He lua ko kāu keiki liʻiliʻi i loko o kona puʻuwai? E aʻo kākou e pili ana i ka Ventricular Septal Defect (VSD) me ka makaʻu ʻole!

I ka wā i hānau ʻia ai kāu keiki liʻiliʻi, ua ʻōlelo anei ke kauka i kekahi mea e like me, "Hmm, aia kahi murmur puʻuwai liʻiliʻi" i kona nānā ʻana i kona puʻuwai? A i ʻole ua manaʻo ʻoe ua pilikia kāu pēpē i ka hanu ʻana a i ʻole ka hou ʻana i ka wā e hānai waiū ana a i ʻole e holo ana a puni? I kekahi manawa, ʻo ke kumu o kēia mau mea he lua liʻiliʻi i loko o ka puʻuwai. I ka lāʻau lapaʻau, kapa mākou i kēia he `(Ventricular Septal Defect)` a i ʻole `VSD` . No laila i kēia lā, e kamaʻilio mākou e pili ana i kēia me nā kikoʻī a maʻalahi loa. ʻAʻohe pono e makaʻu, no ka mea, ʻo ka mea nui loa, ʻo ia ka ʻike i kēia.

He aha ka VSD? He aha ka mea e hana nei?

I ka ʻōlelo maʻalahi, ʻo ka VSD he lua i loko o ka paia (i kapa ʻia ʻo ka septum) ma waena o nā keʻena nui ʻelua (i kapa ʻia ʻo nā ventricles) o ko kākou puʻuwai. E noʻonoʻo iā ia e like me kahi hale liʻiliʻi me ʻehā lumi. Aia nā paia ma waena o kēia mau lumi e pale aku i ke koko mai ka hui pū ʻana me kekahi. ʻO ke "koko maikaʻi" me ka nui o ka oxygen e kahe ana ma kekahi ʻaoʻao, a ʻo ke "koko maikaʻi ʻole" me ka emi ʻana o ka oxygen e kahe ana ma kekahi ʻaoʻao.

I kēia manawa, he aha ka mea e hana ai inā he `VSD` kēia, ʻo ia hoʻi, inā he lua ma ka paia ma waena o kēlā mau keʻena haʻahaʻa ʻelua? ʻO ke koko i loaʻa ka nui o ka oxygen e kahe ana ma o ka lua i loko o ke koko i loaʻa ka liʻiliʻi o ka oxygen. A laila pono ka puʻuwai a me nā māmā e hana ikaika iki. ʻO kēia ʻano kekahi o nā maʻi puʻuwai hānau maʻamau. I kekahi manawa hiki ke hana pū ʻia kēia `VSD` me nā maʻi puʻuwai ʻē aʻe.

E hoʻomanaʻo, ʻaʻole he mea weliweli nā VSD āpau. I ka hapanui o nā hihia, pani ʻia nā lua liʻiliʻi ma o lākou iho me ka ʻole o nā hōʻailona.

Aia kekahi mau ʻano o VSD?

ʻAe, ʻehā mau ʻano nui o VSD, ma muli o kahi e loaʻa ai a me ke ʻano o ka lua. E nānā kākou i ke ʻano o lākou:

• VSD Membranous: ʻO kēia ke ʻano maʻamau. Aia ka lua ma ka ʻaoʻao o luna o ka paia ma waena o nā keʻena ʻelua o lalo o ka puʻuwai.
• VSD ʻiʻo: Ma kēia ʻano, loaʻa ka lua ma ka ʻaoʻao haʻahaʻa, ʻiʻo o ka paia. I kekahi manawa, hiki ke loaʻa ma mua o hoʻokahi lua ma kēia ʻano VSD.
• VSD Komo: Aia kēia lua ma lalo pono o ka valve tricuspid ma ka ventricle ʻākau o ka puʻuwai a me ka valve mitral ma ka ventricle hema. ʻOi aku ka pololei, kokoke i kahi e komo ai ke koko i loko o nā ventricles.
• VSD Puka: I kēia hihia, aia ka lua ma kahi kokoke i ka valve pulmonary, ka mea e lawe i ke koko mai ka ventricle ʻākau a i nā māmā, a me ka valve aortic, ka mea e lawe i ke koko mai ka ventricle hema a i ke kino. ʻO ke ʻano kēia, pono ke koko e hele ma o kēia VSD ke haʻalele ia i nā ventricles.

