Tapvr

Ukubuyela okungajwayelekile okuphelele kwe-pulmonary venous (TAPVR)

Ekubuyeleni okungajwayelekile okuphelele kwe-pulmonary venous (TAPVR), imithambo ye-pulmonary veins ithumela igazi ngokungalungile ekamelweni eliphezulu lasekunene lenhliziyo. Leyo kamelwane ibizwa ngokuthi yi-right atrium. Ngenxa yalokho, igazi elicebile nge-oksijini lixuba negazi elingenayo i-oksijini, njengoba kuboniswe ngombala oluhlaza okwesibhakabhaka. Enhliziyweni ejwayelekile, eboniswe ngakwesobunxele, igazi elicebile nge-oksijini ligeleza kusuka kwi-pulmonary veins ukuya ekamelweni eliphezulu lasekunxele, elibizwa nangokuthi yi-left atrium.

Ukubuyela okungajwayelekile okuphelele kwe-pulmonary venous (TAPVR) kuyinkinga yenhliziyo engavamile ekhona ngesikhathi sokuzalwa. Lokho kusho ukuthi kuyi-congenital heart defect.

Amanye amagama alolu phawu yi:

• Ukuxhumana okungajwayelekile okuphelele kwe-pulmonary venous
• TAPVC

Kulolu phawu lenhliziyo, imithambo yegazi yephango, ebizwa ngokuthi yi-pulmonary veins, ixhumeka endaweni engafanele enhliziyweni.

Enhliziyweni ejwayelekile, igazi elicebile nge-oksijini ligeleza kusuka emaphaphweni ukuya ekamelweni eliphezulu lasekunxele lenhliziyo, elibizwa ngokuthi yi-left atrium. Igazi bese ligeleza emzimbeni.

Ku-TAPVR, ukuxhumana kwemithambo yegazi kuguqukile. Igazi ligeleza ekamelweni eliphezulu lasekunene lenhliziyo, elibizwa ngokuthi yi-right atrium. Lolu shintsho ekugelezeni kwegazi lubangela igazi elingenayo i-oksijini ukuba lixube negazi elicebile nge-oksijini. Ngenxa yalokho, igazi eligeleza emzimbeni alinawo i-oksijini eyanele.

Uhlobo oluthile lwe-TAPVR kuncike lapho imithambo yegazi ixhuma khona. Abantwana abaningi abazalwa be-TAPVR abanalo umlando womndeni wesifo senhliziyo esizalwa naso.

Umntwana onelungunya le-TAPVR angaba nobunzima bokuqhekeza. Isikumba somntwana singase sibukeke siluhlaza okwesibhakabhaka noma oluhlaza okwesibhakabhaka ngenxa yezinga eliphansi loketshezi. Lokhu kubizwa ngokuthi i-cyanosis.

Umhlinzeki wezempilo angase aphawule izimpawu ze-TAPVR ngokushesha ngemva kokuzalwa. Kodwa abanye abantwana abanazo izimpawu kuze kube kamuva.

Umhlinzeki wezempilo yengane yakho uqhuba ukuhlolwa komzimba futhi ulalele inhliziyo yengane yakho nge-stethoscope. Umsindo wokugijima, obizwa ngokuthi i-heart murmur, ungase uzwakale.

I-echocardiogram yivivinyo elisetshenziswa ukuxilonga ukubuyela okungalungile kwe-pulmonary venous. Leli vivinyo lisebenzisa amaza omsindo ukudala izithombe zenhliziyo ehambayo. I-echocardiogram ingabonisa imithambo ye-pulmonary, noma yimiphi imingxuma enhliziyweni nobukhulu bezingxenye zenhliziyo. Ibonisa futhi ukugeleza kwegazi ngenhliziyo nezinsimbi zenhliziyo.

Ezinye izivivinyo ezifana ne-electrocardiogram, i-X-ray yesifuba noma i-CT scan zingase zenziwe uma kudingeka olunye ulwazi.

