Tetralogy Ya Fallot

Tetralogi ya Fallot ni ihuriro ry'impinduka enye z'umutima zibaho kuva umwana avutse. Hariho umwobo mu mutima witwa umwobo wa ventricular septal. Hari kandi gukomera kw'umuvure wa pulmonary cyangwa ahandi hantu mu nzira iri hagati y'umutima n'ibihaha. Gukomera kw'umuvure wa pulmonary bita pulmonary stenosis. Umuhanda mukuru w'amaraso w'umubiri, witwa aorta, uba utari aho ukwiye kuba. Idirango ry'icyumba cy'iburyo cyo hasi cy'umutima riba ryoroheye, iyi ndwara bita right ventricular hypertrophy. Impinduka za Tetralogi ya Fallot zigira ingaruka ku buryo amaraso acura mu mutima no mu bindi bice by'umubiri.

Tetralogi ya Fallot (teh-TRAL-uh-jee of fuh-LOW) ni indwara y'umutima idakunze kugaragara ibaho kuva umwana avutse. Bisobanura ko ari indwara y'umutima ivuka. Umwana wavutse afite iyi ndwara afite ibibazo bine bitandukanye by'umutima.

Ibi bibazo by'umutima bigira ingaruka ku buryo umutima umeze. Iyi ndwara itera amaraso gucura nabi mu mutima no mu bindi bice by'umubiri. Abana bafite Tetralogi ya Fallot bakunze kugira uruhu rw'ibara ry'ubururu cyangwa icyatsi kubera ipfa ry'umwuka muke.

Tetralogi ya Fallot imenyekana mu gihe cyo gutwita cyangwa nyuma gato y'ivuka ry'umwana. Niba impinduka z'umutima n'ibimenyetso ari bike, Tetralogi ya Fallot ishobora kutamenyekana cyangwa kutagenzurwa kugeza ku myaka y'ubukure.

Abantu bapimwe bafite Tetralogi ya Fallot bakeneye kubagwa kugira ngo bakire umutima. Bazakenera kujya gukorerwa isuzuma buri gihe ubuzima bwabo bwose.

Uburyo bwiza bwo kuvura buracyatumamo impaka, ariko muri rusange, gusana byuzuye birabujijwe mu mezi atatu cyangwa atandatu ya mbere y'ubuzima. Ni ngombwa ko gushyiraho uburyo bwa Blalock-Taussig shunt nk'uburyo bwo kuvura byoroheje bikorwa gake cyane muri iki gihe. Intego y'abaganga ni ugukora isana yuzuye, irimo gufunga umwobo wa ventricular septal no kugabanya inzitizi mu nzira y'amaraso ava mu cyumba cy'iburyo cy'umutima, bikorwa neza hagamijwe kubungabunga imikorere y'umuvure wa pulmonary. Ikorwa ry'umutima risanzwe rikorwa cyane mu bantu bakuru ni ukubaga umuvure wa pulmonary nyuma yo gusana Tetralogi ya Fallot mu buto cyangwa mu bwana.

