Ingabe ingane yakho encane inale nkinga yenhliziyo? Ake sifunde nge-Pulmonary Artery Stenosis!

Ingabe ingane yakho ngezinye izikhathi izizwa iphelelwa umoya? Noma ingabe ikhathala ngokushesha ngisho nangemva kokudlala isikhashana? Ezinye izingane ezincane zingaba nezifo zenhliziyo ezizalwa nazo. Namuhla sizokhuluma ngesifo senhliziyo esinjalo, esingajwayelekile, kodwa esibaluleke kakhulu okufanele sazi ngaso. Lokhu sikubiza ngokuthi `(Pulmonary Artery Stenosis)`. Kalula nje, ukuvaleka komthambo oyinhloko othwala igazi liye emaphashini.

Kuyini i-Pulmonary Artery Stenosis?

Kalula nje, kukhona umthambo omkhulu wegazi othwala igazi lisuka ohlangothini lwesokudla lwenhliziyo yethu (esilubiza ngokuthi "i-ventricle yesokudla") liye emaphashini. Lokhu kubizwa ngokuthi "umthambo wamaphaphu". Uma ufika emaphashini, leli gazi lifakwa umoya-mpilo, bese lelo gazi elifakwe umoya-mpilo lithwalwa kuwo wonke umzimba.

Manje, kulesi simo esibizwa ngokuthi `(Pulmonary Artery Stenosis)`, umthambo wegazi othwala igazi emaphashini uyavaleka noma unciphe endaweni ethile noma kwelinye lamagatsha awo. Kufana nombhobho wamanzi ovaleka phakathi. Kwenzekani-ke? Kuba nzima ukuthi igazi ligeleze emaphashini. Uma igazi lingahambi kahle, umzimba awutholi inani lomoya-mpilo olidingayo. Ngenxa yalokhu, inhliziyo yengane kanye nomzimba wonke akukwazi ukusebenza kahle.

Lokhu kuvinjelwa kungenzeka emthanjeni oyinhloko wamaphaphu (`(umthambo oyinhloko wamaphaphu)`), noma emagatsheni awo angakwesobunxele noma kwesokudla (`(amagatsha angakwesobunxele noma kwesokudla)`). Uma lokhu kuvinjelwa kwenzeka, uhlangothi lwesokudla lwenhliziyo (`(i-ventricle yesokudla)`) kufanele lusebenze kanzima kakhulu ukupompa igazi lidlule ekuvinjweni. Kufana nokusebenzisa amandla amaningi ukusunduza amanzi ngepayipi elivinjiwe. Ngokuhamba kwesikhathi, lo mzamo oqhubekayo ungalimaza imisipha yenhliziyo.

Yiziphi izinkinga ezingavela kulesi simo?

Uma lokhu kungelashwa kahle, ngokuhamba kwesikhathi uhlangothi lwesokudla lwenhliziyo lungase lungasebenzi kahle. Okusho ukuthi, kungenzeka ukuthi kube nesimo esibizwa ngokuthi "ukwehluleka kwenhliziyo ohlangothini lwesokudla". Ngakho-ke, kubaluleke kakhulu ukunakekela lokhu.

Ubani othinteka kakhulu yilesi simo?

Lesi simo esibizwa ngokuthi `(Pulmonary Artery Stenosis)` empeleni asivamile . Lokho kusho ukuthi akwenzeki kuwo wonke umuntu. Ezinye izingane zingaba naso kanye nezinye izifo zenhliziyo (`(isifo senhliziyo esizalwa naso)` - okungukuthi, izifo zenhliziyo ezikhona lapho kuzalwa). Ngezinye izikhathi kungaba yiso sodwa esingenazo ezinye izinkinga zenhliziyo. Futhi, lesi simo singavela ngemva kokuhlinzwa kwenhliziyo.

Ziyini izimpawu zalokhu? Bheka ukuthi ingane yakho nayo inazo yini lezi zimpawu.

