I kekahi manawa, loaʻa iā mākou ka ʻeha ʻaʻole e nalo ma hope o ka lawe ʻana i ka lāʻau lapaʻau a i ʻole ka hana ʻana i kekahi mea. Ua ʻeha anei ʻoe i ka ʻeha, ʻoiai ma ke poʻo, ka ʻāʻī, ka umauma o luna, a i ʻole nā lima, no ka manawa lōʻihi? Malia paha ke kumu o kēia he pilikia me kāu ʻōnaehana nerve. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau kūikawā a nā kauka e hoʻohana ai i ia mau hihia. Ua kapa ʻia kēia ʻo Stellate Ganglion Block, a i ʻole SGB no ka pōkole.
I ka ʻōlelo maʻalahi, he aha ka Stellate Ganglion Block (SGB)?
I ka ʻōlelo maʻalahi, he lāʻau hoʻopau ʻeha kēia. Akā, ʻaʻole like kēia me ka lāʻau maʻamau. Hoʻokomo ʻia kēia lāʻau i loko o kahi pūʻolo aʻalolo kūikawā i loko o ko kākou ʻāʻī, ma nā ʻaoʻao ʻelua o ko kākou pahu leo. Ua kapa ʻia kēia pūʻolo aʻalolo ʻo 'Stellate Ganglion'.
E noʻonoʻo i kā mākou ʻōnaehana nerve e like me kahi pūnaewele o nā uea kelepona e lawe ana i nā leka. I kekahi manawa, hiki ke hoʻouna ʻia nā leka i makemake ʻole ʻia (nā hōʻailona ʻeha) i kekahi mau ʻāpana o kēia pūnaewele. I kēlā mau manawa, ʻo ka hana a kēia lāʻau lapaʻau SGB, ʻo ia ke "hoʻomoe" i kēlā pūʻolo nerve (ganglion) no kekahi manawa. Ua like ia me ka hoʻopau ʻana i kahi kuapo. A laila e pau nā hōʻailona ʻeha i makemake ʻole ʻia mai kēlā mau nerve i ka lolo. Hiki i kēia ke hōʻoluʻolu i ka ʻeha ma ke poʻo, ka ʻāʻī, nā lima, a me ka umauma o luna. Eia kekahi, kōkua kēia lāʻau i ka hoʻonui ʻana i ke kahe koko i nā lima.
No laila, he aha kēia ganglion stellate?
He hui kēia o nā aʻalolo e kokoke ana i nā iwi ʻaoʻao mua ʻelua, ma lalo pono o ka iwi ʻāʻī, ma ke alo o ko kākou ʻāʻī. Loaʻa iā kākou kekahi o kēia ma kēlā me kēia ʻaoʻao o ko kākou ʻāʻī. ʻO ke ʻano o ka huaʻōlelo 'stellate' ʻo ia hoʻi 'e like me ka hōkū'. No laila, ua kapa ʻia kēia pūʻolo aʻalolo no ka mea ua like ia me ke ʻano o ka hōkū.
ʻO ka ʻōnaehana nerve sympathetic ka ʻāpana o ka ʻōnaehana nerve autonomic e kaohi ana i nā hana o ko mākou kino a mākou e noʻonoʻo ʻole ai (e.g., ka helu o ka puʻuwai, ke koko, ka hou ʻana). No laila, ʻo ka hapa nui o nā hōʻailona nerve sympathetic i ke poʻo, ka ʻāʻī, nā lima, a me ka umauma luna e hele mai ana mai kēia ganglion stellate.
ʻOiaʻiʻo hoihoi: ʻO 80% wale nō o ka heluna kanaka o ka honua i hoʻokumu piha ʻia kēia ganglion stellate. I nā poʻe ʻē aʻe, ʻaʻole pili ka ganglion cervical haʻahaʻa a me ka ganglion thoracic mua ma ka ʻāʻī. Akā, ʻaʻole ia he ʻokoʻa nui.
He aha nā kūlana e hoʻohana ʻia ai ka lāʻau lapaʻau SGB?
