He aha ke Kaʻina Hana Mitrofanoff? E kamaʻilio maʻalahi kākou e pili ana.

I kekahi manawa, pono mākou e kū i nā pilikia olakino hiki ʻole iā mākou ke noʻonoʻo. ʻOiai i ka wā e pili ana i nā pilikia o ka ʻōpū mimi, he mea paʻakikī loa ka hiki ʻole ke mimi maʻamau. ʻO ka noho ʻana me ia mau kūlana he pilikia nui ia no ke keiki a me ka pākeke. No ke kōkua ʻana i ia poʻe, i kēia lā ke kamaʻilio nei mākou e pili ana i kahi ʻoki kūikawā i hana ʻia e maʻalahi ai ko lākou ola. Ua kapa ʻia kēia ʻo ke Kaʻina Hana Mitrofanoff. ʻOiai he mea ʻē iki ka inoa, he waiwai nui nā pono o kēia.

I ka ʻōlelo maʻalahi, he aha kēia ʻoki kino Mitrofanoff?

ʻO ke ʻoki ʻana ʻo Mitrofanoff kahi hana ʻoki e hana ai i kahi puka liʻiliʻi (i kapa ʻia he stoma ) i loko o ka ʻōpū e ʻae ai i ka mimi e kahe mai ka ʻōpū mimi. He hana kūikawā loa kēia no ka mea hoʻohana nā kauka ʻoki i kahi ʻāpana o kou kino ponoʻī e hana i kēia puka. ʻO ia kou appendix .

E noʻonoʻo, me ka hoʻohana ʻana i kou scrotum, hana ʻoe i kahi ala liʻiliʻi e like me ka paipu mai kou ʻōpū mimi a i kou ʻōpū. A laila, ke pono ʻoe e mimi, hiki iā ʻoe ke hoʻokomo i kahi catheter , kahi paipu palupalu, ma o kēia puka (stoma) e hoʻokahe i kāu ʻōpū mimi.

Ua hoʻolauna mua ʻia kēia kaʻina hana i ka makahiki 1976 e kekahi polopeka i kapa ʻia ʻo Paul Mitrofanoff. ʻO ia ke kumu i loaʻa ai kona inoa. Ua kapa ʻia hoʻi ʻo ia ʻo 'appendicovesicostomy'.

E hoʻomaopopo mua kākou i kekahi mau mea e pili ana i kēia mau ʻāpana o ko kākou kino.

No ka hoʻomaopopo piha ʻana i kēia ʻoki kino, he mea kōkua ke loaʻa kahi manaʻo iki i ke ʻano o ka hana ʻana o ka ʻōnaehana mimi a me ka ureter o ko mākou kino.

• ʻŌpū mimi: He ʻeke ʻiʻo kēia e like me ka pōpō. ʻO ka mimi a ko kākou mau puʻupaʻa e hana ai mai ka kānana ʻana i ke koko e kahe ana ma o ʻelua mau ʻōmole liʻiliʻi (ureters) a hōʻiliʻili i loko o kēia ʻōpū mimi. Ke piha, manaʻo mākou i ka pono e mimi. A laila, haʻalele ka mimi i ke kino ma o ka urethra.
• Pākuʻi: He ʻāpana kēia o kā mākou ʻōnaehana hoʻoheheʻe. He ʻōmole liʻiliʻi ia e waiho ana ma ka ʻaoʻao ʻākau haʻahaʻa o kou ʻōpū, e pili ana i ka ʻāpana mua o kou ʻōpū nui. ʻAʻole ʻike nā kauka i kāna hana ʻē aʻe. Akā hiki iā kākou ke ola i ke ola olakino me ka ʻole o ia mea. He nui ka poʻe e wehe ʻia ma ke ʻoki ʻana ke loaʻa iā lākou ka appendicitis. No laila, ʻaʻohe pilikia me ka hoʻohana ʻana iā ia i nā hoʻohana pono ʻē aʻe.

E noʻonoʻo inā ʻaʻohe ou appendix, ʻo ia hoʻi, ua wehe ʻia ia i kahi ʻoki kino ma mua, he aha kāu e hana ai? Aia kekahi hopena no kēlā. I kēlā hihia, e wehe ke kauka ʻoki i ka appendix mai kou ʻōpū liʻiliʻi.Lawe lākou i kahi ʻāpana liʻiliʻi a hana i kēia ala. Ua kapa ʻia ʻo ia ke ʻano Monti a i ʻole Monti-Yang.

