Uvuyo lokuzisa usana olusandul’ ukuzalwa ekhaya alunakuchazwa, akunjalo? Kodwa ngamanye amaxesha, kunye nolo vuyo, kukho amaxesha apho uloyiko oluncinci lufika engqondweni. Nabani na umama okanye utata angaxhalaba ukuba ubona ukuba imilebe kunye neminwe yomntwana wakhe iluhlaza okwesibhakabhaka. Ukuba babona into efana nale, isenokuba ibangelwa yimeko yentliziyo yokuzalwa. Namhlanje sithetha nge- Pulmonary Atresia , imeko yentliziyo enzima kodwa enyangekayo.
Ngamafutshane, yintoni i-Pulmonary Atresia?
Oku kusenokuvakala kuyinkimbinkimbi kancinci, kodwa masikwenze kube lula. Intliziyo yethu ifana nendlu encinci enamagumbi amane. Umsebenzi ophambili wamagumbi amabini kwicala lasekunene lale ndlu (i-atrium yasekunene kunye ne-ventricle) kukuqokelela igazi "elingcolileyo" eliphelelwe yioksijini njengoko lihamba emzimbeni wonke, lize lithunyelwe emiphungeni ukuze licocwe.
Igazi lithunyelwa emiphungeni ngomthambo omkhulu wegazi obizwa ngokuba yiPulmonary Artery . Ekuqaleni kwalo mthambo wegazi, kukho ivalvu esebenza njengomnyango. Siyibiza ngokuba yiPulmonary Valve . Xa lo mnyango uvula, igazi lingena emiphungeni.
Khawucinge nje, kwenzeka ntoni ukuba olu cango, ivalvu yemiphunga, alwenziwanga xa luzalwa, okanye ukuba luvalwe ngokupheleleyo? Leyo yimeko esiyibiza ngokuba yiPulmonary Atresia .
Ngamafutshane, kule meko, isango eliphambili elithumela igazi elineoksijini lisuka entliziyweni liye emiphungeni livalekile kwasekuzalweni. Ngenxa yoko, igazi elinombala oluhlaza okwesibhakabhaka, elingenaoksijini, lijikeleza emzimbeni wonke.
Le yimeko engaqhelekanga kakhulu. Kwanakwilizwe elifana neMelika, ngumntwana omnye kuphela kwiintsana ezingama-6,700 ezizalwayo onayo le meko.
Ezinye iziphene zentliziyo ezinokubonwa xa kukho le meko
Umntwana one-pulmonary atresia unokuba nezinye iingxaki ezininzi zentliziyo ukongeza kwesi siphene siphambili.
- Icala lasekunene lentliziyo elingaphuhli kakuhle: I-ventricle yasekunene, epompa igazi ukuya emiphungeni, kunye nevalvu ye-tricuspid engaphezulu kwayo isenokungaphuhli kakuhle kwaye ibe ncinci.
- Umngxuma entliziyweni: Ngokwesiqhelo, umntwana uba nomngxuma omncinci (iForamen Ovale) phakathi kwamagumbi amabini aphezulu (i-atria) yentliziyo xa esesibelekweni. Oku kuyavaleka emva kokuzalwa. Nangona kunjalo, kwabanye abantwana, umngxuma usenokuhlala uvulekile. Kwakhona, kunokubakho umngxuma eludongeni phakathi kwamagumbi amabini asezantsi (ii-ventricles) entliziyo (i-Ventricular Septal Defect - VSD). Lo mngxuma uvumela igazi elinamaqondo aphantsi eoksijini ukuba lixubane negazi elinamaqondo aphezulu eoksijini.
Uyazi njani ukuba umntwana wakho unale meko? Iimpawu
Iimpawu ze-Pulmonary Atresia zihlala ziqala ukubonakala kwiiyure ezimbalwa zokuqala okanye kwiintsuku emva kokuzalwa. Uphawu oluphambili noluqondakala lula zezi:Imeko ebizwa ngokuba yi -cyanosis .
Oku kuthetha ukuba imilebe yomntwana, iiminwe yakhe, kunye neenzwane zakhe zibonakala ziluhlaza okwesibhakabhaka ngenxa yokunqongophala kweoksijini egazini. Lo mbala uluhlaza okwesibhakabhaka yingakho abanye abantu bebiza le meko ngokuthi "i-blue baby syndrome."
