He aha te Pulmonary Atresia me te Ventricular Septal Defect? Ngā Tōmhanga, Ngā Take, me te Maimoatanga

Ko te pulmonary atresia me te ventricular septal defect he mate ngākau nui e whānau mai ana ngā pēpi, kāre e hanga tika te poka pulmonary, ā, he rua kei waenganui i ngā ruma pupuhi matua o te ngākau. Ko te tikanga, kāre e taea e te toto iti-oxygen te rere noa mai i te ngākau ki ngā pūkahukahu kia tango i te oxygen.

Whakaarohia tō ngākau he whā ruma me ngā tatau kei waenganui. I roto i tēnei āhuatanga, kua ārai katoa tetahi o aua tatau (te poka pulmonary), ā, he tuwhera kei te pakitara kei waenganui i ngā ruma e rua kāre e tika. Ka hanga tēnei i te āhuatanga uaua e kaha ake ai te mahi a te ngākau o tō pēpi kia whiwhi oxygen te tinana.

He aha te Pulmonary Atresia me te Ventricular Septal Defect?

Ka puta te pulmonary atresia me te ventricular septal defect (PA-VSD) ina puta tahi ngā mate ngākau e rua mai i te wā whānau. Ko te poka pulmonary, me whakatuwhera kia rere te toto mai i te ngākau ki ngā pūkahukahu, kua ārai katoa, kāre rānei.

I te wā kotahi, he rua kei te pakitara (septum) e wehe ana i ngā ruma iti e rua o te ngākau (ventricles). Ka uaua rawa tenei whakakotahitanga mō te toto kia tae ki ngā pūkahukahu kia tango i te oxygen.

Ka ngana te tinana o tō pēpi ki te whakatikatika mā te whakawhanake i ngā oko toto taapiri e kiia nei ko te collateral circulation. Ka āwhina ēnei ara taapiri i ētahi toto kia tae ki ngā pūkahukahu, engari kāre i te pai penei i te ara noa.

Ka pā tēnei āhuatanga ki te 1 i roto i ngā pēpi 10,000 e whānau ana. Ahakoa ka rangona he nui, kua tino angitu te maimoatanga i te wā o mua, nā ngā whakapainga i te pokanga ngākau tamariki.

He aha ngā Tōmhanga o te Pulmonary Atresia me te Ventricular Septal Defect?

Ka puta ngā tōmhanga o te PA-VSD i roto i ngā rā, wiki rānei tuatahi o te oranga o tō pēpi. Ka kite pea koe i te kiri, ngutu, me ngā maihao o tō pēpi e huri ana ki te kikorangi, ina tangi, kai rānei.

Ko ēnei ngā tohu matua hei titiro:

• Te kikorangi o te kiri, ngutu, me ngā maihao (cyanosis)
• Te uaua ki te manawa, te tere o te manawa rānei
• Te kai kino, te ngenge rānei i te wā e kai ana
• Te kore e piki te taumaha noa
• Te riri nui ake, te ngangau rānei
• Te pupuhi o ngā maihao me ngā waewae (ka porotaka, ka nui ngā pito o ngā maihao)
• Ngā wā ngenge, ngā wā rānei e ngenge ai tō pēpi

Ka whānau pea ētahi pēpi i ngā raruraru nui ake penei i te ngoikore o te ngākau, kei te whakapakeke te ngākau ki te pupuhi toto.

Ka rereke te kaha o ngā tōmhanga, kei te nui o te toto e tae ana ki ngā pūkahukahu mā ngā ara taapiri i kōrerotia e mātou i mua.

He aha ngā Momo o te Pulmonary Atresia me te Ventricular Septal Defect?

Ka whakarōpūtia e ngā tākuta te PA-VSD i runga i te āhua o te rere o te toto ki ngā pūkahukahu, me te hanganga motuhake o te ngākau o ia tamaiti. Ko te wehenga matua ko te mea kei a tō tamaiti te rere toto pai ki ngā pūkahukahu, kāre rānei.

