Rikeke

ʻO Rickets kahi maʻi i hoʻokumu ʻia e ka nele o ka wikamina D, calcium, a i ʻole phosphate. Ke alakaʻi nei ia i ka palupalu a nāwaliwali ʻana o nā iwi.

Kōkua ka Wikamina D i ke kino e kaohi i ka pae o ka calcium a me ka phosphate. Inā haʻahaʻa loa ke kiʻekiʻe o ke koko o kēia mau minelala, hana paha ke kino i nā hormones e hoʻokuʻu ai i ka calcium a me ka phosphate mai nā iwi. Alakaʻi kēia i nā iwi nāwaliwali a palupalu hoʻi.

Hoʻomoʻa ʻia ka Vitamin D mai ka meaʻai a i hana ʻia e ka ʻili ke hōʻike ʻia i ka lā. Loaʻa ka nele o ka huaola D e ka ʻili i ka poʻe e:

• Noho i nā aniau me ke kū iki o ka lā
• Pono e noho i loko o ka hale
• E hana i ka hale ma nā hola o ke ao

ʻAʻole paha lawa ʻoe i ka wikamina D mai kāu papaʻai inā ʻoe:

• Intolerant lactose (pilikia i ka hoʻoulu ʻana i nā huahana waiū)
• Mai inu i nā huahana waiū
• E hāhai i ka papaʻai vegetarian

ʻO nā pēpē i hānai ʻia i ka umauma wale nō e hoʻomohala i ka hemahema o ka wikamina D. ʻAʻole hāʻawi ka waiū umauma kanaka i ka nui kūpono o ka wikamina D. Hiki i kēia ke lilo i pilikia pilikia no nā keiki ʻili ʻili i nā mahina hoʻoilo. ʻO kēia no ka mea aia nā pae haʻahaʻa o ka lā i kēia mau mahina.

ʻO ka lawa ʻole o ka calcium a me ka phosphorous i kāu papaʻai hiki ke alakaʻi ʻia i nā rikeke. ʻO ka Rickets i hoʻokumu ʻia e ka nele o kēia mau minelala i ka papaʻai he mea laha ʻole ia i nā ʻāina kūkulu. Loaʻa ke kalima a me ka phosporous i ka waiū a me nā mea kanu ʻōmaʻomaʻo.

Hiki i kāu mau gen ke hoʻonui i kāu makaʻi i nā rickets. ʻO nā rikeke hoʻoilina he ʻano maʻi ia e hoʻoili ʻia e nā ʻohana. Hana ʻia ia ke hiki ʻole i nā puʻupaʻa ke hoʻopaʻa i ka mineral phosphate. Hoʻokumu pū ʻia ʻo Rickets e nā maʻi ʻōpū e pili ana i ka acidosis tubular renal.

ʻO nā maʻi e hōʻemi ana i ka digestion a i ʻole ka omo ʻana o nā momona e ʻoi aku ka paʻakikī o ka lawe ʻia ʻana o ka wikamina D i loko o ke kino.

I kekahi manawa, hiki mai nā rikeke i nā keiki i loaʻa i nā maʻi o ke ake. ʻAʻole hiki i kēia mau keiki ke hoʻolilo i ka wikamina D i kāna ʻano hana.

He kakaikahi ʻo Rickets i ʻAmelika Hui Pū ʻIa. Kūpono paha ia i nā keiki i nā wā o ka ulu wikiwiki. ʻO kēia ka makahiki e pono ai ke kino i nā kiʻekiʻe o ka calcium a me ka phosphate. ʻIke ʻia paha ʻo Raka i nā keiki mai nā makahiki 6 a 24 mau mahina. He mea maʻamau ia i nā keiki hānau hou.

ʻO nā ʻōuli o ka rikeke:

• ʻEhaʻeha a palupalu paha i nā lima, nā wāwae, nā pelvis, a me nā kuamoʻo
• Hoʻoemi i ke kani o ka mākala (ka nalowale o ka ikaika o nā mākala) a nāwaliwali e ʻoi aku ka maikaʻi
• Kahua niho deformities, me ka hoʻopaneʻe ʻana i ka hana ʻana o nā niho, nā kīnā o ka hanana niho, nā puka o ka enamel, a me nā māhuahua hoʻonui (nā niho niho)
• Hoʻonui ulu
• Hoʻonui i nā haʻi iwi
• Pākuʻi kaʻiʻo
• ʻO ke kino pōkole (nā mākua ma lalo o 5 kapuaʻi a i ʻole 1.52 mau mika ke kiʻekiʻe)
• ʻO nā kino iwi e like me ka iwi poʻo, ʻano kīkō, nā puʻupuʻu i ka iwi ʻaoʻao (rosary rosary), ka umauma i hoʻokokoke ʻia i mua (pigeon chest), pelvic deformities, a me nā spine deformities (ʻōiwi i ʻōwili kūpono ʻole, e like me scoliosis a kyphosis)

Hōʻike kahi hoʻokolohua kino i ka palupalu a i ʻole ka ʻeha o nā iwi, akā ʻaʻole i nā hono a i nā mākala.

