Ingabe ingane yakho encane inalezi zinkinga ezine zenhliziyo eziyinkimbinkimbi? (Tetralogy of Fallot) - Ake sixoxe ngalokhu!

I-Tetralogy of Fallot, noma i-ToF ngamafuphi, yisimo lapho kwenzeka khona izinkinga ezine enhliziyweni yengane yakho lapho izalwa. Lezi zinkinga zenza kube nzima ngenhliziyo yengane ukupompa igazi elanele elinomoya-mpilo emzimbeni wonke. Uyazi ukuthi umoya-mpilo ubaluleke kangakanani ukuze konke okusemizimbeni yethu kusebenze kahle. Kuvamile ukuzizwa wesaba uma uzwa ngalesi simo, kodwa ake sixoxe ngakho ngokuningiliziwe ukuze usiqonde kangcono.

Kungani lokhu '(Tetralogy of Fallot)' kukhetheke kangaka? Kwenzekani enhliziyweni?

Kalula nje, enhliziyweni enempilo, igazi lihamba ngendlela ethile. Okusho ukuthi, igazi elingenawo umoya-mpilo liya emaphashini, lithathe umoya-mpilo, bese libuyela enhliziyweni ukuze lisakazwe kuwo wonke umzimba. Kodwa ngenxa yalezi zinkinga ezine zesakhiwo enhliziyweni yomntwana one-"Tetralogy of Fallot", elinye igazi elingenawo umoya-mpilo liya ngqo emzimbeni esikhundleni sokuya emaphashini. Lena inkinga eyinhloko.

Manje ake sibone ukuthi ziyini lezi zinkinga ezine zenhliziyo:

1. I-Ventricular Septal Defect (VSD) : Cabanga ukuthi inhliziyo yakho inamakamelo amabili amakhulu, elinye ngakwesokudla nelinye ngakwesobunxele. Uma kwenzeka i-VSD odongeni phakathi kwalawa amabili, igazi elingenawo umoya-mpilo (igazi eliluhlaza okwesibhakabhaka) e-ventricle yesokudla lihlangana negazi eline-oxygen (igazi elibomvu) e-ventricle yesokudla. Lokhu akukuhle, ngoba umzimba udinga igazi elihlanzekile, eline-oxygen.

2. I-Pulmonary Artery Stenosis : Umthambo wegazi oyinhloko othwala igazi elingenawo umoya-mpilo lisuka e-ventricle yesokudla yenhliziyo liye emaphashini (umthambo wamaphaphu) bese i-valve yalo (i-valve) incipha. Kufana nepayipi lamanzi elivalekile. Lokhu kunciphisa inani legazi elingaya emaphashini ngokushaya kwenhliziyo ngakunye. Lokhu kunciphisa inani le-oxygen elingafakwa egazini.

3. Umthambo wegazi oyinhloko othwala igazi emzimbeni usendaweni engafanele (`Overriding Aorta`) : `(Aorta)` umthambo wegazi omkhulu kunayo yonke othwala igazi elinomoya-mpilo emzimbeni wethu wonke. Ngokuvamile, lokhu kuxhunywe ekamelweni elingezansi kwesobunxele senhliziyo. Kodwa nge-`(VSD)`, le `(Aorta)` itholakala ngaphezu kwamakamelo womabili, ivulekela womabili. Ngenxa yalokhu, igazi elingenawo umoya-mpilo kanye negazi elinomoya-mpilo liqala ukugeleza ngale `(Aorta)` liye emzimbeni. Ukubeka ngokusobala, elinye igazi okufanele liye emaphashini ukuze lithole umoya-mpilo liya ngqo emzimbeni.

4. Ukwandiswa kodonga lwegumbi elingezansi kwesokudla senhliziyo (`Ventricular Hypertrophy`) : Ngenxa yazo zonke izinkinga ezishiwo ngenhla, ikakhulukazi ukuncishiswa komthambo wegazi othumela igazi emaphashini, igumbi elingezansi lenhliziyo (`(Right Ventricle)`) kufanele lisebenze kanzima ukupompa igazi. Njengoba nje umsipha uba mkhulu uma uphakamisa isisindo, ungqimba lwemisipha odongeni lwaleli gumbi nalo luyakhula ngokuhamba kwesikhathi. Lokhu kungaphazamisa kakhulu ukusebenza kwenhliziyo.

Uma lezi zinkinga ezine zihlangana, kuvela isimo esaziwa ngokuthi "i-Tetralogy of Fallot".

