I tēnei rā, ka matapakihia e tātou tētahi tukanga tino nui e puta ana i roto i tō tinana i tēnei wā tonu: te rere o te toto i roto i ō uaua toto, e mōhiotia whānuitia ana i te taha hauora ko te hemodynamics . Ahakoa he kupu pūtaiao uaua te ahua, he tino māmā noa iho te ariā. Kia mārama koe, ka mārama ake koe ki te hauora o tō ngākau me te pānga o ngā mate pūnaha toto ki a koe.
He aha tonu te Hemodynamics?
Ki te whakarapopoto, ko te hemodynamics e pā ana ki ngā kaha me ngā tikanga e pā ana ki te rere o tō toto i roto i tō pūnaha manawa—ina koa ko ō uaua toto (ngā oko toto e kawe ana i te toto whai hāora mai i tō ngākau) me ō uaua toto (ngā oko toto e whakahoki ana i te toto kore hāora ki tō ngākau).
I raro i ngā āhuatanga hauora noa, ka rere pai, ka rere tika hoki ō toto, he rite tonu ki te awa marino, e rere pūmau ana. Ka kiia tēnei he rere laminar . Ina rere te toto i tēnei ara, he iti noa te waku ki ngā pakitara o te uaua toto, ā, ko te toto i waenganui tonu o te uaua toto te mea tere rawa te neke.
Heoi, i ētahi wā ka pōrearea, ka koretake hoki te rere o te toto, he rite ki te wai e hurihuri ana i ngā toka i roto i ngā awa tere. E mōhiotia ana tēnei ko te rere pōrearea . I te nuinga o te wā ka kitea te rere pōrearea i roto i ngā rūma o raro o tō ngākau (ngā ventricles ), i ngā wāhi e peka ana ngā oko toto, i ngā wāhi rānei e whaiti haere ana, e whānui haere ana rānei te oko toto. He nui ake te kaha e hiahiatia ana e tō ngākau ki te pupuhi toto i raro i ngā āhuatanga pōrearea nā te mea he tino koretake te rere.
Whakaarohia tō ngākau he papu pokapū tino matatau. Ina pā, ka panaia te toto puta noa i tō tinana katoa. Ko tō uaua nui rawa atu, ko te aorta , me tōna whatunga uaua peka e kawe ana i te hāora me ngā matūkai nui ki ō kiko katoa. Kia tangohia e ō whekau te hāora e hiahiatia ana e rātou, ka hoki te toto ki tō ngākau mā roto i ō uaua. Kātahi ka panaia e tō ngākau tēnei toto kore-hāora ki ō pukahukahu hei tiki i tētahi puna hāora hou, ā, ka tīmata anō te huringa.
I ētahi wā, ka taea e ngā arai te whakararuraru i tēnei huarahi tonu. Hei tauira, ka taea e te cholesterol (he momo ngako, e mōhiotia ana ko te cholesterol ) te hanga i roto i ō uaua. Ka kiia ēnei putunga ngako he paraka , ā, he rite ki ngā "pūpū tere" e aukati ana i te rere o te toto. Mena ka pakaru ohorere te putunga paraka, ka taea te hanga he totoka ka aukati katoa i te uaua.
Hei tāpiritanga, ka taea e te toto totoka te aukati i te oko toto. Waihoki, ki te ngoikore te uaua o tō ngākau, e kore e taea e ia te pupuhi me te kaha e ranea ana hei whakatutuki i te hiahia o ō kiko mō te hāora me ngā matūkai.
Ina puta tētahi o ēnei whakararuraru, ka uaua te mahi a tō pūnaha tohanga toto. Ko te tikanga tēnei kāore ō pūtau, ō kiko, me ō whekau nui e whiwhi i te toto e tika ana—ā, nō reira, te hāora me ngā matūkai—e hiahiatia ana e rātou kia tika ai te mahi.
He aha te hiranga o te Hemodynamics ki a koe?
I tēnei wā, tera pea koe e whakaaro ana, "Āe, koinei te rere o te toto. He aha te take o tēnei ki ahau?" Ko te mea pono, he mea tino nui te mārama ki te āhua o tō toto ki te whakahaere i tō hauora.
