Kei te pāngia tō tamaiti e tēnei mate manawa? Me ako tātou mō te Pulmonary Artery Stenosis!

Ka pāngia tō tamaiti e te poto o te manawa i ētahi wā? Kāore rānei ia e ngenge wawe ahakoa kua takaro mō tētahi wā? Ka pāngia ētahi tamariki nohinohi e ngā mate manawa whānau. I tēnei rā ka kōrero tātou mō tētahi o aua mate manawa, he onge noa iho, engari he mea nui kia mōhiotia. Ka karangatia tēnei e tātou ko te '(Pulmonary Artery Stenosis)'. He kupu ngāwari, he aukati i te uaua matua e kawe ana i te toto ki ngā pukahukahu.

He aha te Stenosis o te Arorangi Pūkahukahu?

Hei whakarāpopototanga, he oko toto nui kei reira e kawe ana i te toto mai i te taha matau o tō tātou ngākau (e kiia nei e tātou ko te "ventricular matau") ki ngā pūkahukahu. Ka kiia tēnei ko te "pūkahukahu pūkahukahu". Ina tae atu ki ngā pūkahukahu, ka whakakiia tēnei toto ki te hāora, kātahi ka haria taua toto kua whakakiia ki te hāora puta noa i te tinana.

I tēnei wā, i roto i tēnei āhuatanga e kiia nei ko te `(Pulmonary Artery Stenosis)`, ka āraia, ka whaiti rānei te oko toto e kawe ana i te toto ki ngā pūkahukahu i tētahi wāhi, i tētahi rānei o ōna manga. He rite ki te paipa wai e āraia ana i waenganui. Ka ahatia? Ka uaua te rere o te toto ki ngā pūkahukahu. Ki te kore e rere tika te toto, kāore te tinana e whiwhi i te nui o te hāora e hiahiatia ana. Nā tēnei, kāore e taea e te ngākau o te tamaiti me te tinana katoa te mahi tika.

Ka puta pea tēnei aukati i roto i te uaua pūkahukahu matua (`(main pulmonary artery)`), i roto rānei i ōna peka maui, matau rānei (`(left, right branches)`). Ina puta tēnei aukati, me kaha te mahi a te taha matau o te ngākau (`(right ventricle)`) ki te pupuhi toto i tua atu i te aukati. He rite ki te whakamahi i te kaha nui ki te pana i te wai mā roto i tētahi paipa kua aukatia. I roto i te wā, ka taea e tēnei mahi tonu te kino i te uaua o te ngākau.

He aha ngā raruraru ka puta mai i tēnei āhuatanga?

Ki te kore tēnei e rongoatia tika, ka roa te wā ka kore e mahi tika te taha matau o te ngākau. Arā, tera pea ka pāngia e te mate e kiia nei ko te "ngoikore o te ngākau taha matau". Nō reira, he mea tino nui kia tiakina tēnei.

Ko wai te mea tino pāngia e tēnei āhuatanga?

He tino onge tēnei āhuatanga e kiia nei ko te `(Pulmonary Artery Stenosis)`. Arā, kāore e pā ki te katoa. Ka pāngia ētahi tamariki e tēnei mate me ētahi atu mate ngākau (`(congenital heart disease)` - arā, ngā mate ngākau e kitea ana i te whānautanga). I ētahi wā, koinei anake te mate kāore he raruraru ngākau. Waihoki, ka pā mai pea tēnei āhuatanga i muri i ētahi pokanga ngākau.

He aha ngā tohu o tēnei? Tirohia mēnā kei tō tamaiti ēnei tohu anō hoki.

Ka whakawhirinaki ēnei tohu ki te whaiti o te ngongo. I ētahi wā, ki te tino ngawari te stenosis ('mild stenosis'), kāore pea he tohu . Engari i te kino haere o te stenosis, ka puta pea ngā mea pēnei i tāu tamaiti:

