Tapvr

Gusubira inyuma kw’amaraso ya pulmona yose (TAPVR)

Mu gusubira inyuma kw’amaraso ya pulmona yose (TAPVR), imiyoboro y’amaraso ya pulmona ituma amaraso ajya mu cyumba cyo hejuru cy’iburyo bw’umutima. Icyo cyumba kitwa atriyum y’iburyo. Ingaruka ni uko amaraso akungahaye kuri ogisijeni avangwa n’amaraso adafite ogisijeni ihagije, nk’uko bigaragazwa n’umutuku. Mu mutima usanzwe, nk’uko bigaragazwa ibumoso, amaraso akungahaye kuri ogisijeni ava mu mihombo y’amaraso ya pulmona ajya mu cyumba cyo hejuru ibumoso, cyitwa atriyum y’ibumoso.

Gusubira inyuma kw’amaraso ya pulmona yose (TAPVR) ni ikibazo cy’umutima gicye cyane kiboneka kuva umuntu avutse. Bisobanura ko ari uburwayi bw’umutima bwavutse umuntu afite.

Amazina yandi y’iyi ndwara ni:

• Gusaba kw’amaraso ya pulmona yose
• TAPVC

Muri iki kibazo cy’umutima, imiyoboro y’amaraso y’ibihaha, yitwa imiyoboro y’amaraso ya pulmona, ihuza n’aho bitari byo mu mutima.

Mu mutima usanzwe, amaraso akungahaye kuri ogisijeni ava mu bihaha ajya mu cyumba cyo hejuru cy’ibumoso cy’umutima, cyitwa atriyum y’ibumoso. Hanyuma amaraso aca mu mubiri.

Muri TAPVR, uburyo imiyoboro y’amaraso ihuza buhinduka. Amaraso aca mu cyumba cyo hejuru cy’iburyo cy’umutima, cyitwa atriyum y’iburyo. Iyi mpinduka mu nzira y’amaraso itera amaraso adafite ogisijeni ihagije kuvanga n’amaraso akungahaye kuri ogisijeni. Ingaruka ni uko amaraso ajya mu mubiri adafite ogisijeni ihagije.

Ubwoko bwa TAPVR bugaragara biterwa n’aho imiyoboro y’amaraso ihuza. Abana benshi bavuka bafite TAPVR nta mateka y’uburwayi bw’umutima bwavutse bafite mu muryango wabo.

Umwana ufite TAPVR ashobora kugira ikibazo cyo guhumeka. Uruhu rw'umwana rushobora kugaragara nk'icyatukura cyangwa kibisi kubera ipungufu ry'umwuka. Ibi bita cyanose.

Umuforomokazi ashobora kubona ibimenyetso bya TAPVR nyuma gato y'ivuka. Ariko bamwe mu bana nta bimenyetso bagira kugeza nyuma.

Umuganga wita ku mwana wawe akora isuzuma ngaruka mbere kandi akumva umutima w'umwana wawe akoresheje stetoskope. Ujwi rwumvikana nk'urw'amazi, bita guhumeka kw'umutima, rushobora kumvikana.

Echocardiogram ni ikizamini gikoreshwa mu kuvura indwara y'imitsi y'amaraso igana mu mutima. Iki kizamini gikoreshwa mu gukora amashusho y'umutima urimo kugenda. Echocardiogram ishobora kwerekana imitsi y'amaraso igana mu mutima, ibyuho byose biri mu mutima n'ingano y'ibice by'umutima. Igaragaza kandi imiterere y'amaraso mu mutima no mu mitsi y'umutima.

Ibindi bizamini nka electrocardiogram, X-ray y'ibituza cyangwa CT scan bishobora gukorwa niba hari amakuru menshi akenewe.

Kubaga TAPVR bisanzwe bikenewe iyo umwana akiri umwana muto. Igihe cyo kubaga biterwa n'uko hari inzitizi. Kugira ngo basane umutima, ababagisha bahuza imitsi y'amaraso igana mu mutima n'igice cyo hejuru cy'umutima ibumoso. Basiba kandi icyuho kiri hagati y'ibice byo hejuru by'umutima.

Umuntu ufite indwara y'imitsi y'amaraso igana mu mutima agomba gukorerwa isuzuma ngaruka mbere buri gihe kugira ngo barebe niba hari indwara, inzitizi cyangwa ibibazo by'umutima. Muganga wahuguwe mu ndwara z'umutima wavutse agomba kwita kuri uwo muntu. Uyu muhanga witwa umuganga w'umutima wavutse.

