Kaha vaskular

ʻO ke apo vascular kahi hana kūpono ʻole o ka aorta, ke aʻa nui e lawe i ke koko mai ka puʻuwai a i ke koena o ke kino. He pilikia kūpuna ia, ʻo ia hoʻi aia i ka wā hānau.

Kākaʻikahi ke apo vascular. Loaʻa ia ma lalo o 1% o nā pilikia puʻuwai congenital āpau. Kū pinepine ke ʻano i nā kāne me nā wahine. ʻO kekahi pēpē me ke apo vascular kekahi i kahi pilikia puʻuwai congenital.

Kū koke ke apo vascular i ka ulu ʻana o ka pēpē i loko o ka ʻōpū. ʻO ka maʻamau, hoʻomohala ka aorta mai kekahi o nā ʻāpana o ke kiko (arches). Hōʻoki ke kino i kekahi o nā pio i koe, ʻo kekahi e hana i nā aʻa. ʻO kekahi mau aʻa e pono e wāwahi, ʻaʻole ia, kahi e hana ai i ke apo vascular.

Me nā apo vascular, aia kekahi o nā pio a me nā moku i pono e loli i loko o nā aʻa a i ʻole nalo i kēia manawa ke hānau ʻia ka pēpē. Kūkulu kēia mau piʻo i ke apo o nā kīʻaha koko, e hoʻopuni ana a kaomi i lalo i ka puka makani (trachea) a me ka esophagus.

Aia kekahi mau ʻano like ʻole o ke apo vascular. I kekahi mau ʻano, hoʻopuni puni ke kinipōpō i ka trachea a me ka esophagus, akā hiki ke kumu i nā ʻōuli.

ʻO kekahi mau keiki me ke apo vascular ʻaʻole loa e hoʻomohala i nā ʻōuli. Eia nō naʻe, i ka nui o nā hihia, ʻike ʻia nā ʻōuli i ka wā pēpē. ʻO ke kaomi ʻana i ka pehu (trachea) a me ka esophagus hiki ke alakaʻi i nā pilikia hanu a me ka digestive. ʻO ke kaomi ʻana o ke apo i lalo, ʻo ka ʻoi loa o nā hōʻailona.

Hiki paha i nā pilikia hanu ke komo pū:

• Kaha kiʻekiʻe
• Hanu nui (stridor)
• Pākuʻi pinepine a i ʻole nā ​​maʻi hanu
• Hoʻopilikia hanu
• ʻUhihi

Hiki i ka ʻai ke hana i nā ʻōuli hanu.

Kākaʻikahi nā ʻōnaehana Digestive, akā hiki ke hoʻopili ʻia:

• Kāpena
• Paʻa i ka ʻai ʻana i nā meaʻai paʻa
• Pilikia i ka ale ʻana (disphagia)
• Reflux Gastroesophageal (GERD)
• Hānai hānai a hānai ʻōpala paha
• ʻO ka luaʻi

E hoʻolohe ka mea mālama ola i ka hanu ʻana o ka pēpē e kāpae i nā maʻi hanu ʻē aʻe e like me ka hānō. ʻO ka hoʻolohe ʻana i ka puʻuwai o ke keiki ma o kahi stethoscope hiki ke kōkua i ka ʻike ʻana i nā namunamu a me nā pilikia puʻuwai ʻē aʻe.

Hiki i nā hoʻokolohua aʻe ke kōkua i ka diagnose vascular ring:

• Pākuʻi x-ray
• ʻO ka tomography compute (CT) scan o ka puʻuwai a me nā kīʻaha koko nui
• ʻO ka pahu paʻi kiʻi i lalo i ka ʻāʻī e nānā i nā kahawai (bronchoscopy)
• ʻO ke kiʻi resonance ʻume mākenēki (MRI) o ka puʻuwai a me nā kīʻaha koko nui
• ʻImi ultrasound (echocardiogram) o ka puʻuwai
• X-ray o nā kīʻaha koko (angiography)
• X-ray o ka esophagus e hoʻohana ana i kahi kala make kūikawā e hoʻokāʻoi aʻe i ka wahi (esophagram a i ʻole barium ale)

Hana pinepine ʻia ke ʻoki kino i nā keiki me nā ʻōuli. ʻO ka pahuhopu o ke kaha ʻana e hoʻokaʻawale i ke apo vascular a hoʻomaha i ke kaomi ma nā hale e pili ana. Hana pinepine ʻia ke kaʻina hana ma o kahi ʻoki ʻoki liʻiliʻi i ka ʻaoʻao hema o ka umauma ma waena o nā iwi ʻaoʻao.

Ke kōkua nei i ka hoʻololi ʻana i ka ʻai a ke keiki e hōʻoluʻolu ai i nā ʻōuli o ka digestive o ke apo vascular. Kauoha ka mea hāʻawi i nā lāʻau (e like me antibiotic) e mālama i nā maʻi maʻi hanu, inā kū lākou.

ʻAʻole pono nā keiki i loaʻa ʻole nā ​​ʻōuli i ka lapaʻau akā pono e nānā pono ʻia i mea e maikaʻi ʻole ai ke ʻano.

Aia ka maikaʻi o ke pēpē i ka hilinaʻi o ka pēpē vascular i ka esophagus a me ka trachea a me ka wikiwiki e ʻike a mālama ʻia ai ke pēpē.

Hana maikaʻi ke kahakaha ma ka hapanui o nā hihia a hoʻomaha pinepine i nā ʻōuli. He mau mahina paha ka hala ʻana o nā pilikia hanu nui. Hiki i kekahi mau keiki ke hoʻomau i ka hanu nui ʻana, keu hoʻi ke hana nui a loaʻa paha i nā maʻi hanu.

ʻO ka hoʻopaneʻe ʻana i ke kaha ʻana ma nā hihia koʻikoʻi hiki ke alakaʻi i nā pilikia koʻikoʻi, e like me ka hōʻino ʻana i ka trachea a me ka make.

Kāhea i kāu mea hāʻawi inā loaʻa kāu pēpē i nā ʻōuli o ke apo vascular. ʻO ka hōʻoia ʻana a mālama ʻia me ka wikiwiki e hiki ke pale i nā pilikia koʻikoʻi.

ʻAʻohe ala i ʻike ʻia e pale ai i kēia ʻano.

Kahi aortic ʻākau me ka subclavian aberrant a me ka ligamentum arteriosus hema; Hōʻino puʻuwai Congenital - vascular ring; Hānau kīnā kīnā ʻole - ring vascular

• Kaha vaskular

ʻO Bryant R, Yoo S-J. ʻO nā apo vascular, ka maʻa o ka pulmonary, a me nā kūlana e pili ana. I: Wernovsky G, Anderson RH, Kumar K, et al, eds. Ka Pediatric Cardiology o Anderson. ʻEhā ed. Piladelapia, PA: Elsevier; 2020: chap 47.

ʻO Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM. ʻO nā puʻuwai congenital a me nā malformations vascular. 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 459.

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.