He aha te Pectus Excavatum? Ngā Tōmhanga, Ngā Take, me te Maimoatanga

Ko te pectus excavatum tētahi āhuatanga o te pakitara uma e whakawhāiti ana i te upoko o tō uma (sternum) me ngā riu, e hanga ana i te ahua hohonu, “kūiti” rānei i waenganui i tō uma. Ka puta tēnei i te wā e whanau mai ana koe, ā, ka kitea ake te nui o te rerekētanga i te wā e tipu haere ana koe, ina koa i ngā tau o te taiohi i te wā e tere haere ana te tipu.

Ka mōhio pea koe ki tēnei āhuatanga mā ētahi atu ingoa pēnei i te “uma pūnaha” (funnel chest) rānei te “uma hohonu” (sunken chest). Koinei tonu te āhuatanga tino noa o te pakitara uma, e pā ana ki te 1 i roto i ngā whānau 400. Ahakoa ka āta whakaarohia, he maha ngā tāngata e ora ana i te ora noa, hauora, ahakoa he pectus excavatum.

He aha ngā tōmhanga o te pectus excavatum?

Ko te tohu tino marama ko te kōwhiu o roto o tō uma, ka rere ke te nui mai i te iti ki te tino hohonu. Ki te nuinga o te iwi, ko tēnei huringa whakairohoro te tohu anake e pā ana ki a rātou, kāore hoki e pā ki ō rātou mahi o ia rā, ki te hauora rānei.

Heoi, ka kite pea etahi i ngā tohu tinana, ina koa ki te tino hohonu te kōwhiu. Tirohia ngā mea ka pā pea ki a koe:

• Te poto o te manawa i te wā e whakakori tinana ana, e mahi tinana ana rānei
• Te mamae uma, te kore ranei e pai, ina koa i te wā e whakakori ana
• Te tere o te ngākau, te āta whakaaro rānei kei te tere te ngākau
• Te ngenge e kore e rite ki tō taumata mahi
• Ngā mate manawa maha, te āta whakaaro rānei kaore e taea te hopu manawa
• Te mamae o te tuara mai i ngā huringa i te tū, i te wā e ngana ana koe ki te huna i te ahua o te uma

Ka puta ēnei tohu nā te mea ka pēhi pea te uma hohonu ki tō ngākau me ngā pūkahukahu, e whakaiti ana i te wāhi hei mahi tika.

I tua atu i ngā tohu tinana, ka pā pea tēnei āhuatanga ki te āhua o tō whakaaro ki a koe. Ka āta whakaaro pea koe ki tō ahua, ina koa i ngā wā e tangohia ana e koe tō koti, pēnei i te kaukau, i ngā mahi hākinakina rānei.

He aha ngā take o te pectus excavatum?

Ka whanake te pectus excavatum i te wā e tipu kino ana te kirikiri e hono ana i ō riu ki tō upoko uma i te wā e whanau mai ana. Whakaarohia tēnei kirikiri hei hononga ngawari e pupuri ana i tō pouaka riu – ki te tino tipu rānei ki te tauira koretake, ka taea e rātou te toia tō upoko uma ki roto.

Kāore i tino mōhiotia te take tino o tēnei, engari he tino nui te mahi a te ira. E 40% te tokomaha o ngā tāngata he pectus excavatum kei a rātou tētahi mema whānau he āhuatanga rite, he āhuatanga rerekē rānei o te pakitara uma.

He maha ngā take ka āwhina ki te whanaketanga o tēnei āhuatanga:

• Ngā rerekētanga ira e pā ana ki te whanaketanga o te kōpū hono
• Te hītori whānau o ngā āhuatanga kōwhiu uma
• Ngā āhuatanga ira motuhake pēnei i te mate Marfan, te mate Ehlers-Danlos rānei
• Ngā mate kōpū hono e pā ana ki te tipu o te kirikiri me ngā wheua

He mea nui kia mōhio kōrua kāore te pectus excavatum i puta mai i tetahi mea i mahi koe, i ō mātua rānei i te wā hapu. Ko te āhua noa o te tipu o tō uma i mua i te whānau, ā, ka kitea ake te nui o te rerekētanga i ngā wā e tere haere ana te tipu, ina koa i ngā tau o te taiohi.

Nōhea te haere ki te taote mō te pectus excavatum?

