Ka pā kino te manawa i ētahi wā, kāore he take? He rite ki te pahu e pā ana i roto i tō uma, kāore he manawataki, ā, he tino whakamataku, kāore? Tērā pea ka ngenge koe, ka pōuri, ka poto hoki te manawa i tēnei āhuatanga. Ko tēnei momo pā o te manawa kāore i te tika, inā koa ko te āhuatanga e kīia nei e ngā tākuta ko te 'Atrial Fibrillation' (AFib), i ētahi wā kāore e pai te whakahaere mā te whakamahi i ngā rongoā kua tohua hei whakahaere. Koinā te wā e whakaarohia ai e ngā tākuta he maimoatanga motuhake e kīia nei ko te 'AV Node Ablation'.
He aha te tikanga o te AV Node Ablation?
Āe, he kupu uaua pea tēnei, engari kia māmā noa iho.
Tuatahi, me titiro tātou ki te pūnaha hiko o tō tātou ngākau. Whakaarohia tō ngākau he whare e whā ngā rūma. Ko ngā rūma iti e rua i runga e kiia ana ko te atria. Ko ngā rūma nui e rua i raro e kiia ana ko ngā ventricles. Kia tika ai te mahi a te ngākau, me whakawhāiti ēnei rūma i roto i te tikanga raupapa, i te āhua manawataki. Ko tēnei mahi e whakahaerehia ana e te pūnaha hiko tūturu i roto i te ngākau.
I roto i tētahi āhuatanga pēnei i te 'Atrial Fibrillation' (AFib), ka pōrearea ngā tohu hiko i roto i ngā rūma e rua o runga o te ngākau (atria), ka tere rawa te patu, ka koretake hoki. He rite ki tētahi ōkestra kāore he kaiārahi, ko ia tangata e takaro ana i tā rātou ake rangi.
I konei, i mua i te haere o ēnei tohu hiko pōrearea mai i ngā rūma o runga ki ngā rūma matua (ngā pūtau), me haere rātou mā roto i tētahi "kūaha" iti. Ko tēnei kūaha te mea e kīia nei e tātou ko te pūnga AV . He rite tēnei pūnga AV ki tētahi pirihimana waka. E ngana ana ia ki te whakahaere i te āhuatanga mā te tuku noa i tētahi iti noa o ngā tohu tere, pōrearea e puta mai ana i runga kia haere.
Engari i ētahi wā ka tino kino rawa tēnei raruraru, ā, kāore e taea e te pūnga AV te whakahaere. Koinei te wā e mahi ai ngā tākuta i te mea e kiia nei ko te `AV Node Ablation'.
Ko te tikanga o te 'Ablation' he whakakore i tētahi wāhanga o te kiko mā te whakamahi i te wera, i te makariri rawa rānei. Nō reira, ko te tikanga o te 'AV Node Ablation' he whakakore ā-tauira i te "kūaha" (te pūnga AV) e haere atu ai ngā tohu pōrearea.
Nā tēnei ka mutu rawa te rere o ngā ngaru hiko pōrearea i roto i ngā rūma i runga ki ngā rūma papu matua i raro.
He aha i tino hiahiatia ai he taputapu whakatere?
Koinei te mea tino nui me mōhio koe mō tēnei maimoatanga.
Kia kati rawatia te kuaha e tuku ana i ngā tohu mai i runga kia heke iho (te pūnga AV), kāore ngā rūma e rua (ngā pūtau) o te ngākau e whiwhi tohu hei patu. Ka mutu rānei te patu o te ngākau? Kāore. Koia te take ka whakatōngia ai e ngā tākuta he taputapu whakaterenga ngākau tūturu ki roto i a koe hei otinga.
He taputapu tēnei mīhini whakatere e whakamahi ana i tētahi pākahiko iti.Ka tukuna e ia ngā tohu hiko ki ngā rūma o raro o te ngākau kia pāorooro ai i roto i tētahi manawataki motuhake me tētahi tere motuhake. He māmā noa iho, ka monohia e tātou tētahi wāhanga o te pūnaha hiko tūturu o te ngākau e kore e mahi tika, ka whakakapia ki tētahi kaiwhakahaere hiko horihori e mahi pai ana.
Ko te mea nui ko te maimoatanga e kiia nei ko te AV Node Ablation he mea kore e taea te whakakore, ā, he pumau tonu. Ko te tikanga, i muri i te otinga, me noho koe me te taputapu pacemaker mō te toenga o tō oranga.
