Ke polū nei kāu pēpē? He maʻi puʻuwai cyanotic anei kēlā? E kamaʻilio kākou e pili ana i kēia!

Ke uliuli nei nā lehelehe, ke alelo, a me nā manamana lima o kāu keiki liʻiliʻi i kekahi manawa? A i ʻole ke manaʻo nei ʻoe e paʻakikī ana lākou i ka hanu ʻana a i ʻole e nalowale koke ana ka ʻike? Hiki ke hana ʻia kēia mau mea i kekahi manawa e kahi pilikia liʻiliʻi me ka puʻuwai. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi puʻuwai i loaʻa i ka wā hānau. Ua kapa nā kauka i kēia he maʻi puʻuwai hānau cyanotic (CCHD) . I ka ʻōlelo maʻalahi, he maʻi puʻuwai ia e hoʻolilo ai i ke kino i polū.

No laila, he aha kēia maʻi puʻuwai cyanotic?

I ka ʻōlelo maʻalahi, ʻo ka "maʻi puʻuwai hānau" e pili ana i hoʻokahi a ʻoi aku paha mau ʻano ʻē, a i ʻole nā ​​kīnā, o ka puʻuwai i loaʻa i ka wā hānau. ʻElua ʻano nui o kēia:

1. Maʻi Puʻuwai Cyanotic Congenital (CCHD): He kūlana kēia i hiki ʻole ai i ka puʻuwai ke lawe i ka oxygen lawa i ke koena o ke kino. I kekahi manawa ua kapa ʻia kēia he maʻi puʻuwai congenital koʻikoʻi . Ke hānau ʻia kahi pēpē me kēia kūlana, ʻike ʻia ko lākou ʻili he uliuli, kahi kūlana i kapa ʻia ʻo cyanosis . Hoʻokumu ʻia kēia kala polū e ka loaʻa ʻole o ka oxygen lawa i ke kino.

2. Maʻi Puʻuwai Hānau ʻAcyanotic: Ma kēia ʻano kīnā puʻuwai, ʻaʻole i hoʻopilikia nui ʻia ka nui o ka oxygen e hiki ana i ke koena o ke kino. ʻO ke ʻano kēia, ʻaʻole e polū ka pēpē.

I kēia lā, ke kamaʻilio nui nei mākou e pili ana i ke ʻano mua, ʻo ia hoʻi ka maʻi puʻuwai cyanotic (CCHD).

Pehea ka hopena o kēia maʻi puʻuwai cyanotic i ke kino?

ʻIke ʻoe, pono ko kākou kino i ka oxygen e hana pono ai. E like me ke kaʻa e pono ai ka ʻaila e holo ai. I ka maʻi puʻuwai cyanotic, ʻaʻole loaʻa i ke kino ka oxygen e pono ai. Hiki i kēia mau ʻano ʻē, a i ʻole nā ​​kīnā, i loko o ka puʻuwai ke hana i nā pilikia koʻikoʻi a i kekahi manawa hiki i ka make.

E noʻonoʻo e pili ana i ia mea, lawe ko kākou koko i ka oxygen ma o ko kākou kino. Hoʻopuka ka puʻuwai i kēia koko ma ke kino holoʻokoʻa. I kēia manawa, he aha ka mea e hana ai inā komo ke koko nele i ka oxygen i loko o ke kino ma muli o ka pilikia o ka puʻuwai? ʻO ia ka mea e hana ai ma kēia hihia.

Pehea ka maʻamau o kēia ʻano?

Ma ke ao holoʻokoʻa, ma kahi o 8 a i ʻole 9 o kēlā me kēia 1,000 hānau ola i loaʻa i ka maʻi puʻuwai hānau. Ma waena o kēia mau mea , ma kahi o 25%, a i ʻole hapaha paha, i loaʻa i ke ʻano (CCHD) . No laila, ʻoiai ʻaʻole kēia he mea maʻamau loa, he mea nui e makaʻala kākou.

He aha nā hewa e hiki ke hana me ka `CCHD`?

Hiki ke hoʻokaʻawale ʻia ka maʻi puʻuwai cyanotic i ʻekolu ʻano nui. ʻOiai he mau huaʻōlelo lapaʻau kēia, e wehewehe maʻalahi wau iā lākou.

