Ke haʻi aku ke kauka iā ʻoe he pilikia puʻuwai ko kāu pēpē hānau hou, he mea maʻamau ia no ʻoe, ma ke ʻano he makuahine a he makuakāne paha, ke manaʻo nui i ka makaʻu a me ka haʻalulu. ʻOiai inā he kūlana ia me ka inoa maʻa ʻole e like me 'Tricuspid Atresia', nui nā nīnau e hiki mai ana i ka noʻonoʻo. "He aha kēia? E maikaʻi anei kaʻu pēpē? No ke aha i hana ʻia ai kēia?" Ke holo nei paha nā mea e like me ia i loko o kou noʻonoʻo. Mai hopohopo. I kēia lā, e kamaʻilio mākou e pili ana i kēia ma ke ʻano maʻalahi loa hiki iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha ka Tricuspid Atresia?
I mea e hoʻomaopopo ai i kēia, e nānā mua kākou i ke ʻano o ka hana ʻana o ka puʻuwai olakino. ʻEhā mau keʻena nui o ko kākou puʻuwai. ʻElua keʻena o luna a ʻelua keʻena o lalo. ʻO ke koko i hoʻohana ʻia e ke kino a haʻahaʻa i ka oxygen e komo mua i ke keʻena o luna ma ka ʻaoʻao ʻākau o ka puʻuwai (Atrium ʻĀkau). Mai laila mai, wehe ʻia kahi valve e hana ana e like me ka puka, a hele kēlā koko i ke keʻena o lalo ma ka ʻaoʻao ʻākau (Ventricle ʻĀkau). Ua kapa ʻia kēia puka
ʻo Tricuspid Valve . A laila, ʻaelike ke keʻena o lalo a hoʻouna i kēlā koko i nā māmā e loaʻa ai ka oxygen. Eia naʻe, i loko o kahi pēpē me kahi kīnā hānau i kapa ʻia ʻo
Tricuspid Atresia , ʻaʻole i
hana pono ʻia kēia mea i kapa ʻia ʻo Tricuspid Valve. ʻO ia hoʻi, ma kahi o kēlā puka, aia kekahi mea e like me ka membrane mānoanoa.
E noʻonoʻo inā he pā ma waena o nā lumi ʻelua ma kahi o ka puka. A laila, ʻaʻole hiki iā ʻoe ke hele mai kekahi lumi a i kekahi, ʻeā? ʻO ia ka mea e hana nei ma ʻaneʻi.
ʻO ka hopena, ʻaʻohe ala o ke koko nele i ka oxygen e komo ana i ka ventricle ʻākau o luna e hiki ai i ke keʻena haʻahaʻa. Ma muli o ke ālai ʻia ʻana o kēia ala, ʻaʻole ulu pono ka ventricle ʻākau o lalo, ʻaʻole hiki ke pamu i ke koko, a he liʻiliʻi loa ia. No laila, ʻaʻohe ala e hoʻouna ai i ke koko e pono ai ke hoʻouna ʻia i nā māmā e loaʻa ai ka oxygen. ʻO ka hopena kēia i
ka emi ʻana o ka nui o ka oxygen i loaʻa i ke kino holoʻokoʻa.
He kūlana koʻikoʻi anei kēia?
ʻAe, he kīnā puʻuwai hānau koʻikoʻi loa kēia a nā kauka e manaʻo nei he kīnā puʻuwai hānau koʻikoʻi. Pono ka pēpē me kēia maʻi i ka mālama ʻia ma kahi keʻena mālama koʻikoʻi (ICU) i loea i nā maʻi puʻuwai paʻakikī ma hope koke o ka hānau ʻana. I nā hihia he nui, pono ke ʻoki kino ulia pōpilikia e hoʻopakele i ke ola o ka pēpē ma mua o ko lākou hoʻi ʻana i ka home. Inā ʻaʻole i ʻike ʻia a mālama pono ʻia kēia, hiki iā ia ke loaʻa ka hopena koʻikoʻi i ke ola o ka pēpē. Aia kekahi mau ʻano nui o kēia maʻi?
