Xa ugqirha ekuxelela ukuba umntwana wakho unengxaki yentliziyo, kuyinto eqhelekileyo ukuba, njengomzali, uzive uloyiko olukhulu kunye nexhala. Ingakumbi ukuba yimeko enegama elintsonkothileyo njenge-'Double Inlet Left Ventricle', kwaye kunqabile, olo loyiko lunokuba lukhulu nangakumbi. Kodwa ungakhathazeki. Masithethe ngale nto ngokulula, ngendlela onokuyiqonda. Ukwazi olu lwazi kuya kukunika amandla amaninzi okujongana nolu hambo.
Yintoni kanye kanye le Double Inlet Left Ventricle?
Ngamafutshane, esi sisifo sentliziyo esizalwa naso. Oko kukuthi, utshintsho olwenzeka xa intliziyo isenziwa ngelixa umntwana esesesibelekweni sikanina. Intliziyo yethu ineegumbi ezimbini eziphambili ezisezantsi (amagumbi). I-ventricle yasekunene kunye ne-ventricle yasekhohlo. Kodwa entliziyweni yomntwana onesi simo, linye kuphela kula magumbi mabini asezantsi elisebenza ngokufanelekileyo . Leyo yi-ventricle yasekhohlo.
Ngokwesiqhelo, amagumbi amabini aphezulu entliziyo (i-atria) adibene namagumbi amabini asezantsi ngokwahlukeneyo. Kodwa kule meko, omabini amagumbi aphezulu adibene negumbi elifanayo lokusebenza, i-ventricle yasekhohlo . Le yimeko engaqhelekanga ebizwa ngokuba yi-`single ventricle defect`.
Le meko iwuchaphazela njani umzimba womntwana?
Ukuze sikuqonde oku, masiqale sijonge indlela esebenza ngayo intliziyo ephilileyo. Khawuthelekelele ukuba intliziyo yethu ifana nendlu encinci enamagumbi amane.
1. Intliziyo ephilileyo: Igazi lomzimba "elingcolileyo" elingenaoksijini, lingena kwi-atrium yasekunene. Ukusuka apho, liya kwi-ventricle yasekunene, eliyipompa iye emiphungeni ukuze ithathe ioksijini. Igazi "elicocekileyo", eliye lafakwa ioksijini yimiphunga, libuyela kwi-atrium yasekhohlo yentliziyo. Ukusuka apho, liya kwi-ventricle yasekhohlo, elipompa igazi elicocekileyo liye kuwo wonke umzimba. Ngale ndlela, igazi elicocekileyo nelingcolileyo alidibani.
2. Imeko ye-DILV: Kumntwana onesi sifo, igazi elingena-oksijini kunye negazi eline-oksijini eninzi ziyaqokelelana kwigumbi elinye lokusebenza (i-ventricle yasekhohlo) . Okwenzekayo kukuba la magazi mabini ayaxubana. Emva koko eli gazi lixubeneyo liya emiphungeni yomntwana nakuwo wonke umzimba. Ngenxa yoko, izicubu zomzimba zomntwana azifumani i-oksijini eyaneleyo.
Zithini iimpawu zale meko?
Ezi mpawu zihlala zibonakala kwiintsuku okanye kwiiveki ezimbalwa emva kokuba umntwana ezelwe. Ngamanye amaxesha ezi mpawu zinokuba nzima ngequbuliso.
| Uphawu | Icacisiwe ngokulula |
|---|---|
| Umbala oluhlaza okwesibhakabhaka wolusu kunye nemilebe (iCyanosis) | Ulusu, imilebe, kunye neenzipho zibonakala ziluhlaza okwesibhakabhaka/mfusa ngenxa yokungabikho komoya-mpilo owaneleyo egazini elijikeleza emzimbeni. Oku kwaziwa nangokuthi "umntwana oluhlaza okwesibhakabhaka." |
| Ubunzima bokuncancisa kunye nokunciphisa umzimba | Xa umntwana encancisa, uyadinwa aze abe nobunzima bokuphefumla, ngoko ke uyayeka ukuncancisa. Oku kuthintela umntwana ekutyebeni ngokufanelekileyo. |
| Ubunzima bokuphefumla | Isantya sokuphefumla siphezulu, kwaye unokubona isifuba singena xa uphefumla. |
| Ukubila | Ingakumbi xa usela ubisi, ibunzi lakho nentloko yakho ziyamanziswa kukubila. Oku kungenxa yokuba intliziyo kufuneka isebenze nzima. |
| Ukubetha kwentliziyo okungaqhelekanga | Isantya sentliziyo sikhawuleza kakhulu, okanye kukho utshintsho kwisigqi. |
| Izandi zentliziyo ezingaqhelekanga (iHeart Murmur) | Xa ugqirha ejonga nge-stethoscope, uva isandi sentliziyo esongezelelweyo. |
Yintoni ebangela oku? Ngaba ezinye izifo zentliziyo nazo zinokwenzeka?
