Ma ke ʻano he makuahine a makua kāne paha, he mea paʻakikī ke haʻi aku i ka makaʻu a me ka hopohopo a mākou e manaʻo ai i ka wā e maʻi ai kā mākou keiki liʻiliʻi, ʻeā? ʻOiai ke anu a i ʻole ke kuni maʻamau hiki ke hoʻonāukiuki iā mākou. No laila, ʻaʻole ia he mea kupanaha ke haʻalulu ko mākou mau puʻuwai ke hōʻike kā mākou keiki i kekahi mau hōʻailona ʻē. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi āu i lohe ʻole ai, akā he mea nui loa ia e ʻike. ʻO ia ka maʻi Kawasaki , a i ʻole "Kawasaki Disease". Mai hopohopo, he maʻi hiki ke ho'ōla loa ʻia kēia inā ʻike mua ʻia a mālama pono ʻia.
He aha ka maʻi Kawasaki? I ka pōkole...
I ka ʻōlelo maʻalahi, ʻo ka maʻi Kawasaki kahi maʻi e pehu ai a mumū paha nā paia o nā kīʻaha koko (nā kīʻaha koko) i loko o ko kākou kino . Hoʻopilikia nui ia i nā keiki ʻōpio, ma lalo o ʻelima mau makahiki, a ʻike pinepine ʻia i nā pēpē ma waena o 6 mahina a me 2 mau makahiki. Eia naʻe, ʻoiai he mea kakaikahi, hiki iā ia ke hoʻopilikia i nā keiki makua a me nā ʻōpio.
Ua ʻike mua ʻia a wehewehe ʻia kēia maʻi e kekahi kauka Kepanī, ʻo Kauka Tomisaku Kawasaki. ʻO ia ke kumu i kapa ʻia ai ʻo ka maʻi Kawasaki.
ʻO ka mea nui loa, ʻaʻole kēia he maʻi lele . ʻO ke ʻano kēia, ʻaʻole e hoʻolaha kāu keiki iā ia i kekahi. No laila, mai hopohopo no ia mea.
Hoʻopilikia nui kēia maʻi i nā kīʻaha koko e lawe ana i ke koko i ka puʻuwai. Kāhea mākou iā lākou he mau aʻa coronary . Inā pehu kēlā mau kīʻaha koko, hiki iā ia ke loaʻa kekahi mau hopena i ka puʻuwai. ʻO ia ke kumu e hopohopo nui nei mākou no kēia maʻi.
Pehea e ʻike ʻia ai kēia maʻi? He aha nā hōʻailona?
He ʻano ʻē iki nā hōʻailona o ka maʻi Kawasaki. ʻAʻole lākou e ʻike pinepine ʻia i ka manawa hoʻokahi, akā e lohi iki. Hoʻohana nā kauka i kahi hana liʻiliʻi e hoʻomanaʻo ai i kēia mau hōʻailona, i kapa ʻia ʻo "CRASH and Burn." E nānā kākou i ke ʻano o lākou.
- "Pū" (kuni): ʻO kēia ka hōʻailona nui a mua. Aia ke kuni kiʻekiʻe no ʻelima a ʻoi aku paha mau lā . Hiki i kēia kuni ke piʻi i 39-40 degere Celsius (102-104 Fahrenheit). ʻOiai me nā lāʻau lapaʻau maʻamau e hoʻohaʻahaʻa i ke kuni, ʻaʻole pinepine kēia kuni e emi.
I kēia manawa, e nānā kākou i ke ʻano o "CRASH":
- C - Conjunctivitis (ʻulaʻula o nā maka): ʻUlaʻula nā keʻokeʻo o nā maka ʻelua o ke keiki . Ua like ia me kahi maʻi maka. Akā ʻo ka mea kūikawā, ʻaʻohe waimaka e puka mai ana. He ʻulaʻula wale nō.
- R - Rash: ʻIke ʻia nā ʻāpana ʻulaʻula a ʻānai ma ke kino holoʻokoʻa, ʻoi aku hoʻi ma ka umauma, ka ʻōpū, ke kua, a i kekahi manawa nā lima a me nā wāwae. Hiki i kēia mau ʻāpana ke loaʻa i nā ʻano like ʻole. Hiki i kekahi mau keiki ke ʻike pinepine i kēia mau ʻāpana ma kahi diaper (nā ʻūhā a me nā puʻupuʻu).