• Te āhua uaua ki te manawa (`(Te poto o te manawa)`).
• Te ngenge tonu (`(Te ngenge)`).
• Me te mea kei te tere rawa tō manawa , kei te haruru nui rānei tō manawa.He pēnei te āhua? (`(Manawa taumaha, manawa tere rānei)`).
• Kei te tere rawa te pao o tō manawa ? (Te tere o te pao o tō manawa).
• He pupuhi kei roto i ō waewae, i ō pona waewae, i tō mata, i ō kamo, i tō puku rānei? (`(Pupuhi)`).
• Ka pōuri koe , ka ngaro rānei tō hinengaro i ētahi wā? (`(Pōuri, ngaro rānei tō hinengaro)`).
• Ka kikorangi ō ngutu, ō maihao, me ō matimati ? Koinei te mea e kiia nei e te rongoā he "Cyanosis".
• Ka tere tō ngenge i a koe e tākaro ana me ētahi atu tamariki? Kāore e taea e koe te oma me te pekepeke pērā i ētahi atu tamariki? (`(He iti te manawanui ki te whakakori tinana)`).

Kia maumahara, ahakoa kotahi, e rua rānei o ēnei tohu, ehara i te mea kei a koe te mate. Engari, ki te pāngia tō tamaiti e tētahi o ēnei tohu, he pai ake te rapu tohutohu hauora.

He aha i āraia ai tēnei uaua pūkahukahu? He aha ngā take?

Ka whānau mai ētahi tamariki me tēnei mate (Pulmonary Artery Stenosis), ā, ka pāngia pea hoki e ngā raruraru ki ngā takirere, ki ngā pakitara, ki ētahi atu wāhanga rānei o te ngākau. Tērā pea ka whānau mai ētahi me tēnei mate engari kāore he atu raruraru ngākau. Hei tāpiri, ka puta pea tēnei mate i muri i te pokanga ngākau, i ētahi atu mate rānei, he tino onge.

Ngā take whānautanga

I te katoa, tata ki te 40% o ngā tāngata ka whānau mai me tēnei mate (Pulmonary Artery Stenosis), engari kāore he raruraru manawa kē atu.

Heoi, i waenga i te 2% me te 3% o te hunga whai mate ngākau whānau ka pāngia pea e tēnei mate (Pulmonary Artery Stenosis). Anei ētahi o ngā mate ngākau e tino kitea ana:

• (Tetralogy of Fallot): I tēnei, e whā ngā raruraru o te ngākau o te tamaiti, e whakararuraru ana i te rere o te toto.
• (Atresia pūkahukahu): I tēnei, kāore te takirere (takirere pūkahukahu) i waenganui i te ventricle matau o te ngākau me te uaua pūkahukahu (uaua pūkahukahu) e hanga. Nō reira, kāore te toto e rere ki ngā pūkahukahu.
• (Truncus arteriosus): He oko toto nui kotahi, kaua ki ngā oko toto e rua noa. Mā tēnei ka konatunatua te toto whai hāora ki te toto kore hāora.
• Te whakatōtōtanga o te takirere aorta: He raruraru kei te takirere i roto i te uaua matua e kawe ana i te toto mai i te ngākau ki te tinana, ka whakaiti i te nui o te toto e rere ana ki te tinana.
• Te hapa o te septal atrial: He kōhao kei te pakitara i waenganui i ngā rūma o runga e rua o te ngākau (te atria). Mā tēnei ka taea te whakaranu i te toto whai hāora me te toto kore hāora.
• Te hapa o te septal ventricular: He kōhao kei te pakitara e wehe ana i ngā rūma o raro e rua (ventricles) o te ngākau. Ka nui rawa te toto e turuturu ana ki roto i ngā pukahukahu.
• (Te whakawhiti o ngā oko toto nui): Ka hurihia ngā oko toto matua e rua e kawe ana i te toto mai i te ngākau. Ka whakararuraru tēnei i te rere noa o te toto, ā, ka whakawhāiti i te nui o te hāora e tae atu ana ki ngā pūtau o te tinana.
• (Te arai toto o te pūnaha ārai mate):He hononga tēnei i waenganui i te uaua pūkahukahu o te pēpi me te uaua matua e kawe ana i te toto ki te tinana (te aorta). Me kati tēnei i muri i te whānautanga, engari ki te kore, ka nui rawa te toto ka rere ki ngā pukahukahu.

