Ndiyaqonda ukuba kunzima kangakanani kumzali ukuxelelwa ngugqirha ukuba umntwana wakho osandul’ ukuzalwa uneengxaki zentliziyo. Ngexesha elinje, xa usiva nge-'BTT shunt', mhlawumbi unemibuzo emininzi malunga nokuba yintoni na, kutheni yenziwa, ingaba iya kumlimaza umntwana, kwaye ngaba kukho naziphi na iingozi. Ungakhathazeki. Namhlanje, siza kuthetha ngayo yonke into ngokucacileyo nangokulula.
Ngamafutshane, yintoni le BTT Shunt?
I-BTT shunt, okanye i-Blalock-Taussig-Thomas shunt, lutyando olukhethekileyo olwenziwa ukunceda iintsana ezingafumani ioksijini eyaneleyo emizimbeni yazo. Le meko ibangelwa yimeko yentliziyo yokuzalwa .
Cinga nje, imizimba yethu ifumana ioksijini emoyeni esiwuphefumlelayo emiphungeni yethu. Le oksijini kufuneka yongezwe egazini ize ithwalwe emzimbeni wonke. Nangona kunjalo, kwabanye abantwana abanesifo sentliziyo, umthambo wegazi oyintloko othwala igazi ukusuka entliziyweni ukuya emiphungeni , umthambo wemiphunga , awufumani gazi laneleyo. Emva koko umzimba awufumani oksijini yaneleyo.
Ngoko ke, into eyenziwa yi-BTT shunt kukudala indlela entsha ngokufaka ityhubhu encinci yokwenziwa (i-shunt okanye i-graft) esuka kumthambo wegazi oyintloko othwala igazi ukusuka entliziyweni ukuya emzimbeni ukuya emiphungeni. Kufana nendlela encinci edlula kwindlela exakekileyo. Oku kwandisa inani legazi eliya emiphungeni, kwaye umzimba ufumana ioksijini engcono.
Into ebalulekileyo kukuba esi sisisombululo sexeshana. Xa umntwana ekhulile kancinci kwaye enamandla, kwenziwa utyando olukhulu ukulungisa ngokupheleleyo ingxaki yentliziyo yokuqala. Ngexesha lotyando, i-BTT shunt iyasuswa. Nangona kunjalo, kunqabile kakhulu, ezinye iintsana zinokufuna ukuba nale shunt njengesisombululo sexesha elide.
Ziziphi iintlobo zezifo zentliziyo ezifuna utyando lwe-BTT Shunt?
Olu tyando luluncedo kwizifo ezininzi zentliziyo ezizalwa nazo ezinciphisa ukuhamba kwegazi ukuya emiphungeni.
| Iimeko zentliziyo zokuzalwa |
|---|
| Isifo sentliziyo sasekhohlo esingenaplastiki |
| I-Tetralogy of Fallot (TOF) |
| I-Truncus arteriosus |
| Ingxaki ka-Ebstein |
| I-Pulmonary atresia |
| I-Tricuspid atresia |
| Ezinye iindlela zokuguqulwa kwemithambo emikhulu |
Kwenzeka ntoni ngaphambi kotyando?
Ngaphambi kotyando, iqela lezonyango lomntwana wakho liza kuqokelela lonke ulwazi olufunekayo. Liza kumhlola umntwana wakho ngononophelo lize lijonge imbali yakhe yempilo ukususela ekukhulelweni kwakho. Banokwenza novavanyo olungangenisi ntsholongwane.
| Iintlobo zovavanyo ezinokwenziwa |
|---|
| Iskeni sentliziyo (i-Transthoracic echocardiogram) |
| Uvavanyo lwegazi |
| I-X-reyi yesifuba |
| Uvavanyo lwe-ECG (i-Electrocardiogram) |
| Ngamanye amaxesha i-angiogram okanye i-CT angiogram (i-Coronary angiogram okanye i-CT angiogram) |
Uza kufumana nemiyalelo yokuba ungamhlamba njani umntwana wakho ngaphambi kotyando kunye nokuba ungayeka nini ukutya nokuncancisa.
Kwenzeka ntoni ngexesha lotyando?
Olu tyando luthatha iiyure ezininzi kwaye lunobuthathaka kakhulu. Ugqirha wenza oku kulandelayo:
- Ithambo eliphakathi kwesifuba somntwanaIntliziyo ifikelelwa ngokusika i-sternum .
- Ukuze isondele entliziyweni, i -thymus gland ekufutshane isusiwe ngokupheleleyo.
- Njengoko bekutshiwo ngaphambili, i-graft yokwenziwa iqhagamshelwe phakathi komthambo ophambili onika igazi emzimbeni (umthambo we-subclavian) kunye nomthambo wegazi onika igazi emiphungeni (umthambo we-pulmonary).
- Olu qhagamshelo lujongwa ngononophelo ukuze kubonwe ukuba lusebenza kakuhle na, ukuba kukho amahlwili egazi, okanye ukuba kukho ukuvuza kwegazi.
- Ukuba yonke into ilungile, isifuba somntwana siya kuvala kwakhona.
Kwenzeka ntoni emva kotyando?
