Ko te pūnaha parepare o tō tinana, te pūnaha ārai mate, he rite ki tētahi ope taua e tiaki ana i tētahi whenua. Ko te mahi a tēnei ope taua he tautuhi me te whakaeke i ngā hoariri pērā i ngā iroriki me ngā huaketo e puta mai ana i waho, me te whakaora i a tātou i ngā mate. Engari, whakaarohia he aha te momo whakangaromanga ka puta mēnā ka hē te haere o tēnei ope taua, ka tīmata ki te whakaeke i ngā tāngata pai o tō tātou ake whenua, me te whakaaro he hoariri rātou? Koinei te mea e tupu ana i roto i tētahi mate e kiia nei ko te Autoimmune Pancreatitis (AIP). I konei, ka whakaaro hē tō tātou ake pūnaha parepare he hoariri tō tātou ake repe taiaki, ā, ka tīmata ki te whakaeke i a ia.
He aha te tikanga o te Autoimmune Pancreatitis (AIP)?
He āhua onge tēnei. E ai ki tā mātou i kōrero ai i mua ake nei, ka whakaekea e tō tātou pūnaha ārai mate tō tātou repe taiaki, ka puta ai te mumura mau tonu, te pancreatitis rānei. Mēnā ka puta tēnei kino i roto i te wā, ka tīmata te puta o ngā raruraru nui. He maha ngā wā, kāore pea tātou e kite i tētahi tohu tae noa ki te puta he kino nui.
He uaua pea te tautuhi i tēnei mate. Nā te mea he mate onge tēnei, kāore i te kitea tonu ngā tohu, ā, ahakoa i runga i ngā matawai, ka rite tonu ki ētahi atu mate, inā koa te mate pukupuku repeure . He mea whakamataku tēnei mō te tini o te tangata. Engari ko te mea pai rawa atu, ina kitea tō mate, ā, ka tīmata te maimoatanga tika, ka tere te ora .
E rua ngā momo matua o te Pancreatitis Autoimmune (AIP):
E rua ngā momo matua o tēnei mate. He rerekē te āhua o te pānga ki ō tātou tinana. Me titiro tātou ki te aha rātou.
| Āhuatanga | Momo 1 (Momo 1 AIP) | Momo 2 (Momo 2 AIP) |
|---|---|---|
| Ētahi atu ingoa | E mōhiotia ana hoki ko te mate e pā ana ki te IgG4. | E mōhiotia ana hoki ko te pancreatitis mau tonu e aro ana ki ngā awaawa kore-pūnaha (IDCP). |
| Ngā whekau e pāngia ana | Haunga te repe taiaki, ka pāngia anō hoki ētahi atu okana pēnei i ngā awaawa au, ngā whatukuhu, te ate, ngā pukahukahu, me ngā repe huware. | He maha ngā wā ka pā ki te repe taiaki anake . |
| Ngā whakamātautau toto | Ka piki ake te taumata o ngā paturopi IgG4 i roto i te toto. | Kāore ngā taumata IgG4 e piki ake i te nuinga o te wā. |
| Te pakeke tino noa | I muri i te 60 tau te pakeke te nuinga. He nui ake te kitea i roto i ngā tāne. | Ka puta i te wā taitamariki . He ōrite te pānga ki ngā ira e rua. |
| Ētahi atu mate e pā ana | Tērā pea ka hono atu ki ētahi atu mate pūnaha ārai mate. | Tata ki te 30% o ngā tūroro ka pāngia pea e te mate e kiia nei ko te mate puku mumura (IBD) . |
| Hoki anō | He nui te tūponotanga ka hoki mai anō ngā tohu i muri i te whakamutua o te maimoatanga. | He iti te tūponotanga o te hokinga mai o ngā tohu. |
He kōrero anō mō te Momo 1 AIP...
He whakarāpopototanga noa iho tēnei, he wāhanga tēnei o tētahi rōpū nui ake o ngā mate e kiia nei ko ngā mate e pā ana ki te IgG4. Ko te IgG4 he momo paturopi e hangaia ana e tō tātou tinana. I roto i tēnei mate, ka honoa te IgG4 me ngā pūtau ārai mate e kiia nei ko ngā pūtau plasma ki te haere i roto i ngā kiko o te repeure, ka puta te mumura me te whara.
He kōrero anō mō te AIP Momo 2...