Me whakaaro koe ki te haere ki te taote mēnā kei te pāngia koe e ngā tohu e pā ana ki tō oranga o ia rā, mēnā rānei kei te manukanuka koe ki te ahua o tō uma. Ka taea e te aromatawai wawe te āwhina i te whakatau mēnā he pai te maimoatanga.

Ko ēnei ngā wā motuhake e tūtohutia ana te tiaki hauora:

• Kei te poto tō manawa i ngā mahi noa
• He mamae uma kei te āwangawanga ki te whakakori, ki ngā mahi o ia rā rānei
• Kei te kite koe kei te hohonu ake tō kōwhiu uma i te wā
• Kei te kite koe kei te tere, kei te ngaro rānei ngā whiu o tō ngākau
• Kei te pā te āhuatanga ki tō whakaaro ki a koe, ki tō kounga oranga rānei
• He mema whānau kei a rātou ngā mate kōpū hono

Mō ngā tamariki me ngā taiohi, he mea nui rawa te tirotiro i ngā wā e tere haere ana te tipu. Ka kaha ake pea te āhuatanga i ēnei wā, ā, ka nui ake pea te whai hua o ngā whiringa whakauru wawe.

Kaua e whakaroa ki te tono tohutohu hauora ahakoa he iti ngā tohu. Ka taea e te kaiwhakarato hauora te aromatawai mēnā kei te pā tō pectus excavatum ki tō mahi ngākau, ki tō mahi pūkahukahu rānei, ā, ka kōrero mō ngā whiringa maimoatanga ka taea te āwhina i a koe kia pai ake te noho me te whakapono.

He aha ngā take morearea mō te pectus excavatum?

He maha ngā take ka piki ake ai tō tūponotanga ki te whanaketanga o te pectus excavatum, ahakoa te mea kei a koe ēnei take morearea, kāore e whakamana ka whanake koe i te āhuatanga. Ka taea e te mōhiotanga ki ēnei te āwhina i a koe ki te kite i te wā hei rapu aromatawai hauora.

Ko ēnei ngā take morearea tino nui:

• Ko te tane – e 3 ki te 5 wā te tūponotanga o ngā tama ki te whanake i te pectus excavatum i ngā kōhine
• Te hītori whānau o ngā āhuatanga kōwhiu uma, o ngā mate kōpū hono rānei
• Te whai i ngā āhuatanga ira motuhake pēnei i te mate Marfan, te mate Ehlers-Danlos, te mate Poland rānei
• Te scoliosis, ngā raruraru kōwhiu tuaiwi rānei
• Te mitral valve prolapse, ngā āhuatanga o te waewae ngākau rānei
• Te roa me te ahua angiangi o te tinana

He mea nui hoki te tau ki te āhua o te āhuatanga. Ahakoa kei te noho te pectus excavatum mai i te whānau, ka kitea ake te nui o te rerekētanga i te wā o te taiohi i te wā e tere haere ana te tipu. Koinei te take i kitea ai e te nuinga o te iwi tō rātou āhuatanga i ngā tau o te taiohi.

Ko te whai i ēnei take morearea kāore e tikanga me manukanuka koe, engari he tikanga me mōhio koe ki te āhuatanga, me aroturuki ngā huringa i te ahua o tō uma, i ngā tauira manawa rānei i te wā.

He aha ngā raruraru pea o te pectus excavatum?

Ko te nuinga o ngā tāngata he pectus excavatum kāore e pāngia e ngā raruraru nui, ina koa ki te iti ki te waenga te kōwhiu. Heoi, ka taea e ngā take tino nui te pā ki tō mahi ngākau me tō mahi pūkahukahu.

Ko ēnei ngā raruraru ka puta, ina koa ki ngā kōwhiu uma hohonu:

• Te whakaiti i te kaha o te pūkahukahu me te uaua ki te manawa i te wā e whakakori ana
• Te pēhinga o te ngākau e ārai ana i te putanga o te ngākau
• Te kore e taea te whakakori me te ngenge wawe i ngā mahi tinana
• Ngā mate manawa maha nā te whakaiti o te mahi pūkahukahu
• Ngā whiu ngākau koretake i ngā take onge
• Ngā pānga hinengaro tae atu ki te iti o te whakaaro ki a koe me te wehe atu i te iwi

Kaua e whakaiti i te pānga hinengaro. He maha ngā tāngata he pectus excavatum e karo ana i ngā mahi pēnei i te kaukau, te haere ki te takutai, te takaro hākinakina rānei e hiahia ana rātou ki te tango i ō rātou koti. Ka taea e tēnei te pā ki ngā hononga pāpori me te kounga oranga katoa.

