Uma udokotela ekutshela ukuthi ingane yakho inenkinga yenhliziyo, kuyinto evamile ngawe, njengomzali, ukuzwa ukwesaba okukhulu nokukhathazeka. Ikakhulukazi uma kuyisimo esinegama eliyinkimbinkimbi njenge-'Double Inlet Left Ventricle', futhi kungavamile, lokho kwesaba kungaba kukhulu nakakhulu. Kodwa ungakhathazeki. Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda. Ukwazi lolu lwazi kuzokunika amandla amaningi okubhekana nalolu hambo.
Iyini ngempela le Double Inlet Left Ventricle?
Kalula nje, lokhu kuyisifo senhliziyo esizalwa naso. Okusho ukuthi, ushintsho olwenzeka lapho inhliziyo yakheka ngesikhathi umntwana esesesibelethweni sikanina. Inhliziyo yethu inezindawo ezimbili eziyinhloko ezingezansi (amakamelo). I-ventricle yesokudla kanye ne-ventricle yesobunxele. Kodwa enhliziyweni yomntwana onalesi simo, elilodwa kuphela kula makamelo amabili aphansi elisebenza kahle . Lelo yi-ventricle yesobunxele.
Ngokuvamile, amakamelo amabili aphezulu enhliziyo (i-atria) axhunywe emakamelweni amabili aphansi ngokwahlukana. Kodwa kulokhu, womabili amakamelo aphezulu axhunywe ekamelweni elifanayo lokusebenza, i-ventricle yesobunxele . Lesi yisimo esingavamile esibizwa ngokuthi `i-single ventricle defect`.
Lesi simo sithinta kanjani umzimba womntwana?
Ukuze siqonde lokhu, ake siqale sibheke ukuthi inhliziyo enempilo isebenza kanjani. Cabanga ukuthi inhliziyo yethu ifana nendlu encane enamakamelo amane.
1. Inhliziyo enempilo: Igazi lomzimba "elingcolile" elingenawo umoya-mpilo lingena ku-atrium efanele. Ukusuka lapho, liya ku-ventricle efanele, eliyipompa emaphashini ukuze lithathe umoya-mpilo. Igazi "elihlanzekile", eliye lafakwa umoya-mpilo emaphashini, libuyela ku-atrium yesobunxele yenhliziyo. Ukusuka lapho, liya ku-ventricle yesobunxele, elipompa igazi elihlanzekile liye kuwo wonke umzimba. Ngale ndlela, igazi elihlanzekile nelingcolile alihlangani.
2. Isimo se-DILV: Enganeni enalesi simo, igazi elingenawo umoya-mpilo kanye negazi elinomoya-mpilo liqoqana ekamelweni elifanayo lokusebenza (i-ventricle yesobunxele) . Okwenzekayo ukuthi la magazi amabili ayahlangana. Bese leli gazi elixubile liya emaphashini engane kanye nasemzimbeni wonke. Ngenxa yalokho, izicubu zomzimba wengane azitholi umoya-mpilo owanele.
Ziyini izimpawu zalesi simo?
Lezi zimpawu zivame ukuvela zingakapheli izinsuku noma amasonto ambalwa umntwana ezelwe. Ngezinye izikhathi lezi zimpawu zingaba zimbi kakhulu ngokuzumayo.
| Isibonakaliso | Kuchazwe kalula |
|---|---|
| Umbala oluhlaza okwesibhakabhaka wesikhumba nezindebe (i-Cyanosis) | Isikhumba, izindebe, nezinzipho zibonakala ziluhlaza okwesibhakabhaka/zinsomi ngenxa yokunganeli komoya-mpilo egazini elijikeleza emzimbeni. Lokhu kwaziwa nangokuthi "umntwana oluhlaza okwesibhakabhaka." |
| Ubunzima bokuncelisa nokwehlisa isisindo | Uma uncelisa, umntwana uyakhathala futhi abe nobunzima bokuphefumula, ngakho-ke uyayeka ukuncelisa. Lokhu kuvimbela umntwana ekutholeni isisindo ngendlela efanele. |
| Ubunzima bokuphefumula | Izinga lokuphefumula liphezulu, futhi ungabona isifuba singena uma uphefumula. |
| Ukujuluka | Ikakhulukazi uma uphuza ubisi, ibunzi lakho nekhanda lakho kumanzi ngenxa yokujuluka. Lokhu kungenxa yokuthi inhliziyo kufanele isebenze kanzima. |
| Ukushaya kwenhliziyo okungavamile | Inhliziyo ishaya ngokushesha kakhulu, noma kukhona ushintsho lwesigqi. |
| Imisindo yenhliziyo engavamile (i-Heart Murmur) | Lapho udokotela ebheka nge-stethoscope, uzwa umsindo wenhliziyo owengeziwe. |
Kubangelwa yini lokhu? Ingabe ezinye izifo zenhliziyo nazo zingavela?
