Kua kite koe i tētahi wā he kōhao kei waenganui o te uma o ētahi tāngata? Tērā pea kei a koe, kei tāu tamaiti rānei tēnei. Ka tino whakamā, ka tino whakamā hoki ina kakahuria e koe he T-hāte, inā koa ina haere koe ki te puna kaukau. Waihoki, kei te ahua uaua ake tō manawa, ā, ka tere ake tō ngenge ina oma haere koe, ina tākaro? I roto i te rongoā, ka kiia tēnei mate ko Pectus Excavatum . Nō reira, i tēnei rā ka kōrerohia e tātou katoa, he tino māmā noa iho, i roto i tētahi huarahi e mārama ai koe.
He aha te Pectus Excavatum?
He tino māmā noa iho. Ko te wheua papatahi i waenganui o tō tātou uma e kiia ana ko te sternum. Ko te wheua kaha i waenganui o te uma ka taea e koe te rongo ina pā atu koe. I roto i te āhua e kiia nei ko te Pectus Excavatum , kāore tēnei wheua uma e puta ki waho, engari ka tipu kē ki roto i te uma. Ka totohu ki roto i te uma pērā i te kōrere. Koia te take e kiia ai e ētahi he "funnel chest".
Ina totohu te sternum ki roto, ka tōia ngā rara e whā, e rima rānei e piri ana ki roto i ngā taha e rua. Ka whakaitihia te nui o te wāhi i roto i te uma. Ka taea e tēnei te whakawhāiti i te wāhi e taea ai e te ngākau me ngā pukahukahu te mahi noa.
He mate whānau tēnei. Arā, ka whānau mai te tangata me tēnei mate. Heoi, kāore e kitea i te whānautanga. He maha ngā wā, ka kitea nuitia tēnei piko o te uma ina pakeke haere te tamaiti, inā koa i te 12-14 tau te pakeke, i te wā e tere tipu haere ana te tinana.
Mō tōna auau, e pāngia ana te kotahi ki te waru o ngā tamariki i roto i te 1,000. He nui ake hoki te auau o ngā tama i ngā kōtiro.
He aha ngā tohu o tēnei mate?
E rua ngā wāhanga o ngā tohu o te Pectus Excavatum. Ko tētahi ko te mamae tinana, ko tētahi ko te pānga hinengaro. Ka pā nui ēnei ki te oranga o te tangata.
| Momo āhuatanga | Whakamārama me ngā tauira |
|---|---|
| Ngā tohu ā-tinana |
|
| Ngā tohu hinengaro |
|
Ko te mea nui, ki te pēnei tō whakaaro, kaua e huna ki a koe anō. Ehara i te he nāu. He rongoā whai hua anō hoki kei reira mō tēnei.
He aha tēnei e tupu nei? He aha te take?
Kāore anō kia kitea te tino pūtake o te Pectus Excavatum i roto i te tini o te tangata. Ko te tikanga, ka taea noa iho tēnei te puta noa mai, kāore he take.
Heoi, i ētahi wā kua honoa ki ētahi atu āhuatanga hauora, inā koa ngā mate e pā ana ki te kiko honohono o te tinana. Hei tauira:
- Te mate Marfan
- Te mate Ehlers-Danlos
He mate ira ēnei. Nō reira, ki te pāngia koe e tēnei momo mate, kei te tūpono koe ki te pāngia e te Pectus Excavatum.
He mea tēnei nō ngā whakatipuranga?
Kāore anō kia kitea e ngā kairangahau tētahi ira motuhake e puta ai te Pectus Excavatum. Heoi, e whakapae ana rātou he ira tuku iho pea. I waenga i te 40% me te 53% o te hunga whai Pectus Excavatum he mema whānau (pērā i te matua tāne, teina rānei) kei a rātou te mate. Nō reira, ki te pāngia tētahi o tō whānau e tēnei mate, he nui ake te tūponotanga ka pāngia koe.
Me pēhea te tātaritanga a te tākuta i tēnei?
Ehara i te mea uaua te tautuhi i te mate. Ina haere koe ki te tākuta, ka taea e rātou te tautuhi mā te tirotiro tinana noa iho . Ka taea e te tākuta te kite i tēnei rua i te wā e tirotirohia ana e ia tō uma.