I ngā take onge rawa, ka taea e te pectus excavatum tino nui te tino pēhi i te ngākau me ngā pūkahukahu, e ārai ana i ngā raruraru manawa nui, i ngā raruraru ngākau rānei. Heoi, mā ngā taputapu whakamātautau hou, ka taea e ngā taote te kite wawe i ēnei take me te tūtohu i te maimoatanga tika.

Me pēhea te whakamātautau i te pectus excavatum?

Ko te whakamātautau i te pectus excavatum e tīmata ana i te tirotiro tinana ka taea ai e tō taote te kite me te ine i te kōwhiu uma. Ka ui rātou ki ō tohu, ki tō hītori whānau, me te āhua o te pā o te āhuatanga ki ō mahi o ia rā.

Ka tino mahi pea tō taote i ētahi whakamātautau hei mōhio ki te nui o tō āhuatanga, me te mea kei te pā rānei ki tō mahi ngākau, ki tō mahi pūkahukahu rānei. Ko te tukanga aromatawai e whakauru ana:

• Te tirotiro tinana e ine ana i te hohonu me te whānui o te kōwhiu uma
• Ngā X-ray uma hei kite i te hanganga wheua me te tirotiro i te neketanga o te ngākau
• Te CT scan hei tiki i ngā whakaahua taipitopito me te tatau i te tohu nui
• Ngā whakamātautau mahi pūkahukahu hei ine i te pai o te mahi a ō pūkahukahu
• Te echocardiogram hei tirotiro mēnā kei te pā tō mahi ngākau
• Te whakamātautau ahotea whakakori hei kite i te āhua o te whakautu a tō ngākau me ō pūkahukahu ki te mahi

He mea nui rawa te CT scan nā te mea ka āwhina i ngā taote ki te tatau i te mea e kiia nei ko te “Haller Index” – he ine e āwhina ana ki te whakatau i te nui o tō āhuatanga. Ka whakataurite tēnei tohu i te whānui o tō uma ki te tawhiti i waenganui i tō upoko uma me tō tuaiwi.

Kāore ēnei whakamātautau e mamae, ā, ka whakarato rātou i ngā mōhiohio whai hua e āwhina ana i tō rōpū hauora ki te tūtohu i te huarahi maimoatanga pai mō tō āhuatanga motuhake.

He aha te maimoatanga mō te pectus excavatum?

Ko te maimoatanga mō te pectus excavatum e whakawhirinaki ana ki te nui o tō āhuatanga, me te mea kei te pā rānei ki ngā tohu, ki tō mahi ngākau me tō mahi pūkahukahu rānei. Kāore te nuinga o ngā take iti e hiahia ana ki te maimoatanga, engari he maha ngā whiringa whai hua kei te wātea mō ngā take tino nui.

Mō ngā take iti kāore he tohu, ka tūtohu pea tō taote:

• Te aroturuki noa hei titiro ki ngā huringa i te wā
• Te rongoā tinana me ngā whakakori hei whakapai ake i te tū me te manawa
• Ngā whakakori uma hei whakakaha i ngā uaua huri noa i tō pouaka riu
• Ngā whakakori manawa hei whakanui i te kaha o te pūkahukahu

Ki te wātea ngā tohu, ki te tino nui rānei te kōwhiu, ka nui ake te whai hua o ngā whiringa pokanga. Ko ngā huarahi pokanga e rua matua ko:

Ko te tukanga Nuss e whakauru ana i te whakauru i te paepae rino kōwhiu i raro i tō upoko uma hei pehi atu ki waho. Ko tēnei pokanga iti te whakamahi i ngā wahi iti i ngā taha o tō uma. Ka noho te paepae i te wāhi mō ngā tau 2-4 i te wā e hurihuri ana tō uma, katahi ka tangohia i tetahi tukanga poto ake.

