Ke paʻakikī nei kāu pēpē i ka hanu ʻana a me ka ʻai ʻana? E aʻo kākou e pili ana i kēia (Vascular Ring).

Ke manaʻo nei paha kāu keiki liʻiliʻi e paʻakikī ana ʻo ia i ka hanu ʻana i kekahi manawa? A i ʻole e ʻū mau ana ʻo ia i ka wā e hānai ana a hānai waiū paha? A i ʻole e luaʻi ana ʻo ia ma hope o ka ʻai ʻana? ʻO kekahi o nā kumu o kēia he maʻi i kapa ʻia ʻo `(Vascular Ring)`, a mākou e kamaʻilio nei i kēia lā. He mea nui paha ka inoa, akā mai makaʻu . E kamaʻilio maʻalahi kākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha kēia `(Apo Vascular)`? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, he ʻano hana hewa ka Vascular Ring i loko o ka aorta o kahi pēpē. I kēia manawa ke noʻonoʻo nei paha ʻoe i ke ʻano o ka aorta. ʻO ia ke kīʻaha koko nui loa e lawe ana i ke koko oxygenated mai ko mākou puʻuwai a i ke koena o ko mākou kino. Ua like ia me ka paipu nui e lawe ana i ka wai mai kahi pahu wai i nā ʻāpana āpau o ka hale.

Ma kēia kūlana "Apo Vascular", ʻo ka aorta a i ʻole kona mau lālā, ka trachea o ke pēpē (ka paipu hanu) , ka esophagus ( ka paipu meaʻai), a i ʻole nā ​​mea ʻelua, ua ʻomi ʻia a ʻōwili ʻia a puni. E noʻonoʻo iā ia e like me kekahi mea ʻē aʻe e ʻōwili ana iā ia iho a puni kahi paipu wai, e paʻakikī ai ke kahe ʻana o ka wai.

No laila, he aha ka mea e hana ai ke paʻa ʻoe e like me kēia?

• Inā paʻa ka trachea, paʻakikī paha i ka pēpē ke hanu .
• Inā paʻa ka esophagus, pilikia paha ka pēpē i ka ʻai ʻana, ka hānai waiū , a i ʻole ke ale ʻana.

He kīnā hānau kēia. ʻO ke ʻano kēia, ua hānau ʻia ke pēpē me kēia maʻi i loko o ka ʻōpū. I kekahi manawa hiki ke koʻikoʻi, akā ʻo ka mea maikaʻi loa, hiki ke mālama pono ʻia me ke ʻoki ʻana.

Pehea e hana pinepine ʻia ai ka aorta? He aha ka mea e hana ʻia i loko o ke apo vascular?

E nānā kākou pehea e kau mau ai ka aorta o kahi pēpē.

ʻO ka maʻamau, hoʻomaka ka aorta ma ke keʻena hema haʻahaʻa o ka puʻuwai o ka pēpē (ventricle hema). A laila piʻi i luna i ka trachea, piʻo i loko o kahi ʻāʻī (aortic arch), a laila iho hou i lalo i ka trachea (descending aorta). Mai kēia ʻāʻī a me ka ʻāpana iho, nui nā kīʻaha koko liʻiliʻi e lālā e hoʻolako i ke koko i nā ʻāpana like ʻole o ke kino.

Eia nō naʻe, i loko o kahi pēpē me kahi maʻi i kapa ʻia ʻo "Vascular Ring", ʻo kēia aʻa nui "(Aorta)" a i ʻole kona mau lālā, ʻo ka trachea, ka esophagus, a i ʻole nā ​​mea ʻelua, e ʻōwili a puni ia e like me ke apo, ma ka hapa a i ʻole ma ka ʻāpana. ʻO ia ke kumu i kapa ʻia ai ʻo "Vascular Ring".

E noʻonoʻo, ua like kēia me ke kāʻei ʻana i kahi paipu wai i loko o kā mākou māla a puni ke aʻa o kahi lāʻau, e hōʻemi ana i ka nui o ka wai e kahe ana.

He aha nā ʻano nui o ke apo koko?

Aia kekahi mau ala e hiki ai ke hana ʻia kēia `(Vascular Ring)`. ʻO nā ʻano ʻekolu i maʻamau ʻia:

1. `ʻO ke kīkoʻo aortic pālua`:ʻO ka mea e hana ʻia ma kēia, hoʻomaka maʻamau ka aorta, a laila māhele i ʻelua mau ʻāʻī. Hoʻopuni a hoʻopaʻa kēia mau ʻāʻī ʻelua a puni ka ʻōpū hanu o ke pēpē, ka trachea, a me ka esophagus. A laila hui pū nā ʻāʻī ʻelua ma kekahi ʻaoʻao a lilo hou i hoʻokahi kīʻaha koko.