Isizathu esichanekileyo soku asikaziwa okwangoku . Sidla ngokuvela kwiiveki ezisi-8 zokuqala zokukhulelwa xa intliziyo yomntwana ikhula. Kukholelwa ukuba yindibaniselwano yefuthe lemfuza kunye nezinto ezingqongileyo.
Eyona nto ibalulekileyo kukuba oku akulotyala lakho. Musa ukuziva kakubi ngenxa yento oyenzileyo okanye ongayenzanga ngexesha lokukhulelwa kwakho.
Amaxesha amaninzi, iintsana ezinesi simo se-'Double Inlet Left Ventricle' nazo zinezinye iziphene zentliziyo. Ezi zinokuphazamisa ukuhamba kwegazi ukuya emiphungeni.
- Ukuhlanganiswa kwe-Aorta:Ukuncitshiswa komthambo oyintloko (i-aorta) othwala igazi emzimbeni.
- I-Pulmonary Atresia: Ivalvu ye-pulmonary ethwala igazi ukuya emiphungeni ayenziwanga kakuhle.
- I-Pulmonary Valve Stenosis: Ukuncitshiswa kwevalvu ethwala igazi ukuya emiphungeni.
Indlela yokuxilonga esi sifo?
Ukuxilongwa ngexesha lokukhulelwa
Ngamanye amaxesha imeko yomntwana wakho inokubonwa ngaphambi kokuba azalwe . Oku kwenziwa ngeskeni ekhethekileyo ebizwa ngokuba yi-fetal echocardiogram. Oku kudla ngokwenziwa phakathi kweeveki ezili-18 nezingama-24 zokukhulelwa. Ugqirha wakho angacebisa olu vavanyo:
- Ukuba kukho into efana nesingqisho esingaqhelekanga esibonakala entliziyweni yomntwana ngexesha lokuhlolwa rhoqo.
- Ukuba kukho umntu kusapho onesifo sentliziyo esizalwa naso.
- Ukuba umama unesifo esichaphazela isifo sentliziyo, esifana nesifo seswekile.
Ukuchongwa emva kokuzalwa komntwana
Le meko idla ngokufunyaniswa emva kokuba umntwana ezelwe.
- Uvavanyo lwe-Pulse Oximetry (i-Pulse Ox): Olu vavanyo lwenziwa kwiiyure ezingama-24 emva kokuzalwa komntwana. Lulinganisa inqanaba le-oksijini egazini lomntwana. Ukuba inqanaba le-oksijini liphantsi, inokuba yingxaki yentliziyo.
- Uvavanyo lwezonyango: Xa ugqirha ehlola umntwana, unokukrokrela oku ngokuva isandi sentliziyo esingaqhelekanga (ukumbombozela) okanye ukubona umntwana ejika abe luhlaza okwesibhakabhaka.
Uvavanyo lokuqinisekisa imeko
Xa kuvela ukurhanelwa, kwenziwa uvavanyo oluninzi ukuqinisekisa oko nokuqonda ngcono imeko yentliziyo.
| Uvavanyo | Yintoni le iyenzayo? |
|---|---|
| I-Echocardiogram (I-Echo) | Olu lolona vavanyo lubalulekileyo. Lufana nokuskena. Lukuvumela ukuba ubone ngokucacileyo amagumbi entliziyo, iivalvu, kunye nendlela igazi elihamba ngayo. |
| I-X-reyi yesifuba | Ungafumana umbono wobukhulu kunye nokuma kwentliziyo, kunye nobungakanani begazi eligeleza emiphungeni. |
| I-Electrocardiogram (ECG/EKG) | Umsebenzi wombane wentliziyo ulinganiswa ukujonga naziphi na iingxaki ngesingqisho sentliziyo. |
| Ukucoca Intliziyo | Olu vavanyo lwenziwa ngaphambi kotyando ukuze kulinganiswe ngokuchanekileyo uxinzelelo kunye namanqanaba eoksijini entliziyweni. Oku kwenziwa ngokudlulisa ityhubhu encinci kakhulu ngemithambo esesinqeni iye entliziyweni. |
Zithini iindlela zonyango zoku?
Le meko inyangwa ngotyando oluninzi olwenziwa ngamanqanaba . Olu tyando alwenzi intliziyo ibe "yinto eqhelekileyo", kodwa luhlengahlengisa ukuhamba kwegazi entliziyweni ukuze umntwana aphile kakuhle kwixesha elide.
