Umama okanye utata onosana olusandul’ ukuzalwa unokoyika kakhulu nokuba baphawula utshintsho oluncinci kumntwana wabo. Ngoko ke ubuya kukhathazeka kangakanani ukuba ugqirha uhlole umntwana aze athi, "Kukho ukurhawuzelela kwentliziyo okuncinci"? Kodwa ungoyiki. Namhlanje sithetha ngesifo sentliziyo esibonakala rhoqo kwiintsana ezisandul’ ukuzalwa kwaye kulula ukunyanga. Oku kubizwa ngokuba yiPatent Ductus Arteriosus, okanye iPDA njengoko ibizwa ngoogqirha ngamafutshane.
Ngamafutshane, yintoni le PDA?
Ukuze siqonde oku, masibuyele emva xa umntwana esesiswini sikanina. Khawuthelekelele, umntwana akaphefumli esesiswini. Umntwana ufumana ioksijini ayidingayo ngentambo yomntwana. Ke ngoko, imiphunga yomntwana ayisebenzi ngelo xesha. Ngoko ke, kukho indlela encinci, efana nonxibelelwano 'lokudlula', phakathi komthambo oyintloko othwala igazi ukusuka entliziyweni ukuya emzimbeni (i-aorta) kunye nomthambo othwala igazi ukuya emiphungeni (umthambo wepulmonary). Oku sikubiza kumayeza `(ductus arteriosus)`. Umsebenzi wayo kukudlula imiphunga, engasebenziyo, nokuthumela igazi kuwo wonke umzimba.
Emva kokuba umntwana ezelwe aze aphefumle okokuqala, imiphunga iqala ukusebenza. Emva koko akukho mfuneko yokuba kubekho loo ndlela 'yokudlula'. Ngoko ke, ngesiqhelo kwiintsuku ezimbalwa zokuqala emva kokuba umntwana ezelwe, lo mthambo wegazi uya kuzincipha uze uzivalele ngokwawo.
Kodwa kwezinye iintsana, lo mthambo wegazi obizwa ngokuba yi-"ductus arteriosus" awuvaleki kakuhle. Ushiya umngxuma omncinci. Yiyo loo nto siwubiza ngokuba yiPatent Ductus Arteriosus (PDA) .
Le meko ye-PDA imchaphazela njani umntwana?
Ngoku, kwenzeka ntoni xa loo ndlela yokungena ingavalwanga? Uxinzelelo lwegazi kumthambo oyintloko othwala igazi emzimbeni, i-aorta, luphezulu. Uxinzelelo kumthambo othwala igazi emiphungeni, umthambo wemiphunga, luphantsi. Ngoko ke, ngalo mngxuma, igazi elingafunekiyo liphuma kwindawo enoxinzelelo oluphezulu ukuya kwindawo enoxinzelelo oluphantsi, oko kukuthi, ukuya emiphungeni.
Oku kubangela iingxaki ezimbini eziphambili:
1. Umsebenzi ongakumbi kwintliziyo nemiphunga: Intliziyo nemiphunga yomntwana kufuneka isebenze nzima ukupompa lonke eli gazi lingaphezulu.
2. Ukonakala kwemiphunga: Ukuba le meko iyaqhubeka ngaphandle konyango, uxinzelelo lwegazi emiphungeni lunokunyuka, nto leyo ekhokelela kwimeko ebizwa ngokuba yi-pulmonary hypertension. Oku kungonakalisa nemithambo yegazi emiphungeni.
Into ebalulekileyo kukuba zonke ezi ngxaki zinokuthintelwa ukuba le meko ifunyaniswa kwangethuba kwaye inyangwe ngokufanelekileyo.
Ngubani osengozini enkulu yokuphuhlisa le PDA?
Nangona le meko inokwenzeka nakuwuphi na umntwana, abanye abantwana basengozini enkulu.
- Iintsana ezingekafiki ixesha:Eli lelona qela liphambili elinomngcipheko. Okukhona usana luzalwa iiveki ezimbalwa, kokukhona kunokwenzeka ukuba lube ne-PDA. Malunga nama-80% eentsana ezizelwe ngaphambi kweeveki ezingama-28 zinokuyibona le meko.