Inā ʻōlelo ke kauka he VSD ko kāu pēpē, e wehewehe pū lākou i kona ʻano.

He aha nā hōʻailona o ka VSD? He ʻokoʻa anei lākou no nā keiki a me nā pākeke?

ʻO nā hōʻailona o ka VSD e pili ana i ka nui o ka lua. ʻO kahi lua liʻiliʻi loa (ʻaʻole iʻoi aku ma mua o 3 millimeters, e like me ka nui o ka niho niho) ʻaʻole paha e hōʻike i kekahi mau hōʻailona. Eia nō naʻe, inā ʻoi aku ka nui o ka lua (waena, 3-5 millimeters, a nui paha, 6-10 millimeters, e like me ka nui o ka pi), hiki ke ʻike ʻia nā hōʻailona.

Nā hōʻailona i nā pēpē hānau hou

Inā loaʻa i kahi pēpē hānau hou kahi VSD nui, loaʻa paha iā ia nā hōʻailona e like me ka hāʻule ʻana o ka puʻuwai . ʻO kēia mau mea:

• Paʻakikī ka hanu ʻana: Nā mea e like me ka hanu wikiwiki ʻana, ka hakakā ʻana e hanu.
• Ka hou ʻana a i ʻole ka luhi i ka wā e hānai waiū ai: Hiki i ka pēpē ke luhi ma hope o ka inu ʻana i kahi waiū liʻiliʻi.
• ʻAʻole e piʻi ke kaumaha: Inā ʻaʻole e piʻi pono ke kaumaha o ke pēpē no ko lākou mau makahiki.
• Nā maʻi hanu pinepine: Inā loaʻa pinepine iā ʻoe ke anu a me ke kunu.

Nā hōʻailona i nā keiki makua a me nā pākeke

Inā loaʻa i kahi keiki makua a makua paha ka VSD, hiki iā lākou ke luhi a pōkole paha ka hanu i ka wā o ka hana kino . Inā luhi maʻalahi lākou i ka wā e pāʻani ana, holo ana, a lele paha, pono ʻoe e hopohopo.

Ke hoʻopilikia nei hoʻi ka nui o ka lua iā ia?

ʻAe, ʻoiaʻiʻo nō. E like me ka mea i ʻōlelo ʻia ma mua, inā liʻiliʻi ka lua, ʻaʻohe pilikia paha. Akā i ka wā e nui ai ka lua, kahe ke koko ma waena o nā keʻena ʻelua o ka puʻuwai. ʻO ia ka manawa e ʻike ʻia ai nā hōʻailona.

No ke aha e kū mai ai kēia VSD? He aha nā kumu?

ʻAʻole ʻike ʻia ke kumu kikoʻī o ka VSD . Hoʻomaka pinepine ia i ka wā ʻaʻole i ulu pono ka puʻuwai i ka wā e ulu ana ka pēpē i loko o ka ʻōpū. ʻO ia hoʻi, ʻaʻole pani piha ka paia ma waena o nā keʻena o ka puʻuwai.

Eia nō naʻe, i kekahi manawa hiki ke hana pū ʻia ka VSD me nā maʻi hānau ʻē aʻe. No ka laʻana, ʻoi aku ka nui o ka loaʻa ʻana o ka VSD i nā keiki me nā maʻi genetic e like me Down syndrome .

He mea kākaʻikahi loa, hiki i ka hāʻule puʻuwai i loko o kahi pākeke ke hōʻino i ka paia ma waena o nā ʻāpana o ka puʻuwai a hoʻoulu i kahi VSD hou e hana. He mea kākaʻikahi loa kēia.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka VSD?

