He mea noa te mataku ina kī mai tō tākuta he raruraru tō te takirere ngākau. Ina koa ka kī mai ia me pokanga koe mōna. Engari ko te Tukanga Ross ka kōrerohia e tātou i tēnei rā he pokanga tino angitu ka taea te hoatu i te ora hou ki te hunga e pāngia ana e ngā mate takirere ngākau, inā koa ko te hunga rangatahi. Nō reira, me kōrero tātou mō tēnei mea, he māmā noa iho.
He aha te tikanga Ross?
He mahi uaua tēnei, engari he tino pūkenga te mahi pokanga ngākau. Kei roto i tēnei mahi ko te whakamahi i ō ake wāhanga tinana hei whakatika i te takirere ngākau mate. Kia tika ake, e rua ngā mahi e whai ake nei:
1. Ka tangohia te takirere aorta mate o tō ngākau, ka whakakapia ki tō ake takirere pūkahukahu hauora.
2. Kātahi ka whakatōkia he takirere pūkahukahu mai i tētahi kaituku hauora ki te wāhi i tangohia ai te takirere pūkahukahu.
Whakaarohia he rite ki te whakamahi i tētahi wāhanga o tō tinana ake hei whakatika i tētahi hapa nui. He maha ngā painga o tēnei i te whakauru i tētahi takirere horihori.
He aha tātou i hiahia ai ki tēnei pokanga?
He rite te takirere aorta ki tētahi kūaha tino nui i roto i tō tātou ngākau. Ka huaki tēnei kūaha, ā, ka taea te rere o te toto ma, whai hāora, mai i te ngākau ki te toenga o te tinana. Ka ārai hoki i te rere o te toto ki roto i te ngākau i waenga i ngā pā o te ngakau, i te mea ka kati tēnei takirere.
Engari i ētahi wā ka pāngia tēnei takirere e te mate. E rua ngā huarahi matua:
- Te mate pūmau: Koinei te wā kāore e tuwhera tika te takirere, ā, ka whaiti. Ka ārai tēnei i te tinana ki te whiwhi toto e ranea ana.
- Te ruaki: Koinei te wā kāore e kati tika te takirere, ka turuturu, ka rere anō te toto ki roto i te ngākau.
Ka taea e ēnei raruraru e rua te whakaputa i ngā tohu pēnei i te ngenge me te poto o te manawa. Ki te kore e rongoatia, ka taea e ēnei te whakanui ake i tō tupono ki te ngoikore o te ngakau me ngā mate kino. Ka tangohia e te Tikanga Ross te takirere mate ka whakahokia mai te mahi noa o te ngakau.
He aha i whiriwhiria ai te takirere pūkahukahu kaua te takirere aorta?
Tērā pea kei te whakaaro koe he aha i mahia ai tēnei whakarerekētanga, he aha e kore ai e hoko noa i tētahi atu takirere horihori? He maha ngā take motuhake mō tēnei.
- Ātete Pēhanga: He nui te pēhanga o te takirere aorta, nō reira me tino pakari, me tino pakari hoki te takirere hou e whakanohoia ana ki roto. He pai te takirere pūkahukahu mō tēnei.
- Ngā mōrearea o ngā takirere horihori: He mōrearea kei te toto totoka ina whakauruhia ngā takirere horihori. Nō reira, me tango e koe he rongoā whakangawari toto mō te toenga o tō oranga. Engari ki te whakamahi koe i tō ake kiko, tata kore rawa taua mōrearea.
- Te Whakaurunga: He rite tonu te rahi me te āhua o te takirere pūkahukahu ki te takirere aorta.
- Rohe pēhanga iti: Ka whakanohoia he takirere kaituku ki te wāhi i noho ai te takirere pūkahukahu i mua. Kei raro taua wāhi i te pēhanga iti. Nō reira, ahakoa he ngoikore te takirere, kāore e nui te pānga.
Ko wai te mea e tika ana, ā, ko wai kāore e tika ana mō tēnei pokanga?
Ehara te Tukanga Ross i te pokanga mō te katoa. Ka tīpakohia e ngā tākuta ngā tūroro mōna i runga i ētahi āhuatanga.
| Te hunga e tika ana mō te pokanga | Ngā tāngata kāore e tika ana mō te pokanga |
|---|---|
| Ngā tāngata kei raro iho i te 60 tau te pakeke. | Ngā tāngata whai mate pūnaha ārai mate pērā i te lupus me te rumatiki rheumatoid. |
| Ngā tāngata whai mate pūkahukahu ā-roto whānau. | Ngā tāngata whai mate hononga hononga pērā i te Marfan syndrome . |
| Ngā tāngata whai mate kē atu o te takirere aortic. | Te hunga e pāngia ana e te mate uaua o te ngākau, arā, he aukati i roto i ngā oko toto neke atu i te toru i roto i te ngākau. |
| Ngā tāngata e pangia ana e te mate takirere aorta (aortic valve endocarditis). | Ngā tāngata e mate ana i te mate takirere pūkahukahu. |
Ko te mea nui ko te whakatau whakamutunga mā tō tākuta ngakau mēnā he tika tēnei pokanga māu.
Me pēhea te mahi i te pokanga i te taahiraa i te taahiraa
He pokanga tino whakamaheretia tēnei, ā, e hia hāora te roa.
1. Whakamamae:Tuatahi, ka tukuna koe ki raro i te rongoā whakamoe whānui. Nō reira, kāore koe e rongo i tetahi mea, ā, kāore hoki he maharatanga mō te pokanga.