Sivame kangakanani lesi simo? Ubani onamathuba amaningi okuba naso?

I-Tetralogy of Fallot empeleni iyisimo esingavamile.Ngokwezibalo zaseMelika, lokhu kwenzeka cishe koyedwa ezinganeni ezingu-2,000 ezizalwayo. Kodwa-ke, phakathi kwezifo zenhliziyo ezizalwa nazo (`(Congenital Heart Disorders)`), lesi yisimo esivame kakhulu. Lesi simo sivame kakhulu ezinganeni zesilisa. Futhi, odokotela baqaphele ukuthi `(ToF)` ingabonakala naphakathi kwezingane ezinezinye izinkinga ze-chromosome ezifana `(Down Syndrome)`.

Akuvamile kakhulu, uma abanye abantu bengatholi ukwelashwa ebuntwaneni, lokhu kungadala izinkinga ngisho nasebudaleni.

Odokotela bayixilonga kanjani i-Tetralogy of Fallot?

Udokotela wakho angase abone lesi simo ngesikhathi sokukhulelwa noma ngemva kokuzalwa komntwana . Ngokuvamile, sitholakala emavikini ambalwa okuqala noma ezinyangeni ngemva kokuzalwa komntwana.

Ukuhlolwa kwangaphambi kokubeletha

Uma ukuhlolwa kwe-ultrasound okuvamile ngesikhathi sokukhulelwa kubonisa noma yikuphi ukukhubazeka enhliziyweni, udokotela angenza ukuhlolwa okukhethekile okubizwa ngokuthi i-fetal echocardiogram . Lokhu kungenziwa phakathi kwamasonto ayi-18 nama-22 okukhulelwa ukuze kubonakale ngokucacile isakhiwo senhliziyo yengane futhi kutholakale ukuthi kukhona yini izinkinga.

Ukuhlolwa ngemva kokuzalwa komntwana

Ngemva kokuzalwa komntwana, lapho udokotela ehlola umntwana futhi elalele inhliziyo, kungase kuzwakale umsindo ongavamile (`Heart Murmur`) . Lolu uphawu oluvamile olubonakala ezinganeni ezine-`(ToF)`.

Ngaphezu kwalokho, kwenziwa ezinye izivivinyo eziningana ukuqinisekisa lesi simo:

• I-Pulse Oximetry : Lokhu kuyindlela elula kakhulu yokuhlola, engenabuhlungu. Ngaphambi kokuba uyise ingane yakho ekhaya, kufakwa inzwa encane engalweni noma emlenzeni wengane yakho ukuze kulinganiswe izinga lomoya-mpilo egazini layo. Amazinga aphansi omoya-mpilo angaba uphawu lwesimo esibizwa ngokuthi (ToF).
• I-Echocardiogram (eyaziwa nangokuthi i-echo) : Lokhu kufana nokuskena. Kusebenzisa amaza omsindo ukuze kubonakale ngokucacile isakhiwo senhliziyo yengane, okuhlanganisa ama-valve ayo kanye nokugeleza kwegazi.
• I-X-ray yesifuba noma i-Cardiac CT Scan : Lokhu ngezinye izikhathi kungabonisa ukubukeka okungavamile kwenhliziyo "okufana nebhuthi". Lokhu kuyisici se-ToF.
• I-Electrocardiogram (EKG noma i-ECG) : Lokhu kuhlola ukusebenza kukagesi kwenhliziyo. Kungabona noma yikuphi ukukhubazeka kwesigqi senhliziyo noma ukuthi amakamelo enhliziyo asebenza kanzima kakhulu.
• Ukuhlolwa kwe-Catheterization Yenhliziyo : Lokhu ukuhlolwa okuyinkimbinkimbi kancane. Kwenziwa kuphela uma kudingeka. Ithubhu elincane (i-catheter) lidluliselwa emthanjeni wegazi osemlenzeni noma engalweni liye enhliziyweni ukuze kulinganiswe ingcindezi engaphakathi kwenhliziyo, kuthathwe amasampula egazi, futhi kubonwe isakhiwo ngokucacile.

Uma kutholakala lesi simo kumuntu omdala noma enganeni endala kancane, izivivinyo ezishiwo ngenhla, njenge-`(EKG)` kanye ne-`(Cardiac Catheterization),` zingasetshenziswa.

Lesi simo `(Tetralogy of Fallot)` selashwa kanjani?

