Ke pilikia nei kāu keiki hānau hou i ka moni ʻana i ka waiū? He Esophageal Atresia paha ia.

Ke hoʻomaka koke nei kāu keiki hānau hou e ʻū a ʻūlū i ka wā e hāʻawi ai ʻoe iā ia i ka waiū? Ke huʻa nei kona waha? Ma ke ʻano he makuahine a makua paha, pono ʻoe e makaʻu nui ke ʻike ʻoe i kēia mau mea. I kekahi manawa hiki ke hana ʻia kēia mau hōʻailona e kahi maʻi hānau i kapa ʻia ʻo Esophageal Atresia. Mai hopohopo. E kamaʻilio kākou e pili ana i kēia ma nā ʻōlelo maʻalahi i kēia lā a e hoʻomaopopo i nā mea āpau.

I ka ʻōlelo maʻalahi, he aha ka Esophageal Atresia (EA)?

ʻO ka Esophageal Atresia (i kapa ʻia ʻo "esophagus") he kīnā hānau. I ka pololei, he pilikia ia me ka esophagus o ka pēpē. ʻO ka paipu e lawe ana i ka meaʻai mai ka waha a i ka ʻōpū i ka wā e moni ai mākou. ʻO ke ʻano o ka huaʻōlelo "atresia" ua ālai ʻia a i ʻole ua ālai ʻia kahi alahele i loko o ke kino. No laila, i ke ʻano o ka esophageal atresia, ʻaʻole e ulu ka esophagus o ka pēpē i lalo mai kahi e pono ai ke pili i ka ʻōpū, akā e kū i ka hapalua a ua ālai ʻia. Ua like ia me kahi paipu wai i haki i ʻelua. Ma muli o kēia, ʻaʻole hiki i ka pēpē ke inu waiū a ale paha i ka meaʻai maʻamau. ʻO kekahi pilikia koʻikoʻi e ʻike ʻia me kēia kūlana ʻo ia ka tracheoesophageal fistula (TEF) . I kēia hihia, ma kahi o ka hoʻopili ʻana i ka esophagus i ka ʻōpū, pili ia i ka trachea o ka pēpē, ʻo ia ka paipu hanu. He mea weliweli loa kēia, no ka mea, ʻo nā mea e like me ka waiū a me ka lawai a ka pēpē e moni ai hiki ke hele pololei i loko o nā māmā.

Aia kekahi mau ʻano like ʻole o kēia ʻano maʻi?

ʻAe, ua māhele ʻia kēia mau kūlana Esophageal Atresia a me Tracheoesophageal Fistula (TEF) i kekahi mau ʻano nui ma muli o ke ʻano o ko lākou hui pū ʻana a i ʻole kaʻawale. E hoʻolālā kāu kauka i kāu lāʻau lapaʻau ma muli o ke ʻano kikoʻī.

Pehea ʻoe e ʻike ai inā loaʻa i kāu pēpē kēia maʻi? He aha nā hōʻailona?

Hoʻolohe pono nā kauka a me nā kahu maʻi i kēia mau hōʻailona i ka nānā ʻana i kahi pēpē hānau hou. Ma ke ʻano kūikawā, hoʻolohe lākou i 3 mau hōʻailona nui.

• ʻŪhū: ʻOi loa aku i ka wā e hoʻāʻo ai e inu i ka waiū.
• ʻUmiʻumi : Hiki mai ka ʻūmiʻumi no ka mea ʻaʻole hiki ke ale ʻia ka waiū a i ʻole ka lawai.
• Cyanosis: Lilo ka ʻili a me nā lehelehe i polū ma muli o ka nele o ka oxygen i loko o ke kino.

Eia nā hiʻohiʻona hou aʻe:

• Puka ʻana o ka huʻa mai ka waha mai.
• Ka nui o ka salivation.
• Ka luaʻi ʻana a i ʻole ka ʻū ʻana i ka wā e hoʻāʻo ai e hānai i ka waiū.
• Ka paʻakikī o ka hanu ʻana a me ka hanu wikiwiki.

ʻO ka maʻamau, ʻo nā maʻi ʻē aʻe e pilikia ai ka ale ʻana, ʻaʻole ia e pilikia ai ka hanu ʻana. Eia nō naʻe, inā hui pū ʻia ka paʻakikī o ka ale ʻana a me ka paʻakikī o ka hanu ʻana , ʻo ia paha ma muli o ke ʻano i kapa ʻia ʻo Esophageal Atresia me Tracheoesophageal Fistula (TEF).

No ke aha e hana ai kēia i nā pēpē? He aha ke kumu nui?

He maʻi hānau kēia. ʻO ia hoʻi, hana ʻia ia i ka wā e ulu ana ke pēpē i loko o ka ʻōpū. ʻO ka maʻamau, i nā wā mua o ka fetus, ʻo ka esophagus a me ka trachea he paipu hoʻokahi. Ma hope wale nō e hoʻokaʻawale ʻia ai kēia ʻāpana i ʻelua ʻāpana, e hana ana i ka esophagus a me ka trachea. I ke ʻano o ka esophageal atresia , ʻaʻole i pau loa kēia kaʻina hana hoʻokaʻawale. ʻAʻole i hiki i nā kānaka noiʻi ke ʻike pono i ke kumu e pau ai kēia kaʻina hana i ka hapalua. Akā manaʻoʻiʻo lākou he kuleana ko ka hui pū ʻana o nā kumu genetic a me ke kaiapuni .

Pehea e ʻike ai nā kauka i kēia maʻi?

I kekahi manawa hiki i nā scan prenatal ke hāʻawi i nā hōʻailona, ​​​​akā ʻo ka hapa nui o ka maʻi i ʻike ʻia ma hope o ka hānau ʻana o ka pēpē.

Ka Hōʻailona Ma mua o ka Hānau ʻana

I kekahi manawa hiki ke ʻike ʻia nā hōʻailona e pili ana i kēia i ka wā o kahi scan anomaly, i hana ʻia ma kahi o 20 mau pule o ka hāpai ʻana.

• Polyhydramnios: Inā nui loa ka wai amniotic a puni ka pēpē. ʻO kēia no ka mea maʻamau ka ale ʻana o ka pēpē i kēia wai. Hōʻiliʻili ka wai no ka mea ʻaʻole hiki i ka pēpē ke ale.
• ʻŌpū liʻiliʻi a ʻike ʻole ʻia paha: Inā ʻaʻole i piha ka ʻōpū o ke pēpē i ka wai i ka wā o ke kiʻi ʻana .

Inā ʻike ʻoe i kahi mea e like me kēia, hiki i kāu kauka ke ʻōlelo hou aku i nā hoʻāʻo hou aʻe, e like me ka MRI fetal.

Ma hope o ka hānau ʻana o ke pēpē (Postnatal Diagnosis)

Manaʻo nā kauka i kēia kūlana ke hōʻike kahi pēpē i nā hōʻailona i luna i ka wā hānau. ʻO ka hoʻāʻo nui e hōʻoia i ia mea, ʻo ia ka hoʻāʻo ʻana e hoʻokomo i kahi ʻōmole liʻiliʻi (ʻōmole nasogastric) ma o ka ihu a i loko o ka ʻōpū. Inā paʻa ka esophagus, e pau ka ʻōmole i ka hapalua me ka ʻole o ke komo ʻana i loko o ka ʻōpū. A laila hana ʻia kahi X-ray e ʻike pono i kahi i paʻa ai ka esophagus, inā paha e pili ana i ka trachea, a inā ua komo ka wai i loko o nā māmā. Inā hōʻoia ʻia kēia maʻi, nānā pū nā kauka no nā kīnā hānau ʻē aʻe e pili ana.

Hiki ke ho'ōla loa ʻia kēia maʻi me ke ʻoki kino?

ʻAe. I ka hapanui o nā hihia, hiki nō. Ke ʻike ʻia ke kūlana, ua paʻa ke kūlana o ka pēpē a ua hoʻoponopono ʻia ka pilikia me ke ʻoki ʻana i ka wā hikiwawe loa. Eia nō naʻe, pono paha kekahi mau pēpē e noho ma ka haukapila no kekahi manawa ma mua o ke ʻoki ʻana.

• A hiki i ka wā e piʻi ai ke kaumaha o nā pēpē hānau mua.
• Inā nui loa ka hakahaka ma waena o nā ʻāpana ʻelua o ka esophagus (Long-gap esophageal atresia - LGEA). I ​​ia mau hihia, pono ʻoe e kali a ulu iki nā ʻāpana ʻelua a kokoke mai.
• Inā he mau pilikia ʻē aʻe e hoʻoweliweli ana i ke ola, e like me nā pilikia koʻikoʻi o ka puʻuwai, pono e mālama mua ʻia kēlā mau mea.

I loko o kēia manawa, loaʻa i ka pēpē nā mālama pono āpau ma lalo o ka nānā ʻana a nā kauka loea a me nā kahu maʻi ma ka Neonatal Intensive Care Unit (NICU) . Hāʻawi ʻia ka pēpē i ka meaʻai e pono ai ma o kahi paipu (enteral nutrition) a i ʻole intravenously (parenteral nutrition). No laila, ʻaʻole pono ʻoe e hopohopo e pili ana i ka hiki ʻole i ka pēpē ke ʻai.

Pehea e hana ʻia ai nā lāʻau lapaʻau a me ke ʻoki kino?

Aia kekahi mau pahuhopu nui i ka mālama ʻana: ka hoʻopaʻa ʻana i ka hanu ʻana o ka pēpē, ka hāʻawi ʻana i ka meaʻai palekana, a me ka hoʻoponopono hope ʻana i ke kūlana ma o ke ʻoki ʻana.

