Ingabe ingane yakho encane inalolu hlobo lwenkinga yenhliziyo? Ake sifunde nge-Endocardial Cushion Defect!

Uma ingane yakho izalwa, ukhathazeka kakhulu ngakho konke ngaye, akunjalo? Ngezinye izikhathi izingane ezincane zingaba nezinkinga zenhliziyo ezizalwa nazo. Esinye salezo zinkinga zenhliziyo, nakuba siyinkimbinkimbi kancane, okubaluleke kakhulu ukusazi sibizwa ngokuthi i-Endocardial Cushion Defect (ECD) . Igama lingase lizwakale liyesabeka kancane, kodwa ungakhathazeki. Ake sixoxe ngalokhu kalula, ngendlela ongayiqonda, kulungile?

Iyini le Endocardial Cushion Defect?

Kalula nje, lokhu kuyisici esisezinhliziyweni zezingane zethu ezincane, esizalwa naso , okungukuthi, isici esenzeka zisesesibelethweni sikamama. Cabanga ngenhliziyo yethu njengendlu enamakamelo amane. Kunamakamelo amabili esitezi esiphezulu (esikubiza ngokuthi i-atria), namakamelo amabili esitezi esingezansi (okuyi-ventricles). La makamelo ahlukaniswe yizindonga (ama-septum). Ngenxa yalezi zindonga, igazi ligeleza ngendlela ehlelekile, ohlangothini olulodwa kuphela.

Futhi, kukhona ama-valve afana nesango phakathi kwala makamelo asiza ukugeleza kwegazi ohlangothini olulodwa kuphela. Ikakhulukazi, i-valve ye-tricuspid kanye ne-valve ye-mitral, etholakala phakathi kwamakamelo aphezulu (i-atria) kanye namakamelo aphansi (amakamelo e-mitral ), kumele akhiwe kahle.

Kodwa-ke, enganeni enalesi sifo se-endocardial cushion (ECD), izingxenye zenhliziyo ezibizwa ngokuthi ama-endocardial cushion – izicubu eziyisisekelo ezakha lezi zindonga nama-valve – azikhuli kahle. Ngenxa yalokho, izindonga ezihlukanisa amakamelo enhliziyo zingase zingakhuli kahle, noma zingase zingabi khona nhlobo. Ama-valve amabili abalulekile esikhulume ngawo (i-tricuspid ne-mitral) nawo angase angakhuli kahle.

Ake ucabange nje, kwenzekani uma lokhu kuhlukana enhliziyweni, lezi zindonga, kungasebenzi kahle, futhi ama-valve, njengamasango, engasebenzi kahle? Indlela igazi eligeleza ngayo ngaphakathi enhliziyweni iyaphazamiseka.

• Igazi eliningi kunokuvamile ligeleza emaphashini engane , okubangela umfutho wegazi ophezulu emithanjeni yegazi ngaphakathi kwamaphaphu (umfutho wegazi ophezulu wamaphaphu).
• Ngenxa yalokhu kucindezela okuphezulu emaphashini, igazi liqala ukugeleza ngendlela engafanele. Bese kuthi igazi eligcwele umoya-mpilo, elihlanzekile kanye negazi elingcolile elingenawo umoya-mpilo liqale ukuhlangana .
• Inhliziyo kufanele isebenze kanzima ukupompa igazi ngalokhu kugeleza kwegazi okuphazamiseka. Kufana nokukhuphuka intaba. Ngokuhamba kwesikhathi, lokhu kungenza buthaka imisipha yenhliziyo yengane.

Ingabe kunezinhlobo ezahlukene ze-endocardial cushion defect (ECD)?

Yebo, kunezinhlobo eziningana zalesi simo, kuye ngokuthi umonakalo ungakanani. Ezinye izingane zingase zibe nezinkinga kuphela odongeni oluphakathi kwamakamelo aphezulu enhliziyo (i-atria). Ezinye zingase zibe nezinkinga odongeni oluphakathi kwamakamelo angaphansi (ama-ventricles). Ngezinye izikhathi zombili izinkinga zingase zenzeke ndawonye. Futhi, amaphutha kuma-valve e-mitral kanye ne-tricuspid angahluka.

