Pono ʻoe i makaʻu loa i ka wā i haʻi aku ai ke kauka iā ʻoe he lua ko kāu keiki liʻiliʻi i loko o kona puʻuwai, ʻeā? He mea maʻamau loa ia. Akā ʻo ka mea nui loa, ʻo ia ka maʻi puʻuwai hānau maʻamau i ʻike ʻia i waena o nā keiki ma Sri Lanka. ʻO ka hapa nui o ka manawa, ʻaʻole weliweli kēia mau mea. No laila, mai makaʻu. E kamaʻilio kākou e pili ana i kēia maʻi i kapa ʻia ʻo VSD (Ventricular Septal Defect) ma ke ʻano maʻalahi e hiki ai iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha kēia VSD?
Ua like ko kākou puʻuwai me kahi hale liʻiliʻi me nā keʻena ʻehā. ʻElua keʻena luna a ʻelua keʻena haʻahaʻa. ʻO nā keʻena nui a ikaika ʻelua ma lalo, ʻo ia ka mea a kākou e kapa nei he ventricles . Aia kahi pā mānoanoa ma waena o kēia mau ventricles ʻelua. Ua kapa ʻia kēia pā he septum . ʻO ka hana a kēia pā, ʻo ia ke pale aku i ke koko maʻemaʻe a ʻoi aku ka oxygen ma kekahi ʻaoʻao o ka puʻuwai mai ka hui pū ʻana me ke koko haumia a ʻoi aku ka oxygen ma kekahi ʻaoʻao.
ʻO ka Ventricular Septal Defect (VSD) , i ka ʻōlelo maʻalahi, he lua ia ma ka paia (septum). Hana ʻia kēia lua ke ʻole i hoʻokumu piha ʻia kēia paia i ka wā e ulu ana kahi pēpē i loko o ka ʻōpū. ʻAe kēia lua i ke koko waiwai i ka oxygen e hui pū me ke koko haʻahaʻa i ka oxygen. Pale kēia i ka puʻuwai mai ka hana pono ʻana, ʻo ia hoʻi, pono ka puʻuwai e hana ikaika.
I ka hapa nui o ka manawa, he liʻiliʻi loa kēia mau lua a ʻaʻole ia e hōʻike i kekahi mau hōʻailona. Akā i kekahi manawa, hiki i kēia mau lua ke nui aʻe. I kēlā hihia, loaʻa paha i ke keiki kekahi mau pilikia a pono e mālama ʻia.
Aia kekahi mau ʻano o VSD?
ʻAe, ua māhele ʻia kēia mau lua i ʻehā ʻano nui ma muli o ko lākou wahi i loko o ka paia puʻuwai. ʻAʻole pono ʻoe e ʻike hohonu i kēia mau mea, akā maikaʻi ke loaʻa kahi ʻike maʻamau.
| ʻAno VSD | Ka wehewehe maʻalahi |
|---|---|
| VSD membranous | ʻO kēia ke ʻano maʻamau. Aia ka lua ma ka ʻaoʻao o luna o ka paia puʻuwai. |
| VSD ʻiʻo | Aia kēia ʻano lua ma ka ʻaoʻao haʻahaʻa a ʻoi aku ka ikaika o ka paia. I kekahi manawa aia paha ma mua o hoʻokahi lua. |
| VSD komo | Aia kēia lua ma kahi kokoke loa i nā kiwikā o ka puʻuwai. |
| VSD puka kūʻai | Aia kēia lua ma kahi kokoke i nā kīʻaha koko nui e lawe ana i ke koko mai loko mai o ka puʻuwai. |
He aha nā hōʻailona o kēia?
I ka hapanui o ka manawa, inā liʻiliʻi loa ka lua VSD (ʻaʻole iʻoi aku ma mua o 3 millimeters, e like me ka nui o ka niho niho), ʻaʻohe hōʻailona. Eia nō naʻe, inā waena ka nui o ka lua (3-5 millimeters) a nui paha (6-10 millimeters, e like me ka nui o ka pi), hiki ke ʻike ʻia nā hōʻailona.
| Pūʻulu makahiki | Nā hōʻailona maʻamau |
|---|---|
| Nā pēpē hānau hou |
|
| Nā keiki makua a me nā mākua |
|
He aha nā kumu o ka VSD?
ʻAʻole ʻike ʻia ke kumu kikoʻī o kēia, akā i kekahi manawa hiki ke hana ʻia ka VSD me nā kūlana genetic ʻē aʻe, e like me Down syndrome .
Ua manaʻo ʻia hoʻi e hoʻonui paha kekahi mau lāʻau lapaʻau i lawe ʻia e ka makuahine i ka wā hāpai (e laʻa, nā lāʻau antiepileptic) a i ʻole ka inu ʻana i ka waiʻona i ka pilikia. Eia nō naʻe, ʻaʻole i lawa ka noiʻi e hōʻoia i kēia mau kumu.
He aha nā pilikia e hiki ai i kēia ke hana?
Inā nui ka lua o ka VSD, pono ka puʻuwai e hana ikaika aʻe, hiki ke hōʻino i ka puʻuwai a me nā māmā i ka hala ʻana o ka manawa. Hoʻonui kēia i ka nui o ke koko e hele ana mai ka ʻaoʻao ʻākau o ka puʻuwai i nā māmā, e hoʻoulu ai i ke koko kiʻekiʻe i loko o nā māmā. Ua kapa ʻia kēia he Pulmonary Hypertension .
ʻO ka mea nui, inā ʻaʻole mālama ʻia kahi VSD nui ma mua o ka piha ʻana o ke keiki i 2 mau makahiki, hiki i ka hōʻino ʻana i nā māmā ke lilo i mea hoʻihoʻi ʻole a mau loa. Ua kapa ʻia kēia ʻo Eisenmenger syndrome . No laila, he mea nui loa ka mālama mua ʻana.
Nā pilikia ʻē aʻe:
- Ka hāʻule ʻana o ka puʻuwai
- ʻO ka regurgitation aortic (ke kahe ʻana o ke koko mai nā valves puʻuwai)
- Ka hoʻonui ʻia ʻana o nā ventricles o ka puʻuwai
- Ka maʻi puʻuwai (Endocarditis)
- Puʻuwai puʻuwai maʻamau ʻole
- Hahau
Pehea ʻoe e ʻike ai i kēia, e Kauka?
I ka manawa pinepine, ke nānā ke kauka i ke keiki a hoʻolohe i ka umauma me ka stethoscope, lohe ʻia kahi leo keu i kapa ʻia ʻo "heart murmur" . ʻO ka hoʻolohe ʻana i kēia leo hiki ke alakaʻi i ka kānalua o kahi VSD.
No ka hōʻoia ʻana i kēlā kānalua, ua ʻōlelo ke kauka i kekahi mau hoʻokolohua e like me:
- Echocardiogram (Echo): ʻO kēia ka hoʻāʻo koʻikoʻi loa. Ua like ia me ke kiʻi ʻana o kahi pēpē i loko o ka ʻōpū. Lawe ia i kahi wikiō o ka puʻuwai a hōʻike i kahi o ka lua, kona nui, a pehea e kahe ai ke koko.
- Electrocardiogram (ECG/EKG): Hoʻāʻo i ka hana uila o ka puʻuwai.
- X-ray o ka umauma: He nānā ʻana i ka umauma me ke kiʻi X-ray.
- Cardiac MRI a i ʻole CT scan: ʻAʻole pono pinepine kēia mau mea.
- Catheterization Cardiac: He hoʻāʻo kahi e hoʻokomo ʻia ai kahi ʻōmole liʻiliʻi i loko o ka puʻuwai. ʻAʻole pono kēia i nā manawa a pau.
He aha nā lāʻau lapaʻau no VSD?
Inā paha e mālama ʻia kēia a ʻaʻole paha, a pehea e mālama ʻia ai, ma muli ia o ka nui o ka lua a me nā hōʻailona o ke keiki.
Ke Kali Makaʻala
ʻO ka hapa nui o ka manawa, ʻo ia hoʻi, ʻo ka hapa nui o nā lua VSD he liʻiliʻi loa. Pani kēia mau mea iā lākou iho i ka wā e hiki ai ke keiki ma kahi o 6 mau makahiki. I ia mau hihia, ʻaʻole hana ke kauka i kekahi lāʻau lapaʻau, akā nānā mau i ka ulu ʻana o ke keiki a me nā hōʻailona ma ke keʻena lapaʻau.
