Kunzima ukuchaza ukuthi umama noma ubaba uzizwa kanjani lapho bezwa ukuthi ingane yabo esanda kuzalwa inenkinga enkulu yenhliziyo. Kodwa namuhla, ezokwelapha sezithuthuke kakhulu. Ngezinye izikhathi, kunezindlela zokwelapha ezincane kodwa ezibaluleke kakhulu ezingagcina ingane iphila kuze kube yilapho kwenziwa ukuhlinzwa okukhulu. Namuhla, sikhuluma ngenye yezindlela zokwelapha ezinjalo ezisindisa impilo. Lokhu kubizwa ngokuthi i-septostomy.
Kalula nje, iyini i-septostomy?
I-septostomy iyindlela esindisa impilo esiza izingane ezinezinkinga zenhliziyo ezizalwa nazo ukuba ziphile kuze kube yilapho sezikwazi ukuhlinzwa okukhulu ukuze kulungiswe inhliziyo yazo. Ibizwa nangokuthi 'i-balloon atrial septostomy'.
Lokhu akusikho ukuhlinzwa kwenhliziyo evulekile. Okwenzekayo lapha ukuthi udokotela ufaka inalithi encane esikhumbeni somntwana bese edlulisela ipayipi elincane kakhulu (i-catheter) ngayo iye enhliziyweni. Ekupheleni kwaleli payipi kukhona ibhaluni elincane. Leli bhaluni lisetshenziselwa ukukhulisa imbobo encane ekhona ngokwemvelo enhliziyweni yomntwana.
Lo mgodi uvumela igazi elinomoya-mpilo kanye negazi elingenawo umoya-mpilo ukuthi lihlangane . Bese kuthi, elinye igazi elinomoya-mpilo lijikeleze umzimba wonke wengane. Uma lokhu kwelashwa kungenziwa, kuphela igazi elinomoya-mpilo ophansi kakhulu elijikeleza emzimbeni wengane. Lokhu kuyingozi kakhulu empilweni yengane.
Khumbula, lokhu akusikho ukuhlinzwa kwenhliziyo okukhulu. Lokhu kuyisisombululo sesikhashana sokugcina umntwana ephephile aze alungele ukuhlinzwa okukhulu.
Hlobo luni lomntwana oludinga lokhu kwelashwa?
Ezinye izingane ezinezifo zenhliziyo ezizalwa nazo zinombala oluhlaza okwesibhakabhaka esikhumbeni sazo. Ngokwezokwelapha, lokhu kubizwa ngokuthi i-cyanosis . Lokhu kwenzeka ngoba umzimba awutholi umoya-mpilo owanele egazini. Lokhu kusho ukuthi igazi elingenawo umoya-mpilo liya ngqo emaphashini futhi alihlanzwa, kodwa kunalokho lihamba emzimbeni wonke. Lesi simo siyingozi kakhulu futhi sidinga ukwelashwa okuphuthumayo .
I-septostomy ivame ukudingwa kakhulu ezinganeni ezinesifo senhliziyo esibizwa ngokuthi i-cyanotic. Kunezimo ezimbili eziyinhloko zenhliziyo lapho lokhu kwelashwa kuvame ukusetshenziswa khona.
| Isimo senhliziyo | Kuchazwe kalula |
|---|---|
| Ukuguqulwa kwe-Dextro kwemithambo emikhulu (d-TGA) | Lokhu kwenzeka lapho imithambo yegazi emibili eyinhloko ethwala igazi liphuma enhliziyweni (umthambo wamaphaphu kanye ne-aorta) ishintshwa. Kufana namapayipi amabili amanzi endlini ashintshwayo. Ngenxa yalokho, igazi elingenawo umoya-mpilo liya emzimbeni, kanti igazi elinomoya-mpilo libuyela emaphashini. Lokhu kuvimbela umzimba ekutholeni umoya-mpilo. |
| I-Tricuspid atresia | Kulesi simo, ivalvu ye-tricuspid, ebangela ukugeleza kwegazi kusuka ku-atrium yangakwesokudla kuya ku-ventricle yangakwesokudla, ayisebenzi kahle. Esikhundleni salokho, kwakheka izicubu ezijiyile, ezivimba ngokuphelele ukugeleza kwegazi. Lokhu kuvimbela igazi ukuthi lifinyelele emaphashini ukuze lithole umoya-mpilo. |
Iyini indaba yalomgodi omncane obizwa ngokuthi i-Foramen Ovale?
Ukuze siqonde lokhu, kufanele sibuyele emuva kancane esikhathini lapho umntwana wayesesiswini sikanina.