Lesi simo, esibizwa ngokuthi i-endocardial cushion defect (ECD), saziwa nangokuthi i-atrioventricular septal defect (AVSD) noma i-atrioventricular canal defect .

Lesi simo ngezinye izikhathi singahlotshaniswa nezinye izinkinga zenhliziyo ezizalwa nazo. Isibonelo:

• I-Tetralogy ye-Fallot
• I-ventricle yesokudla ephuma kabili
• Ukuguqulwa kwemithambo emikhulu (ukuguqulwa kwemithambo emibili emikhulu yegazi ezindaweni ezingafanele)
• I-patent ductus arteriosus
• I-ventricle eyodwa (i-ventricle eyodwa)

Sivame kangakanani lesi simo?

Uma ubheka izibalo emazweni afana ne-United States, cishe ingane eyodwa kwezingu-1,800 ezizalwa minyaka yonke ingase ibe nalesi sifo se-endocardial cushion (ECD). Enye into ebalulekile ukuthi cishe abantu abangu-20% abane- Down syndrome banalesi simo se-ECD.

I-ECD iwuthinta kanjani umzimba wengane yami?

Uma lesi simo se-ECD singaphathwa kahle, singaba sibi kakhulu futhi sibangele izinkinga ezinkulu.

• Ukulimala kwamaphaphu: Njengoba sixoxile ngaphambili, ukugeleza kwegazi ngokweqile emaphashini, ukucindezeleka okukhulu, kanye nokuhamba kwesikhathi, kungabangela umonakalo ohlala njalo emaphashini.
• Isigqi senhliziyo esingajwayelekile: Umsebenzi kagesi wenhliziyo uyaphazamiseka, futhi ukushaya kwenhliziyo kungase kungabi ngendlela evamile.
• Ukwehluleka kwenhliziyo okubangelwa ukuminyana: Isimo lapho inhliziyo iba buthakathaka futhi ingakwazi ukupompa igazi elanele emzimbeni.
• I-Eisenmenger syndrome: Lesi yisimo esibi kakhulu. Ingcindezi emaphashini iyanda kakhulu, okwenza ukugeleza kwegazi kubuyele emuva ngokuphelele, okubangela ukuba igazi elingenawo umoya-mpilo lijikeleze kuwo wonke umzimba.

Kwezinye izimo ezinzima, lesi simo singaba yingozi ngisho nokuphila .

Futhi, ngisho nangemva kokulungiswa kwephutha ngokuhlinzwa, ingane yakho ingase ibe sengozini yokuthola isifo senhliziyo esibizwa ngokuthi i-endocarditis . Ngakho-ke, odokotela bangase batuse ukuthatha ama-antibiotic ngaphambi kokuhlinzwa kwamazinyo.

Ziyini izimpawu zalesi simo?

Ngezinye izikhathi, izingane ezine-endocardial cushion defect engaphelele zingase zingabonisi zimpawu kuze kube yilapho zisencane kakhulu. Kodwa-ke, izingane ezine -endocardial cushion defect ephelele (i-ECD ephelele) zingase zibe nezimpawu zingakapheli amasonto ambalwa zizelwe. Kubalulekile ukuqaphela lezi zimpawu:

• Ukushaya kwenhliziyo okusheshayo
• Isikhumba esikhanyayo noma esiluhlaza okwesibhakabhaka:Bheka ukushintsha kombala okuluhlaza okwesibhakabhaka, ikakhulukazi izindebe, ulimi, kanye neminwe. Lokhu kubizwa ngokuthi i-cyanosis.
• Ubunzima bokudla nokukhula kwesisindo: Bheka ukuthi ingane yakho iyaxakeka yini, iyajuluka ngemva kokuphuza ubisi, noma ayikhuli kahle.
• Ukuntuleka kwamandla: Ingabe ingane yakho ihlala ilele futhi ayinasithakazelo sokudlala?
• Ukuphefumula okusheshayo noma okunzima: Hlola ukuthi isifuba somntwana sizwakala siqinile, siphefumula ngokushesha, noma ukuthi isifuba siyangena yini ngaphakathi lapho ephefumula.
• Ukutheleleka okuvamile: Qaphela ukutheleleka okuvamile, ikakhulukazi ukutheleleka kokuphefumula.

