Ke ʻeha nei hoʻi ʻoe i nā pōhaku puʻupaʻa? E aʻo kākou e pili ana i kēia ʻoki kino kūikawā (Percutaneous Nephrolithotomy)!

He pilikia olakino nā pōhaku puʻupaʻa e kū nei i nā kānaka he nui ma ko kākou ʻāina. I kekahi manawa he liʻiliʻi loa kēia mau pōhaku, no laila hiki ke wehe ʻia mai ke kino ma ka lawe ʻana i ka lāʻau lapaʻau a me ka inu ʻana i ka wai he nui. Akā i kekahi manawa, hiki i kēia mau pōhaku ke lilo i mea nui iki. Ke lilo lākou i mea nui, ʻaʻole lākou e puka mai ma o lākou iho, a he paʻakikī hoʻi ke wehe ʻia me nā lāʻau lapaʻau maʻalahi ʻē aʻe. I ia mau hihia, i kēia lā e kamaʻilio mākou e pili ana i kahi ʻoki kūikawā a nā kauka e ʻōlelo nei. Ua kapa ʻia kēia ʻo 'Percutaneous Nephrolithotomy' a i ʻole PCNL no ka pōkole.

He aha ke ʻoki kino PCNL? E hoʻomaopopo maʻalahi kākou

ʻOiai paha he mea paʻakikī iki ka inoa, he maʻalahi loa ke kaʻina hana. ʻO "Percutaneous" ke ʻano "ma o ka ʻili ." ʻO "Nephrolithotomy" ke ʻano "ka wehe ʻana i kahi pōhaku mai ka puʻupaʻa." No laila, i ka ʻōlelo maʻalahi, ʻo PCNL kahi ʻoki ʻana kahi i hana ʻia ai kahi ʻoki liʻiliʻi loa i loko o ka ʻili a hoʻokomo ʻia kahi mea hana ma o ia mea e wehe i kahi pōhaku nui mai ka puʻupaʻa.

He ʻano hana ʻoki kino kēia i kapa ʻia ʻo "minimally invasive." ʻO ia hoʻi, ma kahi o ka hana ʻana i kahi ʻoki nui ma ka ʻōpū e like me ma mua, hana ʻia kēia hana ʻoki kino ma o kahi ʻoki liʻiliʻi loa. Ua like ia me ka "keyhole surgery."

ʻO wai ka mea e pono ai kēia ʻoki kino?

ʻAʻole hana ʻia kēia ʻoki kino no nā mea a pau i loaʻa ka pōhaku puʻupaʻa. ʻO ka maʻamau, e ʻōlelo ke kauka i kēia ʻoki kino i nā hihia aʻe:

• Inā nui loa kou pōhaku puʻupaʻa (no ka laʻana, ʻoi aku ka nui ma mua o 2 kenimika).
• Inā ʻaʻole hiki ke wehe ʻia ka pōhaku me nā lāʻau ʻē aʻe, e like me ka shock wave lithotripsy a i ʻole ka laser ureteroscopy,
• Inā ke hōʻino nei ka pōhaku puʻupaʻa a i ʻole ke kumu o ka ʻeha nui.

ʻO ke kiʻekiʻe o ka holomua o kēia ʻoki kino he 75% a 98%. ʻO ia hoʻi, hiki ke hoʻokō pono ʻia i ka hapa nui o nā hihia.

Pehea e hana ʻia ai ke ʻoki kino?

Hana ʻia kēia ʻoki kino e ke kauka loea i nā maʻi a me ke ʻoki kino o ka ʻōnaehana mimi. Kāhea mākou iā ia he Urologist . E nānā kākou pehea e hana ʻia ai ke ʻoki kino i kēlā me kēia ʻanuʻu.

1. Anesthesia: ʻO ka mea mua, e hoʻokomo ʻia ʻoe ma lalo o ka anesthesia laulā e kahi anesthesiologist. ʻO ke ʻano kēia, ʻaʻole ʻoe e ʻeha a e hiamoe loa ʻoe.

