He aha te Patent Ductus Arteriosus? Tohutohu, Take, me te Maimoatanga

Ko te patent ductus arteriosus (PDA) tētahi āhuatanga o te ngākau kei te tuwhera tonu te uaua toto e tika ana kia kati i muri i te whānautanga. I te wā hapu, ka awhina tēnei hononga, e kiia nei ko te ductus arteriosus, kia kaua e haere te toto ki ngā pūkahukahu o te pēpi. Ki te kore e kati pai i muri i te whānautanga, ka pā ki te rere o te toto i roto i tō ngākau me ō pūkahukahu.

He aha te Patent Ductus Arteriosus?

Ka puta te patent ductus arteriosus ina kore te hononga uaua toto noa e kati rite tonu i muri i te whānautanga. I te wā hapu, kāore te pēpi e whakamahi i ōna pūkahukahu mō te hāora, no reira ka awhina tēnei uaua kia kaua e haere te toto ki ngā pūkahukahu.

Ina whānau te pēpi ka tīmata te manawa, me kati tēnei hononga i roto i ngā rā tuatahi o te ora. Ki te tuwhera tonu, ka rere te toto i waenganui i te aorta (te uaua nui o te tinana) me te uaua pūkahukahu (e kawe ana i te toto ki ngā pūkahukahu).

Ka pēhi tēnei rere toto atu ki te ngākau me ngā pūkahukahu i te roa. Ka rereke te āhuatanga o te mate, mai i ngā take ngawari e kore rawa e pā ki te ora o ia rā ki ngā āhuatanga nui ake e hiahia ana ki te tiaki hauora.

He aha ngā Tohutohu o te Patent Ductus Arteriosus?

He tokomaha ngā tāngata he PDA iti e kore e kite i tetahi tohu, inā koa i te wā tamariki. Ki te puta mai ngā tohu, ka tupu haere pea i te wā e mahi nui ana te ngākau ki te pupuhi i te toto atu.

Ko ngā tohu tino noa ka kite koe:

• Te poto o te manawa, inā koa i te wā mahi tinana
• Te ngāwari o te ngenge i te wā mahi o ia rā
• Te tere, te kore ranei o te whiti o te ngākau
• Te nui atu o te werawera, inā koa i te wā whāngai i ngā pēpi
• Te iti o te taumaha, te puhoi ranei o te tipu i ngā tamariki
• Te maha o ngā mate manawa, te mate pūkahukahu ranei

I ngā take nui ake, ka kite pea koe i te mamae uma, te tere ranei o tō ngākau ahakoa i te okioki. Ka kite etahi i te tae kikorangi o ō kiri, ngutu, me ngā maihao, e puta ana ina kore te hāora i roto i te toto.

Ka kitea pea enei tohu i te wā e koroheke ana koe, i te mea kua mahi nui te ngākau mo nga tau maha. Ko te rongo pai, ko te mohiotanga wawe ki enei tohu ka awhina i a koe ki te whiwhi i te maimoatanga tika.

He aha ngā Take o te Patent Ductus Arteriosus?

Ka puta te patent ductus arteriosus ina kore te tukanga kati noa i muri i te whānautanga e mahi tika ana, engari kāore ngā tākuta e mohio tonu he aha te take o tēnei. Me kati noa te ductus arteriosus i roto i ngā rā 2-3 i muri i te whānautanga i te mea ka piki ake te taumata hāora me te huri o etahi homoni.

He maha ngā take ka piki ake te tūponotanga o te whanaketanga o te PDA:

• Te whānautanga wawe - he tino nui ake te tūponotanga o ngā pēpi i whānau i mua i te wiki 37 ki te PDA
• Te whānautanga i ngā teitei teitei kei reira ngā taumata hāora iti
• Te whai i ētahi āhuatanga ira penei i te mate Down
• Te hītori whānau o ngā hapa ngākau whānau
• Te mate rubella o te whaea i te wā hapu
• Te mate huka o te whaea, te kore ranei o te mana whakahaere huka i te wā hapu
• Ētahi rongoā i tangohia i te wā hapu

Ko ngā pēpi wawe te tino tūponotanga, no te mea kāore i roa te wā o tō rātou ductus arteriosus ki te whānau i te kaha ki te kati pai. I etahi wā onge, ka raru pea te hanganga o te pakitara uaua e aukati ana i te kati noa.