1. Nā ʻeha pale puʻuwai hema (Nā ʻeha pale puʻuwai hema)

Hoʻemi kēia mau kīnā puʻuwai hānau i ka nui o ke koko e kahe ana mai ka puʻuwai a i ke koena o ke kino (i kapa ʻia ʻo 'systemic blood flow'). ʻO nā hiʻohiʻona o kēia:

• ʻO ka Hypoplastic Left Heart Syndrome (HLHS):ʻO kēia ka manawa ʻaʻole e ulu pono ka ʻaoʻao hema o ka puʻuwai. E noʻonoʻo ua liʻiliʻi loa ka ʻaoʻao hema o ka puʻuwai, ka ʻāpana nui e pamu i ke koko i ke kino. A laila, ʻaʻole hiki iā ia ke pamu i ke koko lawa i ke kino.
• ʻO ke kīkoʻo aortic i haki: ʻO kēia ka wā i piha ʻole ai ka aorta, ke kīʻaha koko nui e lawe ana i ke koko mai ka puʻuwai a i ke kino. Ua like ia me ka paipu wai e haki ana i waenakonu.

2. Nā ʻeha pale o ka puʻuwai ʻākau

Hoʻemi kēia kīnā puʻuwai hānau i ka nui o ke koko e kahe ana mai ka puʻuwai a i nā māmā (i kapa ʻia ʻo 'pulmonary flow'). Hele ke koko i nā māmā e kiʻi i ka oxygen. No laila, he pilikia ka hōʻemi ʻana. Nā hiʻohiʻona o kēia:

• ʻO ka Pulmonary Atresia (PA): ʻO ka valve pulmonary, ka mea e lawe ana i ke koko mai ka ʻaoʻao ʻākau o ka puʻuwai i nā māmā, ua like ia me ka puka. I kēia kūlana, ʻaʻole i hana pono ʻia ka valve a i ʻole ua ālai ʻia.
• ʻAtresia Tricuspid: ʻO ka valve tricuspid ka valve ma waena o nā keʻena ʻelua (atrium a me ventricle) ma ka ʻaoʻao ʻākau o ka puʻuwai. I kēia kūlana, ʻaʻole hana pono ka valve. ʻO kahi ʻāpana mānoanoa o nā ʻiʻo e ālai ana i ke kahe o ke koko mai ka atrium ʻākau a i ka ventricle ʻākau.
• ʻO Tetralogy o Fallot (TOF): ʻO kēia ke ʻano maʻamau o ka maʻi puʻuwai hānau (CCHD). Hōʻike ʻia ia e ke alo o ʻehā mau kīnā puʻuwai.

3. Ke kāwili ʻana i nā ʻeha

ʻO kēia ke kolu o ke ʻano o ka ``(CCHD)``. ʻO kēia kīnā puʻuwai ke kumu o ka hui pū ʻana o ke koko e hele ana i nā māmā (ke koko me ka oxygen haʻahaʻa) a me ke koko e hele ana i ke kino (ke koko me ka oxygen kiʻekiʻe). ʻO nā hiʻohiʻona o kēia:

• Ke Hoʻololi ʻana o nā ʻAʻa Nui (TGA): Ma kēia kūlana, ua hoʻololi ʻia nā kīʻaha koko nui ʻelua e haʻalele ana i ka puʻuwai (ke aʻa pulmonary nui a me ka aorta). ʻO ke ʻano kēia, ʻaʻole kahe ke koko i kahi e pono ai. ʻO kēia ka lua o ke kūlana maʻamau ma hope o CCHD.
• ʻO ka hoʻihoʻi ʻana o ka Venous Pulmonary Anomalous Total (TAPVR): I loko o kahi pēpē me TAPVR, ʻaʻole kahe ke koko waiwai i ka oxygen mai nā māmā i ka ʻaoʻao hema o ka puʻuwai e like me ka mea e pono ai. Akā, kahe ke koko i ka ʻaoʻao ʻākau o ka puʻuwai.
• Truncus Arteriosus: Ma kēia kūlana, hoʻokahi wale nō kīʻaha koko nui ma kahi o ʻelua mau kīʻaha koko kaʻawale e lawe ana i ke koko i ke kino a me nā māmā.

ʻOiai paha he mea paʻakikī iki kēia mau mea, ʻike a mālama nā kauka iā lākou. He mea nui iā ʻoe e makaʻala he loaʻa paha iā ʻoe kēia maʻi.

He aha nā kumu o ka maʻi puʻuwai cyanotic congenital?

ʻAʻole maopopo i ka poʻe ʻepekema ke kumu o ka CCHD, akā ua pili kekahi mau hihia i:

• Nā chromosomes ʻano ʻē.
• ʻIke hoʻoilina.
• ʻO kekahi mau kūlana olakino e loaʻa paha i ka makuahine i ka wā hāpai: No ka laʻana, ka maʻi diabetes, phenylketonuria (kahi maʻi koko), ka hoʻohana ʻana i nā lāʻau lapaʻau, a i ʻole nā ​​​​maʻi viral.

He aha nā hōʻailona o ka maʻi ʻōpū (CCHD)?

