Ingabe ingane yakho encane yazalwa inenkinga yenhliziyo eyinkimbinkimbi? Ngezinye izikhathi odokotela kungenzeka ukuthi bakutshele ukuthi inhliziyo yengane yakho inephampu eyodwa eyinhloko, i-ventricle. Ukuhlinzwa okukhethekile odokotela abakuncomayo ezimweni ezinjalo kubizwa ngokuthi 'inqubo ye-Fontan'. Empeleni kuyinto evamile ukuzizwa wesaba futhi ungaqiniseki uma uzwa leli gama. Kodwa uma sikwazi ngokugcwele lokhu, uzothola amandla amakhulu kanye namandla okuqhubeka nalolu hambo. Ingabe singakhuluma ngalokhu kalula?
Iyini inqubo yeFontan ngamagama alula?
Ukuze siqonde lokhu, ake siqale sibheke ukuthi inhliziyo enempilo isebenza kanjani. Inhliziyo enempilo inamakamelo amane amakhulu. Amabili phezulu (i-atria) kanye namabili phansi (ama-ventricle). La makamelo amabili ayizimpompi ezimbili eziyinhloko zenhliziyo. Elinye lithumela igazi elingenawo umoya-mpilo emaphashini ukuze lithathe umoya-mpilo. Elinye liphampa igazi elihlanzekile neligcwele umoya-mpilo liye kuwo wonke umzimba.
Kodwa-ke, ezinye izingane zizalwa zinelinye lala maseli amabili elingakhekile kahle. Bese kuthi iseli elilodwa elenza umsebenzi lenze yomibili le misebenzi. Cabanga ukuthi kukhathaza kangakanani ngomuntu ofanayo ukwenza imisebenzi emibili. Kanjalo nje, leli seli elilodwa lingakhathala ngokushesha ngoba kufanele lipompe igazi liye emaphashini nasemzimbeni.
Lokho okwenziwa yinqubo yeFontan ukunciphisa umthwalo womsebenzi kulelo seli elilodwa. Kufana nokunikeza omunye umuntu ukuthi akusize usebenze kanzima.
Kule nqubo, odokotela abahlinzayo baxhuma igazi elingenawo umoya-mpilo osuka emzimbeni ongezansi liye emthanjeni wamaphaphu, bedlula inhliziyo. Lokhu kufana nokudala 'indlela emfushane' entsha. Ngokuvamile, ngaphambi kwale nqubo, kwenziwa enye inqubo ebizwa ngokuthi inqubo kaGlenn ukuqondisa igazi elingenawo umoya-mpilo osuka emzimbeni ongaphezulu liye emaphashini. Inqubo kaFontan iyisinyathelo sokugcina kulolu chungechunge lwezinqubo.
Uma kudalwa izindlela ezintsha ngale ndlela, umsebenzi walelo seli elilodwa kuphela ukupompa igazi elihlanzekile, elinomoya-mpilo emzimbeni wonke. Lokhu kuyimpumuzo enkulu kuleyo nhliziyo encane.
Ubani odinga lokhu kuhlinzwa futhi kungani?
Lokhu kuhlinzwa kwenziwa kakhulu ezinganeni ezizalwa zine-ventricle eyodwa. Ngokuvamile kwenziwa phakathi kweminyaka emi-2 neyi-5 .
Kodwa lokhu kuhlinzwa akulona olwawo wonke umuntu. Udokotela uzohlola ingane yakho ngokucophelela ukuze abone ukuthi iyakufanelekela yini lokhu. Isibonelo:
- Iseli elisebenzayo lengane lidinga ukuba liqine kakhulu.
- Amaphaphu kumele abe nempilo eyanele ukuze athole igazi eliza ngqo emaphashini.
Ithebula elingezansi libala ezinye zezinkinga zenhliziyo eziyinhloko eziphathwa ngalokhu kuhlinzwa.
| Isimo | Incazelo elula |
|---|---|
| I-Hypoplastic Left Heart Syndrome (HLHS) | Uhlangothi lwesobunxele lwenhliziyo (kufaka phakathi i-ventricle yesobunxele) alukhuli kahle. (Lesi yisona sizathu esivame kakhulu sokuhlinzwa kwe-Fontan) |
| I-Tricuspid Atresia | Ivalvu ye-tricuspid ohlangothini lwesokudla lwenhliziyo ayikhuli kahle. |
| I-Pulmonary Atresia | Ukuvaleka kwevalvu yamaphaphu ethwala igazi liye emaphashini. |
| I-Ventricle Engakwesokunxele Ephindwe Kabili | Yomibili imithambo yegazi eyinhloko engena enhliziyweni ixhumeka kwi-ventricle yesobunxele. |
Kwenzekani ngaphambi nangesikhathi sokuhlinzwa?
Ngemva kokunquma ukuthi ingane yakho ifanele ukuhlinzwa, udokotela uzokwenza izivivinyo eziningana.
- I-Transthoracic Echocardiogram (TTE): Lokhu ukuskena kwenhliziyo nge-ultrasound. Kunikeza isithombe esihle sesakhiwo senhliziyo, ama-valve, kanye nomsebenzi wayo.
- I-Electrocardiogram (EKG): Ilinganisa umsebenzi kagesi wenhliziyo.
- Ukufakwa kwe-Catheterization Yenhliziyo: Ithubhu elincane (i-catheter) lidluliselwa emthanjeni wegazi liye enhliziyweni ukuze kulinganiswe ukucindezela kanye namazinga omoya-mpilo ngaphakathi kwenhliziyo.
