Kua tonoa e tō tākuta tētahi whakamātautau motuhake hei tirotiro i ngā raruraru o tō ngākau? He whakamātautau `(Transesophageal Echocardiogram)` pea, e kīia nei ko `(TEE)` rānei. Ahakoa he ahua rerekē te tangi, he tikanga tēnei e taea ai e koe te kite mārama i te āhua o tō ngākau, mai i roto tonu. Nō reira, tera pea koe e mataku ana, e hiahia ana rānei ki te mōhio ki tēnei. Nō reira, me kōrero noa tātou mō tēnei whakamātautau `(TEE)`, i roto i tētahi huarahi e mārama ai koe.
He aha tēnei whakamātautau (TEE)? Me pēhea te mahi?
He whakarāpopototanga noa iho, he whakamātautau te Transesophageal Echocardiogram e whakamahi ana i ngā ngaru oro hei tango pikitia o tō ngākau. He whakamātautau whakaata anō hoki tēnei. Engari he rerekē tēnei i te Transthoracic Echocardiogram (TTE) e mahia ana i runga i te uma. Nā te mea i tangohia ngā pikitia mai i roto i te tinana.
Ko te Tākuta, he taputapu angiangi, roa, rite tonu ki te ngongo, e kiia nei e mātou he "Endoscope," ka whakaurua marietia ki roto i tō korokoro ki roto i tō paipa kai (esophagus). Kei te pito o tēnei ngongo he "Transducer" iti. Ka tukuna e tēnei "Transducer" ngā ngaru oro. Ka pā ēnei ngaru oro ki ngā wāhanga rerekē o te ngākau, ka whakaata mai anō, pērā i te echo. Ka kohia e te "Transducer" aua ngaru e hoki mai ana, ka tukuna atu ki te rorohiko. Ka hurihia e te rorohiko aua raraunga hei whakaahua. Ka whakaatuhia e ēnei whakaahua te āhua me te mahi a te ngākau me te tino taipitopito.
I ētahi wā ka whakamahia e ngā tākuta ngā tikanga motuhake e kiia nei ko te Doppler ultrasound me te Color Doppler me tēnei whakamātautau TEE. Ka taea e ēnei te ine tika i te tere me te ahunga o te rere o te toto i roto i te ngākau.
He aha ngā kitenga a ngā tākuta i roto i tēnei whakamātautau (TEE)?
Mā tēnei whakamātautau `(TEE)` ka taea te whakarato i tētahi pikitia mārama mō te hanganga o te ngākau, arā, te whakaritenga o ōna wāhanga, me te mahi a te ngākau. Ka taea e tēnei te āwhina ki te tautuhi i ngā momo mate me te whakahaere i aua mate i te wā e rongoatia ana. Anei ētahi tauira:
- Te aneurysm o te aorta: Koinei te wā e ngoikore ai te pakitara o te oko toto nui rawa atu o te tinana (te aorta) ka pupuhi pērā i te poihau.
- Ngā toto totoka i roto i te ngākau: Ko te hunga whai mate atrial fibrillation, ina koa, he nui ake te tūponotanga ka pāngia e ngā toto totoka i roto i ngā rūma o runga o te ngākau (atria).
- Ngā pukupuku ngākau: He pukupuku ēnei, he kore pukupuku rānei.
- Mate ngakau whānau: E pā ana tēnei ki ngā mate ngakau maha e kitea ana i te whānautanga.
- Mate takirere ngākau: Hei tauira, te mate takirere mitral. Ka taea e tēnei takirere te whaiti (stenosis) te turuturu toto rānei ki muri (regurgitation). Waihoki, ka taea te tirotiro i te hunga whai takirere prosthetic mō ngā raruraru o ō rātou takirere, pērā i te mate pāwera, te toto toto rānei.
- Ngā mate urutā o te kiko o te ngākau, o ngā takirere rānei: Hei tauira, ngā āhuatanga pēnei i te `(Infective endocarditis)`.
- Mate puku: E pā ana tēnei ki ngā mate e puta ana i roto i te pēke angiangi (pericardium) e karapoti ana i te ngākau.
He aha i mahia ai tēnei whakamātautau (TEE)? I roto i ēhea āhuatanga?
He maha ngā take e tika ai te whakamātautau TEE. Me titiro tātou ki ēnei:
1. Mena kāore e ranea te echocardiogram auau (TTE): Whai muri i te echocardiogram auau (TTE) e mahia ana ki tō uma, me mārama ake, me āta tirohia hoki tō ngākau e tō tākuta. I roto i ēnei āhuatanga, ka taea te whakahaere i tētahi whakamātautau TEE hei tāpiri atu ki te TTE hei āwhina i te tautuhi i tētahi raruraru ngākau, hei whakamahere rānei i tētahi maimoatanga.
