Hoʻonā i nā pōhaku puʻupaʻa nui: He wehewehe maʻalahi no ke ʻoki ʻana o ka PCNL (Percutaneous Nephrolithotomy)

He pilikia nā pōhaku puʻupaʻa i loaʻa i nā kānaka he nui, a i kekahi manawa ke kumu o ka ʻeha hiki ʻole ke hoʻomanawanui. Hele pinepine nā pōhaku liʻiliʻi ma o ka mimi ma hope o ka inu ʻana i ka wai he nui a me ka lawe ʻana i ka lāʻau lapaʻau i kuhikuhi ʻia e ke kauka. Akā, he nui loa kekahi mau pōhaku. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻoki kino kūikawā a holomua loa a nā kauka e ʻōlelo nei i ka wā hiki ʻole ke wehe ʻia e nā ʻano hana ʻē aʻe.

I ka ʻōlelo maʻalahi, he aha ka PCNL?

ʻO Percutaneous Nephrolithotomy ka inoa piha o PCNL. ʻOiai paha e kani iki ka inoa me he mea paʻakikī lā, he maʻalahi loa ka manaʻo.

• ʻO ke ʻano o "Percutaneous" ʻo ia hoʻi "ma o ka ʻili."
• ʻO ke ʻano o "Nephrolithotomy" ʻo ia hoʻi "ka wehe ʻoki ʻana i ka pōhaku mai loko mai o ka puʻupaʻa."

I nā huaʻōlelo maʻalahi, ʻo PCNL kahi hana kahi e hana ʻia ai kahi ʻoki liʻiliʻi loa ma kou kua a wehe ʻia kahi pōhaku nui mai ka puʻupaʻa. Hoʻohana nui ʻia ia e wehe i nā pōhaku nui i mālama ʻole ʻia me nā lāʻau ʻē aʻe, e like me ka lāʻau lapaʻau, ka shock wave lithotripsy, a i ʻole nā ​​​​kaʻina hana ʻē aʻe.

He hana ʻoki kino nui anei ʻo PCNL?

ʻAe, ua manaʻo ʻia ʻo PCNL he ʻoki kino nui. Akā, mai hopohopo. ʻAʻole ia e like me ke ʻoki kino hāmama kuʻuna. ʻO ke ʻoki kino hāmama e pili ana i kahi ʻoki nui aʻe, ʻo ia hoʻi, ʻoi aku ka lōʻihi o ka ho'ōla ʻana a ʻoi aku ka ʻeha.

Akā, he ʻoki kino "minimally invasive" ʻo PCNL. ʻO ia hoʻi, no ka mea, ua hana ʻia ma o kahi ʻoki liʻiliʻi loa, ʻoi aku ka liʻiliʻi o ka hopena ma kou kino, emi nā pilikia, a hiki iā ʻoe ke ho'ōla koke. Akā, no ka mea, he ʻoki kino nui ia, hana ʻia e kahi hui o nā kauka loea ma kahi haukapila.

ʻO wai ka mea e pono ai kēia ʻoki kino?

I ka hapa nui o ka manawa, puka pū nā pōhaku puʻupaʻa me ka mimi. A i ʻole, e kuhikuhi ke kauka iā ʻoe i nā lāʻau lapaʻau maʻalahi ʻē aʻe. Hana ʻia ke ʻoki ʻana o ka PCNL i nā hihia aʻe:

• Inā nui loa ka pōhaku puʻupaʻa: ʻOi aku ka maikaʻi o kēia ʻano hana no ka wehe ʻana i nā pōhaku i ʻoi aku ma mua o 2 kenimika.
• Inā ʻaʻole holo pono nā lāʻau ʻē aʻe: Inā ʻaʻole hiki ke wehe ʻia ka pōhaku me nā lāʻau e like me ka shock wave lithotripsy a i ʻole ka laser ureteroscopy, ʻo ia hoʻi ke kau ʻana i kahi kāmela i lalo o ka urethra a me ka wehe ʻana i ka pōhaku me ka laser.
• Inā aia ka pōhaku ma kahi paʻakikī: Inā aia ka pōhaku ma kahi paʻakikī i loko o ka puʻupaʻa e wehe.

E aʻo kākou i kēlā me kēia ʻanuʻu pehea e hana ʻia ai ke ʻoki kino.

