Ingabe isikhumba nezindebe zomntwana wakho osanda kuzalwa zibukeka ziluhlaza okwesibhakabhaka? Ingabe kubonakala sengathi unenkinga yokuphefumula? Noma ujuluka kakhulu uma ephuza ubisi? Ungamane nje ulahle lokhu njengokungathi kwenzeka ngokuhlangana. Ngezinye izikhathi lokhu kungaba izimpawu zesifo senhliziyo ingane yakho ezalwa naso. Namuhla sikhuluma ngesimo senhliziyo esingavamile okufanele wena, njengomzali, usiqaphele. Leso yi-Double Outlet Right Ventricle, noma i-DORV ngamafuphi.
Kalula nje, iyini i-Double Outlet Right Ventricle (DORV)?
Ukuze siqonde lokhu, ake siqale sicabange ngendlela inhliziyo enempilo esebenza ngayo. Inhliziyo yethu ifana nendlu encane enamakamelo amane. Amakamelo amabili aphezulu namakamelo amabili aphansi. Amakamelo amabili amakhulu, aqinile ngezansi abizwa ngokuthi ama-ventricle. Elinye lingakwesokudla (i-Ventricle Yesokudla), kanti elinye lingakwesokunxele (i-Ventricle Yesokudla).
Yilokhu okuvame ukwenzeka:
- Umthambo wegazi oyinhloko othwala igazi "elingcolile" elingenawo umoya-mpilo uliyise emaphashini, umthambo wamaphaphu, uqala e-ventricle efanele .
- Umthambo wegazi omkhulu kunayo yonke, i-aorta, uqala kusukela e-ventricle yesobunxele, uthwala igazi "elihlanzekile" eliye lafakwa umoya-mpilo lisuka emaphashini kuwo wonke umzimba.
Kuhle kakhulu, akunjalo? Ipayipi elilodwa elikhulu ekamelweni ngalinye.
Manje, endabeni ye-DORV, lokhu kuhleleka kuyaphazamiseka. Kumntwana one-DORV, yomibili imithambo yegazi eyinhloko esikhulume ngayo, i-Pulmonary Artery kanye ne-Aorta, ixhunywe ngokuphelele noma ngokwengxenye kwi-Right Ventricle. Ngemuva kwalokho, i-Left Ventricle ayixhunyiwe kunoma yimuphi umthambo wegazi oyinhloko, noma ingxenye encane kakhulu exhunywe kuyo.
Kalula nje, i-aorta, ethwala igazi elinomoya-mpilo emzimbeni wonke, kanye nomthambo wamaphaphu, othwala igazi elingenawo umoya-mpilo emaphashini, kokubili kuvela endaweni efanayo, i-ventricle yesokudla. Lesi yisifo senhliziyo esizalwa naso.
Lokhu kuphakamisa imibuzo emibili:
1. Igazi elihlanzekile nelicebile ngomoya-mpilo okudingeka lihambe liye kwezinye izingxenye zomzimba lixutshwa negazi elingcolile nelingenawo umoya-mpilo.
2. Kuphampunwa igazi eliningi emaphashini kunalokho okudingekayo. Lokhu kubeka ukucindezeleka okukhulu enhliziyweni nasemaphashini. Ngokuhamba kwesikhathi, lezi zitho zingalimala.
Yiziphi ezinye izinkinga ezingabonakala nge-DORV?
Izingane ezine-DORV ngezinye izikhathi zibhekana nezinye izinkinga zokubeletha. Ezinye zalezi zinkinga zifaka:
- Ukungasebenzi kahle kwe-ciliary: Izinkinga ngokusebenza kwezingxenye ezithambile kakhulu, ezifana nezinwele zomgudu wokuphefumula womntwana.
- I-Heterotaxy:Izitho zomntwana esifubeni nasesiswini zibekwe kwezinye izindawo ngaphandle kwalapho zivame ukuba khona.
- Ukuwohloka kwamathumbu: Ukusonteka okungavamile kwamathumbu omntwana.
- I-pulmonary stenosis: Ukunciphisa noma ukunciphisa ivalvu phakathi kwe-ventricle yesokudla kanye nomthambo wamaphaphu.
- I-Ventricular hypoplasia: Ikamelo elilodwa noma womabili enhliziyo mancane kunejwayelekile.
Ingabe kunezinhlobo ezahlukene ze-DORV? Zingahlukaniswa kanjani lezi?