Izindlela zokwelapha eziyinhloko zengane ene-`(ToF)` imithi nokuhlinzwa . Njengesinyathelo sokuqala, odokotela banganikeza ingane imithi efana ne-`(Beta-blockers)` ukulawula izimpawu zengane nokuthuthukisa ukujikeleza kwegazi. Banganikeza nomoya-mpilo owengeziwe.

Ukuhlinzwa ukuze kulungiswe zonke lezi zinkinga ezine zenhliziyo kuvame ukwenziwa phakathi kwezinyanga ezintathu neziyisithupha ngemva kokuzalwa komntwana. Ngemva kwalokhu kuhlinzwa, indlela igazi eligeleza ngayo enhliziyweni ibuyela esimweni sayo esijwayelekile.

Yiziphi izinketho zokuhlinzwa?

Izinketho zokwelapha zingahluka kuye ngesimo somntwana. Ngezinye izikhathi, uma umntwana emncane kakhulu noma ebuthaka kakhulu, kungaba nzima ukwenza ukuhlinzwa okukhulu ngesikhathi esisodwa. Ezimweni ezinjalo, ukuhlinzwa okulula (`(Ukuhlinzwa Kokuhlinza Okungalalisi)`) kungenziwa ukuze kulawulwe izimpawu okwesikhashana kuze kube yilapho umntwana esekhulile kancane futhi enamandla. Kulapho kuphela lapho `(Ukulungisa Okuphelele)` kungenziwa khona.

Kunezinqubo eziningana eziyinhloko zokuhlinzwa:

• Ukulungiswa Okuphelele : Kule nqubo, udokotela ohlinzayo wandisa ivalvu encane kanye nendlela ethwala igazi emaphashini. Futhi, imbobo ephakathi kwamakamelo amabili aphansi enhliziyo (i-VSD) ivalwa nge-patch.
• Inqubo Yokuhlinza I-BTT : Lokhu ukuhlinzwa kwesikhashana okukhulunywe ngakho ekuqaleni. Kufakwa ipayipi elincane (i-Shunt) phakathi komthambo wengalo yomntwana (i-Subclavian Artery) kanye nomthambo wamaphaphu (i-Pulmonary Artery). Lokhu kuvumela igazi eliningi ukuthi ligeleze emaphashini.
• Inqubo ye-Catheter : Ngezinye izikhathi, i-stent ingafakwa enhliziyweni nge-catheter ngaphandle kokuhlinzwa ukuze kugcinwe i-ventricle efanele ivulekile. Ingasetshenziswa futhi ukugcina i-ductus arteriosus yengane (ithubhu elixhumanisa umthambo wamaphaphu kanye ne-aorta) ukuthi ingavali.

Ukuhlinzwa kwabantu abadala

Akuvamile kakhulu ukuthi abanye abantu baphile ebuntwaneni ngaphandle kokuhlinzwa futhi bafinyelele ebudaleni. Ochwepheshe beluleka abantu abanjalo ukuba bahlinzwe ngokuphelele ukuze bavimbele izinkinga zesikhathi esizayo futhi banciphise ingozi yokufa ngokuzumayo.

Kule nqubo, udokotela ohlinzayo ochwepheshe besifo senhliziyo sokuzalwa kwabantu abadala (VSD) uvala lesi siphene nge-patch, avule i-atrium efanele, bese elungisa noma ashintshe i-valve yamaphaphu. Umthambo wamaphaphu, ohlinzeka ngegazi kuwo womabili amaphaphu, uyakhuliswa. Ngezinye izikhathi kufakwa ipayipi phakathi kwe-atrium efanele nomthambo wamaphaphu ukuze kuthuthukiswe ukugeleza kwegazi.

Iningi labantu abadala abalungiswa ngenxa yesifo senhliziyo (ToF) ngeke badinge ukwelashwa okwengeziwe, kodwa kufanele baqhubeke nokubona udokotela wenhliziyo womuntu omdala ozelwe ukuze ahlolwe njalo.

Yiziphi izinkinga ezingaba khona ngemva kokuhlinzwa?

Ngemva kokuhlinzwa kwe-Tetralogy of Fallot, ngezinye izikhathi (futhi ngezinye izikhathi ngisho nangemva kwesikhathi), kungase kuvele izinkinga ezithile. Kodwa ungakhathazeki, odokotela bahlala bekunaka lokhu.

