Ipatent ductus arteriosus

I-patent ductus arteriosus (PDA) yimeko apho i-ductus arteriosus ingavali. Igama "patent" lithetha ukuvula.

I-ductus arteriosus ngumthambo wegazi ovumela igazi ukuba lijikeleze imiphunga yosana ngaphambi kokuzalwa. Kungekudala emva kokuba usana luzelwe kwaye imiphunga igcwalisa umoya, i-ductus arteriosus ayisadingeki. Ihlala ivalwa kwiintsuku ezimbalwa emva kokuzalwa. Ukuba inqanawa ayivaleki, ibizwa ngokuba yi-PDA.

I-PDA ikhokelela ekuhambeni kwegazi ngokungaqhelekanga phakathi kwemithambo yegazi emikhulu ethwala igazi lisuka entliziyweni liye emiphungeni nakulo lonke umzimba.

I-PDA ixhaphake kakhulu kumantombazana kunamakhwenkwe. Imeko ixhaphake kakhulu kwiintsana ezingaphambi kwexesha kunye nezo zinesifo sokuphefumla kokubeleka. Iintsana ezineziphene zemfuza, ezinjenge-Down syndrome, okanye iintsana ezinomama abane-rubella ngexesha lokukhulelwa zisengozini ephezulu ye-PDA.

I-PDA ixhaphakile kwiintsana ezineengxaki zentliziyo yokuzalwa, ezinje ngesifo sentliziyo esekhohlo, ukuhanjiswa kweenqanawa ezinkulu, kunye ne-pulmonary stenosis.

I-PDA encinci ayinakubangela naziphi na iimpawu. Nangona kunjalo, ezinye iintsana zinokuba neempawu ezinje:

• Ukuphefumla ngokukhawuleza
• Imikhwa yokutya engalunganga
• Ukubetha ngokukhawuleza
• Ukuqhawukelwa ngumphefumlo
• Ukubila ngelixa utyisa
• Ukudinwa ngokulula
• Ukukhula kakubi

Iintsana ezine-PDA zihlala zikrokrela iintliziyo ezinokuviwa ngestethoscope. Nangona kunjalo, kwiintsana ezingaphambi kwexesha, intliziyo inokumbombozela ingavakali. Umboneleli wezempilo unokuyirhanela imeko ukuba usana lunokuphefumla okanye ukondla iingxaki emva nje kokuzalwa.

Utshintsho lunokubonwa kwisifuba x-reyi. Ukuxilongwa kuqinisekiswa nge-echocardiogram.

Ngamanye amaxesha, i-PDA encinci ayinakufunyanwa kude kube kamva kubuntwana.

Ukuba azikho ezinye iziphene zentliziyo ezikhoyo, rhoqo injongo yonyango kukuvala i-PDA. Ukuba umntwana unezinye iingxaki zentliziyo okanye iziphene, ukugcina i-ductus arteriosus ivulekile kunokusindisa ubomi. Amayeza angasetyenziselwa ukuwayeka ukuvala.

Ngamanye amaxesha, i-PDA inokuvala yodwa. Kwiintsana ezizelwe ngaphambi kwexesha, ihlala ivala kwiminyaka emibini yokuqala yobomi. Kwiintsana ezisisigxina, i-PDA ehlala ivulekile emva kweeveki zokuqala inqabile ukuvala yodwa.

Xa kufuneka unyango, amayeza afana ne-indomethacin okanye ibuprofen ahlala ekhethwa kuqala. Amayeza anokusebenza kakuhle kakhulu kwiintsana ezisanda kuzalwa, zineziphumo ebezingalindelekanga ezimbalwa. Unyango lwakwangoko lunikwa, kokukhona kunokwenzeka ukuba luphumelele.

Ukuba la manyathelo awasebenzi okanye angenakusetyenziswa, umntwana kungafuneka enze inkqubo yonyango.

Ukuvalwa kwesixhobo se-transcatheter yinkqubo esebenzisa ityhubhu ecekeceke, engenanto ibekwe kwisitya segazi. Ugqirha udlulisa i-coil encinci yentsimbi okanye esinye isixhobo esikhusela nge-catheter ukuya kwindawo ye-PDA. Oku kuthintela ukuhamba kwegazi kwinqanawa. Ezi coil zinokunceda umntwana ukuba aphephe utyando.

Utyando lunokufuneka ukuba inkqubo ye-catheter ayisebenzi okanye ayinakusetyenziswa ngenxa yesayizi yomntwana okanye ezinye izizathu. Utyando kubandakanya ukusika okuncinci phakathi kweembambo ukulungisa i-PDA.

Ukuba i-PDA encinci ihlala ivulekile, umntwana ekugqibeleni angakhula eneempawu zentliziyo. Iintsana ezine-PDA enkulu zinokuphuhlisa iingxaki zentliziyo ezinje ngokusilela kwentliziyo, uxinzelelo lwegazi oluphezulu kwimithambo yemiphunga, okanye usulelo lwangaphakathi lwentliziyo ukuba iPDA ayivali.

Le meko ihlala ifunyanwa ngumboneleli ovavanya usana lwakho. Ukuphefumla kunye nokondla iingxaki kusana ngamanye amaxesha kunokuba ngenxa ye-PDA engafumaniswanga.

I-PDA

• Ukuhlinzwa kwentliziyo yabantwana-ukukhutshwa

• Icandelo lentliziyo phakathi embindini
• Ipatent ductus arteriosis (PDA) - uthotho

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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.