I ka wā i haʻi aku ai ke kauka iā ʻoe e pono i kāu keiki liʻiliʻi ke hana ʻia kahi hana 'Glenn' ma muli o kahi pilikia puʻuwai, ua manaʻo paha ʻoe i ka makaʻu nui a me ka haʻalulu. He nui nā nīnau i loko o kou manaʻo, e like me ke ʻano o kahi 'Glenn Procedure', he aha ia mea e pili ana, a no ke aha e hana ʻia ai. Mai hopohopo. He mea maʻamau kēlā mau manaʻo. E kamaʻilio kākou e pili ana i kēia mau mea a pau me ka maʻalahi, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
He aha ke Kaʻina Hana ʻo Glenn, ma ka ʻōlelo maʻalahi?
E noʻonoʻo e pili ana i ia mea, ʻo ko kākou puʻuwai ka mīkini e pamu i ke koko ma ke kino holoʻokoʻa. He ʻehā ona ʻāpana (ʻehā keʻena). Hānau ʻia kekahi mau pēpē me kekahi o kēia mau keʻena ʻaʻole i ulu piha a i ʻole he liʻiliʻi loa. I kēia hihia, ʻaʻole hiki i ka puʻuwai ke pamu pono i ke koko.
I ka ʻōlelo maʻalahi, ʻo ke kaʻina hana Glenn he kaʻina hana 'bypass' e kōkua ana i ka puʻuwai nāwaliwali e like me kēia.
Maanei, hoʻopili nā kauka ʻoki i ke kīʻaha koko nui (superior vena cava), ka mea e lawe ana i ke koko haumia a nele i ka oxygen mai ke kino o luna o ke pēpē, pololei i ke aʻa pulmonary, ma kahi o ka hoʻouna ʻana i ka puʻuwai.
Ua like kēia me ke kūkulu ʻana i alanui hou a maʻalahi hoʻi e hoʻohana e kāpae ana i kahi alanui paʻahana. ʻAe kēia i ke koko e pono ai ke loaʻa ka oxygen e kāpae i ka ʻāpana pilikia o ka puʻuwai a hele pololei i nā māmā.
ʻO ka lua kēia o ke ʻoki kino i loaʻa i kahi pēpē. Hana ʻia kekahi ʻoki kino ʻē aʻe i kekahi mau makahiki ma hope mai e hāʻawi i kahi hopena mau loa i ke kūlana.
I ke ʻano o nā keiki hea e hana ʻia ai kēia ʻoki kino?
Hana nui ʻia ke ʻoki ʻana o Glenn ma nā keiki me nā kīnā puʻuwai hānau. He mea pono loa ia no nā keiki ʻōpio loa, a i ʻole no ka poʻe i hana pono ʻole kekahi o nā keʻena nui ʻelua (ventricles) o ka puʻuwai e pamu ana i ke koko. Ua kapa ʻia kēia kūlana he 'defect ventricle hoʻokahi'.
Aia ma lalo iho kekahi o nā pilikia puʻuwai nui e pono ai ke ʻoki ʻana iā Glenn.
| Inoa o ka maʻi puʻuwai (Kūlana Lapaʻau) | He wehewehe maʻalahi |
|---|---|
| ʻO ka maʻi puʻuwai hema Hypoplastic | ʻAʻole e ulu pono ka ʻaoʻao hema o ka puʻuwai (ventricle hema, valves). |
| ʻO ka Atresia Tricuspid | ʻAʻole i hoʻokumu pono ʻia ka valve tricuspid, aia ma waena o nā keʻena ma ka ʻaoʻao ʻākau o ka puʻuwai. |
| ʻO ka Atresia Pulmonary | Ua ālai ʻia ka kiwikā pulmonary e lawe ana i ke koko i nā māmā. |
| ʻO ka Ventricle Hema a ʻĀkau paha ka puka komo pālua | Hoʻohui nā keʻena ʻelua o luna o ka puʻuwai (atria) i hoʻokahi keʻena haʻahaʻa (ventricle). |
I ka manawa hea e hana pinepine ʻia ai ke ʻoki ʻana o Glenn?
ʻO ka maʻamau, ʻōlelo nā kauka i kēia ʻoki kino ke piha ka pēpē i 3 a 6 mahina . Hana pinepine ʻia ia ma ke ʻano he ʻoki kino ʻelua, ma hope o ka hana mua ʻana o ka pēpē i kahi ʻoki kino e hoʻomaikaʻi i ke kahe koko (e like me ka Blalock-Taussig (BT) shunt) ma hope o ka hānau ʻana.
He aha ka mea e hana ʻia ma mua a i ka wā o ke ʻoki kino?
Ma mua o ke ʻoki kino
Ma mua o ke ʻoki ʻana, e hana kāu kauka i kekahi mau hoʻokolohua e loiloi maikaʻi i ke kūlana o ka puʻuwai o kāu pēpē.
- Catheterization Cardiac: Hana ʻia kēia hoʻāʻo e ana i ke kaomi a me nā pae oxygen i loko o ka puʻuwai a e nānā i ke ʻano o ka puʻuwai.
- MRI o ka puʻuwai: Kōkua kēia i ka loaʻa ʻana o nā kiʻi kikoʻī ʻekolu-dimensional o ka puʻuwai.
- He mea nui loa e hoʻomaopopo i ke kauka e pili ana i nā lāʻau lapaʻau a pau (me nā huaora a me nā mea hoʻopihapiha) a kāu pēpē e lawe nei .
