Kunzima ukuchaza ngamazwi indlela umama okanye utata avakalelwa ngayo xa efumanisa ukuba usana lwabo olusandul’ ukuzalwa lunengxaki enkulu yentliziyo. Kodwa namhlanje, amayeza aphucuke kakhulu. Ngamanye amaxesha, kukho unyango oluncinci kodwa olubaluleke kakhulu olunokugcina umntwana ephila de kwenziwe utyando olukhulu. Namhlanje, sithetha ngolunye unyango olunjalo olusindisa ubomi. Olu lubizwa ngokuba yi-septostomy.
Ngamafutshane, yintoni i-septostomy?
I-Septostomy yinkqubo esindisa ubomi enceda iintsana ezineziphene zentliziyo ezizelwe nazo ukuba ziphile zide zibe notyando olukhulu lokulungisa intliziyo yazo. Ikwabizwa ngokuba yi-'balloon atrial septostomy'.
Olu asilotyando lwentliziyo evulekileyo. Okwenzekayo apha kukuba ugqirha ufaka inaliti encinci eluswini lomntwana aze adlulisele ityhubhu encinci kakhulu (i-catheter) ngayo entliziyweni. Ekupheleni kwalo mbhobho kukho ibhaluni encinci. Le bhaluni isetyenziselwa ukwandisa umngxuma omncinci okhoyo ngokwemvelo entliziyweni yomntwana.
Lo mngxuma uvumela igazi elinomoya-mpilo omninzi kunye negazi elingenawo umoya-mpilo omninzi ukuba zixubane . Emva koko, igazi elithile elinomoya-mpilo omninzi lijikeleza emzimbeni womntwana. Ukuba olu nyango alwenziwanga, kuphela igazi elineoksijini ephantsi kakhulu elijikeleza emzimbeni womntwana. Oku kuyingozi kakhulu kubomi bomntwana.
Khumbula, olu asilotyando olukhulu lwentliziyo. Olu sisisombululo nje sexeshana sokugcina umntwana ekhuselekile de alungele utyando olukhulu.
Luhlobo luni losana oludinga olu nyango?
Ezinye iintsana ezinezifo zentliziyo ezizalwa nazo zinombala oluhlaza okwesibhakabhaka kulusu lwazo. Ngokwezonyango, oku kubizwa ngokuba yi-cyanosis . Oku kwenzeka kuba umzimba awufumani ioksijini eyaneleyo egazini. Oku kuthetha ukuba igazi elingenaoksijini liya ngqo emiphungeni kwaye alicocwa, kodwa endaweni yoko lihamba emzimbeni wonke. Le meko iyingozi kakhulu kwaye ifuna unyango olungxamisekileyo .
I-Sepstostomy idla ngokufuneka kakhulu kwiintsana ezinesifo sentliziyo esibizwa ngokuba yi-cyanotic heart disease. Kukho iimeko ezimbini eziphambili zentliziyo apho olu nyango lusetyenziswa kakhulu khona.
| Imeko yentliziyo | Icacisiwe ngokulula |
|---|---|
| Ukuguqulwa kwe-Dextro yemithambo emikhulu (d-TGA) | Kulapho ke imithambo yegazi emibini ephambili ekhupha igazi entliziyweni (umthambo wemiphunga kunye ne-aorta) itshintshwa khona. Kufana nemibhobho yamanzi emibini endlwini etshintshwayo. Ngenxa yoko, igazi elingenaoksijini liya emzimbeni, kwaye igazi elineoksijini eninzi libuyela emiphungeni. Oku kuthintela umzimba ekufumaneni ioksijini. |
| I-Tricuspid atresia | Kule meko, ivalvu ye-tricuspid, enoxanduva lokuhamba kwegazi ukusuka kwi-atrium yasekunene ukuya kwi-ventricle yasekunene, ayisebenzi kakuhle. Endaweni yoko, kuvela izicubu ezijiyileyo, ezithintela ngokupheleleyo ukuhamba kwegazi. Oku kuthintela igazi ekufikeleleni emiphungeni ukuze lifumane ioksijini. |
Ithini ibali lalo mngxuma mncinci obizwa ngokuba yiForamen Ovale?
Ukuze sikuqonde oku, kufuneka sibuyele umva kancinci kwixesha apho umntwana wayesesibelekweni sikanina.