Ko te momo 1 e pā ana ki ngā tamariki he oko toto collateral pai kua whānau mai ki te whakarato i ngā pūkahukahu. Ka taea e ēnei ara taapiri te whakarato i te rere toto pai, ahakoa kāre i te nui penei i te ngākau noa.

Ko te momo 2 e whakauru ana i ngā tamariki he collateral circulation iti, kāre rānei. He maha ngā pēpi nei e hiahia ana ki te whakauru tere na te mea kāre e whiwhi toto pai ō rātou pūkahukahu.

He whakarōpū ano hoki i runga i te mea kei te whānuitia, kei te iti rānei ngā oko pulmonary matua (ngā oko nui e kawe ana i te toto ki ia pūkahukahu). Ko ngā tamariki he oko pulmonary nui, pai te hanganga, he pai ake te hua.

Ka whakatau te kaitātari ngākau o tō tamaiti ko tehea momo kei a tō pēpi mā ngā rangahau whakaahua taipitopito, ā, ka āwhina tēnei ki te aratohu i te mahere maimoatanga.

He aha ngā Take o te Pulmonary Atresia me te Ventricular Septal Defect?

Ka whānau te PA-VSD i roto i ngā wiki 8 tuatahi o te hapu ina hanga ana te ngākau o tō pēpi. Kāre i tino mōhiotia te take pono, engari he whakakotahitanga pea o ngā take ira me ngā taiao.

Ko te nuinga o ngā take ka puta noa mai kāre he take mārama. Kāre noa iho te hanganga o te ngākau o tō pēpi i te wā o aua wiki matua i te wā e hanga ana ngā whekau.

Ko ēnei etahi take ka piki ake te tūponotanga:

• Ngā mate ira penei i te DiGeorge syndrome, te CHARGE syndrome rānei
• Te hītori whānau o ngā mate ngākau whānau
• Te mate huka o te whaea i te wā hapu
• Ētahi rongoā i tangohia i te wā hapu tuatahi
• Ngā mate o te whaea penei i te rubella i te wā hapu
• Te inu waipiro a te whaea i te wā hapu
• Te pakeke o te whaea (neke atu i te 35)

I roto i ngā take onge, ka taea te PA-VSD hei wāhanga o te mate ira nui ake e pā ana ki ngā pūnaha tinana maha. Heoi, ko te nuinga o ngā tamariki he mate ngākau motuhake tēnei.

He mea nui kia mōhio kāre he mea i mahi koe, kāre rānei i mahi i te wā hapu i puta ai tēnei āhuatanga. Ka puta ngā mate ngākau penei i te PA-VSD i te wā hapu tino tuatahi, i mua pea i te mōhio koe kei te hapu koe.

Nōhea te Tiro ki te Tākuta mō te Pulmonary Atresia me te Ventricular Septal Defect?

Ka kitea te PA-VSD i te wā hapu mā ngā whakamātau ultrasound noa, i te 18-22 wiki pea. Mena ka whakapaetia, ka tono tō tākuta i te ultrasound motuhake e kiia nei ko te fetal echocardiogram kia whiwhi whakaahua taipitopito o te ngākau o tō pēpi.

I muri i te whānau, ka whakauru te whakatau i ngā whakamātau maha kia mōhiotia te hanganga ngākau motuhake o tō pēpi. Ko te tae o te kiri o tō pēpi, ngā āhua manawa, me ngā uaua kai ka whakaatu i ngā tohu tuatahi e hiahia ana ki te aro.

Ko te tukanga whakatau i te nuinga o te wā e whakauru ana:

1. Te tirohanga tinana me te whakarongo ki te ngākau
2. Te X-ray uma ki te kite i te rahi o te ngākau me te rere toto pūkahukahu
3. Te echocardiogram (ultrasound ngākau) mō te hanganga ngākau taipitopito
4. Te electrocardiogram (EKG) ki te tirotiro i te āhua o te ngākau
5. Te pulse oximetry ki te ine i ngā taumata oxygen
6. Te cardiac catheterization mō ngā ine tika
7. Te MRI, te CT scan rānei mō te whakaahua taipitopito

He mea nui te cardiac catheterization na te mea ka taea e ngā tākuta te kite tika i te āhua o te rere o te toto i roto i te ngākau o tō pēpi, me te ine i ngā pehanga i roto i ngā ruma rerekē. He mea nui tēnei mōhiohio mō te whakarite i te maimoatanga.