Hariho uburyo bubiri busanzwe bwo gusana byuzuye. Ubwa mbere ni uburyo bwa transatrial-transpulmonary, ubwa kabiri ni uburyo bwa transventricular. Uburyo bwa transatrial-transpulmonary bufite akamaro ko kubungabunga imikorere y'umuvure wa pulmonary ariko bushobora kuba bwiza, kandi byoroshye gato, nyuma y'amezi ane y'amavuko. Gukoresha igice gito cy'umuvure wa infundibular bishobora gufasha kugabanya inzitizi mu nzira y'amaraso ava mu cyumba cy'iburyo cy'umutima cyangwa kunoza ishusho y'umwobo wa ventricular septal mu bihe bimwe na bimwe. Ugeragezo ukomeye ukorwa kugira ngo ugumane munsi y'umuvure wa pulmonary annulus, kandi ubungabunge umuvure wa pulmonary igihe bikorwa, cyane cyane niba ingano y'umuvure wa pulmonary annulus ari nziza, bityo bikaba bikenewe gukora pulmonary valvotomy gusa. Uburyo bwa transventricular bushobora gukoreshwa mu myaka yose. Nubwo bwamaze igihe kinini, twamenye ko abarwayi benshi bahora bakenera kubagwa umuvure wa pulmonary nyuma y'imyaka kubera pulmonary regurgitation. Kubwibyo, niba uburyo bwa transventricular bukoreshwa, gusana kwagutse kwa transannular birindwa kugira ngo bigabanye kwaguka kw'icyumba cy'iburyo cy'umutima n'imikorere mibi yacyo, pulmonary regurgitation ikomeye, no kwirinda ventricular arrhythmias. Nubwo ari ngombwa kugabanya inzitizi mu nzira y'amaraso ava mu cyumba cy'iburyo cy'umutima, gusiga inzitizi nke inyuma bifatwa nk'ibyemerwa, cyane cyane niba kubungabunga no gukora neza kw'umuvure wa pulmonary bishobora kubungabungwa. Muri rusange, inzitizi ishigaje ya milimetero 20 kugeza kuri 30 za mercury ku muvure wa pulmonary irashobora kwihanganirwa kandi yemewe.

Kuba hari umuvure wa anomalous left anterior descending coronary artery akenshi ntabwo ari ikibazo cyo gusana byuzuye muri iki gihe. Igice gito cya transannular gishobora gukorwa kidakora ku muvure wa anomalous left anterior descending coronary artery kandi gishobora gukoreshwa kugira ngo hagabanywe inzitizi mu nzira y'amaraso ava mu cyumba cy'iburyo cy'umutima, niba ari ngombwa. Icyemezo cyo gufunga patent foramen ovale gishingira cyane cyane ku myaka y'umurwayi niba gusana kwa transannular byakozwe. Muri rusange, patent foramen ovale isigara ifunguye igihe gusana byuzuye bikorwa ku mwana wavutse cyangwa igihe gusana kwa transannular byakozwe kandi pulmonary regurgitation ikomeye ibayeho. Gukoresha uburyo bwa monocusp gusana kugira ngo kunoze imikorere y'umuvure wa pulmonary bishobora gufasha muri iki gihe kandi bishobora kunoza igihe cyo kuvura nyuma y'ubuganga.

Muri iki gihe, gusana Tetralogi ya Fallot bishobora gukorwa n'ipfa rike cyane, hafi 1%, kandi ubuzima bwiza n'ubuzima bwiza nyuma y'imyaka myinshi ni byiza ku barwayi benshi. Muri rusange, abana bajya ku ishuri kandi bashobora kwitabira imikino myinshi y'abana nta mbogamizi. Gusana hakiri kare mu mezi atandatu ya mbere y'ubuzima ni itegeko, kandi kubungabunga umuvure wa pulmonary no kugabanya pulmonary regurgitation ni intego. Ubukeneye bwo kugenzura ubuzima bw'umuntu ubuzima bwe bwose ntibugomba gusuzugurwa, kugira ngo igihe gikwiye cy'ibikorwa byose bishoboka byakurikiyeho gishobora kunoza.

