Kua rongo koe i te ahua pupuhi noa iho tō puku, he tino taumaha, ā, kua pēhia ō kākahu? Tērā pea kua piki ake tō taumaha tinana mā te kotahi, e rua rānei kirokaramu i roto i ētahi rā. Ehara tēnei i te pikinga noa, engari he āhuatanga pea tēnei e kiia nei ko te 'ascites', arā, he āhuatanga e kī ana te puku i te wai. He maha ngā wā ka puta mai tēnei hei tohu mō tētahi atu mate kino o roto i tō tātou tinana. Nō reira, me kōrero noa tātou mō tēnei i tēnei rā.
He aha tonu te Ascites?
Ki te kī māmā noa, ko te ascites te kohikohinga o te wai nui i roto i tō puku. Ka taea tēnei te tupu mārire, ka taea rānei te tupu katoa i te wā kotahi.
Whakaarohia, he kiriuhi angiangi kei te taha o ngā whekau o roto i tō tātou puku, pērā i te puku, ngā whekau, te ate, me ngā whatukuhu. Ka kiia tēnei ko te peritoneum. E rua ngā paparanga. I te nuinga o te wā, he iti noa te wai i waenganui i ēnei paparanga e rua, kia taea ai e ngā whekau te neke ngāwari me te kore e tukinga tetahi ki tetahi. Engari i roto i te take o te ascites, ka kohia he nui te wai rerekē i waenganui i ēnei paparanga e rua. Koinā te wā ka nui haere te puku, ā, ka rite ki te mea he pōro wai kei roto i te puku.
Tirohia mēnā kei a koe ēnei āhuatanga anō hoki.
Ko ngā tohu matua o te ascites ko te pikinga ohorere o te rahi o te puku me te pikinga ohorere o te taumaha o te tinana i roto i ngā rā e rua ki te toru. Tērā pea ka pupuhi ngā waewae o ētahi tāngata (edema).
| Tohu | Whakaahuatanga |
|---|---|
| Te uaua ki te manawa | I te nui haere o te wai i roto i tō puku, ka pēhi i ō pukahukahu, ka uaua ai te manawa. |
| He uaua ki te neke haere me te noho ki raro | Ka pāngia te tinana e te kore whakamarie i te tipu o te puku. Ka uaua te mahi i ngā mea pēnei i te noho, te hikoi, me te piko. |
| Ngā raruraru nakunaku | Tērā pea ka pupuhi, ka mamae te puku, ka ngaro te hiahia kai, me te mate kōroke. |
| Mamae tuara | Ka taea e te taumaha kua piki ake i roto i te puku te tāpiri i te pēhanga ki runga i te tuara, me te mamae hoki o te tuara. |
| Te ngenge | Tērā pea ka ngenge tonu koe nā te mamae tinana me te mate. |
He aha te take e kī ana tōku puku i te wai? He aha ngā take matua?
Ko te tino take o te ascites ko te cirrhosis o te ate . Ko te tikanga o tēnei ka whakangaromia ngā pūtau ate, ka whakakapia ki ngā kiko muka (ngā koha) e kore ai e mahi tika te ate. Engari ehara i te mea koinei anake te take.
Tērā pea ētahi atu take:
- Te ngoikore o te ngākau
- Te ngoikore o te whatukuhu
- Ngā mate pukupuku o ngā whekau puku me te pelvis
- Te mate kohi
- He tino onge, ko te mate tākihi e kiia nei ko te nephrotic syndrome te take.
Me pēhea te whanaketanga o te ascites i te cirrhosis o te ate?
Me whakamārama tēnei. Whakaarohia he uaua matua e kawe ana i te toto mā roto i tō tātou ate, e kiia nei ko te uaua portal. Ina pāngia te ate e te cirrhosis, arā, ina whara te ate, ka āraia ēnei uaua toto. Kātahi ka tino piki te toto i roto i tēnei uaua. I roto i te rongoā, e kiia ana tēnei ko te portal hypertension .
