Akukho nto ivuyisa ngaphezu kokubukela usana olusandul’ ukuzalwa. Kodwa ngamanye amaxesha, xa loo mntwana eqala ukukhala ngelixa encanca ubisi, aze ngequbuliso atshintshe abe luhlaza okwesibhakabhaka, wonke umama notata bayoyika. Namhlanje siza kuthetha ngemeko engaqhelekanga kodwa enzulu yentliziyo ekhoyo ekuzalweni, ebonisa iimpawu ezinjalo. Kwizonyango, sibiza le Pulmonary Atresia . Musa ukoyika xa usiva eli gama. Ngonyango oluphambili olufumanekayo namhlanje, le meko inokusingathwa ngempumelelo. Masiqonde oku kwasekuqaleni.
Ngamafutshane, yintoni i-Pulmonary Atresia?
Ukuze siqonde oku, masiqale sikhumbule indlela esebenza ngayo intliziyo yethu. Intliziyo yethu ineegumbi ezine eziphambili. Igumbi elisezantsi ngasekunene (i-ventricle yasekunene) limpompa igazi elingcolileyo nelingenawo umoya-mpilo ukuya emiphungeni ukuze lithathe umoya-mpilo. Umthambo wegazi oyintloko othwala eli gazi ukuya emiphungeni yi-pulmonary artery.
Khawucinge nje, kukho inxalenye efana nesango phakathi kwe-ventricle yasekunene yentliziyo kunye nalo mthambo wemiphunga. Oku sikubiza ngokuba yivalvu yemiphunga. Le valve iyavuleka ize ivalwe ukuze ithumele igazi emiphungeni.
I-pulmonary atresia yimeko apho ivalvu yemiphunga ingaphuhli kakuhle ngelixa umntwana ekhula esibelekweni. Ngamanye amaxesha, le valve inokugqunywa ngokupheleleyo yi-membrane etyebileyo. Oku kuthetha ukuba indlela ephambili yokuhamba kwegazi ukusuka kwi-ventricle yasekunene ukuya emiphungeni ivalwe ngokupheleleyo.
Kuza kwenzeka ntoni ke ngoko? Igazi alikwazi ukuya emiphungeni ukuze lifumane ioksijini. Ngenxa yoko, igazi eliluhlaza okwesibhakabhaka elingenayo ioksijini lijikeleza emzimbeni wonke. Esi sesona sizathu siphambili sokuba imilebe yomntwana, iiminwe yakhe, kwaye ngamanye amaxesha umzimba wonke ubonakale uluhlaza okwesibhakabhaka. Le meko siyibiza ngokuba yi-cyanosis.
"Iindlela ezizezinye" zentliziyo kunye neendlela ezahlukeneyo zesi sifo
Xa le ndlela iphambili ivaliwe, imiphunga kufuneka ifumane igazi ukuze iphile. Ngethamsanqa, ezinye iindlela "zexeshana" entliziyweni ngexesha lokukhulelwa zisebenza njengokusindisa ubomi ngeli xesha.
- I-Foramen Ovale: Umngxuma omncinci phakathi kwamagumbi amabini aphezulu entliziyo. Oku kuvumela igazi elingenaoksijini ukuba lihambe ukusuka kwicala lasekunene ukuya ekhohlo.
- I-Ductus Arteriosus: Unxibelelwano oluncinci phakathi komthambo oyintloko othwala igazi emzimbeni (i-aorta) kunye nomthambo othwala igazi emiphungeni (umthambo wepulmonary). Ngale nto, inani elincinci legazi elivela emzimbeni libuyela emiphungeni.
Kuqhelekile ukuba ezi ndlela zokungena zexeshana zivaleke kwiintsuku ezimbalwa emva kokuzalwa. Nangona kunjalo, umntwana one-Pulmonary Atresia unokuphila kuphela logama nje ezi ndlela zihlala zivulekile. Ngoko ke, kwangoko nje umntwana ezelwe, oogqirha baya kunika umntwana amayeza okugcina ezi ndlela zokungena (ingakumbi i-Ductus Arteriosus) zivulekile.
Sinokuyibona imeko ye-Pulmonary Atresia ngeendlela ezimbini eziphambili.
1. I-Pulmonary Atresia ene-Intact Ventricular Septum (IVS): Apha, udonga oluphakathi kwamagumbi amabini asezantsi entliziyo (septum) lugqityiwe. Akukho mingxunya. Nangona kunjalo, ngenxa yoku, i-ventricle yasekunene ayinandawo yokupompa igazi, kwaye idla ngokungaphuhli kakuhle kwaye incinci.