2. ʻOki:ʻO ka mea aʻe, e hana ke kauka i kahi ʻoki liʻiliʻi loa (ma kahi o 1 cm) ma kou kua a i ʻole ka ʻūhā, kahi i loaʻa ai kou puʻupaʻa.

3. Hoʻokomo ʻia ʻana o ka ʻōmole: Hoʻokomo ʻia kahi ʻōmole pale (ʻūpā) ma o ka ʻoki ʻana i loko o ka puʻupaʻa.

4. Ke ʻimi ʻana i ka pōhaku: A laila, hoʻokomo ʻia kahi mea liʻiliʻi loa i lako me ke kāmela (nephroscope) ma o ka ʻōmole e ʻimi ai i ka pōhaku i loko o ka puʻupaʻa.

5. Ka wehe ʻana i ka pōhaku: Inā liʻiliʻi ka pōhaku, e lawe pololei ʻia i waho. Inā nui ka pōhaku, e wāwahi ʻia i mau ʻāpana liʻiliʻi me ka hoʻohana ʻana i kahi kukuna laser a i ʻole kahi mea nalu leo ​​kūikawā (lithotripter).

6. No ke kōkua ʻana i ka ho'ōla ʻana: Ma hope o ka wehe ʻia ʻana o ka pōhaku, hoʻokomo ʻia kekahi ʻōmole liʻiliʻi (kahi `drainage tube`) a i ʻole ka ureteral stent i loko e kōkua i ke kahe pono ʻana o ka mimi a me ka ho'ōla wikiwiki ʻana o ka ʻeha. ʻO ka hope loa, ua pani ʻia ka ʻoki ʻana ma ka ʻili me nā humuhumu.

ʻO ka maʻamau, ʻelua a ʻehā hola ka lōʻihi o kēia kaʻina hana holoʻokoʻa.

Nā mea e pono ai ʻoe e ʻike ma mua a ma hope o ke ʻoki ʻana

Pono ʻoe e hoʻomākaukau ma mua a ma hope o ke ʻoki kino. E nānā kākou i kēlā.

Aia kekahi mau pilikia i kēia ʻoki kino?

E like me nā ʻoki kino āpau, aia kekahi mau pilikia e pili ana. He mea kākaʻikahi loa kēia, akā he mea nui e makaʻala iā lākou.

• Nā pilikia e pili ana i ka anesthesia.
• Ka maʻi ma kahi i hana ʻia ai ke ʻoki.
• Ke kahe nui ʻana o ke koko a i ʻole ke koko ʻūlū (hematoma).
• Ua hōʻino kekahi mau puʻupaʻa.
• Nā maʻi ʻeha koʻikoʻi o ke ala mimi (e like me ka sepsis).
• I kekahi manawa, ʻaʻole hiki ke wehe loa i ka pōhaku.

Mai hopohopo e pili ana i kēia mau pilikia. E hoʻolālā kāu kauka i ke ʻoki kino ma ke ʻano e hoʻokele ai i kēia mau mea āpau.

I ka manawa e ʻimi koke ai i ke aʻo lapaʻau

Ke hoʻi ʻoe i ka home ma hope o ke ʻoki ʻana, e makaʻala pono i kou kino. Inā ʻike ʻoe i kekahi mea ʻē, pono ʻoe e kāhea koke i kāu kauka. E makaʻala pono i kēia mau hōʻailona:

• Inā e kahe nui ana ke koko o ka ʻoki.
• Inā ʻoe e hele ana i nā ʻōpū koko mānoanoa e like me ka mea ʻala kamato me kou mimi.
• Inā lilo ka mimi i ʻulaʻula ʻeleʻele a ʻeleʻele paha.
• Inā he kuni kou ma luna o 38 Celsius (100 Fahrenheit) .
• Inā ʻoe e anu a me ka haʻalulu.
• Inā e ʻoi aku ka ʻeha.