Ka mataku ngā whaea me ngā pāpā katoa ina kite rātou i tētahi pēpi hou e huri kikorangi ana, e uaua ana hoki ki te manawa. I ētahi wā ko te take o tēnei he raruraru ngākau whānau. Ina kōrero mai ngā tākuta ki a koe mō tētahi raruraru o te ngākau o tō pēpi, ā, me mahi rātou i tētahi pokanga 'Arterial Switch', he mea noa te rongo i tētahi taumahatanga nui me te wehi. Engari kaua e mataku. I tēnei rā, ka kōrerohia tēnei i roto i tētahi huarahi tino māmā ka taea e koe te mārama me te kimi whakautu ki ngā pātai maha kei roto i tō hinengaro.
He aha tēnei pokanga Whakawhiti Arteri?
He whakarāpopototanga noa iho, he pokanga ngākau tuwhera te whakawhiti uaua, he mea onge, engari he mea nui rawa, e mahia ana ki ngā pēpi hou. Ko te tikanga he whakahoki i ngā oko toto matua e rua i roto i te ngākau o te pēpi, te aorta me te uaua pūkahukahu, ki ō rātou tūranga noa.
Whakaarohia ō tātou tinana he pūnaha paipa. Mēnā ka honoa ngā paipa hē ki ngā wāhi hē, ka hē pea ngā mea. Ka hono anō te taote pokanga i te aorta o te pēpi ki te ventricle maui o te ngākau me te uaua pūkahukahu ki te ventricle matau. Ko te tikanga ka mahia tēnei pokanga i roto i ngā wiki tuatahi e rua o te whānautanga o te pēpi.
He aha te momo mate e rongoatia ana e tēnei pokanga?
Ka rongoāhia e tēnei pokanga tētahi mate manawa whānau e kiia nei ko te d-transposition of the great arteries (D-TGA) , arā, ko ngā oko toto matua e rua e wehe atu ana i te manawa e hono ana ki ngā wāhi hē i te whānautanga.
I roto i te D-TGA, ka rere te toto poke, kāore i te nui te hāora, puta noa i te tinana, kaua ki ngā pukahukahu kia purea. Waihoki, ko te toto whai hāora e puta mai ana i ngā pukahukahu ka hoki ki ngā pukahukahu, kaua ki te tinana. Mā tēnei ka kore e taea e te pēpi te whiwhi i te hāora e hiahiatia ana e ia.
Mā te pokanga Arterial Switch ka whakatikahia tēnei raruraru. Mā tēnei ka taea te rere tika o te toto o te pēpi, ka hoki ngā taumata hāora ki te āhua noa, ā, ka pai ake te mahi a te ngākau. Mā tēnei pokanga ka nui te whai wāhi o tō pēpi ki te tipu hei pakeke hauora.
He aha tāu e mahi ai i mua i te pokanga?
He maha ngā mahi a ngā tākuta hei whakatau i te āhua o te pēpi i mua i te pokanga, hei whakarato hoki i te nui o te hāora ki te tinana.
- Septostomy: He tikanga rangitahi tēnei. Ka hangaia he kōhao iti i waenganui i ngā rūma o te ngākau kia uru ai ētahi toto whai hāora ki te toto iti iho te hāora.
- Pūwero manawa: Kua honoa ki tētahi mīhini hei whakangāwari i te manawa o te pēpi.
- Ngā Rongoā: Ka hoatu ngā rongoā pēnei i te 'Prostaglandin' hei pupuri i te tuwhera o ngā oko toto, hei whakanui ake hoki i te rere o te hāora ki te tinana.
Hei whakarite mō te pokanga, ka mahia ētahi whakamātautau kore mamae, pērā i te echocardiogram (he matawai i te ngākau), he hihi-X o te uma, me te EKG (electrocardiogram) hei tirotiro i te rahi me te mahi a te ngākau o te pēpi.
He aha ngā mea ka tupu i te wā o te pokanga?
He pokanga uaua tēnei e roa ai ngā hāora. Kia mārama noa tātou ki te āhua o tēnei.