I ka wā o ke ʻoki kino
ʻO ka maʻamau, ʻehā hola ka lōʻihi o ka ʻoki ʻana ma kahi o c-section, akā hiki ke loli kēia manawa ma muli o ke kūlana o ka pēpē.
I ka wā o ke ʻoki ʻana, hāʻawi ʻia ka anesthesia i ka pēpē, no laila ʻaʻole ʻeha ka pēpē. Ke hiamoe nui nei ka pēpē. Hoʻopili ʻia kekahi mau keiki i kahi mīkini kūikawā e lawe manawa pōkole i ka hana o ka puʻuwai a me nā māmā i ka wā o ke ʻoki ʻana. Ua kapa ʻia kēia he mīkini bypass cardiopulmonary . A laila, e like me ka mea i ʻōlelo ʻia ma mua, hana ke kauka ʻoki i ka hoʻopili hou ʻana i nā kīʻaha koko a me nā hoʻoponopono puʻuwai ʻē aʻe inā pono.
Nā pono a me nā pilikia kūpono o ke ʻoki kino
E like me nā ʻoki kino āpau, loaʻa i ke kaʻina hana Glenn nā pono a me nā pilikia. He mea nui i nā mākua ke makaʻala i kēia mau mea.
| Nā Pōmaikaʻi | Nā pilikia/pilikia hiki ke loaʻa |
|---|---|
| Ua emi ke kaumaha o ke keʻena puʻuwai hana wale nō (ventricle). | Ua emi nā pae oxygen i loko o ke koko. |
| Ke pale nei i ka hoʻonui ʻia ʻana o ka puʻuwai ma muli o ka hana nui. | Ke koko kiʻekiʻe. |
| E maʻalahi ka hana ʻoki Fontan e hiki mai ana. | Ka hoʻokahe ʻana o ka pleural. |
| Hoʻonui ʻia nā manawa kūpono e hoʻopakele ai i ke ola o ke keiki ma hope o ke ʻoki ʻana o Fontan. | Pono e hānai ʻia ma o kahi ʻōmole ma muli o ka paʻakikī o ka ʻai ʻana. |
| He koho ʻē aʻe no nā keiki i pono ʻole a i ʻole ʻaʻole hiki ke hana i ke ʻoki Fontan. | Pono e hana ʻia kekahi ʻoki kino ʻē aʻe. |
ʻO ka mea nui loa, ʻo ia ke kiʻekiʻe loa o ka nui o ke ola ʻana o ke keiki ma hope o ke ʻoki ʻana iā Glenn. Ma kahi o 99% . He ʻoki holomua loa kēia.
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki kino, e hoʻokomo ʻia ke pēpē i ka ʻāpana mālama koʻikoʻi (ICU). E makaʻu paha ʻoe ke ʻike ʻoe i nā ʻōmole a me nā mea nānā i hoʻopili ʻia i ke kino o ke pēpē. Akā he mea maʻamau kēlā. E nānā pono loa ke kime lapaʻau i ke pēpē.
E noho ka pēpē i loko o ka keʻena mālama koʻikoʻi no ʻekolu lā, a laila e hoʻoneʻe ʻia i kahi keʻena maʻamau. He mau pule paha e ola hou ai ka pēpē a hoʻi i ka home.
He nui nā keiki, i kekahi mau makahiki ma hope o ke kaʻina hana Glenn, i ka wā e hoʻomaka ai lākou e hele, pono lākou e hana i ke kaʻina hana aʻe, kahi kaʻina hana Fontan , ka mea e hāʻawi ana i kahi hopena mau loa i ka ʻōnaehana kahe koko o ka puʻuwai.
Āhea ʻoe e pono ai e ʻike i ke kauka ma hope o kou hoʻi ʻana i ka home?
He mea nui loa ka mālama pono ʻana i kāu pēpē ma hope o kou hoʻi ʻana i ka home. Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei , e kāhea koke aku i kāu kauka.
- Inā loaʻa i ka pēpē ke kuni.
- Inā e kahe ana ke koko a i ʻole kekahi wai ʻē aʻe mai ka ʻeha ʻoki.
- Inā pilikia ʻoe i ka inu ʻana i ka waiū.
- Inā he pilikia kou me ka piʻi ʻana o ke kaumaha.
Pono kāu keiki e hele i ke keʻena lapaʻau o ke kauka puʻuwai a lawe i ka lāʻau lapaʻau no ka manawa lōʻihi. ʻO ia kekahi hapa o kēia huakaʻi.
Leka Lawe-Home
- ʻO ke Kaʻina Hana ʻo Glenn kahi hana hoʻolālā ʻelua i hana ʻia ma nā pēpē me ka maʻi puʻuwai hānau paʻakikī.
- ʻO ke ʻano kēia, ua hoʻouna pololei ʻia ke koko nele i ka oxygen i nā māmā, e kāpae ana i ka puʻuwai, e hōʻemi ana i ka ukana hana ma ka puʻuwai.
- He kiʻekiʻe loa ka holomua o kēia ʻoki kino (ma kahi o 99%). No laila, mai makaʻu.
- Ma hope o ke ʻoki ʻana, pono ke keiki i ka nānā lapaʻau a me ka lāʻau lapaʻau no ka manawa lōʻihi, no laila he mea nui loa e hahai i nā ʻōlelo a ke kauka.
- E kamaʻilio ākea me kāu kauka e pili ana i nā nīnau a i ʻole nā makaʻu āu e loaʻa nei. Aia lākou ma laila e kōkua iā ʻoe.

💬 Comments (0)
No comments yet. Be the first to share your thoughts here.
Add Your Comment