Ukungena kabini kwi-ventricle yasekhohlo

Ukungena kabini kwi-ventricle yasekhohlo (i-DILV) sisiphene sentliziyo esivela ekuzalweni (kokuzalwa). Ichaphazela iivali kunye namagumbi entliziyo. Iintsana ezizalwe zikule meko zinegumbi elinye lokumpompa (i-ventricle) entliziyweni.

I-DILV yenye yeempazamo zentliziyo ezininzi ezibizwa ngokuba zezinye (okanye eziqhelekileyo) iziphene ze-ventricle. Abantu abane-DILV bane-ventricle enkulu yasekhohlo kunye ne-ventricle encinci yasekunene. I-ventricle yasekhohlo ligumbi lokumpompa kwentliziyo elithumela igazi eline-oksijini emzimbeni. I-ventricle elungileyo ligumbi lokumpompa elithumela igazi elingena-oxygen kwimiphunga.

Kwintliziyo eqhelekileyo, ii-ventricle zasekunene nezasekhohlo zifumana igazi kwi-atria yasekunene nasekhohlo. I-atria ngamagumbi aphezulu entliziyo.Igazi elihlwempuzekileyo le-oksijeni elivela emzimbeni liphuma liye kwi-atrium elungileyo kunye ne-ventricle elungileyo. I-ventricle elungileyo emva koko ipompa igazi kwimithambo ye-pulmonary. Esi sisitya segazi esihambisa igazi liye emiphungeni siyokuthatha ioksijini.

Igazi elinoksijini entsha libuyela kwi-atrium yasekhohlo kunye ne-ventricle yasekhohlo. I-aorta ke ihambisa igazi eline-oksijini kuwo wonke umzimba ukusuka kwi-ventricle yasekhohlo. I-aorta yeyona nto ibangela ukuba umthambo omkhulu uphume entliziyweni.

Kubantu abane-DILV, kuphela i-ventricle yasekhohlo ephuhliswayo. Zombini i-atria zingenagazi kule ventricle. Oku kuthetha ukuba igazi eline-oksijini eline-oksijini egazini Lo mxube upontshwa kuwo wonke umzimba kunye nemiphunga.

I-DILV inokwenzeka ukuba imithambo yegazi emikhulu evela entliziyweni ikwindawo ezingalunganga. I-aorta ivela kwi-ventricle encinci yasekunene kwaye i-pulmonary artery ivela kwi-ventricle yasekhohlo. Inokwenzeka kwakhona xa imithambo ikwindawo yesiqhelo kwaye ivela kwii-ventricles eziqhelekileyo. Kule meko, igazi lihamba ukusuka ngasekhohlo ukuya ngasekunene kwimingxunya phakathi kwamagumbi abizwa ngokuba yi-ventricular septal defect (VSD).

I-DILV inqabile kakhulu. Oyena nobangela awaziwa. Ingxaki inokwenzeka kakhulu ukuba yenzeke kwasekuqaleni ngexesha lokukhulelwa, xa intliziyo yomntwana ikhula. Abantu abane-DILV bahlala benezinye iingxaki zentliziyo, ezinje:

• Ukudibanisa i-aorta (ukunciphisa i-aorta)
• I-pulmonary atresia (i-valve yemiphunga yentliziyo ayibunjwanga kakuhle)
• I-valve stenosis ye-pulmonary (ukunciphisa i-valve ye-pulmonary valve)

Iimpawu ze-DILV zinokubandakanya:

• Umbala oluhlaza okwesibhakabhaka kulusu kunye nemilebe (cyanosis) ngenxa yeoksijini esegazini
• Ukusilela ukutyeba kunye nokukhula
• Ulusu oluthuthu (pallor)
• Ukutya okungalunganga ngenxa yokudinwa ngokulula
• Ukubila
• Imilenze idumbile okanye isisu
• Ingxaki yokuphefumla

Iimpawu ze-DILV zingabandakanya:

• Isingqisho sentliziyo esingaqhelekanga, njengoko sibonile kwi-electrocardiogram
• Ukwakhiwa kolwelo olujikeleze imiphunga
• Ukumelwa yintliziyo
• Ukumbombozela kwentliziyo
• Ukubetha kwentliziyo okukhawulezayo

Uvavanyo lokufumanisa i-DILV lunokubandakanya:

• I-x-ray yesifuba
• Umlinganiso womsebenzi wombane entliziyweni (i-electrocardiogram, okanye i-ECG)
• Uvavanyo lwe-Ultrasound lwentliziyo (i-echocardiogram)
• Ukugqithisa ityhubhu encinci, eguqukayo entliziyweni ukuvavanya imithambo (i-catheterization yentliziyo)
• I-MRI yentliziyo

Utyando luyafuneka ukuphucula ukujikeleza kwegazi emzimbeni nasemiphungeni. Olona tyando luqhelekileyo lokunyanga i-DILV luthotho lwemisebenzi emibini ukuya kwemithathu. Olu tyando luyafana nolo lusetyenziselwa ukunyanga isifo sentliziyo yasekhohlo kunye ne-tricuspid atresia.