I tēnei momo, kāore ngā taumata IgG4 e piki ake. Ā, kāore ētahi atu okana e pāngia. Heoi, ka taea e ēnei tāngata te whakawhanake i ētahi wā o te pancreatitis whakapeka. Arā, ka mumura ohorere te repe taiaki, ka puta ngā tohu, kātahi ka memeha haere i muri i ētahi rā.
He aha ngā tohu o tēnei mate?
Ahakoa kāore pea he tohu mō te wā roa, ko te tohu tuatahi e kitea pinepine ana ko te jaundice kore mamae . He tohu tino nui tēnei. Tērā pea ka pāngia ētahi tāngata e te mamae i te puku o runga, i te tuara rānei. Nā te mea kei waenganui i te puku me te tuaiwi te repe taiaki.
Whakaarohia, kei reira tētahi tangata e 65 tau te pakeke. Kātahi ka kōwhai ōna kanohi, ka kōwhai tōna tinana. Kua ngaro tōna taumaha. Engari kāore he mamae nui i roto i tōna puku. Ka mataku te tangata ki te kite i tētahi mea pēnei. I tana haerenga ki te tākuta me te mahi i ngā whakamātautau maha, ka kitea e ia ehara tēnei i te mate pukupuku, engari he mate pāwera ā-tinana.
Hei tāpiri, ka taea hoki e koe te kite i ēnei tohu:
- Te mimi pouri me ngā tūtae mā (ka memeha haere ki te mā)
- Ngenge
- Te koretake o te kai
- Te ngaronga o te hiahia kai me te mate taimaha
- Whakapairuaki me te ruaki
He aha i puta ai tēnei mate? He aha ngā āhuatanga mōrearea?
Ina hoki, kāore anō kia taea e ngā kaipūtaiao te kī 100% he aha i puta ai ēnei mate ārai mate. E whakapono ana rātou he huinga o ngā ira me ngā āhuatanga taiao . Hei tauira, ina pāngia tō tātou tinana e te mate kino, ka kaha rawa te mahi a tō tātou pūnaha ārai mate ki te whawhai atu. I ētahi wā, i muri i te mutunga o te whawhai, ka wareware te pūnaha ki te marino me te tīmata ki te whakaeke i ōna ake pūtau.
Waihoki, ko te tangata kua pāngia e tētahi atu mate pūnaha ārai mate, he iti ake te tūponotanga ka pāngia e te AIP. Hei tauira:
- Te mate a Hashimoto (he mate e pā ana ki te repe tairoi)
- Te mumura o te whekau nui (ulcerative colitis)
- te rumatiki
- Te mate a Sjögren (he mate e maroke ai ngā repe huware me ngā repe roimata)
He aha ngā raruraru pea ka pā mai i tēnei mate?
Ka taea e te mumura roa te kino ki ō tātou whekau. Ka hua ake tēnei i te hanganga o te kiko whara. Ka taea e tēnei whara te whakararu i te mahi a te repe taiaki. Kātahi ka mutu te hanga o te tinana i ngā homoni me ngā whākōkī e hiahiatia ana, ka hua ake ai ngā raruraru nakunaku me te mate huka.
E rua ngā raruraru matua ka kitea:
1. Te whakawhāititanga o te biliary: Ko ngā awaawa biliary e kawe ana i te au, he wai e puta ana i roto i tō tātou ate, ki ngā whekau ka haere mā te pancreas. Ina mumura, ina whara rānei te pancreas, ka āraihia ēnei awaawa. Kātahi ka kohia te au i roto i te tinana, ka puta te jaundice.
2. Te mōrearea o te mate pukupuku repeure: Koinei te mea e wehingia ana e te tini tāngata. Ehara te mate pukupuku autoimmune i te mate pukupuku. Heoi, he iti noa te mōrearea o te tangata e pangia ana e te mate pukupuku repeure mau tonu (tata ki te 1% - 2%) ki te whakawhanake i te mate pukupuku repeure. Nā te mea he rite ngā tohu o ngā mate e rua, he mea nui kia wehewehea ngā mea e rua. Koia te take ka tirotirohia tēnei e tō tākuta.
Me pēhea te tautuhi tika a ngā tākuta i tēnei mate?
