Loaʻa i kāu keiki liʻiliʻi kēia pilikia liʻiliʻi me ko lākou puʻuwai? (Patent Ductus Arteriosus - PDA) E aʻo kākou e pili ana i ia mea!

Ua manaʻo paha ʻoe ua paʻakikī kāu keiki liʻiliʻi i ka hanu ʻana ma hope o ka hānau ʻana? A i ʻole ua ʻike paha ʻoe e hou ana a e hanu ana i ka wā e hānai waiū ana? I kekahi manawa hiki ke hana ʻia kēia e kahi pilikia liʻiliʻi i loko o ka puʻuwai o nā keiki liʻiliʻi. ʻO kekahi o ia ʻano maʻi a mākou e kamaʻilio nei i kēia lā ua kapa ʻia ʻo 'Patent Ductus Arteriosus' a i ʻole '(PDA)'. Mai hopohopo, e kamaʻilio maʻalahi kākou e pili ana i kēia.

He aha ke ʻano o ka Patent Ductus Arteriosus (PDA)?

I ka ʻōlelo maʻalahi, ʻo ka `PDA` he maʻi puʻuwai hiki ke loaʻa i nā pēpē hānau hou. Hana ʻia ia i ka wā e pani pono ʻole ai kahi kīʻaha koko i kapa ʻia ʻo `ductus arteriosus`, ka mea i manaʻo ʻia e pani ma hope o ka hānau ʻana o ke pēpē. E noʻonoʻo iā ia e like me kahi lua liʻiliʻi i waiho ʻia i loko o kahi paipu wai.

He aha ka mea e hana ʻia me ka 'Ductus Arteriosus'?

I mea e maopopo ai kēia, pono kākou e hoʻi iki i ka wā i loko o ka ʻōpū o ka makuahine ka pēpē. I ka wā i loko o ka ʻōpū o ka pēpē, hana iki kona mau māmā. ʻO kēia no ka mea loaʻa i ka pēpē ka oxygen e pono ai mai ka makuahine ma o ke kaula umbilical. No laila, i loko o kēia manawa, ʻo ka hapa nui o ke koko e pono ai ke hele mai ka puʻuwai o ka pēpē a i nā māmā e kāpae ana i nā māmā. ʻO kahi kīʻaha koko kūikawā e kōkua ana i kēia ua kapa ʻia ʻo 'ductus arteriosus'. ʻO kēia, e ʻōlelo pololei, ua like me ke alahaka liʻiliʻi ma waena o ke aʻa nui o ka puʻuwai (ka 'aorta') a me ke aʻa nui e hele ana i nā māmā (ka 'pulmonary artery'). Ke hānau ʻia ka pēpē a hoʻomaka e hanu iā ia iho, ʻaʻole pono hou kēia 'ductus arteriosus', no laila e pani pinepine ia iā ia iho i loko o kekahi mau lā.

He aha ka mea e hana ʻia i nā pēpē me ka 'PDA'?

I kēia manawa, ʻo ka mea e hana ʻia ana i loko o kahi pēpē me ka `PDA` ʻo ia ka pani ʻole ʻana o ka `ductus arteriosus`, e waiho ana i kahi lua liʻiliʻi. Ma muli o kēia, kahe ke koko keu mai ke aʻa nui o ka puʻuwai (`aorta`) i nā aʻa e hele ana i nā māmā (`pulmonary arteries`). Ma muli o ka nui o kēia lua, pono ka puʻuwai a me nā māmā o ka pēpē e hana ikaika e pamu i ke koko. I mea e pololei ai, pono lākou e hana i nā hana hou aku.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana 'PDA'?

ʻO kēia maʻi 'PDA' ka mea maʻamau i nā pēpē hānau mua ʻole ʻia, ʻo ia hoʻi ka poʻe i hānau mua ʻia i hoʻokahi mahina. Ua ʻike ʻia hoʻi he ʻoi aku ka maʻamau i nā kaikamahine ma mua o nā keikikāne.

Pehea ka maʻamau o ka 'PDA'?

ʻO ka ʻoiaʻiʻo, ʻo PDA kekahi o nā maʻi puʻuwai maʻamau i ʻike ʻia i nā pēpē hānau hou. He mea maʻamau ia i nā pēpē hānau mua. ʻOkoʻa ka pilikia ma muli o ka pule i hānau ʻia ai ka pēpē.