He mea hōʻoluʻolu nui ka ʻike maikaʻi ʻia e pili ana i kēia ʻano hana ma mua o kou hana ʻana. E nānā kākou pehea e hana ai kēia kaʻina hana.

1. He aha kaʻu e hana ai ma mua o ke ʻoki kino?

Pono ʻoe e ʻike i ke kauka i kekahi mau lā ma mua o ke ʻoki kino. Ma laila:

• Nānā ʻia kou kūlana olakino: ana ʻia nā mea e like me ke koko a me ka helu o ka puʻuwai.
• E makaʻala i kāu mau lāʻau lapaʻau: Pono ʻoe e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei, me nā huaora a me nā lāʻau lapaʻau lāʻau. Inā ʻoe e lawe ana i nā lāʻau hoʻokahe koko (e.g., aspirin) , pono paha ʻoe e hoʻōki i ka lawe ʻana iā lākou ma mua o ke ʻoki ʻana. Akā, mai hoʻōki i ka lawe ʻana i kekahi lāʻau lapaʻau me ka ʻole o ka nīnau mua ʻana i kāu kauka.
• E haʻi mai iā mākou e pili ana i kāu mau maʻi allergies: E hōʻoia e hoʻomaopopo mai iā mākou inā he mau maʻi allergies kāu i kekahi lāʻau lapaʻau, meaʻai, a i ʻole kekahi mea e like me ka plaster.
• ʻO ka hoʻokē ʻai: E aʻo ʻia ʻoe ʻaʻole e ʻai a inu paha i kekahi mea ma hope o ke aumoe o ka pō ma mua o ke ʻoki kino. Inā pono ʻoe e lawe i kekahi lāʻau lapaʻau koʻikoʻi, hiki iā ʻoe ke lawe me kahi ʻuʻuku wai.
• Nā hoʻāʻo: E noi ʻia paha ʻoe e hana i kahi `CT (computed tomography) scan`, `Ultrasound scan`, a i ʻole `X-ray` e ʻike i kahi a me ka nui pololei o ka pōhaku puʻupaʻa.

2. He aha ka mea e hana ʻia i ka wā o ke ʻoki kino?

Hana ʻia ke ʻoki kino e kahi hui o nā kauka loea, kahi anesthesiologist, a me kahi limahana kahu maʻi.

• Anesthesia: ʻO ka mea mua, e hoʻokomo ʻia ʻoe ma lalo o ka anesthesia laulā. No laila, ʻaʻole ʻoe e ʻeha i ka wā o ke ʻoki ʻana, a e hiamoe loa ʻoe.
• Kūlana: Hana pinepine ʻia ke ʻoki kino me ʻoe e moe ana ma kou ʻōpū (kūlana moe) ma luna o kahi moe. ʻAe kēia i ke komo maʻalahi ʻana i ka puʻupaʻa mai ke kua.
• ʻOki liʻiliʻi: E hana ke kauka i kahi ʻoki liʻiliʻi, ma kahi o 1 kenimika, ma kou kua, kahi o kou puʻupaʻa.
• Hoʻokomo ʻana i ka mea hana: Ma o ka ʻoki ʻana, hoʻokomo ʻia kahi paipu pale (ʻūpā) i loko o ka puʻupaʻa. A laila, hoʻokomo ʻia kahi kāmela liʻiliʻi (nephroscope) ma o ka paipu a nānā ʻia ka pōhaku i loko o ka puʻupaʻa ma kahi pale.
• Ka wehe ʻana i ka pōhaku: Inā liʻiliʻi ka pōhaku, lawe ʻia me ka mea hana like. Inā nui ka pōhaku, hoʻohana ʻia kahi kukuna laser a i ʻole kahi mea haʻalulu kūikawā "lithotripter" e wāwahi i ka pōhaku i mau ʻāpana liʻiliʻi a wehe i kēlā mau ʻāpana.
• Hoʻokomo ʻia ʻana o kahi ʻōmole: Ma hope o ka wehe loa ʻia ʻana o ka pōhaku, hiki ke hoʻokomo ʻia kahi ʻōmole liʻiliʻi (ʻōmole hoʻokahe) a i ʻole kahi stent ureteral i loko o ka ʻōpū mimi e ʻae i ka mimi a me ke koko e kahe i waho o ka puʻupaʻa. Kōkua kēia i ka ho'ōla ʻana o ka ʻeha.
• Suturing: ʻO ka hope loa, ua pani ʻia ka ʻoki liʻiliʻi i hana ʻia ma ke kua me nā humuhumu.