Ko te tukanga Ravitch he pokanga tuwhera tuku iho e tangohia ana e te taote te kirikiri koretake, e whakatūria ana te upoko uma. Ka tūtohu pea tēnei huarahi mō ngā tuakana, mō ngā tāngata rānei he tino nui ngā āhuatanga kōwhiu.

He nui te raru o ēnei pokanga e rua, ā, ka taea te whakapai ake i te ahua me ngā tohu. Ka āwhina tō taote i a koe ki te whiriwhiri i te whiringa pai e whakaaro ana ki tō tau, ki te nui o te āhuatanga, ki ō hiahia whaiaro rānei.

Me pēhea te whakahaere i te pectus excavatum i te kāinga?

Ahakoa kāore te maimoatanga kāinga e taea te whakatika i te kōwhiu uma, he maha ngā mea ka taea e koe te mahi hei whakahaere i ngā tohu me te pai ake te noho ki tō āhuatanga. Ka pai te mahi o ēnei huarahi mō ngā take iti, mēnā rānei kei te whakaaro koe ki ētahi atu whiringa maimoatanga.

Ka taea e ngā whakakori manawa te āwhina i te whakanui i te kaha o ō pūkahukahu me te whakaiti i te poto o te manawa. Whakamahia ngā tikanga manawa hohonu i ia rā, kia aro ki te whakawhanui i tō uma me te whakamahi i tō diaphragm katoa. Ka taea e tēnei te āwhina i a koe ki te whakamahi i tō wāhi pūkahukahu e wātea ana.

He mea nui te whakapai ake i te tū, nā te mea he maha ngā tāngata he pectus excavatum e ngana ana ki te kōwhiu ki mua hei huna i ō rātou uma. Ko ēnei ngā rautaki whai hua:

• Whakamahia te tū me te noho me ō pakihiwi ki muri me tō uma tuwhera
• Whakakaha i ō uaua tuara mā ngā whakakori pēnei i ngā rō me ngā pakaru hurihuri
• Tāia ō uaua uma i ia rā hei ārai i te kaha
• Whakaarohia te yoga, te Pilates rānei hei whakapai ake i te tū katoa me te kaha o te pūtau

Ka taea e te whakakori ngākau noa te āwhina i te whakapai ake i tō oranga tinana katoa me te kaha o te manawa. Tīmata noa, ā, whakaitihia te kaha i te wā e pai ake ana tō manawanui. He mea whai hua rawa te kaukau nā te mea e whakakori ana i tō ngākau me ō pūkahukahu i te wā e whakakaha ana i ngā uaua uma.

He mea nui te whakautu ki ngā āhuatanga hinengaro. Whakaarohia te kōrero ki ngā hoa, ki te whānau, ki te kaitohutohu rānei mō te āhua o te pā o te āhuatanga ki a koe. He maha ngā tāngata e kite ana ko te hono atu ki ētahi atu he pectus excavatum mā ngā rōpū tautoko, ngā hapori ipurangi rānei e āwhina ana i a rātou kia iti ake te noho kotahi.

Me pēhea te whakarite mō tō hui taote?

Ko te whakarite mō tō hui ka āwhina i a koe ki te whakamahi pai i tō wā me te taote, me te whakarite kua whakautuhia ngā āwangawanga katoa. Tīmata mā te tuhi i ō tohu, tae atu ki te wā e puta mai ana rātou me te āhua o te pā ki ō mahi o ia rā.

Kawe mai tētahi rārangi o ngā pūrongo e hiahia ana koe ki te ui. Whakaarohia te whakauru:

• Nōhea te nui o taku pectus excavatum?
• Kei te hono atu ō tohu ki te kōwhiu uma?
• He aha ngā whiringa maimoatanga kei te wātea mō taku āhuatanga?
• Ka kaha ake pea taku āhuatanga i te wā?
• Me karo pea ahau i ētahi mahi, i ngā whakakori rānei?
• Nōhea ka whakaaro ahau ki te pokanga?

Kohikohia tō hītori hauora, tae atu ki tetahi hītori whānau o ngā āhuatanga kōwhiu uma, o ngā mate kōpū hono rānei. Mēnā kua whai koe i ngā X-ray uma o mua, ngā whakaahua rānei, kawe mai ngā kōpe, kia taea rānei e tō taote te uru atu ki a rātou.

Whakaarohia te kawe mai i tētahi mema whānau, hoa rānei hei tautoko, ina koa mēnā kei te kōrero koe mō ngā whiringa pokanga. Ka taea e rātou te āwhina i a koe ki te mahara ki ngā mōhiohio nui me te ui ki ngā pūrongo ka wareware pea koe.

Kia rite ki te kōrero mō te āhua o te pā o te āhuatanga ki tō kounga oranga, tae atu ki ngā ārai i ngā mahi tinana, i ngā āhuatanga pāpori rānei. Ka āwhina ēnei mōhiohio i tō taote ki te mōhio ki te pā katoa o tō āhuatanga me te tūtohu i te maimoatanga tika.

He aha te mea nui mō te pectus excavatum?

Ko te pectus excavatum tētahi āhuatanga ka taea te whakahaere e pā ana ki te maha o te iwi, ā, kāore koe e noho kotahi ki te whakahaere i tēnei. Ahakoa ka āta whakaarohia te ahua o te kōwhiu uma, ko te nuinga o ngā tāngata he āhuatanga nei e ora ana i te ora katoa, mahi kaore he raruraru hauora nui.

Ko te mea nui hei mahara ko ngā maimoatanga whai hua kei te wātea mēnā kei te pā tō āhuatanga ki ngā tohu, ki tō kounga oranga rānei. Mai i ngā whakakori ngāwari me ngā tikanga manawa ki ngā tukanga pokanga tino angitu, he whiringa kei reira hei āwhina i a koe kia pai ake te noho tinana me te hinengaro.

Kaua e tuku i te pectus excavatum ki te ārai i ō mahi, i tō whakapono ki a koe rānei. Mēnā kei te pāngia koe e ngā tohu, mēnā rānei kei te āta whakaaro koe ki tō ahua, ko te kōrero atu ki te kaiwhakarato hauora ka taea te āwhina i a koe ki te mōhio ki ō whiringa me te whakatau whakamārama mō te maimoatanga.

Kia mahara ko te rapu āwhina he tohu o te tiaki pai i a koe, ehara i te ngoikore. Ahakoa ka whiriwhiri koe i te whakahaere mā te kore pokanga, ka whakatau rānei koe ki te whakatika pokanga, ko te whāinga ko te āwhina i a koe kia pai te noho, kia whakapono, kia taea te pai ki ngā mahi katoa e nui ana ki a koe.

Ngā pūrongo e ui pinepinetia ana mō te pectus excavatum

Q1: Ka kaha ake pea te pectus excavatum i te wā e pakeke haere ana ahau?

Ko te pectus excavatum e kitea ake ana i ngā wā e tere haere ana te tipu o te taiohi, engari ka pumau tonu i te wā e mutu ana te tipu. Ki te nuinga o ngā pakeke, kāore te āhuatanga e kaha ake te kino i te wā.

Q2: Ka taea e ahau te whakakori noa me te pectus excavatum?

Ko te nuinga o ngā tāngata he pectus excavatum iti ki te waenga e taea te whakakori noa me te whai wāhi ki ngā hākinakina kaore he ārai. Mēnā kei te pāngia koe e te poto o te manawa, e te mamae uma rānei i te wā e whakakori ana, he mea tika te kōrero ki tō taote, engari kaua e whakaaro me karo koe i te mahi tinana.

Q3: Ko te pokanga anake te huarahi hei whakatika i te ahua o te pectus excavatum?

I tēnei wā, ko te pokanga anake te huarahi hei whakatika tonu i te kōwhiu uma. Heoi, ka taea e ngā whakakori e whakakaha ana i ō uaua uma me te whakapai ake i te tū te whakaiti i te ahua me te pai ake te whakapono.

Q4: I tehea tau te pai ki te mahi i te pokanga pectus excavatum?

Ko te tau pai mō te pokanga e whakawhirinaki ana ki ngā take maha, engari he maha ngā taote e pai ana ki te mahi i ngā tau o te taiohi i te wā e tipu tonu ana te uma me te ngawari ake.

Q5: Ka hipoki pea te inihua i te maimoatanga pectus excavatum?

He rerekē te hipoki a te inihua, engari he maha ngā mahere ka hipoki i te maimoatanga i te wā e pā ana te pectus excavatum ki ngā raruraru mahi pēnei i ngā raruraru manawa, i te pēhinga ngākau rānei.