Ke lohe nei kāu keiki liʻiliʻi i kahi leo ʻē mai ko lākou puʻuwai mai? He leo ʻē paha ia!

Ke lawe ʻoe i kāu keiki liʻiliʻi i ke kauka, he mea maʻamau ke hopohopo iki inā ʻōlelo ke kauka, "Aia kahi ʻōhumu liʻiliʻi i loko o ka puʻuwai o kāu pēpē." Eia naʻe, ʻaʻole weliweli nā ʻōhumu puʻuwai a pau. I kēia lā e kamaʻilio mākou e pili ana i ka Still's Murmur , kahi ʻōhumu puʻuwai ʻino ʻole, a i ʻole "hala ʻole" e kū pinepine ana i nā keiki ʻōpio. No laila, e aʻo hou kākou e pili ana i ia mea me ka makaʻu ʻole.

He aha maoli ka Murmur a Still?

I ka ʻōlelo maʻalahi, ʻo ka Still's Murmur he leo keu i lohe ʻia e ka puʻuwai olakino ʻaʻole pili i ka maʻi puʻuwai a i ʻole kekahi kūlana olakino ʻē aʻe. Ua like ia me kahi leo mele liʻiliʻi e puka mai ana mai loko mai o ka puʻuwai. He mea maʻamau ia i nā keiki ʻōpio. Hana ʻia kēia leo i ka wā e kahe ai ke koko ma o ka puʻuwai.

E noʻonoʻo, i ka wā e kahe ai ka wai ma o kahi paipu wai, lohe ʻoe i kekahi manawa i kahi leo liʻiliʻi, ʻeā? Pēlā nō ia. I kēia hihia, lohe maopopo ʻia kēia leo ke hoʻohana ke kauka i kahi stethoscope a hoʻolohe i ka umauma o ke keiki. Lohe nui ʻia kēia leo i ka wā e moe ana ke keiki i lalo, ʻo ia hoʻi, e kū pono ana i luna, ma ke kūlana moe .

ʻO ka mea nui, ʻaʻole ia he hoʻoweliweli o Still's Murmur i ke olakino o kāu pēpē, a ʻaʻole pono ia e mālama ʻia.

ʻO wai ka mea e lohe ana i kēia leo? Pehea ka maʻamau o ia leo?

ʻOiaʻiʻo, hiki ke loaʻa kēia kani puʻuwai i kapa ʻia ʻo Still's Murmur i kekahi o kēlā me kēia makahiki. Eia nō naʻe, ʻike pinepine ʻia ia i nā keiki ma waena o 3 a me 6 mau makahiki. ʻO ka nūhou maikaʻi, i ka wā e ulu iki ai ke keiki, ʻo ia hoʻi , i ka wā ʻōpio, nalowale pinepine kēia kani iā ​​ia iho.

He mea maʻamau kēia a ua ʻike ʻia ma nā noiʻi ua lohe paha ma kahi o 72% o nā keiki i kahi ʻōhumu puʻuwai hala ʻole i kekahi manawa o ko lākou ola. Ma waena o kēia mau mea, ʻo Still's Murmur ka ʻōhumu puʻuwai hala ʻole maʻamau i nā keiki ʻōpio.

No ke aha wau e lohe nei i kēia leo? He aha nā kumu?

Ua haʻi ʻia mai iā mākou ua hana ʻia ka Still's Murmur e ke koko e kahe ana ma ka puʻuwai o ka pēpē. Eia naʻe, ʻaʻole i loaʻa i nā kauka ke kumu pololei o kēia kani. Eia nō naʻe, aia kekahi mau kumu a nā kānaka noiʻi e manaʻo nei e kōkua paha i ia mea:

• ʻO kekahi mau kāʻei fibrous (nā tendon wahaheʻe) i loko o ka ventricle hema , ke keʻena nui ma ka ʻaoʻao hema o ka puʻuwai, hiki ke hana i kahi haʻalulu a me ke kani ke kahe ke koko ma loko.
• I kekahi manawa, ʻo kahi kūlana e like me ka anemia (ka emi ʻana o nā hunaola koko ʻulaʻula i loko o ke kino) hiki ke hoʻonui i ke kahe o ke koko ma o ka puʻuwai, hiki nō hoʻi ke hana i kēia ʻano walaʻau.
• ʻO ka valve triangular ma ka ʻaoʻao ʻākau o ka puʻuwai (Tricuspid valve)Hiki ke hana ʻia kēia kani e kekahi mau ʻāpana lahilahi a ikaika e like me ke kaula (chordae) e puka mai ana mai ka ventricle ʻākau o ka puʻuwai , i pili i ke ala kahe koko.
• Hiki ke lohe ʻia kēia kani ma muli o nā haʻalulu i hoʻokumu ʻia e ke koko e kahe ana ma loko o nā keʻena o ka puʻuwai e like me ka maʻamau.

