Wonke umama nobaba bayesaba lapho bebona umntwana osanda kuzalwa ephenduka abe luhlaza okwesibhakabhaka futhi enobunzima bokuphefumula. Ngezinye izikhathi imbangela yalokhu inkinga yenhliziyo yokuzalwa nayo. Lapho odokotela bekutshela ngenkinga yenhliziyo yengane yakho nokuthi kudingeka benze ukuhlinzwa 'kwe-Arterial Switch', kuyinto evamile ukuzizwa uthwele umthwalo omkhulu nokwesaba. Kodwa ungesabi. Namuhla, sizoxoxa ngalokhu ngendlela elula kakhulu ongayiqonda futhi uthole izimpendulo zemibuzo eminingi esengqondweni yakho.
Kuyini lokhu kuhlinzwa kwe-Arterial Switch?
Kalula nje, ukushintsha kwemithambo yegazi kuyindlela engavamile, kodwa ebaluleke kakhulu, yokuhlinzwa kwenhliziyo okwenziwa ezinsaneni ezisanda kuzalwa. Kuhilela ukubeka kabusha imithambo yegazi emibili eyinhloko enhliziyweni yengane, i-aorta kanye ne-pulmonary artery, ibuyele ezikhundleni zayo ezijwayelekile.
Cabanga ngemizimba yethu njengohlelo lwamapayipi. Uma amapayipi angalungile exhunywe ezindaweni ezingalungile, izinto zingahamba kabi. Udokotela ohlinzayo uxhuma kabusha i-aorta yengane ne-ventricle yesobunxele yenhliziyo kanye nomthambo wamaphaphu ne-ventricle yesokudla. Lokhu kuhlinzwa kuvame ukwenziwa phakathi kwamasonto amabili okuqala okuzalwa kwengane.
Lolu hlobo lwesimo oluphathwa yilolu hlinzo?
Lokhu kuhlinzwa kwelapha isimo senhliziyo esizalwa naso esibizwa ngokuthi i-d-transposition of the great arteries (D-TGA) , lapho imithambo yegazi emibili eyinhloko ephuma enhliziyweni ixhunywa ezindaweni ezingafanele lapho izalwa.
Ku-D-TGA, igazi elingcolile nelingenawo umoya-mpilo lijikeleza emzimbeni wonke esikhundleni sokuya emaphashini ukuze lihlanzwe. Ngokufanayo, igazi elicebile ngomoya-mpilo elivela emaphashini libuyela emaphashini esikhundleni sokuya emzimbeni. Lokhu kuvimbela ingane ekutholeni umoya-mpilo eyidingayo.
Ukuhlinzwa kwe-Arterial Switch kulungisa le nkinga. Lokhu kuvumela igazi lengane ukuthi lijikeleze kahle, amazinga omoya-mpilo abuyele esimweni esijwayelekile, futhi ukusebenza kwenhliziyo kuyathuthuka. Lokhu kuhlinzwa kunikeza ingane yakho ithuba elikhulu lokukhula ibe umuntu omdala onempilo.
Wenzani ngaphambi kokuhlinzwa?
Odokotela benza izinto ezahlukene ukuze bazinzise isimo somntwana ngaphambi kokuhlinzwa futhi banikeze umzimba umoya-mpilo omningi ngangokunokwenzeka.
- I-Septostomy: Lena inqubo yesikhashana. Kwenziwa imbobo encane phakathi kwamakamelo enhliziyo ukuze igazi elithile elinomoya-mpilo lihlangane negazi elincane elinomoya-mpilo.
- I-ventilator: Ixhunywe emshinini ukuze kube lula ngengane ukuphefumula.
- Imithi: Imithi efana ne-'Prostaglandin' inikezwa ukugcina imithambo yegazi ivulekile nokwandisa ukugeleza komoya-mpilo emzimbeni.
Futhi, ekulungiseleleni ukuhlinzwa, kwenziwa izivivinyo eziningana ezingenabuhlungu, njenge-echocardiogram (ukuskena kwenhliziyo), i-X-ray yesifuba, kanye ne-EKG (i-electrocardiogram) ukuhlola usayizi kanye nokusebenza kwenhliziyo yengane.
Kwenzekani ngesikhathi sokuhlinzwa?
Lokhu ukuhlinzwa okuyinkimbinkimbi okuthatha amahora amaningi. Ake siqonde ukuthi kwenzekani kulokhu.
