Kuchita Zachiwerewere (TOF)

Ndani Akufunika Chithandizo cha TOF?

Chithandizo cha TOF chimasonyezedwa kwa odwala onse omwe ali ndi vutoli. Popanda kuthandizidwa, TOF ingayambitse mavuto aakulu, monga sitiroko, kulephera kwa mtima, ndi imfa.

Ofuna kuchiza ndi awa:

• Makanda ndi makanda amapezeka ndi TOF, panthawi yomwe ali ndi pakati kapena atangobadwa kumene.
• Ana omwe ali ndi ma cyanotic spelling, omwe amadziwikanso kuti "Tet spells", omwe amakhala ndi vuto losowa mpweya wambiri.
• Ana okalamba ndi akuluakulu omwe ali ndi TOF yosakonzedwa kapena zotsalira zotsalira pambuyo pokonza kale.

Kulowererapo mwachangu kudzera Kuwongolera opaleshoni ya TOF m'chaka choyamba cha moyo ndikofunikira kukonza moyo ndi ntchito.

Mitundu ya Njira Zochiritsira za TOF

Njira zochizira za TOF zimaphatikizapo kukonza opaleshoni, yomwe ingachitike ngati kukonzanso kwathunthu kapena mwadongosolo.

Kukonza Opaleshoni Yathunthu

• Ndi njira yomwe amaikonda kwambiri makanda ambiri (nthawi zambiri pakati pa miyezi 3-12)
• Zimaphatikizapo kutseka kwa ventricular septal defect ndi chigamba
• Amachepetsa kutsekeka kwa ventricular outflow thirakiti mwa kukulitsa mitsempha ya m'mapapo kapena kusintha valavu ngati pakufunika.

Njira Zosakhalitsa (Zothandizira).

• Ndikofunikira nthawi iliyonse pamene mwana wabadwa msanga kapena ali ndi mitsempha ya m'mapapo yomwe ili yochepa. 
• Blalock-Taussig (BT) shunt - uku ndi kulumikizana kwakanthawi pakati pa subclavia mtsempha wamagazi ndi pulmonary artery kuti magazi aziyenda m'mapapo.

Pulmonary Valve Replacement (ngati pakufunika)

• Odwala ena adzafunika kusintha ma valve a m'mapapo ngati pali kuwonongeka kwakukulu kwa valve
• Izi zikhoza kuchitika pa nthawi ya kukonzanso koyamba kapena pambuyo pake m'moyo.

Pre-Surgery Evaluation ndi Diagnostics

Before ndi kulowererapo opaleshoni, zambiri diagnostic workups adzakhala zichitike kutsimikizira matenda a TOF, kuyesa kuopsa kwa matendawa, ndi konza bwinobwino ndondomeko ya opaleshoni yomaliza Opaleshoni Kulowererapo kwa TOF. 

Zochita zazikulu zidzakhala ndi: 

• Echocardiogram
• Pesi X-ray
• Electrocardiogram
• Cardiac Catheterization
• Pulse Oximetry

Ntchito zowonjezera zitha kuchitidwa kuti athetse matenda aliwonse amtundu (mwachitsanzo, DiGeorge syndrome) omwe angagwirizane ndi TOF.

Kusankha ndi Kukonzekera Opaleshoni

Kukonzekera opaleshoni kumaphatikizapo:

• Kusankha nthawi yoyenera potengera kulemera kwa khanda, zizindikiro zake, komanso kuchuluka kwa okosijeni.
• Kusankha kuchita kukonzanso kwathunthu kapena opaleshoni yochepetsera makanda owopsa kwambiri a cyanotic.
• Dongosolo la opaleshoni liyenera kuphatikizapo kuwunika kwa mitsempha ya m'mapapo ndi valavu kuti alole kukonzekera kukonzanso kwa odwala kapena kusintha kwa valve.
• Kukonzekera kutsatiridwa kwa nthawi yayitali kapena mtsogolo, makamaka ngati m'malo mwa pulmonary valve ikuyembekezeka.

Gulu la akatswiri a matenda amtima kwa ana, maopaleshoni amtima, ogonetsa, ndi chisamaliro cha mwana wakhanda asanachite opaleshoni komanso pambuyo pake madokotala adzakumana kuti agwirizane pa njira yotetezeka komanso yotheka ya opaleshoni.

Njira ya Opaleshoni ya TOF

Opaleshoni ya TOF imaphatikizapo njira zotsatirazi:

