Ke ʻeha pinepine nei kāu keiki liʻiliʻi i ka ʻōpū a luaʻi i ka luaʻi ʻōmaʻomaʻo-melemele? Ua ʻōlelo paha ke kauka he pilikia hānau ko ka pēpē me kona ʻōpū, ʻo ia hoʻi, ua kau hewa ʻia nā ʻōpū? ʻO kēia ka mea a mākou e kapa nei ma ke ʻano lapaʻau he `(Malrotation)`. Ua ʻōlelo paha ke kauka he pono iā ia ke hana i kahi hana `Ladd' ma ke ʻano he lāʻau lapaʻau no kēia. No laila, he mea maʻamau loa iā ʻoe ke manaʻo nui i ka makaʻu a me ka hopohopo. No laila i kēia lā e kamaʻilio mākou e pili ana i nā mea āpau me ka maopopo, maʻalahi, a ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.
He aha ke kaʻina hana Ladd?
I ka ʻōlelo maʻalahi, ke kūlana kūpono ʻole nā ʻōpū i loko o ka ʻōpū i ka wā e noho ana ke pēpē i loko o ka ʻōpū, kapa mākou i kēia he `(Malrotation)`. He maʻi hānau kēia.
ʻO ka mea weliweli loa e pili ana i kēia, ʻo ia kekahi manawa hiki i nā ʻōpū i kūlike ʻole ma kēia ʻano ke wili pū. E noʻonoʻo e like me ka paʻa ʻana i kahi paipu wai ma nā ʻaoʻao ʻelua a wili iā ia. Kāhea mākou i kēia he volvulus . Ke hana ʻia kēia, hiki ke ʻoki loa ʻia ke kahe koko i nā ʻōpū, a hiki i kēlā mau ʻāpana ke make (necrosis). He kūlana pilikia loa kēia.
Eia kekahi, hiki i nā kāʻei ʻokoʻa o nā ʻiʻo i kapa ʻia ʻo "Ladd's bands" ke hana a ālai i ka ʻāpana mua o ka ʻōpū (duodenum). Hiki i kēia ke kumu i ka hiki ʻole i ka pēpē ke ʻeli i ka meaʻai a luaʻi pinepine.
No laila, ʻo ka hana a kēia ʻoki LAD, ʻo ia ka hoʻopololei ʻana o nā kauka ʻoki i kēia mau ʻōpū i wili ʻia, ʻokiʻoki i kēlā mau ʻāpana ʻiʻo e ālai ana, a kau i nā ʻōpū ma kahi kūpono a palekana hoʻi i loko o ka ʻōpū.
Maopopo iaʻu ka hopohopo āu e manaʻo ai ke lohe ʻoe e pili ana i ke ʻoki ʻana no kāu pēpē. Akā ʻo kēia wale nō ka lāʻau lapaʻau maikaʻi loa no `(Malrotation)`. ʻAʻole e waiho wale kāu hui lapaʻau iā ʻoe a me kāu pēpē ma kēia huakaʻi, e wehewehe lākou i nā mea āpau.
Pehea e hoʻomākaukau ai i kahi pēpē no ke ʻoki kino?
Hana pinepine ʻia kēia ʻoki kino ma nā pēpē ma lalo o hoʻokahi makahiki. No laila, ʻaʻole lākou maopopo i ka mea e hana nei. ʻO ia ke kumu he mea nui kou aloha a me kou mālama ʻana ma ke ʻano he makua i kāu pēpē i kēia manawa. Aia kekahi mau mea hiki iā ʻoe ke hana.
- E hoʻomākaukau no ka noho ʻana ma ka haukapila: Pono ʻoe e noho ma ka haukapila no kekahi mau lā, ʻelua pule paha, ma hope o ke ʻoki ʻana. E hoʻāʻo e noho kokoke i kāu pēpē i ka hiki. ʻO kou leo, kou pā hōʻoluʻolu he kumu hōʻoluʻolu nui ia no kāu pēpē. Ke pono ʻoe i kahi hoʻomaha, e noi i kahi lālā o ka ʻohana i ʻike maikaʻi i kāu pēpē e noho me ʻoe.
