Ukuthi yini i-Pulmonary Atresia? Izimpawu, Izimbangela, kanye Nokwelashwa

I-Pulmonary atresia yisifo esinzima senhliziyo esikhona ngesikhathi sokuzalwa lapho i-pulmonary valve ingakhi kahle noma ivaliwe ngokuphelele. Lokhu kusho ukuthi igazi alikwazi ukugeleza ngokujwayelekile kusuka enhliziyweni kuya emaphashini ukuze lithole i-oksijini.

Lesi simo sithinta cishe ingane eyodwa kuzo zonke izinkulungwane ezingu-10,000 ezelwe. Nakuba kuzwakala kukhulu, ukuthuthuka kwezokwelapha kwenze kwaba nokwenzeka ukuthi abantwana abaningi abane-pulmonary atresia baphile impilo egcwele, esebenzayo ngokwelashwa okufanele nokunakekelwa.

Ukuthi yini i-Pulmonary Atresia?

I-Pulmonary atresia kwenzeka lapho i-pulmonary valve, ehlala phakathi kwe-right ventricle yenhliziyo ne-pulmonary artery, ihluleka ukuthuthuka kahle. Cabanga ngayo njengomnyango ongakwazi ukuvula phakathi kwamagumbi abalulekile enhliziyweni yakho.

Enhliziyweni enempilo, i-right ventricle iphompa igazi nge-pulmonary valve kuya emaphashini. Uma une-pulmonary atresia, le ndlela ivaliwe ngokuphelele noma ayikho nhlobo. Umuthi womntwana wakho uthola izindlela ezintsha zokuthola igazi kuya emaphashini ngezinye izinhlangano, kodwa lezi azikho ukuba zibe izixazululo ezihlala njalo.

Kunezinhlobo ezimbili eziyinhloko zalesi simo. Uhlobo luya ngokuthi i-right ventricle ithuthukile kahle noma ihlale incinci futhi ingathuthukanga.

Zithini Izinhlobo ze-Pulmonary Atresia?

I-Pulmonary atresia ene-intact ventricular septum isho ukuthi udonga oluphakathi kwamagumbi angaphansi enhliziyo luphelele, kodwa i-right ventricle ivame ukuba incinci futhi ingathuthukanga. Lolu hlobo luvamise ukudinga ukwelashwa okunzima ngoba i-right ventricle ingase ingabi namandla okuphompa igazi ngokuphumelelayo.

I-Pulmonary atresia ene-ventricular septal defect ihilela i-hole odongeni oluphakathi kwamagumbi angaphansi enhliziyo, futhi i-right ventricle ivame ukuba yisayizi evamile. Lolu hlobo luvamise ukuba nezinye izithombo zegazi ezisiza ekuthwaleni igazi kuya emaphashini, okungenza ukuhlela ukwelashwa kuhluke.

Zithini Izimpawu ze-Pulmonary Atresia?

Abantwana abaningi abane-pulmonary atresia babonisa izimpawu ezinsukwini ezimbalwa zokuqala noma emavikeni okuqala okuphila. Isimpawu esibonakalayo kakhulu yi-cyanosis, okusho ukuthi isikhumba somntwana wakho, izindebe, noma iinena zingase zibonakale zibomvu noma zibomvu ngoba igazi labo alithwali i-oksijini eyanele.

Ungase uqaphele ezinye izimpawu ezikhathazayo ezibonisa ukuthi umntwana wakho akatholi i-oksijini eyanele:

• Ubunzima bokuqeda umoya noma ukuqeda umoya ngokushesha
• Ukudla okubi noma ukukhathala ngokushesha ngesikhathi sokudla
• Ukulala ngokweqile noma ukungabi namandla
• Ukukhula okubi kobunzima naphezu kokuthanda ukudla okuvamile
• Ukucasuka noma ukukhathazeka okungavamile
• Ukubila ngesikhathi sokudla noma umsebenzi olula

Abanye abantwana bangase babe nezimpawu ezincane, ikakhulukazi uma benesondlo esihle segazi eya emaphashini abo. Noma kunjalo, ngisho nezimpawu ezincane akufanele ziganeshwe ngoba isimo singaba sibi njengoba izindlela zokusekela zemvelo zivala ngemuva kokuzalwa.

