Ua manaʻo paha ʻoe e like me kāu kaikamahine a keiki paha e hana ana e like me ke keiki liʻiliʻi ma mua o ko lākou manawa, a i ʻole ke hōʻike nei i nā loli kino? Hiki i kekahi mau keiki ke hōʻike maoli i nā hōʻailona o ka wā ʻōpiopio ma mua o ko lākou manawa. I kēia lā e kamaʻilio mākou e pili ana i kēia kūlana i kapa ʻia ʻo 'precocious puberty' a i ʻole e like me ke kāhea ʻana o nā kauka, `(Precocious Puberty)`. Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i kēia.
No laila he aha kēia wā ʻōpiopio mua?
ʻO ka wā ʻōpiopio ka manawa e loli nui ai ke kino o ke keiki a hoʻomaka mālie lākou e hoʻomohala i nā ʻano o kahi pākeke. He mea maoli loa kēia. ʻO ka maʻamau, aia kahi ʻāpana liʻiliʻi o ka lolo o kāu keiki i kapa ʻia ʻo hypothalamus. Maanei e hoʻomaka ai ka hypothalamus. Hoʻokuʻu ia i kekahi mau kemika i kapa ʻia ʻo hormones. A laila hoʻouna kēia mau hormones i kahi hōʻailona i kahi gland liʻiliʻi ʻē aʻe i loko o ka lolo i kapa ʻia ʻo ka pituitary gland. A laila hoʻokuʻu ka pituitary gland i kahi ʻano hormone ʻē aʻe i kapa ʻia ʻo gonadotropins. Hele pololei kēia mau gonadotropins i nā gland wahine o ke keiki, i kapa ʻia ʻo gonads. I nā keikikāne, ʻo ia nā "testicles." Hoʻopuka kēia i ka hormone "testosterone." I nā kaikamahine, ʻo ia nā "ovaries." Hoʻopuka kēia i ka hormone "estrogen."
ʻO ka maʻamau, hoʻomaka ke kaikamahine i ka wā ʻōpiopio ma waena o 8 a me 13 mau makahiki. Hoʻomaka ke keikikāne i ka wā ʻōpiopio ma waena o 9 a me 14 mau makahiki. Eia nō naʻe, i kēia hihia, ʻo "Precocious Puberty", hoʻomaka mua kēia kaʻina hana. ʻO ia hoʻi, hoʻomaka ke kaikamahine e hōʻike i kēia mau hōʻailona ma mua o 8 mau makahiki, a hoʻomaka ke keikikāne e hōʻike i kēia mau hōʻailona ma mua o 9 mau makahiki .
Aia kekahi mau ʻano nui o ka wā ʻōpiopio mua?
ʻAe, ʻelua mau ʻano nui. E nānā kākou i ke ʻano o lākou.
1. Waena o ka wā ʻōpiopio mua
ʻO kēia ke ʻano maʻamau . ʻO ka mea e hana ʻia ma ʻaneʻi, hoʻomaka ka lolo o ke keiki e hoʻokuʻu i kahi hormone i kapa ʻia ʻo 'Gonadotropin-releasing hormone (GnRH)' ma mua o ka manawa i manaʻo ʻia. ʻO kēia ke kumu o ka hoʻokuʻu ʻana o nā testicles a me nā ovaries i nā hormones wahine, e like me 'androgens', i ka wā ʻōpiopio.
2. ʻO ka wā ʻōpiopio mua o ka wā ʻōpiopio
Hoʻokumu ʻia kēia ʻano e kahi pilikia me nā ʻōpū hānau o ke keiki, e like me nā ovaries, testicles, a i ʻole nā gland adrenal. I kekahi manawa, hiki ke hoʻokumu ʻia kēia kūlana e nā hormones e komo ana i ke kino mai ke kaiapuni waho. Ua kapa ʻia hoʻi kēia he gonadotropin-independent precocious puberty.
ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi? Pehea ka maʻamau o ia mea?