- A - Adenopathy: ʻO kahi lymph node (node) ma ka ʻāʻī, ma kekahi ʻaoʻao, e pehu.Hiki i kēia ke lawa ka nui e paʻa ai i ka lima, ʻoi aku paha ma mua o 1.5 kenimika.
- S - Ke alelo ʻōhelo a me nā loli waha ʻē aʻe:
- Hiki i nā lehelehe o ke keiki ke maloʻo, māwae, a i kekahi manawa ʻulaʻula e lawa ai ke kahe ʻana o ke koko .
- Uhi mua ʻia ke alelo me kahi ʻili keʻokeʻo, a nalowale ma hope a lilo ke alelo i ʻulaʻula, me nā puʻupuʻu liʻiliʻi e ʻike ʻia ana, a ua like ia me ka ʻōpena . ʻO ia ke kumu i kapa ʻia ai ʻo "ʻōpena ʻōpena."
- Hiki i ka ʻaoʻao o loko o ka waha a me ka puʻu ke lilo i ʻulaʻula.
- H - Nā loli o nā lima a me nā wāwae:
- I nā lā mua, lilo nā poho lima a me nā kapuwaʻi o nā wāwae i ʻulaʻula a pehu . Manaʻo paha ia ua pehu nā lālā.
- Ma hope o hoʻokahi pule a me ka hapa a ʻelua paha pule, e hoʻomaka ka ʻili e ʻili mai nā manamana lima a i kekahi manawa nā poho lima a me nā kapuwaʻi o nā wāwae . Hiki i kēia ke hemo ma ke ʻano he mau ʻāpana nui.
Ma waho aʻe o kēia mau hōʻailona nui, hiki i kekahi mau keiki ke loaʻa nā pilikia ʻē aʻe. Eia kekahi laʻana:
- Huhū loa, uē .
- Luaʻi, ʻeha ʻōpū, kahe koko.
- ʻEha a me ka pehu ʻana o nā hono.
- I kekahi manawa hiki ke ʻike ʻia nā hōʻailona e like me ka jaundice.
E noʻonoʻo wale, inā ʻaʻole e emi ke kuni o kāu keiki no 4-5 mau lā, a ke hōʻike nei hoʻi lākou i kekahi o nā hōʻailona i ʻōlelo ʻia ma luna, pono ʻoe e ʻike i ke kauka.
No ke aha e hana ʻia ai kēia? He aha ke kumu o ka maʻi Kawasaki?
ʻO ka ʻoiaʻiʻo, ʻaʻole i ʻike ʻia ke kumu pololei o ka maʻi Kawasaki . Ke noiʻi nei nā kauka a me nā ʻepekema i kēia. Eia nō naʻe, aia kekahi mau kumu i manaʻo ʻia he kuleana no ia:
- He maʻi: Manaʻo ʻia he hana nui paha ka ʻōnaehana pale o ke kino a hoʻouka i kona mau kīʻaha koko ponoʻī ma muli o kahi mea e like me ka bacteria a i ʻole ka virus. Akā, ʻaʻole maopopo loa he aha ia germ.
- ʻO ke kūlana hoʻoilina: Ua ʻike ʻia he ʻoi aku ka nui o ka loaʻa ʻana o kēia i nā keiki i kekahi mau ʻohana. ʻO ke ʻano kēia he pilina hoʻoilina paha. Eia naʻe, ʻaʻole kēia he maʻi i hoʻoilina pololei ʻia mai nā mākua a i nā keiki.
- Nā kumu kaiapuni: Ke noiʻi nei mākou inā pili kekahi mau kumu kaiapuni i kēia.
ʻO ka mea nui loa, ʻaʻole kēia he maʻi i hoʻokumu ʻia e kekahi hewa āu i hana ai. Mai hopohopo no ia mea.
Pehea e ʻike ai nā kauka i kēia? (Diagnosis)
ʻAʻohe hoʻāʻo paʻa hoʻokahi e ʻike ai i ka maʻi Kawasaki. ʻO ia hoʻi, ʻaʻohe hoʻāʻo e hiki ke lawe i kahi koko liʻiliʻi a ʻōlelo, "ʻAuē, eia ʻo Kawasaki."