ʻIke pinepine ʻia nā hōʻailona o ka CCHD i loko o nā pule mua o ke ola , akā ʻaʻole paha e ʻike ʻia a hiki i ka wā kamaliʻi. ʻO nā hōʻailona:

• ʻIli polū a poni paha (Cyanosis): ʻoiai nā lehelehe, ke alelo, a me nā manamana lima.
• Ka hanu wikiwiki ʻana (Tachypnea).
• Ka wikiwiki o ka puʻuwai (Tachycardia).
• ʻEdema puʻuwai.
• He kani puʻuwai ʻē aʻe (Heart murmur): Lohe ʻia kēia kani ke hoʻolohe ke kauka me ka stethoscope.
• Ka hoʻomaha pinepine ʻole a hiamoe nui paha, nele i ka hoihoi `(Irritability or lethargy)`.
• Ua emi nā pae oxygen i loko o ke kino.
• Lohi ka piʻi ʻana o ke kaumaha.
• Ke hou nei a ke uē nei paha i ka wā e hānai waiū ana.
• Hiki i nā keiki makua ke pilikia i ka hanu ʻana i ka wā e hoʻoikaika kino ai.
• Ka naʻau palupalu.

Inā loaʻa i kāu pēpē kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​​​he mea nui loa e ʻimi koke i ke kōkua lapaʻau .

Pehea e ʻike ʻia ai ka maʻi puʻuwai cyanotic?

I kekahi manawa, hiki ke ʻike ʻia ka CCHD ma mua o ka hānau ʻana o ka pēpē . Inā hōʻike kahi scan maʻamau i ka wā hāpai (ultrasound fetal) i kahi pilikia me ka puʻuwai o ka pēpē, hiki i ke kauka ke kauoha i kahi echocardiogram fetal . Pili kēia i ka hoʻouna ʻana i kahi mea kūikawā ma o ka ʻōpū o ka makuahine a i ʻole ka vagina e kiʻi i nā kiʻi kikoʻī o ka puʻuwai o ka pēpē.

Ma hope o ka hānau ʻana o kahi pēpē, ʻo ka hana mua i ka ʻike ʻana i ka CCHD he nānā ʻana i ka pulse oximetry . He hoʻāʻo maʻalahi kēia a ʻeha ʻole e hoʻohana ana i nā mea ʻike e ana i nā pae oxygen i loko o ke kino. ʻO kēia kekahi o nā hoʻāʻo maʻamau i hana ʻia ma mua o ka hoʻokuʻu ʻia ʻana o kahi pēpē i ka home mai ka haukapila.

Eia kekahi, hiki ke hana ʻia nā hoʻokolohua hou aʻe:

• X-ray umauma: Lawe kēia i nā kiʻi o loko o ka umauma e nānā i nā ʻano ʻē. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā he pilikia puʻuwai a he pilikia māmā paha ka pēpē.
• Hoʻāʻo Hyperoxia (hoʻokūkū oxygen): Kōkua kēia hoʻāʻo i nā kauka e hoʻoholo inā he CCHD a he pilikia paha ka māmā o kahi pēpē. Ana ʻia ka pae oxygen koko o ka pēpē i ko lākou hanu ʻana i ka ea lumi maʻamau, a laila ma hope o 10 mau minuke o 100% oxygen.
• Electrocardiogram (EKG a i ʻole ECG): Ke ana kēia i ka hana uila o ka puʻuwai.
• Echocardiogram (Echo): He hoʻāʻo kēia e hoʻohana ana i ka ʻenehana ultrasound e kiʻi i nā kiʻi o nā valves a me nā keʻena o ka puʻuwai.

Pehea e mālama ʻia ai ka CCHD?

Pono ka nui o nā pēpē me CCHD i ka lāʻau lapaʻau e ola ai. ʻO kēia kekahi:

• Oxygen therapy: Hāʻawi i ka oxygen ʻoi aku ma mua o ka mea i loaʻa i ka ea lumi maʻamau.
• Prostaglandin E1: Hoʻomaha kēia i nā ʻiʻo laumania o ka puʻuwai a wehe i ka ductus arteriosus (kahi kīʻaha koko kūikawā). Kōkua kēia i ke kahe ʻana o ke koko.
• ʻOki kino: Hana ʻia ke ʻoki kino e hoʻoponopono i nā kīnā i loko o ka puʻuwai a i ʻole e hoʻololi i ke ala e kahe ai ke koko.

Hoʻoholo nā kauka i kēia mau lāʻau lapaʻau ma muli o ke kūlana o ke pēpē a me ke ʻano o ke kīnā o ka puʻuwai.