Xa umntwana esesibelekweni, imiphunga yomntwana ayisebenzi. Umntwana ufumana ioksijini ayidingayo kumama ngentambo yesisu. Ngoko ke, eli gazi lifakwe ioksijini lithunyelwa ngqo emzimbeni ngaphandle kokuya emiphungeni, kwaye le foramen ovale ngumngxuma omncinci wendalo entliziyweni. Oku kufumaneka eludongeni phakathi kwamagumbi amabini aphezulu (i-atria) yentliziyo.
Emva kokuba umntwana ezelwe, imiphunga iqala ukusebenza. Emva koko, ekubeni le ndawo incinci ingasafuneki, idla ngokuzivalela yodwa.
Kutheni ke le mngxuma ibalulekile kunyango lwe-septostomy?
Kwabo bantwana banesifo sentliziyo esithethe ngabo ngaphambili, abajika babe luhlaza okwesibhakabhaka, lo mngxuma ubizwa ngokuba yi-foramen ovale ubanceda baphile iintsuku ezimbalwa emva kokuzalwa. Ngawo, igazi elithile elineoksijini eninzi lixubana negazi elingenaoksijini kwaye lingene emzimbeni.
Nangona kunjalo, xa lo mngxuma uqala ukuvala wodwa, loo mngxuma uyavaleka. Emva koko ubomi bomntwana buba yingozi kakhulu. Kulapho ke unyango lwe-septostomy luba yimfuneko. Okwenziwa ngoogqirha kukusebenzisa loo bhaluni ukwenza umngxuma kwi-foramen ovale osele uza kuvala ube mkhulu kancinci kwaye uwugcine uvulekile . Emva koko umntwana angagcinwa ephila de kwenziwe utyando olukhulu.
Ngamanye amaxesha, ukuba lo mngxuma uvalekile ngokupheleleyo, oogqirha banokusebenzisa ityhubhu ekhethekileyo eneblade ukwenza umngxuma omtsha. Kusenokuvakala kungaqhelekanga ukucinga ngokwenza umngxuma entliziyweni, kodwa kusenokuba yindlela ekuphela kwayo yokusindisa ubomi beentsana ezinje.
Lwenziwa njani olu nyango lwe-septostomy?
Olu nyango lwenziwa kwilabhoratri ekhethekileyo (ilabhoratri ye-catheterization) kwiyunithi yentliziyo yesibhedlele okanye kwiyunithi yokhathalelo olunzulu lweentsana ezisandula ukuzalwa (i-Neonatal ICU). Lwenziwa yingcali yentliziyo efumene uqeqesho olukhethekileyo ngale njongo.
1. Ukufumana uncedo: Okokuqala, ugqirha ufaka inaliti encinci kumthambo omkhulu wegazi kwindawo yemiphunga yomntwana. Ngamanye amaxesha oku kungenziwa ngentambo yosana.
2. Ukufakwa kwe-catheter: Emva koko inaliti iyasuswa, kwaye kufakwa ityhubhu encinci (i-catheter) enebhaluni ngomngxuma ukuya kwimithambo yegazi.
3. Ukuya entliziyweni: Ugqirha ukhokela ngononophelo le tube ngemithambo yegazi ukuya entliziyweni ngelixa ebukele imifanekiso kwi-echocardiogram .
4. Ukwandiswa komngxuma: Nje ukuba umngxuma ube kwi-atrium yasekunene yentliziyo, udlula kwi-foramen ovale uye kwi-atrium yasekhohlo. Emva koko, ibhaluni ekupheleni komngxuma iyavuthelwa ize itsalwe ibuyele kwicala lasekunene. Oku kutsalwa kwandisa umngxuma omncinci.
5. Ukuphela konyango: Wakuba umngxuma umkhulu ngokwaneleyo, ibhaluni iyavuthuluka kwaye ityhubhu isuswe ngononophelo.
Lonke eli xesha lenziwa ngelixa umntwana enikwa i-anesthesia kunye ne-painkillers ezifunekayo, kwaye ejongwa ngononophelo umntwana.
Oogqirha bagqiba njani ukuba unyango luphumelele?
Oogqirha bajonga izinto ezininzi ukuze babone ukuba unyango luphumelele na.
- Bajonga ukuba inqanaba leoksijini egazini lomntwana linyukile ubuncinane nge-10% .
- Bayajonga ukuba umngxuma owenziwe entliziyweni ukhule ngama-33% ubuncinane kunangaphambili.
- Sijonga ukuba kukho umahluko omkhulu na kuxinzelelo lwegazi phakathi kwe-atriums yentliziyo yasekunene neyasekhohlo.
Ukuba enye okanye ezingaphezulu kwezi zinto ziyafezekiswa, unyango luthathwa njengoluphumeleleyo.
