Ua ʻike paha ʻoe inā maʻi kekahi ʻano o loko o kou umauma, e like me kou puʻuwai a i ʻole kou māmā, pono ʻoe i kekahi manawa e hana i ke ʻoki kino e mālama ai. No laila, i ia manawa, pono ke kauka ʻoki kino e komo i loko o kou umauma a nānā i kēlā ʻano, e nānā iā ia, a i ʻole e wehe i kahi hapa o ia mea. ʻO kekahi o nā ʻano ʻoki kino nui i hana ʻia no kēia ʻano mea ʻo ia ka mea a mākou e kamaʻilio nei i kēia lā, he thoracotomy.
I ka ʻōlelo maʻalahi, he aha ka thoracotomy?
He hana ʻoki kino ka thoracotomy kahi e hana ai ke kauka lapaʻau i kahi ʻoki ma waena o ʻelua o kou mau iwi ʻaoʻao e wehe i ka lua o kou umauma. Wehe kēia i ka umauma a hiki i ke kauka ke nānā pololei, hoʻopā, nānā, a mālama i nā ʻōpū i loko.
E noʻonoʻo e pono ʻoe e mālama i kahi ʻōkana e like me kou puʻuwai, ka aorta, ka esophagus, nā māmā, a i ʻole ka trachea. I kekahi manawa hoʻohana ʻia kēia ʻoki kino e hiki ai i ke alo o ka iwi kuamoʻo.
Hana ʻia kēia ʻoki ma ka ʻaoʻao hema a ʻākau paha o ka umauma. Aia kēia i ka ʻaoʻao o ke kino e pono ai ke mālama ʻia. I kekahi mau hihia, pono paha e haki a wehe ʻia paha kahi iwi ʻaoʻao. Hana ʻia kēia ʻoki mai ka umauma a i ke kua ma lalo o ka ʻāʻī. ʻO ka nui a me kahi o ka ʻoki e pili ana i ke ʻano o ke ʻoki ʻana āu e hana nei. Ua kapa ʻia hoʻi kēia he "ʻoki wehe."
No ke aha e makemake ai kekahi e hana i kēia ʻano ʻoki kino?
Aia kekahi mau kumu e hana ʻia ai ka thoracotomy. I kekahi manawa, hana ʻia ia e wehe i kahi ʻāpana ʻiʻo no ka hoʻokolokolo ʻana, i kapa ʻia he biopsy, e hoʻoholo ai i ke kumu pololei o kahi maʻi. Hana ʻia nō hoʻi ia ma ke ʻano he lāʻau lapaʻau no kahi maʻi.
E nānā kākou i ka papa ma lalo nei e ʻike i nā kumu nui no kēia ʻoki kino.
| Ke kumu no ke ʻoki kino | He wehewehe maʻalahi |
|---|---|
| ʻO ka Biopsy e ʻike ai i ka maʻi māmā | No ka ʻike pono ʻana i ke kumu o ka pilikia o nā māmā, e lawe i kahi ʻāpana ʻiʻo a nānā iā ia. |
| Ka wehe ʻana i ka maʻi ʻaʻai māmā | Wehe i kahi puʻupuʻu kanesa a i ʻole kekahi ʻāpana o ka māmā. |
| Nā kūlana cardiovascular | E mālama i kekahi mau pilikia ma ka puʻuwai a i ʻole nā kīʻaha koko nui e pili ana. |
| Nā pilikia diaphragm | E mālama i kekahi mau pilikia ma ka diaphragm e hoʻokaʻawale ana i ka umauma a me ka ʻōpū. |
| Pneumothorax | E mālama i ka puka ʻana o ka ea i loko o nā māmā a lilo i haumia. |
| Tamponade Puʻuwai | Inā hōʻiliʻili ka wai i loko o ka ʻeke a puni ka puʻuwai a kau i ke kaomi ma luna o ka puʻuwai, e wehe iā ia. |
| Nā maʻi ʻōpū | E mālama i ka maʻi ʻaʻai ʻāʻī a i ʻole nā maʻi ʻē aʻe. |
| Ka hoʻokahe ʻana o ka pleural | Ke hōʻiliʻili ka wai a puni nā māmā, ʻoiai me kahi maʻi, e wehe i ka wai. |
He aha ka mea e hana ʻia ma mua o ke ʻoki kino?
