Injabulo yokuletha umntwana osanda kuzalwa ekhaya ayichazeki, akunjalo? Kodwa ngezinye izikhathi, kanye naleyo njabulo, kunezikhathi lapho kufika khona ukwesaba okuncane engqondweni. Noma yimuphi umama noma ubaba angakhathazeka uma ebona ukuthi izindebe neminwe yengane yakhe iluhlaza okwesibhakabhaka kancane. Uma bebona into efana nale, kungenzeka ukuthi ibangelwa yisifo senhliziyo sokuzalwa. Namuhla sikhuluma nge- Pulmonary Atresia , isifo senhliziyo esibi kodwa esingelapheka.
Kalula nje, iyini i-Pulmonary Atresia?
Lokhu kungase kuzwakale kuyinkimbinkimbi kancane, kodwa masikugcine kulula. Inhliziyo yethu ifana nendlu encane enamakamelo amane. Umsebenzi oyinhloko wamakamelo amabili ohlangothini lwesokudla lwale ndlu (i-atrium yesokudla kanye ne-ventricle) ukuqoqa igazi "elingcolile" eliphelelwe umoya-mpilo njengoba lihamba emzimbeni wonke, bese lithunyelwa emaphashini ukuze lihlanzwe.
Igazi lithunyelwa emaphashini ngomthambo wegazi omkhulu obizwa ngokuthi i-Pulmonary Artery . Ekuqaleni kwalo mthambo wegazi, kukhona i-valve esebenza njengomnyango. Siyibiza ngokuthi i-Pulmonary Valve . Uma lo mnyango uvuleka, igazi lidlulela emaphashini.
Ake ucabange nje, kwenzekani uma lo mnyango, ivalvu yamaphaphu, ungakheki lapho uzalwa, noma uma uvalwe ngokuphelele? Leso yisimo esisibiza ngokuthi i-Pulmonary Atresia .
Kalula nje, kulesi simo, isango eliyinhloko elithumela igazi elinomoya-mpilo lisuka enhliziyweni liye emaphashini livinjiwe kusukela ekuzalweni. Ngenxa yalokho, igazi elinombala oluhlaza okwesibhakabhaka elingenawo umoya-mpilo lijikeleza kuwo wonke umzimba.
Lesi yisimo esingavamile kakhulu. Ngisho nasezweni elifana neMelika, ingane eyodwa kuphela kwezingu-6,700 ezizalwayo inalesi simo.
Ezinye izinkinga zenhliziyo ezingase zibonakale ngalesi simo
Ingane ene-pulmonary atresia ingaba nezinye izinkinga eziningana zenhliziyo ngaphezu kwalesi sici esiyinhloko.
- Uhlangothi lwesokudla lwenhliziyo olungakhuli kahle: I-ventricle yesokudla, epompa igazi emaphashini, kanye ne-valve ye-tricuspid engaphezulu kwayo kungase kungakhuli kahle futhi kube kuncane.
- Imbobo enhliziyweni: Ngokuvamile, umntwana uba nembobo encane (i-Foramen Ovale) phakathi kwamakamelo amabili aphezulu (i-atria) yenhliziyo uma esesibelethweni. Lokhu kuyavaleka ngemva kokuzalwa. Kodwa-ke, kwabanye abantwana, imbobo ingase ihlale ivulekile. Futhi, kungase kube nembobo odongeni phakathi kwamakamelo amabili aphansi (ama-ventricles) enhliziyo (i-Ventricular Septal Defect - VSD). Lembobo ivumela igazi elinamazinga aphansi omoya-mpilo ukuxubana negazi elinamazinga aphezulu omoya-mpilo.
Wazi kanjani ukuthi ingane yakho inalesi simo? Izimpawu
Izimpawu ze-Pulmonary Atresia zivame ukuqala ukuvela emahoreni ambalwa okuqala noma ezinsukwini ngemuva kokuzalwa. Uphawu oluyinhloko nolubonakala kalula yilolu:Isimo esibizwa ngokuthi i-cyanosis .
Lokhu kusho ukuthi izindebe zomntwana, iminwe yakhe, kanye nezinzwane zakhe zibonakala ziluhlaza okwesibhakabhaka ngenxa yokuntuleka komoya-mpilo egazini. Lo mbala oluhlaza okwesibhakabhaka yingakho abanye abantu bebiza lesi simo ngokuthi "i-blue baby syndrome."
| Isibonakaliso | Incazelo |
|---|---|
| Isikhumba esiluhlaza okwesibhakabhaka (i-Cyanosis) | Ukushintsha kombala wezindebe, iminwe, kanye nangaphansi kwezinzipho okwesibhakabhaka noma onsomi. |
| Ubunzima bokuphefumula | Ukuphefumula okusheshayo, ukuphefumula kanzima (i-Dyspnea). |
| Ukukhathala okungavamile | Ingane ayinawo ngisho namandla okuncela, futhi ihlale ilele. |
| Ubunzima bokuphuza ubisi | Ukwenqaba ukuphuza ubisi ngoba kukwenza uzizwe udidekile ngisho nangemva kokuphuza kancane. |
| Isikhumba esibandayo nesinomswakama | Uma uthinta izitho zomntwana, zizizwa zibanda futhi zinamathela, njengokujuluka. |
| Ukukhala njalo/ukungaphumuli | Ingane ayikhululekile futhi ihlala ikhala ngaphandle kwesizathu. |
Kungani lokhu kwenzeka? Izimbangela kanye nezici eziyingozi
Imbangela eqondile yalesi simo ayaziwa okwamanje . Lokhu kukhubazeka kwenhliziyo kwenzeka emavikini okuqala ayisishiyagalombili okukhula komntwana esibelethweni. Kodwa-ke, kutholakale ukuthi kunezici ezithile ezandisa ingozi.
