Mwoyo Wakarurama Wakauya paKuberekwa
Kuchinja kwemasimba makuru (TGA), anonziwo kugoverwa kwemidziyo mikuru, inokanganisa mwoyo yakaremara iripo pakuberekwa. Mumamiriro ezvinhu aya, nzvimbo yemidziyo midzi miviri yeropa inotakurisa ropa kubva pamwoyo, aorta uye mishonga yemapurmita, inoshandurwa. Inofungidzirwa kuti kuchinja kwemasimba makuru kunoitika mumakore ekuberekwa 3 500 kusvika ku5 000, nevakomana vanobatwa kakawanda kupfuura vasikana.
Hazvizivikanwi chii chinokonzera TGA.
Mwoyo wakajairika , ropa kubva mumuviri rinouya mumoyo uye rinobva pamwoyo kusvika kumapapu kuburikidza nemapirmita arteri kuti iwane oxygen. Iyo inodzokera kumwoyo uye inoputirwa kunze kumuviri kuburikidza ne aorta. Sezvo mishonga yemapurmoni uye aorta inoshandiswa muTGA, ropa kubva mumuviri rinouya mumoyo asi rinongodzokorora kumutumbi zvakare risina kuenda kumapapu eoksijeni.
Kuchinja kwemasimba makuru anowanzoitika nemamwe mafungiro emwoyo zvakadai se ventricular septal defect (VSD). Muna 10% yemhosva, pane mamwe marudzi ekuremara kwekuberekwa aripo kuwedzera kuTGA.
Zviratidzo
Zviratidzo zvekushandurwa kwemasimba makuru aripo pakuberekwa kana nguva pfupi. Zviratidzo zvinosanganisira:
- Cyanosis - MuTGA kune mhepo shoma shoma muropa inoputirwa kumuviri. Mwana ane ruvara rwebhuruki kune ganda rake uye ane nguva shoma yekufema.
- Kukurumidza kufema uye moyo wekura
Izvo zvakanyanya zviratidzo izvi zvinoenderana nokuti pane chero oxygen inogona kupinda muropa iro rinotumirwa kunze kwomuviri. Nechipfuva chinomwe chinokonzera septal chidzitiro mumadziro mukati memwoyo. Kana iripo iyo inogona kubvumira rimwe ropa iro rine oxygen mairi kuti rizvivhenganidzwe neropa richibuda kumunhu.
Muchiitiko ichi, mwana wacho aizenge aine cyanosis shoma, kana achingova nazvo apo iye / achichema kana kutsamwa.
Kuziva
Kuongororwa kwekuchinja kwemasimba makuru kunosimbiswa ne ultrasound ye mwoyo, inonzi echocardiogram . Kana TGA ichifungidzirwa asati aberekwa, echocardiogram inogona kuitwa pamucheche mudumbu. Kuona kushandurwa kwemasimba makuru asati aberekwa kunobatsira kuona kuti mwana anogamuchira rudzi rwemhando yehutano iye aizoda mushure mokuberekwa.
Kurapa
Nguva pfupi mushure mekuberekwa, mwana ane TGA anotanga kupiwa mushonga unonzi intravenous (IV) unonzi prostaglandin . Kana pasina pango mukati memasvingo mukati memwoyo kubvumira ropa nemhepo yakasanganiswa mukati uye neropa richienda kumuviri, gomba richagadzirwa nekushandisa shanduro inonzi balloon atrial septostomy (inozivikanwawo seRashkind nzira).
Aya marapirwo, zvisinei, ndeaya kwenguva pfupi. Mwana anozofanira kuva nekuvhiyiwa kwepfungwa yakajeka kugadzirisa kukanganisa kwemwoyo, kuisa mishonga yemapurmoni uye aorta kumashure munzvimbo dzavo dzakanaka (inonzi arterial switch operation). Kuvhiyiwa kunowanzoitwa mumwedzi wokutanga wemwana wehupenyu uye kunogona kudiwa mukati mavhiki maviri ekutanga ehupenyu kana cyanosis yakaoma.
Kusvikira muzana remakore remakumi maviri nemakumi maviri, vana vakawanda vakaberekerwa nekugadziriswa kwemasimba makuru haana kupona makore mashoma. Sezvo zvitsva, nzira dzakapetwa dzokuvhiya uye kuchengetwa kwakanaka mushure mekuvhiyiwa zvakagadzirwa, mifananidzo yakashanduka, uye vana vakawanda vane TGA vanorarama pasina zvinetso zvakakomba.
Kunobva:
> Martins, Paula, & Eduardo Castela. "Kuchinja kwemasimba makuru." Orphanet Journal yeRare Diseases 3 (2008): ePub.