Ukuthi yini i-Patent Ductus Arteriosus? Izimpawu, Izimbangela, & Ukwelashwa

I-Patent ductus arteriosus (PDA) iyisimo senhliziyo lapho i-blood vessel okufanele ivalwe ngemva kokuzalwa ihlala ivulekile. Lokhu kuvulwa, okubizwa ngokuthi i-ductus arteriosus, ngokuvamile kuhlanganisa ama-blood vessel amabili amakhulu eduze kwenhliziyo ngesikhathi sokukhulelwa ukuze kusize igazi liphephe amaphaphu omntwana. Uma kungavalwa kahle ngemva kokuzalwa, kungathinta indlela igazi eligeleza ngayo enhliziyweni nakumaphaphu akho.

Iyini i-Patent Ductus Arteriosus?

I-Patent ductus arteriosus kwenzeka lapho uxhumano lwe-blood vessel oluvamile lungavalwa njengoba kufanele ngemva kokuzalwa. Ngesikhathi sokukhulelwa, izingane azidingi ukusebenzisa amaphaphu azo ngokuthola i-oksijini, ngakho-ke le vessel iyasiza igazi liphephe amaphaphu ngokuphelele.

Uma ingane izalwe bese iqala ukuphefumula, loxhumano kufanele luvalwe ezinsukwini ezimbalwa zokuqala zokuphila. Uma luhlala luvulekile, igazi ligeleza phakathi kwe-aorta (i-artery enkulu yomzimba) ne-pulmonary artery (ethwala igazi eya emaphaphwini).

Lokhu kugeleza kwegazi okwengeziwe kubekela uxinzelelo enhliziyweni nakumaphaphu ngokuhamba kwesikhathi. Lesi simo singaba ngamacala alula kakhulu angathinti impilo yansuku zonke kuya ezimweni ezinzima ezidinga ukunakekelwa kwezokwelapha.

Ziyini Izimpawu ze-Patent Ductus Arteriosus?

Abantu abaningi abane-PDAs ezincane abanawo noma yimiphi impawu, ikakhulukazi ngesikhathi sobuntwana. Uma izimpawu zivele, zivame ukuthuthuka kancane njengoba inhliziyo isebenza nzima ukugeza igazi elengeziwe.

Izimpawu ezivame kakhulu ongazibona zihlanganisa:

• Ukuphefumula okufushane, ikakhulukazi ngesikhathi somsebenzi womzimba noma ukuzivocavoca
• Ukuqeda amandla kalula kunokujwayelekile ngesikhathi semisebenzi yansuku zonke
• Ukubetha kwenhliziyo okusheshayo noma okungajwayelekile ongakwazi ukulizwa
• Ukukhishwa okuningi kunokujwayelekile, ikakhulukazi ngesikhathi sokudla kubantwana abasanda kuzalwa
• Ukukhula okungekuhle noma ukukhula okuhamba kancane ezinganeni
• Ukutheleleka kwamaphaphu okuphindaphindayo noma i-pneumonia

Ezimweni ezinzima, ungase ube nobuhlungu esifubeni noma uzwe inhliziyo yakho ibheka ngisho nalapho ukhuluphala. Abanye abantu baphawula umbala oluhlaza okwesibhakabhaka olusuka esibukweni sabo, ezindebeni, noma ezinzipeni, okuyinto eyenzeka uma kungekho oksijini eyanele egazini.

Lezi zimpawu zivame ukuba zibonakale ngokuhamba kwesikhathi, njengoba inhliziyo ibilokhu isebenza nzima iminyaka eminingi. Izindaba ezinhle ukuthi ukuqaphela lezi zimpawu ngokushesha kungakusiza uthole ukwelashwa okulungile.

Ziyini Izimbangela ze-Patent Ductus Arteriosus?

I-Patent ductus arteriosus kwenzeka lapho inqubo evamile yokuvimba ngemva kokuzalwa ingasebenzi kahle, kodwa odokotela abazi ngaso sonke isikhathi ukuthi kungani lokhu kwenzeka. I-ductus arteriosus kufanele ivalwe ngokwemvelo phakathi kwezinsuku ezingu-2-3 ngemva kokuzalwa njengoba amazinga e-oksijini ekhuphuka nezinye izinhlobo ze-hormones zishintsha.