- Izici zofuzo: Ingozi iphezulu uma othile emndenini enesifo senhliziyo noma izifo ezithile zofuzo (isib. i-DiGeorge's syndrome).
- Impilo kamama ngesikhathi sokukhulelwa:
- Ukubhema ngesikhathi sokukhulelwa.
- Isifo sikashukela asilawulwa kahle.
- Ukusetshenziswa kwemithi ethile (imithi ye-teratogenic) engafanele ukusetshenziswa ngesikhathi sokukhulelwa.
- Izici zabazali:
- Ukuba nesifo senhliziyo sokuzalwa komunye wabazali.
- Ubudala obuphezulu bomama.
Odokotela basithola kanjani lesi sifo ngokunembile?
Ezimweni eziningi, lezi zimo zingabonakala ngaphambi kokuba umntwana azalwe, okungukuthi, ngokusebenzisa ama-scan akwenziwa ngesikhathi sokukhulelwa.
- Ngesikhathi sokukhulelwa: Uma udokotela enokungabaza ngenhliziyo yengane ngesikhathi sokuhlolwa okuvamile (i-ultrasound), uzokuthumela ukuthi uyohlolwa ngokukhethekile okubizwa ngokuthi i-fetal echocardiogram . Lokhu kuvumela ukusebenza kwenhliziyo yengane kanye nesakhiwo sayo ukuthi kubonakale ngokucacile.
- Ngemva kokuzalwa komntwana: Uma udokotela ezwa umsindo ongajwayelekile (ukububula kwenhliziyo) lapho elalele inhliziyo yomntwana, noma uma ingane iluhlaza okwesibhakabhaka, kusolwa lesi sifo. Ngemuva kwalokho, kwenziwa izivivinyo eziningana ukuqinisekisa lesi sifo.
| Ukuhlolwa | Lokhu kwenzani? |
|---|---|
| I-Pulse Oximetry | Idivayisi encane efana ne-clip ixhunywe ozwaneni olukhulu lomntwana futhi ilinganisa inani lomoya-mpilo egazini. |
| I-X-ray yesifuba | Inikeza umbono ophelele ngobukhulu, ukuma, kanye nendlela igazi eligeleza ngayo emaphashini. |
| I-Electrocardiogram (ECG) | Umsebenzi kagesi wenhliziyo ulinganiswa ukuze kubonakale ukuthi kukhona yini ingcindezi emisipheni yenhliziyo noma ukuthi kukhona yini isigqi esingajwayelekile. |
| I-Echocardiogram (i-Echo) | Lesi isivivinyo esibaluleke kakhulu . Kufana nokuskena kwenhliziyo. Isakhiwo senhliziyo, umsebenzi wama-valve, indlela igazi eligeleza ngayo, nokuthi ngabe kukhona yini izimbobo kungabonakala kahle. |
Yiziphi izindlela zokwelapha lokhu?
I-Pulmonary Atresia kufanele yelashwe ngokushesha nje lapho isitholakele. Ayikwazi ukwelapheka ngokuphelele ngemithi. Kodwa-ke, imithi nezinye izindlela zisetshenziswa ukusindisa impilo yengane nokuqinisa isimo kuze kube yilapho isilungele ukuhlinzwa. Isixazululo sokugcina ukwenza uchungechunge lokuhlinzwa .
1. Ukwelashwa okusheshayo (imithi nezinqubo)
- Ukwelashwa: Ngemva kokuzalwa komntwana, kuba nomthambo wegazi okhethekile (i-Ductus Arteriosus) ovame ukuvala. Umuthi obizwa ngokuthi i-Alprostadil unikezwa ngemithambo yegazi (IV) ukuze ugcine lo mthambo wegazi uvulekile. Uma lo mthambo wegazi uvulekile, elinye igazi elingenawo umoya-mpilo lingaya emaphashini ukuze lithole umoya-mpilo. Lesi yisisombululo sesikhashana.
- Izinqubo: Ngezinye izikhathi, kufakwa i- stent ukuze kugcinwe umthambo wegazi uvulekile. Noma kwenziwa i-septostomy ukuze kwandiswe imbobo ephakathi kwamakamelo amabili aphezulu enhliziyo. Lokhu kwenzelwa ukuthuthukisa ukugeleza kwegazi kancane.