Ina piki ake tēnei pēhanga, ka whiwhi ā tātou whatukuhu i te tohu hē hei pupuri i te tote (konutai) me te wai i roto i te tinana. I roto i te wā, ko te tote me te wai e puritia ana i tēnei ara, nā taua pēhanga kua piki ake, ka tīmata te turuturu mai i ngā oko toto ka kohia ki roto i te kōhao puku. Koinei te āhua o te kī o te puku i te wai.
Ko wai kei te nui ake te mōrearea ki te whakawhanake i te ascites?
Ko te tangata kua pāngia e te kino o te ate, ka arahi pea ki te cirrhosis, ka nui ake te tūponotanga ki te whakawhanake i te ascites. Ko ēnei āhuatanga ko:
- Ngā mate e pā ana ki te ate momona (Metabolic dysfunction-associated steatohepatitis - MASH)
- Te mate whakamahi waipiro
- Ngā mate urutā Hepatitis B me te Hepatitis C
- Ngā mate e whakaekea ai te ate e te pūnaha ārai mate o te tinana (Autoimmune hepatitis)
- Ngā mate ate ira pēnei i te hemochromatosis me te mate a Wilson
He aha ngā raruraru ka pā mai i te ascites?
Ehara i te pupuhi puku anake te ascites. Ka taea hoki e ia te whakararu i ētahi atu raruraru hauora nui.
He tohu nui te ascites e whakaatu ana kāore te ate e mahi tika ana, nō reira kaua e warewarehia.
| Pānga taha | Whakaahuatanga |
|---|---|
| Te mamae tonu o te puku | Mā te mamae, te kore whakamarie, me te uaua ki te manawa e hua mai ana i te wai i roto i te puku ka uaua ai te mahi i ngā mahi o ia rā pēnei i te kai me te hikoi. |
| Ngā mate urutā | Ka pangia pea te wai e kohia ana i roto i te puku e ngā huakita. Ka kiia tēnei ko te peritonitis. Ka puta te kirika me te mamae nui o te puku. Tērā pea me werohia he paturopi IV. |
| He wai e karapoti ana i ngā pukahukahu (Hepatic hydrothorax) | Ka turuturu pea te wai i roto i te puku ki roto i te uma, ka kohia ki te taha o ngā pukahukahu. Ka uaua pea te manawa, ka maremare, ka iti hoki te hāora i roto i te toto (hypoxemia). |
| Hernia | Nā te pikinga o te pēhanga i roto i te puku, ka puta mai ngā mea pēnei i ngā whekau mā roto i ngā wāhi ngoikore o te puku. Ka kiia tēnei he hernia. |
| Te ngoikore o te whatukuhu | Ina kino haere te cirrhosis o te ate, ka pāngia hoki te mahi a te whatukuhu, ā, ka arahi atu hoki ki te ngoikore o te whatukuhu. |
Me pēhea te kitenga a te tākuta i tēnei?
Ina haere koe ki te tākuta, ka pātai tuatahi ia ki a koe mō ō tohumate, ā, ka tirotirohia hoki tō puku. Ka taea e koe te whakatau tata mēnā he wai kei roto i te puku mā te patopato ki tō maihao.
Hei whakaū i te āhua tika, ka taea te whakahaere i ngā whakamātautau e whai ake nei:
- Matawai Ultrasound, Matawai CT rānei: Ka taea e ēnei momo matawai te kite mārama i ngā mea pēnei i te nui o te wai i roto i te puku me te āhua o te ate.
- Paracentesis: Ko te werohanga o tētahi ngira angiangi rawa ki roto i te puku, me te tango i tētahi wai iti mai i te puku. Ka taea te whakamātautau i tēnei wai kia kitea ai mēnā kei roto he pūtau matepukupuku, he huakita rānei. He mea tino nui tēnei whakamātautau hei whakatau i te tino pūtake o te ascites.
He aha ngā maimoatanga mō te ascites?
Ko te whāinga matua mō te rongoā i te ascites ko te whakaiti i te nui o te wai e kohia ana i roto i te puku, me te ārai i tōna kohi anō.
