Ua hoʻololi ʻia anei nā aʻa nui o ka puʻuwai o kāu pēpē? (Ke hoʻololi ʻana o nā aʻa nui) - E kamaʻilio kākou e pili ana i kēia!

He mea paʻakikī ke haʻi aku i ka makaʻu a me ke kaumaha āu e manaʻo ai ke lohe ʻoe ua loaʻa i kāu pēpē hānau hou kahi maʻi puʻuwai, ʻeā? Akā, mai hopohopo. I kekahi manawa, hiki i nā pēpē ke hoʻololi i ʻelua o nā kīʻaha koko nui i loko o ko lākou puʻuwai i ka wā e hānau ʻia ai lākou. I kēia lā, ke kamaʻilio nei mākou e pili ana i kekahi ʻano maʻi, i kapa ʻia ʻo `(Transposition of the Great Arteries)`. He mea paʻakikī paha kēia, akā e mālama kākou i ka maʻalahi.

He aha ka Transposition o nā Arteries Nui?

I ka ʻōlelo maʻalahi, he ʻano "hānau" kēia e kū mai ana i ka wā e hānau ʻia ai kahi pēpē. ʻO ia hoʻi, kū mai kēia pilikia i ka wā e noho ana ke pēpē i loko o ka ʻōpū o ka makuahine. Loaʻa iā kākou ʻelua mau kīʻaha koko nui e lawe ana i ke koko mai ko kākou puʻuwai a i ke koena o ko kākou kino. ʻO kekahi ʻo ke aʻa pulmonary, ka mea e lawe ana i ke koko i nā māmā , a ʻo kekahi ʻo ka aorta, ka mea e lawe ana i ke koko i ke koena o ko kākou kino . ʻO ka mea e hana ʻia ana i kēia ʻano, ua pili kēia mau kīʻaha koko nui ʻelua i ka puʻuwai ma nā wahi kūpono ʻole, ʻaʻole ma nā wahi kūpono. Ua like ia me nā paipu e hele ana i ʻelua mau pahu wai i hoʻololi ʻia.

Pehea ke ʻano maʻamau o ke kahe ʻana o ke koko? He aha ka mea e hana ʻia ma kēia kūlana?

ʻO ka maʻamau, penei ka mea e hana ʻia: hele ke koko ʻilihune oxygen o ke kino (koko polū) i ka puʻuwai, mai laila aku i nā māmā e lawe i ka oxygen. A laila, hoʻi ke koko hou, waiwai oxygen (koko ʻulaʻula) i ka puʻuwai, mai laila aku a i ke kino holoʻokoʻa ma o nā aʻa nui. Akā ma kēia kūlana "Transposition of the Great Arteries", no ka mea ua hoʻololi ʻia nā kīʻaha koko ʻelua, hoʻi ke koko ʻilihune oxygen i ke kino ma kahi o ka hele ʻana i nā māmā. Pēlā nō, hoʻi ke koko waiwai oxygen mai nā māmā i nā māmā ma kahi o ka hele ʻana i ke kino. E noʻonoʻo i ka emi ʻana o ka oxygen e hiki ai i nā ʻōpū o ka pēpē.

Aia kekahi mau ʻano o kēia?

ʻAe, ʻelua ʻano nui o kēia: 1. Levo-transposition (Levo-transposition a i ʻole l-TGA): I kēia hihia, aia ka aorta o ka pēpē ma ka ʻaoʻao hema o ke aʻa pulmonary. I kēia hihia, ʻaʻole wale nā ​​​​kīʻaha koko ʻelua, akā ʻo nā keʻena haʻahaʻa o ka puʻuwai e hoʻololi ʻia. Eia naʻe, i kēia ʻano, hele ke koko deoxygenated i nā māmā a hele ke koko oxygenated i ke kino, no laila ʻaʻole ia e hōʻeha nui. He ʻano maʻamau ʻole kēia. 2. Dextro-transposition (Dextro-transposition a i ʻole d-TGA): I kēia hihia, aia ka aorta o ka pēpē ma ka ʻaoʻao ʻākau o ke aʻa pulmonary. ʻO kēia ke ʻano maʻamau, a ʻo ia hoʻi ke ʻano e pono ai ka nānā hou aku. E kamaʻilio hou mākou e pili ana i kēia `(d-TGA)` ma kēia ʻatikala.