ʻOiaʻiʻo, hiki i kekahi keiki ke ʻike i kēia ʻano o ka wā ʻōpiopio. Eia nō naʻe, ʻoi aku ka maʻamau o ia mea i nā kaikamahine ma mua o nā keikikāne.
Ma ke ʻano o ka laha ʻana, pili kēia maʻi i kahi 20 mai loko mai o 10,000 mau kaikamahine, akā emi ma lalo o 5 mai loko mai o 10,000 mau keikikāne.
No ke aha i hiki ai i nā kānaka ke hiki i ka wā ʻōpio i ka wā ʻōpiopio? He aha nā kumu?
ʻOkoʻa nā kumu ma muli o ke ʻano i ʻōlelo ʻia ma mua.
Nā kumu o ka wā ʻōpiopio mua waena
E like me ka mea i ʻōlelo ʻia ma mua, ua hoʻokumu ʻia kēia e ka hoʻokuʻu mua ʻana o ka hormone `(GnRH)` mai ka lolo. I nā hihia he nui, ʻoi aku hoʻi i nā kaikamahine, he paʻakikī ke loaʻa kahi kumu maopopo no kēia. Eia naʻe, i kekahi manawa hiki i nā mea e like me kēia ke kumu:
- ʻEha o ka lolo
- Nā puʻupuʻu lolo
- Nā maʻi lolo
- Nā ʻano ʻino o ka lolo
- Ke hana nei i ka lāʻau lapaʻau radiation
Nā kumu o ka Peripheral Precocious Puberty
Hoʻokumu ʻia kēia ʻano e nā pilikia me nā ʻōpū hānau o ke keiki a i ʻole nā kelepa adrenal. Eia kekahi laʻana:
- ʻO nā ʻōpū o ka ovary, nā testes a i ʻole nā pūpū adrenal gland
- ʻO nā puʻupuʻu e hana ana i kahi hormone i kapa ʻia ʻo "Human Chorionic Gonadotropin (HCG)"
- ʻO kekahi mau kūlana genetic, no ka laʻana, ʻo McCune-Albright syndrome.
- Hypothyroidism koʻikoʻi
- Nā maʻi o nā kelepa adrenal, no ka laʻana, "Congenital adrenal hyperplasia".
I kekahi manawa, ʻo ka ʻike ʻana i nā hormones mai waho o ke kino o ke keiki kekahi kumu. E noʻonoʻo i nā mea e like me nā kirīmi, nā lāʻau lapaʻau, a i ʻole nā mea hoʻohui i loaʻa ka estrogen a i ʻole testosterone, a i ʻole androgens.
He aha nā hōʻailona o ka wā ʻōpiopio mua? Pehea ʻoe e ʻike ai?
ʻO nā hōʻailona maʻamau e ʻike ʻia i nā kāne a me nā wahine e komo pū ana me ka ʻāʻī, ka piʻi ʻana o ke ʻala o ke kino, a me ka piʻi koke ʻana o ke kiʻekiʻe . Eia kekahi, hoʻomaka mua nā ʻano moekolohe.
E noʻonoʻo, ʻike koke kāu kaikamahine ʻehiku makahiki i ka ulu ʻana o kona mau umauma, a i ʻole e loli ka leo o kāu keiki kāne ʻewalu makahiki a hoʻomaka ʻo ia e ulu i kahi ʻumiʻumi. ʻO kēia nā mea a mākou e kapa nei he mau hōʻailona.
Nā hōʻailona i ʻike ʻia i nā kaikamahine:
- Ka ulu ʻana o ka umauma
- Hoʻomaka ka menstruation
- Ka ulu ʻana o ka lauoho ma nā armpits a me nā wahi pilikino
Nā hōʻailona i ʻike ʻia i nā keikikāne:
- Ka leo haʻalulu
- Ka ulu ʻana o ka lauoho ma ka maka, nā ʻūpā lima, a me nā wahi pilikino
- Ka hoʻonui ʻia ʻana o ka penis a me nā testicles
- Ka ulu ʻana o nā ʻiʻo
ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o kēia maʻi?
