Ingaba umntwana wakho unengxaki yentliziyo elolu hlobo? Masifunde nge (Atrioventricular Canal Defect)!

Ngamanye amaxesha usenokuba uqaphele ukuba umntwana wakho osandul’ ukuzalwa unobunzima bokuphefumla, uyasokola ukondla, okanye ude abe luhlaza okwesibhakabhaka. Oku ngamanye amaxesha kunokuba ziimpawu zengxaki encinci entliziyweni yomntwana wakho. Kunjalo, imeko yentliziyo ekhoyo ekuzalweni ibizwa ngokuba yi -Atrioventricular Canal Defect , esithetha ngayo namhlanje.

Yintoni le (i-Atrioventricular Canal Defect)?

Ngamafutshane, i-Atrioventricular Canal Defect sisifo sentliziyo esibakho xa umntu ezalwa. Oogqirha ngamanye amaxesha basibiza ngokuba yi -AVSD - i-Atrioventricular Septal Defect . Ngokuchanekileyo, sisifo sentliziyo esibangelwa ziingxaki ezininzi. Eyona nto iphambili kukuba kukho umngxuma okanye imingxuma eludongeni embindini wentliziyo (esiyibiza ngokuba yi -septum) . Sikwabandakanya neevalvu ezisentliziyweni ezingasebenzi kakuhle.

Cinga ngayo njengomngxuma osembhobhoni wamanzi. Kwintliziyo ephilileyo, igazi elinomoya-mpilo omninzi elimpontshwa kwicala lasekhohlo lentliziyo yethu alihlali lixubana negazi elinomoya-mpilo omninzi elivela kwicala lasekunene. Kodwa ngenxa yalo mngxuma, elo gazi linomoya-mpilo omninzi lixubana negazi elinomoya-mpilo omninzi. Uninzi lwexesha, lo mngxuma ubangela ukuba igazi elininzi liye emiphungeni. Emva koko inani legazi eliya emzimbeni wonke liyancipha. Ukuba oku kuqhubeka ixesha elide, ngamanye amaxesha kunokuhamba ngenye indlela. Oko kukuthi, igazi elinomoya-mpilo omninzi liya emzimbeni, kwaye elincinci liya emiphungeni. Xa oko kusenzeka, inqanaba leoksijini emzimbeni liyancipha kwaye ulusu lunokuguquka lube luhlaza okwesibhakabhaka. Silubiza ngokuba yi -cyanosis .

Oku kubangela ukuba intliziyo isebenze nzima, nto leyo enokubangela ezinye iingxaki zempilo ezifana nokusilela kwentliziyo .

Ukuba le (Atrioventricular Canal Defect) ayinyangwanga kakuhle, ngamanye amaxesha inokuchaphazela ubomi bomntwana. Ngaphandle kotyando, abantwana abanale meko banokuphila ixesha elifutshane, malunga neminyaka emibini ukuya kwemithathu. Kodwa ungakhathazeki! Eyona nto ilungileyo kukuba utyando lokulungisa oku luphumelele kakhulu. Oogqirha banokuyibona le meko ngaphambi kokuba ibe yingozi, kwanangaphambi kokuba umntwana azalwe.

Ngokomyinge, kumazwe afana ne-United States, malunga nosana olunye kwi-1,700 luzalwa lunesi siphene minyaka le. Oku kubalelwa phakathi kwe-3% kunye ne-5% yazo zonke iziphene zentliziyo ezizalwa nazo.

Le meko ibizwa ngamanye amagama aliqela. Ugqirha wakho angasebenzisa elinye lala magama:

• I-Atrioventricular septal defect (AVSD)
• Isiphene somqamelo we-endocardial

Ngaba kukho iintlobo ezahlukeneyo ze-Atrioventricular Canal Defect?

Ewe, esi siphene sentliziyo sinokuza ngeendlela ezahlukeneyo. Oko kukuthi, kuxhomekeke kwizinto ezifana nobukhulu bomngxuma entliziyweni kunye nenani leevalvu.

