Kua pā mai rānei te tere o te pao o tō ngākau, te tere rānei o te pao? He ahua rerekē rānei kei roto i tō uma e rere ana te pūrerehua? I roto i ngā kupu hauora, ka kiia tēnei mate ko te 'Arrhythmia', arā, ko te pao o te ngākau he rerekē te auau. I tēnei rā, e kōrero ana tātou mō tētahi tikanga maimoatanga motuhake, engari he tino matatau, e whakamahia ana e ngā tākuta ina kore e taea te whakahaere mā te rongoā.
He aha te tikanga o te cardiac ablation?
Ko te Whakakore i te Ngākau (e mōhiotia ana ko te Whakakore i te Catheter) he tikanga hei rongoā i ngā manawataki ngākau rerekē (arrhythmias). Whakaarohia he pūnaha hiko tō tō tātou ngākau, ā, ko ngā tohu e whiwhi ana ia e tika ai te patu. I ētahi wā, ka taea e ngā wāhi iti o tēnei pūnaha hiko te whakaputa i ngā irahiko hiko rerekē. Ka rapua e tēnei tikanga ngā wāhi kiko e tuku ana i aua tohu rerekē, ā, ka "whakawetohia".
Ehara tēnei i te pokanga nui. Mā te tākuta ngakau e mahi. Ka whakaurua e ia he ngongo angiangi rawa (catheter) ki roto i tō ngākau mā roto i te uaua i tō hope, i tō ringa, i tō kaki rānei. Kātahi ka tukuna te wera (radiofrequency ablation), te makariri rawa (cryoablation), ngā ngaru pūngao poto rānei (pulsed field ablation) mā roto i tēnei ngongo, ka hangaia he koha iti ki roto i te kiko e puta mai ana ngā tohu rerekē. Ka aukatihia e ēnei koha te haere o ngā tohu hiko rerekē, ā, ka whakahokia te manawataki o te ngākau ki te noho noa.
I tēnei maimoatanga, ka taea te whakamoe i a koe, te whakamāuiui rānei i te tinana. Mā tēnei ka kore koe e pāngia e te mamae. Kāore ngā koha i puta mai i tēnei tikanga e pā ki te mahi a te ngākau.
He aha ngā momo mate e rongoatia ana e tēnei maimoatanga?
He maimoatanga te whakawātea ngakau mō ngā pāwera tere o te ngakau (tachyarrhythmias). Heoi, kāore i te nuinga o te wā e hoatu ana hei maimoatanga raina tuatahi. Tērā pea ka tūtohu tō tākuta i tēnei maimoatanga mēnā kāore e taea te whakahaere i tō arrhythmia ki te rongoā. Ka tirotirohia e tō tākuta tō ngākau me tō hauora whānui i mua i te whakatau mēnā he tika tēnei maimoatanga māu.
Ko tēnei maimoatanga te mea e whakamahia whānuitia ana mō ngā āhuatanga e whai ake nei.
| Āhua | He whakamārama māmā |
|---|---|
| Te Whakapūpū Atrial (Afib) me te Atrial Flutter | Ka tere, ka koretake te pā o ngā rūma o runga o te ngākau (atria). Ka piki ake pea te mōrearea o te toto totoka me te whiu. |
| Te Tachycardia o te Supraventricular (SVT) | Ka tīmata te manawa ki te pā tere rawa (tae atu ki te 300 ngā wā i te meneti). Mēnā ka haere tonu tēnei, ka taea te kino i te manawa. |
| Te Tachycardia Ventricular (VT) | Ka tere rawa te pā o ngā rūma o raro o te ngākau (ngā ventricles). He tino morearea tēnei āhuatanga, nā te mea ka arahi pea ki te aukati o te ngākau. |
Hei tāpiritanga, ka tūtohutia pea tēnei maimoatanga mō te hunga e tino mōrearea ana ki ngā āhuatanga morearea pērā i te hopukanga ohorere o te ngakau, te Ventricular Fibrillation rānei (V-Fib).
Me pēhea te whakarite i mua i te maimoatanga?
I mua i tēnei tukanga, me mahi e koe ēnei e whai ake nei:
- Kati te tango i ngā rongoā whakaiti toto: Mena kei te tango koe i ngā rongoā pēnei i te aspirin, i te warfarin rānei, tera pea ka tonoa koe kia mutu te tango i aua rongoā mō ētahi rā. Engari me mahi noa i tēnei i runga i ngā tohutohu a tō tākuta, mai i te rā anake e kī atu ai ia. Kaua e mutu i te wā e hiahia ana koe.
- Kaua e kai, e inu rānei: Ka tonoa koe kia mutu te kai, te inu rānei mō ētahi haora i mua i te tikanga, i muri i te waenganui pō. Ka hoatu e tō tākuta he tohutohu motuhake ki a koe mō tēnei.
- He tangata hei āwhina i a koe ki te hoki ki te kāinga: Whakaritea i mua kia haria koe e tetahi ki te kāinga i muri i te mahi.
- Ka whakatakotoria he raina IV: Ka whakatakotoria he raina IV (pērā i te ngongo e whakamahia ana hei hoatu tote ki a koe) ki roto i tētahi uaua i roto i tō ringa. Koinei te wāhi ka hoatu ai ki a koe ngā rongoā e tika ana me te rongoā whakamoe.
- Kākahu me ngā taonga: Kia pai te kakahu. He pai ake te waiho i ngā whakapaipai me ngā taonga utu nui ki te kāinga.
He aha ngā mea ka tupu i te wā e rongoatia ana?
Anei tētahi whakamārama taipitopito mō ngā mea e tupu ana i te wā o te tukanga tango i te kiri:
1. Tuatahi, ka horoia te wāhi e whakaurua ai te catheter (te nuinga o te wā ko te hope) ā, ka whakangāwarihia te kiri.
2. Muri iho, ka whakauruhia he ngongo iti (hipoki) ki roto i te uaua toto, ka waihangahia he ara hei urunga mā te catheter.
3. Ka tukuna ngā katitere pai me ngā irahiko mā roto i te pūtu, ā, mā roto i te uaua toto ki te ngākau. Ka mahia tēnei i raro i te arataki o tētahi tikanga rite ki te hihi-X.
4. Kia tae ki te ngākau, ka 'mahere' ēnei katitere i te mahi hiko o te ngākau, ā, ka tohu i te pūtake mai o ngā tohu hapa.
5. Kia kitea te wāhi raruraru, ka tukuna ngā ngaru wera, makariri, pūngao rānei mai i te pito o te catheter hei rongoā i te kiko, hei aukati hoki i ngā tohu hē kei puta mai.
6. Hei whakamutunga, ka ata tangohia te katitere me te hipoki.
E rua ki te whā hāora te roa o tēnei tukanga katoa, ā, i ētahi wā ka roa ake.
He aha te mea ka tupu i muri i te maimoatanga?
I muri i te tikanga, ka haria koe ki te rūma whakaora. Me noho koe ki reira mō ētahi haora. Ka aroturuki tonu te nēhi i tō āhua, tō tere o te manawa, me tō toto toto. I runga i tō āhua, ka taea pea e koe te hoki ki te kāinga i taua rā anō, me noho rānei koe ki te hōhipera mō te pō.
Ina hoki koe ki te kāinga, ka hoatu he tohutohu mārama ki a koe hei whai māu i te kāinga. Ka tohua e tō tākuta he āpipirini, he rongoā rānei hei whakaiti i te toto hei ārai i te toto e pupuhi ana. Tērā pea me tango tēnei mō ētahi marama, neke atu rānei.
Ngā painga me te angitu o te maimoatanga
He tikanga iti noa te whakaekenga tēnei, kāore e hiahiatia he noho roa ki te hōhipera, ā, ka taea e ia te āwhina ki te whakahoki mai i ngā manawataki o te ngakau kāore e taea te whakahaere mā te rongoā. I ētahi wā, ka taea e ia te waiho hei maimoatanga whakaora ora .
Mena ka angitu, ka whakawhirinaki ki te momo arrhythmia kei a koe.
- Ko te angitu o ngā āhuatanga pēnei i te SVT he teitei, arā , 90% - 95% .
- Mō ngā āhuatanga pēnei i a Afib me VT, kei waenga i te 60% - 80% te ōrau angitu.
He aha ngā mōrearea me ngā mea hei mōhio?
He tino iti ngā mōrearea o te tango i te ngākau. He onge ngā raruraru, inā koa i roto i te hōhipera e whakahaerehia ana tēnei momo maimoatanga. Heoi, tera pea ētahi mōrearea hei mōhio māu:
- Ngā toto totoka
- Te pakaru o te catheter ki ngā oko toto, ki ngā takirere ngākau rānei
- Te mate urutā, te toto rānei
- Whiu
- Me whakauru he taputapu whakatere pumau
Mena he whaea hāpu koe, kōrero ki tō tākuta mēnā ka taea te whakaroa i tēnei maimoatanga kia whānau rā anō te pēpi.
I ētahi wā, kāore pea e taea e te maimoatanga tango-ngā-whatu kotahi te whakaora katoa i te mate. Mēnā ka hoki mai ngā tohu, me whai maimoatanga tango-ngā-whatu anō pea ā muri ake nei. Waihoki, kāore pea ngā hua o te maimoatanga e puta wawe tonu. Tērā pea ka roa ētahi tohu mō ētahi wiki i te wā e ora ana te kiko o te ngākau.
Te whakaoranga me te wā e tika ai kia kite i te tākuta
Tērā pea ka roa pea ētahi wiki kia tino ora ai. Kaua e hiki i te taumaha neke atu i te 5 kg, kaua hoki e mahi i ngā mahi whakakori tinana taumaha mō te wiki kotahi pea i muri i te tikanga. Pātai atu ki tō tākuta āhea koe ka taea te hoki ki te mahi me te taraiwa.
Ki te pāngia koe e tētahi o ngā tohu e whai ake nei, waea atu ki tō tākuta tonu atu.
| Ngā tohu e hiahia ana kia aro wawe tonu ki te hauora | |
|---|---|
| Te toto, te pupuhi rānei i te wāhi i whakaurua ai te catheter, pērā i te puku | Mamae o te uma |
| Pōuriuri , ngoikore rānei | Te ahua kei te tere te pao o te ngakau |
| Te pupuhi (edema) te mamae rānei i te wāhi i whakaurua ai te catheter | Te ngoikore o te waewae (mēnā i mahia mai i te hope) |
| Āhua ohorere! - Haere tonu ki te ETU: te piko o te taha kotahi o te mata, te ngoikore o te ringa, o te waewae rānei, te uaua ki te kōrero (he tohu pea ēnei o te whiu). | |
Karere Tangohia ki te Kāinga
- He maimoatanga haumaru, kore-whakaeke te Cardiac Ablation mō te ngakau pāhekeheke (arrhythmias).
- Ko te tikanga tēnei ka tūtohutia ina kore e taea te whakahaere i te mate mā te rongoā.
- Ka mahia ngā mahi e tika ana kia kore ai koe e mamae i te wā e rongoatia ana.
- E hia wiki te roa kia tino ora ai, ā, i taua wā, me karo koe i te hiki taumaha me te mahi uaua.
- Kia tūpato ki ngā tohu whakatūpato ka puta i muri i te maimoatanga. Mena he āwangawanga āu, me whakamōhio tonu atu ki tō tākuta.
- He mea noa te mataku ina rongo koe mō tētahi tikanga manawa. Engari he maimoatanga angitu, he iti te mōrearea o tēnei. Kaua e wehi ki te kōrero ki tō tākuta mō ō pātai katoa.
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