Ingabe ingane yakho inalolu hlobo lwenkinga yenhliziyo? Ake sifunde nge-(Atrioventricular Canal Defect)!

Ngezinye izikhathi kungenzeka ukuthi uke waphawula ukuthi ingane yakho esanda kuzalwa inobunzima bokuphefumula, iyahluleka ukuncelisa, noma iphenduke ibe luhlaza okwesibhakabhaka. Lokhu kungaba ngezinye izikhathi izimpawu zenkinga encane enhliziyweni yengane yakho. Kunjalo, isimo senhliziyo esikhona lapho izalwa sibizwa ngokuthi i-Atrioventricular Canal Defect , esikhuluma ngaso namuhla.

Kuyini lokhu (i-Atrioventricular Canal Defect)?

Kalula nje, i-Atrioventricular Canal Defect iyisifo senhliziyo esiba khona lapho kuzalwa. Odokotela ngezinye izikhathi basibiza ngokuthi i-AVSD - i-Atrioventricular Septal Defect . Uma sikhuluma iqiniso, kuyinhlanganisela yezinkinga eziningana zenhliziyo. Eyinhloko ukuthi kukhona imbobo noma imigodi odongeni phakathi kwenhliziyo (lokhu sikubiza ngokuthi i-septum) . Kuhilela futhi ama-valve enhliziyweni angasebenzi kahle.

Cabanga ngakho njengomgodi osepayipini lamanzi. Enhliziyweni enempilo, igazi elinomoya-mpilo elimpontshwe lisuka ohlangothini lwesobunxele lwenhliziyo yethu alivamisile ukuhlangana negazi elinomoya-mpilo elivela ohlangothini lwesokudla. Kodwa ngenxa yalo mgodi, lelo gazi elinomoya-mpilo lihlangana negazi elinomoya-mpilo elingenayo. Esikhathini esiningi, lo mgodi ubangela igazi eliningi kakhulu ukuba liye emaphashini. Bese inani legazi eliya kuwo wonke umzimba liyancipha. Uma lokhu kuqhubeka isikhathi eside, ngezinye izikhathi kungahamba ngenye indlela. Okusho ukuthi, igazi elinomoya-mpilo eliningi liya emzimbeni, kanti elincane liya emaphashini. Uma lokho kwenzeka, izinga lomoya-mpilo emzimbeni liyancipha futhi isikhumba singaphenduka sibe luhlaza okwesibhakabhaka. Sikubiza ngokuthi i-cyanosis .

Lokhu kubangela ukuthi inhliziyo isebenze kanzima, okungaholela kwezinye izinkinga zempilo njengokwehluleka kwenhliziyo okubangelwa ukuminyana .

Uma lesi (i-Atrioventricular Canal Defect) singelashwa kahle, ngezinye izikhathi singathinta impilo yengane. Ngaphandle kokuhlinzwa, izingane ezinalesi simo zingaphila isikhathi esifushane kuphela, cishe iminyaka emibili kuya kwemithathu. Kodwa ungakhathazeki! Into engcono kakhulu ukuthi ukuhlinzwa ukulungisa lokhu kuphumelele kakhulu. Odokotela bangasithola lesi simo ngaphambi kokuba sibe sibi kakhulu, ngisho nangaphambi kokuba umntwana azalwe.

Ngokwesilinganiso, emazweni afana ne-United States, cishe ingane eyodwa kwezingu-1,700 izalwa inalesi sici minyaka yonke. Lokhu kubalwa phakathi kuka-3% no-5% wazo zonke izinkinga zenhliziyo ezizalwa nazo.

Lesi simo sibizwa ngamanye amagama amaningana. Udokotela wakho angase asebenzise elinye lala magama:

• I-Atrioventricular septal defect (AVSD)
• Iphutha lomcamelo we-Endocardial

Ingabe kunezinhlobo ezahlukene ze-Atrioventricular Canal Defect?

Yebo, lesi sifo senhliziyo singavela ngezindlela ezahlukene. Okusho ukuthi, kuncike ezintweni ezifana nosayizi wembobo enhliziyweni kanye nenani lama-valve.