E hoʻoholo ke kauka inā loaʻa i ke keiki kēia maʻi ma muli o nā hōʻailona a lākou e ʻike nei. Inā ua loaʻa kekahi o nā hōʻailona "CRASH and Burn" i ʻōlelo ʻia ma luna no kekahi manawa, hiki i ke kauka ke kānalua.
Eia kekahi, hiki i ke kauka ke hana i nā mea e like me:
- E nānā pono i ke keiki: E nānā inā he kuni, nā maka, ka waha, ka ʻili, ka ʻāʻī, a me nā lālā.
- Nā hoʻāʻo koko:
- Hana ʻia nā hoʻāʻo e like me `(CRP - C-Reactive Protein)` a me `(ESR - Erythrocyte Sedimentation Rate)` e ʻike inā he mumū i loko o ke kino. Inā loaʻa iā ʻoe ʻo Kawasaki, hiki ke kiʻekiʻe loa kēia mau mea.
- Hoʻopaʻa ʻia ka helu o nā keʻokeʻo koko a me nā platelets.
- Hiki ke hana ʻia nā hoʻokolohua hana ate.
- Nā hoʻāʻo mimi: Kōkua i ke kāpae ʻana i nā maʻi maʻi ʻē aʻe.
- Hoʻāʻo puʻuwai `(Echocardiogram - Echo)`: He hoʻāʻo koʻikoʻi loa kēia. Hiki i kēia ke nānā i ka hana o ka puʻuwai, nā valves o ka puʻuwai, a ʻoi aku hoʻi ke kūlana o nā aʻa coronary. Hiki i kēia hoʻāʻo ke ʻike inā ua pehu a hoʻonui ʻia kēia mau aʻa (aneurysm) i ka maʻi Kawasaki. Hana pinepine ʻia kēia hoʻāʻo `(Echo)` ma hope o ka ʻike ʻia ʻana o ka maʻi, ma hope o kekahi mau pule.
E hoʻohui ke kauka i kēia mau mea a pau e hoʻoholo ai inā he maʻi Kawasaki ia a ʻaʻole paha.
He aha ka mea e hana ʻia inā ʻaʻole ia e mālama ʻia? He mea weliweli anei kēia?
Hiki i ka maʻi Kawasaki ke alakaʻi i nā pilikia inā ʻaʻole mālama koke ʻia a kūpono hoʻi . No laila he mea nui e ʻike mua iā ia a hoʻomaka i ka mālama ʻana.
ʻO ka pilikia koʻikoʻi a weliweli hoʻi, ʻo ia ka hoʻonui ʻia ʻana o nā aʻa coronary (Coronary Artery Aneurysms). ʻO ke ʻano kēia, e pehu nā kīʻaha koko e hoʻolako ana i ke koko i ka puʻuwai e like me ka pōpō. Inā loaʻa kēlā ʻano "(Aneurysm)", hiki ke ālai ʻia ke kahe koko ma o ia mea, hiki ke hana ʻia nā ʻūpā koko, a i kekahi manawa hiki ke pahū ke aʻa (hiki pinepine ʻole kēia). Hoʻonui kēia i ka pilikia o nā hōʻeha puʻuwai i ka wā e hiki mai ana.
Nā pilikia ʻē aʻe:
- ʻO ka maʻi puʻuwai
- ʻO ka mumū o ka membrane e hoʻopuni ana i ka puʻuwai (pericarditis)
- Nā pilikia o ka valve puʻuwai
- Nā ʻano ʻino o ka puʻuwai (Arrhythmias)
Akā, mai makaʻu ʻoe e lohe i kēia mau mea. Inā ʻike mua ʻia ka maʻi Kawasaki a hoʻomaka ʻia ka mālama ʻana i loko o 10 mau lā o ka hoʻomaka ʻana o nā hōʻailona, hiki ke hoʻemi nui ʻia ka pilikia o kēia mau pilikia. ʻO ia ke kumu e ʻōlelo ai mākou e ʻike koke i ke kauka.
Pehea e mālama ʻia ai kēia?
