E noʻonoʻo ʻoe ua lawe ʻoe i kāu keiki liʻiliʻi i ke kauka no ka nānā maʻamau. Inā kau ke kauka i kahi stethoscope a ʻōlelo, "Aia kahi leo liʻiliʻi e puka mai ana mai ka puʻuwai o kāu pēpē, he 'murmur'," ʻaʻole anei e lele kou puʻuwai ma ke ʻano he makua? He mea maʻamau iā mākou ke makaʻu i ka wā e lohe ai mākou i ke kani o ka puʻuwai. Akā, mai hopohopo. ʻAʻole nā kani puʻuwai a pau, nā 'murmur' a pau he mea weliweli. I kēia lā, ke kamaʻilio nei mākou e pili ana i kahi maʻi maʻamau a ʻaʻole hoʻi he mea ʻino i kapa ʻia ʻo 'Still's Murmur.'
I ka ʻōlelo maʻalahi, he aha ʻo Still's Murmur?
He leo mele ʻino ʻole ka Murmur a Still i lohe pinepine ʻia i loko o ka puʻuwai o nā keiki olakino ma waena o 3 a me 6 mau makahiki. Ua wehewehe mua ʻia i ka makahiki 1909 e Kauka George Frederick Still, he kauka keiki. Ua wehewehe ʻo ia he "leo 'ting', e like me ke kaula ma kahi mea kani e kaomi ʻia ana." ʻO ka mea nui, ʻaʻole i hoʻokumu ʻia kēia leo e kekahi maʻi puʻuwai, nāwaliwali, a i ʻole kīnā hānau .
ʻO ia ke kumu i kapa ai nā kauka i kēia he 'innocent murmur'. ʻO ia hoʻi, ʻaʻole ia e hōʻeha i ke keiki. I ka hapanui o nā hihia, nalowale kēia leo i ka wā e hiki ai ke keiki i ka wā ʻōpio.
No ke aha lā kēia walaʻau? He aha ke kumu?
ʻO kaʻoiaʻiʻo, ʻaʻole i loaʻa i nā kauka kahi kumu kūpono 100% no kēia, akā aia kekahi mau manaʻo nui.
- ʻAno o ka puʻuwai: He palupalu a palupalu loa ka puʻuwai a me nā kīʻaha koko o nā keiki liʻiliʻi. I ka wā e kuʻi ai ka puʻuwai a kahe wikiwiki ke koko, hiki i nā haʻalulu palupalu i loko o kēia mau ʻiʻo palupalu ke hana i kēia leo mele. Ua like ia me ke kani a mākou e hana ai i ka wā e puhi ai mākou i ka ea ma luna o kahi ʻōmole hakahaka.
- Nā ʻiʻo wahaheʻe: Loaʻa paha i kekahi mau keiki nā ʻiʻo lahilahi a fibrous i loko o ka ventricle hema o ka puʻuwai. Manaʻo kekahi e haʻalulu kēia mau mea i ke kahe ʻana o ke koko ma o lākou, e hana ana i ke kani.
- Ka haʻalulu ʻana o Chordae: Hiki ke hana ʻia kēia kani e ka haʻalulu ʻana o nā olonā lahilahi, e like me ke kaula (chordae) i hoʻopaʻa ʻia i nā kiwikā o ka puʻuwai i ke kahe ʻana o ke koko ma o lākou.
- Hoʻonui ʻia ke kahe koko: Ke loaʻa i ke keiki ke kuni, a i ʻole ke holo nei a pāʻani a mehana, piʻi aʻe ko lākou puʻuwai. Eia kekahi, aia kekahi mau loli i ke kahe koko i nā keiki me ka anemia. I kēlā mau manawa, hiki ke lohe maopopo ʻia kēia 'murmur' i ka wā e holo wikiwiki ai ke koko ma o ka puʻuwai.
ʻO ka mea nui, ʻaʻole kekahi o kēia mau kumu he hana hewa a he maʻi paha o ka puʻuwai. He mau loli maʻamau wale nō kēia e ʻike ʻia i loko o ka puʻuwai olakino.
He aha nā ʻano o kēia ʻōhumu? Pehea e ʻike ai ke kauka?
