Ngaba umntwana wakho omncinci unengxaki yentliziyo elolu hlobo? Masifunde nge-Endocardial Cushion Defect!

Xa umntwana wakho ezelwe, ukhathazeka kakhulu ngayo yonke into ngaye, akunjalo? Ngamanye amaxesha abantwana abancinci banokuba neziphene zentliziyo zokuzalwa. Esinye sezifo zentliziyo, nangona zinzima kancinci, esibaluleke kakhulu ukuba siqapheleke sibizwa ngokuba yi -Endocardial Cushion Defect (ECD) . Igama lisenokuvakala lisoyikisa kancinci, kodwa ungakhathazeki. Makhe sithethe ngale nto ngokulula, ngendlela onokuyiqonda, kulungile?

Yintoni le Endocardial Cushion Defect?

Ngamafutshane, esi sisiphene esisezintliziyweni zabantwana bethu abancinci, esizalwa naso , oko kukuthi, isiphene esenzeka ngoxa besesesibelekweni sikanina. Cinga ngentliziyo yethu njengendlu enamagumbi amane. Kukho amagumbi amabini kumgangatho ophezulu (esiwubiza ngokuba yi-atria), kunye namagumbi amabini kumgangatho osezantsi (angama-ventricles). La magumbi ahlukaniswe ngodonga (i-septums). Ngenxa yezi ndonga, igazi lihamba ngendlela ehlelekileyo, kwicala elinye kuphela.

Kwakhona, kukho iivalvu ezifana nesango phakathi kwezi gumbi ezinceda ukuhamba kwegazi kwicala elinye kuphela. Ngokukodwa, ivalvu ye-tricuspid kunye nevalvu ye-mitral, ezifumaneka phakathi kwegumbi eliphezulu (atria) kunye negumbi elisezantsi (mitral chambers), kufuneka zenziwe ngokugqibeleleyo.

Nangona kunjalo, kumntwana one-endocardial cushion defect (ECD), iindawo zentliziyo ezibizwa ngokuba yi -endocardial cushions – izicwili ezisisiseko ezenza ezi ndonga kunye neevalvu – azikhuli kakuhle. Ngenxa yoko, iindonga ezahlula amagumbi entliziyo zisenokungakhuli kakuhle, okanye zisenokungabikho kwaphela. Iivalvu ezimbini ezibalulekileyo esizikhankanyileyo (i-tricuspid kunye ne-mitral) nazo zisenokungakhuli kakuhle.

Khawucinge nje, kwenzeka ntoni xa la macala entliziyweni, ezi ndonga, engasebenzi kakuhle, kwaye iivalvu, njengeengcango, zingasebenzi kakuhle? Indlela igazi elihamba ngayo ngaphakathi entliziyweni iyaphazamiseka.

• Igazi elingaphezulu kuneliqhelekileyo lingena emiphungeni yomntwana , nto leyo ebangela uxinzelelo lwegazi oluphezulu kwimithambo yegazi engaphakathi emiphungeni (uxinzelelo lwegazi oluphezulu lwepulmonary).
• Ngenxa yolu xinzelelo luphezulu emiphungeni, igazi liqala ukuhamba ngendlela engalunganga. Emva koko , igazi elinomoya-mpilo omninzi, elicocekileyo kunye negazi elingcolileyo, elingenawo umoya-mpilo omninzi, liqala ukudibana .
• Intliziyo kufuneka isebenze nzima ukupompa igazi ngale ndlela yokuphuma kwegazi ephazamisekileyo. Kufana nokunyuka intaba. Ekuhambeni kwexesha, oku kunokwenza buthathaka izihlunu zentliziyo yomntwana.

Ngaba kukho iintlobo ezahlukeneyo ze-endocardial cushion defect (ECD)?

