Kumelwe ukuba wesaba kakhulu lapho udokotela ekutshela ukuthi ingane yakho inomgodi enhliziyweni yayo, akunjalo? Empeleni kuyinto evamile kakhulu. Kodwa into ebaluleke kakhulu ukuthi lesi yisifo senhliziyo esivame kakhulu ukuzalwa naso esibonakala ezinganeni eSri Lanka. Esikhathini esiningi, lezi aziyingozi. Ngakho ungesabi. Ake sixoxe ngalesi simo esibizwa ngokuthi i-VSD (Ventricular Septal Defect) ngendlela elula ongayiqonda.
Kalula nje, iyini le VSD?
Inhliziyo yethu ifana nendlu encane enamakamelo amane. Amakamelo amabili aphezulu namakamelo amabili aphansi. Amakamelo amabili amakhulu, aqinile phansi yilokho esikubiza ngokuthi ama-ventricle . Kukhona udonga oluqinile phakathi kwala ma-ventricle amabili. Lolu donga lubizwa ngokuthi i-septum . Umsebenzi walolu donga ukuvimbela igazi elinomoya-mpilo omningi, elihlanzekile ohlangothini olulodwa lwenhliziyo ukuthi lingahlangani negazi elingenawo umoya-mpilo omningi, elingangcolile kolunye uhlangothi.
I-Ventricular Septal Defect (VSD) , uma sibeka kalula, iyimbobo odongeni (septum). Lo mbobo uvela lapho lolu donga lungakheki ngokugcwele lapho umntwana ekhula esibelethweni. Lo mbobo uvumela igazi elinomoya-mpilo ukuthi lihlangane negazi elinomoya-mpilo ophansi. Lokhu kuvimbela inhliziyo ukuthi isebenze kahle, okusho ukuthi inhliziyo kufanele isebenze kanzima.
Esikhathini esiningi, lezi zimbobo zincane kakhulu futhi azibangeli zimpawu. Kodwa ngezinye izikhathi, lezi zimbobo zingakhula zibe zinkulu. Uma kunjalo, ingane ingase ibe nezinkinga ezithile futhi idinge ukwelashwa.
Ingabe zikhona izinhlobo ze-VSD?
Yebo, lezi zimbobo zihlukaniswe ngezinhlobo ezine eziyinhloko kuye ngokuthi zikuphi odongeni lwenhliziyo. Akudingeki uzazi ngokujulile lezi zimbobo, kodwa kuhle ukuba nokuqonda okuvamile.
| Uhlobo lwe-VSD | Incazelo elula |
|---|---|
| I-VSD ye-Membranous | Lolu uhlobo oluvame kakhulu. Imbobo itholakala engxenyeni engenhla yodonga lwenhliziyo. |
| I-VSD yemisipha | Lolu hlobo lwembobo lwenzeka engxenyeni engezansi, enemisipha eminingi yodonga. Ngezinye izikhathi kungaba nembobo engaphezu kweyodwa. |
| I-VSD yokungena | Lo mgodi useduze kakhulu nama-valve enhliziyo. |
| I-VSD yesitolo | Lo mgodi useduze nemithambo emikhulu ethwala igazi enhliziyweni. |
Ziyini izimpawu zalokhu?
Esikhathini esiningi, uma imbobo ye-VSD incane kakhulu (ngaphansi kwamamilimitha angu-3, cishe ngobukhulu be-toothpick), ngeke kube khona zimpawu. Kodwa-ke, uma imbobo iphakathi nendawo (amamilimitha angu-3-5) noma inkulu (amamilimitha angu-6-10, cishe ngobukhulu be-pea), izimpawu zingase zivele.
| Iqembu lobudala | Izimpawu ezivamile |
|---|---|
| Izinsana ezisanda kuzalwa |
|
| Izingane ezindala kanye nabantu abadala |
|
Yini ebangela i-VSD?
Imbangela eqondile yalokhu ayaziwa okwamanje, kodwa ngezinye izikhathi i-VSD ingenzeka kanye nezinye izimo zofuzo, njenge -Down syndrome .
Kusolwa nokuthi imithi ethile ethathwa ngumama ngesikhathi sokukhulelwa (isib., imithi yokulwa nesifo sokuwa) noma ukuphuza utshwala kungandisa ingozi. Kodwa-ke, ucwaningo alukatholakali ukuqinisekisa lezi zimbangela.
Yiziphi izinkinga ezingabangelwa yilokhu?
Uma imbobo ye-VSD inkulu, inhliziyo kufanele isebenze kanzima, okungalimaza inhliziyo namaphaphu ngokuhamba kwesikhathi. Lokhu kubangela ukwanda kwegazi elihamba lisuka ohlangothini lwesokudla lwenhliziyo liye emaphashini, okubangela umfutho wegazi ophezulu emaphashini. Lokhu kubizwa ngokuthi i-Pulmonary Hypertension .
Into ebalulekile ukuthi uma i-VSD enkulu ingelashwa ngaphambi kokuba ingane ibe neminyaka emi-2 ubudala, umonakalo wamaphaphu ungaba ongenakulungiseka futhi ohlala njalo. Lokhu kubizwa ngokuthi i-Eisenmenger syndrome . Ngakho-ke, ukwelashwa kwasekuqaleni kubaluleke kakhulu.
Ezinye izinkinga:
- Ukwehluleka kwenhliziyo
- Ukubuyela kwe-aorta (ukuvuza kwegazi kusuka kuma-valve enhliziyo)
- Ukwandiswa kwama-ventricle enhliziyo
- Ukutheleleka kwenhliziyo (i-Endocarditis)
- Ukushaya kwenhliziyo okungavamile
- Isifo sohlangothi
Ukuthola kanjani lokhu, Dokotela?
