Ngaba ulusu nemilebe yomntwana wakho osandul’ ukuzalwa zibukeka ziluhlaza okwesibhakabhaka? Ngaba ubonakala enengxaki yokuphefumla? Okanye ubila kakhulu xa esela ubisi? Musa nje ukuzithatha njengezizenzekela. Ngamanye amaxesha ezi zinokuba ziimpawu zesifo sentliziyo umntwana wakho azalwe enaso. Namhlanje sithetha ngesifo sentliziyo esingaqhelekanga ekufuneka wena, njengomzali, usiqaphele. Yiyo leyo iDouble Outlet Right Ventricle, okanye iDORV ngamafutshane.
Ngamafutshane, yintoni iDouble Outlet Right Ventricle (DORV)?
Ukuze siqonde oku, masiqale sicinge ngendlela intliziyo ephilileyo esebenza ngayo. Intliziyo yethu ifana nendlu encinci enamagumbi amane. Amagumbi amabini aphezulu kunye namagumbi amabini asezantsi. Amagumbi amabini amakhulu, aqinileyo angaphantsi abizwa ngokuba zii-ventricles. Elinye likwicala lasekunene (iVentricle yasekunene), kwaye elinye likwicala lasekhohlo (iVentricle yasekhohlo).
Oku kwenzeka rhoqo:
- Umthambo wegazi oyintloko othwala igazi "elingcolileyo" elingenaoksijini ukuya emiphungeni, umthambo we-pulmonary, uqala kwi-ventricle yasekunene .
- Umthambo wegazi omkhulu, i-aorta, uqala kwi-ventricle yasekhohlo, uthwala igazi "elicocekileyo" eliye lafakwa ioksijini lisuka kwimiphunga emzimbeni wonke.
Icocekile kakhulu, akunjalo? Ityhubhu enye enkulu kwigumbi ngalinye.
Ngoku, kwimeko ye-DORV, olu lungelelwaniso luyaphazamiseka. Kumntwana one-DORV, zombini imithambo yegazi ephambili esiyikhankanyileyo, i-Pulmonary Artery kunye ne-Aorta, zidibene ngokupheleleyo okanye ngokuyinxenye ne-Right Ventricle. Emva koko, i-Left Ventricle ayidibani nakweyiphi na imithambo yegazi ephambili, okanye yinxalenye encinci kakhulu edityanisiweyo.
Ngamafutshane, i-aorta, ethwala igazi elineoksijini emzimbeni wonke, kunye nomthambo wemiphunga, othwala igazi elingenaoksijini ukuya emiphungeni, zombini zivela kwindawo enye, kwi-ventricle yasekunene. Esi sisifo sentliziyo esizalwa naso.
Oku kuphakamisa imibuzo emibini:
1. Igazi elicocekileyo nelicebileyo ngeoksijini ekufuneka lihambe liye kwezinye iindawo zomzimba lixutywe negazi elingcolileyo nelingenaoksijini.
2. Igazi elingaphezulu liphampuzwa emiphungeni kunokuba kufuneka. Oku kubeka uxinzelelo olukhulu entliziyweni nasemiphungeni. Ekuhambeni kwexesha, la malungu anokonakala.
Ziziphi ezinye iingxaki ezinokubonwa nge-DORV?
Iintsana ezine-DORV ngamanye amaxesha ziba nezinye iingxaki zokuzalwa. Ezinye zezi ziquka:
- Ukungasebenzi kakuhle kwe-ciliary: Iingxaki ngokusebenza kweendawo ezibuthathaka kakhulu, ezifana neenwele zendlela yokuphefumla yomntwana.
- I-Heterotaxy:Izitho zomntwana esifubeni nasesiswini zibekwe kwezinye iindawo ezingezizo ezo ziqhelekileyo.
- Ukuwohloka kwamathumbu: Ukujijeka okungaqhelekanga kwamathumbu omntwana.
- I-pulmonary stenosis: Ukuncitshiswa okanye ukuncitshiswa kwevalvu phakathi kwe-ventricle yasekunene kunye nomthambo we-pulmonary.
- I-Ventricular hypoplasia: Igumbi elinye okanye omabini entliziyo lincinci kuneliqhelekileyo.
Ngaba kukho iintlobo ezahlukeneyo ze-DORV? Zingahlulwa njani ezi?