Umuganga w’umutima w’abana Jonathan Johnson, M.D., arasubiza ibibazo bikunze kubaho cyane ku bijyanye n’ubumuga bw’umutima wavutse ufite ku bana.

Ubwoko bumwe bw’indwara y’umutima ivutse ifite, nko guturika guto cyane mu mutima cyangwa gufungana gato cyane kw’amavavu y’umutima, bishobora gusa gukurikiranwa buri myaka ibiri hamwe n’uburyo bwo kubona amashusho nka echocardiogram. Ubundi bwoko bukomeye bw’indwara y’umutima ivutse ifite bushobora gusaba kubagwa bishobora gukorwa hakoreshejwe uburyo bwo kubaga umutima, cyangwa bishobora gukorwa muri laboratoire y’ubuvuzi bw’umutima hakoreshejwe ibikoresho bitandukanye cyangwa uburyo butandukanye. Mu bihe bimwe na bimwe bikomeye cyane, niba kubagwa bitashoboka, gushimwa kw’umutima bishobora kugaragazwa.

Ibimenyetso byihariye umwana ashobora kugira afite indwara y’umutima ivutse ifite biterwa cyane n’imyaka y’umwana. Ku bana bato, isoko yabo ikomeye yo gukoresha ingufu ni ukuriye. Kandi bityo ibimenyetso byinshi by’indwara y’umutima ivutse ifite cyangwa gucika intege kw’umutima bigaragara iyo bari kurya. Ibi bishobora kuba harimo guhumeka nabi, kugorana guhumeka, cyangwa no gucana ibyuya mu gihe bari kurya. Abana bato bazagaragaza ibimenyetso bifitanye isano n’uburyo bwabo bw’inda. Bashobora kugira isereri, kuruka mu gihe bari kurya, kandi bashobora kubona ibyo bimenyetso mu gihe bakora imyitozo ngororamubiri. Abangavu bakuru, bahita bagaragaza ibimenyetso nko kubabara mu kifuba, gucika intege cyangwa guhumeka cyane. Bashobora kandi kugaragaza ibimenyetso mu gihe bakora imyitozo ngororamubiri cyangwa imikorere. Kandi ibyo ni ikimenyetso gikomeye cyane kuri njye nk’umuganga w’umutima. Ndabonye umwana, cyane cyane umwangavu wagize ububabare mu kifuba, cyangwa waguye mu gihe yakoraga imyitozo ngororamubiri cyangwa imikorere, ngomba kubona uwo mwana kandi ngomba kwemeza ko abona ubuvuzi bukwiye.

Akenshi iyo umwana wawe aherutse kuvurwa indwara y’umutima ivutse ifite, biragoye kwibuka byose byavuzwe kuri we muri urwo ruzinduko rwa mbere. Ushobora kuba uri mu gihe cyo guhagarika umutima umaze kumva aya makuru. Kandi kenshi ushobora kutazibuka byose. Bityo ni ngombwa mu buvuzi bw’inyongera kubabaza ibibazo nk’ibi. Imiryango yanjye itanu itaha izaba imeze ite? Hariho uburyo ubwo aribwo bwose buzakenerwa muri iyo myaka itanu? Kubagwa? Ubwoko bwo kugenzura, ubwoko bw’ubugenzuzi, ubwoko bw’ibigo by’ubuvuzi bizakenerwa? Ibi bisobanura iki ku bikorwa by’umwana wanjye, imikino ngororamubiri, n’ibintu bitandukanye ashaka gukora buri munsi. Kandi ikintu cy’ingenzi, dukorana dute kugira ngo uyu mwana abashe kugira ubuzima busanzwe bishoboka nubwo afite iyo ndwara y’umutima ivutse ifite.

Wagomba kubabaza muganga wawe ubwoko bw’uburyo bushobora kuba bukenewe kuri ubwo bwoko bw’indwara y’umutima ivutse ifite mu gihe kizaza. Bishobora gukorwa hakoreshejwe uburyo bwo kubaga umutima, cyangwa bishobora gukorwa hakoreshejwe uburyo bwo kuvura umutima. Kubaga umutima, ni ngombwa kubabaza muganga wawe igihe cyo kubagwa. Kubwoko butandukanye, bw’ibanze bw’indwara y’umutima ivutse ifite, hariho igihe runaka aho ari byiza gukora kubagwa kuruta ibindi kugira ngo tugire umusaruro mwiza, haba mu gihe gito no mu gihe kirekire kuri uwo mwana. Bityo, baza muganga wawe niba hari igihe runaka gikora neza kuri iyo ndwara kandi kuri umwana wawe.

