Ua lohe paha ʻoe i ke kauka e ʻōlelo ana, "He wai kou a puni kou mau māmā" ke pilikia ʻoe i ka hanu ʻana. He mea maʻamau ke manaʻo iki i ka makaʻu ke lohe ʻoe i kēia. Akā, mai hopohopo, aia kekahi hana lapaʻau maʻalahi a palekana hoʻi e hiki ke hana ʻia e mālama i kēia kūlana a loaʻa ke kumu. ʻO ia ka mea a mākou e kapa nei he thoracentesis. I kēia lā, e kamaʻilio mākou e pili ana i ia mea ma ke ʻano maʻalahi a maʻalahi hoʻi e hoʻomaopopo.
He aha ka Thoracentesis?
I ka ʻōlelo maʻalahi, ʻo ka thoracentesis ke kaʻina hana o ka wehe ʻana i ka wai keu (wai) mai kou mau māmā me ka hoʻohana ʻana i kahi mea hana like me ka syringe.
E noʻonoʻo ʻoe aia ko kākou mau māmā i loko o ko kākou umauma. He wahi liʻiliʻi loa ma waena o kēia mau māmā a me ka paia o ka umauma. Kāhea mākou i kēia wahi ʻo ka pleural space. ʻElua mau membrane lahilahi loa ma kēia wahi. Ke hanu mākou, hoʻonui a ʻūlū ko mākou mau māmā. I mea e holo mālie ai kēia kaʻina hana, me ka ʻole o ke kuʻi ʻana kekahi i kekahi, pono kahi wai liʻiliʻi loa ma waena o kēlā mau membrane ʻelua. E like me ke kau ʻana i kahi ʻaila liʻiliʻi ma luna o ka hinge puka e maʻalahi ai ka wehe a me ka pani ʻana, kōkua kēia nui o ka wai i ko mākou mau māmā e hana maʻalahi.
Akā ma muli o kekahi mau maʻi, hoʻomaka ka nui o ka wai e hōʻiliʻili ma kēia wahi ma mua o ka mea e pono ai. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia he pleural effusion . Ke piha kēia wai, ʻaʻohe wahi lawa no nā māmā e hoʻonui manuahi, kahi e hoʻoulu ai i nā hōʻailona e like me ka paʻakikī o ka hanu ʻana a me ka manaʻo kaumaha ma ka umauma.
No laila, ʻo ka mea i hana ʻia i ka mālama ʻana i ka thoracentesis, ʻo ia ka wehe ʻana i kēia wai keu.
ʻO ka ʻokoʻa ma waena o Thoracentesis a me Paracentesis
ʻO kēia mau mea ʻelua he mau lāʻau lapaʻau e wehe ai i ka wai keu mai ke kino. Eia nō naʻe, wehe ka thoracentesis i ka wai mai ka umauma, ʻo ia hoʻi, a puni nā māmā. Wehe ka paracentesis i ka wai i hōʻiliʻili ʻia i loko o ka ʻōpū (ʻōpū).
He hana ʻoki kino nui anei ka thoracentesis?
ʻAʻole loa. ʻAʻole ʻo Thoracentesis he ʻoki kino nui. Ua kapa ʻia ʻo ia he kaʻina hana 'minimally invasive', ʻo ia hoʻi he lāʻau lapaʻau ia e hōʻino iki ai i ke kino. ʻAʻohe ʻoki nui a ʻeha paha. No laila, he pōkole loa ka manawa hoʻōla, a he haʻahaʻa loa nā pilikia.
No ke aha mākou e pono ai i kēia lāʻau lapaʻau?
ʻElua kumu nui no ka hana ʻana i ka thoracentesis.
1. Hōʻoia: No ka ʻike ʻana i ke kumu he wai a puni nā māmā. Lawe ʻia kahi hāpana o ka wai a hoʻouna ʻia i kahi keʻena hoʻokolohua e nānā i ka maʻi, nā hunaola kanesa, a i ʻole nā hōʻailona ʻē aʻe o ka maʻi.
2. No ka hōʻoluʻolu ʻana i nā hōʻailona (Therapeutic): Inā ua hōʻiliʻili ʻia kahi nui o ka wai a puni nā māmā a ke hoʻolilo nei iā ʻoe i mea paʻakikī loa ke hanu, hana ʻia kēia lāʻau lapaʻau e wehe i kēlā wai a hāʻawi iā ʻoe i ka hōʻoluʻolu.