- Iintsana ezingamantombazana: Le meko ixhaphake kakhulu kwiintsana ezingamantombazana kunakwiintsana ezingamankwenkwe.
- Izizathu zofuzo: I-PDA inokwenzeka kwizifo ezithile zofuzo.
- Usulelo lweRubella kumama ngexesha lokukhulelwa: Ukuba umama ufumana iGerman measles ngexesha lokukhulelwa, umntwana usemngciphekweni omkhulu wokufumana i-PDA.
Zithini iimpawu ze-PDA?
Iimpawu ziyahluka ngokuxhomekeke kubukhulu bePDA. I-PDA encinci kakhulu isenokungabonakalisi zimpawu . Kunokubakho kuphela ukugquma kwentliziyo okuviwa ngugqirha nge-stethoscope. Nangona kunjalo, ukuba une-PDA ephakathi ukuya kwenkulu, unokuzibona ezi mpawu.
| Uphawu | Ingcaciso elula |
|---|---|
| Ukuphefumla ngokukhawuleza | Ngenxa yokuba igazi elininzi liphuma liye emiphungeni, umntwana uphefumla ngokukhawuleza kunesiqhelo. Ngamanye amaxesha ukuphelelwa ngumphefumlo kunokubakho. |
| Ukubila ngelixa usela ubisi | Ngenxa yokuba intliziyo kufuneka isebenze nzima, nokuba yinto nje elula yokusela ubisi ivakala ngathi kukujima okukhulu kumntwana. Yiyo loo nto ibunzi lakhe nentloko yakhe zibila xa esela ubisi. |
| Ukudinwa lula nokusela ubisi oluncinci | Umntwana udinwa ngokukhawuleza, ngoko ke uyayeka ukusela ubisi oluncinci. Kunzima ukuqhubeka esela ubisi rhoqo. |
| Ukutyeba kakubi | Ngenxa yokuba umntwana akaseli ubisi olwaneleyo kwaye umzimba uchitha amandla amaninzi, ubunzima bomntwana abunyuki ngendlela efanelekileyo ngokweminyaka yakhe. |
| Ukubetha kwentliziyo ngokukhawuleza | Intliziyo ibetha ngokukhawuleza ukuze ipompe igazi elingakumbi. |
Uyifumana njani le nto, Gqirha?
Ukuba ubona naziphi na ezi mpawu kumntwana wakho, xelela ugqirha wakho ngoko nangoko. Ngokwesiqhelo, xa uhlola umntwana wakho, ugqirha unokuva "ukukhala koomatshini" entliziyweni. Kulapho kurhanelwa khona i-PDA.
Emva koko, ukuqinisekisa oku, uza kuthunyelwa kwiNgcali yeNtliziyo yabantwana . Ingenza olu vavanyo lulandelayo:
- I-Echocardiogram (Echo): Olu lolona vavanyo lubalulekileyo noluchanekileyo . Lufana nokuskena intliziyo. Lunokubona ngokucacileyo yonke into efana nokuba i-PDA ikhona na, inkulu kangakanani, kwaye ingakanani igazi elihamba ngayo. Olu ayilovavanyo lubuhlungu.
- I-X-reyi yesifuba: I-X-reyi yesifuba inokujonga ukuba intliziyo ikhulu na okanye kukho igazi elininzi elingena emiphungeni.
- I-Electrocardiogram (ECG): Ngokujonga umsebenzi wombane wentliziyo, kunokufunyanwa ukuba intliziyo iphantsi koxinzelelo olukhulu na.
Ziziphi iindlela zonyango ze-PDA?
Unyango lumiselwa bubudala bomntwana, ubunzima bakhe, imeko yakhe yempilo, kunye nobungakanani be-PDA. Ayizizo zonke ii-PDA ezinyangwa ngaxeshanye.
1. Ukulinda Ngokulinda
Ukuba yi-PDA encinci kakhulu, kwaye ayibangeli monakalo kumntwana, ugqirha unokugqiba ekubeni alinde ixesha elithile. Kuba abanye babo bazivalela bodwa. Kodwa kubalulekile ukuqhubeka nokutyelela ikliniki kagqirha ukuze uhlolwe ngeli xesha.