Izici eziningana zingandisa amathuba okukhula kwe-PDA:

• Ukuzalwa ngaphambi kwesikhathi - izingane ezazalwa ngaphambi kwamasonto angu-37 zivame kakhulu ukuba ne-PDA
• Ukuzalwa emazingeni aphezulu lapho amazinga e-oksijini aphansi khona
• Ukuba nezinye izimo ze-genetic njenge-Down syndrome
• Umbukiso womndeni wezifo zenhliziyo ezingokwemvelo
• Ukutheleleka kwe-rubella yomzali ngesikhathi sokukhulelwa
• I-diabetes yomzali noma ukwalama-blood sugar control okubi ngesikhathi sokukhulelwa
• Imithi ethile ethathwe ngesikhathi sokukhulelwa

Izingane ezazalwa ngaphambi kwesikhathi zisesengozini enkulu ngoba i-ductus arteriosus yazo ayikabi nethuba elanele lokukhula ikwazi ukuvala kahle. Kwezinye izimo ezingavamile, udonga lwe-vessel ngokwalo lungaba nezinkinga zokwakheka ezivikela ukuvala okuvamile.

Kakhulu, i-PDA ivela ngaphandle kwesizathu esicacile, futhi kubalulekile ukwazi ukuthi akukho lutho wena noma abazali bakho abalwenzile olubangele lesi simo ukuba sikhule.

Nini Okufanele Ubone Udokotela nge-Patent Ductus Arteriosus?

Kufanele uxhumane nodokotela wakho uma ubona noma yimiphi impawu ebonisa ukuthi inhliziyo yakho ingase isebenze nzima kunokujwayelekile. Lokhu kubaluleke kakhulu uma uhlushwa ukuphefumula okufushane ngesikhathi semisebenzi eyake yaba lula.

Funani ukunakekelwa kwezokwelapha ngokushesha uma una:

• Ubuhlungu noma uxinzelelo esifubeni, ikakhulukazi ngomsebenzi womzimba
• Ukuphefumula okufushane okukhulu noma ukuhlupheka ekuphefumuleni
• Ukuqeda amandla noma ukuzizwa sengathi ungase udle
• Ukukhula kwesisindo okukhulu noma ukukhula kwezinyawo, izikhokhonkwane, noma isisu
• Umbala oluhlaza okwesibhakabhaka olusuka ezindebeni, ezinzipeni, noma esibukweni

Kubazali, kubalulekile ukubuka izimpawu ezinganeni njengokudla okungekuhle, ukukhishwa okukhulu ngesikhathi sokudla, noma ukungakhuli ngesisindo njengoba kulindelekile. Ukutheleleka kwamaphaphu okuphindaphindayo noma ukubonakala ukhathele kakhulu kunabanye abantwana ngesikhathi sokuzijabulisa kungaba nezibonakaliso zezexwayiso.

Ngisho noma izimpawu zibonakala zilinganiselwe, ukuhlolwa ngokushesha kungasiza ukuvimbela izinkinga kamuva. Udokotela wakho angabona ukuthi izimpawu zakho zihambelana ne-PDA noma okuthile ngokuphelele.

Ziyini Izici Zengozi ze-Patent Ductus Arteriosus?

Izici ezithile zenza kube lula ukuthi i-ductus arteriosus ihlale ivulekile ngemva kokuzalwa, nakuba ukuba nalezi zici zengozi akusho ukuthi uzokhula nge-PDA. Ukuqonda lokhu kungasiza ekuchazeni ukuthi kungani abanye abantu bathinteka kakhulu kunabanye.

Izici zengozi ezibaluleke kakhulu zihlanganisa:

• Ukuzalwa ngaphambi kwesikhathi (ikakhulukazi ngaphambi kwamasonto angu-28 okukhulelwa)
• Isisindo esincane sokuzalwa (ngaphansi kwamapounds angu-3.3 noma ama-kilogram angu-1.5)
• Ukuzalwa emazingeni aphezulu kunamamitha angu-8,000
• Ubulili besifazane - amantombazane amathuba amabili okuba ne-PDA kunamadodana
• Umbukiso womndeni wezifo zenhliziyo ezingokwemvelo
• I-genetic syndromes njenge-Down syndrome noma i-DiGeorge syndrome
• Ukutheleleka komzali ngesikhathi sokukhulelwa, ikakhulukazi i-rubella
• I-diabetes yomzali noma i-gestational diabetes

Ezinye izici zengozi ezingavamile zihlanganisa ukubonisana nezikhemikhali ezithile noma imithi ngesikhathi sokukhulelwa, nokuba nezinye izifo zenhliziyo ezikhona ekuzalweni. Omama abaphuza utshwala kakhulu ngesikhathi sokukhulelwa bangase babe nezingane ezingozi enkulu.