Ibimenyetso bya Tetralogi ya Fallot biterwa n'ingano y'amaraso adashobora kuva mu mutima yerekeza mu mwijima. Ibimenyetso bishobora kuba birimo: Ibara ry'uruhu rwera cyangwa ry'ibara ry'ikizungu.Guhumeka bugufi no guhumeka vuba, cyane cyane mu gihe cyo konsa cyangwa imyitozo ngororamubiri. Kugorana kwiyongera ibiro. Kwumva unaniwe vuba mu gihe cyo gukina cyangwa imyitozo ngororamubiri. Kwiheba. Kurira igihe kirekire. Kugwa. Bamwe mu bana bafite Tetralogi ya Fallot batungurwa n'uruhu rw'ibara ry'ikizungu cyangwa rwera, imisumari n'iminwa. Ibi bikunda kubaho iyo umwana arira, arya cyangwa aramutse ahindutse. Ibi bihe bita tet spells. Tet spells biterwa no kugabanuka k'umuvuduko w'oxygène mu maraso. Bikunze kugaragara mu bana bato, hagati y'amezi 2 na 4. Tet spells ishobora kuba idagaragara cyane mu bana bato n'abakuze. Ni ukubera ko bakunda kwicara mu gihe bahumeka nabi. Kwicara bituma amaraso menshi ajya mu mwijima. Indwara zikomeye z'umutima zivuka zikunze kuvurwa mbere cyangwa nyuma gato y'ivuka ry'umwana wawe. Niba ubona ko umwana wawe afite ibi bimenyetso, shaka ubufasha bw'abaganga: Kugira ikibazo cyo guhumeka. Ibara ry'uruhu rwera. Kubura ubwenge. Kugwa. Kugira intege nke. Kwiheba kurusha igihe. Niba umwana wawe ahinduka umweru cyangwa wera, umushyire ku ruhande maze umukubite amavi ku gituza. Ibi bifasha kongera amaraso ajya mu mwijima. Hamagara 911 cyangwa nimero y'ubufasha bw'ihutirwa muri ako karere.

Ibibazo bikomeye by'umutima ku bana bavuka bavuka akenshi bimenyekana mbere yuko umwana wawe avuka cyangwa nyuma gato. Shaka ubufasha bw'abaganga niba ubona ko umwana wawe afite ibi bimenyetso:

• Kugira ikibazo cyo guhumeka.
• Uruhu rufite ibara ry'ubururu.
• Kubura ubwenge.
• Kugwa mu nsazi.
• Intege nke.
• Kurusha ubundi igihe arakaza.

Niba umwana wawe ahinduka umweru cyangwa umukara, umushyire ku ruhande maze ukure amukubita ku gituza. Ibi bifasha kongera amaraso ajya mu mwijima. Hamagara 911 cyangwa nimero y'ubufasha bw'ihutirwa muri ako karere ako kanya.

Tetralogy of Fallot ibaho igihe umutima w'uruhinja ugikura mu nda. Ubusanzwe, ntabwo umutwe uzwi.

Tetralogy of Fallot irimo ibibazo bine bijyanye n'imiterere y'umutima:

• Kugabanyuka kw'agakombe kari hagati y'umutima n'impyiko, bitwa pulmonary valve stenosis. Iki kibazo kigabanya umusaruro w'amaraso uva mu mutima ujya mu mpyiko. Kugabanyuka bishobora kuba ku gakombe gusa. Cyangwa bishobora kuba ahantu henshi hagati y'umutima n'impyiko. Hari igihe agakombe kadakorwa. Ahubwo, urupapuro rw'umubiri ruziba umusaruro w'amaraso uva ku ruhande rw'iburyo rw'umutima. Ibi bita pulmonary atresia.
• Umunwa uri hagati y'ibice byo hasi by'umutima, bitwa ventricular septal defect. Ventricular septal defect ihindura uko amaraso anyura mu mutima no mu mpyiko. Amaraso adafite ogisijeni mu gice cyo hasi cy'iburyo avangwa n'amaraso afite ogisijeni mu gice cyo hasi cy'ibumoso. Umutima ugomba gukora cyane kugira ngo upompe amaraso mu mubiri. Iki kibazo gishobora kugabanya imbaraga z'umutima uko iminsi igenda.
• Guhindurwa kw'umuyoboro mukuru w'amaraso. Umuyoboro mukuru w'amaraso mu mubiri witwa aorta. Ubusanzwe uhurira ku gice cyo hasi cy'ibumoso cy'umutima. Muri tetralogy of Fallot, aorta iba ahantu hatari ho. Ihindurwa ikajya iburyo ikaba hejuru y'umunwa uri ku rukuta rw'umutima. Ibi bihindura uko amaraso ava muri aorta ajya mu mpyiko.
• Kugira urukuta rukomeye rw'igice cyo hasi cy'iburyo cy'umutima, bitwa right ventricular hypertrophy. Igihe umutima ugomba gukora cyane, urukuta rw'igice cyo hasi cy'iburyo cy'umutima rukura. Uko iminsi igenda, ibi bishobora gutuma umutima ucika intege ndetse ukananirwa.

