Ngaba umntwana wakho omncinci unale ngxaki zine zentliziyo ezintsonkothileyo? (Tetralogy of Fallot) - Masithethe ngale nto!

I-Tetralogy of Fallot, okanye i-ToF ngamafutshane, yimeko apho iingxaki ezine zenzeka kunye entliziyweni yomntwana wakho ekuzalweni. Ezi ngxaki zenza kube nzima entliziyweni yomntwana ukupompa igazi elaneleyo elineoksijini emzimbeni wonke. Uyazi ukuba ioksijini ibaluleke kangakanani ukuba yonke into emizimbeni yethu isebenze ngokufanelekileyo. Kuqhelekile ukuziva usoyika xa usiva ngale meko, kodwa masithethe ngayo ngokweenkcukacha ukuze uyiqonde ngcono.

Kutheni le nto ikhethekile kangaka le `(Tetralogy of Fallot)`? Kwenzeka ntoni entliziyweni?

Ngamafutshane, entliziyweni ephilileyo, igazi lihamba ngendlela ethile. Oko kukuthi, igazi elingenaoksijini liya emiphungeni, lithathe ioksijini, lize libuyele entliziyweni ukuze lisasazwe emzimbeni wonke. Kodwa ngenxa yezi ngxaki zine zesakhiwo entliziyweni yomntwana one-"Tetralogy of Fallot", elinye igazi elingenaoksijini liya ngqo emzimbeni endaweni yokuya emiphungeni. Le yingxaki ephambili.

Ngoku makhe sibone ukuba zeziphi ezi ngxaki zine zentliziyo:

1. I-Ventricular Septal Defect (VSD) : Khawuthelekelele ukuba intliziyo yakho inamagumbi amabini amakhulu, elinye lingasekunene nelinye lingasekhohlo. Xa i-VSD isenzeka eludongeni phakathi kwezi zimbini, igazi elingenaoksijini (igazi eliluhlaza okwesibhakabhaka) kwi-ventricle yasekunene lixubana negazi elineoksijini (igazi elibomvu) kwi-ventricle yasekhohlo. Oku akulunganga, kuba umzimba udinga igazi elicocekileyo nelineoksijini.

2. I-Pulmonary Artery Stenosis : Umthambo wegazi oyintloko othwala igazi elingenaoksijini ukusuka kwi-ventricle yasekunene yentliziyo ukuya emiphungeni (umthambo we-pulmonary) kwaye i-valve yawo (i-valve) iyancitshiswa. Kufana nombhobho wamanzi ovalwayo. Oku kunciphisa inani legazi elinokuya emiphungeni ngentliziyo nganye. Oku kunciphisa inani leoksijini enokongezwa egazini.

3. Umthambo wegazi oyintloko othwala igazi emzimbeni ukwindawo engafanelekanga (`Overriding Aorta`) : `(Aorta)` yeyona mthambo wegazi mkhulu othwala igazi elineoksijini emzimbeni wonke. Ngokwesiqhelo, oku kuqhagamshelwe kwigumbi elisezantsi lasekhohlo lentliziyo. Kodwa nge `(VSD)`, le `(Aorta)` ikwindawo engaphezulu kwamagumbi omabini, ivulekela omabini. Ngenxa yoku, igazi elingenaoksijini kunye negazi elineoksijini ziqala ukugeleza ngale `(Aorta)` ukuya emzimbeni. Ukubeka ngokucacileyo, elinye igazi elifanele liye emiphungeni ukuze lifumane ioksijini liya ngqo emzimbeni.

4. Ukwandiswa kodonga lwegumbi elisezantsi lasekunene lentliziyo (`Ventricular Hypertrophy`) : Ngenxa yazo zonke iingxaki ezikhankanyiweyo apha ngasentla, ingakumbi ukucutheka komthambo wegazi othumela igazi emiphungeni, igumbi elisezantsi lentliziyo (`(Right Ventricle)`) kufuneka lisebenze nzima ukupompa igazi. Njengokuba umsipha ukhula xa uphakamisa ubunzima, umaleko wemisipha eludongeni lweli gumbi nawo uyakhula ngokuhamba kwexesha. Oku kunokuphazamisana nokusebenza kwentliziyo.

