Umama noma ubaba onengane esanda kuzalwa angazizwa esaba kakhulu ngisho noma bebona ushintsho oluncane enganeni yabo. Pho ubungakhathazeka kangakanani uma udokotela ehlola ingane bese ethi, "Kukhona ukububula kwenhliziyo okuncane"? Kodwa ungesabi. Namuhla sikhuluma ngesimo senhliziyo esivame ukubonakala ezinganeni ezisanda kuzalwa futhi esingelapheka kalula. Lokhu kubizwa ngokuthi i-Patent Ductus Arteriosus, noma i-PDA njengoba ibizwa kanjalo phakathi kodokotela ngamafuphi.
Kalula nje, iyini le PDA?
Ukuze siqonde lokhu, ake sibuyele emuva lapho ingane isesiswini sikanina. Cabanga nje, ingane ayiphefumuli isesiswini. Ingane ithola umoya-mpilo eyidingayo ngentambo kamama. Ngakho-ke, amaphaphu engane awasebenzi ngaleso sikhathi. Ngakho-ke, kukhona indlela encane, njengokuxhumana 'kokudlula', phakathi komthambo oyinhloko othwala igazi lisuka enhliziyweni liye emzimbeni (i-aorta) kanye nomthambo othwala igazi liye emaphashini (umthambo wamaphaphu). Lokhu yilokho esikubiza ngokuthi '(ductus arteriosus)' kwezokwelapha. Umsebenzi wayo ukudlula amaphaphu, angasebenzi, bese uthumela igazi kuwo wonke umzimba.
Ngemva kokuzalwa kwengane futhi ithatha umoya wayo wokuqala, amaphaphu aqala ukusebenza. Ngemuva kwalokho asikho isidingo saleyo ndlela 'yokudlula'. Ngakho-ke ngokuvamile phakathi nezinsuku ezimbalwa zokuqala ngemva kokuzalwa kwengane, lo mthambo wegazi uzoncipha futhi uzivale wodwa.
Kodwa kwezinye izingane, lo mthambo wegazi obizwa ngokuthi "i-ductus arteriosus" awuvaleki kahle. Ushiya imbobo encane. Yingakho siwubiza ngokuthi i-Patent Ductus Arteriosus (PDA) .
Lesi simo se-PDA siyithinta kanjani ingane?
Manje, kwenzekani uma leyo ndlela yokudlula ingavaliwe? Umfutho wegazi emthanjeni oyinhloko othwala igazi emzimbeni, i-aorta, uphakeme. Umfutho wegazi emthanjeni othwala igazi emaphashini, umthambo wamaphaphu, uphansi. Ngakho-ke, ngale mbobo, igazi eliningi elingadingekile ligeleza lisuka endaweni enomfutho ophezulu liye endaweni enomfutho ophansi, okungukuthi, liye emaphashini.
Lokhu kubangela izinkinga ezimbili ezinkulu:
1. Umsebenzi owengeziwe wenhliziyo namaphaphu: Inhliziyo namaphaphu engane kufanele asebenze kanzima ukuze ampompe lonke leli gazi elengeziwe.
2. Ukulimala kwamaphaphu: Uma lesi simo siqhubeka ngaphandle kokwelashwa, umfutho wegazi emaphashini ungakhuphuka, okuholela esimweni esibizwa ngokuthi i-pulmonary hypertension. Lokhu kungalimaza nemithambo yegazi emaphashini.
Into ebalulekile ukuthi zonke lezi zinkinga zingavinjelwa uma lesi simo sitholakala kusenesikhathi futhi selashwa ngendlela efanele.
Ubani osengozini enkulu yokuthola le PDA?
Nakuba lesi simo singase senzeke kunoma yimuphi umntwana, ezinye izingane zisengozini enkulu.
- Izingane ezizalwa ngaphambi kwesikhathi:Leli yiqembu eliyinhloko eliyingozi. Uma ingane izalwa amasonto ambalwa, kulapho amathuba okuba ne-PDA enyuka khona. Cishe u-80% wezingane ezizalwa ngaphambi kwamasonto angu-28 zingabona lesi simo.
