Yoyamba Yopanda Mtima Pa Kubadwa
Kusintha kwa mitsempha yayikuru (TGA), yomwe imatchedwanso kusintha kwa ziwiya zazikulu, ndi vuto lalikulu la mtima lomwe liripo pakubereka. Mu chikhalidwe ichi, malo a mitsempha ikuluikulu ya magazi yomwe imanyamula magazi kutali ndi mtima, aorta ndi mitsempha ya pulmonary, amasinthidwa. Zikuoneka kuti kusinthika kwa mitsempha yayikuluyi imapezeka m'mabanja okwana 3,500 mpaka 5,000, ndipo anyamata amakhudzidwa kwambiri kuposa atsikana.
Sikudziwika chomwe chimayambitsa TGA.
Mu mtima wamba , magazi ochokera m'thupi amabwera mumtima ndipo amapita kuchokera pamtima kupita kumapapu kupyolera mu mitsempha ya pulmonary kuti atenge oksijeni. Ikubwerera kumtima ndipo imaponyedwa ku thupi kudzera mu aorta. Popeza mitsempha ya pulmonary ndi aorta imasinthidwa mu TGA, magazi kuchokera mu thupi amabwera mumtima koma amangothamangidwanso ku thupi kachiwiri popanda kupita m'mapapu a mpweya.
Kusintha kwa mitsempha yaikulu nthawi zambiri kumachitika ndi zofooka zina za mtima monga ventricular septal defect (VSD). Mu 10% ya milandu, pali mitundu ina ya zilema zoberekera zilipo kuphatikizapo TGA.
Zizindikiro
Zizindikiro za kusinthika kwa mitsempha yayikulu imakhalapo pakubereka kapena posakhalitsa. Zizindikiro zikuphatikizapo:
- Cyanosis - Mu TGA muli mpweya wochepa kwambiri m'magazi omwe amaponyedwa ku thupi. Mwanayo ali ndi mtundu wa bluu ku khungu lake ndipo ali ndi mpweya wochepa.
- Kupuma mofulumira ndi kuthamanga kwa mtima
Momwe zizindikiro zimakhalira zimadalira kuti mpweya uliwonse ukhoza kulowa m'magazi omwe amaponyedwa ku thupi. Mphuno yamtundu wa septal ndi dzenje la khoma pakati pa mtima. Ngati ilipo ikhoza kulola magazi ena omwe ali ndi oxygen mmenemo kuti asakanike ndi magazi omwe amapita ku thupi.
Pachifukwa ichi, mwanayo amakhala ndi kachilombo kochepa, kapena amakhala nayo pamene akulira kapena kukwiya.
Kudziwa
Kuzindikira kwa kusintha kwa mitsempha yayikulu kumatsimikiziridwa ndi ultrasound of heart, yotchedwa echocardiogram . Ngati TGA akuyikiridwa asanabadwe, echocardiogram ingakhoze kuchitidwa pa mwana wosabadwa m'mimba. Kuzindikira kusinthidwa kwa mitsempha yayikulu isanakwane kubadwa kumathandiza kutsimikizira kuti mwanayo akulandira chithandizo chamankhwala chofunikira chomwe adzafunikire atabadwa.
Chithandizo
Mwanayo atangobereka, mwana yemwe ali ndi TGA adzayamba kulandira mankhwala osokoneza bongo (IV) otchedwa prostaglandin . Ngati palibe pakhoma pakati pa mtima kulola magazi ndi oxygen kusakanikirana ndi magazi kupita ku thupi, dzenje lidzachitidwa opaleshoni pogwiritsa ntchito njira yotchedwa bulloon atrial septostomy (yomwe imatchedwanso Rashkind ndondomeko).
Komabe, mankhwalawa ndi osakhalitsa. Mwanayo ayenera kuchitidwa opaleshoni yotseguka kuti athetse vuto la mtima, kuyika mitsempha ya pulmonary ndi aorta kubwerera kumalo awo olondola (otchedwa kusinthasintha magetsi). Kuchita opaleshoni kawirikawiri kumachitika mwezi woyamba wa moyo wa mwana ndipo zingakhale zofunikira mkati mwa masabata awiri oyambirira a moyo ngati cyanosis ndi yovuta.
Mpaka zaka za m'ma 200, ana ambiri obadwa ndi kusintha kwa mitsempha yayikulu sanapulumutse miyezi ingapo. Popeza njira zatsopano zopangira opaleshoni komanso chithandizo chabwino pakapita opaleshoni, chithunzichi chasintha, ndipo ana ambiri omwe ali ndi TGA amakhala opanda mavuto aakulu.
Chitsime:
> Martins, Paula, & Eduardo Castela. "Kusintha kwa mitsempha yayikulu." Orphanet Journal ya Matenda Odalirika 3 (2008): ePub.