Bamwe mu bantu bafite tetralogy of Fallot bagira ibindi bibazo byangiza aorta cyangwa imiyoboro y'amaraso y'umutima. Hari kandi u munwa ushobora kuba hagati y'ibice byo hejuru by'umutima, bitwa atrial septal defect.

Impamvu nyakuri y'indwara ya Tetralogi ya Fallot ntiiramenyekana. Hari ibintu bimwe bishobora kongera ibyago byo kuvuka ufite indwara ya Tetralogi ya Fallot. Ibintu byongera ibyago birimo:

• Amateka y'umuryango.
• Kwandura virusi mu gihe utwite. Ibi birimo rubella, izwi kandi nka kizami cy'Abadage.
• Kunywa inzoga mu gihe utwite.
• Kurya nabi mu gihe utwite.
• Kunywa itabi mu gihe utwite.
• Umubyeyi w'umugore ufite imyaka irenga 35.
• Sindwome cyangwa DiGeorge syndrome mu mwana.

Tetralogi ya Fallot itabyazwe ikunze gutera ingaruka zikomeye zishobora kwica. Izo ngaruka zishobora gutera ubumuga cyangwa urupfu mbere y'imyaka y'ubukure.

Ikimwe mu bibazo bishobora guterwa na tetralogi ya Fallot harimo kwandura kw'igice cy'imbere cy'umutima cyangwa imiyoboro y'amaraso y'umutima. Ibi bita endocardite yandura. Rimwe na rimwe, imiti ya antibiyotike itangwa mbere yo kuvura amenyo kugira ngo hirindwe ubwo bwoko bw'indwara. Baza itsinda ry'abaganga bawe niba antibiyotike zo kwirinda ari nziza kuri wowe cyangwa umwana wawe.

Ingaruka zishobora kandi kubaho nyuma y'ubuganga bwo kuvura tetralogi ya Fallot. Ariko abantu benshi bakira neza nyuma y'ubwo buganga. Iyo habaye ingaruka, zishobora kuba:

• Amaraso asubira inyuma mu muyoboro w'amaraso w'umutima.
• Gukubita kw'umutima kudahwitse.
• Umunwa mu mutima utakize nyuma y'ubuganga.
• Impinduka mu bunini bw'ibice by'umutima.
• Kubyimba kw'igice cy'aorta, bitwa aortic root dilation.
• Urupfu rutunguranye rw'umutima.

Ubundi buryo cyangwa ubuganga bushobora kuba bukenewe kugira ngo dukosore ibyo bibazo.

Abantu bavuka bafite ikibazo gikomeye cy'umutima wavutse bashobora kuba bafite ibyago byo kugira ibibazo mu gihe batwite. Ganira n'itsinda ry'abaganga bawe ku bibazo bishoboka n'ingaruka zo gutwita. Hamwe muzaganira kandi mugategura ubufasha bwihariye bukenewe.

Kubera ko impamvu nyamukuru y'ubumuga bwinshi bw'umutima ku bana bavuka itazwi, bishobora kuba bitashoboka gukumira ibyo bibazo. Niba ufite ibyago byinshi byo kubyara umwana ufite ubumuga bw'umutima ku bwana, ibizamini bya genetique no gusuzuma bishobora gukorwa mu gihe cyo gutwita. Hari intambwe zimwe na zimwe ushobora gufata kugira ngo ugabanye ibyago rusange by'umwana wawe byo kugira ubumuga ku bwana, nka:

