Akukho okujabulisa ngaphezu kokubuka umntwana osanda kuzalwa. Kodwa ngezinye izikhathi, lapho lowo mntwana eqala ukukhala ngenkathi encela ubisi, futhi lapho ephenduka okwesibhakabhaka ngokuzumayo, wonke umama nobaba bayesaba. Namuhla sizokhuluma ngesimo esingavamile kodwa esibucayi senhliziyo esikhona lapho kuzalwa, esibonisa izimpawu ezinjalo. Kwezokwelapha, sibiza lokhu ngokuthi i -Pulmonary Atresia . Ungesabi uma uzwa leli gama. Ngezindlela zokwelapha ezithuthukisiwe ezitholakala namuhla, lesi simo singaphathwa ngempumelelo. Masiqonde lokhu kusukela ekuqaleni.
Kalula nje, iyini i-Pulmonary Atresia?
Ukuze siqonde lokhu, ake siqale sikhumbule ukuthi inhliziyo yethu isebenza kanjani. Inhliziyo yethu inezindawo ezine eziyinhloko. Igumbi elingezansi ngakwesokudla (i-ventricle yesokudla) liphampa igazi elingcolile, elingenawo umoya-mpilo eliya emaphashini ukuze lithathe umoya-mpilo. Umthambo wegazi oyinhloko othwala leli gazi uye emaphashini umthambo wamaphaphu.
Cabanga nje, kukhona ingxenye efana nesango phakathi kwe-ventricle yesokudla yenhliziyo kanye nalo mthambo wamaphaphu. Lokhu sikubiza ngokuthi i-valve yamaphaphu. Le valve iyavuleka futhi ivale ukuze ithumele igazi emaphashini.
I-pulmonary atresia yisimo lapho i -pulmonary valve ingakhuli kahle ngesikhathi umntwana ekhula esibelethweni. Ngezinye izikhathi, le valve ingambozwa ngokuphelele yi-membrane ejiyile. Lokhu kusho ukuthi indlela eyinhloko yokugeleza kwegazi isuka kwi-ventricle yesokudla iye emaphashini ivinjiwe ngokuphelele.
Ngakho-ke kwenzekani-ke? Igazi alikwazi ukufika emaphashini ukuze lithole umoya-mpilo. Ngenxa yalokho, igazi eliluhlaza okwesibhakabhaka elingenawo umoya-mpilo lijikeleza emzimbeni wonke. Lesi yisona sizathu esiyinhloko esenza izindebe zomntwana, iminwe yakhe, futhi ngezinye izikhathi wonke umzimba wakhe ubonakale uluhlaza okwesibhakabhaka. Lesi simo sibizwa ngokuthi i-cyanosis.
"Izindlela ezihlukile" zenhliziyo kanye nezinhlobo zalesi sifo
Uma lo mgwaqo omkhulu uvaliwe, amaphaphu kufanele athole igazi ngandlela thile ukuze asinde. Ngenhlanhla, eminye imigwaqo "yesikhashana" enhliziyweni ngesikhathi sokukhulelwa isebenza njengomsindisi wokuphila ngalesi sikhathi.
- I-Foramen Ovale: Imbobo encane phakathi kwamakamelo amabili aphezulu enhliziyo. Lokhu kuvumela igazi elingenawo umoya-mpilo ukuthi ligeleze lisuka ohlangothini lwesokudla liye kwesobunxele.
- I-Ductus Arteriosus: Ukuxhumana okuncane phakathi komthambo oyinhloko othwala igazi emzimbeni (i-aorta) nomthambo othwala igazi emaphashini (umthambo wamaphaphu). Ngale ndlela, inani elincane legazi elivela emzimbeni libuyela emaphashini.
Kujwayelekile ukuthi lezi zindlela zesikhashana zivaleke zingakapheli izinsuku ezimbalwa ngemva kokuzalwa. Kodwa-ke, umntwana one-Pulmonary Atresia angasinda kuphela uma lezi zindlela zihlala zivulekile. Ngakho-ke, ngokushesha nje lapho umntwana ezalwa, odokotela bazonikeza umntwana imithi yokugcina lezi zindlela zivulekile (ikakhulukazi i-Ductus Arteriosus).
Singabona isimo se-Pulmonary Atresia ngezindlela ezimbili eziyinhloko.
1. I-Pulmonary Atresia ene-Intact Ventricular Septum (IVS): Lapha, udonga oluphakathi kwamakamelo amabili aphansi enhliziyo (septum) luphelele. Azikho izimbobo. Kodwa-ke, ngenxa yalokhu, i-ventricle yesokudla ayinayo indawo yokupompa igazi, futhi ivame ukungakhuli kahle futhi incane.