Hiki ke pale ʻia ka CCHD?

ʻAʻole maopopo loa i nā kānaka ʻepekema ke kumu o ka maʻi puʻuwai cyanotic, no laila ʻaʻohe ala i hōʻoia ʻia e pale aku ai. Akā, he mea nui i ka makuahine ke noho olakino i ka wā hāpai, e kāohi i nā maʻi e like me ka maʻi diabetes, a e noho mamao mai nā lāʻau lapaʻau.

He aha ka wā e hiki mai ana o nā pēpē me ka maʻi puʻuwai cyanotic?

Pono nā pēpē me ka maʻi puʻuwai cyanotic i ke ʻoki kino e ola ai. Eia nō naʻe, ʻoi aku ka kiʻekiʻe o ka make. Ma kahi o 75% o nā pēpē me CCHD e ola no hoʻokahi makahiki, a ma kahi o 69% e ola no 18 mau makahiki .

Ma muli o ka haʻahaʻa o ka oxygen i loko o ke kino a me nā kīnā puʻuwai hānau, hiki i nā keiki me CCHD ke pilikia no:

• Nā lohi o ka hoʻomohala ʻana.
• Nā ʻano like ʻole o ka puʻuwai (Arrhythmia).
• Ka hāʻule ʻana o ka puʻuwai.
• Paʻa koke ka puʻuwai.
• Hahau.

Eia nō naʻe, hiki ke hoʻokele nui ʻia kēia mau pilikia me ka mālama lapaʻau kūpono a me ka hahai ʻana .

He aha nā mea e pono ai ʻoe e ʻike i ka wā e noho ana me ka maʻi puʻuwai cyanotic?

Inā loaʻa iā ʻoe a i kāu keiki paha ka CCHD, e ʻōlelo pinepine kāu kauka i kēia mau mea:

• E kiʻi i kāu mau lāʻau pale āpau: Hiki i kēia ke kōkua iā ʻoe e pale aku iā ʻoe mai nā maʻi ʻē aʻe.
• E hele i nā hoʻokolohua maʻamau a me nā hoʻomaʻamaʻa e like me ka ʻōlelo a kāu cardiologist.
• E pale iā ʻoe iho mai nā maʻi e like me ka Respiratory Syncytial Virus (RSV): E hoʻomaʻemaʻe pono a e noho mamao aku mai ka poʻe maʻi.
• E lawe i nā lāʻau antibiotic e pale aku i ka maʻi ma mua o nā kaʻina hana niho (pono e hana ʻia kēia e like me ke kuhikuhi a kāu kauka).

ʻO ka mea nui loa, ʻaʻole ia e makaʻu a hopohopo paha, a e hahai pono i nā ʻōlelo a ke kauka. He mau lāʻau lapaʻau kūpono loa ko ka lāʻau lapaʻau hou no ia mau ʻano.

ʻO ka mea nui loa āu e hoʻomanaʻo ai (Leka Lawe-Home)

ʻO ka maʻi puʻuwai hānau cyanotic (CCHD) kahi ʻano e polū ai ka ʻili o kahi pēpē ma muli o kahi kīnā puʻuwai hānau e hōʻemi ana i ka nui o ka oxygen e kaapuni ana i loko o ke kino.

• He mea nui e ʻike i nā hōʻailona mua. Inā polū kāu pēpē, paʻakikī ka hanu ʻana, a nalowale koke paha ka ʻike, e ʻimi koke i ke kōkua lapaʻau.
• Aia nā hoʻokolohua e hiki ke ʻike i kēia ʻano ma mua a ma hope koke iho paha o ka hānau ʻana .
• Pono nā pēpē he nui me CCHD i ka oxygen therapy a me ke ʻoki ʻana e ola ai.
• Me ka mālama kūpono a me ka nānā pono ʻana o ke kauka i ka wā lōʻihi, loaʻa i kēia mau keiki ka manawa kūpono e ola i ke ola maʻamau e like me ka hiki.
• ʻAʻole ʻoe hoʻokahi. Ma ke ʻano he makua, ke pilikia nei paha ʻoe i ka naʻau i ke alo ʻana i kahi kūlana e like me kēia. E ʻimi i ke kōkua mai nā kauka, ka ʻohana, a, inā pono, nā lawelawe aʻoaʻo.

Ke lana nei koʻu manaʻo he kōkua kēia ʻike iā ʻoe. Ke makemake nei au i ka wikiwiki o ka ho'ōla ʻana o kāu pēpē!

ʻO ka maʻi puʻuwai ʻino, nā kīnā puʻuwai hānau, CCHD, ʻeha pēpē, ʻoki puʻuwai, nele i ka oxygen, maʻi puʻuwai pediatric