Utyando lokuqala lunokufuneka xa umntwana eneentsuku nje ezimbalwa ezelwe. Kwiimeko ezininzi, umntwana usenokuya ekhaya esibhedlele emva koko. Umntwana uya kuhlala efuna ukuthatha amayeza yonke imihla kwaye alandelwe ngokusondeleyo ngugqirha wentliziyo wabantwana (ugqirha wentliziyo). Ugqirha womntwana uya kugqiba xa inqanaba lesibini lotyando kufuneka lenziwe.

Utyando olulandelayo (okanye uqhaqho lokuqala, ukuba umntwana khange ayidinge inkqubo njengosana olusandul 'ukuzalwa) lubizwa ngokuba yi-bidirectional Glenn shunt okanye inkqubo ye-Hemifontan. Olu tyando luhlala lwenziwa xa umntwana eneenyanga ezi-4 ukuya kwezi-6 ubudala.

Kwanasemva kwale misebenzi ingentla, umntwana usenokujongeka eblowu (cyanotic). Inyathelo lokugqibela libizwa ngokuba yinkqubo yePontian. Olu tyando luhlala lusenziwa xa umntwana eneenyanga ezili-18 ukuya kwiminyaka emi-3 ubudala. Emva kweli nyathelo lokugqibela, umntwana akasekho luhlaza.

Umsebenzi we-Fontan awenzi ukujikeleza okuqhelekileyo emzimbeni. Kodwa, iyayiphucula ukuhamba kwegazi ngokwaneleyo ukuze umntwana aphile kwaye akhule.

Umntwana unokufuna utyando olungaphezulu kwezinye iziphene okanye ukwandisa impilo ngelixa elinde inkqubo yeFontan.

Umntwana wakho kungafuneka athathe amayeza ngaphambi nasemva kotyando. Oku kunokubandakanya:

• I-Anticoagulants zokuthintela ukujiya kwegazi
• I-ACE inhibitors ukunciphisa uxinzelelo lwegazi
• I-Digoxin ukunceda isivumelwano sentliziyo
• Iipilisi zamanzi (i-diuretics) ukunciphisa ukudumba emzimbeni

Ukufakelwa kwentliziyo kunokucetyiswa, ukuba ezi ndlela zingasentla aziphumeleli.

I-DILV sisiphene sentliziyo esinzima kakhulu ekungekho lula ukunyanga. Indlela aqhuba ngayo umntwana ixhomekeke:

• Isimo esipheleleyo somntwana ngexesha lokuxilongwa kunye nokunyangwa.
• Ukuba kukho ezinye iingxaki zentliziyo.
• Sibuhlungu kangakanani isiphene.

Emva konyango, uninzi lweentsana ezine-DILV zihlala ukuba ngabantu abadala. Kodwa, baya kufuna ukulandelelwa kobomi bonke. Banokujamelana neengxaki kwaye kuya kufuneka banciphise imisebenzi yabo yomzimba.

Iingxaki ze-DILV zibandakanya:

• Iiklabhu (ukuqina kweebhedi zezikhonkwane) kwiinzwane neminwe (uphawu lwasemva kwexesha)
• Ukumelwa yintliziyo
• Inyumoniya rhoqo
• Iingxaki zesingqi sentliziyo
• Ukufa

Fowunela umboneleli wakho wezempilo ukuba umntwana wakho:

• Kubonakala ngathi ukudinwa ngokulula
• Unengxaki yokuphefumla
• Inesikhumba esimnyama okanye imilebe

Thetha nomboneleli wakho ukuba umntwana wakho akakhuli okanye uzuza ubunzima.

Akukho sithintelo saziwayo.

I-DILV; I-ventricle enye; I-ventricle eqhelekileyo; Intliziyo engenziwanga; Univentricular yentliziyo yohlobo lwasekhohlo lwe-ventricular; Isiphene sentliziyo yentliziyo - i-DILV; Isiphene sentliziyo yeCyanotic - i-DILV; Isiphene sokuzalwa-DILV

• Ukungena kabini kwi-ventricle yasekhohlo

IKanter KR. Ulawulo lwe-ventricle enye kunye nokunxibelelana kwe-cavopulmonary. Ku: Sellke FW, del Nido PJ, Swanson SJ, ii-eds. Ugqirha weSabiston kunye noSpencer wesifuba. Umhla we-9. IPhiladelphia, PA: Elsevier; I-2016: isahluko 129.

IKliegman RM, iSt. Geme JW, iBlum NJ. U-Shah SS, uMsebenzi we-RC, uWilson KM. ISchor NF. Isifo sentliziyo esizalwa sisifo seCyanotic: izilonda ezinxulunyaniswa nokunyuka kwegazi kwimiphunga. 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 458.

UWohlmuth C, uGardiner HM. Intliziyo. Ku: Pandya PP, Oepkes D, Sebire NJ, Wapner RJ, ii-eds. Unyango lwe-Fetal: iSayensi esisiseko kunye nokuziqhelanisa neKlinikhi. Ngomhla wesi-3. IPhiladelphia, PA: Elsevier; 2020: isahluko 29.