Hewa septal ʻo Ventricular

ʻO ka hemahema septal ʻo Ventricular kahi lua i ka paia e hoʻokaʻawale i nā ventricle ʻākau a hema o ka puʻuwai. ʻO ka hemahema septal ʻo Ventricular kekahi o nā congenital maʻamau (kahi mai ka hānau ʻana) maʻi kīnā ʻole. Kū ʻia ia ma kahi o ka hapalua o nā keiki āpau me nā maʻi puʻuwai congenital. Hiki iā ia iho a i ʻole me nā maʻi hānau hou aʻe.

Ma mua o ka hānau ʻana o kahi pēpē, ʻaʻole hoʻokaʻawale ka ventricle ʻākau a me ka hema o ka puʻuwai. Ke ulu nei ka ʻōpū, puka kahi septal paia e hoʻokaʻawale i kēia mau ventricle 2. Inā kū ʻole ka paia, koe ka lua. ʻIke ʻia kēia lua ma ke ʻano he kīnā septal ventricular, a i ʻole VSD. Hiki i ka lua ke hana i nā wahi like ʻole ma ka paia septal. Hiki i hoʻokahi puka a i ʻole nā ​​puka he nui.

ʻO ka hemahema septal Ventricular kahi kīnā o ka naʻau maʻamau. ʻAʻohe paha he hōʻailona o ka pēpē a hiki i ka lua ke pani i ka manawa ke hoʻomau ka ulu ʻana o ka paia ma hope o ka hānau ʻana. Inā nui ka lua, e kaomi ʻia ka nui o ke koko i nā ake māmā. Hiki i kēia ke alakaʻi i ka puʻuwai puʻuwai. Inā liʻiliʻi ka lua, ʻaʻole paha e ʻike ʻia no nā makahiki a ʻike wale ʻia i ka wā makua.

ʻAʻole i ʻike ʻia ke kumu o VSD. Kū pinepine kēia hemahema me nā kīnā o ka naʻau congenital.

I ka poʻe mākua, hiki i nā VSD ke kākaʻikahi, akā koʻikoʻi, hoʻopiʻi ʻana i nā puʻuwai puʻuwai. ʻAʻole ka hopena o kēia mau lua mai kahi kīnā hānau.

ʻAʻole loaʻa nā ʻōuli i ka poʻe me VSDs. Eia nō naʻe, inā nui ka lua, loaʻa pinepine ka pēpē i nā ʻōuli e pili ana i ka maikaʻi ʻole o ka puʻuwai.

ʻO nā hōʻailona maʻamau e pili pū me:

• Pokole o ka hanu
• Hanu wikiwiki
• Hanu paʻakikī
• Maʻaleʻa
• ʻO ka loaʻa ʻole o ke kaupaona
• Ka helu puʻuwai wikiwiki
• Ke houu nei i ka hānai ʻana
• ʻO nā maʻi hanu pinepine

ʻO ka hoʻolohe ʻana me ka stethoscope e hōʻike pinepine ai i ka ʻōhumu o ka puʻuwai. Pili ka leo nui o ka namunamu i ka nui o ka hemahema a me ka nui o ke koko e hele aʻe i ka hemahema.

E komo pū paha nā hoʻāʻo:

• Kāleka Cardiac (ʻaʻole makemake ʻia, ke ʻole nā ​​hopohopo o ke kahe koko kiʻekiʻe i nā akemāmā)
• ʻO x-ray umauma - ke nānā aku inā he puʻuwai nui me ka wai i loko o nā akemāmā
• ECG - hōʻike i nā hōʻailona o ka ventricle hema nui i hoʻonui ʻia
• ʻO Echocardiogram - hoʻohana ʻia e hana i kahi ʻike paʻa
• MRI a i ʻole CT scan o ka puʻuwai - hoʻohana ʻia e ʻike i ke kīnā a ʻike i ka nui o ke koko e kiʻi ana i nā akemāmā

Inā liʻiliʻi ka hemahema, ʻaʻohe pono e mālama ʻia. Akā e kiaʻi pono ʻia ka pēpē e ka mea mālama ola. ʻO kēia e hōʻoia i ka pani hope ʻana o ka lua a ʻaʻole kū nā hōʻailona o ka puʻuwai ʻole.

