Ke koko kiʻekiʻe - nā keiki

ʻO ke kaomi koko ke ana o ka ikaika i hoʻokau ʻia i nā paia o kou aʻa i ke kolo ʻana o kou puʻuwai i ke koko i kou kino. ʻO ke koko kiʻekiʻe (hypertension) kahi hoʻonui i kēia ikaika. Kuhi kēia ʻatikala i ke kaomi koko kiʻekiʻe i nā keiki, ʻo ka hopena pinepine ia o ka momona.

Hāʻawi ʻia nā heluhelu kaomi koko ma ke ʻano he ʻelua helu. Kākau ʻia nā ana kaomi koko i kēia ala: 120/80. Hiki ke kiʻekiʻe a hoʻokahi a ʻelua paha o kēia mau helu.

• ʻO ka helu mua (luna) ka pākēkē systolic.
• ʻO ka lua (lalo) ka helu kaomi diastolic.

ʻO ke kiʻekiʻe o ke koko kiʻekiʻe i nā keiki a hiki i nā makahiki 13 ke ana ʻokoʻa ʻia ma mua o nā mākua. ʻO kēia no ka mea i manaʻo ʻia he loli ke kahe o ke koko i ka ulu ʻana o kahi keiki. Hoʻohālikelike ʻia nā helu kaomi koko o kahi keiki me nā ana o ke koko i nā keiki ʻē aʻe i ka makahiki, ke kiʻekiʻe, a me ka wahine.

ʻO nā pae kahe koko i nā keiki mai 1 a 13 mau makahiki e paʻi ʻia e kahi keʻena aupuni. Hiki iā ʻoe ke nīnau i kāu mea mālama ola. Hōʻike ʻia nā heluhelu ʻana o ke kaomi koko ʻole e like me kēia:

• Piʻi koko kiʻekiʻe
• Kahua 1 kiʻekiʻe ke koko
• ʻOihana 2 kiʻekiʻe ke koko

ʻO nā keiki ma mua o 13 mau makahiki e ukali i nā kulekele like no ke koko kiʻekiʻe ma ke ʻano he mākua.

Hiki i nā mea he nui ke hoʻololi i ke koko, me:

• Nā pae Hormone
• ʻO ke olakino o ka ʻōnaehana, ka puʻuwai, a me nā kīʻaha koko
• Ke olakino o nā puʻupaʻa

ʻO ka hapa nui o ka manawa, ʻaʻohe kumu o ke kahe kiʻekiʻe i loaʻa. Kapa ʻia kēia ʻo hypertension mua (pono).

Eia nō naʻe, hiki i kekahi mau mea ke hoʻonui i ka makaʻi o ke kiʻekiʻe o ke koko i nā keiki.

• Ka momona a momona paha
• Mōʻaukala ʻohana o ke koko kiʻekiʻe
• Heihei - Hoʻonui ka makaʻu o ʻAmelika ʻApelika i ke kahe o ke koko kiʻekiʻe
• Loaʻa i ka maʻi diabetes 2 a i ʻole ke kō kō
• Loaʻa i ka kolesterol kiʻekiʻe
• Nā pilikia e hanu ana i ka wā hiamoe, e like me ka snoring a i ʻole ka sleep apnea
• ʻO ka maʻi kīwī
• Mōʻaukala hānau mua a i ʻole kaumaha kaumaha hānau

I ka hapanui o nā keiki, pili ke koko kiʻekiʻe i ka paona.

Hiki ke hoʻokumu ʻia ke koko kiʻekiʻe e kekahi pilikia olakino. Hiki iā ia ke kumu i ka lāʻau a kāu keiki e lawe nei. ʻOi aku ka nui o nā kumu kiʻekiʻe i nā pēpē a me nā keiki ʻōpio. ʻO nā kumu maʻamau ka:

• Nā pilikia thyroid
• Nā pilikia puʻuwai
• Nā pilikia ʻiʻo
• ʻO kekahi mau tumors
• ʻAlena moe
• ʻO nā lāʻau e like me nā steroid, nā lāʻau hoʻomalu hānau, NSAID, a me kekahi o nā lāʻau anuanu maʻamau

E hoʻi ke koko kiʻekiʻe i ka maʻamau ke kū ʻia ka lāʻau a mālama ʻia paha ke ʻano.