Mā te mōhio ki ngā āhuatanga e whakahaere ana i tō rere toto, ka taea e koe te mārama ake ki te mate ngakau me te mahi a ngā maimoatanga. Hei tauira, ki te mōhio koe ka akiakihia tō ngakau e te toto toto tiketike kia kaha ake te mahi ki te pupuhi toto, he tino tika te take ka tohua e tō tākuta he rongoā hei whakangā me te whakawhānui i ō oko toto. Mā tēnei ara whānui ka whakaitihia te ātete, ka taea ai e tō toto toto te heke.
Ka whakamahia e tō tākuta ngā raraunga hemodynamic hei hanga i tētahi tātaritanga tika me te whakatau i tō matapae(me pēhea te whanaketanga o tētahi āhuatanga). Hei tauira, ka taea e rātou te aromatawai mēnā kei te tukuna e te takirere ngākau e turuturu ana te toto kia hoki whakamuri, kia kore ai e tae ki tōna ūnga. Ka āwhina hoki i a tātou ki te whai mēnā kei te angitu te pokanga tata nei, te rongoā hou rānei ki te whakapai ake i te rere o tō toto.
He kupu noa iho rānei te kupu Hemodynamics mō te toto toto?
Kāore rawa. Ahakoa he mea nui te toto toto, he mea noa iho tēnei o ngā āhuatanga maha e tirohia ana e tō tākuta ina aromatawai ana i tō toto toto whānui. He maha atu anō ngā kaha hihiri e whakatau ana i te rere o te toto i roto i tō tinana.
He aha ngā āhuatanga e pā ana ki te rere o tō toto? (Ngā āhuatanga hemodynamic)
Me tūhura tātou i ngā āhuatanga matua o te toto e whakahaere ana i tō tohanga toto. Ka taea e ēnei āhuatanga te whakangāwari, te whakararu rānei i te rere o te toto ki ō whekau. Ka whakatikatika tonu tō tinana i ēnei taurangi kia whiwhi ai ō pūtau i te mea e hiahiatia ana e rātou i tētahi hēkona.
Anei ngā āhuatanga matua:
- Te whānui o ngā oko toto: Mā ngā oko toto nui ake, whānui ake ka taea te rere o te toto me te ngāwari. I tetahi atu taha, ki te whaiti te uaua toto nā te hanga paraka (nā ngā āhuatanga pēnei i te cholesterol teitei), me kaha te rere o tō toto mā roto i tētahi wāhi iti ake.
- Te Waku me te Ātete: I te mirimiritanga o te toto ki ngā pakitara o te oko toto, ka puta he waku, ka whakaroa i te rere o te toto . Koia te take e puhoi ake ai te rere o te toto e tata ana ki ngā pakitara o te oko toto, i te mea ka rere te toto i waenganui tonu i te tere tino tere.
- Te Āhuatanga me te Urupare o ngā Uaua: Hei whakahaere i te pēhanga me te rere o te toto, he kaha whakamiharo tō ōu uaua toto ki te whakawhanui (whakanui) ki te whakawhāiti rānei (whakapiripiri) ina hiahiatia. He tikanga tino tika, he tikanga whakahaere-ā-ia anō!
- Te Rerenga Pēhanga: Ka rere te toto mai i ngā wāhi pēhanga teitei ki ngā wāhi pēhanga iti. Me pupuhi tō ngākau me te kaha e tika ana hei wikitoria i te ātete pūnaha i roto i ō uaua toto. Ina he toto toto tiketike tōu, me kaha ake te mahi a tō ngākau ki te whawhai ki tēnei ātete.
- Putanga o te Manawa: Koinei te nui o te toto e pupuhihia ana e tō manawa ia meneti. I runga i te taumata o tō mahi o nāianei, ka taea e tō tinana te whakarerekē i tēnei nui. Hei tauira, i a koe e whakakori tinana ana, ka nui ake te hāora e hiahiatia ana e ō pūtau, ka akiaki i tō manawa kia whakanuia ake tana putanga o te manawa.
- Te Auau o te Manawa : Koinei te maha o ngā wā e pā ai tō manawa i ia meneti. Ka piki ake tō auau o te manawa i te wā e whakapau kaha ana koe kia tere ai te tuku toto whai hāora ki ngā uaua e kaha ana.
