Ukuhlushwa Kwe-Tricuspid Atresia? Izimpawu, Izimbangela, Nokwelashwa

I-Tricuspid atresia yisimo sengqondo senhliziyo esingavamile esikhona ekuzalweni lapho i-tricuspid valve ingazenzi kahle. Le valvu ivame ukuba phakathi kwe-atrium yasekunene ne-ventricle yasekunene, ivumela igazi ukuthi ligeleze emakhameni aphezulu ngakwesokudla kuya emakhameni angezansi ngakwesokudla kwenhliziyo yakho.

Uma le valvu ingapheli noma ivaliwe ngokuphelele, igazi alikwazi ukugeleza ngokujwayelekile ngakwesokudla kwenhliziyo yakho. Kunalokho, igazi lithola izindlela ezihlukile zokufinyelela emaphashini omzimba wakho, kodwa lokhu kwenza inhliziyo yakho isebenze kakhulu futhi ayinikezi igazi elanele lokufakelwa umoya emithonjeni yomzimba wakho.

Ziyini izimpawu ze-tricuspid atresia?

Izimpawu ze-tricuspid atresia zivame ukuvela ezinsukwini ezimbalwa zokuqala noma emaviki ngemva kokuzalwa. Abathandana abaningi abanesimo esinjalo babonisa izimpawu ezicacile zokuthi kukhona okuphuthumayo ngomsebenzi wenhliziyo yabo.

Nawa zimpawu ezivame kakhulu ongaziqaphela:

• Umbala oluhlaza okwesibhakabhaka noma oluhlaza okumnyama, ikakhulukazi eduze kwemilomo, iinzipho, nezinzipho zezinyawo (okubizwa ngokuthi i-cyanosis)
• Ukuphefumula okuqine noma ukuphefumula okusheshayo, ikakhulukazi ngesikhathi sokudla noma ukukhala
• Ukudla okubi nokukhula okunciphile kwesisindo
• Ukukhathala okukhulu noma ukudinwa ngesikhathi semisebenzi evamile
• Ukucasuka noma ukukhathazeka okubonakala kungavamile
• Ukukhipha ukushisa ngesikhathi sokudla noma ezinye imisebenzi elula

Abanye abathandana bangase babe nezimpawu ezinzima kakhulu njengokutheleleka okuvamile komphefumulo noma izigameko lapho imilomo nezinwele zabo ziphenduka oluhlaza okwesibhakabhaka kakhulu ngesikhathi sokukhala noma ukucindezela. Lezi zimpawu zenzeka ngoba umzimba womntwana wakho awutholi igazi elanele lokufakelwa umoya.

Kwezinye izimo ezingavamile, abanye abantwana abanesimo esibuthakathaka se-tricuspid atresia bangase bangabonisi izimpawu ezicacile kuze kube yilapho bekhula futhi beba namandla. Noma kunjalo, izimo eziningi zitholakala ekuqaleni ngoba izimpawu ziyaqaphela.

Yini ebangela i-tricuspid atresia?

I-Tricuspid atresia ithuthukiswa phakathi kwamasonto ayisishiyagalombili okuqala okukhulelwe lapho inhliziyo yomntwana wakho yakhiwa. Imbangela eqondile ayiqondakali ngokuphelele, kodwa kwenzeka lapho i-tricuspid valve ihluleka ukuthuthuka kahle phakathi nalesi sikhathi esibalulekile.

Lesi simo asibangelwa yilutho owenzile noma awenzanga ngesikhathi sokukhulelwa. Ukuphazamiseka kwenhliziyo njenge-tricuspid atresia kwenzeka ngokungahleliwe njengoba inhliziyo ithuthuka, futhi ayikho indlela yokuvimbela.

