Ingabe imithambo emikhulu yenhliziyo yengane yakho isishintshiwe? (Ukuguqulwa kwemithambo emikhulu) - Ake sixoxe ngalokhu!

Kunzima ukuchaza ukwesaba nokudabuka ozizwayo uma uzwa ukuthi ingane yakho esanda kuzalwa inesifo senhliziyo, akunjalo? Kodwa ungakhathazeki. Ngezinye izikhathi izingane zingaba nemithambo yegazi emibili eyinhloko ezinhliziyweni zazo lapho zizalwa. Namuhla sikhuluma ngesinye isimo esinjalo, esibizwa ngokuthi `(Ukuguqulwa Kwemithambo Emikhulu)`. Lokhu kungase kubonakale kuyinkimbinkimbi kancane, kodwa masikwenze kube lula.

Kuyini Ukuguqulwa Kwemithambo Emikhulu?

Kalula nje, lesi yisimo "sokuzalwa" esenzeka lapho kuzalwa umntwana. Okusho ukuthi, le nkinga yenzeka ngesikhathi umntwana esesesibelethweni sikanina. Sinemithambo yegazi emibili eyinhloko ethwala igazi lisuka enhliziyweni yethu liye kuwo wonke umzimba wethu. Omunye umthambo wamaphaphu, othwala igazi emaphashini , kanti omunye yi -aorta, othwala igazi liye kuwo wonke umzimba wethu . Okwenzekayo kulesi simo ukuthi le mithambo yegazi emibili emikhulu ixhunywe enhliziyweni ezindaweni ezingafanele, hhayi ezindaweni ezifanele. Kufana nokuthi amapayipi aya emathangini amanzi amabili ashintshiwe.

Igazi lihamba kanjani ngokuvamile? Kwenzekani kulesi simo?

Ngokuvamile, yilokhu okwenzekayo: igazi lomzimba elingenawo umoya-mpilo (igazi eliluhlaza okwesibhakabhaka) liya enhliziyweni, lisuka lapho liye emaphashini ukuze lithathe umoya-mpilo. Bese igazi elisha, elinomoya-mpilo (igazi elibomvu) libuyela enhliziyweni, lisuka lapho liye kuwo wonke umzimba ngemithambo emikhulu. Kodwa kulesi simo "sokuguquka kwemithambo emikhulu", ngoba imithambo yegazi emibili ishintshiwe, igazi elingenawo umoya-mpilo libuyela emzimbeni esikhundleni sokuya emaphashini. Ngokufanayo, igazi elinomoya-mpilo elivela emaphashini libuyela emaphashini esikhundleni sokuya emzimbeni. Cabanga ukuthi lokhu kuzofinyelela umoya-mpilo omncane kangakanani ezithweni zomntwana.

Ingabe zikhona izinhlobo zalokhu?

Yebo, kunezinhlobo ezimbili eziyinhloko zalokhu: 1. I-Levo-transposition (i-Levo-transposition noma i-l-TGA): Kulesi simo, i-aorta yengane ikwesobunxele somthambo wamaphaphu. Kulesi simo, akuzona nje imithambo yegazi emibili, kodwa namakamelo aphansi enhliziyo ayashintsha. Kodwa-ke, kulolu hlobo, igazi elingenawo umoya-mpilo liya emaphashini kanti igazi elinomoya-mpilo liya emzimbeni, ngakho-ke alibangeli monakalo omkhulu. Lokhu akuvamile kangako. 2. I-Dextro-transposition (i-Dextro-transposition noma i-d-TGA): Kulesi simo, i-aorta yengane ikwesokunene somthambo wamaphaphu. Lolu uhlobo oluvame kakhulu, futhi futhi uhlobo oludinga ukunakwa okwengeziwe. Sizokhuluma kabanzi ngale `(d-TGA)` kulesi sihloko.

Kungani lesi simo esibizwa ngokuthi i-d-TGA siyingozi ezinganeni?

Njengoba ngishilo ngaphambili, endabeni ye-`(d-TGA)`, umzimba womntwana ugcwele igazi elingenawo umoya-mpilo. Lokhu kusho ukuthi zonke izitho ezibalulekile zomntwana, njengobuchopho, izinso, nesibindi, azitholi inani elidingekayo lomoya-mpilo. Lokhu kuyingozi kakhulu empilweni yomntwana. Ngezinye izikhathi, lapho lezi zingane zizalwa, kungase kube nomgodi phakathi kwamakamelo aphezulu enhliziyo `(Atrial Septal Defect noma ASD)` noma umgodi phakathi kwamakamelo aphansi enhliziyo `(Ventricular Septal Defect noma VSD)`. Nakuba lezi zimbobo ziyizimo ezingavamile ngempela, ezimweni ezinjalo, lezi zimbobo zingaba usizo kangako. Okusho ukuthi, lezi zimbobo zivumela igazi elithile elinomoya-mpilo ukuthi lihlangane negazi elingenawo umoya-mpilo. Kodwa-ke, inani lomoya-mpilo elitholwayo alanele nhlobo. Ngakho-ke, umntwana udinga ukwelashwa nakanjani.