I te nuinga o te wā, ka puta te PDA kahore he take mārama, a he mea nui kia mōhio kei te kore he mea i mahi koe, i ō mātua rānei i puta ai tēnei āhuatanga.

Nōhea te Tiro ki te Tākutu mō te Patent Ductus Arteriosus?

Me whakapiri atu koe ki tō tākutu ki te kite koe i tetahi tohu e whakaatu ana pea kei te mahi nui atu tō ngākau i te noa. He mea nui tēnei ki te kite koe i te poto o te manawa i ngā mahi i ngāwari noa.

Rapua te awhina hauora i te wa poto ki te whai koe i:

• Te mamae uma, te pehanga ranei, inā koa i te mahi
• Te poto nui o te manawa, te raruraru ranei o te manawa
• Te ngaro o te mohio, te ngāwari ranei ki te ngaro o te mohio
• Te nui o te taumaha, te pupuhi ranei o ō waewae, ngutu, puku ranei
• Te tae kikorangi o ō ngutu, maihao, kiri ranei

Mō ngā mātua, he mea nui te matawai mō ngā tohu i ngā tamariki penei i te whāngai ngoikore, te nui o te werawera i ngā kai, te kore ranei e piki te taumaha rite ki te tumanako. Ko te maha o ngā mate manawa, te āta ngenge ranei i ētahi atu tamariki i te wā takaro ka taea hoki te tohu whakatūpato.

Ahakoa ngāwari te tohu, ko te aromatawai wawe ka āwhina i te aukati i ngā raruraru i muri mai. Ka taea e tō tākutu te whakatau mena kei te hono atu ō tohu ki te PDA, ki ētahi atu mea ranei.

He aha ngā Take Tūponotanga mō te Patent Ductus Arteriosus?

He maha ngā take ka nui ake te tūponotanga o te tuwhera o te ductus arteriosus i muri i te whānautanga, ahakoa te whai i enei take tūponotanga e kore e whakamana ka whānau koe i te PDA. Ko te mārama ki ēnei ka āwhina i te whakamārama he aha i pā atu ai etahi atu i ētahi.

Ko ngā take tūponotanga tino nui:

• Te whānautanga wawe (inā koa i mua i te wiki 28 o te hapu)
• Te iti o te taumaha whānau (i raro i te 3.3 pauna, 1.5 kiromita ranei)
• Te whānautanga i ngā teitei neke atu i te 8,000 waewae
• Te wahine - he rua te tūponotanga o ngā kōhine ki te PDA i ngā tama
• Te hītori whānau o ngā hapa ngākau whānau
• Ngā mate ira penei i te mate Down, te mate DiGeorge ranei
• Ngā mate o te whaea i te wā hapu, inā koa te rubella
• Te mate huka o te whaea, te mate huka hapu ranei

Ko ētahi atu take tūponotanga iti ake ko te whakaū ki ētahi matū, rongoā ranei i te wā hapu, me te whai i ētahi atu hapa ngākau i te wā whānau. Ko ngā whaea e inu nui ana i te waiū i te wā hapu ka nui ake te tūponotanga o ō rātou pēpi.

He mea tika te kōrero he tokomaha ngā pēpi he take tūponotanga enei e kore e whānau i te PDA, engari ko ētahi atu kahore he take tūponotanga e mohiotia ana e whānau ana. Ko te mahi tahi o ngā ira me ngā take taiao he uaua, kei te ako tonu hoki ngā kairangahau.

He aha ngā Raruraru Ka Taea o te Patent Ductus Arteriosus?

Ina iti te PDA, he tokomaha ngā tāngata e ora ana i te ora noa kahore he raruraru. Heoi, ka arahi ngā tuwhera nui ake ki ngā raruraru i te roa i te mea e mahi nui ana te ngākau me ngā pūkahukahu ki te whakahaere i te rere toto atu.

Ko ngā raruraru tino noa ka pa atu koe:

• Te kore o te ngākau - ina ngoikore rawa tō ngākau ki te pupuhi i te toto
• Te teitei o te toto i ngā pūkahukahu (pulmonary hypertension)
• Ngā whiti ngākau kore noa (arrhythmias)
• Te piki o te tūponotanga o ngā mate ngākau (endocarditis)
• Te pōkaikaha mai i ngā toto
• Te mate Eisenmenger - he āhuatanga onge, nui hoki kei reira te huri o te rere toto

Ka tupu haere pea te kore o te ngākau i ngā tau maha. Ka kite pea koe i te ngenge e piki haere ana, te pupuhi o ō waewae, puku ranei, te raruraru ranei o te manawa ina takoto.

