Hoʻoponopono hernia diaphragmatic hernia

ʻO ka hoʻomaikaʻi ʻana ʻo Congenital diaphragmatic hernia (CDH) kahi ʻoki e hoʻoponopono i kahi wehe a wahi paha i ka diaphragm o kahi pēpē. Kapa ʻia kēia wehe he hernia. ʻO ia ʻano ʻano kīnā o ka hānau hānau. ʻO ka manaʻo ʻo congenital aia ka pilikia i ka wā hānau.

Ma mua o ka hoʻopau ʻia ʻana, kokoke i nā pēpē āpau e pono i kahi mea hanu e hoʻomaikaʻi i ko lākou mau oxygen.

Hana ʻia ke ʻokiʻoki ʻoiai kāu keiki ma lalo o ka anesthesia ākea (hiamoe a ʻaʻole hiki ke ʻeha). Hana pinepine ka mea lapaʻau i kahi ʻoki (incision) i loko o ka ʻōpū ma lalo o nā iwi i luna. ʻAe kēia i nā ʻōpū o ka wahi e hiki. Huki mālie ke kaukipoki i kēia mau lālā i loko o ka wahi ma o ka wehe ʻana o ka diaphragm a i loko o ka lua o ka ʻōpū.

I nā hihia ʻoi aku ka paʻakikī, hiki ke hana i ke kaha me ka hoʻohana ʻana i nā ʻokiʻoki liʻiliʻi i ka umauma. Hoʻokomo ʻia kahi pahu paʻi wikiō liʻiliʻi i kapa ʻia ʻo ka thoracoscope ma o kekahi o nā ʻokiʻoki. ʻAe kēia i ke kaukipō e ʻike i loko o ka umauma. Hoʻokomo ʻia nā mea hana e hoʻoponopono ai i ka lua ma ka diaphragm ma o nā ʻokiʻoki ʻē aʻe.

I kēlā me kēia ʻano o ka hana, hoʻoponopono ka mea hoʻolāʻau i ka lua o ka diaphragm. Inā liʻiliʻi ka lua, e hoʻoponopono paha me nā humuhumu. A i ʻole, e hoʻohana ʻia kahi ʻāpana palaka e uhi i ka lua.

ʻO ka diaphragm kahi mākala. He mea nui ia no ka hanu ʻana. Hoʻokaʻawale ia i ka lua o ka pahu (kahi o ka puʻuwai a me nā akemāmā) mai kahi o ka ʻōpū.

I kahi keiki me ka CDH, ʻaʻole i hoʻokumu paʻa ʻia ka mākala diaphragm. Hāʻawi ka wehe CDH i nā mea mai ka ʻōpū (ʻōpū, palu, ake, a me nā ʻōpū) e piʻi i ka lua o ka umauma kahi o nā māmā. ʻAʻole ulu ulu nā māmā a noho liʻiliʻi no nā pēpē e hanu iā lākou iho ke hānau ʻia lākou. ʻO nā kīʻaha koko i loko o nā akemā e hoʻomohala maʻamau hoʻi. ʻO kēia ka hopena i ka lawa ʻole o ka oxygen i ke kino o ka pēpē.

Hiki i kahi hernia diaphragmatic ke hoʻoweliweli i ke ola a ʻo ka hapa nui o nā pēpē me CDH he maʻi nui loa lākou. Pono e hana i kahi ʻoki kino e hoʻomaikaʻi hou iā CDH ma mua o ka hānau ʻana o ka pēpē.

ʻO nā pōʻino no kēia ʻoki ʻana:

• Nā pilikia hanu, ʻoi aku paha ka nui
• Kahena
• Pulupā naha
• Nā pilikia o ka lepa e hele ʻole
• Maʻi kīnā
• Nā hopena i nā lāʻau

ʻAe ʻia nā pēpē i hānau ʻia me CDH i kahi neonatal intensive care unit (NICU). He mau lā a he mau pule paha ma mua o ka paʻa o ka pēpē no ke kaha ʻana. Ma muli o ke ʻano hoʻoweliweli o ke ola a me ka lawe ʻana i kahi keiki hānau maʻi loa he mea weliweli ia, ʻo nā pēpē i ʻike ʻia he CDH ko lākou e pono e lawe ʻia i waenakonu me nā kaukō pediatric a me nā neonatologists.

• I ka NICU, pono paha i kāu pēpē i mīkini mīkini hanu (ʻenekini mīkini) ma mua o ke ʻoki. Kōkua kēia i ka pēpē e hanu.
• Inā maʻi nui kāu keiki, pono paha kahi mīkini bypass puʻuwai puʻuwai (extracorporeal membrane oxygenator, a i ʻole ECMO) e hana i ka hana o ka puʻuwai a me nā akemāmā.
• Ma mua o ke kahakaha ʻana, loaʻa i kāu pēpē nā x-ray a me nā hoʻokolohua koko maʻamau e ʻike ai i ka maikaʻi o ka hana o nā mumū. Hoʻopili ʻia kahi mea uila (i kapa ʻia he pulse oximeter) i ka ʻili o ka pēpē e nānā i ke kiʻekiʻe o ka oxygen i loko o ke koko.
• Hāʻawi ʻia kāu pēpē i nā lāʻau e kāohi ai i ke koko a noho ʻoluʻolu.