Heoi, kia tino mōhio ai koe ki te nui o te pānga o tēnei mate ki tō ngākau me tō pukahukahu, ka tūtohu te tākuta i ētahi atu whakamātautau.
He aha aua whakamātautau?
- Matawai CT uma (Tomography Rorohiko) matawai MRI rānei (Imaging Āhua-Matehiko): Ka taea e ēnei matawai te tango whakaahua toru-ahu o roto o te uma. Kātahi ka taea te ine tika i te nui o te totohu o te sternum me te nui o te pēhanga o te ngākau me ngā pukahukahu.
- Whakamātautau whakakori ngākau me te pūkahukahu: Ko te tikanga me oma koe i runga i te mīhini oma hei tirotiro me pēhea te mahi a tō ngākau me ō pūkahukahu me te whakakori tinana.
- Electrocardiogram (EKG): Mā tēnei ka whakamātautau i te ngohe hiko o te ngākau kia kitea ai mēnā he hapa kei roto i te oro o te ngakau.
- Echocardiogram: He matawai tēnei o te ngākau. Ka āwhina ki te kite i te mahi a te ngākau me te āhua o ngā takirere (pērā i te mitral valve prolapse).
- Ngā Whakamātautau Mahi Pūkahukahu (PFT): Ka ine ēnei i te nui o te hau ka taea e ō pūkahukahu te mimiti me te mimiti, hei whakaatu i te pai o te mahi a ō pūkahukahu.
I muri i te whakahaere i ēnei whakamātautau katoa, ka whakatau te tākuta mēnā me pokanga koe, kāore rānei.
He aha ngā maimoatanga? Kāore e taea te whakaora?
He tino taea! He tino whai hua ngā maimoatanga mō tēnei. E rua ngā tikanga pokanga matua e whakamahia ana. Ka whakamahia ēnei pokanga hei whakahoki i te sternum kua hurihia ki tōna tūranga tika, arā, ki waho.
Mō ēnei pokanga e rua:
- Ka whakaiti i te taumahatanga ki tō ngākau me ō pukahukahu, kia pai ake ai te mahi a aua pukahukahu.
- Ka whakaora i te āhua o tō uma.
Mena kei te pāngia koe e ngā tohu ā-tinana (te uaua ki te manawa, te mamae o te uma), kei te pāngia rānei koe e te pouri nui nā tō āhua, ko te pokanga pea te otinga pai rawa atu.
Ko te tau pai rawa atu mō te mahi i tēnei pokanga ko te 10 ki te 14 tau te pakeke. Nā te mea i taua tau, kei te ngāwari tonu ngā wheua me te kiriuhi o te uma. Nō reira, he ngāwari te mahi i te pokanga, ā, he tino angitu ngā hua.
Nā, kia titiro tātou he aha ēnei tikanga pokanga e rua.
| Tikanga pokanga | Me pēhea te mahi |
|---|---|
| Te tikanga Nuss (Pokanga iti rawa te whakaekenga) | Koinei te tikanga e whakamahia whānuitia ana i te ao i ēnei rā. Kāore he tapahi nui.
|
| Te tikanga Ravitch (Pokanga tuwhera) | He pokanga tuwhera tuku iho tēnei.
|
Ka tirohia koe e tō taote pokanga, ā, ka whakatau ko tēhea pokanga te mea pai mōu.
Kia pēhea te roa o te wā e ora ai i muri i te pokanga? He tino kino te mamae?
He mea tēnei e wehingia ana e te tini tāngata. Engari ko te rongo pai rawa atu , nā ngā tikanga hou mō te whakahaere mamae, ka iti ake te mamae i muri i te pokanga, ā, ka poto ake te wā whakaora.
Ko tētahi o ngā tikanga tino angitu e whakamahia ana i tēnei wā ko te cryoablation .
He whakarāpopototanga noa iho tēnei, arā, ko te whakatio i ngā io e kawe ana i te mamae ki te uma (i waenganui i ngā rara) i mua i te pokanga. He rite ki te whakangāwari i ō kapia i mua i te tangohanga niho. Ko te tikanga, kāore koe e tino mamae mō ētahi rā i muri i te pokanga.