Xa ezi ngxaki zine zidibana, imeko eyaziwa ngokuba yi-"Tetralogy of Fallot" iyenzeka.

Ixhaphake kangakanani le meko? Ngubani onokuba nayo?

I-Tetralogy of Fallot yimeko engaqhelekanga ngokwenene.Ngokwezibalo zaseMelika, oku kwenzeka kumntwana omnye kwabangama-2,000 abazelweyo. Nangona kunjalo, phakathi kwezifo zentliziyo ezizalwa nazo (`(Congenital Heart Disorders)`), le yimeko eqhelekileyo. Le meko ixhaphake kancinci phakathi kweentsana ezingamakhwenkwe. Kwakhona, oogqirha baye baqaphela ukuba `(ToF)` inokubonwa nakwiintsana ezinezinye iingxaki ze-chromosome ezifana `(Down Syndrome)`.

Kunqabile kakhulu, ukuba abanye abantu abafumani unyango ebuntwaneni, oku kunokubangela iingxaki kwanaxa sele bekhulile.

Oogqirha bayixilonga njani iTetralogy of Fallot?

Ugqirha wakho angayibona le meko ngexesha lokukhulelwa okanye emva kokuba umntwana ezelwe . Ngokuqhelekileyo, ifunyaniswa kwiiveki okanye kwiinyanga zokuqala emva kokuba umntwana ezelwe.

Uvavanyo lwangaphambi kokubeleka

Ukuba i-ultrasound scan eqhelekileyo ngexesha lokukhulelwa ibonisa naziphi na iingxaki entliziyweni, ugqirha angenza i-scan ekhethekileyo ebizwa ngokuba yi-fetal echocardiogram . Oku kungenziwa phakathi kweeveki ezili-18 nezingama-22 zokukhulelwa ukuze kubonwe ngokucacileyo ulwakhiwo lwentliziyo yomntwana kwaye kuchongwe ukuba kukho naziphi na iingxaki.

Uvavanyo emva kokuba umntwana ezelwe

Emva kokuba umntwana ezelwe, xa ugqirha ehlola umntwana aze amamele intliziyo, isandi esingaqhelekanga (`Heart Murmur`) sinokuvakala. Olu luphawu oluqhelekileyo olubonwa kwiintsana ezine `(ToF)`.

Ukongeza, kwenziwa ezinye iimvavanyo ezininzi ukuqinisekisa le meko:

• I-Pulse Oximetry : Olu luvavanyo olulula kakhulu, olungenazintlungu. Ngaphambi kokuba umntwana wakho asiwe ekhaya, kufakwa isensa encinci engalweni okanye emlenzeni womntwana wakho ukulinganisa inqanaba le-oksijini egazini lakhe. Amanqanaba e-oksijini aphantsi anokuba luphawu lwesifo esibizwa ngokuba yi-(ToF).
• I-Echocardiogram (ekwaziwa ngokuba yi-echo) : Oku kufana ne-scan. Isebenzisa amaza esandi ukuze ibone ngokucacileyo ulwakhiwo lwentliziyo yomntwana, kuquka iivalvu zayo kunye nokuhamba kwegazi.
• I-X-reyi yesifuba okanye i-Cardiac CT Scan : Oku ngamanye amaxesha kunokubonisa inkangeleko engaqhelekanga "emile okwesihlangu". Olu luphawu lwe-ToF.
• I-Electrocardiogram (EKG okanye i-ECG) : Le nkqubo ivavanya ukusebenza kombane kwentliziyo. Ingabona naziphi na iingxaki kwisingqisho sentliziyo okanye ukuba amagumbi entliziyo asebenza nzima kakhulu.
• Uvavanyo lweCatheterization yentliziyo : Olu vavanyo lunzima kancinci. Lwenziwa kuphela xa kuyimfuneko. Ityhubhu encinci (i-catheter) idluliselwa ngemithambo yegazi emlenzeni okanye engalweni iye entliziyweni ukuze kulinganiswe uxinzelelo olungaphakathi entliziyweni, kuthathwe iisampulu zegazi, kwaye kubonwe isakhiwo ngokucacileyo.

Xa kuchongwa le meko kumntu omdala okanye kumntwana omdala kancinci, uvavanyo olukhankanyiweyo apha ngasentla, olufana ne-`(EKG)` kunye ne-`(Cardiac Catheterization),` lungasetyenziswa.