E noʻonoʻo e pili ana i kēia ʻano:

• Ma kahi o 10% o nā pēpē i hānau ʻia ma waena o 30 a me 37 mau pule.
• Ma kahi o 80% o nā pēpē i hānau ʻia ma waena o 25 a me 28 mau pule.
• Ma kahi o 90% o nā pēpē i hānau ʻia ma mua o 24 mau pule o ka hāpai ʻana e loaʻa paha i kēia ʻano, i ʻike ʻia ʻo 'PDA'.

Mai hopohopo i kēia mau helu. Hōʻike wale kēia i ka pilikia. ʻAʻole kēia he mea koʻikoʻi no nā kānaka a pau.

Pehea ka hopena o ka PDA i kāu pēpē?

Inā loaʻa iā ʻoe kahi PDA waena a nui paha, hiki i kāu pēpē ke hanu wikiwiki a paʻakikī ma mua o ka maʻamau. ʻO kēia no ka mea ke hoʻāʻo nei ke kino e hoʻoponopono i ke koko keu e hele ana i nā māmā. Inā waiho ʻole ʻia kēia ʻano no ka manawa lōʻihi, hiki iā ia ke alakaʻi i ke koko kiʻekiʻe i loko o nā māmā (Pulmonary Hypertension) a me ka hōʻino ʻana i nā kīʻaha koko. ʻO ia ke kumu he mea nui e makaʻala i kēia.

He aha nā kumu o ka 'PDA'?

ʻAʻole hiki i nā kānaka noiʻi ke ʻōlelo pololei i ke kumu o kēia ʻano i kapa ʻia ʻo `PDA`. Eia nō naʻe, ua ʻike ʻia kekahi mau kumu.

• Nā mana hoʻoilina: Hiki i kekahi mau kūlana hoʻoilina a i ʻole ka mōʻaukala ʻohana o ka maʻi puʻuwai ke loaʻa ka hopena.
• ʻO Rubella i ka wā hāpai: Inā loaʻa ka makuahine i ka rubella i ka wā hāpai, ua piʻi aʻe ka pilikia o ka pēpē i ka hoʻomohala ʻana i ka PDA.
• ʻO ka Neonatal Respiratory Distress Syndrome: Hiki ke loaʻa kēia pilikia hanu i nā pēpē i loaʻa ʻole ka surfactant lawa ma mua o ka hānau ʻana. ʻOi aku ka nui o ka loaʻa ʻana o ka PDA i kēlā mau pēpē.

He aha nā hōʻailona o PDA?

ʻOkoʻa nā hōʻailona o ka PDA ma muli o ka nui o ka PDA. ʻAʻole paha e hana kahi PDA liʻiliʻi i kekahi mau hōʻailona, ​​koe wale nō ka murmur puʻuwai, kahi e lohe ai ke kauka me ka stethoscope.

Eia nō naʻe, hiki i kahi PDA nui iki ke hōʻike i nā hōʻailona e like me:

• Ka hanu wikiwiki ʻana.
• Ka paʻakikī o ka hanu ʻana (dyspnea).
• E hou ana i ka wā e hānai ana i ka waiū a i ʻole ka hānai ʻana.
• Ka luhi koke, ka luhi.
• Nā pilikia i ka ʻai ʻana a me ka inu ʻana, ka emi ʻana o ka lawe ʻana i ka waiū.
• ʻAʻole i loaʻa ke kaumaha a i ʻole ka ulu ʻana.
• Ka pulse wikiwiki a i ʻole nā ​​palpitations o ka puʻuwai.

Inā loaʻa i kāu pēpē kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ka ʻike ʻana i kahi pediatrician i ka wā hikiwawe loa.

Pehea e ʻike ai nā kauka i ka PDA?

Ke lawe ʻoe i kāu pēpē no nā nānā maʻamau a i ʻole ke lawe ʻoe iā ia no kahi maʻi, lohe paha ke kauka i ka murmur puʻuwai i ʻōlelo ʻia ma luna ('PDA heart murmur`) i ka wā e nānā ana i kāu pēpē. Inā kānalua ke kauka i kēia, e kuhikuhi ʻo ia iā ʻoe i kahi kauka puʻuwai pediatric.

He aha nā hoʻokolohua e hana ʻia no ka ʻike ʻana i ka 'PDA'?

