Total Anomalous Pulmonary Venous Connection (TAPVC)

Total Anomalous Pulmonary Venous Connection (TAPVC) ndi vuto lobadwa lomwe silinachitike pomwe mitsempha yonse ya m'mapapo imalumikizana molakwika ndi atrium yakumanja ya mtima m'malo mwa atrium yakumanzere. Izi zimapangitsa kuti magazi omwe ali ndi okosijeni asakanikane ndi magazi omwe alibe mpweya wabwino, zomwe zimapangitsa kuti thupi likhale lochepa kwambiri. Ana omwe ali ndi TAPVC amatha kupuma mofulumira, khungu la bluish (cyanosis), vuto la kudya kapena kunenepa, komanso kutopa.
Popanda chithandizo, TAPVC imatha kuyambitsa vuto la kupuma kapena kulephera kwa mtima. Kukonza opaleshoni ndiko kukonza kokha. Kuzindikira koyambirira kumapulumutsa miyoyo ndikuwongolera zotsatira zanthawi yayitali.
Sungitsani MisonkhanoNdani Akufunika Chithandizo cha TAPVC?
Nawa magulu a ana omwe amafunikira chithandizo cha TAPVC.
- Ana onse omwe amabadwa ndi TAPVC chifukwa amatsogolera ku mavuto aakulu a oxygen.
- Ana obadwa kumene omwe akuwonetsa zizindikiro za cyanosis (khungu la buluu), kupuma mofulumira, kuvutika kudya, kukula pang'onopang'ono, ngakhale kulephera kwa mtima.
Mitundu ya Njira Zowongolera za TAPVC
Mitundu ya TAPVC imatsimikiziridwa ndi komwe mitsempha imalumikizana mosayenera:
- Supracardiac: mitsempha imakhetsa pamwamba pa mtima
- Zamtima: mitsempha imalumikizana mkati mwa mtima
- Intracardiac: Mitsempha imatuluka pansi pa mtima, nthawi zambiri kudzera m'chiwindi
- Zosakaniza: a kuphatikiza pamwamba
Mosasamala mtundu, kuwongolera opaleshoni ndiko chithandizo: mitsempha ya m'mapapo imayendetsedwanso ndikusokedwa kumanzere kwa atrium, ndipo mabowo aliwonse omwe ali pamtima amatsekedwa. Milandu yolephereka ndizochitika zadzidzidzi, ndipo odwala omwe sanasokonezedwe amathandizidwa msanga, makamaka m'mwezi woyamba. Izi zimathandiza kuti mpweya wabwino ukhale wabwino komanso chitukuko. TAPVC yotsekeka ndi vuto ladzidzidzi lomwe likufunika kuthandizidwa mwachangu chifukwa cha kutsekeka kwa mtsempha wa m'mapapo. TAPVC yosatsekeka imakhala ndi zizindikiro zochepa ndipo nthawi zambiri imakhala yopanda zizindikiro.
Pre-Surgery Evaluation ndi Diagnostics
Zina mwazomwe zimayesedwa musanachite opaleshoni ndi:
- Kuyeza mtima kwa mwanayo
- Kuchita echocardiography ndi catheterization yamtima
- Mbiri yachipatala ya mwanayo
Kusankha ndi Kukonzekera Opaleshoni
Pambuyo pa matenda a TAPVC, gulu lachipatala, lopangidwa ndi dokotala wa ana ndi opaleshoni ya mtima, limakonzekera opaleshoni.
- Amawunikanso zomwe apeza pojambula kuti asankhe njira yabwino yopangira opaleshoni: mwachitsanzo, kudulidwa pachifuwa chapakati (sternotomy) kapena mini-thoracotomy yocheperako.
- Nthawi zimatengera momwe zilili bwino okhazikika khanda ndi if mitsempha yatsekeka.
- Makanda omwe amafunikira kutsekereza amachitidwa opaleshoni pa mwachangu; ena amachitidwa opareshoni posachedwa, mkati mwa milungu ingapo.
- Kukonzekera kwa mankhwala oletsa ululu, kudutsa m'mapapo a mtima, kulumikizanso mitsempha ya m'mapapo, ndi kukonza zolakwika zina zamtima zimakonzedwanso.
Kukonzekera mwatsatanetsatane kumachepetsa zoopsa panthawi ya opaleshoni.
Njira ya Opaleshoni ya TAPVC
Njira ya opaleshoni ya TAPVC ikuchitika motere:
- General Anesthesia - Chinthu choyamba ndikuyika mwanayo pansi pa anesthesia wamba ndikugwirizanitsa ndi makina a mtima-mapapu
- Kucheka - Mu sitepe yotsatira, adokotala amadula pachifuwa, amachotsa mitsempha ya m'mapapo, ndikuyilumikizanso kumanzere kwa atrium.