Zithini iingenelo kunye neengozi zoku?
Iingenelo
Eyona nzuzo inkulu yolu nyango kukuba lunokusindisa ubomi bomntwana . Umntwana ongenayo ioksijini ngenxa yesifo sentliziyo unokunikwa ioksijini ngokukhawuleza aze anikwe ithuba lokuphila de kufike utyando olukhulu.
Iingozi
Njengakwezinye iindlela zonyango, kukho iingozi. Naluphi na unyango lweentsana ezinesifo sentliziyo esinzulu luneengozi. Ezinye izifundo zibonise ukuba olu nyango lunokubangela isifo sohlangothi. Nangona kunjalo, akukacaci ukuba oku kungenxa yonyango ngokwalo okanye kukungabikho komoya-mpilo emzimbeni ngenxa yesifo sentliziyo.
Kodwa eyona nto ibalulekileyo kukuba iingozi zokunganyangi esi sifo ziphezulu kakhulu kuneengozi zokusinyanga. Ngaphandle konyango, umntwana onesifo esifana ne-d-TGA unethuba eliphantsi lokusinda iveki, malunga ne-30%.
Liza kuba njani ikamva lomntwana emva konyango?
Kuphela yi-94% yeentsana ezisebenzisa i-septostomy ezisindayo . Emva koko kufuneka zenziwe utyando olukhulu ukuze kulungiswe imeko yentliziyo yazo.
Umzekelo, iintsana ezine-d-TGA zenza utyando olubizwa ngokuba yi-Arterial Switch Operation (ASO) emva nje kokuzalwa. Oku kuquka ukusika imithambo yegazi emibini etshintshiweyo kunye nokuyidibanisa kwakhona ngokufanelekileyo. Phakathi kwama-97% nama-98% eentsana ziyaphila kakuhle emva kolu tyando.
Emva kotyando olukhulu olunje, umntwana wakho uya kufuna unyango oluqhubekayo. Oku kuthetha ukubona ugqirha wakho rhoqo, ukufumana uvavanyo, kunye nokumnyamekela kakuhle umntwana wakho. Ekubeni umntwana ngamnye wahlukile, ugqirha wakho unokukunika ulwazi olungcono malunga nekamva lomntwana wakho.
Izinto ekufuneka uzazi njengomzali
Kuqhelekile ukuziva usoyika, ukhathazekile, kwaye unemibuzo emininzi xa ufumanisa ukuba umntwana wakho unesifo esinzulu. Kunzima kakhulu ukuba kude nomntwana wakho ngelixa esesibhedlele. Abasebenzi bezonyango bayayiqonda indlela ovakalelwa ngayo.
- Musa ukoyika ukubuza imibuzo: Buza ugqirha okanye abasebenzi bomongikazi nayiphi na imibuzo onayo malunga namayeza anikwa umntwana wakho, unyango, okanye okuza kwenzeka emva koko. Ukuba awuqondi, bacele ukuba bakuchazele kwakhona ngokulula.
- Funa inkxaso: Ukuthetha nabanye abazali abaye baba namava afanayo kunokuba ngumthombo omkhulu wokhuthazo. Buza ugqirha wakho malunga namaqela enkxaso.
Ezi ntlobo zezifo zentliziyo zisenokungaqhelekanga, kodwa awuwedwa. I-septostomy inokuba linyathelo lokuqala nelibalulekileyo ebomini bomntwana wakho. Ngonyango olufanelekileyo kunye nothando lwakho kunye nenkathalo, unokuqiniseka ukuba umntwana wakho uza kuba nekamva elisempilweni.
Umyalezo Wokuya Ekhaya
- I-Septostomy ayilotyando lwentliziyo evulekileyo. Lunyango lwexeshana olwenziwa ngaphambi kotyando olukhulu ukusindisa ubomi beentsana ezineengxaki zentliziyo ezinzulu.
- Oku kubandakanya ukwandisa umngxuma wendalo entliziyweni (i-foramen ovale), ukuvumela ukuba igazi elinomoya-mpilo omninzi nelinomoya-mpilo omninzi lixubane.
- Olu nyango lusetyenziswa kakhulu kwiimeko zentliziyo ezine-cyanotic ezifana ne-d-TGA kunye ne-tricuspid atresia.
- Unyango lusebenza kakhulu, kwaye iingozi ziphantsi kakhulu. Iingozi zokunganyangi ziphezulu kakhulu.
- Njengomzali, ungoyiki ukubuza abasebenzi bezonyango ngayo nantoni na ongayiqondiyo. Basoloko bekulungele ukukunceda.
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