Ukushintshwa kwemithambo emikhulu

Ukushintshwa kwemithambo emikhulu (i-TGA) yisici senhliziyo esivela ekuzalweni (kokuzalwa). Imithambo emibili emikhulu esusa igazi lisuke enhliziyweni - i-aorta kanye nomthambo wamaphaphu - ishintshiwe (idlulisiwe).

Imbangela ye-TGA ayaziwa. Akuhlotshaniswa nanoma yikuphi ukungajwayelekile okuvamile kofuzo. Kuyaqabukela kwenzeka kwamanye amalungu omndeni.

I-TGA yinkinga yenhliziyo e-cyanotic. Lokhu kusho ukuthi kunciphile i-oksijini egazini elikhishwa lisuka enhliziyweni liye kuwo wonke umzimba.

Ezinhliziyweni ezijwayelekile, igazi elibuya emzimbeni lingena ngasohlangothini lwesokunene senhliziyo nomthambo wamaphaphu emaphashini ukuze lithole umoya-mpilo. Igazi bese libuyela ohlangothini lwesobunxele lwenhliziyo bese liphuma lisiya emzimbeni.

Ku-TGA, igazi le-venous libuyela ngokujwayelekile enhliziyweni nge-atrium efanele. Kepha, esikhundleni sokuya emaphashini ukuyomunca umoya-mpilo, leli gazi likhishwa nge-aorta libuyele emzimbeni. Leli gazi alizange ligcwaliswe nge-oxygen futhi liholela ku-cyanosis.

Izimpawu zivela lapho kuzalwa noma ngokushesha kakhulu ngemuva kwalokho. Ukuthi zimbi kangakanani izimpawu kuncike ohlotsheni nosayizi wezinkinga zenhliziyo ezingeziwe (ezinjenge-atrial septal defect, i-ventricular septal defect, noma i-patent ductus arteriosus) nokuthi igazi lingaxubana kangakanani phakathi kwale mibono emibili engajwayelekile.

Izimpawu zingafaka:

• I-Blueness yesikhumba
• Ukushayisana kweminwe noma izinzwane
• Ukudla okungafanele
• Ukuphelelwa umoya

Umhlinzeki wezokunakekelwa kwempilo angabona ukukhononda kwenhliziyo ngenkathi elalele isifuba nge-stethoscope. Umlomo nesikhumba sengane kuzoba umbala oluhlaza okwesibhakabhaka.

Ukuhlolwa kuvame ukufaka okulandelayo:

• I-catheterization yenhliziyo
• I-x-ray yesifuba
• ECG
• I-Echocardiogram (uma yenziwa ngaphambi kokuzalwa, ibizwa nge-fetal echocardiogram)
• I-pulse oximetry (ukuhlola izinga le-oxygen yegazi)

Isinyathelo sokuqala ekwelashweni ukuvumela igazi elicebile oksijini lihlangane negazi elingenawo umoya-mpilo. Ingane izothola ngokushesha umuthi obizwa nge-prostaglandin nge-IV (intambo efaka emithanjeni).Lo muthi usiza ukugcina umthambo wegazi obizwa nge-ductus arteriosus uvulekile, uvumela ukuxubana okuthile kokujikeleza kwegazi okubili. Kwezinye izimo, ukuvula phakathi kwe-atrium yangakwesokudla nangakwesobunxele kungakhiwa ngenqubo kusetshenziswa ipayipi lebhaluni. Lokhu kuvumela igazi ukuba lihlangane. Le nqubo yaziwa njenge-balloon atrial septostomy.

Ukwelashwa unomphela kuhilela ukuhlinzwa kwenhliziyo lapho imithambo yegazi emikhulu isikwa futhi ithungwe ibuyele endaweni yayo efanele. Lokhu kubizwa ngokuthi yi-arterial switchch operation (ASO). Ngaphambi kokuthuthuka kwalokhu kuhlinzwa, kusetshenziswe ukuhlinzwa okubizwa nge-atrial switch (noma inqubo ye-Mustard noma inqubo yeSenning).

Izimpawu zengane zizothuthuka ngemuva kokuhlinzwa ukulungisa iphutha. Iningi lezinsana ezishintshelwa emithambo yegazi azinazo izimpawu ngemuva kokuhlinzwa futhi ziphila impilo ejwayelekile. Uma kungenziwa ukuhlinzwa kokulungisa, isikhathi sokuphila siyizinyanga kuphela.

Izinkinga zingafaka:

• Izinkinga zomthambo weCoronary
• Izinkinga ze-valve yenhliziyo
• Isigqi senhliziyo esingajwayelekile (arrhythmias)

Lesi simo singatholakala ngaphambi kokuzalwa kusetshenziswa i-echocardiogram yombungu. Uma kungenjalo, kuvame ukutholakala ngokushesha ngemuva kokuzalwa kwengane.

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma isikhumba sengane yakho siba nombala oluhlaza okwesibhakabhaka, ikakhulukazi ebusweni noma esiqwini.

Shayela umhlinzeki wakho uma ingane yakho inale nkinga futhi kuvela izimpawu ezintsha, ziba zimbi kakhulu, noma ziqhubeke ngemuva kokwelashwa.

Abesifazane abahlela ukukhulelwa kufanele bagonywe i-rubella uma bengekho omzimba. Ukudla kahle, ukugwema utshwala, nokulawula isifo sikashukela ngaphambi nangesikhathi sokukhulelwa kungasiza.

d-TGA; Ukukhubazeka kwenhliziyo okuzalwa - ukuguquka; Isifo senhliziyo se-cyanotic - ukuguquka; Ukukhubazeka kokuzalwa - ukuguquka; Ukuguqulwa kwemikhumbi emikhulu; I-TGV

• Ukuhlinzwa kwenhliziyo yezingane - ukukhishwa

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• Ukuguqulwa kwemikhumbi emikhulu

UBernstein D. Isifo senhliziyo esizalwa naso seCyanotic: ukuhlolwa kwe-neonate egula kakhulu nge-cyanosis nokucindezeleka kokuphefumula. Ku: Kliegman RM, Stanton BF, St Geme JW, Schor NF, ama-eds. Incwadi kaNelson Yezingane. Umhlaka 21. IPhiladelphia, PA: Elsevier; 2019: isahluko 456.

I-Fraser CD, uKane LC. Isifo senhliziyo esizalwa naso. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa: Isisekelo Sebhayoloji Sokuzijwayeza Kwamanje Kokuhlinzwa. 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.