I kekahi manawa ke haʻi aku ke kauka iā ʻoe a i ʻole kekahi o kou ʻohana e pono ʻoe e hana i ke ʻoki umauma, hiki iā lākou ke ʻōlelo pū i ka huaʻōlelo "thoracotomy." He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe i kēia huaʻōlelo. "He aha ke ʻano o ke ʻoki ʻana?", "He mea weliweli anei?", "E ʻeha nui anei?" he mau nīnau a pau e hiki mai ana i ka noʻonoʻo. No laila i kēia lā, e kamaʻilio kākou e pili ana i ke ʻano maoli o kēia ʻoki thoracotomy, nā kumu i hana ʻia ai, a me nā mea āpau e pono ai ʻoe e ʻike e pili ana i ia mea.
He aha maoli ka Thoracotomy?
I ka ʻōlelo maʻalahi, ʻo ka thoracotomy kahi ʻoki a ke kauka lapaʻau e hana ai ma waena o nā iwi ʻaoʻao ʻelua e ʻike a mālama paha i nā kino i loko o kou umauma. E noʻonoʻo e like me ka wehe ʻana i ka uhi o kahi puke e ʻike i nā ʻaoʻao, pono ke kauka lapaʻau e wehe i ka umauma e hiki ai i nā kino i loko o ka umauma.
ʻO nā ʻōkana nui e ʻike ʻia ke wehe ʻia ka umauma ma kēia ʻano:
- Nā māmā
- ʻO ka puʻuwai a me kona mau kīʻaha koko nui e pili ana (no ka laʻana, ka aorta)
- ʻEsophagus
- Trachea
I kekahi manawa hoʻohana ʻia kēia ʻano hana e hiki ai i ke alo o ka iwi kuamoʻo. Hana pinepine ʻia kēia ʻoki ma ka ʻaoʻao hema a ʻākau paha o ka umauma. Aia kēia ma ka ʻaoʻao o ke kino e mālama ʻia ana. Hoʻomaka ka ʻoki ma ka umauma a iho i lalo i ke kua ma lalo o ka ʻāʻī. ʻOkoʻa ka nui a me kahi o ka ʻoki ma muli o ke ʻano o ke ʻoki ʻana e hana ʻia ana. I kekahi manawa, pono paha ke kauka ʻoki e uhaʻi a wehe paha i kahi iwi ʻaoʻao. Ua kapa ʻia hoʻi kēia ʻo 'open surgery' .
No ke aha mākou e pono ai e hana i ka thoracotomy?
Aia kekahi mau kumu e hana ʻia ai ka thoracotomy. I kekahi manawa hana ʻia ia e kiʻi i kahi hāpana ʻiʻo (biopsy) e ʻike ai i kahi maʻi. I kekahi manawa, hana ʻia ia ma ke ʻano he lāʻau lapaʻau no kahi maʻi. E nānā kākou i nā kumu nui no kēia ʻoki kino.
| Ke kumu no ke ʻoki kino | He wehewehe maʻalahi |
|---|---|
| He biopsy | Inā he kānalua no kahi maʻi māmā, hiki ke kiʻi ʻia kahi hāpana ʻiʻo e ʻike pono ai. |
| Ka maʻi ʻaʻai māmā | No ka wehe ʻana i nā puʻupuʻu kanesa i loko o nā māmā 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 i ka puʻuwai. |
| Māmā i Hiolo | No ka mālama ʻana i nā hihia o nā māmā hiolo, i ʻike ʻia ma ke ʻano lapaʻau he pneumothorax . |
| Ka hōʻiliʻili ʻana o ka wai a puni nā māmā/puʻuwai | No ka mālama ʻana i ka pleural effusion a i ʻole ka cardiac tamponade , ʻoiai inā i hoʻokumu ʻia e ka maʻi. |
| Nā maʻi ʻōpū | No ka mālama ʻana i ke kanesa a i ʻole nā maʻi ʻē aʻe o ka esophagus. |
He aha ka mea e hana ʻia ma mua o ke ʻoki kino?
He hana 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 hana.
He mea nui loa: He mea nui e haʻi aku i kāu kauka e pili ana i kēlā me kēia lāʻau lapaʻau, wikamina, a i ʻole mea hoʻohui āu e lawe nei, ʻoiai nā mea hiki iā ʻoe ke kūʻai ma luna o ke kūʻai aku. ʻO kekahi mau lāʻau lapaʻau, ʻoiai nā lāʻau hoʻokahe koko, pono paha ʻoe e hoʻōki i ka lawe ʻana iā lākou i kekahi mau lā ma mua o ke ʻoki ʻana. E hahai pono i kēia mau ʻōlelo aʻoaʻo.
Inā ʻaʻole he ʻoki kino ulia pōpilikia, e haʻi maoli aku nā kauka iā ʻoe e hoʻōki i ka puhipaka . He kōkua nui ia i ke kaʻina hana ho'ōla.
He aha ka mea e hana ʻia i ka wā o ke ʻoki kino?
I ka wā o ke ʻoki kino, e hoʻohuli ke kime lapaʻau iā ʻoe i kekahi ʻaoʻao a kau iā ʻoe i kahi kūlana ʻoluʻolu me kekahi lima ma luna o kou poʻo.
ʻO ke kauka anesthesiologist nāna e anesthesiologist iā ʻoe i kēia hana ʻoki kino he loea i ke ʻoki kino umauma. E kāohi ʻo ia i kou hanu ʻana i hoʻokahi wale nō māmā e hana ana (hoʻokahi māmā ventilation) . ʻO ke ʻano kēia, ua pio ka māmā ma ka ʻaoʻao o ke hana no kekahi manawa a ua ʻae ʻia ʻoe e hanu mai ka māmā ʻē aʻe wale nō. ʻOi aku ka maʻalahi o kēia no ke kauka ʻoki kino e hana i ke hana.