Ewe, kukho iintlobo ezahlukeneyo ze-DORV. Olu hlobo lumiselwa yinto enye ebaluleke kakhulu. Oko kukuthi, phantse wonke umntwana one-DORV unendawo enomngxuma eludongeni phakathi kwamagumbi amabini entliziyo (i-Ventricular Septal Defect - VSD). Lo mngxuma uthintela igazi ukuba lingaphumi libuye libuye phakathi kwamagumbi amabini.
Oogqirha bahlula i-DORV ngokusekelwe apho i-VSD, okanye umngxuma, ikhoyo.
| Uhlobo lwe-DORV | Ingcaciso elula |
|---|---|
| I-DORV ene-VSD ye-subaortic | Umngxuma osentliziyweni (VSD) ungaphantsi kwe-aorta. |
| I-DORV ene-VSD engaphantsi kwemiphunga (iTaussig-Bing) | Umngxuma osentliziyweni uphantsi komthambo wemiphunga. Oku kukwabizwa ngokuba yimeko yeTaussig-Bing. |
| I-DORV ene-VSD ephindwe kabini | Umngxuma ufumaneka phantsi kwemithambo yegazi emibini emikhulu (i-Aorta kunye ne-Pulmonary Artery). |
| I-DORV ene-VSD enganyanzelekanga (ekude) | Umngxuma ubekwe kude nale mithambo yegazi mibini iphambili, kwindawo engenanxibelelwano. |
Ukwazi kakuhle ukuba loluphi uhlobo lonyango kubaluleke kakhulu ekucwangciseni unyango.
Mama noTata, qaphelani ezi mpawu!
Iimpawu zeDORV zihlala zibonakala kwiintsuku zokuqala okanye kwiiveki emva kokuzalwa. Kufuneka uzilumkele kakhulu ezi zinto.
| Uphawu | Ithetha ntoni le nto? |
|---|---|
| Ubuluhlaza (iCyanosis) | Ulusu lomntwana, imilebe, okanye iinzipho zakhe zinokuba luhlaza okwesibhakabhaka okanye zimfusa. Oku kungenxa yokunqongophala kweoksijini egazini. |
| Ubunzima bokuphefumla | Ukuphefumla ngokuvakalayo, ngokukhawuleza (i-tachypnea) okanye ukuziva uphelelwa ngumphefumlo. |
| Ubunzima bokutya/ukusela | Ukungafuni ukusela ubisi, nokuba usela kancinci, uza kuyeka emva kwexesha elithile. Oku kunokubangela ukuba umzimba wakho ungabi mkhulu kangako. |
| Ukumbombozela kwentliziyo | Xa ugqirha ehlola intliziyo nge-stethoscope, uva isandi esahlukileyo ukongeza kwintliziyo. |
| Ukubetha kwentliziyo ngokukhawuleza (iTachycardia) | Isantya sentliziyo sikhawuleza kune-100 beats ngomzuzu. |
| Ukubila okugqithisileyo | Usana lubila kakhulu, ingakumbi xa luncancisa. |
| Ukozela okungaqhelekanga | Usana luhlala lulele kwaye lungenabomi. |
Yintoni ebangela le meko? Ziziphi iingxaki ezinokubakho?
Enyanisweni, abaphandi abakafumani sizathu sicacileyo se-DORV. Nangona kunjalo, kufunyenwe ukuba malunga ne-50% yeentsana ezinale meko zinotshintsho oluthile kwiichromosomes zazo, iindawo zolwazi lwethu lwemfuza (i-DNA).
Kodwa khumbula oku. Asikuko oku okwenzekileyo, asikuko oku okwenzekileyo. Ngoko ke ungaze ucinge ngako uze uzibeke ityala.
Ukuba i-DORV ayinyangwa kakuhle, iingxaki zinokuvela ngokuhamba kwexesha.
- Ukungahambi kakuhle kwentliziyo (iiArrhythmias)
- Iingxaki zevalvu yentliziyo
- Ukumelwa yintliziyo
- Uxinzelelo lwegazi oluphezulu lwemiphunga
- Usulelo lwengaphakathi lentliziyo (i-Endocarditis)
Oogqirha bayixilonga njani imeko ye-DORV?