Ezinye izinto zingase zikhulise ingozi kancane, yize abathandana abaningi abane-tricuspid atresia bezalwa kubazali abangenazo izinto ezingozi ezaziwayo:

• Izimo ze-genetic njenge-Down syndrome
• Umbukiso womndeni wokuphazamiseka kwenhliziyo okuzalwa nako
• I-diabetes yomzali engalawulwa kahle ngesikhathi sokukhulelwa
• Imithi ethile ethathwe ngesikhathi sokukhulelwa ekuqaleni
• Ukutheleleka komzali njenge-rubella ngesikhathi sokukhulelwa

Kubalulekile ukuqonda ukuthi ngisho nalokhu okungozini, amathuba okuzalwa nomntwana one-tricuspid atresia ahlala encane kakhulu. Lesi simo sithinta cishe umntwana oyedwa ku-10,000 abazalwayo.

Ziyini izinhlobo ze-tricuspid atresia?

Odokotela bahlukanisa i-tricuspid atresia ngezinhlobo ezahlukene ngokusekelwe endleleni izakhiwo zenhliziyo ezihleliwe ngayo nezinye izifo zenhliziyo ezikhona. Ukuqonda uhlobo oluthile lomntwana wakho kusiza odokotela ukuthi bahlele indlela yokwelapha engcono kakhulu.

Izinhlobo eziyinhloko zihlanganisa:

• Uhlobo 1: I-arteries enkulu (i-aorta ne-pulmonary artery) zisesimweni sazo esivamile, kodwa kungase kube nokuncipha kwe-pulmonary valve
• Uhlobo 2: I-arteries enkulu ishintshiwe (i-transposed), okunethemba indlela igazi egeleza ngayo enhliziyweni
• Uhlobo 3: Ezinye izakhiwo eziyinkimbinkimbi zezitho ezikhulu zegazi lenhliziyo

Uhlobo ngalunye luhlukaniswe ngezinye izinhlobo ngokusekelwe ekutheni i-pulmonary valve ivamile, incinci noma ivaliwe. I-cardiologist yomntwana wakho izochaza ngokuqondile ukuthi yiluphi uhlobo olukhona kumntwana wakho nokuthi kusho ukuthini ngokunakekelwa kwabo.

Nini okufanele ubona udokotela nge-tricuspid atresia?

Izimo eziningi ze-tricuspid atresia zitholakala ngokushesha ngemva kokuzalwa lapho odokotela beqaphela umbala oluhlaza okwesibhakabhaka oluvamile olusendaweni yesikhumba somntwana wakho noma ezinye izimpawu ezinkulu. Inqubo yokuxilongwa ihlanganisa izinyathelo eziningana ukuze uthole isithombe esiphelele sesakhiwo senhliziyo yomntwana wakho.

Udokotela wakho uzoqala ngokuhlolwa komzimba, alalele ngokucophelela inhliziyo yomntwana wakho nge-stethoscope. Bahlola imisindo engavamile yenhliziyo noma i-murmurs engase ibonise inkinga ngokugeleza kwegazi.

Izivivinyo eziyinhloko zokuxilongwa zihlanganisa:

• I-Echocardiogram: Le ultrasound yenhliziyo ibonisa isakhiwo senhliziyo nokuthi igazi ligeleza kanjani ngayo
• I-X-ray yesifuba: Iyaqondisa odokotela ukubona usayizi nokuma kwenhliziyo nemiphunga yomntwana wakho
• I-Electrocardiogram (ECG): Ibhalisa izinga lenhliziyo yomntwana wakho nomsebenzi wama-elekthrikhi
• I-Pulse oximetry: Ilinganisa amazinga okufakelwa umoya egazini lomntwana wakho
• I-Cardiac catheterization: Ngesinye isikhathi kudingeka ukuze kutholakale ukulinganiswa okuningiliziwe kokucindezela ngaphakathi kwenhliziyo

Kwezinye izimo, i-tricuspid atresia ingase itholakale ngesikhathi sokukhulelwa nge-fetal echocardiogram, ikakhulukazi uma i-ultrasounds evamile ibonisa ukuphazamiseka okungenzeka kwenhliziyo. Lokhu kuvumela odokotela ukuthi balungiselele ukunakekelwa komntwana wakho ngokushesha ngemva kokuzalwa.

Yini ukwelashwa kwe-tricuspid atresia?