Kubalulekile ukuphawula ukuthi izingane eziningi ezinalezi zici zengozi azikhuli nge-PDA, kanti ezinye ezingenazo izici zengozi ezaziwayo ziyakhula. Ukusebenzisana kwe-genetics nezici zemvelo kuyinkimbinkimbi futhi kusafundwa ochwepheshe.

Ziyini Izinkinga Ezingase Zivele ze-Patent Ductus Arteriosus?

Uma i-PDA incinyane, abantu abaningi baphila impilo evamile ngaphandle kwanoma yiziphi izinkinga. Noma kunjalo, ukuvulwa okukhulu kungabangela izinkinga ngokuhamba kwesikhathi njengoba inhliziyo namaphaphu asebenza nzima ukuqapha ukugeleza kwegazi okwengeziwe.

Izinkinga ezivame kakhulu ongabhekana nazo zihlanganisa:

• Ukwehluleka kwenhliziyo - lapho inhliziyo yakho iye ibuthakathaka kakhulu ukugeza igazi ngokuphumelelayo
• Uxinzelelo lwegazi oluphezulu emaphaphwini (i-pulmonary hypertension)
• Ukungahambisani komjikelezo wenhliziyo (i-arrhythmias)
• Ukungena engozini enkulu yokutheleleka kwenhliziyo (i-endocarditis)
• Isifo sobuchopho esivela ezigcawini zegazi
• I-Eisenmenger syndrome - isimo esingavamile kodwa esinzima lapho ukugeleza kwegazi kuphenduka

Ukwehluleka kwenhliziyo ngokuvamile kuthuthuka kancane eminyakeni eminingi. Ungase uqaphele ukukhathala okwandayo, ukukhula kwezinyawo noma isisu, noma ukuphefumula okunzima uma ulele phansi.

I-pulmonary hypertension ivela lapho ukugeleza kwegazi okwengeziwe konakalisa ama-blood vessel amancane emaphaphwini akho. Lokhu ekugcineni kungaba yinto engenakulungiswa, kungakho ukwelashwa ngokushesha kubalulekile nge-PDAs ezinkulu.

Izindaba ezinhle ukuthi izinkinga eziningi zingavikeleka ngokwelashwa okufanele. Ngisho nalapho izinkinga zivele, eziningi zingaphathwa kahle ngemithi nokushintsha indlela yokuphila.

I-Patent Ductus Arteriosus Ihlonishwa Kanjani?

Ukuhlola i-PDA ngokuvamile kuqala lapho udokotela wakho ezwa umsindo ongajwayelekile wenhliziyo obizwa ngokuthi i-murmur ngesikhathi sokuhlolwa okuvamile. Le murmur inomsindo ohlukile “njengomshini” abaguli abanolwazi bangawubona.

Udokotela wakho cishe uzokubeka ezinye izivivinyo ukuqinisekisa ukuxilongwa nokulinganisa ukuthi lesi simo sibunzima kangakanani. I-echocardiogram ngokuvamile iyivivinyo lokuqala nelibaluleke kakhulu - isebenzisa amaza omsindo ukwenza izithombe ezihamba zenhliziyo yakho.

Izivivinyo ezengeziwe zingase zihlanganise:

• I-X-ray yesifuba ukuhlola usayizi wenhliziyo nesimo samaphaphu
• I-Electrocardiogram (ECG) ukuqapha umsebenzi womgogodla wenhliziyo yakho
• I-Cardiac catheterization yokulinganisa okuningiliziwe kokucindezela
• I-CT scan noma i-MRI yezithombe ezengeziwe zenhliziyo
• I-Pulse oximetry ukuhlola amazinga e-oksijini egazini lakho

I-echocardiogram ingabonisa ukuthi ukuvulwa kuphi, ubukhulu bayo, nokuthi igazi ligeleza kuphi. Lolu lwazi lusiza udokotela wakho anqume ukuthi ukwelashwa kuyadingeka yini nokuthi yiluphi uhlobo oluzosebenza kangcono.

