He mea maʻamau ka manaʻo nui i ka makaʻu a me ka hopohopo ke haʻi aku kāu kauka iā ʻoe e pono ana kāu keiki liʻiliʻi i ke ʻoki puʻuwai. ʻOiai i ka wā e pili ana i kahi 'Glenn Procedure,' ʻaʻole paha ʻoe i noʻonoʻo i ke ʻano o ia mea ma hope o ka lohe ʻana i kona inoa. Akā, mai hopohopo. E kamaʻilio mākou e pili ana i kēia ʻoki kino, no ke aha i hana ʻia ai, a me nā mea e hana ʻia ma hope ma ke ʻano maʻalahi loa e hiki ai iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha ke Kaʻina Hana Glenn?
E noʻonoʻo, aia kekahi aa koko nui e hōʻiliʻili ana i ke koko ʻilihune oxygen, 'lepo' mai nā ʻāpana o luna o ko kākou kino (poʻo, ʻāʻī, lima) a lawe mai i ka puʻuwai. Kāhea mākou i kēia ʻo 'Superior Vena Cava' . ʻO ka maʻamau, i loko o ka puʻuwai olakino, hele kēia koko ma nā keʻena o ka puʻuwai a hoʻokuʻu ʻia i nā māmā, kahi e 'hoʻomaʻemaʻe ʻia' ai ma ka lawe ʻana i ka oxygen.
Akā, ʻaʻole hiki i kekahi mau pēpē me nā maʻi puʻuwai hānau ke hana pono i kēia huakaʻi ma muli o nā pilikia me ke ʻano o ko lākou mau puʻuwai. Malia paha ʻaʻole i ulu pono kekahi ʻaoʻao o ka puʻuwai, a i ʻole he pilikia paha me kahi valve.
Hoʻopau ke kaʻina hana Glenn i kēia ʻāpana pilikia o ka puʻuwai a hoʻopili i ke koko 'lepo' e hele mai ana mai luna mai i nā aʻa pulmonary. I nā huaʻōlelo ʻē aʻe, hana ia i kahi ala pōkole (bypass) e lawe pololei i ke koko i nā māmā ma kahi o ka hele ʻana ma waena o ka puʻuwai. ʻAe kēia i ke koko nele i ka oxygen e hele i nā māmā me ka ʻole o ke keʻakeʻa.
I loko o nā ʻano maʻi puʻuwai hea e pono ai ke hana ʻia kēia ʻoki kino?
ʻO ke kaʻina hana ʻo Glenn kahi lāʻau lapaʻau no kekahi mau maʻi puʻuwai kakaʻikahi a paʻakikī hoʻi. Paipai pinepine nā kauka i kēia kaʻina hana no nā pēpē me kēia mau maʻi:
| Maʻi puʻuwai (Kūlana olakino) | I ka ʻōlelo maʻalahi... |
|---|---|
| ʻO ka maʻi puʻuwai hema Hypoplastic | ʻAʻole e ulu pono ka ʻaoʻao hema o ka puʻuwai (ka ʻāpana nui e pamu i ke koko) i ka wā hānau. |
| ʻO ka Atresia Tricuspid | ʻAʻole i hoʻokumu pono ʻia ka valve tricuspid ma ka ʻaoʻao ʻākau o ka puʻuwai. |
| ʻO ka Atresia Pulmonary | ʻAʻole e wehe pono ʻia ka valve pulmonary, ka mea e lawe i ke koko mai ka puʻuwai a i nā māmā. |
| ʻO ka Ventricle Hema a ʻĀkau paha ka puka komo pālua | Ke kahe nei ke koko mai nā keʻena ʻelua o luna o ka puʻuwai i loko o hoʻokahi keʻena haʻahaʻa (ventricle). |
| Nā hemahema o ke kahawai Atrioventricular kaulike ʻole | ʻO ke alo o nā kīnā paʻakikī i nā paia a me nā valves ma waena o nā keʻena o ka puʻuwai. |
Āhea e hana ʻia ai ke ʻoki kino a he aha ka mea e hana ʻia ma mua?
