Umele ukuba woyika kakhulu xa ugqirha ekuxelela ukuba umntwana wakho omncinci unesandi esincinci entliziyweni yakhe, 'ukubhomboloza kwentliziyo'. Okanye, ngaba ukwiminyaka yakho engama-40 kwaye usaziva uphelelwa ngumphefumlo kwaye udiniwe ngalo lonke ixesha, nokuba usenza umthambo omncinci? Mhlawumbi imbangela yezi zinto zombini ngumngxuma omncinci entliziyweni. Ngokwezonyango, oku sikubiza ngokuba yi-'Atrial Septal Defect' okanye i-ASD. Musa ukoyika xa usiva eli gama. Esi sisifo sentliziyo esiqhelekileyo esizalwa naso. Masithethe ngayo yonke into ngokulula nangendlela enobuhlobo namhlanje.
Kalula nje, yintoni le mngxuma entliziyweni (ASD)?
Kulungile, ukuze siqonde oku, masicinge ngentliziyo yethu njengendlu enamagumbi amane. Le ndlu inamagumbi amabini phezulu namagumbi amabini phantsi. Kwizonyango, la magumbi mabini phezulu siwabiza ngokuba yi-atria . Oko kukuthi, i-atrium yasekunene kunye ne-atrium yasekhohlo. Kukho udonga phakathi kwala magumbi mabini aphezulu. Olu donga silubiza ngokuba yi-atrial septum .
Okuqhelekileyo kukuba igazi lomzimba elingenaoksijini, elingcolileyo lingena kwi-atrium yasekunene, liye emiphungeni, lihlanjululwe (lifakwe ioksijini), lize libuyele kwi-atrium yasekhohlo. Eli gazi licocekileyo, lizele yioksijini, liza kupompa umzimba wonke.
Khawucinge nje, bekuya kwenzeka ntoni ukuba bekukho umngxuma omncinci eludongeni (septum) owahlula amagumbi amabini aphezulu? Emva koko, elinye igazi elinomoya-mpilo omninzi, elilungileyo elivela kwigumbi lasekhohlo liza kuphuma kulo mngxuma liye kwigumbi lasekunene. Emva koko, eli gazi lilungileyo liza kuxubana negazi elingcolileyo elivela kwicala lasekunene. Ngenxa yoko, igazi elingafunekiyo liza kuqokelelana kwicala lasekunene, kwaye icala lasekunene lentliziyo kuya kufuneka lisebenze nzima ukupompa elo gazi lingaphezulu libuyele emiphungeni. Yiyo loo nto i-ASD iyiyo.
Kubalulekile: Abanye abantu babhidanisa i-ASD nesifo esibizwa ngokuba yiPatent Foramen Ovale (PFO). Ezi zimbini azifani, kodwa zimbini iimeko ezahluke ngokupheleleyo.
Ngaba kukho iintlobo eziphambili ze-ASD?
Ewe, kukho iintlobo ezine eziphambili ze-atrial fibrillation, kuxhomekeke ekubeni umngxuma ukuphi eludongeni lwentliziyo. Oku kubalulekile ukwazi, njengoko iindlela zonyango ngamanye amaxesha zixhomekeke kuhlobo.
| Uhlobo lwe-ASD | Inkcazo |
|---|---|
| ISecundum ASD | Olu lolona hlobo luxhaphakileyo . Abantu abasibhozo kwabalishumi abane-ASD banalo olu hlobo. Umngxuma uphakathi kodonga phakathi kwe-atria. |
| I-ASD yePrimum | Lo mngxuma ufumaneka kwinxalenye esezantsi yodonga. Abanye abantwana abalolu hlobo banokuba nezinye iziphene kwiivalvu zentliziyo okanye eludongeni oluphakathi kwamagumbi asezantsi (ii-ventricles). |
| I-Sinus Venosus ASD | Lo mngxuma uhlala uphezulu okanye ngasemva kodonga. Olu hlobo ngamanye amaxesha lunokunxulunyaniswa neziphene kwimithambo ephambili ethwala igazi liye entliziyweni. |
| I-Coronary Sinus engagqunywanga | Olu lolona hlobo lunqabileyo . Lwenzeka xa udonga oluphakathi kweqela lemithambo edibana nentliziyo kunye ne-atrium yasekhohlo lungekho okanye lungaphelelanga. |
Zithini iimpawu zale meko?
