Hōʻino puʻuwai Congenital - hoʻoponopono ʻoki

Hoʻoponopono a hoʻoponopono paha ka naʻau kūlohelohe Congenital i kahi kīnā o ka naʻau i hānau ʻia ai kahi keiki. ʻO kahi pēpē i hānau ʻia me hoʻokahi a ʻoi paha kīnā o ka naʻau i loaʻa i ka maʻi puʻuwai congenital. Pono ka ʻoki ʻana inā hiki i ka kīnā ke hōʻeha i ke olakino olakino o ke keiki a me ka maikaʻi.

Nui a hewahewa nā ʻano o ke kāpili puʻuwai pediatric.

Patent ductus arteriosus (PDA) ligation:

• Ma mua o ka hānau ʻana, he kīʻaha koko ko ka pēpē e holo ma waena o ka aorta (ke aʻa nui i ke kino) a me ka aʻa o ka pulmonary (ke aʻa nui i nā akemāmā), i kapa ʻia ʻo ductus arteriosus. Pani pinepine kēia moku liʻiliʻi ma hope koke o ka hānau ʻana ke hoʻomaka ka pēpē e hanu iā lākou iho. Inā ʻaʻole ia e pani. Kapa ʻia ia he patent ductus arteriosus. Hiki i kēia ke kumu i nā pilikia ma hope o ke ola.
• I ka hapanui o nā hihia, e pani ke kauka i ka wehe me ka hoʻohana ʻana i ka lāʻau. Inā ʻaʻole holo pono kēia, a laila hoʻohana ʻia nā ʻenehana ʻē aʻe.
• I kekahi manawa hiki ke pani ʻia ka PDA me ke kaʻina hana i pili ʻole i ke ʻoki. Hana pinepine ʻia ke kaʻina hana i kahi keʻena hoʻokolohua e hoʻohana ai i nā kukuna x. I kēia kaʻina hana, hana ka mea ʻokiʻoki i kahi ʻoki liʻiliʻi i ke aʻa. Hoʻokomo ʻia kahi uea a me ka paipu i kapa ʻia he catheter i loko o ke aʻa o ka wāwae a hoʻoili ʻia i ka puʻuwai. A laila, hoʻoili ʻia kahi wili liʻiliʻi a i ʻole kekahi mea hana e ka catheter i loko o ka pēpē ductus arteriosus artery. ʻO ka wili a i ʻole nā ​​mea hana ʻē aʻe e ālai i ke kahe o ke koko, a hoʻoponopono kēia i ka pilikia.
• ʻO kekahi hana e hana i kahi ʻoki liʻiliʻi ma ka ʻaoʻao hema o ka umauma. ʻIke ka mea lapaʻau i ka PDA a laila nakinaki a ʻokiʻoki paha i ka ductus arteriosus, a hoʻokaʻawale a ʻoki iā ia. ʻO ke kāʻei ʻana i ka ductus arteriosus i kapa ʻia ʻo ligation. Hana ʻia kēia kaʻina hana i loko o ka neonatal intensive care unit (NICU).

ʻO ka Coarctation o ka hoʻoponopono aorta:

• Kū ka coarctation o ka aorta ke loaʻa kahi ʻāpana o ka aorta i kahi ʻāpana liʻiliʻi loa. ʻO ke ʻano me he uaki hola nei. He mea paʻakikī ka hoʻopili ʻana i ke koko e hele i nā ʻaoʻao haʻahaʻa. I ka hala ʻana o ka manawa, hiki iā ia ke alakaʻi i nā pilikia e like me ke koko kiʻekiʻe loa.
• No ka hoʻoponopono ʻana i kēia kīnā, hana pinepine ʻia kahi ʻoki ma ka ʻaoʻao hema o ka umauma, ma waena o nā iwi ʻaoʻao. Nui a hewahewa nā ala e hoʻoponopono ai i ka coarctation o ka aorta.
• ʻO ke ala maʻamau e hoʻoponopono iā ia ke ʻoki i ka ʻāpana ʻololī a hoʻonui iā ia me ka pā i hana ʻia ʻo Gore-tex, kahi mea hana a ke kanaka (synthetic).
• ʻO kekahi ala e hoʻoponopono ai i kēia pilikia ʻo ka wehe ʻana i ka ʻāpana haiki o ke aorta a humuhumu pū i nā wēlau i koe. Hiki ke hana pinepine i kēia i nā keiki nui.
• ʻO ke ala ʻekolu e hoʻoponopono i kēia pilikia i kapa ʻia ʻo flap subclavian. ʻO ka mea mua, hana ʻia kahi ʻoki ma ka ʻaoʻao haiki o ka aorta. A laila, lawe ʻia kahi āpau mai ke aʻa subclavian hema (ke aʻa i ka lima) e hoʻonui i ka ʻāpana ʻololī o ke aorta.
• ʻO ke ala ʻehā e hoʻoponopono ai i ka pilikia e hoʻopili i kahi paipu i nā ʻāpana maʻamau o ke aorta, ma nā ʻaoʻao ʻelua o ka ʻāpana ʻololī. Kahe ke koko i loko o ka paipu a kāpae i ka ʻāpana haiki.
• ʻAʻole pono kahi hana hou i ke ʻoki. Hoʻokomo ʻia kahi uea liʻiliʻi ma o ke aʻa o ke aʻa a hiki i ke aorta. Wehe ʻia kahi pāluna liʻiliʻi ma kahi ākea. Waiho ʻia kahi stent a i ʻole paipu liʻiliʻi e kōkua i ka wehe ʻana o ke aʻa. Hana ʻia ke kaʻina hana i kahi keʻena hoʻokolohua me nā kukuna x. Hoʻohana pinepine ʻia kēia hana ke hana hou ka coarctation ma hope o ka hoʻopaʻa ʻana.

Hoʻoponopono ka hewa septtr attrial septal (ASD):

• ʻO ka septial atrial ka paia ma waena o ka atria hema a me ka akau (keena kiʻekiʻe) o ka puʻuwai. Ua kapa ʻia kahi puka ma kēlā paia he ASD. I ke alo o kēia kīnā, hiki ke kāwili ʻia ke koko me ka ʻole o ka oxygen a ma hope o ka manawa, ke kumu o nā pilikia olakino a me nā arrhythmia.
• I kekahi manawa, hiki ke pani ʻia kahi ASD me ka ʻole o ke kīpē puʻuwai hāmama. ʻO ka mea mua, ʻokiʻoki ke kaukoki i ka ʻūlū. A laila hoʻokomo ke kauka i ka uea i loko o kahi kīʻaha koko e hele i ka puʻuwai. A laila, hoʻonoho ʻia i ʻelua mau hāmeʻa "clamshell" liʻiliʻi ma ka ʻaoʻao ʻākau a hema o ka septum. Hoʻopili kēia mau hāmeʻa ʻelua i kekahi. Pani kēia i ka lua o ka puʻuwai. ʻAʻole nā ​​kikowaena lapaʻau āpau e hana i kēia kaʻina hana.
• Hiki paha ke hana i ka ʻoki puʻuwai puʻuwai e hoʻoponopono iā ASD. I kēia hana, hiki ke pani ʻia ka septum me ka hoʻohana ʻana i nā humuhumu. ʻO kekahi ala e uhi ai ka lua me kahi patch.

Hoʻoponopono i ka hemahema septal Ventricular (VSD):