2. I-Pulmonary Atresia ene-Ventricular Septal Defect (VSD): Apha, ukongeza kwivalvu yepulmonary evalekileyo, kukho umngxuma eludongeni phakathi kwamagumbi amabini asezantsi entliziyo (Ventricular Septal Defect - VSD). Lo mngxuma uvumela igazi ukuba liphume kwigumbi lasekunene liye ekhohlo, ngoko igumbi lasekunene linokuba likhulu kancinci kunesiqhelo.
Iindlela zonyango zimiselwa ngokusekelwe ekubeni loluphi uhlobo lwezi ntlobo zimbini umntwana analo.
Ziziphi iimpawu abazali abanokuzijonga?
Ezi mpawu zihlala zibonakala kwiiyure zokuqala okanye kwiintsuku emva kokuba umntwana ezelwe. Nangona oogqirha beyiqwalasela kakhulu le nto esibhedlele, kubalulekile ukuba uyiqaphele emva kokuba ufikile ekhaya.
| Uphawu | Ithetha ntoni le nto? |
|---|---|
| Ukutshintsha kombala oluhlaza okwesibhakabhaka komzimba (iCyanosis) | Imilebe, ulwimi, iiminwe, nangaphantsi kwezinzipho zijika zibe luhlaza okwesibhakabhaka okanye zibe mfusa. Oku kunokwanda xa umntwana ekhala okanye esela ubisi. Oku kungenxa yokunqongophala kweoksijini egazini. |
| Ukuphefumla ngokukhawuleza okanye okunzima | Nokuba umntwana uhleli nje, uphefumla ngokukhawuleza kakhulu, isifuba sakhe sibonakala ngathi siya ngaphakathi, aze aphefumle. Olu luvavanyo lokufumana ioksijini efunekayo emzimbeni wakhe. |
| Ukuhluza ngelixa usela ubisi | Ufunxa ubisi, alutshice, ayeke, aze aphinde alufunxe. Ngamanye amaxesha uyalala ngelixa esela. Kunzima ukusela rhoqo njengomntwana oqhelekileyo. |
| Ukozela okungaqhelekanga kunye nokudinwa | Usana luhlala lulele. Alunamdla wokudlala okanye wokushukumisa amalungu alo. Luziva lungenabomi. |
| Ulusu olubandayo, oluthambileyo | Izandla neenyawo zomntwana zisenokuvakala zibanda xa uzichukumisa. Ngamanye amaxesha zinokuba nemvakalelo yokuncamathela nokubila. |
Kutheni oku kwenzeke kumntwana wam? Zithini izinto ezibangela umngcipheko?
Lo mbuzo ufika engqondweni yomzali ngamnye. "Ngaba ndenze into engalunganga?" Usenokuzibuza. Okokuqala, isizathu esichanekileyo soku asikaziwa okwangoku. Asikuko ukuba unetyala. Kubangelwa kukungasebenzi kakuhle kwenkqubo enzima kakhulu eyenzeka xa intliziyo yomntwana isenziwa kwiiveki ezisi-8 zokuqala zokukhulelwa.
Nangona kunjalo, kukho izinto ezininzi eziye zachongwa eziyandisa kancinci amathuba, okanye umngcipheko, wokuba le meko iqhubeke.
- Izinto ezibangela ufuzo: Umngcipheko uphezulu kancinci ukuba umntu kusapho (umama, utata) unesifo sentliziyo esizalwa naso. Sinokunxulunyaniswa neemeko ezithile zofuzo, ezifana ne-DiGeorge's syndrome.
- Impilo kamama ngexesha lokukhulelwa: Umama wayenesifo seswekile esingalawulekiyo ngexesha lokukhulelwa.
- Amayeza athile athathwa ngexesha lokukhulelwa: Ukusetyenziswa kwamayeza athile kunokuba nemiphumo emibi kwimveku engekazalwa (i-teratogenic). Yiyo loo nto kucetyiswa ukuba ungasebenzisi naliphi na iyeza ngexesha lokukhulelwa ngaphandle kwengcebiso kagqirha.
- Ukutshaya: Ukutshaya kukamama ngexesha okanye ngaphambi kokukhulelwa.
- Ubudala bomama: Umngcipheko wezi ntlobo zeziphene zokuzalwa unokwanda kancinci njengoko ubudala bomama bukhula.
Into ebalulekileyo kukuba ayinguye wonke umntu oneengozi eziya kuba nale meko. Kwakhona, nomntu ongenazo ezi ngozi unokuba nale meko.