Imbangela eqondile yalokhu ayaziwa okwamanje . Ngokuvamile kwenzeka emavikini okuqala ayisishiyagalombili okukhulelwa lapho inhliziyo yengane ikhula. Kukholakala ukuthi kuyinhlanganisela yamathonya ezakhi zofuzo kanye nezici zemvelo.
Into ebaluleke kakhulu ukuthi lokhu akulona iphutha lakho. Ungazizwa kabi ngalokho ngenxa yento oyenzile noma ongayenzanga ngesikhathi sokukhulelwa kwakho.
Ngokuvamile, izingane ezinalesi simo esithi 'Double Inlet Left Ventricle' nazo zinezinye izinkinga zenhliziyo. Lokhu kungaphazamisa ukugeleza kwegazi emaphashini.
- Ukuhlangana kwe-Aorta:Ukuncishiswa komthambo oyinhloko (i-aorta) othwala igazi uye emzimbeni.
- I-Pulmonary Atresia: I-valve yamaphaphu ethwala igazi emaphashini ayakheki kahle.
- I-Pulmonary Valve Stenosis: Ukuncipha kwevalvu ethwala igazi emaphashini.
Ungasithola kanjani lesi sifo?
Ukuxilongwa ngesikhathi sokukhulelwa
Ngezinye izikhathi isimo somntwana wakho singatholakala ngaphambi kokuzalwa . Lokhu kwenziwa nge-scan ekhethekile ebizwa ngokuthi i-fetal echocardiogram. Lokhu kuvame ukwenziwa phakathi kwamasonto ayi-18 nama-24 okukhulelwa. Udokotela wakho angancoma lokhu kuhlolwa:
- Uma into efana nesigqi esingajwayelekile ibonakala enhliziyweni yengane ngesikhathi sokuhlolwa okuvamile.
- Uma kukhona emndenini onesifo senhliziyo esizalwa naso.
- Uma umama enesifo esingathinta isifo senhliziyo, njengesifo sikashukela.
Ukuhlonza ngemva kokuzalwa komntwana
Ngokuvamile lesi simo sitholakala ngemva kokuzalwa komntwana.
- Ukuhlolwa kwe-Pulse Oximetry (i-Pulse Ox): Lokhu kuhlolwa kwenziwa zingakapheli amahora angama-24 kusukela umntwana ezelwe. Kukala izinga lomoya-mpilo egazini lomntwana. Uma izinga lomoya-mpilo liphansi, kungaba yinkinga yenhliziyo.
- Ukuhlolwa kwezokwelapha: Lapho udokotela ehlola ingane, angase akusole lokhu ngokuzwa umsindo wenhliziyo ongavamile (ukububula) noma ukubona ingane iphenduka ibe luhlaza okwesibhakabhaka.
Ukuhlolwa kokuqinisekisa isimo
Uma kuvela ukusola, kwenziwa izivivinyo eziningana ukuze kuqinisekiswe futhi kuqondwe kangcono isimo senhliziyo.
| Ukuhlolwa | Lokhu kwenzani? |
|---|---|
| I-Echocardiogram (i-Echo) | Lesi isivivinyo esibaluleke kakhulu. Kufana nokuskena. Sikuvumela ukuthi ubone ngokucacile amakamelo enhliziyo, ama-valve, nokuthi igazi ligeleza kanjani. |
| I-X-ray yesifuba | Ungathola umbono ngobukhulu nesimo senhliziyo, kanye nenani legazi eligeleza emaphashini. |
| I-Electrocardiogram (ECG/EKG) | Umsebenzi kagesi wenhliziyo ulinganiswa ukuze kuhlolwe noma yiziphi izinkinga ngesigqi senhliziyo. |
| Ukufakwa kwe-Catheterization Yenhliziyo | Lokhu kuhlolwa kwenziwa ngaphambi kokuhlinzwa ukuze kulinganiswe ngokunembile amazinga okucindezela kanye nomoya-mpilo enhliziyweni. Lokhu kwenziwa ngokudlulisa ipayipi elincane kakhulu ngemithambo esesinqeni liye enhliziyweni. |
Yiziphi izindlela zokwelapha lokhu?
Lesi simo selashwa ngochungechunge lokuhlinzwa okwenziwa ngezigaba . Lokhu kuhlinzwa akwenzi inhliziyo ibe "ejwayelekile", kodwa kulungisa kabusha ukugeleza kwegazi enhliziyweni ukuze umntwana aphile kahle isikhathi eside.