Hana pinepine ʻia ke ʻoki ʻana iā Glenn i ka wā ma waena o 3 a me 6 mahina o ka pēpē. I ka hapanui o nā hihia, ʻo ia ka lua o ke ʻoki ʻana. No nā pēpē me kēia ʻano maʻi puʻuwai, hana ʻia kahi ʻoki mua (e like me ka Blalock-Taussig (BT) shunt) i ka wā hānau e hoʻomaikaʻi iki i ke kahe koko. A laila, i ka wā e ʻelemakule iki ai ka pēpē, hana ʻia ke ʻoki ʻana iā Glenn ma ke ʻano he hana aʻe.
Ma mua o ke ʻoki kino
Ma mua o ke koho ʻana i kahi lā no ke ʻoki kino, pono nā kauka e loaʻa kahi kiʻi maopopo loa o ka puʻuwai o ka pēpē. No ka hana ʻana i kēia, hana lākou i nā hoʻokolohua e like me:
- Ka Catheterization o ka Puʻuwai: He hoʻāʻo kahi e hoʻokomo ʻia ai kahi ʻōmole liʻiliʻi ma o kahi aa koko ma ka wāwae a i ʻole ka lima i ka puʻuwai, e ana ana i ke kaomi i loko o ka puʻuwai a nānā pono i kona ʻano.
- MRI o ka puʻuwai: Kōkua kēia i ka hoʻolālā ʻana i ke ʻoki kino ma o ka loaʻa ʻana o nā kiʻi kikoʻī ʻekolu-dimensional (3D) o ka puʻuwai.
- Pono ʻoe e haʻi i ke kauka e pili ana i nā lāʻau lapaʻau a pau a kāu pēpē e lawe nei (me nā huaora a me nā mea hoʻopihapiha) .
He aha ka mea e hana ʻia i ka wā a ma hope o ke ʻoki kino?
I ka wā o ke ʻoki kino
ʻO ka maʻamau, he 4 mau hola ka lōʻihi o ke hana ʻana iā Glenn. Eia nō naʻe, hiki ke loli ka manawa ma muli o ke kūlana o ka pēpē. I loko o kēia manawa holoʻokoʻa, aia ke pēpē ma lalo o ka anesthesia laulā. ʻO ia hoʻi, ʻaʻole ʻo ia e manaʻo i kekahi mea, ua hiamoe loa ʻo ia.
Pono paha kekahi mau keiki i kahi mīkini bypass cardiopulmonary e lawe i ka hana o ko lākou puʻuwai a me nā māmā i ka wā o ke ʻoki ʻana. E hoʻohana ke kauka ʻoki i nā koena o nā ʻoki ʻana ma mua e hoʻopili i ka vena cava superior i ke aʻa e lawe ana i ke koko i nā māmā.
Ma hope o ke ʻoki kino
Hiki ke hopohopo ka ʻike ʻana i kāu pēpē ma hope o ke ʻoki ʻana. E hoʻopili ʻia ʻo ia i kahi ʻano o nā paipu a me nā mea nānā e hōʻike ana i kona helu puʻuwai a me nā pae oxygen. Akā ʻo kēia mau mea a pau e nānā pono i ke kūlana o ka pēpē. E mālama ʻia ke pēpē ma ka Intensive Care Unit (ICU) no kahi o 3 mau lā a e nānā pono ʻia. Ma hope o kēlā, e hoʻoneʻe ʻia ʻo ia i kahi keʻena maʻamau a hiki ke hoʻi i ka home i loko o kekahi mau lā hou aku.
ʻO ka mea nui, ʻo ke kaʻina hana Glenn pinepine ka lua o ka hana i kahi hopena piha. Ke ʻoi iki aʻe ka pēpē a hoʻomaka e hele (ma waena o 2-4 mau makahiki), pono pinepine ʻia kekahi hana ʻē aʻe i kapa ʻia ʻo ke kaʻina hana 'Fontan'. E wehewehe kāu kauka i kēia iā ʻoe.