Uma umntwana esesiswini, amaphaphu engane awasebenzi. Ingane ithola umoya-mpilo eyidingayo kunina ngentambo yesisu. Ngakho-ke, leli gazi elinomoya-mpilo lithunyelwa ngqo emzimbeni ngaphandle kokuya emaphashini, futhi leli qabunga le-foramen liyisikhala esincane semvelo enhliziyweni. Lokhu kutholakala odongeni oluphakathi kwamakamelo amabili aphezulu (i-atria) yenhliziyo.
Ngemva kokuzalwa kwengane, amaphaphu aqala ukusebenza. Bese kuthi, njengoba lesi simbobo esincane singasadingeki, sivame ukuvala sodwa.
Ngakho-ke kungani le mbobo ibalulekile ekwelashweni kwe-septostomy?
Kulabo bantwana abanesifo senhliziyo esikhulume ngabo ngaphambilini, abaphenduka babe luhlaza okwesibhakabhaka, lo mgodi obizwa ngokuthi i-foramen ovale ubasiza ukuba baphile izinsuku ezimbalwa ngemva kokuzalwa. Ngawo, igazi elithile elinomoya-mpilo lixubana negazi elingenawo umoya-mpilo bese lingena emzimbeni.
Kodwa-ke, uma lo mgodi uqala ukuvala wodwa, lowo mgodi uyavaleka. Khona-ke impilo yengane iba yingozi kakhulu. Yilapho-ke ukwelashwa nge-septostomy kuba yimfuneko. Okwenziwa odokotela ukusebenzisa lelo bhaluni ukwenza umgodi ku-foramen ovale osuzovala ube mkhulu kancane bese uwugcina uvulekile . Khona-ke umntwana angagcinwa ephila kuze kube yilapho kwenziwa ukuhlinzwa okukhulu.
Ngezinye izikhathi, uma lo mgodi uvalekile ngokuphelele, odokotela bangasebenzisa ipayipi elikhethekile elinomsila ukudala umgodi omusha. Kungase kuzwakale kungavamile ukucabanga ngokwenza umgodi enhliziyweni, kodwa kungaba yindlela kuphela yokusindisa izimpilo zezingane ezinjengalezi.
Kwenziwa kanjani lokhu kwelashwa nge-septostomy?
Lokhu kwelashwa kwenziwa elabhorethri ekhethekile (ilabhorethri yokulungisa izinzwa) eyunithi yenhliziyo yesibhedlela noma eyunithi yokunakekelwa okujulile kwezingane ezisanda kuzalwa (i-Neonatal ICU). Kwenziwa udokotela wenhliziyo othole ukuqeqeshwa okukhethekile ngale njongo.
1. Ukuthola ithuba lokungena: Okokuqala, udokotela ufaka inalithi encane emthanjeni omkhulu wegazi endaweni yengquza yomntwana. Ngezinye izikhathi lokhu kungenziwa ngentambo yesisu.
2. Ukufakwa kwe-catheter: Inaliti iyasuswa, bese kufakwa ipayipi elincane (i-catheter) elinebhaluni ngembobo eya emthanjeni wegazi.
3. Ukuya enhliziyweni: Udokotela uqondisa ngokucophelela leli payipi ngemithambo yegazi liye enhliziyweni ngenkathi ebuka izithombe ku-echocardiogram .
4. Ukwandiswa kwembobo: Uma ithubhu seliku-atrium yesokudla yenhliziyo, lidlula ku-foramen ovale liye ku-atrium yesobunxele. Bese, ibhaluni ekugcineni kwethubhu liyafuthwa bese lidonswa libuyele ohlangothini lwesokudla. Lokhu kudonsa kwandisa imbobo encane.
5. Ukuphela kokwelashwa: Uma imbobo isinkulu ngokwanele, ibhaluni liyaphuma bese ipayipi lisuswa ngokucophelela.
Lonke lolu hlelo lwenziwa ngenkathi kunikezwa umntwana umuthi wokubulala izinzwa odingekayo kanye nowokuhlunguphaza, futhi kubhekwa ngokucophelela umntwana.
Odokotela banquma kanjani ukuthi ukwelashwa kuyaphumelela yini?
Odokotela babheka izici eziningana ukuze banqume ukuthi ukwelashwa kuyaphumelela yini.
- Bahlola ukuthi izinga lomoya-mpilo egazini lomntwana likhuphuke okungenani ngo-10% .
- Bayahlola ukuthi imbobo eyenziwe enhliziyweni isikhule okungenani ngo-33% kunangaphambili.
- Sihlola ukuze sibone ukuthi kukhona yini umehluko omkhulu ekucindezelweni kwegazi phakathi kwe-atrium yesokudla nesobunxele yenhliziyo.
Uma kuhlangatshezwana nesinye noma ngaphezulu salezi zici, ukwelashwa kubhekwa njengokuphumelelayo.
Yiziphi izinzuzo nezingozi zalokhu?