Ukuhlinzwa kwe-TAPVR kudingeka ngokuvamile lapho umntwana eseyingane. Isikhathi sokuhlinzwa siyasekelwa ekutheni kukhona ukuphahlazeka yini. Ukuze kulungiswe inhliziyo, ochwepheshe bokuhlinzwa baxhuma imithambo ye-pulmonary egumbini eliphezulu lenhliziyo ngakwesobunxele. Baphinda bavale umgodi phakathi kwamagumbi aphezulu enhliziyo.

Umuntu onelungunya lokubuyela okungalungile kwe-pulmonary venous udinga ukuhlolwa okujwayelekile kwezempilo ukuphila konke ukuhlola ukutheleleka, ukuphahlazeka noma izinkinga zokugeleza kwenhliziyo. Udokotela oqeqeshwe ezifweni zenhliziyo ezingazalwa kufanele anikeze ukunakekelwa. Lo mhlinzeki uhlobo lubizwa ngokuthi i-congenital cardiologist.

Udokotela wezingane wezinhliziyo uJonathan Johnson, uM.D., uyaphendula imibuzo ebuzwa kakhulu mayelana nokuphazamiseka kwenhliziyo ezelwe naye kubantwana.

Ezinye izinhlobo ezincane kakhulu zesifo senhliziyo esizalwa naye, njengeziqu ezincinyane kakhulu enhliziyweni noma i-stenosis ephansi kakhulu yama-valve ahlukahlukene enhliziyweni kungadingeka nje ukuba kulandelelwe njalo eminyakeni embalwa ngokuhlolwa kwezithombe njenge-echocardiogram. Ezinye izinhlobo ezinkulu zesifo senhliziyo esizalwa naye zingadinga ukuhlinzwa okungenziwa ngokuhlinzwa kwenhliziyo evulekile, noma kungenziwa ekamelweni lokuhlola i-catheterization yenhliziyo usebenzisa amadivayisi ahlukene noma amasu ahlukene. Ezimweni ezithile ezinzima kakhulu, uma ukuhlinzwa kungenakwenziwa, ukutshalwa kwengxenye kungase kubonakale.

Izimpawu ezithile umntwana angaba nazo uma enesifo senhliziyo esizalwa naye ziyaqondana ngempela nobudala bomntwana. Kubantwana, umthombo wabo omkhulu wokusetshenziswa kwamandla yi-calorie empeleni ngenkathi bedla. Ngakho-ke izimpawu eziningi zesifo senhliziyo esizalwa naye noma ukwehluleka kwenhliziyo empeleni zivele lapho bedla. Lokhu kungafaka ukuphefumula okusheshayo, ubunzima bokuqeda, noma ukukhipha ukushisa ngenkathi bedla. Abantwana abancinyane bavame ukubonisa izimpawu ezihlobene nesistimu yabo yesisu. Bangaba nokuhlanza, ukugabha ngokudla, futhi bangathola lezo zimpawu ngomsebenzi futhi. Abesifazane abadala, ngesikhathi esifanayo, bavame ukubonisa izimpawu ezifana nobuhlungu esifubeni, ukuphelelwa yizinzwa noma ukushaya kwenhliziyo okusheshayo. Bangabonisa futhi izimpawu ngesikhathi sokwenza umsebenzi noma umsebenzi. Futhi lokho empeleni yibala elikhulu elibukhali kimi njengodokotela wezingane wezinhliziyo. Uma ngizwa ngomntwana, ikakhulukazi owesilisa osele ekuqaleni kweminyaka yakhe yobusha oye waba nobuhlungu esifubeni, noma uqede izinzwa ngomsebenzi noma ngokuzivocavoca, ngidinga ukubona lowo mntwana futhi ngidinga ukuqinisekisa ukuthi uthola umsebenzi ofanele.