Emva kotyando, umntwana wakho uza kungeniswa kwigumbi lokunyamekela abagula kakhulu (ICU) .
Musa ukoyika oku. Usenokuziva ungakhululekanga xa ubona umntwana wakho emva kotyando. Umntwana uya kuba neetyhubhu ezininzi kunye neengcingo ezinamathele kuye. Kodwa khumbula, zonke ezo zixhobo zikho ukunceda umntwana aphile ngokukhawuleza. Ngoko ke hlala uqinile.
Umntwana unikwa isithambisi segazi, esifana ne -heparin, ukuthintela ukuqhekeka kwegazi. Baqala ne -aspirin . Umntwana kuya kufuneka asele le aspirin ubomi bakhe bonke. Kunqabile kakhulu ukuba ezinye iintsana zifune uncedo lomatshini wokuxhasa ubomi wexeshana, ofana ne -ECMO .
Ziziphi iingenelo kunye neengozi zalo tyando?
Inzuzo ephambili:
Eyona nzuzo inkulu yolu tyando kukuba lunyusa ubungakanani beoksijini efikelela kwiiseli zomzimba womntwana. Oku kunciphisa umbala oluhlaza okwesibhakabhaka (i-cyanosis) obonakala kulusu, imilebe, kunye nezinzipho zezinye iintsana ngenxa yokunqongophala kweoksijini. Le yindlela entle yokuba umntwana ahlale esempilweni kwaye enamandla de kufike utyando olukhulu olulandelayo.
Iingozi kunye neengxaki:
Njengakwezinye iintlobo zotyando, kukho iingozi ezithile. Ugqirha wakho uza kukuchazela ezi ngxaki ngokweenkcukacha. Ezinye zeengxaki ezinokubakho ziquka:
- Igazi elingaphezulu lihamba nge-shunt ukuya emiphungeni kunokuba kuyimfuneko (i-pulmonary overcirculation).
- Amahlwili egazi.
- Ukonakala komthambo okufutshane nendawo yotyando (ingakumbi umthambo ochaphazela ubunzulu belizwi lomntwana).
- Ukuphazamiseka kwentliziyo (i-Arrhythmia).
- Ukubanjwa kwe-cardiac.
Ezi ngozi ziphantsi kakhulu, kwaye iqela lezonyango lenza konke okusemandleni alo ukuthintela izinto ezinje.
Kuthatha ixesha elingakanani ukuba ndiphile kwaye kufuneka ndidibane nogqirha nini?
Usana luhlala esibhedlele kangangeeveki ezimbini. Iveki yokuqala okanye ngaphezulu iya kuchitha kwiyunithi yokhathalelo olunzulu (ICU). Kwanasemva kokuba ubuyele ekhaya, kuya kufuneka uyise umntwana wakho ukuze ahlolwe rhoqo. Utyelelo lokuqala ludla ngokuba kwiveki enye okanye ezimbini emva kokuba ubuyele ekhaya.
Emva kokubuyela ekhaya, ukuba ubona ezi mpawu zilandelayo, kufuneka ufowunele ugqirha wakho ngoko nangoko.
| Iimpawu zesilumkiso ekufuneka uziqaphele |
|---|
| Ukudumba kwindawo yotyando okanye kwenye indawo emzimbeni |
| Ububomvu obujikeleze inxeba lotyando |
| Ukuba ulusu kunye nemilebe zibonakala ziluhlaza okwesibhakabhaka kwakhona |
| Ukuba umntwana ubonakala ediniwe kakhulu okanye ediniwe |
| Ukuba unomkhuhlane |
| Ukuba ulwelo luvuza kwinxeba lotyando |
Njengomzali, siyazi ukuba ufuna ukunika umntwana wakho okona kulungileyo unako. Eyona nto ingcono onokuyenza ngeli xesha kukubuza iqela lezonyango yonke imibuzo onayo. Thetha ngokucacileyo ngemeko yomntwana wakho, utyando, kunye nekamva lakhe. Ukukhetha isibhedlele kunye noogqirha abanamava amaninzi kolu tyando kuya kukuzisela uxolo olukhulu lwengqondo.
Umyalezo Wokuya Ekhaya
- I-BTT Shunt lutyando olwenziwa kwiintsana ezinesifo sentliziyo sokuzalwa ukuze kwandiswe inani legazi elihamba liye emiphungeni kwaye kubonelelwe ngeoksijini emzimbeni.
- Oku kudla ngokuba sisisombululo sexeshana. Nje ukuba umntwana akhule, kuya kufuneka olunye utyando ukuze kulungiswe imeko yentliziyo engaphantsi.
- Emva kotyando, umntwana uya kufuna unyango oluqatha kwaye usenokufuna ukuthatha amayeza anjenge-aspirin ubomi bakhe bonke.
- Njengakwezinye iintlobo zotyando, kukho iingozi. Thetha ngokukhululekileyo nogqirha wakho ngazo.
- Emva kokuba ubuyele ekhaya, qwalasela indlela umntwana wakho aziphethe ngayo, umbala wolusu lwakhe, umkhuhlane, njl. Ukuba ubona naluphi na utshintsho, funa ingcebiso kagqirha ngoko nangoko.
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