| Isinyathelo Senqubo | Ngamagama alula... |
|---|---|
| Ukuhlinzwa kwe-sternum (ukuvulwa kwe-sternum) | Udokotela ohlinzayo uvula isifuba somntwana phakathi bese efinyelela enhliziyweni. |
| I-Cardiopulmonary Bypass | Ngesikhathi sokuhlinzwa, inhliziyo namaphaphu kuhlinzwa ngomshini okhethekile (umshini wenhliziyo namaphaphu). Lo mshini uhlanza igazi bese ulipompa ulibuyisele emzimbeni. |
| Ukusindisa nokudlulisa imithambo yegazi | I-aorta kanye nomthambo wamaphaphu oxhumene kabi kuyasuswa enhliziyweni. |
| Ukunamathiselwa Kabusha Kwemithambo Yenhliziyo | Lena yingxenye ebucayi kakhulu nebaluleke kakhulu yokuhlinzwa. Imithambo emincane yenhliziyo ehambisa igazi enhliziyweni ngokwayo isuswa ngokucophelela ku-aorta elahlekile bese ixhunywa kabusha ku-aorta esanda kuxhunywa endaweni efanele. |
| Ukuxhumeka kabusha kwemithambo yegazi | I-aorta ixhunywe kwi-ventricle yesobunxele kanye nomthambo wamaphaphu kwi-ventricle yesokudla ezindaweni zayo ezifanele. |
| Ukuvalwa kwesifuba | Uma konke sekwenziwe kahle, udokotela ohlinzayo uvala isifuba somntwana futhi. |
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, ingane yakho izolaliswa egunjini lokunakekela abagula kakhulu (ICU) izinsuku ezimbalwa. Uma uya ukuyobona ingane yakho, uzobona amapayipi amaningi, izintambo, nemishini exhunywe kuyo. Lokhu kungaba yinto eyesabekayo, kodwa ungakhathazeki. Khumbula, yonke le mishini ikhona ukuze iqaphe ingane yakho futhi iyisize ilulame ngokushesha.
Yiziphi izinzuzo, amazinga empumelelo, kanye nezingozi zalokhu kuhlinzwa?
Izinzuzo kanye nempumelelo
Lokhu kuyindlela yokuhlinzwa esindisa impilo. Inikeza ingane umoya-mpilo eyidingayo, okuyenza ikhule kahle.
- Ngaphandle kokuhlinzwa, ama-50% ezinsana ezine-D-TGA ziyafa zingakapheli inyanga yokuqala.
- Kodwa izinga lempumelelo ngemva kokuhlinzwa liphezulu kakhulu. Ingozi yokufa ingaphansi kuka-2%.
- Kubikwe ukuthi cishe amaphesenti angama-96 alabo asebehlinzwe basaphila eminyakeni engama-25 kamuva. Iningi lezingane lingaphila impilo evamile ngaphandle kwemingcele yokusebenza ngokomzimba.
Izinkinga ezingaba khona (Izingozi)
Akuvamile ukuthi kube nezinkinga ezithile ngemva kweminyaka eminingi.
- Ukuvaleka kwemithambo yenhliziyo noma indlela yokuphuma kwegazi esuka kwi-ventricle yesokudla.
- Ukwandiswa noma ukuncishiswa kwemithambo yegazi exhunywe kabusha.
- Ama-valve enhliziyo avuzayo.
Uma lezi zinkinga zenzeka, kungase kudingeke ukuhlinzwa okwengeziwe ukuze kulungiswe kamuva. Futhi, ngenxa yamazinga aphansi omoya-mpilo ekuzalweni, ezinye izingane zingase zibe nokukhubazeka okuncane ezintweni ezifana nenkumbulo, ukunaka, noma ngisho nokukhathazeka okuncane. Kubalulekile ukuqaphela lokhu kusenesikhathi. Ngemuva kwalokho, uma ubona noma yiziphi izinguquko enganeni yakho, unganikeza usizo oludingekayo ngokushesha.
Kuthatha isikhathi esingakanani ukululama kanye neseluleko sezokwelapha?
Ingane ngokuvamile kufanele ihlale esibhedlela cishe amasonto amabili . Inqubo yokuphulukiswa iyaqhubeka ngisho nangemva kokuba usubuyele ekhaya. Udokotela uzokweluleka ngokuthi ungayinakekela kanjani inxeba nokuthi yimiphi imithi okufanele uyinikeze.
Uyafuna ukubona udokotela futhi?
Yebo, impela. Kufanele uye ekhaya uyobona udokotela ohlinzayo ngemva kwesonto noma amabili. Kufanele futhi ubonane nodokotela wenhliziyo wezingane.
Into ebaluleke kakhulu ukuthi ingane yakho ihlolwe okungenani kanye ngonyaka impilo yayo yonke. Ngaleyo ndlela, uma kuvela izinkinga, zingabonakala ngaphambi kokuba zibe zimbi kakhulu.
Uma udinga ukushayela udokotela ucingo ngokushesha
Ngemva kokubuyela ekhaya, uma inxeba lokuhlinzwa lomntwana wakho liba bomvu, livuvukele, noma liphuma uketshezi, noma uma enomkhuhlane , shayela ithimba lakho lezokwelapha ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- Ukuhlinzwa kwe-Arterial Switch kuyindlela ebalulekile futhi ephumelela kakhulu yokusindisa impilo yezinsana ezine-D-TGA.
- Nakuba lokhu kuwukuhlinzwa okukhulu, izingane eziningi zingaphila impilo evamile nenempilo ngemva kwalokho.
- Ungesabi imishini namapayipi owabonayo e-ICU ngemuva kokuhlinzwa. Konke kulapho ukusiza ingane yakho ukuthi ilulame ngokushesha.
- Ingane yakho izodinga ukuhlolwa kwezokwelapha impilo yayo yonke. Qiniseka ukuthi uyayilandela.
- Njengomzali, kuyilungelo lakho ukuxoxa nodokotela wakho nganoma yimiphi imibuzo, ukukhathazeka, noma ukungabaza onakho. Bahlala bekulungele ukukusiza.
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