Iki ni ikibazo gikunze kubaho cyane mbaza ababyeyi n’abana nyuma yo kuvura indwara y’umutima ivutse ifite. Imikino ngororamubiri ni ingenzi cyane ku buzima bw’aba bana benshi, ku matsinda yabo y’ubucuti n’uburyo bahura n’abaturage babo. Mu bwoko bwinshi bw’indwara y’umutima ivutse ifite, dukora uko dushoboye kugerageza kubona uburyo bashobora kugira uruhare. Hariho ubundi bwoko bw’indwara y’umutima ivutse ifite, ariko, aho imikino imwe na imwe ishobora kutamererwa neza. Urugero, kuri bamwe mu barwayi bacu, bashobora kugira ubwoko bumwe bw’uburwayi bwa gene bwongera imbaraga z’imitsi yabo. Kandi abo barwayi, ntidushaka ko bakora imyitozo yo kurondera imitsi cyangwa gukora igikorwa cyo gukanda cyakongera imitsi yabo kandi bikaba byatera kwangirika. Ariko muri byinshi, dushobora kubona uburyo abana bakina imikino bakunda buri munsi.

Ku barwayi bacu bafite indwara y’umutima ivutse ifite, uko bakura, akenshi tubagira inama ko ubwoko bumwe bw’indwara y’umutima ivutse ifite burashobora kuba bukomoka ku miryango. Ibi bivuze ko niba umubyeyi afite indwara y’umutima ivutse ifite, hari ibyago bike ko umwana we ashobora kandi kugira indwara y’umutima ivutse ifite. Ibi bishobora kuba ubwoko bumwe bw’indwara y’umutima ivutse ifite umubyeyi afite, cyangwa bishobora kuba bitandukanye. Bityo, niba abo barwayi batwite, tugomba kubakurikirana hafi mu gihe cyo gutwita, harimo gukora ibizamini by’inyongera by’umwana utaravuka hakoreshejwe echocardiography mu gihe cyo gutwita. Ku bw’amahirwe, umubare munini w’abarwayi bacu bafite indwara y’umutima ivutse ifite bashobora kubyara abana babo mu gihe cy’ubu.

Ubufatanye hagati y’umurwayi, umuryango we n’umuganga w’umutima ni ingenzi cyane. Akenshi dukurikirana abo barwayi mu myaka ijana uko bakura. Turabareba kuva ku bana bato kugeza ku bakuru. Niba hari ikintu kigaragara ko kitumvikana, ariko ntikumvikana, baza ibibazo. Ntukagire ubwoba bwo kuvugana natwe. Ugomba guhora wumva ufite uburenganzira bwo kuvugana n’itsinda ryacu ry’abaganga b’umutima kandi ubabaza ibibazo byose bishobora kuvuka.

Uburyo bwo kubona amashusho ya 2D y’umwana utaravuka bushobora gufasha umuganga wawe gusuzuma uko umwana wawe akura n’iterambere rye.

Ubumuga bw’umutima wavutse ufite bushobora kuvurwa mu gihe cyo gutwita cyangwa nyuma yo kuvuka. Ibimenyetso by’ubumuga bumwe bw’umutima bishobora kuboneka ku igenzura rya ultrasound ryo gutwita (ultrasound y’umwana utaravuka).

Nyuma y’uko umwana avutse, umuganga ashobora gutekereza ko hari ubumuga bw’umutima wavutse ufite niba umwana afite:

• Gutinda gukura.
• Ihinduka ry’amabara mu minwa, mu ndimi cyangwa mu misumari.

Umuganga ashobora kumva ijwi, ryitwa guhumeka, mu gihe yumva umutima w’umwana akoresheje stethoscope. Ibihumeka byinshi ni nta cyo bitwaye, bisobanura ko nta bumuga bw’umutima kandi guhumeka ntibibangamira ubuzima bw’umwana wawe. Ariko, imihumeka imwe na imwe ishobora guterwa n’impinduka z’amaraso ajya mu mutima ava mu mutima.