Ungakhathazeki, kukhona ukuhlinzwa kwalesi simo. Odokotela bebelokhu bekwenza lokhu kuhlinzwa ngempumelelo iminyaka eminingi.

Yiziphi izimpawu uma ingane yakho inalesi simo? (Izimpawu)

Izingane ezisanda kuzalwa ezine-`(d-TGA)` zingase zibe nesifo esibizwa ngokuthi `(cyanosis),` esiwumbala wesikhumba oluhlaza okwesibhakabhaka/ompunga ngenxa yokuntuleka komoya-mpilo. Zingase futhi zibe nenhliziyo ebuthakathaka. Izimpawu eziyinhloko yilezi:

• Ubunzima bokuphefumula .
• Ukushaya kwenhliziyo kubuthakathaka kakhulu.
• Ubonisa ukungafuni nobunzima bokuphuza ubisi.
• Inhliziyo yami izwakala sengathi ishaya kakhulu, sengathi ishaya ngokushesha okukhulu.
• Isikhumba kanye nomhlophe wamehlo kungabonakala kuluhlaza okwesibhakabhaka (ezinganeni ezinesikhumba esikhanyayo) noma kumpunga (ezinganeni ezinesikhumba esimnyama).

Ziqala nini lezi zimpawu?

Ingane ene-`(d-TGA)` izoqala ukukhombisa lezi zimpawu lapho izalwa. Kodwa-ke, ngezinye izikhathi, ngenxa yezinto ezifana ne-`(ASD)`, izimbobo ezincane enhliziyweni yengane zingabangela ukuba igazi elithile elinomoya-mpilo lifike emzimbeni, ngakho izimpawu zingase zingabonakali kakhulu. Futhi, i-`(patent ductus arteriosus)`, umthambo wegazi osetshenziswa yingane ngesikhathi isesibelethweni, ingahlala ivulekile izinsuku ezimbalwa ngemva kokuzalwa, okubangela ukuba igazi lihlangane. Kodwa-ke, uma lezi zimbobo zesikhashana namapayipi zivaleka, izimpawu zinganda ngokuzumayo. Kuleso simo, ingane idinga ukunakekelwa kwezokwelapha okusheshayo.

Kungani lokhu kwenzeka? (Izizathu)

Odokotela abakakazi kahle ukuthi yini ebangela ukuguqulwa kwemithambo emikhulu. Njengezinye izifo zenhliziyo ezizalwa nazo, kucatshangwa ukuthi zibangelwa ukuguquka kwezakhi zofuzo noma ukuchayeka ebuthi ngesikhathi sokukhulelwa. Ezinye zezici ezingaba nomthelela kulesi simo zifaka:

• Uma unesifo sikashukela sokukhulelwa ngesikhathi sokukhulelwa .
• Uma unesifo esifana ne -rubella ngesikhathi sokukhulelwa.
• Uma uke wabhekana nezibulala-zinambuzane noma imithi yokubulala ukhula ethile.
• Uma uke wathatha imithi ethile yesifo sokuwa.

Ungakhathazeki ngalezi zinto. Akuwona wonke umuntu oke waba nenye yalezi zinto ozobhekana nalokhu.

Odokotela bakuthola kanjani lokhu? (Ukuxilongwa)

Ngezinye izikhathi, odokotela bangasithola lesi simo ngenkathi usakhulelwe. Lokhu kwenziwa ngokuhlolwa kokukhulelwa. Uma udokotela wakho esola ukuthi kukhona okungahambi kahle ngesikhathi sokuhlolwa kwe-ultrasound kwengane yakho, angase akucele ukuthi wenze i-echocardiogram yengane yakho. Lokhu kufana ne-ultrasound, kodwa kubheka inhliziyo yengane ngokuningiliziwe. Lokhu kungaqinisekisa ukuthi unayo yini i-d-TGA. Uma ingatholakali ngesikhathi sokukhulelwa, ivame ukutholakala phakathi nesonto lokuqala ngemva kokuzalwa.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Ukuhlolwa odokotela abakusebenzisayo ukuqinisekisa lesi simo yile:

• I-Echocardiogram (Echo): Lokhu futhi kuyi-ultrasound scan yenhliziyo.
• I-Electrocardiogram (EKG): Ukuhlolwa okubheka ukusebenza kukagesi kwenhliziyo.
• Ukuhlolwa kwe-pulse oximetry yokuzalwa: Lokhu kuvame ukwenziwa kuzo zonke izingane ezisanda kuzalwa.
• Ukuhlolwa kwe-X-ray yesifuba.
• Ukufakwa kwe-catheter enkabeni yenhliziyo: Lokhu kuhlolwa okuyinkimbinkimbi kakhulu. Ipayipi elincane ( i-catheter ) lifakwa ngomlenze noma engalweni enhliziyweni. Lokhu kwenziwa uma ezinye izivivinyo zingacacile.
• I-CT scan iyisivivinyo.