2. ʻĀkau Aortic Arch: Maanei, hoʻomaka hewa ka aorta, ma ka ʻaoʻao ʻākau o ka trachea ma kahi o ka hema. A laila, hoʻomaka hewa kahi kīʻaha koko maʻamau a hele ma hope o ka esophagus. Hāʻawi kēia lālā i kahi aʻa ʻē aʻe (ka aʻa subclavian hema ) e lawe ana i ke koko i ka lima hema o ka pēpē. Hoʻopau ʻia kēia apo e ke koena o kahi kīʻaha koko i wehe ʻia i ka wā o ke ola fetal a laila pani ʻia (ka Ligamentum Arteriosum). Hiki i kēia mau kīʻaha koko ke hui pū a ʻomi i ka trachea o ka pēpē, esophagus, a i ʻole nā ​​​​mea ʻelua.

3. ʻO ke Aberrant Right Subclavian Artery (RSA): Ua kapa ʻia hoʻi kēia ʻo Arteria Lusoria. ʻO ka maʻamau, hoʻomaka kēia aʻa mai ka Brachiocephalic Trunk, kekahi o nā aʻa ʻekolu e hele mai ana mai ka Aortic Arch. Eia nō naʻe, i kēia hihia, hoʻomaka pololei ka Aberrant RSA mai ka Aortic Arch. ʻAʻole ia he apo piha , no laila ʻaʻole paha e hōʻike i nā hōʻailona.

Pehea ka maʻamau o kēia kūlana `(Vascular Ring)`?

He maʻi laha ʻole ke apo koko. ʻAʻole hoʻokahi o nā pēpē 100 e loaʻa ana. ʻOiai me nā kīnā puʻuwai hānau, ma waena o 1% a me 3% o lākou e loaʻa ai ke apo koko. No laila, ʻaʻole ia he mea e hana ʻia i nā poʻe he nui.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?

Hiki ke loaʻa kēia ʻano maʻi i nā pēpē o kēlā me kēia lāhui a i ʻole ka lāhui kanaka. ʻOiai ʻaʻole ʻike ʻia ke kumu pololei, ua ʻike ʻia he pālua ka nui o ia maʻi i nā pēpē kāne ma mua o nā pēpē wahine .

He aha ke kumu o kēia `(Apo Vascular)` e hana ʻia ai?

ʻAʻole maopopo loa i nā kānaka ʻepekema ke kumu o kēia "apo vascular" i ka wā o ka ulu ʻana o ka fetal. He pinepine ka hana ʻana i ka wā e ulu ana ka pēpē i loko o ka ʻōpū, aia nā ʻāpana o ka aorta e hāʻule wale. Eia nō naʻe, ua manaʻo ʻia e loaʻa kēia ʻano ke hāʻule ʻole kēlā mau ʻāpana .

He aha nā hōʻailona o kahi Vascular Ring?

Inā hōʻike ke apo vascular i nā hōʻailona, ​​a inā pēlā, i ka manawa hea, ma muli ia o ke ʻano a me ke koʻikoʻi o ke kaomi ʻana i ka trachea a i ʻole ka esophagus.

Hiki i kekahi mau pēpē ke hōʻike i nā hōʻailona i ko lākou wā kamaliʻi . Hiki i kekahi ke loaʻa nā hōʻailona i ka wā ʻelemakule iki a i ʻole ma hope o ke ola. ʻO ka mea kupanaha, ʻaʻole paha e hōʻike iki kekahi poʻe i kekahi mau hōʻailona .

I kekahi manawa, ua pilikia paha ke kanaka i ka hanu ʻana a i ʻole ke ale ʻana no ka manawa lōʻihi, a ʻoiai ua ʻike ʻo ia i kahi pulmonologist a i ʻole kahi gastroenterologist no ka mālama ʻana, ʻaʻole paha lākou e hiki ke ʻike pono i ke kumu o ka pilikia.

Nā hōʻailona e kū mai inā pilikia ka trachea:

ʻO ke trachea ka ʻōpū hanu. No laila, inā e haiki ana, e ʻike paha ʻoe i nā hōʻailona e like me kēia:

• ʻŪhā pinepine.
• Nā maʻi hanu pinepine (e.g. pneumonia).
• Ka puka ʻana o ka ihu ( ka puka ʻana o ka ihu i ka wā e hanu ana).
• He leo ʻē i ka wā e hanu ana (e.g., `(Wheezing)` - he leo wheezing mai ka umauma mai, `(Stridor)` - he leo nui mai ka puʻu mai).
• ʻO ka cyanosis hanu ka ʻili i lilo i mea poni ke kala ma muli o ka paʻakikī o ka hanu ʻana.

