Ua piha anei ʻoe i ka ʻai ʻana? A i ʻole e luaʻi pinepine ana ʻoe? ʻO kekahi kumu o kēia, he pilikia paha ia me ka valve muscular ma ka hopena o kou ʻōpū, a i ʻole, kahi e hele ai ka meaʻai mai ka ʻōpū a i ka ʻōpū liʻiliʻi. Kāhea mākou i kēia valve ʻo 'pylorus'. Inā ʻaʻole wehe pono kēia puka, e paʻa ana ka meaʻai ma laila. ʻO ka Pyloroplasty kahi ʻoki kino e kōkua i kēlā mau manawa. E kamaʻilio wale kākou e pili ana i kēia i kēia lā.
I ka ʻōlelo maʻalahi, he aha ka Pyloroplasty?
E noʻonoʻo i kou ʻōpū e like me kahi ʻeke. Mālama ʻia ka meaʻai a kākou e ʻai ai i loko o kēia ʻeke, hoʻoheheʻe ʻia, a laila hoʻouna ʻia i ka ʻōpū liʻiliʻi. Ma ka hopena o kēia ʻeke ʻōpū, aia kahi apo ʻiʻo e hana ana e like me ka puka. Ua kapa ʻia ʻo ia ʻo pylorus . Wehe kēia puka i ka wā e pono ai, e ʻae ana i ka meaʻai i hoʻoheheʻe ʻia e hele i loko o ka ʻōpū liʻiliʻi, a laila pani.
No laila, inā no kekahi kumu e ālai ʻia ai kēia puka, e haiki ana, a i ʻole e wehe pono ʻole ʻia, ʻaʻole hiki i ka meaʻai ke puka i waho o ka ʻōpū. I kēlā manawa, kapa mākou i kēia puka i kapa ʻia ʻo pylorus he hana ʻoki kino i hoʻohana ʻia e hoʻoponopono hou a hoʻonui iā ia. I kekahi manawa, inā ua hōʻino ʻia kēia ʻāpana ma muli o kekahi ʻoki kino ʻē aʻe, hana ʻia kēia ʻoki kino e hoʻoponopono iā ia.
I nā hihia hea e pono ai ke ʻoki ʻana i ka pyloroplasty?
Inā ʻaʻole hana pono kāu pylorus, ʻo ia hoʻi ua lohi ka hoʻokahe ʻana o ka ʻōpū, he mea kōkua paha kēia ʻoki kino. Manaʻo nui ʻia ka Pyloroplasty ma nā kūlana aʻe:
1. Nā ʻōpū ʻeha (Peptic Ulcer Disease)
Pono kekahi mau ʻōpū ʻeha nui i ke ʻoki kino. No ka laʻana, inā he mau ʻōpū kou e kahe mau ana ke koko a i ʻole ʻaʻole e ho'ōla me ka lāʻau lapaʻau, hiki i kāu kauka ke ʻōlelo i kahi hana i kapa ʻia he vagotomy e hōʻemi i ka hana ʻakika o ka ʻōpū. Pili kēia i ka ʻoki ʻana i kekahi o nā aʻalolo e hele ana i ka ʻōpū.
Akā, aia kekahi mea liʻiliʻi ma ʻaneʻi. ʻOiai ʻo kēia ʻoki vagotomy e hōʻemi ana i ka waikawa o ka ʻōpū, hiki i nā aʻalolo e hōʻailona ana i ka pylorus e wehe a pani ke lilo i mea hana ʻole. A laila, ʻaʻole e wehe ka puka. ʻO ia ke kumu, inā ʻoe e hana i kahi ʻoki vagotomy, hana pū ʻoe i kahi ʻoki pyloroplasty e hoʻonui iki i ka puka.
Eia kekahi, i kekahi manawa hiki i kahi ʻōpū ke lilo i pehu a i ʻole hiki ke hana ʻia nā ʻiʻo ʻeha, e ālai loa ana i ke ala ma o ka pylorus. I loko o ia mau pilikia, pono nō hoʻi kēia ʻoki kino.
2. ʻO ka maʻi ʻōpū
ʻO kēia ka manawa ʻaʻole hana pono nā ʻiʻo o ka ʻōpū, me ka pylorus. Me he mea lā ua lilo nā ʻiʻo o ka ʻōpū i mea palaho hapa. Hoʻopaneʻe nui kēia i ka ʻai ʻana a me ka hoʻokahe ʻana i ka meaʻai mai ka ʻōpū. Ke lilo kēia i mea koʻikoʻi, hiki ke alakaʻi i ka nausea mau a me ka luaʻi ʻana, e hiki ʻole ai ke ʻai. Inā ʻaʻole holomua nā lāʻau ʻē aʻe, hiki i kāu kauka ke kuhikuhi i ka wehe ʻana i ka pylorus me kahi ʻoki pyloroplasty.