Ibizamini byo kuvura ubumuga bw’umutima wavutse ufite birimo:

• Pulse oximetry. Uburyo bwo gupima umwuka bukoreshwa ku ntoki bwanditse ingano y’umwuka uri mu maraso. Umwuka muke ushobora kuba ikimenyetso cy’ikibazo cy’umutima cyangwa cy’ibihaha.
• Electrocardiogram (ECG cyangwa EKG). Iki kizamini cyihuse cyanditse ibikorwa by’amashanyarazi y’umutima. Bigaragaza uko umutima ukora. Ibitambara bito bifite ibyuma byo gupima, byitwa electrodes, bihambirwa ku kifuba kandi rimwe na rimwe ku maboko cyangwa amaguru. Imisumari ihuza ibitambara kuri mudasobwa, icapa cyangwa igaragaza ibyavuye.
• Echocardiogram. Amashanyarazi akoreshwa mu gukora amashusho y’umutima uri gukora. Echocardiogram igaragaza uko amaraso yinjira mu mutima n’amavavu y’umutima. Niba ikizamini gikorewe ku mwana utaravuka, cyitwa fetal echocardiogram.
• X-ray y’ikifuba. X-ray y’ikifuba igaragaza uko umutima n’ibihaha bimeze. Ishobora kugaragaza niba umutima ari munini, cyangwa niba ibihaha birimo amaraso menshi cyangwa ibindi bintu by’amazi. Ibi bishobora kuba ibimenyetso byo gucika intege kw’umutima.
• Cardiac catheterization. Muri iki kizamini, umuganga ashyiramo umuyoboro muto, woroshye witwa catheter mu mubiri w’amaraso, akenshi mu gice cy’imbere, kandi akayobora mu mutima. Iki kizamini gishobora gutanga amakuru arambuye ku maraso n’uko umutima ukora. Ubuvuzi bumwe bw’umutima bushobora gukorwa mu gihe cyo gukora cardiac catheterization.
• Heart MRI. Nanone yitwa cardiac MRI, iki kizamini ikoresha uburyo bwa magnétique n’amashanyarazi kugira ngo ikore amashusho arambuye y’umutima. Cardiac MRI ishobora gukorwa kugira ngo ivure kandi isuzume ubumuga bw’umutima wavutse ufite mu bangavu n’abakuze. Heart MRI ikora amashusho ya 3D y’umutima, ibintu byemerera gupima neza ibice by’umutima.

Ubuvuzi bw'ubumuga bw'umutima bwavutse hamwe mu bana biterwa n'ikibazo cy'umutima runaka n'uburemere bwacyo.

Ubumuga bumwe bw'umutima bwavutse hamwe ntabwo bugira ingaruka z'igihe kirekire ku buzima bw'umwana. Bashobora kutavuzwa neza.

Ubundi bumuga bw'umutima bwavutse hamwe, nko gutobora gato mu mutima, bishobora gufunga uko umwana akura.

Ubumuga bukomeye bw'umutima bwavutse hamwe bugomba kuvurwa vuba nyuma yo kububona. Ubuvuzi bushobora kuba:

• Imiti.
• Ibibujijwe by'umutima.
• Ubuganga bw'umutima.
• Gusimbuza umutima.

Imiti ishobora gukoreshwa mu kuvura ibimenyetso cyangwa ingaruka z'ubumuga bw'umutima bwavutse hamwe. Ishobora gukoreshwa yonyine cyangwa hamwe n'ubundi buvuzi. Imiti y'ubumuga bw'umutima bwavutse hamwe irimo:

• Amapasipuli y'amazi, azwi kandi nka diuretiques. Uyu bwoko bw'imiti bufasha gukura amazi mu mubiri. Bifasha kugabanya umuvuduko ku mutima.
• Imiti y'umutima, yitwa anti-arrhythmiques. Iyi miti ifasha kugenzura ibitotsi bidakozwe neza by'umutima.

Niba umwana wawe afite ubumuga bukomeye bw'umutima bwavutse hamwe, ubuganga bw'umutima cyangwa ubuganga bushobora gusabwa.