Zithini Izimbangela ze-Pulmonary Atresia?

I-Pulmonary atresia ithuthuka phakathi kwamasonto ayisishiyagalombili okuqala okukhulelwe lapho inhliziyo yomntwana wakho ikha.

Izimo eziningi zenzeka ngokungahleliwe ngaphandle komlando womndeni wezifo zenhliziyo. Izakhiwo zenhliziyo yomntwana wakho zikha ngenqubo enzima, futhi ngezinye izikhathi i-pulmonary valve ayithuthuki njengoba kufanele. Lokhu akubangelwa yilutho owalwenza noma awungenzanga ngesikhathi sokukhulelwa.

Izici ezithile zingase zikhulise ingozi kancane, yize zingayibangeli ngokuqondile isimo. Lokhu kuhlanganisa ukuba nesifo sikashukela ngesikhathi sokukhulelwa, ukuthatha imithi ethile, noma ukuba nomlando womndeni wezifo zenhliziyo ezelwe nazo. Noma kunjalo, abantwana abaningi abane-pulmonary atresia bazalwa kubazali abangenazo lezi zici zengozi.

Nini Okufanele Ubheke Udokotela Nge-Pulmonary Atresia?

Uma umntwana wakho ebonisa umbala oluhlaza okwesibomvu oqhele ngezindebe, iinena, noma isikhumba, kufanele ufunuke ukunakekelwa kwezokwelapha ngokushesha. Lo mbala oluhlaza okwesibomvu usho ukuthi umntwana wakho akatholi i-oksijeni eyanele futhi udinga ukunakekelwa okusheshayo ngokushesha.

Kufanele uxhumane nodokotela wakho wezingane ngokushesha uma umntwana wakho enenkinga yokudla, ebonakala ekhathele ngokungavamile, eqeda umoya ngokushesha, noma engakhulumi ngokujwayelekile. Lezi zimpawu zingase zithuthuke kancane, kodwa zibonisa ukuthi inhliziyo yomntwana wakho isebenza nzima kunokuba kufanele.

Ngesikhathi sokuhlola okujwayelekile, udokotela wakho uzolalela inhliziyo yomntwana wakho futhi angase azwe umsindo wenhliziyo. Nakuba imisindo eminingi yenhliziyo ingonakali, eminye ingase ibonise izimo ezinkulu njenge-pulmonary atresia edinga ukuhlolwa ngokushesha ngudokotela wezingane we-cardiologist.

Zithini Izici Zengozi ze-Pulmonary Atresia?

Izici eziningi zingase zikhulise amathuba okuba nomntwana onenhliziyo ye-pulmonary atresia, yize ukuba nalezi zici zengozi akusho ukuthi umntwana wakho uzoba naleli simo. Abantwana abaningi abane-pulmonary atresia bazalwa kubazali abangenazo lezi zici.

Izici ze-genetic zidlalela indima kwezinye izimo. Uma unemlando womndeni wezifo zenhliziyo ezelwe nazo, ingozi yakho ingase ikhuphuke kancane. Izifo ezithile ze-genetic, njenge-DiGeorge syndrome noma i-Noonan syndrome, zihlanganiswe nengozi ephakeme yezifo zenhliziyo.

Isimo sempilo sikamama ngesikhathi sokukhulelwa singase sibe nomthelela engonzini. Ukuba nesifo sikashukela, ikakhulukazi uma singalawulwa kahle, kungase kukhulise amathuba ezifo zenhliziyo. Ukuthatha imithi ethile ngesikhathi sokukhulelwa kwasekuqaleni, ikakhulu imithi ethile yokubamba noma ukwelapha isikhumba, kungase futhi kuthonye ukuthuthuka kwenhliziyo.