He aha ka mea e hana maoli me kahi hana Mitrofanoff?

ʻAe kēia iā ʻoe e hoʻokahe i kou ʻōpū mimi ma o ke komo ʻana i kahi catheter ma kahi lua i loko o kou ʻōpū (stoma). Ua kapa ʻia kēia he self-catheterization .

I loko o ka lā a pau, i nā manawa kikoʻī (ʻo kēlā me kēia 3-4 hola), pono ʻoe e hana i kēia mau mea:

1. Hoʻokomo ʻia kahi ʻōmole palupalu (catheter) ma o ka puka (stoma) i loko o ka ʻōpū a alakaʻi ʻia ma ke ala i hana ʻia i ka ʻōpū mimi.

2. Hoʻokahe ʻia nā mimi a pau i loko o ka lua a i ʻole kahi pahu ma ka paipu.

3. Ke hakahaka loa ka ʻōpū mimi, wehe ʻia ke catheter. A laila pani koke ʻia ka puka (stoma). ʻAʻohe mimi e kahe mai laila mai.

He maʻalahi kēia ʻano hana, emi ka ʻeha, a ʻoi aku ka ʻoluʻolu no nā poʻe he nui ma mua o ke komo ʻana i kahi catheter ma o ka urethra maʻamau.

ʻO wai ka mea e pono ai kēia ʻoki kino?

Pono paha ke ʻoki ʻana o Mitrofanoff no nā keiki a me nā pākeke. E nānā mākou iā lāua ʻelua ma ke kaʻawale.

No ke aha e pono ai i kahi keiki ke ʻoki ʻana ʻo Mitrofanoff?

Hānau ʻia kekahi mau keiki me kekahi mau nāwaliwali i loko o ko lākou ʻōnaehana nerve. ʻO kēia ke kumu o ko lākou hiki ʻole ke kaohi i ko lākou mau ʻiʻo mimi. Ua kapa ʻia kēia he mimi neurogenic . Eia kekahi, ʻo nā keiki i loaʻa nā maʻi ʻōnaehana mimi hānau e pono paha i kēia ʻoki kino.

ʻO nā kumu maʻamau e pono ai i nā keiki kēia ʻoki kino:

• Spina Bifida: ʻO ia ka nāwaliwali o ka iwi kuamoʻo i loaʻa i ka wā hānau.
• ʻO ka exstrophy bladder a i ʻole ka cloacal exstrophy: ʻO ka hōʻike ʻana o ka ʻōpū mimi i waho ma muli o ke kūkulu piha ʻole ʻia ʻana o ka paia ʻōpū i ka wā hānau.
• Cerebral Palsy: He kūlana e hoʻopilikia ai i ka neʻe ʻana o ke kino a me ka kaohi ʻana o nā ʻiʻo ma muli o ka hōʻino ʻia o ka lolo.
• ʻO ke agenesis sacral: ʻO ka nele hānau ʻana o ka ʻāpana haʻahaʻa loa o ka iwi kuamoʻo.
• ʻEha o ke kaula kuamoʻo.

No ke aha e pono ai ke ʻoki ʻana o Mitrofanoff i kahi pākeke?

Hiki paha i nā mākua ke hiki ʻole ke kaohi i ko lākou ʻōpū mimi no nā kumu like ʻole.

• Nā kūlana maʻi ʻaʻai: Nā kūlana e like me ke kanesa ʻōpū, ke kanesa prostate, a i ʻole ke kanesa colorectal.
• ʻAʻole hiki ke kāohi i ka mimi: ʻO ka paʻa ʻole o ka mimi.
• Ka mumū ʻana o ka ʻōpū mimi (Cystitis).
• Nā maʻi ʻōnaehana nerve: ʻO ka ʻōpū neurogenic i hoʻokumu ʻia e nā kūlana e like me ka sclerosis maha a i ʻole ka maʻi o Parkinson.
• Nā ʻeha o ke kaula kuamoʻo, ka maʻi lolo, a i ʻole nā ​​puʻupuʻu kuamoʻo.
• Hahau.

He aha ka mea e hana ʻia ma mua, i ka wā, a ma hope o ke ʻoki kino?