2. I-Pulmonary Atresia ene-Ventricular Septal Defect (VSD): Lapha, ngaphezu kwe-valve yamaphaphu evinjiwe, kukhona imbobo odongeni phakathi kwamakamelo amabili aphansi enhliziyo (i-Ventricular Septal Defect - VSD). Le mbobo ivumela igazi ukuthi ligeleze lisuka ekamelweni lesokudla liye kwesobunxele, ngakho igumbi lesokudla lingase libe likhulu kancane kunokujwayelekile.
Izindlela zokwelapha zinqunywa ngokusekelwe ekutheni ingane inaluphi uhlobo kulezi ezimbili.
Yiziphi izimpawu abazali abangazibheka?
Lezi zimpawu zivame ukuvela emahoreni ambalwa okuqala noma ezinsukwini ngemuva kokuzalwa komntwana. Nakuba odokotela beqaphela kakhulu lokhu esibhedlela, kubalulekile ukuthi uqaphele lokhu ngemva kokufika ekhaya.
| Isibonakaliso | Kusho ukuthini lokhu? |
|---|---|
| Ukushintsha kombala womzimba okuluhlaza okwesibhakabhaka (i-Cyanosis) | Izindebe, ulimi, iminwe, kanye nangaphansi kwezinzipho kuphenduka kube luhlaza okwesibhakabhaka noma onsomi. Lokhu kunganda uma ingane ikhala noma iphuza ubisi. Lokhu kungenxa yokuntuleka komoya-mpilo egazini. |
| Ukuphefumula okusheshayo noma okunzima | Ngisho noma umntwana ehleli nje, uzophefumula ngokushesha okukhulu, abonakale sengathi uyangena ngaphakathi, bese ephefumula kanzima. Lokhu kuwumzamo wokuthola umoya-mpilo odingwa umzimba. |
| Ukuhluza ngenkathi uphuza ubisi | Uphuza ubisi, alukhafule, ayeke, aphinde aluncele. Ngezinye izikhathi uyalala ngenkathi ephuza. Kunzima ukuqhubeka nokuphuza njengomntwana ojwayelekile. |
| Ukozela okungavamile kanye nokuzola | Ingane ihlala ilele. Ayinasithakazelo sokudlala noma sokuhambisa imilenze yayo. Izizwa ingaphili. |
| Isikhumba esibandayo nesinomswakama | Izandla nezinyawo zengane zingase zizwe zibanda uma zithintwa. Ngezinye izikhathi zingase zibe nomuzwa wokunamathela nokujuluka. |
Kungani lokhu kwenzeke enganeni yami? Yiziphi izinto eziyingozi?
Lo mbuzo ufika engqondweni yabo bonke abazali. "Ingabe ngenze into engalungile?" Ungase uzibuze. Okokuqala, imbangela eqondile yalokhu ayaziwa okwamanje. Akulona iphutha lakho. Kubangelwa ukungasebenzi kahle enkambisweni eyinkimbinkimbi kakhulu eyenzeka lapho inhliziyo yengane yakheka emavikini okuqala ayisishiyagalombili okukhulelwa.
Kodwa-ke, kunezici eziningana eziye zatholakala ezikhulisa kancane amathuba, noma ingozi, yokuthi lesi simo sivele.
- Izici zofuzo: Ingozi iphakeme kancane uma othile emndenini (umama, ubaba) enesifo senhliziyo azalwa naso. Kungahlotshaniswa nezimo ezithile zofuzo, njenge-DiGeorge's syndrome.
- Impilo kamama ngesikhathi sokukhulelwa: Umama wayenesifo sikashukela esingalawuleki ngesikhathi sokukhulelwa.
- Imithi ethile ethathwa ngesikhathi sokukhulelwa: Ukusetshenziswa kwemithi ethile kungaba nemiphumela emibi embungwini (i-teratogenic). Yingakho kunconywa ukuthi ungaphuzi noma yimuphi umuthi ngesikhathi sokukhulelwa ngaphandle kweseluleko sikadokotela.
- Ukubhema: Ukubhema kukamama ngesikhathi sokukhulelwa noma ngaphambi kokukhulelwa.
- Iminyaka yomama: Ingozi yalezi zinhlobo zokukhubazeka kokuzalwa inganda kancane njengoba iminyaka kamama ikhula.
Into ebalulekile ukuthi akuwona wonke umuntu onalezi zici eziyingozi ozoba nalesi simo. Futhi, ngisho nomuntu ongenazo lezi zici eziyingozi angasithola lesi simo.
Odokotela bakuthola kanjani lokhu?