ʻO kēia nā kumu kūpono o kēia manawa. Akā, e hoʻomanaʻo, ʻoiai ke kumu, ʻaʻole weliweli ʻo Still's Murmur .

He aha nā hōʻailona o Still's Murmur?

ʻO ke ʻano nui o Still's Murmur he leo palupalu a haʻalulu mele . Wahi a kekahi poʻe ua like ia me ke kani o ka hapa Aeolian . ʻAʻole paha ʻoe e hiki ke lohe i kēia leo ma ka hoʻolohe wale ʻana iā ia. Eia nō naʻe, hiki ke ʻike ʻia e ke kauka me ka hoʻohana ʻana i ka stethoscope.

E like me kā mākou i ʻōlelo ai ma mua, ʻoi aku ka leo o kēia leo ke moe ka pēpē ma kona kua , a ʻoi aku ka mālie ke noho a kū paha. Eia kekahi, ʻaʻole mau kēia leo. I kekahi manawa hiki ke hele mai a hele aku. Hiki ke leo nui aʻe kēia leo ke maʻi ka pēpē a hauʻoli loa paha .

ʻO ka mea nui loa, ʻaʻole e hoʻoulu ʻo Still's Murmur i nā hōʻailona kino ʻē aʻe a i ʻole nā ​​​​pilikia olakino ʻē aʻe.

E ke kauka, pehea ʻoe i ʻike pono ai he Still's Murmur kēia?

Ke lawe ʻoe i kāu keiki i ke kauka, e nīnau mua lākou e pili ana i ka mōʻaukala olakino o kāu keiki a hana i kahi hoʻokolokolo kino piha . E nānā pono kēia hoʻokolokolo ʻana i kēia mau mea:

• Hana ʻia ka palpation ʻōpū e nānā i ka ate i hoʻonui ʻia a me nā hōʻailona o ka hāʻule ʻana o ka puʻuwai.
• Ke ana ʻia nei ke kaomi koko.
• Hana ʻia ka palpation umauma e nānā i ka puʻuwai i hoʻonui ʻia (cardiomegaly).
• Nānā ʻia nā pae oxygen koko (Pulse oximetry).
• Nānā ʻia nā wāwae o ke keiki no ka pulse (distal pulse palpation) e ʻike ai inā maikaʻi ke kahe ʻana o ke koko.

A laila, hoʻohana ke kauka i kahi stethoscope e hoʻolohe i nā leo e puka mai ana mai loko mai o ke kino o ke keiki. I kēlā manawa:

• Walaʻau ʻē
• Ke kani kaomi ʻana
• Nā leo puʻuwai keu (murmurs)

Ke nānā pono nei i nā mea e like me ia.

Inā lohe ke kauka i kahi leo puʻuwai keu, e nānā pono lākou i kēia mau mea e hōʻoia ai inā he Still's Murmur ia:

• Ke loli nei ke kani ke neʻe ka pēpē? ʻOi aku ka leo nui ke moe ka pēpē ma kona kua.
• Lohe ʻia ke kani i ka wā e ʻū ai ka puʻuwai (Systolic murmur), i ka wā e hoʻomaha ai ka puʻuwai (Diastolic murmur), a i ʻole i nā manawa a pau? Lohe ʻia ka murmur Still ma hope o ka ʻū ʻana o ka puʻuwai, ʻo ia hoʻi, ma waenakonu (Mid-systolic).
• Ua lohe ʻia ke kani mai kahi hoʻokahi wale nō, a ua pālahalaha paha i nā ʻāpana like ʻole o ka umauma (radiation)? ʻAʻohe pālahalaha like i nā murmurs stills.
• Kahi o ke kani. Lohe nui ʻia ka murmur a Still ma ka ʻaoʻao haʻahaʻa o ka umauma, ma ka ʻaoʻao hema o ka sternum , ka iwi ma waenakonu o ka umauma.
• Pehea ka leo nui/palupalu o ke kani? `(Ka ikaika)`? Hoʻopuka ka hāwanawana mālie i kahi leo palupalu.
• ʻO ke ʻano o ke kani a me ka pitch (kiʻekiʻe, waena, haʻahaʻa). He leo mele, puhi, a haʻahaʻa ka murmur stills.

Inā nānā ke kauka i kēia mau mea a pau a hoʻoholo he Still's Murmur ia, ʻaʻole pono kāu keiki i kekahi hoʻāʻo hou aku.

Eia nō naʻe, inā kānalua ke kauka e pili ana i ke kani, a manaʻo paha he murmur puʻuwai ia ʻaʻole hewa ʻole, hiki iā lākou ke kuhikuhi i ke keiki i kahi kauka cardiologist nāna e hana i kekahi mau hoʻokolohua hou aʻe. ʻO kēia mau hoʻokolohua:

• Electrocardiogram (EKG): Hoʻopaʻa kēia i ka hana uila o ka puʻuwai.
• Echocardiogram (echo): Hoʻohana kēia i nā nalu alapine kiʻekiʻe e kiʻi i nā kiʻi o nā keʻena a me nā valves o ka puʻuwai.