He hana ʻoki kino nui kēia a pono ʻoe e noho ma lalo o ka anesthesia laulā. No laila, pono ʻoe e olakino maikaʻi e ʻae i kēia ʻano anesthesia. E aʻo aku ke kime lapaʻau iā ʻoe i ka wā e hoʻōki ai i ka ʻai ʻana a me ka inu ʻana ma mua o ke ʻoki kino.
He mea nui e haʻi aku i kāu hui mālama ola e pili ana i nā lāʻau lapaʻau, nā huaora, a i ʻole nā mea hoʻohui āu e lawe nei, ʻoiai nā mea hiki iā ʻoe ke kūʻai ma ke kūʻai aku ma ka hale kūʻai lāʻau lapaʻau. ʻO kekahi mau lāʻau lapaʻau, ʻoiai nā mea hoʻokahe koko,E aʻo ʻia ʻoe e hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau ma mua o nā poʻe ʻē aʻe.
No ke ʻoki kino ʻaʻole pilikia, inā he mea puhi paka ʻoe, e aʻo ikaika nā kauka iā ʻoe e haʻalele .
He aha ka mea e hana ʻia i ka wā o ke ʻoki kino?
I ka wā o ke ʻoki ʻana, e hoʻohuli ke kime ʻoki iā ʻoe i ka ʻaoʻao kūpono, e kau i kekahi lima ma luna o kou poʻo i loko o kahi mea paʻa kūikawā, a e kākoʻo i kou lima a me kou poʻohiwi me kahi pākeke i ʻōwili ʻia.
He loea kāu anesthesiologist i ke ʻoki ʻana i ka thoracic. Hiki iā ia ke hana i kahi kaʻina hana i kapa ʻia ʻo "single lung ventilation." I ka ʻōlelo maʻalahi, pili kēia i ka pani ʻana i ka māmā ma ka ʻaoʻao e ʻoki ʻia ana, e ʻae ana iā ʻoe e hanu wale ma o kekahi māmā. Hāʻawi kēia i ke kauka ʻoki i kahi ākea e hana ai.
A laila hana ke kauka ʻoki i kahi ʻoki ma waena o nā iwi ʻaoʻao ʻelua. Inā pono, hiki ke haki a māhele ʻia paha kahi iwi ʻaoʻao. Hiki ke hoʻohana ʻia kahi mea hana kūikawā e hoʻohana ana i ka wela e komo i loko o nā ʻiʻo a me nā ʻiʻo ʻē aʻe. A laila hoʻokomo ʻia nā mea hana kūikawā (nā mea hoʻokiʻekiʻe a me nā mea hoʻolaha iwi ʻaoʻao) e hana i kahi ākea i loko o ka umauma e nānā a mālama i nā ʻōpū.
Ma hope o ka pau ʻana o ke ʻoki ʻana a pani ʻia ka ʻoki, hoʻokomo ʻia kahi ʻōmole umauma e ʻae i ka wai a me ka ea e hōʻiliʻili ana i loko e kahe i waho.
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki kino, pono ʻoe e noho ma ka haukapila no hoʻokahi pule. E noho mau ana ka ʻōmole umauma no kekahi mau lā.
I loko o kēia manawa, e paipai kāu hui lapaʻau iā ʻoe e ʻū, e hoʻohana i kahi mea hanu kūikawā (incentive spirometer), a e hele wāwae iki me ke kōkua . He mea nui loa ka hana ʻana i kēia mau mea no ka hoʻōla ʻana o kou mau māmā. E kōkua pū lākou i ka kaohi ʻana i kou ʻeha.
Inā ua hana ʻia kāu ʻoki kino no ka ʻike ʻana i kahi maʻi, e wehewehe ke kauka iā ʻoe a e aʻo aku iā ʻoe i ka mea e hana ai ma hope.
He aha nā pilikia a me nā pilikia o kēia ʻoki kino?
