He ' turuturu' ā-roto i muri i te pokanga? (Tuturutanga Anastomotic) Me ako ngāwari tātou!

Kua whakaarohia e koe i muri i tētahi pokanga nui, tera pea ka puta he raruraru ohorere i roto i te tinana? Pērā i te wā e honoa ai ngā paipa wai e rua, i ētahi wā ka turuturu te wai mai i te hononga, ka taea hoki te tupu i taua mea anō ina honoa ngā uaua toto e rua i roto i tō tātou tinana mā te pokanga. I roto i te rongoā, ka kiia tēnei he turuturu anastomotic . Nā te mea he tino kino tēnei, he mea nui kia mōhio koe me ō whanaunga ki tēnei.

He aha tonu te turuturu anastomosis?

He whakarāpopototanga noa iho, ko te anastomosis te pokanga e honoa ai ngā pito o ngā ngongo tinana e rua. Whakaarohia me tango e koe tētahi wāhanga o tō whekau. Kātahi ka hono anō koe i ngā wahi whekau e rua kua tapahia. Ka kiia taua hononga he anastomosis.

Nā, ko tēnei turuturu ā-roto ko te wā kāore te hononga e hiri tika, ā, ka turuturu ngā mea o roto i taua ngongo. He mea morearea tēnei, nā te mea kāore e pai kia haere ngā mea o roto i ngā ngongo o tō tātou tinana ki ētahi atu wāhi. Hei tauira, kei roto i ngā mea o roto o tō pūnaha nakunaku he huakita . Ki te tae atu ēnei ki ētahi atu wāhi o tō puku, ka pā mai he mate.

He aha te mea ka tupu mēnā he turuturu i muri i te pokanga puku?

He tikanga noa te tango i te puku, e mahia ana he anastomosis, ā, ka puta he turuturu anastomosis. Mēnā ka turuturu ngā mea o roto o te puku ki roto i te kōhao puku, ka pangia te arai o te puku (peritoneum) ka pupuhi. Ka kiia tēnei ko te peritonitis . Ka horapa tēnei mate ki ētahi atu okana o te puku, ka uru ki roto i te toto. Mēnā ka kino rawa, ka arahi pea ki tētahi mate morearea e kiia nei ko te sepsis . Ko te sepsis te tauhohenga nui rawa atu o te tinana ki tētahi mate. Ka arahi pea tēnei ki te ohorere , te ngoikore o ngā okana, tae noa ki te mate.

Whakaarohia te mea ka tupu mēnā ka maringi ngā mea o roto i ā tātou para o te kīhini ki roto i te rūma noho. Ka pērā anō te mea ka tupu mēnā ka maringi ngā mea o roto i ō tātou whekau ki roto i ō tātou puku. Koia te take he tino morearea tēnei.

Ko tētahi atu mea ka turuturu ki roto i te kōhao puku ko tō ara mimi. Hei tauira, i te wā e whakawhitihia ana ō whatukuhu, e tangohia ana rānei te prostate, me pokanga pea koe. Ki te turuturu tēnei, ka kohia te mimi ki roto i te kōhao puku. Ka kiia tēnei he urinoma . He tūponotanga anō hoki kei te pangia koe e te mate me te sepsis i waho o te kōhao puku. Hei tauira, ki te mea he turuturu anastomotic kei roto i tō esophagus, he wāhanga o tō paipa kai, ka arahi pea tēnei ki te pangia o te kōhao o tō uma.

Āhea ka puta te turuturu anastomotic?

I ētahi wā ka kitea pea tēnei turuturu i te wā o te pokanga. Engari ka tirohia e ngā taote pokanga i taua wā tonu. I te nuinga o te wā, ka puta tēnei i te wā e ora ana. Ko te nuinga o ngā turuturu ka puta i roto i te wiki tuatahi i muri i te pokanga , engari ko ētahi ka whakaroa. Ka aroturukihia tēnei e ngā tākuta mō ētahi wiki i muri i te pokanga. Tērā pea ka roa ake te wā e puta ai ngā turuturu iti. He tino onge ngā turuturu e puta ana i muri i te 30 rā (`(Tutukinga Anastomotic Whakaroa)`).

He pēhea te noa o tēnei āhuatanga?

E ai ki ngā pūrongo , e 5% pea o ngā pokanga anastomosis ka puta ngā turuturu o te anastomotic. O ēnei, 75% e pā ana ki ngā pokanga colectomy. He tino teitei tēnei mōrearea i ngā pokanga e mahia ana i te pito o te koroni, te rectum, te koroni sigmoid rānei. Nā te mea he whaiti te rohe, ā, he uaua ki te pokanga, inā koa i roto i ngā tāne.

