Injabulo oyizwayo uma ubheka ingane yakho esanda kuzalwa ayichazeki, akunjalo? Ngesikhathi esifanayo, kunomthwalo wemfanelo omkhulu enhliziyweni yakho ngaleyo mpilo encane. Ngezinye izikhathi kuyinto evamile ukuzizwa wesaba kakhulu futhi ukhathazekile uma uzwa ngezifo ezithile izingane ezincane ezingase zihlupheke ngazo. Namuhla, sikhuluma ngesifo senhliziyo esibi esingase senzeke ezinganeni ezisanda kuzalwa, kodwa esingavamile kakhulu, futhi sidinga ukunakekelwa kwezokwelapha ngokushesha. Lesi simo sibizwa ngokuthi i-Interrupted Aortic Arch, noma (IAA) ngamafuphi.
Kalula nje, iyini i-Interrupted Aortic Arch (IAA)?
Ukuze siqonde lokhu, ake siqale sibheke ukuthi inhliziyo yethu isebenza kanjani. Cabanga ngenhliziyo yethu njengephampu yamanzi. Le phampu inamakamelo amane amakhulu. Amabili phezulu namabili phansi. Igazi, elisetshenziswe ngumzimba futhi linamazinga aphansi omoya-mpilo, okuluhlaza okwesibhakabhaka kancane, lingena ekamelweni eliphezulu kwesokudla. Ukusuka lapho, liya ekamelweni elingezansi bese liphonswa emaphashini. Emaphashini, leli gazi ligcwele umoya-mpilo futhi liba nombala obomvu omuhle.
Manje leli gazi elibomvu elinomoya-mpilo lingena ekamelweni eliphezulu kwesobunxele senhliziyo. Ukusuka lapho, liya ekamelweni eliphansi kwesobunxele bese liphonswa emzimbeni wonke ngemithambo yegazi emikhulu nebaluleke kakhulu emzimbeni wethu, i-aorta . Le aorta ifana nohlelo oluyinhloko lwamapayipi oluthwala amanzi esuka ethangini lethu lamanzi ukuya endlini yonke. Lime njengenduku yomusi.
Ngakho-ke, okwenzeka enganeni enesifo esibizwa ngokuthi i-Interrupted Aortic Arch (IAA) ukuthi umthambo wegazi oyinhloko, i-aorta, awuphelele. Kukhona ukuvinjelwa endaweni ethile kuwo, njengesikhala esiphukile. Kalula nje, ipayipi lamanzi eliyinhloko liphukile phakathi. Ngenxa yalokhu, kungakhathaliseki ukuthi inhliziyo iphampa kanzima kangakanani, igazi elihle elinomoya-mpilo aliyi ezingxenyeni ezingezansi zomzimba.
Lesi yisimo esibi kakhulu, esisongela impilo ngoba uma izitho zomzimba zingawutholi umoya-mpilo, ziqala ukuvala. Kwezokwelapha, lokhu sikubiza ngokuthi 'ukushaqeka'.
Wazi kanjani ukuthi ingane yakho inalesi simo? Ziyini izimpawu?
Izingane ezine-IAA zivame ukuqala ukukhombisa izimpawu emahoreni ambalwa okuqala noma ezinsukwini ngemuva kokuzalwa. Njengabazali, kubaluleke kakhulu ukuthi nikwazi lokhu.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ukungafuni ukuphuza ubisi nokukhathala | Ingane ingase izwe ikhathele ngemva kokumunca, ingase ikhathale ngemva kokuphuza kancane, noma ingase ilale njalo. |
| Ukuphefumula okusheshayo | Ingane ingase iphefumule ngokushesha kunokujwayelekile. Lokhu kungenxa yokuthi inhliziyo kufanele isebenze kanzima. |
| Ukushaya kwenhliziyo okusheshayo | Uma ubeka isandla sakho esifubeni somntwana, uzozwa ukuthi inhliziyo ishaya ngokushesha okukhulu. |
| Ubuthakathaka obungavamile kanye nokozela | Ingane ingase izizwe ingaphili, ihlale ilele, futhi kube nzima ukuvuka. |
| Ukushintsha kombala wesikhumba | Imilenze, izinyawo, kanye nomzimba ongezansi wengane, ikakhulukazi ngoba ingenayo igazi, kungase kubonakale kumpunga noma kuluhlaza okwesibhakabhaka. Lo mehluko ungabonakala lapho izandla nobuso ngokuvamile kuba bopinki. |
Uma ubona eyodwa noma ngaphezulu yalezi zimpawu enganeni yakho, kufanele ubone udokotela ngokushesha noma uyise ingane yakho e-Emergency Treatment Unit (ETU) yesibhedlela ngokushesha .