• ʻO ka septum ventricular ka paia ma waena o ka ventricle hema a me ka ʻākau (nā keʻena lalo) o ka puʻuwai. Kapa ʻia kahi puka ma ka septum ventricular ʻo VSD. Mālama kēia lua i ke koko me ka oxygen hui pū me ke koko i hoʻohana ʻia e hoʻi i nā akemāmā. I ka hala ʻana o ka manawa, hiki i nā puʻuwai puʻuwai kūlike ʻole a me nā pilikia puʻuwai ʻē aʻe ke kū.
• Ma ka makahiki 1, pani ka hapa nui o nā VSD liʻiliʻi iā lākou iho. Eia nō naʻe, pono e pani ʻia kēlā mau VSD e noho hāmama ma hope o kēia makahiki.
• ʻO nā VSD nui, e like me nā mea liʻiliʻi i kekahi mau ʻāpana o ka septum ventricular, a i ʻole nā ​​mea e hopena i ka puʻuwai a i ʻole endocarditis, (mumū) pono ke ʻoki puʻuwai puʻuwai. ʻO ka lua o ka septum e pani pinepine ʻia me kahi patch.
• Hiki ke pani ʻia kekahi mau hemahema septal me ka hana ʻole. ʻO ke kaʻina hana e pili ana i ka waiho ʻana i kahi uea liʻiliʻi i loko o ka puʻuwai a kau i kahi mea liʻiliʻi e hoʻopau i ka kīnā.

Hoʻoponopono Tetralogy o Fallot:

• ʻO Tetralogy o Fallot kahi kīnā o ka puʻuwai i kū mai ka hānau ʻana (congenital). Hoʻokomo pinepine ia i ʻehā mau kīnā i ka puʻuwai a hoʻohuli i ka pēpē i ke kala bluish (cyanosis).
• Pono ka ʻoki puʻuwai puʻuwai, a hana pinepine ia ke ke keiki ma waena o 6 mau mahina a me 2 mau makahiki.

Hoʻopili ke ʻoki:

• Ke pani nei i ka kīnā septtr ventricular me kahi patch.
• Ke wehe nei i ka pahu pulmonary a me ka hemo ʻana i nā mākala mānoanoa (stenosis).
• Ke kau nei i kahi patch ma ka ventricle ʻākau a me ke aʻa nui o ka pulmonary e hoʻomaikaʻi i ke kahe o ke koko i nā akemāmā.

He hana shunt paha kā ke keiki i hana mua ʻia. Hoʻoneʻe kahi shunt i ke koko mai kekahi wahi a i kahi ʻē aʻe. Hana ʻia kēia inā pono e hoʻopaneʻe ʻia ke kīpoki puʻuwai hāmama no ka mea maʻi nui ke keiki e hele i ke ʻoki.

• I ka wā o kahi shunt kaʻina hana, hana ka mea lapaʻau i kahi ʻokiʻoki ma ka ʻaoʻao hema o ka umauma.
• Ke hele a makua ke keiki, paʻa ka shunt a hoʻokō ʻia ka hana nui i ka puʻuwai.

Hoʻololi o ka hana hou o nā moku nui:

• I loko o ka puʻuwai maʻamau, hele mai ka aorta mai ka ʻaoʻao hema o ka puʻuwai, a ʻo ka ʻāpana pulmonary mai ka ʻaoʻao ʻākau. I ka transposition o nā moku nui, hele mai kēia mau aʻa mai nā ʻaoʻao ʻaoʻao o ka puʻuwai. He mau kīnā hānau hou paha kā ke keiki.
• ʻO ka hoʻoponopono ʻana i ka transposition o nā moku nui pono ke ʻoki puʻuwai puʻuwai. Inā hiki, hana ʻia kēia ʻoki ma hope koke iho o ka hānau ʻana.
• Kapa ʻia ka hoʻoponopono maʻamau ʻo ke kuapo arterial. Hoʻokaʻawale ʻia ke aorta a me ke aʻa puʻukū. Pili ka aʻa o ka pulmonary i ka ventricle ʻākau, kahi nona. A laila, pili nā aorta a me nā aʻa coronary i ka ventricle hema, kahi e pili ai lākou.