A laila hana ke kauka ʻoki i kahi ʻoki ma waena o nā iwi ʻaoʻao ʻelua, hoʻohana i nā mea hana kūikawā (retractors) e hoʻonui i ka ʻoki, a nānā i nā ʻōpū o loko a hana paha i ka lāʻau e pono ai.
Ma hope o ka pau ʻana o ke ʻoki ʻana a pani ʻia ka ʻoki ʻana, hoʻokomo ʻia kahi ʻōmole umauma e hoʻokahe i kekahi wai a me ka ea i hōʻiliʻili ʻia i loko. Ua like kēia me kahi ʻōmole.
He aha ka mea e hana ʻia ma hope o ke ʻoki ʻana a pehea ka lōʻihi e hoʻōla ai?
Ma hope o ke ʻoki ʻana, 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 hāʻawi ke kime lapaʻau iā ʻoe i ka lāʻau lapaʻau e kāohi i kou ʻeha.
He mea nui loa nō hoʻi kāu hāʻawina i ke kaʻina hana ho'ōla.
- E paipai ke kime lapaʻau iā ʻoe e ʻū a hanu hohonu .
- Paipai lākou e hoʻohana i kahi mea i kapa ʻia ʻo 'incentive spirometer' no nā hoʻomaʻamaʻa hanu.
- Noi ʻo ia e hele iki me ke kōkua.
ʻOiai paha he mea paʻakikī iki kēia mau mea i ka wā mua, he mea nui lākou no ka pale ʻana i nā maʻi o ka māmā (e like me ka maʻi pneumonia).
Ma hope o kou hoʻi ʻana i ka home mai ka haukapila, hiki ke hala a ʻelua mahina e hoʻōla piha ai a hoʻi hou i nā hana maʻamau. E nīnau i kāu kauka i ka wā hiki iā ʻoe ke hoʻi hou i nā hana e like me ka hāpai ʻana i nā kaumaha a me ka pāʻani ʻana i nā haʻuki.
He aha nā pilikia o kēia ʻoki kino?
E like me nā ʻoki kino āpau, loaʻa i ke ʻoki ʻana o ka Thoracotomy kekahi mau pilikia. Mai hopohopo, e hana ka hui lapaʻau i kā lākou mea maikaʻi loa e hōʻemi i kēia mau pilikia.
- Nā pilikia maʻamau e pili ana i ke ʻoki ʻana: nā pilikia me ka anesthesia, ka maʻi, ke kahe ʻana o ke koko, a me ka ʻeha.
- Nā pilikia e hiki mai ana ma hope:
- Pneumonia: He maʻi maʻi māmā.
- Atelectasis: Hiolo a hiolo paha nā ʻāpana o ka māmā.
- ʻO ka maʻi ʻeha post-thoracotomy: ʻO ka ʻeha e mau ana no nā mahina ma hope o ke ʻoki ʻana.
Āhea ʻoe e makemake ai e ʻike hou i ke kauka?
Ma hope o kou haʻalele ʻana i ka haukapila, e hoʻomaopopo ʻia ʻoe e pili ana i nā lā e pono ai ʻoe e hoʻi i ke keʻena lapaʻau. Eia nō naʻe, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, pono ʻoe e kāhea koke i kāu kauka .
- Inā loaʻa iā ʻoe ke kuni.
- Inā hoʻomaka hou ke kahe ʻana o ke koko i ka wā e ʻoki ai ʻoe a i ʻole inā puka mai ke koko i waho i kou wā e ʻū ai.
- Inā pilikia ʻoe i ka hanu ʻana.
- Inā he pus ka wahi i ʻoki ʻia, pehu, ʻulaʻula, a ʻokoʻa paha ke kala.
- Inā ʻaʻole hiki iā ʻoe ke kāohi i ka ʻeha ma hope o ka lawe ʻana i ka lāʻau lapaʻau.
Inā loaʻa iā ʻoe kahi pilikia, e like me ka paʻakikī nui o ka hanu ʻana a i ʻole ke kahe koko nui, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa .
Leka Lawe-Home
- He ʻoki kino nui ka Thoracotomy i hana ʻia no ka mālama ʻana i nā ʻōpū o ka umauma. ʻOiai he mea maʻamau ka makaʻu no ia mea, hiki ke lilo i kaʻina hana e pono ai a hoʻōla ola. (Ua loaʻa i ka ʻōlelo ma mua kahi huaʻōlelo Tamil ma ke kuhihewa. Ke hoʻoponopono nei iā ia i Sinhala maʻemaʻe e like me nā kuhikuhi.) Eia naʻe, hiki ke lilo i kaʻina hana e hoʻōla ola ai a pono.
- E hahai pono i nā ʻōlelo a ke kauka ma mua o ke ʻoki ʻana, ʻoiai e pili ana i ka haʻalele ʻana i ka puhipaka a me ka hoʻomaopopo ʻana iā ia e pili ana i nā lāʻau lapaʻau āna e lawe nei.
- He mea nui loa ka mālama ʻana i ka ʻeha ma hope o ke ʻoki ʻana a me nā hoʻomaʻamaʻa hanu hohonu no ka ho'ōla koke ʻana a no ka pale ʻana i nā pilikia e like me ka maʻi pneumonia.
- Inā kū mai kekahi mau pilikia a i ʻole nā hōʻailona weliweli i ka wā hoʻōla, e hoʻomaopopo koke i kāu kauka.
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