2. Unyango ngamayeza
Ingakumbi kwiintsana ezizelwe ngaphambi kwexesha , amanye amayeza (umz., i-Ibuprofen, i-Indomethacin) anikwa ngeenaliti ukuzama ukuvala le PDA. La mayeza anceda ukuba imithambo yegazi iqine kwaye ivaleke. Oku kuphumelela kuphela kwiiveki ezimbalwa zokuqala emva kokuba umntwana ezelwe.
3. Ukucoca Intliziyo
Olu asilotyando. Umntwana ufakwa i-anesthesia ngokupheleleyo, kwaye kufakwa ityhubhu encinci kakhulu (i-catheter) ngemithambo yegazi emqolo ize isiwe entliziyweni. Emva koko, isixhobo esincinci (okanye i-coil) sidluliselwa kwityhubhu kwaye umngxuma we-PDA uvalwe. Oku kudla ngokwenziwa kwiintsana ezinobunzima obuncinci ezineenyanga ezimbalwa ubudala. Inzuzo yale ndlela kukuba umntwana akufuneki abhandishwe, ukuze umntwana aphile ngokukhawuleza aze abuyele ekhaya.
4. Utyando
Kwezinye iimeko, ingakumbi kwiintsana ezingafanelekanga ukufakwa kwi-catheterization okanye ukuba i-PDA inkulu kakhulu, utyando lunokufuneka. Kwimeko enjalo, ugqirha wenza umngxuma omncinci ecaleni kwesifuba, phantsi kwekhwapha, aze awuvale nge-PDA ngezitishi okanye nge-clip encinci yesinyithi.
Kwenzeka ntoni emva konyango?
Emva konyango nokuvalwa kwe-PDA, ukuhamba kwegazi lomntwana kubuyela esiqhelweni. Iimpawu ziyaphela kancinci kancinci.
Emva konyango, ugqirha uza kukuxelela ukuba uthathe amayeza okubulala iintsholongwane kangangeenyanga ezi-6 ukuthintela usulelo lwentliziyo (endocarditis). Kubaluleke kakhulu ukuya ekliniki ngexesha kwaye ubonise umntwana.
Emva kokufumana unyango olufanelekileyo, zonke iintsana ezine-PDA ziyaqhubeka nokuphila ubomi obusempilweni nobusebenzayo ngaphandle kweengxaki. Ngoko ke ungakhathazeki ngokungeyomfuneko ngale nto.
Ixesha lokufuna ingcebiso yezonyango ngokukhawuleza
Ukuba uyazi ukuba umntwana wakho une-PDA, fowunela ugqirha wakho ngokukhawuleza ukuba kukho naziphi na iimpawu ezintsha ezibonakala (umz., ukuncipha kokusela ubisi, ubunzima bokuphefumla).
Ukuba umntwana wakho ngequbuliso uba nobunzima bokuphefumla okanye imilebe yakhe ijika ibe luhlaza okwesibhakabhaka, mse kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele esikufutshane ngaphandle kokulibazisa.
Umyalezo Wokuya Ekhaya
- I-PDA yimeko yentliziyo enyangekayo ebonwa kwiintsana ezisandul’ ukuzalwa.
- Lo mngcipheko uphezulu kwiintsana ezizelwe ngaphambi kwexesha.
- Ukuba umntwana wakho uphefumla ngokukhawuleza, ubila ngelixa encancisa, okanye akatyebi, bona ugqirha ngokukhawuleza.
- Oku kunokuxilongwa ngokuchanekileyo ngeskeni ebizwa ngokuba yi-echocardiogram (Echo).
- Kukho iindlela zonyango (amayeza, ukufakwa kwe-catheter, utyando). Emva konyango olufanelekileyo, umntwana angaphila ubomi obusempilweni ngokupheleleyo.
- Musa ukoyika oku ngokungeyomfuneko. Thetha nogqirha wakho ukuze ufumane ulwazi oluchanekileyo.
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