Ua ʻōlelo anei ke kauka i kāu nānā ʻana i ka wā o ka prenatal ua pehu iki kekahi o nā puʻupaʻa o kāu pēpē? A i ʻole loaʻa pinepine i kāu keiki liʻiliʻi nā maʻi mimi? Malia paha ke kamaʻilio nei ʻoe e pili ana i kahi ʻeha iki ma ka ʻaoʻao o kou ʻōpū? I kēia lā, e kamaʻilio mākou e pili ana i kahi maʻi e hiki ai ke hana i kēia, akā ʻaʻole i kamaʻilio nui ʻia. Ua kapa ʻia kēia ʻo Ureteropelvic Junction Obstruction, a i ʻole UPJ Obstruction no ka pōkole.
I ka ʻōlelo maʻalahi, he aha ka UPJ Obstruction?
I mea e hoʻomaopopo ai i kēia, e nānā mua kākou i ke ʻano o ka hana ʻana o ko kākou mau puʻupaʻa. E noʻonoʻo i ko kākou mau puʻupaʻa e like me ʻelua mau kānana wai. Kānana ʻia ke koko i loko o ko kākou kino, a hōʻiliʻili ʻia nā ʻōpala a me ka wai pono ʻole i loko a hoʻolilo ʻia i mimi.
ʻO ka mimi e hana ʻia ma kēia ʻano e hōʻiliʻili i loko o kahi ʻāpana e like me ka funnel i loko o ka puʻupaʻa (ka pelvis renal) . A laila, hele ka mimi i lalo i kahi ʻōmole lahilahi (ka ureter) e hoʻomaka ana mai kēia funnel a hōʻiliʻili i loko o ka ʻōpū mimi.
ʻO kahi e pili ai ka funnel kidney a me ka ureter e hoʻomaka ana ma laila ʻo ia ka mea a mākou e kapa nei ʻo Ureteropelvic Junction (UPJ).
I kēia manawa ua maopopo iā ʻoe, ʻeā? ʻO ka UPJ Obstruction ka wā e loaʻa ai kahi ālai a i ʻole kahi mea e ālai ai ma kēlā hui ʻana, ʻo ia hoʻi, kahi e hui ai ka funnel a me ka tube. E like me ka wā e ālai ʻia ai kahi paipu i loko o kahi poho holoi, ʻaʻole hiki i ka mimi ke iho i lalo a hoʻomaka e hoʻopiha i loko o ka puʻupaʻa. Ma nā ʻōlelo lapaʻau, ua kapa ʻia kēia (Hydronephrosis) ke hoʻopiha ka puʻupaʻa me ka mimi.
He maʻi hānau pinepine kēia ʻano a hoʻopilikia pinepine i hoʻokahi puʻupaʻa wale nō.
He koʻikoʻi anei kēia kūlana?
ʻAe, he ʻano maʻi ka UPJ Obstruction e pono e mālama ʻia. No ka mea, inā ʻaʻole mālama pono ʻia, hiki ke hōʻino ʻia ka puʻupaʻa a hiki ke hoʻemi ʻia kāna hana ma muli o ka piha ʻana o ka mimi i loko o ka puʻupaʻa no ka manawa lōʻihi. I nā hihia ʻino loa, hiki i ka puʻupaʻa ke lilo i mea hana ʻole loa (kidney failure).
Akā, mai hopohopo. Inā loaʻa koke a mālama pono ʻia, hiki ke ho'ōla loa ʻia. Hiki i ka hapa nui o nā keiki ke ola olakino me ka ʻole o nā hopena lōʻihi.
He aha nā hōʻailona o kēia maʻi?
Hiki ke ʻokoʻa nā hōʻailona o ka UPJ Obstruction me ka makahiki. I kekahi manawa ʻaʻole paha e hōʻike kekahi keiki ʻōpio i kekahi mau hōʻailona. Eia nō naʻe, aia kekahi mau hōʻailona maʻamau e ʻike ʻia.
| Hōʻailona | He wehewehe maʻalahi |
|---|---|
| He puʻupuʻu ma ka ʻōpū e hopu ana i ka lima | Ke pehu ka puʻupaʻa ma muli o ka hoʻopiha ʻia ʻana o ka ʻōpū mimi, hiki ke manaʻo ʻia he puʻu ma ka ʻaoʻao o ka ʻōpū. |
| Nā maʻi ʻōpū mimi pinepine (UTIs) | Ma muli o ka noho ʻana o ka mimi ma kahi hoʻokahi, hiki ke ulu maʻalahi nā maʻi bacteria, a hiki ke alakaʻi i ke kuni. |
| ʻEha ʻaoʻao | Hiki paha iā ʻoe ke ʻike i kahi ʻeha ʻūlū ma luna o ka pūhaka a ma ke kua, ʻoiai ma hope o ka inu ʻana i ka nui o nā wai, e like me ka wai. |
| Nā pōhaku puʻupaʻa | Ma muli o ka noho ʻana o ka mimi ma kahi hoʻokahi, aia ka pilikia o ka loaʻa ʻana o nā pōhaku puʻupaʻa i ka hala ʻana o ka manawa. |
| Ke koko i loko o ka mimi (Hematuria) | I kekahi manawa hiki i ka mimi ke lilo i poni a ʻulaʻula paha. |
| Ka luaʻi a me ka luaʻi | Hiki ke loaʻa ka luaʻi a me ka luaʻi ʻana, ʻoiai i ka wā ʻeha. |
| Ka lohi o ka ulu ʻana | Hiki ke hoʻopilikia ʻia ka piʻi ʻana o ke kaumaha a me ka ulu ʻana o nā keiki ʻōpio. |
He aha ke kumu o kēia? No ke aha lā kēia e hana nei?