Hiki i nā hoʻokolohua aʻe ke kōkua i ka hōʻoia ʻana i nā rikeke.

• Nā ʻenekini koko arterial
• Nā ho'āʻo koko (calcium serum)
• Biopsy iwi (hana iki ʻole ʻia)
• Iwi-kukuna
• Serum alkaline phosphatase (ALP)
• Pōhaku paʻakai

ʻO nā hōʻike a me nā kaʻina hana ʻē aʻe e like me kēia:

• ALP isoenzyme
• Kalipuna (ionized)
• ʻO ka hormone Parathyroid (PTH)
• Kāmiwa mimi

ʻO nā pahuhopu o ka mālama ʻana e hoʻomaha i nā ʻōuli a hoʻoponopono i ke kumu o ke ʻano. Pono e mālama ʻia ke kumu e pale ai i ka hoʻi ʻana mai o ka maʻi.

ʻO ka pani ʻana i ka calcium, phosphorus, a i ʻole ka wikamina D i nele e hoʻopau ʻia ka hapanui o nā hōʻailona o ka rickets. ʻO nā kumuwaiwai meaʻai o ka wikamina D pū ka iʻa iʻa a me ka waiū i hana ʻia.

Paipai ʻia ka hōʻike ʻana i ka huina o ka lā. Inā hopena ʻia ka rickets e kahi pilikia metabolic, pono ʻia kahi kuhikuhi no nā mea hoʻohui vitamin D.

Hiki ke hoʻohana i ke kau ʻana a i ka pale ʻana paha e hōʻemi a pale aku paha i nā hemahema. Pono paha kekahi mau deformities i ke kino e ʻoki ʻia e hoʻoponopono iā lākou.

Hiki ke hoʻoponopono ʻia ka maʻi ma ke kuapo ʻana i ka wikamina D a me nā minelala. Hoʻonui maikaʻi nā waiwai o ka hale hana a me nā x-ray ma hope o hoʻokahi pule. Pono paha kekahi mau hihia i nā kaha he nui o nā minelala a me ka huaola D.

Inā ʻaʻole e hoʻoponopono ʻia nā rikeke i ka wā e ulu mau ana ke keiki, paʻa mau nā kino iwi a me nā kino pōkole. Inā hoʻoponopono ia i ka wā ʻōpio o ke keiki, hoʻomaikaʻi a nalowale pinepine paha nā iwi kino me ka manawa.

ʻO nā pilikia kūpono:

• ʻEha ʻiwi iwi wā lōʻihi (mau)
• Nā hemahema iwi
• Nā haki iwi, hiki ke hana me ke kumu ʻole

Kāhea i kāu kahu mālama ola inā ʻike ʻoe i nā ʻōuli o ka rikeke.

Hiki iā ʻoe ke pale aku i nā rikeke ma ka hōʻoia ʻana i ka lawa o ka calcium, phosphorous, a me ka wikamina D i kāu keiki i kā lākou papaʻai. ʻO nā keiki i loaʻa ka digestive a i ʻole nā ​​maʻi ʻē aʻe e pono paha e lawe i nā mea hoʻopihapiha i kuhikuhi ʻia e ka mea hāʻawi o ke keiki.

ʻO nā maʻi ʻākoaki (renal) i kumu e hōʻola ʻia ai ka huamona vitamin D pono koke ʻia. Inā loaʻa ʻoe i nā maʻi hōʻeha, nānā pinepine i ka pae o ka calcium a me ka phosphorus.

Hiki i nā ʻōlelo aʻoaʻo genetic ke kōkua i ka poʻe i loaʻa ka moʻolelo ʻohana o nā maʻi hoʻoilina i hiki ke hana i nā rikeke.

ʻO Osteomalacia i nā keiki; Deficiamina D; Nā Rikeke Renal; Rikeke Hepatic

• X-ray

ʻO Bhan A, Rao AD, Bhadada SK, Rao SD. ʻO Rickets a me ka osteomalacia. Ma Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 31.

ʻO Demay MB, Krane SM. Nā maʻi o ka mineralization. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 71.

Greenbaum LA. ʻO ka hemahema o ka Vitamin D (rickets) a ʻoi aku. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 64.

ʻO Weinstein RS. ʻO Osteomalacia a me nā rikeke. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 231.