Ngokuvamile lapho umntwana wakho usanda kuxilongwa ngesifo senhliziyo esizalwa naye, kunzima ukukhumbula konke okwakushiwo kuwe kulowo mhlangano wokuqala. Ungaba ekudumazekeni usanda kuzwa lezi zindaba. Futhi ngezikhathi eziningi ungase ungakhumbuli konke. Ngakho-ke kubalulekile emihlanganweni yokulandelela ukubuza le mibuzo. Iminyaka yami emihlanu elandelayo izoba njani? Ingabe kukhona izinqubo ezizodingwa kule minyaka emihlanu? Noma yikuphi ukuhlinzwa? Hlobo luni lokuhlola, hlobo luni lokulandelela, hlobo luni lokuvakasha kwezokwelapha oluzodingwa? Lokhu kusho ukuthini ngezinto zomntwana, ezemidlalo, nezinto ezahlukene abazifuna ukwenza nsuku zonke. Futhi okubaluleke kakhulu, singasebenzisana kanjani ukuze lo mntwana akwazi ukuba nokuphila okujwayelekile ngangokunokwenzeka naphezu kwalelo xilongo lesifo senhliziyo esizalwa naye.

Kufanele ubuze udokotela wakho ukuthi hlobo luni lwezinqubo ezingase zidingeke yilolu hlobo lesifo senhliziyo esizalwa naye esikhathini esizayo. Zingase zenziwe usebenzisa ukuhlinzwa kwenhliziyo evulekile, noma zingase zenziwe usebenzisa i-catheterization yenhliziyo. Ngokuhlinzwa kwenhliziyo evulekile, kubalulekile ukubuza udokotela wakho ngesikhathi salo lokuhlinzwa. Ngalezo zinhlobo ezahlukene, ezithile zesifo senhliziyo esizalwa naye, empeleni kukhona izikhathi ezithile lapho kungcono ukwenza khona ukuhlinzwa kunokunye ukuze kube nemiphumela emihle kakhulu, kokubili yesikhathi esifushane nangesikhathi eside ngalowo mntwana. Ngakho-ke buza udokotela wakho uma kukhona isikhathi esithile esisebenza kangcono ngaleso sifo esithile nangomntwana wakho.

Lo mbuzo empeleni uwumbuzo ovame kakhulu engiwuthola kubazali nakubantwana ngemuva kokuba senze isixazululo sesifo senhliziyo esizalwa naye. Umdlalo wezemidlalo ubaluleke kakhulu empilweni yabaningi balaba bantwana, emaqenjini abo abangane nendlela abaxhumana ngayo nemiphakathi yabo. Ezinhlobo eziningi zesifo senhliziyo esizalwa naye, senza konke okusemandleni ethu ukuzama ukuthola indlela abangase baqhubeke behlanganyela ngayo. Nokho, kukhona ezinye izinhlobo zesifo senhliziyo esizalwa naye lapho ezinye imidlalo ingase ingeluleki. Isibonelo, kwabanye abantu bethu, bangaba nohlobo oluthile lwesimpawu ye-genetic okwenza izindonga ze-arteries zabo zibuthakathaka kakhulu. Futhi labo bantu, asifuni ukuba baphakamise isisindo noma benze noma yiluphi uhlobo lokucindezela okunzima okungabangela lezo arteries ukwanda futhi zichithake. Kepha ezimweni eziningi, sikwazi ukuthola indlela yokwenza abantwana badlale imidlalo abayithandayo nsuku zonke.

Kubantu bethu abanesifo senhliziyo esizalwa naye, njengoba bekhula, sivame ukubacebisa ukuthi ezinye izinhlobo zesifo senhliziyo esizalwa naye ziyefa. Lokhu kusho ukuthi uma umzali enesifo senhliziyo esizalwa naye, kunengozi ethile encane yokuthi umntwana wabo angaba nesifo senhliziyo esizalwa naye. Lokhu kungaba uhlobo olufanayo lwesifo senhliziyo esizalwa naye umzali wabo anayo, noma kungaba ohlukile. Ngakho-ke, uma labo bantu bekhulelwe, sidinga ukubalandela eduze ngesikhathi sokukhulelwa, kufaka phakathi ukwenza ukuhlola okwengeziwe kwe-fetus usebenzisa i-echocardiography ngesikhathi sokukhulelwa. Ngenhlanhla, iningi labantu bethu abanesifo senhliziyo esizalwa naye bakwazi ukuba nabantwana babo siqu esikhathini samanje.