Nā kumu hānau
I ka hapanui o nā hihia, ʻoi aku ma mua o 95% o nā hihia, he maʻi hānau ʻia ka UPJ Obstruction.ʻO ke ʻano o kēia, hana ʻia ka paʻa ʻana ma muli o ka hana pono ʻole ʻana o nā puʻupaʻa a me ke ala mimi i ka wā e ulu ana ke pēpē i loko o ka ʻōpū. ʻAʻole i loaʻa ke kumu pololei o kēia. Hana wale ia.
ʻO ka mea nui loa, ʻaʻole kēia ma muli o kou hewa (a i ʻole ko kou mau mākua). Mai manaʻo ʻino ʻoe ua no kekahi mea āu i ʻai ai, inu ai, a hana paha i ka wā hāpai.
I kekahi manawa, hiki ke hana ʻia kēia ālai ʻia e kahi kīʻaha koko e hoʻolako ana i ke koko i ka puʻupaʻa e hele ana ma kahi kūpono ʻole, ʻo ia hoʻi ma luna pono o ka hui UPJ.
Nā kumu e kū mai ana i ka wā makua
He mea kākaʻikahi loa kēia ʻano maʻi i nā pākeke. Inā loaʻa ia, hiki ke kumu ʻia e:
- Ka paʻa ʻana o ka pōhaku puʻupaʻa
- Nā maʻi ʻōpū mimi o luna
- Nā ʻōpala ma hope o ke ʻoki ʻana ma ia wahi
- ʻO ka pehu ʻana ma ka ʻaoʻao o luna o ka ʻōnaehana urinary
Pehea ʻoe e ʻike ai i kēia, e Kauka?
Hoʻomaopopo pinepine ʻia kēia ʻano i ka wā hāpai, ma mua o ka hānau ʻana o ka pēpē, i ka wā o kahi scan ultrasound . Inā hōʻike ka scan ua pehu kekahi o nā puʻupaʻa o ka pēpē ma mua o ka nui maʻamau (hydronephrosis), e kānalua nā kauka i kēia.
Ma hope o ka hānau ʻana o ke pēpē, hiki ke hana ʻia kekahi mau hoʻokolohua hou aʻe e hōʻoia i kēia kūlana a ʻike i ka nui o ka pōʻino i hana ʻia i nā puʻupaʻa.
| Hoʻāʻo | He aha ka hana a kēia? |
|---|---|
| Nā hoʻāʻo koko a me ka mimi (Urinalysis) | E nānā i ka hana o nā puʻupaʻa (BUN, Creatinine) a me nā maʻi ʻōpū mimi. |
| ʻO ke kiʻi ʻana o ka ultrasound | E kiʻi i kahi kiʻi maopopo o ka nui, ka pehu ʻana, a me ke ʻano o nā puʻupaʻa. |
| ʻO ka nānā ʻana i ka puʻupaʻa (Real Scan / Nuclear Scan) | ʻO kēia ka mea a lākou e hana ai. Hoʻokomo lākou i kahi liʻiliʻi o ka mea radioactive i loko o kahi aa a nānā i ka wikiwiki o kona hele ʻana ma o nā puʻupaʻa a me ka wikiwiki o kona kahe ʻana i lalo. Lohi loa ke kahe ʻana o ka mimi ma ka ʻaoʻao kahi i paʻa ai. |
| ʻO ke kiʻi CT a i ʻole MRI | I kekahi manawa hoʻohana ʻia kēia mau mea e kiʻi i nā kiʻi kikoʻī o ka puʻupaʻa a me nā wahi a puni. |
He aha nā lāʻau lapaʻau no kēia?
Hoʻoholo ʻia ke ʻano o ka mālama ʻana e nā kumu he nui, e like me ke koʻikoʻi o ka poloka, ka hana o nā puʻupaʻa, a me ka makahiki o ke keiki.
1. Ke Kali Makaʻala
Mai kahaha, ʻo ka hapa nui o nā pēpē i hānau ʻia me kēia maʻi e mālama mua ʻia me ka nānā ʻana me ka ʻole o ke ʻoki kino. ʻO kēia no ka mea he manawa kūpono e hoʻopau ʻia ke ālai ʻana ma kāna iho i ka wā e ulu ana ke keiki. Hiki ke hana ʻia kēia i loko o nā mahina 18 mua o ke ola o ke keiki.