Hoʻokaʻawale nā kauka i kēia kūlana me nā kikoʻī hou aku. ʻO ke kumu o kēia, aia paha he mau loli ʻē aʻe i loko o ka puʻuwai o ka pēpē ma waho aʻe o kēia kīnā nui. E ʻokoʻa ke ʻano o ka hoʻolālā ʻana o ka hoʻolālā lapaʻau ma muli o kēlā mau loli. ʻEkolu mau ʻano nui (ʻAno I, II, III).- ʻAno I: ʻO kēia ke ʻano maʻamau. Maanei, aia nā kīʻaha koko nui e haʻalele ana i ka puʻuwai (ke aʻa pulmonary a me ka aorta) ma ko lākou mau wahi kūpono. Eia nō naʻe, aia paha he lua ma waena o nā keʻena haʻahaʻa o ka puʻuwai (kahi kīnā septal ventricular) a i ʻole he pilikia me ka valve e lawe ana i ke koko i nā māmā .
- ʻAno II: Maanei, aia nā kīʻaha koko nui ʻelua i kahi kūlana ʻokoʻa. Aia kekahi puka ma waena o nā keʻena haʻahaʻa (Ventricular Septal Defect).
- ʻAno III: He ʻano kākaʻikahi loa kēia. Maanei, aia kekahi mau loli paʻakikī i nā kīʻaha koko nui a me nā keʻena.
ʻAʻole pono ʻoe e hopohopo nui e pili ana i kēia mau ʻano. E nānā nā kauka e mālama ana i kāu pēpē i kēia mau mea a pau a wehewehe iā ʻoe i ka hoʻolālā lapaʻau kūpono loa no kāu pēpē. He aha nā hōʻailona o ka pēpē?
I ka hapa nui o ka manawa, hōʻike nā pēpē me kēia maʻi i nā hōʻailona i loko o ka pule mua o ka hānau ʻana. E ʻike paha ʻoe i kēia mau mea. | Hōʻailona | Ua wehewehe maʻalahi ʻia |
|---|
| Polū o ka ʻili a me nā lehelehe (Cyanosis) | ʻO ka hōʻailona nui, he ʻano polū a poni paha ke ʻano o ka ʻili, nā lehelehe, a me nā kui, ʻoiai ʻaʻole i loaʻa i ke kino ke koko i lawa ka oxygen. |
| Ka paʻakikī o ka hanu ʻana (Dyspnea) | Ke hanu wikiwiki nei ka pēpē a me he mea lā ke pilikia nei ʻo ia i ka hanu ʻana. |
| Ka paʻakikī a me ka luhi i ka hānai waiū | Luhi ka pēpē ma hope o ka inu ʻana i kahi waiū liʻiliʻi, hoʻōki i ka inu ʻana i ka hapalua o ka manawa, a hou paha i ka hou ʻana i ka wā e inu ana. |
| Ka lohi o ka ulu ʻana | ʻOiai inā inu nui ke pēpē i ka waiū, ʻaʻole e piʻi pono kona kaumaha. |
| Nā leo puʻuwai ʻē aʻe (Heart Murmur) | ʻOiai ke kauka e nānā ana i ka puʻuwai me ka stethoscope, lohe ʻo ia i kahi kani puʻuwai keu. |
No ke aha i hiki mai ai kēia i kaʻu pēpē?
Ua nīnau pinepine paha ʻoe iā ʻoe iho i kēia nīnau. ʻO ka mea mua e hoʻomaopopo ai, ʻaʻole kēia kou hewa . ʻAʻole i loaʻa i nā kauka ke kumu pololei o kēia ʻano maʻi puʻuwai hānau. Hana ʻia ia i nā pule 6 mua o ka ulu ʻana o kahi pēpē i loko o ka ʻōpū, i ka wā e hoʻokumu ʻia ai ka puʻuwai. Eia nō naʻe, ua ʻike ʻia kekahi mau mea pilikia e hoʻonui ai i ka pilikia o kēia ʻano. Hiki i kēia mau mea ke hoʻopilikia i ka makuahine i ka wā hāpai:- Nā maʻi viral : ka loaʻa ʻana o kahi maʻi viral e like me ka German measles i ka wā hāpai .