Yini ebangela lokhu kuphazamiseka komcamelo we-endocardial?

Imbangela eqondile ye-endocardial cushion defect (ECD) ayaziwa okwamanje. Kodwa-ke, kutholakale ukuthi ihlotshaniswa kakhulu ne -Down syndrome . Lokhu kukhubazeka kwenzeka ekuqaleni kokukhula komntwana esibelethweni. Inkinga enkulu ukuthi izicubu ezibizwa ngokuthi i-endocardial cushion esikhulume ngazo ekuqaleni azikhuli kahle. Lezi yizindonga nama-valve kamuva ahlukanisa amakamelo enhliziyo.

Odokotela bakuthola kanjani lesi simo?

Udokotela wengane yakho uzoqala ngokuyihlola ngokuphelele . Uma kuzwakala umsindo ongajwayelekile (ukububula kwenhliziyo) lapho ulalele inhliziyo nge-stethoscope, kungaba yinkomba yalesi simo.

Ngaphezu kwalokho, kungenziwa ezinye izivivinyo eziningana:

• I-Electrocardiogram (EKG/ECG): Lokhu kuhlola ukusebenza kukagesi kwenhliziyo.
• I-Echocardiogram: Lesi isivivinyo esibaluleke kakhulu. Sisebenzisa amaza omsindo ukuthatha isithombe senhliziyo. Singabona ngokucacile konke kusukela esimweni senhliziyo, kuya ezimbobeni ezisezindongeni zayo kanye nendlela ama-valve asebenza ngayo.
• I-X-ray yesifuba: Lokhu kungahlola ubukhulu benhliziyo kanye nesimo samaphaphu.
• I-MRI Yenhliziyo: Ngezinye izikhathi lokhu kuhlolwa kwenziwa uma kudingeka imininingwane eyengeziwe.
• Ukufakwa kwe-catheter enkabeni yenhliziyo: Kule nqubo, ithubhu elincane (i-catheter) lidluliselwa emthanjeni wegazi liye enhliziyweni ukuze kulinganiswe ingcindezi engaphakathi kwenhliziyo bese kuthathwa amasampula egazi. Lokhu kungadingeka ngaphambi kokuhlinzwa.

Into ebaluleke kakhulu ukuqhubeka ubona udokotela wakho ngesikhathi sokukhulelwa kwakho futhi wenze ama-ultrasound scan.Ukwenza kahle. Ngezinye izikhathi, i-ECD ingatholakala ngaphambi kokuba umntwana azalwe, ngokuskena okwenziwa ngesikhathi umntwana esesesibelethweni (i-echocardiogram yengane). Uma lokhu kwaziwa kusenesikhathi, kungenzeka ukuhlela ukuthi ukwelashwa okudingekayo kuqale ngokushesha nje lapho umntwana ezalwa.

Kuphathwa kanjani lokhu?

Ukwelashwa okuyinhloko nokungcono kakhulu kwalesi sifo se-endocardial cushion (ECD) ukuhlinzwa. Kodwa-ke, kuze kube yilapho ukuhlinzwa sekuqediwe, eminye imithi inganikezwa ukusiza ingane ukuba iqine futhi ikhuluphale. Isibonelo, ama-diuretics (abizwa nangokuthi 'amaphilisi amanzi') anciphisa uketshezi oluningi emzimbeni kanye ne -digoxin (Cardoxin® noma i-Lanoxin®) esiza ukuthuthukisa ukusebenza kwenhliziyo ngezinga elithile.