2. Ukuhlinzwa (ukuhlinzwa)
Uhlobo lokuhlinzwa ingane eludingayo luncike ekukhuleni kohlangothi lwesokudla lwenhliziyo yayo nokuthi ngabe kukhona yini imigodi enhliziyweni noma cha.
Into ebalulekile ukuthi lokhu kuhlinzwa "akulaphi" ngokuphelele lesi sifo. Kunalokho, kubuyisela ukusebenza kwenhliziyo ngangokunokwenzeka, okuvumela umntwana ukuba aphile impilo evamile.
Izingane eziningi zithola uchungechunge lwezigaba ezintathu zokuhlinzwa kwenhliziyo evulekile , okwenziwa eminyakeni embalwa yokuqala yokuphila komntwana.
1. Ukuhlinzwa kokuqala (BTT Shunt): Lokhu kuvame ukwenziwa zingakapheli izinsuku ezimbalwa zokuqala ngemva kokuzalwa komntwana. Lapha, ithubhu elincane lokwenziwa (shunt) lixhunywe egatsheni lomthambo oyinhloko ohlinzeka ngegazi emzimbeni, okuwumthambo othwala igazi emaphashini. Lokhu kudala indlela entsha yokuthi igazi ligeleze emaphashini.
2. Ukuhlinzwa kwesibili (Inqubo kaGlenn): Lokhu kuhlinzwa kwenziwa lapho umntwana ephakathi kwezinyanga ezi-4 neziyi-8 ubudala . Lapha, ipayipi elifakwe ngaphambilini liyasuswa bese igazi elingenawo umoya-mpilo elivela emzimbeni ongaphezulu lixhunywa ngqo emaphashini.
3. Ukuhlinzwa kwesithathu (Inqubo yeFontan): Lesi yisigaba sokugcina salolu chungechunge lokuhlinzwa. Umntwana uneminyaka ephakathi kwemi-2 neyi-4 ubudala.Lokhu kwenziwa phakathi. Lapha, igazi elingenawo umoya-mpilo elivela engxenyeni engezansi yomzimba nalo liqondiswa ngqo emaphashini.
Uma lokhu kuhlinzwa okuthathu sekuqediwe, lonke igazi elingenayo i-oxygen emzimbeni lizoya ngqo emaphashini ukuze lithole i-oxygen, esikhundleni sokuya ohlangothini lwesokudla lwenhliziyo.
Kwenzekani ngemva kokuhlinzwa?
Ngenxa yokuthi lokhu kuyizinqubo zokuhlinzwa ezinkulu, ingane kuzodingeka ihlale esibhedlela, egunjini lokunakekelwa okujulile (ICU), cishe isonto elilodwa noma amabili. Izodinga izinto ezifana nomshini wokuphefumula ukuze ibasize baphefumule, iziqaphi zokuqapha ukusebenza kwenhliziyo yabo, kanye nemithi yobuhlungu.
Ezinye izingane zingase zingakwazi ukuncela ngemva kokuhlinzwa. Ezimweni ezinjalo, ubisi lunikezwa ngepayipi elinomlomo. Ngisho nangemva kokuba usubuyele ekhaya, kufanele unake kakhulu isisindo nokukhula kwengane yakho.
Into ebaluleke kakhulu ukuthi lo mntwana kuzodingeka abe ngaphansi kokuqondisa kukadokotela wenhliziyo impilo yakhe yonke . Kubalulekile ukuya emitholampilo ukuze ayohlolwa ngezikhathi ezihleliwe.
Njengoba ukhula, ungadinga ukuhlinzwa okwengeziwe noma ezinye izindlela zokwelapha. Futhi, ukuhlolwa njalo kwezokwelapha kubaluleke kakhulu ngoba kunengozi yezinkinga ezifana nokuphazamiseka kwenhliziyo kanye nokwehluleka kwenhliziyo.
Umlayezo Wokuya Nawe Ekhaya
- I-pulmonary atresia yisifo senhliziyo esibi kakhulu esibangelwa ukuzalwa lapho i-valve ethwala igazi lisuka enhliziyweni liya emaphashini ivaleka khona.
- Uphawu oluyinhloko ukushintsha kombala wezindebe neminwe yengane (i-cyanosis). Ubunzima bokuphefumula kanye nokungathandi ukuphuza ubisi nakho kungabonakala.
- Lesi simo singatholakala ngokuskena ngesikhathi sokukhulelwa noma ngokushesha ngemva kokuzalwa komntwana.
- Ukwelashwa kuwuchungechunge lokuhlinzwa kwenhliziyo okuvulekile okwenziwa ngezigaba. Nakuba lokhu kungelaphi lesi sifo, kunikeza ingane ithuba lokuphila impilo enhle.
- Lezi zingane zidinga ukubhekwa impilo yazo yonke kanye nokulandelwa udokotela wezifo zenhliziyo.
- Uma ingane yakho inalezi zimpawu, ungesabi futhi ubone udokotela ngokushesha okukhulu. Ukuxilongwa okusheshayo kanye nokwelashwa kubalulekile ekusindiseni impilo yengane.
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