Inyangwa njani le meko `(Tetralogy of Fallot)`?

Unyango oluphambili lomntwana one-`(ToF)` ngamayeza notyando . Inyathelo lokuqala, oogqirha banokunika umntwana amayeza anjenge-`(Beta-blockers)` ukulawula iimpawu zomntwana nokuphucula ukujikeleza kwegazi. Banokunika neoksijini eyongezelelweyo.

Utyando lokulungisa zonke ezi ngxaki zine zentliziyo ludla ngokwenziwa phakathi kweenyanga ezintathu ukuya kwezintandathu emva kokuzalwa komntwana. Emva kolu tyando, indlela igazi elihamba ngayo entliziyweni ibuyela esiqhelweni.

Ziziphi iindlela zotyando?

Iindlela zonyango zinokwahluka ngokuxhomekeke kwimeko yomntwana. Ngamanye amaxesha, ukuba umntwana umncinci kakhulu okanye ubuthathaka kakhulu, kunokuba nzima ukwenza utyando olukhulu ngaxeshanye. Kwiimeko ezinjalo, utyando olulula (`(Utyando lwePalliative)`) lunokwenziwa ukulawula okwethutyana iimpawu de umntwana abe mdala kancinci kwaye aqine. Kulapho kuphela apho `(Ukulungiswa Okupheleleyo)` kunokwenziwa.

Kukho iinkqubo ezininzi eziphambili zotyando:

• Ukulungiswa Okupheleleyo : Kule nkqubo, ugqirha wotyando wandisa ivalvu encitshisiweyo kunye nendlela ethwala igazi ukuya emiphungeni. Kwakhona, umngxuma ophakathi kwamagumbi amabini asezantsi entliziyo (VSD) uvalwa ngepatch.
• Inkqubo ye-BTT Shunt : Olu lutyando lwexeshana olukhankanyiweyo ngaphambili. Kufakwa ityhubhu encinci (iShunt) phakathi komthambo wengalo yomntwana (i-Subclavian Artery) kunye nomthambo wemiphunga (i-Pulmonary Artery). Oku kuvumela igazi elingakumbi ukuba lihambe liye emiphungeni.
• Inkqubo yeCatheter : Ngamanye amaxesha, i-stent inokufakwa entliziyweni nge-catheter ngaphandle kotyando ukugcina i-ventricle yasekunene ivulekile. Ingasetyenziswa nokugcina i-ductus arteriosus yomntwana (ityhubhu edibanisa umthambo we-pulmonary kunye ne-aorta) ukuba ingavali.

Utyando lwabantu abadala

Kunqabile kakhulu ukuba abanye abantu baphile ebuntwaneni ngaphandle kotyando baze bafikelele ebudaleni. Iingcali zicebisa abantu abanjalo ukuba benze utyando olupheleleyo ukuze kuthintelwe iingxaki ezizayo kwaye kuncitshiswe umngcipheko wokufa ngequbuliso.

Kule nkqubo, ugqirha ogqirha ogxile kwizifo zentliziyo zabantu abadala (VSD) uvala isiphene nge-patch, avule i-atrium yasekunene, aze alungise okanye atshintshe ivalvu ye-pulmonary. Umthambo we-pulmonary, ohambisa igazi kwimiphunga yomibini, uyandiswa. Ngamanye amaxesha ityhubhu ibekwa phakathi kwe-atrium yasekunene kunye nomthambo we-pulmonary ukuphucula ukuhamba kwegazi.

Uninzi lwabantu abadala abalungiswayo ngenxa yesifo sentliziyo (ToF) abayi kufuna olunye unyango lotyando, kodwa kufuneka baqhubeke nokubona ugqirha wentliziyo wabantu abadala ukuze alandelelwe rhoqo.

Ziziphi iingxaki ezinokwenzeka emva kotyando?

Emva kotyando lweTetralogy of Fallot, ngamanye amaxesha (kwaye ngamanye amaxesha nasemva kwexesha elithile), kusenokuvela iingxaki ezithile. Kodwa ungakhathazeki, oogqirha bahlala beyikhathalele le nto.