Nā hōʻailona e kū mai ana inā pilikia ka esophagus:

ʻO ka esophagus ka paipu meaʻai. Inā e haiki ana, e ʻike paha ʻoe i nā hōʻailona e like me:

• ʻO ka reflux waikawa.
• ʻO ka loaʻa ʻole o ke kaumaha a me ka hānai pono ʻole ʻia ʻana, ʻo ia hoʻi ka "Hōʻole e Ola".
• He manaʻo e like me he mea lā ua paʻa i loko o kou puʻu .
• Paʻakikī ka ʻai ʻana , ʻū pinepine ʻia i ka wā e ʻai ana.
• Paʻakikī ke ale ʻana (Dysphagia), ʻoiai ke ale ʻana i nā meaʻai paʻa.
• Ka luaʻi pinepine ʻana.

Nā hōʻailona puʻuwai ʻē aʻe:

I kekahi manawa, loaʻa paha i ka poʻe me ke Apo Vascular kekahi mau kīnā puʻuwai hānau ʻē aʻe. I kēia hihia, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• ʻO kahi leo ʻē i lohe ʻia i loko o ka puʻuwai ʻo ia ka "Heart Murmur".
• Nā Palpitations (puʻuwai wikiwiki a i ʻole ka puʻuwai kūpono ʻole).
• Paʻakikī ka hanu ʻana (Dyspnea).

Pehea e ʻike ʻia ai kēia maʻi `(Vascular Ring)`? (Diagnosis)

Inā kānalua ke kauka i kahi apo vascular, hiki iā lākou ke hana i kekahi mau hoʻokolohua e hōʻoia i ke kūlana:

• X-ray umauma: Lawe kēia i nā kiʻi o nā ʻōpū i loko o ka umauma o ke pēpē. ʻO kēia ka hoʻāʻo mua i hana ʻia.
• CT scan: Hiki i kēia ke kiʻi i nā kiʻi maopopo o nā mea i loko o ke kino, ʻoiai ka puʻuwai, trachea, a me ka esophagus.
• Echocardiogram: Kapa ʻia hoʻi he echo, lawe kēia i nā kiʻi wikiō e like me ke wikiō o ka puʻuwai o ke pēpē a me ka aorta.

Ma waho aʻe o kēia mau hoʻokolohua, hiki ke hana ʻia nā hoʻokolohua ʻē aʻe e ʻike i ke ʻano o ka trachea a i ʻole esophagus:

• ʻAi ʻia ʻo Barium `(ʻAi ʻia ʻo Barium)` / `(Esophagogram)`:Ma kēia, hāʻawi ʻia kahi wai kūikawā i kapa ʻia ʻo `(Barium)` i ka pēpē e inu. A laila, lawe ʻia kahi X-ray e ʻike pehea e neʻe ai kēia wai `(Barium)` i lalo o ka esophagus `(Esophagus). Inā ua ālai ʻia ka esophagus `(Esophagus)` e kahi `(Vascular Ring), hiki ke ʻike ʻia me kēia hoʻāʻo.
• Bronchoscopy: Ma kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi me kahi kāmela liʻiliʻi a me ke kukui ma o ka waha a ihu paha o ka pēpē, ma o ka windpipe (trachea) a i loko o nā māmā, e nānā i loko.
• ʻO ka Endoscopy Kiʻekiʻe: He ʻōmole nō hoʻi kēia. Akā, ua hoʻokomo ʻia ma ka waha a i lalo i ka esophagus e nānā i loko.

He aha nā lāʻau lapaʻau no kēia `(Vascular Ring)`?

Inā he apo vascular ke kumu o ka paʻa ʻana o ka trachea a i ʻole ka esophagus o ke pēpē, e pilikia ai ka hanu ʻana a i ʻole ka ʻai ʻana, pono paha ke ʻoki ʻana .

Eia nō naʻe, ʻaʻole pono e hoʻoponopono ʻia nā apo vascular āpau i ka wā kamaliʻi. Eia nō naʻe, pono ke ʻoki ʻia kekahi mau ʻano, e like me ke kīkoʻo aortic pālua, ma mua o ka manawa.

