I te kīnga atu a te tākuta me whai pokanga 'Glenn' tāu tamaiti nā te mate ngākau, kua tino mataku koe, kua ohorere hoki. He maha ngā pātai kei roto i tō hinengaro, pērā i te aha te 'Pokanga Glenn', he aha ngā mahi e pā ana ki tēnei, me te take e mahia ai. Kaua e manukanuka. He mea noa aua kare ā-roto. Me kōrero noa tātou mō ēnei mea katoa, i roto i te huarahi e mārama ai koe.
He aha te Tukanga Glenn, i te whakarapopototanga?
Whakaarohia, ko tō tātou ngākau te motuka e pupuhi ana i te toto puta noa i te tinana. E whā ōna wāhanga (e whā ngā rūma). Ka whānau mai ētahi pēpi me tētahi o ēnei rūma kāore anō kia tino whanake, he iti rawa rānei. I tēnei wā, kāore e taea e te ngākau te pupuhi tika i te toto.
He māmā noa iho, he tikanga 'takahi' te tikanga Glenn e āwhina ana i te ngākau ngoikore pēnei.
I konei, ka honoa e ngā taote pokanga te uaua toto matua (te vena cava teitei), e kawe ana i te toto poke, kāore i te nui te hāora mai i te tinana o runga o te pēpi, tika atu ki te uaua pūkahukahu, kaua ki te tuku ki te ngākau.
He rite tēnei ki te hanga i tētahi rori hou, ngāwari ake te whakamahi, e karo ana i tētahi rori pukumahi. Mā tēnei ka taea e te toto e hiahia ana ki te tiki hāora te karo i te wāhanga raruraru o te ngākau, ka haere tika atu ki ngā pukahukahu.
Koinei te tuarua o ngā pokanga e mahia ana ki tētahi pēpi. Ka mahia anō tētahi atu pokanga i muri i ētahi tau hei whakaora i te mate.
He aha te momo tamariki e mahia ana tēnei pokanga?
Ko te nuinga o te wā, ka mahia te pokanga a Glenn ki ngā tamariki he whānautanga o ngā mate ngākau. He mea nui rawa atu tēnei mō ngā tamariki nohinohi, mō te hunga rānei kāore e mahi tika ana tētahi o ngā rūma matua e rua (ngā ventricle) o te ngākau e pupuhi ana i te toto. Ka kiia tēnei āhuatanga he 'mate ngākau kotahi'.
Kei raro nei ētahi o ngā mate ngakau matua e hiahia ana ki te pokanga Glenn.
| Ingoa o te mate manawa (Āhuatanga Hauora) | He whakamārama māmā |
|---|---|
| Te Mate Ngākau Mauī Hypoplastic | Kāore te taha maui o te ngākau (te ventricle maui, ngā takirere) e whanake tika ana. |
| Te Atresia o te Tricuspid | Kāore te takirere tricuspid, kei waenganui i ngā rūma i te taha matau o te ngākau, i hangaia tika. |
| Te Atresia o te Pūkahukahu | Kua āraia te takirere pūkahukahu e kawe ana i te toto ki ngā pūkahukahu. |
| Putanga Takirua o te Ventricle Mauī, Matau rānei | Ka hono ngā rūma o runga e rua o te ngākau (atria) ki te rūma o raro kotahi (ventricle). |
Āhea te tikanga o te pokanga Glenn e mahia ai?
Ko te tikanga, ka tūtohu ngā tākuta i tēnei pokanga ina kei waenganui i te 3 me te 6 marama te pakeke o te pēpi. He maha ngā wā ka mahia hei pokanga tuarua, i muri i te pokanga tuatahi o te pēpi hei whakapai ake i te rere o te toto (pēnei i te Blalock-Taussig (BT) shunt) i muri i te whānautanga.
He aha ngā mea ka tupu i mua atu, ā, i te wā o te pokanga?
I mua i te pokanga
I mua i te pokanga, ka whakahaerehia e tō tākuta ētahi whakamātautau hei aromatawai pai ake i te āhua o te manawa o tō pēpi.
- Te Tātā o te Ngākau: Ka mahia tēnei whakamātautau hei ine i te pēhanga me ngā taumata hāora i roto i te ngākau, hei tirotiro hoki i te hanganga o te ngākau.
- MRI o te ngākau: Mā tēnei ka āwhina i te tiki whakaahua taipitopito o te ngākau e toru-ahu ana.
- He mea tino nui kia whakamōhiotia te tākuta mō ngā rongoā katoa (tae atu ki ngā huaora me ngā tāpiringa) e tangohia ana e tāu pēpi .