Ngezinye izikhathi i-PDA itholakala ngesikhathi sokukhulelwa nge-fetal echocardiography, ikakhulukazi uma kunesinye isifo senhliziyo esithathwe. Kwezinye izimo, ingase ingaxilongwa kuze kube ubudala lapho izimpawu zikhula khona noma ngesikhathi sokuhlolwa kwezinye izinkinga zempilo.

Ukwelashwa kwe-Patent Ductus Arteriosus Kuyini?

Ukwelashwa kwe-PDA kuncike ezicini eziningana, kufaka phakathi ubukhulu bokuvulwa, iminyaka yakho, nokuthi uhlushwa yizimpawu yini. I-PDAs encane engabangeli izinkinga ingase idinge ukulandelelwa njalo ngaphandle kokungenelela.

Nge-PDAs edinga ukwelashwa, unamakhetho amaningana:

• Imithi yokusiza ukuvala i-ductus, ikakhulukazi kubantwana abasanda kuzalwa abangakabi yisikhathi
• Ukuvalwa kwe-Transcatheter usebenzisa idivayisi encane efakwe nge-blood vessel
• Ukuvalwa kokuthunga ngokusika okuncane esifubeni
• Imithi yokuphatha izimpawu njengokwehluleka kwenhliziyo noma uxinzelelo lwegazi oluphezulu

I-Indomethacin iyimithi engasiza ngezinye izikhathi i-ductus ivale ngokwemvelo kubantwana abancane kakhulu. Lokhu kusebenza kangcono ezinsukwini ezimbalwa zokuqala zokuphila futhi kusebenza kakhulu kubantwana abangakabi yisikhathi.

Ukuvalwa kwe-Transcatheter kube ukwelashwa okuthandwa kakhulu nge-PDAs eziningi ezidinga ukungenelela. Ngalesi senzo, i-cardiologist ihola idivayisi encane yokuvala nge-blood vessel ukuvala ukuvulwa. Lokhu kwenziwa ngenkathi ukhuluphala, kodwa akudingi ukuhlinzwa okuvulekile.

Ukuvalwa kokuthunga kungase kunconywe uma i-PDA inkulu kakhulu noma isakhiwo sayo senza ukuthi ukuvalwa kwe-transcatheter kube nzima. Ukuhlinzwa kuhilela ukwenza isiki esincane phakathi kwezinhlangothi zakho ukuze ufike enhliziyweni bese uvala ukuvulwa ngokuphelele.

Indlela Yokunakekela Wena Ekhaya nge-Patent Ductus Arteriosus?

Uma une-PDA encane engadingi ukwelashwa ngokushesha, kunezinto eziningana ongazenza ekhaya ukuze uhlale uphilile futhi uqaphe isimo sakho. Okubalulekile ukugcina impilo enhle yenhliziyo ngokujwayelekile ngenkathi uqaphela noma yikuphi ukushintsha ezimpawu zakho.

Nazi izinyathelo ezibalulekile zokunakekela wena:

• Hlala usebenza ngokuvivinya umzimba okujwayelekile, okujwayelekile njengoba kuvunyelwe udokotela wakho
• Dla ukudla okunempilo kwenhliziyo okugcwele izithelo, imifino, nama-grains aphelele
• Gcina isisindo esinempilo ukuze unciphise uxinzelelo enhliziyweni yakho
• Gwema ukubhema futhi ubeke umkhawulo ekusebenziseni utshwala
• Thatha noma iyiphi imithi ebekiwe ngokuqondile njengoba kuqondiswe
• Yenza ukuhlanzeka okuhle kwamazinyo ukuvimbela ukutheleleka
• Thola ukugonywa okunconywayo, ikakhulukazi nge-pneumonia ne-flu

Kubalulekile ukwazi imingcele yakho uma kuziwa emisebenzini yomzimba. Nakuba ukuvivinya umzimba kuzuzisa ngokuvamile, kufanele uyeke uphumule uma uzizwa ukuphefumula okufushane okungajwayelekile, ukukhathala, noma ubuhlungu esifubeni.