Hoʻokumu ke kahe koko maikaʻi loa no nā keiki i ka moekolohe o ke keiki, ke kiʻekiʻe, a me ka makahiki. Hiki i kāu kauka olakino ke haʻi aku iā ʻoe i ke kaomi koko o kāu keiki.

ʻAʻole loaʻa ka hapanui o nā keiki i nā ʻōuli o ke koko kiʻekiʻe. ʻIke pinepine ʻia ke kahe koko kiʻekiʻe i ka wā o ka nānā ʻana ke nānā ka mea hāʻawi i ke kahe koko o kāu keiki.

I ka hapanui o nā hihia, ʻo ka hōʻailona o ke kaomi kiʻekiʻe wale nō ke ana o ke koko. No nā keiki kaupaona olakino, pono e lawe i ke kahe o ke koko i kēlā me kēia makahiki e hoʻomaka ana i ka makahiki 3. No ka loaʻa ʻana o kahi heluhelu pololei, e hoʻohana ka mea hāʻawi i kāu keiki i kahi cuff kaomi koko e pili pono i kāu keiki.

Inā hoʻokiʻekiʻe ʻia ke kaomi koko o kāu keiki, pono ke ana i ka mea hāʻawi i ke kaomi koko ʻelua a lawe i ka awelika o nā ana ʻelua.

Pono e lawe i ke kaomi koko i kēlā me kēia kipa no nā keiki:

• Ua momona
• E lawe i ka lāʻau e hoʻāla i ke koko
• Loaʻa i ka maʻi puʻuwai
• Loaʻa nā pilikia me nā kīʻaha koko e alakaʻi i ka puʻuwai
• Loaʻa diabetes

E ana ka mea hāʻawi i ke kahe koko o kāu keiki i nā manawa he nui ma mua o ka hōʻoia ʻana i kāu keiki me ke koko kiʻekiʻe.

E nīnau ka mea hāʻawi e pili ana i ka mōʻaukala ʻohana, ka mōʻaukala hiamoe o kāu keiki, nā pilikia pilikia, a me ka papaʻai.

E hana pū ka mea hāʻawi i kahi hoʻokolohua kino e nānā i nā hōʻailona o ka maʻi puʻuwai, hōʻino i nā maka, a me nā hoʻololi ʻē aʻe i ke kino o kāu keiki.

ʻO nā hoʻokolohua ʻē aʻe e makemake ana kāu mea hāʻawi keiki e hoʻopili pū:

• Nā hoʻāʻo ʻana o ke koko a me ka mimi
• Hōʻike kō kō
• ʻEchocardiogram
• Ultrasound o nā puʻupaʻa
• ʻImi hiamoe e ʻike ai i ka ʻāne apnea

ʻO ka pahuhopu o ka mālama ʻana e hōʻemi i ke koko kiʻekiʻe i mea ka haʻahaʻa haʻahaʻa o kāu pilikia i kāu keiki. Hiki i ka mea lawelawe o kāu keiki ke haʻi iā ʻoe i ke ʻano o nā pahuhopu kaomi koko o kāu keiki.

Inā hoʻokiʻekiʻe kāu keiki i ke koko kiʻekiʻe, e hōʻike ka mea hāʻawi i nā loli nohona e kōkua i ka hoʻohaʻahaʻa i ke kahe o kāu keiki.

Hiki i nā hana olakino ke kōkua i kāu keiki mai ka loaʻa hou o ke kaumaha, lilo i ke kaupaona, a hoʻohaʻahaʻa i ke kaomi o ke koko. ʻO ka hana pū ʻana me ka ʻohana ke ala maikaʻi loa e kōkua ai i kāu keiki e lilo kaupaona. Hana pū e kōkua i kāu keiki:

• E hāhai i ka papaʻai DASH, ka mea haʻahaʻa i ka paʻakai me ka nui o nā huaʻai a me nā mea kanu, nāʻiʻo momona, nā kīʻaha holoʻokoʻa, a me ka momona momona a momona ʻole.
• E ʻoki i nā mea inu momona a me nā meaʻai me ke kō kō
• E kiʻi iā 30 i 60 mau minuke hoʻoikaika kino i kēlā me kēia lā
• Palena i ka manawa pale a me nā hana sedentary ʻē aʻe ma lalo o 2 mau hola i ka lā
• E hiamoe nui

E nānā hou ʻia ke kaomi koko o kāu keiki ma 6 mau mahina. Inā mau ke kiʻekiʻe, e nānā ʻia ke kaomi koko i nā lālā o kāu keiki. A laila e nānā hou ʻia ke kaomi koko ma 12 mau mahina. Inā kū kiʻekiʻe ke koko, a laila hiki i ka mea hāʻawi ke paipai i ka nānā ʻana o ke kaomi koko ma luna o 24 a 48 mau hola. Kāhea ʻia kēia ke nānā aku i ke kahe o ke koko. Pono paha kāu keiki e ʻike i ke kauka puʻuwai a i ʻole hakuʻala.

Hana ʻia paha nā hōʻike ʻē aʻe e nānā no:

• Pae kiʻekiʻe kolesterol
• Diabetes (hōʻike A1C)
• ʻO ka maʻi puʻuwai, e hoʻohana ana i nā hoʻokolohua e like me ka echocardiogram a i ʻole ka electrocardiogram
• ʻO ka maʻi kīnā, e hoʻohana ana i nā hoʻāʻo e like me ka pan metabolic panel maʻamau a me ka urinalysis a i ʻole ultrasound o nā puʻupaʻa

E hana ka hana like no nā keiki me ka pae 1 a i ʻole pae 2 kiʻekiʻe kiʻekiʻe ke koko. Eia nō naʻe, e hoʻāʻo ʻia ka loiloi a me ka ʻimi loea loea i ka 1 a i ka 2 mau pule no ka pae kiʻekiʻe 1 ke koko kiʻekiʻe, a ma hope o 1 hebedoma no ka pae 2 kiʻekiʻe o ke koko.

Inā hoʻololi ʻole ka nohona wale nō ʻaʻole holo, a i ʻole he pilikia ʻē aʻe kāu keiki, pono paha i kāu keiki i nā lāʻau no ke koko kiʻekiʻe. Hoʻohana pinepine ʻia nā lāʻau kaomi koko no nā keiki:

• ʻO nā mea kūpale enzyme hoʻohuli Angiotensin
• ʻO nā poloka Angiotensin receptor blockers
• Nā poloka beta
• Nā poloka ʻauana kalipuna
• ʻO Diuretics

E paipai paha ka mea hāʻawi i kāu keiki e kiaʻi i ke kaomi koko o kāu keiki ma ka home. Hiki ke kōkua i ka nānā ʻana i ka home inā e loli ke ʻano o ka nohona a i ʻole nā ​​lāʻau.

ʻO ka hapanui o ka manawa, hiki ke kāohi ʻia ke koko kiʻekiʻe i nā keiki me nā loli o ka nohona a me nā lāʻau, inā pono.

ʻO ke kaomi koko kiʻekiʻe i hoʻomaʻamaʻa ʻole ʻia i nā keiki e alakaʻi i nā kūpikipiki i ke ʻano makua, i hiki ke hoʻopili ʻia:

• Hahau
• Maʻi hohola
• Hewa puʻuwai
• ʻO ka maʻi kīwī

Kāhea i ka mea hāʻawi i kāu keiki inā hōʻike ka nānā home e piʻi mau ana ke kahe koko o kāu keiki.

E ana ke kahu o kāu keiki i ke kaomi koko o kāu keiki ma ka liʻiliʻi i hoʻokahi manawa i ka makahiki, e hoʻomaka ana i ka makahiki 3.

Hiki iā ʻoe ke kōkua i ke pale ʻana i ke koko kiʻekiʻe i kāu keiki ma ka ukali ʻana i nā loli nohona i hoʻolālā ʻia e lawe i ke koko i lalo.

Hiki ke kuhikuhi ʻia i kahi nephrologist pediatric no nā keiki a me nā ʻōpio me ke kiʻekiʻe kiʻekiʻe.

Hypertension - keiki; HBP - keiki; Pediatric hypertension

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CD Hanevold, Flynn JT. Hypertension i loko o nā keiki: diagnose a me ka lapaʻau. I: Bakris GL, Sorrentino MJ, eds. Hypertension: He Hoa i ka Maʻi Puʻuwai ʻo Braunwald. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2018: chap 17.

ʻO Macumber IR, ʻo Flynn JT. Ka piʻi kiʻekiʻe ʻōnaehana. 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 472.