Ka tirotiro hoki te kaitātari ngākau o tō pēpi mō ētahi āhuatanga ira, ētahi atu mate ngākau rānei e puta mai ana. Ka āwhina tēnei aromatawai whānui ki te hanga i te mahere maimoatanga tino pai mō te āhuatanga motuhake o tō tamaiti.

He aha te Maimoatanga mō te Pulmonary Atresia me te Ventricular Septal Defect?

Ko te maimoatanga mō te PA-VSD i te nuinga o te wā e whakauru ana i te pokanga, engari ko te wā me te huarahi e whakawhirinaki ana ki te āhuatanga motuhake o tō tamaiti me ngā tōmhanga. Ko te whāinga ko te āwhina i te nui ake o te toto kia tae ki ngā pūkahukahu, kia whakaitihia te mahi a te ngākau o tō pēpi.

Ko te nuinga o ngā pēpi e hiahia ana ki tā rātou pokanga tuatahi i roto i ngā marama tuatahi o te oranga. Ko tēnei tukanga tuatahi, e kiia ana ko te Blalock-Taussig shunt, ka hanga i te ara hou mō te toto kia tae ki ngā pūkahukahu mā te whakamahi i te pūtau iti.

Ko te mahere maimoatanga katoa i te nuinga o te wā e whakauru ana i ngā pokanga maha i roto i ngā tau maha:

1. Te pokanga shunt tuatahi (i roto i ngā marama tuatahi o te oranga)
2. Te pokanga waenga ki te whakapai ake i te rere toto pūkahukahu (tata ki te 4-6 marama)
3. Te pokanga whakatikatika katoa (i waenganui i te 6 marama ki te 2 tau)
4. Ngā pokanga taapiri pea i te wā e tipu ana tō tamaiti

I waenganui i ngā pokanga, ka hiahia tō tamaiti ki ngā rongoā hei āwhina i te ngākau kia mahi pai ake, kia ārai hoki i ngā raruraru. Ka whakauru pea ēnei i ngā diuretics hei whakaiti i te kohinga wai, me ngā rongoā hei whakakaha i ngā pupuhi o te ngākau.

Ka hiahia pea ētahi tamariki ki ētahi atu tukanga penei i te balloon angioplasty hei whakatuwhera i ngā oko toto pōturi, te whakanoho rānei i te taputapu hei kati i ngā hononga e kore e hiahiatia kei waenganui i ngā oko toto.

Ka mahi ngātahi te rōpū pokanga ki a koe ki te wā pai mō ia tukanga, mā te whakaaro ki te tipu o tō tamaiti, ngā tōmhanga, me te hauora whānui. He tino pai ngā hua o te pokanga ngākau tamariki hou mō te whakatikatika PA-VSD.

Me pēhea te Whakarato i te Tiaki Kāinga i te wā o te Pulmonary Atresia me te Ventricular Septal Defect?

Ko te tiaki i te tamaiti he PA-VSD i te kāinga e hiahia ana ki te arotahi motuhake, engari ka pai te whakarite o te nuinga o ngā whānau mā te aratohu tika. Ko tō arotahi matua ko te tirotiro i ngā tōmhanga o tō tamaiti, me te whakarite kia whiwhi kai me te okioki pai.

Ka uaua pea te whāngai na te mea ka ngenge ngāwari ngā pēpi he PA-VSD. Tuku ngā kai iti ake, maha atu, ā, whakaarohia ngā hāora nui-calorie mena ka tūtohu tō tākuta kia āwhina i te piki o te taumaha.

Ko ēnei ngā āhuatanga matua o te tiaki kāinga:

• Tirohia te tae o te kiri, ina koa te ngutu me ngā maihao
• Tirohia ngā huringa i ngā āhua manawa
• Aroturuki i te piki o te taumaha me ngā āhua whāngai
• Hoatu ngā rongoā penei i te whakahau
• Ārai i ngā mate mā te horoi pai
• Whakaitihia te whakapiri ki ngā tāngata mate ina taea
• Whakaritea ngā kaupapa moe noa
• Whai i ngā ārahitanga mahi penei i te whakahau

Tūhonohia te rārangi o ngā tōmhanga o tō tamaiti, ngā rahinga whāngai, me ētahi atu huringa e awangawanga ana. Ka āwhina tēnei mōhiohio i tō rōpū hauora ki te whakatau i ngā whakatau mō te wā maimoatanga me ngā whakatikatika.

Hangaia he taiao mālie, tautoko i te kāinga. Ko ngā tamariki he mate ngākau ka pai ake te mahi mā ngā kaupapa pumau me te iti o te ahotea. Kaua e whakaroa ki te tono awhina ki te whānau me ngā hoa mō ngā mahi o ia rā kia taea ai e koe te aro ki te tiaki o tō tamaiti.

Me pēhea te Whakarite mō tō Hui Tākuta?

Ko te whakarite mō ngā hui kaitātari ngākau e āwhina ana kia whiwhi koe i te hua pai o ia haerenga, ā, kaua e wareware i ngā pātai, ngā awangawanga rānei nui. Pupurihia he rārangi o ngā tirohanga mō te āhuatanga o tō tamaiti i waenganui i ngā haerenga.

Kawe mai i te rēkōti hauora katoa o tō tamaiti, tae atu ki ētahi whakamātau, tukanga rānei hou mai i ētahi atu tākuta. Mena kua pupuri koe i te rārangi tōmhanga, kawe mai tēnā na te mea ka whakarato i ngā mōhiohio nui mō ngā āhua me ngā huringa.

Ko ēnei ngā mea hei whakarite i mua i ia hui:

• Rārangi o ngā rongoā o nāianei me ngā horoinga
• Ngā pātai mō te āhuatanga o tō tamaiti me te maimoatanga
• Ngā awangawanga mō ngā tōmhanga, ngā huringa whānau rānei
• Mōhiohio mō te whāngai, te tipu, me te whanaketanga
• Ngā kāri inihua me ngā tuhinga e hiahiatia ana
• Mōhiohio whakapā āwhāwhā
• Ngā taonga whakamārie mō tō tamaiti

Tuhia ngā pātai matua i mua, penei i te uiui mō ngā ārahitanga mahi, nōhea pea te pokanga e whai ake mai, ngā tōmhanga rānei e hiahia ana ki te arotahi tere. Kaua e manukanuka ki te ui i ngā pātai maha – e hiahia ana tō rōpū hauora kia mōhio koe.

Whakaarohia te kawe mai i te mema whānau, te hoa rānei mō te tautoko, ina koa i ngā hui ka korerohia ngā whakatau nui. Ka taea e tetahi atu tangata te āwhina i a koe ki te mahara ki ngā mōhiohio nui, me te whakarato tautoko ngākau.

He aha te Tākutake Matua mō te Pulmonary Atresia me te Ventricular Septal Defect?

Ko te PA-VSD he mate ngākau nui engari ka taea te whakaora e hiahia ana ki te tiaki hauora motuhake me ngā pokanga maha i te wā. Ahakoa ka rangona he nui te whakatau, kua tino whakapai ake ngā whakapainga i te pokanga ngākau tamariki i ngā hua mō ngā tamariki he āhuatanga tēnei.

Ko te nuinga o ngā tamariki he PA-VSD ka taea te noho ora, mahi ora i muri i te maimoatanga angitu. Ahakoa ka hiahia rātou ki te whai i te ngākau i te ora katoa, ā, ka taea pea te ārahitanga mahi, ka taea e te nuinga te whakauru ki te kura, hākinakina, me ētahi atu mahi tamariki. Ko te matua ko te mahi tahi me tō rōpū hauora ki te whakahaere tika i te āhuatanga, ki te tirotiro hoki i ngā huringa i te wā.