Whakaarohia kei te hikoi koe i te huarahi, ā, ka kite koe i ētahi pereti ataahua i roto i tētahi toa mā roto i te karāhe. Ka kite koe he tauira putiputi kei roto i ngā pereti, engari kāore i te tino mārama he aha ngā putiputi, he aha ngā taipitopito, nā te mea he tangata kei te taha, ā, he karāhe anō hoki. Nō reira, ka tomo koe ki roto i te toa ka titiro matatau atu ki ngā pereti. Ko te wā tēnā ka kite koe he rōhi.
Koinei te āhua o te echocardiogram (TTE) noa e mahia ana i runga i te uma, he rite ki te titiro mā roto i te karāhe i roto i te toa. He maha ngā mea ka taea e ia te kōrero ki a koe. Engari ko tēnei TEE he rite ki te haere ki roto i te toa ka tiki i tētahi pereti. He mārama rawa ētahi wāhanga o te ngākau, inā koa ko ērā kei muri, i runga i tēnei TEE. Nā te mea kei muri i tō ngākau tō korokoro, he wāhi pai mō te transducer ki te tuku me te whiwhi i ngā ngaru oro.
He mea tika kia tirohia motuhake ēnei wāhanga:
* Te ātrium maui: Te rūma maui o runga o te ngākau.
* Te atrium maui (LAA): He pēke iti, rite ki te taringa, kei roto i te atrium maui. Koinei te wāhi e puta ai ngā toto totoka i ētahi wā.
* Septum Interatrial: Ko te pakitara e wehe ana i te atria maui me te atria matau.
* Aorta thoracic: Ko te wāhanga o te aorta e tika ana mā roto i te uma.
I ētahi wā ka whakamahia e ngā tākuta he TEE hei utu mō te TTE. Nā ēnei take e whai ake nei tēnei:
- Mena kei tētahi tūranga te hanganga o te uma, ka uaua ki te mahi i tētahi TTE.
- Mena kei a koe ngā mate pūkahukahu (nā te mea ka ārai i te tirohanga o te ngākau).
2. I roto i ngā āhuatanga ohorere, ngā āhuatanga morearea ora: I roto i ētahi āhuatanga ohorere, me tere te tirotiro a ngā tākuta i te āhua o te ngākau. Kātahi ka tino whai hua te `(TEE)`. Hei tauira:
- Te kore pumau o te toto (te toto toto me ngā raruraru tohanga toto)
- Te toto toto iti (hypotension)
- Te hekenga o ngā taumata hāora (Hypoxia)
- Ngā āhuatanga ohorere e hiahia ana kia arotakehia tonutia, pērā i te tapahi aortic.
- Ina whakapaetia he mate ngakau.
- Ngā raruraru ki ngā takirere hangai (pērā i te toto totoka, te mate pukupuku).
- Te whara ki te uma.
3. Tirohia mēnā he toto totoka i mua i tētahi tikanga hauora: I te wā e rongoatia ana ētahi mate manawa o te ngākau (arrhythmias), pērā i te catheter ablation, te cardioversion hiko rānei, ka mahia he TEE hei tirotiro mēnā he toto totoka i roto i te ngākau i mua i te tikanga. Nā te mea mēnā he toto totoka, ka pakaru pea i te wā o te tikanga ka aukati i tētahi oko toto (thromboembolism).
4. Hei āwhina i ngā pokanga me ētahi atu tikanga hauora: He taputapu tino whai hua te TEE i ētahi pokanga me ngā tikanga hauora. Ka whakamahia hei tirotiro i te hanganga o te ngākau i mua i te pokanga, hei whakaū hoki i te angitu o te pokanga i muri i te otinga. Tauira:
- Te pokanga mō te mate manawa whānau.
- Te whakatikatika i te takirere.
- Te whakakapinga o te takirere.
Waihoki, i roto i ētahi maimoatanga e whakamahi ana i te catheter, arā, ngā maimoatanga e tukuna ana he ngongo angiangi mā roto i te uaua toto ki te ngākau, ka whakamahia he TEE hei tirotiro i roto i te tinana, hei whakarato i ngā whakaahua tūturu hei ārahi i te tukanga. Hei tauira:
- `(Whakakapinga takirere aorta whakawhiti-kātere - TAVR)`
- `(Te whakatikatika i te takirere mitral transcatheter)`
- `(Te whakatikatika i te takirere tricuspid transcatheter)`
- `(Te kati i te hononga atrium maui o te catheter)`
Kei roto i te tinana te whakamātautau TEE? Kei te whakamahia te rongoā whakamoe?
