Ventricular septal chilema

Ventricular septal defect ndi dzenje pakhoma lomwe limasiyanitsa ma ventricle akumanja ndi kumanzere a mtima. Ventricular septal defect ndi chimodzi mwazofala kwambiri zobadwa nazo (zobadwa kuyambira kubadwa) za mtima. Zimapezeka pafupifupi theka la ana onse omwe ali ndi matenda amtima obadwa nawo. Zitha kuchitika zokha kapena matenda ena obadwa nawo.

Mwana asanabadwe, ma ventricle akumanja ndi kumanzere a mtima samasiyana. Pamene mwana wakhanda amakula, khoma lina limasiyanitsa ma ventricle awiriwa. Ngati khoma silipangidwe kwathunthu, dzenje limatsalira. Bowo limadziwika kuti vuto lamitsempha yamagetsi, kapena VSD. Bowo limatha kuchitika m'malo osiyanasiyana kukhoma lanyumba. Pakhoza kukhala bowo limodzi kapena mabowo angapo.

Ventricular septal defect ndi vuto lobadwa nalo la mtima. Mwanayo sangakhale ndi zisonyezo ndipo dzenje limatha kutseka pakapita nthawi popeza khoma limakulirabe pambuyo pobadwa. Ngati bowo ndi lalikulu, magazi ambiri amapopedwa m'mapapu. Izi zitha kubweretsa kulephera kwamtima. Ngati bowo ndi laling'ono, mwina sangalipeze kwa zaka zambiri ndipo amangopezeka atakula.

Zomwe zimayambitsa VSD sizikudziwika. Vutoli limachitika nthawi zambiri limodzi ndi ziwalo zina zobadwa nazo za mtima.

Kwa achikulire, ma VSD amatha kukhala osowa, koma owopsa, amisala yamatenda amtima. Mabowo amenewa samabwera chifukwa cha vuto lobadwa nalo.

Anthu omwe ali ndi VSD sangakhale ndi zizindikilo. Komabe, ngati bowo ndi lalikulu, mwanayo nthawi zambiri amakhala ndi zizindikilo zokhudzana ndi kulephera kwa mtima.

Zizindikiro zofala kwambiri ndi izi:

• Kupuma pang'ono
• Kupuma mofulumira
• Kupuma movutikira
• Khungu
• Kulephera kunenepa
• Kuthamanga kwa mtima
• Kukhetsa thukuta uku mukudya
• Matenda opuma pafupipafupi

Kumvetsera ndi stethoscope nthawi zambiri kumavumbula kung'ung'udza kwamtima. Phokoso lakudandaula limakhudzana ndi kukula kwa chilemacho ndi kuchuluka kwa magazi omwe akudutsa chilemacho.

Mayeso atha kuphatikiza:

• Catheterization yamtima (yosafunikira kwenikweni, pokhapokha ngati pali nkhawa za kuthamanga kwa magazi m'mapapu)
• X-ray pachifuwa - amayang'ana kuti awone ngati pali mtima waukulu wokhala ndi madzi m'mapapo
• ECG - imawonetsa zizindikiro zakukula kwamanzere kwamanzere
• Echocardiogram - imagwiritsidwa ntchito kupanga chidziwitso chotsimikizika
• Kujambula kwa MRI kapena CT pamtima - kumawoneka kupunduka ndikupeza magazi omwe akupita m'mapapu

Ngati chilemacho ndi chaching'ono, palibe chithandizo chofunikira. Koma mwanayo ayenera kuyang'aniridwa mosamalitsa ndi wothandizira zaumoyo. Izi ndikuwonetsetsa kuti dzenjelo limatsekedwa bwino ndipo zizindikiritso za mtima sizichitika.

Ana omwe ali ndi VSD yayikulu omwe ali ndi zizindikilo zokhudzana ndi kufooka kwa mtima angafunike mankhwala kuti athetse zizindikilo ndi maopareshoni kuti atseke dzenje. Mankhwala okodzetsa amagwiritsidwa ntchito nthawi zambiri kuti athetse vuto la mtima woperewera.

Ngati zizindikiritso zikupitilira, ngakhale ndi mankhwala, kuchitidwa opaleshoni kuti atseke chilembocho ndi chigamba kumafunika. Ma VSD ena amatha kutsekedwa ndi chida chapadera panthawi yamatenda amtima, omwe amapewa kufunika kochitidwa opaleshoni. Izi zimatchedwa kutsekedwa kwa transcatheter. Komabe, mitundu yokhayo yaziphuphu ndi yomwe imatha kuthandizidwa motere.

Kuchita opaleshoni ya VSD yopanda zizindikiro ndizovuta, makamaka ngati palibe umboni wowonongeka kwa mtima. Kambiranani izi mosamala ndi omwe akukuthandizani.

Zolakwika zambiri zazing'ono zimangotseka zokha. Opaleshoni imatha kukonza zolakwika zomwe sizimatseka. Nthawi zambiri, munthu samakhala ndi zovuta zamankhwala zomwe zikuchitika zokhudzana ndi vuto ngati litatsekedwa ndi opareshoni kapena kutseka lokha. Zovuta zimatha kuchitika ngati vuto lalikulu silichiritsidwa ndipo mapapo ali ndi vuto lokhalitsa.

Zovuta zingaphatikizepo:

• Kulephera kwa aortic (kutuluka kwa valavu yomwe imalekanitsa mpweya wamanzere kuchokera ku aorta)
• Kuwonongeka kwa magwiridwe amagetsi opangira mtima panthawi yochita opareshoni (kuyambitsa kusakhazikika kapena kuchepa kwa mtima)
• Kukula kwakuchedwa kukula (kulephera kukula bwino akadali akhanda)
• Mtima kulephera
• Matenda opatsirana a endocarditis (matenda a bakiteriya amtima)
• Kuthamanga kwa magazi m'mapapo (kuthamanga kwa magazi m'mapapu) kumabweretsa kufooka kwa dzanja lamanja la mtima

Nthawi zambiri, vutoli limapezeka mukamayesa khanda mwachizolowezi. Itanani omwe amakupatsani khanda ngati mwana akuwoneka kuti akuvutika kupuma, kapena ngati mwanayo akuwoneka kuti ali ndi matenda achilengedwe angapo.

Kupatula VSD yomwe imayambitsidwa ndi vuto la mtima, vutoli limakhalapo pakubadwa.

Kumwa mowa komanso kugwiritsa ntchito mankhwala ochepetsa mphamvu ya depakote ndi dilantin panthawi yapakati kumawonjezera chiopsezo cha ma VSD. Kupatula kupewa zinthu izi panthawi yapakati, palibe njira yodziwika yopewera VSD.

VSD; Interventricular septal chilema; Kobadwa nako mtima chilema - VSD

• Kuchita opaleshoni yamtima wa ana - kutulutsa

• Mtima - gawo kupyola pakati
• Mtima - kuwonera kutsogolo
• Ventricular septal chilema

CD ya Fraser, Kane LC. Matenda amtima obadwa nawo. Mu: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: Maziko Achilengedwe a Njira Zamakono Zopangira Opaleshoni. Wolemba 20th. Philadelphia, PA: Elsevier; 2017: chap 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Matenda obadwa nawo mumtima mwa wamkulu komanso wodwala. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 75.