He aha nā pōmaikaʻi a me nā pilikia o ke kaʻina hana Glenn?
E like me nā ʻoki kino āpau, loaʻa i ke kaʻina hana Glenn kona mau pono a me kekahi mau pilikia. He mea nui e makaʻala i kēia mau mea.
| Nā Pōmaikaʻi | Nā Pōpilikia/Pilikia Hiki Ke Loaʻa |
|---|---|
| Hoʻemi ia i ke kaumaha ma luna o ke keʻena hana wale nō o ka puʻuwai (ventricle). | Ua emi nā pae oxygen i loko o ke koko. |
| Pale i ka hoʻonui ʻia ʻana o ka puʻuwai ma muli o ka hana nui. | Ke koko kiʻekiʻe. |
| Hoʻomaʻalahi ia i ke ʻoki ʻana o Fontan ma hope. | Ka hoʻokahe ʻana o ka pleural. |
| Hoʻonui i nā manawa ola o ke keiki. | Pono e hānai ma o kahi ʻōmole ma muli o ka paʻakikī o ka inu ʻana i ka waiū. |
| Hāʻawi ke ʻoki Fontan i kahi koho ʻē aʻe no ka poʻe makemake ʻole a i ʻole hiki ʻole ke loaʻa. | Pono hou e hana ʻoki kino. |
He kiʻekiʻe loa ka holomua o kēia ʻoki kino, ma kahi o 99% . No laila, mai hopohopo. Ua ʻike maikaʻi nā kauka i kēia mau pilikia a ua aʻo maikaʻi ʻia lākou e hoʻokele iā lākou.
E mālama pono i kēia ma hope o kou hoʻi ʻana i ka home!
Ma hope o kou hoʻi ʻana i ka home mai ka haukapila, pono ʻoe e makaʻala loa i ke kūlana o kāu pēpē. Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, pono ʻoe e kāhea koke i kāu kauka .
- Kuni.
- Ke kahe ʻana o ke koko mai kahi ʻeha ʻoki a i ʻole kekahi wai ʻē aʻe.
- Ka paʻakikī i ka inu waiū a i ʻole ka hōʻole ʻana e inu waiū.
- ʻAʻole ke piʻi pono nei ke kaumaha o ke pēpē.
- Paʻakikī ka hanu ʻana a i ʻole e polū ana nā lehelehe/maiʻu lima o ke pēpē.
Ma mua o kou hoʻokuʻu ʻia ʻana mai ka haukapila, e hāʻawi ʻia ʻoe i kahi lā no kāu hālāwai hou me ke kauka cardiologist. E hōʻoia e lawe pū me ʻoe i kāu pēpē i kēlā mau lā.
Leka Lawe-Home
- He hana hoʻōla ola ke kaʻina hana ʻo Glenn no nā pēpē me nā maʻi puʻuwai hānau paʻakikī. Hoʻomaikaʻi ia i ke kahe koko.
- Hana pinepine ʻia kēia i ka wā he 3-6 mahina ka pēpē. ʻO ka pinepine, ʻo kēia ka lua o ka hana i loko o kekahi mau ʻoki kino.
- He kiʻekiʻe loa ka holomua o ke ʻoki kino (ma kahi o 99%). Eia nō naʻe, e hoʻomaopopo e like me nā ʻoki kino āpau, aia kekahi mau pilikia.
- Ma hope o ke ʻoki ʻana, pono e hoʻomau ʻia ke pēpē ma lalo o ka nānā ʻana a ke kauka. E hahai pono i nā ʻōlelo a ke kauka.
- Inā he mau nīnau kāu, hopohopo, a kānalua paha e pili ana i kēia, mai kānalua e kūkākūkā me kāu kauka. He mea nui loa ia e ʻike i kou manaʻo.
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo