Isangqa semithambo

Iringi yeVascular kukwakheka ngokungaqhelekanga kwe-aorta, umthambo omkhulu ohambisa igazi lisuka entliziyweni liye kuwo wonke umzimba. Ingxaki yokuzalwa, oko kuthetha ukuba ikhona ekuzalweni.

Iringi yeVascular inqabile. Ibalelwa ngaphantsi kwe-1% yazo zonke iingxaki zentliziyo yokuzalwa. Imeko yenzeka rhoqo kumadoda njengabasetyhini. Abanye abantwana abanesangqa semithambo banenye ingxaki yentliziyo yokuzalwa.

Iringi yeVascular yenzeka kwangoko kakhulu ngexesha lokukhula komntwana esibelekweni. Ngokwesiqhelo, i-aorta ivela kwelinye lamaqhekeza egoso (arches). Umzimba uqhekeza ezinye iiarches eziseleyo, ngelixa ezinye zisenza imithambo. Eminye imithambo ekufuneka ichithakele ayenzi, eyakha isangqa semithambo.

Ngomsesane we-vascular, ezinye iiarches kunye neenqanawa ebekufanele ukuba zitshintshile zaba yimithambo okanye zanyamalala zisekhona xa umntwana ezalwa. Ezi arches zenza isangqa semithambo yegazi, ejikelezayo kwaye icinezele kwi-windpipe (trachea) nakwi-esophagus.

Iindidi ezahlukeneyo zeringi yemithambo ekhoyo. Kwezinye iintlobo, iringi ye-vascular ijikeleza kuphela i-trachea kunye ne-esophagus, kodwa isenokubangela iimpawu.

Abanye abantwana abanesangqa semithambo abaze babe neempawu. Nangona kunjalo, kwiimeko ezininzi, iimpawu zibonwa ngexesha lokuzalwa komntwana. Uxinzelelo kwi-windpipe (i-trachea) kunye ne-esophagus inokukhokelela kwingxaki yokuphefumla kunye nokwetyisa. Okukhona iringi icinezela ezantsi, kokukhona ziya kubakho ezi mpawu.

Iingxaki zokuphefumla zinokubandakanya:

• Ukukhwehlela okuphezulu
• Ukuphefumla okukhulu (stridor)
• Iinyumoniya eziphindiweyo okanye usulelo lokuphefumla
• Uxinzelelo lokuphefumla
• Ukukhawuleza

Ukutya kunokwenza ukuba iimpawu zokuphefumla zibe mandundu.

Iimpawu zokugaya zinqabile, kodwa zinokubandakanya:

• Ukukrwitsha
• Kunzima ukutya ukutya okuqinileyo
• Kunzima ukugwinya (iDysphagia)
• I-Reflux yesisu (GERD)
• Ukuncancisa ibele okanye ukuncancisa ibhotile
• Ukuhlanza

Umboneleli wezempilo uya kumamela ukuphefumla komntwana ukuze akhuphe ezinye iingxaki zokuphefumla ezifana nesifuba. Ukumamela intliziyo yomntwana nge-stethoscope kunokunceda ekuchongeni ukumbombozela kunye nezinye iingxaki zentliziyo.

Ezi mvavanyo zilandelayo zinokukunceda ekufumaniseni iringi yemithambo:

• I-x-ray yesifuba
• Ikhompyuter ye-tomography (CT) yentliziyo kunye nemithambo yegazi emikhulu
• Ikhamera ezantsi emqaleni ukujonga iindlela zomoya (i-bronchoscopy)
• Imagnetic resonance imaging (MRI) yentliziyo kunye nemithambo yegazi ephambili
• Uvavanyo lwe-Ultrasound (i-echocardiogram) yentliziyo
• X-reyi yemithambo yegazi (angiography)
• I-X-ray ye-esophagus isebenzisa idayi ekhethekileyo ukuqaqambisa ngcono indawo (i-esophagram okanye ukugwinya kwe-barium)

Utyando lwenziwa rhoqo ngokukhawuleza kubantwana abaneempawu. Injongo yotyando kukwahlula isangqa semithambo kunye nokunciphisa uxinzelelo kulwakhiwo olungqongileyo. Inkqubo ihlala isenziwa ngokusikwa okuncinci kwicala lasekhohlo lesifuba phakathi kweembambo.

Ukutshintsha ukutya komntwana kunokunceda ekunciphiseni iimpawu zokugaya iringi yemithambo. Umboneleli uya kumisela amayeza (anje ngeyeza lokubulala iintsholongwane) ukunyanga nasiphi na isifo sokuphefumla, ukuba siyenzeka.

Abantwana abangenazo iimpawu abanokufuna unyango kodwa kufuneka bajongwe ngononophelo ukuqinisekisa ukuba imeko ayibi mandundu.

Indlela usana olwenza kakuhle ngayo ixhomekeke ekubeni uxinzelelo lwe-vascular lubeka kangakanani kwi-esophagus kunye ne-trachea kunye nokuba usana lufunyenwe kwaye lunyangwe njani ngokukhawuleza.

Utyando lusebenza kakuhle kwiimeko ezininzi kwaye zihlala zikhupha iimpawu kwangoko. Iingxaki zokuphefumla ezinzima zingathatha iinyanga ukuba ziphele. Abanye abantwana banokuqhubeka nokuphefumla ngamandla, ngakumbi xa besebenza kakhulu okanye benesifo sokuphefumla.

Ukulibaziseka kotyando kwiimeko ezinzulu kunokukhokelela kwiingxaki ezinzulu, ezinje ngomonakalo kwitrachea nasekufeni.

Fowunela umboneleli wakho ukuba umntwana wakho uneempawu zeringi yemithambo. Ukuchongwa nokunyangwa ngokukhawuleza kunokuthintela iingxaki ezinzulu.

Akukho ndlela yaziwayo yokuthintela le meko.

I-arortic arch yasekunene ene-aberrant subclavian kunye ne-ligamentum arteriosus yasekhohlo; Isiphene sentliziyo esibelekwe - iringi yemithambo; Isiphene sokuzalwa kwentliziyo - isangqa semithambo

• Isangqa semithambo

UBryant R, uYoo SJ. Iiringi zeVascular, isilingi semithambo, kunye neemeko ezinxulumene noko. Ku: Wernovsky G, Anderson RH, Kumar K, et al, ii-eds. Anderson's Cardiology yabantwana. Ngomhla we-4. IPhiladelphia, PA: Elsevier; 2020: isahluko 47.

IKliegman RM, iSt. Geme JW, iBlum NJ, i-Shah SS, iTasker RC, uWilson KM. Olunye uqondo lokuzalwa kunye nokungasebenzi kakuhle kwemithambo. 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 459.

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.