Utyando lokuqala: Blalock-Taussig Shunt
Oku kwenziwa kwiintsuku ezimbalwa zokuqala okanye kwiiveki emva kokuba umntwana ezelwe. Oku kuquka ukufaka ityhubhu encinci (i-shunt) ukunceda ukugcina ubungakanani begazi eliya emiphungeni ukuba kukho ukuhamba kwegazi okuphantsi. Oku kuvumela umntwana ukuba akhule kakuhle de kube lutyando lwesibini.
Utyando lwesibini: Inkqubo yeGlenn Shunt
Olu tyando lwenziwa xa umntwana eneminyaka emalunga neenyanga ezi-4-6 ubudala . Okwenziwayo apha kukudibanisa igazi elingenaoksijini elivela emzimbeni ongaphezulu ukuya emiphungeni, nto leyo ethintela intliziyo. Oku kunciphisa kakhulu uxinzelelo entliziyweni.
Utyando lwesithathu nolokugqibela: Inkqubo yeFontan
Oku kwenziwa xa umntwana eneminyaka eyi- 2-3 ubudala . Apha, igazi elingenaoksijini elivela kwinxalenye esezantsi yomzimba liqhagamshelwe ngqo emiphungeni. Emva kolu tyando, ukuxubana kwegazi elingenaoksijini nelinooksijini phantse kuyeke ngokupheleleyo. Inqanaba leoksijini emzimbeni womntwana lisondela kakhulu kwelomntwana ophilileyo.
Amayeza anikwayo ukongeza kutyando
Umntwana kuya kufuneka anikwe iintlobo ezahlukeneyo zamayeza ngaphambi nasemva kotyando.
- I-Digoxin: Yomeleza ukufinyela kwentliziyo.
- Izithinteli ze-ACE: Uxinzelelo lwegazi oluphantsi.
- Izinto ezithintela ukujiya kwegazi: Zithintela ukujiya kwegazi (umz. i-Aspirin).
- I-Diuretics: Susa amanzi angaphezulu emzimbeni.
Kubalulekile: Ngaphambi kokuba ufumane unyango lwamazinyo (njengokukhupha amazinyo), kubalulekile ukuba aba bantwana banikwe amayeza okubulala iintsholongwane ukuthintela usulelo lwentliziyo (endocarditis). Kufuneka uxoxe ngale nto nogqirha wakho kunye nogqirha wamazinyo.
Ufanele ucinge ntoni ngekamva lomntwana?
Lo ngumbuzo onzima ukuwubuza, kodwa kubalulekile ukwazi. Kwiminyaka embalwa eyadlulayo, iintsana ezinale meko azizange ziphile ixesha elide. KodwaNgenxa yotyando oluphambili olufumanekayo namhlanje, imeko yahlukile kakhulu.
Namhlanje, ngaphezu kwe- 70% - 80% yabantwana abagqibezela olu luhlu lotyando baphila ngaphaya kweminyaka eli-10. Abaninzi bade bafikelele kwiminyaka yobudala ngempumelelo.
Nangona kunjalo, aba bantwana bafuna ukulandelwa ngugqirha wentliziyo ubomi babo bonke . Ezinye iingxaki zinokubakho, njengeengxaki zesingqisho sentliziyo kunye ne-pneumonia exhaphakileyo. Banokuthintelwa kwimidlalo enzima. Nangona kunjalo, uninzi lwabantwana lunokuba nobomi obuqhelekileyo besikolo.
Umyalezo Wokuya Ekhaya
- I-Double Inlet Left Ventricle sisifo sentliziyo esingaqhelekanga esizalwa naso apho kusebenza elinye lamagumbi asezantsi entliziyo kuphela.
- Oku kubangela ukuba igazi elineoksijini nelingenaoksijini lixubane kwaye lihambe emzimbeni, nto leyo ebangela iimpawu ezifana nokuba umntwana abe luhlaza okwesibhakabhaka kwaye abe nobunzima bokuphefumla.
- Oku kunyangwa ngotyando olunezigaba ezintathu oluphucula ukujikeleza kwegazi lomntwana.
- Nangona umntwana eza kufuna ulwalathiso lwezonyango ubomi bakhe bonke emva kolu tyando, abantu abaninzi bayaqhubeka bephila ubomi obuphumelelayo nobusebenzayo.
- Thetha ngokukhululekileyo nogqirha wakho ngayo yonke imibuzo yakho kunye noloyiko lwakho. Awuwedwa kolu hambo.
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