Isiphelo (Isiphene seCanal ye-Atrioventricular)

Okwenzekayo koku kukuba amagumbi amabini aphezulu entliziyo (esiwabiza ngokuba yi -atria) kunye namagumbi amabini asezantsi (esiwabiza ngokuba yi-ventricles)(ebizwa ngokuba yi) Umngxuma omkhulu uvela phakathi kwamagumbi amabini entliziyo. Oko kukuthi, onke amagumbi amane entliziyo adibene. Ngokwesiqhelo, kufuneka kubekho iivalvu ezimbini phakathi kwamagumbi aphezulu nasezantsi. Kodwa kule meko, kukho ivalvu enye enkulu kuphela. I-flap yayo isenokungavuleki okanye ingavaleki kakuhle.

Inxalenye (I-Partial Atrioventricular Canal Defect)

Kule meko, umngxuma uphakathi kwamagumbi amabini aphezulu entliziyo (le yeyona ixhaphakileyo) okanye phakathi kwamagumbi amabini asezantsi. Onke amagumbi amane awadibani. Kukho iivalvu ezimbini phakathi kwamagumbi aphezulu nasezantsi. Kodwa ivalvu enye (idla ngokuba yivalvu ye-mitral, efumaneka phakathi kwegumbi eliphezulu (i-atrium yasekhohlo) kunye negumbi elisezantsi (i-ventricle yasekhohlo) kwicala lasekhohlo) ayisebenzi kakuhle.

Isiphene seNqanawa yeAtrioventricular yeTshintsho

Kule ndawo, kukho umngxuma phakathi kwamagumbi amabini aphezulu kunye nomngxuma omncinci phakathi kwamagumbi amabini asezantsi. Iivalvu ezimbini eziphakathi kwamagumbi aphezulu naphantsi (iivalvu ze-AV) zahlukile.

Isiphene seCanal seAtrioventricular esingalinganiyo

Uyakhumbula ukuba kwintliziyo enesiphene esipheleleyo kukho ivalvu enye enkulu? Loo valve ikufutshane negumbi elingaphantsi (i-ventricle) kunelinye. Emva koko igumbi elifumana igazi elingakumbi liba likhulu kunelinye. Oogqirha babiza elo gumbi lincinci ngokuthi 'yi-hypoplastic' .

Zithini iimpawu zoku?

Iimpawu zesi sifo sentliziyo zinokubonakala nangaphambi kokuba umntwana wakho azalwe. Jonga ukuba umntwana wakho unayo na enye yezi zinto:

• Umbala wolusu oluhlaza okwesibhakabhaka (iCyanosis): Ingakumbi kwiindawo ezifana nemilebe, ulwimi, kunye neminwe.
• Ubunzima bokusela ubisi: Ukuziva udiniwe kwaye udiniwe emva kokusela ubisi oluncinci.
• Ukubila emva kokusela ubisi.
• Ukudinwa ngokukhawuleza: Ukudinwa nasemva kokwenza into encinci.
• Ukubetha kwentliziyo.
• Ubunzima bokuphefumla (ukuphelelwa ngamandla) okanye ukuphefumla ngokukhawuleza.
• Ukwanda kobunzima kwenzeka kancinci.
• Ukudumba (ukudumba) esiswini okanye emilenzeni.
• Ukubetha kwentliziyo okubuthathaka.

Nangona kunjalo, iintsana ezineengxaki ezithile okanye eziguqukayo zisenokungazibonisi ezi mpawu ekuqaleni. Ezi mpawu zinokuvela kamva ebuntwaneni, okanye ekukhuleni, okanye kwanasebudaleni.

Kutheni le nto (i-Atrioventricular Canal Defect) yenzeka?

Abaphandi abakayazi kakuhle into ebangela i-Atrioventricular Septal Defect (AVSD) . Kucingelwa ukuba yindibaniselwano yezinto zemfuza kunye neemeko ezingqongileyo . Kodwa into enye icacile: kukho unxibelelwano oluqinileyo phakathi kwesi sifo sentliziyo kunye ne-Down syndrome . Malunga nama-40% eentsana ezine- Down syndrome zine -AVSD .

Ziziphi izinto ezibangela umngcipheko ezichaphazela oku?

Iingcali azikazifumani ezona zinto zibangela oku. Kusenokubakho impembelelo yemfuza. Mhlawumbi i-gene engaqhelekanga edluliselwa kumama okanye kutata inokunyusa amathuba omntwana okuba nesifo sentliziyo ngelixa esesesibelekweni.

