Ua ʻike anei ʻoe i kou puʻuwai e kuʻi wikiwiki ana a ʻano ʻē? ʻO kēia ʻano, kahi e like me ka mea e lele ana i loko o kou umauma, ua kapa ʻia ʻo Atrial Fibrillation ma ke ʻano lapaʻau. Ke hiki ʻole ke kāohi ʻia kēia me ka lāʻau lapaʻau, ke kamaʻilio nei mākou e pili ana i kahi ʻano lapaʻau paʻakikī akā maikaʻi loa i hoʻohana ʻia ma ke ʻano he hopena. ʻO ia ke Kaʻina Hana Maze.
He aha kēia Kaʻina Hana Maze?
I ka ʻōlelo maʻalahi, ua like ia me kahi maze. Ua pāʻani paha ʻoe me nā maze i kou wā kamaliʻi, kahi āu e komo ai ma ka puka hoʻokahi a pono ʻoe e hele i hoʻokahi ala pololei e puka ai i waho. Ua like kēia ʻoki kino.
Hoʻokele ʻia ko mākou mau kuʻi puʻuwai e nā hōʻailona uila. I ka fibrillation atrial, lilo nā hōʻailona uila i loko o nā keʻena ʻelua o luna o ka puʻuwai, i kapa ʻia ʻo atria, i mea ʻano ʻē a hoʻomaka e hoʻouna i nā hōʻailona hewa. A laila hoʻomaka ka puʻuwai e kuʻi me ke ʻano ʻē.
Ma ke Kaʻina Hana Maze, hana ke kauka ʻoki i nā ʻiʻo ʻeha ma ke ʻano palupalu a hoʻolālā ʻia i loko o ka atria o ka puʻuwai. Hana kēia ʻiʻo ʻeha e like me ka pale, e kāohi ana i nā hōʻailona uila hewa mai ka hele ʻana ma loko o ka puʻuwai. Eia naʻe, waiho ia i kahi ala no nā hōʻailona kūpono e pono ai no ka puʻuwai e paʻi pono. E like me hoʻokahi wale nō ala pololei i loko o kēlā maze. ʻAe kēia i ka puʻuwai e paʻi maʻamau hou.
ʻElua mau ʻano hana i hoʻohana ʻia no ka hana ʻana i kēia ʻiʻo scar:
- Cryoablation: Hoʻopau ʻana i nā ʻiʻo me ka hoʻohana ʻana i ke anu nui (hau).
- ʻO ka Ablation Radiofrequency: Hoʻomehana ʻana o nā ʻiʻo me ka hoʻohana ʻana i ka wela kiʻekiʻe (nā nalu lekiō).
Hiki ke hana ʻia kēia ʻoki kino ma ke ʻano he ʻoki kino ʻokoʻa, a i ʻole hiki ke hana ʻia i ka manawa like me ke ʻoki bypass a i ʻole ke ʻoki valve puʻuwai.
No ke aha e hana ʻia ai kēia Kaʻina Hana Maze?
ʻAʻole ʻōlelo ʻia kēia ʻoki kino no nā kānaka a pau. Aia kekahi mau kūlana e hiki ai i kāu kauka ke ʻōlelo i kēia lāʻau lapaʻau:
- Inā ʻaʻole e hana ana nā lāʻau lapaʻau i kuhikuhi ʻia no ka fibrillation atrial iā ʻoe a i ʻole he mau hopena ʻaoʻao kāu e pale ai iā ʻoe mai ka lawe ʻana iā lākou.
- Inā ua hoʻoulu kēia ʻano i nā ʻūpā koko i loko o kou kino a ua loaʻa nā maʻi koʻikoʻi e like me ka hahau ʻana .
- Inā ʻoe e hana ʻia nei i kekahi ʻoki puʻuwai ʻē aʻe (e like me ka bypass, ke pani ʻana i ka valve) a loaʻa iā ʻoe kekahi fibrillation atrial.
- Inā ʻaʻole i holomua nā lāʻau lapaʻau ma mua e like me `(Catheter Ablation)`.
ʻAʻole he mea maʻalahi ka Atrial Fibrillation. Hoʻonui ia i ka pilikia o ka hahau ʻana ma kahi o ʻelima mau manawa. Hiki iā ia ke hana i ka hāʻule ʻana o ka puʻuwai. No laila, he mea nui loa ka loaʻa ʻana o ka lāʻau kūpono no kēia.
He aha ka mea e hana ʻia ma mua a i ka wā o ke ʻoki kino?
ʻOiai he hana ʻoki nui kēia, e nānā pono ʻia ʻoe ma mua o ka hoʻomaka ʻana.
| Hoʻomākaukau ma mua o ke ʻoki kino | |
|---|---|
| Nā hoʻāʻo |
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| Nā kuhikuhi | E hāʻawi ʻia nā ʻōlelo aʻoaʻo no ka mea e ʻai ai a me ka mea e inu ai ma mua o ke ʻoki ʻana a me nā lāʻau lapaʻau e lawe ai/e hoʻōki ai i ka lawe ʻana. |
| Ka manawa o ke kauka | E loaʻa iā ʻoe ka manawa kūpono e hālāwai ai a kamaʻilio me kāu kauka ʻoki kino, kauka cardiologist, a me ka anesthesiologist. |
ʻElua mau ʻano hana ʻoki kino
ʻElua mau ʻano hana nui o ke ʻoki kino. Na kāu hui lapaʻau e hoʻoholo i ke ʻano hana kūpono loa iā ʻoe.
1. ʻOki Hāmama (ʻAno Sternotomy): Ma kēia ʻano hana, hana ʻia ke ʻoki ma o kahi ʻoki ʻana he 6-8 ʻīniha ma waenakonu o ka iwi umauma.
2. ʻO ke ʻoki kino liʻiliʻi loa (ʻAno Thoracoscopic): Ma kēia ʻano hana, ma kahi o kahi ʻoki nui ma ka umauma, hana ʻia kekahi mau ʻoki liʻiliʻi ma waena o nā iwi ʻaoʻao a hoʻokomo ʻia kahi kāmela a me nā mea hana palupalu. ʻOi aku ka pōkole o ka manawa hoʻōla ma kēia ʻano hana.
Ka Wehe ʻana i ka Appendage Atrial Hema
ʻO kekahi ʻāpana koʻikoʻi loa o kēia ʻoki kino ʻo ia ka pani ʻana a i ʻole ka wehe ʻana i kahi ʻāpana liʻiliʻi i kapa ʻia ʻo ka Left Atrial Appendage . He ʻeke liʻiliʻi kēia, i ke ʻano o ka pepeiao, i hoʻopili ʻia i ka atrium hema o ka puʻuwai.
90% o nā ʻūpā koko e hoʻoulu ai i nā hahau i nā maʻi me ka atrial fibrillation e hana ʻia i loko o kēia ʻeke liʻiliʻi.Ua ʻike ʻia. No ka mea, ʻaʻole e paʻi pono ka puʻuwai, hōʻiliʻili ke koko ma kēia wahi a paʻa. Inā haki kēia paʻa koko a hele i ka lolo, loaʻa kahi hahau. No laila, i ka wā o ke kaʻina hana Maze, ua pani ʻia kēia wahi me nā humuhumu, nā staples, a i ʻole kahi mea hana kūikawā. Hiki i kēia ke hōʻemi nui i ka pilikia o ka hahau.
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki kino, e mālama ʻia ʻoe i loko o ka ʻāpana mālama koʻikoʻi (ICU) no ka nānā ʻana no hoʻokahi a ʻelua paha lā, a laila e hoʻoneʻe ʻia i kahi keʻena maʻamau. Inā ua hana ʻia ʻoe i ke ʻoki kino minimally invasive (thoracoscopic), hiki iā ʻoe ke hoʻi i ka home ma kahi o 4 mau lā. Inā ua hana ʻia ʻoe i ke ʻoki kino hāmama, e noho ʻoe ma ka haukapila no kahi o hoʻokahi pule.
Pono ʻoe e lawe i kekahi mau ʻano lāʻau lapaʻau no kekahi mau mahina ma hope o kou hoʻi ʻana i ka home.
- Nā lāʻau hoʻokahe koko (Anticoagulants): Pono ʻoe e lawe i nā lāʻau lapaʻau e like me 'Warfarin' a i ʻole 'Apixaban' no ka liʻiliʻi he 3 mau mahina e pale ai i nā ʻūpā koko. Ma hope o kēlā, e hoʻoholo kāu kauka inā pono ʻoe e hoʻomau i ka lawe ʻana iā lākou.
- Lāʻau lapaʻau kaohi o ka helu o ka puʻuwai: No ka kaohi ʻana i nā puʻuwai kū ʻole i hiki ke hana i nā wā mua o ka hoʻōla ʻana o ka puʻuwai.
- Diuretics: E hōʻemi i ka hōʻiliʻili ʻana o ka wai pono ʻole i loko o ke kino.
He aha nā pōmaikaʻi a me nā pilikia o kēia ʻoki kino?
| Nā Pōmaikaʻi | Nā Pōʻino/Nā Pilikia |
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ʻEhia ka lōʻihi e ho'ōla ai a āhea wau e ʻike hou ai i ke kauka?
E hoʻi i kāu mau hana maʻamau e like me ka mea maʻamau.Hiki ke hala ma waena o 3 a me 6 mau pule . Inā ua hana ʻia ke ʻoki ʻana me ka hoʻohana ʻana i kahi ʻano hana minimally invasive, ʻoi aku ka pōkole o ka manawa hoʻōla.
Ma hope o ke ʻoki ʻana, pono ʻoe e ʻike i ke kauka ma kahi papa manawa i hoʻonohonoho ʻia.
- Hoʻokahi pule ma hope o ka haʻalele ʻana i ka haukapila.
- Hoʻokahi mahina ma hope o ka haʻalele ʻana i ka haukapila (cardiologist).
- Nā hoʻāʻo ECG ma 3, 6, a me 12 mau mahina.
- ʻO kahi hoʻāʻo `Holter Monitor` (kahi mea e nānā ai i ka helu o ka puʻuwai no 24 mau hola) ma 6 a me 12 mau mahina.
He mea nui no kou olakino maikaʻi ke hele ʻana i kēia mau hoʻokolohua a me nā manawa hoʻonohonoho.
Leka Lawe-Home
- He ʻoki kino holomua loa ke Kaʻina Hana Maze no ka fibrillation atrial i kāohi ʻole ʻia e ka lāʻau lapaʻau.
- Hoʻokumu kēia i kahi ʻano o ka ʻiʻo ʻeha e ālai ai i nā hōʻailona uila hewa o ka puʻuwai, e hoʻihoʻi ana i ka puʻuwai maʻamau.
- Aia ʻelua mau ʻano hana, ke ʻoki kino hāmama a me ka minimally invasive, a na kāu kauka e hoʻoholo i ke ʻano hana kūpono loa iā ʻoe.
- ʻO ka pani ʻana i ka `Left Atrial Appendage` i hana ʻia i ka wā o kēia ʻoki kino e kōkua nui i ka hōʻemi ʻana i ka pilikia o ka hahau ʻana.
- He lōʻihi ka manawa e hoʻōla ai ma hope o ke ʻoki ʻana, a he mea nui loa e lawe pono i nā lāʻau lapaʻau i kuhikuhi ʻia e ke kauka (ʻoi aku hoʻi nā lāʻau hoʻokahe koko) a e ʻike i ke kauka i nā lā i hoʻonohonoho ʻia.
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