I-atresia yamaphaphu

I-pulmonary atresia iyindlela yesifo senhliziyo lapho i-valve yamaphaphu ingakhi kahle. Sikhona kusukela ekuzalweni (isifo senhliziyo esizalwe naso). I-valve yamaphaphu iyimbobo engakwesokudla senhliziyo elawula ukugeleza kwegazi kusuka ku-ventricle yangakwesokudla (ikamelo lokudonsa ohlangothini lwangakwesokudla) kuya emaphashini.

Ku-atresia yamaphaphu, amapheshana e-valve ahlanganisiwe. Lokhu kubangela ukuthi kuvele ishidi eliqinile lezicubu lapho kufanele kuvulwe khona i-valve. Ukugeleza kwegazi okujwayelekile okuya emaphashini kuyavinjwa ngenxa yalokho. Ngenxa yale nkinga, igazi elivela ohlangothini lokunene lwenhliziyo livinjelwe ekufinyeleleni emaphashini ukuyolanda umoya-mpilo.

Njengezifo eziningi zenhliziyo ezelwe, asikho isizathu esaziwayo se-pulmonary atresia. Lesi simo sixhunyaniswe nolunye uhlobo lwesici senhliziyo sokuzalwa esibizwa nge-patent ductus arteriosus (PDA).

I-atresia ye-Pulmonary kungenzeka noma ngaphandle kwesici se-ventricular septal (VSD).

• Uma umuntu engenayo i-VSD, lesi simo sibizwa ngokuthi yi-pulmonary atresia ene-intricular septum (PA / IVS).
• Uma umuntu enezinkinga zombili, lesi simo sibizwa ngokuthi yi-pulmonary atresia ene-VSD. Le ndlela eyeqisayo ye-tetralogy ye-Fallot.

Yize zombili lezi zimo zibizwa ngokuthi yi-pulmonary atresia, empeleni zinamaphutha ahlukile. Lo mbhalo ukhuluma nge-atresia yamaphaphu ngaphandle kwe-VSD.

Abantu abane-PA / IVS bangaba ne-valve ye-tricuspid engakhi kahle. Bangaba ne-ventricle yangakwesokudla engathuthukile noma eminyene kakhulu, nemithambo yegazi engajwayelekile yokondla inhliziyo. Ngokuvamile, izakhiwo ku-ventricle yangakwesobunxele, i-aortic valve, ne-atrium yesokudla ziyabandakanyeka.

Izimpawu zivame ukwenzeka emahoreni ambalwa okuqala okuphila, noma kungathatha izinsuku ezimbalwa.

Izimpawu zingafaka:

• Isikhumba esinemibala eluhlaza okwesibhakabhaka (i-cyanosis)
• Ukuphefumula ngokushesha
• Ukukhathala
• Imikhuba emibi yokudla (izingane zingakhathala ngenkathi zinakekela noma zijuluka ngesikhathi sokuphakelwa)
• Ukuphelelwa umoya

Umhlinzeki wezokunakekelwa kwempilo uzosebenzisa i-stethoscope ukulalela inhliziyo namaphaphu. Abantu abane-PDA banokububula kwenhliziyo okungazwakala nge-stethoscope.

Lezi zivivinyo ezilandelayo zinga-odwa:

• I-x-ray yesifuba
• I-Echocardiogram
• I-Electrocardiogram (ECG)
• Inhliziyo i-catheterization
• I-Pulse oximetry - ikhombisa inani le-oxygen egazini

Umuthi obizwa nge-prostaglandin E1 uvame ukusetshenziselwa ukusiza ukuhamba kwegazi (ukujikeleza) emaphashini. Lo muthi ugcina umthambo wegazi uvulekile phakathi komthambo wamaphaphu kanye nomthambo i-aorta. Umkhumbi ubizwa nge-PDA.

Izindlela zokwelashwa eziningi zingenzeka, kepha kuncike ebukhulwini bokungahambi kahle kwenhliziyo okuhambisana nesici se-valve yamaphaphu. Ukwelashwa okungahle kwenzeke kufaka phakathi:

• Ukulungiswa kwe-biventricular - Lokhu kuhlinzwa kwehlukanisa ukugeleza kwegazi kuye emaphashini kusuka ekusakazeni kuye kuwo wonke umzimba ngokwakha ama-ventricles amabili okumpompa.
• I-univentricular palliation - Lokhu kuhlinzwa kwehlukanisa ukugeleza kwegazi kuye emaphashini kusuka ekusakazeni kuye kuwo wonke umzimba ngokwakha i-ventricle eyodwa yokupompa.
• Ukufakelwa kwenhliziyo.

Amacala amaningi angasizwa ngokuhlinzwa. Ukuthi ingane yenza kahle kangakanani kuya ngokuthi:

• Usayizi nokuxhuma komthambo wamaphaphu (umthambo othatha igazi uye emaphashini)
• Inhliziyo ishaya kahle kanjani
• Athi akhiwe kahle kanjani amanye ama-valve enhliziyo noma ukuthi avuza kangakanani

Umphumela uyehluka ngenxa yezinhlobo ezahlukahlukene zale nkinga. Ingane ingadinga inqubo eyodwa kuphela noma ingadinga ukuhlinzwa kathathu noma ngaphezulu futhi ibe ne-ventricle eyodwa kuphela yokusebenza.

Izinkinga zingafaka:

• Ukukhula okubambezelekile nentuthuko
• Ukuquleka
• Unhlangothi
• I-endocarditis ethathelwanayo
• Ukwehluleka kwenhliziyo
• Ukufa

Shayela umhlinzeki wakho uma ingane:

• Izinkinga ukuphefumula
• Isikhumba, izinzipho noma izindebe ezibonakala ziluhlaza okwesibhakabhaka (i-cyanosis)

Ayikho indlela eyaziwayo yokuvikela lesi simo.

Bonke abesifazane abakhulelwe kufanele bathole ukunakekelwa okuvamile ngaphambi kokubeletha. Ukukhubazeka okuningi kokuzalwa kungatholakala ezivivinyweni ezijwayelekile ze-ultrasound.

Uma ukukhubazeka kutholakala ngaphambi kokuzalwa, ongoti bezokwelapha (njengodokotela wenhliziyo yezingane, udokotela ohlinzayo we-cardiothoracic, kanye neonatologist) bangaba khona lapho kuzalwa, futhi bakulungele ukusiza lapho kudingeka. Lokhu kulungiselelwa kungasho umehluko phakathi kokuphila nokufa kwezinye izingane.

I-pulmonary atresia - i-sectum eqinile ye-ventricular; I-PA / IVS; Isifo senhliziyo esiyizalwa - i-atresia yamaphaphu; Isifo senhliziyo i-cyanotic - i-atresia yamaphaphu; I-Valve-disorder atresia yamaphaphu

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili

I-Fraser CD, uKane LC. Isifo senhliziyo esizalwa naso. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 58.

I-Webb GD, iSmallhorn JF, uTherrien J, uRedington AN. Isifo senhliziyo esizalwa naso esigulini esidala nesingane. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 75.