Ukuzisa umntwana osandul’ ukuzalwa ekhaya sisihlandlo esivuyisayo kusapho. Kodwa kwangaxeshanye, kunokubangela uloyiko kubazali. "Ngaba umntwana uphilile?", "Ngaba umntwana uphefumla kakuhle?", "Kutheni elila kangaka?" Usenokuba ukhe waba nemibuzo efana nale. Nangona uninzi lwexesha ezi zizinto eziqhelekileyo, ngamanye amaxesha kukho iimeko ezingaqhelekanga ezifuna ukuba silumke ngakumbi. Namhlanje siza kuthetha ngesifo sentliziyo esingaqhelekanga kakhulu esinokwenzeka kwiintsana ezisandul’ ukuzalwa, kodwa esifuna unyango olukhawulezileyo. Oko yiInterrupted Aortic Arch, okanye i-IAA ngamafutshane.
Ngamafutshane, yintoni i-Interrupted Aortic Arch (IAA)?
Ukuze sikuqonde oku, masiqale sijonge indlela esebenza ngayo intliziyo yethu. Khawuthelekelele ukuba intliziyo yakho yimpompo yamanzi eyintloko enamagumbi amane.
- Amagumbi amabini aphezulu (i-Atria): Igazi "eliluhlaza okwesibhakabhaka" elingena-oxygen emzimbeni lingena kwelinye igumbi, kwaye igazi "elibomvu" elino-oxygen elivela emiphungeni lingena kwelinye.
- Iigumbi ezimbini ezisezantsi (ii-ventricles): Ezi ziigumbi eziphambili zokumpompa. Kwelinye icala, zithumela igazi elingenaoksijini emaphashini ukuze lilithathe. Kwelinye icala, zimpompa igazi elibomvu elineoksijini eninzi ukuze lisasazwe emzimbeni wonke.
Umthambo wegazi oyintloko othwala igazi elineoksijini emzimbeni wonke ubizwa ngokuba yiAorta . Uhlala umile njengenduku, okanye igophe.
Ngoku, kwimeko ye -Interrupted Aortic Arch (IAA) , i-arch ye-aorta ayiphelelanga. Kufana nombhobho ophambili othwala amanzi ukusuka kwitanki yamanzi ukuya endlwini yonke oqhekeke waba ngamacandelo amabini . Ngenxa yesi sizathu, nokuba intliziyo ipompa nzima kangakanani na, ayinakuthumela igazi elineoksijini kwiindawo ezisezantsi zomzimba. Le yimeko embi kakhulu, esongela ubomi . Kuba ukuba iindawo zomzimba azifumani igazi, ezo zitho zinokungaphumeleli kwaye zibe yingozi enkulu kumntwana.
Le meko ayiqhelekanga kakhulu. Ichaphazela malunga neentsana ezimbini kwi-100,000 ezizalwa eSri Lanka. Ngoko ke nangona kubalulekile ukuqaphela oku, ungoyiki ngokungeyomfuneko.
Uyazi njani ukuba umntwana wakho unale meko? Zithini iimpawu?
Umntwana one-IAA udla ngokubonisa iimpawu kwiintsuku ezimbalwa zokuqala emva kokuzalwa. Oku kungenxa yokuba ngaphambi kokuzalwa, intliziyo yomntwana ifumana ioksijini emzimbeni kamama, nto leyo engeyongxaki, kodwa emva kokuzalwa, intliziyo yomntwana kufuneka isebenze yodwa. Kulapho kuvela khona le ngxaki.
Kufuneka ulumke kakhulu ngezi mpawu zilandelayo.
| Uphawu | Icacisiwe ngokulula |
|---|---|
| Ubunzima bokuncancisa kunye nokudinwa kakhulu | Nokuba umntwana uncanca ubisi oluncinci, ubonakala enengxaki, ebila, kwaye esebenza nzima kakhulu. Kuba nalo msebenzi mncinci ufuna umgudu omkhulu osuka entliziyweni. |
| Ukuphefumla ngokukhawuleza | Ngenxa yokuba umzimba awufumani ioksijini eyaneleyo, umntwana uqala ukuphefumla ngokukhawuleza ukuze abuyisele amandla akhe. Isifuba sisenokubonakala ngathi siyabetha. |
| Ukubetha kwentliziyo ngokukhawuleza | Ngenxa yokuba intliziyo kufuneka isebenze nzima ukupompa igazi emzimbeni wonke, intliziyo iqala ukubetha ngokukhawuleza. |
| Ulusu lujika lube ngwevu okanye lube luhlaza okwesibhakabhaka | Ingakumbi ekubeni igazi elinomoya-mpilo omninzi lingahambi kakuhle kwiindawo ezisezantsi zomzimba womntwana, njengemilenze neenyawo, ulusu kwezo ndawo lunokuba ngwevu okanye ludane. |
| Ukozela okungaqhelekanga kunye nobuthathaka | Ukuba umntwana wakho uhlala elele kwaye ediniwe, kusenokwenzeka ukuba umzimba wakhe awufumani amandla owadingayo. |
Ukuba ubona naziphi na kwezi mpawu, bonana nogqirha ngokukhawuleza ngaphandle kokulibazisa. Ukuba kuyimfuneko, thatha umntwana wakho umse kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele esikufutshane.
Ezinye iziphene zentliziyo ezinokwenzeka kule meko
Iintsana ezine-IAA zinokuba nezinye iziphene ezininzi zentliziyo ngaxeshanye.
- I-Ventricular Septal Defect (VSD): Lo ngumngxuma eludongeni phakathi kwamagumbi amabini asezantsi okupompa (ii-ventricles) zentliziyo. Okumangalisayo kukuba, ukuba ne-VSD ngamanye amaxesha kunokuba luncedo lwexeshana kwiimeko ze-IAA, njengoko kuvumela igazi elithile elineoksijini ukuba lidlule emngxunyeni liye emzimbeni.
- I-Atrial Septal Defect (ASD): Lo ngumngxuma eludongeni phakathi kwamagumbi amabini aphezulu entliziyo.
- I-Truncus Arteriosus: Kulapho imithambo yegazi emibini ephambili ephuma entliziyweni (i-aorta kunye nomthambo we-pulmonary) idibana khona ukuze yenze inye.
Kutheni oku kusenzeka kwiintsana? Yintoni isizathu?
Njengabazali, umbuzo wokuqala oza engqondweni yakho xa usiva oku ngulo, "Ingaba le yimpazamo yethu?" Kakade akunjalo.
I-Interrupted Aortic Arch (IAA) yimeko ebangelwa sisiphene semfuza . Ngamafutshane, ii-chromosomes zethu 'ziyincwadi' equlethe yonke imiyalelo yendlela eyakhiwe ngayo imizimba yethu. Kule meko, iqhekeza elincinci kakhulu le-chromosome equlethe imiyalelo yendlela eyakhiwe ngayo intliziyo nemithambo yegazi alikho. Oku kubangela ukuba i-aorta ingasebenzi kakuhle.
Amaxesha amaninzi, iintsana ezine-IAA nazo zinesinye isifo semfuza esibizwa ngokuba yi-DiGeorge syndrome . Oku kubangelwa nayinxalenye engekhoyo ye-chromosome efanayo. Abantwana abane-DiGeorge syndrome banokuba nosulelo oluqhelekileyo kunye notshintsho oluthile ebusweni (njengomlebe oqhekekileyo).
Oogqirha bakufumanisa njani oku kanye kanye?
Xa usisa umntwana wakho esibhedlele, ukuba oogqirha bayamxilonga umntwana baze bacinge ukuba unesimo sentliziyo esinje, uvavanyo oluphambili lokuqinisekisa ukuba unesifo sentliziyo yi- echocardiogram .
I-echocardiogram ifana nokubukela ividiyo yentliziyo yomntwana. Ayibuhlungu. Isebenzisa amaza e-ultrasound ukubona ngokucacileyo amagumbi entliziyo, iivalvu, kunye nemithambo yegazi. Kwimeko ye-IAA, ingabonisa ngokucacileyo ukuvaleka kwe-aorta.
Ngamanye amaxesha, isiphene sentliziyo esifana nesi sinokubonwa ngexesha le-anomaly scan (ultrasound scan) eyenziwa ngelixa umntwana esesesibelekweni.
Zithini iindlela zonyango zoku? Ngaba umntwana anganyangeka?
Ewe, ngokuqinisekileyo. Nangona le yimeko enzima, inokunyangeka ngokupheleleyo ngotyando . Inkqubo yonyango inokwahlulwahlulwa ibe ziinxalenye ezimbini eziphambili.
1. Yintoni omawuyenze ngaphambi nje kotyando
Emva kokuxilongwa, umntwana ungeniswa kwangoko kwiyunithi yokhathalelo oluphezulu lweentsana (i-NICU). Injongo ephambili kukugcina ukuhamba kwegazi emzimbeni de umntwana alungele utyando.
Oogqirha basebenzisa icebo elinobuchule ukwenza oku. Ngaphambi kokuba umntwana ngamnye azalwe, kukho unxibelelwano lwexeshana (i-ductus arteriosus) phakathi kwe-aorta kunye nomthambo othwala igazi ukuya emiphungeni. Oku kuvala ngokwako kwiiyure okanye iintsuku ezimbalwa emva kokuzalwa.
Kodwa kwimeko ye-IAA, oogqirha abayi kuvumela olu qhagamshelo lwexeshana luvaleke. Lufana 'nendlela yokudlula' esetyenziswa xa indlela enkulu ivaliwe. Gcina le ndlela yokudlula ivuliwe.Iyeza elibizwa ngokuba yiProstaglandin E1 linikwa umntwana ngetyuwa. Oku kuvumela umzimba ongezantsi womntwana ukuba ufumane igazi de kube lutyando.
2. Utyando olusindisa ubomi
Xa imeko yomntwana izinzile, utyando lwenziwa ngoogqirha bentliziyo babantwana.
- Eyona nto iphambili: Iinxalenye ezimbini ze-aorta eziqhawuliweyo zaza zahlulwa ziyaxhunyaniswa, nto leyo eyenza i-arch epheleleyo.
- Izinto ezongezelelweyo: Kwangaxeshanye, ukuba umntwana une-VSD (umngxuma entliziyweni), uya kuvalwa nalo ngexesha lotyando. I-bypass (PDA) eyavulwa ngamayeza ngaphambili nayo iya kuvalwa, kuba ngoku ekubeni indlela ephambili igqityiwe, akukho mfuneko yayo.
Olu lutyando oluntsonkothileyo kakhulu, kodwa oogqirha abanobuchule eSri Lanka benza olu tyando ngempumelelo.
Liza kuba njani ikamva lomntwana emva kotyando?
Le yeyona nto ibalulekileyo. Emva kotyando oluphumeleleyo, uninzi lwabantwana lunokuphila ubomi obuqhelekileyo nobusempilweni . Ngokwezibalo, nokuba yiminyaka eli-10 emva kotyando, abantu abangaphezu kwama-81% basaphila.
Kodwa eyona nto ibalulekileyo ekufuneka uyikhumbule kukuba nasemva kotyando, kufuneka uhlale phantsi kogqirha wentliziyo ubomi bakho bonke . Kufuneka uye kwiikliniki ngexesha elicwangcisiweyo kwaye wenze uvavanyo olufana ne-echocardiogram ukuze ubone ukuba intliziyo yakho isebenza kakuhle na. Ngamanye amaxesha, xa ukhula, unokufuna unyango kwakhona. Ke ngoko, kubalulekile ukulandela imiyalelo kagqirha wakho.
Kuqhelekile ukuba uzive ngathi lonke ihlabathi lakho liwile xa ufumanisa ukuba umntwana wakho unale meko. Kodwa khumbula, isayensi yezonyango ihambele phambili kakhulu namhlanje. Ukuba isifo sichongiwe kwangethuba kwaye sinyangwa ngokufanelekileyo, umntwana wakho unethuba elihle lokonwaba njengaye nawuphi na omnye umntwana.
Umyalezo Wokuya Ekhaya
- I-Interrupted Aortic Arch (IAA) kuxa umthambo wegazi oyintloko othwala igazi ukusuka entliziyweni yomntwana ukuya emzimbeni ungaphelelanga.
- Le yimeko engaqhelekanga kakhulu, kodwa inzima kakhulu efuna unyango olukhawulezileyo .
- Lumka kakhulu ngeempawu ezifana nobunzima bokuncancisa, ukuphefumla ngokukhawuleza, kunye nolusu olungwevu.
- Oku kubangelwa sisiphene semfuza, kungekhona ityala labazali.
- Unyango lutyando, kwaye emva kotyando oluphumeleleyo, uninzi lwabantwana lunokuphila ubomi obuqhelekileyo .
- Kubalulekile ukuhlala phantsi kweliso likagqirha wentliziyo ubomi bakho bonke, nokuba emva kotyando.
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