Nā lāʻau lapaʻau
Inā loaʻa nā hōʻailona o kāu keiki i ka wā e ho'ōla ana ka lua, a i ʻole e hoʻomākaukau ʻia ana no ke ʻoki ʻana, hiki i ke kauka ke hāʻawi iā ʻoe i kekahi mau lāʻau lapaʻau.
- Diuretics: Kōkua kēia i ka hoʻēmi ʻana i ka nui o ka wai keu e hōʻiliʻili ana i loko o ke kino a me nā māmā.
- Nā lāʻau lapaʻau no ka maʻi puʻuwai: Kōkua lākou i ka kaohi ʻana i ka hana o ka puʻuwai.
ʻO ke ʻoki kino a me nā ʻano hana ʻē aʻe
Inā nui ka lua a pilikia ka pēpē, pono e pani ʻia. ʻElua ala nui e hana ai i kēia.
1. ʻO ke ʻoki puʻuwai hāmama: Ma kēia kaʻina hana, pani ke kauka ʻoki i ka lua me nā humuhumu a i ʻole kahi "patch" hana. I ka hala ʻana o ka manawa, ulu ka ʻiʻo puʻuwai o ke keiki a puni ka ʻāpana, e lilo ana i ʻāpana o ka paia puʻuwai.
2. Ke kaʻina hana Transcatheter: ʻAʻole kēia e pili ana i kahi ʻoki ma ka umauma. Akā, ua hoʻokomo ʻia kahi paipu liʻiliʻi (catheter) ma o kahi kīʻaha koko nui ma ka wāwae a i ka puʻuwai, a ua hoʻokomo ʻia kahi mea hana ma o ia mea e pani ai i ka lua. He kaʻina hana maʻalahi kēia ma mua o ke ʻoki ʻana.
Āhea ʻoe e ʻike koke ai i ke kauka?
Inā loaʻa i kāu keiki kahi VSD, e makaʻala mau i nā hōʻailona ma lalo nei.
Inā pilikia nui kāu keiki i ka hanu ʻana, a inā polū/palalelale ka ʻili, nā lehelehe, a i ʻole nā mākuʻu lima (cyanosis), e lawe koke iā lākou i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa.
Eia kekahi, e kamaʻilio me kāu kauka inā ʻike ʻoe i nā hōʻailona aʻe:
- Inā ʻaʻole e piʻi ana ke kaumaha o ke keiki e like me ka mea i manaʻo ʻia.
- Inā ʻoe e hou a hoʻoikaika nui paha iā ʻoe iho i ka wā e inu ana i ka waiū.
- Inā loaʻa pinepine iā ʻoe nā maʻi hanu (huhū umauma).
He aha kā mākou e manaʻo ai i ka wā e hiki mai ana?
ʻO kēia ka nūhou maikaʻi loa. ʻO ka hapa nui o nā keiki me ka VSD he ola maʻamau a olakino hoʻi ko lākou. ʻOiai inā he liʻiliʻi ka lua a ua mālama ʻia a hoʻōla loa ʻia, ʻaʻohe mea e makaʻu ai no ka wā e hiki mai ana.
Eia nō naʻe, inā ʻaʻole mālama koke ʻia kahi VSD nui a hōʻino i ka māmā (Eisenmenger syndrome), hiki ke hoʻopōkole ʻia ke ola. No laila he mea nui loa ka ʻimi ʻana i ke aʻo lapaʻau i ka manawa kūpono .
Leka Lawe-Home
- ʻO VSD ka maʻi puʻuwai hānau maʻamau i nā keiki. No laila, mai hopohopo, ʻaʻole ʻoe hoʻokahi.
- He liʻiliʻi loa ka hapa nui o nā lua VSD. Pani lākou iā lākou iho i ka wā e ulu ana ke keiki, me ka ʻole o kekahi lāʻau lapaʻau.
- Inā nui ka lua a aia nā hōʻailona, aia nā lāʻau lapaʻau kūpono loa no ia.
- ʻO ka mea nui loa, ʻo ia ka hoʻolohe ʻana i nā hōʻailona o kāu keiki, e ʻike i ke kauka i ka manawa kūpono, a e hahai i kāna mau kuhikuhi.
- Inā he mau nīnau kāu, makaʻu, a kānalua paha e pili ana i kēia, e kūkākūkā ākea me ke kauka e mālama ana i ke keiki.
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