Ko wai te mea tino tūpono ka pāngia e te turuturu anastomosis?

Ina hoki, ka taea e te hunga kua pokaia te hononga ki te uaua te pāngia e tēnei raruraru. Heoi anō, kei reira ētahi āhuatanga mōrearea e whakanui ake ai i te tūponotanga o tēnei.

Ko ngā āhuatanga mōrearea:

• Te momi hikareti.
• Te kore kai pai, te anemia rānei.
• Te whakamahinga o ngā rongoā ārai mate.
• He iti te taumata o ngā pukupuku.
• Kua whiwhi i te rongoā irahiko.
• Kua pā kē te mate ki te tinana e kiia nei ko te "Sepsis" me te "Septic Shock" rānei.
• I te mea kua whakawhiti toto ki a koe i te wā o te pokanga (`(Intraoperative Blood Transfusion)`).
• He momona, he mate huka rānei (`(Diabetes Mellitus)`).
• Pokanga ohorere.
• He roa rawa te wā e pokanga ai.
• Te Anastomosis o te Rectal.
• He tāne i te whānautanga (`(Ira Tāne Kua Tohaina)`).

He aha te take o tēnei turuturu?

Ko te turuturu i roto i te anastomosis te tikanga nā te korenga o te tukanga whakaora patunga . He uaua ki te tautuhi i tētahi take kotahi, engari he maha ngā āhuatanga ka whai wāhi. Hei tauira:

• Te taumahatanga nui rawa atu i te wāhi pokanga: Koinei te mea e ngana ana ngā taote pokanga ki te karo hei ārai i te turuturu. Ka taea te kumea, te whakawhāiti rānei i tēnei hononga i te wā e nekehia ana. Ka nui ake tēnei mōrearea mēnā he whaiti, he uaua rānei te uru atu ki te wāhi pokanga.
• Te mate urutā o mua i roto i te kōhao tinana: Mena he mate urutā o mua, ka pupuhi te kiko, ka mumura hoki. Ka taea hoki e te mumura roa te whakaheke i te nui o te collagen . Ka horoia e ngā taote pokanga te wāhi ki ngā wai patu huakita, ā, ka tohua he rongoā paturopi.Ahakoa ka ngana koe ki te whakahaere i te mate ki ngā paturopi, tera pea ka ngoikore tonu te kiko i te wā o te pokanga.
• Te hekenga o te rere o te toto ki te oko toto hono (`(Ischemia)`): Tērā pea he mate kua pā mai i mua i te `(Ischemia)`, ka puta rānei hei urupare ki te pokanga.
• Te ngoikore o te ārai mate: Ka taea e ētahi āhuatanga hauora, te momi hikareti, te kai koretake, te whakamahi rānei i ngā `(Immunosuppressants)` te ngoikore o te pūnaha ārai mate. Ka kino hoki ngā kiko me te pūnaha ārai mate i te rongoā irahiko. Nā te mea he maha ngā tāngata e pokangahia ana ki te `(Anastomosis)` he tūroro matepukupuku.

He aha ngā tohu o te turuturu anastomotic?

Ko ngā tohu tuatahi me ngā tohu tino kitea i roto i tēnei mate ko:

• Mamae Puku (`(Mamae Puku)`) .
• Kirika (`(Kirika)`) .
• Te pupuhi o te puku (tērā pea nā te Peritonitis).
• Te ileus pararutiki pumau (te ngoikore o te puku) i muri i te pokanga .

Ina kino ake te āhua, ka puta pea ēnei tohu:

• Te tere o te manawa o te ngakau (Tachycardia) .
• Pōrangi (`(Pōrangi)`) .
• Te Mate Huka `(Te Mate Huka)` .
• Te ohorere .

Me pēhea koe e tino mōhio ai ki tēnei?

Ina haere koe ki te kite i tō tākuta i muri i te pokanga, ka tirotirohia e ia tō āhua. Ka tirohia tonutia ō tohu ora (pēnei i tō pā o te manawa, tō tere manawa, tō pāmahana, me te toto toto), ngā whakamātautau toto, me te mahi a te puku. Mena he tohu mate kei a koe, kāore rānei ō puku e mahi tika ana i muri i te pokanga koroni, tera pea ka whakapae tō tākuta kei te turuturu te hononga anastomotic. Ka whakamahia e ia ngā whakamātautau whakaahua (pēnei i ngā matawai) hei whakaū i tēnei – he matawai CT te nuinga o te wā, e whakamahi ana i te tae rerekē .