Hoʻoponopono Truncus arteriosus:

• ʻO Truncus arteriosus kahi kūlana laha ʻole e kū ʻia ke aorta, nā aʻa aʻa, a me nā aʻa pulmonary a pau i puka mai loko mai o kahi pahu maʻamau. He maʻalahi paha ka maʻi, a paʻakikī paha. I nā hihia āpau, koi ʻia i kahi kīʻaha puʻuwai hamama e hoʻoponopono i ka hemahema.
• Hana pinepine ʻia ka hoʻoponopono i nā lā mua a i ʻole mau pule o ke ola o ke pēpē. Hoʻokaʻawale ʻia nā aʻa pulmonary mai ke kumu aortic, a hoʻopili ʻia nā kīnā ʻole. ʻO ka maʻamau, loaʻa i nā keiki kahi kīnā septal ventricular, a pani pū ʻia kēlā. Hoʻonoho ʻia kahi pilina ma waena o ka ventricle ʻākau a me nā aʻa pulmonary.
• Pono ka hapa nui o nā keiki i hoʻokahi ʻelua mau kaha hou aʻe ke ulu lākou.

Hoʻoponopono Tricuspid atresia:

• Loaʻa ka paepae tricuspid ma waena o nā keʻena luna a me lalo ma ka ʻaoʻao ʻākau o ka puʻuwai. Hana ʻia ʻo Tricuspid atresia ke hana hewa ʻole ʻia kēia kiwikā, ololi a nalowale paha.
• Polū nā pēpē i hānau ʻia me ka atresia tricuspid no ka mea hiki ʻole ke kiʻi i ke koko i nā akemāmā e ʻohi i ka oxygen.
• No ka hele ʻana i nā māmā, pono ke koko e hele i kahi hemahema septal atrial (ASD), kīnā o ka septal ventricular (VSD), a i ʻole kahi patent ductus artery (PDA). (Hōʻike ʻia kēia mau ʻano ma luna.) Kapu loa kēia ʻano i ke kahe o ke koko i nā akemāmā.
• Ma hope koke o ka hānau ʻana, hāʻawi ʻia paha i ka pēpē kahi lāʻau i kapa ʻia ʻo prostaglandin E. E kōkua kēia lāʻau i ka hāmama ʻana o ka patent ductus arteriosus i hiki i ke kahe ke hoʻomau i ke kahe i nā akemāmā. Eia naʻe, e holo wale nō kēia. Pono ke keiki i kahi ʻokiʻoki.
• Pono paha ke keiki i kahi o nā shunts a me nā ʻoki ʻana e hoʻoponopono i kēia kīnā. ʻO ka pahuhopu o kēia ʻoki ʻana e ʻae i ke kahe o ke koko mai ke kino i loko o nā akemāmā. Hiki paha i ke kauka ke hoʻoponopono i ke kiwikā tricuspid, pani i ka nohona, a i ʻole hoʻokomo i kahi shunt i hiki i ke koko ke hele i nā akemāmā.

Ka hoʻoponopono ʻana o ka venous pulmonary venous anomal total (TAPVR):

• Hana ʻia ʻo TAPVR ke lawe nā veins pulmonary i ke koko momona o ka oxygen mai nā akemāmā i ka ʻaoʻao ʻākau o ka puʻuwai, ma kahi o ka ʻaoʻao hema o ka puʻuwai, kahi e hele pinepine ai i nā kānaka olakino.
• Pono e hoʻoponopono i kēia ʻano me ke ʻoki. Hiki ke hana i ke ʻoki i ka wā hānau inā loaʻa nā ʻōuli koʻikoʻi o ke keiki. Inā ʻaʻole i hana pono ʻia ma hope o ka hānau ʻana, hana ʻia ia i loko o nā malama 6 mua o ko ke pēpē ola ʻana.
• Pono ka hoʻoponopono TAPVR i kahi ʻoki puʻuwai puʻuwai. Hoʻoiho ʻia nā veins pulmonary i ka ʻaoʻao hema o ka puʻuwai, kahi e pili ai lākou, a pani ʻia nā pilina maʻamau.
• Inā loaʻa kahi PDA, nakinaki ʻia a mahele ʻia.