I-Atrioventricular Canal Defect ephelele (Iphutha Lomsele)

Okwenzekayo kulokhu ukuthi amakamelo amabili aphezulu enhliziyo (siwabiza ngokuthi i-atria) kanye namakamelo amabili aphansi (siwabiza ngokuthi ama-ventricle)(okubizwa ngokuthi) Umgodi omkhulu wakheka phakathi kwamakamelo amabili enhliziyo. Okusho ukuthi, wonke amakamelo amane enhliziyo axhumene ndawonye. Ngokuvamile, kufanele kube nama-valve amabili phakathi kwamakamelo aphezulu nangaphansi. Kodwa kulokhu, kune-valve eyodwa enkulu kuphela. I-flap yayo ingase ingavuli noma ingavali kahle.

Ingxenye (Iphutha Lomsele We-Atrioventricular Elingaphelele)

Kulesi simo, imbobo iphakathi kwamakamelo amabili aphezulu enhliziyo (lena evame kakhulu) noma phakathi kwamakamelo amabili aphansi. Wonke amakamelo amane awaxhunyiwe. Kukhona ama-valve amabili phakathi kwamakamelo aphezulu naphansi. Kodwa i-valve eyodwa (ngokuvamile i-valve ye-mitral, etholakala phakathi kwekamelo eliphezulu (i-atrium yesobunxele) kanye negumbi elingezansi (i-ventricle yesobunxele) ohlangothini lwesobunxele) ayisebenzi kahle.

Iphutha Lomsele We-Atrioventricular Wesikhashana

Kulokhu, kukhona imbobo phakathi kwamakamelo amabili aphezulu kanye nembobo encane phakathi kwamakamelo amabili aphansi. Amavalvu amabili aphakathi kwamakamelo aphezulu naphansi (amavalvu e-AV) ahlukene.

Iphutha Lomsele Ophelele We-Atrioventricular Elingalingani

Uyakhumbula ukuthi esicini senhliziyo esiphelele kukhona ivalvu eyodwa enkulu? Leyo valve iseduze negumbi elingaphansi (i-ventricle) kunelinye. Bese igumbi elithola igazi eliningi liba likhulu kunelinye. Odokotela babiza lelo gumbi elincane ngokuthi 'i-hypoplastic' .

Ziyini izimpawu zalokhu?

Izimpawu zalesi sifo senhliziyo zingavela ngisho nangaphambi kokuba ingane yakho izalwe. Hlola ukuthi ingane yakho inayo yini yalezi zinto:

• Umbala wesikhumba oluhlaza okwesibhakabhaka (i-Cyanosis): Ikakhulukazi ezindaweni ezifana nezindebe, ulimi, kanye neminwe.
• Ubunzima bokuphuza ubisi: Ukuzizwa ukhathele futhi ukhathele ngemva kokuphuza ubisi oluncane.
• Ukujuluka ngemva kokuphuza ubisi.
• Ukukhathala ngokushesha: Ukukhathala ngisho nangemva kokwenza into encane.
• Ukushaya kwenhliziyo.
• Ubunzima bokuphefumula (i-Dyspnea) noma ukuphefumula ngokushesha.
• Ukwanda kwesisindo kwenzeka kancane kancane.
• Ukuvuvukala (i-edema) esiswini noma emilenzeni.
• Ukushaya kwenhliziyo okubuthakathaka.

Kodwa-ke, izingane ezinenkinga engaphelele noma eguquguqukayo zingase zingabonisi lezi zimpawu ekuqaleni. Lezi zimpawu zingase zivele kamuva ebuntwaneni, noma ebusheni, noma ngisho nasebudaleni.

Kungani lokhu (i-Atrioventricular Canal Defect) kwenzeka?

Abacwaningi abakakazi kahle ukuthi yini ebangela i-Atrioventricular Septal Defect (AVSD) . Kucatshangwa ukuthi kuyinhlanganisela yezici zofuzo kanye nezemvelo . Kodwa into eyodwa icacile: kukhona ukuxhumana okuqinile phakathi kwalesi simo senhliziyo kanye ne-Down syndrome . Cishe ama-40% ezinsana ezine- Down syndrome zine -AVSD .

Yiziphi izinto eziyingozi ezithinta lokhu?

Ochwepheshe abakakazitholi izici eziqondile ezibangela lokhu. Kungase kube nethonya lezakhi zofuzo. Mhlawumbe isakhi sofuzo esingajwayelekile esidluliselwa kumama noma kuyise singandisa amathuba engane okuthola isifo senhliziyo isesesibelethweni.