Izinzuzo
Inzuzo enkulu yalokhu kwelashwa ukuthi kungasindisa impilo yengane . Ingane entula umoya-mpilo ngenxa yesifo senhliziyo inganikwa umoya-mpilo ngokushesha futhi inikwe ithuba lokuphila kuze kube yilapho ihlinzwa kakhulu.
Izingozi
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunezingozi. Noma yikuphi ukwelashwa kwezinsana ezinesifo senhliziyo esibi kunezingozi. Ezinye izifundo zikhombisile ukuthi lokhu kwelashwa kungabangela isifo sohlangothi. Kodwa-ke, akukacaci ukuthi lokhu kungenxa yokwelashwa ngokwako noma ukuntuleka komoya-mpilo emzimbeni ngenxa yesifo senhliziyo.
Kodwa into ebaluleke kakhulu ukuthi izingozi zokungalaphi lesi sifo ziphakeme kakhulu kunezingozi zokusilapha. Ngaphandle kokwelashwa, ingane enesifo esifana ne-d-TGA inethuba eliphansi lokusinda isonto lonke, cishe u-30%.
Lizoba njani ikusasa lomntwana ngemva kokwelashwa?
Ama-94% kuphela ezinsana ezithola i-septostomy ezisindayo . Bese kudingeka ukuthi zenze ukuhlinzwa okukhulu ukuze kulungiswe isimo senhliziyo yazo.
Isibonelo, izingane ezine-d-TGA zenza ukuhlinzwa okubizwa ngokuthi i-Arterial Switch Operation (ASO) ngemuva nje kokuzalwa. Lokhu kuhilela ukusika imithambo yegazi emibili eshintshiwe bese uyixhumanisa kabusha ngendlela efanele. Phakathi kuka-97% no-98% wezingane ziyalulama kahle ngemva kwalokhu kuhlinzwa.
Ngemva kokuhlinzwa okukhulu okunje, ingane yakho izodinga ukunakekelwa okuqhubekayo kwezokwelapha. Lokhu kusho ukubona udokotela wakho ngezikhathi ezithile, ukuthola izivivinyo, nokunakekela kahle ingane yakho. Njengoba ingane ngayinye ihlukile, udokotela wakho angakunikeza ulwazi olungcono kakhulu ngekusasa lengane yakho.
Izinto okudingeka uzazi njengomzali
Kuvamile ukuzizwa wesaba, ukhathazekile, futhi unemibuzo eminingi uma uthola ukuthi ingane yakho inesifo esibucayi. Kunzima kakhulu nokuba kude nengane yakho ngesikhathi isesibhedlela. Abasebenzi bezokwelapha bayaqonda imizwa yakho.
- Ungesabi ukubuza imibuzo: Buza udokotela noma abasebenzi abahlengikazi noma yimiphi imibuzo onayo mayelana nemithi enikezwa ingane yakho, ukwelashwa, noma okuzokwenzeka ngokulandelayo. Uma ungaqondi, bacele ukuthi bakuchazele futhi kalula.
- Funa ukwesekwa: Ukukhuluma nabanye abazali abaye baba nokuhlangenwe nakho okufanayo kungaba umthombo omkhulu wesikhuthazo. Buza udokotela wakho ngamaqembu okusekelana.
Lezi zinhlobo zezifo zenhliziyo zingase zingajwayelekile, kodwa awuwedwa. I-septostomy ingaba yisinyathelo sokuqala nesibaluleke kakhulu empilweni yengane yakho. Ngokunakekelwa okufanele kwezokwelapha kanye nothando lwakho nokunakekelwa, ungaqiniseka ukuthi uzonikeza ingane yakho ikusasa elinempilo.
Umlayezo Wokuya Nawe Ekhaya
- I-septostomy akuyona ukuhlinzwa kwenhliziyo evulekile. Kuyindlela yokwelapha yesikhashana eyenziwa ngaphambi kokuhlinzwa okukhulu ukuze kusindiswe izimpilo zezingane ezinezinkinga zenhliziyo ezimbi kakhulu.
- Lokhu kuhilela ukukhulisa imbobo yemvelo enhliziyweni (i-foramen ovale), okuvumela igazi elinomoya-mpilo omningi kanye negazi elinomoya-mpilo omningi ukuxubana.
- Lokhu kwelashwa kuvame ukusetshenziswa ezimweni zenhliziyo ezi-cyanotic njenge-d-TGA kanye ne-tricuspid atresia.
- Ukwelashwa kusebenza kahle kakhulu, futhi izingozi ziphansi kakhulu. Izingozi zokungakwelashwa ziphakeme kakhulu.
- Njengomzali, ungesabi ukubuza abasebenzi bezokwelapha nganoma yini ongayiqondi. Bahlala bekulungele ukukusiza.
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