Ukwelashwa kwe-tricuspid atresia kuhlale kuhlanganisa ukuhlinzwa ngoba lesi simo asikhona ukulungiswa ngemithi kuphela. Umgomo ukuguqula ukugeleza kwegazi ukuze umzimba womntwana wakho uthole igazi elanele lokufakelwa umoya.

Abantwana abaningi badinga uchungechunge lokuhlinzwa okwenziwa eminyakeni eminingana. Le ndlela yesigaba ivumela inhliziyo yomntwana wakho ukuthi ilungise ngokuhamba kwesikhathi futhi iyanikeza ithuba elihle lokuphila impilo enempilo.

Uchungechunge oluvamile lokuhlinzwa luhlanganisa:

1. Ukuhlinzwa kokuqala (ngokuvamile phakathi kwamasonto ambalwa okuzalwa): Kwakha uxhumano oluyimfihlo ukuthuthukisa ukugeleza kwegazi emaphashini
2. Ukuhlinzwa kwesibili (cishe ngenyanga eziyi-4-6): Kuxhuma i-superior vena cava ngokuqondile kwi-pulmonary artery
3. Ukuhlinzwa kwesithathu (cishe eminyakeni eyi-2-4): Kuqeda ukugeleza kwe-Fontan, kuqondisa yonke igazi ebuyayo ngokuqondile emaphashini

Phakathi kokuhinzwa, umntwana wakho angase adinge imithi ukuze asize inhliziyo yakhe isebenze kahle noma ukuvimbela ukwakheka kwegazi. Ithimba lakho le-cardiology lizoqapha ukukhula nokuthuthuka komntwana wakho eduze.

Abanye abantwana bangase badinge izinqubo ezengeziwe, njengokufakwa kwe-pacemaker uma izinkinga zokulingana kwenhliziyo zithuthuka, noma ukungenelela okuqondiswe yi-catheter ukugcina izitho zegazi zivulekile. Uhlelo oluthile lokwelashwa luxhomeke ekwakheni komntwana wakho okuhlukile nokuthi bayaphendula kanjani kuyo yonke ukuhlinzwa.

Unganakekela kanjani ekhaya ngesikhathi sokwelashwa kwe-tricuspid atresia?

Ukukhathalela umntwana one-tricuspid atresia ekhaya kudinga ukunakekelwa kwezindawo ezibalulekile, kodwa ngesiqondiso esifanele, ungasiza umntwana wakho ukuba akhule phakathi nemihlangano yezokwelapha nokuhlinzwa.

Ukudla nokudla kubaluleke kakhulu ngoba abantwana abanezimo zenhliziyo bavame ukudinga ama-calories engeziwe ukuze basekele ukukhula kwabo. Ungase udinge ukondla umntwana wakho njalo ngezinani ezincane, futhi abanye abantwana bazuza kumafomu noma izongezo eliphezulu lama-calories.

Izindlela eziyinhloko zokunakekelwa ekhaya zihlanganisa:

• Ukuqapha ukuphefumula komntwana wakho namanqanaba kwamandla ngesikhathi semisebenzi yansuku zonke
• Ukuqinisekisa ukuthi umntwana wakho uthola ukuphumula okwanele futhi ugweme ukusebenza ngokweqile
• Ukuvikela umntwana wakho ekuthelelekeni ngokuhlanza izandla okuhle nokugwema abantu abagulayo
• Ukupha imithi ngokuqondile njengoba kuqokiwe, ikakhulukazi abaphuli begazi uma kudingeka
• Ukugcina ukunakekelwa kwamazinyo okuvamile ukuvimbela ukutheleleka okungase kuthonye inhliziyo
• Ukugcina ulwazi loxhumano oluphuthumayo olutholakala kalula

Izinga lomsebenzi womntwana wakho lizohluka kuye esimweni sabo esithile nesigaba sokuhlinzwa. Abanye abantwana bangase babe yingxenye yemisebenzi evamile, kanti abanye bangase badinge ukuguqulwa. I-cardiologist yakho izonikeza imiyalo ethile mayelana nemisebenzi ephephile.