Ngaphandle kwalokho, izinto ezilandelayo ngesikhathi sokukhulelwa zingandisa ingozi yokuba ingane yakho ihlaselwe yisifo senhliziyo:

• Imithi ethile.
• Izidakamizwa ezingekho emthethweni (Izidakamizwa zokuzijabulisa).
• Iziphuzo eziqukethe utshwala.
• Ukuchayeka ebuthi noma amakhemikhali emvelo.
• Ukuntuleka kwezakhamzimba noma amavithamini.
• Ukukhuluphala ngokweqile.
• Imikhiqizo kagwayi.
• Ukungalawuli izifo ezingamahlalakhona njenge-Diabetes Mellitus noma i-Hypertension.
• Izifo ezibangelwa amagciwane ezifana nomkhuhlane (flu) noma umkhuhlane.

Yiziphi izinkinga ezingaba khona ze-Atrioventricular Canal Defect?

Uma lesi simo sibi kakhulu, okusho ukuthi asiphathwa kahle, izinkinga ezinjengalezi zingavela:

• Amaphethini okushaya kwenhliziyo angajwayelekile (i-Arrhythmia).
• Ukwehluleka kwenhliziyo okubangelwa ukuminyana.
• Ukutheleleka kwenhliziyo (i-Endocarditis).
• Umfutho wegazi ophezulu emithanjeni yegazi oholela emaphashini (i-pulmonary hypertension).

Lesi sifo sitholakala kanjani?

Izindaba ezinhle ukuthi ezimweni eziningi, odokotela bangathola i-Atrioventricular Septal Defect ngaphambi kokuba umntwana azalwe ngokuhlolwa okumbalwa:

• I-ultrasound yangaphambi kokubeletha: Lokhu kungabona izithombe zokunyakaza komntwana esibelethweni, okuhlanganisa nenhliziyo. Kungabona futhi iphutha elikhulu le-septal .
• I-echocardiogram yengane esanda kuzalwa: Lokhu kukhombisa izithombe zenhliziyo ngokucacile kune-ultrasound. Udokotela angathola umbono ongcono wokuthi inhliziyo yakheke kanjani nokuthi ipompa kanjani igazi.

Ngemva kokuzalwa kwengane, udokotela angalalela ukushaya kwenhliziyo yengane nge -stethoscope . Uma kuzwakala umsindo "ophezulu" ongavamile (esiwubiza ngokuthi ukububula kwenhliziyo ), kungaba umsindo wegazi eligeleza emgodini.

Ezinye izivivinyo ezenziwa ngemva kokuzalwa zifaka:

• Ama-X-ray esifubeni: Hlola usayizi nesimo senhliziyo yengane.
• I-Electrocardiogram (EKG/ECG): Hlola ukusebenza kukagesi kwenhliziyo yengane.
• I-Echocardiogram: Ukuhlola okuningiliziwe isakhiwo senhliziyo yengane.
• Ukufakwa kwe-catheter emithanjeni yenhliziyo: Funda kabanzi ngobucayi besimo sengane.
• I-Cardiac Magnetic Resonance Imaging (I-Heart MRI): Bona izingxenye zenhliziyo yengane yakho nokuthi zisebenza kanjani.

Ngezinye izikhathi, uma ingane inesici esincane se-septal , ingase ingakhombisi zimpawu ekuqaleni. Uma kunjalo, kungase kuthathe iminyaka eminingana ngaphambi kokuba udokotela athole lesi simo.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa okuvame kakhulu kwe -Atrioventricular Canal Defect ukuhlinzwa kwenhliziyo evulekile . Kulokhu kuhlinzwa, udokotela ohlinzayo uvula imbobo enhliziyweni yengane bese eyivala. Uma isici sesiphelele , ivalvu yenhliziyo eyodwa ihlukaniswa kabili, kwakheka amavalvu amabili ahlukene, elinye ngakwesokudla nelinye ngakwesokunxele.

Ingane enenkinga yomgudu we-AV engalingani kahle ingadinga ukuhlinzwa okuningana, okuphetha ngokuhlinzwa okubizwa ngokuthi inqubo ye-Fontan .

Kungcono ukwenza lokhu kuhlinzwa ngokushesha okukhulu, ngaphambi kokuba lesi simo sibangele umonakalo ohlala njalo enhliziyweni. Iningi lezingane lenza lokhu kuhlinzwa zingakapheli izinyanga eziyisithupha zokuqala zokuphila. Ezinye izingane ezinesici esithile kodwa ezingenazo izimpawu zingase zenze lokhu kuhlinzwa zingakapheli iminyaka emithathu yokuqala yokuphila.