Gcina uqaphele noma yiziphi izimpawu ezintsha noma ukushintsha endleleni ozizwa ngayo ngesikhathi semisebenzi yansuku zonke. Abanye abantu bathola ukuthi kuwusizo ukugcina idayari elula ebhala amazinga amandla abo, ukuphefumula, nanoma yimiphi imizwa engavamile.

Qiniseka ukuthi uya kuwo wonke ama-aphoyintimenti okulandelela ahlelwe nodokotela wakho we-cardiologist, ngisho noma uzizwa kahle. Ukulandelelwa njalo kusiza ekuqapheni noma yikuphi ukushintsha ngokushesha futhi kuqinisekisa ukuthi uhlelo lwakho lokwelashwa luhlala lufanele.

Kufanele Uzilungiselele Kanjani I-Aphoyintimenti Yakho Yodokotela?

Ukulungiselela kahle i-aphoyintimenti yakho ye-cardiology kungakusiza uthole okuningi kakhulu ekuhambeleni kwakho futhi kuqinisekise ukuthi udokotela wakho uneyonke imininingwane edingekayo ukukunikeza ukunakekelwa okungcono kakhulu. Qala ngokuqoqa noma yimiphi imiphumela yezivivinyo zangaphambili noma amarekhodi ezempilo ahlobene nesimo senhliziyo yakho.

Ngaphambi kwe-aphoyintimenti yakho, bhala phansi:

• Zonke izimpawu ozibonile, ngisho noma zibonakala zilinganiselwe
• Lapho izimpawu zivele khona nokuthi yini ezenza zibe ngcono noma zibe zimbi
• Yonke imithi kanye nezinye izinto ezingezona imithi ozithatha njengamanje
• Imibuzo ofuna ukuyibuza udokotela wakho
• Umbukiso womndeni wezinkinga zenhliziyo
• Noma yikuphi ukushintsha kwamuva emazingeni omsebenzi wakho noma umkhuba wakho wansuku zonke

Cabanga ngezibonelo ezithile zendlela izimpawu ezithinta ngayo impilo yakho yansuku zonke. Ngokwesibonelo, ungakwazi yini ukukhuphuka izitebhisi ngaphandle kokuphefumula okufushane? Ingabe udinga ukuphumula ngesikhathi semisebenzi eyake uyenza kalula?

Letha uhlu lwayo yonke imithi yakho yangamanje, kufaka phakathi amagama aqondile, izilinganiso, nokuthi uyayithatha kangaki. Ungakhohlwa ukufaka imithi yokuthengwa ngaphandle komthetho, amavithamini, kanye nezinye izinto ezingezona imithi.

Cabanga ukuletha ilungu lomndeni omethembayo noma umngani ongakusiza ukukhumbula imininingwane ebalulekile exoxwe ngesikhathi se-aphoyintimenti. Bangase bacabange ngemibuzo ongayicabanganga.

Yini Eyinhloko Yokuthatha Nge-Patent Ductus Arteriosus?

I-Patent ductus arteriosus iyisimo senhliziyo esilawuleka esithinta abantu ngezindlela ezahlukene kuye ngobukhulu bokuvulwa nezici zomuntu ngamunye. Abantu abaningi abane-PDAs ezincane baphila impilo evamile ngokuphelele, kanti abanye bazuza kakhulu ekwelapheni okungase kwenziwe ngaphandle kokuhlinzwa okukhulu.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukutholakala ngokushesha nokukhathalela okufanele kungavimbela izinkinga eziningi. Uma unezimpawu njengokuphefumula okufushane okungachazeki noma ukukhathala, ungangabazi ukuxoxa nazo udokotela wakho.

Ukwelashwa kwamanje kwe-PDA kusebenza kakhulu futhi akunakwenzeka kakhulu kunakuqala. Abantu abaningi abadinga ukwelashwa baqhubeka bephila impilo esebenzayo, enempilo ngokulinganiselwe okuncane.

Hlala uxhumene neqembu lakho lokukhathalela impilo, landela izincomo zabo, futhi ungavumeli ukukhathazeka ngesimo sakho kukuvimbele ekujabuleleni impilo. Ngokunakekelwa okufanele nokulandelelwa, i-PDA ayidingi ukulinganisela imigomo yakho noma imisebenzi yakho kakhulu.