• Kwita neza ku buzima bw'umubyeyi mu gihe atwite. Gusuzuma buri gihe n'itsinda ry'ubuvuzi mu gihe cyo gutwita bishobora gufasha umubyeyi n'umwana kuguma bakomeye.
• Fata vitamine nyinshi irimo acide folique. Gufata microgram 400 za acide folique buri munsi byagaragaye ko bigabanya ubumuga ku bwana mu bwonko no mu mugongo. Bishobora kandi gufasha kugabanya ibyago by'ubumuga bw'umutima.
• Ntunywe cyangwa utanywe. Izo ngeso zo kubaho zishobora kwangiza ubuzima bw'umwana. Irinde kandi itabi rya kabiri.
• Fata urukingo rwa rubella (igicurane cy'Abadage). Ikibazo cya rubella mu gihe cyo gutwita gishobora kugira ingaruka ku iterambere ry'umutima w'umwana. Fata urukingo mbere yo kugerageza gutwita.
• Genzura isukari y'amaraso. Niba ufite diyabete, kuyigenzura neza bishobora kugabanya ibyago by'ubumuga bw'umutima ku bana bavuka.
• Genzura indwara zidakira. Niba ufite izindi ndwara, harimo phenylketonuria, vugana n'itsinda ryawe ry'ubuvuzi ku buryo bwiza bwo kuzivura no kuzimenyereza.
• Irinde ibintu byangiza. Mu gihe cyo gutwita, reka undi muntu akore isuku n'isukura bifite ibicuruzwa bifite impumuro ikomeye.
• Suzuma n'itsinda ryawe ry'ubuvuzi mbere yo gufata imiti iryo ari ryo ryose. Imiti imwe na imwe ishobora gutera ubumuga ku bwana. Bwira itsinda ryawe ry'ubuvuzi imiti yose ufashe, harimo n'iyaguze utabifashijwemo na muganga.

Tetralogiya ya Fallot ikunze kuvurwa vuba nyuma y’ivuka. Uruhu rw’umwana wawe rushobora kugaragara rufite ibara ry’ubururu cyangwa umukara. Urashobora kumva ijwi ry’umuhondo iyo uteze amatwi umutima w’umwana ukoresheje stethoscope. Ibi bita guhindagurika kw’umutima.

Ibizamini byo kuvura tetralogiya ya Fallot birimo:

• Kupima urwego rw’oxygène. Icapfu kito cyashyizwe ku rutoki cyangwa ku rutugu gipima vuba umubare w’oxygène uri mu maraso. Ibi bita ikizamini cya pulse oximetry.
• Echocardiogram. Iki kizamini gikoreshwa amajwi yo gukora amashusho y’umutima uri gukora. Kigaragaza umutima n’amavavu y’umutima n’uburyo bikora.
• Electrocardiogram, izwi kandi nka ECG cyangwa EKG. Iki kizamini cyandika ibikorwa by’amashanyarazi by’umutima. Kigaragaza uburyo umutima ukubita. Ibicupa bito bita electrodes bijya ku gatuza, rimwe na rimwe no ku maboko cyangwa amaguru. Uturango duhuza ibicupa n’ikoranabuhanga. Ikiranabuhanga ricapa cyangwa rigaragaza ibisubizo. Electrocardiogram ishobora gufasha kuvura guhindagurika kw’umutima. Impinduka mu bimenyetso by’umutima zishobora kandi guterwa no kuba umutima uri munini.
• X-ray y’ibituza. X-ray y’ibituza igaragaza ishusho n’imiterere y’umutima n’ibihaha. Ikimenyetso gisanzwe cya tetralogiya ya Fallot kuri X-ray ni umutima ufite ishusho y’inkweto. Bisobanura ko icyumba cyo hasi iburyo kiri kinini.
• Cardiac catheterization. Iki kizamini gifasha kuvura cyangwa kuvura ibibazo bimwe by’umutima. Bishobora gukorwa kugira ngo bategurire imiti. Muganga ashyiramo imiyoboro myinshi, ndende, ndende mu mubiri w’amaraso, akenshi mu kibuno. Iyo miyoboro bita catheters. Muganga ayobora iyo miyoboro ku mutima. Mu gihe cy’ikizamini, abaganga bashobora gukora ibizamini bitandukanye by’umutima cyangwa imiti.