E mārama ana ahau ki te uaua o te kōrero a te tākuta ki tētahi mātua he mate manawa whānau tō tāu pēpi hou. I tēnei wā, ina rongo koe mō te 'BTT shunt', tera pea he maha āu pātai mō te aha, te take i mahia ai, ka pāngia te pēpi, ā, he aha ngā tūponotanga. Kaua e manukanuka. I tēnei rā, ka kōrerohia e tātou katoa i roto i te mārama me te ngāwari.
He aha te tikanga o tēnei BTT Shunt?
Ko te BTT shunt, ko te Blalock-Taussig-Thomas shunt rānei, he pokanga motuhake e mahia ana hei āwhina i ngā pēpi kāore e whiwhi ana i te nui o te hāora ki ō rātou tinana. Ka puta tēnei mate i te mate manawa whānau .
Whakaarohia, ka whiwhi ō tātou tinana i te hāora mai i te hau e manawahia ana e tātou ki roto i ō tātou pukahukahu. Me tāpiri tēnei hāora ki te toto, me kawe puta noa i te tinana. Heoi, i roto i ētahi pēpi he mate manawa, ko te uaua toto matua e kawe ana i te toto mai i te ngākau ki ngā pukahukahu , arā, te uaua pūkahukahu , kāore e whiwhi toto nui. Kātahi ka kore e whiwhi te tinana i te hāora nui.
Nō reira, ko tā te BTT shunt he hanga i tētahi ara hou mā te whakauru i tētahi ngongo horihori iti (shunt, graft rānei) mai i te uaua toto matua e kawe ana i te toto mai i te ngākau ki te tinana ki ngā pūkahukahu. He rite ki tētahi ara iti e karo ana i tētahi ara pukumahi. Mā tēnei ka nui ake te toto e haere ana ki ngā pūkahukahu, ā, ka pai ake te hāora e whiwhi ai te tinana.
Ko te mea nui, he otinga rangitahi noa iho tēnei. Kia pakeke ake, kia kaha ake hoki te pēpi, ka mahia he pokanga nui hei whakatika i te raruraru ngākau taketake. I roto i taua pokanga, ka tangohia te BTT shunt. Heoi, he tino onge, ka hiahia pea ētahi pēpi ki tēnei shunt hei otinga mō te wā roa.
He aha ngā momo mate ngākau e hiahia ana ki te pokanga BTT Shunt?
He pai tēnei pokanga mō ētahi mate manawa whānau e whakaiti ana i te rere o te toto ki ngā pukahukahu.
| Ngā mate ngākau whānau |
|---|
| Te mate ngākau maui hypoplastic |
| Tetralogy o Fallot (TOF) |
| Truncus arteriosus |
| Te āhua rerekē o Ebstein |
| Te ngoikore o te pūkahukahu |
| Te ngoikore o te tricuspid |
| Ētahi momo whakawhiti o ngā uaua nui |
He aha ngā mea ka tupu i mua i te pokanga?
I mua i te pokanga, ka kohia e te tīma hauora o tō pēpi ngā mōhiohio katoa e tika ana. Ka tirotirohia e rātou tō pēpi me te tirotiro i tōna hītori hauora mai i tō hapūtanga. Tērā pea ka whakahaerehia e rātou ētahi whakamātautau kore-whakaeke.
| Ngā momo whakamātautau ka taea te mahi |
|---|
| He matawai ngākau (echocardiogram transthoracic) |
| Ngā whakamātautau toto |
| X-ray o te uma |
| Whakamātautau ECG (Electrocardiogram) |
| I ētahi wā, he angiogram, he CT angiogram rānei (Coronary angiogram, CT angiogram rānei) |
Ka whiwhi hoki koe i ngā tohutohu mō te kaukau i tāu pēpi i mua i te pokanga me te wā me mutu te kai me te whāngai ū.
He aha ngā mea ka tupu i te wā o te pokanga?
He maha ngā hāora te roa o tēnei mahi, ā, he tino ātaahua hoki. Ko te mahi matua a te taote pokanga ko ēnei e whai ake nei:
- Te wheua i waenganui o te uma o te pēpiKa uru atu ki te ngākau mā te tapahi i te sternum .
- Hei whakatata atu ki te ngākau, ka tangohia katoatia te repe thymus e tata ana.
- E ai ki te kōrero i mua ake nei, ka honoa he tākai hangai i waenga i te uaua matua e tuku toto ana ki te tinana (te uaua subclavian) me te uaua e tuku toto ana ki ngā pukahukahu (te uaua pulmonary).
- Ka tirohia marietia tēnei hononga kia kitea ai mēnā kei te pai te mahi, mēnā he toto totoka kei roto, mēnā rānei he turuturu toto.
- Ki te pai ngā mea katoa, ka kati anō te uma o te pēpi.
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka tukuna tō pēpi ki te wāhanga tiaki nui (ICU) .
