Ua manaʻo paha ʻoe ua hoʻomaka koke kou puʻuwai e kuʻi wikiwiki loa, a i ʻole ua kuʻi ʻole ia ma ke ʻano o ka puʻuwai? A i ʻole loaʻa iā ʻoe kahi manaʻo ʻē e like me ka lele ʻana o ka pulelehua i loko o kou umauma? Ma nā ʻōlelo lapaʻau, kapa mākou i kēia maʻi ʻo 'Arrhythmia' a i ʻole ka puʻuwai puʻuwai kūpono ʻole. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi ʻano lapaʻau kūikawā, akā holomua loa a nā kauka e hoʻohana ai i ka wā hiki ʻole ke hoʻomalu ʻia me ka lāʻau lapaʻau.
I ka ʻōlelo maʻalahi, he aha ka cardiac ablation?
ʻO ka Cardiac Ablation (i ʻike ʻia hoʻi ʻo Catheter Ablation) kahi ʻano hana no ka mālama ʻana i nā ʻano puʻuwai maʻamau ʻole (arrhythmias). E noʻonoʻo he ʻōnaehana uila ko ko kākou puʻuwai, a ʻo nā hōʻailona i loaʻa iā ia e hoʻokō pono ai. I kekahi manawa, hiki i nā wahi liʻiliʻi o kēia ʻōnaehana uila ke hana i nā impulses uila maʻamau ʻole. Ke ʻimi nei kēia kaʻina hana i nā wahi ʻiʻo e hoʻouna ana i kēlā mau hōʻailona maʻamau ʻole a "hoʻopau iā lākou."
ʻAʻole kēia he hana nui. Hana ʻia e ke kauka puʻuwai. Hoʻokomo ʻo ia i kahi ʻōmole lahilahi loa (catheter) i loko o kou puʻuwai ma o kahi aʻa koko ma kou ʻūhā, lima, a ʻāʻī paha. A laila, hoʻouna ʻia ka wela (radiofrequency ablation), ke anu nui (cryoablation), a i ʻole nā nalu ikehu pōkole (pulsed field ablation) ma o kēia ʻōmole, e hana ana i nā ʻeha liʻiliʻi ma ka ʻiʻo kahi e puka mai ai nā hōʻailona maʻamau ʻole. Hoʻōki kēia mau ʻeha i nā hōʻailona uila maʻamau ʻole mai ka hele ʻana, a hoʻihoʻi ʻia ke ʻano o ka puʻuwai i ka maʻamau.
I loko o kēia lāʻau lapaʻau, hiki ke hoʻomaha ʻia ʻoe a loaʻa paha iā ʻoe ka anesthesia laulā. E hōʻoia kēia ʻaʻole ʻoe e ʻike i kekahi ʻeha. ʻAʻole hoʻopilikia nā ʻeha i hana ʻia e kēia kaʻina hana i ka hana o ka puʻuwai.
He aha nā ʻano kūlana e mālama ai kēia lāʻau?
ʻO ka Cardiac ablation kahi lāʻau lapaʻau no nā puʻuwai wikiwiki loa (tachyarrhythmias). Eia naʻe, ʻaʻole ia e hāʻawi pinepine ʻia ma ke ʻano he lāʻau lapaʻau mua. Hiki i kāu kauka ke kuhikuhi i kēia lāʻau lapaʻau inā ʻaʻole hiki ke kāohi ʻia kou arrhythmia me ka lāʻau lapaʻau. E nānā pono kāu kauka i kou puʻuwai a me kou olakino holoʻokoʻa ma mua o ka hoʻoholo ʻana inā kūpono kēia lāʻau lapaʻau iā ʻoe.
Hoʻohana pinepine ʻia kēia lāʻau lapaʻau no nā kūlana ma lalo nei.
| Kūlana | He wehewehe maʻalahi |
|---|---|
| ʻO ka Fibrillation Atrial (Afib) a me ka Atrial Flutter | Kuʻi wikiwiki a ʻano ʻole nā keʻena o luna o ka puʻuwai (atria). Hiki i kēia ke hoʻonui i ka pilikia o nā ʻūpā koko a me ka hahau ʻana. |
| ʻO ka Tachycardia Supraventricular (SVT) | Hoʻomaka koke ka puʻuwai e kuʻi wikiwiki loa (a hiki i 300 mau manawa i kēlā me kēia minuke). Inā hoʻomau kēia, hiki iā ia ke hōʻino i ka puʻuwai. |
| ʻO ka Tachycardia Ventricular (VT) | Kuʻi wikiwiki loa nā keʻena haʻahaʻa o ka puʻuwai (ventricles). Hiki i kēia ke lilo i kūlana weliweli loa , no ka mea, hiki ke alakaʻi i ka hopu ʻana o ka puʻuwai. |
Eia kekahi, hiki ke ʻōlelo ʻia kēia lāʻau lapaʻau no ka poʻe i loaʻa i ka pilikia nui o nā kūlana hoʻoweliweli ola e like me ka hopu koke ʻana o ka puʻuwai a i ʻole ka Ventricular Fibrillation (V-Fib).
Pehea ʻoe e hoʻomākaukau ai ma mua o ka mālama ʻana?
Ma mua o kēia kaʻina hana, pono ʻoe e hana i kēia mau mea:
- E ho'ōki i ka lawe ʻana i nā lāʻau hoʻokahe koko: Inā ʻoe e lawe ana i nā lāʻau lapaʻau e like me ka aspirin a i ʻole warfarin, e noi ʻia paha ʻoe e hoʻōki i ka lawe ʻana iā lākou no kekahi mau lā. Akā e hana i kēia e like me ke kuhikuhi a kāu kauka, a mai ka lā wale nō āna e ʻōlelo ai iā ʻoe. Mai hoʻōki i ka wā āu e makemake ai.
- Mai ʻai a inu paha: E noi ʻia ʻoe e hoʻōki i ka ʻai ʻana a inu paha no kekahi mau hola ma mua o ke kaʻina hana, ma hope o ke aumoe. E hāʻawi kāu kauka iā ʻoe i nā ʻōlelo kikoʻī no kēia.
- Kekahi e kōkua iā ʻoe e hoʻi i ka home: E hoʻonohonoho mua i kahi e lawe iā ʻoe i ka home ma hope o ke kaʻina hana.
- Hoʻokomo ʻia kahi laina IV: Hoʻokomo ʻia kahi laina IV (e like me ka ʻōmole i hoʻohana ʻia e hāʻawi iā ʻoe i ka saline) i loko o kahi aa koko ma kou lima. Maanei e hāʻawi ʻia ai ʻoe i nā lāʻau lapaʻau e pono ai a me ka anesthesia.
- Nā lole a me nā mea pono: E ʻaʻahu i nā lole ʻoluʻolu. ʻOi aku ka maikaʻi o ka waiho ʻana i nā mea nani a me nā mea pono waiwai ma ka home.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
Eia kahi wehewehe ʻana i kēlā me kēia ʻanuʻu o nā mea e hana ʻia ana i ka wā o ke kaʻina hana ablation:
1. ʻO ka mea mua, hoʻomaʻemaʻe ʻia kahi e hoʻokomo ʻia ai ke catheter (ʻo ka ʻūhā maʻamau) a hoʻomānoʻo ʻia ka ʻili.
2. A laila, hoʻokomo ʻia kahi ʻōmole liʻiliʻi (ʻūpā) i loko o ke kīʻaha koko, e hana ana i ala no ke komo ʻana o ke catheter.
3. Hoʻokomo ʻia nā catheters maikaʻi me nā electrodes ma o ka ʻūpā a ma ke aʻa koko a hiki i ka puʻuwai. Hana ʻia kēia ma lalo o ke alakaʻi ʻana o kahi ʻano hana like me ke kukuna X.
4. Ke komo i loko o ka puʻuwai, hoʻohālikelike kēia mau catheters i ka hana uila o ka puʻuwai a kuhikuhi i kahi e puka mai ai nā hōʻailona hewa.
5. Ke loaʻa ka wahi pilikia, hoʻouna ʻia ka wela, ke anu, a i ʻole nā nalu ikehu mai ka piko o ke catheter e mālama i nā ʻiʻo a pale i nā hōʻailona hewa mai ka hele ʻana mai.
6. ʻO ka hope loa, ua wehe pono ʻia ke catheter a me ka ʻūpā.
Hiki i kēia kaʻina hana holoʻokoʻa ke hala i ʻelua a ʻehā hola, i kekahi manawa ʻoi aku ka lōʻihi.
He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?
Ma hope o ke kaʻina hana, e lawe ʻia ʻoe i kahi lumi hoʻōla. Pono ʻoe e noho ma laila no kekahi mau hola. E hoʻomau ke kahu maʻi i ka nānā ʻana i kou kūlana, ka helu o ka puʻuwai, a me ke koko. Ma muli o kou kūlana, hiki paha iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi, a i ʻole pono paha ʻoe e noho i ka haukapila i ka pō.
Ke hoʻi ʻoe i ka home, e hāʻawi ʻia ʻoe i nā ʻōlelo aʻoaʻo maopopo e hahai ai ma ka home. E kuhikuhi kāu kauka i ka aspirin a i ʻole kekahi lāʻau lapaʻau hoʻokahe koko ʻē aʻe e pale aku i nā ʻūpā koko. Pono paha kēia e lawe ʻia no kekahi mau mahina a ʻoi aku paha.
Nā pono a me ka holomua o ka mālama ʻana
He hana hoʻopilikia iki kēia ʻaʻole pono e noho lōʻihi ma ka haukapila, a hiki iā ia ke kōkua i ka hoʻihoʻi ʻana i nā ʻano puʻuwai maʻamau i hiki ʻole ke kāohi ʻia me ka lāʻau lapaʻau. I kekahi mau hihia, hiki ke lilo i lāʻau lapaʻau e hoʻōla ai i ke ola .
Inā holomua, pili ia i ke ʻano o ka arrhythmia āu e loaʻa nei.
- ʻO nā kūlana e like me SVT he kiʻekiʻe ka holomua o 90% - 95% .
- No nā kūlana e like me Afib lāua ʻo VT, aia ka helu holomua ma waena o 60% - 80% .
He aha nā pilikia a me nā mea e pono ai ke ʻike?
He haʻahaʻa loa nā pilikia o ka cardiac ablation. He mea kākaʻikahi nā pilikia, ʻoiai ma kahi haukapila kahi e hana mau ʻia ai kēia ʻano lapaʻau. Eia nō naʻe, aia kekahi mau pilikia e pono e makaʻala:
- Nā ʻūpā koko
- Ka hōʻino ʻana o ka catheter i nā kīʻaha koko a i ʻole nā kīwaha puʻuwai
- Ka maʻi a i ʻole ke kahe ʻana o ke koko
- Hahau
- Pono e hoʻokomo ʻia kahi pacemaker mau loa
Inā he makuahine hāpai ʻoe, e kamaʻilio me kāu kauka e pili ana i ka hiki ke hoʻopanee ʻia kēia lāʻau a hiki i ka hānau ʻana o ke pēpē.
I kekahi manawa, ʻaʻole paha e hoʻōla piha ʻia ke ʻano e kahi lāʻau ablation hoʻokahi. Inā hoʻi mai nā hōʻailona, pono paha kekahi lāʻau ablation ʻē aʻe i ka wā e hiki mai ana. Eia kekahi, ʻaʻole paha e ʻike koke ʻia nā hopena o ka lāʻau. Hiki i kekahi mau hōʻailona ke hoʻomau no kekahi mau pule i ka wā e ho'ōla ai ka ʻiʻo puʻuwai.
Hoʻōla hou a me ka wā e ʻike ai i ke kauka
Hiki ke hala kekahi mau pule e ho'ōla piha ai. Mai hāpai i nā mea ma mua o 5 kg a i ʻole e hana i ka hoʻoikaika kino no hoʻokahi pule ma hope o ke kaʻina hana. E nīnau i kāu kauka i ka wā hiki iā ʻoe ke hoʻi i ka hana a hoʻokele.
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, e kāhea koke aku i kāu kauka.
| Nā hōʻailona e pono ai ke kōkua koke ʻana o ke kauka | |
|---|---|
| Ke kahe koko a i ʻole ka pehu ʻana e like me ka puʻupuʻu kahi i hoʻokomo ʻia ai ke catheter | ʻEha umauma |
| Pōʻino a i ʻole ka nawaliwali | Manaʻo e kuʻi wikiwiki ana ka puʻuwai |
| ʻO ka pehu (edema) a i ʻole ka ʻeha ma kahi i hoʻokomo ʻia ai ke catheter | ʻO ka ʻeha ma ka wāwae (inā hana ʻia mai ka ʻūhā) |
| Pilikia! - E hele koke i ka ETU: ke kūlou ʻana o kekahi ʻaoʻao o ka maka, nāwaliwali o ka lima a i ʻole ka wāwae, paʻakikī ke ʻōlelo (he mau hōʻailona paha kēia o ka hahau ʻana). | |
Leka Lawe-Home
- He lāʻau palekana a ʻaʻohe invasive ka Cardiac Ablation no nā puʻuwai puʻuwai kūpono ʻole (arrhythmias).
- ʻO ka maʻamau, paipai ʻia kēia ke hiki ʻole ke kaohi ʻia ka maʻi me ka lāʻau lapaʻau.
- E hana ʻia nā hana e pono ai e hōʻoia ʻaʻole ʻoe e ʻeha i ka wā o ka mālama ʻana.
- He mau pule e ho'ōla piha ai, a i loko o ia manawa, pono ʻoe e pale i ka hāpai kaumaha a me ka hana luhi.
- E makaʻala i nā hōʻailona hōʻike e hiki mai ana ma hope o ka mālama ʻana. Inā he mau hopohopo kāu, e haʻi koke aku i kāu kauka.
- He mea maʻamau ke makaʻu i ka lohe ʻana e pili ana i kahi kaʻina hana puʻuwai. Akā, he lāʻau lapaʻau haʻahaʻa ka pilikia a holomua kēia. Mai makaʻu e kamaʻilio me kāu kauka e pili ana i kāu mau nīnau.
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo