Kei te nui haere tō puku me te mea kua kī tonu i te wai? Me kōrero tātou mō tēnei pupuhi puku (ascites)

Kua rongo koe i te ahua o tō puku e nui haere ana, pērā i te poihau wai, ā, e ahua ana kei te piki haere tō taumaha? Ahakoa ngā kākahu e mau ana koe ka tīmata te piri... Ehara tēnei i te pupuhi noa iho. Ka taea e tēnei mate te kino. I roto i ngā kupu hauora, ka kiia tēnei he ascites, he ascites rānei. I tēnei rā, ka kōrerohia tēnei mea me te tino māmā, i roto i te huarahi e mārama ai koe.

He aha tēnei wai o te puku (ascites)?

I te whakarapopototanga, ko te ascites te kohikohinga o te wai nui, pērā i te wai, i roto i tō puku, arā, i roto i tō kōhao puku. Tērā pea kei te whakaaro koe me pēhea te urunga o te wai ki roto i tō puku.

Whakaarohia, he kiriuhi angiangi rawa e kiia nei ko te "peritoneum" e karapoti ana i ngā whekau nui o roto i tō tātou puku pērā i te ate, ngā whekau, me ngā whatukuhu. He rite ki te pepa kirihou e takai ana i ngā huawhenua. E rua ngā paparanga. I te nuinga o te wā, he iti noa te wai i waenganui i ēnei paparanga e rua hei ārai i te tukinga o ngā whekau ina neke haere. Engari i roto i te take o te ascites, ka kī te wāhi i waenganui i ēnei paparanga e rua i te nui rawa o te wai. Kātahi ka pupuhi te puku, ā, me te mea kua horomia he merengi, he poitūkohu rānei. Nā tēnei ka tino uaua te hikoi, te noho rānei.

He aha tēnei i puta ai? He aha ngā take matua?

Ko te tino take o te ascites i te ao ko te cirrhosis o te ate . Ko te cirrhosis he mate e pakaru ana, e whara ana hoki te ate nā ngā momo take, inā koa ko te waipiro, ētahi mate huaketo (Hepatitis B, C), me te ate momona. Ka mārō haere te ate, ka rite ki te toka, ā, kāore e taea te mahi tika.

Nā, kia titiro tātou me pēhea te pupuri wai i roto i te puku e te mate ate.

He oko toto matua kei reira e kawe ana i te toto kei roto ngā matūkai mai i ō tātou whekau ki te ate. Ko te Utauta Pouaka tēnei e kiia ana ko te Utauta Pouaka. Ina pakari te ate nā te mate ate, ka āraia tēnei oko toto ki te kawe tika i te toto. Kātahi ka tino piki te toto i roto i tēnei oko toto. E kiia ana tēnei ko te Toto Nui Pouaka .

Ka tukuna e tēnei pēhanga teitei te tohu hē ki ngā whatukuhu, e whakaaro ana me nui te tote (konutai) me te wai e te tinana, ā, hei utu mō te pana atu, ka tīmata te pupuri i aua tote. I roto i te wā, ka tīmata te turuturu o te tote me te wai tāpiri e kohia ana i tēnei ara mai i ngā oko toto ki roto i te kōhao puku nā te pēhanga teitei. Koinei te whanaketanga o te ascites.

Haunga te cirrhosis, tera atu anō ngā take o te ascites.

He aha ngā tohu o te ascites? Me pēhea te mōhio ki tēnei?

He maha ngā tohu ka taea e te tangata whai mate pēnei te rongo me te kite tonu.