Hiki i ke kauka puʻuwai pediatric ke hana i kekahi mau hoʻokolohua e hōʻoia i ka hōʻoia o PDA:

• X-ray umauma.
• He ultrasound o ka puʻuwai (echocardiogram). Hiki i kēia ke nānā i nā mea e like me ka hana o ka puʻuwai a me ka nui o ka ductus arteriosus.
• Electrocardiogram (EKG). Hoʻāʻo kēia i ka hana uila o ka puʻuwai.

Hiki i nā mākua ke loaʻa ka PDA?

ʻAe, i kekahi manawa ua ʻike ʻia ka PDA i nā pākeke. Inā waiho ʻole ʻia kahi PDA liʻiliʻi i ka wā kamaliʻi, ʻaʻole paha e ʻike ʻia a hiki i ka wā e nui ai. ʻO nā hōʻailona i nā pākeke:

• Hamumu puʻuwai.
• Nā palpitations o ka puʻuwai.
• Ke koko kiʻekiʻe o ka puʻuwai.

Hiki ke hana ʻia nā mea e like me ia.

Pehea e mālama ʻia ai ka PDA?

E hoʻoholo ke kauka i kahi hoʻolālā lapaʻau e pili ana i nā mea e like me ka makahiki o kāu pēpē, ke kaumaha, a me ke olakino.

• Ke kali makaʻala: I kekahi manawa e nānā pono paha ke kauka i ka pēpē, e nānā a hoʻāʻo ana e ʻike inā e pani ʻia ka PDA ma kāna iho. ʻAʻole pono iki ka lāʻau lapaʻau i kahi PDA liʻiliʻi.
• Lapaʻau me ka lāʻau lapaʻau: Hiki ke hāʻawi ʻia nā lāʻau anti-inflammatory nonsteroidal (NSAID) e kōkua i ka pani ʻana i ka PDA, ʻoi aku hoʻi no nā pēpē hānau mua. Kōkua kēia i ka duct e emi a pani. Eia naʻe, ʻaʻole hāʻawi pinepine ʻia kēia mau lāʻau lapaʻau i nā keiki makua a i ʻole nā ​​​​mākua.
• Nā lāʻau lapaʻau ʻē aʻe:
• Ka Catheterization o ka Puʻuwai: ʻO kēia ke komo ʻana i kahi paipu lahilahi a palupalu (catheter) ma o ka ʻūhā a hoʻokomo iā ia ma o kahi kīʻaha koko i ka puʻuwai. A laila, hoʻokomo ʻia kahi mea liʻiliʻi (kahi plug a coil paha) ma o ka paipu i ka PDA a hoʻopaʻa ʻia. Hoʻōki kēia i ke kahe koko keu. ʻAʻole hana pinepine ʻia kēia kaʻina hana no nā pēpē hānau mua, akā hiki ke hana ʻia no nā pēpē makua a me nā keiki.
• ʻO ke ʻoki ʻana o ka ʻili PDA (ʻoki ʻana o ka Patent Ductus Arteriosus): Ma kēia, hana nā kauka ʻoki i kahi ʻoki liʻiliʻi ma ka ʻaoʻao o ka umauma a pani i ka PDA me nā sutures a i ʻole kahi clip metala liʻiliʻi.

E noʻonoʻo i kēia mau lāʻau lapaʻau e like me ka hoʻoponopono ʻana i kahi lua i loko o ka paipu wai. ʻO ʻoe paha e hoʻopili iā ia me kahi plug liʻiliʻi, a i ʻole ʻoe e ʻoki i ka lua a hana i mea hou.

ʻEhia ka manawa e hoʻi hou ai ke kahe koko i ka maʻamau ma hope o ka lāʻau lapaʻau?

Ma hope o ka pani ʻia ʻana o ka PDA, inā paha ma o ka catheterization cardiac a i ʻole ke ʻoki ʻana, hoʻi koke ke kahe o ke koko i ka maʻamau, inā ʻaʻohe kīnā puʻuwai ʻē aʻe.

Hiki i ka PDA ke hoʻoulu i nā pilikia ʻē aʻe?