Ngaphandle koko, ezi zinto zilandelayo ngexesha lokukhulelwa zinokunyusa umngcipheko wokuba umntwana wakho afumane isifo sentliziyo:

• Amayeza athile.
• Iziyobisi ezingekho mthethweni (Iziyobisi zokuzonwabisa).
• Iziselo ezinotywala.
• Ukuchanabeka kwiityhefu okanye kwiikhemikhali ezisingqongileyo.
• Ukunqongophala kwezondlo okanye iivithamini.
• Ukutyeba kakhulu.
• Iimveliso zecuba.
• Ukungalawuli izifo ezingapheliyo ezifana neDiabetes Mellitus okanye iHypertension.
• Izifo ezibangelwa yintsholongwane ezifana nomkhuhlane (flu) okanye umkhuhlane.

Ziziphi iingxaki ezinokubakho ze-Atrioventricular Canal Defect?

Ukuba le meko inzima, oko kuthetha ukuba ayinyangwa kakuhle, iingxaki ezinje ngezi zinokwenzeka:

• Iipateni zesantya sentliziyo ezingaqhelekanga (i-Arrhythmia).
• Ukungaphumeleli kwentliziyo okubangelwa kukunganyamezelani.
• Usulelo lwentliziyo (i-Endocarditis).
• Uxinzelelo lwegazi oluphezulu kwimithambo yegazi olukhokelela emiphungeni (i-Pulmonary hypertension).

Sifunyaniswa njani esi sifo?

Iindaba ezimnandi zezokuba uninzi lwexesha, oogqirha banokuyibona le nto (i-Atrioventricular Septal Defect) ngaphambi kokuba umntwana azalwe ngovavanyo olumbalwa:

• I-ultrasound yangaphambi kokuzalwa: Oku kungabona imifanekiso yeentshukumo zomntwana esibelekweni, kuquka nentliziyo. Kungabona nesiphene esikhulu se-septal .
• I-echocardiogram yosana olusandul’ ukuzalwa: Oku kubonisa imifanekiso yentliziyo ngokucacileyo kune-ultrasound. Ugqirha unokufumana umbono ongcono wendlela eyakhiwe ngayo intliziyo kunye nendlela epompa ngayo igazi.

Emva kokuba umntwana ezelwe, ugqirha unokumamela ukubetha kwentliziyo yomntwana nge -stethoscope . Ukuba kuvakala isandi "esikhulu" esingaqhelekanga (esisithi yi -heart murmur ), isenokuba sisandi segazi eliphuma emngxunyeni.

Ezinye iimvavanyo ezenziwa emva kokuzalwa ziquka:

• Ii-X-reyi zesifuba: Jonga ubungakanani kunye nokuma kwentliziyo yomntwana.
• I-Electrocardiogram (EKG/ECG): Jonga ukusebenza kombane kwentliziyo yomntwana.
• I-Echocardiogram: Ukujonga ngokucokisekileyo ukwakheka kwentliziyo yomntwana.
• Ukufakwa kwe-catheter kwintliziyo: Funda ngakumbi malunga nobunzima bemeko yomntwana.
• I-Cardiac Magnetic Resonance Imaging (I-Heart MRI): Jonga iindawo zentliziyo yomntwana kunye nendlela ezisebenza ngayo.

Ngamanye amaxesha, ukuba umntwana unesiphako esincinci se-septal , usenokungabonakalisi zimpawu ekuqaleni. Kwimeko enjalo, kungathatha iminyaka eliqela ngaphambi kokuba ugqirha ayifumanise le meko.

Zithini iindlela zonyango zoku?

Olona nyango luqhelekileyo lwe -Atrioventricular Canal Defect lutyando lwentliziyo evulekileyo . Kolu tyando, ugqirha uvula umngxuma entliziyweni yomntwana aze awuvale. Ukuba isiphene siphelele , ivalvu yentliziyo enye yahlulwe ibe zimbini, yenze iivalvu ezimbini ezahlukeneyo, enye kwicala lasekunene nenye ngasekhohlo.

Usana olune -AV canal engalunganga lunokufuna utyando oluninzi, oluya kuphelela kutyando olubizwa ngokuba yiFontan procedure .

Kungcono ukwenza olu tyando ngokukhawuleza, ngaphambi kokuba imeko ibangele umonakalo ongunaphakade entliziyweni. Uninzi lweentsana lutyando olu kwiinyanga ezintandathu zokuqala zobomi. Ezinye iintsana ezinesiphene esincinci kodwa ezingenazo iimpawu zinokwenza olu tyando kwiminyaka emithathu yokuqala yobomi.

