Kei te kōwhai haere ō kanohi, tō kiri rānei, ā, kei te pāngia koe e te mākūkū nui, e kore e taea te whakamātau? Koinei ngā tohu o te mea e kīia nei e tātou ko te jaundice. Ka puta pinepine tēnei ina āraia ngā awaawa aukume—ngā ngongo e kawe ana i te aukume mai i tō ate hei āwhina i te nakunaku. Ina puta tēnei ārai, ka kohikohi te aukume i roto i te ate, ka kōwhai haere tō kiri me te mākūkū tonu. I roto i ēnei āhuatanga, ka whakamahia e ngā tākuta tētahi tikanga motuhake e kīia nei ko te biliary drainage. I roto i te poto, ko te whakauru i tētahi ngongo iti ki roto i te awaawa aukume kua āraia kia rere noa ai te aukume. Me matapakihia ngā mea katoa e hiahia ana koe ki te mōhio mō tēnei tikanga.
He aha te rerenga wai o te pāhare pākawa waro, ā, he aha ngā momo?
Ko te tango wai i te wai o te ate he tikanga e whakamahi ana i tētahi ngongo angiangi, ngāwari (catheter) hei karo i tētahi aukati i roto i tō awaawa wai, kia rere ai te wai mai i te ate ki roto i te whekau iti. Whakaarohia he rite ki te hanga i tētahi arai mō tētahi paipa wai kua purua.
E rua ngā huarahi matua mō tēnei. Mā tō tākuta e whakatau ko tēhea tikanga e tino tika ana mō tō āhua.
| Momo Tukanga | Whakamārama Māmā |
|---|---|
| Te Wairewa o te Puku Āpiti ā-Kiri (PTBD) | I tēnei tikanga, ka whakaurua e te tākuta he ngongo mā roto i tō kiri, ka tika ki roto i te ate kia tae atu ai ki te awaawa waikura. Mā te whakamahi i tētahi tikanga hihi-X motuhake (fluoroscopy), ka ārahi tika te tākuta i te ngongo ki te wāhi tika. Kātahi ka ringihia te waikura mā roto i te ngongo ki roto i tētahi pēke iti o waho. |
| Te Wairewa o te Piri Endoscopic (EBD) | Mō tēnei tikanga, ka tukuna he ngongo angiangi, kei roto i te kāmera (endoscope) mā roto i tō waha, ka heke iho i tō ara nakunaku kia tae atu ki te awaawa waikura. Kia tae ki reira, ka whakamahia e te tākuta te endoscope hei whakakore i te aukati, hei whakauru rānei i tētahi ngongo iti (stent) hei tuku i te waikura kia rere noa ki roto i te whekau. |
He aha te Stenting?
I ētahi wā, inā koa mēnā he pūmau te aukati (pērā i te pukupuku), ka whakanohoia pea e tō tākuta he ngongo iti, he rite ki te mata, e kiia nei ko te stent hei pupuri i te awaawa o te ate kia tuwhera tonu. He maha ngā wā ka mahia tēnei i muri i ētahi rā i muri i te whakatakotoranga o te ngongo mimiti tuatahi.
He aha i hiahiatia ai tēnei tukanga?
Ko te take matua mō tēnei tikanga he aukati, he whaiti rānei (`stricture`) i roto i te awaawa au, ka puta ai te au ki te ate (`cholestasis`). Pērā i te waikeri kua purua i roto i tō totohu kīhini, ka ārai te aukati i te rere noa.
Ko ngā take noa mō te aukati i te awaawa o te ate ko:
- Ngā kōhatu o te pūhā (choledocholithiasis).
- Te mate pukupuku repeure , te mate pāwera rānei.
- Te mate pukupuku o te awa au ('Cholangiocarcinoma').
- Te mate pukupuku ate , te mate pukupuku pūkahukahu rānei.
- Te pupuhi o ngā kōpū lymph e tata ana ki te ate, ki tete repe taiaki nā te mate pukupuku.
- Ngā mate pirinoa o ētahi.
- Ngā whara o mua i ngā awaawa o te ate.
- Te mumura mau tonu o ngā awaawa au, pērā i te Primary Sclerosing Cholangitis.
Ko te mea nui, ki te pā mai ēnei tohu ki a koe, me toro atu ki tō tākuta tonu kia kitea ai te take. Kaua e ngana ki te rongoā i a koe anō.
Me pēhea tāu whakarite?
Ka hoatu e tō tākuta he tohutohu motuhake ki a koe, me mātua whai koe i ēnei tohutohu.
1. Kai me te Inu: Me mutu pea te kai, te inu, me te momi hikareti i te iti rawa i te 6 hāora i mua i te tikanga. Ma tō tākuta koe e tohutohu mēnā ka taea e koe te inu i te iti o te wai.
2. Mate pāwera: Me whakamōhio atu ki tō tākuta mō ngā mate pāwera katoa, inā koa ki te rongoā whakamoe, ki ngā tae rerekē e whakamahia ana mō ngā hihi-X, ki ngā kirihou/whakarewa rānei.
3. Ngā Rongoā: Kōrerotia ki tō tākuta ngā rongoā katoa e tangohia ana e koe i tēnei wā, tae atu ki ngā huaora. Mena kei te tango koe i ngā rongoā whakaiti toto pēnei i te aspirin, i te warfarin rānei, pātai atu ki tō tākuta āhea me mutu te tango i aua rongoā i mua i te mahi.
