Me tino mataku koe i te wā i kī mai ai te tākuta kei te kōwhai te tinana o tāu tamaiti, ā, ko te take he aukati i ngā awaawa o te ate, he mate e kiia nei ko te Biliary Atresia. Ināianei kei te kōrero pea te tākuta mō tētahi pokanga e kiia nei ko 'Kasai'. He aha rawa tēnei pokanga? He pai mō te pēpi? Me maha āu pātai kei roto i tōu mahunga. Kaua e manukanuka. Me kōrero noa iho, kia mārama ai koe.
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He aha te Tukanga Kasai?
He whakarāpopototanga noa iho tēnei, he pokanga motuhake tēnei e mahia ana hei rongoā i tētahi mate e kiia nei ko te Biliary Atresia . Ka puta he wai i roto i tō tātou ate e kiia nei ko te 'bile'. Ko tēnei au te mea e āwhina ana i te tinana ki te nakunaku i ngā ngako me ētahi huaora i roto i te kai e kainga ana e tātou, me te mimiti i aua mea. I roto i tētahi pēpi e pāngia ana e te Biliary Atresia, ka āraia, kāore rānei i hangaia ngā ngongo angiangi (ngā awa au) e kawe ana i te au mai i te ate ki ngā whekau i te whānautanga.
Nō reira, i roto i tēnei tikanga Kasai, ka tangohia e te taote pokanga ēnei awaawa pūwero kua āraia, kua kore e mahi tika. Kātahi ka tangohia e rātou tētahi wāhanga o te whekau iti o te pēpi ka hono tika atu ki te ate, ka hangaia he ara hou mō te rere o te awaawa. He rite ki te tango i tētahi paipa pūwero e aukati ana i te rere o te wai, ka tāutahia he paipa hou.
He aha i hiahiatia ai tēnei pokanga mō te pēpi?
Whakaarohia, he aha te mea ka tupu ina kore he ara e puta ai te au e puta mai ana i te ate? Ka kohia katoatia taua au ki roto i te ate. Ka tīmata mārire te kino o ngā pūtau ate i tēnei au kua kohia. I roto i te wā, ka whara te ate, ka whakapakeke, ā, kāore e taea te mahi. Ka kiia tēnei he cirrhosis .
Ki te kore e rongoatia, ka taea e te atresia biliary te arahi ki te ngoikore katoa o te ate i roto i ētahi marama. He mea morearea tēnei ki te ora.
Mā tēnei pokanga Kasai ka aukati, ka whakaroa rānei i te kino o te ate. He nui te tūponotanga ka ora te pēpi.
He aha ngā mea ka tupu i mua atu, ā, i te wā o te pokanga?
I mua i te pokanga, ka hoatu e ngā tākuta he wai IV ki te pēpi kia mau ai tōna makuku, ā, ka hoatu hoki he paturopi hei whakaiti i te tūponotanga o te mate.
I mua i te tīmatanga o te pokanga, me tino mōhio te taote pokanga kei te pāngia te pēpi e te Biliary Atresia. Ko te tikanga o tēnei he whakamātautau e kīia nei ko te 'Cholangiogram' . I roto i tēnei, ka tapahia he puku iti ki te puku o te pēpi, ka whakaurua he ngongo iti ki roto i te pūkahukahu, ā, ka werohia he rongoā motuhake ka kitea i runga i te hihi-X. Mā tēnei ka taea e te tākuta te kite mārama mēnā kua āraia te awaawa o te pūkahukahu, kāore rānei.
Mena ka whakaūtia te atresia biliary, ka haere tonu te tākuta ki te pokanga. Ka tangohia te pūkahukahu o te pēpi me ngā awaawa biliary kua āraia, ā, ka hangaia he hononga hou ki te ate mā te whakamahi i tētahi wāhanga o te whekau iti (jejunum). Ka roa pea tēnei pokanga mō ētahi hāora.
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka puritia te pēpi ki te wāhanga tiaki nui (ICU) mō te 5 ki te 10 ngā rā, ā, ka tiakina pai.
- Kai: Kāore e hoatu he kai mō ngā rā tuatahi, kia ora ai ngā patunga. Ka hoatu te kai e tika ana mā te tote. Whai muri i tēnā, ka tīmata te whāngai i te waiū mā te ngongo nasogastric. Mā te āta haere, ka whāngaihia te tamaiti ki te waha.
- Te Tirotiro: Kei te tirotirohia te pēpi e ngā tākuta me ngā nēhi kia kite mēnā kei te toto, kei te tukuna rānei te au. Ka huri te paru o te pēpi ki te kōwhai, ki te kakariki rānei, hei tohu kua tīmata te rere o te au.
- Te hoki ki te kāinga: Ka whakaaetia koe kia hoki ki te kāinga ina tīmata te ora o ngā patunga, ina pai ake te mahi a te ate, ā, ka taea e te pēpi te whāngai ū pai.
He pēhea te angitu o te mahi a Kasai?
He pātai tino nui tēnei. Ko te angitu o te pokanga e whakawhirinaki ana ki ētahi āhuatanga:
- Te Wā: He nui ake te tūponotanga ka angitu tēnei pokanga mēnā kei waenga i te 6 wiki me te 2 marama te pakeke o te pēpi . Nō reira, he mea tino nui kia toro atu koe ki te tākuta ina kite koe i ngā tohu.
- Te āhua o te ate: Mena he iti noa te kino o te ate i te wā o te pokanga, he pai ngā hua.
