He mea noa te mataku me te manukanuka ina kī mai tō tākuta me pokanga te ngākau o tāu tamaiti. Ina koa ka tae ki te 'Glenn Procedure', kāore pea koe i whakaaro he aha te āhua o te pokanga ahakoa i muri i te rongonga i tōna ingoa. Kaua e manukanuka. Ka kōrerohia e mātou tēnei pokanga, te take i mahia ai, me ngā mea ka tupu i muri mai i roto i te huarahi tino māmā ka taea e koe te mārama.
He aha te tikanga Glenn?
Whakaarohia, he uaua nui kei reira e kohi ana i te toto 'paru', kāore i te nui te hāora, mai i ngā wāhanga o runga o tō tātou tinana (upoko, kaki, ringa) ka haria ki te ngākau. Ka kiia tēnei ko te 'Superior Vena Cava' . I te nuinga o te wā, i roto i te ngākau hauora, ka haere tēnei toto mā roto i ngā rūma o te ngākau ka pamuhia ki ngā pukahukahu, ka 'horoia' mā te kohi hāora.
Engari kāore e taea e ētahi pēpi he mate manawa whānau te haere tika i tēnei haerenga nā te mea he raruraru kei te hanganga o ō rātou manawa. Tērā pea kāore tetahi taha o te manawa i tino whanake, he raruraru rānei kei te takirere.
Ka karohia tēnei wāhanga raruraru o te ngākau e te tikanga Glenn, ā, ka honoa te toto 'paru' e puta mai ana i runga ki ngā uaua pūkahukahu. Arā, ka hangaia he ara poto (takahi) e kawe tika ana i te toto ki ngā pūkahukahu, kaua e haere mā roto i te aukati o te ngākau. Mā tēnei ka taea e te toto rawakore-hāora te haere ki ngā pūkahukahu me te kore he aukati.
I roto i ēhea momo mate ngakau me mahi tēnei pokanga?
He maimoatanga te tikanga Glenn mō ētahi mate ngakau tino onge, tino uaua hoki. Ko te tikanga, ka tūtohu ngā tākuta i tēnei tikanga mō ngā pēpi me ēnei mate e whai ake nei:
| Mate manawa (āhua hauora) | Hei whakarāpopototanga... |
|---|---|
| Te Mate Ngākau Mauī Hypoplastic | Kāore te taha maui o te ngākau (te wāhanga matua e pupuhi ana i te toto) e whanake tika ana i te whānautanga. |
| Te Atresia o te Tricuspid | Kāore te takirere tricuspid i te taha matau o te ngākau i hangaia tika. |
| Te Atresia o te Pūkahukahu | Kāore te takirere pūkahukahu, e kawe ana i te toto mai i te ngākau ki ngā pūkahukahu, e tuwhera tika ana. |
| Putanga Takirua o te Ventricle Mauī, Matau rānei | Ka rere te toto mai i ngā rūma o runga e rua o te ngākau ki roto i te rūma o raro kotahi (ventricle). |
| Ngā hapa o te awaawa atrioventricular kore taurite | Te kitea o ngā hapa uaua i roto i ngā pakitara me ngā takirere i waenganui i ngā rūma o te ngākau. |
Āhea ka mahia te pokanga, ā, he aha ngā mahi i mua atu?
Ko te pokanga Glenn te tikanga ka mahia ina kei waenganui i te 3 me te 6 marama te pakeke o te pēpi. I te nuinga o te wā, koinei te pokanga tuarua. Mō ngā pēpi he pēnei te mate ngākau, ka mahia he pokanga tuatahi (pēnei i te Blalock-Taussig (BT) shunt) i te whānautanga hei whakapai ake i te rere o te toto. Kātahi, ina pakeke ake te pēpi, ka mahia te pokanga Glenn hei taahiraa e whai ake nei.
I mua i te pokanga
I mua i te whakatau i te rā mō te pokanga, me mārama te tirohanga a ngā tākuta ki te ngākau o te pēpi. Hei mahi i tēnei, ka whakahaerehia e rātou ngā whakamātautau pēnei i:
- Te Tātaritanga o te Manawa: He whakamātautau e tukuna ai he ngongo iti mā roto i tētahi uaua i te waewae, i te ringa rānei ki te manawa, hei ine i te pēhanga i roto i te manawa, hei tirotiro hoki i tōna hanganga.
- MRI o te ngākau: Mā tēnei ka āwhina i te whakamahere pokanga mā te tiki whakaahua taipitopito o te ngākau e toru-ahu (3D).
- Me kōrero e koe ki te tākuta ngā rongoā katoa e tangohia ana e tō pēpi (tae atu ki ngā huaora me ngā tāpiringa) .
He aha ngā mea ka tupu i te wā o te pokanga, ā, i muri hoki i te pokanga?
I te wā o te pokanga
E whā hāora te roa o te pokanga Glenn. Heoi, ka rerekē pea te roa i runga i te āhua o te pēpi. I roto i tēnei wā katoa, kei raro te pēpi i te rongoā whakamoe whānui. Ko te tikanga tēnei kāore ia e rongo i tetahi mea, kua moe katoa ia.
