He aha te Hernia Diaphragmatic Whānau? Tōna Tohutohu, Ngā Take, me te Maimoatanga

Ko te hernia diaphragmatic whānau (CDH) tētahi mate whānau e puta mai ana te rua i roto i te diaphragm, te uaua e āwhina ana i a koe ki te manawa. Ka taea e tēnei rua te whakatūpato i ngā kōpū mai i te puku ki te haere ki roto i te kōpū uma, ā, ka uaua pea te manawa mō ngā pepeke.

Whakaarohia tō diaphragm hei pakitara kaha e wehewehe ana i tō uma me tō puku. Ki te mea he rua tēnei pakitara, ka taea e ngā kōpū penei i te puku, te kopu rānei te ngāwari ki te haere ki te wāhi e tika ana kia noho ai ngā pūkahukahu. Ka pā tēnei āhuatanga ki te 1 i roto i ngā pepeke 2,500 ki te 3,000 e whānau ana.

He aha ngā tohu o te hernia diaphragmatic whānau?

Ko te nuinga o ngā pepeke me te CDH ka whakaatu i ngā raruraru manawa i muri tonu i te whānau. Ka rere ke ngā tohu mai i te ngawari ki te kino, kei te nui o te wāhi e tangohia ana e ngā kōpū i nekehia ki roto i te uma.

Ko ēnei ngā tohu matua ka kite koe:

• Te manawa tere, te uaua rānei ki te hopu manawa
• Te tae kikorangi, te hina rānei o te kiri, ina koa i te taha o ngā ngutu me ngā maihao
• Te tere o te ngākau
• Te uma ā-pū, e titiro ana he porowhita rawa
• Te puku e titiro ana he hohonu, he konuka rānei
• Te iti o ngā oro manawa i tetahi taha o te uma

Ka uaua pea etahi pepeke ki te kai, ki te ahua rānei he raruraru.

He aha ngā momo o te hernia diaphragmatic whānau?

Ka puta mai te CDH i roto i ngā momo rerekē, kei te wāhi e puta mai ana te rua i roto i te diaphragm. Ko te momo tino noa ko te hernia Bochdalek, e puta ana i muri me te taha o te diaphragm.

Ko ēnei ngā momo matua:

• Hernia Bochdalek: Ko te 85-90% o ngā take, e puta ana i te taha maui
• Hernia Morgagni: E puta ana i mua o te diaphragm, he iti te noa engari he ngawari
• Hernia diaphragmatic pokapū: He tino onge, e puta ana i waenganui o te diaphragm
• Eventration: He angiangi, he ngoikore te uaua diaphragm, kāore he rua

Ko ngā hernia taha maui te tino kino, no te mea ka whakauru pea ki te neke atu o ngā kōpū ki roto i te uma. He iti te noa o ngā hernia taha matau, engari ka taea tonu te whakatūpato i ngā raruraru manawa nui.

He aha ngā take o te hernia diaphragmatic whānau?

Ka puta te CDH ina kore te diaphragm e hanga katoa i te wā o te haputanga. Ka puta tēnei i waenga i te 8 me te 12 wiki o te haputanga, ina kei te whanake tonu ngā kōpū o tō pēpi.

Kāore i tino mōhiotia te take tika, engari e whakapono ana ngā kairangahau he whakakotahitanga pea o ngā take ira me ngā taiao. I te nuinga o ngā take, kāore he take mārama he aha i puta ai, ā, ehara i te mea i mahi, i kore rānei e mahi ngā mātua.

Ko ēnei etahi take āwhina pea:

• Ngā huringa ira, ngā rerekētanga rānei e pā ana ki te whanaketanga o te diaphragm
• Ngā rerekētanga chromosomal penei i te trisomy 18, 13 rānei
• Te hītori whānau o te CDH, ahakoa he onge tēnei
• Ngā rongoā e inu ana i te wā haputanga
• Te mate huka o te whaea, ngā āhuatanga hauora rānei

He mea nui kia mōhio ko te CDH e puta ana i te wa tūturu i te nuinga o ngā take. Ahakoa he tamaiti tētahi o ō tamariki me te CDH, he iti rawa te tūponotanga o te whānau i tētahi pēpi me te āhuatanga kotahi.

Nōhea te haere ki te taote mō te hernia diaphragmatic whānau?