1. General Opaleshoni - Wodwalayo amaikidwa pansi pa anesthesia kuti atsimikizire kuti achitidwa opaleshoni yopanda ululu. 
2. Cardiopulmonary Bypass - Ntchito za mapapu ndi mtima zimatengedwa ndi makina a mtima-mapapo, zomwe zimathandiza dokotala kuchita opaleshoni yamtima. 
3. Kutsekedwa kwa VSD - VSD ndi dzenje pakati pa ma ventricles a mtima, ndipo limatsekedwa ndi chigamba. Izi zimalepheretsa kusakanikirana kwa magazi opanda okosijeni ndi okosijeni. 
4. Kuchepetsa Pulmonary Stenosis - Kuchepetsa kwa thirakiti lotuluka ndi valavu ya m'mapapo kumayankhidwa mu sitepe iyi. Zingaphatikizepo kuchotsa zopinga kapena kukulitsa valavu kuti magazi aziyenda m'mapapo. 
5. Kuyamwa kuchokera ku Bypass - Akamaliza kukonza mtima, wodwalayo amachotsedwa pang'onopang'ono panjira yodutsa pamtima. Kenako mapapo ndi mtima zimayambiranso kugwira ntchito zake zachibadwa. 
6. Kusamalira Pambuyo pa Opaleshoni - Wodwalayo amayang'aniridwa mosamala mu ICU (odwala kwambiri) kuti atsimikizire kuchira koyenera komanso kuthandizani aliyense n'zotheka zovuta. 

Zowopsa & Zovuta Zomwe Zingachitike pa Chithandizo cha TOF

Ngakhale zotsatira za opaleshoni za TOF zakhala zikuyenda bwino, zoopsa zomwe zingakhalepo zikuphatikizapo:

• Kutuluka magazi kapena matenda
• Arrhythmias (kugunda kwa mtima kosakhazikika)
• Chotchinga chamtima chomwe chimafuna kuyika pacemaker
• Zotsalira za ventricular septal defects kapena pulmonary obstruction
• Low cardiac output syndrome
• Kuthamanga kwa valve ya pulmonary
• Kukula kwa ventricular yakumanja kapena kusagwira ntchito bwino
• Kufunika kosinthira valavu ya m'mapapo pambuyo pa moyo

Ndi chisamaliro choyenera cha opaleshoni ndi kutsata nthawi zonse, zambiri mwazovutazi zingathe kuthetsedwa bwino.

Zoyenera Kuyembekezera Pambuyo pa Opaleshoni ya TOF?

Nthawi Yamsanga Pambuyo Opaleshoni

• ICU khalani kwa masiku 2-5 kuti muyang'ane mosamala
• Kusiya kuyamwa pang'onopang'ono kuchokera ku chithandizo cha mpweya wabwino ndi mankhwala a inotropic
• Kukhala m'chipatala nthawi zambiri kumatenga milungu 1-2

kuchira

• Ana ambiri amachira bwino ndipo amawonetsa mpweya wabwino komanso magwiridwe antchito
• Kudyetsa ndi kulemera kusintha kwambiri pambuyo pa opaleshoni
• Zoletsa kuchita masewera olimbitsa thupi mwamphamvu zitha kulangizidwa kwakanthawi

Londola

• Kuyendera pafupipafupi kwa cardiology ndi echocardiograms ndi ECGs
• Kuwunika kwa nthawi yayitali kwa ma arrhythmia kapena zovuta zokhudzana ndi ma valve

Kuchira Pambuyo pa Chithandizo & Kusamalira Kwanthawi Yaitali

Kuwongolera kwanthawi yayitali kumaphatikizapo:

• Kujambula kwapamtima kwapang'onopang'ono kuti awone momwe mtima umagwirira ntchito komanso magwiridwe antchito a pulmonary valve
• Kuyang'anira ma arrhythmias, omwe amatha kuwonjezeka paunyamata kapena uchikulire
• Kukonzekera kusintha ma valve a m'mapapo ngati valavu itaya kwambiri
• Thandizo lamalingaliro ndi kuwunika kwachitukuko kuti zitsimikizire kukula bwino ndi kuphunzira

Odwala ambiri amakhala moyo moyo wathunthu, wokangalika wokhala ndi zoletsa zochepa kutsatira kukonza bwino TOF.

Kupambana kwa Chithandizo cha TOF ku India

Malo otsogola kwambiri okhudza mtima wa ana ku India akuwonetsa zotsatira zabwino za opaleshoni ya TOF.

Malipoti ochita bwino:

• Mlingo Wopulumuka Opaleshoni: Oposa 95% m'malo odziwa zambiri
• Kuchepetsa Zizindikiro: Ana ambiri amawona kusintha kwakukulu kwa oxygenation ndi milingo yamphamvu
• Kupulumuka Kwa Nthawi Yaitali: Pamwamba, makamaka ndi kutsata nthawi zonse komanso kuyang'anira nthawi yake ya zovuta mochedwa
• Miyezo Yochepa Yogwiriranso Ntchito: Pamene kukonza koyamba kumachitika ndi njira zamakono

Mtengo wa Opaleshoni ya TOF ku India

Mtengo wa opaleshoni ya TOF ku India ukhoza kusiyana mosiyanasiyana malinga ndi zifukwa zingapo, kuphatikizapo chipatala, zochitika za dokotala, ndi momwe wodwalayo alili. Pafupifupi, mtengo umachokera ku USD 7,500 mpaka USD 9,000. Mtengowu nthawi zambiri umakhudza kuwunika koyambirira, opaleshoni yokha, komanso chisamaliro chapambuyo pa opareshoni. Zipatala zambiri zapamwamba ku India zimapereka zipatala zapamwamba komanso akatswiri odziwa za opaleshoni yamtima, zomwe zingathandize kuti pakhale zotsatira zabwino. Kuphatikiza apo, zipatala zina zimatha kupereka phukusi kapena thandizo landalama kwa odwala omwe akufunika thandizo. Ponseponse, dongosolo lazaumoyo ku India limadziwika kuti limapereka chisamaliro chabwino chamtima pamtengo wotsika poyerekeza ndi mayiko ena ambiri.