• Ukuphazamiseka Kukagesi: I-patch evala i-VSD ngezinye izikhathi ingaphazamisa izimpawu zikagesi ezivela emakamelweni aphezulu enhliziyo (i-Atria) kuya emakamelweni aphansi (ama-Ventricles). Lokhu kungalungiswa nge-pacemaker. Nge-ToF elungisiwe, kunengozi ye-arrhythmias (ukushaya kwenhliziyo okungajwayelekile) emakamelweni aphezulu naphansi enhliziyo. Uma une-syncopal episode, kufanele uhlolwe lokhu.
• I-Residual Ventricular Septal Defect : Ngezinye izikhathi kungase kube nokuvuza okuncane okuzungeze i-patch esetshenziselwa ukuvala i-VSD.
• I-Aneurysm : I-patch esetshenziselwa ukulungisa i-valve ingabangela ukuthi izindawo ezibuthakathaka ku-valve ziqhume bese kwakheka i-aneurysm (iqhuma elifana nebhaluni emthanjeni wegazi). Kukhona futhi nengozi enkulu yokuba ne-aneurysm ku-aeroscending aorta.
• Izinkinga ze-Shunt : Ngenxa ye-shunt ebekwe ngesikhathi sokuhlinzwa kwesikhashana kokuqala, izinkinga ezifana nokuncipha (i-stenosis), umfutho wegazi ophezulu emthanjeni wamaphaphu, kanye nokucindezeleka okwandisiwe ohlangothini lwesobunxele lwenhliziyo kungenzeka.
• Ama-Valve Avuzayo : Igazi lingavuza libuyele emuva ngama-valve emaphashini akho, i-aorta, noma ohlangothini lwesokudla lwenhliziyo yakho (i-Tricuspid). Ngezinye izikhathi, kungadingeka i-valve yamaphaphu (Ukufakwa Kwe-Valve Esikhundleni).

Yini ongayilindela uma uphila nalesi simo?

Ngisho noma ukugeleza kwegazi enhliziyweni kubuyela esimweni esijwayelekile ngemva kokuhlinzwa kwe-Tetralogy of Fallot, kusenezinto ezimbalwa wena noma ingane yakho okudingeka nizazi:

• Ingozi Yokutheleleka Kwenhliziyo : Ingozi ye-endocarditis iphakeme kancane. Ngakho-ke, kufanele uqaphele kakhulu impilo yamazinyo akho. Udokotela wakho angase akucebise ukuthi uthathe ama-antibiotics ukuvimbela ukutheleleka ngesikhathi sokwelashwa kwamazinyo.
• Ukukhula Okuhamba Kancane : Izingane ezine-Tetralogy of Fallot zingase zikhule kancane futhi zikhule kancane. Zingase zidinge ukwelashwa ngokomzimba, ngenkulumo, noma ngokomsebenzi.
• Izingozi Zokukhulelwa : Abesifazane asebekhulile kufanele bahlolwe inhliziyo ngokukhethekile ngaphambi kokukhulelwa. Ingozi yokuphuphuma kwesisu ingaba phezulu kancane kunokujwayelekile.
• Imikhawulo Yemithi : Njengomuntu omdala, kungadingeka ukuthi usebenzise imithi ethile kanye nezindlela zokuvimbela inzalo kuphela ngesimo senhliziyo yakho.

Liyini ikusasa lesimo `(ToF)`?

Ngokuthuthuka kwesayensi yezokwelapha, ikusasa lezinsana ezine-`(Tetralogy of Fallot)` lingcono kakhulu kunangaphambili. Ukwelashwa ngokuhlinzwa kuphumelela kakhulu ekulungiseni amaphutha esakhiweni senhliziyo nokugeleza kwegazi. Izinga lempumelelo lokuhlinzwa kwabantu abadala ngudokotela ohlinza inhliziyo onolwazi nalo liphezulu kakhulu.

Namuhla, iningi lezinsana ezihlinzwa ukuze kulungiswe i-Tetralogy of Fallot ziphila impilo esebenzayo. Kodwa-ke, kungase kube nemikhawulo ethile emisebenzini enzima, njengemidlalo yokuncintisana. Izinga lokusinda isikhathi eside ngemva kokuhlinzwa kwe-ToF lihle kakhulu. Iningi labantu abahlinzwayo liphila iminyaka engama-30. Kodwa-ke, uma ukuhlinzwa kungenziwa, cishe umuntu oyedwa kwabathathu abane-Tetralogy of Fallot uzophila iminyaka eyi-10.

