Ingabe ukugeleza kwegazi kwenhliziyo yakho kuphambukisiwe? Ake sifunde nge-PAPVR (Partial Anomalus Pulmonary Venous Return)!

Ingabe ngezinye izikhathi uzizwa ukhathele? Ingabe ukuthola kunzima ukuphefumula uma ukhuphuka izitebhisi? Noma ingabe uyangabaza kancane ngokukhula kwengane yakho? Kungaba nezizathu eziningana zalezi zinto. Kodwa ngezinye izikhathi imbangela yalokhu ingaba ushintsho oluncane enhliziyweni esizalwa nalo. Namuhla sizokhuluma ngesimo esinjalo, esihlobene nokujikeleza kwegazi enhliziyweni, kodwa esingavamile kakhulu. Lokhu kubizwa ngokuthi i-PAPVR, okusho ukuthi (Partial Anomalous Pulmonary Venous Return).

Uyazi ukuthi iyini i-PAPVR (Partial Anomalous Pulmonary Venous Return)?

Kalula nje, i-PAPVR isifo senhliziyo esizalwa naso . Okwenzekayo kulokhu ukuthi kunenkinga encane ngendlela igazi elihlanziwe, elinomoya-mpilo elivela emaphashini ethu elibuyela ngayo enhliziyweni. Ngokuvamile, lonke leli gazi elinomoya-mpilo liya ohlangothini lwesobunxele lwenhliziyo. Bese, uhlangothi lwesobunxele lwenhliziyo lupompa lelo gazi liye kuwo wonke umzimba.

Kodwa kumuntu one-PAPVR, ingxenye encane kuphela yaleli gazi elinomoya-mpilo elivela emaphashini liya ohlangothini lwesokudla lwenhliziyo . Uyazi, uhlangothi lwesokudla lwenhliziyo luvame ukuthola igazi elisetshenziswe ngumzimba, elinomoya-mpilo ophansi. Ngakho-ke lapho elinye igazi elinomoya-mpilo lihamba ngendlela engafanele, inani legazi eliza ohlangothini lwesokudla lwenhliziyo liyanda. Kwenzekani-ke? Uhlangothi lwesokudla lwenhliziyo kufanele lusebenze naleli gazi elengeziwe, okusho ukuthi kufanele lisebenze kanzima . Lo mthwalo owengeziwe ungakheka enhliziyweni ngokuhamba kwesikhathi, futhi ungathinta ngisho nempilo yethu iyonke.

Kodwa i-PAPVR ayithinti wonke umuntu ngendlela efanayo. Kuncike enanini legazi eliphambukisiwe. Abanye abantu bangase babe nesimo esingesihle kakhulu, futhi bangase bangabi nazimpawu impilo yabo yonke. Kodwa uma kuvela izimpawu noma kuvela ezinye izinkinga, odokotela bethu bangakwazi ukuphatha lesi simo kahle. Ezimweni eziningi, ukuhlinzwa kungayiphatha ngempumelelo i-PAPVR futhi kukusize uphile impilo ende nenempilo.

Lena yindlela evamile yokugeleza kwegazi ezinhliziyweni zethu, nokuthi lishintsha kanjani uma sine-PAPVR.

Ukuze siqonde umthelela we-PAPVR ekugelezeni kwegazi, ake siqale sibheke ukuthi igazi ligeleza kanjani ngokuvamile phakathi kwenhliziyo namaphaphu ethu. Cabanga ngakho njengohambo oluncane.

1. Okokuqala, igazi elisetshenzisiwe, eliphelelwe umoya-mpilo emzimbeni ligeleza ngemithambo emibili emikhulu (i-vena cava ephezulu kanye ne-vena cava engaphansi) bese lingena ekamelweni eliphezulu (i-atrium efanele) ngakwesokudla kwenhliziyo.

2. Bese, leli gazi elingenawo umoya-mpilo lisuka ekamelweni eliphezulu kwesokudla liye ekamelweni eliphansi kwesokudla (`(i-ventricle yesokudla)`).

3. Leli gazi liphampulwa lisuka ekamelweni elingezansi kwesokudla liye emaphashini , okusizwa yimithambo yamaphaphu. Emaphashini, leli gazi liphinde lifakwe umoya-mpilo, njengokungathi linikezwe ithuba elisha lokuphila.

4. Igazi elisha, elinomoya-mpilo manje libuyela enhliziyweni ngemithambo eminingana (imithambo yamaphaphu) lisuka emaphashini, liqonde ngqo ekamelweni eliphezulu kwesobunxele senhliziyo.(`(i-atrium yesobunxele)`).