ʻOi aku ka nui o ka pilikia o kekahi mau hui i kēia wā ʻōpiopio mua. ʻO lākou kēia:
- Nā kaikamahine
- Nā keiki momona a kaumaha paha
- Nā keiki o kekahi mau hui lāhui (Ua hōʻike ʻia e ka noiʻi he mea maʻamau kēia i waena o nā keiki ʻeleʻele ma nā ʻāina ʻē. Pono e aʻo hou ʻia kēia ma ko mākou ʻāina.)
He aha nā pilikia e hiki ke kū mai ma muli o ka wā ʻōpiopio mua?
ʻOiai ke piʻi koke nei ke kiʻekiʻe o ke keiki i ka wā ʻōpiopio, ua pau ka ulu ʻana ke pau ka hana ʻōpiopio. No laila, ʻoi aku paha ko lākou pōkole ma mua o nā keiki ʻē aʻe o ka makahiki like. Hiki i kēia ke hoʻopilikia i ke keiki ma ke ʻano noʻonoʻo.
ʻO kekahi mea ʻē aʻe, hiki i nā keiki ke hilahila a ʻoluʻolu ʻole ke loli koke ko lākou kino ma mua o nā keiki ʻē aʻe. E noʻonoʻo i ka paʻakikī o ke keiki e ʻike i ko lākou kino ponoʻī e loli nui ana ʻoiai he mau kamaliʻi wale nō kā lākou mau hoa papa.
Hiki i kēia mau pilikia ke alakaʻi i nā pilikia pili i ke ʻano, ka naʻau, a me ka nohona i nā keiki. Hiki iā lākou ke ʻike i ka hopohopo a me ke kaumaha. Hiki paha iā lākou ke pilikia nui aʻe i ka hoʻohana ʻana i nā mea ʻona a me ke komo ʻana i nā hana weliweli.
Pehea e ʻike ai nā kauka i kēia maʻi?
Ke lawe ʻoe i kāu keiki i ke kauka, e nānā pono mua ʻo ia i ke keiki. E nīnau pū ʻo ia iā ʻoe e pili ana i ka mōʻaukala olakino o kāu keiki a inā paha ua loaʻa i kekahi o kou ʻohana nā kūlana like.
A laila hiki ke hana i nā hoʻokolohua penei:
- X-ray o ka lima a me ka pulima lima: Nānā kēia i ka makahiki o ka iwi o ke keiki. Inā hana ke kino i ka nui o nā hormones moekolohe, ʻoi aku ka maʻamau o nā iwi ma mua o ka maʻamau. ʻO kēia kekahi hōʻailona o ka wā ʻōpiopio mua.
- Nā hoʻāʻo koko: Nānā kēia i nā pae hormone o ke keiki. ʻO ke kikoʻī, nānā ia i nā pae o nā hormones "Luteinizing Hormone (LH)" a me "Follicle-Stimulating Hormone (FSH)", i hana ʻia e ka pituitary gland. ʻO kēia nā hormones e kaohi ana i ka wā ʻōpiopio. Nānā pū ia i nā pae o nā hormones wahine.
- ʻO ke scan MRI lolo: Kōkua kēia hoʻāʻo i ka hoʻoponopono ʻana i nā pilikia e like me nā ʻōpū lolo.
- ʻO ke kani ultrasound Pelvic: Hiki ke hana ʻia kēia hoʻāʻo inā manaʻo ʻoe he peripheral precocious puberty kāu keiki. Nānā kēia hoʻāʻo no nā puʻupuʻu i loko o nā ovaries a i ʻole nā gland adrenal i nā kaikamahine, no ka mea, hiki i kēia mau mea ke kumu i ka wā ʻōpiopio mua.
Ma muli o nā hopena o kēia mau hoʻokolohua, hiki i kāu kauka ke kuhikuhi iā ʻoe i kahi endocrinologist pediatric, he kauka i loea i nā maʻi pili i ka hormone i nā keiki.
He aha nā lāʻau lapaʻau no kēia?