Mā wai tēnei maimoatanga e tūtohu?
Ehara te AV Node Ablation i te rongoā mō te katoa. He maha ngā take matua e taunaki ai te tākuta i tēnei rongoā māu:
- Mena kāore i angitu ngā rongoā katoa i hoatu hei whakahaere i tō ngakau pākiki.
- Mena kāore e taea e koe te whakamahi tonu i te rongoā nā te mea he nui ngā pānga taha .
- Mena kua tāuta kētia he taputapu whakatere manawa mō tētahi atu take.
- Mena kei te ngoikore te mahi a tō ngākau nā te mate 'AFib'.
Ka whakatauhia tēnei i muri i te tirotiro a tō tākuta ngakau i a koe.
Me pēhea te whakarite i mua i te maimoatanga?
Mena kāore anō kia whai taputapu whakateretere koe, ka whakauruhia e tō tākuta he taputapu whakateretere māu i ētahi wiki i mua i te tango i te uaua o te ngākau, i te wā kotahi e tango ana i te uaua o te ngākau, i muri rānei i tōna otinga.
Hei tāpiritanga, i mua i te mahi i te `ablation`, ka whakahaerehia e ngā tākuta he Rangahau EP (`Rangahau Hikohiko`) . Kei roto i tēnei ko te mahere i ngā ara hiko o te ngākau kia kitea ai te wāhi tika o te pūnga AV ka whakakorehia e tātou.
Me pēhea te mahi a te maimoatanga - taahiraa i te taahiraa
Kaua e wehi ki te kī he pokanga nui tēnei. Ko te AV Node Ablation he tikanga iti rawa te whakaekenga e mahia ana mā roto i tētahi kōhao iti i roto i te kiri, kāore he tapahi nui. Me titiro tātou ki te āhua o te mahi.
| Ngā Hipanga | He whakaahuatanga māmā mō ngā mea e tupu ana |
|---|---|
| 1. Te Whakarite | Ka whakanohoia he cannula iti (IV) ki roto i tētahi uaua i tō ringa, ā, ka hoatu he rongoā ki a koe hei āwhina i a koe ki te moe me te whakangā, kia kore ai koe e tino mamae. |
| 2. Te ngoikore | Ka whakangāwaritia tō hope, tō ringa, tō kaki rānei. Koinei te wāhi ka whakaurua ai te catheter. |
| 3. Te whakauru i te catheter | He tino angiangi, he roa, he ngāwari ngā katitā e kuhua ana mai i te wāhi e pāngia ana mā roto i te uaua ki te ngākau. |
| 4. Te Aroturuki | I te roanga o te maimoatanga, ka aroturukihia e ngā tākuta me ngā nēhi ngā mea pēnei i te tere o te manawa me te toto toto i runga i ngā mata rorohiko. |
| 5. Te kimi i te pūnga AV | Mā te whakamahi i ngā hihi-X me te mahere hiko o te ngākau, ka kitea e te tākuta te taunga tika o te pūngao AV. |
| 6. Te Whakakorenga (Te Whakakorenga) | Ka whakamahia e tētahi taputapu motuhake kei te pito o te catheter te wera ('radiofrequency energy') te tino makariri rānei ('cryoablation') hei whakakore i te pona AV. |
Ka roa pea tēnei tukanga katoa mai i te iti iho i te kotahi hāora ki ētahi hāora.
He aha ngā painga me ngā mōrearea?
Pērā i ngā maimoatanga hauora katoa, he iti noa ngā painga, engari he iti noa ngā mōrearea.
Ngā painga matua
- Kāore koe e hiahia ki te tango rongoā hei whakahaere i tō tere o te ngakau (engari me haere tonu pea koe ki te tango i ngā rongoā whakaiti toto).
- Ka whakaitihia ngā tohu pēnei i te whanoke, te ngenge, me te poto o te manawa, ā, ka pai ake te kounga o te oranga.
- Ka taea e koe te whai wāhi atu ki ngā mahi ā-tinana maha atu i tō mua.
- Ka whakaitihia te hiahia ki te haere ki te hōhipera, ki te haere rānei ki te Tari Whawhati Tata (ETU) i ngā wā katoa nā ngā raruraru o te ngakau.
- He tino angitu, he tino haumaru hoki tēneiHe tikanga maimoatanga.
Ngā raruraru pea (tino onge)
He onge ngā raruraru, engari he mea nui kia mōhio ki ēnei.