He mea maʻamau ke manaʻo iki i ka makaʻu i ka wā e kamaʻilio ai e pili ana i kahi ʻoki kino nui e like me kēia. Akā, ʻo ka ʻike pono ʻana i ke ʻano o ka hana ʻana o kēia mau mea hiki ke kōkua i ka hōʻemi ʻana i kēlā makaʻu.

Ma mua o ke kaʻina hana

I mea e hōʻemi ai i ka pilikia o ka maʻi i ka wā o ke ʻoki ʻana, pono e hakahaka kou ʻōpū e like me ka hiki. Pono kēia e hahai pono i nā kuhikuhi a kāu kauka. Hiki i kēia mau mea ke komo pū me:

• Ka hoʻokē ʻai ʻana i ka lā ma mua o ke ʻoki kino.
• Ke lawe ʻana i kahi mea inu kūikawā e hoʻomaʻemaʻe loa i nā ʻōpū (bowel cleanse).

I ka wā o ke kaʻina hana

Hana ʻia kēia ʻoki kino ma lalo o ka anesthesia laulā . ʻO ke ʻano kēia, ʻaʻole ʻoe e manaʻo i kekahi mea i ka wā o ke ʻoki kino, a e hiamoe loa ʻoe.

Hana ke kauka lapaʻau i kēia mau hana:

1. E hana ʻia kahi ʻoki ma kou ʻōpū.

2. Ua hoʻokaʻawale ʻia ka appendix mai ka ʻōpū nui.

3. Hoʻopili ʻia kekahi ʻaoʻao o ia mea i kahi ʻoki liʻiliʻi i hana ʻia ma ka ʻōpū mimi, a hoʻopili ʻia kekahi ʻaoʻao i kahi lua liʻiliʻi (stoma) i hana ʻia ma ka ʻili o ka ʻōpū.

4. Hana ʻia kahi ʻano e like me ka valve kahi e pili ai ka ureter i ka ʻōpū mimi e pale ai i ka mimi mai ke kahe ʻana i hope. Hoʻopaʻa a pani ʻia kēia valve ke piha ka ʻōpū mimi, e pale ana i ka mimi mai ke kahe ʻana ma o ke ala i hana ʻia.

5. I mea e kōkua ai iā ʻoe e mimi a hiki i ka ho'ōla ʻana o kou ʻōpū mimi, ua hoʻokomo pololei ʻia kahi ʻōmole manawa pōkole (ʻōmole suprapubic) i loko o kou ʻōpū mimi. Hoʻiliʻili kēia i ka mimi i loko o kahi ʻeke ma waho o kou kino.

6. I kekahi manawa, hiki ke kau ʻia nā ʻōmole liʻiliʻi (ureteral stents) i loko o nā ʻōmole e lawe ana i ka mimi mai nā puʻupaʻa a i ka ʻōpū mimi (ureters). ʻAʻole pono kēia no nā kānaka a pau.

7. ʻO ka hope loa, ua pani ʻia ka ʻoki nui i hoʻohana ʻia no ke ʻoki ʻana me nā humuhumu hiki ke hoʻoheheʻe ʻia.

Ma hope o ke kaʻina hana

Ma hope o ke ʻoki kino, pono ʻoe e noho ma ka haukapila no hoʻokahi pule. I loko o kēia manawa:

• ʻAʻole ʻoe e ʻae ʻia e ʻai no kekahi mau lā. Akā, e hāʻawi ʻia ʻoe i nā wai IV e hāʻawi i kou ʻōpū i ka manawa e ho'ōla ai.
• No ka lā mua a ʻelua paha, pono ʻoe e moe pālahalaha ma kahi moe. Hiki iā ʻoe ke ʻōwili a hoʻoneʻe i kou mau wāwae, akā ʻaʻole ʻoe e ʻae ʻia e ala a noho i luna.
• Ke hoʻi ʻoe i ka home, e kau ʻia kahi catheter a me kahi ʻōmole `suprapubic` no ka manawa pōkole i loko o ke alahele hou i hana ʻia (Mitrofanoff tunnel) e pale aku ai i kona pani ʻana. Pono e waiho ʻia kēia catheter ma kahi no 4 mau pule.
• Inā hoʻokomo ʻia kēlā mau 'stent ureter', pono e hana ʻia kekahi hana liʻiliʻi ʻē aʻe e wehe iā lākou ma kahi o 6-8 mau pule.
• I ka lā e aʻo ʻia ai ʻoe i ke kāpili ʻana iā ʻoe iho, e wehe ke kauka i nā ʻōmole manawa pōkole ʻelua ma ke keʻena. ʻAʻole pono kēia i kahi ʻoki kino ʻē aʻe.