Ukwelapha kanjani lokhu? Ingane yakho idinga usizo ngokushesha!

Ingane ezelwe ine-`(d-TGA)` kumele ihlinzwe ukuze isinde. Esikhathini esiningi, lokhu kuhlinzwa kwenziwa phakathi nesonto lokuqala lokuzalwa. Lokhu kuhlinzwa kubizwa ngokuthi inqubo yokushintsha imithambo yegazi . Kalula nje, lokhu kuhilela ukuxhuma kabusha imithambo yegazi emibili eshintshiwe (i-aorta kanye nomthambo wamaphaphu) ibuyele ezindaweni zayo ezifanele. Lokhu kuvumela igazi ukuthi ligeleze kahle. Uma ingane yakho inembobo enhliziyweni yayo, njenge-`(VSD)`, nayo izolungiswa phakathi nalokhu kuhlinzwa.

Izinto zesikhashana okufanele zenziwe ngaphambi kokuhlinzwa

Odokotela basebenzisa izindlela eziningana zokwelapha zesikhashana ukuze bazinzise isimo somntwana kuze kube yilapho kwenziwa ukuhlinzwa okukhulu. Lokhu kufaka phakathi:

• I-Prostaglandin: Lo muthi usetshenziselwa ukuvula i-ductus arteriosus, umthambo wegazi owawukhona esibelethweni somntwana kodwa uvaleka ngemva kokuzalwa. Uma lokhu sekuvuliwe, igazi elithile elinomoya-mpilo liqala ukugeleza emzimbeni.
• Inqubo ebizwa ngokuthi i-Balloon atrial septostomy:Kulokhu, kusetshenziswa ithubhu elincane (i-catheter) ukukhulisa umgodi wemvelo phakathi kwamakamelo amabili aphezulu enhliziyo. Lokhu kuvumela igazi elinomoya-mpilo kanye negazi elingenawo umoya-mpilo ukuxubana, okuhlinzeka umzimba ngomoya-mpilo othile.

Ingabe lesi simo singavinjelwa?

Ayikho indlela eyaziwayo yokuvimbela ukuguqulwa kwemithambo emikhulu. Kodwa-ke, kubalulekile ukulandela imikhuba emihle yezempilo ngesikhathi sokukhulelwa kwakho. Thola yonke imijovo yakho ngesikhathi, thatha amavithamini amaningi, futhi ugcine ama-aphoyintimenti akho nodokotela. Uma kukhona emndenini wakho onomlando wesifo senhliziyo esizalwa naso, khuluma nodokotela wakho ngaso. Angase akuncome ukwelulekwa ngofuzo.

Kwenzekani ngemva kokuhlinzwa? Ungaphila kanjani ne-TGA

Nakuba ukuhlinzwa kungayiqedi ngokuphelele leso simo, abantu abaningi abane-`(d-TGA)` baphila impilo egcwele nenempilo. Kodwa-ke, labo abanalesi simo '(sokuzalwa)' badinga ukubhekwa kwezokwelapha impilo yonke. Udokotela wenhliziyo uzoqapha njalo isimo sengane yakho futhi anikeze noma yisiphi iseluleko esidingekayo. Izinga lokusinda ngemva kokuhlinzwa '(kwe-arterial switch)' lingaphezu kuka-95%. Kuthiwa leli zinga lihlala lifana ngisho nangemva kweminyaka engu-25.

Ingabe ingane yakho ingaphila kahle ne-TGA?

Yebo, impela. Ngemva kokwelashwa kwesimo `(Ukuguqulwa Kwemithambo Emikhulu)`, ingane yakho ingaphila impilo evamile. Kodwa-ke, inhliziyo idinga ukunakekelwa impilo yonke. Lokho kusho ukuthi:

• Kufanele uhlale uxhumana nodokotela wenhliziyo ochwepheshe kulezi zimo.
• Udinga ukuthatha imithi oyinikezwe udokotela ngqo.
• Ukuhlolwa okuhlola ukusebenza kwenhliziyo, njenge-`(EKG), `(Holter monitor), `(ukuhlolwa kokucindezeleka kokuzivocavoca), kanye ne-`(echocardiogram)' kuzodingeka kwenziwe njalo.