3. Pyloric Stenosis
ʻIke pinepine ʻia kēia ʻano maʻi i nā pēpē hānau hou . I kēia ʻano, lilo nā paia o ka pylorus o ka pēpē i mānoanoa, e haiki ana a e ālai ana i ke ala no ka meaʻai. ʻO ka hopena, ʻaʻole hiki i ka pēpē ke kiʻi i ka waiū āna i inu ai a luaʻi pinepine. No ia mau pēpē, he mea pono kēia ʻoki kino inā makemake lākou e hoʻokomo pono i ka meaʻai i loko o ko lākou kino.
Pehea e hana ʻia ai kēia ʻoki kino a he aha nā ʻano hana?
Hiki ke hana ʻia kēia ʻoki kino ma nā ʻano ʻelua. ʻO kekahi he ʻoki kino hāmama, ʻo ia hoʻi ke ʻoki ʻana i ka ʻōpū. ʻO kekahi he ʻoki kino laparoscopic , ʻo ia hoʻi ka hana ʻana i kekahi mau ʻoki liʻiliʻi ma ka ʻōpū a me ka hoʻohana ʻana i kahi kāmela a me nā mea hana palupalu. ʻO kēlā me kēia ʻano, e hoʻokomo ʻia ʻoe ma lalo o ka anesthesia laulā, no laila ʻaʻole ʻoe e manaʻo i kekahi mea.
Aia kekahi mau ʻano hana nui o ke ʻoki ʻana i ka pyloroplasty. Koho ke kauka i ke ʻano kūpono loa ma muli o ke kūlana o ka mea maʻi.
| ʻAno hana ʻoki kino | Wehewehe wale nō |
|---|---|
| ʻO ka hana hoʻopili ʻana o Heineke-Mikulicz | ʻO kēia ke ʻano hana maʻamau. ʻOki ke kauka lapaʻau i ka pylorus ma ka lōʻihi a laila humuhumu iā ia ma ke ʻano keʻa. Hoʻonui kēia i ka puka a hoʻomaha i ka ʻiʻo. |
| ʻO ka hana ʻoki ʻana i ka ʻiʻo o ka ʻiʻo (Pyloroplasty o Ramstedt) | Hoʻohana nui ʻia kēia ʻano hana i nā pēpē hānau hou. Maanei, ʻoki wale ʻia nā papa ʻiʻo o waho o ka pylorus, e waiho ana i ka uhi palupalu o loko (mucosa). ʻO kēia ke kumu o ka uhi o loko e puʻupuʻu i waho, e hoʻonui ana i ka hakahaka i loko. |
| Hoʻonui ʻia ka Pyloric | ʻAʻole kēia he hana ʻoki kino. Ua like ia me ka endoscopy , kahi e hoʻokomo ʻia ai kahi ʻōmole ma ka waha, a hoʻonui ʻia ka pylorus me kahi mea hana kūikawā. |
| ʻO ka Jaboulay/Finney Pyloroplasty | ʻAʻole kēia he mau kaʻina hana maʻamau loa. Hoʻohana ʻia lākou inā he mumū koʻikoʻi a i ʻole ka ʻeha ma ka pylorus. Pili kēia i ka pale ʻana i ka pylorus a me ka hana ʻana i kahi pilina hou ma waena o ka ʻōpū a me ka ʻōpū liʻiliʻi (gastroduodenostomy) . |
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki ʻana, inā ua hana ʻia ʻoe i kahi hana laparoscopic, hiki paha iā ʻoe ke hoʻi i ka home i ka lā hoʻokahi. Inā ua hana ʻia ʻoe i kahi ʻoki hāmama, pono ʻoe e noho i ka haukapila no kekahi mau lā no ka mea he nui ka ʻoki. ʻAʻole ʻoe e hāʻawi ʻia i ka meaʻai paʻa no nā lā mua. E hāʻawi ʻia ʻoe i ka meaʻai ma o kahi paipu i kau ʻia i loko o kou ihu a i ʻole ma o ka saline i hāʻawi ʻia i loko o kahi aa.
He aha nā pilikia e hiki ke loaʻa mai ke ʻoki kino?
E like me nā hana ʻoki kino āpau, aia kekahi mau pilikia e pili ana, akā haʻahaʻa ka likelika o kēia mau mea.