ʻO kēia kaʻina hana holoʻokoʻa maʻamauHiki ke hala ma kahi o ʻelua a ʻehā hola.

3. He aha ka mea e hana ʻia ma hope o ke ʻoki kino?

Ma hope o ka pau ʻana o ke ʻoki ʻana, e hoʻōki ke kauka anesthesiologist i ka hāʻawi ʻana i ka anesthesia. E hoʻi mālie ʻoe i ka ʻike i loko o kekahi mau minuke.

• Lumi Hoʻōla: E lawe mua ʻia ʻoe i ka lumi hoʻōla, kahi e nānā pono ʻia ai kou olakino.
• Hoʻokele ʻeha: E ʻeha paha ʻoe ma hope o ka hoʻi hou ʻana o ka ʻike. E hāʻawi aku ke kahu maʻi iā ʻoe i nā mea hoʻomaha ʻeha e kōkua i kēia.
• Noho ma ka haukapila: Pono ʻoe e noho ma ka haukapila no hoʻokahi lā. I loko o ia manawa, e nānā nā kauka i kou ho'ōla hou ʻana.
• Koko i loko o ka mimi: He mea maʻamau ka loaʻa ʻana o kahi koko liʻiliʻi i loko o kou mimi no hoʻokahi a ʻelua paha pule ma hope o ke ʻoki ʻana. Mai hopohopo no ia mea.

He aha nā pōmaikaʻi a me nā pilikia o ke ʻoki ʻana o ka PCNL?

E like me nā lāʻau lapaʻau āpau, he mau pono kēia a me nā pōʻino liʻiliʻi.

Nā Pōmaikaʻi:

• ʻO ka hiki ke aneane wehe loa i nā pōhaku puʻupaʻa nui i hiki ʻole ke wehe ʻia e nā ʻano hana ʻē aʻe.
• He hana ʻoki kino kēia me ka nui o ka holomua ma waena o 75% - 98%.
• ʻOi aku ka liʻiliʻi o ka ʻoki ma mua o ke ʻoki hāmama, no laila e ola wikiwiki ka ʻeha.
• Ua emi ka manawa e hoʻolilo ai i loko o ka haukapila.

Nā Pōʻino:

ʻOiai he mau mea kakaikahi loa kēia, he mea nui e ʻike iā lākou.

• Nā pilikia e pili ana i ka anesthesia.
• Ka maʻi ma kahi i hana ʻia ai ke ʻoki.
• Ke kahe koko nui ʻana.
• Ka hoʻokumu ʻia ʻana o ke koko `(hematoma)`.
• Ua hōʻino kekahi mau puʻupaʻa.
• I kekahi manawa, ʻaʻole hiki ke wehe i ka pōhaku holoʻokoʻa.
• Ka maʻi ʻeha nui o ke ala mimi (Sepsis).

ʻEhia ka lōʻihi e hoʻōla ai? He aha nā hana palekana e pono e hana ʻia ma ka home?

ʻO ka maʻamau, ma kahi o ʻelua a ʻehā pule e hoʻōla piha ai. He mea nui loa i kou kino ke hoʻomaha i kēia manawa.

• Mai hāpai i nā mea kaumaha: Mai hāpai i kekahi mea kaumaha ma mua o ke kaumaha o hoʻokahi lita o ka waiū (ma kahi o 4 kg) no ʻelua pule .
• Hoʻoikaika Kino: E noho mamao mai ka hoʻoikaika kino ikaika no kekahi manawa.
• Ke hoʻi nei i ka hana: Inā he hana keʻena kāu, hiki iā ʻoe ke hoʻi i ka hana i loko o hoʻokahi pule. Eia nō naʻe, inā koi kāu hana i ka hoʻoikaika kino, ʻoi aku ka maikaʻi o ka hoʻomaha ʻana ma ka liʻiliʻi he ʻelua pule.

Pono e ʻike koke i ke kauka!

Inā loaʻa iā ʻoe kekahi mau hōʻailona ʻē ma hope o ke ʻoki ʻana, mai hoʻowahāwahā iā lākou. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e kāhea koke aku i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.

E ʻike hou i kāu kauka i ʻehā a ʻeono pule ma hope o ke ʻoki kino no ka nānā ʻana.