Ingabe ingane yakho encane inalolu hlobo lwenkinga yenhliziyo? (Ukubuya Kwemithambo Yemithambo Engamaphaphu Okungajwayelekile - TAPVR) Ake sixoxe ngalokhu!

Uma ingane yakho izalwa, ingabe ngezinye izikhathi kuba sengathi kunzima ukuphefumula? Ingabe ngezinye izikhathi kubukeka sengathi isikhumba siphenduka sibe luhlaza okwesibhakabhaka? Kuvamile ukuzizwa wesaba kakhulu uma ubona into efana naleyo. Namuhla sizokhuluma ngesifo senhliziyo esizalwa naso esibonisa lezi zimpawu. Lokhu kubizwa ngokuthi i-TAPVR (Total Anomalous Pulmonary Venous Return) . Nakuba igama lingase libonakale liyinkimbinkimbi kancane, masiliqonde kalula.

Iyini i-TAPVR? Kalula nje...

Cabanga ngakho, imizimba yethu ithola umoya-mpilo emaphashini, akunjalo? Ngakho-ke, kula maphaphu, igazi elinomoya-mpilo (asibize ngokuthi "igazi elihle") lilethwa enhliziyweni ngemithambo yegazi , uhlobo lomthambo wegazi. Ngokuvamile, leli "gazi elihle" kufanele lize e-atrium yangakwesobunxele ohlangothini lwesobunxele lwenhliziyo. Ukusuka lapho, igazi liphampulwa ukuze linikeze umoya-mpilo kuwo wonke umzimba.

Kodwa-ke, enganeni ene-TAPVR, esikhundleni sokuxhuma ku-atrium yesobunxele yenhliziyo, lo mthambo wamaphaphu uxhuma endaweni engafanele, okuyi -atrium yesokudla . I-atrium yesokudla ivame ukuthola "igazi elibi" elisetshenziswe ngumzimba wonke, elinomoya-mpilo ophansi. Manje "igazi elihle" eligcwele umoya-mpilo lihlangana naleli "gazi elibi." Kwenzekani-ke? Inani lomoya-mpilo egazini okufanele liye kuwo wonke umzimba liyancipha. Lesi yisimo esiyingozi kakhulu nesisongela impilo yengane. Lesi yisifo senhliziyo esizalwa naso .

Cishe zonke izingane ezine-TAPVR zinembobo encane (i-Atrial Septal Defect - ASD) phakathi kwamakamelo amabili enhliziyo yazo, i-atrium yesokudla kanye ne-atrium yesobunxele. Lombobo uvumela igazi elithile elinomoya-mpilo ukuthi ligeleze liye ohlangothini lwesobunxele lwenhliziyo bese liye kuwo wonke umzimba. Ngaphandle kwalokho, isimo besingaba sibi kakhulu.

Into ebaluleke kakhulu ukuthi izingane ezine-TAPVR zidinga ukuhlinzwa nakanjani. Uma ukuhlinzwa kwenziwa kusenesikhathi, izingane eziningi zingaphila impilo enempilo zize zibe ngabantu abadala. Kodwa-ke, ngezinye izikhathi, izinto ezifana nokuncipha kwemithambo yegazi kamuva ekuphileni zingadinga ukuhlinzwa okwengeziwe noma ezinye izindlela zokwelapha. Ngakho-ke, ngisho nangemva kokuhlinzwa kwe-TAPVR, kuzodingeka uqashwe udokotela wenhliziyo impilo yakho yonke.

Ngezinye izikhathi odokotela babiza lesi simo ngokuthi i-TAPVC (Total Anomalous Pulmonary Venous Connection). Zombili ziyisimo esifanayo.

Ingabe kunezinhlobo ezahlukene ze-TAPVR?

Yebo, kunezinhlobo eziningana eziyinhloko ze-TAPVR. Lezi zihlukaniswa ngokwendlela "igazi elihle" elivela emaphashini elixhunywe ngayo ngendlela engafanele ku-atrium efanele.