5. Leli gazi elinomoya-mpilo elivela ekamelweni eliphezulu ngakwesobunxele liya ekamelweni eliphansi ngakwesobunxele (`(i-ventricle yesobunxele)`).

6. Ekugcineni, leli gazi elinomoya-mpilo elivela ekamelweni elingezansi ohlangothini lwesobunxele lisakazwa kuwo wonke umzimba ngomthambo wegazi omkhulu kunayo yonke (i-aorta).

Uyabona, ngokuvamile igazi elinomoya-mpilo omncane lisemagumbini angakwesokudla, kanti igazi elinomoya-mpilo omningi lisemagumbini angakwesokunxele. Awaphambani.

Kodwa nge-PAPVR, le ndlela ayisebenzi kahle. I-PAPVR ibangela iphethini yokugeleza kwegazi okungavamile enhliziyweni, ebizwa ngokuthi i-cardiac shunt esuka kwesobunxele iye kwesokudla. "Okungavamile ngokwengxenye" ​​kusho ukuthi ingxenye yegazi elinomoya-mpilo elivela emaphashini ayifinyeleli enhliziyweni ngokujwayelekile.

Lokhu kungenxa yokuthi imithambo yakho eyodwa noma ngaphezulu yamaphaphu ipompa igazi elinomoya-mpilo liye ekamelweni eliphezulu ngakwesokudla, esikhundleni sokulifaka ekamelweni eliphezulu ngakwesokudla. Kwenzekani-ke? Igazi elingenawo umoya-mpilo ekamelweni lakho eliphezulu ngakwesokudla lixubene negazi elinomoya-mpilo omningi. Ngakho-ke, leli gazi elixubile lipompa liye ekamelweni eliphansi ngakwesokudla, liye emaphashini.

Lokhu kunemiphumela emibi emibili:

• Okokuqala ukuthi elinye igazi elicebile ngomoya-mpilo libuya ngokungadingekile ngendlela efanayo nelafika ngayo, okungukuthi, emaphashini.
• Okwesibili, inani legazi elifanele elimpontshelwa egumbini lakho eliphansi lesokudla emaphashini akho liyakhula . Lo msebenzi owengeziwe ungafaka ukucindezeleka enhliziyweni yakho ngokuhamba kwesikhathi.

Ingabe ezinye izifo zenhliziyo zingaba khona nge-PAPVR?

Abanye abantu bangase babe ne-PAPVR yodwa, ngaphandle kwanoma yisiphi esinye isifo senhliziyo. Lokhu kubizwa ngokuthi "i-PAPVR ehlukanisiwe". Kodwa-ke, abantu abaningi abane-PAPVR bangase babe nezinye izinkinga, njengomgodi ophakathi kwamakamelo amabili aphezulu enhliziyo . Lokhu kubizwa ngokuthi i-Atrial Septal Defect (ASD).

Akuvamile kakhulu, i-PAPVR ingahlotshaniswa nokukhula kabi kwephaphu langakwesokudla kanye nomthambo othwala igazi uye emaphashini (`(Scimitar syndrome)`).

I-PAPVR ingavamile kangakanani?

Abacwaningi balinganisela ukuthi cishe abantu abangu-4 kuya kwabangu-7 kwabayi-1,000 bane-PAPVR. Kodwa-ke, inani lingaba likhulu kakhulu, njengoba abanye abantu bengase bangabi nazimpawu futhi bangase bangatholakali benalesi simo.

Ziyini izimpawu ze-PAPVR?

Uma inani legazi eliya ohlangothini olungafanele (olubizwa ngokuthi 'i-shunting') liphansi, i-PAPVR ayibangeli izimpawu ngaso sonke isikhathi. Kodwa-ke, lapho lokhu 'shunting' kukhuphuka, ungase uqaphele izimpawu. Izingane ezincane zingase zibe nezimpawu uma zinalesi simo kanye nezinye izimo zenhliziyo. Kodwa-ke, abantu abaningi abane-PAPVR baqala ukuba nezimpawu lapho beneminyaka engama-20 noma engama-30 .

Izimpawu ezinganeni ezincane:

• Ukulibaziseka kokukhula.
• Ukukhathala ngokushesha ngenkathi uzivocavoca noma udlala.
• Izifo zokuphefumula ezivame ukwenzeka (isib. ukuminyana kwesifuba).
• Ukuphelelwa umoya.
• Ubunzima bokuthola isisindo.