Aia kekahi lāʻau lapaʻau no kēia? Pehea lā e pili ai i ka pēpē?

Eia ka mea nui loa. ʻAʻole pono ke keiki me ka Still's Murmur i kekahi lāʻau lapaʻau. E nalo wale nō ia i ka hala ʻana o ka manawa.

ʻAʻole e hoʻopilikia ka Still's Murmur o kāu keiki i kā lākou hana o kēlā me kēia lā, pāʻani, a i ʻole nā ​​​​hana kula ma kekahi ʻano. Hiki iā lākou ke ola i kahi ola maʻamau a olakino .

Aia kekahi ala e pale aku ai i ka Still's Murmur?

ʻAʻole. ʻAʻohe mea hiki iā mākou ke hana e pale aku ai i ka hanana ʻana o Still's Murmur . No ka mea, ʻaʻole ia he maʻi.

He aha nā mea a kākou e ʻike ai ma ke ʻano he mau mākua inā loaʻa i kā kākou pēpē ʻo Still's Murmur?

Ke ʻike ʻoe ua loaʻa i kāu keiki ʻo Still's Murmur , e hoʻomanaʻo i kēia mau mea:

• Nalowale pinepine kēia ma kāna iho ma mua o ka hiki ʻana o ke keiki i ka wā ʻōpio .
• Loaʻa paha i kekahi poʻe mākua kēia kani, akā ʻaʻole paha lākou e hōʻike i kekahi mau hōʻailona.
• ʻAʻole ʻo Still's Murmur he hōʻailona o ka maʻi puʻuwai a i ʻole kekahi maʻi olakino ʻē aʻe .
• Hiki i ke keiki ke pāʻani, hoʻoikaika kino, hele i ke kula, a hana i nā hana ʻē aʻe e like me ka maʻamau.
• ʻO ka mea nui loa, ʻo ia ka nānā mau ʻana i kāu keiki i ka manawa kūpono.A laila hiki i ke kauka ke nānā pono i ke olakino holoʻokoʻa o ke keiki.

Āhea mākou e ʻike ai i ke kauka?

ʻOiai ʻaʻole pono ka lāʻau lapaʻau no Still's Murmur , he mea nui e ʻike koke i ke kauka inā loaʻa i kāu keiki kekahi o kēia mau hōʻailona hou:

• Inā ʻoe e ʻeha ana i ka umauma, ka ʻoluʻolu ʻole, a i ʻole ka paʻa .
• Inā manaʻo ʻoe ua luhi loa (luhi loa).
• Inā loaʻa kahi mea e like me ka maʻi ʻana .
• Inā pilikia ʻoe i ka hanu ʻana (Dyspnea) a i ʻole manaʻo ʻoe e like me ʻoe e hanu ana.

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ka ʻimi ʻana i ke kōkua lapaʻau i ka hikiwawe loa, no ka mea, ʻaʻole paha lākou e pili ana iā Still's Murmur .

No laila, ʻo ka leka lawe home hope loa:

ʻAe, ua kamaʻilio nui mākou e pili ana iā Still's Murmur . ʻO ka mea hope loa, eia nā mea nui e pono ai ʻoe e hoʻomanaʻo:

• He leo maʻemaʻe ʻole ka Still's Murmur i maʻa mau i nā keiki liʻiliʻi (ʻoi aku hoʻi i nā makahiki 3-6).
• ʻAʻole pili kēia i kekahi maʻi puʻuwai a i ʻole nā ​​​​pilikia olakino ʻē aʻe .
• ʻAʻole pono kēia i kekahi lāʻau lapaʻau , a nalo pinepine ia ma kāna iho i ka wā e ulu aʻe ai ke keiki.
• Hoʻoponopono nā kauka i kēia ma o ka hoʻokolokolo kino a ma ka hoʻolohe ʻana i ka puʻuwai me ka hoʻohana ʻana i ka stethoscope.
• ʻOiai paha he mea hopohopo iki ka lohe ʻana i kahi ʻōhumu puʻuwai e like me kēia, ʻaʻole ia e hōʻeha i ke olakino o ke pēpē.
• Inā paha he maʻi kēia kāu keiki, hiki iā lākou ke ola i kahi ola olakino a ikaika hoʻi .

No laila, inā haʻi aku ke kauka o kāu keiki iā ʻoe i kekahi mea e like me kēia, mai hopohopo pono ʻole, e kamaʻilio pono me ke kauka a e ʻike i nā kikoʻī. E hoʻomanaʻo mau, ʻo ka mea nui loa ka hoʻoholo ʻana e pili ana i ke olakino o kāu keiki ma muli o ka ʻōlelo aʻoaʻo lapaʻau.

ʻO ka Murmur Still, Ke kani o ka puʻuwai, Murmur Hala ʻole, Pediatrics, Ola o ka puʻuwai, Murmur Hala ʻole, ʻO ka Murmur Still