Ka puta te pulmonary hypertension ina pakaru te rere toto atu i ngā uaua toto iti i ō pūkahukahu. Ka taea tēnei te kore e taea te whakahoki mai, koia te take i nui ai te maimoatanga wawe mō ngā PDA nui ake.

Ko te rongo pai, ko te nuinga o ngā raruraru ka taea te aukati me te maimoatanga tika. Ahakoa ka puta mai ngā raruraru, he maha ka taea te whakahaere pai me ngā rongoā me ngā huringa ora.

Me pēhea te Whakatau o te Patent Ductus Arteriosus?

Ko te whakatau i te PDA ka tīmata ina rongo te tākutu i tetahi oro ngākau kore noa e kiia nei he murmur i te wā o te tirotiro noa. He āhua "rite ki te mīhini" tēnei murmur e taea ai e ngā tākuta wheako te mohio.

Ka tono pea tō tākutu i ētahi whakamātautau ki te whakau i te whakatau me te aromatawai i te āhuatanga o te āhuatanga. Ko te echocardiogram te whakamātautau tuatahi me te tino nui - ka whakamahi ia i ngā ngaru oro ki te hanga i ngā pikitia neke o tō ngākau.

Ko ētahi atu whakamātautau pea:

• Te X-ray uma ki te tirotiro i te rahi o te ngākau me te āhuatanga o te pūkahukahu
• Te electrocardiogram (ECG) ki te ine i te mahi hiko o tō ngākau
• Te catheterization ngākau mō ngā ine pehanga taipitopito
• Te CT scan, MRI ranei mō ngā pikitia ngākau taipitopito ake
• Te pulse oximetry ki te tirotiro i ngā taumata hāora i roto i tō toto

Ka taea e te echocardiogram te whakaatu tika kei hea te tuwhera, te rahi o te tuwhera, me te āhua o te rere o te toto i roto i a ia. Ka awhina tēnei mōhiohio i tō tākutu ki te whakatau mena ka hiahiatia te maimoatanga me te momo mahi pai.

I etahi wā ka kitea te PDA i te wā hapu mā te fetal echocardiography, inā koa ki te whakaarohia ētahi atu raruraru ngākau. I ētahi atu wā, ka kore pea e whakatauhia tae noa ki te pakeketanga ina puta mai ngā tohu, i te wā aromatawai ranei mō ētahi atu take hauora.

He aha te Maimoatanga mō te Patent Ductus Arteriosus?

Ko te maimoatanga mō te PDA e whakawhirinaki ana ki ētahi take, tae atu ki te rahi o te tuwhera, tō tau, me te kite koe i ngā tohu. Ko ngā PDA iti e kore e pā ki ngā raruraru ka hiahia noa pea ki te matawai noa kahore he whakauru.

Mō ngā PDA e hiahia ana ki te maimoatanga, he maha ngā kōwhiringa kāu:

• Ngā rongoā hei awhina i te kati i te ductus, inā koa i ngā pēpi wawe
• Te kati transcatheter mā te whakamahi i te taputapu iti e whakauruhia ana mā te uaua toto
• Te kati pokanga mā te wahi iti i te uma
• Ngā rongoā hei whakahaere i ngā tohu penei i te kore o te ngākau, te teitei ranei o te toto

Ko te Indomethacin he rongoā ka taea te awhina i te kati o te ductus i ngā pēpi iti rawa. Ka pai ake tēnei mahi i roto i ngā rā tuatahi o te ora, a he tino whai hua i ngā pēpi wawe.

Kua waiho te kati transcatheter hei maimoatanga pai mō te nuinga o ngā PDA e hiahia ana ki te whakauru. I te wā o tēnei tukanga, ka arataki te kaitātari ngākau i te taputapu kati iti mā te uaua toto ki te tāpui i te tuwhera. Ka oti tēnei i te wā e moe ana koe, engari e kore e hiahia ki te pokanga tuwhera.

Ka tūtohutia pea te kati pokanga ki te nui rawa te PDA, te āhua ranei i te huarahi e uaua ai te kati transcatheter. Ko te pokanga e whakauru ana i te wahi iti i waenganui i ō riu ki te tae atu ki te ngākau me te kati tonu i te tuwhera.

Me pēhea te Tiaki i a koe i te Kāinga me te Patent Ductus Arteriosus?