Kungani lokhu kwenzeka ezinganeni?
Uma uzwa into efana nale, umbuzo wokuqala ofika engqondweni yakho njengomzali uthi, "Kungani lokhu kwenzeke enganeni yethu? Ingabe senze into engalungile?"
Into yokuqala okufanele uyikhumbule ukuthi lokhu akubangelwa yiphutha labazali . I-IAA yisimo sofuzo .
Kalula nje, lesi simo senzeka lapho umntwana ekhula esibelethweni, ngenxa yokulahlekelwa yingxenye encane kakhulu ye-chromosome ethinta ukwakheka kwenhliziyo nemithambo yegazi emikhulu.
Izingane ezine-IAA zivame ukuba ne -DiGeorge syndrome.Kungenzeka ngesinye isimo sofuzo esibizwa ngokuthi i-DiGeorge syndrome. Lokhu kubangelwa ukulahlekelwa yingxenye ye-chromosome efanayo njengoba kushiwo ngenhla. Izingane ezine-DiGeorge syndrome zingase zibe nezifo ezivame ukutheleleka futhi zingase zibe nezinguquko ezithile ebusweni (njengokuqhekeka komlomo).
Ezinye izinkinga zenhliziyo ezihambisana ne-IAA
Izinsana ezine-IAA zivame ukuba nesinye isifo senhliziyo esisodwa noma ngaphezulu. Esinye sezici ezivame kakhulu yi-Ventricular Septal Defect (VSD).
- I-Ventricular Septal Defect (VSD): Kalula nje, lokhu kuyimbobo odongeni (septum) phakathi kwamakamelo amabili amakhulu okupompa (ama-ventricles) enhliziyo. Nakuba lokhu kuvame ukuba yiphutha, i-VSD ingaba ngumsindisi wempilo wesikhashana wengane ene-IAA. Cabanga ukuthi lapho igazi lingakwazi ukugeleza e-aorta, elinye igazi elinomoya-mpilo ohlangothini lwesobunxele lwe-aorta lingageleza ngalembobo liye ohlangothini lwesokudla, lapho lingageleza khona liye emaphashini ukuze linikeze igazi ezingxenyeni ezingezansi zomzimba. Kufana nokuba ne-bypass encane lapho umgwaqo omkhulu uvaliwe. Kodwa lokhu kuyisixazululo sesikhashana nje.
Yiziphi izindlela zokuxilonga kanye nokwelapha?
Kubalulekile ukuqaphela nokwelapha lesi simo ngokushesha okukhulu.
Ukuxilongwa
Lesi simo sivame ukuxilongwa nge- Echocardiogram . Simane sikubize ngokuthi 'ukuhlolwa kwe-Echo'. Lokhu kufana nokuskena kwenhliziyo. Lokhu kuhlolwa okungenabuhlungu kungabona ngokucacile ukuma nokusebenza kwamagumbi enhliziyo, ama-valve, kanye nemithambo yegazi. Ngezinye izikhathi, lesi simo singatholakala ngisho kusenesikhathi ngokuskena okwenziwa ngesikhathi umntwana esesesibelethweni.
Ukwelashwa
Ukwelashwa kwe-IAA ukuhlinzwa . Kodwa-ke, kuze kube yilapho ingane isilungele ukuhlinzwa, odokotela bazokwenza okunye kuqala ukusindisa impilo yomntwana.