Ngamanye amaxesha, ukuba umntwana akaphilile ngokwaneleyo ukuba angatyandwa, okanye akanamzimba ufanelekileyo, anganikwa amayeza okulawula iimpawu ade atyebe aze aqine.

• I-Diuretics ngamayeza asusa amanzi agqithisileyo emzimbeni.
• I-Digoxin inceda intliziyo yomntwana ukuba ibethe ngamandla ngakumbi.
• Izithinteli ze-ACE zandisa imithambo yegazi kwaye zenze kube lula ukuhamba kwegazi.

Esinye isisombululo sexesha elifutshane yinkqubo ebizwa ngokuba yi -pulmonary artery banding . Oku kunciphisa inani legazi elihamba nge-pulmonary artery ukuya emiphungeni yomntwana. Iintsana eziye zafakwa i-pulmonary artery banding zinokulungiswa ngokusisigxina kamva.

Ngaba iingxaki zinokwenzeka emva konyango?

Ewe, ngamanye amaxesha izinto ezinje zinokwenzeka emva kotyando:

• Ukuvaleka kwentliziyo: Oku kuthetha ukuba isignali yentliziyo ayifikeleli kwinxalenye esezantsi yentliziyo ngokufanelekileyo.
• Ivalvu ye-AV ephumayo ekhohlo okanye ekunene.
• Umngxuma eludongeni lwegumbi elisezantsi (i-Ventricular septal defect).
• Ukuncitshiswa (i-Stenosis) kwevalvu ye-AV yasekhohlo okanye yasekunene.
• Ukuphazamiseka kokuhamba kwegazi phantsi kwevalvu ye-aortic (i-Subaortic stenosis).

Ngaba oku (i-Atrioventricular Canal Defect) akunakuthintelwa?

Akukho ndlela yokuthintela oku (i-Atrioventricular Septal Defect) ukuba kwenzeke, kuba kudla ngokunxulunyaniswa nezizathu zemfuza.

Nangona kunjalo, ukuba ukhulelwe, ungenza ezi zinto ukunciphisa umngcipheko wokuba umntwana wakho abe nesifo sentliziyo sokuzalwa:

• Ziphephe ngokupheleleyo iziyobisi ezingekho mthethweni, utywala, kunye neemveliso zecuba.
• Fumana zonke izitofu ozidingayo ukuze uzikhusele kwizifo.
• Gcina ubunzima bakho busempilweni.
• Ukuba uneengxaki zempilo ezingapheliyo, zilawule kakuhle.
• Sela iivithamini zokukhulelwa, ingakumbi i-folic acid, njengoko ugqirha wakho ekucebisile.

Ukuba umntwana wam unale meko, liza kuba njani ikamva?

Ngaphandle kotyando, abantwana abane- AV canal defect banokuphila iminyaka emibini ukuya kwemithathu kuphela. Abanye baphila baze babe ngabantu abadala.

Kodwa iindaba ezimnandi zezokuba malunga nama-90% abantwana abaye benza utyando lokulungisa baphila iminyaka eli-10 emva kolo nyango. Oko kuthetha ukuba bahlala bephila ubuncinane eminye iminyaka eli-10 emva kotyando. Malunga nama-65% baphila iminyaka engama-20 emva kotyando.

Kodwa khumbula oku: Nokuba emva kotyando, umntu one-Atrioventricular Canal Defect (AVCD) akayi kuba nentliziyo eqhelekileyo ngokupheleleyo. Kuya kufuneka aqhubeke esenziwa ii-echocardiograms rhoqo ukuze ajonge ukusebenza kwentliziyo yakhe. Oku kuya kunceda ekubambeni naziphi na iingxaki kwangethuba.

Isiciko esibekwe phezu komngxuma sihlala ubomi bonke. Kodwa ngokuhamba kwexesha, enye yeevalvu zentliziyo ezilungisiweyo inokuqala ukuvuza. Ukuba oko kuyenzeka, phakathi kwe-10% kunye ne-20% yabantu kuya kufuneka benze utyando lwesibini .