Imibuzo Evame Ukubuzwa Nge-Patent Ductus Arteriosus

Q1: Ingabe i-patent ductus arteriosus ingazivala yodwa kubantu abadala?

Ngeshwa, i-PDAs ayivami ukuvala ngokwemvelo kubantu abadala. Nakuba i-ductus arteriosus ngezinye izikhathi ingazivala ngokwemvelo ezinyangeni ezimbalwa zokuqala zokuphila, ikakhulukazi ngosizo lwemithi kubantwana abangakabi yisikhathi, lokhu kuba yinto engavamile ngemva konyaka wokuqala. Uma ungumuntu omdala one-PDA, ukuvulwa cishe kuzohlala kuze kuvalwe ngokungenelela kwezokwelapha. Noma kunjalo, abantu abadala abaningi abane-PDAs ezincane baphila impilo evamile ngaphandle kokudingela ukwelashwa.

Q2: Kuphephile yini ukuvivinya umzimba uma ngine-patent ductus arteriosus?

Abantu abaningi abane-PDA bangasebenza ngokuphepha, kodwa uhlobo nobukhulu kuncike esimweni sakho esithile. Uma une-PDA encane ngaphandle kwezimpawu, ngokuvamile ungabamba iqhaza kuzo zonke imisebenzi evamile kufaka phakathi imidlalo yokuncintisana. Noma kunjalo, uma une-PDA enkulu noma izimpawu njengokuphefumula okufushane, udokotela wakho angase ancome ukugwema imisebenzi enzima kakhulu. Hlala uxoxa ngezinhlelo zakho zokuzivocavoca nodokotela wakho we-cardiologist ukuthola izincomo eziqondene nesimo sakho.

Q3: Ingabe abesifazane abane-patent ductus arteriosus bangaba nokukhulelwa okuphephile?

Abesifazane abaningi abane-PDA bangaba nokukhulelwa okuphephile, okunempilo, kodwa lokhu kuncike ngobukhulu be-PDA yakho nokuthi unawo noma yikuphi ukuphazamiseka. I-PDAs encane ngokuvamile ayibangeli izinkinga ngesikhathi sokukhulelwa. Noma kunjalo, i-PDAs enkulu noma leyo ebangela i-pulmonary hypertension ingenza ukukhulelwa kube ngozi enkulu. Uma uhlela ukukhulelwa, xoxa nalokhu nodokotela wakho we-cardiologist nodokotela wakho we-obstetrician kusengaphambili ukuze udale uhlelo lokukhathalela oluphephile.

Q4: Ingane yami izokwazi yini i-patent ductus arteriosus uma ngiyina?

Nakuba i-PDA ngezinye izikhathi ingasebenza emindenini, izingane eziningi zabazali abane-PDA azikhuli ngalesi simo. Ingozi iphezulu kancane kunasesigabeni jikelele, kodwa isalula. Uma une-PDA futhi uhlela ukuba nezingane, udokotela wakho angase ancome i-fetal echocardiography ngesikhathi sokukhulelwa ukuhlola ukuthuthukiswa kwenhliziyo yengane yakho. Ukuqondisa kwe-genetic kungakusiza uqonde izici zengozi zomndeni wakho.

Q5: Isikhathi sokuphulukisa sibe yikuphi ngemva kwezinqubo zokuvala i-PDA?

Isikhathi sokuphulukisa sihluka kuye ngohlobo lwenqubo onayo. Ngemva kokuthunga kwe-transcatheter (inqubo esekelwe e-catheter), abantu abaningi bangabuyela emisebenzini evamile phakathi kwezinsuku ezimbalwa kuya kwesonto elilodwa. Ungase ube nokuqhuma lapho i-catheter ifakwe khona, kodwa lokhu siyaphola ngokushesha. Ukuvalwa kokuthunga ngokuvamile kudinga isikhathi eside sokuphulukisa - ngokuvamile amasonto angu-2-4 ngaphambi kokubuyela emisebenzini evamile namasonto angu-6-8 ngaphambi kokuphakamisa okunzima noma ukuvivinya umzimba okunzima. Udokotela wakho uzokunikeza imiyalo ethile esekelwe enkambweni yakho nenqubo yakho yokuphulukisa.