Ngiyaqonda ukuthi kungaba nzima kangakanani ngomzali ukutshelwa udokotela ukuthi ingane yakho esanda kuzalwa inesici senhliziyo. Ngesikhathi esinjengalesi, uma uzwa nge-'BTT shunt', cishe unemibuzo eminingi mayelana nokuthi iyini, kungani yenziwa, ingabe izoyilimaza ingane, futhi ingabe zikhona izingozi. Ungakhathazeki. Namuhla, sizoxoxa ngakho konke ngokucacile nangokulula.
Kalula nje, iyini le BTT Shunt?
I-BTT shunt, noma i-Blalock-Taussig-Thomas shunt, iwukuhlinzwa okukhethekile okwenziwa ukusiza izingane ezingatholi umoya-mpilo owanele emizimbeni yazo. Lesi simo sibangelwa yisimo senhliziyo esizalwa naso .
Cabanga ngakho, imizimba yethu ithola umoya-mpilo emoyeni esiwuphefumulayo emaphashini ethu. Lo moya-mpilo udinga ukungezwa egazini futhi uthwalwe emzimbeni wonke. Kodwa-ke, kwabanye abantwana abanesifo senhliziyo, umthambo wegazi oyinhloko othwala igazi lisuka enhliziyweni liye emaphashini , umthambo wamaphaphu , awutholi igazi elanele. Khona-ke umzimba awutholi umoya-mpilo owanele.
Ngakho-ke, okwenziwa yi-BTT shunt ukudala indlela entsha ngokufaka ithubhu elincane lokwenziwa (i-shunt noma i-graft) elisuka emthanjeni wegazi oyinhloko elithwala igazi lisuka enhliziyweni liye emzimbeni liye emaphashini. Kufana nomgwaqo omncane odlula ngendlela ephithizelayo. Lokhu kwandisa inani legazi eliya emaphashini, futhi umzimba uthola umoya-mpilo ongcono.
Into ebalulekile ukuthi lokhu kuvame ukuba yisisombululo sesikhashana. Uma ingane isikhulile futhi inamandla, kwenziwa ukuhlinzwa okukhulu ukuze kulungiswe ngokuphelele inkinga yokuqala yenhliziyo. Phakathi nalolo kuhlinzwa, i-BTT shunt iyasuswa. Kodwa-ke, akuvamile kakhulu, ezinye izingane zingadinga ukuba nale shunt njengesixazululo sesikhathi eside.
Yiziphi izinhlobo zezifo zenhliziyo ezidinga ukuhlinzwa kwe-BTT Shunt?
Lokhu kuhlinzwa kuyasiza ezifweni eziningana zenhliziyo ezizalwa nazo ezinciphisa ukugeleza kwegazi emaphashini.
| Izimo zenhliziyo ezizalwa nazo |
|---|
| Isifo senhliziyo esingaphansi kwe-hypoplastic |
| I-Tetralogy of Fallot (TOF) |
| I-Truncus arteriosus |
| I-Ebstein's anomaly |
| I-Pulmonary atresia |
| I-Tricuspid atresia |
| Ezinye izinhlobo zokuguqulwa kwemithambo emikhulu |
Kwenzekani ngaphambi kokuhlinzwa?
Ngaphambi kokuhlinzwa, ithimba lezokwelapha lomntwana wakho lizoqoqa lonke ulwazi oludingekayo. Bazohlola ingane yakho ngokucophelela futhi babheke umlando wayo wempilo kusukela ekukhulelweni kwakho. Bangase benze nokuhlolwa okungangenisi ukutheleleka.
| Izinhlobo zokuhlolwa ezingenziwa |
|---|
| Ukuskena kwenhliziyo (i-Transthoracic echocardiogram) |
| Ukuhlolwa kwegazi |
| I-X-ray yesifuba |
| Ukuhlolwa kwe-ECG (i-Electrocardiogram) |
| Ngezinye izikhathi i-angiogram noma i-CT angiogram (i-Coronary angiogram noma i-CT angiogram) |
Uzothola nemiyalelo yokuthi ungageza kanjani ingane yakho ngaphambi kokuhlinzwa nokuthi kufanele uyeke nini ukudla nokuncelisa.
Kwenzekani ngesikhathi sokuhlinzwa?
Lokhu kuhlinzwa kuthatha amahora amaningana futhi kubucayi kakhulu. Udokotela ohlinzayo wenza okulandelayo ikakhulukazi:
- Ithambo eliphakathi kwesifuba somntwanaInhliziyo ifinyelelwa ngokusika i-sternum .
- Ukuze kusondele enhliziyweni, i -thymus gland eseduze isuswa ngokuphelele.
- Njengoba kushiwo ngaphambili, i-graft yokwenziwa ixhunywe phakathi komthambo oyinhloko ohlinzeka ngegazi emzimbeni (umthambo we-subclavian) kanye nomthambo wegazi ohlinzeka ngegazi emaphashini (umthambo we-pulmonary).
- Lokhu kuxhumana kuhlolwa ngokucophelela ukuze kubonakale ukuthi kusebenza kahle yini, ukuthi kukhona yini amahlule egazi, noma ukuthi kukhona yini ukuvuza kwegazi.
- Uma konke kulungile, isifuba somntwana sizophinde sivaleke.