Kwenzekani ngemva kokuhlinzwa?

Ngesikhathi sokuhlinzwa, odokotela abahlinza inhliziyo bavala imigodi ebangela ukuba igazi livuze phakathi kwamakamelo enhliziyo. Basebenzisa i-patch ekhethekile ukwenza lokhu. Futhi, uma ingane ine-valve eyodwa kuphela, bazokwenza ama-valve amabili ahlukene e-mitral kanye ne-tricuspid kuyo. Ngezinye izikhathi, uma i-valve ye-mitral yengane ivuza, ingalungiswa noma ishintshwe uma kudingeka.

Lokhu kuhlinzwa kuvame ukwenziwa enganeni eneminyaka ephakathi kwezinyanga ezintathu neziyisithupha ubudala . Kodwa-ke, uma ingane yakho inesici esiphelele se-endocardial cushion, kubalulekile ukuthi kwenziwe ukuhlinzwa ngaphambi kokuba ingane ibe nonyaka owodwa ubudala . Lena yindlela kuphela yokuvimbela ukulimala kwamaphaphu unomphela.

Ngezinye izikhathi ingane ingase igule kakhulu noma ibe nesisindo esingaphansi kwesisindo ukuze ihlinzwe ngokugcwele. Kuleso simo, odokotela bazokwenza okunye ukuhlinzwa okulula kuqala ukuze banciphise inani legazi eliya emaphashini engane. Lokhu kubizwa ngokuthi i-pulmonary artery banding . Lokhu kungasiza ekulawuleni izimpawu kuze kube yilapho ingane inamandla futhi ikhuluphala. Ngemuva kwalokho, ngesikhathi esifanele, ukulungiswa okuphelele kungenziwa.

Ingabe kukhona izinkinga ekwelashweni?

Njenganoma yikuphi ukuhlinzwa, kunezinkinga ezithile ezingase zenzeke ngemva kokuhlinzwa kwe-ECD. Kodwa-ke, isikhathi esiningi, lezi zingalawulwa.

• I-valve ye-mitral evuzayo: Ngezinye izikhathi ngemva kokuhlinzwa, i-valve ye-mitral ingase ingavaleki kahle futhi igazi elithile lingase livuze emuva.
• Isigqi senhliziyo esingajwayelekile: Kungase kube nokuphazamiseka okuthile ekushayeni kwenhliziyo.

Lezi zinkinga ngezinye izikhathi zingavela lapho ingane isikhulile kancane, ngisho nasebusheni bayo. Yingakho ukuhlolwa njalo kwezokwelapha kubalulekile.

Ingabe lesi simo singavinjelwa?

Njengoba imbangela eqondile ye-ECD ingaziwa, kunzima ukusho ukuthi ungayivimbela kanjani ngokuphelele. Kodwa-ke, uma othile emndenini wakho enalolu hlobo lwesifo senhliziyo (ECD) noma ezinye izinkinga zofuzo, kungaba ngumqondo omuhle ukuthola ukwelulekwa ngofuzo ngaphambi kokuba ukhulelwe.

Uma ingane yami ine-ECD, yini okufanele ngiyilindele?

Lona ngumbuzo omkhulu abazali abaningi abanawo. Izindaba ezinhle ukuthi ngemva kokuhlinzwa ukuze kulungiswe i-ECD, izingane eziningi ziyaqhubeka nokuphila impilo evamile nenempilo. Kodwa-ke, impilo yesikhathi esizayo yengane incike ezintweni ezifana nobunzima be-ECD yayo, ukuthi amaphaphu ayo alimele yini, kanye nempilo yayo iyonke.

Ngokwezibalo, amathuba okusinda ngonyaka wokuqala ngemva kokuhlinzwa angaba ngu-80%. Amathuba okusinda eminye iminyaka eyi-10 angaba ngu-75%, kanti amathuba okusinda iminyaka engama-20 angaba ngu-65%.