• Ukuphazamiseka kombane: I-patch evala i-VSD ngamanye amaxesha inokuphazamisana nemiqondiso yombane esuka kumagumbi aphezulu entliziyo (i-Atria) ukuya kumagumbi asezantsi (iiVentricles). Oku kungalungiswa nge-pacemaker. Nge-ToF elungisiweyo, kukho umngcipheko we-arrhythmias (ukubetha kwentliziyo okungaqhelekiyo) kumagumbi aphezulu nasezantsi entliziyo. Ukuba une-syncopal episode, kufuneka uhlolwe oku.
• I-Residual Ventricular Septal Defect : Ngamanye amaxesha kunokubakho ukuvuza okuncinci okujikeleza i-patch esetyenziselwa ukuvala i-VSD.
• I-Aneurysm : I-patch esetyenziselwa ukulungisa i-valve inokubangela ukuba iindawo ezibuthathaka kwi-valve ziqhume zize zenze i-aneurysm (iqhuma elifana nebhaluni kwimithambo yegazi). Kukwakho nomngcipheko ophezulu wokuba ne-aneurysm kwi-aorta enyukayo.
• Iingxaki zeShunt : Ngenxa yeshunt ebekwe ngexesha lotyando lokuqala lwexeshana, iingxaki ezinje ngokuncipha (stenosis), uxinzelelo lwegazi oluphezulu kumthambo wemiphunga, kunye noxinzelelo olugqithisileyo kwicala lasekhohlo lentliziyo zinokwenzeka.
• IiValve Ezivuzayo : Igazi linokuvuza libuyele umva ngeevalve ezikwimiphunga yakho, kwi-aorta, okanye kwicala lasekunene lentliziyo yakho (iTricuspid). Ngamanye amaxesha, ivalve yepulmonary (iValve Replacement) inokufuneka.

Yintoni onokuyilindela xa uphila nale meko?

Nangona ukuhamba kwegazi entliziyweni kubuyela esiqhelweni emva kotyando lweTetralogy of Fallot, kusekho izinto ezimbalwa wena okanye umntwana wakho ekufuneka nizazi:

• Umngcipheko Wokosuleleka Yintliziyo : Umngcipheko we-endocarditis uphezulu kancinci. Ke ngoko, kufuneka ulumke kakhulu ngempilo yamazinyo akho. Ugqirha wakho unokukucebisa ukuba uthathe amayeza okubulala iintsholongwane ukuthintela ukosuleleka ngexesha lonyango lwamazinyo.
• Uphuhliso olucothayo : Iintsana ezineTetralogy of Fallot zinokukhula kancinci kwaye zityebe kancinci. Zisenokufuna unyango lomzimba, lokuthetha, okanye lonyango lomsebenzi.
• Iingozi zokukhulelwa : Abafazi abadala kufuneka bahlolwe intliziyo ngokukodwa ngaphambi kokuba bakhulelwe. Umngcipheko wokukhulelwa kwesisu unokuba phezulu kancinci kunesiqhelo.
• Imiqathango Yamayeza : Njengomntu omdala, unokufuneka usebenzise amayeza athile kunye neendlela zokulawula ukuzala kuphela xa unesimo sentliziyo.

Lithini ikamva lesimo se-`(ToF)`?

Ngokuhambela phambili kwesayensi yezonyango, ikamva leentsana ezine-`(Tetralogy of Fallot)` lingcono kakhulu kunangaphambili. Unyango lotyando luphumelela kakhulu ekulungiseni iziphene kwisakhiwo sentliziyo nokuhamba kwegazi. Izinga lempumelelo lotyando kubantu abadala ngugqirha wentliziyo onamava wokuzalwa nalo liphezulu kakhulu.

Namhlanje, uninzi lweentsana ezityandwayo ukuze zilungiswe iTetralogy of Fallot ziphila ubomi obuxakekileyo. Nangona kunjalo, kunokubakho imida ethile kwimisebenzi enzima, efana nemidlalo yokhuphiswano. Izinga lokusinda ixesha elide emva kotyando lweToF lilungile kakhulu. Uninzi lwabantu abatyandwayo baphila bade bafikelele kwiminyaka yabo engama-30. Nangona kunjalo, ukuba utyando alwenziwa, malunga nomntu omnye kwabathathu abaneTetralogy of Fallot baya kuphila iminyaka eli-10.

Abanye abantu abadala abaye batyandwa iTetralogy of Fallot besengabantwana banokuba neengxaki xa bebadala ezifuna amayeza, unyango, okanye utyando olongezelelweyo. Ke ngoko, kubalulekile ukuba abantu abadala badibane nogqirha wabo wentliziyo ngaphambi kokuba benze utyando kwenye inxalenye yomzimba.

Ngaba kukho into endinokuyenza ukuze umntwana wam azive ngcono?

Ngelixa umntwana wakho elinde utyando, ungamnceda xa ene "tet spells" (xa ejika abe luhlaza okwesibhakabhaka kwaye enengxaki yokuphefumla). Xa enengxaki yokuphefumla, mbeke kwindawo yokuquleka amadolo akhe ethe tye esifubeni sakhe . Le ndawo yonyusa ukuhamba kwegazi ukuya emiphungeni, nto leyo enokunceda umntwana wakho azive ngcono.

Kwakhona, kubaluleke kakhulu ukunika umntwana ulwelo olwaneleyo lokusela nokumthintela ekubeni azibhokoxe kakhulu.

Ndifanele ndimbone nini ugqirha wam?

Ukuba umntwana wakho une "tet spell" enzima, oko kuthetha ukuba ujika abe luhlaza okwesibhakabhaka kwaye unengxaki yokuphefumla, mse kwigumbi likaxakeka lesibhedlele esikufutshane ngoko nangoko . Ukuba ungumntu omdala, ukuba uziva ubuthathaka, unesiyezi, unengxaki yokuphefumla, okanye unentlungu esifubeni, kufuneka uye kwigumbi likaxakeka.

Abantu abadala abenze utyando lwabo lokuqala lwevalvu yentliziyo (ToF) besebancinci kufuneka bahlolwe intliziyo ngokupheleleyo rhoqo ngonyaka okanye emibini . Kunokwenziwa uvavanyo olwahlukeneyo ukujonga ukusebenza kwentliziyo, umzekelo:

• `(I-Holter Monitor)` (Isixhobo esirekhoda i-`ECG` imini yonke)
• I-Electrocardiogram (EKG)
• Uvavanyo loxinzelelo lomzimba
• I-Echocardiogram (ukuskena kwentliziyo)
• I-MRI yentliziyo

Kwakhona, ugqirha wakho uya kujonga rhoqo ubungakanani kunye nokusebenza kwecala lasekunene lentliziyo yakho.

Emva kokulungiswa kweTetralogy of Fallot, umntwana wakho kuya kufuneka ahlolwe rhoqo ngugqirha wentliziyo wabantwana. Olu nyango luqhelekileyo luya kuqhubeka de abe ngumntu omdala.

Eminye imibuzo onokuyibuza ugqirha wakho:

• Ngaba umntwana wam uza kunciphisa imisebenzi yakhe yezemidlalo emva kotyando?
• Ngaba umntwana wam uza kufuna olunye utyando?
• Ngawaphi amanye amayeza (ukuba akhona) umntwana wam afanele awathathe?

Okokugqibela, kufuneka ndithi... (Umyalezo Wokuya Ekhaya)

Kuqhelekile ukuziva uxinezelekile kwaye ulusizi xa ufumanisa ukuba umntwana wakho osandul’ ukuzalwa unesifo sentliziyo. Kodwa khumbula, iqela lakho lezonyango lincede abanye abazali abaninzi abaye bajongana neemeko ezifanayo, kwaye nabo banokukunceda. Ukuba uziva uxinezelekile malunga nokunyamekela umntwana oneTetralogy of Fallot, ungoyiki ukuthetha nogqirha wengqondo. Kwakhona, ugqirha wengqondo unokunceda abantwana kunye nabantu abadala abaselula abaziva bephambili kunontanga babo ekuphuhlisweni. Kholosa ukuba ngonyango olufanelekileyo nokhathalelo lothando, aba bantwana banokuba nobomi obuhle nabo.

I- Tetralogy of Fallot, Isifo seNtliziyo sabantwana, Iziphene zeNtliziyo ezizalwa nazo, Imingxunya entliziyweni, iBlue Baby Syndrome, utyando lwentliziyo, ulwakhiwo lwentliziyo