Ko te aorta te oko toto nui rawa atu o tō tātou tinana, e kiia nei e tātou ko te "Aorta" i te reo Pākehā. Whakaarohia he rite ki te paipa wai matua o tō tātou tinana. Koinei te mea e tohatoha ana i te toto mai i te ngākau ki te tinana katoa. I ētahi wā, ka ngoikore te pakitara o tēnei oko toto, ka tīmata te pupuhi mai pērā i te poihau. Koinei te mea e kiia nei e tātou ko te "Aneurysm" i roto i te rongoā. Ko te mea tino morearea ko te piki haere o tēnei pupuhi, ā, tera pea ka pakaru ohorere. Nō reira, i tēnei rā ka kōrero tātou mō tētahi tikanga maimoatanga hou ka taea te karo i tēnei āhuatanga morearea me te kore e hanga he tapahi nui ki te tinana, me te iti o te kaha.
He aha te EVAR?
Ko te tikanga whānui o EVAR ko `(Endovascular Aneurysm Repair)`. I te reo Sinhala, he whakatikatika e mahia ana i roto i te uaua toto. Ehara tēnei i te pokanga nui . Arā, kaua e mahi i tētahi pokanga nui mā te tapahi i te puku, engari ka mahia tēnei maimoatanga mā te whakamahi i tētahi kōhao iti noa iho.
Whakaarohia kua pupuhi tetahi paipa wai tawhito, ā, kua tata pakaru. Engari ko te mea e tupu ana i konei he rite ki te whakatika mā te whakauru i tētahi paipa angiangi, kaha ake ki roto. Ka whakauruhia e ngā tākuta he ngongo motuhake (Stent Graft) ki roto i te oko toto pupuhi. He rite tēnei ki tētahi arai motuhake i hangaia ki te kakahu me te mata whakarewa. Ina whakaurua tēnei, ka rere te toto mā roto i te ngongo hou. Kātahi, kāore he pēhanga e pā ki te pakitara ngoikore, pupuhi. Nō reira, ka tino whakakorea te tūponotanga o tōna pakaru.
He aha tātou e hiahia ai ki te maimoatanga EVAR?
Ko te kaupapa matua, ko te kaupapa anake o tēnei, he ārai i te pakaru o te Abdominal Aortic Aneurysm . Mēnā ka tupu tēnā, he mate tino morearea, he mate hoki.
Ina ngoikore te pakitara o te uaua toto, ka pupuhi te toto e puta mai ana i ia pao o te ngakau i taua wāhi ngoikore. He rite ki te mirumiru i roto i te potae. Kāore e taea te whakawhānui tonu. I tētahi wā, ka pahū. Ki te tupu tēnā, ka rere te nui o te toto ki roto i te tinana, ā, ka mate pea i roto i ngā meneti.
Nā reira, ko tā te maimoatanga EVAR he whakauru i taua "(Stent Graft)", ka whakarerekē i te rere o te toto, ā, ka whakamama i te pēhanga ki te pakitara pupuhi. Ka tata mutu katoa te mōrearea o te pakaru.
He rite tēnei ki te whakakore i tētahi poma. Ka whakakorea e koe te tūponotanga i mua i tōna pahūtanga.
Mā wai tēnei maimoatanga EVAR e tika?
Kāore tēnei maimoatanga e mahia tonutia mō te hunga katoa he aneurysm puku. Ka tirohia e tō tākuta ētahi āhuatanga hei whakatau mēnā he tika tēnei maimoatanga māu.
- Mena he nui rawa tō aneurysm , heMena ka whakaatuhia e ngā matawai kei te tere tipu i roto i te wā poto.
- Mena kāore e taea e koe te aro atu ki te mōrearea o te pokanga nui pēnei i te pokanga puku nā runga i ētahi atu āhuatanga hauora (pēnei i te mate ngakau, te mate pūkahukahu rānei).
- Mena he hauora, he kaha hoki ngā uaua toto i runga ake, i raro hoki i te puku (nā te mea me whai wāhi pai hei whakauru i te ngongo hou).
I muri i te whakaaro ki ēnei āhuatanga, ka whakatau te tākuta ko te maimoatanga EVAR te mea pai rawa atu māu.
He aha te tikanga motuhake e kiia nei ko te FEVAR?
He rite te uaua nui o te iliac i roto i tō tātou puku ki te pūtake rākau. Ka peka atu ki roto i ngā uaua toto iti e kawe ana i te toto ki ngā whekau i roto i tō tātou puku (pērā i ngā whatukuhu me ngā whekau). I ētahi wā ka puta he aneurysm tata rawa ki te wāhi e peka ana aua manga. I taua wā, kāore e taea te whakauru i te ngongo tika e whakamahia ana i roto i te EVAR noa, nā te mea mā te mahi pēnā ka tapahia te rere o te toto ki aua manga.