4. Hapūtanga: Mena kei te hapu koe, kei te whakaaro rānei koe kei te hapu, me whakamōhio atu koe ki tō tīma hauora.
5. Te Waka: Nā te mea ka whiwhi koe i te rongoā whakamoe, kāore e taea e koe te taraiwa. Tena koa whakaritea he tangata hei kawe i a koe ki te kāinga.
He aha ngā mea ka tū i te wā o te Tukanga?
Ka rerekē ngā mahi i runga i te mea kei te pāngia koe e te PTBD, e te EBD rānei, engari kia mārama koe, ka whakamāramahia e tō tīma hauora ngā mea katoa i mua i te wā.
Te Mahi a te PTBD:
- Ka horoia te kiri o tō puku, ka whakangāwaritia hoki.
- Ka werohia e te tākuta he ngira angiangi mā roto i te kiri ki roto i te awaawa au i roto i te ate.
- Ka werohia he tae rerekē kia kitea ai ngā awa i runga i ngā hihi-X.
- Kia kitea te mea i āraia, ka whakatakotoria te ngongo waikeri kia rere ai te au.
- Ka tāpirihia te pito o waho o te ngongo ki tētahi pēke o waho hei kohi i te au. (Me whakawātea e koe tēnei pēke i ia wā, i ia wā).
Te Mahi a te EBD:
- Ka tukuna he rongoā whakamoe ā-rohe, he rongoā whakamoe whānui rānei ki a koe kia noho whakamarie ai koe.
- Ka tukuna te endoscope mā roto i tō waha ka heke ki roto i te rohe o ngā paipa.
- Ka whakamahia e te tākuta ngā taputapu i tukuna mā te endoscope hei karo i te aukati.
- I runga i te āhuatanga, ka whakanohoia pea e rātou he stent hei pupuri i te awaawa kia tuwhera tonu.
Ngā Mōrearea me te Tiaki i Muri i te
Pērā i ngā tikanga hauora katoa, tera pea ētahi mōrearea.
- Ngā raruraru pea:
- Tērā pea ka motu te ngongo, ka piko, ka ārai rānei.
- Te mamae, te kore whakamarie rānei.
- Te mate urutā (ka tohua e tō tākuta he rongoā paturopi hei ārai i tēnei).
- Te toto.
- Ngā taurite kore o te irahiko.
- He onge noa iho, ka puta ngā raruraru pūkahukahu pērā i te pneumothorax.
Ka kōrerohia ēnei mōrearea e tō tākuta ki a koe, ā, ka tohutohu i a koe me aha koe mēnā ka puta he raruraru.
Te Manaaki i a Koe Anō i te Kāinga:
Mena he ngongo me he putea o waho tāu, mā te hunga nēhi koe e ako ki te tiaki i aua mea.
- Āta karohia te pēhanga ki te wāhi i werohia ai, nā te mea ka taea e tēnei te takai i te ngongo.
- Ki te tohua, horoia te ngongo i ia rā ki te tote e ai ki te tohutohu.
- Kia mau tonu te wai māori ki ngā inu whai irahiko-kore mēnā kua tohua e tō tākuta hei whakakapi mō te ngaronga o te wai.
- Ka taea e koe te kaukau i roto i ngā hāora 48 i muri i te tikanga, engari kaua e kaukau i roto i ngā puna kaukau, i te moana, i ngā roto rānei i te mea kei te mau tonu te ngongo.
- Kaua e hiki i ngā mea taumaha kia whakaaetia rā anō koe e tō tākuta.
Āhea koe me rapu awhina hauora ohorere?
Mena ka pāngia koe e tētahi o ngā mea e whai ake nei, whakapā atu ki tō tākuta tonu atu, haere rānei ki te wāhanga ohorere o te hōhipera tata.
- Te kirika, te makariri rānei.
- Te nui haere o te mamae, te pupuhi, te whero rānei i te wāhi i werohia ai te ngongo.
- Te turuturu mai o te waikura, te wai rānei e rerekē ana te āhua mai i te wāhi.
- Te mamae o te puku hou, te mamae kino rānei.
- Te hoki mai anō o te kiri, o ngā kanohi rānei he kōwhai.
- Te ruaki tonu.
- Mena te āhua nei kei te tōia te ngongo, kei te wetekina rānei.
- Ki te kore e taea e koe te tuku tūtae, te hau rānei.
He tino whai hua te rerenga wai o te ate mō ngā aukati o te awaawa ate. Mā tō rōpū hauora koe e āwhina ki te whiriwhiri i te huarahi pai mō tō hauora. Kaua e mangere ki te pātai atu ki a rātou mēnā he pātai āu.
Ngā Whakaaro Matua
- Ko te tango wai i te wai o te ate he tikanga hei whakamama i ngā aukati o te awaawa o te ate kia rere tika ai te wai o te ate.
- Ko ngā tohu he kowhai te kiri/kanohi, te mākūkū, me te mimi pouri.
- Ka whakahaerehia te tikanga mā te PTBD (kiri-endoscopic) EBD rānei.
- He mea nui te whai i ngā tohutohu i mua i te tikanga e pā ana ki te nohopuku me ngā rongoā.
- Rapua he awhina whawhati tata mēnā ka pāngia koe e te kirika, te mamae nui, te turuturu rānei i te wāhi i muri i te tikanga.
Te rerenga wai o te ate, ngā awaawa wai kua purua, te kiriuhi waikura, te mate ate PTBD, te mate pukupuku ate, ngā kohatu pūkahukahu, tuhinga hauora Nirogi Lanka