Izici zemvelo njengokubhema, ukuphuza utshwala, noma ukubhekana nezikhemikhali ezithile ngesikhathi sokukhulelwa kungase kuhlanganyele engonzini. Noma kunjalo, omama abaningi ababhekana nalezi zinto bazala abantwana abanezinhliziyo ezimpilo.

Zithini Izingozi Ezingase Zenzeke Nge-Pulmonary Atresia?

Ngaphandle kokwelashwa, i-pulmonary atresia ingabangela ubunzima obukhulu ngoba umzimba womntwana wakho awutholi i-oksijeni eyanele. Ukukhathazeka okukhulu kakhulu ukuthi amazinga e-oksijeni omntwana wakho angase awe phansi kakhulu, ikakhulukazi njengoba izinhlangano zokusekela zemvelo zivala ezinsukwini zokuqala ngemuva kokuzalwa.

Ngokokuhamba kwesikhathi, i-pulmonary atresia engalashwanga ingabangela izinkinga eziningi emzimbeni womntwana wakho:

• Ukwehluleka kwenhliziyo kusuka enhliziyweni esebenza nzima kakhulu ukuphompa igazi
• Ukukhula nokuthuthuka okulandelayo ngenxa yokunikezwa kwe-oksijeni okubi
• Ukungena engozini ephakeme yama-blood clots nokushaya
• Izinkinga zezinso ngenxa yokunciphisa ukugcwala kwegazi
• Ukulimala kwengqondo ngenxa yokushoda kwe-oksijeni
• Ukutheleleka okuvamile kokuphefumula

Ngisho nokwelashwa, abanye abantwana bangase babhekane nezinselele zesikhathi eside. Lokhu kungase kuhlanganise ukudinga ukuhlinzwa okuningi phakathi nobuntwana, ukuthatha imithi impilo yonke, noma ukuba nemikhawulo yemisebenzi. Noma kunjalo, ngokunakekelwa kwezokwelapha okufanele, abantwana abaningi bangaphila impilo evamile, esebenzayo.

Izindaba ezinhle ukuthi ukuxilongwa kwasekuqaleni nokwelashwa kungavimbela ubunzima obuningi. Amathuluzi okuhlinzwa amanje aqhubekile akhuphule imiphumela kubantwana abane-pulmonary atresia.

Ukuthi i-Pulmonary Atresia Ixilongwe Kanjani?

I-Pulmonary atresia ivame ukuxilongwa ezinsukwini ezimbalwa zokuqala zokuphila lapho abantwana bebonisa izimpawu zamazinga e-oksijeni aphansi. Udokotela wakho wezingane uzolalela inhliziyo yomntwana wakho kuqala futhi angase azwe imisindo engavamile ebonisa inkinga yenhliziyo.

Ivivinyo eliyinhloko elisetshenziswa ukuxilonga i-pulmonary atresia yi-echocardiogram, esebenzisa amaza omsindo ukwenza izithombe ezihamba zenhliziyo yomntwana wakho. Leli vivinyo alibuhlungu futhi libonisa odokotela isakhiwo senhliziyo nokuthi igazi ligeleza kanjani ngayo. I-echocardiogram ingabonisa ngokucacile uma i-pulmonary valve ivaliwe noma ayikho.

Udokotela wakho angase futhi a-ode amavivinyo engeziwe ukuze athole isithombe esiphelele senhliziyo yomntwana wakho. I-X-ray yesifuba ingabonisa usayizi nokuma kwenhliziyo namaphashini. I-electrocardiogram (EKG) ilinganisa umsebenzi womgogodla wenhliziyo futhi ingabonisa uma inhliziyo isebenza nzima kunokujwayelekile.

Kwezinye izimo, odokotela bangase basebenzise i-cardiac catheterization, lapho i-tube encane ifakwa esithombeni segazi futhi iqondiswe enhliziyweni. Leli vivinyo linikeza ulwazi oluqondile ngokugeleza kwegazi kanye nokucindezela ngaphakathi kwenhliziyo futhi ngezinye izikhathi lingase lisetshenziswe ekwelapheni ngesikhathi esifanayo.