2. Mīhini ngākau-pūkahukahu: Muri iho, ka honoa koe ki tētahi mīhini karo manawa . Ka tangohia e tēnei mīhini te mahi a tō ngākau me ō pūkahukahu i te wā pokanga. Mā tēnei ka taea e ngā taote pokanga te mahi haumaru i te pokanga me te kore e aukati i tō ngākau.
3. Te whakatuwhera i te uma: Ka tapahia e ngā taote pokanga te waenganui o te uma, ka tapahia te wheua uma i ia taha (sternotomy) kia tae atu ai ki te ngākau.
4. Whakamātautau takirere: Ka āta tirohia te takirere pūkahukahu kia kitea ai mēnā he pai te hauora hei whakakapi i te takirere aorta.
5. Whakakapinga takirere: Muri iho, ka tangohia te takirere aorta kua pakaru, ā, ka ata whakatōkia tō ake takirere pūkahukahu ki tōna wāhi.
6. Te whakatō takirere kaituku: Muri iho, ka whakatōkia he takirere i tangohia mai i tētahi kaituku hauora ki te wāhi takoto kau i reira te takirere pūkahukahu.
7. Whakaora manawa: Kia oti te whakatō i ngā takirere e rua ki ngā wāhi tika, ka tīmata anō tō manawa, ā, ka tangohia mārire koe i te mīhini manawa-pūkahukahu. Ka tirohia hoki ngā takirere hou e rua kia tika ai te mahi.
8. Te otinga o te pokanga: Hei whakamutunga, ka honoa anō te sternum, ka mau ki ngā waea, ka tuia te tapahi, ā, ka hipokina ki te takai ma.
Ngā painga me ngā mōrearea pea o tēnei pokanga
Pērā i ngā pokanga katoa, he pai, he mōrearea hoki ngā painga me ngā mōrearea o te Tikanga Ross. Ka taea te whakaiti i ngā mōrearea mā te whai maimoatanga i raro i te tirotiro a tētahi taote pokanga mātau e mahi tonu ana i ēnei tikanga.
| Ngā Painga Matua | Ngā tūponotanga pea |
|---|---|
| Ka taea e koe te noho i tētahi oranga hohe, tae atu ki te whakakorikori tinana me te taraiwa. | Te whānui haere o te oko toto tata ki te takirere hou (te whakawhanuitanga o te aorta). |
| Ki te hiahia ngā wāhine kia hapu, ka taea e rātou te mahi haumaru. | Ngā rerekētanga o te pā o te ngakau (Arrhythmia) . |
| Ka tutuki pai te tohanga toto (hemodynamics) puta noa i te tinana. | Te whakaekenga ngākau . |
| Kāore koe e hiahia ki te tango i ngā rongoā whakaiti toto mō te toenga o tō oranga. | Te toto nui rawa (Hemorrhage) . |
| Ka tere te memeha o ngā tohu. Ka pai ake te āhua o te tūroro i muri tata i te pokanga. | Te mate urutā . |
| He turuturu, he mau rānei te takirere. |
Te wā whakaora i muri i te pokanga me te wā hei toro atu ki te tākuta
I muri i te pokanga, ka hoki anō tō māramatanga ki te ICU o te Ngākau . I te tīmatanga, ka honoa pea koe ki tētahi mīhini manawa hei āwhina i a koe ki te manawa. Ka noho koe ki te ICU mō te rima rā pea.
E hia pea ngā marama ka roa pea hei whakaora katoa i muri i te hokinga ki te kāinga. I tēnei wā, he mea noa te mate kōroke, te kore hiahia kai, te kore moe, te ngoikore me te pupuhi huri noa i te motu.
He mea nui: Kāore e roa te mau o te takirere pūkahukahu i tangohia mai i tētahi kaituku. I te nuinga o te wā me whakakapi i muri i ngā tau 15-20. Nō reira, he mea tino nui ngā tirotiro hauora me te aroturuki mō te wā katoa.
Mena ka pāngia koe e ētahi tohu o ngā raruraru i muri i te pokanga, me whakamōhio tonu koe ki tō tākuta . Kia tūpato ki ngā tohu e whai ake nei:
- Mamae o te uma
- Te kirika, te makariri rānei
- Pōuriuri, ngoikore rānei
- Te maremare toto
- He maru, he toto rānei rerekē
- Te ngoikore o ngā peka
- Ruaki
- Te toto i roto i te tūtae (whero kanapa)
Karere Tangohia ki te Kāinga
- Ko te Tikanga Ross te maimoatanga pai rawa atu mō te hunga e pāngia ana e te mate takirere aorta kino, inā koa ko te hunga rangatahi.
- Ko te tikanga tēnei ko te tango i tō ake takirere pūkahukahu hauora, ka whakatōkia hei whakakapi i te takirere aorta mate.
- Nā te mea ka whakamahia e koe tō ake kiko, kāore koe e hiahia ki te tango i ngā rongoā whakaiti toto mō te toenga o tō oranga. Ka taea hoki e koe te noho ora.
- Pērā i ngā pokanga katoa, he tūponotanga kei roto, engari ka taea te whakaiti i ēnei tūponotanga mā te whai maimoatanga i raro i te tirotiro a te taote pokanga mātau.
- Mena ka pāngia koe e ētahi tohu rerekē i muri i te pokanga, whakapā atu ki tō tākuta tonu atu.
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