Pulmonary atresia

Pulmonary atresia chimiro chehosha yemoyo umo iyo vharuvhu yemapapu haina kuumba mushe. Iyo iripo kubva pakuberekwa (chirwere chepfungwa chepfungwa). Iyo pulmonary vharuvhu yakavhurika kurudyi kwemoyo iyo inodzora kuyerera kweropa kubva kurudyi ventricle (kurudyi kurudyi kupomha kamuri) kuenda kumapapu.

Mune pulmonary atresia, mapepa evhavha akasanganiswa. Izvi zvinoita kuti jira rakasimba rezvinyama riumbe apo panofanira kuvhurwa vharuvhu. Ropa rakajairwa kuyerera kumapapu rakavharwa semhedzisiro. Nekuda kwekuremara uku, ropa rinobva kurudyi kwemoyo rinotadziswa kusvika pamapapu kunotora oxygen.

Sezvo nezvizhinji zvezvirwere zvepfungwa zvepamoyo, hapana chinozivikanwa chikonzero cheplmonary atresia. Mamiriro acho akabatanidzwa neimwe mhando yekuberekwa kwemoyo kuremara inonzi patent ductus arteriosus (PDA).

Pulmonary atresia inogona kuitika kana kana isina ventricular septal defect (VSD).

• Kana munhu wacho asina VSD, mamiriro acho anonzi pulmonary atresia ine intact ventricular septum (PA / IVS).
• Kana munhu wacho aine matambudziko ese ari maviri, mamiriro acho anonzi pulmonary atresia ine VSD. Iyi ndiyo fomu yakanyanyisa ye tetralogy yeFallot.

Kunyangwe zvese zviri zviviri mamiriro anonzi pulmonary atresia, iwo akatokanganisa zvakasiyana. Ichi chinyorwa chinokurukura pulmonary atresia isina VSD.

Vanhu vane PA / IVS vanogona zvakare kuve neyakagadziriswa tricuspid vharuvhu. Ivo vanogona zvakare kuve vasina kusasimukira kana wakakora kwazvo kurudyi ventricle, uye zvisina kujairika tsinga dzeropa dzinofudza moyo. Zvishoma kazhinji, zvivakwa mune yekuruboshwe ventricle, aortic vharafu, uye kurudyi atrium inosanganisirwa.

Zviratidzo zvinowanzoitika mumaawa mashoma ekutanga ehupenyu, kunyange zvichitora kusvika mazuva mashoma.

Zviratidzo zvinogona kusanganisira:

• Bluish ganda ganda (cyanosis)
• Kukurumidza kufema
• Kuneta
• Tsika dzakashata dzekudya (vacheche vanogona kuneta vachiri kuyamwa kana kutuka panguva yekudya)
• Kufema kwekufema

Anopa hutano anoshandisa stethoscope kuteerera kune moyo nemapapu. Vanhu vane PDA vane moyo kugunun'una kunogona kunzwika ne stethoscope.

Iyi bvunzo inotevera inogona kurairwa:

• Chest x-ray
• Echocardiogram
• Electrocardiogram (ECG)
• Moyo catheterization
• Pulse oximetry - inoratidza huwandu hweokisijeni muropa

Mushonga unonzi prostaglandin E1 unowanzo shandiswa kubatsira kufamba kweropa (kutenderera) mumapapu. Mushonga uyu unochengeta tsinga yeropa yakavhurika pakati peye pulmonary arteri uye aorta. Mudziyo unonzi PDA.

Mishonga yakawanda inogoneka, asi zvinoenderana nekuwanda kwemoyo zvisirizvo zvinofambidzana neplmonary vharuvhu kukanganisa. Mishonga inogona kuitika inosanganisira:

• Kugadziriswa kwebiventricular - Kuvhiya uku kunopatsanura kuyerera kweropa kuenda kumapapu kubva mukutenderera kuenda kune iyo yese muviri nekugadzira maviri ekupomba ma ventricles.
• Univentricular palliation - Kuvhiya uku kunopatsanura kuyerera kweropa kuenda kumapapu kubva mukutenderera kuenda kune imwe muviri wese nekuvaka imwe yekupomba ventricle.
• Kuisa moyo.

Kazhinji kesi dzinogona kubatsirwa nekuvhiya. Kunyatsoita mwana zvinoenderana ne:

• Kukura nekubatana kwepurmonary arteri (iyo arter inotora ropa kuenda kumapapu)
• Moyo unorova zvakadii
• Akanaka sei mamwe mavharuvhu emoyo akaumbwa kana kuti ari kubuda zvakadii

Mhedzisiro inosiyana nekuda kwenzira dzakasiyana dzeichi chirema. Mucheche angangoda chete maitiro kana angangoda matatu kana anopfuura kuvhiiwa uye ane chete chete inoshanda ventricle.

Zvinetso zvinogona kusanganisira:

• Kunonoka kukura uye kusimudzira
• Kufenda
• Kurohwa
• Inotapukira endocarditis
• Kutadza kwemoyo
• Rufu

Fonera mupiki wako kana mwana aine:

• Matambudziko kufema
• Ganda, nzara kana miromo inoratidzika bhuruu (cyanosis)

Iko hakuna inozivikanwa nzira yekudzivirira iyi mamiriro.

Vakadzi vese vane nhumbu vanofanirwa kuwana kurapwa kwepamuviri. Zvizhinji zvekuzvarwa zvakashata zvinogona kuwanikwa pane zvakajairwa ultrasound bvunzo.

Kana hurema hukawanikwa asati aberekwa, nyanzvi dzezvekurapa (senge chiremba wevana, cardiothoracic surgeon, uye neonatologist) vanogona kunge varipo pakuzvarwa, uye vakagadzirira kubatsira pazvinenge zvichidikanwa. Kugadzirira uku kunogona kureva mutsauko pakati pehupenyu nerufu kune vamwe vacheche.

Pulmonary atresia - isina kunyatsoita ventricular septum; PA / IVS; Congenital chirwere chemoyo - pulmonary atresia; Chirwere cheCyanotic chemwoyo - pulmonary atresia; Valve - kusagadzikana pulmonary atresia

• Mwoyo - chikamu kuburikidza nepakati
• Moyo - pamberi pekutarisa

Fraser CD, Kane LC. Congenital chirwere chemoyo. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Chinyorwa Chekuvhiya. 20th ed. Philadelphia, PA: Elsevier; 2017: chitsiko 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital chirwere chemoyo mune mukuru uye wevarwere murwere. Mune: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Chirwere Chemwoyo cheBraunwald: A Chinyorwa cheCardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019: chits. 75.