Ubuhlobo phakathi komuntu, umndeni wakhe nodokotela wezingane wezinhliziyo kubaluleke kakhulu. Ngokuvamile silandela laba bantu amashumi eminyaka njengoba bekhula. Sibabuka bephuma ezinganeni zibe abantu abadala. Uma kukhona okuvela ongaqondi kahle ngakho, kodwa lokho akusho lutho kuwe, buza imibuzo. Sicela ungesabi ukufinyelela. Kufanele uhlale uzizwa ukwazi ukuxhumana neqembu lakho lezokwelapha zenhliziyo futhi ubabeze imibuzo engase ivela.

I-ultrasound ye-2D ye-fetal ingasiza ochwepheshe bakho bezempilo ukuhlola ukukhula nokuthuthuka komntwana wakho.

Ukuphazamiseka kwenhliziyo okuzelwe naye kungase kuxilongwe ngesikhathi sokukhulelwa noma ngemuva kokuzalwa. Izimpawu zezinye izifo zenhliziyo zingabonwa ekuhlolweni okujwayelekile kwe-ultrasound ngesikhathi sokukhulelwa (i-ultrasound ye-fetal).

Ngemva kokuzalwa komntwana, ochwepheshe bezempilo bangase bacabange ukuthi kukhona ukuphazamiseka kwenhliziyo okuzelwe naye uma umntwana enezimpawu ezilandelayo:

• Ukulibaziseka kokukhula.
• Ukushintsha kombala ezindebeni, elizwini noma ezinzwini.

Ochwepheshe bezempilo bangase bezwe umsindo, obizwa ngokuthi yi-murmur, ngenkathi belalele inhliziyo yomntwana nge-stethoscope. Iningi le-murmurs liyi-innocent, okusho ukuthi ayikho ukuphazamiseka kwenhliziyo futhi i-murmur ayilimazi impilo yomntwana wakho. Noma kunjalo, ezinye i-murmurs zingase zibangelwe ukushintsha kokugeleza kwegazi kuya enhliziyweni nasekuyini.

Izivivinyo zokuxilonga ukuphazamiseka kwenhliziyo okuzelwe naye zihlanganisa:

• Pulse oximetry. Isinsipho esibekwe esithombini somunwe sibhala inani lokuxuba legazi. Ukuxuba okuncane kakhulu kungaba uphawu lwenkinga yenhliziyo noma yephunga.
• Electrocardiogram (ECG noma EKG). Lolu vivinyo olukhulu lubhala umsebenzi wama-elekthronikhi wenhliziyo. Kubonisa ukuthi inhliziyo ishaya kanjani. Izicucu ezinamathelayo ezinamasinsi, ebizwa ngama-electrodes, zinamathela esifubeni futhi ngezinye izikhathi ezandleni noma ezinyaweni. Izingcingo zixhuma izicucu kukhompyutha, ephrinta noma ebonisa imiphumela.
• Echocardiogram. Amaza omsindo asebenza ukwenza izithombe zenhliziyo ehambayo. I-echocardiogram ibonisa ukuthi igazi lihamba kanjani ngenhliziyo nama-valve enhliziyo. Uma ukuhlolwa kwenziwa kumntwana ngaphambi kokuzalwa, kubizwa ngokuthi yi-fetal echocardiogram.
• X-ray yesifuba. I-X-ray yesifuba ibonisa isimo senhliziyo nemiphunga. Ingabonisa uma inhliziyo ikhulu, noma uma imiphunga inenani elikhulu legazi noma amanye amafutha. Lokhu kungaba izimpawu zokwehluleka kwenhliziyo.
• Cardiac catheterization. Kulolu vivinyo, udokotela ufake i-tube encane, eguquguqukayo ebizwa nge-catheter esitsheni legazi, ngokuvamile endaweni yesisu, futhi uyikhomba enhliziyweni. Lolu vivinyo lunganikeza ulwazi oluqondile ngokugeleza kwegazi nendlela inhliziyo esebenza ngayo. Ezinye izindlela zokwelapha inhliziyo zingase zenziwe ngesikhathi se-catheterization yenhliziyo.
• Heart MRI. Ebizwa nangokuthi yi-cardiac MRI, lo mkhuba usebenzisa ama-magnetic fields namaza omsakazo ukwenza izithombe ezinemininingwane yenhliziyo. I-cardiac MRI ingase yenziwe ukuxilonga nokulinganisa ukuphazamiseka kwenhliziyo okuzelwe naye kubantu abasha nabantu abadala. I-heart MRI yenza izithombe ze-3D zenhliziyo, okuvumela ukulinganiswa okuqondile kwamakhamera enhliziyo.