Ukuthi ukwelashwa kwe-Pulmonary Atresia kuyini?

Ukwelashwa kwe-pulmonary atresia cishe kuhlale kudinga ukuhlinzwa, kodwa isikhathi nohlobo kuya ngesimo esithile somntwana wakho nokuthi izimpawu zakhe zinzima kangakanani. Umgomo ukudala indlela yokuthi igazi lifike emaphashini futhi kuqinisekiswe ukuthi umntwana wakho uthola i-oksijeni eyanele.

Abantwana abaningi badinga ukwelashwa ngokushesha ukuze bahlale beqinile. Udokotela wakho angase anikeze imithi ebizwa nge-prostaglandin E1 ukuze agcine izithombo zegazi ezithile zivulekile okwesikhashana. Le mithi iyasiza ekuqinisiseni ukugcwala kwegazi kuya emaphashini kuze kube yilapho ukuhlinzwa kwenzeka.

Indlela yokuhlinzwa iyancika ekutheni uhlobo luni lwe-pulmonary atresia umntwana wakho anayo. Kubantwana abane-right ventricle enkulu, odokotela bavame ukufuna ukwenza ukulungiswa okuphelele okuvumela i-right ventricle iphompe igazi kuya emaphashini ngokujwayelekile. Lokhu kungase kuhilele ukuvula i-valve evaliwe nokuvala noma yimaphi ama-hole phakathi kwamagumbi enhliziyo.

Kubantwana abane-right ventricle encane, ukwelashwa kuvame ukubandakanya uchungechunge lokuhlinzwa okuthiwa yi-single ventricle palliation. Lezi zinqubo ziqondisa ukugcwala kwegazi ukuze i-ventricle eyodwa yenze umsebenzi wazo zombili, ngokuphumelelayo ihambise i-right ventricle engathuthukanga.

Abanye abantwana bangase badinge izinqubo ezengeziwe njengoba bekhula. Ama-valve enhliziyo angase adinge ukushintshwa, futhi izithombo zegazi zingase zidinga ukulungiswa noma ukwandiswa. Iqembu lakho le-cardiology lizobaqapha eduze futhi liqondise ukwelashwa njengoba kudingeka.

Ukuthi Unganakekela Kanjani Ekhaya Ngesikhathi Sokwelashwa?

Ukukhathalela umntwana onenhliziyo ye-pulmonary atresia ekhaya kudinga ukunakekelwa kwezidingo zakhe ezikhethekile, kodwa izici eziningi zokunakekelwa zifana nomntwana oyedwa. Kuzodingeka uqaphele izimpawu zokuthi umntwana wakho akatholi i-oksijeni eyanele, njengokwanda kombala oluhlaza okwesibomvu, ubunzima bokudla, noma ukukhathala okungavamile.

Ukudla kungase kuthathe isikhathi eside futhi kudinge ukuzeka kade umsindo. Umntwana wakho angase akhathale kalula ngesikhathi sokudla, ngakho-ke ungase udinge ukumnika ukudla okuncane, okuningi.

Gcina indawo yomntwana wakho ithobekile futhi ingaphethwe ukucindezeleka. Ukukhala okweqile noma ukukhathazeka kungenza kube nzima ukuba bathole i-oksijeni eyanele. Amathuluzi okuthula okuthambile nokuqapha ubushushu obuhle kungasiza ekuqinisiseni umntwana wakho.

Landela isimiso sakho semithi ngokuqondile njengoba kulotshiwe. Abantwana abaningi abane-pulmonary atresia badinga imithi ukuze basize inhliziyo yabo isebenze kahle noma ukuvimbela ama-blood clots. Ungalokothi ushiye izilinganiso noma uyeke imithi ngaphandle kokukhuluma nodokotela wakho kuqala.