Ua ʻike ʻia kekahi mau kumu e hoʻonui iki i ka pilikia o ka hoʻomohala ʻana i kahi VSD:

• Nā pēpē hānau mua ʻole: Nā pēpē i hānau ʻia ma mua o ka lā palena.
• Kekahi mau kūlana hoʻoilina: E like me ka mea i ʻōlelo ʻia ma mua, nā kūlana e like me ka "Down syndrome".
• ʻO kekahi mau lāʻau lapaʻau i lawe ʻia i ka wā hāpai: ʻO nā lāʻau lapaʻau e like me ka valproic acid a me ka phenytoin, i hoʻohana ʻia e mālama i nā hopu ʻana.
• ʻO ka inu ʻana i ka waiʻona i ka wā hāpai: Manaʻo ʻia he mea pilikia kēia, akā pono e noiʻi hou ʻia.

He mau mea pilikia wale nō kēia, a ʻaʻole hiki ke ʻōlelo ʻia e ulu aʻe ka VSD no ka mea aia kēia mau mea.

He aha nā pilikia e hiki mai ana o ka VSD? He mea weliweli anei kēia?

Ke kahe ke koko ma o ka VSD, lilo ia i mea paʻakikī no ka puʻuwai o kāu pēpē e hana pono. Inā nui ka lua, pono ka puʻuwai e hana ikaika. Ke hana nui ka puʻuwai no ka manawa lōʻihi, hiki ke loaʻa nā pilikia like ʻole i loko o ka puʻuwai a me nā māmā. I kekahi manawa hiki ke koʻikoʻi kēia.

Ma muli o ke ʻokoʻa o ke kaomi i loko o nā keʻena ʻelua o ka puʻuwai, hiki i ke koko ke kahe i nā māmā. Hiki i kēia ke alakaʻi i nā kūlana koʻikoʻi e like me ke koko kiʻekiʻe pulmonary . Inā ʻaʻole mālama ʻia kahi VSD waena a nui paha i loko o 2 mau makahiki , hiki iā ia ke alakaʻi i kahi kūlana i kapa ʻia ʻo Eisenmenger syndrome . Hiki i kēia ke hōʻino mau loa i nā kīʻaha koko i loko o nā māmā.

ʻO nā pilikia ʻē aʻe paha:

• Ka hāʻule ʻana o ka puʻuwai
• ʻO ka luaʻi ʻana o ke aorta
• Nā ventricles i hoʻonui ʻia
• Ka maʻi o ka ʻili o loko o ka puʻuwai (Endocarditis)
• ʻAno ʻē ka puʻuwai
• Hahau

ʻO ia ke kumu he mea nui e ʻimi i ka ʻōlelo aʻo a ke kauka i ka wā e ʻike ai ʻoe he VSD kou.

Pehea e ʻike ai nā kauka i ka VSD?

E ʻike ke kauka i kahi VSD ma muli o nā hōʻailona o kāu pēpē, kahi hoʻokolokolo kino, a me kekahi mau hoʻokolohua kūikawā. Inā liʻiliʻi loa ka lua, ʻaʻole paha e hiki ke ʻike i kahi VSD no ka mea ʻaʻohe hōʻailona.

ʻIke pinepine ʻia ka VSD i ka wā o ka hoʻokolokolo kino . Ke hoʻolohe ke kauka i ka puʻuwai o kahi pēpē me ka stethoscope, lohe ʻia kahi murmur puʻuwai inā loaʻa kahi VSD. Hiki i kēia leo ke hāʻawi i kahi manaʻo maʻamau o ka nui o ka lua.

Aia kekahi mau hoʻokolohua e hiki ke hōʻike i nā loli i ke ʻano o ka puʻuwai, ka puʻuwai, a me ke kahe o ke koko ma muli o ka VSD:

• Echocardiogram: ʻO kēia ka hoʻāʻo koʻikoʻi loa. Ua like ia me kahi scan ultrasound o ka puʻuwai. Hiki iā ia ke hōʻike i ka nui o ka lua, kona wahi, a me ka nui o ke koko e kahe ana.
• Electrocardiogram (EKG): He hoʻāʻo e nānā i ka hana uila o ka puʻuwai.
• ʻO ke kiʻi X-ray o ka umauma: Hiki ke hoʻohana ʻia kēia e ʻike inā ua hoʻonui ʻia ka puʻuwai a inā paha he nui loa ke koko i loko o nā māmā.
• ʻO ke kiʻi CT puʻuwai
• MRI o ka puʻuwai `(MRI o ka puʻuwai)`
• Catheterization Cardiac: Pili kēia i ka hoʻolei ʻana i kahi ʻōmole liʻiliʻi ma o kahi kīʻaha koko i loko o ka puʻuwai e ana i ke kaomi a lawe i nā laʻana.

Pehea e mālama ai i kahi keiki me VSD?

He liʻiliʻi loa ka hapa nui o nā VSD a ʻaʻole ia e hoʻoulu i kekahi pilikia. I kēlā mau hihia, e nānā ke kauka i nā hōʻailona a ʻike inā pani ʻia ka lua ma kāna iho. I ka hapanui o nā hihia , pani ʻia kēia mau lua liʻiliʻi ma kā lākou iho i ka piha ʻana o 6 mau makahiki.I kekahi mau hihia, hiki ke lōʻihi. Akā ma hope o 20 mau makahiki, ʻaʻole paha e pani ʻia kahi `VSD` ma kāna iho.

Inā loaʻa iā ʻoe kahi VSD waena a nui paha, e ʻōlelo paha kāu kauka i kahi ʻoki kino a i ʻole kekahi hana ʻē aʻe e pani ai i ka lua . I kēia manawa, hiki ke hāʻawi ʻia iā ʻoe ka lāʻau lapaʻau e kāohi i kāu mau hōʻailona.

ʻO ka mea nui, inā e hoʻoponopono ʻia kahi VSD nui ma mua o ka piha ʻana o nā makahiki 2, hiki iā ia ke pale i ka hōʻino ʻana i ka puʻuwai a me nā māmā o ke pēpē. A i ʻole, hiki i ka hōʻino ke lilo i mea mau loa a ʻoi aku ka ʻino i ka hala ʻana o ka manawa.

Nā lāʻau lapaʻau

No ka hoʻomalu ʻana i nā hōʻailona ma mua o ke ʻoki ʻana, a inā paha e manaʻo ʻia e pani ka lua iā ia iho, hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e like me:

• Nā Diuretics: Hana kēia ma ka hoʻēmi ʻana i ka wai keu e hōʻiliʻili ana a puni ka puʻuwai o ke pēpē.
• Nā lāʻau lapaʻau no ka hāʻule ʻana o ka puʻuwai: Hoʻomalu kēia i ka wikiwiki a me ka ikaika o ka puʻuwai o ka pēpē.

Nā ʻoki kino a i ʻole nā ​​​​kaʻina hana ʻē aʻe

ʻElua ala nui e hoʻoponopono ai i kahi `VSD`:

• ʻOki kino: Pani ke kauka puʻuwai i ka lua. Hiki ke humuhumu ʻia ka lua, a i ʻole e hoʻopili ʻia kahi ʻāpana i hana ʻia mai kahi mea synthetic a i ʻole nā ​​​​ʻiʻo ponoʻī o ka pēpē.
• Nā kaʻina hana Transcatheter: ʻAʻole pili kēia i ke ʻoki kino. Hoʻokomo ʻia kahi ʻōmole liʻiliʻi (catheter) ma o kahi kīʻaha koko nui ma ka wāwae a i ʻole ka lima i ka puʻuwai, a hoʻokomo ʻia kahi mea hana kūikawā ma o ia mea e pani ai i ka lua.

Ma kēia mau ʻano hana ʻelua, i ka hala ʻana o ka manawa, ulu ka ʻiʻo puʻuwai o ke pēpē a puni ka ʻāpana a i ʻole ka mea hana, e lilo ana i ʻāpana o ka paia puʻuwai ponoʻī.

