I-Present Defect Heart at Birth
Ukuguqulwa kwemithambo emikhulu (TGA), ebizwa ngokuthi ukuguqulwa kwezitsha ezinkulu, kuyisimo esibi senhliziyo esikhona lapho kuzalwa. Kulesi simo, isikhundla sezindlela zombili zegazi ezithwala igazi kude nenhliziyo, umshini we-aorta ne-pulmonary, zishintsha. Kulinganiselwa ukuthi ukuguqulwa kwemithambo emikhulu kubangelwa ukuzalwa oku-1 ku-3 500-5,000, abafana abathintekayo kaningi kunamantombazane.
Ayaziwa ukuthi yini ebangela i-TGA.
Enhliziyweni evamile , igazi elivela emzimbeni lifika enhliziyweni futhi liphuma enhliziyweni liya emaphashini ngokusebenzisa umshini wepulmonary ukuze uthole umoya-mpilo. Ibuyela enhliziyweni futhi iqhutshelwa emzimbeni nge-aorta. Njengoba umthambo we-pulmonary ne-aorta ushintshwe ku-TGA, igazi elivela emzimbeni lifika enhliziyweni kodwa liphinde liphindwe libuyele emzimbeni futhi ngaphandle kokuya emaphashini oksijini.
Ukuguqulwa kwamathambo amakhulu ngokuvamile kubonakala ngezinye izinkinga zenhliziyo ezifana ne-ventricular septal defect (VSD). Ezingamaphesenti angu-10, kunezinye izinhlobo zokukhubazeka okuzalwa ezikhona ngaphezu kwe-TGA.
Izimpawu
Izimpawu zokuguquguquka kwemithambo emikhulu zikhona ngesikhathi sokuzalwa noma ngokushesha. Izimpawu zihlanganisa:
- I-Cyanosis - Ku-TGA kune-oksijini encane kakhulu egazini elikhishwa emzimbeni. Umntwana unemibala ebluhlaza ebusweni bakhe futhi unomoya omfushane.
- Ukuphefumula okusheshayo nenhliziyo
Yeka ukuthi lezi zimpawu zinzima kakhulu kuncike ekutheni ikhona yini i-oksijeni engangena egazini elitholwa emzimbeni. I-septric defect defect kuyinto imbobo odongeni phakathi kwenhliziyo. Uma ikhona ingavumela igazi elithile elinomoya-mpilo kuwo ukuthi lixubane negazi eliphuma emzimbeni.
Kulesi simo, umntwana uzoba ne-cyanosis encane, noma abe nayo kuphela lapho ekhala noma edabukile.
Ukuxilongwa
Ukubona ukuguqulwa kwemithambo emikhulu kuqinisekiswa yi-ultrasound yenhliziyo, ebizwa ngokuthi i- echocardiogram . Uma i-TGA icatshangwa ngaphambi kokuzalwa, i-echocardiogram ingenziwa ebusweni esibelethweni. Ukubona ukuguqulwa kwemithambo emikhulu ngaphambi kokuzalwa kusiza ukuqinisekisa ukuthi ingane ithola uhlobo olukhethekile lokunakekelwa kwezempilo oluzodinga emva kokuzalwa.
Ukwelapha
Ngemva nje kokubeletha, umntwana ophethe i-TGA uzoqala ukuthola imithi ebizwa nge-intraveous (IV) ebizwa ngokuthi i- prostaglandin . Uma kungekho mgobo odongeni phakathi kwenhliziyo ukuvumela igazi nge-oksijini ukuba lixubane negazi eliya emzimbeni, imbobo izohlinzwa ngokusebenzisa inqubo ebizwa nge-balloon i-serialtopomystomy (eyaziwa nangokuthi i-Rashkind inqubo).
Nokho, lezi zokwelapha zingezesikhashana. Ingane izodinga ukuhlinzwa ngenhliziyo evulekile ukulungisa ukukhubazeka kwenhliziyo, ukubeka umthambo we-pulmonary ne-aorta emuva ezindaweni zazo ezifanele (okubizwa ngokuthi ukusebenza komshini wokuguqula). Ukuhlinzwa ngokuvamile kuvame ngenyanga yokuqala yokuphila yengane futhi kungadingeka ngaphakathi kwamasonto amabili okuqala okuphila uma i-cyanosis inzima.
Kuze kube sekhulwini leminyaka leshumi nambili, iningi lezingane ezalwa ngokuguqulwa kwemithambo emikhulu alizange liphile ngaphezu kwezinyanga ezimbalwa. Njengoba amasu amasha, izindlela zokuhlinzeka kangcono nokunakekelwa kangcono ngemva kokuhlinzwa, sekushicilelwe isithombe, futhi iningi labantwana abane-TGA basinda ngaphandle kwezinkinga ezinkulu.
Umthombo:
> Martins, Paula, & Eduardo Castela. "Ukuguqulwa kwemizwa emikhulu." I-Orphanet Journal ye-Rare Diseases 3 (2008): iPub.