Ua hoʻokomo ʻia anei iā ʻoe a i ʻole kekahi āu i ʻike ai kahi pacemaker a i ʻole kahi implantable cardioverter defibrillator (ICD)? Inā pēlā, ua lohe paha ʻoe e pili ana i nā uea, i ʻike ʻia ʻo 'leads.' I kekahi manawa, inā he pilikia me kēia lead, pono e wehe ʻia ma ke ʻoki ʻana. ʻO kēia ka mea a nā kauka e kapa nei he 'lead extraction.' Hiki ke hopohopo iki ka lohe ʻana i kēia inoa. Akā, mai hopohopo, e kamaʻilio mākou e pili ana i ia mea me ka maʻalahi a me ka maopopo i kēia lā.
E nānā mua kākou, he aha ka 'Lead'?
I ka ʻōlelo maʻalahi, he uea kūikawā i hoʻokaʻawale ʻia ke kaula e lawe ana i nā hōʻailona uila mai kāu pacemaker a i ʻole ka mea ICD (Implantable Cardioverter-Defibrillator) i kou puʻuwai. Ua like ia me kahi uea e lawe ana i ke au i ke kukui i loko o ko mākou hale.
Ke lilo kou puʻuwai i mea ʻano ʻē (Arrhythmia), ʻo kēia alakaʻi e ʻike iā ia a hoʻouna i ka hōʻailona uila kūpono i ka puʻuwai e kōkua i ka hoʻihoʻi ʻana i ke alapine. ʻO ka maʻamau, hiki ke loaʻa hoʻokahi, ʻelua, a ʻekolu paha mau alakaʻi like, ma muli o ka mea i hoʻokomo ʻia i loko o ka umauma o ke kanaka. Hoʻopili ʻia kēia mau mea i ka ʻaoʻao ʻākau o ka puʻuwai ma ke ala koko (vein).
No ke aha he mea pono e hoʻokaʻawale i kēia ʻāpana?
Hiki ke loaʻa kekahi mau kumu no ka wehe ʻana i kahi kēpau. Akā ʻo ka hapa nui o ke kumu nui he maʻi. E noʻonoʻo, inā komo kahi germ i ke koko (Bacteremia), hiki i kēlā maʻi ke hele ma kēia kēpau a hoʻopili i nā valves o ka puʻuwai (Infective Endocarditis). I ia hihia, pono e wehe ʻia ka hāmeʻa a me ke kēpau.
ʻO ka mea nui loa, he mea weliweli loa ka waiho ʻana i kahi maʻi e like me kēia me ka mālama ʻole ʻia. No laila, inā ʻōlelo ke kauka, he mea nui e wehe i kēia mau mea.
Ma waho aʻe o nā maʻi, pono paha e wehe ʻia kahi kēpau no kekahi mau kumu ʻē aʻe.
| Kumu | He wehewehe maʻalahi |
|---|---|
| Ka haki ʻana o ke kēpau a i ʻole ka hana hewa ʻana | Nā mea e like me ka haki, ka haki ʻana, a i ʻole ka hoʻihoʻi ʻana mai e ka mea hana, ma loko a ma waho paha o ke kaula. |
| Nā mea keakea i hana ʻia e ka ʻiʻo palapū | I ka hala ʻana o ka manawa, nui nā ʻiʻo ʻeha e hōʻiliʻili a puni ka piko o ke kaula. A laila, ʻaʻole hele pono ka hōʻailona uila mai ka hāmeʻa i ka puʻuwai. Kāhea mākou i kēia he poloka puka . |
| Ka paʻa ʻana o nā kīʻaha koko | Hiki ke hana ʻia nā ʻūpā koko a i ʻole nā ʻiʻo palapū a puni ke kēpau, e ālai ana i ke kahe koko ma loko. |
| ʻO ka arrhythmia i hoʻokumu ʻia e ke alakaʻi ponoʻī | I kekahi mau hihia kakaikahi, hiki i kahi kēpau ke hoʻopilikia i ka mele o ka puʻuwai a hoʻoulu i kahi puʻuwai kū ʻole. |
Pehea e hana ʻia ai kēia kaʻina hana?
He mea paʻakikī iki kēia a pono e hana ʻia e ke kauka akamai loa. No ka mea, ma hope o kekahi manawa, hiki i ke kēpau ke hoʻopaʻa pono i ke kīʻaha koko ma muli o ka ʻiʻo ʻeha e hana ʻia a puni. No laila, pono e wehe ʻia me ka hoʻohana ʻana i nā lako kūikawā e pale aku ai i ka hōʻino ʻana i ke kīʻaha koko.
Hana ʻia kēia ʻoki kino ma lalo o ka anesthesia laulā , ʻo ia hoʻi, ʻaʻole ʻoe e manaʻo i kekahi mea, e hiamoe ana ʻoe.