- Tīma hauora: He mea tino nui hoki kia whakahaerehia te pokanga e te taote pokanga mohio me te tīma hauora e whai wheako ana ki ēnei pokanga.
I raro i ngā āhuatanga tino pai, ka taea e tēnei pokanga te whakaiti i ngā tohu, tae atu ki te jaundice, i roto i te neke atu i te 60% o ngā pēpi. E whakaaro ana ngā tākuta he angitu te pokanga mēnā kāore te pēpi e pāngia anō e te jaundice i roto i ngā marama e 6 o te pokanga.
A, mehemea kāore i angitu te pokanga?
I ētahi wā, ahakoa i muri i te pokanga Kasai, kāore pea ngā awaawa o te ate e rere tika. Mēnā ka tupu tēnā, me whai whakawhitinga ate te pēpi. Kaua e mataku ki tēnei. Inaa, tata ki te haurua o ngā pēpi e pokanga Kasai ana me whai whakawhitinga ate i te wā e rua tau te pakeke. He piriti te pokanga Kasai hei hoko wā kia hiahiatia rā anō he whakawhitinga ate.
Me pēhea te tiaki i tāu pēpi i muri i tana kawe mai i a ia ki te kāinga?
E toru, e whā rānei ngā marama ka ora pai ai te pēpi. Me tino tupato koe ki ēnei mea ina tiaki ana koe i te pēpi i te kāinga.
- Hoatu te rongoā kia tika:Tangohia ō rongoā kia rite ki tā te tākuta i tohutohu ai, i te wā tika. Tērā pea me hoatu he paturopi ā-waha hei ārai i ngā mate mō ētahi marama. Tērā pea me hoatu he rongoā hei whakapai ake i te rere o te aukume mō ngā tau.
- Tiakina te patunga: Pātai atu ki tō tākuta, ki tō nēhi rānei, mō ngā tohutohu motuhake mō te horoi i te patunga me ngā takai hei whakamahi.
- Kaua e mahue te whare hauora: Kia mahara ki te haere ki te whare hauora i ngā rā kua whakaritea i muri i te pokanga. He mea tino nui kia whakamōhiotia tonutia te tākuta mō te tukanga whakaora o te pēpi.
- He mea tino nui te whāngai ū: Ki te taea, whāngaihia tō pēpi ki te ū. Ka ngawari te mimiti o ngā ngako i roto i te waiū ū e te ate. Ki te kore e taea te whāngai ū, whakamahia he miraka motuhake kua tūtohutia e tō tākuta.
- Kia ma: Horoia ō ringaringa i ngā wā katoa i mua i te pā atu ki tāu pēpi. Āta tirohia mēnā he makariri, he kirika rānei tō tetahi o te whānau.
| Ngā tohu mōrearea me whakamōhio tonu ki te tākuta | |
|---|---|
| Tohu Whakatūpato | Whakaahuatanga |
| Kirika | He kirika o te 38 Celsius (100.4 Fahrenheit) neke atu rānei. He tohu pea tēnei nō te mate pāwera. |
| Te whakakore i te kai | Mena ka tino whakakahore te pēpi ki te inu miraka. |
| Ngā huringa o te patunga | Ka pupuhi te patunga pokanga, ka whero, ka puta rānei he wai/pū. |
| Mamae puku | Te tangi i te mamae, te pupuhi rānei ina pāngia te puku o te pēpi. |
| Te hokinga mai o te jaundice | Ka huri anō te mā o ngā kanohi, o te kiri rānei o te pēpi ki te kōwhai, ka nui haere rānei te kōwhai. |
| Tae tūru | Ko te tūtae he parauri, he uku rānei te tae, he tohu kua mutu te rere o te au. |
| Te toto | He toto i roto i te tūtae, he ruaki rānei. |
| Ki te kite koe i tētahi o ēnei tohu, whakamōhio atu ki tō tākuta tonu atu, kawe rānei i tō pēpi ki te Tari Ohotata (ETU) o te hōhipera tata. | |
E mārama ana ahau ki tō ohorere, ki tō pouri, me tō mataku ina mōhio koe me pāngia tō pēpi e tēnei āhuatanga. Ina tere rawa te puta o ngā mea katoa, me tino hiahia koe ki te āwhina. Inoi atu ki tō whānau, ki ō hoa, me ō whanaunga. Kia maumahara, ehara i te mea ko koe anake i tēnei haerenga. Whakaarohia hoki koe i tēnei haerenga. Kia tumanako, kia mōhio tonu, me te rapu tautoko mai i te hunga e karapoti ana i a koe.
Karere Tangohia ki te Kāinga
- Ko te tikanga Kasai te tikanga pokanga matua mō te atresia biliary, he mate ate e pā ana ki ngā pēpi.
- Ko te tikanga o tēnei ko te tango i te awaawa aukume kua āraia, me te whakamahi i tētahi wāhanga o te whekau hei waihanga i tētahi ara hou mō te rere o te aukume.
- Ko te wawe o te mahi pokanga (i mua i te rua marama te pakeke o te pēpi), ka nui ake te tūponotanga ka angitu.
- He mea tino nui te tiaki i tāu pēpi i te kāinga i muri i te pokanga. Me whai i ngā tohutohu a te tākuta.
- Ki te kore e angitu te pokanga, tera pea e hiahiatia he whakawhitinga ate, he wāhanga hoki tēnei o te tukanga maimoatanga mō tēnei mate.
- Ki te kite koe i ētahi tohu kino pēnei i te kirika, te kore kai, te puta anō o te waikura whero, te mā rānei o ngā tūtae, me whakamōhio tonu atu ki tō tākuta.
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