I loko o kēia manawa, e hana ke kauka i nā scan ultrasound i nā manawa maʻamau e nānā i kekahi pehu i loko o ka puʻupaʻa. Hiki iā ia ke hoʻomau i ka hāʻawi ʻana i nā lāʻau antibiotic haʻahaʻa e pale aku i nā maʻi ʻōpū mimi.
2. ʻOki kino
Inā piʻi ka pehu ʻana o ka puʻupaʻa i ka wā nānā ʻana, inā emi iho ka hana a ka puʻupaʻa, inā pinepine ka ʻeha o ke keiki, a inā ʻaʻole hoʻi e hoʻomaikaʻi ke kūpikipikiʻana ma hope o 18 mau mahina, e ʻōlelo ke kauka i ke ʻoki kino.
ʻO ke ʻoki kino nui i hana ʻia no kēia ua kapa ʻia ʻo Pyeloplasty .
- Pyeloplasty: ʻO kēia ke ʻoki ʻana i ka ʻāpana i paʻa a haiki o ka ureter a hoʻopili hou i ka ureter olakino i ka puʻupaʻa. Hoʻokumu kēia i kahi ala ākea no ke kahe ʻana o ka mimi. Ua holomua loa kēia ʻoki kino (ʻoi aku ma mua o 95% ka holomua).
- Hiki ke hana ʻia kēia ʻoki kino ma ke ʻano he ʻoki kino hāmama maʻamau a i ʻole ma o nā ʻoki liʻiliʻi, e like me ke ʻoki laparoscopic.
ʻO kekahi ʻano lapaʻau ʻo Endopyelotomy . Ma kēia, me ka ʻole o nā ʻoki ʻana, ua hoʻokomo ʻia kahi kāmela liʻiliʻi (endoscope) ma ke urethra, a ua ʻoki ʻia ka mea i paʻa mai loko a hoʻonui ʻia. Eia nō naʻe, ʻaʻole i kūleʻa kēia ma mua o Pyeloplasty.
He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?
ʻO ka maʻamau, ma kahi o ʻelua a ʻehā pule e hoʻōla piha ai mai ke ʻoki ʻana. Akā, ʻokoʻa ia mai kēlā kanaka a kēia kanaka. E wehewehe pono kāu kauka i kēia iā ʻoe.
Inā ʻike mua ʻia a mālama pono ʻia, maikaʻi loa ka nānā ʻana no kēia maʻi . Hiki i ka hapa nui o nā keiki ke ola i kahi ola maʻamau me ka ʻole o nā pilikia lōʻihi.
Āhea ʻoe e pono ai e ʻike i ke kauka?
Inā loaʻa iā ʻoe a i ʻole kāu keiki nā hōʻailona ma lalo nei, e ʻike koke i ke kauka.
- Inā he koko i loko o ka mimi
- Inā he puʻupuʻu i loko o kou ʻōpū ʻaʻole hiki iā ʻoe ke kiʻi i kou mau lima
- Inā loaʻa iā ʻoe ka ʻeha ma ka ʻōpū o luna a i ʻole ke kua
- Inā loaʻa iā ʻoe ke kuni (ʻoi aku hoʻi me ka maʻi ʻōpū urinary)
- Inā ʻaʻole e piʻi ana ke kaumaha o kahi keiki ʻōpio a me he mea lā ʻaʻole e ulu pono ana
He mea nui loa: Inā ʻaʻole hiki iā ʻoe ke mimi, ʻo ia hoʻi ua ālai loa ʻia kāu mimi, e hele koke i ka lumi pilikia haukapila kokoke loa (ETU).
He mea maʻamau ka manaʻo nui i ka makaʻu a me ka hopohopo ke lohe ʻoe e pili ana i kēia maʻi, ʻoiai no ka makuahine hāpai. E noʻonoʻo paha ʻoe, "Ua hana hewa anei au?" Akā e hoʻomanaʻo, ʻaʻole hewa kēia na kekahi. Hana wale ia. ʻO ka mea nui, aia nā lāʻau lapaʻau kūpono loa no kēia. E kamaʻilio me kāu kauka e pili ana i kēia me ka wehe. E nīnau iā ia i nā nīnau āu e loaʻa ai.
Leka Lawe-Home
- ʻO ke ālai ʻana o ka UPJ kahi ālai ʻia e kū mai ana ma ka hui ʻana o ka puʻupaʻa a me ka ureter.
- He maʻi hānau pinepine kēia, ʻaʻole ia ma muli o kekahi hewa o nā mākua.
- Hiki ke ʻike mua ʻia kēia ʻano ma o kahi scan i ka wā hāpai.
- Aia kahi manawa kūpono e hoʻoholo ponoʻī kēia maʻi i nā pēpē ʻōpio i ka hala ʻana o ka manawa, me ka ʻole o ka lāʻau lapaʻau.
- Inā ʻaʻole e ho'ōla ʻia a inā koʻikoʻi paha ke ʻano, hiki ke mālama pono ʻia kahi ʻoki kino i kapa ʻia ʻo Pyeloplasty.
- Inā loaʻa iā ʻoe nā hōʻailona o ka maʻi urinary e like me ke koko i loko o kou mimi, ka ʻeha ʻaoʻao, a i ʻole ke kuni, e ʻike koke i kāu kauka.
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