• I-Supracardiac TAPVR: Kulokhu, imithambo yamaphaphu iyahlangana futhi ixhumane nomthambo omkhulu otholakala ngaphezu kwenhliziyo (obizwa ngokuthi i-vena cava ephezulu , okuwumthambo omkhulu othwala igazi lisuka ezingxenyeni ezingaphezulu zomzimba liye ohlangothini lwesokudla lwenhliziyo).
• I-TAPVR yenhliziyo: Lapha, umthambo wamaphaphu ugeleza ngqo ungene e-coronary sinus ohlangothini lwesokudla lwenhliziyo.Iyaxhuma. Lo mthambo wenhliziyo uyindawo lapho igazi elingenawo umoya-mpilo livame ukuqoqana khona emisipheni yenhliziyo.
• I-Infracardiac TAPVR: Kulolu hlobo, umthambo wamaphaphu udlula ngaphansi kwenhliziyo, udlule esibindini, bese uxhuma emthanjeni omkhulu ( i-inferior vena cava ) othwala igazi lisuka ezingxenyeni ezingezansi zomzimba liye ohlangothini lwesokudla lwenhliziyo.
• I-TapVR Exubile: Lolu uhlobo olungavamile nolunzima kakhulu ukululungisa. Lapha, kungase kuxhunywe imithambo engaphezu kowodwa evela emaphashini, ngokuhlanganiswa kohlobo olulodwa noma ngaphezulu olushiwo ngenhla.

Lokhu kuhlukaniswa kubalulekile kodokotela ukuhlela ukuhlinzwa nokunquma izindlela zokwelapha.

Ivame kangakanani i-TAPVR?

I-TAPVR yisifo senhliziyo esingavamile kakhulu . Ngisho nasezweni elifana neMelika, lesi simo sithinta ingane eyodwa kuphela kwezingu-7,500 ezisanda kuzalwa. Futhi asivamile eSri Lanka.

Ziyini izimpawu ze-TAPVR?

Izimpawu ze-TAPVR zivame ukubonakala lapho kuzalwa , ikakhulukazi uma kukhona ukuncipha kwemithambo yamaphaphu lapho ixhumana khona nenhliziyo. Kodwa-ke, ezinye izingane zingase zingabonisi izimpawu amasonto amaningana.

Izimpawu eziyinhloko yilezi:

• I-Cyanosis: Ukushintsha kombala wesikhumba, izinzipho, nezindebe okuluhlaza okwesibhakabhaka noma okumpunga (ezinganeni ezinesikhumba esimnyama). Lokhu kubangelwa ukuntuleka komoya-mpilo egazini.
• Ubunzima bokuncela: Ingane inenkinga yokuncela futhi iyakhathala ngemva kokuphuza kancane.
• Ukukhathala nokuzola: Ingane ihlala ikhathele futhi ibonakala ikhathele.
• Ukububula kwenhliziyo: Lapho udokotela elalele inhliziyo yengane (nge-stethoscope), kuzwakala umsindo ongajwayelekile.
• Ukuphelelwa umoya (ukuphelelwa umoya): Ingane iphefumula ngokushesha futhi kubonakala sengathi inenkinga yokuphefumula.
• Ukukhula okungekuhle kanye nokukhuluphala: Ingane ayikhuli kahle futhi ayikhuli kahle.

Uma ingane yakho inesinye noma ngaphezulu salezi zimpawu, kufanele ufune iseluleko sezokwelapha ngokushesha .

Yini ebangela i-TAPVR?

Eqinisweni, odokotela abakayazi imbangela eqondile ye-TAPVR. Ibangelwa ukukhubazeka enhliziyweni nasemithanjeni yegazi ngesikhathi sokukhula komntwana osanda kuzalwa .

Ngokuvamile akubhekwa njengesimo esizuzwe njengefa. Kodwa-ke, kube nemibiko yamacala ayenzeka ezinganeni zakubo emndenini ofanayo. Ezinye izifundo ziphakamise ukuthi kungase kube nokuxhumana phakathi kwezingane ezinezifo ezithile kanye nokuchayeka ezisuseni upende, izibulala-zinambuzane, kanye nomthofu ngesikhathi sokukhulelwa. Kodwa-ke, lokhu akukafakazelwa okwamanje.

Yiziphi izinkinga ezingaba khona ze-TAPVR?

Ingane ene-TAPVR inokwehluleka kwenhliziyo kanye nomfutho wegazi ophezulu emaphashini.Ngisho nangemva kokuhlinzwa, ngezinye izikhathi izigqi zenhliziyo ezingavamile noma ukuvaleka kwemithambo yamaphaphu kungenzeka. Yingakho ukuhlolwa okuqhubekayo kwezokwelapha kubalulekile.

Itholakala kanjani i-TAPVR?

Ngezinye izikhathi, lesi simo singatholakala ngaphambi kokuba umntwana azalwe, nge -echocardiogram (ukuskenwa kwenhliziyo) okwenziwa ngesikhathi sokukhulelwa. Kodwa-ke, ngokuvamile ukuxilongwa kwenziwa ngemva kwamasonto noma izinyanga ezimbalwa umntwana ezelwe.

Uma umntwana ezalwa, udokotela uzokwenza ukuhlolwa ngokomzimba futhi alalele inhliziyo yengane. Idivayisi encane ebizwa ngokuthi i-pulse oximeter (isiqeshana esifanelana nozwane olukhulu lwengane) ingasetshenziswa ukukala izinga lomoya-mpilo egazini.