Ngisho nangemva kokuhlinzwa, ezinye izingane zingase zibe nezinkinga kamuva. Inkinga evamile ukuthi i-valve ye-mitral ayivaleki kahle futhi igazi liyavuza. Uma lokhu kwenzeka, kungase kwenziwe olunye ukuhlinzwa ukuze kulungiswe lokhu.

Isimo se-ECD sihlala isikhathi esingakanani?

Lokhu kubaluleke kakhulu. I-Endocardial cushion defect (ECD) akuyona inkinga ezophola ngokwayo. Inkinga izohlala kuze kube yilapho udokotela ohlinza inhliziyo ehlinza ukuze alungise le nkinga. Ngaphandle kokuhlinzwa, izingane eziningi ngeke ziphile iminyaka engaphezu kwemibili noma emi-3 ubudala. Yingakho ukuhlinzwa ngesikhathi kubalulekile.

Ngingamnakekela kanjani umntwana wami?

Ngemva kokuba ingane yakho itholakale ine-ECD, ngisho nangemva kokuhlinzwa, ingane yakho kuzodingeka ihlolwe njalo nodokotela wenhliziyo . Lokhu kuhlolwa okulandelayo kungaba kanye noma kabili ngonyaka. Lokhu kuhlolwa kuzoqhubeka kuyo yonke ingane yakho isencane kuze kube yilapho isikhulile. Lokhu kuvumela udokotela ukuthi aqaphe isimo sengane yakho, abone ukuthi kukhona yini izinkinga nge-patch noma i-valve, njengokuvuza, futhi angenelele kusenesikhathi uma kudingeka.

Kufanele ngiyise nini ingane yami kudokotela?

Uma ingane yakho ikhombisa noma yiziphi izimpawu ezilandelayo, xhumana nodokotela ngokushesha:

• Ukuphefumula kanzima
• Ukukhathala ngaphandle komzamo omkhulu ngemva kokugijima nokudlala isikhashana
• Ukungakhuli noma ukukhuluphala njengoba kulindelekile
• Ukuba nesikhumba esiluhlaza okwesibhakabhaka

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Kubaluleke kakhulu ukususa noma yikuphi ukungabaza ongase ube nakho. Ungesabi ukubuza udokotela wakho imibuzo efana nale:

• "Dokotela, ingabe ingane yami inesici esiphelele noma esiyingxenye se-endocardial cushion?"
• "Udokotela uncoma luphi uhlelo lokwelapha ngesimo somntwana wami?"
• "Dokotela, zingaki izinhlinzeko ze-ECD ozenzile kanje?"
• "Yiziphi izinto ezikhethekile okudingeka ngizinakekele ngemva kokuhlinzwa?"

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kungenzeka ukuthi awukaze uphuphe ngokuhlinzwa kwengane yakho encane. Kodwa-ke, ukuhlinzwa kuyindlela engcono kakhulu nephumelelayo yokulungisa i-endocardial cushion defect (ECD). Le nkinga ngeke ilulame ngokwayo. Ngakho-ke, uma kukhona ongakuqondi, cela udokotela wakho akuchazele kona.

Into ebaluleke kakhulu ukuthi awuwedwa. Odokotela, abahlengikazi, kanye nethimba lonke lezokunakekelwa kwempilo bakhona ukukusiza nokukuqinisa kulolu hambo. Ngisho nangemva kokuhlinzwa, ungaphuthelwa imitholampilo yengane yakho futhi ulandele imiyalelo kadokotela njengoba kuyalelwe. Ngaleyo ndlela, wena nomntwana wakho nizokwazi ukubona noma yiziphi izinkinga ezingase zivele esikhathini esizayo futhi nibhekane nazo ngempumelelo. Hlala uqinile!

I- Endocardial Cushion Defect, i-AVSD, isifo senhliziyo, ukukhubazeka kokuzalwa, isifo senhliziyo sezingane, ukuhlinzwa kwenhliziyo, i-Down syndrome, isifo senhliziyo sokuzalwa, i-cardiology yezingane