Okumangalisayo kukuba, nangona i-ASD yimeko yokuzalwa, abantu abaninzi ababonakalisi zimpawu de kube yiminyaka kamva, mhlawumbi bafikelele kwiminyaka ephakathi. Ukuba umngxuma mncinane kakhulu (ungaphantsi kweemilimitha ezi-5), usenokungabi namiphumo ibalulekileyo entliziyweni okanye emiphungeni, ngoko ke kusenokungabikho zimpawu.
Iimpawu kubantwana abancinci
Amaxesha amaninzi, uphawu lokuqala lokuba umntwana omncinci une-ASD luvakalelo olungaqhelekanga lwentliziyo (ukugungqa kwentliziyo) oluviwa ngugqirha ngexesha lovavanyo lwe-stethoscope. Elo lolona phawu luqhelekileyo.
Ukongeza, abanye abantwana banokubonisa iimpawu ezifana nezi:
- Ukwehla kobunzima obuhambelana nobudala kunye nokulibaziseka kokukhula.
- Iintsholongwane zokuphefumla ezixhaphakileyo (ezifana nomkhuhlane, i-pneumonia).
- Ukudinwa ngokukhawuleza ngelixa udlala.
- Ubunzima bokuphefumla.
- Ukungahambi kakuhle kwesantya sentliziyo (i-arrhythmias) - kodwa oku kunqabile ebantwaneni.
Iimpawu kubantu abadala
Ukuba unomngxuma omkhulu ongazange ubonwe ebuntwaneni, iimpawu zisenokuqala ukubonakala malunga neminyaka engama-40 ubudala. Oku kungenxa yokuba icala lasekunene lentliziyo nemiphunga belisebenza nzima kangangeminyaka kwaye lidiniwe.
Abantu abadala banokufumana iimpawu ezifana nezi:
- Ukudinwa kakhulu ngaphandle kwesizathu.
- Ubunzima bokuphefumla, njengokuba uhamba umgama omfutshane okanye unyuka izinyuko.
- Ukuziva ukubetha kwentliziyo okungaqhelekanga (ukubetha kwentliziyo okungaqhelekanga).
- Ukubetha kwentliziyo ngokukhawuleza (i-tachycardia).
- Ukudumba (ukudumba) kwemilenze, amaqatha, nezandla.
- Ngamanye amaxesha imilebe kunye nolusu luba luhlaza okwesibhakabhaka (i-cyanosis).
Ukuba unayo nayiphi na kwezi mpawu, nceda ubone ugqirha wakho ngokukhawuleza. Ezi zinokuba ziimpawu ze-ASD enganyangwanga, okanye zinokuba ziimpawu zesinye isifo sentliziyo. Ukuba ufumana iintlungu esifubeni, yiya kwicandelo lezonyango ezingxamisekileyo (ETU) elikufutshane nawe ngoko nangoko.
Kutheni le meko isenzeka?
Isizathu esichanekileyo soku asikaziwa okwangoku. Nangona kunjalo, uninzi lwezi ziphene zokuzalwa zibangelwa lutshintsho lwemfuza olwenzeka ngexesha lokukhula komntwana esibelekweni. Utshintsho kwimfuza ezifana ne-NKX2.5/CSX, i-GATA4, kunye ne-TBX5 lufunyenwe lunxulumene ne-ASD.
Kwakhona, ngamanye amaxesha iintsana ezine-ASD zinokuba nezinye iziphene zentliziyo okanye ezinye izifo zemfuza, ezifana ne-Down syndrome.
Izinto ezonyusa umngcipheko ngexesha lokukhulelwa
Ukuba umama okhulelweyo uneemeko ezithile, umntwana unokuba sengozini yokwanda kancinci yokuba nesifo sentliziyo sokuzalwa.