- Kusoka - Zitatha izi, madokotala amayang'ana mabowo ena owonjezera (matenda a ventricular septal) ndikuwasoka.
- Kuchotsa - Asanachotse makina amtima-mapapo, adotolo amawona ngati pali kutulutsa kapena kutuluka magazi.
- Kutseka - Pamapeto pake, chifuwa chimatsekedwa ndi ma sutures kapena ma staples, ndipo mwanayo amasamutsidwira ku chipinda cha odwala mwakayakaya (ICU).
Zowopsa ndi Zovuta Zomwe Zingachitike pa Chithandizo cha TAPVC
Pali zoopsa zina zomwe zimagwirizanitsidwa ndi chithandizo cha TAPVC. Izi zikuphatikizapo:
- Kusuta
- Kuphatikizika kwa mtima
- Kuchulukana kwamadzi mozungulira mtima
- Kuopsa kwa matenda
Ana ena angafunikire nthawi yowonjezereka kuti achire ndipo angafunikire kuwaika pa makina olowera mpweya kapena m'malo othandizira kuti athandizire kupopa mtima. M'kupita kwa nthawi, pali ndi mwayi kuchepa kwa mitsempha yolumikizananso, zomwe zingayambitsenso zovuta za rhythm. Zowopsazi zitha kuchepetsedwa bwino pokambirana pafupipafupi ndi akatswiri.
Zoyenera Kuyembekezera Pambuyo pa Chithandizo cha TAPVC?
Mwana wanu adzasungidwa ku ICU pambuyo pa opaleshoni. Nazi zomwe mungayembekezere.
- Atha kukhala pa makina opangira mpweya ndipo amafunikira chithandizo chamtima komanso kuchepetsa ululu.
- Kupuma, kugunda kwa mtima, ndi kuchuluka kwa okosijeni m’magazi adzayang'aniridwa mosamala ndi madokotala.
- Zakudya zimayamba kuperekedwa kudzera mu chubu mpaka ana azitha kuyamwa bwino.
- Pakapita masiku angapo, chithandizo cha kupuma chimachotsedwa, ndipo kudyetsa kumakula bwino.
- Pambuyo pa kukhazikika, khandalo limasamutsidwa ku ward yaikulu.
- Makolo amalangizidwa za chisamaliro cha zilonda, mankhwala, zakudya, ndi ndondomeko yotsatila asanatuluke.
- Ana ambiri amatulutsidwa mkati mwa milungu ingapo pambuyo pa opaleshoniyo.
Kuchira Pambuyo pa Chithandizo & Kusamalira Kwanthawi Yaitali
Nazi zina zofunika pambuyo pa chithandizo komanso chisamaliro chanthawi yayitali kumbukirani.
- Kuchira pambuyo pa chithandizo pambuyo pa opaleshoni ya TAPVC zofunika kwambiri kwa moyo wautali wa mwanayo.
- Opaleshoniyo ikachitika, mwanayo amafunika kukaonana ndi madokotala nthawi ndi nthawi.
- Zotsatirazi zidzaphatikizapo kuyang'anira bwino momwe umoyo uliri zosiyana mayesero, ngati echocardiogram.
- Makolo ayenera kuyang'ana zizindikiro za kudyetsa kosauka, zovuta ndi kupuma, ndi ena.
Ana ambiri amachira pambuyo pa opaleshoniyo. Komabe, ena aiwo amatha kukhala ndi vuto la kugunda kwamtima, zomwe ziyenera kukambidwa ndi akatswiri.
Mlingo Wopambana wa Chithandizo cha TAPVC ku India
Pali zinthu zingapo zomwe zimapangitsa kuti chithandizo cha TAPVC chikhale chopambana. Kupambana kwa TAPVC ku India kuli pafupifupi 90% m'malo akatswiri. Ana ambiri amachira popanda vuto lililonse kwa nthawi yayitali. Komabe, kuchira kogwira mtima kwa ana kumadaliranso chisamaliro cha akatswiri pambuyo pa opaleshoni komanso kuwunika pafupipafupi.
Makolo nthawi zonse akulimbikitsidwa kuonetsetsa kuti ana awo kupeza kuyezetsa pafupipafupi ndi kuyezetsa tamaliza ku onetsetsani ayi zovuta zina.
Mtengo wapatali wa magawo TAPVC
Mtengo wa chithandizo cha TAPVC ku India ukhoza kusiyana kwambiri malinga ndi chipatala ndi ndondomeko yeniyeni ya chithandizo. Pa avareji, ndalama zothandizira opaleshoni zimatha kuchokera USD 5,000 mpaka USD 10,000. Mtengowu umaphatikizapo kuyezetsa kusanachitike opaleshoni, opaleshoni, ndi chisamaliro chapambuyo pa opaleshoni. Kuphatikiza apo, zipatala zina zimatha kupereka mapulani olipira kapena thandizo lazachuma kwa mabanja in zosowa. Nthawi zonse zimakhala bwino kufufuza ndikufunsana ndi zipatala zingapo kuti mupeze chithandizo chabwino kwambiri chomwe chili mkati mwa bajeti yanu.