- E hōʻoluʻolu i kāu pēpē: E lawe mai i kahi mea a kāu pēpē e makemake ai, e like me kahi mea pāʻani a i ʻole kahi kapa moe liʻiliʻi. ʻO ka lawe ʻana iā ia me ʻoe ma mua a ma hope o ke ʻoki ʻana e kōkua i kāu pēpē e ʻoluʻolu.
- E nīnau e pili ana i ka meaʻai a me ka mea inu: Pono paha ʻoe e hoʻōki i ka hānai ʻana i ka waiū umauma a me ka hānai ʻana i kāu pēpē i kekahi mau hola ma mua o ke ʻoki ʻana. Hiki ke ʻokoʻa kēia no kēlā me kēia pēpē, no laila e kamaʻilio me kāu kauka ʻoki e pili ana i kēia.
Pehea e hana ʻia ai ke ʻoki kino?
ʻO ka hapa nui o ka manawa, hana ʻia kēia ʻoki laparoscopically. ʻO ia hoʻi, ka mea a mākou e kapa nei he ʻoki 'keyhole', i hana ʻia me kahi kāmela. Ma kēia, he mau ʻoki liʻiliʻi wale nō i hana ʻia ma ka ʻōpū. I kekahi manawa, ma muli o ke kūlana, hiki ke hana ʻia kahi ʻoki hāmama i kapa ʻia ʻo 'laparotomy'. Na ke kauka lapaʻau e hoʻoholo i ke ʻano hana maikaʻi loa no kāu pēpē.
| He aha ka mea e hana ʻia ma mua a i ka wā o ke ʻoki kino | |
|---|---|
| Hoʻomākaukau ma mua o ke ʻoki kino | |
| ʻŌmole ihu (ʻōmole NG) | Hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o ka ihu i loko o ka ʻōpū e hoʻokahe i nā mea o loko o ka ʻōpū o ke pēpē. |
| Ke kau nei i ka saline i loko o ka lima (laina IV) | Hoʻokomo ʻia kahi wai saline i loko o kahi aa koko ma ka lima. Maanei e hāʻawi ʻia ai nā wai e pono ai, nā lāʻau hoʻomaha ʻeha, a me nā lāʻau lapaʻau e pale aku ai i ka maʻi. |
| Anesthesia Laulā | Hoʻomoe loa ʻia ka pēpē, no laila ʻaʻohe ʻeha i ka wā o ke ʻoki ʻana. |
| I ka wā o ke ʻoki kino | |
| Ke hana ʻana i nā ʻoki liʻiliʻi | No ke ʻano laparoscopic, hana ʻia he 3 a 4 paha mau ʻoki liʻiliʻi o 3-5 mm i loko o ka ʻōpū. |
| Hoʻoponopono ʻōpū | Hoʻolōʻihi pono ʻia ka ʻōpū i wili ʻia a ʻoki ʻia a wehe ʻia ke ʻiʻo e ālai ana i nā "kāʻei o Ladd". |
| Wehe ʻana i ka pākuʻi | Ke hoʻololi hou ʻia nā ʻōpū, aia ka appendix ma kahi kūpono ʻole. No ka mea he pilikia paha ia i ka wā e hiki mai ana, ua wehe ʻia nō hoʻi i ka wā o kēia ʻoki kino. ʻAʻole ia e hōʻeha i ka pēpē. |
| Ke hoʻololi hou ʻana o ka ʻōpū | Inā loaʻa i ka ʻōpū kahi lako koko maikaʻi, ua waiho palekana ʻia ma ka ʻaoʻao hema o ka ʻōpū. |
I kekahi manawa, inā he kānalua ua ʻoki ʻia ke kahe koko ma muli o ka wili ʻana o nā ʻōpū a me ka hōʻino ʻana i nā ʻōpū, pono paha kekahi hana ʻoki kino ʻē aʻe i loko o 24-48 mau hola o ke hana ʻoki kino mua e hōʻoia i ke olakino o nā ʻōpū.