ʻO nā pēpē me kahi VSD nui i loaʻa nā hōʻailona e pili ana i ka puʻuwai puʻuwai pono paha i ka lāʻau e kāohi ai i nā ʻōuli a me nā ʻoki e pani ai ka lua. Hoʻohana pinepine ʻia nā lāʻau diuretic e hōʻoluʻolu i nā ʻōuli o ka puʻuwai puʻuwai congestive.

Inā hoʻomau nā ʻōuli, ʻoiai me ka lāʻau, pono ke ʻoki e pani i ka hemahema me kahi pāʻina. Hiki ke pani ʻia kekahi mau VSD me kahi mea hana kūikawā i ka manawa o ka catheterization puʻuwai, kahi e pale ai i ka pono no ke kaha ʻana. Kapa ʻia kēia he transcatheter closure. Eia nō naʻe, hiki ke mālama pono ʻia kekahi ʻano o nā hemahema i kēia ala.

ʻO ka ʻoki ʻana no kahi VSD me ka ʻole o nā ʻōuli he mea hoʻopaʻapaʻa, keu hoʻi inā ʻaʻohe hōʻike o ka hōʻino puʻuwai. E kūkākūkā pono i kēia me kāu mea hāʻawi.

Nui nā kīnā liʻiliʻi e pani iā ​​lākou iho. Hiki i ke keʻoki kino ke hoʻoponopono i nā kīnā ʻaʻole kokoke. I ka hapanui o nā hihia, ʻaʻole e loaʻa i kekahi kanaka nā pilikia olakino e pili ana i ka hemahema inā pani ʻia me ke ʻoki a pani ʻia ʻana nona iho. Hiki i nā pilikia ke mālama ʻole ʻia kahi kīnā nui a aia kekahi mau pōʻino mau loa i nā mumū.

Komo pū nā pilikia:

• Ka lawa ʻole o Aortic (ka liu ʻana o ka kiwikā e hoʻokaʻawale i ka ventricle hema mai ke aorta)
• Ka hōʻino ʻana i ka ʻōnaehana hoʻoliʻiliʻi uila o ka puʻuwai i ka wā o ke ʻoki ʻana (e hoʻoulu ana i kahi puʻuwai puʻuwai a i ʻole lohi)
• Lohi ka ulu ʻana a me ka hoʻomohala ʻana (ʻole e ulu pono i ka wā kamaliʻi)
• Hewa puʻuwai
• Infocarditis infective (koʻohune maʻiʻaʻai o ka puʻuwai)
• Pulmonary hypertension (ke koko kiʻekiʻe ma nā akemāmā) e alakaʻi ana i ka holo pono ʻole o ka ʻaoʻao ʻākau o ka puʻuwai

ʻO ka pinepine, ʻike ʻia kēia ʻano i ka wā o ka hoʻokolohua maʻamau o kahi pēpē. Kāhea i kāu pēpē inā loaʻa ka pilikia o ka pēpē i ka hanu ʻana, a i ʻole inā he helu ʻokoʻa kā ka pēpē i nā maʻi hanu.

Koe no VSD i kumu ʻia e ka puʻuwai puʻuwai, aia mau kēia ʻano i ka wā hānau.

ʻO ka inu ʻana i ka ʻalekohola a me ka hoʻohana ʻana i nā lāʻau antiseizure depakote a me dilantin i ka wā hāpai hāpai e hoʻonui ai i ka makaʻu no VSDs. Ma mua o ka hōʻalo ʻana i kēia mau mea i ka wā hāpai, ʻaʻohe ala i ʻike ʻia e pale aku ai i kahi VSD.

VSD; Ka hemahema septal interventricular; Hapa puʻuwai Congenital - VSD

• ʻOki puʻuwai Pediatric - hoʻokuʻu

• Puʻuwai - ʻāpana ma waena o ka waena
• Puʻuwai - ʻike mua
• Hewa septal ʻo Ventricular

Fraser CD, Kane LC. Maʻi maʻi ʻōpū. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery: Ke kumu kumu olaola o ka hana ʻoki ʻana o kēia ao. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 58.

Webb GD, Smallhorn JF, Therrien J, Redington AN. ʻO ka maʻi puʻuwai Congenital i ke kanaka makua a me ka mea maʻi pediatric. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 75.