ʻO ke ʻano o ke ʻoki kino e hana ʻia ma muli o ke kūlana o ka pēpē, ke ʻano o ke apo vascular, a me kona koʻikoʻi. ʻO ka maʻamau, pili ka ʻoki kino i kēia mau mea:

• Ke ʻoki ʻana a me ka hoʻokaʻawale ʻana i kahi ʻāpana o ke apo vascular e hōʻemi i ke kaomi.
• Ke wehe ʻana i kahi ʻāpana liʻiliʻi o ka aorta a i ʻole kekahi aʻa ʻē aʻe.

ʻO ka hapa nui o ka manawa, hana ʻia kēia ʻoki ma o kahi ʻoki liʻiliʻi ma ka ʻaoʻao o ka umauma o ka pēpē (he hana hāmama - `(Thoracotomy)`) . ʻO ke ʻano kēia, pono kahi ʻoki nui iki. Eia naʻe, i kekahi manawa, no nā keiki ʻoi iki aku ka nui, hiki ke hana i kahi hana minimally invasive .

Aia kekahi mau ala e pale aku ai i ke kūkulu ʻia ʻana o kēia `(Vascular Ring)`?

ʻO ka ʻoiaʻiʻo, ʻaʻole maopopo loa i nā kānaka ʻepekema ke kumu o ke ʻano o ke "apo vascular" i ka wā o ka embryonic, no laila ʻaʻohe ala kikoʻī e pale aku ai .

He aha ke ʻano o ka wā e hiki mai ana e hiki i kekahi me kēia maʻi ke manaʻo?

He palekana loa a holomua hoʻi ke ʻoki ʻana e hana i kahi apo vascular. ʻOiai e mau ana kekahi mau hōʻailona no kekahi mau mahina ma hope o ke ʻoki ʻana, ʻaneʻane pau loa ka hapa nui o ka poʻe i nā hōʻailona ʻole i loko o hoʻokahi makahiki .

ʻAʻole pono ka hapa nui o nā kānaka e hana hou i ke ʻoki kino. Eia nō naʻe, he mea kākaʻikahi loa, pono paha kekahi ʻoki kino ʻē aʻe.

ʻOiai ma hope o ke ʻoki ʻana, pono paha ʻoe e ʻike i nā loea no ka ʻōlelo aʻoaʻo (follow-up) no nā makahiki. Hiki i kēia mau mea ke komo pū me:

• He kauka puʻuwai.
• He kauka loea i ka ʻōnaehana hoʻoheheʻe (Gastroenterologist).
• He kauka loea i ka ʻōnaehana hanu (Pulmonologist).

He aha hou aʻe kaʻu e nīnau aku ai i ke kauka e pili ana i ka Vascular Ring?

Inā loaʻa iā ʻoe a i ʻole kāu keiki kahi maʻi i kapa ʻia ʻo "Vascular Ring", he mea maikaʻi ke nīnau i kāu kauka i kēia mau nīnau:

• He aha ke ʻano o kēia `(Apo o ke koko)`?
• Aia kēia a puni koʻu trachea, esophagus, a i ʻole nā ​​​​mea ʻelua?
• Ke paipai nei ʻoe i ke ʻoki kino? Inā pēlā, ua hāmama a i ʻole he minimally invasive paha?
• ʻEhia ka lōʻihi e ho'ōla ai?
• E nalo loa anei koʻu mau hōʻailona ma hope o ke ʻoki ʻana?
• Pono anei au e ʻike i nā loea ʻē aʻe?
• He mau maʻi puʻuwai ʻē aʻe koʻu? Inā pēlā, hiki ke mālama ʻia i ka manawa like me kēia ʻoki kino?

I ka hōʻuluʻulu manaʻo, eia nā mea e pono ai mākou e hoʻomanaʻo (Leka Lawe-Home):

ʻO ke apo vascular kahi maʻi hānau ʻia kahi i hoʻokumu ʻia ai ka aorta o kahi pēpē i ke ʻano ʻē, e hoʻoulu ai i ke kaomi ma luna o ka trachea a i ʻole ka esophagus, a i ʻole nā ​​​​mea ʻelua. Hiki i kēia ke pilikia i ka hanu ʻana a i ʻole ke ale ʻana.

ʻO ka mea nui loa, hiki ke hoʻoponopono pono ʻia kēia kūlana me ke ʻoki ʻana a hiki ke hoʻopau ʻia nā hōʻailona.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e kamaʻilio me kāu kauka. E hāʻawi lākou iā ʻoe i ka ʻike āpau āu e pono ai.

ʻO ke apo o ke koko, ʻAorta, Trachea, ʻEsophagus, Nā kīnā hānau, Nā pilikia hanu, Nā pilikia ʻai