He aha nā pōmaikaʻi a me nā pilikia o kēia ʻoki kino?

E like me nā hana lapaʻau a pau, aia kekahi mau pono a me kekahi mau pilikia.

Hoʻōla hou a me ke ola ma hope o ke ʻoki kino

I nā pule mua ma hope o ke ʻoki ʻana, hiki iā ʻoe ke ʻike:

• He koko liʻiliʻi i loko o ka mimi (hematuria).
• ʻEha ka ʻūmiʻi ʻana o nā ʻiʻo o ka ʻōpū mimi (bladder spasms).

E kuhikuhi ana kāu kauka i nā lāʻau ʻeha a me nā lāʻau hoʻomaha ʻiʻo no kēia mau mea.

Ma hope o 6 mau pule, pono ʻoe e ʻike i kāu kauka e aʻo pehea e hoʻokomo ai i ka catheter iā ʻoe iho (self-catheterization).

Eia nō naʻe, pono ʻoe e makaʻala mau i ka hana o kāu ʻōnaehana mimi. Pono ʻoe e hana i kēia mau hoʻokolohua i kēlā me kēia makahiki:

• Nā hoʻāʻo koko e nānā i ka pae o nā electrolytes i loko o ke koko a me ka hana o nā puʻupaʻa.
• Cystoscopy (ka nānā ʻana i loko o ka ʻōpū ʻōpū).
• ʻO ke nānā ʻana i ka ultrasound o nā puʻupaʻa a me ka ʻōpū mimi.
• Nā hoʻokolokolo X-ray o nā puʻupaʻa, ka ʻōpū mimi, a me ka urethra.

I ka manawa e ʻike koke ai i ke kauka

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​​​pono ʻoe e kāhea koke i kāu kauka :

• ʻAʻole hiki ke hoʻokuʻu loa i ka ʻōpū mimi.
• Ke kahe nui ʻana o ke koko, ka pehu ʻana, a i ʻole ka palapū.
• Ka luaʻi a me ka luaʻi.
• ʻEha nui.
• Nā hōʻailona o kahi maʻi, e like me ka hoʻokuʻu ʻana o ke koko a i ʻole ke kuni.

He aha ka ʻokoʻa ma waena o Mitrofanoff a me Urostomy?

ʻO kēia mau ʻano hana ʻelua e pili ana i ka hoʻohele ʻana i ka mimi ma o kahi lua i loko o ka ʻōpū. Eia nō naʻe, me ka urostomy , hana ʻia kahi ala e kāpae i ka ʻōpū mimi a hoʻokahe pololei i ka mimi mai nā puʻupaʻa. Pono kekahi poʻe me ka urostomy e ʻaʻahu i kahi ʻeke hōʻiliʻili mimi i nā manawa a pau. ʻO ke ʻano kēia ʻaʻole hiki iā lākou ke kāohi i ke kahe o ko lākou mimi. Eia nō naʻe, me ka Mitrofanoff, loaʻa iā ʻoe ke kūʻokoʻa hou aʻe no ka mea hiki iā ʻoe ke hoʻokahe i kāu ʻōpū mimi me kahi catheter ke pono ʻoe.

He hana mau loa anei kēia ʻoki kino?

Hiki ke hoʻohuli ʻia kēia. ʻO ia hoʻi, hiki ke wehe ʻia ke ana ma ke ʻoki ʻana. Eia naʻe, ʻaʻole i hoʻopili hou ʻia ka appendix i ka ʻōpū, no ka mea, ʻaʻole ia he ʻano koʻikoʻi. Ma hope o ka wehe ʻia ʻana o kahi Mitrofanoff, pono paha ʻoe e mimi maʻamau ma o ka urethra, a i ʻole pono paha ʻoe e hoʻokomo i kahi catheter ma o ia mea e hoʻokahe i kāu ʻōpū mimi, a i ʻole pono paha ʻoe e hana i kahi urostomy. He mea kēia āu e kūkākūkā ai me kāu kauka.