ʻO ka manawa hoʻōla ma hope o ka hoʻoponopono ʻana o ka VSD e pili ana i ke ʻano i hoʻohana ʻia. Hiki i nā ʻano hana Transcatheter ke hala i kekahi mau lā a i kekahi mau pule e ho'ōla ai. Hiki i ke ʻoki ʻana ke hala i kekahi mau pule a i ʻole mau mahina. I ka hapanui o nā hihia, e emi nā hōʻailona VSD ma hope o kēia mau lāʻau lapaʻau.

I ka manawa hea e pono ai iaʻu ke ʻike i ke kauka?

Inā loaʻa iā ʻoe a i ʻole kāu pēpē kahi VSD, e makaʻala i nā hōʻailona maʻamau o ka VSD, a me nā loli koke a i ʻole nā ​​​​hōʻailona ʻē. Ma keʻano laulā, inā pilikia ʻoe a i ʻole kāu pēpē i ka hanu ʻana, a inā e uliuli/palalelale ka ʻili, nā lehelehe, a i ʻole nā ​​​​kui lima (ua kapa ʻia kēia he cyanosis), pono ʻoe e hele koke i ka haukapila.

E kamaʻilio me ke kauka o kāu pēpē inā ʻike ʻoe i kekahi o kēia mau hōʻailona:

• ʻOi aku ka lohi o ka piʻi ʻana o ke kaumaha ma mua o ka mea i manaʻo ʻia.
• Ke hou nei a i ʻole ke kaumaha ʻana i ka wā e hānai ai i ka waiū.
• Hoʻomaha mau, pilikia ka hanu ʻana.
• Nā maʻi hanu pinepine.

Inā loaʻa iā ʻoe kahi VSD ma ke ʻano he kanaka makua, e kamaʻilio me kāu kauka e pili ana i kēia mau mea:

• Inā luhi koke ʻoe a i ʻole pōkole ka hanu i ka wā o ka hana kino.
• Inā ʻoe e keʻokeʻo mau ana, a inā ʻike ʻoe i kou mau manamana lima a i ʻole kou mau lehelehe e polū ana.

Eia kekahi, inā loaʻa iā ʻoe kahi VSD, pono ʻoe e haʻi i kāu kauka ma mua o ka hana ʻana i kekahi ʻoki kino ʻē aʻe a i ʻole ka mālama niho.

He aha nā nīnau koʻikoʻi e nīnau aku ai i ke kauka?

Hiki iā ʻoe ke nīnau i ke kauka o kāu pēpē i kēia mau nīnau:

• Pehea ka nui o ke kīnā septal ventricular o kaʻu pēpē?
• He aha ke ʻano o ka lāʻau lapaʻau āu e paipai nei?
• Pono anei au i nā calorie keu e kōkua i kaʻu pēpē e piʻi koke ke kaumaha?
• ʻEhia pinepine e pono ai kaʻu pēpē e hele mai no nā manawa hoʻonohonoho ma hope?

Ma waho aʻe o kēia mau nīnau, mai makaʻu e nīnau i kekahi mea āu e noʻonoʻo ai.

He aha kāu e manaʻo ai i ka wā e noho ana me ka VSD? He aha nā mea hiki i nā mākua ke hana e kōkua ai i kā lākou keiki liʻiliʻi?

I ke ʻano o kahi VSD waena a nui paha, ʻo ka hoʻoponopono ʻana i ka lua ka mea maʻamau e lawa ai e pale aku i nā pilikia. He mea kākaʻikahi loa, inā loaʻa ke kahe koko hou a puni ka hoʻoponopono ʻana, pono paha ke ʻoki hou ʻana.