Oogqirha bayifumana njani le nto?
Ngobuchwepheshe bangoku, le meko ngamanye amaxesha inokufunyanwa ngaphambi kokuba umntwana azalwe, oko kukuthi, ngexesha lokukhulelwa .
- Ngexesha lokukhulelwa: Ukuba i-ultrasound scan eqhelekileyo ibonisa naziphi na iingxaki entliziyweni yomntwana wakho, ugqirha wakho unokukuthumela kwi-scan ekhethekileyo ebizwa ngokuba yi-fetal echocardiogram . Oku kukuvumela ukuba ubone ulwakhiwo kunye nomsebenzi wentliziyo yomntwana wakho ngokucacileyo.
Emva kokuba umntwana ezelwe, ukuba ugqirha uva ukurhawuzelela kwentliziyo okungaqhelekanga okanye ubona umbala oluhlaza okwesibhakabhaka (i-cyanosis) ngelixa ehlola umntwana, baya kwenza iimvavanyo ezininzi ukuqinisekisa le meko.
- I-Pulse Oximetry: Olu luvavanyo olulula kakhulu, olungenabuhlungu. Isixhobo esincinci esifana ne-clip sincamathiselwa kubhontsi omkhulu womntwana kwaye silinganisa inqanaba le-oksijini egazini. Ukuba inqanaba le-oksijini liphantsi, luphawu lwengxaki yentliziyo.
- I-X-reyi yesifuba: I-X-reyi yesifuba inokunika umbono ocacileyo wobukhulu, imilo, kunye nokuhamba kwegazi emiphungeni.
- I-Electrocardiogram (ECG/EKG): Uvavanyo olurekhoda umsebenzi wombane wentliziyo. Oku kunokujonga naluphi na uxinzelelo kwimisipha yentliziyo kunye naluphi na utshintsho kwisingqisho sentliziyo.
- I-Echocardiogram (i-'Echo' scan): Olu lolona vavanyo lubalulekileyo nolukhethekileyo. Lufana ne-ultrasound scan. Lubona ngokucacileyo yonke into esentliziyweni, kuquka amagumbi, iivalvu, imithambo yegazi, kunye nendlela igazi elihamba ngayo. I-Pulmonary Atresia ifunyaniswa ngokuchanekileyo ngolu vavanyo.
Ziziphi iindlela zonyango zomntwana?
Nangona le meko ingenakunyangwa ngokupheleleyo, utyando kunye nezinye iindlela zonyango zinokuphucula kakhulu ukuhamba kwegazi entliziyweni yomntwana, okumenza aphile ubomi obuqhelekileyo. Isicwangciso sonyango siyahluka kumntwana ngamnye.
Inyathelo Lokuqala: Ukuzinzisa Umntwana
Kwangoko nje umntwana ezelwe, injongo yokuqala kukugcina umthambo wegazi osindisa ubomi obizwa ngokuba yiDuctus Arteriosus uvulekile kwaye uthintelwe ukuba ungavaleki.
- Amayeza: Iyeza elibizwa ngokuba yi -alprostadil linikwa rhoqo ngomthambo (IV). Oku kugcina umthambo wegazi wexeshana ungavaleki. Oku kudala indlela eyongezelelweyo yokuba igazi lihambe liye emiphungeni.
- Ezinye iindlela: Ngamanye amaxesha, iingcali zentliziyo zisebenzisa ityhubhu encinci kakhulu (i-catheter) edlula kwimithambo yegazi emlenzeni iye entliziyweni ize ibeke isiqwenga esincinci esifana ne-mesh (i-stent) ngaphakathi kwi-Ductus Arteriosus ukuze ihlale ivulekile.
Inyathelo lesiBini: Inkqubo yotyando
Amaxesha amaninzi, umntwana one-Pulmonary Atresia kuya kufuneka enze utyando oluninzi kwiminyaka embalwa yokuqala yobomi bakhe. Olu tyando alunakwenziwa ngaxeshanye, kodwa lwenziwa ngamanqanaba njengoko umntwana ekhula.
Olu luhlu lweenkqubo zotyando lufana nokudala "umbhobho" omtsha ngokupheleleyo wokuhamba kwegazi entliziyweni. Konke oku kugqitywa liqela leengcali zentliziyo kunye noogqirha abanyanga umntwana wakho.