Inā hōʻoia ke kauka ua loaʻa i ke keiki ka maʻi Kawasaki, e hoʻokomo ʻia ke keiki i ka haukapila a mālama ʻia . ʻAʻole hiki ke mālama ʻia kēia ma ka home.
ʻElua mau ʻano lapaʻau nui:
1. Intravenous Immunoglobulin (IVIG): ʻO kēia ka lāʻau lapaʻau nui. ʻO ka IVIG kahi hopena e loaʻa ana nā antibodies i lawe ʻia mai nā poʻe olakino. Hāʻawi ʻia i ke keiki ma o kahi aʻa, e like me ka saline. Hoʻomālielie ia i ka ʻōnaehana pale ikaika loa i loko o ke kino a hōʻemi i ka pehu ʻana i loko o nā kīʻaha koko. Hāʻawi pinepine ʻia i hoʻokahi manawa, a he 8-12 mau hola e hoʻopau ai.
2. ʻAspirina:
- I ka wā mua, hāʻawi ʻia nā dosis kiʻekiʻe o ka aspirin a hiki i ka emi ʻana o ke kuni a me ka emi ʻana o ka mumū i loko o ke kino.
- Ma hope o kēlā, pono e hāʻawi ʻia ka aspirin haʻahaʻa no kahi o 6-8 mau pule, a ʻoi aku paha, e pale aku i nā ʻūpā koko i loko o nā aʻa coronary. E hoʻoholo ke kauka i ka lōʻihi ma muli o ka echocardiogram o ke keiki.
ʻAʻole mākou e ʻōlelo nui e hāʻawi i ka aspirin i nā keiki no ka mea hiki iā ia ke hoʻoulu i kahi maʻi weliweli i kapa ʻia ʻo Reye's Syndrome. Eia nō naʻe, i ka maʻi Kawasaki, ʻoi aku ka nui o nā pono o ka aspirin ma mua o nā pilikia. No laila, hāʻawi ʻia ma ke ʻōlelo aʻo a ke kauka.
I ka wā o ka mālama ʻana, nānā pono nā kauka a me nā kahu maʻi i ke keiki, e nānā mau ana i ka hana o ka puʻuwai, ke kuni, a me nā hōʻailona ʻē aʻe.
He aha ka mea e hana ʻia ma hope o ka mālama ʻana? E hoʻi hou anei ke keiki i ke ʻano maʻamau?
I ka hapanui o nā hihia, i loko o hoʻokahi a ʻelua paha lā o ka hoʻomaka ʻana o ka lāʻau IVIG, e emi ana ke kuni o ke keiki a e hoʻomaikaʻi mālie nā hōʻailona ʻē aʻe. E hoʻomaka ke keiki e ʻoluʻolu.
He mea nui kēia mau mea ma hope o ka mālama ʻana:
- Nā manawa hoʻopaʻa: Ma hope o ka haʻalele ʻana i ka haukapila, pono ʻoe e lawe i kāu keiki i nā manawa hoʻopaʻa o ke kauka.
- Nā hoʻāʻo `(Echocardiogram)` i hana hou ʻia: E hana ʻia nā hoʻāʻo `(Echo)` i kēlā me kēia mau pule a i kēlā me kēia mau mahina e nānā i ke kūlana o nā aʻa coronary. ʻO ka pinepine o ka hana ʻana i kēia e pili ana i ke kūlana o ka puʻuwai o ke keiki.
- E hoʻomau i ka hāʻawi ʻana i ka aspirin haʻahaʻa: Mai hoʻōki i ka hāʻawi ʻana i ka aspirin haʻahaʻa a hiki i ka wā e ʻōlelo aku ai kāu kauka iā ʻoe.
- E makaʻala i ka loaʻa ʻana o ke anu a i ʻole ka maʻi palū: Inā loaʻa i kāu keiki ka maʻi puʻupuʻu a i ʻole ka maʻi palū i ka wā e lawe ana i ka aspirin, aia kahi pilikia o Reye's Syndrome, no laila e mālama i kāu keiki mai ka poʻe me ia mau maʻi. He manaʻo maikaʻi nō hoʻi e hoʻopili ʻia kāu keiki no ka maʻi palū i kēlā me kēia makahiki e like me ka ʻōlelo a kāu kauka.
