Aia kekahi ʻōpū i loko o kekahi ʻōpū ʻē aʻe? ʻO nā mea āpau e pili ana i ka Intussusception, kahi mea maʻamau i nā keiki ʻōpio

E noʻonoʻo i kāu pēpē liʻiliʻi e pāʻani maikaʻi ana, a laila ʻōwili koke i loko o kahi pōpō, huki i kona mau kuli i kona ʻōpū, a hoʻomaka e uē nui. ʻOiai pehea ʻoe e hoʻāʻo ai e hōʻoluʻolu iā ia, ʻaʻole e pau ka uē ʻana. Akā ma hope o 15-20 mau minuke, pau ka uē ʻana a hoʻomaka hou ʻo ia e pāʻani, me he mea lā ʻaʻohe mea i hana ʻia. Manaʻo paha ʻoe he ʻeha ʻōpū wale nō ia. Akā hiki i kēia ke lilo i ʻano koʻikoʻi loa i kapa ʻia ʻo Intussusception , kahi e pono ai ke kōkua koke ʻia e ke kauka. He mea nui i nā mākua āpau ke makaʻala i kēia, no ka mea, he pilikia olakino ia.

I ka ʻōlelo maʻalahi, he aha ka Intussusception?

ʻOiai paha he mea ʻē iki ke kani ʻana o ka inoa, he mea maʻalahi loa ka mea e hana ʻia. ʻO ka intussusception ka wā e ale ai kekahi ʻāpana o ko kākou ʻōpū, e like me ka telescope, i kekahi ʻāpana ʻē aʻe. Ua like ia me kahi sock e ʻōwili ʻia ana i loko ona iho. Hana pinepine kēia i loko o ka ʻōpū liʻiliʻi.

Ke hana ʻia kēia, ua aneane pau loa ka neʻe ʻana o ka meaʻai ma o ka ʻōpū, e hana ana i kahi ālai ʻana o ka ʻōpū . Eia kekahi, ua ʻomi ʻia nā kīʻaha koko e hoʻolako ana i ke koko i kēlā ʻāpana o ka ʻōpū, e ʻoki ana i ke kahe koko. Inā ʻaʻole e mālama koke ʻia, hiki i kēia ālai ke hoʻoulu i ka ʻōpū e pehu, e mumū, a e hoʻoulu i nā pilikia koʻikoʻi e hiki ai ke hoʻoweliweli i ke ola.

Pehea ka maʻamau o kēia ʻano?

ʻOiai hiki ke loaʻa ka intussusception i kēlā me kēia makahiki, ʻoi aku ka maʻamau i nā keiki ma waena o 3 mau mahina a me 3 mau makahiki . ʻO ka ʻoiaʻiʻo, ʻo ka intussusception ke kumu nui o ka ālai ʻana o ka ʻōpū i nā keiki ma lalo o 3 mau makahiki. Ua manaʻo ʻia ma kahi o 1 i loko o 2,000 mau keiki e loaʻa i kēia maʻi i loko o ko lākou makahiki mua o ke ola.

He mea kākaʻikahi loa ia i nā pākeke. ʻO ka intussusception wale nō ma kahi o 1% o nā mea ālai ʻōpū āpau i nā pākeke.

Pehea e ʻike ai i nā hōʻailona o ka intussusception?

Inā kānalua ʻoe ua loaʻa i kāu keiki kēia maʻi, he mea nui loa ia e makaʻala pono i kēia mau hōʻailona.

Nā hōʻailona i nā keiki ʻōpio

He ʻokoʻa iki nā hōʻailona i nā keiki. ʻO ka hōʻailona nui ka ʻeha nui o ka ʻōpū e nalowale ana ma hope o kekahi manawa.Ke hiki mai kēia ʻeha, e kaomi nā keiki liʻiliʻi i ko lākou mau kuli i ko lākou ʻōpū a uē nui. Hiki i kēia ʻeha ke mau no kahi o 15-20 mau minuke. A laila nalowale koke ka ʻeha, a hoʻomaka hou ke pēpē e hana maʻamau, ʻoiai ke pāʻani nei. Hiki i kēia manawa ʻeha ʻole ke mau no kahi o 20-30 mau minuke. A laila hoʻomaka hou ka ʻeha weliweli.

I ka hoʻomau ʻana o kēia pōʻaiapuni o ka ʻeha, hiki i ka pēpē ke luhi, hiamoe, a palaualelo . Hiki iā lākou ke loaʻa i ke kuni a, i nā hihia koʻikoʻi, komo i ka haʻalulu.

E hoʻolohe pū i nā hōʻailona ma lalo nei.

I kekahi manawa, hiki ke ʻike ʻia kēia mau hōʻailona i kekahi mau pule ma hope o ka loaʻa ʻana o kahi keiki i kahi mea e like me ke kuni viral. No laila, inā ua maʻi kāu keiki i kēia manawa, pono ʻoe e kānalua i kēia.

Nā hōʻailona i nā pākeke

He ʻokoʻa iki nā hōʻailona o ka intussusception i nā pākeke. Hiki i ka ʻeha o ka ʻōpū ke hele mai a hele aku e like me nā keiki, a i ʻole hiki ke mau. He mea maʻamau nō hoʻi ka luaʻi ʻana, ka pehu ʻana, a me nā ʻōpala koko i nā pākeke. Eia nō naʻe, no ka mea he mea maʻamau kēia mau hōʻailona i nā maʻi ʻōpū ʻē aʻe he nui, nui ka poʻe e hoʻāʻo e hoʻowahāwahā iā ia. Eia nō naʻe, he mea weliweli loa ka intussusception.

No ke aha e hana ʻia ai kēia? He aha nā kumu?

I ka manawa pinepine, he paʻakikī ke loaʻa kahi kumu kikoʻī no ka intussusception, ʻoiai hoʻi i nā keiki ʻōpio.

Akā ua ʻike ʻia e hiki i kekahi mau mea ke hoʻopilikia i kēia.

• I nā keiki: Me he mea lā he pilina ma waena o nā maʻi viral a me kēia kūlana. Loaʻa i ka hapa nui o nā keiki i ka wā anuanu, i ka wā e maʻamau ai ke anu a me ka gastroenteritis viral. Hiki ke hana ʻia e nā ʻano maʻi congenital o nā ʻōpū, e like me ke kūlana i kapa ʻia ʻo Meckel's diverticulum a i ʻole nā ​​​​​​mea ulu liʻiliʻi i loko o nā ʻōpū (polyps).
• I nā pākeke: ʻOi aku ka maopopo o nā kumu i nā pākeke. Hoʻokumu pinepine ʻia ka intussusception e kahi mea e like me nā puʻupuʻu malignant a i ʻole nā ​​​​​​ulu maikaʻi ʻole i loko o ka colon. I kekahi manawa, hiki ke hana ʻia e nā maʻi mumū lōʻihi o ka colon, e like me ka maʻi Crohn.

Nā pilikia weliweli e hiki ke kū mai inā ʻaʻole mālama ʻia

He mea kēia e pono e ʻōlelo hou ʻia. Hiki i ka intussusception ke hoʻoweliweli i ke ola inā ʻaʻole e mālama koke ʻia.

• Ka puka ʻana o ka ʻōpū: Ke ālai ʻia ka ʻōpū, hōʻiliʻili ka meaʻai a me nā wai ʻai ma hope ona, e hoʻonui ana i ke kaomi. Hiki i kēia kaomi ke hoʻoulu i ka ʻōpū e pehu a pahū i ka hopena, e hana ana i lua.
• ʻO ka maʻi koʻikoʻi (peritonitis): Ke puka ka ʻōpū, e kahe ana kona mau mea i loko o ka lua ʻōpū. Hiki i kēia ke hana i kahi maʻi koʻikoʻi e laha ana ma loko o ka lua ʻōpū, e hana ana i kahi maʻi hoʻoweliweli i ke ola i kapa ʻia ʻo sepsis.
• ʻO ka necrosis o ka ʻōpū: Ke ʻoki ʻia ke kahe o ke koko i kahi ʻāpana o ka ʻōpū, hoʻomaka ka ʻiʻo ma ia ʻāpana e make me ka loaʻa ʻole o ka oxygen. Inā hana ʻia kēia, pono paha e wehe ʻia kēlā ʻāpana o ka ʻōpū ma ke ʻoki ʻana.

Hiki i kēia mau pilikia ke hiki koke mai. ʻO ia ke kumu he mea nui e mālama i kēia ma ke ʻano he pilikia a hele koke i ka ʻOihana Pilikia o ka haukapila (ETU) .

Pehea e ʻike ai a mālama ai nā kauka i kēia?

ʻO ka maʻamau, hana like ʻia ka ʻike ʻana a me ka mālama ʻana i kēia maʻi. Ke lawe ʻia mai kahi keiki i ka haukapila me kēia mau hōʻailona, ​​ʻo ka mea mua a nā kauka e hana ai, ʻo ia ka nānā ʻana i ka ultrasound. Hiki i kēia ke hoʻoholo me ka pololei 100% inā he intussusception a ʻaʻole paha.

ʻO ka hana aʻe a koʻikoʻi loa, ʻo ia ke kaʻina hana i kapa ʻia ʻo Air Enema a i ʻole Contrast Enema .

He aha ke ʻano o kēia lāʻau lapaʻau "Enema"?

ʻAʻole kēia he hana ʻoki kino. Ma kēia hana, hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o ka rectum o ke keiki, a hoʻokomo ʻia ka ea (Air Enema) a i ʻole kahi wai kūikawā e like me `(barium)` (Contrast Enema) ma o ia mea i loko o ka ʻōpū. ʻO ke kaomi i hana ʻia e kēia ea a wai paha e hoʻokuke i ka ʻāpana o ka ʻōpū i piholo i loko, e hoʻopololei ana i ka ʻōpū. Nānā ke kauka i kēia kaʻina holoʻokoʻa ma o kahi wikiō X-ray.

ʻoki kino

ʻO ka maʻamau, pono ke ʻoki ʻia ka intussusception i nā pākeke. Eia kekahi, pono paha kekahi mau keiki i ke ʻoki ʻia. ʻO kēia ma muli o:

• Inā ʻaʻole holomua ka mālama ʻana i ka enema.
• Inā ua loaʻa mua kahi pilikia e like me ka lua i loko o ka ʻōpū (perforation).

Hiki ke hana ʻia ke ʻoki kino ma ke ʻano kuʻuna, ma o hoʻokahi ʻoki nui ma ka ʻōpū (ʻoki kino hāmama), a i ʻole ma o ke kaʻina hana i kapa ʻia ʻo laparoscopy, ma o kekahi mau ʻoki liʻiliʻi ma ka ʻōpū a me ke kōkua o kahi kāmela. I ka wā o ke ʻoki kino, e hoʻāʻo ke kauka e hoʻopololei i ka ʻāpana o ka ʻōpū i paheʻe. Inā ʻaʻole hiki kēia, a inā ua hōʻino ʻia ka ʻāpana, e ʻoki ʻia ka ʻāpana a hoʻopili ʻia nā ʻāpana olakino ʻelua i koe.

I loko o kēia ʻoki kino, e mālama ke kauka anesthesiologist pediatric i ke keiki i ʻole ʻo ia e ʻeha. No laila, ʻaʻohe pono e hopohopo no ia mea.

Pehea ka manaʻo o ke pēpē ma hope o ka lāʻau lapaʻau?

Ma hope o ka mālama ʻana i ka enema, hiki i ke keiki ke manaʻo i ka pehu no kekahi mau hola. Hiki ke hāʻawi ʻia nā lāʻau lapaʻau e like me ka paracetamol e kāohi i ka ʻeha a me ke kuni.

Ma hope o ke ʻoki ʻana, pono kāu keiki i ka lāʻau ʻeha. E hāʻawi ʻia iā lākou nā wai IV no kekahi mau lā a hiki i ka hoʻōla ʻana o ko lākou ʻōpū. Hiki iā lākou ke hoʻomaka hou e ʻai i loko o hoʻokahi a ʻekolu mau lā. Hiki ke hala kekahi mau pule no kāu keiki e hoʻi i kā lākou mau hana maʻamau.

Inā mālama koke ʻia kēia maʻi, kiʻekiʻe loa ka nui o ka hoʻōla ʻana no nā keiki. Eia nō naʻe, aia kahi manawa kūpono he 10% - 20% e hana hou ʻia kēia. No laila, ma mua o ka haʻalele ʻana i ka haukapila, e nīnau pono i kāu kauka e pili ana i nā hōʻailona e nānā ai inā hana hou ʻia kēia maʻi.