Iyonke imbuyekezo yemiphunga yemiphunga

Ukubuya okungafunekiyo kwemiphunga kwemiphunga (TAPVR) sisifo sentliziyo apho imithambo emi-4 ethatha igazi kwimiphunga isiya entliziyweni ingadibanisi ngesiqhelo kwi-atrium yasekhohlo (kwigumbi eliphezulu lasekhohlo lentliziyo). Endaweni yoko, banamathela komnye umthambo wegazi okanye kwindawo engalunganga yentliziyo. Kukho ngexesha lokuzalwa (isifo sentliziyo).

Unobangela wokubuya okupheleleyo kwemiphunga okungafunekiyo.

Kumjikelo oqhelekileyo, igazi lithunyelwa livela kwivrikhi yangoku elungileyo ukuya kuthabatha ioksijini emiphungeni. Emva koko ibuya ngemithambo yemiphunga (yemiphunga) kwicala lasekhohlo lentliziyo, elithumela igazi nge-aorta nangokujikeleza umzimba.

Kwi-TAPVR, igazi elityebileyo le-oksijini libuya kwimiphunga liye kwi-atrium yasekunene okanye kumthambo ogeleza ungene kwi-atrium elungileyo, endaweni yecala lasekhohlo lentliziyo. Ngamanye amagama, igazi lijikeleza ngokulula lisuka kwimiphunga kwaye alize liphume liye emzimbeni.

Ukuze usana luphile, isiphene se-atrial septal (ASD) okanye i-patent foramen ovale (indawo phakathi kwe-atria yasekhohlo nasekunene) kufuneka ibekhona ukuvumela igazi elinomoya-mpompo libaleke liye kwicala lasekhohlo lentliziyo kunye nomzimba uphela.

Ukuba nzima kangakanani le meko kuxhomekeke ekubeni ngaba imithambo yamaphemoni ivaliwe okanye iphazamisekile njengoko idreyini. I-TAPVR ethintelweyo ibangela iimpawu kwasekuqaleni ebomini kwaye inokubulala ngokukhawuleza okukhulu ukuba ayifumaneki kwaye ilungiswe ngotyando.

Usana lunokubonakala lugula kakhulu kwaye lunokuba nezi mpawu zilandelayo:

• Umbala oluhlaza okwesibhakabhaka (cyanosis)
• Izifo ezenzeka rhoqo ekuphefumlweni
• Ukuhamba
• Ukutya okungalunganga
• Ukukhula kakubi
• Ukuphefumla ngokukhawuleza

Qaphela: Ngamanye amaxesha, akukho zimpawu zinokubakho ebusaneni okanye ebuntwaneni.

Uvavanyo lunokubandakanya:

• I-catheterization yentliziyo inokuqinisekisa ukuxilongwa ngokubonisa ukuba imithambo yegazi incamathele ngokungaqhelekanga
• I-ECG ibonisa ukwandiswa kwee-ventricles (i-ventricular hypertrophy)
• I-Echocardiogram inokubonisa ukuba iinqanawa zemiphunga ziqhotyoshelwe
• I-MRI okanye i-CT yokuskena kwentliziyo ingabonisa unxibelelwano phakathi kweenqanawa ze-pulmonary
• I-X-ray yesifuba ibonisa okuqhelekileyo ukuya kwentliziyo encinci enamanzi emiphungeni

Utyando ukulungisa ingxaki luyafuneka ngokukhawuleza. Ngoqhaqho, imithambo yemiphunga idityaniswe kwi-atrium yasekhohlo kwaye isiphene phakathi kwe-atrium yasekunene nesekhohlo sivaliwe.

Ukuba le meko ayinyangwa, intliziyo iya kuba nkulu, ikhokelele kukusilela kwentliziyo. Ukulungiswa kwesiphene kwangoko kubonelela ngeziphumo ezibalaseleyo ukuba akukho kuthintelwa kwemithambo yamaphemnamu kunxibelelwano olutsha oluya entliziyweni. Iintsana ezithintele imithanjeni ziye zanda ubomi.

Iingxaki zinokubandakanya:

• Ubunzima bokuphefumla
• Ukumelwa yintliziyo
• Ngokungaqhelekanga, ngokukhawuleza kwentliziyo (arrhythmias)
• Usulelo lwemiphunga
• Uxinzelelo lwegazi

Le meko inokubonakala ngexesha lokuzalwa. Nangona kunjalo, iimpawu zisenokungabikho de kube kamva.

Fowunela umboneleli wakho wezempilo ukuba ubona iimpawu ze-TAPVR. Kufuneka ingqalelo ekhawulezileyo.

Akukho ndlela yaziwayo yokuthintela i-TAPVR.

I-TAPVR; Imithambo iyonke; Isiphene sentliziyo esibelekwe - iTAPVR; Isifo sentliziyo seCyanotic- TAPVR

• Icandelo lentliziyo phakathi embindini
• Ukubuya ngokupheleleyo kwe-pulmonary venous-X-ray
• Ukubuya ngokupheleleyo kwe-pulmonary venous-x-ray
• Ukubuya ngokupheleleyo kwe-pulmonary venous-X-ray

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.