- Izingane zabesifazane: Lesi simo sivame kakhulu ezinganeni zabesifazane kunabantwana besilisa.
- Izimbangela zofuzo: I-PDA ingenzeka ngezifo ezithile zofuzo.
- Ukutheleleka nge-rubella kumama ngesikhathi sokukhulelwa: Uma umama ethola isimungumungwane saseJalimane ngesikhathi sokukhulelwa, umntwana usengozini enkulu yokuthola i-PDA.
Ziyini izimpawu ze-PDA?
Izimpawu ziyahlukahluka kuye ngobukhulu be-PDA. I-PDA encane kakhulu ingase ingakhombisi zimpawu . Kungase kube nokububula kwenhliziyo kuphela udokotela angakuzwa nge-stethoscope. Kodwa-ke, uma une-PDA ephakathi nendawo kuya kwenkulu, ungase uzibone lezi zimpawu.
| Isibonakaliso | Incazelo elula |
|---|---|
| Ukuphefumula okusheshayo | Ngenxa yokuthi igazi eliningi ligeleza emaphashini, umntwana uphefumula ngokushesha kunokujwayelekile. Ngezinye izikhathi kungase kube nokuphelelwa umoya. |
| Ukujuluka ngenkathi uphuza ubisi | Ngenxa yokuthi inhliziyo kufanele isebenze kanzima, ngisho nesenzo esincane sokuphuza ubisi sizwakala sengathi kuwukuzivocavoca okukhulu enganeni. Yingakho ibunzi layo nekhanda layo kujuluka lapho iphuza ubisi. |
| Ukukhathala kalula nokuphuza ubisi oluncane | Ingane ikhathala ngokushesha, ngakho-ke iyeka ukuphuza ubisi oluncane. Kunzima ukuqhubeka nokuphuza ubisi njalo. |
| Ukukhuluphala okubi | Ngenxa yokuthi umntwana akaphuzi ubisi olwanele futhi umzimba usebenzisa amandla amaningi, isisindo somntwana asikhuphuki ngendlela efanele iminyaka yakhe. |
| Ukushaya kwenhliziyo okusheshayo | Inhliziyo ishaya ngokushesha ukuze ipompe igazi eliningi. |
Ukuthola kanjani lokhu, Dokotela?
Uma ubona noma yiziphi zalezi zimpawu enganeni yakho, tshela udokotela wakho ngokushesha. Ngokuvamile, lapho ehlola ingane yakho, udokotela angezwa "ukukhala komshini" enhliziyweni. Yilapho kusolwa khona i-PDA.
Ngemuva kwalokho, ukuqinisekisa lokhu, uzothunyelwa kudokotela wezifo zenhliziyo wezingane . Angenza izivivinyo ezilandelayo:
- I-Echocardiogram (Echo): Lesi isivivinyo esibaluleke kakhulu nesinembile . Sifana nokuskena kwenhliziyo. Singabona ngokucacile konke njengokuthi i-PDA ikhona yini, inkulu kangakanani, nokuthi lingakanani igazi eligeleza kuyo. Lokhu akulona isivivinyo esibuhlungu.
- I-X-ray yesifuba: I-X-ray yesifuba ingahlola ukuthi inhliziyo ikhulisiwe noma ukuthi kunegazi eliningi eligeleza emaphashini.
- I-Electrocardiogram (ECG): Ngokubheka umsebenzi kagesi wenhliziyo, kungatholakala ukuthi inhliziyo icindezeleke kakhulu yini.
Yiziphi izindlela zokwelapha i-PDA?
Ukwelashwa kunqunywa iminyaka yengane, isisindo sayo, isimo sayo sempilo kanye nosayizi we-PDA. Akuwona wonke ama-PDA aphathwa ngesikhathi esisodwa.
1. Ukulinda Ngokuqaphile
Uma kuyi-PDA encane kakhulu, futhi ingabangeli monakalo enganeni, udokotela angase anqume ukulinda isikhashana. Ngoba abanye babo bayazivala bodwa. Kodwa kubalulekile ukuqhubeka nokuvakashela umtholampilo kadokotela ukuze uhlolwe phakathi nalesi sikhathi.