| Hipanga Tukanga | I roto i ngā kupu māmā noa iho... |
|---|---|
| Te whakatuwheratanga o te sternum (te tango i te sternum) | Ka huakina e te taote pokanga te uma o te pēpi i waenganui, ka tae atu ki te ngākau. |
| Te Ārai i te Manawa me te Pūkahukahu | I te wā o te pokanga, ka whakahaerehia te mahi ki te ngākau me ngā pukahukahu e tētahi mīhini motuhake (mīhini ngākau-pukahukahu). Ka horoia te toto e tēnei mīhini, ka panaia anō ki roto i te tinana. |
| Te whakaora me te whakawhiti i te uaua | Ka tangohia te aorta me te uaua pūkahukahu i hono hē mai i te ngākau. |
| Te Whakahoutanga o te Arorangi o te Koronari | Koinei te wāhanga tino uaua, tino nui hoki o te pokanga. Ka tangohia marietia ngā uaua iti o te ngakau e tuku toto ana ki te ngākau mai i te aorta kua hē te tūnga, ā, ka honoa anō ki te aorta hou kua honoa ki te wāhi tika. |
| Te hono anō i te uaua | E honoa ana te aorta ki te ventricle maui, me te uaua pūkahukahu ki te ventricle matau i ō rāua tūranga tika. |
| Te kati o te uma | Kia oti ngā mea katoa te mahi tika, ka kati anō te uma o te pēpi e te taote pokanga. |
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka whakaurua tō pēpi ki te wāhanga tiaki nui (ICU) mō ētahi rā. Ina haere koe ki te tirotiro i tō pēpi, ka kite koe i ngā ngongo, ngā waea, me ngā mīhini maha e hono ana ki a ia. He mea whakamataku pea tēnei, engari kaua e manukanuka. Kia mahara, kei reira katoa ēnei taputapu hei aroturuki i tō pēpi, hei āwhina hoki i a ia kia tere te ora.
He aha ngā painga, ngā reiti angitu, me ngā mōrearea o tēnei pokanga?
Ngā Painga me te Angitū
He pokanga whakaora ora tēnei. Ka hoatu ki te pēpi te hāora e hiahiatia ana e ia, kia ora ai tōna tipu.
- Ki te kore he pokanga, e 50% o ngā pēpi me te D-TGA ka mate i roto i te marama tuatahi.
- Engari he tino teitei te ōrau angitu i muri i te pokanga. Ko te mōrearea o te mate he iti iho i te 2%.
- Kua pūrongohia tata ki te 96% o te hunga i pokangahia kei te ora tonu i muri i te 25 tau. Ka taea e te nuinga o ngā tamariki te noho noa me te kore he here i roto i ngā mahi ā-tinana.
Ngā raruraru pea (Ngā Tūponotanga)
He onge tonu te puta mai o ētahi raruraru i muri i ngā tau maha.
- Te aukati i ngā uaua o te ngakau, i te ara rere rānei mai i te ventricle matau.
- Te whānui, te whaiti rānei o ngā oko toto kua honoa anō.
- Ngā takirere ngākau e turuturu ana.
Mena ka puta ēnei raruraru, me mahi pokanga anō pea hei whakatika i ēnei ā muri ake nei. Waihoki, nā te iti o te hāora i te whānautanga, ka pāngia pea ētahi tamariki e ngā ngoikoretanga ngawari o te mahara, te aro, te manukanuka ngawari rānei. He mea nui kia mōhio koe ki tēnei i mua i te wā. Kātahi, ki te kite koe i ētahi huringa i roto i tāu tamaiti, ka taea e koe te tuku wawe i te āwhina e tika ana.
Kia pēhea te roa o te wā e ora ai, ā, kia whiwhi tohutohu hauora anō hoki?
I te nuinga o te wā, me noho te pēpi ki te hōhipera mō te rua wiki pea . Ka haere tonu te tukanga whakaora ahakoa kua hoki koe ki te kāinga. Mā te tākuta koe e tohutohu ki te tiaki i te patunga me ngā rongoā hei hoatu.
Kei te hiahia koe ki te kite anō i te tākuta?
Āe, tino tika. Me hoki koe ki te kāinga ka kite i te taote pokanga i roto i te wiki, i ngā wiki e rua rānei. Me kite hoki koe i te taote ngakau o ngā tamariki.
Ko te mea nui ko te tirotiro hauora i tāu tamaiti i te iti rawa kotahi i te tau puta noa i tōna oranga. Pērā ai, mēnā ka puta he raruraru, ka taea te tautuhi i mua i te kino haere.
Ina hiahia koe ki te waea atu ki te tākuta tonu
I muri i te hokinga ki te kāinga, ki te whero te patunga pokanga o tō pēpi, ki te pupuhi, ki te turuturu rānei te wai, ki te pāngia rānei e te kirika , waea atu ki tō tīma hauora tonu atu.
Karere Tangohia ki te Kāinga
- He mahi tino angitu, he mahi whakaora ora hoki te pokanga Arterial Switch mō ngā pēpi me te D-TGA.
- Ahakoa he pokanga nui tēnei, ka taea e te nuinga o ngā tamariki te noho ora noa, te hauora i muri i tēnei.
- Kaua e wehi i ngā taputapu me ngā ngongo e kitea ana e koe i roto i te ICU i muri i te pokanga. Kei reira katoa hei āwhina i tō pēpi kia tere te ora.
- Me tirotirohia tō tamaiti e te rata puta noa i tōna oranga. Kia mahara ki te whai i aua tirotiro hauora.
- Hei mātua, he tika ki a koe te kōrero ki tō tākuta mō ō pātai, āwangawanga, feaa rānei. Kei te rite tonu rātou ki te āwhina i a koe.
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