Patent ductus arteriosus

ʻO Patent ductus arteriosus (PDA) kahi ʻano i kokoke ʻole ke ductus arteriosus. ʻO ka huaʻōlelo "patent" e wehe.

ʻO ke ductus arteriosus kahi kīʻaha koko e ʻae ai i ke koko e hele a puni nā māmā o ka pēpē ma mua o ka hānau ʻana. Ma hope koke iho o ka hānau ʻia ʻana o ke pēpē a hoʻopiha nā māmā me ka ea, ʻaʻole pono ka ductus arteriosus. Pani pinepine ia i loko o nā lā ʻelua ma hope o ka hānau ʻana. Inā ʻaʻole pani ka moku, ua kapa ʻia ia he PDA.

Alakaʻi ʻo PDA i ke kahe o ke koko ʻokoʻa ma waena o nā kīʻaha koko nui 2 e lawe i ke koko mai ka puʻuwai i nā akemāmā a i ke koena o ke kino.

ʻOi aku ka maʻamau o PDA i nā kaikamahine ma mua o nā keikikāne. ʻOi aku ka maʻamau o ke ʻano i nā pēpē a me nā mea me nā maʻi pēpē hanu neonatal. ʻO nā pēpē me nā maʻi genetics, e like me Down Syndrome, a i ʻole nā ​​pēpē i loaʻa i ko lākou mau makuahine i ka wā rubella i ka makaʻu kiʻekiʻe no PDA

Kūleʻa ʻo PDA i nā pēpē me nā pilikia puʻuwai congenital, e like me ka hypoplastic left heart syndrome, transposition o nā moku nui, a me stenosis pulmonary.

ʻAʻole hiki i kahi PDA liʻiliʻi ke hana i kekahi ʻōuli. Eia nō naʻe, loaʻa i kekahi mau pēpē nā ʻōuli e like me:

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• Piʻi maikaʻi ʻole

Loaʻa pinepine nā pēpē me PDA i ka ʻōhumu o ka puʻuwai e hiki ke lohe ʻia me kahi stethoscope. Eia nō naʻe, i nā kamaliʻi ʻōpio, ʻaʻole e lohe ʻia ka ʻōhumu o ka naʻau. E kānalua paha ka mea mālama ola i kēia ʻano inā he hanu a hānai paha ka pēpē ma hope koke o ka hānau ʻana.

ʻIke ʻia paha nā hoʻololi ʻana ma nā kukuna x. Hōʻoia ʻia ka hōʻailona me kahi echocardiogram.

I kekahi manawa, ʻaʻole e ʻike ʻia kahi PDA liʻiliʻi a hiki i ka wā kamaliʻi.

Inā ʻaʻohe kīnā o ka puʻuwai e kū nei, pinepine ka pahuhopu o ka mālama ʻana e hoʻopau i ka PDA. Inā loaʻa i ka pēpē kekahi mau pilikia puʻuwai ʻē aʻe a i ʻole kīnā paha, ke mālama nei i ka ductus arteriosus hāmama ke ola. Hoʻohana ʻia ka lāʻau lapaʻau e hōʻoki iā ia mai ka panina ʻana.

I kekahi manawa, pani paha kahi PDA ma kāna iho. I nā pēpē premature, pani pinepine ia i loko o nā makahiki 2 mua o ke ola. I nā pēpē wā piha, kahi PDA e hāmama mau ana ma hope o nā pule he mau pule mua ʻaʻole paʻakikī e pani iā ​​ia iho.

Ke pono ka lapaʻau ʻana, ʻo nā lāʻau e like me indomethacin a i ʻole ibuprofen ka koho mua loa. Hiki ke hana maikaʻi nā lāʻau lapaʻau no kekahi mau keiki hānau hou, me nā hopena ʻaoʻao. Hāʻawi ʻia ka lāʻau ma mua, ʻo ka ʻoi aku paha o ke kūleʻa.

Inā ʻaʻole holo pono kēia mau ana a ʻaʻole hiki ke hoʻohana ʻia, pono paha i ka pēpē ke loaʻa i kahi kaʻina olakino.

ʻO ka pani ʻana o ka mea transcatheter kahi hana e hoʻohana ai i kahi paipu lahilahi a hollow i waiho ʻia i loko o kahi kīʻaha koko. Hāʻalo ke kauka i kahi wili liʻiliʻi a i ʻole nā ​​mea paʻa ʻē aʻe ma o ka catheter a hiki i ka pūnaewele o ka PDA. Mālama kēia i ke kahe o ke koko ma o ka moku. Hiki i kēia mau ʻōwili ke kōkua i ka pēpē e hōʻalo i ke ʻoki.

Pono paha ke ʻoki kino inā ʻaʻole holo ka hana catheter a ʻaʻole hiki ke hoʻohana ʻia ma muli o ka nui o ka pēpē a i ʻole nā ​​kumu ʻē aʻe. ʻO ke ʻoki kino ke hana i kahi ʻoki liʻiliʻi ma waena o nā iwi ʻaoʻao e hoʻoponopono ai i ka PDA.

Inā wehe hamama kahi PDA liʻiliʻi, hiki i ka pēpē ke hoʻomōhala i nā ʻōuli o ka naʻau. Hiki i nā pēpē me ka PDA nui aʻe ke hoʻomohala i nā pilikia o ka puʻuwai e like me ka maikaʻi ʻole o ka puʻuwai, ke koko kiʻekiʻe ma nā aʻa o nā akemāmā, a i ʻole kahi maʻi o ka uhi o ka puʻuwai inā ʻaʻole pili ka PDA.

Hoʻomaopopo pinepine ʻia kēia ʻano e ka mea nāna e nānā i kāu pēpē. ʻO nā pilikia hanu a me ka hānai ʻana i kahi pēpē i kekahi manawa ma muli o kahi PDA i hōʻike ʻole ʻia.

PDA

• ʻOki puʻuwai Pediatric - hoʻokuʻu

• Puʻuwai - ʻāpana ma waena o ka waena
• Patent ductus arteriosis (PDA) - ke kaʻina

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.