Hoʻoponopono i ka naʻau hema hema

• ʻO kēia kahi kīnā puʻuwai nui loa i hoʻokumu ʻia e ka puʻuwai hema hema hemahema loa. Inā ʻaʻole mālama ʻia, make ia i ka hapa nui o nā pēpē i hānau pū ʻia me ia. ʻAʻole like me nā pēpē me nā kīnā o ka puʻuwai ʻē aʻe, ʻo ka poʻe me ka puʻuwai hema hypoplastic ʻaʻohe ona kīnā ʻē aʻe. Hana ʻia nā hana e mālama i kēia kīnā ma nā kikowaena lapaʻau kūikawā. ʻO ka maʻamau, hoʻoponopono ka ʻoki i kēia hemahema.
• ʻO ke kaʻina o nā hana puʻuwai ʻekolu e makemake nui ʻia. Hana ʻia ka hana mua i ka pule mua o ke ola o ka pēpē. ʻO kēia kahi kahakaha paʻakikī kahi i hoʻokumu ʻia ai kahi kīʻaha koko mai ka aʻa aʻa a me ka aorta. Hāpai kēia moku hou i ke koko i nā akemāmā a me ke koena o ke kino.
• ʻO ka hana ʻelua, i kapa ʻia he hana Fontan, hana pinepine ʻia inā 4 a 6 mau makahiki paha ka pēpē.
• Hana ʻia ke kolu o ka hana i hoʻokahi makahiki ma hope o ka hana ʻelua.

ʻOki puʻuwai Congenital; Patent ductus arteriosus ligation; Hoʻoponopono naʻau hema hema Hypoplastic; Hoʻoponopono Tetralogy o Fallot; Coarctation o ka hoʻoponopono aorta; Hoʻoponopono i ka hemahema septtr attrial; Hoʻoponopono i nā hemahema septal Ventricular; Hoʻoponopono Truncus arteriosus; Ka hoʻoponopono ʻana o ke aʻa aʻa kaupuna anomaly; Hoʻololi i ka hoʻololi o nā moku nui; Hoʻoponopono Tricuspid atresia; Hoʻoponopono VSD; Hoʻoponopono ASD

• Ka palekana o ka lumipaku - keiki
• Ke lawe nei i kāu keiki e kipa i kahi kaikaina maʻi loa
• ʻOki puʻuwai Pediatric - hoʻokuʻu
• Mālama ʻeha ʻeha - wehe

• Puʻuwai - ʻāpana ma waena o ka waena
• ʻO ka catheterization Cardiac
• Puʻuwai - ʻike mua
• Ultrasound, pēpē maʻamau - kuʻi puʻuwai
• Ultrasound, kīnā septal ventricular - kīʻaha puʻuwai
• Patent ductus arteriosis (PDA) - ke kaʻina
• ʻOki puʻuwai puuwai hamama

Bernstein D. Nā loina laulā o ka mālama ʻana i nā maʻi puʻuwai congenital. 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 461.

Bhatt AB, Foster E, Kuehl K, et al; ʻAha ʻAha ʻAhahui ʻAmelika e pili ana i ka Cardiology Clinical. ʻO ka maʻi puʻuwai Congenital i ka makua makua: kahi ʻōlelo ʻepekema mai ka ʻAmelika ʻAmelika Hui Pū ʻIa. Kaapuni. 2015; 131 (21): 1884-1931. PMID: 25896865 www.ncbi.nlm.nih.gov/pubmed/25896865.

LeRoy S, Elixson EM, O'Brien P, et al; ʻAmelika Hui Pū ʻIa ʻAmelika Hui Pū ʻIa Pediatric o ka ʻaha kūkā ma ka hanai maʻi Cardiovascular; ʻO ka ʻaha kūkā no nā maʻi Cardiovascular o ka ʻōpio. Nā ʻōlelo paipai no ka hoʻomākaukau ʻana i nā keiki a me nā ʻōpio no ka hana naʻau cardiac invasive: kahi ʻōlelo a ka American Heart Association Pediatric Nursing Subcommite o ka ʻAha Kūkā no Cardiovascular Nursing me ka hui pū ʻana me ka Council on Cardiovascular Diseases of the Young. Kaapuni. 2003; 108 (20): 2250-2564. PMID: 14623793 www.ncbi.nlm.nih.gov/pubmed/14623793.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Maʻi maʻi ʻōpū.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.