Njengomzali, ngiyaqonda ukuthi inhliziyo yakho kumelwe ukuba izwa ubuhlungu obukhulu kangakanani lapho udokotela wakho ekutshela ukuthi ingane yakho inesifo senhliziyo esizalwe naso. Ukuzwa lawo mazwi kungase kuzwakale sengathi umhlaba wakho wonke uwile. Kodwa ungakhathazeki. Ake sixoxe ngalesi simo esibizwa ngokuthi i-Tricuspid Atresia kalula nangokucacile. Uzozizwa ukhululekile kakhulu uma uqonda kahle ukuthi siyini, kungani senzeka, nokuthi yini engenziwa.
Kalula nje, iyini i-Tricuspid Atresia?
Cabanga ngenhliziyo yethu njengendlu encane enamakamelo amane. Kunamakamelo amabili phezulu namakamelo amabili phansi. Kuneminyango yegazi eligeleza phakathi kwala makamelo. I-Tricuspid Atresia iyisici esizalwa naso ku-Tricuspid Valve, okuyi-valve ephakathi kwegumbi eliphezulu (Right Atrium) kanye negumbi elingezansi (Right Ventricle) ngakwesokudla kwenhliziyo.
Esikhundleni salo mnyango, kukhona udonga olwenziwe ngezicubu ezijiyile. Kunjengokungathi othile wakha udonga lapho kufanele kube nomnyango khona. Ngakho igazi elingenawo umoya-mpilo elivela ekamelweni eliphezulu ngakwesokudla alinandlela yokufika ekamelweni elingezansi. Leli gazi kufanele liye ekamelweni elingezansi bese lipompiwa emaphashini ukuze lithole umoya-mpilo.
Ngakho-ke, ukuvalwa ngokuphelele kwalo mgwaqo kudala izinkinga ezimbili ezinkulu:
1. Ikamelo elingezansi liyancipha: Ikamelo elingezansi ohlangothini lwesokudla (i-Right Ventricle) alikhuli kahle ngoba igazi alifiki kulo. Livame ukuba lincane futhi libe buthaka.
2. Igazi aligelezi emaphashini: Inani legazi elidinga ukuya emaphashini ukuze kutholakale umoya-mpilo liyancipha kakhulu. Lokhu kuholela ekutheni umoya-mpilo onganele ulethwe kuwo wonke umzimba.
I-Tricuspid atresia yisifo senhliziyo esingavamile futhi esibi kakhulu esizalwa naso, kodwa singaphathwa ngempumelelo ngokwelashwa nokuhlinzwa okufanele.
Ingabe lesi simo sisongela ukuphila?
Yebo. Odokotela babheka i-Tricuspid Atresia njengesifo senhliziyo esibi kakhulu . Lapho nje umntwana onalesi simo ezalwa, kudingeka anakekelwe egunjini lokunakekelwa okujulile (ICU) eligxile ekwelapheni izingane ezinezinkinga zenhliziyo eziyinkimbinkimbi. Ezimweni eziningi, umntwana uzodinga ukuhlinzwa kwenhliziyo okuphuthumayo ngaphambi kokuba abuyele ekhaya. Uma lesi simo singaqashelwa futhi singalashwa, singaba yingozi. Ngakho-ke, ukunakekelwa kwezokwelapha okusheshayo kubalulekile.
Ingabe zikhona izinhlobo eziyinhloko ze-Tricuspid Atresia?