Ētahi atu take

Haunga tēnei, tera pea ētahi atu take:

• Te mate rubella: Ki te pāngia koe e te rubella i te wā e hapu ana, tera pea ka pāngia tō pēpi e te mate manawa me ētahi atu mate hauora.
• (Te mate Williams): Ka puta he maha ngā āhuatanga rerekē i roto i te ngākau o te tamaiti me ētahi atu okana.
• (Alagille syndrome): Ka puta ngā raruraru ate me ngā mate manawa i tēnei.
• Te mate pūkahukahu o Takayasu: He mumura tēnei e kino ai ngā oko toto nui.
• Ko ētahi raruraru e pā ana ki te pana ki waho o te uaua pūkahukahu o te tamaiti.

Ngā take pokanga

Tērā pea ka pāngia ētahi tāngata e tēnei mate i muri i te pokanga. Hei tauira:

• He whakawhitinga pukahukahu.
• He pokanga hei whakatika i tētahi hapa ngākau whānau i roto i tētahi tamaiti, hei whakapai ake rānei i te rere o te toto i roto i te ngākau.
• He pokanga e kiia nei ko te "Pulmonary artery ribbing". I roto i tēnei, ka āta whakawhāitihia te uaua kia iti ai te nui o te toto e rere ana ki ngā pukahukahu.

Me pēhea te tautuhi i tēnei mate?

Ina tirohia tāu tamaiti e te tākuta, tera pea ka rongo rātou i tētahi tangi o te ngākau rerekē (he "murmur"). Mena koinā, ka tonoa e rātou ētahi atu whakamātautau. Ko ētahi o ēnei ko:

• Irahiko-karukaru - ECG, EKG rānei: Ka tuhia e tēnei ngā huringa hiko e puta ana ina pā te manawa. Ka taea e ia te kite i ngā pā o te manawa kāore i te tika (arrhythmias) me te ahotea ki te uaua o te manawa.
• He hihi-X o te uma: Ka taea e tēnei te whakaatu i te rahi me te āhua o te ngākau, ngā pukahukahu, me ngā uaua pūkahukahu.
• Echocardiogram: He rite tēnei ki tētahi pikitia neke o te ngākau. Ka whakamahia ngā ngaru oro hei tirotiro i te uaua o te ngākau me ngā takirere.
• Whakaahua aukume o te ngākau (MRI): He tikanga whakaahua toru-ahu (3D) tēnei e taea ai te kite i te rere o te toto i roto i te ngākau me ngā uaua toto o tāu tamaiti.
• (Matawai CT): He whakamātautau `(X-ray)` anō hoki tēnei. Ka whakamahia e te rorohiko he raupapa whakaahua `(X-ray)` o te ngākau o te tamaiti hei hanga tirohanga whakawhiti-wāhanga. Ka werohia he tae motuhake (`(IV contrast)`) ki roto i te ngākau hei tirotiro i te hanganga me te rere o te toto o te ngākau.
• Te whakaurunga o te catheter ki te ngākau: I tēnei tikanga, ka whakauruhia he ngongo angiangi (catheter) ki roto i te uaua, i te uaua rānei, ka arahina ki roto i te ngākau. Mā tēnei ka taea e te tākuta te aroturuki i ngā taumata hāora, ngā huringa pēhanga, me te tango i ngā hihi-X o te ngākau.
• Angiography pūkahukahu: Ka tangohia he hihi-X o ngā uaua pūkahukahu me ngā uaua o te ngākau mā te whakamahi i tētahi tae.
• (Matawai toto): I roto i tēnei, ka werohia he iti noa o te rauemi irahiko. Kātahi ka whakamahia he mīhini motuhake hei tirotiro i te pai o te rere o te toto ki ia pukahukahu.

Ki te whakatau tō tākuta kei te pāngia tō tamaiti e te Pulmonary Artery Stenosis, ka tukuna koe e rātou ki tētahi tohunga ngākau whānau. Kei tēnei momo tākuta ngā pūkenga me ngā whakangungu hei tātaritanga tika i te raruraru ngākau o tō tamaiti, hei whakahaere i ngā whakamātautau e tika ana, hei whakarato maimoatanga hauora, hei mahi pokanga ngākau, me te whakarato tirotiro whai muri . Tērā pea ka mahia e rātou ētahi atu whakamātautau mēnā e tika ana.

