Uvuyo oluvayo xa ujonge umntwana wakho osandul’ ukuzalwa alunakuchazwa, akunjalo? Kwangaxeshanye, kukho uxanduva olukhulu entliziyweni yakho ngaloo bomi buncinci. Ngamanye amaxesha kuyinto eqhelekileyo ukuziva usoyika kakhulu kwaye ukhathazekile xa usiva ngezifo ezithile ezinokuthi zihlupheke ngabantwana abancinci. Namhlanje, sithetha ngesifo sentliziyo esinzulu esinokwenzeka kwiintsana ezisandul’ ukuzalwa, kodwa sinqabile kakhulu, kwaye sifuna unyango olukhawulezileyo. Esi simo sibizwa ngokuba yiInterrupted Aortic Arch, okanye (IAA) ngamafutshane.
Ngamafutshane, yintoni i-Interrupted Aortic Arch (IAA)?
Ukuze siqonde oku, masiqale sijonge indlela intliziyo yethu esebenza ngayo. Cinga ngentliziyo yethu njengempompo yamanzi. Le mpompo inamagumbi amane aphambili. Amabili phezulu namabili ezantsi. Igazi, eliye lasetyenziswa ngumzimba kwaye linamanqanaba aphantsi eoksijini, eliluhlaza okwesibhakabhaka kancinci, lingena kwigumbi eliphezulu lasekunene. Ukusuka apho, liya kwigumbi elingezantsi lize liphampelwe emiphungeni. Emiphungeni, eli gazi lifunxwa kakuhle ioksijini kwaye liba nombala obomvu omhle.
Ngoku eli gazi libomvu lingena kwigumbi eliphezulu lasekhohlo lentliziyo. Ukusuka apho, liya kwigumbi elisezantsi lasekhohlo lize limpompe umzimba wonke ngemithambo yegazi emikhulu neyona ibalulekileyo emzimbeni wethu, i-aorta . Le aorta ifana nenkqubo ephambili yepayipi ethwala amanzi esuka kwitanki yethu yamanzi ukuya endlwini yonke. Imile okwentonga yelekese.
Ngoko ke, okwenzekayo kumntwana onesifo esibizwa ngokuba yi- Interrupted Aortic Arch (IAA) kukuba umthambo wegazi oyintloko, i-aorta, awuphelelanga. Kukho ukuvaleka kwenye indawo kuwo, njengomngxuma oqhekekileyo. Ngamafutshane, umbhobho wamanzi oyintloko uqhekekile embindini. Ngenxa yesi sizathu, nokuba intliziyo iphampa nzima kangakanani na, igazi elihle elineoksijini aliyi kwiindawo ezisezantsi zomzimba.
Le yimeko embi kakhulu, esongela ubomi kuba ukuba amalungu omzimba awafumani ioksijini, aqala ukuvaleka. Kwizonyango, oku sikubiza ngokuba 'kukuba yingozi'.
Uyazi njani ukuba umntwana wakho unale meko? Zithini iimpawu?
Iintsana ezine-IAA zihlala ziqala ukubonisa iimpawu kwiiyure zokuqala okanye kwiintsuku emva kokuzalwa. Njengabazali, kubaluleke kakhulu ukuba nikwazi oku.
| Uphawu | Ingcaciso elula |
|---|---|
| Ukungafuni ukusela ubisi kunye nokudinwa | Usana lusenokuziva ludiniwe emva kokuncanca, lungase lusele kancinci luze luphelelwe ngamandla, okanye luhlale lulele ngalo lonke ixesha. |
| Ukuphefumla ngokukhawuleza | Usana lusenokuba luphefumla ngokukhawuleza kunesiqhelo. Oku kungenxa yokuba intliziyo kufuneka isebenze nzima. |
| Ukubetha kwentliziyo ngokukhawuleza | Xa ubeka isandla sakho esifubeni somntwana, uya kuziva ukuba intliziyo ibetha ngokukhawuleza kakhulu. |
| Ubuthathaka obungaqhelekanga kunye nokozela | Usana lusenokuziva lungaphili, luhlale lulele, kwaye kube nzima ukuvuka. |
| Ukutshintsha kombala wolusu | Imilenze, iinyawo, kunye nomzimba ongezantsi wosana, ingakumbi kuba lungenayo igazi, lunokubonakala lungwevu okanye luluhlaza okwesibhakabhaka. Lo mahluko unokubonwa xa izandla nobuso buhlala bupinki. |
Ukuba ubona enye okanye ezingaphezulu kwezi mpawu kumntwana wakho, kufuneka ubone ugqirha ngoko nangoko okanye umse umntwana wakho kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele ngaphandle kokulibazisa .
Kutheni oku kusenzeka kubantwana abancinci?
Xa usiva into efana nale, umbuzo wokuqala oza engqondweni yakho njengomzali ngulo, "Kutheni oku kwenzeke kumntwana wethu? Ngaba senze into engalunganga?"
Into yokuqala ekufuneka uyikhumbule kukuba oku akubangelwanga yimpazamo yabazali . IAA yimeko yemfuza .
Ngamafutshane, le meko yenzeka xa umntwana esakhula esibelekweni, ngenxa yokulahlekelwa yinxalenye encinci kakhulu yechromosome echaphazela ukwakheka kwentliziyo kunye nemithambo yegazi emikhulu.
Iintsana ezine-IAA zihlala zine- DiGeorge syndrome.Inokwenzeka nakwesinye isifo semfuza esibizwa ngokuba yiDiGeorge syndrome. Oku kubangelwa kukulahlekelwa yinxalenye yechromosome efanayo njengoko kukhankanyiwe apha ngasentla. Abantwana abaneDiGeorge syndrome banokuba nosulelo oluqhelekileyo kwaye banokuba notshintsho oluthile ebusweni (njengomlebe oqhekekileyo).
Ezinye iziphene zentliziyo ezihamba ne-IAA
Iintsana ezine-IAA zihlala zinesinye okanye ngaphezulu esinye isiphene sentliziyo. Esinye sezona zixhaphakileyo yi-Ventricular Septal Defect (VSD).
- I-Ventricular Septal Defect (VSD): Ngamafutshane, lo ngumngxuma eludongeni (septum) phakathi kwamagumbi amabini amakhulu okumpompa (ii-ventricles) zentliziyo. Nangona oku kudla ngokuba sisiphene, i-VSD ingaba ngumsindisi wobomi wexeshana kumntwana one-IAA. Khawuthelekelele ukuba xa igazi lingakwazi ukuhamba kwi-aorta, elinye igazi elineoksijini kwicala lasekhohlo le-aorta linokuhamba kulo mngxuma liye kwicala lasekunene, apho linokuhamba liye emiphungeni ukuze linike igazi kwiindawo ezisezantsi zomzimba. Kufana nokuba ne-bypass encinci xa indlela enkulu ivaliwe. Kodwa esi sisisombululo sexeshana nje.
Ziziphi iindlela zokuxilonga kunye nonyango?
Kubalulekile ukuqaphela nokunyanga le meko ngokukhawuleza.
Uxilongo
Le meko idla ngokuchongwa nge- Echocardiogram . Siyibiza nje ngokuba 'luvavanyo lwe-Echo'. Oku kufana nokuskena intliziyo. Olu vavanyo olungenabuhlungu lunokubona ngokucacileyo imo kunye nokusebenza kwamagumbi entliziyo, iivalvu, kunye nemithambo yegazi. Ngamanye amaxesha, le meko inokufunyanwa kwangethuba ngokuskena okwenziwe ngelixa umntwana esesesibelekweni.
Unyango
Unyango lwe-IAA lutyando . Nangona kunjalo, de umntwana alungele utyando, oogqirha baya kwenza enye into kuqala ukusindisa ubomi bomntwana.
1. Inyathelo Lokuqala - Ukugcina Umbhobho Wexeshana Uvuliwe:
Usana ngalunye olusandul’ ukuzalwa lunonxibelelwano lwexeshana phakathi kwentliziyo, i-aorta, kunye nombhobho othwala igazi ukuya emiphungeni obizwa ngokuba yiDuctus Arteriosus . Oku kubaluleke kakhulu ngelixa umntwana esesibelekweni. Lo mbhobho uzivalela ngokwawo kwiiyure ezimbalwa emva kokuzalwa.
Kodwa kumntwana one-IAA, kuba i-aorta ikrazukile, enye indlela eyahlukileyo yokuba igazi elineoksijini lihambe emzimbeni kukudlula kwi-Ductus Arteriosus. Ngoko ke into yokuqala eyenziwa ngoogqirha kukunika umntwana iyeza elibizwa ngokuba yiProstaglandin E1 , eligcina loo mbhobho wethutyana ivuliwe ngaphandle kokuvala. Oku kunceda ukugcina ukuhanjiswa kwegazi emzimbeni womntwana kude kube lutyando.
2. Inyathelo lesibini - Utyando:
Xa imeko yomntwana izinzile, oogqirha abaziingcali benza utyando. Oku kuquka:
- Ukuthabatha iziphelo ezimbini eziphukileyo ze-aorta nokuzidibanisa ukuze kudalwe umthambo wegazi opheleleyo, ongenaziphazamiso.
- Ukuvala iDuctus Arteriosus yexeshana eyayivulwe ngokuhambisa i-prostaglandin.
- Ukuba kukho i-VSD (umngxuma eludongeni lwentliziyo), nayo iya kuvalwa ngexesha lotyando.
Umntwana uza kuziva njani emva kotyando?
Akukho nto inzima kubazali njengokuva ukuba usana lwabo lunesifo esisongela ubomi. Kodwa kwinto esixoxe ngayo, ungabona ukuba le meko inokulawulwa ngempumelelo ngonyango olukhawulezileyo.
Impilo yabantwana emva kotyando lwe-IAA inokuba ntle kakhulu . Ngokwezibalo, nokuba kudlule iminyaka eli-10 emva kotyando, ama-81% abantwana basaphila. Oko kuthetha ukuba izinga lempumelelo liphezulu kakhulu.
Kodwa le yingxamiseko. Kwakuba nje iimpawu ziqaphelekile, umntwana kufuneka angeniswe kwigumbi lokunyamekela abagula kakhulu esibhedlele (ICU) kwaye unyango lufanele luqale ngoko nangoko. Kwanasemva kotyando, kubalulekile ukuqhubeka nokusa umntwana ekliniki kwaye kwenziwe uvavanyo olufunekayo, njengoko oogqirha becebisa.
Umyalezo Wokuya Ekhaya
- I-Interrupted Aortic Arch (IAA) yi-aortic arch eqhekekileyo kusana olusandul’ ukuzalwa. Le yimeko embi kakhulu kodwa engaqhelekanga kakhulu.
- Oku kubangelwa yimfuza, kungekhona ukungakhathali kwabazali ngexesha lokukhulelwa.
- Ukuba ubona iimpawu ezinje ngobunzima bokuncancisa, ukuphefumla ngokukhawuleza, ukozela kakhulu, kunye nokujika kolusu lube ngwevu, funa ingcebiso kagqirha ngoko nangoko .
- Le meko inokunyangeka ngempumelelo ngokuxilongwa kwangoko kunye notyando, nto leyo evumela umntwana ukuba aphile ubomi obusempilweni.
- Ukuba uneengxaki ngempilo yomntwana wakho, musa ukuzityeshela njengengxaki encinci. Soloko uthetha nogqirha wakho .
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