Uninzi lwabantu aludingi mayeza okanye utyando olongezelelweyo emva kotyando. Nangona kunjalo, ukungasebenzi kakuhle kwentliziyo kunokuvela kamva. Ukuba oku kuyenzeka, ugqirha unokucebisa iinkqubo ezingangenisi kakhulu ezifana nokukhupha igazi emzimbeni .

Ndingamnyamekela njani umntwana wam?

Kusenokufuneka unciphise imisebenzi yomzimba yomntwana wakho . Buza ingcali yentliziyo yomntwana wakho - ugqirha ogxile kwizifo zentliziyo ebantwaneni - ngale nto.

Abantwana abane- atrioventricular septal defect (AVSD) banokucetyiswa ukuba bathathe amayeza okubulala iintsholongwane ngaphambi kokuba baye kugqirha wamazinyo. Oku kunokunceda ekuthinteleni uhlobo losulelo lwentliziyo olubizwa ngokuba yi-endocarditis . Thetha nogqirha wentliziyo yomntwana wakho ngale nto.

Umntwana wam ufanele aye nini kugqirha?

Ngokuqinisekileyo kufuneka umse umntwana wakho kugqirha wentliziyo wabantwana ngamaxesha athile. Banokujonga intliziyo yomntwana wakho ukuba kukho naziphi na iingxaki. Abanye abantwana abaneengxaki zomjelo we-AV banokufuna unyango olongezelelweyo emva kotyando. I-patch inokuvuza, okanye ivalvu elungisiweyo inokuvuza okanye ibe mxinwa.

Umntwana onesiphene se-AV canal usenokuba neengxaki zemithambo-luvo okanye zophuhliso . Basenokufuna uncedo ngaloo nto.

Xa umntwana wakho ekhulile, kufuneka aye kwingcali yentliziyo yokuzalwa yomntu omdala aze aye kuhlolwa ubuncinane kanye ngonyaka.

Yeyiphi imibuzo endifanele ndiyibuze ugqirha womntwana wam?

Ungabuza ugqirha womntwana wakho imibuzo efana nale:

• Luhlobo luni lwesiphene se-AV emjelweni umntwana wam anaso?
• Ziziphi iimpawu ezibonisa ukuba imeko iya isiba mandundu?
• Uza kufuna nini utyando?
• Ngaba umntwana wam uya kufuna amayeza emva kotyando?
• Ngaba kuya kufuneka ndinciphise imisebenzi yomntwana wam?

Kuqhelekile ukuba neemvakalelo ezahlukeneyo xa usiva ukuba usana lwakho olusandul’ ukuzalwa lunesimo sentliziyo esifana ne -Atrioventricular Canal Defect . Kodwa oogqirha bomntwana wakho bakhona ukukunceda, kwaye bafuna ukwenza okona kulungileyo kumntwana wakho. Fumanisa ukuba yintoni kanye kanye echaphazela imeko yomntwana wakho. Ukuba kukho into ongaqinisekanga ngayo, buza ugqirha wakho ngayo. Ngoku lixesha lokuba ukhuthaze impilo yomntwana wakho.

Ngoko ke, zeziphi izinto ekufuneka sizikhumbule kuzo zonke ezi zinto?

• I-Atrioventricular Canal Defect yimeko yentliziyo ebakho xa umntu ezalwa. Ibangelwa ikakhulu ngumngxuma entliziyweni kunye nengxaki kwiivalvu.
• Ukufunyanwa kwangoko kunye notyando olukhawulezileyo kubaluleke kakhulu. Olu tyando luphumelele kakhulu.
• Iintsana ezine- Down syndrome zinamathuba amaninzi okufumana le meko.
• Kufuneka ujongwe ngugqirha ixesha elide nokuba sele utyando. Kufuneka unxibelelane nogqirha wentliziyo ubomi bakho bonke.
• Ukuba ukhulelwe, ukulandela indlela yokuphila enempilo kunye nokulandela iingcebiso zonyango kunokunceda ukunciphisa umngcipheko wesifo sentliziyo sokuzalwa komntwana wakho.
• Ungoyiki, oogqirha bakhona ukukunceda wena nomntwana wakho. Buza imibuzo, ufumane ulwazi.

Isifo sentliziyo , iziphene zentliziyo zokuzalwa, intliziyo yomntwana, umngxuma entliziyweni, i-Atrioventricular Canal Defect, i-AVSD, isifo sentliziyo sabantwana