul’ ukuzalwa lutshintsha lube luhlaza okwesibhakabhaka kwaye lunengxaki yokuphefumla. Ngamanye amaxesha unobangela woku yingxaki yentliziyo yokuzalwa. Xa oogqirha bekuxelela ngengxaki yentliziyo yomntwana wakho kwaye kufuneka benze utyando lwe-'Arterial Switch', kuyinto eqhelekileyo ukuziva uthwele umthwalo omkhulu kunye noloyiko. Kodwa ungoyiki. Namhlanje, siza kuthetha ngale nto ngendlela elula kakhulu onokuyiqonda kwaye ufumane iimpendulo kwimibuzo emininzi esengqondweni yakho.
Yintoni le Arterial Switch Surgery?
Ngamafutshane, ukutshintsha kwemithambo yegazi lutyando olungaqhelekanga, kodwa olubaluleke kakhulu, olwenziwa kwiintsana ezisandul’ ukuzalwa. Lubandakanya ukuphinda ubeke imithambo yegazi emibini ephambili entliziyweni yomntwana, i-aorta kunye ne-pulmonary artery, kwindawo yayo eqhelekileyo.
Cinga ngemizimba yethu njengenkqubo yemibhobho. Ukuba imibhobho engalunganga iqhagamshelwe kwiindawo ezingafanelekanga, izinto zingahamba kakubi. Ugqirha uqhagamshela kwakhona i-aorta yomntwana kwi-ventricle yasekhohlo yentliziyo kunye nomthambo we-pulmonary kwi-ventricle yasekunene. Olu tyando ludla ngokwenziwa kwiiveki ezimbini zokuqala zokuzalwa komntwana.
Loluphi uhlobo lwemeko olunyangwa lolu tyando?
Olu tyando lunyanga imeko yentliziyo yokuzalwa ebizwa ngokuba yi-d-transposition of the great arteries (D-TGA) , apho imithambo yegazi emibini ephambili ephuma entliziyweni idibene kwiindawo ezingafanelekanga ekuzalweni.
Kwi-D-TGA, igazi elingcolileyo nelingenawo umoya-mpilo lijikeleza emzimbeni wonke endaweni yokuya emiphungeni ukuze lihlanjululwe. Ngokufanayo, igazi elinomoya-mpilo omninzi elivela emiphungeni libuyela emiphungeni endaweni yokuya emzimbeni. Oku kuthintela umntwana ekufumaneni umoya-mpilo awudingayo.
Utyando lwe-Arterial Switch lulungisa le ngxaki. Oku kuvumela igazi lomntwana ukuba lijikeleze kakuhle, amanqanaba eoksijini abuyele esiqhelweni, kwaye ukusebenza kwentliziyo kuyaphucuka. Olu tyando lunika umntwana wakho ithuba elikhulu lokukhula abe ngumntu omdala osempilweni.
Wenza ntoni ngaphambi kotyando?
Oogqirha benza izinto ezahlukeneyo ukuze bazinzise imeko yomntwana ngaphambi kotyando kwaye banike umzimba ioksijini eyaneleyo kangangoko.
- I-Septostomy: Le yinkqubo yexeshana. Kwenziwa umngxuma omncinci phakathi kwamagumbi entliziyo ukuvumela igazi elinomoya-mpilo ukuba lixubane negazi elinomoya-mpilo omncinci.
- Isixhobo sokungenisa umoya: Siqhagamshelwe kumatshini ukuze kube lula kumntwana ukuphefumla.
- Amayeza: Amayeza afana ne-'Prostaglandin' anikwa ukugcina imithambo yegazi ivulekile kunye nokunyusa ukuhamba komoya-mpilo emzimbeni.
Kwakhona, xa kulungiselelwa utyando, kwenziwa uvavanyo olungenazintlungu, olufana ne-echocardiogram (ukuskena kwentliziyo), i-X-ray yesifuba, kunye ne-EKG (i-electrocardiogram) ukujonga ubungakanani kunye nokusebenza kwentliziyo yomntwana.
Kwenzeka ntoni ngexesha lotyando?
Olu lutyando oluntsonkothileyo oluthatha iiyure ezininzi. Masiqonde nje ukuba kwenzeka ntoni koku.
| Inyathelo leNkqubo | Ngamagama alula... |
|---|---|
| Utyando lwe-sternum (ukuvulwa kwe-sternum) | Ugqirha uvula isifuba somntwana embindini aze afikelele entliziyweni. |
| Ukudlula kwiCardiopulmonary | Ngexesha lotyando, intliziyo nemiphunga zityandwa ngomatshini okhethekileyo (umatshini wentliziyo nemiphunga). Lo matshini ucoca igazi aze alipompe kwakhona emzimbeni. |
| Ukusindiswa kwemithambo kunye nokudluliselwa kwayo | I-aorta kunye nomthambo we-pulmonary oqhagamshelwe ngendlela engafanelekanga ziyasuswa entliziyweni. |
| Ukuncamathiselwa kwakhona kwemithambo yeCoronary | Le yeyona nxalenye ibuthathaka nebalulekileyo yotyando. Imithambo emincinci yentliziyo ehambisa igazi entliziyweni ngokwayo isuswa ngononophelo kwi-aorta engafanelekanga ize inamathele kwi-aorta esanda kuqhagamshelwa kwindawo efanelekileyo. |
| Ukunxibelelana kwakhona kwemithambo | I-aorta iqhagamshelwe kwi-ventricle yasekhohlo kunye nomthambo we-pulmonary kwi-ventricle yasekunene kwiindawo zazo ezifanelekileyo. |
| Ukuvalwa kwesifuba | Nje ukuba yonke into yenziwe ngokuchanekileyo, ugqirha uyayivala kwakhona isifuba somntwana. |
Kwenzeka ntoni emva kotyando?
