Ukuletha umntwana osanda kuzalwa ekhaya kuyisenzakalo esijabulisayo emndenini. Kodwa ngesikhathi esifanayo, kungaletha nokwesaba okuncane kubazali. "Ingabe umntwana uphilile?", "Ingabe umntwana uphefumula kahle?", "Kungani ekhala kangaka?" Kungenzeka ukuthi uke waba nemibuzo efana nale. Nakuba isikhathi esiningi lezi ziyizinto ezivamile, ngezinye izikhathi kunezimo ezingavamile ezidinga ukuba siqaphele kakhudlwana. Namuhla sizokhuluma ngesimo senhliziyo esingavamile kakhulu esingaba khona ezinganeni ezisanda kuzalwa, kodwa esidinga ukwelashwa ngokushesha. Leso yi-Interrupted Aortic Arch, noma i-IAA ngamafuphi.
Kalula nje, iyini i-Interrupted Aortic Arch (IAA)?
Ukuze siqonde lokhu, ake siqale sibheke ukuthi inhliziyo yethu isebenza kanjani. Cabanga ukuthi inhliziyo yakho iyiphampu yamanzi eyinhloko enamakamelo amane.
- Amakamelo amabili aphezulu (i-Atria): Igazi "eliluhlaza okwesibhakabhaka" elingenawo umoya-mpilo elivela emzimbeni lingena kwelinye igumbi, kanti igazi "elibomvu" elinomoya-mpilo elivela emaphashini lingena kwelinye.
- Amakamelo amabili aphansi (ama-ventricle): Lawa amakamelo amakhulu okupompa. Ngakolunye uhlangothi, athumela igazi elingenawo umoya-mpilo emaphashini ukuze alithathe. Ngakolunye uhlangothi, aphampa igazi elibomvu elinomoya-mpilo ukuze lisakazwe kuwo wonke umzimba.
Umthambo wegazi oyinhloko othwala igazi elinomoya-mpilo emzimbeni wonke ubizwa ngokuthi i-Aorta . Ngokuvamile ufana nomhlanga, noma i-arch.
Manje, endabeni ye -Interrupted Aortic Arch (IAA) , i-arch ye-aorta ayiphelele. Kufana nepayipi eliyinhloko elithwala amanzi lisuka ethangini lamanzi liye endlini yonke liqhekeke laba izingxenye ezimbili . Ngenxa yalokhu, kungakhathaliseki ukuthi inhliziyo iphampa kanzima kangakanani, ayikwazi ukuthumela igazi elinomoya-mpilo ezingxenyeni ezingezansi zomzimba. Lesi yisimo esibi kakhulu, esisongela impilo . Ngoba uma izingxenye zomzimba zingatholi igazi, lezo zitho zingahluleka futhi zibe yingozi enkulu enganeni.
Lesi simo asivamile kakhulu. Sithinta cishe izingane ezimbili kweziyi-100,000 ezizalwa eSri Lanka. Ngakho-ke nakuba kubalulekile ukuqaphela lokhu, ungesabi ngokungadingekile.
Wazi kanjani ukuthi ingane yakho inalesi simo? Ziyini izimpawu?
Ingane ene-IAA ivame ukukhombisa izimpawu ezinsukwini ezimbalwa zokuqala ngemva kokuzalwa. Lokhu kungenxa yokuthi ngaphambi kokuzalwa, inhliziyo yengane ithola umoya-mpilo emzimbeni kamama, okungeyona inkinga, kodwa ngemva kokuzalwa, inhliziyo yengane kufanele isebenze yodwa. Yilapho kuvela khona le nkinga.
Kufanele uqaphele kakhulu ngalezi zimpawu ezilandelayo.