- Umama wayenesifo seswekile ngaphambi kokuba akhulelwe.
- Ukuhlaselwa zizifo ezibangelwa ziintsholongwane ezifana nomkhuhlane ngexesha lokukhulelwa.
- Ukusetyenziswa kotywala kunye necuba.
- Ukusetyenziswa kwamayeza athile ngaphandle kwengcebiso kagqirha.
- Ukusetyenziswa kweziyobisi ezifana ne-cocaine.
Zeziphi iingxaki ezinokwenzeka ukuba azinyangwa?
Umngxuma omncinci awuyi kubangela umonakalo omkhulu. Nangona kunjalo, ukuba umngxuma omkhulu awunyangwa ixesha elide, unokubangela iingxaki zempilo ezinzulu. Oku kungenxa yokuba icala lasekunene lentliziyo nemiphunga zihlala zisebenza nzima, nto leyo ezonakalisayo.
- Ukwandiswa kwentliziyo ngasekunene: Ukuba oku kuyaqhubeka, kunokukhokelela ekusileleni kwentliziyo.
- Iingxaki zesingqisho sentliziyo (i-Arrhythmia): Malunga nesiqingatha sabantu abane-ASD abangaphezu kweminyaka engama-40 ubudala baba neengxaki zesingqisho sentliziyo (ezifana ne-atrial fibrillation).
- Istroke: Ngamanye amaxesha, amahlwili egazi amancinci ayenzeka entliziyweni anokuhamba kulo mngxuma aye engqondweni, nto leyo ebangela istroke.
- Uxinzelelo lwegazi oluphezulu kwimibhobho yegazi ethwala igazi ukuya emiphungeni. Le yimeko eyingozi.
- Isifo se-Eisenmenger:Ingxaki enkulu eyenzeka xa kukho i-ASD kunye noxinzelelo olukhulu lwegazi oluphezulu emaphaphu.
Oogqirha bayifumana njani le nto?
Baza kukubuza ngeempawu zakho, bakuhlole, baze emva koko benze iimvavanyo ezininzi ukujonga ukusebenza kunye nokwakheka kwentliziyo yakho.
| Uvavanyo | Ufunda ntoni kuloo nto? |
|---|---|
| I-ECG (i-Electrocardiogram) | Umsebenzi wombane wentliziyo uyarekhodwa. Oku kunokunika imiqondiso malunga nokubetha kwentliziyo okungahambelaniyo okanye ukuba icala lasekunene lentliziyo likhulisiwe na. |
| I-X-reyi yesifuba | Ungajonga ukuba amagumbi akwicala lasekunene lentliziyo akhulu na kwaye ukuba imiphunga ichaphazelekile na. |
| I-Echocardiogram (i-Echocardiogram - TTE) | Olu lolona vavanyo lubalulekileyo nolubalulekileyo . Lufana nokuskena intliziyo. Ubungakanani nendawo yomngxuma, indlela igazi elihamba ngayo, kunye nefuthe elinalo entliziyweni kunokubonakala ngokucacileyo. |
| I-Trans-esophageal Echo (TEE) | Uvavanyo olukhethekileyo lwe-ultrasound olubandakanya ukudlulisa ikhamera encinci kwi-larynx. Oku kunceda ukufumana iinkcukacha ezicacileyo malunga nomngxuma. |
Kwezinye iimeko, ii-cardiac CT okanye ii-MRI scans nazo zinokufuneka.
Zithini iindlela zonyango zoku?
Nangona amayeza anokunikwa ukulawula ezinye zeempawu ze-ASD, awanakuwuvala umngxuma. Kukho iindlela ezimbini zokuvala umngxuma: utyando okanye ukuvalwa komngxuma ngaphandle kotyando (ukulungiswa kwesikhumba).
- Ii-ASD ezincinci:Imingxunya emincinci kakhulu, ingakumbi ebantwaneni, isenokuzivalela yodwa. Ukuba akunjalo, kwaye ayibangeli monakalo, ugqirha uya kucebisa "ukulinda ngononophelo," oko kuthetha ukuba ungenzi nto ngaphandle kokujonga rhoqo.
