Chirwere chemwoyo muchecheche. Zviratidzo.

Kukura kwemaitiro emwoyo mutsva mumavangwana kunokonzerwa nezvinetso zvakaoma pakuisa nhengo panguva yekutambisa intrauterine ye fetus uye inosangana nezvinetso zvakanyanya zvehemodynamic izvo, zvichienderana nemhando uye kuoma kwemamiriro ezvinhu, zvinogona kuratidzira pakarepo maawa akawanda mushure mokuberekwa kana mushure memakore akawanda ehupenyu. Mamwe matambudziko epenjemukanana emuviri haafambidzani nehupenyu, uye anoda kuti pakarepo kupindira kunopindira. Kana zvisina kudaro, mwana anogona kufa.

Sezvo mutemo, kusvikira zuva, chirwere chemwoyo mumana achangoberekwa chinotsanangurwa mu utero munguva yekudzivirira pa ultrasound. Vabereki vanokurumidza kuudzwa kuti chii chiri kutyisidzira, uye zvii zviyero zvinoda kutorwa mushure mokuberekwa kwemwana akadaro.

Kune zvakawanda zvakasiyana-siyana zvakasiyana-siyana zvekusawirirana kwemwoyo yematambudziko muvana. Heanoi mumwe wavo.

Zvose zvakaipa zvakakamurwa kuva mapoka makuru maviri:

- chena (nechokuruboshwe-kurudyi shunt), nezvipenzi izvi hapana kusanganiswa kweropa rinopa arterial uye venous;

- bluu (rine kurudyi-kuruboshwe shunt), apo ropa reropa rinovhenganiswa nemhepo.

Izvozvi, mapoka awa akaparadzaniswa kuva mamwe mazita mashoma. Saka kune michero yakachena inosanganisira maitiro, ayo anowirirana nekuputika kweropa rechechi duku rekupararira kweropa, i.e. Makomba (kuzarura arterial duct (OAP), kushaya muviri uye kupindira septal defect (ASD, DMF), kusununguka kweatrio-ventricular, nezvimwewo).

Zvinosanganisirawo chirwere chemwoyo mumana achangoberekwa nehurombo hwehuwandu hwemasaisai eropa, i.e. Kubva mumuviri wose, ichi chirema chakakosha, zvakadai sokukanganiswa kwe aorta (aortic kupera).

Zvisikwa zvebhuruu zvinosanganisira kuberekwa kunokonzera kusvibiswa nechemberedzwa rekupararira kweropa, zvakadai se aortic transposition, Eisenmenger complex, pamwe chete nehupenzi nekubira kwebato rakatenderera (tetralogy ya Fallot et al.).

Kana chirwere chemoyo muchechecheche chisingawanikwi panguva yehupamuviri, zvino gare gare yakagadzwa maererano nekliniki zviratidzo. Zvinogona kuva dzakasiyana zvakasiyana, asi pane zviratidzo zvakawanda zvekliniki zvinosangana nechiremera chero chipi zvacho.

Zviratidzo zvezvirwere zvepfungwa:

- yakaoma kana isingaperi kusakatika kwemoyo, pamwe chete nedyspnea-cyanotic kurwisa, pallor, marbling kana cyanotic ganda, iyo inobatanidza nehana chisingagoneki ye mwana, pallor ye triangle nasolabial, mwana haachengeti kutonhora kwemuviri, nezvimwewo.

- Zviratidzo zvemwoyo zvinokura zvishoma nekufamba nekukura kwomwana, zvinosanganisira kunyunyuta kwemarwadzo mukati memwoyo, zvichida kukura kwe mwoyo hump (nokuti bhokisi rechecheche rinogona kushungurudzika), kukanganiswa kwemwoyo kwakasiyana kunonzwika, uye kusarudzwa kwemoyo uye midziyo huru inoshandurwa.

- kushaya kuputika, kunowedzera mune chero nzira ipi zvayo yekusaziva. Iyo inofambidzana nekushayikwa kwemhepo, mwana anononoka, anopfutira zvikuru, kupera kwepfuuri kunopfuura kudarika kwekufema kwemuitiro. Dzimwe nguva, kubviswa kwezvikamu zviduku zvechipfuva panguva yekudzivirira kuonekwa.

- Munguva yemberi, vana vane urema vanokurudzira hypoxia isingaperi, iyo inoratidzwa nechiratidzo che "doroti" pamaphalanges eminwe, yakakonzerwa nekugadzirisa chero chikamu chemuviri, kana muviri wose.

Chirwere chemwoyo nguva dzose muchecheche chinosangana nemoyo kunong'un'una, iyo inongova nechechi yezvechirwere chekare inogona kunzwa, kunyange zvazvo mhere-mhere dzakajeka uye dzinonzwisisika dzichazonzwikwa nemumwe nyanzvi wevana. Kana iwe uchienda kune chiitiko chekucherechedza kune chiremba wevana, tsunga kuti anoteerera mwoyo zvishoma, asingatauri kuti iwe unofanira kugara uchiyera urefu hwemuviri, rutivi rwemusoro, kuwandisa kwekufema, kupisa uye kuoma. Aya ndiwo magwaro anokosha ekutanga emucheche.