Chifukwa Chiyani Musankhe India pa Chithandizo cha TAPVC?
Pali zifukwa zingapo zomwe munthu ayenera kusankha zipatala zaku India ndi akatswiri pa chithandizo cha TAPVC. Zina mwa zifukwa ndi izi:
- India ali ena a bwino zipatala zokhala ndi zida zamakono zamakono zomwe zimatha kupereka chilichonse chisamaliro kwa odwala.
- India ali ndi madokotala abwino kwambiri padziko lonse lapansi, omwe ambiri a iwo amadziwa zambiri.
- chithandizo mtengo ku India ndizochepa kuposa maiko ena.
- Zipatala zaku India zathana bwino ndi mitundu ina monga infracardiac ndi supracardiac ndi njira zoyendetsera opaleshoni.
- Zipatala za ku India ndizopadera popereka chisamaliro chachifundo ndi chithandizo, zomwe nthawi zambiri zimakhala zofunikira kuti izi zitheke.
Zolemba Zofunikira kwa Odwala Opita ku India ku Chithandizo cha TAPVC
Kwa odwala apadziko lonse omwe akufunafuna chithandizo cha TAPVC 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 TAPVC ku India
Ena mwa akatswiri apamwamba a TAPVC ku India ndi awa:
- Dr. Naresh Trehan, Chipatala cha Medanta, Gurgaon
- Dr. Upendra Kaul, Chipatala cha Batra & Medical Research Center, Delhi
- Dr. Asim Kumar Bardhan, Apollo Gleneagles Hospital, Kolkata
- Dr. Cyrus B Wadia, Jaslok Hospital, Mumbai
- Dr. Prashanta Kumar Ghosh, Indraprastha Apollo Hospital, Delhi
Zipatala Zapamwamba Zachipatala za TAPVC ku India
Zina mwa zipatala zabwino kwambiri ku India zochizira TAPVC ndi izi:
- Chipatala cha Aakash Healthcare Super Specialty, Delhi
- Apollo Hospital, Ahmedabad
- Fortis Hospital, Delhi
- Nanavati Max Super Specialty Hospital, Mumbai
- Chipatala cha Manipal, Bangalore
Mafunso Ofunsidwa Kawirikawiri (FAQs)
Kodi zizindikiro zodziwika kwambiri za TAPVC mwa ana obadwa ndi ziti?
Ana akhanda omwe ali ndi TAPVC amakhala nawo zizindikiro monga bluish mtundu khungu (cyanosis), kupuma mofulumira, kudyetsa bwino, ndi kusowa mphamvu. Zizindikirozi zimachitika chifukwa cha kusowa kwa magazi odzaza ndi okosijeni omwe amafika m'thupi moyenera.
Kodi TAPVC ndi chikhalidwe chowopsa?
Inde, ngati sichitsatiridwa, TAPVC ikhoza kupha. Amachepetsa kuchuluka kwa okosijeni wamagazi m'thupi ndipo angayambitse kulephera kwa mtima kapena vuto lalikulu la kupuma. Opaleshoni yokha is an mankhwala ndi ayenera kuchitidwa posachedwapa kuti mulingo woyenera kwambiri zotsatira.
Kodi TAPVC imazindikiridwa bwanji?
TAPVC yapezeka ndi mayeso monga echocardiography (mtima ultrasound), X-ray pachifuwa, ndipo nthawi zina CT kapena MRI scans. Zimenezi zimathandiza kuti madokotala aziona m’maganizo mwake momwe mtima ndi mitsempha ya m'mapapo zikugwirizana.
Kodi mwana angakhale ndi moyo wabwinobwino pambuyo pa opaleshoni ya TAPVC?
Inde, ana ambiri amakhala ndi moyo wabwinobwino, wathanzi pambuyo pa opaleshoni ya TAPVC yopambana. Ndi kutsata ndi kuwunika pamtima pawo, amatha kukula ndikukula bwino. Angafunike mankhwala kapena kuwunika kowonjezera, koma zotsatira za nthawi yayitali nthawi zambiri zimakhala zabwino ndi kulowererapo koyambirira.
Chifukwa chiyani odwala apadziko lonse lapansi amasankha India kulandira chithandizo cha TAPVC?
India ali ndi akatswiri ochita opaleshoni yamtima, zipatala zotsogola, komanso chithandizo chotsika mtengo. Zipatala zimapereka chisamaliro chapamwamba padziko lonse lapansi ndi zamakono zida ndi ogwira ntchito ophunzitsidwa bwino. Odwala akunja amapatsidwanso maulendo, malo ogona, ndi chithandizo cha visa, kotero India ndi chisankho chodalirika cha opaleshoni ya TAPVC.