Tērā pea ka hiahiatia he mīhini ārai manawa mō ētahi tamariki hei tango i te mahi a ō rātou ngākau me ō rātou pukahukahu i te wā e pokanga ana. Ka whakamahia e te taote pokanga ngā toenga o ngā pokanga o mua hei hono i te vena cava o runga ki te uaua e kawe ana i te toto ki ngā pukahukahu.
I muri i te pokanga
He mea whakamataku te kite i tō pēpi i muri i te pokanga. Ka honoa ia ki ētahi ngongo me ngā taputapu aroturuki e whakaatu ana i tōna tere manawa me ngā taumata hāora. Engari ko ēnei katoa hei aroturuki i te āhua o te pēpi. Ka puritia te pēpi i roto i te Wāhanga Tiaki Kaha (ICU) mō te 3 rā pea, ā, ka tirotirohia hoki. Whai muri i tēnā, ka whakawhitia ia ki tētahi wāhanga noa, ā, ka taea e ia te hoki ki te kāinga i roto i ētahi atu rā.
Ko te mea nui, ko te tikanga Glenn he taahiraa tuarua noa iho i roto i te otinga katoa. Ina pakeke ake te pēpi, ā, ka tīmata te hikoi (i waenga i te 2-4 tau te pakeke), me mahi anō tētahi atu pokanga e kiia nei ko te 'tikanga Fontan'. Mā tō tākuta tēnei e whakamārama ki a koe.
He aha ngā painga me ngā raruraru pea o te tikanga Glenn?
Pērā i ngā pokanga katoa, he pai ngā painga o te pokanga Glenn, ā, he mōrearea anō hoki. He mea nui kia mōhio ki ēnei.
| Ngā Painga | Ngā Mōrearea/Ngā Āhuatanga Raruraru Pea |
|---|---|
| Ka whakaitihia te kawenga ki runga i te rūma mahi kotahi o te ngākau (ventricle). | Te hekenga o ngā taumata hāora i roto i te toto. |
| Ārai i te whakanui o te ngākau nā te nui rawa o te mahi. | Te toto toto tiketike. |
| Mā tēnei ka māmā ake te pokanga Fontan e whai ake nei. | Ngā rerenga wai i roto i te pleural. |
| Ka whakanui ake i te tūponotanga o te tamaiti kia ora. | Me whāngai mā roto i te ngongo nā te uaua ki te inu miraka. |
| He huarahi kē atu te pokanga fontan mō te hunga kāore e hiahia ana, kāore rānei e taea te mahi. | Me pokanga anō. |
He tino teitei te ōrau angitu o tēnei pokanga, tata ki te 99% . Nō reira kaua e manukanuka. E mōhio ana ngā tākuta ki ēnei mōrearea, ā, kua tino whakangungua hoki rātou ki te whakahaere i aua mōrearea.
Kia mataara tonu ki tēnei ina tae koe ki te kāinga!
Kia tae atu koe ki te kāinga i te hōhipera, me tino tupato koe ki te āhua o tō pēpi. Mēnā ka kite koe i tētahi o ngā tohu e whai ake nei, me waea atu tonu koe ki tō tākuta .
- Te kirika.
- Te toto e puta mai ana i te patunga pokanga, i tētahi atu wai rānei.
- Te uaua ki te inu miraka , te kore rānei e inu miraka.
- Kāore te pēpi e piki tika ana tōna taumaha.
- Te uaua ki te manawa, te kikorangi rānei o ngā ngutu/maikuku o te pēpi.
I mua i tō putanga mai i te hōhipera, ka hoatu he rā ki a koe mō tō wā hui e whai ake nei ki te taote ngakau. Kia mahara ki te kawe mai i tāu pēpi i aua rā.
Karere Tangohia ki te Kāinga
- He tikanga whakaora ora te tikanga Glenn mō ngā pēpi e pāngia ana e te mate manawa whānau uaua. Ka whakapai ake i te rere o te toto.
- Ka mahia tēnei i te nuinga o te wā ina tae te pēpi ki waenganui i te 3-6 marama te pakeke. He maha ngā wā, koinei te taahiraa tuarua o tētahi raupapa pokanga.
- He tino teitei te ōrau angitu o te pokanga (tata ki te 99%). Heoi, kia mārama koe, pērā i ngā pokanga katoa, he tūponotanga kei reira.
- I muri i te pokanga, me noho tonu te pēpi i raro i te tirotiro a te tākuta. Me whai i ngā tohutohu a te tākuta.
- Mena he pātai, he āwangawanga, he ruarua rānei āu mō tēnei mea, kaua e mangere ki te kōrero ki tō tākuta. He mea tino nui kia mōhio koe ki ō whakaaro.
💬 Comments (0)
Kaore ano kia tukuna he korero. Tāpirihia to korero ki konei mo te wa tuatahi.
Tāpirihia to korero