Lezi zimpawu zincike ekutheni ipayipi linciphile kangakanani. Ngezinye izikhathi, uma i-stenosis incane kakhulu (`i-stenosis encane`), kungase kungabi nazimpawu nhlobo . Kodwa njengoba i-stenosis iba yimbi kakhulu, ingane yakho ingabonisa izinto ezinjengalezi:

• Ukuzizwa sengathi kunzima ukuphefumula (`(Ukuphefumula okuncane)`).
• Ukuzizwa ukhathele ngaso sonke isikhathi (`(Ukukhathala)`).
• Kuzwakala sengathi uphefumula ngokushesha okukhulu , noma mhlawumbe uphefumula kakhulu.Ingabe kubukeka kanje? (`(Ukuphefumula okunzima noma okusheshayo)`).
• Ingabe ukushaya kwenhliziyo yakho kuzwakala sengathi kushaya ngokushesha kakhulu ? (Ukushaya kwenhliziyo okusheshayo).
• Ingabe kukhona ukuvuvukala emilenzeni yakho, emaqakaleni, ebusweni, ezinkopheni, noma esiswini? (`(Ukuvuvukala)`).
• Ingabe ngezinye izikhathi uzizwa unesiyezi noma uqulekile ? (`(Unesiyezi noma uqulekile)`).
• Ingabe izindebe zakho, iminwe, nezinzwane zakho ziphenduka zibe luhlaza okwesibhakabhaka ? Yilokhu esikubiza ngokwezokwelapha ngokuthi "i-Cyanosis".
• Ingabe uyakhathala ngokushesha uma udlala nezinye izingane? Awukwazi yini ukugijima nokugxuma kahle njengabanye abantwana? (`(Ukubekezelela ukuzivocavoca okuncishisiwe)`).

Khumbula, ukuba nesibonakaliso esisodwa noma ezimbili nje akusho ukuthi unesifo. Kodwa uma ingane yakho inanoma iyiphi yalezi zinto, kungcono ukufuna iseluleko sezokwelapha.

Kungani lo mthambo wamaphaphu uvaleka? Ziyini izimbangela?

Ezinye izingane zizalwa zinalesi simo (i-Pulmonary Artery Stenosis), futhi zingase zibe nezinkinga ngama-valve, izindonga, noma ezinye izingxenye zenhliziyo. Ezinye zingase zizalwe zinalesi simo kodwa azinazo ezinye izinkinga zenhliziyo. Ngaphezu kwalokho, lesi simo singavela ngemva kokuhlinzwa kwenhliziyo noma ngenxa yezinye izimo, ezingavamile kakhulu.

Izimbangela zokuzalwa

Sekukonke, cishe abantu abangu-40% bazalwa benalesi simo (i-Pulmonary Artery Stenosis), kodwa abanazo ezinye izinkinga zenhliziyo.

Kodwa-ke, phakathi kuka-2% no-3% wabantu abanezinye izinkinga zenhliziyo abazalwa nazo bangase babe nalesi simo (i-Pulmonary Artery Stenosis). Nazi ezinye zeziphazamiso zenhliziyo ezivame kakhulu:

• (Tetralogy of Fallot): Kulokhu, ingane inezinkinga ezine ngenhliziyo, eziphazamisa ukugeleza kwegazi.
• (I-Pulmonary atresia): Kulokhu, i-valve (i-pulmonary valve) ephakathi kwe-ventricle yesokudla yenhliziyo nomthambo wamaphaphu (i-pulmonary artery) ayakheki. Ngakho-ke, igazi aligelezi emaphashini.
• (I-Truncus arteriosus): Umthambo wegazi owodwa omkhulu esikhundleni semibili evamile. Lokhu kubangela ukuthi igazi elinomoya-mpilo lihlangane negazi elingenawo umoya-mpilo.
• I-Aortic valve stenosis: Inkinga nge-valve emthanjeni oyinhloko othwala igazi lisuka enhliziyweni liye emzimbeni, okunciphisa inani legazi eligeleza liye emzimbeni.
• I-Atrial septal defect: Imbobo odongeni phakathi kwamakamelo amabili aphezulu enhliziyo (i-atria). Lokhu kuvumela igazi elinomoya-mpilo kanye negazi elingenawo umoya-mpilo ukuthi lihlangane.
• I-Ventricular septal defect: Imbobo odongeni ehlukanisa amakamelo amabili angezansi (ama-ventricles) enhliziyo. Lokhu kungabangela igazi eliningi kakhulu ukuthi lingene emaphashini.
• (Ukuguqulwa kwemithambo emikhulu): Imithambo yegazi emibili eyinhloko ethwala igazi lisuka enhliziyweni ihlehlisiwe. Lokhu kuphazamisa ukugeleza kwegazi okuvamile futhi kunciphise inani lomoya-mpilo ofinyelela emangqamuzaneni omzimba.
• (I-Patent ductus arteriosus):Lokhu kuwukuxhumana phakathi komthambo wephaphu womntwana kanye nomthambo oyinhloko othwala igazi emzimbeni (i-aorta). Lokhu kufanele kuvalwe ngemva kokuzalwa, kodwa uma kungenjalo, igazi eliningi kakhulu lizogeleza liye emaphashini.