- Ii-ASD ezinkulu: Ukuba umngxuma mkhulu, kungcono ukuwuvala, nokuba akukho zimpawu. Oku kunokuthintela iingxaki ezinkulu ezinokubakho kwixesha elizayo. Ngokwesiqhelo, ukuba icala lasekunene lentliziyo likhulisiwe, okanye ukuba igazi elininzi livuza emngxunyeni, ngokuqinisekileyo unyango luyacetyiswa.
Iindlela zonyango
1. Ukuvalwa kwesixhobo esihamba ngeenyawo: Le yindlela esetyenziswa kakhulu ngoku. Ityhubhu encinci (i-catheter) ifakwa ngomthambo omkhulu emlenzeni, iqondiswe entliziyweni, kwaye kufakwa isixhobo esincinci (isixhobo) esifana nesambulela ukuvala umngxuma. Oku akudingi ukusikwa okukhulu. Ixesha lokuhlala esibhedlele lihlala usuku olunye okanye ezimbini kuphela. Le ndlela ayifumaneki kuzo zonke iintlobo ze-ASD.
2. Utyando lweNtliziyo evulekileyo: Olu tyando lwenziwa kwimingxunya engenakuvalwa ngezi ndlela zingasentla okanye kwimingxunya enxulumene nezinye iziphene zentliziyo. Apha, isifuba siyavulwa kwaye umngxuma entliziyweni uvalwa ngezititshi okanye ngephetshana. Olu ngoku lutyando olukhuselekileyo noluphumeleleyo.
Emva konyango, ugqirha wakho uya kukuxelela ukuba uthathe amayeza okunciphisa igazi kunye namayeza okubulala iintsholongwane ukuthintela usulelo lwentliziyo kangangeenyanga ezi-6.
Bunjani ubomi nge-ASD?
Kuqhelekile ukuziva usoyika xa wena okanye umntwana wakho efumanisa ukuba une-ASD. Kodwa iindaba ezimnandi zezokuba ngesayensi yezonyango yanamhlanje ephucukileyo, le meko inokunyangeka ngempumelelo kwaye abantu banokuphila ubomi obusempilweni nobuqhelekileyo .
Umntwana ovalwe umngxuma uya kukwazi ukudlala, ukubaleka, nokudlala imidlalo njengabanye abantwana emva kokuba ephiliswe. Nokuba sele emdala, unokuqhubeka nemisebenzi yakhe yesiqhelo emva konyango.
Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho ngokuchanekileyo kwaye uye kwiikliniki ukuze uhlolwe ngexesha. Ngokukodwa, ukuba phantsi kweliso lengcali yesifo sentliziyo esizalwa naso ngolu hlobo kubaluleke kakhulu kwimpilo yakho.
Umyalezo Wokuya Ekhaya
- I-Atrial Septal Defect (ASD) ngumngxuma eludongeni owahlula amagumbi amabini aphezulu entliziyo. Yimeko eqhelekileyo, yokuzalwa.
- Abantu abaninzi, ingakumbi ukuba umngxuma mncinane, ababi nazimpawu kangangeminyaka.
- Kubantwana, isandi sentliziyo esingaqhelekanga (ukumbombozela) sinokuvakala, kwaye kubantu abadala, ukudinwa kakhulu kunye nobunzima bokuphefumla zinokuba zezona mpawu ziphambili.
- Ukuba ayinyangwa, imingxunya emikhulu inokonakalisa intliziyo nemiphunga ngokuhamba kwexesha.
- Le meko inokunyangeka ngokupheleleyo ngonyango oluphambili lwanamhlanje (olungatyandiyo okanye olungenatyando).
- Ngonyango olufanelekileyo, akukho nto ithintela abantwana nabantu abadala ukuba baphile ubomi obupheleleyo, obusempilweni nobusebenzayo. Themba ugqirha wakho kwaye ulandele icebiso lakhe.
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