- Te Whai Hua o te Puku o te Ngākau: He mea nui te whai huatanga o ngā rūma o raro o tō ngākau (ngā pūku o te ngākau). Mēnā ka ngoikore ēnei pūku o te ngākau i tētahi mate ngākau, kāore e taea e rātou te pupuhi toto, ka whakaiti i te nui o te toto e tukuna ana ki te toenga o tō tinana.
He aha te koretake o te hemodynamic?
Ki te kī ngāwari, ka puta te kore pumau o te toto i te wā e kore e taea e te pūnaha tohanga toto o tō tinana te tuku toto e tika ana ki ō whekau nui. He āhuatanga hauora tino kino tēnei, e morearea ana ki te ora, e mōhiotia ana ko te ru . He maha ngā momo ru rerekē, i runga i te take matua.
Ko ngā momo matua o te ru ko:
- Te ohorere o te ngākau – i puta mai i te korenga o te mahi pupuhi o te ngākau (pērā i te wā o te whakaeke ngākau kino).
- Te ohorere hypovolemic – i puta mai i te ngaronga nui o te toto, o ngā wai tinana rānei (pērā i te toto nui, te matewai nui rānei).
- Te ru ārai– nā te aukati tinana i roto i te pūnaha manawa ka aukati i te rere o te toto (pēnei i te embolism pūkahukahu nui).
- Te ohorere tohatoha – i puta mai i te whānui rawa, te whānui kē o ngā oko toto (e kitea pinepine ana i roto i ngā mate kino, e mōhiotia ana ko te ohorere septic).
- Te ohorere neurogenic – i puta mai i te kino o te pūnaha io matua (pēnei i te whara o te taurakira) e whakararuraru ana i te whakahaerenga o ngā uaua toto.
Me pēhea te ine a ngā tākuta i te hemodynamics?
Hei aromatawai i te whai huatanga o te tohanga o tō toto, ka taea e tō tīma hauora te whakamahi i ētahi taputapu tātaritanga me ngā tikanga aroturuki.
Anei ētahi o ngā huarahi e ine ai mātou i ēnei tawhā:
- Te Tātātanga o te Ngākau: Mā tēnei tikanga ka taea e mātou te ine i te pēhanga i roto tonu i ngā rūma o tō ngākau, me te tirotiro mō ngā raruraru o te takirere ngākau.
- Te Aroturuki i te Pēhanga o te Uaua Waenga (CVP): Mā te whakamahi i te ultrasound, te whakauru rānei i te catheter o te uaua waenga, ka taea e mātou te ine i te pēhanga i roto i ngā uaua nui e whakahoki ana i te toto ki tō ngākau.
- Te Aroturuki i te Pēhanga o ngā uaua pūkahukahu: Ko te whakamahi i tētahi catheter motuhake hei ine i te pēhanga toto i roto i ngā uaua o ō pūkahukahu.
- Te Aroturukitanga o te Putanga o te Manawa: Ka inehia mā te whakamahi i te catheter o te uaua pūkahukahu, i te echocardiogram transthoracic kore-whakaeke rānei (e kiia nei ko te matawai "echo").
- Te hiko o te manawa (ECG/EKG): He whakamātautau paerewa e hopu ana i ngā mahi hiko o tō ngākau hei tirotiro mō ngā manawataki ngākau rerekē.
- Te Aroturukitanga Pēhanga Toto Urupare: Ko te whakaurunga o tētahi aho uaua (he katitere iti ki roto i tētahi uaua) hei aroturuki tonu i te pēhanga toto, i ia patunga, i ngā wāhi tiaki nui.
- Ringa Ine Toto Kore-Whakaeke: Ko te ringaringa ine toto paerewa e karapoti ana i tō ringa, e mōhio ana pea koe ki tēnei.
- Echocardiogram: He whakamātautau oro o tō ngākau e whakaatu ana i te pai o te pupuhi toto o ō ventricles i te wā tonu.
- Whakamātautau Tēpu Honga Upoko-runga: He whakamātautau motuhake e whakamahia ana hei tirotiro i ngā take o te hemonga kore whakamārama (syncope) mā te aroturuki i te urupare a tō ngākau ki ngā huringa tūnga.