Hoʻopili ʻia nā ʻano lapaʻau i ke ʻano o ka wā ʻōpio mua.
Lapaʻau no ka Puberty Precocious Waena
ʻO ka pahuhopu nui o kēia ʻano, ʻo ia ke kāohi i ka hana ʻana o nā hormones `LH` a me `FSH` e ka pituitary gland. Hoʻolohi kēia i nā hōʻailona o ka wā ʻōpiopio a hiki ke hoʻopaneʻe i ka menstruation. Hana pinepine ʻia kēia me kahi lāʻau i kapa ʻia ʻo `GnRH agonist`. Ua kapa ʻia hoʻi kēia ʻo `Puberty Blocker`. He hormone synthetic kēia i hana ʻia e ke kanaka. Hana ʻia kēia e kāohi i ka hana ʻana o nā hormones hānau hou a i ʻole nā hormones ulu. E hāʻawi ke kauka i kēia lāʻau i ke keiki ma ke ʻano he injection i nā manawa kikoʻī. Pono e hoʻomau ʻia kēia lāʻau a hiki i ka manawa kūpono e hoʻomaka ai ka wā ʻōpiopio.
Lapaʻau no ka Peripheral Precocious Puberty
Hoʻōla ʻia kēia ʻano maʻi ma ka wehe ʻana i ke kumu o nā hormones wahine. Pono paha kekahi mau keiki i ke ʻoki ʻana e wehe i kahi puʻupuʻu a i ʻole kekahi puʻupuʻu ʻē aʻe e hoʻoulu ai i ka wā ʻōpiopio. Pono paha kekahi i nā lāʻau steroid, e like me glucocorticoids. I kekahi manawa, hiki ke hoʻomalu ʻia ke ʻano ma ka wehe ʻana i ke kumu o ka hormone waho, e like me nā kirīmi estrogen.
Hiki ke pale ʻia ka wā ʻōpiopio mua?
He mea paʻakikī pinepine ke pale aku i kēia maʻi. Eia nō naʻe, hiki ke pale ʻia i kekahi ʻano ma ka kaupalena ʻana i ka ʻike ʻana o ke keiki i nā hormones wahine mai nā kumu o waho. No ka laʻana, he mea nui e mālama i nā kirīmi, nā lotion, a i ʻole nā lāʻau lapaʻau ʻē aʻe i loaʻa ka estrogen a i ʻole testosterone mai ka hiki ʻana aku o nā keiki.
Pehea lā ka wā e hiki mai ana no nā keiki me kēia maʻi?
ʻO ka wā e hiki mai ana o ke keiki e pili ana i kekahi mau kumu:
- Ka makahiki o ka iwi
- ʻO ka makahiki o ke keiki i ka wā i hoʻomaka ai nā hōʻailona
- Pehea ka wikiwiki o ka ulu ʻana o kēia kūlana
- ʻO ka papahana lapaʻau o ke keiki
Akā, ʻaʻohe mea e makaʻu ai. Inā ʻike mua ʻia a mālama ʻia me ka lāʻau lapaʻau a i ʻole, inā pono, ke ʻoki kino, hiki ke hoʻomalu ʻia ke kūlana. A laila hiki i ke keiki ke ulu i kahi wikiwiki maʻamau a hiki i ka wā makua.
Āhea wau e kamaʻilio ai me ke kauka e pili ana i kēia?
Inā hōʻike kāu keiki i kekahi mau hōʻailona o ka wā ʻōpio mua, ʻoiai inā ʻaʻole i piha ke keiki i ka 8 mau makahiki (inā he kaikamahine) a i ʻole 9 mau makahiki (inā he keikikāne), e ʻike koke i ke kauka.
He aha nā nīnau e pono iaʻu e nīnau aku i ke kauka?
Hiki iā ʻoe ke nīnau i nā nīnau e like me kēia:
- Ke hele maoli nei anei kaʻu keiki i ka wā ʻōpio?
- No ke aha i hiki mai ai kēia i kaʻu keiki?