Ngokuvamile, lapho udokotela ehlola ingane futhi elalele isifuba nge-stethoscope, kuzwakala umsindo owengeziwe obizwa ngokuthi "ukububula kwenhliziyo" . Ukulalela lo msindo kungaholela ekusolweni kwe-VSD.
Ukuqinisekisa lokho kusola, udokotela utusa ukuhlolwa okuningana okufana nalokhu:
- I-Echocardiogram (Echo): Lesi isivivinyo esibaluleke kakhulu. Kufana nokuskena kwengane esibelethweni. Kuthatha ividiyo yenhliziyo bese kukhombisa indawo yomgodi, ubukhulu bayo, nokuthi igazi ligeleza kanjani.
- I-Electrocardiogram (ECG/EKG): Ihlola ukusebenza kukagesi kwenhliziyo.
- I-X-ray yesifuba: Ukuhlolwa kwe-X-ray yesifuba.
- I-MRI yenhliziyo noma i-CT scan: Lokhu akuvamile ukudingeka.
- Ukuhlolwa kwe-Catheterization yenhliziyo: Ukuhlolwa lapho kufakwa khona ipayipi elincane enhliziyweni. Lokhu futhi akudingeki ngaso sonke isikhathi.
Yiziphi izindlela zokwelapha i-VSD?
Ukuthi lokhu kuyelashwa noma cha, nokuthi kanjani, kuncike ngobukhulu bembobo kanye nezimpawu zengane.
Ukulinda Okuqaphile
Esikhathini esiningi, okungukuthi, iningi lemigodi ye-VSD mincane kakhulu. Lezi ziyazivala zodwa lapho ingane isineminyaka engaba ngu-6 ubudala. Ezimweni ezinjalo, udokotela akenzi noma yiluphi uhlobo lokwelapha, kodwa uhlola njalo ukukhula kwengane kanye nezimpawu zayo emtholampilo.
Imithi
Uma ingane yakho inezimpawu ngesikhathi imbobo iphola, noma ilungiselelwa ukuhlinzwa, udokotela angakunika imithi ethile.
- Ama-Diuretics: Lawa asiza ekunciphiseni inani loketshezi oluthe xaxa oluqongelela emzimbeni nasemaphashini.
- Imithi yesifo senhliziyo: Iyasiza ekulawuleni ukusebenza kwenhliziyo.
Ukuhlinzwa nezinye izindlela
Uma imbobo inkulu futhi ibangela izinkinga enganeni, kuzodingeka ivalwe. Kunezindlela ezimbili eziyinhloko zokwenza lokhu.
1. Ukuhlinzwa kwenhliziyo evulekile: Kule nqubo, udokotela ohlinzayo uvala imbobo ngezitishi noma "ngesichibi" sokwenziwa. Ngokuhamba kwesikhathi, izicubu zenhliziyo yengane ziyakhula zizungeze isichibi, zibe yingxenye yodonga lwenhliziyo.
2. Inqubo ye-Transcatheter: Lokhu akubandakanyi ukusikwa esifubeni. Kunalokho, ithubhu elincane (i-catheter) lidluliselwa ngemithambo yegazi emikhulu emlenzeni liye enhliziyweni, bese kudluliselwa ithuluzi kulo ukuze kuvalwe imbobo. Lena inqubo elula kunokuhlinzwa.
Kufanele ubonane nodokotela ngokushesha nini?
Uma ingane yakho ine-VSD, hlala uqaphela izimpawu ezilandelayo.
Uma ingane yakho inenkinga enkulu yokuphefumula, noma uma isikhumba, izindebe, noma izinzipho ziphenduka zibe luhlaza okwesibhakabhaka/ziphaphathekile (i-cyanosis), yiyise eMnyangweni Wezimo Eziphuthumayo (i-ETU) wesibhedlela esiseduze ngokushesha.
Ngaphezu kwalokho, khuluma nodokotela wakho uma ubona izimpawu ezilandelayo:
- Uma isisindo sengane singakhuphuki njengoba kulindelekile.
- Uma ujuluka noma uzikhandla ngokweqile ngenkathi uphuza ubisi.
- Uma uvame ukuba nezifo zokuphefumula (i-mucus esifubeni).
Yini esingayilindela esikhathini esizayo?
Lezi yizindaba ezinhle kakhulu. Iningi lezingane ezine-VSD linempilo futhi liphila isikhathi eside. Ikakhulukazi uma umgodi mncane noma welashwe futhi welapheka ngokuphelele, akukho okufanele ukwesabe ngekusasa.
Kodwa-ke, uma i-VSD enkulu ingelashwa ngokushesha futhi ibangela umonakalo emaphashini (i-Eisenmenger syndrome), isikhathi sokuphila singancishiswa. Yingakho ukufuna iseluleko sezokwelapha ngesikhathi esifanele kubaluleke kakhulu.
Umlayezo Wokuya Nawe Ekhaya
- I-VSD yisifo senhliziyo esivame kakhulu ukuzalwa naso ezinganeni. Ngakho ungakhathazeki, awuwedwa.
- Iningi lemigodi ye-VSD lincane kakhulu. Lizivala lodwa njengoba ingane ikhula, ngaphandle kokwelashwa.
- Uma imbobo inkulu futhi kunezimpawu, kunezindlela zokwelapha ezisebenza kahle kakhulu.
- Into ebaluleke kakhulu ukunaka izimpawu zengane yakho, ukubona udokotela ngesikhathi esifanele, nokulandela imiyalelo yakhe.
- Uma unemibuzo, ukwesaba, noma ukungabaza ngalokhu, xoxa ngakho ngokukhululekile nodokotela owelapha ingane.
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