Ngobuchwepheshe bamanje, lesi simo ngezinye izikhathi singatholakala ngaphambi kokuba umntwana azalwe, okungukuthi, ngesikhathi sokukhulelwa .
- Ngesikhathi sokukhulelwa: Uma ukuhlolwa okuvamile kwe-ultrasound kubonisa noma yikuphi ukukhubazeka enhliziyweni yengane yakho, udokotela wakho angakuthumela kukuhlolwa okukhethekile okubizwa ngokuthi i-fetal echocardiogram . Lokhu kukuvumela ukuthi ubone isakhiwo kanye nokusebenza kwenhliziyo yengane yakho ngokucacile.
Ngemva kokuzalwa kwengane, uma udokotela ezwa ukububula kwenhliziyo okungavamile noma ebona ukushintsha kombala okuluhlaza okwesibhakabhaka (i-cyanosis) ngenkathi ehlola ingane, uzokwenza izivivinyo eziningana ukuqinisekisa lesi simo.
- I-Pulse Oximetry: Lokhu kuyindlela elula kakhulu yokuhlola engenabuhlungu. Idivayisi encane efana ne-clip ixhunywe kuzwane olukhulu lomntwana futhi ilinganisa izinga lomoya-mpilo egazini. Uma izinga lomoya-mpilo liphansi, kuyisibonakaliso senkinga yenhliziyo.
- I-X-ray yesifuba: I-X-ray yesifuba inganikeza umbono oqondile ngobukhulu, ukuma, kanye nokugeleza kwegazi emaphashini.
- I-Electrocardiogram (ECG/EKG): Ukuhlolwa okuqopha umsebenzi kagesi wenhliziyo. Lokhu kungahlola noma yikuphi ukucindezeleka emisipheni yenhliziyo kanye nanoma yiziphi izinguquko esigqini sokushaya kwenhliziyo.
- I-Echocardiogram (i-'Echo' scan): Lesi isivivinyo esibaluleke kakhulu nesiqondile. Sifana nesivivinyo se-ultrasound. Singabona ngokucacile konke okusenhliziyweni, okuhlanganisa amakamelo, ama-valve, imithambo yegazi, nokuthi igazi ligeleza kanjani. I-Pulmonary Atresia ihlolwa ngokunembile kakhulu ngalesi sivivinyo.
Yiziphi izindlela zokwelapha umntwana?
Nakuba lesi simo singelapheki ngokuphelele, ukuhlinzwa kanye nezinye izindlela zokwelapha kungathuthukisa kakhulu ukugeleza kwegazi enhliziyweni yengane, okuyenza iphile impilo evamile. Uhlelo lokwelashwa luyahlukahluka kuye ngengane.
Isinyathelo Sokuqala: Ukuqinisa Umntwana
Lapho nje umntwana ezalwa, umgomo wokuqala ukugcina umthambo wegazi osindisa impilo obizwa ngokuthi i-Ductus Arteriosus uvulekile futhi uvimbele ukuthi uvaleke.
- Imithi: Umuthi obizwa ngokuthi i-alprostadil unikezwa njalo ngomthambo (IV). Lokhu kuvimbela umthambo wegazi wesikhashana ukuthi ungavaleki. Lokhu kudala umzila owengeziwe wokugeleza kwegazi uye emaphashini.
- Ezinye izindlela: Ngezinye izikhathi, odokotela benhliziyo basebenzisa ithubhu elincane kakhulu (i-catheter) elidlula emthanjeni wegazi emlenzeni liye enhliziyweni bese lifaka ucezu oluncane olufana ne-mesh (i-stent) ngaphakathi kwe-Ductus Arteriosus ukuze lihlale livulekile.
Isinyathelo Sesibili: Inqubo Yokuhlinzwa
Ngokuvamile, ingane ene-Pulmonary Atresia kuzodingeka ihlinzwe uchungechunge lweminyaka embalwa yokuqala yokuphila. Lokhu kuhlinzwa akukwazi ukwenziwa ngesikhathi esisodwa, kodwa kwenziwa ngezigaba njengoba ingane ikhula.
Lolu chungechunge lokuhlinzwa lufana nokudala "ipayipi" elisha ngokuphelele lokugeleza kwegazi enhliziyweni. Konke lokhu kunqunywa yithimba lodokotela benhliziyo nodokotela abahlinzayo abelapha ingane yakho.