- Maʻi diabetes : Loaʻa i ka makuahine ka maʻi diabetes a ʻaʻole i kaohi maikaʻi ʻia i ka wā hāpai.
- Ka hoʻohana ʻana i ka waiʻona : Ka inu ʻana i ka waiʻona i ka wā hāpai.
- ʻO kekahi mau lāʻau lapaʻau:Ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau no ka mālama ʻana i nā maʻi ʻili a i ʻole nā maʻi ʻili.
- Nā kūlana genetic: Hiki ke pili pū kēia me nā kūlana genetic ʻē aʻe, e like me Down Syndrome .
Pehea e ʻike ai nā kauka i kēia?
I ka hapanui o nā hihia, hiki ke ʻike ʻia kēia maʻi ma mua o ka hānau ʻana o ke pēpē.- Ma mua o ka hānau ʻana o ka pēpē: I ka wā o kāu scan hāpai (ultrasound), ʻike paha kāu kauka i kahi ʻano ʻē i loko o ka puʻuwai o kāu pēpē. Inā he kānalua, e kuhikuhi ʻia ʻoe no kahi scan kūikawā e kālele wale ana i ka puʻuwai o ka pēpē, i kapa ʻia he echocardiogram fetal .
- Ma hope o ka hānau ʻana o ka pēpē: Inā uliuli ka pēpē ma hope koke iho o ka hānau ʻana, e manaʻo koke nā kauka he pilikia puʻuwai. Inā lohe ʻia kahi kani puʻuwai ʻē (heart murmur) i ka wā e nānā ai i ka puʻuwai me ka stethoscope, he hōʻailona nui nō hoʻi kēlā. ʻO ka hoʻāʻo nui e ʻike pono ai i ka maʻi he echocardiogram . Ua like nō hoʻi kēia me ka scan. Hiki i kēia ke ʻike maopopo inā ua nalowale nā valves puʻuwai, ka nui o nā keʻena, ke ʻano o ke kahe ʻana o ke koko, a inā he mau lua ʻē aʻe.
Eia kekahi, hana ʻia kahi X-ray umauma, kahi hoʻāʻo ECG, a me kahi hoʻāʻo pulse oximetry e nānā i ka pae oxygen i loko o ke koko. He aha nā lāʻau lapaʻau? Hiki ke ho'ōla ʻia kēia?
ʻOiai ʻaʻole hiki ke "ho'ōla piha ʻia," hiki i kahi moʻo o nā ʻoki kino ke hoʻihoʻi i ke kahe koko o ka pēpē a hiki iā lākou ke ola i kahi ola maʻamau. Hiki ke hoʻokaʻawale ʻia ka lāʻau lapaʻau i ʻelua ʻāpana. 1. Lāʻau lapaʻau
I ka wā e hānau ai ke pēpē, hāʻawi ʻia lākou i ka lāʻau lapaʻau e hoʻomau i ka pēpē a hiki i ke ʻoki kino mua. ʻO ka lāʻau lapaʻau nui i hāʻawi ʻia ma ʻaneʻi ʻo Alprostadil . Wehe kēia lāʻau lapaʻau i kahi kīʻaha koko kūikawā (Ductus Arteriosus) i loaʻa i kēlā me kēia pēpē i ka wā hānau a pani ʻia i kekahi mau lā ma hope o ka hānau ʻana. Hoʻokumu kēia i kahi ala hou no ke koko e hiki ai i nā māmā. He hana hoʻōla ola kēia.2. ʻOki kino
ʻAʻole hiki ke mālama ʻia ka atresia Tricuspid me kahi ʻoki hoʻokahi. I ka ulu ʻana o ka pēpē, pono e hana ʻia kekahi mau ʻoki ma nā pae he nui. Ua like kēia me ke kūkulu ʻana i kahi hale nui ma ka ʻāpana.- Pae 1 (i loko o nā pule mua o ke ola): Pili kēia i ka hoʻokumu ʻana i ke kahe koko paʻa i nā māmā. Hana ʻia kēia ma o ke kaʻina hana i kapa ʻia he BTT shunt . Pili kēia i ka hoʻokomo ʻana i kahi ʻōmole liʻiliʻi ma waena o kahi kīʻaha koko nui a me ke kīʻaha koko e lawe ana i ke koko i nā māmā.