Emva kotyando, umntwana wakho uza kungeniswa kwigumbi lokhathalelo olunzulu (ICU) kangangeentsuku ezimbalwa. Xa usiya kubona umntwana wakho, uza kubona iityhubhu ezininzi, iingcingo, kunye noomatshini abadibene naye. Oku kunokuba yinto eyoyikisayo, kodwa ungakhathazeki. Khumbula, zonke ezi zixhobo zikho ukuze zijonge umntwana wakho kwaye zimncede aphile ngokukhawuleza.
Zithini iingenelo, amazinga empumelelo, kunye neengozi zolu tyando?
Iingenelo nempumelelo
Olu lutyando olusindisa ubomi. Lunika umntwana ioksijini ayidingayo, nto leyo emenza akhule kakuhle.
- Ngaphandle kotyando, ama-50% eentsana ezine-D-TGA ziyafa kwinyanga yokuqala.
- Kodwa izinga lempumelelo emva kotyando liphezulu kakhulu. Umngcipheko wokufa ungaphantsi kwe-2%.
- Kuye kwaxelwa ukuba malunga ne-96% yabo baye benza utyando basaphila emva kweminyaka engama-25. Uninzi lwabantwana lunokuphila ubomi obuqhelekileyo ngaphandle kwemiqathango yokusebenza ngokomzimba.
Iingxaki ezinokwenzeka (Iingozi)
Amaxesha amaninzi, ezinye iingxaki zinokwenzeka emva kweminyaka emininzi.
- Ukuvaleka kwemithambo yentliziyo okanye indlela yokuphuma kwegazi kwi-ventricle yasekunene.
- Ukwandiswa okanye ukuncitshiswa kwemithambo yegazi exhunyiwe kwakhona.
- Iivalvu zentliziyo ezivuzayo.
Ukuba ezi ngxaki zenzeka, kunokufuneka utyando olongezelelweyo ukuze zilungiswe kamva. Kwakhona, ngenxa yamanqanaba aphantsi eoksijini ekuzalweni, abanye abantwana banokuba nokuphazamiseka okuncinci kwizinto ezifana nenkumbulo, ingqalelo, okanye ixhala elincinci. Kubalulekile ukukwazi oku kwangaphambili. Emva koko, ukuba ubona naluphi na utshintsho kumntwana wakho, unokubonelela ngoncedo olufunekayo ngokukhawuleza.
Kuthatha ixesha elingakanani ukuchacha kunye neengcebiso zonyango?
Usana ludla ngokuhlala esibhedlele kangangeeveki ezimbini . Inkqubo yokuphiliswa iyaqhubeka nokuba sele ubuyele ekhaya. Ugqirha uza kukunika iingcebiso malunga nendlela yokunyamekela inxeba kunye namayeza omawuwanike.
Uyafuna ukubona ugqirha kwakhona?
Ewe, ngokuqinisekileyo. Ufanele uye ekhaya uye kubona ugqirha wotyando emva kweveki okanye ezimbini. Ufanele ubonane nogqirha wentliziyo wabantwana.
Eyona nto ibalulekileyo kukuba umntwana wakho ahlolwe ngugqirha ubuncinane kanye ngonyaka ubomi bakhe bonke. Ngale ndlela, ukuba kukho naziphi na iingxaki, zinokubonwa ngaphambi kokuba zibe mandundu.
Xa kufuneka ufowunele ugqirha ngoko nangoko
Emva kokubuyela ekhaya, ukuba inxeba lotyando lomntwana wakho liba bomvu, lidumbile, okanye likhupha ulwelo, okanye ukuba unomkhuhlane , fowunela iqela lakho lezonyango ngokukhawuleza.
Umyalezo Wokuya Ekhaya
- Utyando lwe-Arterial Switch lutyando olubalulekileyo noluphumelele kakhulu olusindisa ubomi kwiintsana ezine-D-TGA.
- Nangona olu lutyando olukhulu, uninzi lwabantwana lunokuphila ubomi obuqhelekileyo nobusempilweni emva koko.
- Musa ukoyika izixhobo kunye neetyhubhu ozibonayo kwi-ICU emva kotyando. Konke kulapho ukunceda umntwana wakho aphile ngokukhawuleza.
- Umntwana wakho uya kufuna ukuhlolwa ngugqirha ubomi bakhe bonke. Qiniseka ukuba uyalandela.
- Njengomzali, lilungelo lakho ukuxoxa nogqirha wakho ngayo nayiphi na imibuzo, iinkxalabo, okanye amathandabuzo onawo. Bahlala bekulungele ukukunceda.
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