No ke aha i kapa ʻia ai kēia kūlana ʻo d-TGA he mea weliweli no nā pēpē?

E like me kaʻu i ʻōlelo ai ma mua, i ke ʻano o `(d-TGA)`, ua piha ke kino o ka pēpē i ke koko nele i ka oxygen. ʻO ia hoʻi, ʻaʻole i loaʻa i nā ʻōkana koʻikoʻi a pau o ka pēpē, e like me ka lolo, nā puʻupaʻa, a me ke akepaʻa, ka nui o ka oxygen e pono ai. He mea weliweli loa kēia no ke ola o ka pēpē. I kekahi manawa, i ka wā e hānau ʻia ai kēia mau pēpē, aia paha he lua ma waena o nā keʻena o luna o ka puʻuwai `(Atrial Septal Defect a i ʻole ASD)` a i ʻole he lua ma waena o nā keʻena o lalo o ka puʻuwai `(Ventricular Septal Defect a i ʻole VSD)`. ʻOiai he mau kūlana ʻē kēia mau lua, i ia mau hihia, hiki i kēia mau lua ke kōkua iki. ʻO ia hoʻi, ʻae kēia mau lua i kekahi koko waiwai i ka oxygen e hui pū me ke koko ʻaʻohe oxygen. Eia naʻe, ʻaʻole lawa ka nui o ka oxygen i loaʻa. No laila, pono maoli ka pēpē i ka lāʻau lapaʻau.

Mai hopohopo, aia nā ʻoki kino no kēia maʻi. Ua hana pono nā kauka i kēia mau ʻoki kino no nā makahiki.

He aha nā hōʻailona a me nā ʻōuli inā loaʻa kēia maʻi i kāu pēpē? (Nā ʻōuli)

Hiki i nā pēpē hānau hou me ka `(d-TGA)` ke loaʻa i kahi maʻi i kapa ʻia ʻo `(cyanosis),` ʻo ia hoʻi ke kala polū/hina o ka ʻili ma muli o ka nele o ka oxygen. Hiki iā lākou ke loaʻa i ka puʻuwai nāwaliwali. ʻO nā hōʻailona nui:

• Paʻakikī ka hanu ʻana .
• Ua nāwaliwali loa ka pulse .
• Hōʻike i ka hoʻokaʻulua a me ka paʻakikī e inu waiū.
• Ke kuʻi nei koʻu puʻuwai me he mea lā e kuʻi nui ana, me he mea lā e kuʻi wikiwiki ana.
• Hiki ke ʻike ʻia ka ʻili a me ke keʻokeʻo o nā maka he uliuli (i nā pēpē me ka ʻili keʻokeʻo) a hina paha (i nā pēpē me ka ʻili ʻeleʻele).

Āhea e hoʻomaka ai kēia mau hōʻailona?

E hoʻomaka ana kahi pēpē me ka `(d-TGA)` e hōʻike i kēia mau hōʻailona i ka wā hānau. Eia nō naʻe, i kekahi manawa, ma muli o nā mea e like me `(ASD)`, hiki i nā lua liʻiliʻi i loko o ka puʻuwai o ka pēpē ke hoʻoulu i kekahi koko momona oxygen e hele i ke kino, no laila ʻaʻole hiki ke ʻike nui ʻia nā hōʻailona. Eia kekahi, ʻo ka `(patent ductus arteriosus)`, kahi kīʻaha koko a ka pēpē e hoʻohana ai i loko o ka ʻōpū, hiki ke noho hāmama no kekahi mau lā ma hope o ka hānau ʻana, e hui pū ai ke koko. Eia naʻe, i ka wā e pani ʻia ai kēia mau lua a me nā ʻōmole manawa pōkole, hiki ke hoʻonui koke ʻia nā hōʻailona. I kēlā hihia, pono koke ka pēpē i ke kōkua lapaʻau.

