Ua pilikia anei ʻoe i ka hanu ʻana, ka pehu ʻana i kou mau wāwae, a i ʻole ka pilikia o ka puʻuwai a ua haʻi aku kāu kauka iā ʻoe e pili ana i kahi ʻoki kino i kapa ʻia ʻo "Pericardiectomy"? E makaʻu iki paha ʻoe ke lohe ʻoe i kēlā inoa, a he mea maʻamau kēlā. Akā, mai hopohopo. ʻO ke ala maikaʻi loa e hana ai me kekahi mea, ʻo ia ka ʻike piha ʻana e pili ana i ia mea. No laila, i kēia lā, e kamaʻilio mākou e pili ana i kēia ʻoki kino, no ke aha i hana ʻia ai, pehea e hana ʻia ai, a me nā mea e hana ʻia ma hope o ke ʻoki kino ma ke ʻano maʻalahi loa hiki iā ʻoe ke hoʻomaopopo.
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ʻO ka mea mua, he aha kēia 'pericardium'?
I ka ʻōlelo maʻalahi, ʻo ka pericardium ka ʻeke pale e hoʻopuni ana i kou puʻuwai. I ka pololei, he ʻeke ia me ʻelua paia. Ma waena o kēia mau paia ʻelua he wahi liʻiliʻi loa o ka wai. Kōkua kēia wai i ka puʻuwai e kuʻi mālie, me ka ʻole o ka pilikia, me ka ʻole o ka friction. I nā huaʻōlelo ʻē aʻe, hana ia e like me ka lubricant no ka hana o ka puʻuwai.
Akā, hiki iā ʻoe ke ola me ka ʻole o kēia mea hoʻohauʻoli?
ʻAe, hiki nō ia. ʻAʻole pono kēia ʻano ʻōpū no ka hana maʻamau o ka puʻuwai. Inā maikaʻi kou mau māmā a me ke ʻiʻo nui ma lalo o lākou i kapa ʻia ʻo ka diaphragm, ʻaʻole ia e pilikia. ʻOiaʻiʻo, inā loaʻa iā ʻoe kahi maʻi e like me ka ʻōpū (ka mumū o ka pericardium), ua nalowale nā waiwai lubricating o kāu ʻōpū. No laila, ʻo ka wehe ʻana iā ia ʻaʻole ia e hoʻonui i ka maʻi.
No laila, he aha nā kumu no ka hana ʻana i kēia ʻoki kino (Pericardiectomy)?
ʻO ke kumu nui a maʻamau no kēia ʻoki kino he kūlana i kapa ʻia ʻo Constrictive Pericarditis .
E noʻonoʻo, he aha ka mea e hana ʻia inā e maloʻo kēia ʻeke palupalu a puni kou puʻuwai, mānoanoa, a like me ka pūpū niu paʻakikī? E kaupalena ia i kahi no kou puʻuwai e kuʻi manuahi a piha i ke koko, ʻeā? ʻO ia ka mea i kapa ʻia ʻo 'Constrictive Pericarditis'.
Ke mānoanoa a paʻakikī ka ʻili o ka puʻuwai penei:
- ʻAʻole i piha nā keʻena o ka puʻuwai me ke koko lawa.
- ʻO ke koko e pono e pamu ʻia e ka puʻuwai e hoʻi i luna i loko o nā māmā.
- ʻAʻole hiki i ka puʻuwai ke pamu i ke koko ma ke ʻano maʻamau.
- Hoʻomaka ka pehu ʻana o nā wāwae a me ka ʻōpū.
- He mau hōʻailona like kēia me ka hāʻule ʻana o ka puʻuwai.
I nā hihia o ka 'Constrictive Pericarditis' koʻikoʻi, ʻo ka hopena maikaʻi loa ka wehe ʻana i kēia uhi mānoanoa ma ke ʻoki ʻana.
Aia ma ka papa ma lalo nei kekahi mau kumu e hiki ai ke kumu i ka 'Constrictive Pericarditis'.
| Kumu | Wehewehena |
|---|---|
| Nā kumu i ʻike ʻole ʻia (Idiopathic) | I ka manawa pinepine, ʻaʻole hiki ke hoʻopaʻa ʻia kahi kumu kūpono no kēia ʻano. |
| Nā ʻoki puʻuwai ma mua | Hiki iā ia ke hana ma ke ʻano he hopena ʻaoʻao o ke ʻoki puʻuwai ma mua. |
| Ka lāʻau lapaʻau radiation i ka umauma | Inā ua loaʻa iā ʻoe ka lāʻau radiation ma ka umauma no nā maʻi e like me ke kanesa. |
| Nā maʻi ʻē aʻe | Nā maʻi e like me ka maʻi Tuberculosis a me Mesothelioma. |
| Nā maʻi viral a bacteria paha | Nā maʻi koʻikoʻi e hoʻopilikia ana i ka puʻuwai. |
Ma waho aʻe o kēia kumu nui, hana ʻia ke ʻoki ʻana o Pericardiectomy i kekahi mau hihia ʻē aʻe:
- I nā hihia o ka pericarditis e hoʻi hou ana.
- Ma muli o nā pilikia mai kekahi mau lāʻau lapaʻau.