Ngaphezu kwalokho, ukuhlolwa okufana nalokhu okulandelayo kungenziwa ukuhlola isimo senhliziyo nemithambo yegazi:

• I-X-ray yesifuba
• I-CT scan (i-CT scan - i-computed tomography)
• I-MRI yenhliziyo (i-magnetic resonance imaging)
• I-Echocardiogram
• I-EKG (EKG noma i-ECG - i-Electrocardiogram)

Ezinye zalezi zivivinyo (njenge-MRI) zingadinga ukuthi umntwana alaliswe kancane. Kodwa zonke lezi zivivinyo azihlaseli. Lezi zivivinyo zivumela odokotela ukuthola izithombe ezicacile zenhliziyo namaphaphu engane, babone ukuthi igazi ligeleza kanjani, futhi babheke ukukhubazeka.

Ngezinye izikhathi ukuhlolwa okubizwa ngokuthi i-cardiac catheterization nakho kuyasetshenziswa ukuxilonga lesi sifo. Kodwa-ke, njengoba ulwazi oludingekayo luvame ukutholakala kuma-scan okukhulunywe ngawo ngenhla, umntwana akavamile ukuhlolwa ngokuhlaselayo.

Iphathwa kanjani i-TAPVR?

Cishe zonke izingane ezine-TAPVR zidinga ukuhlinzwa ukuze ziphile. Odokotela bayayelapha ngokuhlinzwa kwenhliziyo evulekile . Ngokuvamile, lokhu kuhlinzwa kwenziwa ngokushesha okukhulu ngemva kokuba lesi simo sitholakale.

Nakuba kungavamile kakhulu, abanye abantu batholakala bene-TAPVR besebakhulile ngaphandle kokuhlinzwa besebancane. Kodwa-ke, ngaleso sikhathi bangase babe nezimo ezifana nomfutho wegazi ophezulu wamaphaphu okwenza ukuhlinzwa kube nzima kakhulu.

Ukwelashwa ngaphambi kokuhlinzwa

Ngesikhathi ulinde ukuhlinzwa, ingane ingadinga ukunikezwa umoya-mpilo owengeziwe noma ixhunywe kumshini wokuphefumula ukuze uyisize iphefumule. Unganikwa nohlobo lomuthi olubizwa ngokuthi i-inotrope , olusiza inhliziyo ukuthi ishaye ngamandla.

Indlela ukuhlinzwa okwenziwa ngayo

Ngemva kokuba umntwana elele ngokuphelele ngaphansi kwe-anesthesia ejwayelekile , udokotela ohlinzayo uzokwenza okulandelayo:

1. Kusikwa isifuba nenhliziyo yengane.

2. Imithambo yamaphaphu ixhunywe kabusha endaweni efanele, okungukuthi, i-atrium yesobunxele yenhliziyo.

3. Imithambo exhumene ngendlela engavamile ivaliwe.

4. Uma kukhona ukuvaleka kwemithambo yamaphaphu, kuyasuswa.

5. Ngokuvamile, imbobo ephakathi kwe-atria yesobunxele nesokudla ( i-Atrial Septal Defect - ASD ) ivalwa.

Nakuba lokhu kuwukuhlinzwa okuyinkimbinkimbi kakhulu, amaqembu ezokwelapha anolwazi akwenza ngempumelelo.

Izinkinga zokwelashwa

Lezi ezinye zezinkinga ezingase zenzeke ngemva kokuhlinzwa:

• Ukuphazamiseka kwenhliziyo (i-Arrhythmias)
• Umfutho wegazi ophezulu wamaphaphu
• Ukuvaleka kwemithambo yegazi yamaphaphu
• Ngezinye izikhathi, ngemva kokusebenzisa umshini wenhliziyo namaphaphu (umshini wokudlula) ngesikhathi sokuhlinzwa, inhliziyo iba nobunzima bokuzishaya yodwa.

Odokotela bahlala beqaphile ngezinto ezinjengalezi.

Ingabe i-TAPVR ingavinjelwa?

Ngeshwa, ayikho indlela yokuvimbela lolu hlobo lwesifo senhliziyo esizalwa naso. Uma othile emndenini wakho enesifo senhliziyo esizalwa naso, noma uma une-TAPVR, kungumqondo omuhle ukukhuluma nodokotela wakho ngaphambi kokuqala umndeni.

Uma ingane yami ine-TAPVR, yini okufanele ngiyilindele?