ʻO ka hōʻailona wale nō o kēia, ʻo ia ke kani ʻokoʻa a ke kauka e lohe ai me ka stethoscope. Ma ke ʻano he makua, ʻaʻole ʻoe e lohe i kēia. ʻAʻole ʻeha ka ʻoluʻolu ʻole o ke keiki, ka ʻeha, ka luaʻi, a i ʻole ka ʻeha o ka umauma. Pāʻani maikaʻi ke keiki, holo, lele, ʻai, a inu e like me nā keiki olakino ʻē aʻe.
E hoʻokaʻawale ke kauka i ka Still's Murmur mai nā murmur ʻino ʻē aʻe ma muli o kēia mau ʻano.
| ʻAno | Wehewehena |
|---|---|
| Ka maikaʻi o ke kani | He leo mele, e haʻalulu ana, e like me ka 'twang' palupalu. |
| Ka ikaika o ke kani | He leo palupalu loa. ʻO ke kauka wale nō ke lohe me ka stethoscope. |
| Hoʻololi me ke kūlana | He hiʻohiʻona koʻikoʻi loa kēia. Ua lohe maopopo ʻia ke kani ke moe nei ka pēpē ma kona kua. Ke noho a kū paha ka pēpē, ua emi iki ka ʻike ʻia o ke kani, a nalo loa paha. |
| Kahi | Lohe nui ʻia ke kani ma waenakonu o ka umauma, ma ka ʻaoʻao hema o ka sternum. ʻAʻole kēia kani e pālahalaha i nā armpits a i ʻole ke kua (ʻaʻohe radiation). |
| Manawa | Lohe ʻia kēia i ka wā e ʻū ai ka puʻuwai (e pamu i ke koko). ʻO ia hoʻi, he murmur mid-systolic ia. |
Pono anei ke keiki i ka lāʻau lapaʻau?
I ka pōkole, ʻaʻole . ʻAʻole he maʻi ʻo Still's Murmur, he leo wale nō ia i lohe ʻia e ka puʻuwai olakino. No laila, ʻaʻole pono ia i kekahi ʻano lāʻau lapaʻau, ʻoki kino, a i ʻole kekahi lāʻau lapaʻau ʻē aʻe .
Hoʻolohe wale ke kauka i kēia leo i ka wā o nā nānā maʻamau o ke keiki. E nānā inā loli. Ma waho aʻe o kēlā, ʻaʻohe pono e kau i kekahi mau kapu ma luna o ke keiki. ʻAʻohe mea keakea no ke keiki e pāʻani i kekahi pāʻani āna e makemake ai, e holo, lele, a i ʻole e komo i nā haʻuki kula. Hiki iā ia ke ola i kahi ola maʻamau a olakino .
I ka wā e ulu ana ke keiki, loli ke ʻano o ko lākou puʻuwai. I ka manawa like, e emi mālie ana kēia ʻōhumu a nalowale loa i ka wā e hiki ai lākou i ka wā ʻōpio. He mea kākaʻikahi loa, inā hoʻomau ke kanaka i kēia ʻōhumu a hiki i ka wā makua, ʻaʻole ia e hōʻeha.
Leka Lawe-Home
- ʻAʻole he maʻi ʻo Still's Murmur. He leo mele ʻino ʻole ia i lohe ʻia e ka puʻuwai olakino i nā keiki ʻōpio.
- He mea maʻamau loa kēia maʻi i waena o nā keiki ma waena o nā makahiki 3-6.
- ʻAʻohe lāʻau lapaʻau e pono ai no kēia. ʻAʻohe pono e pāpā i kāu keiki mai ka pāʻani ʻana, ka holo ʻana, a i ʻole ka hana ʻana i kekahi mea.
- I ka hapanui o ka manawa, nalo aku kēia leo iā ia iho i ka wā e ulu aʻe ai ke keiki.
- Inā haʻi aku ke kauka o kāu keiki iā ʻoe e pili ana i ka murmur puʻuwai, mai hopohopo a hoʻolohe pono. Inā he kānalua a makaʻu paha kāu, e kamaʻilio ākea me kāu kauka e pili ana i ia mea.
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