Kwenzekani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, ingane yakho izongeniswa egunjini lokunakekelwa okujulile (ICU) .
Ungakhathazeki ngalokhu. Ungase uzizwe ungakhululekile uma ubona ingane yakho ngemva kokuhlinzwa. Ingane izoba namapayipi amaningi nezintambo ezixhunywe kuyo. Kodwa khumbula, yonke leyo mishini ikhona ukusiza ingane ukuba ilulame ngokushesha. Ngakho-ke hlala uqinile.
Ingane inikezwa umuthi wokunciphisa igazi, njenge- heparin, ukuvimbela ukuqhekeka kwegazi. Baqala futhi i-aspirin . Ingane kuzodingeka iphuze le-aspirin impilo yayo yonke. Akuvamile kakhulu, ezinye izingane zingadinga usizo lomshini wokusekela impilo wesikhashana, njenge -ECMO .
Yiziphi izinzuzo nezingozi zalokhu kuhlinzwa?
Inzuzo eyinhloko:
Inzuzo enkulu yalokhu kuhlinzwa ukuthi kwandisa inani lomoya-mpilo ofinyelela emangqamuzaneni omzimba womntwana. Lokhu kunciphisa umbala oluhlaza okwesibhakabhaka (i-cyanosis) obonakala esikhumbeni, ezindebeni nasezinzipho zezingane ngenxa yokuntuleka komoya-mpilo. Lokhu kuyibhuloho elihle kakhulu lomntwana ukuze ahlale ephilile futhi enamandla kuze kube yilapho ehlinzwa kakhulu okulandelayo.
Izingozi nezinkinga:
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile. Udokotela wakho uzokuchazela lokhu ngokuningiliziwe. Ezinye zezinkinga ezingaba khona zifaka:
- Igazi eliningi ligeleza nge-shunt liye emaphashini kunokudingekile (ukujikeleza kwegazi ngokweqile kwamaphaphu).
- Amahlule egazi.
- Ukulimala kwenzwa eduze nendawo yokuhlinzwa (ikakhulukazi inzwa ethinta ukujula kwezwi lomntwana).
- Ukuphazamiseka kwenhliziyo (i-Arrhythmia).
- Ukuboshwa kwenhliziyo.
Lezi zingozi ziphansi kakhulu, futhi ithimba lezokwelapha lenza konke okusemandleni alo ukuvimbela izinto ezinjengalezi.
Kuthatha isikhathi esingakanani ukululama futhi kufanele ngibone udokotela nini?
Ingane ivame ukuhlala esibhedlela cishe amasonto amabili. Isonto lokuqala noma ngaphezulu lizochithwa egunjini lokunakekelwa okujulile (ICU). Ngisho nangemva kokuba usuyile ekhaya, kuzodingeka ukuthi uyise ingane yakho ukuze iyohlolwa njalo. Ukuvakasha kokuqala kuvame ukuba phakathi nesonto noma amabili kusukela ubuyile ekhaya.
Ngemva kokubuyela ekhaya, uma ubona izimpawu ezilandelayo, kufanele ushayele udokotela wakho ucingo ngokushesha.
| Izimpawu zesixwayiso okufanele uziqaphele |
|---|
| Ukuvuvukala endaweni yokuhlinzwa noma kwenye indawo emzimbeni |
| Ubomvu obuzungeze inxeba lokuhlinzwa |
| Uma isikhumba nezindebe ziphinde zibonakale ziluhlaza okwesibhakabhaka |
| Uma ingane ibonakala ikhathele kakhulu noma ikhathele |
| Uma unomkhuhlane |
| Uma uketshezi luvuza enxebeni lokuhlinzwa |
Njengomzali, siyazi ukuthi ufuna ukunika ingane yakho okungcono kakhulu ngangokunokwenzeka. Into engcono kakhulu ongayenza ngalesi sikhathi ukubuza ithimba lezokwelapha yonke imibuzo onayo. Khuluma ngokucacile ngesimo somntwana wakho, ukuhlinzwa, kanye nekusasa. Ukukhetha isibhedlela nodokotela abanolwazi olukhulu ekuhlinzeni okunjalo kuzokulethela ukuthula kwengqondo okukhulu.
Umlayezo Wokuya Nawe Ekhaya
- I-BTT Shunt iwukuhlinzwa okwenziwa ezinganeni ezinesifo senhliziyo sokuzalwa ukuze kwandiswe inani legazi eligeleza emaphashini futhi kuhlinzekwe umoya-mpilo emzimbeni.
- Lokhu kuvame ukuba yisisombululo sesikhashana. Uma ingane isikhulile, kuzodingeka olunye ukuhlinzwa ukuze kulungiswe isimo senhliziyo esingaphansi.
- Ngemva kokuhlinzwa, umntwana uzodinga ukwelashwa okujulile futhi kungase kudingeke aphuze imithi efana ne-aspirin impilo yakhe yonke.
- Njenganoma yikuphi ukuhlinzwa, kunezingozi. Khuluma nodokotela wakho ngazo ngokukhululekile.
- Ngemva kokubuyela ekhaya, qaphela kakhulu ukuziphatha kwengane yakho, umbala wesikhumba kanye nomkhuhlane. Uma ubona noma yiziphi izinguquko, funa iseluleko sezokwelapha ngokushesha.
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