I te wā o te pokanga
E whā hāora te roa o te whānautanga c-section, engari ka rerekē pea tēnei wā i runga i te āhua o te pēpi.
I te wā o te pokanga, ka hoatu he rongoā whakamoe ki te pēpi, kia kore ai te pēpi e mamae. Kei roto te pēpi i te moe hōhonu. Ka honoa ētahi tamariki ki tētahi mīhini motuhake e tango ana i te mahi a te ngākau me ngā pukahukahu mō te wā poto i te wā o te pokanga. Ka kiia tēnei he mīhini cardiopulmonary bypass . Kātahi, e ai ki te kōrero i mua ake nei, ka mahi te taote pokanga i te hononga anō o ngā oko toto me ētahi atu whakatikatika ngākau mēnā e tika ana.
Ngā painga me ngā mōrearea pea o te pokanga
Pērā i ngā pokanga katoa, he pai, he mōrearea hoki ngā painga me ngā mōrearea o te tikanga Glenn. He mea nui kia mōhio ngā mātua ki ēnei.
| Ngā Painga | Ngā tūponotanga/ngā raruraru pea |
|---|---|
| Kua heke te taumaha o te ruma ngākau anake e mahi ana (te ventricle). | Te hekenga o ngā taumata hāora i roto i te toto. |
| Te ārai i te whakanui o te ngākau nā te nui rawa o te mahi. | Te toto toto tiketike. |
| Ka māmā ake te pokanga Fontan e haere ake nei. | Ngā rerenga wai i roto i te pleural. |
| Kua piki ake te tūponotanga ki te whakaora i te ora o te tamaiti i muri i te pokanga Fontan. | Me whāngai mā roto i te ngongo nā te uaua ki te kai. |
| Hei huarahi kē atu mā ngā tamariki kāore e hiahia, kāore rānei e taea te mahi i te pokanga Fontan. | Me mahi anō he pokanga. |
Ko te mea nui ko te tino teitei o te ora o te tamaiti i muri i te pokanga Glenn. Tata ki te 99% . He pokanga tino angitu tēnei.
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka whakaurua te pēpi ki te wāhanga tiaki nui (ICU). Tērā pea ka mataku koe ina kite koe i ngā ngongo me ngā aroturuki e piri ana ki te tinana o te pēpi. Engari he mea noa tēnā. Ka tino aroturukihia te pēpi e te tīma hauora.
Ka noho te pēpi ki te wāhanga tiaki nui mō te toru rā pea, kātahi ka whakawhitia ki te wāhanga noa. Tērā pea ka roa ētahi wiki ka ora katoa te pēpi, ka hoki ki te kāinga.
He maha ngā tamariki, i muri i ētahi tau torutoru i te tikanga Glenn, ina tīmata rātou ki te hikoi, me mahi i te taahiraa e whai ake nei, he tikanga Fontan , e whakarato ana i tētahi otinga pumau ake mō te pūnaha tohanga toto o te ngākau.
Āhea koe me toro atu ki te tākuta i muri i tō hokinga ki te kāinga?
He mea tino nui kia tiakina pai tō pēpi i muri i tō hokinga ki te kāinga. Ki te kite koe i tētahi o ngā tohu e whai ake nei , waea atu ki tō tākuta tonu atu.
- Mena he kirika te pēpi.
- Mena kei te turuturu te toto, te wai rānei mai i te patunga pokanga.
- Mena he uaua ki a koe te inu miraka.
- Mena he raruraru tōu ki te whakanui i te taumaha.
Me haere tāu tamaiti ki te whare hauora o te tākuta ngakau, me te tango rongoā mō te wā roa. Koinā tetahi wāhanga o tēnei haerenga.
Karere Tangohia ki te Kāinga
- He pokanga tuarua kua whakaritea te Tukanga Glenn e mahia ana ki ngā pēpi he mate manawa whānau uaua tōna.
- Ko te tikanga o tēnei ka tukuna tika te toto rawakore-hāora ki ngā pukahukahu, ka karo i te manawa, ka whakaiti i te taumahatanga o te manawa.
- He tino teitei te angitu o tēnei pokanga (tata ki te 99%). Nō reira kaua e mataku.
- I muri i te pokanga, me tirotiro te tamaiti e te rata mō te wā roa, me te rongoā hoki, nō reira he mea tino nui kia whai i ngā tohutohu a te tākuta.
- Kōrerotia mārire ki tō tākuta mō ō pātai, ō wehi rānei. Kei reira rātou hei āwhina i a koe.
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