Ewe, kukho iintlobo ezahlukeneyo zale meko, kuxhomekeke kubungakanani bomonakalo. Abanye abantwana banokuba neengxaki kuphela ngodonga oluphakathi kwamagumbi aphezulu entliziyo (atria). Abanye banokuba neengxaki ngodonga oluphakathi kwamagumbi asezantsi (ventricles). Ngamanye amaxesha zombini ezi ngxaki zinokwenzeka kunye. Kwakhona, iziphene kwiivalvu ze-mitral kunye ne-tricuspid zinokuhluka.

Le meko, ebizwa ngokuba yi-endocardial cushion defect (ECD), ikwaziwa ngokuba yi -atrioventricular septal defect (AVSD) okanye i-atrioventricular canal defect .

Le meko ngamanye amaxesha inokunxulunyaniswa nezinye iziphene zentliziyo zokuzalwa nazo. Umzekelo:

• I-Tetralogy yeFallot
• I-ventricle yasekunene ephuma kabini
• Ukutshintshwa kwemithambo emikhulu (ukutshintshwa kwemithambo emibini emikhulu yegazi kwiindawo ezingafanelekanga)
• I-patent ductus arteriosus
• I-ventricle enye (i-ventricle enye)

Ixhaphake kangakanani le meko?

Ukuba ujonga izibalo kumazwe afana ne-United States, malunga ne-1 kwi-1800 yeentsana ezizalwa minyaka le zinokuba nale ngxaki ye-endocardial cushion (ECD). Enye into ebalulekileyo kukuba malunga ne-20% yabantu abane- Down syndrome banale meko ye-ECD.

I-ECD iyichaphazela njani umzimba womntwana wam?

Ukuba le meko ye-ECD ayilawulwa kakuhle, inokuba mandundu ngakumbi kwaye ibangele iingxaki ezinkulu.

• Umonakalo wemiphunga: Njengoko besitshilo ngaphambili, ukuhamba kwegazi okugqithisileyo ukuya emiphungeni, uxinzelelo oluphezulu, kwaye ngokuhamba kwexesha, kunokubangela umonakalo ongunaphakade emiphungeni.
• Isingqisho sentliziyo esingaqhelekanga: Umsebenzi wombane wentliziyo uyaphazamiseka, kwaye ukubetha kwentliziyo kusenokungahambelani.
• Ukusilela kwentliziyo okubangelwa kukungafumani igazi: Imeko apho intliziyo iba buthathaka kwaye ingakwazi ukupompa igazi elaneleyo emzimbeni.
• I-Eisenmenger syndrome: Le yimeko embi kakhulu. Uxinzelelo olusezimpumlweni luyanda kakhulu, nto leyo ebangela ukuba ukuhamba kwegazi kubuyele umva ngokupheleleyo, nto leyo ebangela ukuba igazi elingenaoksijini lijikeleze umzimba wonke.

Kwezinye iimeko ezinzima, le meko inokuba yingozi nakubomi .

Kwakhona, nokuba emva kokuba isiphene silungisiwe ngotyando, umntwana wakho usenokuba sengozini yokufumana usulelo lwentliziyo olubizwa ngokuba yi -endocarditis . Ngoko ke, oogqirha banokucebisa ukuba athathe amayeza okubulala iintsholongwane ngaphambi kokuba anyangwe amazinyo.

Zithini iimpawu zale meko?

Ngamanye amaxesha, iintsana ezine-endocardial cushion defect engaphelelanga zisenokungabonakalisi zimpawu zide zibe ncinci kakhulu. Nangona kunjalo, iintsana ezine -endocardial cushion defect epheleleyo (i-ECD epheleleyo) zinokuba neempawu kwiiveki ezimbalwa emva kokuzalwa. Kubalulekile ukuhlala ulumkele ezi mpawu:

• Ukubetha kwentliziyo ngokukhawuleza
• Ulusu olukhanyayo okanye oluluhlaza okwesibhakabhaka:Khangela umbala oluhlaza okwesibhakabhaka, ingakumbi imilebe, ulwimi, kunye neminwe. Oku kubizwa ngokuba yi-cyanosis.
• Ubunzima bokutya nokunyuka kwesisindo: Jonga ukuba umntwana wakho uyaxakeka, uyabila emva kokusela ubisi, okanye akatyebi kakuhle.
• Ukungabi namandla: Ngaba umntwana wakho uhlala elele kwaye akanamdla wokudlala?
• Ukuphefumla ngokukhawuleza okanye nzima: Jonga ukuba isifuba somntwana sivakala siqinile, siphefumla ngokukhawuleza, okanye ukuba isifuba siyangena ngaphakathi na xa ephefumla.
• Usulelo oluqhelekileyo: Lumka kwiisulelo ezixhaphakileyo, ingakumbi izifo zokuphefumla.

Yintoni ebangela esi siphene se-endocardial cushion?

Isizathu esichanekileyo se-endocardial cushion defect (ECD) asikaziwa okwangoku. Nangona kunjalo, kufunyenwe ukuba sinxulumene kakhulu ne- Down syndrome . Esi siphene senzeka kwasekuqaleni kokukhula komntwana esibelekweni. Ingxaki ephambili kukuba izicubu ezibizwa ngokuba yi-endocardial cushion esithethe ngazo ngaphambili azikhuli kakuhle. Ezi ziindonga kunye neevalvu ezahlula amagumbi entliziyo kamva.

Oogqirha bayixilonga njani le meko?

Ugqirha womntwana wakho uza kuqala anike umntwana wakho uvavanyo olupheleleyo lomzimba . Emva koko, ukuba isandi esingaqhelekanga (ukububula kwentliziyo) sivakala xa umamele intliziyo nge-stethoscope, oko kungaba yimbonakaliso yale meko.

Ukongeza, kunokwenziwa ezinye iimvavanyo ezininzi:

• I-Electrocardiogram (EKG/ECG): Le nkqubo ivavanya ukusebenza kombane kwentliziyo.
• I-Echocardiogram: Olu lolona vavanyo lubalulekileyo. Lusebenzisa amaza esandi ukuthatha umfanekiso wentliziyo. Lubona ngokucacileyo yonke into ukusuka kwimo yentliziyo, ukuya kwimingxunya esezindongeni zayo kunye nendlela esebenza ngayo iivalvu.
• I-X-ray yesifuba: Oku kunokujonga ubungakanani bentliziyo kunye nemeko yemiphunga.
• I-MRI yentliziyo: Ngamanye amaxesha olu vavanyo lwenziwa ukuba kufuneka iinkcukacha ezingaphezulu.
• Ukufakwa kwe-catheter kwintliziyo: Kule nkqubo, ityhubhu encinci (i-catheter) idluliselwa ngemithambo yegazi iye entliziyweni ukuze ilinganise uxinzelelo olungaphakathi entliziyweni kwaye ithathe iisampulu zegazi. Oku kunokuba yimfuneko ngaphambi kotyando.

Eyona nto ibalulekileyo kukuhlala ubona ugqirha wakho ngexesha lokukhulelwa kwakho kwaye wenze ii-ultrasound scans.Ukwenza izinto ngendlela eyiyo. Ngamanye amaxesha, i-ECD inokubonwa ngaphambi kokuba umntwana azalwe, ngeskeni esenziwe ngelixa umntwana esesesibelekweni (i-echocardiogram ye-fetal). Xa oku kwaziwa kwangethuba, kunokwenzeka ukuba kucetywe ukuba unyango olufunekayo luqale kwangoko emva kokuba umntwana ezelwe.

Iphathwa njani le nto?

Unyango oluphambili nolungcono kakhulu kwesi sifo se-endocardial cushion (ECD) lutyando. Nangona kunjalo, de kube utyando lwenziwe, amanye amayeza anokunikwa ukunceda umntwana ukuba aqine aze atyebe. Umzekelo, amayeza okukhupha ulwelo (abizwa ngokuba 'ziipilisi zamanzi') anciphisa ulwelo olugqithisileyo emzimbeni kunye ne -digoxin (Cardoxin® okanye iLanoxin®) enceda ukuphucula ukusebenza kwentliziyo ukuya kwinqanaba elithile.

