He maha ngā wā ka mamae te puku o tāu tamaiti, ka ruaki ruaki kōwhai-kakariki? Tērā pea i kī te tākuta he raruraru whānau tō te pēpi ki ōna whekau, arā, kāore i te tika te tūnga o ngā whekau? Koinei te mea e kīia ana e tātou i roto i te rongoā he `(Malrotation)`. Tērā pea i kī te tākuta me mahi ia i te tikanga `Ladd' hei rongoā mō tēnei. Nō reira, he mea noa kia nui te wehi me te manukanuka. Nō reira, i tēnei rā ka kōrerohia e tātou ngā mea katoa i roto i te mārama, i te ngāwari, i roto hoki i te huarahi e mārama ai koe.
He aha te Tukanga Ladd?
Ki te kī ngāwari, ina kore ngā whekau e tū tika i roto i te puku i te wā e noho ana te pēpi i roto i te kōpū, ka kiia tēnei he `(Malrotation)`. He mate whānau mai tēnei.
Ko te mea tino mōrearea mō tēnei, ko ētahi wā ka takahuri ngā whekau e kore e tū tika ana i tēnei ara. Whakaarohia he rite ki te pupuri i tētahi paipa wai i ngā taha e rua, ka takahurihia. Ka kiia tēnei he volvulus . Ina tupu tēnei, ka taea te motu katoa te rere o te toto ki ngā whekau, ā, ka mate pea aua wāhanga (necrosis). He āhuatanga tino ohorere tēnei.
Hei tāpiritanga, ka taea e ngā here kiko rerekē e kiia nei ko ngā "here a Ladd" te hanga me te aukati i te wāhanga tuatahi o te whekau (duodenum). Ka taea e tēnei te kore e taea e te pēpi te nakunaku i te kai, ā, ka ruaki pinepine.
Nā reira, ko te mahi a tēnei pokanga LAD he whakatikatika i ēnei whekau piko, ka tapahia aua rīpene kiko e ārai ana, kātahi ka whakanoho i ngā whekau ki te wāhi tika, haumaru hoki i roto i te puku.
E mārama ana ahau ki te manukanuka e pā ana ki a koe ina rongo koe mō te pokanga mō tāu pēpi. Engari koinei anake te maimoatanga pai rawa atu mō te `(Malrotation)`. E kore tō rōpū hauora e waiho i a koe me tāu pēpi ko koe anake i tēnei haerenga, mā rātou e whakamārama ngā mea katoa.
Me pēhea te whakarite i te pēpi mō te pokanga?
He maha ngā wā ka mahia tēnei pokanga ki ngā pēpi kei raro iho i te kotahi tau te pakeke. Nō reira, kāore rātou e mārama ki ngā mea e tupu ana. Koia te take he mea nui tō aroha me tō manaaki hei mātua ki tāu pēpi i tēnei wā. He iti noa ngā mea ka taea e koe te mahi.
- Whakarite mō te noho hōhipera: Me noho koe ki te hōhipera mō ētahi rā, e rua wiki pea, i muri i te pokanga. Ngāna kia tata tonu ki tō pēpi i ngā wā katoa e taea ana. Ko tō reo, ko tō pā whakamarie he puna nui o te whakamarie ki tō pēpi. Ina hiahia koe ki te okioki, tonoa he mema o te whānau e mōhio pai ana ki tō pēpi kia noho ki a koe.
- Kia whakamarie tō pēpi: Mauria mai tētahi mea e pai ana ki tō pēpi, pērā i tētahi taonga takaro, i tētahi paraikete iti rānei. Mā te mau i tēnei mea i mua atu, i muri mai hoki i te pokanga ka āwhina i tō pēpi kia noho whakamarie.
- Pātai atu mō te kai me te inu: Me mutu pea te whāngai ū me te whāngai i tāu pēpi i ētahi haora i mua i te pokanga. Tērā pea ka rerekē tēnei mō ia pēpi, nō reira kōrero ki tō taote pokanga mō tēnei.
Me pēhea te mahi i te pokanga?
I te nuinga o te wā, ka mahia tēnei pokanga mā te laparoscopy. Arā, ko tā mātou e kī nei ko te pokanga 'keyhole', he mea mahi mā te kāmera. I roto i tēnei, he torutoru noa ngā tapahi iti ka mahia ki te puku. He onge pea te mahi pokanga tuwhera e kīia nei ko te 'laparotomy', i runga i te āhuatanga. Mā te taote pokanga e whakatau ko tēhea te tikanga pai mō tō pēpi.