Ina kōrero koe mō tēnei āhuatanga, ka kī pea tō tākuta he Momo I, II, III, IV rānei. He whakarōpūtanga tēnei i runga i ngā wāhanga o te uaua kua āraia me te nui.

He aha ngā maimoatanga mō tēnei? (Maimoatanga)

Ko te maimoatanga pai rawa atu ka whakawhirinaki ki ngā tohumate o tāu tamaiti me ētahi atu āhuatanga. Mena he paku whakawhāiti ki te paku whakawhāiti o tētahi, neke atu rānei o ngā peka o te uaua pūkahukahu, kāore pea e hiahiatia he maimoatanga. Heoi, ki te tino kino te whakawhāiti, me rongoā .

Ko ngā maimoatanga mō te `(Pulmonary Artery Stenosis)` ko:

Te whakanui i te poihau / te angioplasty

I roto i tēnei, ka mahi te tākuta:

• Ka whakauruhia he catheter rite ki te poihau (he catheter whakawhanui poihau) ki roto i te paipa kua purua.
• Kātahi ka pupuhihia te poihau mai i te pēhanga iti ki te pēhanga teitei, me te tino āta tupato.
• Kātahi ka whānui haere te paipa kua purua.
• Kātahi ka tangohia te hau mai i te poihau ka tangohia ki waho.

Te whakanui i te poihau me te whakatakotoranga stent (he mea mahi pinepine tēnei)

I roto i tēnei, ka mahi te tākuta:

• Ka whakamahia he stent ka taea te whakawhanui i te poihau (he ngongo mata iti te stent) hei whakatuwhera i te uaua kua purua.
• Ka whakatakotoria tēnei stent ki runga i tētahi catheter angioplasty poihau, ā, ka hipokina ki tētahi hipoki.
• Kei te nekehia te stent ki te wāhi tika.
• Ka tangohia te taupoki o te poihau stent.
• Kātahi ka pupuhihia te poihau ki te pēhanga tika, ka whakawhanuitia te stent, ā, ka noho piri tonu ki reira.

He poihau motuhake e kiia nei ko ``(The Cutting Balloon™)``

He rite tonu tēnei poihau ki tētahi poihau noa. Heoi, he maha ngā mata iti kei tōna roanga. Ina pupuhihia te poihau e te tākuta, ka whakahohehia ēnei mata, ka tapahia te wāhi kua āraia. Mā tēnei ka māmā ake te whakawhanui i te ngongo, ka nui ake te whakatuwheratanga.

He pai ngā hua o tēnei tikanga mō te nuinga o te hunga kāore he mate manawa whānau. Heoi, tata ki te 21% o te hunga ka āraia anō ō rātou uaua i muri i ētahi marama.

Pokanga

He maha ngā tikanga e whakamahia ana e ngā taote pokanga hei rongoā i te pēhanga o te uaua pūkahukahu. Ko te kōwhiringa ka whakawhirinaki ki te āhua o te aukati, ngā oko toto e karapoti ana, me ētahi atu hanganga.

He raruraru kei roto i te maimoatanga?

Mā te whakawhānui i te poihau ka whakaiti i te aukati i roto i te nuinga o te tangata. Heoi, i roto i te wā, ka taea te aukati anō i te uaua mā te 15% ki te 20%, ā, me mahi anō te tukanga. Kei te rangahauhia e ngā kairangahau ngā momo poihau rerekē ka puta he hua pai ake, he hua roa ake.

Ngā raruraru pea i te wā e whakawhanuitia ana te poihau:

• Te aneurysm o te uaua pūkahukahu.
• Te tapahi i te uaua pūkahukahu (Te tapahi i te uaua pūkahukahu).
• Te pakaru o te uaua pūkahukahu (`(Te pakaru o te uaua pūkahukahu)`).
• Pupuhi pūkahukahu (`(Pupuhi pūkahukahu)`).
• He tino onge pea te noho hei mate.

Ngā raruraru pea o te whakamahinga o te stent:

• Ngā toto totoka.
• Ngā koretake o te manawa o te ngakau (`(Ventricular arrhythmias)`).
• Tērā pea kua hē te wāhi o te stent, kua tangohia rānei.
• Me whakawhanui anō te uaua toto (he tino onge tēnei mahi).

He aha ngā painga o te maimoatanga?

Ko ngā take e pai ake ai ki ngā tākuta te whakatakoto i ngā stent mō te Pulmonary Artery Stenosis:

• E 96% te whai huatanga o ēnei i taua wā tonu .
• He roa te wā e hiahiatia ana hei pupuri i te tuwhera o te uaua.
• Ka taea te whakawhānui ake i te wāhi whaiti kia rua te nui ake .
• He iti ake te utu, he pai ake hoki i te whakauru noa i ngā poihau, i te mahi pokanga rānei.
• He angitu ake i te angioplasty poihau.

Ka whiriwhiri pea ngā tākuta i te angioplasty poihau hei utu mō te stent i ngā take e whai ake nei:

• Mena he tino kino te āhua o te tamaiti .
• Mena he uaua te hanganga o roto o te tinana o te tamaiti (`(complex anatomy)`).
• Mena he iti rawa te tamaiti .

He aha ngā mea ka tupu i muri i te pokanga?

Mena he stent tā tāu tamaiti, me tango e ia he paturopi me ētahi atu rongoā whakaheke toto mō tētahi wā. Ka hoatu ēnei rongoā hei ārai i te mate me te aukati i te toto e totohu ana.

Kia pēhea te roa ka pai ake te tamaiti i muri i te maimoatanga?

Ka tere tonu te mahi a te tukanga whakawhanui i te uaua pūkahukahu o tō pēpi. Ko te tikanga ka māmā ake te uru o te toto ki roto i ōna pūkahukahu me te whiwhi hāora mā tō pēpi.

Mena kei taku tamaiti tēnei mate, he aha te āhua o te heke mai? (Te Matapae)

I roto i ngā maimoatanga hauora matatau o ēnei rā, he tokomaha te hunga e pāngia ana e tēnei mate ka ora tae noa ki te pakeketanga. Heoi, ko te hunga e pāngia ana e ngā mate pēnei i te "Williams syndrome" me te "Alagille syndrome" kāore pea e pai te urupare ki te maimoatanga.

Āhea koe me kawe i tāu tamaiti ki te tākuta?

Me haria e koe tāu tamaiti ki ngā tirotiro hauora i ia wā, kia kite ai koe me pēhea ia e pai ana. Me whai hoki koe i ngā echocardiogram i ia wā, kia kite ai mēnā me whakawhanui anō te uaua toto a muri ake nei.

He aha taku e pātai atu ai ki te tākuta?

Ka taea e koe te pātai atu ki te tākuta i ngā pātai penei:

• He aha i pāngia ai taku tamaiti e te `(Pulmonary Artery Stenosis)`?
• He aha te rongoā pai rawa atu mō taku tamaiti?
• He aha ngā tūponotanga ka hiahiatia anō taku tamaiti kia rongoātia mō tēnei?

Mena me rongoā tāu tamaiti mō te Pulmonary Artery Stenosis, ka whakaarohia e te tākuta te rongoā pai rawa atu mō te āhua o tāu tamaiti. Kaua e mangere ki te pātai mō ngā mea kāore koe e mārama ana mō te tikanga o tāu tamaiti.

Karere Tangohia ki te Kāinga

Mō tēnei āhuatanga e kiia nei ko te `(Pulmonary Artery Stenosis)`, ko te mea nui ko te mōhio wawe ki ngā tohu me te rapu tohutohu hauora . He mea nui kia rapu tohutohu i tētahi `(congenital heart specialist)`, inā koa mēnā he tamariki tēnei āhuatanga.

Kaua e manukanuka, kei reira ngā maimoatanga mō tēnei . Ka taea te whakahaere i tēnei āhuatanga mā te whakamahi i ngā mea pēnei i te whakawhānui i te poihau, te whakanoho i te stent, ā, ki te tika, te pokanga. Ahakoa i muri i te maimoatanga, he mea tino nui mō te hauora o te tamaiti kia haere ki ngā tirotiro hauora auau me te whai i ngā tohutohu a te tākuta . Kōrero ki te tākuta mō ngā pātai, ngā āwangawanga rānei kei a koe.

Te Stenosis o te Arorangi Pūkahukahu, Te Mate Manawa o ngā Tamariki, Ngā Hapa Manawa Whānau, Te Uauatanga o te Manawa, Te Pokanga Manawa, Te Stent