Ngezinye izikhathi, uma ingane ingaphilile ngokwanele ukuba ihlinzwe, noma inesisindo esingaphansi kwesisindo, ingase inikezwe imithi yokulawula izimpawu kuze kube yilapho ikhuluphala futhi inamandla.

• Ama-diuretics yimithi esusa amanzi angaphezulu emzimbeni.
• I-Digoxin isiza inhliziyo yengane ukuthi ishaye ngamandla.
• Ama-ACE inhibitors andisa imithambo yegazi futhi asize ukugeleza kwegazi.

Esinye isisombululo sesikhashana inqubo ebizwa ngokuthi i-pulmonary artery banding . Lokhu kunciphisa inani legazi eligeleza nge-pulmonary artery liye emaphashini engane. Izingane ezike zafakwa i-pulmonary artery banding zingalungiswa unomphela kamuva.

Ingabe izinkinga zingaba khona ngemva kokwelashwa?

Yebo, ngezinye izikhathi izinto ezinjengalezi zingenzeka ngemva kokuhlinzwa:

• Ukuvinjwa kwenhliziyo: Lokhu kusho ukuthi isignali yokushaya kwenhliziyo ayifinyeleli engxenyeni engezansi yenhliziyo kahle.
• Ivalvu ye-AV evuzayo kwesobunxele noma kwesokudla.
• Imbobo odongeni lwegumbi elingezansi (i-Ventricular septal defect).
• Ukuncishiswa (i-Stenosis) kwevalvu ye-AV yesobunxele noma yesokudla.
• Ukuphazamiseka kokugeleza kwegazi ngaphansi kwevalvu ye-aortic (i-Subaortic stenosis).

Ingabe lokhu (i-Atrioventricular Canal Defect) akunakuvinjelwa?

Ayikho indlela yokuvimbela lokhu (i-Atrioventricular Septal Defect) ukuthi kwenzeke, ngoba kuvame ukuhlotshaniswa nezimbangela zofuzo.

Kodwa-ke, uma ukhulelwe, ungenza lezi zinto ukunciphisa ingozi yokuba ingane yakho ibe nesifo senhliziyo sokuzalwa:

• Gwema ngokuphelele izidakamizwa ezingekho emthethweni, utshwala, kanye nemikhiqizo kagwayi.
• Thola yonke imijovo oyidingayo ukuze uzivikele ezifweni.
• Gcina isisindo esinempilo.
• Uma unezinkinga zempilo ezingamahlalakhona, ziphathe kahle.
• Thatha amavithamini ngaphambi kokubeletha, ikakhulukazi i-folic acid, njengoba kunconywe udokotela wakho.

Uma ingane yami inalesi simo, ikusasa liyoba njani?

Ngaphandle kokuhlinzwa, izingane ezinezinkinga zomsele we-AV zingaphila iminyaka emibili kuya kwemithathu kuphela. Ezinye ziphila zize zibe zintsha.

Kodwa izindaba ezinhle ukuthi cishe u-90% wezingane ezike zahlinzwa ziphila iminyaka eyi-10 ngemva kwalokho kwelashwa. Lokho kusho ukuthi zivame ukuphila okungenani eminye iminyaka eyi-10 ngemva kokuhlinzwa. Cishe u-65% uphila iminyaka engama-20 ngemva kokuhlinzwa.

Kodwa khumbula lokhu: Ngisho nangemva kokuhlinzwa, umuntu one-Atrioventricular Canal Defect (AVCD) ngeke abe nenhliziyo ejwayelekile ngokuphelele. Kuzodingeka aqhubeke nokuhlolwa kwenhliziyo njalo ngezikhathi ezithile ukuze aqaphe ukusebenza kwenhliziyo yakhe. Lokhu kuzosiza ekubambeni noma yiziphi izinkinga kusenesikhathi.

I-patch ebekwa phezu kwembobo ivame ukuhlala impilo yonke. Kodwa ngokuhamba kwesikhathi, enye yama-valve enhliziyo alungisiwe ingaqala ukuvuza. Uma lokho kwenzeka, abantu abaphakathi kuka-10% no-20% bazodinga ukuhlinzwa kwesibili .