Hoʻohana nui nā kauka i kēia lāʻau lapaʻau e ʻike a mālama i ka ʻeha lōʻihi e hoʻomaka ana i loko o ka ʻōnaehana nerve (ʻeha i hoʻopili ʻia e ka sympathetically) ʻaʻole hiki ke loaʻa ke kumu. Eia kekahi, hiki ke hoʻohana ʻia kēia lāʻau lapaʻau no nā ʻano maʻi ʻē aʻe a me nā kūlana ʻeha.
| Kūlana olakino | Wehewehena |
|---|---|
| ʻO ka Syndrome ʻEha ʻĀpana Paʻakikī (CRPS) | ʻEha nui a lōʻihi hoʻi a me ka pehu ʻana ma ka lima a i ʻole ka wāwae ma hope o kahi ʻeha. |
| ʻEha Limb Phantom | Ke ʻeha nei ma ka lima a i ʻole ka wāwae i wehe ʻia e ke ʻoki ʻana. |
| ʻO ka Neuralgia Postherpetic | ʻEha nā aʻalolo ma hope o ka moa (herpes zoster). |
| ʻO ka maʻi Raynaud | Ua emi ka lako koko i nā manamana lima ma muli o ke anu a i ʻole ke kaumaha. |
| Ka hou nui ʻana (Hyperhidrosis) | Ka hou nui ʻana ma nā wahi e like me nā poho lima a me nā kapuwaʻi. |
| Nā kūlana ʻē aʻe | Hoʻohana ʻia nō hoʻi ia no nā ʻeha poʻo cluster, ka ʻeha maka, ka ʻeha umauma e pili ʻole ana i ka maʻi puʻuwai, a me kekahi mau pilikia o ka puʻuwai (cardiac arrhythmias). |
Ka hoʻohana ʻana i ka SGB no nā pilikia olakino noʻonoʻo
I kēia mau lā iho nei, ua hana ʻia nā noiʻi e pili ana i nā hopena o ka mālama ʻana o SGB no nā kūlana olakino noʻonoʻo e like me ka Post-Traumatic Stress Disorder (PTSD). ʻOiai ua hōʻike kekahi poʻe i ka emi ʻana o nā hōʻailona PTSD, ʻaʻole i hōʻike kekahi. No laila, aia nō kēia i ke kahua noiʻi, a hoʻohana pinepine ʻia "off-label" ma lalo o ka nānā pono ʻana o ke kauka ke hāʻule nā lāʻau ʻē aʻe.
Pehea e hana ʻia ai kēia lāʻau lapaʻau?
ʻAe, e nānā kākou i ka mea e hana ʻia ke hāʻawi ʻia kēia inikini. ʻAʻohe mea e hopohopo ai, ʻaʻole ma mua o 30 mau minuke kēia.
1. Hoʻomākaukau: ʻO ka mea mua, hiki ke hāʻawi ʻia iā ʻoe kahi lāʻau liʻiliʻi (IV sedation) i loko o kahi aa koko ma kou lima e kōkua iā ʻoe e hoʻomaha. A laila, e hoʻomoe ʻia ʻoe ma kou kua ma kahi papa kūikawā.
2. Hoʻomaʻemaʻe: E hoʻomaʻemaʻe pono ke kauka a hoʻomaʻemaʻe i ka ʻāpana o ka ʻāʻī kahi e hāʻawi ʻia ai ka inikini.
3. Ka mae ʻana: ʻO ka mea aʻe, hoʻohana ʻia kahi nila lahilahi loa e hoʻokomo i kahi anesthetic kūloko i loko o ka ʻāpana i hoʻopilikia ʻia o kou ʻāʻī. E mae ʻoe i ka ʻeha.
4. Ka hoʻokomo nui ʻana: A laila, me ka hoʻohana ʻana i ka ʻenehana holomua e like me ke ultrasound a i ʻole ke kiʻi fluoroscopic e ʻike pono i ke aʻa nerve, hoʻokomo ke kauka i kahi nila ʻelua a hoʻokomo i ka lāʻau ʻeha nui. Hoʻemi nui kēia ʻano hana i ka pilikia o ka hoʻokomo ʻana i ka lāʻau lapaʻau ma kahi kūpono ʻole.
Ma hope o ka lāʻau lapaʻau, e nānā ʻia ʻoe e nā limahana lapaʻau no hoʻokahi hola. Ke hōʻoia ʻia ua maikaʻi nā mea āpau, hiki iā ʻoe ke hoʻi i ka home. Eia nō naʻe, pono ʻoe e loaʻa i kekahi e lawe iā ʻoe i ka home, no ka mea, ʻaʻole hiki iā ʻoe ke hoʻokele i kēlā lā.
Pehea nā hopena? Pehea ka lōʻihi o kēia?
He pilikia kēia no kēlā me kēia kanaka. ʻOkoʻa nā hopena mai kēlā kanaka a kēia kanaka. No kekahi poʻe, emi koke ka ʻeha ma hope o ka hoʻokomo ʻia ʻana, akā hiki ke hoʻi hou ka ʻeha i loko o kekahi mau hola ma hope o ka pau ʻana o ka lāʻau hoʻomāʻū. No kekahi poʻe, hiki ke mau no nā pule a i ʻole nā mahina me ka ʻole o ka ʻeha.
