Shanduko yetsinga huru

Kuchinjika kwetsinga huru (TGA) hurema hwemwoyo hunoitika kubva pakuzvarwa (kuberekwa). Iwo maviri makuru arteri anotakura ropa kubva pamoyo - iyo aorta uye pulmonary arteri - inoshandurwa (kutamiswa).

Chikonzero cheTGA hachizivikanwe. Izvo hazvibatanidzwe nechero yakajairika geni kusakwana. Izvo hazviwanzo kuitika mune dzimwe nhengo dzemhuri.

TGA inonzi cyanotic moyo hurema. Izvi zvinoreva kuti okisijeni yakadzikira muropa iyo inoputirwa kubva pamoyo kuenda kune iyo yese muviri.

Mumwoyo yakajairika, ropa rinodzoka kubva mumuviri rinoenda nepaseri rerudyi remoyo uye pulmonary arteri kumapapu kuti uwane oxygen. Ropa rinozodzoka kuruboshwe rwemoyo uye rwunofamba kubuda aorta kumuviri.

MuTGA, ropa rinotyisa rinodzoka zvakajairika pamoyo kuburikidza neatrium chaiyo. Asi, pachinzvimbo chekuenda kumapapu kunotora okisijeni, iri ropa rinoputirwa kunze kuburikidza neaorta uye rodzokera kumuviri. Ropa iri harina kuzadzikiswa neoksijeni uye rinotungamira kune cyanosis.

Zviratidzo zvinoonekwa pakuzvarwa kana munguva pfupi yapfuura. Izvo zvakashata sei zviratidzo zvinoenderana nerudzi uye saizi yekuwedzera kuremara kwemoyo (senge atrial septal kuremara, ventricular septal chirema, kana patent ductus arteriosus) uye kuti iro ropa rinogona kusanganisa sei pakati pemaviri asina kujairika anotenderera.

Zviratidzo zvinogona kusanganisira:

• Blueness yeganda
• Kubhururuka kweminwe kana zvigunwe
• Kudya zvisina tsarukano
• Kufema kwekufema

Anopa hutano anogona kuona kugunun'una kwemoyo achiteerera pachipfuva ne stethoscope. Muromo wemucheche uye ganda rinozove ruvara rwebhuruu.

Miedzo inowanzo sanganisira zvinotevera:

• Catheterization yemwoyo
• Chest x-ray
• ECG
• Echocardiogram (kana ikaitwa usati waberekwa, inonzi fetal echocardiogram)
• Pulse oximetry (kutarisa ropa okisijeni level)

Nhanho yekutanga yekurapa ndeyekutendera ropa-rakazara ropa kuti ribatanidze neropa risina mweya Mwana anobva angogamuchira mushonga unonzi prostaglandin kuburikidza ne IV (intravenous line).Mushonga uyu unobatsira kuchengeta tsinga yeropa inonzi ductus arteriosus yakavhurika, ichibvumira kumwe kusanganisa kwemaviri eropa kutenderera. Mune zvimwe zviitiko, kuvhura pakati pekurudyi uye kuruboshwe atrium kunogona kugadzirwa nemaitiro uchishandisa chibharumu catheter. Izvi zvinobvumira ropa kusanganisa. Iyi nzira inozivikanwa sebhaluni atrial septostomy.

Kurapa zvechigarire kunosanganisira kuvhiyiwa kwemoyo panguva iyo tsinga huru dzinochekwa nekusoserwa panzvimbo dzadzo chaidzo. Izvi zvinodaidzwa kuti arterial switch oparesheni (ASO). Pamberi pekuvandudzwa kwekuvhiyiwa uku, kuvhiya kunodaidzwa kunzi atrial switch (kana Mustard maitiro kana maSenning maitiro) kwakashandiswa.

Zviratidzo zvemwana zvichavandudza mushure mekuvhiyiwa kugadzirisa hurema. Vazhinji vacheche vanochinja arterial havana zviratidzo mushure mekuvhiyiwa uye vanorarama hupenyu hwakajairika. Kana kuvhiya kwekugadzirisa kusingaitwe, iyo tarisiro yehupenyu ingori mwedzi chete.

Zvinetso zvinogona kusanganisira:

• Coronary tsinga matambudziko
• Matambudziko emagetsi emoyo
• Isingawanzo mwoyo moyo mutserendende (arrhythmias)

Aya mamiriro anogona kuongororwa asati aberekwa achishandisa fetal echocardiogram. Kana zvisiri, inowanzoonekwa ichangoburwa mwana achinge azvarwa.

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (senge 911) kana ganda remwana wako rikaita bhuruu ruvara, kunyanya kumeso kana trunk.

Fonera mupiki wako kana mwana wako aine chirwere ichi uye zviratidzo zvitsva zvichikura, zvichitowedzera, kana kuenderera mushure mekurapwa.

Vakadzi vanoronga kuve nepamuviri vanofanirwa kudzivirirwa rubella kana vasati vazvidzivirira. Kudya zvakanaka, kudzivirira doro, uye kudzora chirwere cheshuga zvese usati uye panguva yekuzvitakura zvinogona kubatsira.

d-TGA; Kuberekwa kwemoyo kusakwana - kuchinja; Chirwere cheCyanotic chemwoyo - shanduko; Chibereko chekuzvarwa - shanduko; Kuchinjika kwemidziyo mikuru; TGV

• Chiremba wemwoyo kuvhiya - kubuda

• Mwoyo - chikamu kuburikidza nepakati
• Moyo - pamberi pekutarisa
• Kuchinja kwemidziyo mikuru

Bernstein D. Cyanotic congenital moyo chirwere: kuongororwa kweanorwara zvakanyanya neonate necyanosis uye mweya wekufema. Mune: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Chinyorwa chePediatrics. 21th ed. Philadelphia, PA: Elsevier; 2019: chitsauko 456.

Fraser CD, Kane LC. Congenital chirwere chemoyo. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Chinyorwa Chekuvhiya: Iyo Biological Hwaro hweMazuva Ano Kuvhiya Maitiro. 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.