- Pae 2 – Ke Kaʻina Hana Glenn: Hana ʻia kēia kaʻina hana i ka wā he 4-6 mahina ka pēpē. Maanei, hoʻohuli pololei ʻia ke koko nele i ka oxygen mai ke kino o luna i nā māmā, e pale ana i ka puʻuwai.
- Pae 3 – Kaʻina Hana Fontan: Hana ʻia kēia kaʻina hana hope loa i ka wā e piha ai ke pēpē i 2-4 mau makahiki. Maanei, hoʻohuli pololei ʻia ke koko nele i ka oxygen mai ke kino haʻahaʻa i nā māmā. Ma hope o kēia kaʻina hana, ua aneane pau ka hui ʻana o ke koko waiwai i ka oxygen a me ke koko nele i ka oxygen i loko o ka puʻuwai.
Inā ʻaʻole holomua kēia mau ʻoki kino a inā nāwaliwali ka puʻuwai i ka hala ʻana o ka manawa, ua manaʻo ʻia kahi hoʻoili puʻuwai ma ke ʻano he koho hope loa. Pehea lā ka wā e hiki mai ana o kaʻu pēpē me kēia kūlana?
ʻO kēia ka pilikia nui loa no kēlā me kēia mākua. Me ka ʻole o ka lāʻau lapaʻau, make ka hapa nui o nā pēpē me kēia maʻi ma mua o ko lākou lā hānau mua. Eia nō naʻe, me ke ʻoki ʻana i ka manawa kūpono, ola ka hapa nui o kēia mau keiki a hiki i ka wā makua.
- Hoʻoikaika Kino: Hiki i ka hapa nui o nā keiki ke komo i nā hana maʻamau. Eia nō naʻe, pono paha e kaupalena ʻia nā haʻuki hoʻokūkū a ikaika hoʻi. E kamaʻilio me kāu kauka e pili ana i kēia.
- Nā pilikia olakino ʻē aʻe: Ma mua o kekahi mau kaʻina hana lapaʻau, e like me ka unuhi ʻana i nā niho, pono paha ʻoe e lawe i nā lāʻau antibiotic e pale aku i nā maʻi puʻuwai.
- Ke aʻo ʻana: Loaʻa paha i kekahi mau keiki nā pilikia aʻo a i ʻole ka maʻi hyperactivity deficit hyperactivity (ADHD). He mea nui e makaʻala i kēia.
Leka Lawe-Home
- He maʻi puʻuwai hānau koʻikoʻi ka Tricuspid atresia akā hiki ke mālama ʻia. ʻAʻole na ʻoe ia hewa.
- He mea nui ka ʻike mua ʻana i ka maʻi a me ke ʻoki ʻana i ka wā kūpono no ke ola o ke pēpē.
- Pono kēia mau keiki e nānā pono ʻia no ko lākou ola a pau e ke kauka cardiologist.
- Hiki i ka hapa nui o nā keiki ke ola maikaʻi a ʻeleu hoʻi ma hope o ke ʻoki ʻana. Mai hoʻokuʻu i ka manaʻolana.
- E kamaʻilio ākea me ke kauka o kāu pēpē e pili ana i nā nīnau a hopohopo paha āu e loaʻa ai. Ua mākaukau mau lākou e kōkua iā ʻoe.
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