E like me nā ʻoki kino āpau, aia nā pilikia i loko o ka rhinoplasty. E nānā kākou iā lākou ma ka papa ma lalo.
| Nā pilikia e pili ana i ke ʻoki kino | |
|---|---|
| Nā pilikia koke o ke ʻoki kino | |
| Nā pilikia e pili ana i ka anesthesia | Nā hopena maikaʻi ʻole o ke kino i ka anesthesia laulā. |
| Maʻi | Ka maʻi o ka ʻeha ʻoki a i ʻole i loko o ka umauma. |
| Ke kahe ʻana o ke koko | Ke kahe koko nui ʻana i ka wā a ma hope paha o ke ʻoki kino. |
| ʻEha | ʻEha nui a puni ka ʻoki ʻoki a me nā iwi ʻaoʻao. |
| Nā pilikia hiki ke hana ma hope | |
| Pneumonia | He maʻi hanu i loko o nā māmā (ka hoʻonui ʻia ʻana o ke anu). |
| ʻAtelectasis | Ka hiolo ʻana o kekahi a ʻoi aku paha mau ʻāpana o ka māmā. |
| ʻO ka maʻi ʻeha ma hope o ka thoracotomy | ʻO ka ʻeha lōʻihi e mau ana no nā mahina ma hope o ke ʻoki ʻana. |
ʻEhia ka lōʻihi e ho'ōla ai?
Hiki iā ʻoe ke ʻai maʻamau ma hope o ke ʻoki ʻana. Eia nō naʻe, ʻoi aku ka maikaʻi o ka ʻai ʻana i ka meaʻai kiʻekiʻe i ka fiber e pale aku ai i ka paʻa ʻana o ka ʻōpū. Inā ʻaʻole ʻōlelo kāu kauka iā ʻoe e kaupalena i nā wai, e inu i ka wai nui.
E lawe i nā lāʻau ʻeha e like me ke kauoha. Mai ho'ōki i ka hanu hohonu no ka ʻeha. ʻO ka hana ʻana pēlā e alakaʻi ai i ka maʻi niumonia.
ʻO ka mea nui loa, ʻo ia ke kāohi i ka ʻeha, ka hanu maikaʻi, a me ke kuni. Hiki i kēia ke kōkua nui i ka pale ʻana i nā pilikia o ka māmā.
Pono ʻoe e noho ma ka haukapila no hoʻokahi pule. Eia nō naʻe, hiki ke hala a ʻelua mahina e hoʻi ai i ka hana ma hope o kēia ʻoki kino. E nīnau i kāu hui ʻoki kino i ka wā e hiki ai iā ʻoe ke hoʻomaka hou i nā hana e like me ka moe kolohe, ka hāpai ʻana i nā mea kaumaha, a me ka pāʻani ʻana i nā haʻuki.
ʻOiai ma hope o kou hoʻi ʻana i ka home, pono ʻoe e hoʻomau i ka hoʻomaʻamaʻa ʻana i ka hanu hohonu, ka ʻū ʻana, a me ka hoʻohana ʻana i ka spirometer hoʻoikaika. Hiki i kāu kauka ke ʻōlelo aku i nā hoʻomaʻamaʻa no kou mau lima a me kou mau poʻohiwi.
Āhea wau e ʻike hou ai i ke kauka?
E haʻi aku kāu kauka iā ʻoe i ka manawa e pono ai ʻoe e ʻike hou ʻia. Akā ma mua o kēlā, inā he mau nīnau a hopohopo paha kāu, e kamaʻilio me kāu kauka. Pono ʻoe e ʻike i ke kauka, ʻoiai inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona:
- Inā loaʻa iā ʻoe ke kuni.
- Inā hoʻomaka hou ke kahe ʻana o ke koko i ka ʻeha a inā ʻoe e ʻūhā i ke koko.
- Inā pilikia ʻoe i ka hanu ʻana.
- Inā ʻike ʻoe i ka pus, ka pehu ʻana, a i ʻole kahi loli o ke kala o ka ʻili ma kahi i ʻoki ʻia.
- Inā nui loa ka ʻeha e hiki ʻole ai ke kaohi.
He aha ka ʻokoʻa ma waena o ka Thoracotomy, Sternotomy a me Thoracostomy?