Kwenzeka ntoni emva kotyando?

Ngexesha lotyando, oogqirha bentliziyo bavala imingxunya ebangela ukuba igazi livuza phakathi kwamagumbi entliziyo. Basebenzisa i-patch ekhethekileyo ukwenza oku. Kwakhona, ukuba umntwana unevalvu enye kuphela, baya kwenza iivalvu ezimbini ezahlukeneyo ze-mitral kunye ne-tricuspid kuyo. Ngamanye amaxesha, ukuba ivalvu ye-mitral yomntwana iyavuza, inokulungiswa okanye itshintshwe ukuba kuyimfuneko.

Olu tyando lunokwenziwa kumntwana oneenyanga ezi-3 ukuya kwezi-6 ubudala . Nangona kunjalo, ukuba umntwana wakho unesiphako esipheleleyo se-endocardial cushion, kubalulekile ukuba utyando lwenziwe ngaphambi kokuba umntwana abe nonyaka omnye ubudala . Le yindlela yokuthintela umonakalo osisigxina emaphaphu.

Ngamanye amaxesha umntwana usenokugula kakhulu okanye abe nobunzima obungaphantsi komzimba ukuba angenza utyando olupheleleyo. Kwimeko enjalo, oogqirha baya kuqala benze olunye utyando olulula ukunciphisa inani legazi eliya emiphungeni yomntwana. Oku kubizwa ngokuba yi -pulmonary artery banding . Oku kunokunceda ukulawula iimpawu de umntwana abe namandla kwaye atyebe. Emva koko, ngexesha elifanelekileyo, ukulungiswa okupheleleyo kunokwenziwa.

Ngaba kukho naziphi na iingxaki kunyango?

Njengakwezinye iintlobo zotyando, kukho iingxaki ezithile ezinokwenzeka emva kotyando lwe-ECD. Nangona kunjalo, uninzi lwexesha, ezi zinto zinokulawulwa.

• Ivalvu ye-mitral evuzayo: Ngamanye amaxesha emva kotyando, ivalvu ye-mitral isenokungavaleki kakuhle kwaye igazi elithile linokuvuza umva.
• Isingqisho sentliziyo esingaqhelekanga: Kunokubakho ukungahambelani kakuhle kwentliziyo.

Ezi ngxaki ngamanye amaxesha zinokuvela xa umntwana ekhulile kancinci, nokuba usemncinci. Yiyo loo nto kubalulekile ukuba ahlolwe rhoqo ngugqirha.

Ngaba le meko ingathintelwa?

Ekubeni unobangela we-ECD ungaziwa, kunzima ukutsho ukuba ungawuthintela njani ngokupheleleyo. Nangona kunjalo, ukuba kukho umntu kusapho lwakho oye waba nolu hlobo lwesiphene sentliziyo (ECD) okanye ezinye iingxaki zemfuza, kungaba ngumbono olungileyo ukufumana ingcebiso ngemfuza ngaphambi kokuba ukhulelwe.

Ukuba umntwana wam une-ECD, ndimele ndilindele ntoni?

Lo ngumbuzo omkhulu abazali abaninzi abanawo. Iindaba ezimnandi zezokuba emva kotyando lokulungisa i-ECD, uninzi lweentsana luqhubeka luphila ubomi obuqhelekileyo nobusempilweni. Nangona kunjalo, impilo yekamva lomntwana ixhomekeke kwizinto ezifana nobunzima be-ECD yakhe, nokuba imiphunga yakhe yonakele, kunye nempilo yakhe iyonke.

Ngokwezibalo, ithuba lokusinda kunyaka wokuqala emva kotyando limalunga ne-80%. Amathuba okusinda eminye iminyaka eli-10 amalunga ne-75%, kwaye ithuba lokusinda iminyaka engama-20 limalunga ne-65%.