- Ke kahe ʻana o ke koko
- Nā maʻi
- Ke kāpili ʻana o ke koko
- Ka hōʻino ʻana i nā ʻōpū a puni
Ma waho aʻe o kēia mau pilikia maʻamau, aia kekahi mau pilikia e pili ana i ke ʻoki ʻana i ka pyloroplasty.
1. Ka maʻi hoʻolei ʻana
ʻO kēia ka hopena ʻaoʻao maʻamau ma hope o kēia ʻoki kino. ʻO ke kū'ē loa ia o ka pilikia i hoʻokumu ai iā ʻoe i ke ʻoki kino. ʻO ia hoʻi, neʻe wikiwiki ka meaʻai mai ka ʻōpū i loko o ka ʻōpū liʻiliʻi. He manawa pōkole kēia maʻamau.
Hiki ke loaʻa nā hōʻailona o ka dumping syndrome i ʻelua mau pae. Ma hope koke iho o ka ʻai ʻana, hiki iā ʻoe ke ʻike i nā ʻeha o ka ʻōpū, ka nausea, a me ka maʻi diarrhea. I kekahi mau hola ma hope mai, hāʻule koke kou pae kō koko, e hana ana i nā hōʻailona e like me ka nāwaliwali, ka poniuniu, ka hou ʻana, a me ka puʻuwai wikiwiki.
ʻOiai paha he mea hoʻopilikia iki kēia i ka wā mua, hiki ke hoʻokele ʻia me nā loli i ka meaʻai a, inā pono, nā lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka.
2. ʻO ka reflux bile
Ke hoʻololi ʻia ka valve pyloric, ʻaʻole ia e pani pono, e ʻae ana i nā mea o loko o ka ʻōpū liʻiliʻi, ʻoiai ka bile , e kahe hou i loko o ka ʻōpū. He mea hoʻonāukiuki ka Bile i ka uhi ʻōpū. Inā hoʻomau kēia, hiki iā ia ke hana i ka gastritis .
Kaʻina hana hoʻōla a me ka holomua
Hoʻōla koke ka hapa nui o ka poʻe, ʻoiai ka poʻe i hana ʻia i ke ʻoki laparoscopic. Hiki iā lākou ke hoʻi i kā lākou mau hana maʻamau a me nā ʻano ʻai i loko o kekahi mau pule. Inā loaʻa iā ʻoe nā hōʻailona o ka dumping syndrome, pono ʻoe e makaʻala i kāu ʻai a hiki i ko lākou nalo ʻana (hiki i kekahi mau mahina).
He lāʻau lapaʻau maikaʻi loa ka Pyloroplasty no ka gastroparesis a me ka pale ʻana o ka ʻōpū, me ka holomua o ka holomua a hiki i ka 90%.
I ka hopena, hiki i kahi poloka liʻiliʻi i ka pylorus ke hoʻopilikia i kāu ʻōnaehana hoʻoheheʻe holoʻokoʻa. Aia nā lāʻau lapaʻau ʻoki ʻole no kēia, akā inā ʻaʻole holo pono kēlā mau mea, hiki i ke ʻoki ʻana ke lilo i hopena maikaʻi loa a palekana hoʻi.
Leka Lawe-Home
- ʻO ka Pyloroplasty kahi hana ʻoki e hoʻonui ai i ka puka o ka ʻōpū (pylorus), e ʻae ana i ka meaʻai e hele maʻalahi i loko o ka ʻōpū liʻiliʻi me ka ʻole o ka paʻa.
- Hana nui ʻia kēia ʻoki kino i nā hihia o nā ʻōpū ʻeha koʻikoʻi, gastroparesis, a me ka pyloric stenosis i nā pēpē hānau hou.
- Hiki ke hana ʻia kēia ma ke ʻano he ʻoki hāmama a i ʻole ke ʻoki laparoscopic (keyhole). Na kāu kauka e hoʻoholo i ke ʻano hana kūpono loa iā ʻoe.
- ʻO ka hopena ʻaoʻao maʻamau ma hope o ke ʻoki ʻana, ʻo ia ka dumping syndrome, ʻo ia ka wā e haʻalele koke ai ka meaʻai i ka ʻōpū. Eia nō naʻe, he manawa pōkole kēia a hiki ke kāohi ʻia ma ka hoʻololi ʻana i kāu meaʻai.
- Ma mua o kekahi ʻoki kino, he mea nui loa e kūkākūkā i nā pono a me nā pōʻino me kāu kauka a hoʻoholo.
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