Ko te oko toto matua e kawe ana i te toto mai i tō ngākau ki tō tinana katoa, arā, te aorta, he rite ki te paipa matua e puta mai ana i tō tātou tāke wai i te kāinga. I ētahi wā ka ngoikore tēnei paipa, ka tīmata te pupuhi ki waho pērā i te poihau tawhito. I roto i te rongoā, ka kiia tēnei he aneurysm. Ina koa mēnā ka pupuhi te wāhanga e tata ana ki te ngākau, te aorta piki, pēnei, ka paku kino pea. I tēnei rā ka kōrero tātou mō te pokanga e mahia ana mō tēnei mate.
Me pēhea te mahi i tēnei pokanga?
Ki te whakarāpopototanga, ka whakatikatikaina tēnei āhuatanga mā te pokanga tuwhera tuku iho. Ka tangohia e tō taote ngakau te wāhanga ngoikore me te pupuhi o tō aorta ka whakakapia ki tētahi ngongo i hangaia ki te rauemi hangai, e kiia nei ko te graft. Ka mahi tēnei graft hei arai hou mō tō aorta. Kātahi ka rere te toto mā roto, kāore he ārai. Ka mahia tēnei pokanga i roto i te rūma pokanga o te hōhipera.
Ko wai e hiahia ana ki tēnei pokanga?
Ki te pakaru , ki te wehea rānei tētahi aneurysm i roto i tō aorta piki, he āhuatanga ohorere tēnei. Ka kiia tēnei he momo tapahi momo A. He pokanga ohorere tēnei me mahi tonu hei whakaora i tō ora.
Waihoki, ki te mea he aneurysm tōu e tata ana ki te pahū, ki te pakaru rānei, me mahi pea tēnei pokanga. Ka mahi tō tākuta i ngā whakamātautau whakaahua (pēnei i ngā karapa CT, ngā karapa MRI) kotahi, e rua rānei i te tau hei tirotiro i tōna āhua. I ētahi wā, ki te mea he tino iti te aneurysm, he puhoi rānei te tipu, kāore pea e hiahiatia he pokanga mō tētahi wā. Heoi, ki te mea he nui , he tohu rānei kei te tere te tipu , me whakatika pea mā te pokanga i mua i te pahū, i te pakaru rānei.
Ki te kī māmā noa iho, ki te nui ake ngā mōrearea o te whakaroa i te maimoatanga i ngā mōrearea o te pokanga, ka tūtohu tō tākuta kia pokangahia.
He aha te wā pai rawa atu mō te pokanga?
He maha ngā āhuatanga e whakatau ana i te wā pai mō tēnei pokanga. Ko te mea nui o ēnei ko te kitea o ngā tohu. Hei tāpiri, ko ngā āhuatanga pēnei i te rahi o te aneurysm, te tere o tōna tipu, te rahi o tō tinana, me ētahi atu mate hauora kei a koe, ka whai wāhi anō hoki.
Ngā tohu e hiahia ana ki te pokanga ohorere
Ki te pāngia koe e te mamae o te uma, he tohu pea tēnei kua tata te pahū o te aneurysm. Mēnā he pēnei, me pokanga ohorere.
| Ngā tohu ohorere - haere tonu ki te hōhipera! | |
|---|---|
| Mamae ohorere, mamae nui | He mamae nui i te uma, i te tuara rānei o runga, e rite ana ki te mea kei te haehaetia tetahi mea i roto. |
| Mamae o te uma | Te mamae o te uma i ngā momo katoa. |
| Ngā huringa kiri | Ka piri te kiri, ka werawera. |
| Ngā uauatanga manawa | Maremare, pāorooro, uaua rānei ki te manawa. |
| Ētahi atu āhuatanga | Pōuriuri, ngoikore, tere o te manawa, whakapairuaki me te ruaki, poto te manawa. |
Ki te pāngia koe e tētahi o ēnei tohu, kaua e whakaroa. Waea atu tonu ki te ratonga waka tūroro 1990, haere rānei ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera tata.
Te rahi o te aneurysm
He mea nui te rahi o te aneurysm i roto i te whakamahere pokanga. Tērā pea ka hiahiatia te pokanga ina tae ki ngā rahi e whai ake nei:
- Te toharite: 5.5 henimita
- Mō te hunga whai mate pēnei i te Marfan syndrome: 4.5 henimita
- Mō te hunga whai mate pēnei i te mate Loeys-Dietz: 4.0 henimita
Te tere o te tipu o te aneurysm
Ahakoa he iti iho i te 5.5 henimita te rahi o te aneurysm, ki te tere te tipu, me tere te pokanga.
- Te toharite: 1 henimita ia tau, 0.5 henimita rānei ia 6 marama.
- Mō te hunga whai mate pēnei i te takirere aorta bicuspid): Mena ka tipu ake i te 0.5 cm i te tau.
Ngā mea motuhake ki a koe
Ka whakaarohia hoki e tō tākuta te rahi o tō tinana me ētahi atu āhuatanga hauora. Hei tauira, he mea morearea te aneurysm iti i roto i te tangata iti, ahakoa he iti. Waihoki, ki te pokanga anō tō ngākau, ka tūtohu pea tō tākuta kia whakatikahia e koe te aneurysm i te wā kotahi o taua pokanga. Ka āwhina tēnei ki te ārai i ngā pokanga a muri ake nei.
Kāore e taea te whakamahi i ētahi atu tikanga (endovascular) mō tēnei?
Ko te whakatikatika aorta endovascular thoracic (TEVAR) he tikanga e whakamahia ana hei whakatika i ngā aneurysms i roto i te aorta thoracic heke. Heoi, he onge te whakamahinga o tēnei tikanga i roto i te aorta piki, te uaua e tīmata ana i te ngākau. Nā te mea he rerekē te hanganga me te toto toto o ēnei wāhanga e rua.
Heoi, i roto i ngā āhuatanga ohorere, kua whakamahia te TEVAR hei whakaora i te ora o tētahi tūroro e ngoikore rawa ana ki te mahi pokanga tuku iho. Kei te whakawhanake ngā kairangahau i ngā taputapu hou e uru ana ki te aorta piki. Nō reira, tera pea ka nui haere te whakamahinga o tēnei tikanga ā muri ake nei. Engari i nāianei, ko te pokanga tuwhera te maimoatanga pai rawa atu, ko te maimoatanga paerewa.
He aha ngā mea ka tupu i mua i te pokanga?
Me toro atu koe ki tō tākuta i ētahi wiki i mua i te pokanga. Ka aromatawaitia tō hauora, ā, ka whakahaerehia ētahi whakamātautau e tika ana.
Ngā whakamātautau e mahia ana i te nuinga o te wā:
- Ngā whakamātautau toto: Tirohia te mahi a te whatukuhu.
- CT, MRI rānei o te Manawa: Ka tirohia ngā wāhanga katoa o te aorta. Mena he raruraru kei te takirere aorta, ka taea hoki te whakatika i te wā o tēnei pokanga.
- Angiography coronary: Hei tirotiro mō ngā putunga ngako (atherosclerosis) i roto i ngā uaua e tuku toto ana ki te ngākau.
- Uira-orooro takirua: Ka tirohia te āhua o ngā oko toto i te kaki (ngā uaua carotid). Ka taea e ngā raruraru o ēnei te whakanui ake i te mōrearea o te whiu i te wā e pokanga ana.
Ngā mea hei kōrero ki te tākuta:
- Ngā rongoā e tangohia ana e koe: Me kōrero koe ki tō tākuta mō ngā rongoā katoa, ngā huaora, me ngā rongoā otaota e tangohia ana e koe. Tērā pea ka hiahiatia kia mutu te tango i ētahi rongoā i mua i te pokanga.
- Ētahi atu mate: Mena kei a koe ngā mate pēnei i te toto toto tiketike, me whakahaere pai i mua i te pokanga.
- Ngā kare ā-roto: Kōrero ki tō tākuta mēnā he mate tōu, pērā i te makariri, te rewharewha, te herpes rānei.
- Te kai paipa: Me mutu rawa te kai paipa i te iti rawa i te kotahi marama i mua i te pokanga.
Ka hoatu e tō tākuta he tohutohu mārama ki a koe i te rā o tō pokanga. He mea tino nui te whai i aua tohutohu kia angitu ai tō pokanga.
He aha ngā mea ka tupu i te wā o te pokanga?
I te wā o te pokanga, ka tukuna koe ki raro i te rongoā whakamoe whānui. Nō reira, kāore koe e rongo i tetahi mea. Ka tangohia e te taote pokanga he sternotomy waenga i waenganui o tō uma, ka tangohia te wāhanga ngoikore o tō aorta, ka whakakapia ki te graft. I tētahi wā i te wā o te pokanga, ka honoa koe ki tētahi mīhini cardiopulmonary bypass. Ko te tikanga ka roa te pokanga mō te 3-4 hāora.
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka whakaurua koe ki te wāhanga tiaki nui (ICU). Ka tirotirohia koe i reira mō ētahi rā. Whai muri i tēnā, ka whakawhitia koe ki te wāhanga whānui. Ko te roanga katoa o te noho hōhipera ka taea te 4 ki te 10 rā.
I a ia i te hōhipera,
- Ka whakauruhia he catheter mimi ki a koe.
- Ka hoatu ngā rongoā (anticoagulants) hei ārai i te toto totoka.
- Ka mauhia ngā tōkena pēhi motuhake hei ārai i te toto totoka i roto i ngā waewae.
- Tērā pea ka honoa koe ki tētahi mīhini hei āwhina i a koe ki te manawa.
- Ka hoatu ngā rongoā whakamamae hei whakaiti i te mamae.
Me tīmata mārire te hikoi, kia hoki mai ai tō kaha. Engari me mārire te mahi i ngā mea katoa, kia rite ki ngā tohutohu a te tākuta. Nā te mea kāore e taea e koe te taraiwa i tētahi motuka i te huarahi ki te kāinga, he mea nui kia whai hoa haere koe.