Yebo, odokotela bahlukanisa lesi simo ngezinhlobo eziningana eziyinhloko. Isizathu salokhu ukuthi izindlela zokwelapha ziyahlukahluka kuye ngezinye izinkinga zenhliziyo ezenzeka ngalesi sifo.
| Uhlobo | Incazelo elula |
|---|---|
| Uhlobo I | Lolu uhlobo oluvame kakhulu. Imithambo yegazi eyinhloko ephuma enhliziyweni (umthambo wamaphaphu kanye ne-aorta) isezindaweni ezifanele. Kodwa-ke, kungase kube nembobo odongeni phakathi kwamakamelo angaphansi enhliziyo (i-ventricular septal defect) noma inkinga nge-valve yamaphaphu. |
| Uhlobo II | Lapha, imithambo yegazi emibili eyinhloko iphendukezelwe. Okusho ukuthi, omunye ulapho omunye kufanele ube khona. Kukhona futhi imbobo odongeni phakathi kwamakamelo angaphansi (i-Ventricular Septal Defect). |
| Uhlobo III | Lolu uhlobo lwesifo senhliziyo olungavamile kakhulu. Luhilela inhlanganisela yezinkinga eziyinkimbinkimbi ezihilela imithambo yegazi emikhulu namagumbi enhliziyo. |
Odokotela bazokutshela ukuthi ingane yakho inohlobo luni ngempela ngemva kokuhlolwa kwe-echocardiogram.
Yiziphi izimpawu ongazibona njengomzali?
Esikhathini esiningi, lezi zimpawu ziqala ukuvela phakathi nesonto lokuqala ngemva kokuzalwa komntwana.
- Isikhumba esiluhlaza okwesibhakabhaka nezindebe (i-Cyanosis): Isikhumba somntwana, izindebe, kanye nangaphansi kwezinzipho kuba luhlaza okwesibhakabhaka ngoba umzimba awutholi umoya-mpilo owanele. Lolu uphawu oluyinhloko nolusobala kakhulu.
- Ubunzima bokuphefumula kanye nokuphefumula okusheshayo: Ingane ingase ibe nobunzima bokuphefumula noma ingase ibonakale sengathi iphefumula ngokushesha, njengokungathi iphelelwa umoya.
- Ubunzima bokuphuza nokukhathala ngokushesha: Ingane ingase ikhathale ngemva kokuphuza ubisi oluncane. Ngakho-ke, yeka ukuphuza phakathi nendawo, noma ingase ijuluke ngenkathi iphuza.
- Ukungakwazi ukuthwala umntwana: Ukukhula kwengane kuhamba kancane ngenxa yokuntuleka kokudla okunomsoco kanye nomoya-mpilo odingekayo.
- Ukukhononda Kwenhliziyo: Lapho udokotela ehlola inhliziyo nge-stethoscope, angase ezwe umsindo wenhliziyo ongavamile.
Uma ubona noma yiziphi zalezi zimpawu, bona udokotela ngokushesha ngaphandle kokulibala.
Kungani lokhu kwenzeka ezinganeni?
Yingakho keImbangela eqondile ayaziwa okwamanje. Lezi ziphazamiso zokuzalwa zenzeka ekuqaleni kokukhula komntwana esibelethweni, ikakhulukazi phakathi namasonto okuqala angu-6-8 okukhulelwa lapho inhliziyo yakheka khona. Kodwa-ke, kunezici eziningana ezitholakele ezikhulisa ingozi yalesi simo.
Izici zengozi
Ezinye izimo umama abhekana nazo ngesikhathi sokukhulelwa zingathinta lokhu:
- Ukutheleleka ngegciwane: Ukuthola isifo esibangelwa yigciwane ngesikhathi sokukhulelwa, ikakhulukazi esifana ne-German measles.
- Isifo Sikashukela: Umama unesifo sikashukela futhi asilawulwa kahle ngesikhathi sokukhulelwa.
- Ukusetshenziswa kotshwala: Ukuphuza utshwala ngesikhathi sokukhulelwa.
- Imithi ethile: Ukusetshenziswa kwemithi ethile yokwelapha ukuquleka noma induna.
- Izimbangela zofuzo: Omunye wabazali unesifo senhliziyo azalwa naso noma umntwana unesifo sofuzo njenge-Down syndrome.
Odokotela basithola kanjani lesi sifo?
I-Tricuspid atresia ingatholakala ngaphambi noma ngemva kokuzalwa.