Ezinye izizathu

Ngaphandle kwalokhu, kungase kube nezinye izizathu eziningana:

• I-Rubella syndrome: Uma uthola i-rubella ngesikhathi sokukhulelwa, ingane yakho ingase ibe nezinkinga zenhliziyo nezinye izinkinga zempilo.
• (i-Williams syndrome): Lokhu kubangela ukukhubazeka okuhlukahlukene enhliziyweni yengane nakwezinye izitho zomzimba.
• (i-Alagille syndrome): Lokhu kubangela izinkinga zesibindi nesifo senhliziyo.
• I-arteritis kaTakayasu: Lokhu ukuvuvukala okulimaza imithambo yegazi emikhulu.
• Ezinye izinkinga ngendlela umthambo we-pulmonary wengane ophushelwa ngayo ngaphandle.

Izimbangela zokuhlinzwa

Abanye abantu bangase babe nalesi simo ngemva kokuhlinzwa. Isibonelo:

• Ukufakelwa amaphaphu.
• Ukuhlinzwa ukulungisa inkinga yenhliziyo yokuzalwa enganeni, noma ukuthuthukisa ukugeleza kwegazi enhliziyweni.
• Ukuhlinzwa okubizwa ngokuthi "i-Pulmonary artery banding". Kulokhu, umthambo uncishiswa ngamabomu ukuze kuncishiswe inani legazi eliya emaphashini.

Ungasithola kanjani lesi sifo?

Uma ingane yakho ihlolwa udokotela, ingase izwe umsindo wenhliziyo ongajwayelekile (“ukububula”). Uma kunjalo, izo-oda ezinye izivivinyo eziningana. Ezinye zalezi zifaka:

• I-Electrocardiogram - I-ECG noma i-EKG: Lokhu kurekhoda izinguquko zikagesi ezenzeka lapho inhliziyo ishaya. Kungabona ukushaya kwenhliziyo okungajwayelekile (ama-arrhythmia) kanye nokucindezeleka emisipheni yenhliziyo.
• I-X-ray yesifuba: Lokhu kungabonisa ubukhulu nesimo senhliziyo, amaphaphu, kanye nemithambo yamaphaphu.
• I-Echocardiogram: Lokhu kufana nesithombe esinyakazayo senhliziyo. Kusebenzisa amaza omsindo ukubheka imisipha yenhliziyo nama-valve.
• Ukuthwebula izithombe ze-cardiac magnetic resonance (MRI): Lena yindlela yokuthwebula izithombe enezinhlangothi ezintathu (3D) engabona ukuthi igazi ligeleza kanjani enhliziyweni yengane yakho kanye nasemithanjeni yegazi.
• (I-CT scan): Lokhu futhi ukuhlolwa kwe-`(X-ray)`. Ikhompyutha isebenzisa uchungechunge lwezithombe ze-`(X-ray)` zenhliziyo yengane ukudala imibono ehlukahlukene. Kufakwa idayi ekhethekile (`(IV contrast)`) enhliziyweni ukuze kubhekwe isakhiwo kanye nokugeleza kwegazi kwenhliziyo.
• Ukufakwa kwe-catheter enkabeni yenhliziyo: Kule nqubo, kufakwa ipayipi elincane (i-catheter) emthanjeni noma emthanjeni bese liqondiswa enhliziyweni. Lokhu kuvumela udokotela ukuthi aqaphe amazinga omoya-mpilo, izinguquko zokucindezela, futhi athathe ama-X-ray enhliziyo.
• I-angiography yamaphaphu: I-X-ray yemithambo yamaphaphu kanye nemithambo yenhliziyo ithathwa kusetshenziswa udayi.
• (Ukuskena kwe-Perfusion): Kulokhu, kufakwa inani elincane lezinto ezinemisebe. Bese kusetshenziswa umshini okhethekile ukuhlola ukuthi igazi ligeleza kahle kangakanani emaphashini ngalinye.

Uma udokotela wakho ethola ukuthi ingane yakho ine-Pulmonary Artery Stenosis, uzokudlulisela kuchwepheshe wenhliziyo ozalwa nawo. Lolu hlobo lodokotela lunamakhono nokuqeqeshwa kokuxilonga ngokunembile inkinga yenhliziyo yengane yakho, ukwenza noma yiziphi izivivinyo ezidingekayo, ukunikeza ukwelashwa, ukwenza ukuhlinzwa kwenhliziyo, kanye nokunikeza ukuhlolwa okulandelayo . Bangase futhi benze izivivinyo ezengeziwe uma kudingeka.