Mō ēnei momo take uaua ka whakamahia he tikanga motuhake e kiia nei ko te FEVAR (Fenestrated Endovascular Aneurysm Repair). I roto i te `(Stent Graft)` e whakamahia ana i konei, ka hangaia he kōhao iti rite ki te matapihi kia uru ki ngā manga. I muri i te whakaurunga o te ngongo matua, ka whakauruhia he `(Stent)` iti motuhake mā roto i aua matapihi ki roto i ngā oko toto rite ki te manga kia pai ai te rere o te toto. Ahakoa he ahua uaua tēnei, he painga nui te taea te whakaora i te `(Aneurysm)` i ngā wāhi uaua me te kore e hiahiatia he pokanga nui.
He aha te rerekētanga i waenganui i a EVAR me TEVAR?
He rite tonu ēnei maimoatanga e rua. Ko te rerekētanga kei te wāhi e rongoatia ana.
- EVAR: Ka mahia mō ngā aneurysms o te puku (puku) .
- TEVAR (Thoracic Endovascular Aneurysm Repair): ka mahia mō ngā aneurysm i roto i te uma (thorax) .
He aha ngā painga o te maimoatanga EVAR?
Ki te whakaritea ki te pokanga nui, he maha ngā painga mārama o te maimoatanga EVAR. He iti ake te whakaekenga.
| Painga | Hei whakarāpopototanga... |
|---|---|
| He iti ake te wā i te hōhipera | Ahakoa e kotahi wiki te roa mō tētahi pokanga nui, e rua, e toru rānei ngā rā e pau ai mō tēnei. |
| He iti te nui o te toto e ngaro ana. | Nā te mea kāore he motu nui, he iti noa te toto e puta. |
| He iti ake te mamae i te wā e ora ana | Nā te mea kāore he whara nui, he iti noa te mamae. He poto noa te wā e hiahiatia ana ngā rongoā whakamamae. |
| Ka taea e koe te hoki wawe ki te oranga noa. | Ka taea e koe te hoki ki te mahi i roto i te marama, me te kore e tatari mo nga marama. |
| He iti ngā mōrearea i te wā e pokanga ana. | He iti ake te mōrearea o te mate manawa, te mate rānei i te wā e pokanga ana i tērā i te wā e pokanga nui ana. |
| He poto ake te wā pokanga. | Ka taea te whakaoti i tēnei maimoatanga i roto i te wā poto atu i te pokanga tuwhera. |
He tūponotanga kei roto i te maimoatanga EVAR?
Ahakoa he maimoatanga tino angitu, he haumaru hoki te EVAR, pērā i ngā tikanga hauora katoa, tera pea ētahi mōrearea iti ka puta. Heoi, he tino onge ēnei.
| Mōrearea | Whakaahuatanga |
|---|---|
| Te toto totoka | Tērā te mōrearea o te hanganga o ngā toto totoka i roto i ngā uaua toto, inā koa i roto i ngā uaua hohonu o ngā waewae (Deep Vein Thrombosis - DVT). |
| Endoleak | He iti noa te toto e turuturu ana i waenganui i te tākai stent hou me te pakitara o te uaua toto, ka kī anō te aneurysm i te toto. Koinei te raruraru matua ka puta i roto i tēnei maimoatanga. |
| Ētahi atu raruraru | Ka pā pea ngā mate manawa, ngā mate pāwera, te ngoikore o te whatukuhu, me te toto nui, engari he tino onge ēnei. |
Me pēhea te mahi i te pokanga EVAR? Hipanga i ia taahiraa
Āe, kia titiro tātou me pēhea te whakahaere i tēnei maimoatanga. Kia mārama rawa koe ki tēnei, kāore he mataku koretake.
1. Whakamoe: Tuatahi, ka hoatu he whakamoe ki a koe kia kore ai koe e mamae, e kore rānei e pai. Tērā pea ka tukua koe kia moe katoa, kāore rānei koe i te mōhio i tetahi wāhanga.
2. Te urunga: Ka whakamahia e te tākuta ngā uaua toto matua i roto i tō rohe hope (Femoral Artery). Ka tapahia he iti noa iho te kiri.
3. Te whakaurunga o te catheter: Muri iho, ka whakauruhia he ngongo tino angiangi, ngāwari (catheter) kei roto te stent grafting mā roto i te kōhao ki roto i te uaua toto.