Ngaphandle kokuhlinzwa, ezinye izinhlobo ze-TAPVR zingabulala zingakapheli amasonto okuzalwa. Kodwa-ke, uma lesi sifo sitholakala kusenesikhathi futhi selashwa ngokuhlinzwa, umbono wezingane ezine-TAPVR muhle kakhulu. Izinga lokusinda ngemva kokuhlinzwa licishe libe ngu-97%. Lelo izinga lempumelelo eliphezulu kakhulu.

Njengoba ingane yakho ikhula futhi ifinyelela ebudaleni, kufanele ibone udokotela wenhliziyo njalo . Lokhu kuhlolwa okuvamile kuyo yonke impilo kungasiza ekutholeni nasekuphatheni izinkinga ezifana nokungahambi kahle kwenhliziyo kanye nokuvaleka kwemithambo yegazi. Ngezinye izikhathi, uma kuvela ukuvaleka, kungadinga ukuhlinzwa okwengeziwe futhi kungaba nzima ukukwelapha. Yingakho kubalulekile ukuqhubeka nokulandela imiyalelo kadokotela wakho.

Ingane yakho kungase kudingeke iqhubeke nokuthatha imithi noma ithole ukwelashwa okufana nokufakwa kwe-catheter emithanjeni yenhliziyo .

Ngingayinakekela kanjani ingane yami?

Izingane ezine-TAPVR ngezinye izikhathi zingase zibe nobunzima ngezinyathelo ezivamile zokukhula, njengokusebenza kahle kwemisipha. Ungaqapha izinyathelo zokukhula kwengane yakho bese uzithumela kothile ongamsiza athuthukise lawo makhono uma kudingeka.

Khuluma nodokotela wengane yakho mayelana nokuthi ingane yakho ingakwazi yini ukuhlanganyela kwezemidlalo nakweminye imisebenzi yomzimba. Kungadingeka unciphise ukuzivocavoca okunzima .

Ingane yami kufanele imbone nini udokotela?

Ngemva kokuhlinzwa, ingane yakho izobonwa njalo ezinyangeni ezingu-6 kuya kwezingu-12.Ukuhlolwa kwezokwelapha. Kufanele uqhubeke ubona udokotela wakho njalo empilweni yakho yonke yokuba mdala. Udokotela wengane yakho angase afune ukwenza izivivinyo ezifana ne-EKG, ukuhlolwa kokucindezeleka kokuzivocavoca, noma i-echocardiogram .

Kunini lapho kudingeka uye eGumbini Lezimo Eziphuthumayo (i-ETU) ?

Funa usizo lwezokwelapha ngokushesha (iya ku-ER) uma ingane yakho inanoma yiziphi zalezi zimpawu:

• Uma isikhumba, izinzipho, noma izindebe ziphenduka zibe luhlaza okwesibhakabhaka/mpunga.
• Uma unenkinga yokuphefumula noma yokudla/ukuphuza ubisi.
• Uma ubonakala ulele kakhulu noma ungaphili.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Nazi ezinye zemibuzo ebalulekile okufanele uyibuze udokotela wengane yakho:

• Hlobo luni lwe-TAPVR ingane yami enalo?
• Ucabanga ukuthi ingane yami izodinga ukuhlinzwa kwesibili?
• Zingaki ukuhlinzwa okudingeke ukwenze ukuze ulungise i-TAPVR?

Umyalezo obalulekile okufanele uwuthathe uye ekhaya

Kungenzeka ukuthi ulandele iseluleko sikadokotela wakho sokuhlala uphilile ngesikhathi sokukhulelwa. Kodwa ngezinye izikhathi, umntwana osanda kuzalwa angaba nesifo senhliziyo. Akulona iphutha lomuntu. Ngesayensi yezokwelapha ethuthukisiwe yanamuhla, umntwana wakho angalindela umphumela ongcono kakhulu kunezingane zezizukulwane zangaphambilini. Ukwelashwa ngokuhlinzwa kusebenza kahle kakhulu.

Khumbula, yize i-TAPVR iyisimo esibucayi, ngokuxilongwa kusenesikhathi kanye nokwelashwa okufanele kokuhlinzwa, izingane zinethuba elikhulu lokuphila impilo enhle. Ngemva kokuhlinzwa, kubalulekile ukuyisa ingane yakho ekuhlolweni njalo kwezokwelapha. Lokhu kwenzelwa ukuthi impilo yengane yakho iqashwe futhi noma yiziphi izinkinga ezingase zivele zingelapheke ngokushesha. Awuwedwa, odokotela nabasebenzi bezempilo bakhona ukukusiza wena nomntwana wakho.

I- TAPVR, isifo senhliziyo, umntwana, ukuhlinzwa, imithambo yamaphaphu, i-cyanosis, izifo zokuzalwa