Ki te whai koe i te PDA iti e kore e hiahia ana ki te maimoatanga i te wa poto, he maha ngā mea ka taea e koe i te kāinga ki te noho hauora me te matawai i tō āhuatanga. Ko te matua ko te pupuri i te hauora ngākau pai i te wā e matawai ana i ngā huringa i ō tohu.

Ko ētahi kaupae tiaki whaiaro nui:

• Noho mahi me te whakakori noa, ngawari rite ki te whakaae a tō tākutu
• Kai i te kai hauora ngākau e whai hua ana i ngā hua, ngā huawhenua, me ngā witi katoa
• Pupuri i te taumaha hauora ki te whakaiti i te pēhi ki tō ngākau
• Kaua e whakakī me te whakaiti i te inu waipiro
• Tangohia ngā rongoā i whakaritea rite tonu ki te aratohu
• Whakamahia te horoi niho pai ki te aukati i ngā mate
• Whiwhi i ngā whakakakahu i tūtohutia, inā koa mō te mate pūkahukahu me te mate huka

He mea nui te mohio ki ō rohe mo te mahi tinana. Ahakoa he pai te whakakori, me mutu me te okioki ki te kite koe i te poto o te manawa, te māuiui ranei, te mamae uma ranei.

Tāruahia ngā tohu hou, ngā huringa ranei i te āhua o tō ngakau i ngā mahi o ia rā. Ka kite etahi he whakaaro pai te pupuri i te puka ngāwari e tuhi ana i ō taumata kaha, te manawa, me ngā āhua kore noa.

Kia mau ki ngā hui whakarite katoa me tō kaitātari ngākau, ahakoa kei te pai koe. Ko te matawai noa ka āwhina i te hopu i ngā huringa wawe ka whakarite kia tika tonu tō mahere maimoatanga.

Me pēhea te Whakamahere mō tō Hui Tākutu?

Ko te whakamahere pai mō tō hui kaitātari ngākau ka āwhina i a koe ki te whiwhi i te hua nui o tō haerenga, ka whakarite hoki kei a tō tākutu ngā mōhiohio katoa e hiahiatia ana hei whakarato i te tiaki pai. Tīmata mā te kohikohi i ngā hua whakamātautau o mua, ngā rēkōta hauora ranei e pā ana ki tō āhuatanga ngākau.

I mua i tō hui, tuhia:

• Ngā tohu katoa i kite koe, ahakoa iti rawa
• Te wā e puta ai ngā tohu me te aha e pai ake ai, te kino ranei
• Ngā rongoā me ngā taapiri katoa e tangohia ana e koe inaianei
• Ngā pātai e hiahia ana koe ki te ui ki tō tākutu
• Tō hītori whānau o ngā raruraru ngākau
• Ngā huringa hou i tō taumata mahi, te mahi o ia rā ranei

Whakaarohia ngā tauira motuhake o te āhua o ngā tohu ki tō ora o ia rā. Hei tauira, ka taea e koe te piki i ngā kaupae kahore he manawa poto? Me okioki koe i ngā mahi i ngāwari noa koe?

Kawe mai he rārangi o ō rongoā katoa inaianei, tae atu ki ngā ingoa tika, ngā rāpoi, me te maha o ō tango. Kaua e wareware ki te whakauru i ngā rongoā i hokona i te toa rongoā, ngā huaora, me ngā taapiri otaota.

Whakaarohia te kawe mai i te mema whānau, hoa ranei e whakawhirinaki ana ka taea te awhina i a koe ki te mahara ki ngā mōhiohio nui i kōrerohia i te wā o te hui. Ka taea pea e rātou te whakaaro ki ngā pātai kāore koe i whakaaro.

He aha te Tino Tango Mai mō te Patent Ductus Arteriosus?

Ko te patent ductus arteriosus he āhuatanga ngākau ka taea te whakahaere e pā ana ki ngā tāngata rerekē i runga i te rahi o te tuwhera me ngā take takitahi. He tokomaha ngā tāngata he PDA iti e ora ana i te ora noa, engari ko ētahi atu e tino whai hua ana i te maimoatanga ka taea te mahi kahore he pokanga nui.

Ko te mea tino nui hei mahara ko te kite wawe me te tiaki tika ka taea te aukati i te nuinga o ngā raruraru. Ki te whai koe i ngā tohu penei i te poto o te manawa, te ngenge ranei e kore e whakamāramatia, kaua e whakaroa ki te kōrero ki tō tākutu.