Ngā painga, ngā mōrearea, me te wā whakaora o tēnei pokanga
| Wāhanga | Whakaahuatanga |
|---|---|
| Ngā Painga | Mā te pokanga kua whakaritea ka ārai i te pahūtanga, te pakaru rānei o te aneurysm. Mā te pokanga ohorere ka taea te whakaora i te ora. |
| Ngā Tūponotanga | Pērā i ngā pokanga nui katoa, kei reira ngā mōrearea, pērā i te toto, te toto totoka, te mate pāwera, te mate manawa, te whiu, me te ngoikore o te whatukuhu. He nui ake te mōrearea mō te hunga whai mate hauora kino kē atu. Ka matapakihia e tō tākuta ō mōrearea takitahi. |
| Angitu me te roa o te ora | E 95% - 98% te angitu o ngā pokanga kua whakaritea (whiriwhiri). Ka taea e ēnei tāngata te tumanako ka ora rātou i te roanga o te oranga rite tonu ki te taupori whānui. Heoi, he iti iho te angitu o ngā pokanga ohorere. Nō reira, he mea tino nui te kitenga wawe me te maimoatanga. |
| Te wā whakaora | E 4-6 wiki, e 4-6 marama rānei te roa hei whakaora katoa. I muri i te putanga mai i te hōhipera, ka taea e koe te whakahoki wawe mai i te kaha mā te whai wāhi atu ki tētahi kaupapa whakaora ngākau. |
Ngā mea hei whai i te wā whakaora
- Kaua e taraiwa: Kaua e taraiwa kia whakaaetia rā anō koe e tō tākuta.
- Kaua e hiki i ngā mea taumaha: Kaua e hiki i ngā mea taumaha neke atu i te 10 pauna (4.5 kg) mō ngā wiki 4-6.
- Whakakorikori Tinana: Kaua e whakakorikori tinana taumaha e pōrearea ai tō manawa. Pātai atu ki tō tākuta he aha te whakakorikori tinana e tika ana māu.
- Te Tiaki i te Tapahi: Kia ma te tapahi. Tirohia i ia rā mō ngā tohu whero, pupuhi, pupuhi rānei. Mā te pupuri i te urunga ki tō uma i te wā e maremare ana, e tihe ana rānei, ka āwhina i te whakaiti i te mamae.
Me whakarerekē taku āhua noho i muri i te pokanga?
Āe. He mea tino nui kia hurihia te āhua noho hei whakaiti i te mōrearea o te mate ngakau ā muri ake nei.
- Kai i ngā kai hauora mō te ngākau: whakaitihia te tote (konutai).
- Whakakorikori Tinana: Pātai atu ki tō tākuta mō ngā whakakorikori tinana e tika ana māu.
- Ki te kaipaipa koe, kati tonu: Ka pā kino te kaipaipa ki ō uaua toto.
- Whakahaerehia te toto toto tiketike, te cholesterol me te mate huka.
Āhea ahau me toro atu ki te tākuta?
Kia aro ki tō tinana i a koe e ora ana. Mena kei a koe ētahi o ngā tohu e whai ake nei, waea atu ki tō tākuta tonu.
| Ngā āhuatanga hei tirotiro māu | |
|---|---|
| Ngā raruraru tapahi | |
| - Te whero, te mamae, te mahana, te pupuhi rānei. - He toto, he wai mārama rānei e turuturu ana mā roto i te takai. - He turuturu wai kakariki, he turuturu kōwhai rānei. - Te wehenga taha i te ara tapahi. | |
| Ētahi atu raruraru nui | |
| - Te mamae o te uma, te poto rānei o te manawa ahakoa e okioki ana. - Te pupuhi o ngā waewae, te kore rānei e taea te neke. - Te whanoke, te hemo o te kiri, te ngenge rawa rānei. - Te maremare toto, te hūpē kōwhai/kākāriki rānei. - Te makariri, te kirika rānei. - Te toto i roto i te tūtae. |
He mea noa te maha o ngā pātai i mua i te pokanga pēnei. Kōrerohia ki tō tākuta mō ēnei pātai katoa. Ina tūtohu te tākuta i tēnei pokanga, e kī ana rātou he nui ake ngā mōrearea o te kore pokanga i te pokanga. Ko te hunga e ora ana i ngā pokanga kua whakaritea ka noho tonu ki te oranga noa. Nō reira, me te tīma hauora tika me te tiaki tika, ka taea e koe te ora wawe me te hoki ki tō oranga noa.
Karere Tangohia ki te Kāinga
- Ko te Ascending Aortic Aneurysm he pupuhi o te aorta o te ngākau. He mate kino tēnei e hiahia ana kia aro turukihia.
- He tino teitei te angitu o te pokanga whiriwhiri. Nō reira, kaua e whakaroa te pokanga mēnā he mōrearea.
- Ki te pāngia koe e te mamae ohorere, nui o te uma, o te tuara rānei, he tohu pea tēnei nō te pakaru o te aneurysm. Haere tonu ki te Tari Ohotata (ETU) o te hōhipera.
- He roa te wā e ora ai i muri i te pokanga. Me whai i ngā tohutohu a tō tākuta.
- He mea tino nui te whai i tētahi momo noho hauora mō te ngākau i muri i te pokanga mō tō hauora mō te wā roa.
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