1. Hana ke kauka i kahi ʻoki liʻiliʻi ma lalo o ka iwi ʻāʻī (clavicle) a i ʻole ma ka ʻāpana groin (kokoke i ke aʻa femoral) a komo i loko o ke kīʻaha koko.
2. A laila, hoʻoili ʻia kahi ʻōmole kūikawā (ʻūpā) ma kēia kīʻaha koko a hiki i kahi i loaʻa ai ke kēpau.
3. Ke alakaʻi pololei nei ke kauka i kēia ʻōmole ma ke kaulahao me ka nānā ʻana i kahi pale kūikawā (fluoroscopy) e like me ka X-ray.
4. Me ka hoʻohana ʻana i nā mea hana ma ka piko o kēia ʻōmole, ua wāwahi mālie ʻia nā ʻiʻo ʻeha a puni ke kēpau, e hoʻokuʻu ana i ke kēpau.
5. I kekahi manawa hoʻohana ʻia ka ʻenehana laser e hoʻoheheʻe i kēia ʻiʻo ʻeha.
6. Ke wehe loa ʻia ke kaula, e wehe pono ʻia, e pani ʻia ka ʻoki, a e kau ʻia kahi kāʻei.
Āhea e hoʻolaha ʻia ai kahi alakaʻi hou?
Aia nō ia i ke kumu o ka wehe ʻana i ke kaula. Inā ua wehe ʻia ma muli o kahi maʻi, pono mua ʻoe e kali a hiki i ka ho'ōla piha ʻana o ka maʻi. A laila wale nō e hoʻokomo ʻia ai kahi kaula hou a me kahi hāmeʻa. No nā kumu ʻē aʻe, hiki ke hoʻokomo ʻia kekahi mea hou i ka wā o ke ʻoki ʻana e wehe i ke kaula. E wehewehe kāu kauka i kēia iā ʻoe.
He aha nā pōmaikaʻi a me nā pilikia o kēia ʻoki kino?
E like me nā ʻoki kino āpau, loaʻa i kēia kekahi mau pōmaikaʻi a me kekahi mau pōʻino.
| ✅ Nā Pōmaikaʻi | ⚠️ Nā Pōʻino |
|---|---|
| Ka hiki ke ho'ōla i kahi maʻi inā loaʻa. | Nā pilikia ma muli o ka anesthesia. |
| ʻO ke pani ʻana i kahi kaula hao i haki a hewa paha me kahi kaula hou e hoʻihoʻi i ka hāmeʻa i ke ʻano hana maikaʻi. | E haki ke kaulahao ke wehe ʻia. |
| Hoʻopau ʻia nā mea i ālai ʻia ai nā kīʻaha koko a hoʻihoʻi ʻia ke kahe koko. | Ka hōʻino ʻana i ke kīʻaha koko a i ʻole ka puʻuwai. |
| Hoʻomaha mai nā arrhythmias i hoʻokumu ʻia e ke kēpau. | Ke kahe nui ʻana o ke koko a me ke kahe koko ʻana. |
ʻEhia ka manawa e pono ai ʻoe e kamaʻilio me ke kauka?
Ke hoʻi ʻoe i ka home ma hope o ke ʻoki ʻana, aia kekahi mau mea āu e makaʻala ai. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, mai hoʻonele i ka manawa a kāhea koke i kāu kauka.
- Inā pilikia ʻoe i ka hanu ʻana .
- Inā loaʻa iā ʻoe ke kuni ma luna o 101 degere Fahrenheit (101°F) .
- ʻO ka pehu ʻana ma kahi i ʻoki ʻia ai, ka hoʻokuʻu ʻia ʻana o ke wai e like me ke koko a i ʻole ka pus.
- Ka pehu ʻana o nā manamana lima a i ʻole nā manamana wāwae.
E hoʻomanaʻo, inā loaʻa iā ʻoe kahi pilikia, e like me ka paʻakikī o ka hanu ʻana a i ʻole ka ʻeha nui o ka umauma, e hele koke i ka ʻOihana Pilikia kokoke loa (ETU) .
Leka Lawe-Home
- ʻO ka Unuhi ʻAna i ke Kēpau (Lead Unloading) kahi hana ʻoki kino e wehe ai i nā uea (nā kaula) o kahi pacemaker a i ʻole kahi hāmeʻa ICD.
- ʻO ka hapa nui o kēia ke kumu o nā maʻi, akā hiki ke hana ʻia e ka haki ʻana o ke kēpau a i ʻole ka hana hewa ʻana.
- He hana ʻoki kino paʻakikī kēia e pono e hana ʻia e ke kauka akamai loa, no laila he mea nui e ʻimi i ka lāʻau lapaʻau mai ke kauka akamai no nā hopena maikaʻi loa.
- E hahai pono i nā ʻōlelo a ke kauka ma hope o ke ʻoki ʻana.
- Inā he mau pilikia a hopohopo paha kāu, mai makaʻu e kamaʻilio me kāu kauka e pili ana i ia mea.
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