- Te kohikohinga wai i roto i te kiriuhi e karapoti ana i te ngākau (te rerenga wai o te ngākau).
- Ko tētahi atu momo o te manawa pāpaku koretake.
- Te ngoikore o te mahi a te ventricle maui o te ngākau (ka taea te whakatika mā te whakamahi i tētahi pacemaker motuhake).
- Te mate ohorere (he tino onge tēnei).
Mā tō tākuta ēnei mōrearea e whakamārama atu ki a koe me ngā taipitopito atu.
He aha te mea ka tupu i muri i te maimoatanga?
Kia oti te maimoatanga, ka tangohia e te tākuta ngā katitere ka pupuri i ngā wāhi whakauru mō te 15 meneti pea. Whai muri i tēnā, me takoto koe ki te moenga mō ētahi haora.
I te nuinga o te wā ka noho koe ki te hōhipera mō te pō, ā, ka hoki ki te kāinga i te aonga ake. He mea noa te ngenge me te mamae mō ngā rā e rua, e toru rānei i muri i tō hokinga ki te kāinga. Engari ka taea e koe te hoki anō ki ō mahi o ia rā i roto i ētahi rā.
Ka tonoa koe kia haere mai mō tētahi atu tirotiro hauora i te marama i muri i te whakaurunga o te pacemaker. Whai muri i tēnā, me tirotiro koe i a koe anō kotahi, e rua rānei i te tau.
Āhea te wā e kite ai i te tākuta
I muri i te maimoatanga, ki te pāngia koe e ngā tohu e whai ake nei, me whakamōhio tonu atu ki tō tākuta.
| Whai wāhitanga | Ngā āhuatanga hei tirotiro māu |
|---|---|
| Ngā tohu o te mate | Mena he mamae, he pupuhi, he whero, he kirika, he makariri rānei te wāhi i whakatōkia ai te pacemaker (tērā pea ka puta ēnei i muri i ētahi marama). |
| Ki te whakaaro koe he raruraru kei tō pacemaker | Mena ka pāngia koe e te whanoke pinepine, te ngoikore, te uaua rānei ki te manawa. |
He maimoatanga kē atu anō kei reira?
Āe. Ko tētahi atu maimoatanga e kiia ana he huarahi kē atu i te `AV Node Ablation` ko te `Pulmonary Vein Isolation` (PVI) .
Ko te tikanga o tēnei ko te kimi i ngā wāhi e tīmata ai ngā tohu hiko rerekē e puta ai te AFib (i roto i ngā uaua pūkahukahu) kātahi ka whakawetohia hei aukati. I muri i te maimoatanga PVI, kāore e hiahiatia he taputapu whakatere. Heoi, mā tō tākuta e whakatau ko tēhea o ēnei maimoatanga e rua te mea pai mōu.
Ehara i te mea ngāwari te whakatau kia tangohia te pūngao AV. Kāore e taea te whakakore. Ā, kāore ētahi tāngata e pai ki te whakaaro me noho tahi me te taputapu whakatere mō te toenga o ō rātou oranga. Heoi, e tata ana te angitu o tēnei maimoatanga ki te 100%. Ā, he tino teitei te whakamarie me te kounga o tō oranga ka puta mai i tēnei.
Nō reira, kōrerotia ō pātai me ō wehi katoa ki tō tākuta. Māna e whakamārama ngā mea katoa ki a koe, ā, māna koe e āwhina ki te whakatau i te whakatau pai rawa atu mō tō āhuatanga.
Karere Tangohia ki te Kāinga
- He maimoatanga angitu te AV Node Ablation mō ngā pāorooro o te ngakau kāore i te tika (Atrial Fibrillation) e uaua ana ki te whakahaere mā te rongoā.
- Ka aukati tūturu tēnei i ngā tohu hiko pōrearea e haere ana mai i ngā rūma o runga o te ngākau ki ngā rūma o raro.
- He maimoatanga kore e taea te whakakore i tēnei, arā, kāore e taea te whakakore ina oti.
- I muri i te tango i te pūnga AV, me mau he taputapu pacemaker pumau mō te toenga o tō oranga kia mau tonu ai te auau o te ngakau.
- He tino angitu tēnei maimoatanga, e whakaiti ana i ngā tohumate, ā, e tino whakapai ake ana i te kounga o te oranga.
- I mua i te whakatau i tētahi mea, me kōrero marie ki tō tākuta ngakau mō ngā painga, ngā huakore me ngā kōwhiringa maimoatanga.
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