Kaua e mataku i tēnei. Tērā pea ka pāngia koe e te āhua kino ina kite koe i tō pēpi i muri i te pokanga. He maha ngā ngongo me ngā waea e piri ana ki te pēpi. Engari kia maumahara, kei reira katoa aua taputapu hei āwhina i te pēpi kia tere te ora. Nō reira kia kaha.
Ka hoatu he rongoā whakangawari toto ki te pēpi, pērā i te heparin, hei ārai i te toto e pupū ana. Ka tīmata hoki rātou ki te whakamahi i te aspirin . Me tango e te pēpi tēnei aspirin mō te toenga o tōna oranga. He tino onge, ka hiahia pea ētahi pēpi ki te āwhina o tētahi mīhini tautoko ora rangitahi, pērā i te ECMO .
He aha ngā painga me ngā mōrearea o tēnei pokanga?
Ko te painga matua:
Ko te painga nui o tēnei pokanga ko te whakanui ake i te nui o te hāora e tae atu ana ki ngā pūtau tinana o te pēpi. Ka whakaitihia te tae kikorangi (cyanosis) e kitea ana i roto i te kiri, ngutu, me ngā maikuku o ētahi pēpi nā te kore o te hāora. He piriti pai tēnei mō te pēpi kia noho hauora, kia kaha hoki tae noa ki te pokanga nui e whai ake nei.
Ngā tūponotanga me ngā raruraru:
Pērā i ngā pokanga katoa, he tūponotanga kei reira. Mā tō tākuta ēnei e whakamārama taipitopito atu ki a koe. Ko ētahi o ngā raruraru ka pā mai ko:
- He nui ake te toto e rere ana mā te shunt ki ngā pukahukahu i te mea e tika ana (he nui rawa te tohanga toto o te pukahukahu).
- Ngā toto totoka.
- Te pakaru o te io e tata ana ki te wāhi i pokanga ai (ina koa te io e pā ana ki te hohonutanga o te reo o te pēpi).
- Ngā rerekētanga o te pā o te ngakau (Arrhythmia).
- Te hopukanga o te ngākau.
He tino iti ēnei mōrearea, ā, kei te whakapau kaha te tīma hauora ki te ārai i ēnei mea.
Kia pēhea te roa o te wā e ora ai, ā, āhea ahau me toro atu ki te tākuta?
E rua wiki pea te roa o te noho o te pēpi ki te hōhipera. Ko te wiki tuatahi, neke atu rānei, ka noho ia ki te wāhanga tiaki nui (ICU). Ahakoa kua hoki koe ki te kāinga, me kawe tonu e koe tō pēpi ki ngā tirotiro hauora. Ko te haerenga tuatahi ka puta i roto i te wiki, i ngā wiki e rua rānei i muri i te hokinga ki te kāinga.
I muri i te hokinga ki te kāinga, ki te kite koe i ngā tohu e whai ake nei, me waea atu koe ki tō tākuta tonu atu.
| Ngā tohu whakatūpato hei tirotiro māu |
|---|
| Te pupuhi i te wāhi i pokangahia ai, i tētahi atu wāhi rānei o te tinana |
| Te whero huri noa i te patunga pokanga |
| Ki te mea ka puta kikorangi anō te kiri me ngā ngutu |
| Mena kei te ahua ngenge rawa te pēpi, kei te ngoikore rānei |
| Mena he kirika tōu |
| Mena kei te turuturu te wai mai i te patunga pokanga |
Hei mātua, e mōhio ana mātou e hiahia ana koe ki te hoatu i te mea pai rawa atu ki tāu pēpi. Ko te mea pai rawa atu ka taea e koe i tēnei wā ko te pātai atu ki te tīma hauora i ō pātai katoa. Kōrerohia mārama te āhua o tāu pēpi, te pokanga, me te heke mai. Mā te whiriwhiri i tētahi hōhipera me ngā tākuta he nui ō rātou wheako ki ēnei momo pokanga ka nui ake te rangimarie o te hinengaro.
Karere Tangohia ki te Kāinga
- Ko te BTT Shunt he pokanga e mahia ana i ngā pēpi he mate manawa whānau hei whakanui ake i te nui o te toto e rere ana ki ngā pukahukahu, me te whakarato hāora ki te tinana.
- He otinga rangitahi noa iho tēnei i ētahi wā. Kia tupu te pēpi, ka hiahiatia tētahi atu pokanga hei whakatika i te mate ngākau.
- I muri i te pokanga, me whiwhi te pēpi i te tiaki nui, ā, me tango pea e ia ngā rongoā pēnei i te aspirin mō te toenga o tōna oranga.
- Pērā i ngā pokanga katoa, he tūponotanga anō kei reira. Kōrerotia mā te mahorahora ki tō tākuta mō ēnei tūponotanga.
- I muri i tō hokinga ki te kāinga, kia tino aro ki ngā whanonga a tō pēpi, te tae o tōna kiri, te kirika, me ērā atu mea. Mēnā ka kite koe i ētahi huringa, rapua tonutia he tohutohu hauora.
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