| Uphawu | Inkcazo |
|---|---|
| Ulusu oluluhlaza okwesibhakabhaka (iCyanosis) | Umbala oluhlaza okwesibhakabhaka okanye omfusa wemilebe, iiminwe, naphantsi kwezinzipho. |
| Ubunzima bokuphefumla | Ukuphefumla ngokukhawuleza, ukuphefumla okunzima (i-Dyspnea). |
| Ukudinwa okungaqhelekanga | Usana alunawo namandla okuncancisa, kwaye luhlala lulele. |
| Ubunzima bokusela ubisi | Ukwala ukusela ubisi kuba kukwenza ube nesiyezi nasemva kokusela kancinci. |
| Ulusu olubandayo, oluthambileyo | Xa uchukumisa amalungu omntwana, aziva ebanda kwaye enamathela, njengokubila. |
| Ukukhala rhoqo/ukungazoli | Usana alukhululekanga kwaye luhlala lukhala ngaphandle kwesizathu. |
Kutheni oku kusenzeka? Izizathu kunye nezinto ezibangela umngcipheko
Isizathu esichanekileyo sale meko asikaziwa okwangoku . Esi siphene sentliziyo senzeka kwiiveki ezisi-8 zokuqala zokukhula komntwana esibelekweni. Nangona kunjalo, kuye kwafunyaniswa ukuba kukho izinto ezithile ezonyusa umngcipheko.
- Izinto ezibangela ufuzo: Umngcipheko uphezulu ukuba umntu kusapho unesifo sentliziyo sokuzalwa okanye izifo ezithile ezibangelwa lufuzo (umz. isifo sikaDiGeorge).
- Impilo kamama ngexesha lokukhulelwa:
- Ukutshaya ngexesha lokukhulelwa.
- Isifo seswekile asilawulwa kakuhle.
- Ukusetyenziswa kwamayeza athile (amayeza e-teratogenic) angafanelekanga ukusetyenziswa ngexesha lokukhulelwa.
- Izinto ezibangela abazali:
- Ukuba nesifo sentliziyo sokuzalwa komnye wabazali.
- Ubudala obuphezulu bomama.
Oogqirha bayixilonga njani ngokuchanekileyo le sifo?
Kwiimeko ezininzi, ezi meko zinokubonwa ngaphambi kokuba umntwana azalwe, oko kukuthi, ngokusebenzisa iiskeni ezenziwa ngexesha lokukhulelwa.
- Ngexesha lokukhulelwa: Ukuba ugqirha unamathandabuzo malunga nentliziyo yomntwana ngexesha lokuskena rhoqo (i-ultrasound), uza kukuthumela kwiskena esikhethekileyo esibizwa ngokuba yi-fetal echocardiogram . Oku kuvumela ukuba umsebenzi wentliziyo yomntwana kunye nolwakhiwo lwayo lubonakale ngokucacileyo.
- Emva kokuba umntwana ezelwe: Ukuba ugqirha uva isandi esingaqhelekanga (ukurhawuzelela kwentliziyo) xa emamele intliziyo yomntwana, okanye ukuba umntwana uluhlaza okwesibhakabhaka, esi sifo siyakrokrelwa. Emva koko, kwenziwa uvavanyo oluninzi ukuqinisekisa isifo.
| Uvavanyo | Yintoni le iyenzayo? |
|---|---|
| I-Pulse Oximetry | Isixhobo esincinci esifana nekliphu sincamathiselwe kubhontsi omkhulu womntwana kwaye silinganisa ubungakanani beoksijini egazini. |
| I-X-reyi yesifuba | Inika umbono ocacileyo ngobukhulu, imilo, kunye nendlela igazi elihamba ngayo ukuya emiphungeni. |
| I-Electrocardiogram (ECG) | Umsebenzi wombane wentliziyo ulinganiswa ukuze kubonwe ukuba kukho uxinzelelo kwimisipha yentliziyo okanye ukuba kukho isigqi esingaqhelekanga. |
| I-Echocardiogram (I-Echo) | Olu lolona vavanyo lubalulekileyo . Lufana nokuskena intliziyo. Ulwakhiwo lwentliziyo, umsebenzi weevalvu, indlela igazi elihamba ngayo, kunye nokuba kukho imingxunya na kunokubonakala ngokucacileyo. |
Zithini iindlela zonyango zoku?
I-Pulmonary Atresia kufuneka inyangwe kwangoko nje ukuba ifunyaniswe. Ayinakuphiliswa ngokupheleleyo ngamayeza. Nangona kunjalo, amayeza kunye nezinye iindlela zisetyenziswa ukusindisa ubomi bomntwana kunye nokuzinzisa imeko de alungele utyando. Isisombululo sokugqibela kukwenza uthotho lweenkqubo zotyando .
1. Unyango olukhawulezileyo (amayeza kunye neenkqubo)
- Unyango: Emva kokuba umntwana ezelwe, kukho umthambo wegazi okhethekileyo (i-Ductus Arteriosus) odla ngokuvaleka. Iyeza elibizwa ngokuba yi -Alprostadil linikwa ngomthambo wegazi (IV) ukugcina lo mthambo wegazi uvulekile. Xa lo mthambo wegazi uvulekile, elinye igazi elingenawo umoya-mpilo lingaya emiphungeni ukuze lifumane umoya-mpilo. Esi sisisombululo sexeshana.
- Iinkqubo: Ngamanye amaxesha, kufakwa i- stent ukugcina umthambo wegazi uvulekile. Okanye kwenziwe i-septostomy ukwandisa umngxuma phakathi kwamagumbi amabini aphezulu entliziyo. Oku kwenziwa ukuphucula ukuhamba kwegazi kancinci.
