I-Tricuspid atresia
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I-Tricuspid atresia luhlobo lwesifo sentliziyo esikhoyo ekuzalweni (isifo sentliziyo esibelekweni), apho i-valve yentliziyo ye-tricuspid ilahlekile okanye ikhule ngokungaqhelekanga. Isiphene sithintela ukuhamba kwegazi ukusuka kwi-atrium elungileyo ukuya kwi-ventricle elungileyo. Ezinye iziphene zentliziyo okanye zenqanawa zihlala zikhona ngaxeshanye.
I-Tricuspid atresia yindlela engaqhelekanga yesifo sentliziyo esibelekweni. Ichaphazela malunga ne-5 kuyo yonke i-100,000 yokuzalwa ephilayo. Umntu omnye kwabahlanu onale meko uya kuba nezinye iingxaki zentliziyo.
Ngokwesiqhelo, igazi liphuma emzimbeni liye kwi-atrium elungileyo, emva koko lisebenzise i-tricuspid valve ukuya kwi-ventricle elungileyo nakwimiphunga. Ukuba ivelufa ye-tricuspid ayivuli, igazi alinakuhamba ukusuka kwi-atrium elungileyo ukuya kwi-ventricle elungileyo. Ngenxa yengxaki yevalic tricuspid, ekugqibeleni igazi alinakungena emiphungeni. Kulapho kufuneka iye kulanda ioksijini (iba yioksijini).
Endaweni yoko, igazi lidlula kumngxunya ophakathi kwe-atrium yasekunene neyasekhohlo. Kwi-atrium yasekhohlo, ixubeka kunye ne-oxygen enegazi ebuyayo esuka emiphungeni. Lo mxube we-oxygen-rich kunye ne-oxygen-poor blood uyakhutshelwa ngaphandle emzimbeni ukusuka kwi-ventricle yasekhohlo. Oku kubangela ukuba inqanaba leoksijini egazini libe sezantsi kunesiqhelo.
Kubantu abane-tricuspid atresia, imiphunga ifumana igazi ngomngxunya ophakathi kwe-ventricle yasekunene neyasekhohlo (echazwe apha ngasentla), okanye ngokugcina isitya se-fetal esibizwa ngokuba yi-ductus arteriosus. I-ductus arteriosus idibanisa umthambo we-pulmonary (umthambo wemiphunga) ukuya kwi-aorta (umthambo ophambili emzimbeni). Ikhona xa kuzalwa umntwana, kodwa ngesiqhelo ivala yodwa kungekudala emva kokuzalwa.
Iimpawu zibandakanya:
- Umbala oluhlaza okwesibhakabhaka kulusu (i-cyanosis) ngenxa yenqanaba leoksijini esegazini
- Ukuphefumla ngokukhawuleza
- Ukudinwa
- Ukukhula kakubi
- Ukuqhawukelwa ngumphefumlo
Le meko inokufunyanwa ngexesha lokucingelwa kwe-ultrasound ngaphambi kokubeleka okanye xa umntwana ehlolwa emva kokuzalwa. Ulusu oluhlaza okwesibhakabhaka lukhona xa kuzalwa. Ukumbombozela kwentliziyo kuhlala kukho xa uzalwa kwaye kunokwanda ngengxolo ngaphezulu kweenyanga ezininzi.
Uvavanyo lunokubandakanya oku kulandelayo:
- ECG
- Echocardiogram
- I-x-ray yesifuba
- Ukucinywa kwentliziyo
- I-MRI yentliziyo
- Ukuxilongwa kwe-CT kwentliziyo
Nje ukuba kufunyaniswe isifo, umntwana uya kuhlala engeniswa kwicandelo lokhathalelo olunzulu lwe-neonatal (NICU). Iyeza elibizwa ngokuba yi-prostaglandin E1 linokusetyenziselwa ukugcina i-ductus arteriosis ivulekile ukuze igazi lijikeleze kwimiphunga.
Ngokubanzi, abaguli abakule meko bafuna utyando. Ukuba intliziyo ayikwazi ukumpompa igazi elaneleyo ukuya emiphungeni nasemzimbeni wonke, utyando lokuqala luhlala lusenzeka kwiintsuku zokuqala zobomi. Kule nkqubo, kufakwa i-shunt yokufakelwa ukugcina igazi lihamba liye emiphungeni. Ngamanye amaxesha, olu tyando lokuqala aludingeki.
Emva koko, umntwana uye ekhaya amaxesha amaninzi. Umntwana kuya kufuneka athathe elinye okanye ngaphezulu amayeza emihla ngemihla kwaye alandelwe ngokusondeleyo ngugqirha wezifo zentliziyo yabantwana. Lo gqirha uzakuthatha isigqibo xa inqanaba lesibini lotyando kufuneka lenziwe.
Inqanaba elilandelayo lotyando kuthiwa yiGlenn shunt okanye inkqubo ye-hemi-Fontan. Le nkqubo idibanisa isiqingatha semithambo ephethe igazi elingenayo ioksijini ukusuka kwisiqingatha somzimba ngqo kwi-pulmonary artery. Olu tyando luhlala lusenziwa xa umntwana ephakathi kweenyanga ezi-4 ukuya kwezi-6 ubudala.
Ngexesha lesigaba I no-II, umntwana usenokujongeka eblue (cyanotic).
Isigaba III, inyathelo lokugqibela, libizwa ngokuba yinkqubo yePontian. Eminye imithanjana ephethe igazi elingenayo ioksijini emzimbeni lixhumeke ngqo kwimithambo yemiphunga ekhokelela kwimiphunga. I-ventricle yasekhohlo ngoku kufuneka impompe emzimbeni, hayi kwimiphunga. Olu tyando lwenziwa rhoqo xa umntwana eneenyanga ezili-18 ukuya kwiminyaka emi-3 ubudala. Emva kweli nyathelo lokugqibela, ulusu lomntwana alusekho luhlaza.
Kwiimeko ezininzi, utyando luya kuyiphucula imeko.
Iingxaki zinokubandakanya:
- Ngokungaqhelekanga, ngokukhawuleza kwentliziyo (arrhythmias)
- Urhudo olungapheliyo (ukusuka kwisifo esibizwa ngokuba yi-protein-losing enteropathy)
- Ukumelwa yintliziyo
- Ulwelo esiswini (ascites) nasemiphungeni (ukungxola)
- Ukuvaleka kwe-shunt eyenziweyo
- Ukubetha kunye nezinye iingxaki zenkqubo ye-nervous
- Ukufa ngesiquphe
Nxibelelana nomboneleli wakho wezempilo kwangoko ukuba usana lwakho:
- Utshintsho olutsha kwiipateni zokuphefumla
- Iingxaki zokutya
- Ulusu olujika luhlaza okwesibhakabhaka
Akukho ndlela yaziwayo yokuthintela i-tricuspid atresia.
I-Tri atresia; Ingxaki yeValve- tricuspid atresia; Intliziyo yokuzalwa - i-tricuspid atresia; Isifo sentliziyo seCyanotic- tricuspid atresia
Icandelo lentliziyo phakathi embindini
I-Tricuspid atresia
I-Fraser CD, iKane LC. Isifo sentliziyo. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango. Umhla we-20. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 58.
IWebb GD, i-Smallhorn JF, iTherrien J, iRedington AN. Isifo sentliziyo esibelekwe kumntu omkhulu nakwisigulana sabantwana. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 75.