E nānā kākou i ka papa ma lalo nei e ʻike i nā kumu nui o ka pleural effusion.
| Nā kumu kūpono o ka pleural effusion (hōʻiliʻili wai a puni nā māmā) | |
|---|---|
| Ka hāʻule ʻana o ka puʻuwai paʻa | He kumu maʻamau kēia. |
| Ka maʻi ʻaʻai | Hiki ke hana ʻia kēia e ka maʻi kanesa o ka māmā a i ʻole nā maʻi kanesa ʻē aʻe. |
| Nā maʻi niumonia a me nā maʻi māmā | Hiki ke hana ʻia e nā maʻi bacteria, viral, a fungal paha. |
| ʻO ka maʻi puʻupuʻu (TB) | ʻO kekahi kumu i maʻa mau ʻia ma Sri Lanka. |
| ʻO ke koko i loko o nā māmā (Pulmonary embolism) | He ʻūpā koko i loko o ke kīʻaha koko. |
| Maʻi puʻupaʻa a i ʻole ke akepaʻa | Ma muli o nā loli i ke kaulike wai o ke kino. |
| Nā maʻi autoimmune e like me lupus/SLE | Ke hoʻouka nei ka ʻōnaehana pale o ke kino i kona mau hunaola ponoʻī. |
Pehea ka hana ʻana o kēia lāʻau lapaʻau? He mea anei ia e makaʻu ai?
ʻAʻohe pono e makaʻu iki i kēia lāʻau lapaʻau. E nānā kākou i ka mea e hana ʻia ma kēlā me kēia ʻanuʻu.
Hoʻomākaukau ma mua o ka mālama ʻana
E hāʻawi aku kāu kauka iā ʻoe i kekahi mau kuhikuhi ma mua o kēia lāʻau lapaʻau. Aia kekahi mau mea e pono ai ʻoe e hoʻomaopopo i kāu kauka.
- ʻO ʻoeInā ʻoe e lawe ana i nā lāʻau hoʻokahe koko a i ʻole nā lāʻau lapaʻau e like me ka aspirin, e hoʻomaopopo e haʻi aku.
- Inā he mau pilikia koko kou, e ʻoluʻolu e hoʻomaopopo mai iā mākou.
- E haʻi mai iā mākou e pili ana i nā lāʻau lapaʻau ʻē aʻe, nā huaora, a i ʻole nā mea hoʻohui āu e lawe nei.
- E haʻi mai iā mākou inā he mau maʻi ʻaleka kou i kekahi mau lāʻau lapaʻau (ʻoi aku hoʻi nā lāʻau hoʻomāʻū), latex, a i ʻole lipine .
- Pono ʻoe e haʻi mai iā mākou inā ua hāpai ʻoe a inā paha e hāpai ana.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
Hana pinepine ʻia kēia lāʻau lapaʻau ma kahi haukapila. ʻO ka lōʻihi o ke kaʻina hana holoʻokoʻa ma kahi o 15 mau minuke .
1. Kūlana: E noi ʻia ʻoe e noho ma kahi noho, e hilinaʻi ma luna o kahi papaʻaina i mua ou, a e kau i kou mau lima ma kou mau pūhaka. Hōʻike kēia kūlana i kou kua. Inā paʻakikī iā ʻoe ke noho, hiki iā ʻoe ke hana i kēia ma ke hilinaʻi ʻana ma kou ʻaoʻao.
2. Hoʻomākaukau: E hoʻomaʻemaʻe pono ʻia ka wahi ma kou kua kahi āu e makemake ai e wehe i ke wai me kahi wai antiseptic a uhi ʻia me kahi lole.
3. Hoʻomāʻū: A laila, hoʻohana ʻia kahi nila liʻiliʻi loa e hoʻokomo i kahi lāʻau hoʻomāʻū i loko o ka wahi. I kēia manawa, manaʻo ʻia e like me kahi ʻanuʻu liʻiliʻi e nahu ana iā ʻoe, akā a laila e hoʻomāʻū loa ka wahi.
4. Ka wehe ʻana i ke wai: I kēia manawa, e hoʻokomo ke kauka i kahi nila ʻē aʻe i loko o ka hakahaka ma waena o kou mau iwi ʻaoʻao, ma lalo pono o ka ʻili, kahi o ke wai. I kekahi manawa, hoʻohana ʻia kahi scan ultrasound e kōkua i ke alakaʻi ʻana i ka wahi. E hoʻokahe ʻia ke wai keu ma o kahi ʻōmole i hoʻopili ʻia i ka nila.
5. Pau: Ma hope o ka wehe ʻia ʻana o ka nui o ka wai e pono ai, wehe ʻia ke kui a hoʻopili ʻia kahi kāʻei liʻiliʻi ma ia wahi.
ʻO ka mea nui loa, ʻo ia kou ʻike pono ʻana i loko o kēia lapaʻau ʻana. ʻAʻole ʻoe e ʻike i kekahi ʻeha. Hiki paha iā ʻoe ke manaʻo i kahi kaomi iki a i ʻole ka ʻoluʻolu ʻole ke wehe ʻia ke wai, akā, ʻaʻole ia he mea ʻeha.
Ma hope o ka mālama ʻana
Ma hope o ka lāʻau lapaʻau, loaʻa paha iā ʻoe kekahi X-ray a i ʻole scan e nānā i ke kūlana o kou mau māmā. E nānā ʻia kou pulse a me ke koko no kekahi mau hola ma mua o kou hoʻouna ʻia ʻana i ka home.
He mea maʻamau ke kunu iki no hoʻokahi hola ma hope o ka mālama ʻana. ʻO kēia no ka mea ke hoʻonui hou nei nā māmā ma hope o ka hoʻomaʻemaʻe ʻana o ke wai.
Ka pilikia a me ka manawa ho'ōla
He hana palekana loa ka Thoracentesis. He haʻahaʻa loa ka pilikia o nā pilikia. Eia kekahi o nā pilikia hiki ke loaʻa:
- Ke kahe ʻana o ke koko: Inā pā ka nila i kahi kīʻaha koko liʻiliʻi, aia paha kekahi kahe koko iki. Hoʻōki pinepine kēia ma kāna iho.
- Maʻi:E like me nā ʻoki a pau ma ka ʻili, he wahi liʻiliʻi loa ka manawa e komo ai nā germs a hoʻoulu i kahi maʻi.
- Pneumothorax: He mea kākaʻikahi loa, hiki i ka nila ke hou i ka māmā a hana i kahi lua liʻiliʻi, e ʻae ana i ka ea e komo. Hiki i kēia ke kumu o ka hiolo ʻana o ka māmā.
- ʻEdema pulmonary: Inā wehe koke ʻia ka nui o ka wai, hiki i nā māmā ke hoʻopiha i ka wai.
ʻAʻole lōʻihi ka manawa e ho'ōla ai. E haʻi aku ke kauka iā ʻoe ʻaʻole e hana i kekahi hana kaumaha no ʻelua lā . Hiki ke wehe ʻia ke kāʻei i loko o 24 mau hola.
Inā loaʻa kēia mau hōʻailona ma hope o ka lāʻau lapaʻau, e ʻike koke i ke kauka.
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona ma hope o kou hoʻi ʻana i ka home mai ka lāʻau lapaʻau, e kāhea koke aku i kāu kauka.
- kuni
- ʻUlaʻula, pehu, a i ʻole ke kahe koko/wai ʻē aʻe kahi i hoʻokomo ʻia ai ke nila
- ʻEha ka umauma a i ʻole ka ʻeha i ka wā e hanu hohonu ai
- Ke ʻū ʻana i ke koko (Hemoptysis)
- Ka paʻakikī nui o ka hanu ʻana
Inā loaʻa koke iā ʻoe ka pilikia nui o ka hanu ʻana, he mea nui loa e hele i ka ʻOihana Pōpilikia (ETU) o ka haukapila kokoke loa.
Leka Lawe-Home
- He hana lapaʻau palekana a maʻalahi hoʻi ka Thoracentesis e wehe ana i ke kahe keu i hōʻiliʻili a puni nā māmā.
- Hana ʻia kēia e ʻike ai i ke kumu o ka hōʻiliʻili ʻana o ka wai (diagnosis) a i ʻole e hōʻemi i ka pilikia hanu (relief).
- ʻAʻole kēia he hana ʻoki kino nui. He 15 mau minuke ka lōʻihi, me ka lāʻau hoʻomāʻū, a ua ala ʻoe.
- He haʻahaʻa loa ka pilikia, akā he mea nui e makaʻala i nā hōʻailona hōʻike e hiki mai ana ma hope o ka mālama ʻana.
- Hiki ke hoʻokumu ʻia ka paʻa ʻana o ka wai e kahi maʻi olakino. E kamaʻilio me kāu kauka e pili ana i kēia.
- Inā he mau nīnau a hopohopo paha kāu e pili ana i kēia, e kūkākūkā me kāu kauka.
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