Ukuvakasha okujwayelekile kokulandelela kubalulekile. Umntwana wakho uzodinga ukuhlola okuvamile nodokotela wakhe we-cardiologist ukuze aqaphe isimo sakhe futhi ahlele ukwelashwa kwesikhathi esizayo. Lezi zivivinyo zisiza ekutholeni noma yiziphi izinguquko kwasekuqaleni futhi kuqinisekise ukuthi umntwana wakho ukhula futhi uthuthuka kahle ngangokunokwenzeka.

Ukuthi Ungazilungiselela Kanjani Ukuvakasha Kwenu Kudockotela?

Ngaphambi kokuvakasha kwenu, bhala phansi noma yimiphi imibuzo noma ukukhathazeka okukukhathazayo. Kulula ukukhohlwa imibuzo ebalulekile uma ukhathazekile ngomntwana wakho, ngakho-ke ukuba nohlu kusiza ekuqinisekiseni ukuthi uthola ulwazi oludingayo.

Gcina irekhodi lezimpawu zomntwana wakho, kufaka phakathi ukuthi zenzeka nini nokuthi zinzima kangakanani. Qaphela noma yiziphi izinguquko ezimisweni zokudla, amazinga omsebenzi, noma umbala. Lolu lwazi lusisiza udokotela wakho ukuqonda ukuthi umntwana wakho uqhuba kanjani phakathi kokuvakasha.

Letha uhlu lwemithi yonke umntwana wakho ayithathayo, kufaka phakathi izilinganiso nesikhathi. Letha futhi noma yimiphi imiphumela yokuvivinya yangaphambili noma amarekhodi avela kwabanye odokotela. Uma lokhu kuyivivinyo lokuqala nodokotela omusha, ukuba nomlando ophelele wezokwelapha womntwana wakho kubaluleke kakhulu.

Cabanga ukuletha umuntu osekela nawe ekuvakasheni. Ukuba nomunye umuntu omdala okhona kungakusiza ukukhumbula ulwazi oluqondile nokunikeza ukwesekwa ngokomzwelo ngesikhathi esingase sibe yisikhathi esinzima.

Lungiselela imibuzo yokwenza ngokuphathelene nokukhathalela komntwana wakho kwansuku zonke, njengokuqondisa ukudla, imikhawulo yemisebenzi, nezibonakaliso zokuqaphela. Ukuqonda le mininingwane kuzokusiza uzizwe ukhulu ekunakekeleni umntwana wakho ekhaya.

Yini Okubalulekile Nge-Pulmonary Atresia?

I-Pulmonary atresia yisimo esinzima senhliziyo esidinga ukunakekelwa kwezokwelapha nokwelashwa ngokushesha, kodwa ngokunakekelwa kwenhliziyo yanamuhla, abantwana abaningi bangaphila impilo egcwele, esebenzayo. Ukuxilongwa kwasekuqaleni nokwelashwa kubalulekile ukuze kube nemiphumela emihle.

Nakuba uhambo lungase luhilele ukuhlinzwa okuningi nokunakekelwa kwezokwelapha okuqhubekayo, abantwana abaningi abane-pulmonary atresia bakhula ukuze bahlanganyele emisebenzini yobunye obuvamile, baye esikoleni, futhi balandele amaphupho abo. Iqembu lakho lezokwelapha lizohlangana nawe ukudala ikusasa elihle kakhulu lomntwana wakho.

Khumbula ukuthi awuwedwa kule nqubo. Amaqembu e-cardiac ezingane ahlanganisa ochwepheshe abaqonda kokubili izici zezokwelapha nezingokomzwelo zokunakekela abantwana abanezimo zenhliziyo. Amaqembu asekelayo namanye imindeni ehamba kule ndlela anganikeza isiqondiso esibalulekile nokukhuthaza.

Imibuzo Evamile Ebuzwayo Nge-Pulmonary Atresia

Ingabe i-pulmonary atresia ingatholakala ngaphambi kokuzalwa?