2. Ukwelashwa ngemithi
Ikakhulukazi ezinganeni ezizalwa ngaphambi kwesikhathi , eminye imithi (isib. i-Ibuprofen, i-Indomethacin) inikezwa ngemijovo ukuzama ukuvala le PDA. Le mithi isiza ukubopha nokuvala imithambo yegazi. Lokhu kuphumelela kuphela emasontweni ambalwa okuqala ngemva kokuzalwa komntwana.
3. Ukufakwa kwe-Catheterization Yenhliziyo
Lokhu akusikho ukuhlinzwa. Ingane ihlinzwa ngokuphelele, bese kufakwa ipayipi elincane kakhulu (i-catheter) ngomthambo wegazi esinqeni bese liqondiswa enhliziyweni. Bese kuthi, kudluliselwe ithuluzi elincane (noma i-coil) ngepayipi bese imbobo ye-PDA ivalwe. Lokhu kuvame ukwenziwa ezinganeni ezikhuluphele kancane ezinezinyanga ezimbalwa ubudala. Inzuzo yale ndlela ukuthi ingane ayidingi ukuboshwa, ukuze ingane ilulame ngokushesha futhi ibuyele ekhaya.
4. Ukuhlinzwa
Kwezinye izimo, ikakhulukazi ezinganeni ezingafaneleki ukufakwa i-catheter noma uma i-PDA inkulu kakhulu, kungase kudingeke ukuhlinzwa. Kulesi simo, udokotela ohlinzayo wenza i-incision encane ohlangothini lwesifuba, ngaphansi kwekhwapha, bese evala i-PDA ngezitishi noma nge-clip encane yensimbi.
Kwenzekani ngemva kokwelashwa?
Ngemva kokwelashwa nokuvalwa kwe-PDA, ukugeleza kwegazi lomntwana kubuyela esimweni esijwayelekile. Izimpawu ziyanyamalala kancane kancane.
Ngemva kokwelashwa, udokotela uzokutshela ukuthi uthathe ama-antibiotic cishe izinyanga eziyisithupha ukuze uvimbele ukutheleleka kwenhliziyo (i-endocarditis). Kubaluleke kakhulu futhi ukuya emtholampilo ngesikhathi bese ubonisa umntwana.
Ngemva kokuthola ukwelashwa okufanele, zonke izingane ezine-PDA ziyaqhubeka nokuphila impilo enempilo nesebenzayo ngaphandle kwezinkinga. Ngakho-ke ungakhathazeki ngokungadingekile ngalokhu.
Isikhathi sokuthola iseluleko sezokwelapha ngokushesha
Uma wazi ukuthi ingane yakho ine-PDA, shayela udokotela wakho ngokushesha uma kuvela izimpawu ezintsha (isib. ukuncipha kokuphuza ubisi, ubunzima bokuphefumula).
Uma ingane yakho inenkinga yokuphefumula ngokuzumayo noma izindebe zayo ziphenduka zibe luhlaza okwesibhakabhaka, yiyise eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha.
Umlayezo Wokuya Nawe Ekhaya
- I-PDA yisifo senhliziyo esingelapheka esibonakala ezinganeni ezisanda kuzalwa.
- Le ngozi iphezulu kakhulu ezinganeni ezizalwa ngaphambi kwesikhathi.
- Uma ingane yakho iphefumula ngokushesha, ijuluka ngesikhathi incelisa, noma ingakhuli, bona udokotela ngokushesha.
- Lokhu kungahlolwa ngokunembile nge-scan ebizwa ngokuthi i-echocardiogram (Echo).
- Kunezindlela zokwelapha (imithi, ukufakwa kwe-catheter, ukuhlinzwa). Ngemva kokwelashwa okufanele, umntwana angaphila impilo enempilo ngokuphelele.
- Ungesabi lokhu ngokungadingekile. Khuluma nodokotela wakho ukuze uthole ulwazi olunembile kakhulu.
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