Iinkqubo ezintathu zotyando ezidla ngokwenziwa zezi:
1. I-BTT Shunt (Utyando lokuqala - kwiiveki ezimbalwa zokuqala): Oku kuquka ukudibanisa ityhubhu encinci yokwenziwa (i-shunt) phakathi kwesebe lomthambo wegazi oyintloko othwala igazi emzimbeni kunye nomthambo othwala igazi emiphungeni. Oku kubonelela ngokunikezelwa kwegazi okuzinzileyo emiphungeni.
2.Inkqubo kaGlenn (utyando lwesibini - malunga neenyanga ezi-4-8): Xa umntwana ekhulile kancinci, i-shunt ebekiweyo ngaphambili iyasuswa. Emva koko, igazi elingenaoksijini eliphuma emzimbeni ongaphezulu liqhagamshelwe ngqo kumthambo wemiphunga. Oku kunciphisa kakhulu umthwalo womsebenzi entliziyweni.
3. Inkqubo yeFontan (utyando lwesithathu nolokugqibela - malunga neminyaka emi-2-4 ubudala): Kule meko, igazi elingenaoksijini elivela emzimbeni ongezantsi liqhagamshelwe ngqo kumthambo wemiphunga. Emva kolu tyando, ukuhamba kwegazi kulungiswa ukuze lonke igazi elingenaoksijini elivela emzimbeni liye ngqo emiphungeni, endaweni yokuya kwicala lasekunene lentliziyo.
Emva kolu tyando, umntwana kuya kufuneka ahlale esibhedlele, kwicandelo labagula kakhulu (ICU), kangangeveki enye okanye ezimbini.
Ubomi emva kotyando bunjani?
Emva kolu ngcelele lotyando, umntwana uya kukwazi ukuya esikolweni aze adlale ngendlela eqhelekileyo. Nangona kunjalo, le yimeko efuna ulwalathiso lwezonyango ubomi bakhe bonke.
- Ukuhlolwa rhoqo kwezonyango: Kufuneka uye rhoqo kwintlanganiso yokulandelela kunye nogqirha wentliziyo. Kuya kufuneka wenze iimvavanyo ezifana ne-echo scan kunye ne-ECG ubuncinane kanye ngonyaka.
- Iingxaki: Ekuhambeni kwexesha, kukho umngcipheko weengxaki ezifana nokungasebenzi kakuhle kwentliziyo, iingxaki zesibindi, kunye nokusilela kwentliziyo. Yiyo loo nto kubalulekile ukutyelela rhoqo.
- Ukukhusela kwiintsholongwane: Aba bantwana basengozini enkulu yokuba ne-endocarditis, usulelo lwentliziyo. Ngoko ke, kufuneka ubuze ugqirha wakho ukuba kufuneka uthathe amayeza okubulala iintsholongwane ukuthintela usulelo ngaphambi kweenkqubo ezithile zonyango, ezifana nokukhupha amazinyo.
- Imisebenzi: Kufuneka uthethe nogqirha wakho uze ugqibe ukuba yeyiphi imithambo kunye nemidlalo umntwana wakho anokuyenza nangenakuyenza.
Amazwi awanakuchaza intlungu, uloyiko, kunye nokothuka okuzivayo xa ufumanisa ukuba umntwana wakho unale meko. Kodwa khumbula, awuwedwa. Iqela elikhulu loogqirha kunye nabahlengikazi abanezakhono bazinikele ekuboneleleni ngononophelo olungcono kumntwana wakho. Thetha nogqirha wakho ngayo nayiphi na imibuzo okanye iinkxalabo onokuba nazo.
Umyalezo Wokuya Ekhaya
- I-pulmonary atresia sisifo sentliziyo esibi kakhulu esizalwa naso apho ivalvu ethwala igazi ukuya emiphungeni ivalekile.
- Iimpawu eziphambili kukutshintsha kombala oluhlaza okwesibhakabhaka emzimbeni womntwana, imilebe, kunye neminwe (i-cyanosis), ukukrwitshwa ngelixa encancisa, kunye nobunzima bokuphefumla.
- Le yimeko ebulalayo ukuba ayinyangwa. Nangona kunjalo, ngokuqhubela phambili kwezonyango zanamhlanje, uthotho lweenkqubo zotyando lunokunika umntwana ubomi obungcono.
- Aba bantwana ubomi babo bonkeUkuhlolwa ngugqirha wentliziyo kunye nokuhlolwa rhoqo kwezonyango kubalulekile.
- Njengabazali, ningoyiki ukubuza ugqirha wenu imibuzo, nicacise amathandabuzo, kwaye nibe nolwazi olupheleleyo malunga nesicwangciso sonyango.
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