Ae, e kiia ana te TEE he whakamātautau whakaekenga nā te mea me whakauru he taputapu ki roto i te tinana. Tērā pea ka pāngia koe e te mamae, engari he iti te tūponotanga o ngā raruraru nui.
I te nuinga o te wā, ko te whakamātautau TEE anake e hiahia ana ki te rongoā whakamoe ā-rohe me te whakangāwari ngawari . Ko te tikanga ka rehuhia e te tākuta he rongoā whakangāwari ki te tuara o tō korokoro. Ka hoatu hoki e ia he rongoā ā-uaua (IV) hei āwhina i a koe kia marino.
Kāore te nuinga o te tangata e hiahia ki te rongoā whakamoe whānui, engari he mea pai kia kōrero koe ki tō tākuta mō te mea pai mōu.
Nā, kei te whakamoea tātou i tēnei wā? Kei te mōhio tātou?
Mā te rongoā whakamoe ngawari koe e hiamoe ai, ā, ka taea e koe te whakahaere i te whakamātautau me te kore e nui te mamae. Ka aroturuki tonu ngā kaimahi hauora i a koe kia kite ai mēnā kei te pāngia koe e te mamae. Tērā pea ka hoatu e rātou he rongoā whakamoe anō ki a koe mēnā e tika ana.
Ahakoa ka tukuna he `(Whakamoemiti Whānui)` ki a koe, ka moe rawa koe, ā, kāore e mahara ki tetahi mea mō te whakamātautau. Heoi, ki te tukuna he `(Whakamoemiti Whānui)` ki a koe, me hono atu koe ki tētahi `(Mīhini Manawa).` Waihoki, nā te mea ka moe hohonu koe, ka roa ake te ora ake i te moe ngawari.
Kia pēhea te roa o tēnei whakamātautau?
E 90 meneti pea te roa o te whakamātautau TEE. Heoi anō,Tekau mā rima meneti te roa o te tango whakaahua.
Me pēhea tā tātou whakarite i mua i te whakamātautau (TEE)?
Kia mahara ki te kōrero i tō hītori hauora ki tō tākuta. Tērā pea ka whakararuraru ētahi āhuatanga hauora i te whakamātautau TEE. Kia mahara ki te kōrero ki tō tākuta mēnā kei a koe tētahi o ēnei āhuatanga e whai ake nei:
- Matepukupuku korokoro
- Te mate puku
- GERD (Te rerenga waikawa mau tonu)
- Hernia hiatal
- He hītori o te whakamahinga tarukino ā-uaua (te whakamahinga tarukino IV)
- Ngā raruraru horomi
- Te moe pōrearea
- Matepukupuku puku
Me kōrero mai hoki mēnā kei te tango rongoā koe mō ēnei mea:
- Ngā raruraru moe
- Manukanuka
- Mamae
Ka hoatu e tō tākuta ngā tohutohu taipitopito mō te whakarite mō te whakamātautau TEE. Kia tino whai i aua tohutohu. Kaua e wehi ki te pātai mēnā he mea kāore koe e mārama. Kei roto i ngā tohutohu ēnei e whai ake nei:
- Te wā hei whakamutu i te kai me te inu (i te nuinga o te wā e ono hāora pea i mua i te whakamātautau).
- Āhea koe me tango i ō rongoā o ia rā?
- Kaua e inu waipiro mō tētahi wā (tērā pea he torutoru ngā rā i mua i te whakamātautau).
- Ētahi atu mea me mahi, kāore rānei e tika ana kia mahia e koe i mua i te `(TEE)`.
He aha ngā mea ka tupu i te wā o te whakamātautau (TEE)?
Koinei ngā mahi e mahia ana i te wā o te whakamātautau `(TEE)`:
1. Ka hoatu he kākahu hōhipera hei kakahu māu.
2. Ka tāpirihia e te tākuta he whakapiripiri iti e kīia ana ko ngā "Electrodes" ki tō uma. Ka taea te whakamahi i ēnei hei aroturuki i te mahi hiko o tō ngākau i te wā o te "TEE".
3. Ka whakatakotoria he poroporo ine toto ki tō ringa, ā, ka tāpirihia he oximeter pākia ki tō maihao hei aroturuki i ō taumata hāora.
4. Ka hoatu he rongoā ki a koe hei whakangāwari i tō korokoro. Ka rehuhia e te tākuta he rongoā ki roto i tō korokoro. He rongoā whakamoe ā-rohe tēnei. Koia te take e kore ai koe e mamae i te wā o te TEE.
5. Ka hoatu he rongoā whakangāwari ā-uaua (IV) ki a koe hei āwhina i a koe kia marino.
6. Me whakauru pea he ngongo iti (nasal cannula) ki roto i tō ihu hei hoatu hāora ki a koe.
7. Ka hurihia koe ki te taha maui o te tēpu whakamātautau, ā, ka meinga kia takoto.
8. Ka āta whakaurua e te tākuta te "Endoscope" (he ngongo angiangi, roa, ngāwari) ki roto i tō waha. Kei te pito o te ngongo he "Transducer". Ka heke tēnei ngongo ki raro i tō korokoro, ki roto hoki i tō paipa kai. Ka pania ki te hinu kia māmā ake ai te heke iho. I ētahi wā ka tonoa koe kia horomia hei āwhina i te "Transducer" kia tae ki te wāhi tika. Tērā pea he ahua kore whakamarie tēnei, engari ka tino āta mahi te tākuta i tēnei. Ka hoatu e rātou he rongoā hei whakangāwari i tō korokoro, kia kore ai koe e tino mamae.
9. Kei te tango pikitia te tākuta. Tērā pea ka pāngia koe e te mamae. Engari he rerekē te `(Transducer)`.Tērā pea ka pēhia tō uma ina nekehia. E 10-15 meneti pea te roa o tēnei wāhanga.
10. Ka tangohia e te tākuta te ngongo i tō korokoro, ā, ka aroturuki tonu i tō toto toto, tō manawa, me ngā taumata hāora.
11. Taria kia kī mai te tākuta ka taea e koe te hoki ki te kāinga.
He aha ngā mea ka taea e au te tumanako i muri i te whakamātautau (TEE)?
Me whai tangata koe hei taraiwa i a koe ki te kāinga i muri i te whakamātautau TEE. Kāore e taea e koe te taraiwa mō ngā haora 24 nā te mea ka pāngia koe e ngā rongoā whakangāwari. Ka taea e koe te tumanako atu ki ēnei mea e whai ake nei:
- Ka ngoikore tō korokoro mō te haora pea. Ka memeha haere i muri i tētahi wā. Kaua e kai, kaua e inu i tetahi mea kia ngaro ra ano te ngoikore. Ki te kai tere rawa koe, ki te inu rānei, tera pea ka kōrohia koe.
- Tērā pea ka mamae tō korokoro mō ngā rā e rua. He mea noa tēnei, ā, ka memeha haere i roto i ētahi rā. Heoi, ki te mau tonu te mamae, ki te kino haere rānei, kōrero ki tō tākuta.
He mōrearea kei roto i te tikanga (TEE)?
Ka pāngia ētahi tāngata e te mamae o te korokoro i muri i te TEE. Ka roa pea mō ētahi haora, tae atu ki te toru ki te rima rā rānei.
He onge ētahi atu raruraru, engari ka taea:
- Ngā uruparenga mate pāwera ki ngā rongoā.
- Ko te niumōnia manawa ka puta mai i te kai, i te wai rānei e uru ana ki te ara manawa.
- Ngā raruraru ki te toto totoka, ki te manawataki rānei o te ngakau.
- He toto iti mai i te ara nakunaku.
I mua i te whakamātautau, he mea nui kia kōrero koe ki tō tākuta mō ngā mōrearea o te TEE.
Me pēhea taku whiwhi i ngā hua o te whakamātautau (TEE)?
Ka kōrero tō tākuta ki a koe mō ngā hua o tō whakamātautau. Tērā pea kei roto i tō pūkete hauora hiko (he pūnaha ipurangi hei tiro i ō mōhiohio hauora). Kōrero ki tō tākuta mō te wā ka whiwhi koe i ngā hua me pēhea te tiaki i aua hua.
He mea noa ki ētahi tāngata te mataku, te mataku rānei ina tae mai ki ngā whakamātautau hauora. Heoi, he mea nui te mahi a ngā whakamātautau pēnei i te Transesophageal Echocardiogram (TEE) hei pupuri i tō hauora, hei rongoā rānei i ngā raruraru e puta ake ana. He whakamātautau noa te TEE, he iti te mōrearea o ngā raruraru. Mena kei te pāngia koe e te TEE, kōrero ki tō tākuta mō te whakarite mōna me ngā mea hei tumanako atu.
Hei whakamutunga, kia mahara ki tēnei.
He tikanga motuhake te whakamātautau TEE e āhei ai koe ki te kite mārama i roto i tō ngākau. Ahakoa te āhua whakamā, he āwhina nui ki te tautuhi i ngā mate ngākau me te rongoā tika i aua mate. Ko te mea nui, ki te mea he pātai, he ruarua rānei āu, kōrero ki tō tākuta mō aua mea. Kātahi ka taea e koe te aro atu ki tēnei whakamātautau me te kore wehi, me te maia hoki.
` Echocardiogram transesophageal, TEE, whakamātautau ngākau, ngākau, endoscope, whakamātautau echo, korokoro
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