- Ngaphambi kokuba umntwana azalwe: Uma kutholakala ukungajwayelekile enhliziyweni yengane ngesikhathi sokuhlolwa kwe-ultrasound ngesikhathi sokukhulelwa, odokotela bazokwenza ukuhlolwa okukhethekile okubizwa ngokuthi i-fetal echocardiogram. Lokhu kuvumela ukwakheka kwenhliziyo nokugeleza kwegazi ukuthi kubonakale ngokucacile.
- Ngemva kokuzalwa komntwana: Ngesikhathi sokuhlolwa kokuqala ngemva kokuzalwa komntwana, udokotela angase ezwe umsindo wenhliziyo ongavamile ('ukububula kwenhliziyo'). Futhi, uma umntwana eluhlaza okwesibhakabhaka, kuzosetshenziswa ukuhlolwa okulula okubizwa ngokuthi 'i-pulse oximetry' ukukala izinga lomoya-mpilo egazini. Uma lokhu kuphakamisa ukungabaza, kuzokwenziwa ukuhlolwa kwe -'echocardiogram' (echo) ukuze kutholakale ukuthi isifo sikhona ngempela.
Ukuhlolwa kwe-`Echo` kungabonisa ngokusobala ukuthi i-valve ye-tricuspid ayikho, i-ventricle yesokudla incane, nokuthi ngabe kukhona yini ezinye izimbobo enhliziyweni (`i-atrial septal defect` noma `i-ventricular septal defect`).
Yiziphi izindlela zokwelapha?
Lesi simo asikwazi ukwelapheka ngokuphelele. Kodwa ukwelashwa kuhlose ukugcina ukusebenza kwenhliziyo kusezingeni elingcono kakhulu nokuthuthukisa ukujikeleza kwegazi ukuze umzimba uthole umoya-mpilo owudingayo. Izindlela zokwelapha zingahlukaniswa ngezigaba ezimbili: imithi kanye nokuhlinzwa.
Ukwelashwa ngezidakamizwa
Ngaphambi kokuhlinzwa, umntwana unikezwa imithi yokuzinzisa isimo. Umuthi oyinhloko umuthi obizwa ngokuthi i-`Alprostadil`. Lokhu kugcina umthambo wegazi omncane (`ductus arteriosus`) enhliziyweni yengane, ovame ukuvala lapho izalwa, uvulekile okwesikhashana. Lokhu kudala indlela entsha yokuthi igazi ligeleze emaphashini.
Ukuhlinzwa
Ukuhlinzwa kubalulekile ukuze ingane ene-Tricuspid Atresia isinde. Lokhu ngokuvamile akwenziwa ngokuhlinzwa okukodwa. Kuye ngobudala bomntwana, kudingeka uchungechunge lokuhlinzwa ngezigaba eziningana.
| Igama lokuhlinzwa | Kwenzekani nje |
|---|---|
| I-BTT Shunt | Lokhu kuvame ukwenziwa njengokuhlinzwa kokuqala. Kule nqubo, kuthathwa ithubhu elincane (i-shunt) emthanjeni oyinhloko othwala igazi emzimbeni bese lixhunywa emthanjeni othwala igazi emaphashini. Lokhu kwandisa ukugeleza kwegazi emaphashini. |
| Inqubo kaGlenn | Lokhu kuhlinzwa kwenziwa lapho umntwana eneminyaka engaba ngu-4-6 ubudala. Kule nqubo, igazi elingenawo umoya-mpilo elivela emzimbeni ongaphezulu lidluliselwa ngqo emaphashini, lidlule inhliziyo. |
| Inqubo yeFontan | Lesi yisigaba sokugcina sokuhlinzwa. Kwenziwa lapho umntwana eneminyaka ephakathi kuka-2-4 ubudala. Lapha, igazi elingenawo umoya-mpilo elivela engxenyeni engezansi yomzimba lixhunywe ngqo emaphashini. Ngemva kwalokhu kuhlinzwa, ukuxubana kwegazi elinomoya-mpilo kanye negazi elingenawo umoya-mpilo cishe kuyaphela ngokuphelele. |
Ngemva kwalokhu kuhlinzwa, ingane kuzodingeka ihlale esibhedlela isonto elilodwa kuya kwamabili. Okokuqala egunjini lokunakekelwa okujulile, bese idluliselwa egunjini elivamile. Uma lokhu kuhlinzwa kungaphumeleli noma uma inhliziyo iba buthaka ngokuhamba kwesikhathi, kungacatshangwa ukuthi kufakwe inhliziyo.