Ukuhlinzwa kokuqala: iBlalock-Taussig Shunt
Lokhu kwenziwa ezinsukwini ezimbalwa zokuqala noma emavikini ngemva kokuzalwa komntwana. Lokhu kuhilela ukufaka ithubhu elincane (i-shunt) ukusiza ukugcina inani legazi eliya emaphashini uma kukhona ukugeleza kwegazi okuphansi. Lokhu kuvumela umntwana ukuba akhule kahle kuze kube ukuhlinzwa kwesibili.
Ukuhlinzwa kwesibili: Inqubo ye-Glenn Shunt
Lokhu kuhlinzwa kwenziwa lapho umntwana eneminyaka engaba ngu-4-6 ubudala . Okwenziwa lapha ukuxhumanisa igazi elingenawo umoya-mpilo elivela emzimbeni ongaphezulu namaphaphu, kudlule inhliziyo. Lokhu kunciphisa kakhulu ukucindezeleka enhliziyweni.
Ukuhlinzwa kwesithathu nokokugcina: Inqubo yeFontan
Lokhu kwenziwa lapho ingane ineminyaka engaba ngu -2-3 ubudala . Lapha, igazi elingenawo umoya-mpilo elivela engxenyeni engezansi yomzimba lixhunywe ngqo emaphashini. Ngemva kwalokhu kuhlinzwa, ukuxubana kwegazi elingenawo umoya-mpilo kanye negazi elinomoya-mpilo cishe kuyaphela ngokuphelele. Izinga le-oxygen emzimbeni wengane lisondela kakhulu kwelengane enempilo.
Imithi enikezwa ngaphezu kokuhlinzwa
Ingane kuzodingeka inikwe izinhlobo eziningana zemithi ngaphambi nangemva kokuhlinzwa.
- I-Digoxin: Iqinisa ukufinyela kwenhliziyo.
- Ama-ACE inhibitors: Umfutho wegazi ophansi.
- Ama-anticoagulant: Avimbela ukujiya kwegazi (isib. i-Aspirin).
- I-Diuretics: Susa amanzi angaphezulu emzimbeni.
Okubalulekile: Ngaphambi kokwelashwa ngamazinyo (njengokukhishwa kwamazinyo), kubalulekile ukuthi laba bantwana banikezwe ama-antibiotic ukuvimbela izifo zenhliziyo (i-endocarditis). Kufanele uxoxe ngalokhu nodokotela wakho kanye nodokotela wamazinyo.
Yini okufanele uyicabange ngekusasa lomntwana?
Lo mbuzo unzima ukuwubuza, kodwa kubalulekile ukwazi. Emashumini ambalwa eminyaka edlule, izinsana ezinalesi simo azizange ziphile isikhathi eside. KodwaNjengoba kunezindlela zokuhlinzwa ezithuthukisiwe ezitholakalayo namuhla, isimo sihluke kakhulu.
Namuhla, izingane ezingaphezu kuka- 70% - 80% eziqeda lolu chungechunge lokuhlinzwa zisinda ngale kweminyaka eyi-10. Eziningi zize zifinyelele ebudaleni ngempumelelo.
Kodwa-ke, laba bantwana badinga ukulandelwa udokotela wenhliziyo impilo yabo yonke . Ezinye izinkinga zingase zibe khona, njengezinkinga zesigqi senhliziyo kanye ne-pneumonia evame ukwenzeka. Bangase futhi bavinjelwe emidlalweni enzima. Kodwa-ke, iningi lezingane lingaphila impilo evamile yesikole.
Umlayezo Wokuya Nawe Ekhaya
- I-Double Inlet Left Ventricle yisifo senhliziyo esingavamile esizalwa naso lapho kusebenza khona elinye lamakamelo aphansi enhliziyo kuphela.
- Lokhu kubangela ukuthi igazi elinomoya-mpilo kanye negazi elingenawo umoya-mpilo lihlangane futhi lihambe emzimbeni, okubangela izimpawu ezifana nomntwana ophenduka abe luhlaza okwesibhakabhaka kanye nobunzima bokuphefumula.
- Lokhu kwelashwa ngochungechunge lwezigaba ezintathu lokuhlinzwa okuthuthukisa ukujikeleza kwegazi lomntwana.
- Nakuba ingane izodinga ukubhekwa kwezokwelapha impilo yayo yonke ngemva kwalokhu kuhlinzwa, abantu abaningi bayaqhubeka nokuphila impilo ephumelelayo nesebenzayo.
- Khuluma nodokotela wakho ngokukhululekile ngayo yonke imibuzo yakho kanye nokwesaba kwakho. Awuwedwa kulolu hambo.
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