Chipilala chachiwiri cha aortic

Chipilala chachiwiri cha aortic ndimapangidwe abort aorta, mtsempha waukulu womwe umanyamula magazi kuchokera pamtima kupita ku thupi lonse. Ndi vuto lobadwa nalo, kutanthauza kuti limakhalapo pakubadwa.

Chipilala cha aortic kawiri ndimtundu wamba wamagulu olakwika omwe amakhudza kukula kwa aorta m'mimba. Zolakwika izi zimayambitsa mapangidwe osazolowereka otchedwa mphete yamitsempha (bwalo lamitsempha yamagazi).

Nthawi zambiri, minyewa imayamba kuchokera pachimodzi chamatumba. Pamene ana akukula m'mimba, matanthwewo amagawika m'magawo angapo. Thupi limaphwanya mabowo ena, pomwe ena amakhala mitsempha. Aorta wopangidwa bwino ndi chingwe chimodzi chomwe chimachoka mumtima ndikupita kumanzere.

M'miyala iwiri ya aortic, ina mwa matawo omwe amayenera kutayika adakalipo pakubadwa kuwonjezera pa chipilala chachizolowezi. Ana omwe ali ndi chingwe cha aortic chowirikiza amakhala ndi msempha wopangidwa ndi zotengera ziwiri m'malo mwa imodzi.Magawo awiri opita ku aorta ali ndi mitsempha yaying'ono yomwe imatuluka. Zotsatira zake, nthambi ziwirizo zimayenda mozungulira ndikudina pamphepo ndi chubu (esophagus) chomwe chimanyamula chakudya kuchokera pakamwa kupita kumimba.

Chipilala cha aortic chitha kuchitika m'matenda ena obadwa nawo, kuphatikizapo:

• Zolemba Zachinyengo
• Truncus arteriosus
• Kusintha kwa mitsempha yayikulu
• Ventricular septal chilema

Chipilala chambiri cha aortic ndichosowa kwambiri. Mphete zamitsempha ndizochepa pamatenda onse obadwa nawo amtima. Mwa izi, zopitilira theka zimayambitsidwa ndi chipilala cha aortic. Chikhalidwechi chimachitika chimodzimodzi mwa amuna ndi akazi. Nthawi zambiri imapezeka mwa anthu omwe ali ndi vuto linalake la chromosome.

Chifukwa chakuti zizindikiro za khola la aortic kawiri nthawi zambiri zimakhala zochepa, vutoli mwina silingadziwike mpaka mwana atakwanitsa zaka zochepa.

Chipilala cha aortic chimatha kukanikiza pamtengo ndi pamimba, zomwe zimabweretsa vuto lakupuma komanso kumeza. Kukula kwa zizindikirocho kumatengera kuchuluka kwa chipilala cha aortic chomwe chimakakamiza izi.

Zizindikiro zopumira zimaphatikizapo:

• Phokoso lamphamvu kwambiri mukamapuma (stridor)
• Kupuma mokweza
• Chibayo chobwerezabwereza
• Kutentha

Zizindikiro za m'mimba zimaphatikizapo:

• Kutsamwa
• Kuvuta kudya ndi kumeza
• Kusanza

Zizindikirozi zitha kupangitsa kuti wothandizira zaumoyo akayikire chipilala cha aortic. Mayeso ena adzafunika kuti atsimikizire matendawa.

Mayesero otsatirawa angathandize kupeza kachipangizo ka aortic kawiri:

• X-ray pachifuwa
• Zithunzi zomwe zimapanga zithunzi zamagulu (CT kapena MRI scan)
• Kuyesa kwa ultrasound pamtima (echocardiography)
• X-ray pogwiritsa ntchito chinthu chomwe chimafotokoza za kholingo (barium swallow)

Opaleshoni itha kuchitidwa kuti ikonze arch aortic arch. Dokotalayo amamangiriza nthambi yaying'onoyo ndikulekanitsa ndi nthambi yayikuluyo. Kenako dokotalayo amatseka malekezero a aorta ndi ulusi. Izi zimachepetsa kupanikizika kwa mphuno ndi mphepo.

Ana ambiri amamva bwino atangochitidwa opaleshoni, ngakhale ena amatha kupitiliza kukhala ndi zizindikilo zakupuma kwakanthawi akamaliza kukonza. Izi nthawi zambiri zimachitika chifukwa chofooka kwa trachea chifukwa cha kukakamizidwa kwake isanakwane kukonza opaleshoni.

Nthawi zambiri, ngati chipilalacho chikukanikiza kwambiri panjira yapaulendo, mwanayo amatha kupuma movutikira komwe kumabweretsa imfa.

Zovuta zingaphatikizepo:

• Kulephera kukula bwino
• Matenda opuma
• Kuvala zazingwe za mmero (kukokoloka kwa mmero) ndi mapaipi
• Kawirikawiri, kulumikizana kwachilendo pakati pam'mero ​​ndi aorta (aortoesophageal fistula)

Itanani yemwe akukuthandizani ngati khanda lanu lili ndi zizindikilo za arortic arch.

Palibe njira yodziwika yopewera vutoli.

Kung'ambika Chipilala anomaly; Chipilala chachiwiri; Kobadwa nako mtima chilema - pawiri kungʻambika Chipilala; Mtima wopunduka wobadwa - chipilala cha aortic

• Mphete ya mitsempha
• Chipilala chachiwiri cha aortic

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Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. Matenda ena obadwa nawo a mitima ndi mitima. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 459.

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