Izinqubo ezintathu zokuhlinzwa ezivame ukwenziwa yilezi:
1. I-BTT Shunt (Ukuhlinzwa kokuqala - emasontweni ambalwa okuqala): Lokhu kuhilela ukuxhuma ithubhu elincane lokwenziwa (i-shunt) phakathi kwegatsha lomthambo wegazi oyinhloko othwala igazi emzimbeni kanye nomthambo othwala igazi emaphashini. Lokhu kunikeza ukuhlinzekwa kwegazi okuzinzile emaphashini.
2.Inqubo kaGlenn (ukuhlinzwa kwesibili - cishe izinyanga ezingu-4-8): Lapho umntwana esekhulile kancane, i-shunt ebekiwe ngaphambili iyasuswa. Ngemuva kwalokho, igazi elingenawo umoya-mpilo elivela emzimbeni ongaphezulu lixhunywe ngqo emthanjeni wamaphaphu. Lokhu kunciphisa kakhulu umthwalo womsebenzi enhliziyweni.
3. Inqubo yeFontan (ukuhlinzwa kwesithathu nokokugcina - cishe eminyakeni emi-2-4 ubudala): Kulokhu, igazi elingenawo umoya-mpilo elivela emzimbeni ongezansi lixhunywa ngqo nomthambo wamaphaphu. Ngemva kwalokhu kuhlinzwa, ukugeleza kwegazi kuyalungiswa ukuze lonke igazi elingenawo umoya-mpilo elivela emzimbeni liye ngqo emaphashini, esikhundleni sokuya ohlangothini lwesokudla lwenhliziyo.
Ngemva kwalokhu kuhlinzwa, umntwana kuzodingeka ahlale esibhedlela, egunjini lokunakekelwa okujulile (ICU), isonto elilodwa noma amabili.
Injani impilo ngemva kokuhlinzwa?
Ngemva kwalolu chungechunge lokuhlinzwa, ingane izokwazi ukuya esikoleni futhi idlale ngendlela evamile. Kodwa-ke, lesi yisimo esidinga ukubhekwa kwezokwelapha impilo yonke.
- Ukuhlolwa njalo kwezokwelapha: Kufanele uye kudokotela wezifo zenhliziyo njalo ukuze uthole ama-aphoyintimenti okulandelela. Kuzodingeka wenze izivivinyo ezifana ne-echo scan kanye ne-ECG okungenani kanye ngonyaka.
- Izinkinga: Ngokuhamba kwesikhathi, kuba khona ingozi yezinkinga ezifana nokuphazamiseka kwenhliziyo, izinkinga zesibindi kanye nokwehluleka kwenhliziyo. Yingakho ukuhlolwa njalo kubalulekile.
- Ukuvikela ezifweni: Laba bantwana basengozini enkulu yokuthola i-endocarditis, ukutheleleka kolwelwesi lwenhliziyo. Ngakho-ke, kufanele ubuze udokotela wakho uma udinga ukuthatha ama-antibiotic ukuvimbela ukutheleleka ngaphambi kwezinqubo ezithile zezokwelapha, njengokukhipha amazinyo.
- Imisebenzi: Kufanele ukhulume nodokotela wakho bese unquma ukuthi yiziphi izivivinyo kanye nemidlalo ingane yakho engayenza nengeke iyenze.
Amazwi awakwazi ukuveza ubuhlungu, ukwesaba, kanye nokushaqeka ozizwayo lapho uthola ukuthi ingane yakho inalesi simo. Kodwa khumbula, awuwedwa. Ithimba elikhulu lodokotela nabahlengikazi abanekhono lizinikele ekuhlinzekeni ukunakekelwa okungcono kakhulu kwengane yakho. Khuluma nodokotela wakho nganoma yimiphi imibuzo noma ukukhathazeka ongase ube nakho.
Umlayezo Wokuya Nawe Ekhaya
- I-pulmonary atresia yisifo senhliziyo esibi kakhulu esizalwa naso lapho ivalvu ethwala igazi emaphashini ivalekile.
- Izimpawu eziyinhloko ukushintsha kombala okuluhlaza okwesibhakabhaka komzimba womntwana, izindebe, neminwe (i-cyanosis), ukuminyana ngesikhathi encelisa, kanye nobunzima bokuphefumula.
- Lesi yisimo esibulalayo uma singelashwa. Kodwa-ke, ngokuthuthuka kwezokwelapha zanamuhla, uchungechunge lokuhlinzwa lunganikeza ingane impilo engcono.
- Laba bantwana kukho konke ukuphila kwaboUkubhekwa ngudokotela wezifo zenhliziyo kanye nokuhlolwa njalo kwezokwelapha kubalulekile.
- Njengabazali, ningesabi ukubuza udokotela wenu imibuzo, nicacise ukungabaza, futhi nibe nolwazi oluhle ngohlelo lokwelashwa.
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