Iningi labantu alidingi imithi noma ukuhlinzwa okwengeziwe ngemva kokuhlinzwa. Kodwa-ke, ukungasebenzi kahle kwenhliziyo kungavela kamuva. Uma lokhu kwenzeka, udokotela angase ancome izinqubo ezingangenisi kakhulu njengokuhlanza umzimba .

Ngingayinakekela kanjani ingane yami?

Kungase kudingeke ukuthi unciphise umsebenzi womzimba wengane yakho . Buza udokotela wenhliziyo wengane yakho - udokotela ochwepheshe bezifo zenhliziyo ezinganeni - ngalokhu.

Izingane ezine- atrioventricular septal defect (AVSD) zingase zelulekwe ukuthi zithathe ama-antibiotic ngaphambi kokuvakashela udokotela wamazinyo. Lokhu kungasiza ekuvimbeleni uhlobo lokutheleleka kwenhliziyo olubizwa ngokuthi i-endocarditis . Khuluma nodokotela wenhliziyo wengane yakho ngalokhu futhi.

Ingane yami kufanele ibone nini udokotela?

Kufanele nakanjani uyise ingane yakho kudokotela wenhliziyo wezingane ngezikhathi ezithile. Bangaqapha inhliziyo yengane yakho nganoma yiziphi izinkinga. Ezinye izingane ezinezinkinga zomsele we-AV zingadinga ukwelashwa okwengeziwe ngemva kokuhlinzwa. I-patch ingavuza, noma i-valve elungisiwe ingavuza noma ibe mncane.

Ingane enenkinga ye-AV canal ingase ibe nezinkinga zezinzwa noma zokukhula . Ingase idinge usizo ngalokho.

Uma ingane yakho isikhulile, kufanele iye kudokotela wenhliziyo ozalwa nayo omdala futhi iye kohlolwa okungenani kanye ngonyaka.

Yimiphi imibuzo okufanele ngiyibuze udokotela wengane yami?

Ungabuza udokotela wengane yakho imibuzo efana nale:

• Uhlobo luni lwenkinga ye-AV ekhona ingane yami?
• Yiziphi izimpawu ezibonisa ukuthi isimo siya siba sibi kakhulu?
• Uzodinga nini ukuhlinzwa?
• Ingabe ingane yami izodinga imithi ngemva kokuhlinzwa?
• Ingabe kuzomele nginciphise imisebenzi yengane yami?

Kuvamile ukuba nemizwa eyahlukahlukene uma uzwa ukuthi ingane yakho esanda kuzalwa inesifo senhliziyo esifana ne -Atrioventricular Canal Defect . Kodwa odokotela bengane yakho bakhona ukukusiza, futhi bafuna ukwenza okungcono kakhulu ngengane yakho. Thola ukuthi yini eqondile ngesimo sengane yakho. Uma kukhona ongaqiniseki ngakho, buza udokotela wakho ngakho. Manje sekuyisikhathi sokumela impilo yengane yakho.

Ngakho-ke, yiziphi izinto okudingeka sizikhumbule kukho konke lokhu?

• I-Atrioventricular Canal Defect yisifo senhliziyo esiba khona lapho umuntu ezalwa. Sibangelwa kakhulu yimbobo enhliziyweni kanye nenkinga ngama-valve.
• Ukutholwa kusenesikhathi kanye nokuhlinzwa ngesikhathi kubaluleke kakhulu. Lokhu kuhlinzwa kuphumelele kakhulu.
• Izingane ezine- Down syndrome zinamathuba amaningi okuthola lesi simo.
• Ukuhlolwa kwezokwelapha kwesikhathi eside kuyadingeka ngisho nangemva kokuhlinzwa. Udinga ukuxhumana nodokotela wenhliziyo impilo yakho yonke.
• Uma ukhulelwe, ukulandela indlela yokuphila enempilo nokulandela iseluleko sezokwelapha kungasiza ekunciphiseni ingozi yengane yakho yokuthola isifo senhliziyo.
• Ungesabi, odokotela bakhona ukukusiza wena nomntwana wakho. Buza imibuzo, thola ulwazi.

Isifo senhliziyo, ukukhubazeka kwenhliziyo okuzalwa nakho, inhliziyo yengane, imbobo enhliziyweni, i-Atrioventricular Canal Defect, i-AVSD, isifo senhliziyo sabantwana