Ua like iki kēia mau inoa ʻekolu, no laila hiki ke huikau. E nānā kākou i ka ʻokoʻa.
| ʻAno o ke ʻoki kino | Kahi a me ke kumu o ka ʻoki ʻana |
|---|---|
| Ka hoʻopaʻa ʻana o ka ʻūhā | Hana ʻia ke ʻoki ma waena o nā iwi ʻaoʻao ʻelua . ʻO ka pahuhopu ka wehe ʻana i ka umauma a mālama i nā ʻōpū. |
| ʻO ke kaʻina hana ʻana i ka ihu | Hana ʻia ke ʻoki ʻana ma o ka iwi umauma (sternum) ma waenakonu o ka umauma. ʻOki ʻia kēia iwi i ʻelua a hana ʻia ke ʻoki ʻana. Hoʻohana pinepine ʻia kēia ʻano hana no ke ʻoki ʻana i ka puʻuwai. |
| ʻO ka hoʻopaʻa ʻana o ka ʻōpū | Hana ʻia kahi ʻoki liʻiliʻi loa ma kēia. ʻO ke kumu, ʻo ia ke hoʻokomo i kahi ʻōmole (ʻōmole umauma). Ma o kēia ʻōmole, hiki ke hāʻawi ʻia ka lāʻau lapaʻau a i ʻole hiki ke wehe ʻia ka wai/ea e hōʻiliʻili ana a puni nā māmā. He ʻoi aku ka liʻiliʻi o kēia ʻoki ma mua o ka ʻoki ʻana o ka thoracotomy. |
He ʻeha loa anei kēia ʻoki kino?
ʻAe, he ʻoki ʻeha ka thoracotomy. He ʻoiaʻiʻo. Hiki i kēia ʻeha ke pilikia i ka hanu ʻana, hiki ke alakaʻi i nā maʻi e like me ka pneumonia a i ʻole ka atelectasis.
Akā, mai hopohopo. He nui nā ala o kāu hui lapaʻau e mālama ai i kēia ʻeha. ʻO nā lāʻau ʻeha waha, nā lāʻau ʻeha intravenous, a i ʻole kahi catheter epidural i kau ʻia i loko o kou iwi kuamoʻo e kōkua iā ʻoe e mālama i kou ʻeha.
I kekahi manawa hiki i kēia ʻeha ke mau no ka manawa lōʻihi. Ua kapa ʻia kēia he post-thoracotomy pain syndrome, a mākou i kamaʻilio ai ma mua.
ʻO ka mea hope loa, inā ʻōlelo kāu kauka i kahi thoracotomy, e hōʻoia e kamaʻilio maikaʻi ʻoe me ia e pili ana i ke kumu o ke ʻoki ʻana a me nā mea e manaʻo ʻia. He ʻoki nui kēia. No laila, he mea nui loa ia no kou hoʻōla wikiwiki ʻana e hahai ʻoe i nā ʻōlelo a ke kauka, ʻoiai e pili ana i ka haʻalele ʻana i ka puhipaka ma mua o ke ʻoki ʻana, ka hana ʻana i nā hoʻomaʻamaʻa hanu, a me ka mālama ʻana i ka ʻeha ma hope o ke ʻoki ʻana.
Leka Lawe-Home
- He ʻoki nui a hāmama ka thoracotomy i hana ʻia ma o kahi ʻoki ʻana i ka umauma ma waena o nā iwi ʻaoʻao.
- Hana ʻia kēia no ka mālama ʻana i nā ʻōkana e like me nā māmā a me ka puʻuwai a i ʻole e ʻike i kahi maʻi.
- E hahai pono i nā ʻōlelo a kāu kauka ma mua o ke ʻoki ʻana, ʻoiai e pili ana i ka haʻalele ʻana i ka puhipaka.
- Ma hope o ke ʻoki ʻana, he mea nui ka kaohi ʻana i ka ʻeha, ka ʻū maikaʻi, a me ka hanu hohonu e pale ai i nā pilikia o ka māmā.
- Hiki ke lōʻihi ka manawa hoʻōla. He mau mahina paha e ho'ōla piha ai, no laila e hoʻomanawanui.
- Inā loaʻa iā ʻoe nā hōʻailona hōʻailona e like me ke kuni, ka ʻeha nui, a i ʻole ka paʻakikī o ka hanu ʻana, e hoʻomaopopo koke i kāu kauka.
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