2. Utyando (utyando)
Uhlobo lotyando umntwana aludingayo luxhomekeke ekukhuleni kwecala lasekunene lentliziyo yakhe nokuba kukho imingxunya entliziyweni okanye hayi.
Into ebalulekileyo kukuba olu tyando alunyangi ngokupheleleyo esi sifo. Endaweni yoko, lubuyisela ukusebenza kwentliziyo kangangoko kunokwenzeka, nto leyo evumela umntwana ukuba aphile ubomi obuqhelekileyo.
Abantwana abaninzi badlula kuthotho lwezigaba ezintathu zotyando lwentliziyo evulekileyo , ezenziwa kwiminyaka embalwa yokuqala yobomi bomntwana.
1. Utyando lokuqala (BTT Shunt): Oku kudla ngokwenziwa kwiintsuku ezimbalwa zokuqala emva kokuba umntwana ezelwe. Apha, ityhubhu encinci yokwenziwa (i-shunt) iqhagamshelwe kwisebe lomthambo oyintloko ohambisa igazi emzimbeni, ongulo mthambo othwala igazi ukuya emiphungeni. Oku kudala indlela entsha yokuba igazi lihambe liye emiphungeni.
2. Utyando lwesibini (iNkqubo kaGlenn): Olu tyando lwenziwa xa umntwana ephakathi kweenyanga ezi-4 nezi-8 ubudala . Apha, ityhubhu efakwe ngaphambili iyasuswa kwaye igazi elingenaoksijini emzimbeni ongaphezulu liqhagamshelwe ngqo emiphungeni.
3. Utyando lwesithathu (Inkqubo yeFontan): Eli linqanaba lokugqibela lolu luhlu lotyando. Umntwana uphakathi kweminyaka emi-2 ne-4 ubudala.Oku kwenziwa phakathi. Apha, igazi elingenaoksijini eliphuma kwinxalenye esezantsi yomzimba nalo lithunyelwa ngqo emiphungeni.
Nje ukuba olu tyando luthathu lugqityiwe, lonke igazi elingenaoksijini emzimbeni liya kuya ngqo emiphungeni ukuze lifumane ioksijini, endaweni yokuya kwicala lasekunene lentliziyo.
Kwenzeka ntoni emva kotyando?
Ngenxa yokuba olu lutyando olukhulu, umntwana kuya kufuneka ahlale esibhedlele, kwigumbi lokhathalelo olunzulu (ICU), kangangeveki okanye ezimbini. Baza kufuna izinto ezifana ne-ventilator ebanceda baphefumle, iimonitha zokujonga ukusebenza kwentliziyo yabo, kunye neepilisi zokudambisa iintlungu.
Abanye abantwana basenokungakwazi ukuncancisa emva kotyando. Kwiimeko ezinjalo, ubisi lunikwa ngetyhubhu ye-nasogastric. Kwanasemva kokuba ubuyele ekhaya, kufuneka uqaphele ubunzima bomntwana wakho kunye nokukhula kwakhe.
Eyona nto ibalulekileyo kukuba lo mntwana kuya kufuneka abe phantsi kweliso likagqirha wentliziyo ubomi bakhe bonke . Kubalulekile ukuya kwiikliniki ukuze ahlolwe ngamaxesha amiselweyo.
Njengoko ukhula, unokufuna utyando olongezelelweyo okanye olunye unyango. Kwakhona, ukuvavanywa rhoqo ngugqirha kubaluleke kakhulu kuba kukho umngcipheko weengxaki ezifana nokungasebenzi kakuhle kwentliziyo kunye nokungaphumeleli kwentliziyo.
Umyalezo Wokuya Ekhaya
- I-pulmonary atresia sisifo sentliziyo esibi kakhulu esizalwa naso apho ivalvu ethwala igazi esuka entliziyweni ukuya emiphungeni ivaleka khona.
- Uphawu oluphambili kukutshintsha kombala oluhlaza okwesibhakabhaka kwemilebe kunye neminwe yomntwana (i-cyanosis). Ubunzima bokuphefumla kunye nokungafuni ukusela ubisi nako kunokubonakala.
- Le meko ingafunyanwa nge-scan ngexesha lokukhulelwa okanye kwangoko emva kokuba umntwana ezelwe.
- Olu nyango luluhlu lweenkqubo zotyando lwentliziyo oluvulelekileyo olwenziwa ngamanqanaba. Nangona ezi zinganyangeki esi sifo, zinika umntwana ithuba lokuphila ubomi obulungileyo.
- Aba bantwana bafuna ukujongwa ubomi babo bonke kunye nokulandelwa ngugqirha wentliziyo.
- Ukuba umntwana wakho unezi mpawu, musa ukoyika kwaye ubone ugqirha ngokukhawuleza. Ukuxilongwa ngokukhawuleza kunye nonyango kubalulekile ekusindiseni ubomi bomntwana.
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