Ngamanye amaxesha, olu hlobo lwesifo sentliziyo lunokubonwa nangaphambi kokuba umntwana azalwe, ngexesha le-scan ngexesha lokukhulelwa kwakho. I-scan ekhethekileyo esetyenziselwa oku ibizwa ngokuba yi-"Fetal Echocardiogram".
Ukuba oko akunakwenzeka, oogqirha baya kukrokrela oku kuphela xa iimpawu esithethe ngazo ngaphambili zibonakala emva kokuba umntwana ezelwe. Emva koko baya kumhlola umntwana.
- Jonga ukuba ulusu lomntwana lujika lube luhlaza okwesibhakabhaka na.
- Intliziyo iphulaphulwa nge-stethoscope ukujonga naziphi na izandi ezingaqhelekanga (ukumbombozela).
- I-Pulse Oximetry luvavanyo olulinganisa ubungakanani beoksijini egazini lomntwana ngokubeka isixhobo esincinci esifana nekliphu emnweni okanye endlebeni yomntwana. Olu luvavanyo olulula olungamlimazi umntwana.
Emva kwezi mvavanyo zokuqala, kunokwenziwa ezinye iimvavanyo ezininzi ukuqinisekisa ukuxilongwa.
- Uvavanyo lwemifanekiso olungenalo uhlaselo: Ii-CT scans, ii-MRI scans, kunye nee-X-rays ezenziwa ngaphandle komzimba womntwana.
- I-Electrocardiogram (ECG okanye EKG): Uvavanyo olungenabuhlungu olulinganisa umsebenzi wombane wentliziyo.
- I-Echocardiogram (i-echo): Oku kufana nokuskena kwentliziyo. Isebenzisa amaza esandi ukubona ngokucacileyo yonke into ngentliziyo, kuquka ukuma kwayo, umsebenzi wayo, kunye nendlela imithambo yegazi yayo edibene ngayo.
- Ukufakwa kwe-catheter yentliziyo: Kule nto, kufakwa ityhubhu encinci kakhulu (i-catheter) entliziyweni ngomthambo wegazi osesinqeni okanye engalweni yomntwana ukuze kufunyanwe ulwazi oluchanekileyo malunga noxinzelelo lwentliziyo, amanqanaba eoksijini, kunye nolwakhiwo lwayo.
Ungakhathazeki, kukho unyango loku! - Masifunde ngotyando
Phantse wonke umntwana one-DORV uya kufuna utyando lwentliziyo evulekileyo kunyaka wokuqala wobomi bakhe. Oku kunokuvakala kusoyikisa kuwe. Yinto eqhelekileyo leyo. Kodwa khumbula, ngetekhnoloji yezonyango yanamhlanje, olu tyando lunokwenziwa ngempumelelo enkulu.
Ugqirha wakho kunye nogqirha wentliziyo baza kuqwalasela izinto ezininzi xa besenza izigqibo malunga notyando.
- Luhlobo luni lwe-DORV lomntwana?
- Nokuba kukho ezinye iingxaki ngentliziyo yomntwana okanye ezinye izitho zomzimba.
- Impilo yomntwana iyonke.
Kukho iintlobo ezahlukeneyo zotyando ezenziwa rhoqo.
- Ukulungiswa kwe-intraventricular: Kule nkqubo, ugqirha wenza umngxuma odlula kwi-VSD, okanye umngxuma entliziyweni, esebenzisa i-patch ekhethekileyo. Le mngxuma idala indlela yokuba igazi liphume kwi-ventricle yasekhohlo liye kwi-aorta.
- Ukulungiswa kwe-Biventricular okanye i-arterial switch: Ukuba zombini ii-ventricles zomntwana zikwimeko entle kwaye i-DORV luhlobo lwe-VSD (Taussig-Bing) olungaphantsi kwepulmonary, ugqirha angenza utyando lokususa i-aorta aze ayidibanise ne-ventricle yasekhohlo.
- Ukulungiswa kwe-Univentricular (utyando lweFontan): Ukuba i-DORV inzima kakhulu, ugqirha angacebisa olu tyando. Oku kuquka ukuqondisa igazi elingenaoksijini ukusuka emzimbeni ongezantsi ukuya ngqo emiphungeni. Olu lutyando olunzima olubandakanya amanqanaba aliqela.