Yebo, i-pulmonary atresia ngezinye izikhathi ingatholakala ngesikhathi sokuhlola okujwayelekile kokukhulelwa, ngokuvamile phakathi kwesigamu sesibili sokukhulelwa cishe emasontweni angu-18-22. Noma kunjalo, akuzona zonke izimo ezitholakala ngaphambi kokuzalwa, futhi abanye abantwana baxilongwa kuphela ngemuva kokubonisa izimpawu ngemuva kokuzalwa. Uma kutholakala ngaphambi kokuzalwa, udokotela wakho uzokudlulisa kudokotela wezingane we-cardiologist futhi akusize uhlele ukulethwa esibhedlela esilungele ukunakekela izidingo zomntwana wakho ngokushesha.

Ingabe umntwana wami uzobe ekwazi ukudlala imidlalo nokuzivocavoca ngokujwayelekile?

Abantwana abaningi abane-pulmonary atresia bangase bahlanganyele emisebenzini yomzimba, kodwa izinga lomsebenzi liyancika emisebenzini yabo ethile yenhliziyo nemiphumela yokuhlinzwa. Udokotela wakho wezingane we-cardiologist uzohlola umsebenzi wenhliziyo yabo njalo futhi anikeze imiyalo ethile ngokuzivocavoca nokudlala imidlalo. Abanye abantwana bangase bangabi namikhawulo, kanti abanye bangase badinge ukugwema imisebenzi enzima kakhulu. Okubalulekile ukusebenzisana neqembu lakho lezokwelapha ukuthola ibhalansi efanele yomsebenzi yesimo somntwana wakho.

Bangaki ukuhlinzwa umntwana wami ozokudinga?

Inani lokuhlinzwa liyahluka kakhulu kuye ngohlobo lwe-pulmonary atresia nokuthi umntwana wakho uyaphendula kanjani ekwelapheni. Abanye abantwana abane-anatomy enhle bangase badinge kuphela inqubo eyodwa noma ezimbili, kanti abanye bangase badinge ukuhlinzwa okuningi phakathi nobuntwana nasebudaleni. Iqembu lakho lokuhlinzwa lizoqondisa uhlelo lokwelashwa olufanele sesimo somntwana wakho, yize izinhlelo zingase zishintshe njengoba umntwana wakho ekhula nezidingo zakhe zithuthuka.

Iyini imbono yesikhathi eside kubantwana abane-pulmonary atresia?

Umbono wesikhathi eside uthuthukile kakhulu eminyakeni embalwa edlule ngenxa yokuqhubeka kwezindlela zokuhlinzwa nokunakekelwa kwezokwelapha. Abantwana abaningi abane-pulmonary atresia bakhula ukuze baphile impilo evamile, baye esikoleni, basebenze, futhi babe nemindeni yabo. Noma kunjalo, abaningi bazodinga ukulandelela kwenhliziyo impilo yonke futhi bangase badinge izinqubo ezengeziwe njengabantu abadala. I-prognosis ethile yomntwana wakho iyancika ezintweni eziningi, kufaka phakathi uhlobo lwe-pulmonary atresia, impumelelo yokuhlinzwa kwabo, nempilo yabo yonke.

Ingabe lesi simo singase sibe nomthelela ekukhulelweni kwesikhathi esizayo?

Uma unemfundi oyedwa onenhliziyo ye-pulmonary atresia, ingozi yakho yokuba nomntwana omunye onenhliziyo ezelwe nayo iphakeme kancane kunokuvamile, kodwa isalula. Imindeni eminingi enomntwana oyedwa onenhliziyo ye-pulmonary atresia iyaqhubeka ibe nabanye abantwana abanezinhliziyo ezimpilo. Udokotela wakho angase akuqondise ekuqondiseni kwe-genetic ukuze akusize uqonde izici zakho zengozi futhi uqonde izinketho njengokuqapha okukhulu kokukhulelwa ekukhulelweni kwesikhathi esizayo.