4. Aratohu: Me ārahi tēnei katitere i te taha o te uaua toto, tae noa ki te wāhi o te aneurysm i roto i te puku. Hei kite tika i tēnei, ka whakamahia e te tākuta he hangarau whakaahua motuhake pērā i te X-ray (real-time imaging). Ko te tikanga ka mahia tēnei mā te mātakitaki i te neke ora o te katitere i roto i te tinana.
5. Te Whakatakoto i te Tāruatanga Stent: Kia tae ki te wāhi tika, ka toro atu te tākuta i te tāruatanga stent ki roto i te catheter. Kātahi ka whānui ki roto i te uaua toto, ka piri pūmau ki ngā pakitara, ka hanga he ara hou, kaha ake mō te rere o te toto.
6. Te Whakaoti: Kia tika te whakanoho o te `(Stent Graft)`, ka ata tangohia te catheter. He iti rawa te kōhao i te hope, kāore e hiahiatia kia tuia . Tērā pea ka tāpirihia he mea iti, he rite ki te pāreti.
Kia pēhea te roa o te wā e ora ai i muri i te pokanga?
Ahakoa he rerekē te roa o te wā e ora ai i ia tangata, koinei te mea e tupu ana i te nuinga o te wā.
- Me noho koe ki te hōhipera mō ētahi rā.
- I muri i te rongoā whakamoe, ka taea e koe te kai me te inu i muri tata mai.
- Me te āwhina a ngā nēhi, ka mea atu rātou ki a ia kia ara ake i te moenga i te wā e taea ai, ka tīmata te hikoi.
- Ka paku ngenge koe i ngā rā tuatahi i muri i tō hokinga ki te kāinga, ā, me tango e koe he rongoā mamae. He mea noa tēnā.
- Kaua e taraiwa kia tangohia rā anō e koe ngā rongoā whakamamae mamae .
- Ka taea e te nuinga o te tangata te hoki ki ā rātou mahi i roto i te marama kotahi pea .
- Me karo koe i te hiki taumaha mō ngā wiki 4-6 .
Ki te pā mai ēnei tohu ki a koe, me toro atu ki te tākuta tonu!
I muri i tō hokinga ki te kāinga, he mea nui kia aro nui koe ki tō tinana. Mēnā ka pāngia koe e tētahi o ngā tohu i raro nei, waea atu ki tō tākuta tonu atu.
- Te pupuhi, te mamae, te mātao rānei o te kiri o ngā waewae, inā koa ngā waewae o raro (he tohu pea ēnei o te DVT).
- Ki te mea kei te pōuri koe, kei te ngoikore rānei.
- Mena ka pāngia koe e te mamae nui i roto i tō puku, uma, tuara rānei .
- Ko ngā palpitations te wā e rongo ana koe i te tere o te pao o tō ngakau.
- Mena ka pāngia koe e te whero i te rohe o te hope, e tetahi atu mamae waewae rerekē rānei .
He pai ake te maimoatanga EVAR, he iti ake te mamae, he huarahi kē atu i te pokanga tuwhera tuku iho. Ka taea e koe te ora wawe, ka hoki ki te kāinga. Heoi, kaua e wareware i angitu te maimoatanga. E ai ki te tākuta, he mea nui kia hoki mai i te wā kua whakaritea, kia tirohia anō. Koinei te huarahi ka taea e koe te tirotiro mēnā kei te pai te mahi a te `(Stent Graft)` i whakatakotoria, me te mea he raruraru pēnei i te `(Endoleak)`.
Karere Tangohia ki te Kāinga
- He tikanga maimoatanga hou, he iti noa te whakaekenga a te EVAR, e whakamahia ana hei ārai i te pakaru o te aneurysm i roto i te uaua toto matua o te puku, te aorta.
- I konei, ka whakauruhia he tākai stent ki roto i te oko toto mā te whakamahi i tētahi ngongo angiangi e kiia nei ko te catheter, ka whakauruhia mā roto i te hope, me te kore e tapahia he tapa nui.
- He poto ake te noho hōhipera, te mamae, me te wā whakaora i te pokanga tuwhera.
- Ahakoa kua oti te maimoatanga, he mea nui tonu kia haere tonu ki ngā tirotiro hauora e ai ki ngā tohutohu a te tākuta. Mā tēnei ka āwhina i te tautuhi wawe i ngā raruraru pea.
- Ki te pāngia koe e ētahi tohu rerekē (te pupuhi o ngā waewae, te mamae nui, te whanoke) i muri i te pokanga, rapua tonutia he tohutohu hauora.
💬 Comments (0)
Kaore ano kia tukuna he korero. Tāpirihia to korero ki konei mo te wa tuatahi.
Tāpirihia to korero