Kukho iingozi ngalo naluphi na utyando lwentliziyo. Ezi ziquka ukopha, amahlwili egazi, usulelo, kunye neengxaki ze-anesthesia. Kodwa oogqirha benza konke okusemandleni abo ukunciphisa ezi ngozi.
Buza kuba njani ubomi emva kotyando?
Emva kotyando, umntwana kuya kufuneka ahlale esibhedlele iveki okanye nangaphezulu. Ubude bexesha buya kwahluka ngokuxhomekeke kuhlobo lotyando olwenziweyo kunye nemeko yomntwana.
Into ebalulekileyo kukuba emva kotyando, uninzi lweentsana ezine-DORV zinokuphila ubomi obusempilweni nobuqhelekileyo babantu abadala.
Kodwa into enye ekufuneka uyikhumbule kukuba umntu oye wenza utyando lwe-DORV kufuneka ahlale phantsi kweliso likagqirha wentliziyo ubomi bakhe bonke. Kubalulekile ukuya kuhlolwa ngexesha elimiselweyo kwaye enze uvavanyo olufunekayo.
Abanye abantu banokufumana ukubetha kwentliziyo okungaqhelekanga okanye iingxaki zentliziyo nokuba sele kudlule iminyaka emva kotyando, ngoko ke kubalulekile ukuba uhlale ukhathalela impilo yakho.
Ixesha lokubona ugqirha nexesha lokuya kwi-ETU
Nokuba emva kotyando, mjonge umntwana wakho ngononophelo. Ukuba kuvela ezi mpawu zilandelayo, yazisa ugqirha wakho ngoko nangoko.
- Ukuba uziva ukubetha kwentliziyo okungaqhelekanga, okukhawulezayo, okanye okuhlabayo.
- Ukuba ufumana iintlungu esifubeni okanye ubunzima bokuphefumla (ezi zisenokuba ziimpawu zokuhlaselwa yintliziyo).
Kwiimeko ezilandelayo, mse umntwana kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele esikufutshane ngaphandle kokulibazisa.
Ukuba umntwana wakho unengxaki enkulu yokuphefumla kwaye/okanye iinzipho zakhe, imilebe, okanye ulusu lwakhe lubonakala luluhlaza okwesibhakabhaka, yiya kwi-ETU ngoko nangoko!
Imibuzo ebalulekileyo yokubuza ugqirha wakho
Kuqhelekile ukuba nemibuzo emininzi xa ufumanisa ukuba umntwana wakho une-DORV. Musa ukugcina nantoni na kuwe. Buza ugqirha wakho yonke into uze umchazele. Nazi ezinye zemibuzo onokuzibuza yona.
1. Luhlobo luni lwe-DORV umntwana wam analo?
2. Luhlobo luni lotyando ofuna ukulwenza?
3. Utyando lufanele lwenziwe nini?
4. Zithini iingozi zotyando?
5. Zithini iingozi zokungatyandwa?
6. Ngaba umntwana wam uza kufuna olunye utyando emva kolu tyando?
7. Ngaba umntwana wam kuya kufuneka asele amayeza ubomi bakhe bonke?
Xa uyazi yonke into kakuhle ngokubuza imibuzo efana nale, uya kukwazi ukwenza izigqibo ezinolwazi ngaphandle koloyiko.
Umyalezo Wokuya Ekhaya
- I-Double Outlet Right Ventricle (DORV) sisifo sentliziyo esinzulu, kodwa esinyangekayo, esizalwa naso.
- Ekubeni unobangela ochanekileyo wale meko ungaziwa, ungaze ucinge ukuba nguwe owenze le nto njengomzali.
- Ukuxilongwa kwangoko kunye notyando olukhawulezileyo kunika abantwana ithuba lokuphila ubomi obusempilweni nobude.
- Emva kotyando, kuyimfuneko ukuba ube phantsi kweliso likagqirha wentliziyo ubomi bakho bonke.
- Hlala ulumkile xa kukho iimpawu zesilumkiso ezingxamisekileyo ezifana nobunzima obukhulu bokuphefumla kunye nolusu oluluhlaza okwesibhakabhaka. Kwimeko enjalo, mse umntwana kwiYunithi yoNyango oluNgxamisekileyo (ETU) ngoko nangoko.
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