I-myocarditis - yabantwana

I-myocarditis yabantwana kukudumba kwentliziyo yemisipha kusana okanye kumntwana omncinci.

I-myocarditis inqabile kubantwana abancinci. Kuqheleke kancinane ngakumbi kubantwana abadala nakubantu abadala. Ihlala imbi kakhulu kwiintsana kunye neentsana kunakubantwana abangaphezulu kweminyaka emibini.

Uninzi lweziganeko ebantwaneni zibangelwa yintsholongwane efikelela entliziyweni. Oku kunokubandakanya:

• Umkhuhlane (umkhuhlane) intsholongwane
• Intsholongwane yeCoxsackie
• IParovirus
• Adenovirus

Inokubangelwa zizifo zebhakteria ezinjengesifo seLyme.

Ezinye izizathu ze-myocarditis yabantwana zibandakanya:

• Ukunyanga komzimba kumayeza athile
• Ukubonakaliswa kwimichiza kwindalo esingqongileyo
• Usulelo ngenxa yokungunda okanye iiparasites
• Imitha
• Ezinye izifo (ukuphazamiseka komzimba) ezibangela ukudumba emzimbeni wonke
• Ezinye iziyobisi

Imisipha yentliziyo inokonakaliswa ngqo yile ntsholongwane okanye yintsholongwane eyosulelayo. Impendulo yomzimba yokuzikhusela inokonakalisa izihlunu zentliziyo (ezibizwa ngokuba yi-myocardium) kwinkqubo yokulwa nosulelo. Oku kunokukhokelela kwiimpawu zokungaphumeleli kwentliziyo.

Iimpawu zisenokuba nobulali ekuqaleni kwaye kunzima ukuzibona. Ngamanye amaxesha kwiintsana kunye neentsana, iimpawu zingabonakala ngokukhawuleza.

Iimpawu zingabandakanya:

• Ixhala
• Ukusilela ekukhuleni okanye ekufumaneni ubunzima bomzimba
• Ubunzima bokutya
• Umkhuhlane kunye nezinye iimpawu zosulelo
• Ukungakhathali
• Ukukhutshwa komchamo osezantsi (uphawu lokuncipha komsebenzi wezintso)
• Pale, izandla neenyawo ezipholileyo (uphawu lokuhamba gwenxa)
• Ukuphefumla ngokukhawuleza
• Inqanaba lentliziyo elikhawulezayo

Iimpawu kubantwana abangaphezulu kweminyaka emibini zinokubandakanya:

• Intlungu yendawo yengqumbo kunye nesicaphucaphu
• Iintlungu zesifuba
• Khohlela
• Ukudinwa
• Ukudumba (i-edema) emilenzeni, ezinyaweni, nasebusweni

I-myocarditis yabantwana kunokuba nzima ukuyixilonga kuba iimpawu kunye neempawu zihlala zilingisa ezinye izifo zentliziyo kunye nemiphunga, okanye imeko embi yomkhuhlane.

Umboneleli wezempilo unokuva ukubetha kwentliziyo okukhawulezayo okanye izandi zentliziyo engaqhelekanga ngelixa umamele isifuba somntwana nge-stethoscope.

Uvavanyo lomzimba lunokubonisa:

• Ulwelo emiphungeni nokudumba emilenzeni kubantwana abadala.
• Iimpawu zosulelo, kubandakanya umkhuhlane kunye nerhashalala.

I-x-ray yesifuba ingabonisa ukwanda (ukudumba) kwentliziyo. Ukuba umboneleli ukrokrela i-myocarditis esekwe kuvavanyo nakwisifuba i-x-reyi, kusenokwenziwa i-electrocardiogram ukunceda ukufumanisa isifo.

Olunye uvavanyo olunokufuneka lubandakanya:

• Iinkcubeko zegazi ukujonga usulelo
• Uvavanyo lwegazi ukukhangela izilwa-buhlungu ezichasene neentsholongwane okanye izihlunu zentliziyo uqobo
• Uvavanyo lwegazi ukujonga ukusebenza kwesibindi kunye nezintso
• Gcwalisa ubalo lwegazi
• I-biopsy yentliziyo (eyona ndlela ichanekileyo yokuqinisekisa isifo, kodwa akusoloko ifuneka)
• Uvavanyo olukhethekileyo lokujonga ubukho beentsholongwane egazini (i-viral PCR)

Akukho lonyango lwe-myocarditis. Ukudumba kwentliziyo kwezihlunu kuhlala kuhamba ngokwakho.

Injongo yonyango kukuxhasa ukusebenza kwentliziyo de ukudumba kuphele. Uninzi lwabantwana abanale meko bangeniswa esibhedlele. Umsebenzi uhlala ufuna ukulinganiselwa ngelixa intliziyo ivutha ngenxa yokuba inokuyichukumisa intliziyo.

Unyango lunokubandakanya:

• Iintsholongwane zokulwa nosulelo lwebhaktiriya
• Amayeza alwa nokudumba abizwa ngokuba yi-steroids ukulawula ukudumba
• I-immunoglobulin (IVIG) efakwa ngaphakathi, iyeza elenziwa ngezinto (ezibizwa ngokuba ngamachiza omzimba) elenziwa ngumzimba ukulwa usulelo, ukulawula inkqubo yokuvuvukala
• Inkxaso yoomatshini kusetyenziswa umatshini ukunceda ukusebenza kwentliziyo (kwiimeko ezigwenxa)
• Amayeza okunyanga iimpawu zokwehluleka kwentliziyo
• Amayeza ukunyanga isingqisho sentliziyo esingaqhelekanga

Ukuchacha kwi-myocarditis kuxhomekeke kwisizathu sengxaki nakwimpilo yomntwana iphela. Uninzi lwabantwana bachacha ngokupheleleyo ngonyango olululo. Nangona kunjalo, abanye banokuba nesifo sentliziyo esisigxina.

Iintsana zinomngcipheko omkhulu wesifo esibi kunye neengxaki (kubandakanya ukufa) ngenxa ye-myocarditis. Kwiimeko ezinqabileyo, umonakalo omkhulu kwimisipha yentliziyo ifuna ukufakelwa kwentliziyo.

Iingxaki zinokubandakanya:

• Ukwandiswa kwentliziyo ekhokelela ekunciphiseni ukusebenza kwentliziyo (i-cardiomyopathy edibeneyo)
• Ukumelwa yintliziyo
• Iingxaki zesingqi sentliziyo

Tsalela umnxeba ugqirha wabantwana ukuba kukho iimpawu okanye iimpawu zale meko.

Akukho sithintelo saziwayo. Nangona kunjalo, ukuvavanywa ngokukhawuleza kunye nonyango kunokunciphisa umngcipheko wesifo.

• Isifo esinganyangekiyo

UKnowlton KU, uAnderson JL, uSavoia MC, no-Oxman MN. I-myocarditis kunye ne-pericarditis. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahl. 84.

UMcNamara DM. Ukungaphumeleli kwentliziyo njengesiphumo se-myocarditis yentsholongwane kunye ne-nonviral. Ku: Felker GM, Mann DL, ii-eds. Ukungaphumeleli kwentliziyo: Umlingane kwisifo sentliziyo seBraunwald. Ngomhla we-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 28.

Umzali JJ, Ware SM. Izifo engabalulekanga. Ku: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla wama-21. IPhiladelphia, PA: Elsevier; 2020: isahluko 466.