Uma ekhuluma ngalesi simo, udokotela wakho angase asibize ngokuthi Uhlobo I, II, III, noma IV. Lolu uhlobo olusekelwe ekutheni yiziphi izingxenye zomthambo ovalekile nokuthi zingakanani.

Yiziphi izindlela zokwelapha lokhu? (Ukwelashwa)

Ukwelashwa okungcono kakhulu kuncike ezimpawini zengane yakho kanye nezinye izici. Uma kukhona ukuncishiswa okuncane kuya kokuphakathi kwegatsha elilodwa noma ngaphezulu lomthambo wamaphaphu, ukwelashwa kungase kungadingeki . Kodwa-ke, uma ukuncishiswa kunzima, ukwelashwa kuyadingeka .

Izindlela zokwelapha `(Pulmonary Artery Stenosis)` yilezi:

Ukwandiswa kwebhaluni / i-Angioplasty

Kulokhu, udokotela wenza lokhu:

• I-catheter efana nebhaluni (i-catheter yokukhulisa ibhaluni) ifakwa emgudwini ovalekile.
• Bese, ngokucophelela okukhulu, ibhaluni liyafuthwa kusukela ekucindezelweni okuphansi kuya ekucindezelweni okuphezulu.
• Bese lowo msele ovalekile uyanda.
• Bese umoya ukhishwa ebhaluni bese ukhishwa.

Ukwandiswa kwebhaluni kanye nokubekwa kwe-stent (lokhu kuvame ukwenziwa)

Kulokhu, udokotela wenza lokhu:

• I-stent enwebekayo ngebhaluni (i-stent iyipayipi elincane eline-mesh) isetshenziswa ukuvula umthambo ovalekile.
• Le stent ibekwa phezu kwe-catheter yebhaluni ye-angioplasty bese imbozwa nge-sheath.
• I-stent ithuthelwa endaweni efanele.
• Isembozo esisebhaluni le-stent siyasuswa.
• Bese ibhaluni lifuthwa liye kumfutho ofanele, landise i-stent futhi libangele ukuthi lihlale linamathele lapho.

Ibhaluni elikhethekile elibizwa ngokuthi ``(The Cutting Balloon™)``

Leli bhaluni lifana nebhaluni elivamile. Kodwa-ke, linama-blade amancane amaningana ubude balo. Lapho udokotela efutha ibhaluni, la ma-blade ayasebenza futhi asike indawo evinjiwe. Lokhu kwenza kube lula ukwandisa ithubhu, kwenze kube nokuvulwa okukhulu.

Iningi labantu abangenazo ezinye izifo zenhliziyo abazalwa nazo bathola imiphumela emihle ngale nqubo. Kodwa-ke, cishe abantu abangu-21% bangase bavaleke futhi imithambo yabo yegazi ngemva kwezinyanga ezimbalwa.

Ukuhlinzwa

Odokotela abahlinzayo basebenzisa izindlela ezahlukahlukene zokwelapha i-stenosis yemithambo yamaphaphu. Ukukhetha kuncike ohlotsheni lokuvaleka, imithambo yegazi ezungezile, kanye nezinye izakhiwo.

Ingabe kukhona izinkinga ekwelashweni?

Ukwanda kwamabhaluni kunciphisa ukuvaleka kwabantu abaningi. Kodwa-ke, ngokuhamba kwesikhathi, umthambo ungavaleka futhi ngo-15% kuya ku-20%, futhi inqubo kumele iphindwe. Abacwaningi okwamanje baphenya ngezinhlobo ezahlukene zamabhaluni ezingase zinikeze imiphumela engcono nehlala isikhathi eside.

Izinkinga ezingaba khona ngesikhathi sokuvuleka kwebhaluni:

• I-aneurysm yemithambo yephaphu.
• Ukuhlukaniswa kwemithambo yephaphu (ukuhlukaniswa kwemithambo yephaphu).
• Ukuqhekeka komthambo wamaphaphu (`(Ukuqhekeka komthambo wamaphaphu)`).
• Ukuvuvukala kwamaphaphu (`(Ukuvuvukala kwamaphaphu)`).
• Akuvamile kakhulu ukuthi kube nokufa.

