Kumelwe ukuba wesaba kakhulu lapho udokotela ekutshela ukuthi ingane yakho encane inesifo senhliziyo esizalwa naso. Kungenzeka ukuthi bakutshele ukuthi kuzodingeka inqubo ebizwa ngokuthi i-septostomy ukuze kusindiswe impilo yengane yakho. Kuvamile ukuzizwa ukhungathekile futhi udidekile uma uzwa la mazwi. Kodwa ungakhathazeki. Namuhla, sizoxoxa ngokuthi kuyini, kungani kwenziwa, nokuthi kwenziwa kanjani ngendlela elula kakhulu ongayiqonda.
Iyini ngempela i-septostomy?
Kalula nje, i-septostomy inqubo ekhethekile esiza izingane ezinezimo ezithile zenhliziyo ezizalwa nazo ukuba ziphile kuze kube yilapho sezilungele ukuhlinzwa okukhulu ukulungisa lesi simo. Abanye abantu bayibiza nangokuthi 'i-Balloon Atrial Septostomy'.
Cabanga nje, kukhona udonga oluncane phakathi kwamakamelo amabili aphezulu enhliziyo yethu (i-atria). Kulokhu kwelashwa, imbobo encane ekhona ngokwemvelo kulolo donga yenziwa ibe nkulu kancane kusetshenziswa into efana nebhaluni.
Lokhu akusikho ukuhlinzwa okukhulu kwenhliziyo . Kwenziwa njengesixazululo sesikhashana sokugcina umntwana ephila ngenkathi elungiselelwa ukuhlinzwa okukhulu.
Uma lo mgodi ukhula, igazi elinomoya-mpilo omningi (igazi elihle) kanye negazi elinomoya-mpilo omncane (igazi elibi) ziqala ukuhlangana ndawonye. Bese kuthi, elinye lala gazi elixubile lihambe emzimbeni womntwana. Ngaphandle kwalokho, yigazi elingenawo umoya-mpilo kuphela elihamba emzimbeni womntwana, okuyingozi kakhulu empilweni yakhe.
Hlobo luni lomntwana oludinga lokhu kwelashwa?
Ezinye izingane zizalwa zinezinkinga ezithile zenhliziyo. Ngenxa yalezi zinkinga, igazi elingenawo umoya-mpilo emzimbeni aliyi emaphashini futhi alihlanzwa. Ngemuva kwalokho izicubu zomntwana azitholi umoya-mpilo eziwudingayo. Lesi simo sibizwa ngokuthi 'i-cyanosis'. Kungenzeka ukuthi uke wabona ezinye izingane ezinesikhumba esiluhlaza okwesibhakabhaka. Leso yisibonakaliso esiyinhloko salokhu. Lesi yisimo esiyingozi kakhulu, futhi sidinga ukwelashwa ngokushesha.
Le nqubo, ebizwa ngokuthi i-septostomy, ivame ukusetshenziswa kakhulu ezinhlotsheni ezimbili zesifo senhliziyo.
| Isimo senhliziyo | Incazelo elula |
|---|---|
| d-Ukuguqulwa kweMithambo Emikhulu (d-TGA) | Okwenzekayo kulokhu ukuthi imithambo yegazi emibili eyinhloko ethwala igazi enhliziyweni (i-aorta kanye nomthambo wamaphaphu) iyashintshwa. Kufana nemigwaqo emibili emikhulu eshintshwayo. Ngenxa yalokho, igazi elinomoya-mpilo libuyela emaphashini, bese igazi elingenawo umoya-mpilo lihamba emzimbeni wonke. |
| I-Tricuspid Atresia | Kulesi simo, ivalvu engakwesokudla kwenhliziyo (ivalvu ye-tricuspid) ayakheki kahle. Ngakho-ke, igazi alikwazi ukugeleza lisuka ekamelweni eliphezulu lenhliziyo liye ekamelweni elingezansi, indlela ivaliwe. |
Iyini le 'mbobo yemvelo' ebizwa ngokuthi i-Foramen Ovale?