Ka motuhake te haerenga o tō tamaiti, ā, ka whakaritea ngā mahere maimoatanga ki ia āhuatanga motuhake. Ka hiahia pea ētahi tamariki ki ētahi atu tukanga atu i ētahi atu, engari ko te whāinga tonu ko te āwhina i tō tamaiti kia whiwhi i te kounga ora pai rawa atu.

Kia mahara kāre koe e noho ana kotahi i tēnei haerenga. Ka taea e tō rōpū hauora, whānau, me ngā rōpū tautoko te whakarato i te awhina me te whakatenatena nui. He maha ngā whānau e kite ana he whai hua te hono atu ki ētahi atu kua haere i tēnei ara i mua.

Ngā Pātai Nui e Ui ana mō te Pulmonary Atresia me te Ventricular Septal Defect

Ka taea e taku tamaiti he PA-VSD te noho ora noa?

Ka taea e te nuinga o ngā tamariki he PA-VSD te noho ora, mahi ora i muri i te maimoatanga angitu. Ahakoa ka hiahia rātou ki te whai i te ngākau i te ora katoa, ā, ka taea pea te ārahitanga mahi, ka taea e te nuinga te whakauru ki te kura, hākinakina, me ētahi atu mahi tamariki. Ko te matua ko te mahi tahi me tō rōpū hauora ki te whakahaere tika i te āhuatanga, ki te tirotiro hoki i ngā huringa i te wā.

E hia ngā pokanga e hiahia ana taku tamaiti?

Ko te nuinga o ngā tamariki he PA-VSD e hiahia ana ki te 2-3 pokanga nui i roto i ō rātou tau tuatahi o te oranga, me te āhei pea mō ētahi atu tukanga i te wā e tipu ana. Ko te maha pono e whakawhirinaki ana ki te hanganga motuhake o tō tamaiti me te āhua o te whakautu ki te maimoatanga. Ka kōrero tō kaitātari mō te huarahi pokanga e whakamaheretia ana, ā, ka āwhina i a koe ki te mōhio ki ngā mea e tatari ana i ia wāhanga.

He aha ngā pānga roa o te PA-VSD?

Mā te maimoatanga angitu, ka taea e te nuinga o ngā tamariki he PA-VSD te tumanako i ngā hua pai mo te roa. Heoi, ka hiahia rātou ki te whai i te ngākau i te ora katoa kia tirotirohia te mahi o te ngākau, kia titiro hoki ki ngā raruraru pea. Ka taea pea e ētahi te ārahitanga mahi, te hiahia rānei ki ētahi atu tukanga i muri mai i te ora, engari he maha te noho ora noa mā te tiaki tika.

Ka taea te ārai i te PA-VSD?

I tēnei wā, kāre he huarahi hei ārai i te PA-VSD na te mea ka whānau mai i te wā hapu tuatahi nā ngā take i tua atu o te mana o te tangata. Heoi, ko te pupuri i te tiaki hapu pai, te whakahaere i te mate huka mena kei reira, te karo i te waipiro me te wāhine i te wā hapu, me te tango i ngā taapiringa waikawa folic i whakahaua e taea te tautoko i te whanaketanga peepi hauora whānui.

Me pēhea te pā o te PA-VSD ki te tipu me te whanaketanga o taku tamaiti?

I mua i te pokanga, ko ngā tamariki he PA-VSD i te nuinga o te wā ka piki haere te taumaha, ā, ka taea te tae atu ki ngā tohu whanaketanga i muri iho i te noa. I muri i te maimoatanga angitu, ka taea e te nuinga o ngā tamariki te hopu i te tipu me te whanaketanga. Ka tirotiro tata tō rōpū hauora i ēnei wāhi, ā, ka whakarato i ngā ratonga tautoko mena e hiahiatia ana kia āwhina i tō tamaiti kia tae atu ki tōna kaha katoa.