Yebo, kunezinhlobo eziningana ze-DORV. Lokhu kuhlukaniswa kunqunywa yinto eyodwa ebaluleke kakhulu. Okusho ukuthi, cishe wonke umntwana one-DORV unembobo odongeni phakathi kwamakamelo amabili enhliziyo (i-Ventricular Septal Defect - VSD). Lembobo ivimbela igazi ukuthi ligeleze liye phambili naphambili phakathi kwamakamelo amabili.
Odokotela bahlukanisa i-DORV ngokusekelwe ekutheni i-VSD, noma umgodi, itholakala kuphi.
| Uhlobo lwe-DORV | Incazelo elula |
|---|---|
| I-DORV ene-VSD ye-subaortic | Imbobo enhliziyweni (VSD) itholakala ngaphansi kwe-aorta. |
| I-DORV ene-VSD engaphansi kwamaphaphu (i-Taussig-Bing) | Imbobo enhliziyweni itholakala ngaphansi komthambo wamaphaphu. Lokhu kubizwa nangokuthi isimo se-Taussig-Bing. |
| I-DORV ene-VSD ephindwe kabili | Imbobo itholakala ngaphansi kwemithambo yegazi emibili emikhulu (i-Aorta kanye ne-Pulmonary Artery). |
| I-DORV ene-VSD engazinikele (ekude) | Imbobo itholakala kude nale mithambo yegazi emibili emikhulu, endaweni engenakho ukuxhumana. |
Ukwazi kahle ukuthi lolu hlobo luni kubaluleke kakhulu ekuhleleni ukwelashwa.
Mama noBaba, qaphelani lezi zimpawu!
Izimpawu ze-DORV zivame ukuvela ezinsukwini zokuqala noma emavikini ngemva kokuzalwa. Kufanele uqaphele kakhulu ngalokhu.
| Isibonakaliso | Kusho ukuthini lokhu? |
|---|---|
| Ubuluhlaza Okwesibhakabhaka (i-Cyanosis) | Isikhumba somntwana, izindebe, noma izinzipho zingase zibe luhlaza okwesibhakabhaka noma zibe nsomi. Lokhu kungenxa yokuntuleka komoya-mpilo egazini. |
| Ubunzima bokuphefumula | Ukuphefumula kakhulu, ngokushesha (tachypnea) noma ukuzizwa uphelelwa umoya. |
| Ubunzima bokudla/ukuphuza | Ukungafuni ukuphuza ubisi, futhi noma ngabe uphuza kancane, uzoyeka ngemva kwesikhashana. Lokhu kungaholela nasekunciphiseni isisindo. |
| Ukububula Kwenhliziyo | Uma udokotela ehlola inhliziyo nge-stethoscope, uzwa umsindo ohlukile ngaphezu kokushaya kwenhliziyo. |
| Inhliziyo esheshayo (i-Tachycardia) | Isilinganiso senhliziyo sishesha kakhulu kunezingu-100 ngomzuzu. |
| Ukujuluka ngokweqile | Ingane ijuluka kakhulu, ikakhulukazi uma incelisa. |
| Ukozela okungavamile | Ingane ihlala ilele futhi ingaphili. |
Yini ebangela lesi simo? Yiziphi izinkinga ezingaba khona?
Eqinisweni, abacwaningi abakayitholi imbangela eqondile ye-DORV. Kodwa-ke, kutholakale ukuthi cishe ama-50% ezinsana ezinalesi simo zinohlobo oluthile loshintsho kuma-chromosome azo, izingxenye zolwazi lwethu lwezakhi zofuzo (i-DNA).
Kodwa khumbula lokhu. Akulona iphutha lakho leli, akulona iphutha lakho. Ngakho-ke ungalokothi ucabange ngakho bese uzibeka icala.
Uma i-DORV ingelashwa kahle, izinkinga zingavela ngokuhamba kwesikhathi.
- Ukuphazamiseka kwenhliziyo (i-Arrhythmias)
- Izinkinga ze-valve yenhliziyo
- Ukwehluleka kwenhliziyo
- Umfutho wegazi ophezulu wamaphaphu
- Ukutheleleka kolwelwesi lwangaphakathi lwenhliziyo (i-Endocarditis)
Odokotela basithola kanjani isimo se-DORV?
Ngezinye izikhathi, lolu hlobo lwesifo senhliziyo lungatholakala ngisho nangaphambi kokuba umntwana azalwe, ngesikhathi sokuhlolwa ngesikhathi sokukhulelwa kwakho. Ukuhlolwa okukhethekile okusetshenziselwa lokhu kubizwa ngokuthi "i-Fetal Echocardiogram".
Uma lokho kungenzeki, odokotela bazosola lokhu kuphela uma izimpawu esikhulume ngazo ekuqaleni zivela ngemva kokuzalwa komntwana. Bese bezohlola umntwana.
- Hlola ukuthi isikhumba somntwana siyashintsha sibe luhlaza okwesibhakabhaka.
- Inhliziyo ilalelwa nge-stethoscope ukuhlola noma yimiphi imisindo engavamile (ukububula).
- I-Pulse Oximetry ukuhlolwa okulinganisa inani lomoya-mpilo egazini lomntwana ngokubeka idivayisi encane efana ne-clip emunweni noma endlebeni yomntwana. Lokhu ukuhlolwa okulula okungayilimazi ingane.
Ngemva kwalezi zivivinyo zokuqala, kungase kwenziwe ezinye izivivinyo eziningana ukuqinisekisa ukuxilongwa.
- Ukuhlolwa kwezithombe okungenasihlaseli: Ukuskena kwe-CT, ukuskena kwe-MRI, kanye ne-X-ray okwenziwa ngaphandle komzimba womntwana.
- I-Electrocardiogram (ECG noma EKG): Ukuhlolwa okungenabuhlungu okulinganisa ukusebenza kukagesi kwenhliziyo.
- I-Echocardiogram (echo): Lokhu kufana nokuskena kwenhliziyo. Kusebenzisa amaza omsindo ukubona ngokucacile konke ngenhliziyo, okuhlanganisa ukuma kwayo, umsebenzi wayo, kanye nendlela imithambo yayo yegazi exhumene ngayo.
- Ukufakwa kwe-catheter enhliziyweni: Kulokhu, kufakwa ipayipi elincane kakhulu (i-catheter) enhliziyweni ngomthambo wegazi embotsheni noma engalweni yomntwana ukuze kutholakale ulwazi olunembile kakhulu mayelana nomfutho wenhliziyo, amazinga omoya-mpilo kanye nesakhiwo sayo.
Ungakhathazeki, kukhona ukwelashwa kwalokhu! - Ake sifunde ngokuhlinzwa
Cishe wonke umntwana one-DORV uzodinga ukuhlinzwa kwenhliziyo evulekile phakathi nonyaka wokuqala wokuphila. Lokhu kungase kuzwakale kuyesabisa kuwe. Lokho kuvamile. Kodwa khumbula, ngobuchwepheshe bezokwelapha banamuhla, lokhu kuhlinzwa kungenziwa ngempumelelo enkulu.
Udokotela wakho kanye nodokotela ohlinza inhliziyo bazocabangela izici eziningana lapho benza izinqumo mayelana nokuhlinzwa.
- Luhlobo luni lwe-DORV lomntwana?
- Kungakhathaliseki ukuthi kukhona yini ezinye izinkinga ngenhliziyo yengane noma ezinye izitho zomzimba.
- Impilo yomntwana iyonke.
Kunezinhlobo eziningana zokuhlinzwa ezivame ukwenziwa.
- Ukulungiswa kwe-intraventricular: Kule nqubo, udokotela ohlinzayo udala umhubhe odlula ku-VSD, noma imbobo enhliziyweni, esebenzisa i-patch ekhethekile. Lo mhubhe udala indlela yokugeleza kwegazi kusuka ku-ventricle yesobunxele kuya ku-aorta.
- Ukulungiswa kwe-Biventricular noma ukushintsha kwemithambo yegazi: Uma womabili ama-ventricle engane esesimweni esihle futhi i-DORV iwuhlobo lwe-VSD (Taussig-Bing) olungaphansi kwamaphaphu, udokotela ohlinzayo angenza ukuhlinzwa ukuze asuse i-aorta futhi ayixhume kwi-ventricle yesobunxele.
- Ukulungiswa kwe-Univentricular (ukuhlinzwa kwe-Fontan): Uma i-DORV iyinkimbinkimbi kakhulu, udokotela ohlinzayo angase ancome lokhu kuhlinzwa. Lokhu kuhilela ukuqondisa igazi elingenawo umoya-mpilo lisuka emzimbeni ongezansi liye ngqo emaphashini. Lokhu ukuhlinzwa okuyinkimbinkimbi okuhilela izigaba eziningana.