Izimpawu kubantu abadala:

• Ubunzima bokuphefumula.
• Ukuzizwa ukhathele ngaso sonke isikhathi (`(Ukukhathala)`).
• Ukuzwa ukushaya kwenhliziyo okungavamile (`(Ukushaya kwenhliziyo okungavamile)`).
• Ubuhlungu besifuba (`(Ubuhlungu besifuba)`).
• Isilinganiso senhliziyo siyanda.
• Izifo zokuphefumula ezivame ukwenzeka.

Kungani le PAPVR yenzeka?

Njengezinye izifo zenhliziyo ezizalwa nazo, i-PAPVR yenzeka lapho inhliziyo ingakheki kahle ngesikhathi sokukhula kwengane . Ngokuvamile, emavikini ambalwa okuqala okukhulelwa, imithambo emine yamaphaphu yakheka kusuka emthanjeni ovamile wamaphaphu. Le mithambo ixhuma ekamelweni eliphezulu kwesobunxele senhliziyo yengane. Kodwa-ke, uma kukhona izinguquko kule nqubo, umthambo wamaphaphu ungaxhuma ekamelweni eliphezulu kwesokudla esikhundleni segumbi eliphezulu kwesobunxele, noma kweminye imithambo eseduze (njenge-vena cava ephezulu noma umthambo we-brachiocephalic kwesobunxele). Yilapho i-PAPVR yenzeka khona.

Yiziphi izinkinga ezingaba khona ze-PAPVR?

Ama-shunt asuka kwesobunxele aye kwesokudla ashiywe engelashwa isikhathi eside angabuyela esimweni esibi esibizwa ngokuthi i-Eisenmenger syndrome. Ngakho-ke, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha uma unezimpawu.

Wazi kanjani ukuthi une-PAPVR?

Odokotela baxilonga i-PAPVR ngokuhlolwa ngokomzimba kanye nezinye izivivinyo ezikhethekile . Ngesikhathi ekuxilonga, udokotela wakho uzolalela inhliziyo yakho nge-stethoscope. Abanye abantu abane-PAPVR bangase bezwe umsindo wenhliziyo ongajwayelekile (ukububula kwenhliziyo). Uma lokhu kusolwa, udokotela wakho uzoyala ukuhlolwa okwengeziwe.

Ubudala lapho kutholakala khona i-PAPVR buyahlukahluka kuye ngomuntu nomuntu. Ingatholakala iseyingane, noma ingatholakala lapho isikhulile. Ungaba ne-PAPVR, kodwa ungabi nazimpawu, ngakho-ke ungase ungazi impilo yakho yonke. Ngezinye izikhathi, lesi simo sitholakala ngengozi ngesikhathi sokuhlolwa okwenzelwe enye into.

Yiziphi izivivinyo ezenziwayo?

Ukuhlolwa okusiza ekuxilongeni i-PAPVR yile:

• I-Echocardiogram (Echocardiogram) - ikakhulukazi i-transesophageal echocardiogram (TEE). Lokhu kuthatha isithombe se-ultrasound senhliziyo.
• I-MRI Yenhliziyo (i-MRI Yenhliziyo).
• I-cardiac computed tomography (CT) scan.

Ingabe i-PAPVR idinga ukuhlinzwa?

Ezinye izingane kanye nabantu abadala kudingeka bahlinzwe nge-PAPVR ukuze kulungiswe indlela yokugeleza kwegazi enhliziyweni. Izingane ezitholakale zine-PAPVR cishe zidinga ukuhlinzwa kunabantu abadala. Lokhu kungenxa yokuthi zivame ukuba ne-PAPVR kanye nezinye izimo zenhliziyo ezidinga ukuhlinzwa.

Odokotela batusa ukuhlinzwa.Kuphela uma kudingeka ngempela ukuze kuncishiswe izimpawu noma kuvinjelwe izinkinga zesikhathi esizayo. Wena noma ingane yakho ningadinga ukuhlinzwa uma i-PAPVR ibangela ukushukuma okukhulu kusuka kwesobunxele kuya kwesokudla. Lokhu kusho ukuthi inani elikhulu legazi okufanele liye emzimbeni libuyela ohlangothini lwesokudla lwenhliziyo namaphaphu. Lokhu kungabangela izimpawu nezinkinga ezingakhululekile ezifana nomfutho wegazi ophezulu wamaphaphu (i-PAH) noma ukwehluleka kwenhliziyo. Udokotela wakho uzosebenzisa izivivinyo zezithombe ukuze anqume izinga lalokhu kushukuma.