Izinkinga ezingaba khona zokusetshenziswa kwe-stent:

• Amahlule egazi.
• Ukungahambi kahle kwesigqi senhliziyo (`(Ventricular arrhythmias)`).
• I-stent ingase ilahleke noma ikhishwe.
• Ukudinga ukwandisa umthambo futhi (lokhu kwenzeka kaningi kakhulu).

Ziyini izinzuzo zokwelashwa?

Odokotela bakhetha ukubeka ama-stents e-Pulmonary Artery Stenosis ngenxa yalezi zizathu:

• Zisebenza cishe ngo-96% ngokushesha .
• Kuthatha isikhathi eside ukugcina umthambo uvulekile.
• Indawo encishisiwe ingandiswa cishe kabili .
• Kushibhile futhi kusebenza kangcono kunokufaka amabhaluni noma ukwenza ukuhlinzwa.
• Iphumelela kakhulu kune-balloon angioplasty.

Odokotela bangakhetha i-balloon angioplasty esikhundleni se-stent ezimweni ezilandelayo:

• Uma isimo sengane sibucayi kakhulu .
• Uma isakhiwo sangaphakathi somzimba wengane siyinkimbinkimbi (`(i-anatomy eyinkimbinkimbi)`).
• Uma ingane incane kakhulu .

Kwenzekani ngemva kokuhlinzwa?

Uma ingane yakho ine-stent, kuzodingeka ithathe ama-antibiotic futhi mhlawumbe imithi yokunciphisa igazi isikhashana. Le mithi inikezwa ukuvimbela ukutheleleka nokuvimbela ukujiya kwegazi.

Ingane izozizwa ingcono ngokushesha kangakanani ngemva kokwelashwa?

Inqubo yokwandisa umthambo wephaphu wengane yakho isebenza ngokushesha. Lokhu kusho ukuthi kuba lula kakhulu ngengane yakho ukufaka igazi emaphashini ayo futhi ithole umoya-mpilo.

Uma ingane yami inalesi simo, ikusasa liyoba njani? (Isibikezelo)

Ngenxa yezindlela zokwelapha ezithuthukisiwe zanamuhla, abantu abaningi abanalesi simo baphila baze babe ngabantu abadala. Kodwa-ke, abantu abanezimo ezifana ne-"Williams syndrome" kanye ne-"Alagille syndrome" bangase bangasabeli kahle ekwelashweni.

Kufanele uyiyise nini ingane yakho kudokotela?

Kuzodingeka ukuthi uyise ingane yakho iyohlolwa njalo ukuze ubone ukuthi injani. Kuzodingeka futhi ukuthi wenze i-echocardiogram njalo ukuze ubone ukuthi umthambo udinga yini ukukhuliswa futhi esikhathini esizayo.

Yini okufanele ngiyibuze udokotela?

Ungabuza udokotela imibuzo efana nale:

• Kungani ingane yami yaba ne-`(Pulmonary Artery Stenosis)`?
• Yikuphi ukwelashwa okungcono kakhulu enganeni yami?
• Angakanani amathuba okuthi ingane yami izophinde idinge ukwelashwa ngalokhu?

Uma ingane yakho idinga ukwelashwa kwe-Pulmonary Artery Stenosis, udokotela uzocabangela ukwelashwa okungcono kakhulu kwesimo sengane yakho. Unganqikazi ukubuza imibuzo nganoma yini ongayiqondi ngenqubo yengane yakho.

Umlayezo Wokuya Nawe Ekhaya

Uma kukhulunywa ngalesi simo esibizwa ngokuthi `(Pulmonary Artery Stenosis)`, into ebaluleke kakhulu ukuqaphela izimpawu kusenesikhathi bese ucela iseluleko sezokwelapha . Kubalulekile ukufuna iseluleko sika`(uchwepheshe wenhliziyo ozalwa nawo)`, ikakhulukazi uma izingane zinalesi simo.

Ungakhathazeki, kunezindlela zokwelapha lokhu . Lesi simo singalawulwa ngezinto ezifana nokuvulwa kwebhaluni, ukufakwa kwe-stent, kanye nokuhlinzwa uma kudingeka. Ngisho nangemva kokwelashwa, kubaluleke kakhulu empilweni yengane ukuthi iye kohlolwa njalo kwezokwelapha futhi ilandele imiyalelo kadokotela . Khuluma nodokotela nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.

I- Pulmonary Artery Stenosis, Isifo Senhliziyo Sezingane, Iziphambeko Zenhliziyo Ezizalwa Nazo, Ubunzima Bokuphefumula, Ukuhlinzwa Kwenhliziyo, I-Stent