Kwanasemva kotyando, abanye abantwana banokuba neengxaki kamva. Ingxaki eqhelekileyo kukuba ivalvu ye-mitral ayivaleki kakuhle kwaye igazi liyavuza. Ukuba oku kuyenzeka, kunokwenziwa olunye utyando ukuze kulungiswe .

Ihlala ixesha elingakanani imeko ye-ECD?

Oku kubaluleke kakhulu. I-Endocardial cushion defect (ECD) ayisiyongxaki eza kuphola yodwa. Ingxaki iya kuhlala injalo de ugqirha wentliziyo enze utyando lokulungisa loo ngxaki. Ngaphandle kotyando, iintsana ezininzi aziyi kuphila zingaphezulu kweminyaka emi-2 okanye emi-3 ubudala. Yiyo loo nto utyando olukhawulezileyo lubalulekile.

Ndingamnyamekela njani umntwana wam?

Emva kokuba umntwana wakho efunyenwe ene-ECD, kwaye nasemva kotyando, umntwana wakho kuya kufuneka ahlolwe rhoqo ngugqirha wentliziyo . Ezi ntlanganiso zokulandelela zinokuba kanye okanye kabini ngonyaka. Ezi ntlanganiso ziya kuqhubeka ebuntwaneni bomntwana wakho naxa sele emdala. Oku kuvumela ugqirha ukuba ajonge imeko yomntwana wakho, abone ukuba kukho naziphi na iingxaki nge-patch okanye i-valve, njengokuvuza, kwaye angenelele kwangethuba ukuba kuyimfuneko.

Ndifanele ndimse nini umntwana wam kugqirha?

Ukuba umntwana wakho ubonakalisa naziphi na iimpawu ezilandelayo, bonana nogqirha ngokukhawuleza:

• Ubunzima bokuphefumla
• Ukudinwa ngaphandle komgudu omkhulu emva kokubaleka nokudlala okwethutyana
• Ukungakhuli okanye ukutyeba njengoko kulindelekile
• Ukuba nolusu oluluhlaza okwesibhakabhaka

Ndingayibuza yiphi imibuzo ugqirha wam?

Kubaluleke kakhulu ukususa nawaphi na amathandabuzo onokuba nawo. Musa ukoyika ukubuza ugqirha wakho imibuzo efana nale:

• "Gqirha, ngaba umntwana wam unesiphako esipheleleyo okanye esincinci se-endocardial cushion?"
• "Ugqirha ucebisa luphi unyango ngemeko yomntwana wam?"
• "Gqirha, zingaphi utyando lwe-ECD olwenzileyo ngolu hlobo?"
• "Zeziphi izinto ezikhethekileyo ekufuneka ndizinyamekele emva kotyando?"

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Usenokuba awukaze uphuphe ngotyando lomntwana wakho omncinci. Nangona kunjalo, utyando yeyona ndlela ilungileyo nesebenzayo yokulungisa i-endocardial cushion defect (ECD). Le ngxaki ayizukuphela ngokwayo. Ngoko ke, ukuba kukho into ongayiqondiyo, cela ugqirha wakho akuchazele yona.

Eyona nto ibalulekileyo kukuba awuwedwa. Oogqirha, abahlengikazi, kunye neqela lonke lezempilo bakhona ukukunceda nokukuqinisa kolu hambo. Nokuba emva kotyando, ungaphoswa ziikliniki zomntwana wakho kwaye ulandele imiyalelo kagqirha njengoko iyalelwe. Ngale ndlela, wena nomntwana wakho niza kukwazi ukuchonga naziphi na iingxaki ezinokuvela kwixesha elizayo kwaye nijongane nazo ngempumelelo. Hlala uqinile!

` I-Endocardial Cushion Defect, i-AVSD, isifo sentliziyo, iziphene zokuzalwa, isifo sentliziyo sabantwana, utyando lwentliziyo, i-Down syndrome, isifo sentliziyo sokuzalwa, i-cardiology yabantwana