Kunezingozi nganoma yikuphi ukuhlinzwa kwenhliziyo. Lokhu kufaka phakathi ukopha, amahlule egazi, ukutheleleka, kanye nezinkinga nge-anesthesia. Kodwa odokotela benza konke okusemandleni abo ukunciphisa lezi zingozi.
Impilo izoba njani ngemva kokuhlinzwa?
Ngemva kokuhlinzwa, ingane kuzodingeka ihlale esibhedlela isonto noma ngaphezulu. Ubude besikhathi buzohluka kuye ngohlobo lokuhlinzwa olwenziwe kanye nesimo somntwana.
Into ebalulekile ukuthi ngemva kokuhlinzwa, iningi lezingane ezine-DORV zingaphila impilo enempilo nejwayelekile yabantu abadala.
Kodwa into eyodwa okufanele uyikhumbule ukuthi umuntu oye wahlinzwa i-DORV kumele ahlale ngaphansi kokuqondisa kukadokotela wenhliziyo impilo yakhe yonke. Kubalulekile ukuya kohlolwa ngesikhathi esibekiwe futhi ahlolwe ngokufanele.
Abanye abantu bangase babe nokushaya kwenhliziyo okungajwayelekile noma izinkinga zenhliziyo ngisho nangemva kweminyaka eminingi yokuhlinzwa, ngakho-ke kubalulekile ukuthi uhlale unakekela impilo yakho.
Isikhathi sokubona udokotela nokuthi nini sokuya e-ETU
Ngisho nangemva kokuhlinzwa, qapha ingane yakho ngokucophelela. Uma kuvela izimpawu ezilandelayo, yazisa udokotela wakho ngokushesha.
- Uma uzizwa ukushaya kwenhliziyo okungavamile, okusheshayo, noma okushaya ngamandla.
- Uma uzwa ubuhlungu esifubeni noma ubunzima bokuphefumula (lokhu kungaba izimpawu zokuhlaselwa yinhliziyo).
Ezimweni ezilandelayo, thatha ingane uyiyise e-Emergency Treatment Unit (ETU) yesibhedlela esiseduze ngaphandle kokulibala.
Uma ingane yakho inenkinga enkulu yokuphefumula kanye/noma izinzipho zayo, izindebe, noma isikhumba sayo siluhlaza okwesibhakabhaka ngokusobala, iya ku-ETU ngokushesha!
Imibuzo ebalulekile okufanele uyibuze udokotela wakho
Kuvamile ukuba nemibuzo eminingi uma uthola ukuthi ingane yakho ine-DORV. Ungagcini lutho kuwe. Buza udokotela wakho konke bese uchazelwa ngakho. Nansi eminye imibuzo ongayibuza.
1. Hlobo luni lwe-DORV ingane yami enalo?
2. Hlobo luni lokuhlinzwa ofuna ukulwenza?
3. Ukuhlinzwa kufanele kwenziwe nini?
4. Ziyini izingozi zokuhlinzwa?
5. Yiziphi izingozi zokungahlinzwa?
6. Ingabe ingane yami izodinga ukuhlinzwa okwengeziwe ngemva kwalokhu kuhlinzwa?
7. Ingabe ingane yami kuzodingeka iphuze imithi impilo yayo yonke?
Uma wazi konke kahle ngokubuza imibuzo efana nale, uzokwazi ukwenza izinqumo ezinolwazi ngaphandle kokwesaba.
Umlayezo Wokuya Nawe Ekhaya
- I-Double Outlet Right Ventricle (DORV) iyisifo senhliziyo esibi kakhulu, kodwa esingelapheka, esizalwa naso.
- Njengoba imbangela eqondile yalesi simo ingaziwa, ungalokothi ucabange ukuthi leli yiphutha lakho njengomzali.
- Ukuxilongwa kusenesikhathi kanye nokuhlinzwa ngesikhathi esifanele kunikeza izingane ithuba lokuphila impilo enempilo nende.
- Ngemva kokuhlinzwa, kuyimpoqo ukuba ngaphansi kokuqondisa kukadokotela wenhliziyo impilo yakho yonke.
- Hlala uqaphele izimpawu zesixwayiso eziphuthumayo njengobunzima obukhulu bokuphefumula kanye nesikhumba esiluhlaza okwesibhakabhaka. Esimweni esinjalo, thatha ingane uyiyise e-Emergency Treatment Unit (ETU) ngokushesha.
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