• Te pupuhi o te puku me te tere o te piki o te taumaha: Koinei te tohu matua. Tērā pea ka piki ake tō taumaha ki te kotahi, ki te rua rānei kirokaramu i roto i te wā poto, arā, e toru rā pea.
• Te pupuhi o ngā waewae: He pupuhi, inā koa i te pona waewae. Ka kiia tēnei ko (Edema).
• Te uaua ki te manawa: Ina kī te puku i te wai, ka pana ake ki runga i te uma. Nā tēnei ka uaua ki te pupuhi tika i ngā pukahukahu. Tērā pea ka pāngia koe e te whewhe, ka uaua hoki ki te manawa ahakoa e hikoi ana, e piki arawhata ana rānei.
• Ngā raruraru o te pūnaha nakunaku: Tērā pea ka pupuhi, ka mamae te puku, ka ngaro te hiahia kai, me te mate pāwera nā te mea ka kī te puku i te wai, ā, ka pēhi i ngā whekau.
• Mamae tuara: Ka taea e te taumaha tāpiri i roto i te puku te pēhi i te tuara, ka mamae hoki te tuara.
• Ngenge: Tērā pea ka ngenge tonu koe nā te mamae o te tinana me ngā āhuatanga hauora o raro.

He aha ngā raruraru ka puta mai i tēnei āhuatanga?

Ehara i te mea he mate puku nui noa te ascites. Ki te kore e rongoatia tika, ka arahi pea ki ngā raruraru nui.

• Ngā Mate Pukupuku: He nui te tūponotanga ka uru ngā iroriki ki roto i te wai kua kohia i roto i te puku, ā, ka puta he mate. Ka kiia tēnei ko te (Spontaneous Bacterial Peritonitis). Kātahi ka pāngia koe e te kirika me te mamae nui o te puku. He āhuatanga ohorere tēnei, ā, ka mate pea koe.
• Te Mate Pukupuku o te Ati: I ētahi wā, ka turuturu te wai mai i te puku ki roto i te uma ka kohi ki te taha o ngā pukahukahu, ka uaua ake te manawa.
• Hernia: I te pikinga o te pēhanga i roto i te puku, ka puta ngā whekau mā roto i ngā wāhi ngoikore o te puku (hei tauira, te pito). Ka kiia tēnei he hernia.
• Te ngoikore o te whatukuhu: Ina kino te cirrhosis o te ate, ka pāngia hoki te mahi a ngā whatukuhu, ā, ka arahi atu hoki ki te ngoikore o te whatukuhu.

Me pēhea te kitenga a te tākuta i tēnei?

Mena kei a koe ēnei tohu, ina kite koe i te tākuta, ka mahi ia i ētahi mahi hei whakaū i te mate.

1. Whakamātautau tinana: Tuatahi, ka tirohia koe e tō tākuta. Ka whāwhā rātou i tō puku, ka tirohia mēnā he wai kei roto. Ka tirohia hoki mēnā he pupuhi kei roto i tō ate me ō waewae.

2. Ngā whakamātautau toto: Ka mahia ētahi whakamātautau toto hei tirotiro i te mahi a te ate me ngā whatukuhu me te nui o te tote i roto i te toto.

3. Ngā Matawai: Ka taea te mahi i te matawai ultrasound , i te matawai CT rānei hei tirotiro i te nui o te wai i roto i te puku, te āhua o te ate, me te mea he raruraru kē atu.

4. Paracentesis: He whakamātautau tino nui tēnei. I roto i tēnei, ka whakangāwarihia te kiri o te puku, ka werohia he ngira iti ki roto i te puku, ā, ka tangohia he tauira o te wai kua kohia, ka tukuna ki te taiwhanga. Ka āwhina tēnei ki te whakatau mēnā he mate pukupuku, he mate pāwera rānei te take.

He aha ngā maimoatanga mō te ascites?

E rua ngā whāinga matua o te maimoatanga. Ko tētahi he whakaiti i te nui o te wai kua kohia i roto i te puku, ā, ko tētahi he rongoā i te mate pūtake i puta ai te ascites.

Te maimoatanga tuatahi

Ka whakamātau tuatahi ngā tākuta i ēnei tikanga.