ʻO ka mea nui, ʻo ia ka mea maʻamau e pono ai ʻoe i kahi moʻo o nā inikini e loaʻa ai nā hopena maikaʻi loa. I kekahi manawa hiki iā ʻoe ke loaʻa nā hopena me ʻelua mau inikini wale nō, a ʻo kekahi poʻe e pono paha ma mua o ka ʻumi. ʻO ka nūhou maikaʻi, ʻo ka manawa ʻeha ʻole e hoʻonui pinepine ʻia ke loaʻa iā ʻoe nā inikini kekahi ma hope o kekahi.
Aia kekahi mau hopena ʻaoʻao a me nā pilikia?
E like me nā lāʻau lapaʻau a pau, loaʻa i ka SGB nā hopena ʻaoʻao liʻiliʻi a me nā pilikia koʻikoʻi kakaikahi loa.
| ʻAno o ka maʻi | Nā mea hiki ke hana ʻia |
|---|---|
| Nā hopena ʻaoʻao maʻamau, manawa pōkole (e nalo i loko o kekahi mau hola) | |
| Ka wahi inikini | ʻO kahi palapū a ʻeha iki paha. |
| Nā maka a me ka ihu | Nā lihilihi maka e kulou ana, nā maka ʻulaʻula, nā maka waimaka, a me ka ihu paʻa. |
| ʻĀʻī a me ka leo | Ka leo hāhā, ka manaʻo e like me he mea lā e paʻa ana i ka puʻu, ka paʻakikī i ke ale ʻana. |
| Lima | Manaʻo o ka mehana a i ʻole ka mae ʻana o ka lima. |
| Nā pilikia koʻikoʻi e hiki ke hana pinepine ʻole ʻia | |
| Nā pilikia nui | Ka maʻi ʻana, ke kahe ʻana o ke koko mai kahi kīʻaha koko i hōʻino ʻia, ka hōʻino ʻana o ke aʻalolo, ka hōʻino ʻana o ka māmā (pneumothorax), ka maʻi Horner (kahi maʻi no ka manawa pōkole). |
He haʻahaʻa loa ka likelika o kēia mau pilikia koʻikoʻi, no ka mea, hana pono nā kauka i kēia lāʻau me ka hoʻohana ʻana i nā ʻenehana e like me ka ultrasound.
Āhea ʻoe e ʻike ai i ke kauka?
Ma hope o ka lāʻau lapaʻau, inā loaʻa iā ʻoe kekahi mau hōʻailona hou, no ka laʻana , nā hōʻailona o ka maʻi ma kahi i inikini ʻia (pehu ʻana, ʻulaʻula, ʻeha nui, kuni) a inā paʻakikī ke ale ʻana, e kāhea koke aku i kāu kauka.
He lāʻau lapaʻau waiwai nui ka SGB e hiki ke hāʻawi i ka hōʻoluʻolu mai ka ʻeha lōʻihi. Eia naʻe, ʻaʻole ia e hana no nā mea āpau. Inā he hopohopo a kānalua paha kāu e pili ana i kēia lāʻau lapaʻau, mai kānalua a kamaʻilio ākea me kāu kauka. E pane ʻo ia i kāu mau nīnau a pau.
Leka Lawe-Home
- ʻO ka Stellate Ganglion Block (SGB) kahi inikini hoʻopau ʻeha i loko o kahi puʻupuʻu aʻalolo kūikawā ma ka ʻāʻī.
- Hāʻawi kēia i ka hōʻoluʻolu mai ka ʻeha mau loa, ʻoi aku hoʻi ma ke poʻo, ka ʻāʻī, nā lima, a me ka umauma o luna.
- He lāʻau lapaʻau kēia e hiki ke hana wikiwiki ʻia (ʻaʻole ma mua o 30 mau minuke) a palekana loa no ka mea hoʻohana ia i nā ʻenehana e like me ka ultrasound.
- Hiki ke loaʻa nā hopena ʻaoʻao liʻiliʻi e nalowale i loko o kekahi mau hola, akā he mea kākaʻikahi loa nā pilikia koʻikoʻi.
- Pono paha kekahi mau inikini no nā hopena maikaʻi loa.
- E kūkākūkā mau me kāu kauka inā kūpono kēia lāʻau lapaʻau iā ʻoe a he aha kona mau pono a me nā pōʻino.
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