Me pēhea te rongoā?

Mena ka kitea tēnei momo turuturu kei a koe, ka rongoātia koe ki ngā paturopi hei whakahaere i te mate. Ka whakawhirinaki te rongoā ki te rahi o te turuturu me te kaha o tō mate. Kei roto pea i tēnei:

• Te Whakahekenga Wai: Me whakaheke e te tinana te wai me/ranei te pupuhi kua kohia nā te mate. Mena ka taea, ka mahia tēnei e te tākuta mā te werohanga kiri – arā, mā te ngira tuwhera ka werohia mā roto i te kōhao iti i te kiri.
• Okiokinga o te Puku: Mena kei roto i ngā whekau te turuturu, me mutu te kai, te inu rānei mā te waha i te wā e rongoatia ana. Tērā pea ka hoatu e tō tākuta he wai ki a koe.ka hoatu, ā, ki te tika, ka hoatu he kai mā te uaua.
• Pokanga Anō: Me tirotiro anō pea te taote pokanga i te anastomosis, ā, me mahi anō i tētahi atu pokanga. Mēnā ka taea, ka whakamahia e rātou tētahi tikanga iti rawa te whakaekenga, pērā i te laparoscopy . Ko te whakauru i tētahi kāmera mā roto i tētahi tapahi iti hei tirotiro i te kōhao puku. Ka whakamahia pea e rātou ngā taputapu iti hei tango i te wai i te puku, hei horoi rānei i te kōhao ki ngā otinga paturopi. Mēnā kāore e mahi, me whakatuwhera anō pea te kōhao puku kia tae atu ai ki te turuturu. Me whakapakari pea te anastomosis, me hanga rānei tētahi mea hou ki tētahi wāhi kē atu me ngā kiko hauora. I ētahi wā, me hoatu he wā roa ki te tinana kia ora ai i mua i te mahi anō i te anastomosis. I te wā o te pokanga whekau, me huri pea te taote pokanga i tētahi wāhanga o te whekau ki roto i tētahi ostomy (he kōhao hou e karo ana i te anastomosis, ā, ka roa ake te wā e ora ai).

Kia pēhea te roa o te wā e ora ai?

Ka taea e te turuturu anastomosis te hua ake he noho hōhipera mō ngā wiki e whā, neke atu rānei.

Kāore e taea te ārai i ēnei turuturu?

He maha ngā āhuatanga ka whai wāhi ki te putanga mai o te turuturu anastomotic, he maha o ēnei kāore e taea te whakarerekē. Hei tauira, ko te hauora o te tūroro, te uauatanga o te pokanga, me ētahi atu āhuatanga ka puta i te wā whakaora. Heoi, ka taea e ngā taote pokanga te tirotiro mō ngā turuturu i te wā pokanga.

Te tirotiro

Ko ngā whakamātautau e mahia ana hei tirotiro i ngā turuturu i muri i te anastomosis ko:

• Whakamātautau Hau: Ka whakakīia te kōhao tinana ki te wai tote, ā, ka whakaurua te hau ki roto i te ngongo tinana. Mēnā ka kitea he mirumiru i roto i te wai, he turuturu kei te hononga. I te nuinga o te wā, ka whakatikahia ēnei turuturu mā te tāpiri anō i te hononga, mā te tuitui rānei.
• Whakamātautau Wai: Ka werohia he wai patu huakita ki roto i te ngongo tinana, ā, ka tirohia mēnā he turuturu.
• Whakamātautau Whakarerekētanga: Mēnā he pokanga puku, ka whakamahia pea e te taote pokanga he matawai CT me te tae whakarerekētanga hei tirotiro mēnā he turuturu. Ka tukuna te tae whakarerekētanga mā te nono ki te anastomosis hei tirotiro mēnā he turuturu.

Ahakoa kāore e taea e ēnei whakamātautau i te wā o te pokanga te aukati i ngā turuturu katoa, ka taea e rātou te whakaiti i te maha me te tautuhi i te hunga he nui ake te mōrearea o te turuturu anō.