Ma hope o ka pani ʻia ʻana o ka PDA, ua maʻamau ke kahe koko, no laila ua emi nā pilikia nui. Eia nō naʻe, pono nā pēpē i pani ʻia kā lākou PDA e ka catheterization cardiac e lawe i nā antibiotics no ʻeono mahina e pale aku ai i nā maʻi puʻuwai (endocarditis). E wehewehe pono kāu kauka i kēia iā ʻoe. Pono nō hoʻi nā pākeke e lawe i nā antibiotics ma ke ʻano like ma hope o ka pani ʻia ʻana o ka PDA a hoʻomau i ka nānā mau ʻana me kahi cardiologist.

Hiki iaʻu ke pale aku i ka hoʻomohala ʻana o ka PDA i kaʻu pēpē?

ʻAʻohe mea hiki iā ʻoe ke hana e pale aku i ka ulu ʻana o ka PDA. Pili pinepine ia i ka ulu ʻana o ka pēpē.

Aia kekahi mau kūlana e hoʻonui ai i ka pilikia o ka loaʻa ʻana o ka PDA i kaʻu pēpē?

ʻAe, e like me ka mea i ʻōlelo ʻia ma mua, inā loaʻa iā ʻoe ka maʻi ʻaʻai Kelemania (`Rubella`) i ka wā hāpai, ʻoi aku ka nui o ka pilikia o ka pēpē i ka loaʻa ʻana o ka `PDA`. No laila, inā hāpai ʻoe a ua launa pū me kahi mea i loaʻa i ka maʻi ʻaʻai Kelemania, he mea nui loa e haʻi koke aku i ke kauka.

He aha kaʻu e manaʻo ai inā loaʻa ka PDA i kaʻu pēpē?

ʻO ka nūhou maikaʻi, ma hope o ka mālama ʻana, ʻo ka hapa nui o nā pēpē me PDA e hoʻomau i ke ola olakino a me ka hana. No laila, ʻaʻohe mea e hopohopo ai.

Hiki ke ho'ōla loa ʻia ka PDA?

ʻAe. Inā ʻaʻole pani ka PDA iā ia iho, hiki i nā kauka ke hoʻoponopono iā ia inā pono. Eia nō naʻe, ʻoi aku ka nui o ka pilikia o nā pēpē a me nā keiki me ka PDA waena a nui paha i ka loaʻa ʻana o nā pilikia puʻuwai i ka wā makua inā ʻaʻole mālama koke ʻia. No laila, he mea nui loa e kamaʻilio me kāu kauka e pili ana inā pono kāu pēpē i ka mālama olakino mau.

Pehea e mālama ai i kaʻu pēpē me PDA?

ʻO ka mea nui loa, ʻo ia ka hahai ʻana i nā ʻōlelo a pau a kāu kauka e hāʻawi ai iā ʻoe. E lawe i kāu pēpē no nā nānā ʻana i nā lā i hoʻonohonoho ʻia. Inā loaʻa i kāu pēpē kekahi mau hōʻailona hou, e like me ka paʻakikī o ka hanu ʻana, ka emi ʻana o ka lawe ʻana i ka waiū, a i ʻole ke ʻano luhi ma mua o ka maʻamau, e haʻi koke aku i kāu kauka.

Āhea wau e kāhea aku ai i ke kauka?

Inā loaʻa i kāu pēpē kekahi mau hōʻailona hou, e kāhea koke aku i kāu kauka. ʻOi loa aku inā pilikia kāu pēpē i ka hanu ʻana, he pilikia kēia, no laila e lawe koke iā ia i ka haukapila.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻOiai ʻo ka 'Patent Ductus Arteriosus' a i ʻole '(PDA)' he maʻi puʻuwai hānau ʻia, ʻaʻohe mea e hopohopo ai. Aia nā lāʻau lapaʻau maikaʻi no ia.

ʻO ka mea nui loa, ʻo ia ke ʻike i ka maʻi i ka manawa kūpono a hāʻawi i ka lāʻau lapaʻau e pono ai.

E kamaʻilio me kāu kauka a hoʻoholo i ka lāʻau lapaʻau maikaʻi loa no kāu pēpē. Me ka lāʻau lapaʻau kūpono, hiki i kāu keiki liʻiliʻi ke ola i kahi ola hauʻoli a olakino e like me nā keiki ʻē aʻe. ʻO ka mālama āu e hōʻike ai no kāu pēpē kona ikaika nui loa!

ʻO ka Patent Ductus Arteriosus, PDA, Maʻi Puʻuwai Pēpē, Pēpē Hānau Mua, ʻŌhūhū Puʻuwai, ʻEha Hanu, Ola Kino o ke Keiki