- He mea kākaʻikahi loa, hiki mai kahi kūlana i kapa ʻia ʻo 'Cardiac Tamponade' ke hōʻiliʻili ka wai a puni ka puʻuwai a kaomi i ka puʻuwai.
Pehea e hana ʻia ai ke ʻoki kino a me ka manawa hoʻōla
He ʻoki puʻuwai hāmama ka Pericardiectomy. ʻO ke kime ʻoki:
1. Hana ʻia kahi ʻoki ma ka iwi umauma (sternum) ma waenakonu o kou umauma e komo ai i ka puʻuwai. Ua kapa ʻia kēia kaʻina hana he Median Sternotomy .
2. E hoʻopili pinepine ʻia ʻoe i kahi mīkini e hana manawa pōkole i ka hana o kou puʻuwai a me kou mau māmā (cardiopulmonary bypass). ʻAe kēia i nā kauka e wehe palekana i ka uhi ma ke kua a me nā ʻaoʻao o kou puʻuwai.
3. Ua wehe pono ʻia ka uhi mānoanoa a paʻakikī a puni ka puʻuwai (pericardium).
4. Ma hope o ke ʻoki ʻana, hoʻopili hou ʻia ka sternum me nā uwea a pani ʻia ka ʻoki me nā humuhumu.
ʻO ka maʻamau , ʻelua a ʻekolu paha hola ka lōʻihi o kēia hana ʻoki kino. Ma hope o ke ʻoki kino, e nānā ʻia ʻoe ma ka ʻāpana mālama koʻikoʻi no kekahi mau lā, a maʻamau ePono ʻoe e noho ma ka haukapila no ma waena o 5 a 7 mau lā .
Ma waena o 6 a me 8 mau pule e ho'ōla piha ai. Pono ʻoe e pale i ka hāpai ʻana i nā mea kaumaha i kēia manawa, akā hiki iā ʻoe ke hoʻi mālie i nā hana maʻamau o ka hale.
He aha nā pōmaikaʻi a me nā pilikia o ke ʻoki kino?
E like me nā ʻoki kino nui a pau, loaʻa i kēia nā pono a me nā pilikia. Hiki ke hoʻēmi ʻia nā pilikia ma ka hana ʻana i ke ʻoki kino e kahi kauka lapaʻau puʻuwai akamai.
| Nā Pōmaikaʻi | Nā Pōʻino |
|---|---|
| Aneane nalowale loa nā hōʻailona. | Nā pilikia koko. |
| ʻOi aku ka hiki ke hoʻōla piha ʻia ma mua o ka lāʻau lapaʻau. | Pono e loaʻa kahi hoʻoili koko. |
| Ke pale ʻana i ka hōʻino hou ʻana i ka ʻiʻo o ka puʻuwai. | Nā ʻano ʻino o ka puʻuwai (Atrial Fibrillation). |
| Hoʻonui ʻia ke ʻano o ke ola. | Ka pōʻino o nā puʻupaʻa. |
| ʻAʻole pinepine loa, loaʻa ka hōʻino ʻana i ke aʻalolo e kōkua ai i ka hanu ʻana (aʻalolo phrenic). | |
| Liʻiliʻi loa, 1% - 2% ka pilikia o ka make. |
Āhea wau e ʻike ai i ke kauka ma hope o ke ʻoki ʻana?
Ma hope o kou hoʻi ʻana i ka home mai ka haukapila, pono ʻoe e hoʻomaopopo koke i kāu kauka inā ʻike ʻia kekahi mau hōʻailona hōʻailona.
- Inā loaʻa iā ʻoe ka ʻeha nui o ka umauma .
- Inā he kuni kou.
- Inā ʻoi aku ka nui o ka wai ma mua o ka maʻamau e kahe ana mai ka ʻeha ʻoki.
ʻO ka maʻamau, e ʻike ʻoe i kāu kauka puʻuwai i loko o hoʻokahi a ʻelua paha pule ma hope o kou haʻalele ʻana i ka haukapila. Eia kekahi, e hana ʻia kahi echocardiogram ma kahi o 6 mau pule ma hope e nānā i ke ʻano o ka hana ʻana o kou puʻuwai.
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- ʻO ka Pericardiectomy kahi hana ʻoki nui e wehe ai i ka uhi waho mānoanoa a paʻakikī o ka puʻuwai.
- Hana pinepine ʻia kēia ma ke ʻano he lāʻau lapaʻau no kahi maʻi i kapa ʻia ʻo 'Constrictive Pericarditis'.
- ʻOiai he ʻoki puʻuwai hāmama kēia, hiki ke hoʻokō ʻia nā hopena holomua ke hana ʻia ma lalo o ka nānā ʻana a kahi hui lapaʻau akamai.
- ʻOiai he 6-8 mau pule e ho'ōla piha ai ma hope o ke ʻoki ʻana, he maikaʻi loa nā hopena lōʻihi no ka hapa nui o ka poʻe.
- Inā he mau makaʻu a nīnau paha kāu e pili ana i ke ʻoki kino, e kūkākūkā ākea me kāu kauka. E hāʻawi lākou iā ʻoe i ka ʻike a me ke kākoʻo āpau āu e pono ai.
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