- I-CT noma i-MRI Scan: Kwezinye izimo, lokhu kuyadingeka ukuze kutholakale izithombe zenhliziyo nemithambo yegazi ezizungezile ezinezinhlangothi ezintathu (3D).
Ngosuku lokuhlinzwa, ingane inikezwa i-anesthesia ukuze ilale. Lokhu kusho ukuthi ingane ngeke izwe ubuhlungu. Ngesikhathi sokuhlinzwa, ingane izoxhunywa emshinini okhethekile owenza umsebenzi wenhliziyo namaphaphu okwesikhashana (umshini wenhliziyo namaphaphu) . Lo mshini uzohlinzeka ngegazi emzimbeni kuze kube yilapho udokotela ohlinzayo enza uxhumano olusha (kusukela ku-vena cava engaphansi kuya emthanjeni wamaphaphu).
Ngezinye izikhathi udokotela ohlinzayo wenza imbobo encane (i-fenestration) kule ndlela entsha.Kwenziwa ukunciphisa ingcindezi enhliziyweni ngemva kokuhlinzwa. Ukuhlinzwa konke kungathatha cishe amahora angu-4-5 .
Kwenzekani ngemva kokuhlinzwa? Ingabe zikhona izingozi?
Ngemva kokuhlinzwa, ingane ingeniswa egunjini lokunakekelwa okujulile (ICU) ukuze ibhekwe kahle. Ngemva kwezinsuku ezimbalwa, idluliselwa egunjini elivamile. Isikhathi esijwayelekile sokuhlala esibhedlela siphakathi kwezinsuku ezi-7 nezi-13 .
Lokhu kuhlinzwa kunezinzuzo zako kanye nezingozi nezinkinga, futhi kubaluleke kakhulu ukuzazi.
| Uhlobo lwengozi | Izinkinga ezingaba khona |
|---|---|
| Izingozi zesikhashana (Ngemva kokuhlinzwa) | Ukuphuma kwegazi emithanjeni yegazi, izinkinga zezinso, ukwehluleka kwenhliziyo, ukushaya kwenhliziyo okungavamile, isifo sesibindi. |
| Izingozi zesikhathi eside (ngokuhamba kwesikhathi) | I-enteropathy elahlekelwa amaprotheni, amahlule egazi (i-thromboembolism), isifo sesibindi esihlobene ne-Fontan (FALD), kanye ne-plastic bronchitis. |
Ngokuhamba kwesikhathi, ezinye iziguli zingase zizwe ukwehla kokusebenza kwalokhu kuhlinzwa. Lokhu kubizwa ngokuthi 'i-Fontan ehlulekile'. Ngaleso sikhathi, ukufakelwa inhliziyo kungadingeka. Odokotela babheka lokhu njengengxenye yohambo.
Hlobo luni lwekusasa ingane engalithemba?
Esikhathini esidlule, ikusasa lomntwana ozelwe eneseli elilodwa lalingaqiniseki. Kodwa namuhla, ngokuthuthuka kwesayensi yezokwelapha, ukuhlinzwa kweFontan kunikeze laba bantwana ithuba lokudlulela ngale kobuntwana, ebusheni, nasekukhuleni.
Ngokwezibalo, kulabo abaye bahlinzwa yiFontan:
- Cishe ama-90% ayaphila ngemva kweminyaka eyi-10.
- Cishe ama-85% ayaphila ngemva kweminyaka engama-30.
Abantu abaningi manje baphila impilo enempilo bedlulile eminyakeni engu-50. Kodwa into ebaluleke kakhulu ukuthi, laba bantwanaKubalulekile ukuhlala ngaphansi kokuqondisa kukadokotela wenhliziyo impilo yakho yonke. Kuphoqelekile ukuthi uhlolwe njalo futhi uhlolwe.
Kunini lapho udinga ukubonana nodokotela?
Uma ubuyela ekhaya ngemva kokuhlinzwa, yazisa udokotela wakho ngokushesha uma unezinye zezimpawu ezilandelayo:
- Uma igazi noma olunye uketshezi luvuza enxebeni lokuhlinzwa.
- Uma unomkhuhlane noma ezinye izimpawu zokutheleleka (ukukhwehlela, umkhuhlane).
Njengoba isimo sengane yakho siyinkimbinkimbi, ungesabi ukubuza udokotela nganoma yini ongayiqondi. Ukuqonda kahle isimo sengane yakho kuzokusiza ukuthi uyinakekele kahle ingane yakho.
Umlayezo Wokuya Nawe Ekhaya
- Inqubo yeFontan ayilona ikhambi eliphelele lesifo senhliziyo esineseli elilodwa. Inqubo ebaluleke kakhulu eshintsha ukuhamba kwegazi, yehlisa ingcindezi enhliziyweni, futhi yenza impilo ibe lula.
- Lokhu kuhlinzwa kunciphisa umthwalo womsebenzi esiseleni esisodwa sengane futhi kwandisa kakhulu amazinga omoya-mpilo emzimbeni.
- Kubalulekile ukuqaphela izinkinga zesikhathi eside, njengesifo sesibindi, ezingavela ngokuhamba kwesikhathi.
- Okubaluleke kakhulu: Kubalulekile ukubona udokotela wenhliziyo futhi uhlolwe njalo impilo yakho yonke ngemva kokuhlinzwa.
- Khuluma nodokotela wakho ngokukhululekile. Xoxa nganoma yimiphi imibuzo noma ukukhathazeka onakho naye. Ukuqaphela kwakho kubaluleke kakhulu enhlalakahleni yengane yakho.
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