Hana kupaianaha kā mākou ʻōnaehana hoʻoheheʻe e hoʻoheheʻe pono a omo i ka meaʻai a mākou e ʻai ai. Akā e noʻonoʻo, he aha ka mea e hana ai inā he keʻakeʻa ma kekahi wahi ma kēia huakaʻi, e like me ke alanui i ālai ʻia? ʻAʻole hiki i ka meaʻai ke neʻe i mua. I ia mau hihia, ua kapa ʻia kahi ʻoki kūikawā he Gastrojejunostomy, kahi i hoʻohana ʻia e kāpae i kēlā keʻakeʻa a hana i ala hou no ka meaʻai e hele ai. Ua haʻi aku paha kekahi kauka iā ʻoe e pili ana i kēia, a ua lohe paha ʻoe e pili ana i ia mea a lilo i mea hoihoi. E kamaʻilio kākou e pili ana i kēia me ka maʻalahi, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha ke ʻano o ke ʻoki ʻana o ka Gastrojejunostomy?
ʻO ka gastrojejunostomy kahi hana ʻoki e hana ai i kahi pilina hou ma waena o kou ʻōpū a me ka ʻāpana waena o kou ʻōpū liʻiliʻi, i kapa ʻia ʻo ka jejunum. I nā huaʻōlelo ʻē aʻe, hiki i ka meaʻai ke hele pololei mai ka ʻōpū i loko o ka ʻāpana waena o ka ʻōpū liʻiliʻi, i kapa ʻia ʻo ka duodenum, ma kahi o ke komo ʻana i loko o ka duodenum. Ua kapa ʻia kēia pilina hou he anastomosis ma nā ʻōlelo lapaʻau.
E noʻonoʻo e ʻeli ana i kahi lua nui ma ke alanui a hiki ʻole i nā kaʻa ke hele ma waena. A laila ʻoki mākou i alanui hou ma kēlā ʻaoʻao o ka lua a hoʻouna i nā kaʻa ma waena, ʻeā? ʻO ia ka hana a kēia ʻoki kino.
Akā, hoʻokahi mea e hoʻomanaʻo ai. Aia kekahi mea ʻē aʻe i kapa ʻia ʻo ia ka mea like i kekahi manawa. ʻO ia ka ʻōmole hānai, kahi ʻōmole i hoʻokomo ʻia i loko o ka ʻōpū liʻiliʻi e hānai i kahi mea paʻakikī i ka ʻai ʻana. Hele pū ia ma o ka ʻōpū a i loko o ka jejunum, no laila ua kapa ʻia ʻo ia he ʻōmole gastrojejunostomy. Akā, ʻaʻole ia ke ʻoki kino nui a mākou e kamaʻilio nei. He hana ʻokoʻa kēlā.
No ke aha mākou e pono ai i kēia ʻano hana ʻoki kino?
ʻO ke kumu nui o kēia ʻoki kino, ʻo ia ka mea aia kahi mea e ālai ana i ke kaʻina o ka meaʻai mai ka ʻōpū a i ʻole ma ka ʻāpana mua o ka ʻōpū liʻiliʻi. Pale kēia mea e ālai ana i ka neʻe ʻana o ka meaʻai i mua. Aia kekahi mau ʻano maʻi e like me ia.
| Kūlana | He Wehewehe Maʻalahi |
|---|---|
| Ka Pale ʻana o ka Puka ʻŌpū (GOO) | ʻO ka pylorus, ka puka ma lalo o ka ʻōpū kahi e komo ai ka meaʻai i loko o ka ʻōpū liʻiliʻi, ua ālai ʻia no kekahi kumu. |
| Ka Pale ʻana o ka Duodenal | ʻAʻole ka mea ālai i loko o ka ʻōpū, akā, ma ka ʻāpana mua o ka ʻōpū liʻiliʻi ma hope ona (duodenum). |
| Ka maʻi ʻōpū a i ʻole Duodenal | Ka pale ʻana o ka esophagus ma muli o kahi puʻupuʻu kanesa a i ʻole ma ke ʻano he ʻāpana o ke ʻoki ʻana e wehe i ka puʻupuʻu. |
| Maʻi ʻUlu Peptic | Nā pilikia e like me ke kahe ʻana o ke koko mai nā ʻeha i ho'ōla ʻole ʻia, a i ʻole ka ʻeha o nā ʻeha e hiki ai ke ālai i ke ala ʻai. |
Eia kekahi, i kekahi manawa hana ʻia kēia ʻoki kino e pale ai i kahi pilikia hiki i ka wā e hiki mai ana .
- ʻEha i ka ʻōpū liʻiliʻi: Inā ua hōʻino nui ʻia ka ʻāpana mua o ka ʻōpū liʻiliʻi, e like me kahi ulia, hana ʻia kēia bypass e pale i ka hele ʻana o ka meaʻai ma o ia mea a hiki i ka wā e ho'ōla ai. A i ʻole, hiki ke hana ʻia kahi lua kūpono ʻole (fistula) ma o ka ʻeha, e hōʻino ana i nā ʻōpū kokoke e like me ka pancreas.
- Ka Maʻi ʻAʻai Pancreatic: Inā aia ka maʻi ʻaʻai pancreatic kokoke i ka ʻōpū liʻiliʻi a ʻaʻole hiki ke wehe ʻia ma ke ʻoki ʻana, hiki ke ulu a ālai i ka paipu meaʻai i ka wā e hiki mai ana. Ma mua o kēlā hana ʻana, hiki i nā kauka ke hoʻoholo e hana i kēia ʻoki ma ke ʻano he akahele.
He aha ka mea e hana ʻia ma mua o ke ʻoki kino? Pehea ka hoʻomākaukau ʻana?
E hoʻāʻo ka hui lapaʻau e hoʻoikaika iā ʻoe e like me ka hiki ma mua o ke ʻoki kino. E noʻonoʻo, ʻaʻole hiki i kekahi me ka esophagus paʻa ke ʻai a ke luaʻi mau nei. Hiki i kēia ke alakaʻi i ka maloʻo a me ka ʻai ʻole . No laila, pono e hoʻoponopono ʻia kēia mau mea ma mua o ke ʻoki kino.
Hiki i kāu hui lapaʻau ke hana i nā mea e like me:
- Saline (nā wai IV): Hāʻawi ʻia ka saline i loko o kahi aa koko e hoʻoponopono i ka paʻa ʻana o ka wai a me nā kaulike ʻole electrolyte.
- Meaʻai IV: No ka mea ʻaʻole hiki iā ʻoe ke ʻai ma ka waha, hāʻawi pololei ʻia ka meaʻai e pono ai i loko o kahi aa.
- Ka hoʻoili koko: Inā loaʻa iā ʻoe ka anemia, pono paha ʻoe e hoʻoili koko.
- Nā lāʻau antibiotic: Hāʻawi ʻia nā lāʻau antibiotic ma mua e pale aku i ka maʻi ma hope o ke ʻoki ʻana.
- Hoʻēmi ʻana i ke kaomi ʻōpū:Hoʻokomo ʻia kahi ʻōmole ma o ka ihu i loko o ka ʻōpū, a lawe ʻia kekahi o nā mea i loko e hōʻemi i ke kaomi. Hoʻonui kēia i ka palekana i ka wā e hāʻawi ai i ka anesthesia.
He aha ka mea e hana ʻia i ka wā o ke ʻoki kino?
ʻOiai aia nā ʻano like ʻole e hana ai i kēia ʻoki kino, eia nā ʻanuʻu e hana pinepine ʻia.
1. Anesthesia: ʻO ka mua, e hoʻohiamoe loa ʻia ʻoe (general anesthesia). ʻAʻole ʻoe e manaʻo i kekahi mea.
2. Ka hoʻokahe ʻana i ka ʻōpū: Hoʻokomo ʻia kahi paipu ma ka ihu a i ʻole ka waha e wehe i nā mea o loko o ka ʻōpū a hoʻēmi i ke kaomi.
3. Ke komo ʻana i loko o ka lua ʻōpū: Ke komo nei ke kauka lapaʻau i loko o ka lua ʻōpū. Hiki ke hana ʻia kēia ma nā ʻano ʻelua. ʻO kekahi he ʻoki hāmama , ʻo ia hoʻi ka hana ʻana i kahi ʻoki liʻiliʻi ma ka ʻōpū. ʻO kekahi he ʻoki laparoscopic, ʻo ia hoʻi ka hana ʻana i kekahi mau ʻoki liʻiliʻi ma ka ʻōpū a me ka hoʻokomo ʻana i kahi kāmela a me nā mea hana lahilahi. Ua kapa ʻia hoʻi kēia he "ʻoki puka kī."
4. Ke ʻike ʻana i kahi o ka pilikia: Loaʻa ka wahi kikoʻī o ka mea ālai i loko o ka ʻōpū a i ʻole ka ʻōpū liʻiliʻi.
5. Ke hoʻomākaukau ʻana i ka ʻōpū liʻiliʻi: Hana ʻia kahi loop mai ka ʻāpana waena (jejunum) ma kahi o 10 kenimika mai ka hopena o ka ʻāpana mua o ka ʻōpū liʻiliʻi (duodenum).
6. Ke hana ʻana i kahi pilina hou: Ua hoʻopili ʻia ka ʻāpana ʻōpū liʻiliʻi i hana ʻia i ka ʻōpū ma ka liʻiliʻi he 5 kenimika ma luna o ka mea ālai. ʻO kēia ke ala 'bypass' hou a mākou i ʻōlelo ai ma mua.
7. Nānā: Nānā ʻia ka anastomosis i hana hou ʻia me ka hoʻohana ʻana i nā ʻano hana like ʻole e hōʻoia i ka hoʻopili pono ʻia a ʻaʻohe leaka.
8. Ka pau ʻana o ke ʻoki kino: Inā maikaʻi nā mea a pau, e pani ʻia nā ʻoki/lua i hana ʻia a e hoʻopau ʻia ke ʻoki kino.
ʻO ka maʻamau, hiki i kēia ʻoki kino ke hala ma kahi o ʻelua a ʻehā mau hola .
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki ʻana, e hoʻopaʻa ʻia ʻoe i ka haukapila. ʻAʻole paha ʻoe e hiki ke ʻai maʻamau koke. Hiki paha iā ʻoe ke manaʻo iki i ka luaʻi no nā lā mua. I kekahi manawa, ma hope o ke ʻoki ʻana, lilo kou mau ʻōpū i "palaualelo" iki (ileus paralytic). ʻO ke ʻano kēia e lohi iki kā lākou hana.
I ka wā mua, hiki ke hāʻawi ʻia iā ʻoe ka saline a me ka meaʻai ma o kahi aa koko. A laila, hiki iā ʻoe ke hoʻomaka me kahi papaʻai wai maopopo , e neʻe mālie ana i kahi papaʻai palupalu, a laila e hoʻolauna mālie i nā meaʻai maʻamau ma mua o kou hoʻi ʻana i ka home. He mau pule paha no kekahi poʻe e hoʻomaʻamaʻa i ka pilina hou i loko o ko lākou ʻōpū. I loko o kēia manawa, pono paha ʻoe e hoʻomau i ka hānai ʻia ma o kahi paipu a i ʻole intravenous.
He aha nā pilikia a me nā pilikia e hiki mai ana o kēia ʻoki kino?
E like me nā ʻoki kino āpau, aia kekahi mau pilikia e pili ana. ʻAʻole e ʻike nā kānaka a pau i kēia, akā he mea maikaʻi ke ʻike iā lākou.
| ʻAno pilikia | Wehewehena |
|---|---|
| Nā pilikia maʻamau i kekahi ʻoki kino |
|
| Nā pilikia e pili ana i kēia ʻoki kino | Ka leaka anastomotic: He kūlana kakaikahi kēia. ʻAʻole paʻa pono ka pilina i hana hou ʻia, a kahe nā mea o loko o ka ʻōpū a i ʻole ka naʻau i loko o ka lua ʻōpū. Hiki i kēia ke hana i nā maʻi koʻikoʻi. Inā komo ka maʻi i loko o ke koko, hiki ke hoʻoweliweli i ke ola (sepsis). |
Nā hopena ʻaoʻao e hiki mai ana ma hope o ke ʻoki ʻana
ʻOiai inā holomua ke ʻoki ʻana, hiki ke loaʻa kekahi mau hopena ʻaoʻao i ka hala ʻana o ka manawa. Hiki ke kāohi ʻia ka hapa nui o kēia mau mea.
| Hopena ʻaoʻao | He aha ka mea e hana ʻia ai? |
|---|---|
| ʻO ka maʻi hoʻolei | Hoʻolei koke a wikiwiki hoʻi ka meaʻai mai ka ʻōpū a i loko o ka ʻōpū liʻiliʻi. Hoʻoulu kēia i nā hōʻailona e like me ka nausea, ka pehu ʻana, ka ʻeha o ka ʻōpū, a me ka hou ʻana ma hope o ka ʻai ʻana. Hoʻomaha pinepine kēia ma hope o kekahi manawa ke hoʻomaʻamaʻa ke kino iā ia. |
| ʻUlu ʻaoʻao | ʻO ka maʻamau, aia nā waikawa ʻōpū i loko o ka ʻōpū a me ka hapa mua o ka ʻōpū liʻiliʻi. Ua kūkulu ʻia kēlā mau ʻāpana e kū i mua o lākou. Akā ma muli o kēia ala ʻē aʻe, hele pololei nā waikawa ʻōpū i loko o ka ʻāpana waena o ka ʻōpū liʻiliʻi (jejunum). ʻAʻole hiki i kēlā ʻāpana ke kū i nā waikawa. No laila, hiki ke hana ʻia nā ʻōpū ma laila. |
| ʻO ka reflux bile | ʻO ka maʻamau, ua pale ʻia nā mea e kōkua ai i ka ʻai ʻana, e like me ka bile, mai ke kahe hou ʻana i loko o ka ʻōpū. Akā ma muli o kēia pilina hou, hiki i kēlā mau mea ke kahe hou i loko o ka ʻōpū. Hiki i kēia ke hoʻoulu i ka mumū o nā paia o ka ʻōpū. |
Pehea ka manawa ho'ōla?
ʻO ka maʻamau, he ʻeono pule e hoʻōla piha ai, akā hiki ke loli kēia ma muli o ke ʻano o ke ʻoki kino āu i hana ai (hāmama a laparoscopic paha) a me kou kūlana kino.
E hāʻawi aku kāu hui lapaʻau iā ʻoe i nā kuhikuhi no ka mālama ʻana i kāu mau ʻoki, ka mālama ʻana i ka ʻeha, a me ka wā e hiki ai iā ʻoe ke hoʻi hou i nā hana maʻamau ma hope o kou hoʻi ʻana i ka home. E hāʻawi pū lākou iā ʻoe i kahi lā e ʻike hou ai iā ʻoe i kekahi mau pule ma hope o kāu ʻoki ʻana.
Pono paha ʻoe e hahai i kahi papaʻai kūikawā no kekahi mau mahina ma hope o ke ʻoki ʻana, ʻoiai ke pale ʻana i nā meaʻai kiʻekiʻe i ke kō a me ka lawe ʻana i nā mea hoʻopihapiha huaora.
Inā loaʻa iā ʻoe kēia mau hōʻailona, e kāhea koke aku i kāu kauka.
Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona ma hope o ka hoʻi ʻana i ka home, e hoʻomaopopo koke i kāu kauka a i ʻole ka haukapila kahi i loaʻa ai iā ʻoe ka lāʻau lapaʻau .
- Inā ʻoe e ʻike i ka ʻulaʻula, ka ʻeha, ka pehu ʻana, a i ʻole ka mehana a puni ka ʻoki (he mau hōʻailona kēia o ka maʻi).
- Inā loaʻa iā ʻoe ke kuni ma luna o 100° Fahrenheit (38° Celsius).
- Inā paʻakikī ke kāohi i ka ʻeha.
- Inā pilikia ʻoe i ka ʻai ʻana a i ʻole ka mālama ʻana i ka meaʻai.
- Inā loaʻa iā ʻoe ka maʻi diarrhea mau loa.
- Inā melemele kou ʻili a i ʻole ke keʻokeʻo o kou mau maka.
Leka Lawe-Home
- ʻO ka Gastrojejunostomy kahi ʻoki kino e hana ai i kahi ala 'bypass' hou mai ka ʻōpū a i ka esophagus.
- Hana nui ʻia kēia ma ke ʻano he lāʻau lapaʻau no nā kūlana e like me nā ālai ʻana i ke ala ʻai, ke kanesa, a i ʻole nā ʻeha ʻōpū koʻikoʻi.
- Ma mua o ke ʻoki kino, e hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e pono ai e hoʻokō i ke kūlana kino maikaʻi loa.
- He lōʻihi ka manawa e hoʻōla ai, ʻoiai hoʻi ka hoʻomaʻamaʻa ʻana i nā loli o ka ʻai.
- Hiki ke loaʻa kekahi mau hopena ʻaoʻao ma hope o ke ʻoki ʻana, akā hiki ke mālama ʻia ka hapa nui o lākou.
- E hahai pono i nā ʻōlelo a kāu kauka. Inā ʻike ʻoe i kekahi mau hōʻailona pilikia, e ʻimi koke i ke kōkua lapaʻau.
- He loli nui kēia i kou ola, no laila mai kānalua e kiʻi i ke kōkua a me nā ʻōlelo aʻoaʻo āpau āu e pono ai mai kāu hui lapaʻau i kēia huakaʻi.
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