| Isibonakaliso | Kuchazwe kalula |
|---|---|
| Ubunzima bokuncelisa nokukhathala ngokweqile | Ngisho noma umntwana emunca ubisi oluncane, ubonakala ehlupheka, ejuluka, futhi esebenza kanzima kakhulu. Ngoba ngisho nalowo msebenzi omncane udinga umzamo omkhulu ovela enhliziyweni. |
| Ukuphefumula okusheshayo | Ngenxa yokuthi umzimba awutholi umoya-mpilo owanele, umntwana uqala ukuphefumula ngokushesha ukuze alungise isimo sakhe. Isifuba singase sibonakale sengathi siyashaya. |
| Ukushaya kwenhliziyo okusheshayo | Ngenxa yokuthi inhliziyo kufanele isebenze kanzima ukuze ipompe igazi emzimbeni wonke, inhliziyo iqala ukushaya ngokushesha. |
| Isikhumba siba mpunga noma sibe luhlaza okwesibhakabhaka | Ikakhulukazi njengoba igazi elinomoya-mpilo lingahambi kahle liye ezingxenyeni ezingezansi zomzimba womntwana, njengemilenze nezinyawo, isikhumba kulezo zindawo singaba mpunga noma sidabuke. |
| Ukozela okungavamile kanye nobuthakathaka | Uma ingane yakho ilala njalo futhi ikhathele, kungenzeka ukuthi umzimba wayo awutholi amandla owadingayo. |
Uma ubona noma yiziphi zalezi zimpawu, bonana nodokotela ngokushesha ngaphandle kokulibala. Uma kudingeka, thatha ingane yakho uyise e-Emergency Treatment Unit (ETU) yesibhedlela esiseduze.
Ezinye izinkinga zenhliziyo ezingase zenzeke ngalesi simo
Izingane ezine-IAA zingase zibe nezinye izinkinga eziningana zenhliziyo ngesikhathi esisodwa.
- I-Ventricular Septal Defect (VSD): Lena imbobo odongeni phakathi kwamakamelo amabili aphansi okupompa (ama-ventricles) enhliziyo. Ngokumangalisayo, ukuba ne-VSD ngezinye izikhathi kungaba usizo lwesikhashana ezimweni ze-IAA, njengoba kuvumela igazi elithile elinomoya-mpilo ukuthi lidlule emgodini liye emzimbeni.
- I-Atrial Septal Defect (ASD): Lena imbobo odongeni phakathi kwamakamelo amabili aphezulu enhliziyo.
- I-Truncus Arteriosus: Yilapho imithambo yegazi emibili eyinhloko ephuma enhliziyweni (i-aorta kanye nomthambo wamaphaphu) ihlangana khona ukuze yakhe imithambo yegazi eyodwa.
Kungani lokhu kwenzeka ezinganeni? Iyini imbangela?
Uma uzwa lokhu, umbuzo wokuqala ofika engqondweni yakho njengabazali uthi, "Ingabe leli yiphutha lethu?" Cha akunjalo.
I-Interrupted Aortic Arch (IAA) yisimo esibangelwa yisici sofuzo . Kalula nje, ama-chromosome ethu 'ayincwadi' equkethe yonke imiyalelo yokuthi imizimba yethu yakhiwe kanjani. Kulesi simo, ingxenye encane kakhulu ye-chromosome equkethe imiyalelo yokuthi inhliziyo nemithambo yegazi zakhiwe kanjani ayikho. Lokhu kubangela ukuthi i-aorta ingakheki kahle.
Ngokuvamile, izingane ezine-IAA nazo zinesinye isimo sofuzo esibizwa ngokuthi i-DiGeorge syndrome . Lokhu kubangelwa futhi yingxenye engekho ye-chromosome efanayo. Izingane ezine-DiGeorge syndrome zingase zibe nezifo ezivame ukutheleleka kanye nezinguquko ezithile zobuso (njengomlomo oqhekekile).
Odokotela bakuthola kanjani lokhu ngqo?
Uma uyisa ingane yakho esibhedlela, uma odokotela beyihlola futhi besola ukuthi inesimo senhliziyo esinjengalesi, isivivinyo esiyinhloko sokuqinisekisa ukuthi i- echocardiogram .
I-echocardiogram ifana nokubuka ividiyo yenhliziyo yengane. Ayibuhlungu. Isebenzisa amaza e-ultrasound ukubona ngokucacile amakamelo enhliziyo, ama-valve, kanye nemithambo yegazi. Endabeni ye-IAA, ingabonisa ngokucacile ukuvaleka kwe-aorta.
Ngezinye izikhathi, inkinga yenhliziyo efana nale ingatholakala ngesikhathi kwenziwa i-anomaly scan (ultrasound scan) ngesikhathi umntwana esesesibelethweni.
Yiziphi izindlela zokwelapha lokhu? Ingabe ingane ingelapheka?
Yebo, impela. Nakuba lesi kuyisimo esibucayi, singelapheka ngokuphelele ngokuhlinzwa . Inqubo yokwelashwa ingahlukaniswa izingxenye ezimbili eziyinhloko.