1. Isinyathelo Sokuqala - Ukugcina Ipayipi Lesikhashana Livuliwe:
Usana ngalunye olusanda kuzalwa lunokuxhumana kwesikhashana phakathi kwenhliziyo, i-aorta, kanye nepayipi elithwala igazi liye emaphashini elibizwa ngokuthi i-Ductus Arteriosus . Lokhu kubaluleke kakhulu ngesikhathi umntwana esesibelethweni. Leli payipi lizivalela lodwa emahoreni ambalwa ngemva kokuzalwa.
Kodwa enganeni ene-IAA, ngoba i-aorta idabukile, okuwukuphela kwendlela ehlukile yokuthi igazi elinomoya-mpilo ligeleze emzimbeni iwukusebenzisa i-Ductus Arteriosus. Ngakho into yokuqala odokotela abayenzayo ukunikeza ingane umuthi obizwa ngokuthi i-Prostaglandin E1 , ogcina lelo payipi lesikhashana livulekile ngaphandle kokuvala. Lokhu kusiza ukugcina ukuphakelwa kwegazi emzimbeni wengane kuze kube yilapho ihlinzwa.
2. Isinyathelo sesibili - Ukuhlinzwa:
Uma isimo somntwana sesizinzile, odokotela abangochwepheshe bayahlinza. Lokhu kuhilela:
- Ukuthatha iziphetho ezimbili eziphukile ze-aorta nokuzixhumanisa ndawonye ukuze kwakheke umthambo wegazi ophelele, ongavimbekile.
- Ukuvala i-Ductus Arteriosus yesikhashana eyayivulwe ngokunikeza i-prostaglandin.
- Uma kukhona i-VSD (imbobo odongeni lwenhliziyo), nayo izovalwa phakathi nalokhu kuhlinzwa.
Umntwana uzozizwa kanjani ngemva kokuhlinzwa?
Akukho okunzima ngabazali ukukuthwala njengokuzwa ukuthi usana lwabo lunesifo esisongela ukuphila. Kodwa kulokho esikuxoxile, ungabona ukuthi lesi simo singaphathwa ngempumelelo ngokunakekelwa kwezokwelapha ngokushesha.
Impilo yezingane ngemva kokuhlinzwa kwe-IAA ingaba yinhle kakhulu . Ngokwezibalo, ngisho neminyaka eyi-10 ngemva kokuhlinzwa, ama-81% ezingane asaphila. Lokho kusho ukuthi izinga lempumelelo liphezulu kakhulu.
Kodwa lokhu kuyisimo esiphuthumayo. Lapho nje izimpawu zibonakala, umntwana kufanele angeniswe egunjini lokunakekelwa okujulile esibhedlela (ICU) futhi ukwelashwa kufanele kuqale ngokushesha. Ngisho nangemva kokuhlinzwa, kubalulekile ukuqhubeka nokuyisa umntwana emtholampilo nokwenza izivivinyo ezidingekayo, njengoba odokotela beluleka.
Umlayezo Wokuya Nawe Ekhaya
- I-Interrupted Aortic Arch (IAA) iyi-aortic arch ephukile enganeni esanda kuzalwa. Lesi yisimo esibi kakhulu kodwa esingavamile kakhulu.
- Lokhu kubangelwa yimbangela yofuzo, hhayi ukunganaki kwabazali ngesikhathi sokukhulelwa.
- Uma ubona izimpawu ezinjengobunzima bokuncelisa, ukuphefumula ngokushesha, ukozela ngokweqile, kanye nokuba mpunga kwesikhumba, funa iseluleko sikadokotela ngokushesha .
- Lesi simo singelashwa ngempumelelo ngokuxilongwa kusenesikhathi kanye nokuhlinzwa, okuvumela ingane ukuba iphile impilo enempilo.
- Uma unenkinga ngempilo yengane yakho, ungayinaki njengenkinga encane. Khuluma nodokotela wakho njalo .
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