Hoʻokele koke

Ke ʻike ʻia ka pēpē me kēia maʻi, hana ʻia nā mea aʻe i ka wā e hoʻomākaukau ai no ke ʻoki ʻana:

• Hoʻohemo ʻia ka huʻa a me ka kuha e hōʻiliʻili ana ma ka puʻu a me ka waha ma ka omo ʻana.
• Hoʻokomo ʻia kahi ʻōmole hanu e pale i ke alaea.
• Hoʻohana ʻia kahi ʻōmole hānai a i ʻole ka laina IV e hāʻawi i ka meaʻai a me nā wai.
• Hāʻawi ʻia nā lāʻau antibiotic e pale aku i nā maʻi maʻi o ka māmā (pneumonia).

ʻoki kino (Hoʻoponopono ʻoki kino)

Ke hoʻoholo ka hui lapaʻau ua mākaukau ka pēpē no ke ʻoki ʻana, hana ʻia ke ʻoki ʻana. ʻO nā pahuhopu nui: 1. E hoʻopili hou i nā ʻāpana ʻelua i hoʻokaʻawale ʻia o ka esophagus (anastomosis). 2. E pani i kahi fistula (kahi pilina ma waena o ka esophagus a me ka windpipe), inā loaʻa. I kēia mau lā, i nā manawa hiki, hana nā kauka ʻoki i kēia ʻoki ʻana me ka hoʻohana ʻana i ke ʻoki ʻana minimally invasive . ʻO ke ʻano kēia, ma kahi o ka hana ʻana i kahi ʻoki nui ma ka umauma, hoʻokomo ʻia kahi kāmela (thoracoscope) a me nā mea hana palupalu ma o kekahi mau ʻoki liʻiliʻi. ʻAe kēia i ka pēpē e hoʻōla koke.

Hoʻōla hou ʻana ma hope o ke ʻoki kino

Ma hope o ke ʻoki ʻana, hoʻihoʻi ʻia ke pēpē i ka NICU. I kekahi mau lā ma hope mai, hana ʻia kahi X-ray kūikawā i kapa ʻia he esophagram e nānā inā ua hoʻōla pono ʻia ka ʻoki a inā he kahe ʻana. Ke hōʻoia ʻia ua maikaʻi nā mea āpau, hoʻomaka mālie ke pēpē e hānai waiū ma lalo o ka nānā ʻana a ke kauka. He manawa kēia no ka pēpē e maʻa ai.

Pehea lā ke ola o ke keiki ma hope o ka lāʻau lapaʻau?

Hoʻōla maikaʻi ka hapa nui o nā keiki a ola i nā ola maʻamau. Eia nō naʻe, hiki i kekahi mau keiki ke loaʻa nā pilikia lōʻihi ma muli o kēia kūlana a me ke ʻoki ʻana. Hoʻomaikaʻi pinepine kēia mau mea i ka hala ʻana o ka manawa, akā pono paha ka nānā ʻana o ke kauka no kekahi mau makahiki.

• Tracheomalacia: He ʻano kēia e nāwaliwali ai ke cartilage i loko o ka trachea, e hoʻoemi iki ana i ka trachea i ka wā e hanu ana. Hiki i kēia ke hana i ka wheezing , ka paʻakikī o ka hanu ʻana i ka wā hiamoe, a me nā maʻi umauma pinepine (pneumonia, bronchitis).
• Nā pilikia i ka moni ʻana: Loaʻa paha i kekahi mau keiki ka pilikia i ka moni ʻana ma muli o ka dysmotility esophageal. Hiki ke loaʻa kēia pilikia ke hoʻolauna ʻia nā meaʻai paʻa. Hiki ke mālama ʻia kēia ma ka ʻoki ʻana i ka meaʻai i mau ʻāpana liʻiliʻi a hāʻawi iā ia me nā wai.
• ʻO ka maʻi reflux Gastroesophageal (GERD):ʻO kēia ka manawa e piʻi ai ka waikawa o ka ʻōpū i ka esophagus (like me ka gastritis). Loaʻa kēia maʻi ma kahi o ka hapalua o nā keiki i mālama ʻia me ka EA. He mea nui e mālama i kēia e like me ke kuhikuhi a ke kauka.

Inā loaʻa i kāu keiki kekahi o kēia mau pilikia, e kamaʻilio pinepine me kāu kauka e pili ana i ia mea. Hiki iā ʻoe ke ʻimi i ke kōkua o nā loea e like me nā loea ʻōlelo a me nā kauka meaʻai e hāʻawi i ke kākoʻo e pono ai kāu keiki. ʻO ka atresia esophageal, ka pale ʻana o ka esophageal, ka fistula tracheoesophageal, nā kīnā hānau, nā keiki hānau hou, ka ʻū ʻana o ka pēpē, ke ʻoki kino neonatal, esophagus