1. Okufanele ukwenze ngaphambi nje kokuhlinzwa
Ngemva kokuxilongwa, umntwana ungeniswa ngokushesha egunjini lokunakekelwa okujulile kwezingane ezisanda kuzalwa (i-NICU). Umgomo oyinhloko ukugcina ukugeleza kwegazi emzimbeni kuze kube yilapho umntwana eselungele ukuhlinzwa.
Odokotela basebenzisa icebo elihlakaniphile ukwenza lokhu. Ngaphambi kokuba ingane ngayinye izalwe, kuba nokuxhumana kwesikhashana (i-ductus arteriosus) phakathi kwe-aorta nomthambo othwala igazi emaphashini. Lokhu kuvala ngokwako phakathi kwamahora ambalwa noma izinsuku ezimbalwa ngemva kokuzalwa.
Kodwa esimweni se-IAA, odokotela ngeke bavumele lokhu kuxhumana kwesikhashana kuvalwe. Kufana 'nendlela yokudlula' esetshenziswa lapho umgwaqo omkhulu uvaliwe. Gcina le ndlela yokudlula ivuliwe.Umuthi obizwa ngokuthi i-Prostaglandin E1 unikezwa ingane ngosawoti. Lokhu kuvumela umzimba ongezansi womntwana ukuthi uthole igazi kuze kube yilapho ehlinzwa.
2. Ukuhlinzwa okusindisa impilo
Uma isimo somntwana sesizinzile, ukuhlinzwa kwenziwa odokotela benhliziyo bezingane.
- Into eyinhloko: Izingxenye ezimbili ze-aorta ezinqanyuliwe futhi zahlukaniswa zixhunywa kabusha, kwakha umphetho ophelele.
- Izinto ezengeziwe: Ngesikhathi esifanayo, uma ingane ine-VSD (imbobo enhliziyweni), nayo izovalwa phakathi nalolu hlinzo. I-bypass (PDA) eyavulwa ngemithi ngaphambilini nayo izovalwa, ngoba manje njengoba indlela enkulu isiqediwe, asikho isidingo sayo.
Lokhu ukuhlinzwa okuyinkimbinkimbi kakhulu, kodwa odokotela abanekhono eSri Lanka benza ukuhlinzwa okunjalo ngempumelelo.
Lizoba njani ikusasa lomntwana ngemva kokuhlinzwa?
Lokhu kuyinto ebaluleke kakhulu. Ngemva kokuhlinzwa okuphumelelayo, izingane eziningi zingaphila impilo evamile nenempilo . Ngokwezibalo, ngisho neminyaka eyi-10 ngemva kokuhlinzwa, abantu abangaphezu kuka-81% basaphila.
Kodwa into ebaluleke kakhulu okufanele uyikhumbule ukuthi ngisho nangemva kokuhlinzwa, udinga ukulandelwa udokotela wenhliziyo impilo yakho yonke . Udinga ukuya emitholampilo ngesikhathi esihleliwe futhi wenze izivivinyo ezifana ne-echocardiogram ukuze ubone ukuthi inhliziyo yakho isebenza kahle yini. Ngezinye izikhathi, uma usukhulile, ungadinga ukwelashwa futhi. Ngakho-ke, kubalulekile ukulandela imiyalelo kadokotela wakho.
Kuvamile ukuzizwa sengathi umhlaba wakho wonke uwile uma uthola ukuthi ingane yakho inalesi simo. Kodwa khumbula, isayensi yezokwelapha ithuthuke kakhulu namuhla. Uma lesi sifo sitholakala kusenesikhathi futhi selashwa kahle, ingane yakho inethuba elihle lokujabula njenganoma yimuphi omunye umntwana.
Umlayezo Wokuya Nawe Ekhaya
- I-Interrupted Aortic Arch (IAA) yilapho umthambo wegazi oyinhloko othwala igazi lisuka enhliziyweni yomntwana liye emzimbeni ungaphelele.
- Lesi yisimo esingavamile kakhulu, kodwa esibucayi esidinga usizo lwezokwelapha ngokushesha .
- Qaphela kakhulu izimpawu ezifana nobunzima bokuncelisa, ukuphefumula okusheshayo, kanye nesikhumba esimpunga.
- Lokhu kubangelwa ukukhubazeka kofuzo, hhayi iphutha labazali.
- Ukwelashwa kwenziwa ngokuhlinzwa, futhi ngemva kokuhlinzwa okuphumelelayo, izingane eziningi zingaphila impilo evamile .
- Kubalulekile ukuhlala ngaphansi kokuqondisa kukadokotela wenhliziyo impilo yakho yonke, ngisho nangemva kokuhlinzwa.
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