Ngā Āhuatanga Hauora Noa e Pā Ana ki tō Hemodynamics
Ka whakararuraru te āhua o te toto i ngā āhuatanga e pā ana ki te pūnaha manawa e pupuhi ana i te manawa, i te hanganga rānei o ō oko toto. Anei ētahi o ngā āhuatanga e tino kitea ana:
- Atherosclerosis: Te whaiti me te whakapakeke o ngā uaua toto nā te kohikohinga o ngā papa ngako.
- Te toto toto tiketike (te toto toto tiketike) .
- Te toto toto iti (te toto toto iti) .
- Ngā Mate o te Takirere Manawa: Ngā āhuatanga pēnei i te stenosis, te regurgitation rānei e aukati ana, e turuturu ana rānei i te rere o te toto i roto i te manawa.
- Te ngoikore o te ngākau: He mate mau tonu tēnei e kore ai e taea e te ngākau te pupuhi toto kia rite ki tōna whai huatanga.
- Mate Puku Ā-Taiao (PAD): He whaiti ngā uaua toto e whakaiti ana i te rere o te toto ki ō peka me ō waewae, ko te nuinga o te wā ko ō waewae.
- Te toto totoka o ngā uaua hōhonu (DVT): He toto totoka e puta ana i roto i te uaua hōhonu, i roto i tō waewae i te nuinga o te wā, e aukati ana i te rere o te toto.
- Te Whakaekenga Manawa (Te Mate Pukupuku o te Ngākau): Te aukati ohorere o te rere o te toto ki te uaua o te manawa, ka pakaru ngā kiko me te ahotea hemodynamic tonu.
Te Mōhio ki ngā Tohu o ngā Take Hemodynamic
Mena kei te pāngia koe e ngā raruraru ki te rere o tō toto, ki te whakahaere rānei i te pēhanga, ka tukuna mai e tō tinana ngā tohu whakatūpato. Ko ngā tohu noa o te ngoikore o te hemodynamic ko:
- Te poto o te manawa (dyspnea).
- Te ngoikore, te ngaro rānei o te māramatanga (syncope).
- Pōuriuri, māuiui rānei te upoko.
- Te ngenge tonu, kāore i te mārama te take.
- He kiri mā, he kikorangi rānei (he kiri mā, he kiri cyanosis rānei).
- Kiri makariri, kiri makuku (ina koa i roto i ō ringaringa me ō waewae).
- Te pōhēhē, te koretake o te aronga, te uaua rānei ki te arotahi.
- Ngā tere o te manawa, ngā tere rānei o te manawa (arrhythmia).
Te Kaupapa Matua: Ngā Mea Me Mahara Koe
Ina kōrero tō kaiwhakarato hauora mō ō hemodynamics , e kōrero ana rātou mō te whai huatanga o te rere o ō toto i roto i tō tinana hei tautoko i ō whekau. Mena he raruraru kei roto i tō ngākau, i ō uaua toto rānei, ka taea e ia te whakararu i tēnei pūnaha tuku toto nui.
Ko te mea nui, ki te pāngia koe e tētahi o ngā tohu kua whakarārangihia i runga ake nei, he mea nui kia rapu awhina hauora tonu. Mena he tohu kino tōu pēnei i te poto o te manawa, te mamae o te uma, te hemo rānei, waea atu ki tō ratonga hauora ohorere ā-rohe (pēnei i te 911) me te haere rānei ki te tari ohorere tata tonu. Ka taea e tō rōpū hauora te aromatawai tika i tō pūnaha manawa me te hanga i tētahi mahere maimoatanga hei whakapai ake i te rere o tō toto.
Tērā pea ka uru atu ki tō maimoatanga ngā whakarerekētanga o te āhua noho, ngā rongoā kua tohua, tae atu ki tētahi pokanga – kei runga katoa i te pūtake o tō mate. He mea tino nui te aro atu ki ēnei take i te wā tonu kia taea ai e tō pūnaha tohanga toto te tuku tonu i te hāora hou ki ngā kokonga katoa o tō tinana.
Ahakoa te ahua whakamataku o te kupu hauora "hemodynamics", ko te rere o te ora e whakaahuahia ana e ia he mea nui ki tō oranga o ia rā. Mā te pupuri i tēnei rere kia maeneene, kia pumau, koia tonu te huarahi e ora ai tō ngākau—me tō tinana hoki.
