He makuahine a makua kāne paha kou i loko o kou ʻohana e ʻeha nei i ka ʻeha kuli? A i ʻole ʻoe iho paha e ʻeha nei i kēia ʻeha? ʻIke ka poʻe i ʻike i ke ʻano hoʻonāukiuki o ka loaʻa ʻana o kahi kuli ʻeha e paʻakikī ai ke piʻi i luna o nā alapiʻi, hele wāwae i kahi mamao pōkole, a hele paha i kahi luakini. ʻOiai ke lawe ʻana i nā lāʻau lapaʻau like ʻole a me ka hoʻopili ʻana i nā ʻaila like ʻole, i kekahi manawa ʻaʻole e emi kēia ʻeha. I ia mau hihia, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau kūikawā a nā kauka e ʻōlelo nei.
I ka ʻōlelo maʻalahi, he aha ka Genicular Nerve Block?
He mea maʻalahi loa ia. ʻO ka poloka aʻalolo genicular e pili ana i ka hoʻokomo ʻana i kahi lāʻau hoʻopau ʻeha kokoke i kekahi mau aʻalolo e hoʻouna ana i ka ʻeha i kou kuli. E like me ka hoʻopau ʻana i kahi kuapo kukui, hoʻopau kēia inikini i nā "uea aʻalolo" e lawe ana i ka ʻeha mai kou kuli a i kou lolo. Hāʻawi kēia iā ʻoe i ka hoʻomaha manawa pōkole mai ka ʻeha. I kekahi manawa hiki i kēia hoʻomaha ke mau no ka manawa lōʻihi.
I kēia manawa, e nānā kākou i nā aʻalolo a puni kēia kuli. Ua māhele ʻia ko kākou hui kuli i nā lālā e hele mai ana mai kekahi mau aʻalolo nui e hana pono ai. ʻO kēlā mau aʻalolo nui:
- ʻO ke aʻalolo femoral
- ʻO ke aʻalolo peroneal maʻamau
- ʻO ke aʻalolo Saphenous
- ʻO ke aʻalolo tibial
- ʻO ke aʻalolo Obturator
ʻO nā lālā liʻiliʻi e puka mai ana mai kēia mau aʻalolo a puni ke kuli ua kapa ʻia ʻo "Genicular Ners." ʻO ka huaʻōlelo "Genicular" ʻo ia hoʻi "pili i ke kuli." ʻO kēia mau aʻalolo ka mea e hoʻouna i nā manaʻo i loko o ke kuli, ʻoiai ka ʻeha, i ka lolo. Hoʻoikaika nui nā kauka i kēia mau aʻalolo Genicular ʻehā i ka wā e hāʻawi ai lākou i kēia inikini.
1. ʻO ke aʻalolo genicular superolateral (SLGN)
2. ʻO ke aʻalolo genicular Superomedial (SMGN)
3. ʻO ke aʻalolo genicular inferomedial (IMGN)
4. ʻO ke aʻalolo genicular inferolateral (ILGN)
Akā, aia kekahi mea liʻiliʻi ma ʻaneʻi. ʻEkolu wale nō o kēia mau ʻehā e hoʻokomo ai nā kauka. ʻAʻole lākou e hoʻokomo i ka mea hope loa , ʻo ia hoʻi ke aʻalolo Inferolateral genicular (ILGN) . ʻO ke kumu o ia mea, aia kēlā aʻalolo kokoke loa i ke aʻalolo Common peroneal, he mea nui ia no ka neʻe ʻana o ko kākou mau wāwae. Inā hoʻokomo hewa ʻia, hiki iā ia ke hana i kahi kūlana kahi hiki ʻole ke hāpai ʻia ka wāwae, ʻo ia hoʻi, kekahi mea e like me (Foot Drop) , no laila ke pale aku nei lākou i kēlā aʻalolo no ka palekana.
No wai kēia lāʻau lapaʻau kūpono loa?
ʻElua kumu nui no ka hoʻohana ʻana i ka poloka aʻalolo genicular.
1. Hoʻomaha i ka ʻeha kuli lōʻihi
Inā ua lōʻihi kou ʻeha kuli, he ʻano ia a mākou e kapa nei (ʻeha kuli mau) . Hiki paha kēia ma muli o kahi ʻeha kuli a i ʻole, i nā hihia he nui, (Knee Osteoarthritis) , ʻo ia hoʻi ke ʻano o ka ʻaʻahu a me ka haehae ʻana o ka hui kuli. Inā ua hoʻāʻo ʻoe i ka hoʻōla kino, lawe i nā painkiller (NSAID), a loaʻa nā inikini steroid i kou kuli, akā ʻaʻole i emi ka ʻeha, hiki i kāu kauka ke kuhikuhi i kēia poloka nerve Genicular.
E noʻonoʻo ua luhi nā kuli o kou makuahine, ʻaʻole hiki iā ia ke hiamoe pono i ka pō, uwē ʻo ia i ka ʻeha. He pōkole wale nō ke kōkua ʻana o ka lawe ʻana i ka lāʻau lapaʻau. Hiki i kēia inikini ke hāʻawi i ka hōʻoluʻolu nui i kēlā kanaka.
2. E mālama i ka ʻeha ma hope o ke ʻoki kuli
Pono kekahi poʻe e hana i ka Total Knee Arthroplasty , kahi ʻoki e pani ai i ka hui kuli holoʻokoʻa. No ka hoʻomalu ʻana i ka ʻeha nui e kū mai ana ma hope o ia ʻoki nui, hāʻawi ke kauka anesthesiologist a kauka ʻoki paha i kēia inikini ma mua o ke ʻoki. Hāʻawi ʻia kēia ma waho aʻe o ka anesthesia laulā.
He aha kāu e hana ai ma mua o ka loaʻa ʻana o ka lāʻau pale?
ʻAʻole pono kēia i ka hoʻomākaukau nui. Eia nō naʻe, i kekahi mau hihia, hiki i kāu kauka ke hoʻoholo e hāʻawi iā ʻoe i kahi sedation (kahi sedative akahai). Inā ʻoe e hana i kēia, e noi ʻia ʻoe e hoʻokē ʻai no kahi o 6 a 8 mau hola. E noi ʻia hoʻi ʻoe e hoʻokele kekahi iā ʻoe i ka home , no ka mea, ʻaʻole hiki iā ʻoe ke hoʻokele i kēlā lā.
Eia nō naʻe, e wehewehe pono kāu kauka i kēia mau mea a pau iā ʻoe. E hahai pololei i kēlā mau kuhikuhi. Mai makaʻu e nīnau inā he mau nīnau kāu.
He aha ka mea e hana ʻia i ka wā o ka lāʻau pale? E nānā kākou i kēlā me kēia ʻanuʻu.
Hana pinepine ʻia kēia lāʻau lapaʻau ma ke ʻano outpatient. ʻO ia hoʻi, ʻaʻole pono ʻoe e noho i ka haukapila, a hiki iā ʻoe ke hoʻi i ka home ke pau ke kaʻina hana. He 5 a 10 mau minuke ka lōʻihi.
| Nā ʻanuʻu | He aha ka mea e hana nei? |
|---|---|
| 1. Hoʻomākaukau | E kau ʻia ʻoe ma luna o kahi moe kūikawā me kou lima i hāpai ʻia. E kau ʻia kahi uluna liʻiliʻi ma lalo o ke kuli ʻeha a e kūlou iki ʻia kou kuli. Inā pono, hiki ke hoʻokomo ʻia kahi wai saline i loko o kou lima e hāʻawi iā ʻoe i kahi mea hoʻomaha. |
| 2. Hoʻomaʻemaʻe ʻili | Hoʻomaʻemaʻe pono ʻia ka ʻili a puni ke kuli me kahi antiseptic. |
| 3. Ka mae ʻana o ka ʻili | Ma mua o ka hoʻokomo nui ʻana, hāʻawi ʻia kahi hoʻokomo liʻiliʻi (anesthesia kūloko) e hoʻomānoino i ka wahi. I kēia manawa, hiki iā ʻoe ke manaʻo i kahi ʻano ʻū iki, e like me ke nahu ʻia ʻana e kahi ʻanuʻu. |
| 4. Ke ʻimi nei i kahi kūpono | Hoʻohana ke kauka i nā lako kūikawā e ʻike ai i kahi kikoʻī o ke aʻalolo. Hiki ke hana ʻia kēia me ka hoʻohana ʻana i kahi ultrasound scan a i ʻole kekahi ʻano X-ray i kapa ʻia ʻo fluoroscopy . Ua like kēia me ka nānā ʻana i loko o kou kuli ma o kahi pale TV. ʻAe kēia i ka hāʻawi ʻia ʻana o ka injection ma kahi kūpono. |
| 5. Ka lāʻau pale nui | Ma hope o ka loaʻa ʻana o kahi kūpono, hoʻokomo ke kauka i nā mea ʻeha ma kahi kokoke i nā aʻalolo. |
| 6. Nānā ʻana | Ma hope o ke kuʻi ʻana, e nānā ʻia ʻoe no kahi o 15-30 mau minuke e hōʻoia i ka hana ʻana o ka lāʻau lapaʻau a ʻaʻole ʻoe e ʻike i nā hopena ʻaoʻao ʻē aʻe. Ma hope o kēlā, e ʻae ʻia ʻoe e hoʻi i ka home. |
He aha nā pōmaikaʻi o kēia lāʻau pale?
Hiki iā ʻoe ke loaʻa kekahi mau pono mai kahi poloka aʻalolo genicular.
- Hoʻomaha ʻeha: Ua nalowale ka ʻeha no kekahi manawa a mau loa paha, e ʻae ana iā ʻoe e hana maʻalahi i kāu mau hana o kēlā me kēia lā .
- Hoʻemi ʻia ka pehu ʻana: Hoʻemi ʻia ka pehu ʻana o nā aʻalolo, e kōkua ana iā lākou e ho'ōla.
- Hoʻonā no ka ʻeha ma hope o ke ʻoki ʻana: He hopena maikaʻi no ka ʻeha ma hope o ke ʻoki kuli.
- He koho ʻē aʻe no ka poʻe hiki ʻole ke hana ʻoki kino: No ka poʻe hiki ʻole ke hana ʻoki kino kuli ma muli o nā pilikia olakino ʻē aʻe, he koho maikaʻi kēia no ka hoʻokele ʻeha.
ʻO ka mea nui, ʻaʻole loaʻa i nā kānaka a pau nā hopena like. Loaʻa i kekahi poʻe ka hōʻoluʻolu i loko o kekahi mau hola. No kekahi poʻe, hiki ke hala a hiki i ʻelua pule no ka hana maoli ʻana o ka steroid. Aia kahi manawa liʻiliʻi e loaʻa ʻole ai i kekahi poʻe kekahi hōʻoluʻolu.
Inā ua emi nui kou ʻeha ma hope o kēia inikini, hiki i kāu kauka ke ʻōlelo aku i ka Genicular Nerve Ablation (GNA) ma ke ʻano he hana aʻe.Hiki ke hāpai ʻia kahi lāʻau i kapa ʻia ʻo GNA. Hoʻohana ia i ke alapine radio e hoʻopau i kēia mau aʻalolo no ka manawa lōʻihi. Hiki i ka lāʻau GNA ke hāʻawi i ka hōʻoluʻolu ʻeha no kahi o 18 mau mahina.
Aia kekahi mau pilikia a i ʻole nā pilikia me kēia?
Aia paha he ʻeha a palapū paha ma kahi i ini ʻia ai, akā naʻe, e nalowale pinepine kēia i loko o ʻelua lā.
He mea kākaʻikahi nā pilikia nui, akā e like me nā lāʻau pale āpau, aia kekahi mau pilikia e pono ke makaʻala.
- Ka maʻi ma kahi i inikini ʻia.
- Ke kahe ʻana o ke koko mai kahi i inikini ʻia.
- Ka hoʻokomo ulia ʻana o ka lāʻau lapaʻau i loko o ke kīʻaha koko .
- Ka hoʻokomo ʻana i ka lāʻau lapaʻau i loko o ke ami kuli me ka ulia pōpilikia.
- Hana ʻia ka hāʻule ʻana o ka wāwae (hiki ʻole ke hāpai i ka wāwae) ke hōʻino ʻia ke aʻalolo peroneal maʻamau, a mākou i kūkākūkā ai ma mua.
He haʻahaʻa loa ka manawa kūpono o kēia mau mea no ka mea hoʻohana nā kauka i ka ʻenehana e like me nā scan a hana pono i kēia lāʻau lapaʻau.
Hiki iaʻu ke hele ma hope o ka loaʻa ʻana o ka lāʻau pale?
ʻAe, hiki iā ʻoe. Hiki iā ʻoe ke hele i waho o ka lumi ma hope o ka pau ʻana o ka lāʻau lapaʻau. Akā ʻoi aku ka maikaʻi o ka hoʻomaha no kekahi manawa i kēlā lā. A laila hiki iā ʻoe ke hoʻi i kāu mau hana maʻamau.
Pehea ka lōʻihi o kēia hoʻomaha ʻeha?
ʻOkoʻa loa kēia mai kēlā kanaka a kēia kanaka. Hiki ke mau ka hōʻoluʻolu ʻeha no kekahi mau lā, kekahi mau pule, kekahi mau mahina, a i ʻole nā makahiki. Eia nō naʻe, ʻo ka maʻamau, mau ka hōʻoluʻolu no kahi o 3 mau mahina .
Āhea wau e kāhea aku ai i ke kauka?
Inā loaʻa iā ʻoe nā hōʻailona hou a i ʻole nā pilikia ma hope o kahi poloka nerve genicular , e kāhea koke i kāu kauka . E makaʻala pono i kēia mau mea:
- Inā ʻulaʻula, pehu, a mehana paha kahi i inikini ʻia (nā hōʻailona o ka maʻi).
- Inā hoʻomau ke kahe ʻana o ke koko mai kahi i inikini ʻia.
- Inā ʻoe e ʻike i ke kuni, ka mae ʻana, a i ʻole ka nāwaliwali nui i kou mau wāwae.
He hopena maikaʻi paha kēia lāʻau lapaʻau no kou ʻeha kuli. Eia nō naʻe, ʻokoʻa nā hopena mai kēlā kanaka a kēia kanaka. Inā he hopohopo a kānalua paha kāu e pili ana i kēia inikini, e kamaʻilio ākea me kāu kauka e pili ana. E hiki iā ia ke pane i kāu mau nīnau a pau.
Leka Lawe-Home
- ʻO ka Genicular Nerve Block kahi lāʻau lapaʻau i hoʻomālielie ʻia mai ka ʻeha kuli mau loa, kokoke i nā aʻalolo a puni ke kuli.
- He kūpono kēia no ka poʻe i hōʻoluʻolu ʻole ʻia ko lākou ʻeha e nā lāʻau ʻē aʻe (lāʻau lapaʻau, hoʻōla kino) a no ka ʻeha e kū mai ana ma hope o ke ʻoki kuli.
- He lāʻau maʻalahi kēia e hiki ke hoʻopau ʻia i loko o 10 mau minuke wale nō, a hiki iā ʻoe ke hoʻi i ka home me ka ʻole o ka noho ʻana i ka haukapila.
- Hiki ke ʻokoʻa nā hopena mai kēlā kanaka a kēia kanaka, a ma ka awelika, hiki ke manaʻo ʻia ka hoʻomaha ʻeha no kahi o 3 mau mahina.
- He haʻahaʻa loa ka pilikia o nā pilikia, akā inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē ma hope o ka loaʻa ʻana o ka lāʻau pale, e hoʻomaopopo koke i kāu kauka.
- Inā he kānalua kou, e kamaʻilio me kāu kauka ma mua o ka mālama ʻana a hoʻoponopono i nā hopohopo āpau.
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