Ka kitea te CDH i te nuinga o te wā i mua i te whānau mā ngā whakamātautau ultrasound i te wā haputanga, i te nuinga o te wā i te 18-20 wiki. Ka kite pea tō taote kei te noho ngā kōpū i te wāhi he, kei te iti ake rānei ngā pūkahukahu o te pēpi i te mea e tumanakohia ana.

Ka uru pea ngā whakamātautau whakamārama ki:

• Ultrasound taipitopito hei tiro i te wāhi o ngā kōpū
• MRI pēpi mō ngā whakaahua taipitopito atu
• Amniocentesis hei tirotiro i ngā āhuatanga ira
• X-ray uma i muri i te whānau hei whakau i te whakamārama
• Echocardiogram hei tirotiro i te mahi o te ngākau
• Ngā whakamātautau toto hei aromatawai i ngā taumata o te hau

I etahi wā kāore te CDH e kitea tae noa ki muri i te whānau, ina koa i ngā take ngawari. Ka whakamahi tō rōpū hauora i ngā X-ray uma me ētahi atu whakamātautau whakaahua hei whakau i te whakamārama me te whakarite i te maimoatanga.

He aha te maimoatanga mō te hernia diaphragmatic whānau?

Ko te maimoatanga mō te CDH ko te pokanga hei whakatika i te diaphragm, engari ka whakawhirinaki te wā ki te āhuatanga o tō pēpi. Ko te rōpū hauora te mea tuatahi e aro ana ki te whakau i te manawa me te tautoko i ngā pūkahukahu i mua i te pokanga.

Ko ēnei ngā mahi maimoatanga tuatahi:

• Tautoko manawa me te mīhini manawa
• Ngā rongoā hei āwhina i te toto me te mahi o te ngākau
• Kai IV no te mea ka uaua pea te whāngai
• Te tirotiro i roto i te waahanga tiaki hauora neonatal motuhake

Ka puta te whakatikatika pokanga i te wā e pumau ana tō pēpi, i te nuinga o te wā i roto i ngā rā, wiki rānei o te ora. Ka neke te taote i ngā kōpū i nekehia ki te puku, ka whakatika i te rua i roto i te diaphragm. I etahi wā ka hiahiatia he papatahi ki te nui rawa te rua.

Ka rere ke te ora i runga i te kino o te āhuatanga. Ka hiahia pea etahi pepeke ki te tautoko manawa haere tonu, ka ora tere atu ētahi. Ka mahi ngātahi tō rōpū hauora ki a koe hei tirotiro i te whakahaere me te whakarite i te maimoatanga i runga i te hiahia.

Me pēhea te whakarato i te tiaki kāinga i te wā ora o te hernia diaphragmatic whānau?

Ko te nuinga o ngā pepeke me te CDH ka noho maha wiki, marama rānei i te hōhipera i mua i te haere ki te kāinga. Kia tae atu ki te kāinga, me haere tonu koe ki te tiaki motuhake hei tautoko i te ora me te whanaketanga o tō pēpi.

Ko te tiaki kāinga e whakauru ana ki:

• Te whai i ngā kaupapa whāngai me te tirotiro i te piki o te taumaha
• Te hoatu i ngā rongoā rite tonu ki te whakaritea
• Te tirotiro i ngā tauira manawa me ngā taumata hau mena ka hiahiatia
• Te whai i ngā hui whakarite haere tonu
• Te titiro ki ngā tohu o ngā raruraru penei i te uaua ki te manawa, ki te whāngai rānei
• Te whakarato i te tautoko whanaketanga me te rongoā tinana i runga i te tūtohutanga

Ka whakarato tō rōpū hauora i ngā tohutohu taipitopito me ngā rauemi tautoko. Kaua e whakaroa ki te karanga mena ka kite koe i ētahi huringa i te manawa, te whāngai, te āhuatanga whānui rānei o tō pēpi.

Me pēhea te whakarite mō tō hui taote?

Ko te whakarite mō ngā hui hauora ka taea te āwhina i a koe ki te tiki i te nuinga o ngā haerenga, me te whakarite kua whakautuhia ngā āwangawanga katoa. Tuhia ō patai i mua kia kaua e wareware i ngā mea nui.