- He aha ka lāʻau lapaʻau āu e ʻōlelo ai no kaʻu keiki?
- Pono anei kaʻu keiki i ka lāʻau lapaʻau e kāohi ai i kēia maʻi?
- Aia kekahi mau hui kākoʻo e kōkua ana i nā keiki i hiki i ka wā ʻōpio?
- Pono anei mākou e ʻike i kahi endocrinologist pediatric?
No ke aha i like ai ka wā ʻōpio o nā kaikamahine ma mua o kēia mau lā?
Ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa, ua ʻōlelo ʻia aia kekahi ʻano o nā kaikamahine e komo mua ana i ka wā ʻōpio. ʻO kekahi kumu no kēia hiki ke hoʻopili ʻia i ka piʻi ʻana o ka nui o ka momona ma kēlā mau ʻāina. Wahi a nā kānaka noiʻi, aia kahi pilina ma waena o ka loaʻa ʻana o kahi Body Mass Index (BMI) kiʻekiʻe a me ka ulu mua ʻana o ka umauma. Aia kekahi manaʻoʻiʻo e hiki i ka ʻai nui ʻana i nā meaʻai i hana ʻia a momona nui ke kumu i ka wā ʻōpio.
Eia kekahi, ua ʻōlelo ʻia he hopena ko ka lāhui i kēia. No ka laʻana, ua hōʻike ʻia nā kaikamahine ʻeleʻele a me Hispanic ma ʻAmelika Hui Pū ʻIa e hiki i ka wā ʻōpio ma mua o nā hui lāhui ʻē aʻe. ʻOiai ʻoi aku ka maʻamau o ka momona i waena o kēia mau hui, ʻo ia paha ke kumu o kēia hoʻonui ʻana i ka wā ʻōpio mua.
Eia nō naʻe, he mau haʻawina pinepine kēia i mālama ʻia ma nā ʻāina ʻē. ʻOkoʻa paha ke kūlana ma ko mākou ʻāina. No laila , inā he kānalua kou e pili ana i kāu keiki, ʻo ka mea maikaʻi loa e hana ai, ʻo ia ke ʻimi i ka ʻōlelo aʻoaʻo lapaʻau.
No laila, he aha nā mea nui e pono ai kākou e hoʻomanaʻo mai kēia moʻolelo?
Hiki i ka wā ʻōpiopio ke lilo i mea kaumaha no ke keiki a me nā mākua. Akā, he mea nui e makaʻala i kēia.
- Inā ʻike ʻoe i nā hōʻailona o ka wā ʻōpiopio mua (ma mua o 8 mau makahiki no nā kaikamahine a ma mua o 9 mau makahiki no nā keikikāne), mai hoʻomāmā. E ʻike koke i ke kauka.
- Nui nā kumu no kēia. I kekahi manawa, ʻaʻole paha e loaʻa kahi kumu maopopo. Eia nō naʻe, hiki i nā hoʻokolohua lapaʻau ke kōkua i ka ʻike ʻana.
- Aia nā lāʻau lapaʻau kūpono. Inā ʻike mua ʻia a mālama ʻia, hiki ke mālama ʻia ka ulu ʻana o ke keiki ma ke ʻano maʻamau.
- E hoʻomanaʻo hoʻi i ke olakino noʻonoʻo o kāu keiki. He mea paʻakikī paha iā lākou ke ʻae i kēia hoʻololi. E hāʻawi iā lākou i ke aloha a me ke kākoʻo. E kuhikuhi iā lākou i ke aʻo ʻana inā pono.
ʻO ka mea nui loa, ʻo ia ka ʻike ʻaʻole ʻoe hoʻokahi. Aia nā kauka e kōkua iā ʻoe a me kāu pēpē. No laila, mai makaʻu, a e ʻimi mau i ka ʻōlelo aʻoaʻo lapaʻau ke kānalua.
ʻO ka wā ʻōpiopio mua, nā hormones, ka ulu ʻana o ke keiki, ka wā ʻōpiopio, nā kaikamahine, nā keikikāne
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