• Te whakahaere i te tote (konutai): Koinei te maimoatanga tino nui, tino tuatahi hoki.Ko te tote te tino take o te pupuri wai i roto i te tinana. Nō reira, he mea tika kia whakaitihia te nui o te tote e kainga ana i ia rā ki raro iho i te 2000 mirikaramu. Ko te tikanga me whakaiti te nui o te tote e tāpirihia ana ki tāu kai, ā, me mutu rawa te kai i ngā kai he nui te tote huna, pērā i te ika maroke, te pīkara, te ranu, te pīkara, te hōtiti, me ngā hupa i hokona mai i te toa.
• Ngā rongoā whakaheke toto (ngā "pire wai" rānei): He maha ngā wā ka tohua e mātou ngā rongoā e kiia nei ko ngā "diuretics" hei āwhina i te tinana ki te tango i te wai me te tote nui mā te mimi.

Ngā tikanga maimoatanga matatau

I ētahi wā, ahakoa te whakahaere i te nui o te tote me te tango pire wai, kāore pea e whakaiti i te nui o te wai i roto i te puku. I ēnei āhuatanga, me whakamahi pea ētahi atu maimoatanga.

• Paracentesis: He whakamātautau, he maimoatanga hoki tēnei. Ka taea te tango i te nui o te wai (i ētahi wā tae atu ki te 5-10 rita) i roto i te puku mā te ngira. Mā tēnei ka tere te whakaora. Ka taea tēnei te mahi anō mēnā e tika ana.
• Te Transjugular Intrahepatic Portosystemic Shunt (TIPS): He maimoatanga uaua ake tēnei. Ko te hanga i tētahi ara hou (shunt) kia rere ai te toto i roto i te ate. He rite ki te ara whakawhiti hei karo i te waka. Ka whakaitihia te pēhanga ki runga i te ate, ā, ka whakahaere i te kohikohinga wai. E taunakihia ana mō te hunga kāore e taea te whakahaere i te ate mā ētahi atu maimoatanga.
• Te Whakatō Ate: Mō te hunga he tino kino te mate cirrhosis, me te hunga kāore anō kia aro ki ētahi atu maimoatanga, ko te whakato ate pea te otinga anake.

Āhea ahau me toro atu ki te tākuta?

Me tino tupato koe ki ēnei mea.

He aha taku e taea ai te ārai me te whakahaere i tēnei āhuatanga?

Ko te huarahi pai hei ārai i te ascites ko te tiaki i tō ate.

• Kaua e inu waipiro: Me mutu rawa te inu waipiro. Ko te waipiro te mea matua e kino ai te ate.
• Kaua e kai nui rawa i te tote: E ai ki tā tātou i kōrero ai i mua ake nei, he mea nui te karo i te nui rawa o te tote hei whakahaere i te ascites.
• Kia mau ki te taumaha hauora: Mā te whakahaere i te taumaha tinana ka ārai i te ate momona.
• Whakakorikori Tinana: He mea nui kia mahi i ētahi mahi whakakorikori tinana i ia rā.
• Tiakina koe mai i te Hepatitis B me te C: He huaketo ēnei e kino ai te ate. He kano ārai mate mō te Hepatitis B. Ka taea e koe te tiaki i a koe mai i ēnei mā te whai i ngā tikanga haumaru.

Mena kei a koe te ascites, me mahi ēnei mea.

• Paunatia koe i ia rā: Paunatia koe i ia ata i te wā kotahi, kaua e kakahuria, kaua hoki e mau i ngā kākahu kotahi, ka tuhituhi ki roto i tētahi pukapuka. Mēnā ka nui ake tō taumaha i te kotahi kirokaramu i ia rā mō ngā rā e toru karapīpiti, me kōrero ki tō tākuta.
• Kia tūpato ki ngā rongoā whakamamae mamae: Kaua e whakamahi i ngā rongoā anti-inflammatory kore-steroidal (NSAID), pērā i te ibuprofen, te diclofenac, me te aspirin, nā te mea ka piki ake te pupuri wai me te tote i roto i te tinana. Mena me tango rongoā koe mō tētahi mamae, pātai atu ki tō tākuta.