No ke aha kēia e hana nei? (Nā kumu)

ʻAʻole maopopo loa i nā kauka ke kumu o ka Transposition of the Great Arteries. E like me nā maʻi puʻuwai hānau ʻē aʻe, ua manaʻo ʻia ua hana ʻia e kahi mutation genetic a i ʻole ka ʻike ʻana i nā mea ʻawahia i ka wā hāpai. ʻO kekahi o nā kumu e hiki ke kōkua i ke kūlana:

• Inā loaʻa iā ʻoe ka maʻi diabetes gestational i ka wā hāpai .
• Inā loaʻa iā ʻoe kahi maʻi e like me ka rubella i ka wā hāpai.
• Inā ua pili ʻoe i kekahi mau pesticides a i ʻole herbicides.
• Inā ua lawe ʻoe i kekahi mau lāʻau lapaʻau no ka maʻi epilepsy.

Mai hopohopo i kēia mau mea. ʻAʻole nā ​​​​kānaka a pau i loaʻa i kekahi o kēia mau mea e ʻike i kēia.

Pehea e ʻike ai nā kauka i kēia? (Diagnosis)

I kekahi manawa, hiki i nā kauka ke ʻike i kēia kūlana i kou wā hāpai. Hana ʻia kēia ma o nā hoʻokolohua prenatal. Inā manaʻo kāu kauka he hewa kekahi mea i ka wā o ka ultrasound scan o kāu pēpē, e noi paha ʻo ia iā ʻoe e hana i kahi echocardiogram fetal. Ua like kēia me ka ultrasound, akā nānā pono ia i ka puʻuwai o ke pēpē. Hiki i kēia ke hōʻoia inā loaʻa iā ʻoe ka d-TGA. Inā ʻaʻole i ʻike ʻia i ka wā hāpai, ʻike pinepine ʻia i loko o ka pule mua ma hope o ka hānau ʻana.

He aha nā hoʻokolohua i hana ʻia no kēia?

ʻO nā hoʻokolohua a nā kauka e hoʻohana ai e hōʻoia i kēia kūlana:

• Echocardiogram (Echo): He scan ultrasound kēia o ka puʻuwai.
• Electrocardiogram (EKG): He hoʻāʻo e nānā i ka hana uila o ka puʻuwai.
• Nānā ʻana i ka pulse oximetry o nā keiki hānau hou: Hana pinepine ʻia kēia ma nā keiki hānau hou a pau.
• Hoʻāʻo X-ray umauma.
• Catheterization cardiac: He hoʻāʻo paʻakikī kēia. Hoʻokomo ʻia kahi ʻōmole lahilahi ( catheter ) ma o ka wāwae a lima paha i loko o ka puʻuwai. Hana ʻia kēia inā ʻaʻole maopopo nā hoʻokolohua ʻē aʻe.
• He hoʻāʻo ka CT scan.

Pehea e mālama ai i kēia? Pono kāu pēpē i ke kōkua koke!

Pono ke ʻoki kino i kahi pēpē i hānau ʻia me ka `(d-TGA)` e ola. ʻO ka hapa nui o ka manawa, hana ʻia kēia ʻoki kino i loko o ka pule mua o ka hānau ʻana. Ua kapa ʻia kēia ʻoki kino he kaʻina hana hoʻololi arterial . I ka ʻōlelo maʻalahi, pili kēia i ka hoʻopili hou ʻana i nā kīʻaha koko ʻelua i hoʻololi ʻia (ka aorta a me ke aʻa pulmonary) i ko lākou mau kūlana kūpono. ʻAe kēia i ke koko e kahe pono. Inā he lua ko kāu pēpē i loko o ko lākou puʻuwai, e like me ka `(VSD)`, e hoʻoponopono ʻia hoʻi ia i ka wā o kēia ʻoki kino.