Kuyinto evamile ukuzizwa ukhathazekile ngokunakekela umntwana wakho ekhaya. Unganqikazi ukuxhumana nethimba lakho lezokwelapha ngemibuzo noma ukukhathazeka, kungakhathaliseki ukuthi kuncane kangakanani.

Kufanele ulungiselele kanjani imihlangano yakho yodokotela?

Ukulungiselela imihlangano nethimba le-cardiology lomntwana wakho kusiza ukuqinisekisa ukuthi uthola ulwazi oluwusizo kakhulu futhi uzizwe uqinisekile ngohlelo lokunakekelwa komntwana wakho. Ukulungiselela kancane kungenza lezi zivivinyo zivelise kakhulu.

Ngaphambi kwesikhathi ngasinye sokuqokwa, bhala phansi noma yimiphi imibuzo noma ukukhathazeka okukhona ngesimo somntwana wakho, ukwelashwa, noma ukunakekelwa kwansuku zonke. Kulula ukukhohlwa imibuzo ebalulekile lapho usehhovisi lodokotela, ngakho ukuba nohlu olubhaliwe kusiza.

Ulwazi olumele ulethe luhlanganisa:

• Uhlu lwemithi yamanje yonke ngezinga kanye nesikhathi
• Amanothi mayelana nanoma yiziphi izinguquko ezimpawu zomntwana wakho, ukudla, noma amazinga omsebenzi
• Amarekhodi anoma yiziphi izifo noma ukutheleleka kusukela ekuhambeni kokugcina
• Imibuzo mayelana nokuhlinzwa noma izinqubo ezizayo
• Ukukhathazeka ngokukhula komntwana wakho, ukuthuthuka, noma imisebenzi yansuku zonke
• Ulwazi loku-inshorensi nama-results okuvivinywa ngaphambili uma ubona udokotela omusha

Ungesabi ukubuza udokotela wakho ukuba achaze izinto ngezindlela ezilula uma ungaqondi lutho. Kuyinto evamile ukuzizwa ukhuluselwe ulwazi lwezokwelapha, futhi odokotela abahle bafuna ukuqinisekisa ukuthi uyaqonda isimo somntwana wakho nohlelo lokwelashwa.

Cabanga ukuletha ilungu lomndeni noma umngani emihlanganweni ebalulekile yokusekela ngokomzwelo nokusiza ukukhumbula ulwazi oluxoxwe ngesikhathi sokuvakasha.

Iyini into ebalulekile mayelana ne-tricuspid atresia?

I-Tricuspid atresia yisimo esinzima senhliziyo esingelashwa esidinga ukunakekelwa kwezokwelapha okukhethekile futhi ngokuvamile ukuhlinzwa okuningi eminyakeni eminingana. Nakuba lokhu kuxilongwa kungase kuzwakale kukhulu, abantwana abaningi abane-tricuspid atresia bayaqhubeka bephila impilo esebenzayo, ezele ngokunakekelwa okufanele.

Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukuxilongwa nokwelashwa ekuqaleni kwenza umehluko omkhulu emiphumeleni. Izindlela zokuhinzwa zanamuhla zithuthukise kakhulu isimo sabantwana abanesimo esinjalo.

Umnana wakho uzodinga ukulandelela impilo yonke nge-cardiologist, kodwa lokhu akusho ukuthi impilo yabo izobusa ukunakekelwa kwezokwelapha. Abantwana abaningi abane-tricuspid atresia bahlanganyela emisebenzini yesikole, ezemidlalo (ngezinguquko ezithile), kanye namava avamile ebuntwaneni.

Ukuba nomntwana onenkinga yenhliziyo kunzima, kodwa awuwedwa kule ndlela. Ithimba lakho lezokwelapha, umndeni, namaqembu okusekela anganikeza isiqondiso nokukhuthaza okudingayo ukuze usize umntwana wakho akhule.

Imibuzo evamile ebuzwayo mayelana ne-tricuspid atresia

Ingavikeleka yini i-tricuspid atresia?