Ngā tikanga maimoatanga taketake
- Te whakahaere i te tote (konutai): Ko te tohutohu tuatahi a ngā tākuta kia whakaitihia te nui o te tote e kainga ana e koe. Ka taea e koe te kī me kai koe i raro iho i te 2000 mirikaramu o te tote ia rā. Ko te tikanga me whakaiti e koe te nui o te tote e tāpirihia ana e koe ki tō kai, ā, me karo rawa i ngā kai he tote huna, pērā i ngā hua maroke, ngā pīkara, ngā ranu, ngā hōtiti, ngā kai i hokona mai i te toa, me ngā kai i tākaihia.
- Ngā rongoā whakaheke toto (ngā pire wai): Mā ēnei rongoā ka puta te wai me te tote nui i roto i te tinana i ngā whatukuhu mā te mimi.
- Te rongoā i te mate pūtake: Mena ko te mate pukupuku te pūtake o te ascites, mā te rongoā anō hoki ka whakaitihia te nui o te wai i roto i te puku.
I ētahi wā, kāore pea tēnei maimoatanga e ranea...
He uaua ki ētahi tāngata te whakahaere i te waikawa o te puku ahakoa kua whakahaeretia te kai tote me te inu pire wai. Mēnā koinei te āhua, me whakamahi rātou i ētahi atu tikanga rongoā.
- Paracentesis: He whakamātautau, he maimoatanga hoki tēnei. Ka tangohia e tēnei tikanga he nui te wai mai i te puku mā te whakamahi i te ngira. Ahakoa he tere te whakaora i tēnei, me mahi anō pea i te mea ka taea e te wai te kohi anō.
- Tukanga TIPS (Transjugular intrahepatic portosystemic shunt): He tikanga uaua ake tēnei. Kei roto ko te hanga i tētahi ara iti (shunt) i waenganui i te uaua portal, e pēhia ana, me tētahi atu uaua e kawe ana i te toto mai i te ate. Mā tēnei ka taea e te toto te tango i tētahi ara hou mā roto i te ate, ka karo i te pupū, ka whakaiti i te pēhanga me te nui o te wai i roto i te puku.
- Te whakawhitinga ate: Mō te hunga he tino kino te mate cirrhosis o te ate, me whakawhitinga ate pea hei huarahi whakamutunga.
Āhea koe me toro atu ki te tākuta?
Mena kei a koe tētahi mate pēnei i te cirrhosis o te ate, me toro atu ki tō tākuta tonu mēnā ka pāngia koe e ēnei tohu:
- Ki te piki ohorere te taumaha o tō tinana.
- Ki te mea kei te nui haere tō puku.
- Mena he uaua ki te manawa.
Ki te puta ngā tohu e whai ake nei, haere tonu ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera, kaua e whakaroa:
- Kirika
- Mamae puku tino kino
Karere Tangohia ki te Kāinga
- Ko te ascites te kohikohinga o te wai i roto i te puku. He mate kino tēnei e puta pinepine ana i te cirrhosis, he mate ate.
- Ko ngā tohu matua ko te puku pupuhi, te taumaha ka nui, te uaua ki te manawa, me ngā waewae pupuhi.
- Ko te whakahaere i te tote me te tango i ngā rongoā whakaheke toto (ngā pire wai) ngā huarahi maimoatanga matua.
- Paunatia tō taumaha i ia rā. Mēnā ka nui ake i te kotahi kirokaramu tō taumaha i te rā mō ngā rā e toru karapīpiti, me whakamōhio atu ki tō tākuta.
- Kaua e inu waipiro rawatia. Ka kino ake te ate i tēnei.
- Āta karohia te tango i ngā rongoā mamae NSAID (hei tauira, ibuprofen, aspirin) me te kore tohutohu hauora. Ka whakanui ake ēnei i te pupuri wai me te tote i roto i te tinana.
- Ki te pāngia koe e te kirika me te mamae nui o te puku, he tohu pea tēnei nō te mate urutā. Haere tonu ki te Tari Urupare (ETU) o te hōhipera.
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