Isifo sentliziyo

Isifo sentliziyo ekhulelwe (CHD) yingxaki ngokwakheka kwentliziyo kunye nokusebenza okukhoyo ekuzalweni.

I-CHD inokuchaza inani leengxaki ezahlukeneyo ezichaphazela intliziyo. Luhlobo oluqhelekileyo lwesiphene sokuzalwa. I-CHD ibangela ukusweleka okungaphezulu kunyaka wokuqala wobomi kunazo naziphi na ezinye iziphene zokuzalwa.

I-CHD ihlala yahlulwe yaziindidi ezimbini: i-cyanotic (umbala oluhlaza okwesibhakabhaka obangelwa kukuswela ioksijini) kunye non-cyanotic. Olu luhlu lulandelayo lubandakanya ii-CHDs eziqhelekileyo:

ICyanotic:

• Ukungasebenzi kakuhle kuka-Ebstein
• Intliziyo yasekhohlo engapheliyo
• I-atresia yePulmonary
• Tetralogy yoBuxoki
• Iyonke imbuyekezo yemiphunga yemiphunga
• Ukutshintshwa kweenqanawa ezinkulu
• I-Tricuspid atresia
• Truncus arteriosus

Akukho-cyanotic:

• I-aortic stenosis
• Ivalicic aortic ivelufa
• Isiphene se-Atrial septal (ASD)
• Umjelo we-atrioventricular (isiphelo se-endocardial cushion)
• Ukudibanisa i-aorta
• Ipatent ductus arteriosus (PDA)
• I-Pulmonic stenosis
• Isiphene se-Ventricular septal (VSD)

Ezi ngxaki zinokwenzeka zodwa okanye zidibene. Uninzi lwabantwana abane-CHD abanazo ezinye iintlobo zeziphene zokuzalwa. Nangona kunjalo, iziphene zentliziyo zinokuba yinxalenye yemfuza kunye ne-chromosomal syndromes. Ezinye zezi syndromes zinokudluliselwa kwiintsapho.

Imizekelo ibandakanya:

• Isifo seDiGeorge
• Isifo esiphantsi
• Isifo seMarfan
• Isifo sikaNoonan
• Isifo sikaEdward
• ITrisomy 13
• Isifo sikaTurner

Rhoqo, akukho sizathu sesifo sentliziyo esifumanekayo. Ii-CHDs ziyaqhubeka nokuphandwa kwaye ziphandwe. Iziyobisi ezinjenge-retinoic acid yamabala, iikhemikhali, utywala, kunye nosulelo (njenge-rubella) ngexa lokukhulelwa kunokuba negalelo kwezinye iingxaki zentliziyo yokuzalwa.

Iswekile yegazi elawulwa gwenxa kwabasetyhini abanesifo seswekile ngexesha lokukhulelwa ikwanxulunyaniswe nenqanaba eliphezulu lokukhubazeka kwentliziyo.

Iimpawu zixhomekeke kwimeko. Nangona i-CHD ikhona ngexesha lokuzalwa, iimpawu zisenokungabonakali kwangoko.

Iimpazamo ezinje ngokuthamba kwe-aorta azinakubangela ngxaki kangangeminyaka. Ezinye iingxaki, njenge-VSD encinci, i-ASD, okanye i-PDA ayinakuze ibangele naziphi na iingxaki.

Uninzi lweziphene zentliziyo yokuzalwa lufumaneka ngexesha lokukhulelwa kwe-ultrasound. Xa kufunyanwa isiphene, ugqirha wentliziyo wabantwana, ugqirha wotyando kunye nezinye iingcali banokubakho xa umntwana ezelwe. Ukulungiselela unyango xa luziswa kunokuthetha umahluko phakathi kobomi nokufa kwezinye iintsana.

Zeziphi iimvavanyo ezenziwa emntwaneni ezixhomekeke kwisiphene nakwiimpawu.

Loluphi unyango olusetyenziswayo, kunye nendlela umntwana asabela ngayo kulo, kuxhomekeke kwimeko. Iziphene ezininzi kufuneka zilandelwe ngononophelo. Abanye baya kuphilisa ngokuhamba kwexesha, ngelixa abanye beya kufuna ukunyangwa.

Ezinye ii-CHD zinokunyangwa ngamayeza kuphela. Abanye bafuna ukuphathwa ngendlela enye okanye ezingakumbi zentliziyo okanye ngotyando.

Abasetyhini abakhulelweyo kufuneka bafumane ukhathalelo olufanelekileyo ngaphambi kokubeleka:

• Thintela utywala kunye neziyobisi ezingekho mthethweni ngexesha lokukhulelwa.
• Xelela umboneleli wakho wezempilo ukuba ukhulelwe ngaphambi kokuba uthathe amayeza amatsha.
• Yenza uvavanyo lwegazi kwangoko xa ukhulelwe ukuze ubone ukuba awukhuselekanga kwi-rubella. Ukuba awukhuselekanga, thintela nakuphi na ukubakho kwi-rubella kwaye ugonywe kanye emva kokubeleka.
• Abafazi abakhulelweyo abanesifo seswekile kufuneka bazame ukulawula kakuhle amanqanaba eswekile yegazi.

Ezinye iintlobo zemfuza zinokudlala indima kwi-CHD. Amalungu amaninzi osapho anokuchaphazeleka. Thetha nomboneleli wakho malunga nokucebisa ngemfuza kunye nokuhlolwa ukuba unembali yosapho ye-CHD.

• Icandelo lentliziyo phakathi embindini
• Intliziyo - umbono wangaphambili
• I-Ultrasound, umbungu oqhelekileyo - ukubetha kwentliziyo
• I-Ultrasound, i-ventricular septal defect - ukubetha kwentliziyo
• Ipatent ductus arteriosis (PDA) - uthotho

I-Fraser CD, iKane LC. Isifo sentliziyo. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, ii-eds. Incwadi yeSabiston yoNyango: Isiseko sebhayiloji yoQeqesho lwangoku. 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.