Lokhu kuyinto exakile kakhulu. Ngesikhathi esesibelethweni, wonke umntwana unembobo encane odongeni (septum) phakathi kwezinhlangothi zesokudla nesobunxele zenhliziyo yakhe. Kubizwa ngokuthi i-foramen ovale.
Uma besesibelethweni, izingane aziphefumuli ngamaphaphu azo. Zithola umoya-mpilo wazo ku-placenta kamama, ngentambo yesisu. Leli gazi elinomoya-mpilo livela ohlangothini lwesokudla lwenhliziyo yengane, lihamba ngqo kulowo mgodi liye ohlangothini lwesobunxele. Ukusuka lapho, lihamba emzimbeni wonke. Lokho kusho ukuthi uma zisesibelethweni, igazi aliyi emaphashini.
Kodwa-ke, ngokushesha nje lapho umntwana ezalwa, amaphaphu aqala ukusebenza. Ngemuva kwalokho asikho isidingo salowo mgodi. Ngakho-ke, umgodi uvaleka ngokwemvelo ezinsukwini ezimbalwa ngemva kokuzalwa.
Ngakho-ke, enganeni enesifo senhliziyo okukhulunywe ngaso ngenhla, inkinga enkulu iwukuthi le mbobo ivaleka nini. Ngoba, uma nje leyo mbobo ikhona, igazi elithile elinomoya-mpilo lihlangana negazi elingenawo umoya-mpilo bese lingena emzimbeni. Lapho nje ivaleka, leyo ndlela iyalahleka futhi ingane ayitholi umoya-mpilo owanele. Lokho okwenziwa yi-septostomy ukuvula leyo mbobo evalayo noma evaliwe futhi iyenze ibe nkulu kancane.
Lokho kusho ukuthi, nakuba imbobo enhliziyweni ivame ukuba yisifo, esimweni esikhethekile njengalesi, leyo mbobo yiyo esindisa impilo yengane .
I-septostomy yenziwa kanjani?
Lokhu kwenziwa ekamelweni elikhethekile eyunithi yenhliziyo yesibhedlela (ilabhorethri yokulungisa izinzwa) noma eyunithi yokunakekelwa okujulile kwezinsana ezisanda kuzalwa (i-NICU). Kwenziwa udokotela wenhliziyo othole ukuqeqeshwa okukhethekile kulokhu.
1. Ukulungiselela: Umntwana unikezwa imithi edingekayo ukuze azole futhi angabi nobuhlungu.
2. Ukufaka i-catheter: Ngokuvamile, kusetshenziswa inaliti encane ukubhoboza umthambo omkhulu wegazi embotsheni yomntwana, bese kufakwa ipayipi elincane neliguquguqukayo (i-catheter) ngalo. Leli payipi linebhaluni elincane ekugcineni. Ngezinye izikhathi lokhu kwenziwa nangepayipi elisentabeni.
3. Ukuya enhliziyweni: Udokotela ubheka umshini wokuskena, njenge-'echocardiogram', bese eqondisa ngokucophelela ithubhu lidlule emithanjeni yegazi kuze kufike enhliziyweni.
4. Ukwandisa umgodi:Ithubhu lingena ku-atrium yesokudla yenhliziyo, bese lisuka lapho lifakwa ku-atrium yesobunxele nge-foramen ovale. Bese, ibhaluni ekugcineni kwethubhu liyavuvukala bese lidonswa libuyele ohlangothini lwesokudla. Bese imbobo inwebeka futhi iba nkulu.
5. Isiphetho: Uma umsebenzi usuqedile, susa umoya ebhaluni bese ususa ithubhu ngokucophelela.
Le nqubo yonke ivame ukuthatha isikhathi esingaphansi kwehora.
Wazi kanjani ukuthi lokhu kuyaphumelela? Yiziphi izinzuzo nezingozi?