Cha, i-tricuspid atresia ayikwazi ukuvinjelwa ngoba kwenzeka ngokungahleliwe ngesikhathi sokuthuthuka kwenhliziyo emavikini ayisishiyagalombili okuqala okukhulelwe. Lesi simo asibangelwa yilutho abazali abalenzayo noma abangalenzi ngesikhathi sokukhulelwa.

Nakuba izinto ezithile njenge-diabetes yomzali noma izimo ze-genetic zingase zikhulise ingozi kancane, abathandana abaningi abane-tricuspid atresia bazalwa kubazali abangenazo izinto ezingozi ezaziwayo. Ukuthatha amavithamini okukhulelwa nokugcina impilo enhle ngesikhathi sokukhulelwa kuyelulekwa njalo, kodwa awuvikeli ukuphazamiseka kwenhliziyo okuzalwa nako.

Ingabe umntwana wami uzobe ekwazi ukudlala imidlalo nge-tricuspid atresia?

Abantwana abaningi abane-tricuspid atresia bangase bahlanganyele emisebenzini yomzimba nasemidlalweni, kodwa izinga lomsebenzi lixhomeke esimweni sabo esithile nemiphumela yokuhlinzwa. I-cardiologist yomntwana wakho izonikeza imiyalo ethile mayelana nezinga lomsebenzi ophephile.

Abanye abantwana bangase badinge ukugwema imisebenzi enzima kakhulu noma imidlalo exhumana, kanti abanye bangase bahlanganyele emisebenzini evamile yobunye. Ikhona ukusebenzisana nethimba lakho lezokwelapha ukuthola ibhalansi efanele egcina umntwana wakho enempilo ngenkathi imvumela ukuthi ajabulele indlela yokuphila esebenzayo.

Uzothatha imithi isikhathi esingakanani umntwana wami?

Isidingo semithi sihluka kakhulu kuye esimweni somntwana wakho esithile nokuthi bayaphendula kanjani ekuhlinzweni. Abanye abantwana bangase badinge abaphuli begazi isikhathi eside ukuvimbela ukwakheka kwegazi, kanti abanye bangase badinge imithi okwesikhashana ngemva kokuhlinzwa.

I-cardiologist yomntwana wakho izohlola njalo izidingo zabo zemithi futhi ilungise izimithi njengoba umntwana wakho ekhula nesimo sabo sishintsha. Ungalokothi uyeke noma ushintshe imithi ngaphandle kokubonisana nethimba lakho lezokwelapha kuqala, njengoba eminye imithi ibalulekile ekuvinjeni izinkinga ezinzima.

Iyini ithemba lokuphila labantwana abane-tricuspid atresia?

Ngokwelashwa lokuhlinzwa zanamuhla, abantwana abaningi abane-tricuspid atresia bangalindela ukuphila kuze kube yilapho bekhula. Isimo sithuthukile kakhulu eminyakeni embalwa edlule njengoba izindlela zokuhinzwa zithuthukile.

Kodwa-ke, isimo sangamunye umntwana sihlukile, futhi ithemba lokuphila lixhomeke ezintweni ezifana nohlobo oluthile lwe-tricuspid atresia, ezinye izifo zenhliziyo ezikhona, nokuthi bayaphendula kangcono kanjani ekuwelapheni. Ithimba le-cardiology lomntwana wakho linganikeza ulwazi oluqondile ngokusekelwe esimweni sabo somuntu.

Ingabe umntwana wami uzodinga ukuhlinzwa kwenhliziyo?

Abantwana abaningi abane-tricuspid atresia abadingi ukuhlinzwa kwenhliziyo. Indlela yokuhlinzwa yesigaba (ukugeleza kwe-Fontan) ngokuvamile iphumelela ekuqondiseni ukugeleza kwegazi futhi ivumela abantwana ukuba baphile impilo evamile.

Kodwa-ke, kwezinye izimo lapho ukuhlinzwa kungaphumeleli noma izinkinga zithuthuka ngokuhamba kwesikhathi, ukuhlinzwa kwenhliziyo kungase kubhekwe. Lesi sinqumo sizokwenziwa ngokucophelela yithimba lezokwelapha lomntwana wakho ngemva kokubheka ezinye izindlela zokwelapha.