Ukuhlinzwa ngokuvamile kungayilapha ngempumelelo i-PAPVR. Kubalulekile ukukhuluma nodokotela wakho ngemininingwane yokuhlinzwa kwakho nokuthi yini ongayilindela.

Indlela yokuhlinzwa ingahluka kuye ngesimo senhliziyo yakho kanye nemithambo yamaphaphu. Ngokuvamile, odokotela abahlinzayo bahlose ukushintsha indlela yokugeleza kwegazi ukuze igazi elinomoya-mpilo ligeleze liye emakamelweni angakwesobunxele enhliziyo.

Kodwa-ke, abantu abaningi ngeke badinge ukuhlinzwa . Uma i-PAPVR yakho ithambile, udokotela wakho uzoqapha isimo sakho. Uma uba nezimpawu noma ubonisa izimpawu zezinkinga, udokotela wakho angase akuncome ukuhlinzwa ngaleso sikhathi.

Ingabe i-PAPVR ingavinjelwa?

Ngeshwa, ayikho indlela yokuvimbela i-PAPVR. Kuyinto esizalwa nayo. Kodwa-ke, uma uhlela ukukhulelwa, khuluma nodokotela wakho ngezindlela zokunciphisa ingozi yokuba nomntwana onesici senhliziyo esizalwa naso. Nazi ezinye izeluleko:

• Gwema ngokuphelele utshwala, izidakamizwa, imikhiqizo kagwayi, kanye nokubhema ugwayi.
• Yiba khona kuzo zonke izikhathi zokubeletha nodokotela wakho.
• Sebenzisana nodokotela wakho ukuze uphathe noma yiziphi ezinye izimo zempilo eziyisisekelo ongase ube nazo (isib. isifo sikashukela, umfutho wegazi ophakeme).

Ingabe umuntu one-PAPVR angaphila impilo ejwayelekile?

Kungenzeka ngokuphelele ukuphila impilo ende nenempilo nge-PAPVR. Abantu abaningi baphila iminyaka eminingi ngaphandle kwezimpawu noma izinkinga. Ngisho nalabo abadinga ukuhlinzwa bavame ukuba nemiphumela emihle. Kodwa-ke, imiphumela ingahluka kuye ngesinye isifo senhliziyo noma izimo eziyisisekelo umuntu anazo. Ngakho-ke kungcono ukukhuluma nodokotela wakho ngalokho ongakulindela ngokusekelwe esimweni sakho.

Uma une-PAPVR, uzinakekela kanjani? / Unakekela kanjani ingane yakho?

Ukuphila nesifo senhliziyo esizalwa naso kungaba yinto ekucindezelayo ngezinye izikhathi. Kubalulekile ukukhumbula ukuthatha izinto usuku ngalunye ngesikhathi. Nanka amanye amathiphu ajwayelekile ongawalandela:

• Funa ukwelashwa kudokotela wenhliziyo ogxile ezifweni zenhliziyo zabantu abadala. Uzoqapha isimo sakho ngokuhlolwa njalo nokuhlolwa.
• Buza udokotela wakho ukuthi yiziphi izinhlobo zokuzivocavoca ezifanele wena. Ngokubambisana, ningakha uhlelo lokuzivocavoca.
• Landela ukudla okunempilo kwenhliziyo (isb., Ukudla KwaseMedithera).
• Thatha yonke imithi njengoba nje udokotela wakho ekuyalele.
• Gwema ukubhema kanye nayo yonke imikhiqizo kagwayi. Buza udokotela wakho uma udinga usizo lokuyeka ukubhema.

Uma ingane yakho ine-PAPVR, buza udokotela wayo ukuthi ungayinakekela kanjani kangcono. Ingane yakho kungadingeka ilandele iziqondiso ezikhethekile zokuzivocavoca umzimba noma eminye imisebenzi, ikakhulukazi uma inezinye izifo zenhliziyo ezizalwa nazo.

Kunini lapho udinga ukubonana nodokotela?

Bona udokotela wakho njengoba kuhleliwe. Ukuhlolwa kokulandelela njalo kanye nokuhlolwa kwezithombe kubalulekile ukuqapha isimo se-PAPVR yakho nokuphatha izinkinga.