Ukwelapha ukungasebenzi kahle kwenhliziyo okungokwemvelo kubantwana kuncike esikhathini esithile senkinga yenhliziyo nokuthi kubunzima kangakanani.

Ezinye izinkinga zenhliziyo ezingokwemvelo azinawo umphumela wesikhathi eside empilweni yengane. Zingase ziyeke ukwelashwa ngokuphepha.

Ezinye izinkinga zenhliziyo ezingokwemvelo, njengoba kungumgodi omncane enhliziyweni, zingase zivale njengoba ingane ikhulile.

Izinkinga zenhliziyo ezingokwemvelo ezinzima zidinga ukwelashwa ngokushesha ngemuva kokutholakala. Ukwelashwa kungafaka:

• Imithi.
• Izindlela zokwelapha inhliziyo.
• Ukuhlinzwa kwenhliziyo.
• Ukuhlinzwa kwenhliziyo.

Imithi ingase isetshenziswe ukwelapha izimpawu noma izinkinga zokungasebenzi kahle kwenhliziyo okungokwemvelo. Zingase zisetshenziswe zodwa noma ngezinye izindlela zokwelapha. Imithi yokungasebenzi kahle kwenhliziyo okungokwemvelo ifaka:

• Amaphilisi amanzi, abizwa nangokuthi ama-diuretics. Lolu hlobo lwemi thi lusiza ukususa amanzi emzimbeni. Lusiza ukunciphisa ukucindezela enhliziyweni.
• Imithi yokuhlanza inhliziyo, ebizwa ngokuthi yi-anti-arrhythmics. Le mithi iyasiza ukulawula ukushaya kwenhliziyo okungajwayelekile.

Uma ingane yakho inenkinga enkulu yenhliziyo engakwemvelo, inqubo yenhliziyo noma ukuhlinzwa kungase kunconywe.

Izindlela zokwelapha inhliziyo kanye nokuhlinzwa okwenziwa ukwelapha ukungasebenzi kahle kwenhliziyo okungokwemvelo kufaka:

• Ukuhlolwa kwe-cardiac catheterization. Ezinye izinhlobo zokungasebenzi kahle kwenhliziyo okungokwemvelo kubantwana zingalungiswa ngokusebenzisa izikhwephu ezincinyane, ezithambile ebizwa ngokuthi ama-catheters. Izindlela ezinjalo zivumela odokotela ukulungisa inhliziyo ngaphandle kokuhlinzwa kwenhliziyo evulekile. Udokotela ufake i-catheter ngomthambo wegazi, ngokuvamile emadolweni, bese uyikhomba enhliziyweni. Ngezinye izikhathi kusetshenziswa i-catheter engaphezu kwesisodwa. Uma isikhona, udokotela uqondisa amathuluzi amancane nge-catheter ukulungisa isimo senhliziyo. Isibonelo, udokotela angalungisa imigodi enhliziyweni noma izindawo ezincinyane. Ezinye izindlela zokwelapha i-catheter kufanele zenziwe ngezigaba phakathi nesikhathi seminyaka eminingi.
• Ukuhlinzwa kwenhliziyo. Ingane ingase idinge ukuhlinzwa kwenhliziyo evulekile noma ukuhlinzwa kwenhliziyo okungenayo ukuhlinzwa okukhulu ukulungisa ukungasebenzi kahle kwenhliziyo okungokwemvelo. Uhlobo lokuhlinzwa kwenhliziyo kuncike ekuguqukeni okuthile enhliziyweni.
• Ukuhlinzwa kwenhliziyo. Uma ukungasebenzi kahle kwenhliziyo okungokwemvelo okunzima kungalungiswa, ukuhlinzwa kwenhliziyo kungase kudingeke.
• Ukuhlinzwa kwenhliziyo yomfoti. Lolu hlobo lokwelapha ingane enenkinga yenhliziyo okwenziwa ngaphambi kokuzalwa. Kungase kwenziwe ukulungisa ukungasebenzi kahle kwenhliziyo okungokwemvelo okunzima noma ukuvimbela izinkinga njengoba ingane ikhulile ngesikhathi sokukhulelwa. Ukuhlinzwa kwenhliziyo yomfoti kwenziwa kancane futhi kungenzeka kuphela ezimweni ezithile.