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki ʻana, lawe ʻia ka pēpē i kahi lumi hoʻōla, kahi e nānā ai nā kauka a me nā kahu maʻi i ka puʻuwai o ka pēpē a me ka hanu ʻana. Hāʻawi ʻia nā wai a me nā meaʻai ma o ka saline (IV) a hiki i ka hoʻomaka ʻana o nā ʻōpū o ka pēpē e hana hou (ʻo ia hoʻi, ka hoʻokuʻu ʻana i ke kinoea a me ka ʻōpala ).
Ma hope o ka hoʻomaka ʻana o ka hana ʻana o nā ʻōpū, hiki i ka pēpē ke hoʻomaka e inu i ka waiū a ʻai hou i ka meaʻai i loko o ʻelua a ʻekolu mau lā.
He aha nā pōmaikaʻi a me nā pilikia o kēia ʻoki kino?
ʻO ka pōmaikaʻi nui, ʻo ia ka hoʻōla piha ʻana i ke kūlana "Malrotation". Eia nō naʻe, e like me nā ʻoki kino āpau, aia kekahi mau pilikia liʻiliʻi.
| Nā Pōmaikaʻi | Nā Pōʻino/Nā Pilikia |
|---|---|
| Nalo nā hōʻailona e like me ka ʻeha o ka ʻōpū a me ka luaʻi. | Ka maʻi ma kahi i hana ʻia ai ke ʻoki. |
| Ua hoʻopau ʻia ka pilikia weliweli o ka wili ʻana o ka ʻōpū (volvulus). | ʻO ka ileus paralytic kahi kū ʻana o ka hana o ka ʻōpū no ka manawa pōkole. |
| E hiki i ke pēpē ke inu waiū a ʻai maʻamau. | ʻO ka maʻi ʻōpū pōkole (inā ua wehe ʻia kekahi ʻāpana o ka ʻōpū). |
| Ke ulu a me ka ulu maʻamau nei ke pēpē. | ʻAʻole pinepine, ka wili pinepine ʻana o nā ʻōpū (Volvulus). |
Āhea wau e kāhea aku ai i ke kauka?
Ma hope o kou lawe ʻana mai i kāu pēpē i ka home mai ke ʻoki ʻana, e kāhea koke aku i kāu kauka ʻokiʻoki a i ʻole ka haukapila inā ʻike ʻoe i kekahi o kēia mau hōʻailona. He mau hōʻailona paha kēia o kahi maʻi:
- Kuni: Inā ʻoi aku ka mahana o ka rectum ma mua o 100.4°F (38°C).
- Ka pu e kahe ana mai ka ʻeha: Inā he wai mānoanoa, keʻokeʻo a ʻaila paha e puka mai ana mai ka ʻeha mai.
- Ke wehe ʻana i ka ʻeha: Inā ua hāmama ka ʻeha a ua hemo nā humuhumu, aia kahi hohonu i ʻike ʻia.
- ʻUlaʻula a puni ka ʻeha: Inā ʻulaʻula ka ʻili a puni ka ʻoki a ke pālahalaha nei ka ʻulaʻula.
Eia kekahi, inā ʻeha hou ka ʻōpū o ka pēpē a luaʻi ʻōmaʻomaʻo, ʻo ia hoʻi ke ʻike hou ʻia nei nā hōʻailona. Inā hana ʻia kēlā, pono ʻoe e kāhea koke i ke kauka me ka hoʻokaʻulua ʻole.
Leka Lawe-Home
- ʻO ke Kaʻina Hana ʻo Ladd wale nō ka lāʻau lapaʻau a kūleʻa loa no ka malrotation, kahi kīnā hānau o nā ʻōpū.
- Hiki i kēia ke pale aku i ke kūlana weliweli o "Volvulus", kahi e wili ai nā ʻōpū a nalowale ke koko.
- Inā he mau makaʻu a hopohopo paha kou e pili ana i ke ʻoki kino, e kamaʻilio ākea me kāu kauka e pili ana i ia mea. E wehewehe lākou i nā mea āpau iā ʻoe.
- Inā loaʻa iā ʻoe nā hōʻailona o ka maʻi (ke kuni, ka pehu mai ka ʻeha) a i ʻole e hoʻi hou mai nā hōʻailona (ka luaʻi ʻana, ka ʻeha o ka ʻōpū) ma hope o ke ʻoki ʻana, e ʻimi koke i ke kōkua lapaʻau.
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