- Ke hoʻopanee nei i kekahi mau lāʻau pale: Hiki i kāu kauka ke aʻo aku iā ʻoe e hoʻopanee i kekahi mau lāʻau pale ola (e like me ka measles, mumps, rubella - MMR, ka lāʻau pale chickenpox) no kekahi mau mahina ma muli o ka mālama ʻana iā IVIG. E kamaʻilio pū me kāu kauka e pili ana i kēia.
ʻO ka nūhou maikaʻi, inā e mālama koke ʻia ka maʻi Kawasaki, e hoʻōla piha ka hapa nui o nā keiki a hiki ke ola maʻamau me ka ʻole o nā hopena lōʻihi ma ko lākou puʻuwai.
Pono anei au e ʻike i ke kauka? Āhea wau e hele ai?
ʻAe, ʻoiaʻiʻo nō. Inā loaʻa i kāu keiki kekahi o kēia mau hōʻailona, pono ʻoe e ʻike koke i ke kauka .
E makaʻala loa i kēia mau mea:
- He kuni nui e mau ana ma mua o 4-5 mau lā , ʻoiai inā ʻaʻole ia e emi me nā lāʻau lapaʻau kuni maʻamau.
- Inā hele pū ke kuni me hoʻokahi a ʻoi aku paha mau hōʻailona e like me nā maka ʻulaʻula, nā lehelehe māwae, nā loli i ke alelo, nā kiko o ke kino, ka pehu ʻana o nā lālā, a me kahi puʻupuʻu ma ka ʻāʻī .
He maʻi laha ʻole ka maʻi Kawasaki. Eia nō naʻe, hiki ke paʻakikī i kekahi manawa ke hoʻokaʻawale iā ia mai nā maʻi viral maʻamau ʻē aʻe. No laila, inā he kānalua kou, inā manaʻo ʻoe "ʻaʻole like kēia me he maʻi maʻamau," ʻoi aku ka maikaʻi o ke kipa ʻana i ke kauka no ka ʻōlelo aʻo. ʻO ka wikiwiki o ka ʻike ʻia ʻana, ʻo ka wikiwiki o ka hoʻomaka ʻana o ka lāʻau lapaʻau, a ʻo ka haʻahaʻa o ka pilikia o nā pilikia.
ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)
Ma ke ʻano he makua, e hopohopo paha ʻoe no ka maʻi Kawasaki. He mea maʻamau kēlā. Akā e hoʻomanaʻo i kēia mau mea:
- ʻO ka maʻi Kawasaki kahi maʻi e hoʻoulu ai i ka pehu ʻana o nā kīʻaha koko i nā keiki ʻōpio .
- ʻO nā hōʻailona nui he kuni nui e mau ana no kekahi mau lā, nā maka ʻulaʻula, nā loli i ka waha a me nā lehelehe, nā ʻulaʻula, ka pehu ʻana o nā lālā a laila ka ʻili ʻana o ka ʻili, a me nā kīʻaha lymph pehu ma ka ʻāʻī .
- ʻAʻole kēia he maʻi lele .
- ʻOiai ʻaʻole ʻike ʻia ke kumu kikoʻī, hiki ke ho'ōla loa ʻia inā mālama ʻia i ka manawa kūpono .
- Inā ʻaʻole mālama ʻia, hiki iā ia ke hoʻopilikia i nā kīʻaha koko i loko o ka puʻuwai . No laila he mea nui ka mālama koke ʻana.
- ʻO ka lāʻau lapaʻau ma o ka hoʻokipa ʻana i ka haukapila a me nā lāʻau lapaʻau i kapa ʻia ʻo `(IVIG)` a me `(Aspirin).`
- Inā loaʻa i kāu keiki kēia mau hōʻailona, e ʻike koke i ke kauka. He mea nui e pale aku i ka hopohopo, akā e hana koke.
Ke makemake nei au i ka wikiwiki o ka ho'ōla ʻana o kāu keiki! Ke lana nei koʻu manaʻo e kōkua kēia ʻike iā ʻoe.
ʻO ka maʻi Kawasaki, ka maʻi Kawasaki, ke kuni i nā keiki, nā maka ʻulaʻula, ke alelo ʻōhelopapa, ka maʻi puʻuwai, IVIG, ka lāʻau lapaʻau aspirin
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