Ngaba usana lwakho olusandul’ ukuzalwa luba luhlaza okwesibhakabhaka? Ngaba lunengxaki yokuncancisa? Ngaba lunengxaki yokuphefumla? Ngamanye amaxesha ezi zinokuba ziimpawu zesifo sentliziyo esizalwa naso. Kuqhelekile ukuba umama okanye utata oyike kakhulu xa ebona into efana nale. Namhlanje sithetha ngesifo sentliziyo esingaqhelekanga, kodwa esibaluleke kakhulu ekufuneka siqaphele. Esi sisifo esibizwa ngokuba yiDouble Inlet Left Ventricle.
Yintoni iDouble Inlet Left Ventricle (DILV)?
Ngamafutshane, esi sisifo sentliziyo esingaqhelekanga esibakho xa umntu ezalwa. Ukuze sikuqonde oku, masiqale sijonge indlela esebenza ngayo intliziyo ephilileyo.
Khawuthelekelele ukuba intliziyo yethu ifana nendlu enamagumbi amane. Kukho amagumbi amabini phezulu namagumbi amabini asezantsi.
- Amagumbi amabini aphezulu (i-Atria): Kulapho igazi elivela emzimbeni lingena khona lize liqokelele khona. Igumbi lasekunene (i-Right Atrium) lifumana igazi "elingcolileyo" eliye lasetyenziswa ngumzimba kwaye lineoksijini encinci. Igumbi lasekhohlo (i-Left Atrium) lifumana igazi "elicocekileyo" elizele yioksijini evela emiphungeni.
- Amagumbi amabini asezantsi (ii-ventricles): La ngamaphampu amabini aphambili entliziyweni. I-ventricle yasekunene ipompa igazi elingena-oksijini ukuya emiphungeni ukuze ithathe ioksijini. I-ventricle yasekhohlo ipompa igazi elineoksijini elivela emiphungeni ukuya emzimbeni wonke.
Ngoku, jonga okwenzekayo entliziyweni yomntwana one-Double Inlet Left Ventricle (DILV). Kwaba bantwana, igumbi elinye elisezantsi (ventricle) lisebenza kakuhle. Yi-ventricle yasekhohlo . I-ventricle yasekunene idla ngokuba ncinci kakhulu ukuba isebenze.
Eyona ngxaki inkulu kukuba igazi elivela kumagumbi amabini aphezulu (i-atria yasekunene neyasekhohlo) lidibana kwigumbi elisezantsi elisebenzayo kuphela (i-Left Ventricle). Oku kuthetha ukuba igazi elingena-oxygen negazi eline-oxygen eninzi ziyaxubana . Emva koko eli gazi lixutyiweyo liphampuselwa emzimbeni womntwana nasemaphaphu. Yiyo loo nto kuvela iingxaki ezininzi.
Zithini iimpawu zale meko?
Ezi mpawu zihlala zibonakala kwiintsuku okanye kwiiveki ezimbalwa emva kokuba umntwana ezelwe. Njengomama, kubaluleke kakhulu ukuba uzazi ezi zinto.
| Uphawu | Ingcaciso elula |
|---|---|
| Ulusu oluluhlaza okwesibhakabhaka kunye nemilebe (iCyanosis) | Ulusu lomntwana, imilebe, kunye neenzipho zakhe zibonakala ziluhlaza okwesibhakabhaka ngenxa yegazi elingenaoksijini emzimbeni wonke. Le yenye yeempawu eziphambili. Abanye abantu babiza ngokuba "lusana oluluhlaza okwesibhakabhaka." |
| Ukutya okungalunganga | Xa umntwana encanca ubisi, uziva ediniwe kwaye kunzima ukuphefumla. Ngoko ke usela kancinci aze ayeke. |
| Ubunzima bokuphefumla | Usana luphefumla ngokukhawuleza. Kusenokubonakala ngathi lungena esifubeni. |
| Ukungatyebi | Usana aluyi kukhula kakuhle kuba alufumani amandla aneleyo ngokusela ubisi olwaneleyo. |
| Ukubila | Ingakumbi xa usela ubisi, ubila ebunzini kuba intliziyo yakho kufuneka isebenze nzima. |
| Ukubetha kwentliziyo okungaqhelekanga | Intliziyo inokubetha ngokukhawuleza okanye ibe nesingqisho esingahambelaniyo. Ugqirha unokuva isandi esongezelelweyo (ukugquma kwentliziyo) ngexesha lovavanyo. |
Kutheni oku kusenzeka? Yintoni isizathu sale nto?
Isizathu esichanekileyo soku asikaziwa okwangoku . Sidla ngokuvela kwiiveki zokuqala zokukhulelwa, xa intliziyo yomntwana ikhula. Asikuko ukuba lityala likamama okanye likatata.
Rhoqo, i-DILV ihamba nezinye iingxaki zentliziyo, eziphazamisana nokuhamba kwegazi.
- Ukuqina kwemithambo yegazi: Ukuncitshiswa komthambo wegazi oyintloko (i-aorta) othwala igazi lisuka entliziyweni ukuya emzimbeni.
- I-Pulmonary atresia: Ivalvu ye-pulmonary ethwala igazi ukuya emiphungeni ayenziwanga kakuhle.
- I-pulmonary valve stenosis: Ukuncitshiswa kwevalvu ethwala igazi ukuya emiphungeni.
Oogqirha bayixilonga njani le sifo?
Kukho iindlela ezahlukeneyo zokuxilonga esi sifo.
Ngexesha lokukhulelwa
Ngamanye amaxesha oku kunokubonwa ngelixa umntwana esesesibelekweni. Ukuba ugqirha wakho ufumana naziphi na iingxaki entliziyweni ngexesha leskeni yakho eqhelekileyo (i-ultrasound), uza kukuthumela kwiskeni ekhethekileyo. Ibizwa ngokuba yi-Fetal Echocardiogram . Oku kunokubonelela ngombono ocacileyo wesakhiwo kunye nomsebenzi wentliziyo yomntwana.
Emva kokuba umntwana ezelwe
Esi sifo sidla ngokufunyaniswa emva kokuba umntwana ezelwe.
- Uvavanyo lwe-Pulse Oximetry: Olu vavanyo ngoku lwenziwa kwiintsana ezisandul’ ukuzalwa phantse kuzo zonke izibhedlele eSri Lanka. Olu vavanyo lulinganisa inqanaba le-oksijini egazini lomntwana. Ukuba inqanaba le-oksijini liphantsi, lunokuba luphawu lwesifo sentliziyo.
- Uvavanyo lwezonyango: Ukuba ugqirha uva isandi esingaqhelekanga (ukumbombozela) xa emamele intliziyo yomntwana, okanye ukuba ulusu lwakhe luluhlaza okwesibhakabhaka, usenokuba nexhala.
Emva koko, kwenziwa ezinye iimvavanyo ezininzi ukuqinisekisa isifo.
| Uvavanyo | Wenza ntoni ngale nto? |
|---|---|
| I-X-reyi yesifuba | I-X-reyi yesifuba. Oku kunokunika umbono wobukhulu bentliziyo kunye nobungakanani begazi elihamba liye emiphungeni. |
| I-Electrocardiogram (ECG) | Uvavanyo olulinganisa umsebenzi wombane wentliziyo. Lunokufumanisa iingxaki ngesingqisho sentliziyo. |
| I-Echocardiogram (I-Echo) | Olu lolona vavanyo lubalulekileyo. Lufana nokuskena. Lubona ngokucacileyo amagumbi entliziyo, iivalvu, kunye nendlela igazi elihamba ngayo. |
| Ukucoca Intliziyo | Uvavanyo oluntsonkothileyo olulinganisa uxinzelelo kunye namanqanaba eoksijini entliziyweni ngokudlulisa ityhubhu encinci kakhulu ngemithambo yegazi ekwisinqe somntwana. |
Zithini iindlela zonyango zoku?
Le meko ayinakunyangwa ngokupheleleyo ngamayeza. Unyango oluphambili luluhlu lweenkqubo zotyando.Oku akwenzi amagumbi amabini entliziyweni yomntwana. Endaweni yoko, kusebenzisa i-ventricle enye ekhoyo ukwenza igazi lihambe emzimbeni ngokufanelekileyo kangangoko kunokwenzeka.
Olu asilotyando lwexesha elinye. Olu luhlu lotyando lwenziwa ngamanqanaba ahlukeneyo, kuxhomekeke kubudala bomntwana.
| Amanqanaba otyando | Ubudala (ubuncinane) | Kwenzeka ntoni emva kotyando? |
|---|---|---|
| Inqanaba lokuqala: I-Blalock-Taussig (BT) Shunt | Kwiintsuku ezimbalwa zokuqala okanye kwiiveki emva kokuzalwa | Ukuba akukho gazi laneleyo eliya emiphungeni, olu tyando lubandakanya ukufakwa kombhobho omncinci (i-shunt) ukuvumela ukuhamba kwegazi okwaneleyo emiphungeni. |
| Isigaba sesibini: Inkqubo yeGlenn Shunt | Iinyanga ezi-4 ukuya kwezi-6 | Igazi elingenaoksijini eliphuma emzimbeni ongaphezulu womntwana lithunyelwa ngqo emiphungeni, lidlula intliziyo. Oku kunciphisa umthwalo womsebenzi entliziyweni. |
| Inqanaba lesithathu: Inkqubo yeFontan | Iminyaka emi-2 ukuya kwemi-3 | Olu lutyando lokugqibela. Igazi elingenaoksijini elivela emzimbeni ongezantsi nalo liqhagamshelwe ngqo emiphungeni. Emva kolu tyando, ukuxubana kwegazi elingenaoksijini nelingenaoksijini phantse kuyeke ngokupheleleyo. |
Ukongeza kotyando, ugqirha anganika umntwana amayeza athile.
- I-Digoxin: Yomeleza ukufinyela kwentliziyo.
- Izithinteli ze-ACE: Uxinzelelo lwegazi oluphantsi.
- Ii-Anticoagulants: Zithintela ukujiya kwegazi.
- I-Diuretics: Susa amanzi angafunekiyo emzimbeni.
Kwiimeko ezinzima kakhulu, ukuba olu tyando alunakwenzeka, kusenokucingelwa ukuba kufakwe intliziyo .
Liza kuba njani ikamva? Ngaba singaba nethemba?
Kuyaqondakala ukuba woyike xa usiva ngesifo esifana nesi. Kodwa eyona nto ibalulekileyo ekufuneka uyazi kukuba ngokuhambela phambili kwesayensi yezonyango, ezi ntsana ngoku zinethuba lokuphila ubomi obungcono kakhulu . Izinga lokusinda iminyaka eli-10 emva kotyando liphezulu ukuya kuthi ga kwi-70% - 80%. Abantwana abaninzi bade bafikelele ebudaleni.
Kodwa aba bantwana badinga ukujongwa ngugqirha wentliziyo ubomi babo bonke . Kubalulekile ukuya kwiikliniki kwaye kwenziwe uvavanyo ngexesha. Kunokubakho ezinye iingxaki.
- Iinzipho zeenyawo ezikhule ngaphakathi kunye neminwe emikhulu (ukugquma).
- Izifo ezixhaphakileyo zemiphunga ezifana ne-pneumonia.
- Iingxaki zesingqisho sentliziyo.
Kwakhona, aba bantwana banokuba nemida ethile yokubaleka, ukutsiba, nokudlala imidlalo njengabanye abantwana. Konke oku kufuneka kuxoxwe kwaye kugqitywe ngako nogqirha wakho.
Umyalezo Wokuya Ekhaya
- I-Double Inlet Left Ventricle (DILV) sisifo sentliziyo esingaqhelekanga, esinzulu, kodwa esinokunyangeka, esizalwa naso.
- Ukuba ulusu losana lwakho luba luhlaza okwesibhakabhaka (i-cyanosis), lunobunzima bokutya, okanye lunobunzima bokuphefumla, musa ukulibazisa kwaye ubone ugqirha ngoko nangoko.
- Unyango lubandakanya uthotho lotyando oluntsonkothileyo olwenziwa ngamanqanaba ahlukeneyo ngokuxhomekeke kubudala bomntwana.
- Nangona olu hambo lunzima, ngenxa yokuqhubela phambili kwesayensi yezonyango, uninzi lwaba bantwana ngoku banokuphila bade babe ngabantu abadala.
- Ukuhlolwa ubomi bonke kunye nokulandelelana ngokufanelekileyo ngugqirha wentliziyo kubaluleke kakhulu.
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