Chifukwa Chiyani Musankhe India pa Chithandizo cha TOF?

India ndi amodzi mwa mayiko odalirika kwambiri padziko lonse lapansi zotsika mtengo, chisamaliro chapamwamba chapamtima cha ana.

• Madokotala aluso kwambiri ochita opaleshoni yamtima a ana omwe ali ndi chidziwitso chochuluka pakukonzekera kwa TOF
• Malo apamwamba kwambiri okhala ndi ma ICU apamwamba a mtima
• Phukusi lamankhwala lotsika mtengo poyerekeza ndi mayiko akumadzulo
• Nthawi zochepa zodikirira maopaleshoni ovuta a mtima
• Chisamaliro chophatikizika ndi madokotala a ana, ogonetsa, ndi magulu ochiritsira mtima
• Thandizo lathunthu lazachipatala la zokopa alendo kwa mabanja apadziko lonse lapansi

Zolemba Zofunikira kwa Odwala Opita ku India ku Chithandizo cha TOF

Kwa odwala apadziko lonse omwe akufunafuna chithandizo cha TOF ku India, ndikofunikira kuwonetsa zolemba zina kuti mukhale ndiulendo wosavuta wachipatala. Izi zikuphatikizapo:

• Pasipoti Yovomerezeka: Ndilovomerezeka kwa miyezi isanu ndi umodzi kuchokera tsiku lomwe mwayenda.
• Medical Visa (M Visa): Zoperekedwa ndi Embassy / Consulate waku India pazifukwa zachipatala.
• Kalata Yoyitanira kuchokera ku Chipatala cha India: Kalata yodziwika bwino yofotokoza njira yamankhwala komanso kutalika kwake.
• Zolemba Zaposachedwa Zachipatala: Ma X-ray, ma MRIs, kuyezetsa magazi, ndi zolemba zotumizidwa ndi dotolo wakudziko lakwawo.
• Fomu Yofunsira Visa Yomalizidwa: Ndi zithunzi za kukula kwa pasipoti malinga ndi momwe zimakhalira.
• Umboni wa Njira: Malipoti aku banki a miyezi ingapo yapitayo kapena inshuwaransi yazaumoyo.
• Visa Wachipatala: Ndikofunikira kwa woyenda naye kapena womusamalira amene akuyenda ndi wodwalayo.

Ndibwino kuti mutumize kwa kazembe waku India kapena wotsogolera wanu zachipatala kuti mudziwe zaposachedwa komanso kuthandizidwa ndi zolemba.

Akatswiri apamwamba a TOF ku India

Nawa akatswiri otsogola a TOF ku India. 

1. Dr. Krishna S Iyer, Fortis Escorts Heart Institute, New Delhi
2. Dr. Suresh Joshi, Jaslok Hospital, Mumbai
3. Dr. Muthu Jothi, Indraprastha Apollo Hospital, New Delhi
4. Dr. KR Balakrishnan, MGM Healthcare, Chennai
5. Dr. Devi Prasad Shetty, Narayana Health, Bangalore

Zipatala Zapamwamba Zamankhwala a TOF ku India

Nazi zipatala zotsogola zamankhwala a TOF ku India. 

1. Fortis Escorts Heart Institute, New Delhi
2. Nanavati Max Super Specialty Hospital, Mumbai
3. Chipatala cha Apollo, Chennai
4. Medanta - The Medicity, Gurgaon
5. Jaslok Hospital, Mumbai

Mafunso Ofunsidwa Kawirikawiri (FAQs)

Kodi Tetralogy of Fallot (TOF) ndi yochiritsika?

Inde, kukonzanso kwathunthu kwa opaleshoni kumatha kukonza zolakwika za anatomical, koma kutsata mtima wamoyo wonse ndikofunikira.

Kodi nthawi yabwino yochitira opaleshoni ya TOF ndi iti?

Momwemo, opaleshoni imachitidwa pakati pa miyezi 3-12, koma kulowererapo koyambirira kungafunike pazovuta kwambiri.

Kodi mwana angakhale ndi moyo wabwinobwino pambuyo pokonza TOF?

Ana ambiri amakhala ndi moyo wathanzi, wokangalika pambuyo pokonzanso bwino, ngakhale kuwunika kwamtima nthawi ndi nthawi kumafunika.

Kodi opaleshoni ina idzafunika mtsogolo?

Odwala ena angafunike njira zowonjezera, monga kusintha ma valve a pulmonary, pambuyo pake m'moyo.

Kodi chimachitika ndi chiyani ngati TOF isiyanitsidwa?

Kupanda chithandizo kwa TOF kungayambitse cyanosis, mtima kulephera, sitiroko, ndi kufa msanga.