Shayela udokotela wakho ngokushesha uma wena noma ingane yakho nihlangabezana nanoma yikuphi kwalokhu okulandelayo:

• Uma kuvela izimpawu ezintsha noma izimpawu ezikhona zishintsha.
• Uma kunemiphumela emibi evela emuthini.
• Uma unemibuzo noma ukukhathazeka.

Kukuziphi izimo lapho kudingeka uye e-Emergency Treatment Unit (ETU) ?

Uma wena noma ingane yakho nibonisa noma yiziphi zalezi zimpawu, shayela u-911 noma inombolo yakho yezimo eziphuthumayo yasendaweni ngokushesha:

• Isilinganiso senhliziyo esisheshayo kakhulu (ukushaya okungu-100-150 ngomzuzu) futhi esinganciphisi ijubane.
• Ukulahlekelwa ukwazi kanye nokuquleka.
• Ukuphefumula okufushane kakhulu uma kuqhathaniswa nokuzivocavoca kanye/noma ukungaphumuli ngokuphumula.
• Ubuhlungu besifuba obungazelelwe nobunzima.
• Ikhanda elibuhlungu ngokuzumayo futhi elinzima.
• Ubuthakathaka obungazelelwe noma ukungazweli ezingalweni noma emilenzeni.

Imibuzo ebalulekile okufanele uyibuze udokotela wakho

Khuluma nodokotela wakho ngesimo sakho nokuthi yini ongayilindela esikhathini esizayo. Nansi eminye imibuzo ongayibuza:

Uma une-PAPVR:

• Isimo sami sibi kangakanani?
• Yiziphi izinguquko zendlela yokuphila okudingeka ngizenze?
• Ingabe ngizodinga ukuhlinzwa?
• Yiziphi izinzuzo nezingozi zokuhlinzwa?
• Ikusasa lami liyoba njani?

Uma ingane yakho ine-PAPVR, buza udokotela wayo:

• Ingakanani inkinga yengane yami?
• Ingabe ingane yami inezinye izifo zenhliziyo ezazalwa nazo?
• Ingabe ingane yami izodinga ukuhlinzwa noma olunye ukwelashwa?
• Ngingamnakekela kanjani umntwana wami ekhaya?
• Ingabe unemikhawulo yomsebenzi wakhe?
• Yiziphi izinsiza ezitholakalayo zokusiza ingane yami ukuthi iqonde lokhu ngendlela efanele iminyaka yayo?

Uyini umehluko phakathi kwe-PAPVR ne-TAPVR?

I-PAPVR ihlukile esimweni esibizwa ngokuthi ``Total Anomalous Pulmonary Venous Return (TAPVR)``. Kumuntu one-TAPVR, yonke imithambo emaphashini ixhunywe enhliziyweni ngendlela engavamile. I-TAPVR iyisimo esibi kakhulu kunezinhlobo eziningi ze-PAPVR, futhi ngokuvamile idinga ukwelashwa okuphuthumayo ngemuva nje kokuzalwa. Kodwa-ke, zombili i-PAPVR ne-TAPVR ziyafana ngoba ziphazamisa indlela evamile yokugeleza kwegazi enhliziyweni.

Okokugcina, khumbula lezi zinto:

I-PAPVR ingase ingathinti nhlobo impilo yakho. Noma, ingabangela izimpawu noma izinkinga ezidinga ukwelashwa. Kodwa-ke, kuyinto evamile ukuthi uzizwe ucindezelekile noma ukhathazekile nge-PAPVR. Uma ingane yakho ine-PAPVR, kuyinto evamile futhi ukuthi ukhathazeke ngenhlalakahle yayo. Le mizwa ivamile kakhulu, futhi ungazizwa kabi ngayo.

Yabelana ngezinto ezikukhathazayo nodokotela wakho. Buza ngezinsiza ezingakusiza wena nomndeni wakho. Ukufunda kabanzi ngesifo senhliziyo ozalwa naso - kungakhathaliseki ukuthi sikuthinta wena, ingane yakho, noma othandekayo wakho - kungakusiza ukuthi uphathe kangcono isimo sakho. Ukukhuluma nomeluleki kungakusiza futhi ukuthi ukhululeke. Phakathi nalolu hambo, ungalokothi unqikaze ukubuza udokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho. Awuwedwa.

I- PAPVR, isifo senhliziyo, izifo zokuzalwa, amaphaphu, ukujikeleza kwegazi, ukuhlinzwa kwenhliziyo, isifo senhliziyo sokuzalwa, imithambo yamaphaphu, ukuhlinzwa kwenhliziyo