He rite tēnei ki tētahi kōrero tirotiro. Kāore e taea e te whakamātautau kotahi te whakaū i te mate. Me whakakore hoki i ētahi atu mate, inā koa te mate pukupuku. Koia te take ka whakahaerehia e te tākuta ētahi whakamātautau.
| Tikanga whakamātautau | He aha te mea e mahia ana? |
|---|---|
| Ngā whakamātautau toto | Ka tirohia ngā taumata o te paturopi IgG4, te taumata o te whākōkī ate me te repeure. Ka taea hoki te whakamātautau i ngā mea pēnei i ngā tohu mate pukupuku hei kite mēnā he mate pukupuku. |
| Ngā whakamātautau whakaahua | Mā ngā karapa MRI, CT rānei ka kitea te pupuhi, te whara rānei i roto i te repeure me ētahi atu okana. Mā te karapa MRI motuhake e kīia nei ko te MRCP ka tirohia ngā awaawa ate me te pūnaha awaawa repeure. |
| Te koiora | Ko te Ultrasound Endoscopic, he tikanga e tangohia ai he wahi iti o te kiko mai i te repe taiaki mā te whakamahi i te endoscope ka tirohia i raro i te karuārai, he 100% te tika mō te tautuhi i te mate. |
| Whakamātautau maimoatanga | I ētahi wā, ka tīmata te tākuta i te rongoā e whakamahia ana mō te AIP (corticosteroids) ka tirohia mēnā ka pai ake ngā tohu. Mēnā ka tere te pai ake o ngā tohu, he taunakitanga anō tēnā hei tautoko i te tautuhi mate. |
He aha ngā maimoatanga?
Ko te rongoā matua me te tino whai hua mō te pancreatitis autoimmune ko tētahi momo rongoā e kiia nei ko te corticosteroids . Ko te Prednisone te rongoā e whakamahia whānuitia ana. Ka mahi ēnei rongoā mā te whakamarie i tō tātou pūnaha ārai mate e kaha rawa ana te mahi, me te whakaiti i te mumura.
Ko te tikanga ka tīmata te maimoatanga me te horopeta nui o te rongoā . I te whakapai ake o ō tohu me ngā hua o te whakamātautau, ka whakaiti haeretia e tō tākuta te horopeta. I ētahi wā, i muri i tō whakamutu i te tango i ngā steroids, ka hoatu pea ki a koe ētahi atu rongoā ārai mate hei āwhina i te whakahaere i te mate.
Mena he raruraru kei te pā mai, pērā i te aukati i te awaawa o te ate, me rongoā motuhake tēnei. Hei tauira, ka taea te whakatakoto i tētahi stent hei whakatuwhera i te awaawa kua aukatia. He tino onge pea te hiahia ki te pokanga.
Ka pēhea rā te āhua o te oranga me tēnei mate?
Ko te rongo pai, he mate tino ngāwari te rongoā i te pancreatitis ā-pūnaha. Ka kite koe i te whakapainga nui o ō tohu i roto i ētahi wiki i muri i te tīmatanga o te maimoatanga steroid. He maha ngā tāngata ka taea te whakamutu katoa i te tango i te rongoā i roto i te wā.
Heoi, i ētahi wā (ina koa i roto i te Momo 1 AIP) ka hoki mai ngā tohu (ka hoki anō) i muri i te whakamutu i te maimoatanga. I roto i ēnei āhuatanga, me haere tonu pea koe ki te tango i te rongoā i te horopeta iti iho. Ka haere tonu tāu tākuta ki te aroturuki i tō āhua me te whakawhanake i tētahi mahere maimoatanga e pai ana mōu.
He mate āhua huna pea tēnei. Ka kore pea e kitea ngā tohu mō ngā tau, ā, ina puta mai ngā tohu, ka pōhēhē pea. Nō reira, ka roa pea te wā ki te tautuhi tika i te mate. Heoi, kia mahara he tino whai hua ngā maimoatanga mō tēnei mate, ā, mā te maimoatanga, ka tere te ora. Mā tēnā ka nui te kaha e homai ki a koe.
Karere Tangohia ki te Kāinga
- Ko te mate pāwera ā-tinana (AIP) he mate e pā mai ana i te whakaekenga a tō tātou ake pūnaha ārai mate i tō tātou repeure.
- Ko te kiri māwhero kore mamae me te mate taumaha kāore i te mārama te take pea koinei ngā tohu matua.
- Ahakoa te āhua rite ki te mate pukupuku repeure i runga i ngā matawai, ehara te AIP i te mate pukupuku. He mea nui kia wehewehea ngā mea e rua mā te whakamātautau tika.
- He tino pai te urupare a tēnei mate ki te rongoā corticosteroids, ā, ka taea te whakaora wawe.
- Ki te pā mai ēnei tohu ki a koe, kaua e mataku , me toro atu ki tō tākuta i te wā e taea ai, kia whiwhi tohutohu ai.
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