Odokotela abaningi benhliziyo abancomi ukudlala imidlalo yokuncintisana ngemva kokuhlinzwa kwe-`(d-TGA)`. Ngakho-ke, wena nomntwana wakho, udokotela wakho wezingane, kanye nodokotela wakho wenhliziyo kufanele nibambisane ukuze nenze isinqumo esingcono kakhulu sempilo yengane yakho. Abesifazane abaningi abaye bahlinzwa i-`(d-TGA)` baphumelele ukubeletha izingane. Kodwa-ke, kufanele nakanjani nikhulume nodokotela wakho kanye nodokotela wenhliziyo ngaphambi kokukhulelwa.

Ingabe kuzodingeka ukuhlinzwa okwengeziwe kwenhliziyo esikhathini esizayo?

Yebo, kungase kudingeke ukuhlinzwa okwengeziwe kamuva. Ngokuvamile, kuhloswe ukulungisa inkinga yesigqi senhliziyo noma ukulungisa ama-valve enhliziyo.

Ingabe ikhona ingozi ye-endocarditis?

I-Endocarditis yisimo esenzeka lapho ukutheleleka ngamagciwane kungena enhliziyweni. Abantu abanezinkinga zenhliziyo ezifana ne-TGA banamathuba amaningi okuthola lokhu. Ngakho-ke, abantu abaye bahlinzwa ngokuhlinzwa kokufakelwa amazinyo kungadingeka bathathe ama-antibiotic ngaphambi kokwelashwa kwamazinyo.

Ingabe kungathinta ukukhula kobuchopho?

Ezinye izingane ezike zaba noshintsho lwemithambo yegazi zingase zibe ne-ADHD (isifo sokuntuleka kokugxila ngokweqile). Noma zingase zidinge usizo olukhethekile ngomsebenzi wesikole. Qaphela nalokhu.

Kufanele ngimbone nini udokotela?

Uma ingane yakho inalezi zimpawu...

• Uma uzizwa sengathi unenkinga yokuphefumula.
• Uma ukushaya kwenhliziyo kubuthakathaka kakhulu.
• Uma isikhumba esizungeze umlomo sesiphenduke saba luhlaza okwesibhakabhaka/mhlophe.

Uma ubona into efana nale, bona udokotela ngokushesha.

Uma wahlinzwa lokhu usengumntwana...

Uzodinga ukuhlolwa njalo kwezokwelapha kanye nokuqapha impilo yakho yonke. Bona udokotela wenhliziyo onolwazi ngesifo senhliziyo sabantu abadala (esizalwa naso).

Yimiphi imibuzo okufanele uyibuze udokotela?

Uma ingane yakho ine-Transposition of the Great Artery, ungabuza udokotela le mibuzo:

• Ingabe ingane yami idinga ukuhlinzwa maduze?
• Yikuphi ukwelashwa okungcono kakhulu?
• Hlobo luni lokunakekelwa okulandelayo ingane yami edingayo?
• Ingabe kuzodingeka aphinde ahlinzwe?
• Ingabe ikhona imingcele emisebenzini yakhe?
• Kufanele ngimnakekele kanjani umntwana wami ngemva kokuhlinzwa?

Uma wahlinzwa lesi simo useyingane, ungabuza udokotela wakho:

• Ingabe ngizodinga olunye ukuhlinzwa?
• Hlobo luni lokubhekwa kwezokwelapha engiludingayo?
• Ingabe kukhona imikhawulo emisebenzini yami?
• Ngingaba nomntwana?

Okokugcina, into ebaluleke kakhulu (Umyalezo Wokuya Ekhaya)

Ukuthola ukuthi ingane yakho esanda kuzalwa inesimo senhliziyo akuyona into elindelwe umzali. Kungaba buhlungu kakhulu. Kodwa, awuwedwa. Odokotela bengane yakho bangakusiza kulolu hambo futhi bakuqondise ezinqumweni ozenzayo.

Khumbula, odokotela bebelokhu belapha izingane nge-TGA iminyaka eminingi, futhi imiphumela iphumelela kakhulu. Qina ngengane yakho. Ungesabi ukubuza udokotela wakho imibuzo nganoma yini ongayiqondi noma ongaqiniseki ngayo. Ukuqonda kwakho kungamandla amakhulu engane yakho ukuze ibe nekusasa elinempilo.

Ukuhlinzwa kwenhliziyo, isifo senhliziyo esizalwa naso, ukuhlinzwa kokushintsha kwemithambo yegazi, i-cyanosis, isifo senhliziyo sezinsana, i-d-TGA, ukuhlinzwa kwenhliziyo