Odokotela banquma ukuthi ukwelashwa kuyaphumelela yini ngokusekelwe ezintweni ezifana nalezi:
- Izinga lomoya-mpilo egazini lomntwana likhuphuka okungenani ngo-10% uma kuqhathaniswa nangaphambili.
- Imbobo enhliziyweni iba nkulu okungenani ingxenye yesithathu kunangaphambili.
- Umehluko omkhulu ekucindezelweni kwegazi phakathi kwe-atria yesokudla nesobunxele yenhliziyo uyanyamalala.
Inzuzo enkulu ukuthi lokhu kusindisa impilo yengane. Ingane engakwazi ukuthola umoya-mpilo nganoma iyiphi enye indlela inethuba lokusinda kuze kube yilapho kwenziwa ukuhlinzwa okukhulu.
Uma sikhuluma ngezingozi , kunezingozi nganoma iyiphi inqubo yezokwelapha. Ikakhulukazi ezinganeni ezinezimo zenhliziyo ezimbi njengalezi, noma yini iyingozi. Ezinye izifundo zithole ukuxhumana okungenzeka phakathi kwalokhu kwelashwa nesifo sohlangothi, kodwa akukafakazelwa ngokusobala. Mhlawumbe ingozi ayibangelwa ukwelashwa ngokwako, kodwa ibangelwa ukuntuleka komoya-mpilo emzimbeni ngenxa yesifo senhliziyo.
Kodwa into ebaluleke kakhulu ukuthi ingozi yokungalutholi lolu hlobo lokwelashwa inkulu kakhulu kunengozi yokulwenza . Uma ingane enesifo senhliziyo esinjengalesi ingelashwa ngokushesha, kunzima kakhulu ukusindisa impilo yayo.
Linjani ikusasa lomntwana ngemva kokwelashwa?
Iphesenti eliphezulu kakhulu lezingane ezihlinzwa nge-septostomy, 94%, ziqeda ngempumelelo inqubo. Ngemva kwalokho, kwenziwa ukuhlinzwa okukhulu (isib., ukuhlinzwa kokushintsha kwemithambo yegazi) ukuze kulungiswe inkinga yenhliziyo ngesikhathi esifanele. Izinga lempumelelo yalokhu kuhlinzwa liphezulu kakhulu okwamanje, ku-97-98%.
Ngisho nangemva kokuhlinzwa, ingane yakho izodinga ukunakekelwa okuqhubekayo kwezokwelapha. Kuzodingeka ukuthi uhambisane nezikhathi zokubonana nodokotela wakho, uhlolwe, futhi uphuze imithi. Ingane ngayinye ihlukile, ngakho udokotela wakho angakunikeza ulwazi olungcono kakhulu mayelana nentuthuko yengane yakho.
Ngiyaqonda ukwesaba nokukhathazeka okuzwayo uma kufanele wenze into efana nale enganeni yakho. Kodwa khumbula, isayensi yezokwelapha ithuthuke kakhulu namuhla. Kukhona ithimba lodokotela nabahlengikazi abanekhono lokunakekela ingane yakho. Ungesabi ukubabuza noma yimiphi imibuzo noma ukungabaza onakho.
Umlayezo Wokuya Nawe Ekhaya
- I-Septostomy iyindlela yokwelapha esindisa impilo esiza izingane ezinesifo senhliziyo ezizalwa nazo ukuba ziphile kuze kube yilapho kwenziwa ukuhlinzwa okukhulu.
- Lokhu akusikho ukuhlinzwa kwenhliziyo okuvulekile.
- Lokhu kuhilela ukukhulisa imbobo eyenzeka ngokwemvelo enhliziyweni (i-foramen ovale) ngebhaluni, okuvumela igazi elinomoya-mpilo nelingenawo umoya-mpilo ukuthi lihlangane.
- Impumelelo nokuphepha kwalokhu kwelashwa kuphezulu kakhulu.
- Khuluma nethimba lezokwelapha elilapha ingane yakho nganoma yikuphi ukukhathazeka noma ukungabaza ongase ube nakho. Bahlala bekulungele ukukusiza.
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