| Ngā mea ka tupu i mua me te wā o te pokanga | |
|---|---|
| Te whakarite i mua i te pokanga | |
| Ngongo ihu (ngongo NG) | Ka whakaurua he ngongo iti mā te ihu ki roto i te puku hei tango i ngā mea o roto i te puku o te pēpi. |
| Te tuku tote ki te ringa (raina IV) | Ka whakatakotoria he wai tote ki roto i tētahi uaua i te ringa. Koinei te wāhi e hoatu ai ngā wai e tika ana, ngā rongoā whakamamae, me ngā rongoā hei ārai i te mate. |
| Whakamamae Whānui | Ka whakamoea rawatia te pēpi, kia kore ai he mamae i te wā e pokangahia ana. |
| I te wā o te pokanga | |
| Te hanga i ngā tapahi iti | Mō te tikanga laparoscopy, e 3, e 4 rānei ngā tapahi iti, 3-5 mm te whānui, ka mahia ki te puku. |
| Te whakatikatika i te puku | Ka totoro marietia te whekau piko, ā, ka tapahia, ka tangohia te kiko e ārai ana i ngā "here a Ladd". |
| Te tango i te tāpiritanga | Ina nekehia ngā whekau, ka hē te wāhi o te apeni. Nā te mea ka raru pea ā muri ake nei, ka tangohia hoki i te wā o tēnei pokanga. Kāore e pā kino ki te pēpi. |
| Te nekenekehanga o te puku | Mena he pai te rere o te toto ki te whekau, ka whakanohoia haumaru ki te taha maui o te puku. |
I ētahi wā, ki te whakapaetia kua motuhia te rere o te toto nā te piko o ngā whekau me te kino o ngā whekau, me mahi anō tētahi atu pokanga i roto i ngā haora 24-48 i muri i te pokanga tuatahi hei whakaū i te hauora o ngā whekau.
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka haria te pēpi ki te rūma whakaora, ka aroturukihia e ngā tākuta me ngā nēhi te tere o te manawa me te manawa o te pēpi. Ka hoatu he wai me te kai mā te tote (IV) kia tīmata anō te mahi a ngā whekau o te pēpi (arā, te whakaputa hau me te tūtae ).
Kia tīmata te mahi a ngā whekau, ka taea e te pēpi te tīmata anō ki te inu waiū me te kai kai i roto i ngā rā e rua, e toru rānei.
He aha ngā painga me ngā mōrearea o tēnei pokanga?
Ko te painga matua ko te whakaora katoa i te mate "Malrotation". Heoi, pērā i ngā pokanga katoa, he iti noa iho ngā mōrearea.
| Ngā Painga | Ngā Tūponotanga/Ngā Raruraru |
|---|---|
| Ka ngaro ngā tohu pēnei i te mamae o te puku me te ruaki. | Te mate urutā i te wāhi i pokangahia. |
| Kua whakakorea te mōrearea kino o te piko o te whekau (volvulus). | Ko te ileus paralitika he aukati wā poto o te mahi a te whekau. |
| Ka taea e te pēpi te inu waiū, me te kai noa. | Te mate puku poto (mēnā ka tangohia tetahi wāhanga o te whekau). |
| Kei te tipu me te whanaketanga noa te pēpi. | He onge noa iho, ka pūkohu tonu ngā whekau (Volvulus). |
Āhea ahau me waea atu ki te tākuta?
I muri i tō kawe mai i tō pēpi ki te kāinga mai i te pokanga, waea atu ki tō taote pokanga, ki te hōhipera rānei mēnā ka kite koe i tētahi o ēnei tohu. Tērā pea he tohu mate pāwera ēnei:
- Kirika: Mena he teitei ake te pāmahana o te pūkahukahu i te 100.4°F (38°C).
- Te turuturu o te pūhā mai i te patunga: Mena he wai matotoru, he mā, he kirīmi rānei te tae e puta mai ana i te patunga.
- Te whakatuwhera i te patunga: Mena kua tuwhera te patunga, ā, kua wetekina ngā tuitui, ka kitea te hōhonutanga.
- Te whero huri noa i te patunga: Mena he whero te kiri huri noa i te patunga, ā, kei te horapa te whero.
Waihoki, ki te mamae anō te puku o te pēpi, ā, ka ruaki kakariki, ko te tikanga tērā pea kei te puta anō ngā tohu. Ki te tupu tēnā, me waea atu ki te tākuta tonu tonu.
Karere Tangohia ki te Kāinga
- Ko te Tukanga Ladd anake te maimoatanga tino angitu mō te malrotation, he hapa whānau o ngā whekau.
- Ka taea e tēnei te ārai i te āhua morearea o te "Volvulus", te wāhi e miro ai ngā whekau, e ngaro ai hoki te rere o te toto.
- Ki te mea he āwangawanga, he wehi rānei ōu mō te pokanga, kōrero noa ki tō tākuta. Mā rātou e whakamārama ngā mea katoa ki a koe.
- Ki te puta mai ngā tohu o te mate (kirika, pupuhi mai i te patunga) ka hoki mai rānei ngā tohu (ruaki, mamae puku) i muri i te pokanga, rapua tonutia he tohutohu hauora.
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