Whakaarohia te whakarite:

• Te rārangi o ngā tohu katoa o nāianei me te wā i tīmata ai rātou
• Ngā patai mō ngā whiringa maimoatanga me te mea e tumanakohia ana
• Ngā korero mō te hītori hauora whānau
• Ngā rongoā o nāianei me ngā horoinga
• Ngā korero inihua me ngā pepa tohutoro
• Tētahi tangata tautoko hei āwhina i a koe ki te mahara ki ngā korero

Kaua e wehi ki te tono whakamārama mena he whakapohehe ngā kupu hauora. E hiahia ana tō rōpū hauora kia tino mārama koe ki te āhuatanga o tō pēpi me te mahere maimoatanga.

He aha te mea nui mō te hernia diaphragmatic whānau?

Ko te CDH he mate whānau nui engari ka taea te whakaora e pā ana ki te uaua diaphragm. Ahakoa ka hiahia ki te tiaki hauora motuhake me te pokanga, ka haere tonu te nuinga o ngā tamariki me te CDH ki te ora hauora, noa i te maimoatanga tika.

Ko te mea nui rawa kia mahara ko te whakamārama me te maimoatanga wawe ka puta he rerekētanga nui i roto i ngā hua. Mena ka kitea te CDH i te wā haputanga, ka taea e tō rōpū hauora te whakarite mō te whānau me te tiaki wawe. Me ngā whakahaere i roto i te hangarau hauora me ngā tikanga pokanga, ka haere tonu te titiro mō ngā pepeke me te CDH ki te pai ake.

Kia mahara he rerekē ia take, ka mahi tahi tō rōpū hauora ki a koe hei whakawhanake i te mahere maimoatanga pai rawa atu mō tō āhuatanga motuhake. Noho hono atu ki tō rōpū hauora, uiui, kaua hoki e whakaroa ki te rapu tautoko ina hiahia koe.

Ngā patai e ui pinepinetia ana mō te hernia diaphragmatic whānau

Ka taea te aukati i te hernia diaphragmatic whānau?

I tēnei wā, kāore he huarahi e mohiotia ana hei aukati i te CDH no te mea e puta ana i te wā whanaketanga o te pēpi. Ko te tango i ngā huaora i mua i te whānau, te karo i ngā mea kino i te wā haputanga, me te pupuri i te tiaki hauora i mua i te whānau he mea tūtohutia tonu mō te hauora whānui o te pēpi, engari kāore ēnei mahi e aukati motuhake i te CDH.

He aha te reiti ora mō ngā pepeke me te CDH?

Kua pai ake te reiti ora mō te CDH i ngā tau kua pahure, a kei te 70-90% inaianei, kei te kino o te āhuatanga. Ko ngā pepeke me te CDH ngawari me ngā pūkahukahu pai te whanaketanga he hua pai, engari ko te hunga me ngā take kino atu pea ka raru atu, engari he pai tonu te tūponotanga o te ora me te tiaki hauora tika.

Ka hiahia pea taku tamaiti ki te tiaki hauora haere tonu i muri i te pokanga CDH?

Ko te nuinga o ngā tamariki ka hiahia ki te tiaki whakarite haere tonu hei tirotiro i te mahi pūkahukahu, te tipu, me te whanaketanga. Ka hiahia pea etahi ki ētahi atu maimoatanga mō ngā raruraru penei i te reflux gastroesophageal, ngā raruraru whakarongo rānei. Heoi, ka taea e te nuinga o ngā tamariki me te CDH te whakauru ki ngā mahi noa i a rātou e tipu ana, tae atu ki ngā hākinakina me ētahi atu mahi tinana.

Ka taea te puta mai anō te CDH i ngā haputanga kei te heke mai?

He iti rawa te tūponotanga o te whānau i tētahi pēpi me te CDH, i raro iho i te 2%. Ko te nuinga o ngā take o te CDH e puta ana i te wa tūturu, kāore hoki e whakawhiwhia. Heoi, mena he take ira kei roto, ka tūtohu pea tō taote ki te tohutohu ira hei kōrero mō tō āhuatanga motuhake me ētahi atu whiringa whakamātautau.

Nōhea i muri i te whānau ka puta te pokanga CDH?

Ka rere ke te wā pokanga i runga i te āhuatanga o tō pēpi. Ka hiahia etahi pepeke ki te pokanga i roto i ngā rā tuatahi o te ora, ka tatari etahi atu wiki tae noa ki te wā e pumau atu ana. Ko te rōpū hauora te mea tuatahi e tautoko ana i te manawa me te hauora whānui i mua i te haere ki te pokanga hei whakatika i te diaphragm.