Impilo yengane izoba njani ngemva kokwelashwa?
Lokhu kuhlinzwa kungasondeza ingane empilweni evamile. Kodwa-ke, kuzodingeka ibe ngaphansi kokuqondisa kukadokotela wenhliziyo impilo yayo yonke.
- Ukuhlolwa njalo kwezokwelapha: Ubudala bengane kanye nesigaba sokwelashwa kuzonquma ukuthi udokotela udinga ukumbona kangaki. Ngemva kokuhlinzwa kweFontan, kuzodingeka uye kokuhlolwa okungenani kanye ngonyaka.
- Ukuqapha ekhaya: Ngezinye izikhathi udokotela wakho angakucela ukuthi uqaphe njalo futhi uqophe izinto ezifana nesisindo somntwana wakho kanye namazinga omoya-mpilo ekhaya.
- Ama-antibiotic: Kungase kudingeke ukuthi uthathe ama-antibiotic okuvimbela ukutheleleka ngaphambi kokuthola izinto ezifana nokwelashwa kwamazinyo.
- Umsebenzi womzimba:Kungase kudingeke unciphise imidlalo nemisebenzi enzima. Khuluma nodokotela wakho ngalokhu bese uthola iseluleko.
- Ukukhubazeka Kokufunda: Ezinye izingane ezine-Tricuspid Atresia zisengozini encane yokuthola ukukhubazeka kokufunda noma i-ADHD. Lokhu kubalulekile futhi ukukuqaphela.
Ungathini ngempilo yalaba bantwana?
Lena inkinga ebucayi kakhulu. Eqinisweni, uma ingelashwa, izingane eziningi ezine-Tricuspid Atresia ngeke zikwazi ngisho nokugubha usuku lwazo lokuzalwa lokuqala.
Kodwa-ke, ngokuhlinzwa, lesi simo sishintsha ngokuphelele. Ngokuthuthuka kobuchwepheshe bezokwelapha namuhla, iningi lezingane ezihlinzwayo ziphila zize zibe ngabantu abadala. Ngokwezinye izifundo, iningi lalabo abahlinzwe liphila iminyaka engaphezu kwengu-20. Kulindeleke ukuthi ingane ehlinzwe 'iFontan' ingaphila iminyaka engu-35-40 noma ngaphezulu.
Umlayezo Wokuya Nawe Ekhaya
- I-Tricuspid atresia yisifo senhliziyo esibi kakhulu lapho kungekho khona i-valve ohlangothini lwesokudla lwenhliziyo.
- Izimpawu eziyinhloko isikhumba somntwana siphenduka sibe luhlaza okwesibhakabhaka, ubunzima bokuphefumula, kanye nobunzima bokudla.
- Nakuba lokhu kusongela impilo, ukuhlinzwa okuthuthukile kwanamuhla kunganikeza ingane ithuba lokuphila impilo enhle.
- Ukwelashwa kuvame ukuba nochungechunge lokuhlinzwa okwenziwa ngezigaba eziningana.
- Ngemva kokuhlinzwa, ingane izodinga ukubhekwa impilo yayo yonke ngudokotela wenhliziyo.
- Njengomzali, ungangabazi ukuxoxa nganoma yiziphi izinkinga noma ukwesaba onakho nodokotela wakho. Uma unolwazi oluningi, kulapho uzokwazi khona ukunikeza ingane yakho ukunakekelwa okungcono kakhulu.
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