Nā mea e hana ai no ka manawa pōkole ma mua o ke ʻoki kino

Hoʻohana nā kauka i kekahi mau lāʻau lapaʻau no ka manawa pōkole e hoʻopaʻa i ke kūlana o ka pēpē a hiki i ka wā e hiki ai ke hana ʻia ke ʻoki kino nui. ʻO kēia mau mea:

• Prostaglandin: Hoʻohana ʻia kēia lāʻau lapaʻau e wehe i ka ductus arteriosus, kahi kīʻaha koko i loaʻa i ka pēpē i loko o ka ʻōpū akā pani ʻia ma hope o ka hānau ʻana. Ke wehe ʻia kēia, hoʻomaka kekahi koko oxygenated e kahe i loko o ke kino.
• ʻO ke kaʻina hana i kapa ʻia ʻo Balloon atrial septostomy:Ma kēia, hoʻohana ʻia kahi ʻōmole lahilahi (catheter) e hoʻonui i ka puka kūlohelohe ma waena o nā keʻena ʻelua o luna o ka puʻuwai. ʻAe kēia i ke koko oxygenated a me ke koko deoxygenated e hui pū, e hāʻawi ana i ke kino me kekahi oxygen.

Hiki ke pale ʻia kēia kūlana?

ʻAʻohe ala i ʻike ʻia e pale aku ai i ka Transposition of the Great Arteries. Eia nō naʻe, he mea nui e hahai i nā hana olakino maikaʻi i kou wā hāpai. E kiʻi i kāu mau lāʻau lapaʻau a pau i ka manawa kūpono, e lawe i kāu multivitamin, a e mālama i kāu mau manawa i ke kauka. Inā loaʻa i kekahi o kou ʻohana kahi moʻolelo o ka maʻi puʻuwai hānau, e kamaʻilio me kāu kauka e pili ana i ia mea. Hiki iā ia ke paipai i ka ʻōlelo aʻoaʻo genetic.

He aha ka mea e hana ʻia ma hope o ke ʻoki kino? Pehea e noho ai me TGA

ʻOiai ʻaʻole hiki i ke ʻoki kino ke "ho'ōla piha" i ke kūlana, nui ka poʻe me ka `(d-TGA)` e ola piha a olakino. Eia nō naʻe, ʻo ka poʻe me kēia kūlana `(congenital)` e pono ai ka nānā lapaʻau no ke ola holoʻokoʻa. E nānā mau ana kahi kauka puʻuwai i ke kūlana o kāu keiki a hāʻawi i nā ʻōlelo aʻoaʻo e pono ai. ʻOi aku ka nui o ke ola ma hope o ke ʻoki kino `(arterial switch)` ma mua o 95%. Ua ʻōlelo ʻia e mau ana kēia helu ma hope o 25 mau makahiki.

Hiki i kāu keiki ke ola maikaʻi me TGA?

ʻAe, ʻoiaʻiʻo nō. Ma hope o ka mālama ʻia ʻana no ke kūlana `(Transposition of the Great Arteries)`, hiki i kāu keiki ke ola i ke ola maʻamau. Eia naʻe, pono e mālama ʻia ka puʻuwai i ke ola holoʻokoʻa. ʻO ia hoʻi:

• Pono ʻoe e mālama i ka launa pū ʻana me kahi cardiologist nāna i loea i kēia ʻano kūlana.
• Pono ʻoe e lawe pono i ka lāʻau lapaʻau i kuhikuhi ʻia.
• Pono e hana mau ʻia nā hoʻokolohua e nānā i ka hana o ka puʻuwai, e like me ka `(EKG), `(Holter monitor), `(exercise stress tests), a me `(echocardiogram).

ʻAʻole ʻōlelo ka nui o nā kauka puʻuwai i ka pāʻani ʻana i nā haʻuki hoʻokūkū ma hope o ke ʻoki ʻana `(d-TGA)`. No laila, pono ʻoe a me kāu keiki, kāu kauka keiki, a me kāu kauka puʻuwai e hana pū e hana i ka hoʻoholo maikaʻi loa no ke olakino o kāu keiki. He nui nā wahine i loaʻa i ke ʻoki ʻana `(d-TGA)` ua holomua ka hāpai ʻana. Eia nō naʻe, he mea nui e kamaʻilio me kāu kauka a me ke kauka puʻuwai ma mua o ka hāpai ʻana.

E pono anei nā ʻoki puʻuwai hou aku i ka wā e hiki mai ana?