He tino whai hua ngā maimoatanga hou mō te PDA, he iti ake te whakauru i te wā o mua. Ko te nuinga o ngā tāngata e hiahia ana ki te maimoatanga ka haere tonu ki te ora ora, hauora me ngā herenga iti.

Noho hono atu ki tō rōpū hauora, whai i ō rātou tūtohu, ā, kaua e tuku i te manukanuka mō tō āhuatanga ki te aukati i a koe i te koa o te ora. Me te tiaki tika me te matawai, e kore e hiahia te PDA ki te whakaiti i ō whāinga, mahi ranei.

Ngā Pātai Nui e Uihia Ana mō te Patent Ductus Arteriosus

Q1: Ka taea te kati o te patent ductus arteriosus ake i roto i ngā pakeke?

Aroha mai, kāore ngā PDA e kati noa i roto i ngā pakeke. Ahakoa ka taea e te ductus arteriosus te kati noa i roto i ngā marama tuatahi o te ora, inā koa me te awhina rongoā i ngā pēpi wawe, ka tino kore pea tēnei i muri i te tau tuatahi. Ki te pakeke koe he PDA, ka noho pea te tuwhera kia kore e kati me te whakauru hauora. Heoi, he tokomaha ngā pakeke he PDA iti e ora ana i te ora noa kahore he maimoatanga.

Q2: He haumaru te whakakori ki te whai koe i te patent ductus arteriosus?

Ko te nuinga o ngā tāngata he PDA ka taea te whakakori haumaru, engari ko te momo me te kaha e whakawhirinaki ana ki tō āhuatanga motuhake. Ki te whai koe i te PDA iti kahore he tohu, ka taea pea e koe te whakauru ki ngā mahi noa katoa tae atu ki ngā hākinakina whakataetae. Heoi, ki te whai koe i te PDA nui ake, tohu ranei penei i te poto o te manawa, ka tūtohu pea tō tākutu kia kaua e mahi nui rawa. Kōrero tonu ki tō kaitātari ngākau mō ō mahere whakakori ki te whiwhi i ngā tūtohu motuhake e pā ana ki tō āhuatanga.

Q3: Ka taea e ngā wāhine he patent ductus arteriosus te whai hapu haumaru?

He tokomaha ngā wāhine he PDA ka taea te whai hapu haumaru, hauora, engari e whakawhirinaki ana tēnei ki te rahi o tō PDA me te whai koe i tetahi raruraru. Ko ngā PDA iti e kore e pā ki ngā raruraru i te wā hapu. Heoi, ko ngā PDA nui ake, te pulmonary hypertension ranei ka nui ake te tūponotanga o te hapu. Ki te whakaaro koe ki te hapu, kōrerohia tēnei me tō kaitātari ngākau me tō tohunga whakawhānau i mua atu kia waiho he mahere tiaki haumaru.

Q4: Ka riro i taku tamaiti te patent ductus arteriosus ki te whai ahau i a ia?

Ahakoa ka taea e te PDA te rere i roto i ngā whānau, ko te nuinga o ngā tamariki o ngā mātua he PDA e kore e whānau i te āhuatanga. He iti ake te tūponotanga i te taupori whānui, engari he iti tonu. Ki te whai koe i te PDA, kei te whakaaro koe ki te whānau tamariki, ka tūtohu pea tō tākutu i te fetal echocardiography i te wā hapu ki te tirotiro i te whanaketanga ngākau o tō pēpi. Ka taea e te tohutohu ira te awhina i a koe ki te mārama ki ngā take tūponotanga motuhake o tō whānau.

Q5: E hia te roa o te ora i muri i ngā tukanga kati PDA?

Ka rerekē te roa o te ora i runga i te momo tukanga i whai koe. I muri i te kati transcatheter (te tukanga whakamahi catheter), ka taea e te nuinga o ngā tāngata te hoki ki ngā mahi noa i roto i ngā rā torutoru ki te wiki. Ka whai pea koe i te whero i te wāhi i whakauruhia te catheter, engari ka ora tere tēnei. Ko te kati pokanga e hiahia ana ki te ora roa ake - i te nuinga o te wā 2-4 wiki i mua i te hoki ki ngā mahi noa me te 6-8 wiki i mua i te kawe i ngā mea taimaha, te whakakori nui ranei. Ka hoatu e tō tākutu ngā aratohu motuhake e pā ana ki tō tukanga me tō tukanga ora motuhake.