Ibibujijwe by'umutima n'ubuganga bukorwa mu kuvura ubumuga bw'umutima bwavutse hamwe birimo:

• Cardiac catheterization. Amwe mu bwoko bw'ubumuga bw'umutima bwavutse hamwe mu bana ashobora kuvurwa hakoreshejwe imiyoboro mito, yoroshye yitwa catheters. Ubu buvuzi butuma abaganga bashobora gukosora umutima batakoze ubuganga bw'umutima ufunguye. Muganga ashyira catheter mu mubiri w'amaraso, akenshi mu kibuno, akayijyana ku mutima. Rimwe na rimwe hakoreshwa catheter zirenze imwe. Iyo igeze aho ikwiriye, muganga ashyira ibikoresho bito binyuze muri catheter kugira ngo akosore ikibazo cy'umutima. Urugero, umuganga ashobora gukosora ibibora mu mutima cyangwa ahantu hagakumba. Amwe mu mavuriro ya catheter agomba gukorwa mu ntambwe mu gihe cy'imyaka.
• Ubuganga bw'umutima. Umwana ashobora gukenera ubuganga bw'umutima ufunguye cyangwa ubuganga buto bw'umutima kugira ngo akosore ubumuga bw'umutima bwavutse hamwe. Ubwoko bw'ubuganga bw'umutima biterwa n'impinduka runaka mu mutima.
• Gusimbuza umutima. Niba ubumuga bukomeye bw'umutima bwavutse hamwe budashobora gukosorwa, gusimbuza umutima bishobora kuba bikenewe.
• Fetal cardiac intervention. Ni ubuvuzi bw'umwana ufite ikibazo cy'umutima bukorwa mbere y'uko avuka. Bishobora gukorwa kugira ngo hakosorwe ubumuga bukomeye bw'umutima bwavutse hamwe cyangwa hirindwe ingaruka mbi uko umwana akura mu nda. Fetal cardiac intervention ntibikorwa kenshi kandi bishoboka gusa mu mimerere runaka cyane.

Bamwe mu bana bavuka bafite ubumuga bw'umutima bwavutse hamwe bakenera ubuganga n'ibibujijwe byinshi mu buzima bwabo. Kwitabwaho mu gihe kirekire ni ingenzi. Umwana akeneye kujya gusuzuma buri gihe kwa muganga wahuguwe mu ndwara z'umutima, witwa cardiologue. Kwitabwaho mu gihe kirekire bishobora kuba harimo amaraso n'ibizamini by'amashusho kugira ngo harebwe ingaruka mbi.

[Umwicaro w'umuziki]

Ibyiringiro no gukira imitima mito.

Dr. Dearani: Niba ndeba akazi kanjye, nkora ubuganga buto bw'umutima. Kandi nabashije kubikora kuko nabimenye byose mu bantu bakuru, aho byatangiriye. Rero gukora ubuganga bw'umutima hakoreshejwe robot mu bangavu ni ikintu udashobora kubona mu bitaro by'abana kuko nta ikoranabuhanga bafite aho twabikora hano.

[Umwicaro w'umuziki]

Niba umwana wawe afite ikibazo cy'umutima kivuka, hashobora gusabwa guhindura imibereho kugira ngo umutima ukomeze ube muzima kandi hirindwe ingaruka mbi.

• Imipaka ku mikino n'imikino ngororamubiri. Bamwe mu bana bafite ikibazo cy'umutima kivuka bashobora gukenera kugabanya imyitozo ngororamubiri cyangwa imikino. Ariko kandi, abandi benshi bafite ikibazo cy'umutima kivuka bashobora kwitabira ibikorwa nk'ibyo. Umuhanga wita ku mwana wawe arashobora kukubwira imikino n'uburyo bw'imyitozo ngororamubiri bikwiriye umwana wawe.
• Antibiyotike zirinda. Amwe mu bibazo by'umutima bivuka ashobora kongera ibyago by'indwara mu gice cy'imbere cy'umutima cyangwa mu mivuno y'umutima, bikitwa endocardite yandura. Antibiyotike zishobora gusabwa mbere y'ibikorwa by'amenyo kugira ngo hirindwe indwara, cyane cyane ku bantu bafite umuvuno w'umutima wakozwe n'abantu. Baza muganga wita ku mutima w'umwana wawe niba umwana wawe akeneye antibiyotike zirinda.

Ushobora gusanga kuvugana n'abandi bantu banyuze mu bihe nk'ibyo bikuguha ihumure n'inkunga. Baza itsinda ryita ku buzima niba hari amatsinda y'ubufasha mu karere kawe.

Kubaho ufite ikibazo cy'umutima kivuka bishobora gutuma bamwe mu bana bumva bafite umunaniro cyangwa guhangayika. Kuvugana n'umujyanama bishobora kugufasha wowe n'umwana wawe kwiga uburyo bushya bwo guhangana n'umunaniro n'ihungabana. Baza umuhanga wita ku buzima amakuru yerekeye abajyanama mu karere kawe.