Stoma Ārai (`(Stoma Ārai)`)

I te wā e pokanga ana te puku, ka taea e ngā taote pokanga te huri i te paru i roto i ngā whekau i te wā e ora ana, hei ārai i ngā pānga kino o te turuturu o te puku. Ka mahia tēnei mā te hanga i tētahi colostomy rangitahi, i tētahi ileostomy rānei.Kia oti tētahi te hanga, ka tangohia ngā mea o roto i te whekau mai i te pūwāhi hononga ka tukuna ki roto i tētahi pēke. Ahakoa kāore tēnei e ārai i te turuturu ā-roto, ka ārai i ngā mea o roto i te whekau kei uru ki te kōhao puku mēnā ka puta he turuturu.

Ka hangaia e te ostomy he pūaha horihori hou hei putanga mā te tūtae, e kiia nei ko te stoma . Mā tēnei ka taea e ngā whekau te ora me te kore e mamae i te tūtae. I ētahi wā, ka hangaia e ngā taote pokanga he ostomy ārai-wā poto. E taunakihia ana te ostomy rangitahi hei ārai i te hunga e tino mōrearea ana ki te pāngia e te turuturu anastomotic.

He aha te āhua o te hunga kua pāngia e te turuturu anastomosis?

Ko ngā turuturu e kitea ana ka taea te whakatika. Heoi, he mea nui te tautuhi wawe me te maimoatanga hei whakahaere i te mate me te ārai i te sepsis. I te nuinga o te wā, ko te hunga he turuturu anastomotic he nui ake te tūponotanga o ngā raruraru hauora me te mate a meake nei. Kāore i te mārama te nui o ēnei putanga nā te turuturu anastomotic tonu, mēnā rānei he tohu te turuturu o tētahi raruraru hauora whānui.

Āhea ahau me toro atu ki taku tākuta?

Mena kei te ora ake koe i te anastomosis, me noho tata tonu ki tō tākuta, me te ripoata i ngā tohu ohorere. Rapua tonutia he awhina hauora mena ka kitea he tohu mate. Hei tauira:

• Te kirika.
• Mamae puku.
• Mumura (whero, pupuhi).

He aha ngā pātai me pātai atu ahau ki taku tākuta i mua i te pokanga anastomosis?

Mena kei te whakahaerehia he anastomosis, ā, kei te āwangawanga koe mō te turuturu anastomosis, ka taea e koe te pātai ki tō tākuta mō ō āhuatanga mōrearea whaiaro, he aha ngā mahi ārai ka taea e rātou te mahi, me ngā wawaotanga ka tūtohutia e rātou māu. Hei tauira:

• He nui te mōrearea o te turuturu o te anastomosis i roto i taku pokanga?
• He nui ake te mōrearea mōku ake?
• Me pēhea te whakahaere i te `(Anastomotic Leak)`?
• Ka tirohia e koe ngā turuturu i te wā e pokanga ana?
• Me pēhea te tirotiro i ngā turuturu i muri i te pokanga?
• He aha te mea ka tupu mēnā he turuturu kei muri i te pokanga?

Mena me whai pokanga anastomosis koe, he tikanga whakaora ora pea tēnei. I tēnei wā, he uaua ki te whakaaro ki tētahi raruraru morearea ora mai i te pokanga tonu. Ahakoa te mataku o ngā tākuta, he tūponotanga tonu te turuturu o te pokanga anastomosis. Engari i te nuinga o te wā, he iti te mōrearea. Ā, mā te mōhio me te wawaotanga wawe, he maha ngā take ka taea te whakahaere.

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

• Ko te turuturu anastomosis ko te turuturu o ngā ihirangi mai i ngā ngongo e rua e hono ana i muri i te pokanga.
• Ka taea tēnei te tupu i ngā wāhi katoa, pērā i te whekau, i te ara mimi rānei.
• Ki te pāngia koe e ngā tohu pēnei i te kirika, te mamae o te puku, te pupuhi rānei, me toro atu ki te tākuta tonu.
• Ka taea te whakanui ake i tēnei mōrearea e ngā mea pēnei i te momi hikareti, te mate huka, me te kore kai pai.
• Ki te kitea wawetia, ā, ka rongoatia, ka taea te whakaora. Heoi, ki te kore e rongoatia, ka taea te noho hei mea morearea.
• Ki te mea kei te pokanga koe, kōrero mārire ki tō tākuta mō tēnei mea. Kia mārama koe ki ō tūponotanga, me aha koe hei ārai i aua tūponotanga, me aha hoki koe mēnā ka puta he turuturu. Ko te mōhio te parepare pai rawa atu!

` Tuku Anastomotic, Ngā Āhuatanga Pōkarekare, Pōkarekare Whekau, Peritonitis, Sepsis, Tiaki Whai Muri i te Pōkarekare, Ngā Mōrearea Pōkarekare