Inkohlakalo Yentliziyo Ekuzalweni
Ukuguqulwa kwemithambo emininzi (TGA), ebizwa ngokuba nokuguqulwa kweenqanawa ezinkulu, yintsilelo enzulu yintliziyo ekhoyo ekuzalweni. Kule meko, isikhundla seemibhobho zamanzi eziphambili ezithwala igazi kude nentliziyo, i-aorta kunye ne-pulmary artery, ziyatshintshwa. Kuqikelelwa ukuba ukuguqulwa kweemibhobho ezinkulu ku-1 ku-3 500-5000 ukuzalwa, kunye namakhwenkwe achaphazela ngokuphindaphindiweyo kunamantombazana.
Ayaziwa oko kubangela i-TGA.
Kwintliziyo eqhelekileyo , igazi eliphuma emzimbeni liza entliziyweni kwaye lihamba lisuka entliziyweni ukuya kumaphaphu ngokusebenzisa umthambo we-pulmonary ukuze ufumane i-oxygen. Ibuyela entliziyweni kwaye igxothwe emzimbeni nge-aorta. Ekubeni i-pulmonary artery kunye ne-aorta zitshintshwe kwi-TGA, igazi eliphuma emzimbeni liza entliziyweni kodwa libuye liphinda liphindwe emzimbeni ngaphandle kokuya kwimiphunga ye-oksijini.
Ukuguqulwa kwemithambo emininzi kudla ngokuqhubekayo nezinye iintsilelo zeentliziyo ezifana nesiphene se-septal defect (VSD). Kwi-10% yamatyala, kukho ezinye iintlobo zeziphene zokuzalwa ezikhoyo kwiTGA.
Iimpawu
Iimpawu zokuguqulwa kwemithambo emikhulu zikhona ngexesha lokuzalwa okanye kungekudala emva koko. Iimpawu ziquka:
- I-Cyanosis - Ku-TGA kukho i-oxygen encinci egazini ephoswe emzimbeni. Umntwana unemibala ebomvu kwesikhumba sakhe kwaye unokuphefumula.
- Ukuphefumla ngokukhawuleza kunye nentliziyo
Iimpawu ezinzima zixhomekeke ekubeni ingaba i-oksijeni ingangena egazini elikhupha emzimbeni. I-defricular septal defect ngumngxuma eludongeni phakathi kwentliziyo. Ukuba likhoyo lingavumela igazi elithile elinomoya oksixutyaniswe kuyo kunye negazi eliphuma emzimbeni.
Kule meko, umntwana uya kuba ne-cyanosis encinci, okanye abe nayo kuphela xa ekhala okanye ephazamisekile.
Ukuxilongwa
Ukuxilongwa kwe-transposition yeerteries ezinkulu kuqinisekiswa yi-ultrasound yintliziyo, ebizwa ngokuba yi- echocardiogram . Ukuba i-TGA ikhunjulwa ngaphambi kokuzalwa, i-echocardiogram ingenziwa kwi-fetus kwisibeleko. Ukuchonga ukuguqulwa kweemibhobho ezinkulu ngaphambi kokuzalwa kunceda ukuqinisekisa ukuba umntwana ufumana uhlobo olukhethekileyo lonyango oluya kulufuna emva kokuzalwa.
Unyango
Kungekudala emva kokuzalwa, umntwana ophethe i-TGA uya kuqala ukufumana imithi e-intravenous (IV) ebizwa ngokuthi i- prostaglandin . Ukuba akukho mgobo eludongeni phakathi kwentliziyo ukuvumela igazi kunye ne-oksijeni ukuba lixutywe kunye negazi eliya emzimbeni, imingxuma iya kwenziwa ngokusebenzisa ubuchule obubizwa ngokuba yi-balloon sepattostomy (eyaziwa ngokuba yiRashkind inkqubo).
Ezi zonyango, nangona kunjalo, zisesigxina. Usana luya kufuneka lube nokuvulwa kwentliziyo evulekileyo ukulungisa isiphako senhliziyo, ukubeka umthambo we-pulmonary kunye ne-aorta kwiindawo zazo ezichanekileyo (ezibizwa ngokuba ngumsebenzi wokutshintshwa komgubo). Utyando luvame ukuqhutywa kwinyanga yokuqala yobomi kwaye kunokufuneka kwiiveki zokuqala zokuphila ukuba i-cyanosis inzima.
Kuze kubekho inkulungwane yeshumi leminyaka, ininzi iintsana ezizalwe ngokuguqulwa kwemibhobho emikhulu ayizange iphile ngaphezu kweenyanga ezimbalwa. Ukususela kwindlela entsha, ubugcisa obungcono kunye nokunyamekela kangcono emva kokuhlinzwa, sele imifanekiso ishintshile, kwaye ezininzi iintsana kunye ne-TGA ziphila ngaphandle kweengxaki ezinzima.
Umthombo:
> Martins, Paula, & Eduardo Castela. "Ukuguqulwa kwemithambo emihle." I-Orphanet Journal ye-Rare Diseases 3 (2008): iPub.