Abanye abantwana abazalwa benenkinga yenhliziyo engakwemvelo badinga izindlela eziningi nokuhlinzwa kokuphila konke. Ukukhathalela okulandelayo kokuphila konke kubalulekile. Ingane idinga ukuhlolwa kwempilo njalo ngudokotela oqeqeshwe ezifweni zenhliziyo, obizwa ngokuthi i-cardiologist. Ukukhathalela okulandelayo kungafaka ukuhlolwa kwegazi nokwenza izithombe ukuhlola izinkinga.

[Umculo udlala]

Ithemba nokuphulukiswa kwemizwa emincane.

Dr. Dearani: Uma ngibheka umsebenzi wami, ngenza ukuhlinzwa kwenhliziyo okungenayo ukuhlinzwa okukhulu. Futhi ngikwazi ukwenza lokho ngoba ngikufundile konke kubantu abadala, okuyilapho kwaqala khona. Ngakho-ke ukwenza ukuhlinzwa kwenhliziyo ngama-robot kubasakhuli kuyinto ongayitholi esibhedlela sabantwana ngoba abanawo ubuchwepheshe obutholakalayo lapho singenza khona lokho lapha.

[Umculo udlala]

Uma ingane yakho inenkinga yokuqala yentliziyo, kungenzeka kunconywe ukushintsha indlela yokuphila ukuze ihlale iphilile futhi kuvinjelwe ubunzima.

• Ukulinganiselwa kwezemidlalo nemisebenzi. Ezinye izingane ezine-congenital heart defect zingadinga ukunciphisa ukuzivocavoca noma imisebenzi yezemidlalo. Noma kunjalo, abanye abaningi abane-congenital heart defect bangabamba iqhaza emisebenzini enjalo. Uchwepheshe wokunakekela ingane yakho angakutshela ukuthi yiziphi izimidlalo nohlobo lokuzivocavoca olukhulu kwengane yakho.
• Ama-antibiotics okuvimbela. Ezinye i-congenital heart defects zingandisa ingozi yokutheleleka ekugqokeni kwentliziyo noma ama-valve entliziyo, okuthiwa yi-infective endocarditis. Ama-antibiotics angase acelwe ngaphambi kwezindlela zokwelapha amazinyo ukuvimbela ukutheleleka, ikakhulukazi kubantu abane-mechanical heart valve. Buza udokotela wengane yakho uma ingane yakho idinga ama-antibiotics okuvimbela.

Ungathola ukuthi ukukhuluma nabanye abantu abake badlula isimo esifanayo kukulethela induduzo nokukhuthazwa. Buza iqembu lakho lokunakekela impilo uma kukhona amaqembu wokusekela endaweni yakini.

Ukuphila ne-congenital heart defect kungenza ezinye izingane zibe nomuzwa wokucindezeleka noma ukukhathazeka. Ukukhuluma nomxhumanisi kungakusiza wena nengane yakho ukufunda izindlela ezintsha zokulawula ukucindezeleka nokukhathazeka. Cela ochwepheshe bezempilo ulwazi mayelana nabaxhumanisi endaweni yakini.