ʻAʻole ʻike ka hapa nui o nā pākeke e noho nei me ka VSD ua loaʻa iā lākou ia, no ka mea, he liʻiliʻi ia e hiki ʻole ai ke hoʻopilikia. Akā inā nui ka VSD (ʻoi aku hoʻi inā ʻaʻole i hoʻoponopono ʻia), hiki iā ia ke hoʻopilikia i kou nohona. Inā loaʻa i kahi pākeke kahi VSD, hiki iā ia ke mau i ke ola holoʻokoʻa ke ʻole e hoʻoponopono ʻia.

ʻO ka hapa nui o ka poʻe me VSD ke ola nei i kahi ola maʻamau, e like me ka mea me ka ʻole o ia. He ʻoiaʻiʻo kēia inā he liʻiliʻi ka VSD a pani koke.

Eia nō naʻe, ʻo ka poʻe me ka VSD waena a nui paha (inā i mālama ʻia a ʻaʻole paha) he pōkole iki paha ko lākou ola, ʻoiai inā ʻaʻole i hoʻoponopono mua ʻia ka VSD. Inā ulu kahi kūlana e like me ka maʻi Eisenmenger, hiki ke hoʻemi ʻia ka manaʻolana ola.

Nā mea hiki iā ʻoe ke hana ma ke ʻano he makua:

• Inā loaʻa i kāu pēpē nā hōʻailona o ka VSD, e aʻo aku paha ke kauka iā ia e hoʻomaha a pale i ka hana kino ikaika . ʻOi loa aku inā loaʻa iā ia ka maʻi Eisenmenger, ʻaʻole pono ʻo ia e hana i kekahi mea e hoʻokaumaha nui ai i ka puʻuwai.
• E lawe i kāu lāʻau lapaʻau e like me ke kauoha a kāu kauka. Mai hoʻololi a hoʻōki paha i kāu lāʻau lapaʻau me ka ʻole o ke aʻo ʻana a kāu kauka.
• He mea maʻamau ka hopohopo a me ka makaʻu ke ʻike ʻoe he Ventricular Septal Defect kāu pēpē. Inā ʻoe e manaʻo nei i kēia ʻano, he manaʻo maikaʻi e kamaʻilio me ke kauka o kāu pēpē. Ma kēlā ala, hiki iā ʻoe ke hoʻomaopopo maikaʻi i ke kūlana a me nā mea e manaʻo ai. Hiki i kāu kauka ke kōkua iā ʻoe e hoʻomaopopo pehea e mālama ai i ke kūlana, pale i nā pilikia, a hoʻēmi i ka hopena i ke ola o kāu pēpē.

Leka Lawe-Home:

ʻAe, ua kamaʻilio nui mākou e pili ana i ka `VSD`. E hoʻomanaʻo hoʻi i kēia:

• He lua ka `VSD` ma ka paia ma waena o nā keʻena ʻelua o lalo o ka puʻuwai.
• Hoʻopau wale nā ​​​​VSD liʻiliʻi loa iā lākou iho me ka ʻole o nā hōʻailona.
• Hiki i nā VSD nui ke hana i nā hōʻailona, ​​​​ʻoi aku hoʻi i nā pēpē ʻōpio, e like me ka luhi a me ka paʻakikī o ka hanu ʻana i ka wā e hānai waiū ai.
• Inā kānalua ʻoe he VSD kou, he mea nui e ʻike i ke kauka a hana i kahi hoʻokolohua e like me ka echocardiogram.
• Aia nā hana ʻoki kino no nā VSD nui, a i ʻole nā ​​kaʻina hana transcatheter. Hiki i kēia ke hāʻawi i nā hopena maikaʻi loa.
• ʻO ka mea nui loa, ʻo ia ka ʻike mua ʻana i ka maʻi a loaʻa ka lāʻau lapaʻau e pono ai. Hiki i kēia ke kōkua nui i ka pale ʻana i nā pilikia koʻikoʻi.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai makaʻu e nīnau i kāu kauka. E noho olakino!

VSD , lua i loko o ka puʻuwai, kīnā septal ventricular, maʻi puʻuwai pediatric, kīnā puʻuwai hānau, nā hōʻailona maʻi puʻuwai, mālama ʻana iā VSD