E hoʻokau ʻia nā paipu i kāu pēpē:

• Mai ka waha a i ka ihu a i ka ʻōpū e mālama i ka ea mai ka ʻōpū
• I kahi artery e nānā i ke kahe o ke koko
• I ke aa e hāʻawi i nā meaola a me nā lāʻau

Aia kāu pēpē ma ka mīkini hanu ma hope o ke kaha ʻana a noho i ka haukapila no kekahi mau pule. Ke lawe ʻia aku mai ka mīkini hanu, pono paha i kāu pēpē i ka oxygen a me nā lāʻau no kekahi manawa.

E hoʻomaka ka hānai ʻana ma hope o ka hoʻomaka ʻana o ka ʻōpū o kāu pēpē e hana. Hāʻawi pinepine ʻia nā hānai ma o kahi paipu hānai liʻiliʻi, palupalu mai ka waha a ihu paha i loko o ka ʻōpū a i ʻole ka ʻōpū liʻiliʻi a hiki i kāu pēpē ke lawe i ka waiū ma ka waha.

Ma kahi kokoke i nā pēpē āpau me CDH he reflux ke ʻai lākou. ʻO kēia ka neʻe ʻana o ka meaʻai a i ʻole ka waikawa i loko o ko lākou ʻōpū i loko o kā lākou esophagus, ka paipu e alakaʻi ana mai ka puʻu a i ka ʻōpū. Hiki i kēia ke hōʻoluʻolu ʻole. Alakaʻi hoʻi ia i ka kuha pinepine ʻana a me ka luaʻi, kahi e ʻoi aku ai ka paʻakikī o ka hānai ʻana ke lawe kāu pēpē i ka meaʻai ma ka waha. Hoʻonui ka Reflux i ka makaʻu no ka maʻi ponia inā hemo nā pēpē i ka waiū i loko o kā lākou mau māmā. Hiki iā ia ke lilo i mea paʻakikī no nā pēpē e lawe i lawa nā calorie e ulu.

E aʻo nā kahu maʻi a me nā loea hānai iā ʻoe i nā ala e paʻa a hānai ai i kāu pēpē e pale ai i ka reflux. Pono kekahi mau pēpē ma ka paipu hānai no ka manawa lōʻihi e kōkua iā lākou e lawa i nā calorie e ulu.

Pili ka hopena o kēia ʻoki ʻana i ka maikaʻi o ka ulu ʻana o nā māmā o kāu pēpē. Loaʻa i kekahi mau pēpē nā pilikia olakino ʻē aʻe, keu hoʻi me ka puʻuwai, ka lolo, nā mākala, a me nā ami, kahi e hopena pinepine ai i ke ʻano o ka pēpē.

ʻO ka maʻamau he maikaʻi ka nānā no nā pēpē i hoʻomohala pono i nā kiko o ka māmā a ʻaʻohe pilikia ʻē aʻe. Eia nō naʻe, ʻo ka hapanui o nā pēpē i hānau ʻia me ka hernia diaphragmatic he maʻi nui loa lākou a noho lōʻihi i ka haukapila. Me nā holomua i ka lāʻau, ke hoʻomaikaʻi nei ka nānā no kēia mau pēpē.

Pono e nānā pono nā pēpē āpau i hoʻoponopono iā CDH e ʻike pono ʻaʻole e wehe hou ka lua o kā lākou diaphragm i ko lākou ulu ʻana.

ʻO nā pēpē i loaʻa ka wehe nui a kīnā ʻole paha i ka diaphragm, a i ʻoi aku paha nā pilikia me ko lākou mau māmā ma hope o ka hānau ʻana, he maʻi lolo paha kā lākou i haʻalele ai i ka haukapila. Pono paha lākou i ka oxygen, nā lāʻau, a me ka paipu hānai no nā mahina a mau makahiki paha.

E pilikia paha kekahi pēpē i ke kolo, ka hele wāwae, ke kamaʻilio ʻana, a me ka ʻai ʻana. Pono lākou e ʻike i ke olakino a i ʻole nā ​​limahana hana e kōkua iā lākou e hoʻomōhala i nā mākala a me ka ikaika.

Hnia hernia diaphragmatic - ʻoki kino

• Ke lawe nei i kāu keiki e kipa i kahi kaikaina maʻi loa
• Mālama ʻeha ʻeha - wehe

• Hoʻoponopono hernia Diaphragmatic - moʻo

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ʻO Hollinger LE, Harting MT, Lally KP. Loiloi manawa lōʻihi o ka hernia diaphragmatic hernia. ʻO Semin Pediatr Surg. 2017; 26 (3): 178-184. PMID: 28641757 www.ncbi.nlm.nih.gov/pubmed/28641757.

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ʻO Tsao KJ, Lally KP. Congenital diaphragmatic hernia a me ke ahiahi. I: Holcomb GW, Murphy JP, Ostlie DJ, eds. ʻO Surgery Pediatricʻo Ashcraft. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2014: chap 24.