Nā tēnei tikanga:
- Kāore koe e noho ki te hōhipera mō ngā rā e 5-7 pērā i mua. He maha ngā wā ka taea e koe te hoki ki te kāinga i te rā i muri i te pokanga.
- Kāore koe e hiahia ki te whakawhirinaki ki ngā rongoā whakamamae mamae kaha (opioids) mō te mamae pērā i mua.
- I mua, i te wā hararei kura, me mahi tēnei pokanga mō te tamaiti kura nā te mea e tata ana ki te kotahi marama te roa o te whakaora. Engari ināianei ka taea e rātou te hoki ki te kura i roto i ngā wiki e rua, e toru rānei.
Nō reira, kāore he take e wehi ai koe i te pokanga.
Ētahi pātai e pātai pinepinetia ana
Ki te kore au e pokangahia, ka kino haere tēnei āhua i a au e pakeke haere ana?
Kāore te kikī o te uma e kino haere ana i a tātou e pakeke haere ana. Heoi, i te hekenga o te mahi noa o tō tātou tinana i a tātou e pakeke haere ana, ka tīmata pea tātou ki te rongo i ngā tohu (te poto o te manawa, te ngenge) i puta mai i te taumahatanga o tō tātou ngākau me ō tātou pukahukahu.
Ka whakapotohia rānei te roa o tōku oranga mēnā kāore au e pokangahia? Ka pāngia tonutia rānei tōku ngākau me ōku pukahukahu?
Kāo. Kāore he taunakitanga e whakaatu ana ka whakapotohia e te Pectus Excavatum te roanga o te oranga o te tangata, ka pā kino rānei ki te ngākau, ki ngā pukahukahu rānei i roto i te wā. Heoi, ki te kore e rongoatia, ka uaua haere te noho tahi me ēnei tohu.
Kāore he ara hei ārai i tēnei?
Nā te mea kāore i te mōhiotia te tino take o tēnei, kāore he huarahi hei ārai i tōna puta.
Āhea ahau ka taea ai te hoki ki ngā mahi o ia rā i muri i te pokanga?
Me okioki koe mō tētahi wā i muri i te pokanga. Kia mutu te mamae, ka taea e koe te tīmata te hikoi me te oma. Heoi, mā tō taote pokanga e whakatau āhea koe ka taea te tīmata anō ki te hiki taumaha me te tākaro hākinakina. I te nuinga o te wā, ka taea e te tamaiti kura te hoki ki te kura i roto i ngā wiki e 2-3.
Ko te mea nui kia kaua e pouri mō te āhua o tō tinana. Ki te kī mai tētahi he take āhua noa iho, kaua e whakaae. He pono te mamae tinana me te mamae kare ā-roto e pā ana ki a koe. Nō reira, kōrerotia ki te tākuta kia mārama, kia whiwhi ai i te āwhina e hiahiatia ana e koe.
Karere Tangohia ki te Kāinga
- Ko te Pectus Excavatum he āhuatanga e totohu ai te wheua waenga o te uma (sternum) ki roto. He āhuatanga whānau mai tēnei.
- Ka puta pea ngā tohu ā-tinana pēnei i te poto o te manawa me te ngenge, tae atu ki te whakama me te ahotea hinengaro e pā ana ki te āhua.
- Ka taea e te tākuta te tautuhi i tēnei mā te tirotiro māmā noa iho. Ka taea te whakaū anō i te āhua mā te whakamahi i ngā whakamātautau pēnei i te matawai CT, MRI rānei.
- Ka taea te whakatika i tēnei āhuatanga mā te pokanga (te tikanga Nuss, Ravitch rānei).
- Nā ngā tikanga hou mō te whakahaere mamae (pēnei i te Cryoablation), kua iti ake te mamae o te pokanga, ā, kua poto ake te wā whakaora.
- Ki te pāngia koe, tāu tamaiti rānei e tēnei mate, kaua e wehi, kaua hoki e whakama. Tirohia he tākuta whai tohu mō ētahi tohutohu.
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