Maluso a patent ductus arteriosus

Patent ductus arteriosus (PDA) ndi mkhalidwe womwe ductus arteriosus satseka. Mawu oti "patent" amatanthauza kutseguka.

Ductus arteriosus ndi mtsempha wamagazi womwe umalola magazi kuti azungulira m'mapapu a mwana asanabadwe. Khanda litangobadwa ndipo mapapu adzaza ndi mpweya, ductus arteriosus safunikiranso. Nthawi zambiri imatsekedwa patatha masiku angapo kuchokera pomwe mwana wabadwa. Ngati chotengeracho sichitseka, chimatchedwa PDA.

PDA imabweretsa magazi osazolowereka pakati pamitsempha ikuluikulu iwiri yomwe imanyamula magazi kuchokera pamtima kupita m'mapapu ndi thupi lonse.

PDA imakonda kupezeka mwa atsikana kuposa anyamata. Vutoli limafala kwambiri kwa makanda asanakwane komanso omwe ali ndi matenda opatsirana opatsirana. Makanda omwe ali ndi vuto la chibadwa, monga Down syndrome, kapena makanda omwe amayi awo anali ndi rubella ali ndi pakati ali pachiwopsezo chachikulu cha PDA.

PDA imadziwika mwa makanda omwe ali ndi vuto la mtima wobadwa nawo, monga hypoplastic left heart syndrome, kusintha kwa zotengera zazikulu, ndi kupindika kwa m'mapapo mwanga.

PDA yaying'ono siyingayambitse zizindikiro zilizonse. Komabe, ana ena amatha kukhala ndi zizindikilo monga:

• Kupuma mofulumira
• Zizolowezi zopanda kudya
• Kutentha mwachangu
• Kupuma pang'ono
• Kukhetsa thukuta uku mukudya
• Kutopa mosavuta
• Kukula kosauka

Ana omwe ali ndi PDA nthawi zambiri amakhala ndi kudandaula kwa mtima komwe kumamveka ndi stethoscope. Komabe, makanda asanakwane, kudandaula mtima sikungamveke. Wothandizira zaumoyo atha kukayikira vutoli ngati khanda lipuma kapena kudyetsa mavuto atangobadwa.

Zosintha zitha kuwoneka pachifuwa x-ray. Matendawa amatsimikiziridwa ndi echocardiogram.

Nthawi zina, PDA yaying'ono imatha kupezeka mpaka ali mwana.

Ngati palibe zolakwika zina pamtima zomwe zilipo, nthawi zambiri cholinga chamankhwala ndikutseka PDA. Ngati mwanayo ali ndi mavuto ena amtima kapena zopunduka, kusunga ductus arteriosus kungakhale kopulumutsa moyo. Mankhwala atha kugwiritsidwa ntchito kuti aletse kutseka.

Nthawi zina, PDA imatha kutseka yokha. Ana obadwa masiku asanakwane, nthawi zambiri amatseka zaka ziwiri zoyambirira. M'mwana wakhanda, PDA yomwe imatseguka pakatha milungu ingapo yoyambirira imangotseka yokha.

Pakufunika chithandizo, mankhwala monga indomethacin kapena ibuprofen nthawi zambiri amakhala chisankho choyamba. Mankhwala amatha kugwira ntchito bwino kwa ana obadwa kumene, osakhala ndi zotsatirapo zochepa. Chithandizo choyambirira chimaperekedwa, ndizotheka kuchita bwino.

Ngati njirazi sizikugwira ntchito kapena sizingagwiritsidwe ntchito, mwanayo angafunikire kupita kuchipatala.

Kutseka kwa transcatheter ndichinthu chomwe chimagwiritsa ntchito chubu chopyapyala chomwe chimayikidwa mumtsuko wamagazi. Dotolo amadutsa kachingwe kakang'ono kazitsulo kapena chida china chotsekera kudzera pa catheter kupita kumalo a PDA. Izi zimatseka magazi kutuluka mchombo. Ma coil awa amatha kuthandiza mwana kupewa opaleshoni.

Kuchita opaleshoni kungafunike ngati njira ya catheter siyigwira ntchito kapena singagwiritsidwe ntchito chifukwa cha kukula kwa mwana kapena zifukwa zina. Kuchita opaleshoni kumaphatikizapo kudula pang'ono pakati pa nthiti kuti akonze PDA.

PDA yaying'ono ikakhala yotseguka, mwanayo amatha kukhala ndi zizindikilo za mtima. Ana omwe ali ndi PDA yokulirapo amatha kukhala ndi mavuto amtima monga mtima kulephera, kuthamanga kwa magazi m'mitsempha ya m'mapapo, kapena matenda amkati mwa mtima ngati PDA siyitseka.

Vutoli limapezeka nthawi zambiri ndi omwe amakupatsirani khanda. Kupuma ndi kudyetsa mwana wakhanda nthawi zina kumatha kukhala chifukwa cha PDA yomwe sinapezeke.

PDA

• Kuchita opaleshoni yamtima wa ana - kutulutsa

• Mtima - gawo kupyola pakati
• Patent ductus arteriosis (PDA) - mndandanda

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.