Abanye abantu abadala abaye bahlinzwa i-Tetralogy of Fallot beseyizingane bangase babe nezinkinga lapho sebekhulile ezidinga imithi, ukwelashwa, noma ukuhlinzwa okwengeziwe. Ngakho-ke, kubalulekile ukuthi abantu abadala babonisane nodokotela wabo wenhliziyo ngaphambi kokuhlinzwa kwenye ingxenye yomzimba.

Ingabe kukhona engingakwenza ukuze ngenze ingane yami izizwe ingcono?

Ngesikhathi ingane yakho ilinde ukuhlinzwa, ungayisiza uma ine- "tet spells" (lapho iphenduka ibe luhlaza okwesibhakabhaka futhi inenkinga yokuphefumula). Uma inenkinga yokuphefumula, yibeke endaweni yokuquleka amadolo ayo ebhekene nesifuba sayo . Lesi simo sandisa ukugeleza kwegazi emaphashini, okungasiza ingane yakho ukuthi izizwe ingcono.

Futhi, kubaluleke kakhulu ukunikeza umntwana uketshezi olwanele lokuphuza nokumvimbela ukuthi angazikhandleli ngokweqile.

Kufanele ngimbone nini udokotela wami?

Uma ingane yakho ine-"tet spell" enzima, okusho ukuthi iba luhlaza okwesibhakabhaka futhi inenkinga yokuphefumula, yiyise ekamelweni lezimo eziphuthumayo esibhedlela esiseduze ngokushesha . Uma ungumuntu omdala, uma uzizwa ubuthakathaka, unesiyezi, unenkinga yokuphefumula, noma uzwa ubuhlungu esifubeni, kufanele uye egumbini lezimo eziphuthumayo.

Abantu abadala abahlinzwa okokuqala nge-valve yenhliziyo (ToF) ebuntwaneni kufanele bahlolwe inhliziyo ngokuphelele njalo ngonyaka noma emibili . Kungenziwa izivivinyo ezahlukahlukene ukuhlola ukusebenza kwenhliziyo, isibonelo:

• `(I-Holter Monitor)` (Idivayisi eqopha i-`ECG` usuku lonke)
• I-Electrocardiogram (EKG)
• Ukuhlolwa Kokucindezeleka Kokuzivocavoca
• I-Echocardiogram (ukuskena kwenhliziyo)
• I-MRI yenhliziyo

Futhi, udokotela wakho uzohlala eqapha ubukhulu kanye nokusebenza kohlangothi lwesokudla lwenhliziyo yakho.

Ngemva kokulungiswa kwe-Tetralogy of Fallot, ingane yakho kuzodingeka ihlolwe njalo nodokotela wenhliziyo wezingane. Lokhu kunakekelwa okuvamile kuzoqhubeka kuze kube yilapho isikhulile.

Eminye imibuzo ongayibuza udokotela wakho:

• Ingabe ingane yami kuzodingeka inciphise imisebenzi yayo yezemidlalo ngemva kokuhlinzwa?
• Ingabe ingane yami izodinga ukuhlinzwa okwengeziwe?
• Yimiphi eminye imithi (uma ikhona) okufanele ingane yami iyithathe?

Ekugcineni, kufanele ngithi... (Umyalezo Wokuya Ekhaya)

Kuvamile ukuzizwa ukhungathekile futhi udabuke lapho uthola ukuthi ingane yakho esanda kuzalwa inesifo senhliziyo. Kodwa khumbula, ithimba lakho lezokwelapha lisize abazali abaningi abake babhekana nezimo ezifanayo, futhi nabo bangakusiza. Uma uzizwa ucindezelekile ngokunakekela ingane ene-Tetralogy of Fallot, ungesabi ukukhuluma nodokotela wezifo zengqondo. Futhi, udokotela wezifo zengqondo angasiza izingane kanye nabantu abadala abasebasha abazizwa bephambili kunontanga yabo ekukhuleni. Kholwa ukuthi ngokwelashwa okufanele nokunakekelwa ngothando, lezi zingane zingaba nokuphila okuhle.

I- Tetralogy ye-Fallot, Isifo Senhliziyo Sezingane, Amaphutha Enhliziyo Azalwa Nawo, Izimbobo Enhliziyweni, I-Blue Baby Syndrome, Ukuhlinzwa Kwenhliziyo, Isakhiwo Senhliziyo