ʻAe, pono paha nā ʻoki kino hou aʻe ma hope. ʻO ka hapa pinepine, ʻo ia ke hoʻoponopono ʻana i kahi pilikia o ka puʻuwai a i ʻole e hoʻoponopono i nā valves o ka puʻuwai.

Aia kekahi pilikia o ka endocarditis?

ʻO ka Endocarditis kahi maʻi e kū mai ana ke komo kahi maʻi bacteria i loko o ka puʻuwai. ʻOi aku ka nui o ka poʻe me nā maʻi puʻuwai e like me TGA e loaʻa i kēia. No laila, pono paha ka poʻe i hana ʻia ke ʻoki transposition e lawe i nā antibiotics ma mua o ka mālama ʻana i nā niho.

Hiki iā ia ke hoʻopilikia i ka ulu ʻana o ka lolo?

Loaʻa paha i kekahi mau keiki i loaʻa i kahi hoʻololi arterial ka ADHD (attention deficit hyperactivity disorder). A i ʻole pono paha lākou i ke kōkua kūikawā me nā hana kula. E makaʻala pū i kēia.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa i kāu pēpē kēia mau hōʻailona ...

• Inā manaʻo ʻoe e pilikia ana ʻoe i ka hanu ʻana.
• Inā nāwaliwali loa ka pulse.
• Inā ua lilo ka ʻili a puni ka waha i polū/keʻokeʻo.

Inā ʻike ʻoe i kekahi mea e like me kēia, e ʻike koke i ke kauka.

Inā ua loaʻa iā ʻoe kēia ʻoki kino i kou wā kamaliʻi ...

Pono ʻoe i nā hoʻokolohua lapaʻau maʻamau a me ka nānā ʻana i kou ola a pau. E ʻike i kahi kauka puʻuwai i ʻike i ka maʻi puʻuwai makua (congenital).

He aha nā nīnau āu e nīnau ai i ke kauka?

Inā loaʻa i kāu pēpē ka Transposition of the Great Arteries, hiki iā ʻoe ke nīnau i ke kauka i kēia mau nīnau:

• Pono anei kaʻu pēpē i ke ʻoki kino koke?
• He aha ka lāʻau lapaʻau maikaʻi loa?
• He aha ke ʻano o ka mālama ma hope e pono ai kaʻu pēpē?
• Pono anei ʻo ia e hana i kahi ʻoki kino ʻē aʻe?
• Aia kekahi mau kapu i kāna mau hana?
• Pehea e mālama ai i kaʻu pēpē ma hope o ke ʻoki kino?

Inā ua hana ʻia ʻoe i ke ʻoki kino no kēia ʻano i kou wā kamaliʻi, hiki iā ʻoe ke nīnau i kāu kauka:

• E pono anei au i kahi ʻoki kino ʻē aʻe?
• He aha ke ʻano o ka nānā lapaʻau e pono ai iaʻu?
• Aia kekahi mau kapu i kaʻu mau hana?
• Hiki iaʻu ke loaʻa keiki?

ʻO ka mea hope loa, ʻo ka mea nui loa (Leka Lawe-Home)

ʻO ka ʻike ʻana he maʻi puʻuwai hānau ko kāu pēpē hānau hou, ʻaʻole ia he mea e manaʻo ʻia e kekahi makua. Hiki ke kaumaha ka naʻau. Akā, ʻaʻole ʻoe hoʻokahi. Hiki i nā kauka o kāu pēpē ke kōkua iā ʻoe ma o kēia huakaʻi a alakaʻi iā ʻoe ma o nā hoʻoholo āu e hana ai.

E hoʻomanaʻo, ua mālama nā kauka i nā pēpē me TGA no nā makahiki he nui, a ua holomua loa nā hopena. E ikaika no kāu keiki. Mai makaʻu e nīnau i kāu kauka e pili ana i nā mea āu e maopopo ʻole ai a kānalua paha. ʻO kou ʻike ka ikaika nui o kāu keiki no kahi wā e hiki mai ana.

ʻO ka shunting cardiac, maʻi puʻuwai hānau, ʻoki hoʻololi arterial, cyanosis, maʻi puʻuwai pēpē, d-TGA, ʻoki puʻuwai