Kua rongo kē koe i te kōrero ka pupuhi te uaua toto tino nui o te tinana, pērā i te poihau? He āhuatanga tino whakamataku tēnei. Kaua e manukanuka, nā te whanaketanga o te pūtaiao hauora, ka taea te rongoā i tēnei i roto i tētahi huarahi tino māmā me te kore e tapahia nui. I tēnei rā ka kōrero tātou mō tēnei. Ko te ingoa o tēnei tikanga ko EVAR.
He aha te EVAR?
Ko te tikanga whānui o EVAR ko te Whakatikatika i ngā Aneurysm Endovascular . He pokanga iti rawa te whakaekenga tēnei. Ka whakamahia hei rongoā i ngā aneurysm, e kiia nei e tātou i roto i ngā kupu hauora , aneurysms , i roto i te aorta, te uaua toto matua i roto i tō tātou puku.
Whakaarohia ko te aorta te oko toto nui rawa atu o tō tātou tinana. Koinei te wāhi e tohatohahia ai te toto mai i te ngākau ki te tinana katoa. I ētahi wā, ina ngoikore tetahi wāhi i te pakitara o tēnei oko toto, ka puta te pēhanga o te toto i taua wāhi ngoikore kia pupuhi mai pērā i te poihau. Koinei te mea e kīia nei e tātou he aneurysm.
I roto i te maimoatanga EVAR, e rua noa iho ngā kōhao iti rawa ka hangaia ki ia taha o te uaua, ā, ka tukuna he taputapu motuhake mā roto i aua kōhao hei whakatika i te uaua toto pupuhi mai i roto.
He aha tātou i hiahia ai ki tēnei maimoatanga EVAR?
Ko te whāinga matua o tēnei maimoatanga he ārai i te pahūtanga o te oko toto rite ki te poihau (aneurysm), nā te mea ki te pahū, he tūraru nui ki te ora.
Ki te pakū te uaua toto, ka tīmata te toto nui rawa i roto i te tinana, ā, ka mate pea i roto i ngā meneti.
I roto i te maimoatanga EVAR, ka whakauruhia e ngā tākuta he ngongo motuhake (tārua stent) i hangaia ki te papanga me te mata whakarewa ki roto i te oko toto pupuhi. I muri i te whakaurunga o tēnei ngongo, ka rere te toto mā roto i tēnei ngongo hou. Kātahi ka kore te pēhanga o te toto e pā ki te pakitara ngoikore o te oko toto pupuhi. Nō reira, kua tata kore rawa te tūponotanga o tōna pahūtanga.
Mō wai te maimoatanga EVAR e tino tika ana?
Mena he aneurysm aortic tōu, tera pea he tika tēnei maimoatanga māu. Heoi, kāore e rongoatia ngā aneurysm katoa i te wā kotahi. Tērā pea ka whakaarohia e tō tākuta te EVAR i ngā take e whai ake nei:
- Mena he nui tō aneurysm , he iti rānei engari kei te tere te tipu .
- Ki te kore e taea e tō tinana te aro atu ki te pokanga tuwhera me te tapahi nui.
- Mena he hauora ngā oko toto i runga ake, i raro hoki i te aneurysm .
He tikanga kē atu anō kei te rite ki a EVAR? (FEVAR me TEVAR)
Ae, he iti noa ngā rerekētanga e whakamahia ana i tēnei tikanga maimoatanga, kei runga i te wāhi o te aneurysm.
He aha te FEVAR?
Whakaarohia tō tātou aorta he pūtake rākau. Mai i tēnei pūtake, ka wehea ngā manga (ngā uaua 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 ki te wāhi e wehea ai tētahi o ēnei manga. I taua wā, he uaua ki te mahi i te EVAR auau.
Mō ēnei momo take uaua ka whakamahia he tikanga motuhake e kiia nei ko te FEVAR (Fenestrated Endovascular Aneurysm Repair) . Ko te tākai stent e whakamahia ana i konei he kōhao iti (fenestrations) kua hangaia kia uru ki te wāhi e wehea ana ngā manga. Mā roto i aua kōhao, ka taea te whakatakoto i ngā stent iti motuhake mō aua manga. Pērā i te ngongo kua hangaia kia uru ki te take me ngā manga o te rākau.
Te rerekētanga i waenga i te EVAR me te TEVAR
He tino māmā tēnei.
- Ka mahia te EVAR mō ngā aneurysms i roto i te puku .
- Ka mahia te TEVAR (Thoracic Endovascular Aneurysm Repair) mō ngā aneurysm i roto i te kōhao o te uma (thorax) .
He tino angitu te TEVAR mō ngā aneurysms i roto i ngā uaua nui e rere ana i roto i te uma, he paku tawhiti atu i te ngākau. Heoi, mō ngā aneurysms e tino tata ana ki te ngākau, he maha ngā wā ka hiahiatia he pokanga tuwhera.
| Ngā painga matua o te maimoatanga EVAR | |
|---|---|
| Painga | Whakaahuatanga |
| Kua whakaitihia te maha o ngā rā e noho ana i te hōhipera. | Ka taea e koe te hoki wawe ki te kāinga i tō te pokanga tuwhera. |
| He iti ake te toto | Nā te mea kāore he motu nui, he iti noa te nui o te toto e puta ana i te tinana. |
| He iti ake te mamae i te wā e ora ana | Nā te mea kāore he whara nui, he iti noa te mamae me te kore whakamarie. |
| Kia ora wawe koe | Ka taea e koe te hoki tonu ki ngā mahi o ia rā. |
| He poto ake te wā pokanga. | Ka taea te whakaoti i te pokanga i roto i te wā poto atu i te pokanga tuwhera. |
He tūponotanga kei roto i tēnei maimoatanga?
He maimoatanga tino haumaru, tino angitu hoki te EVAR, engari pērā i ngā pokanga katoa, he iti noa te tūponotanga o ngā raruraru.
- Ngā Totoka Toto: I ētahi wā ka puta he totoka toto i roto i ngā uaua hohonu o ngā waewae. Ka kiia tēnei ko te Thrombosis Utauta Hōhonu (DVT) .
- Endoleak: Ahakoa kua whakatakotoranga te stent, ka turuturu tonu te toto i waenganui i te stent me te pakitara o te uaua toto ka hono atu ki te aneurysm.
- Mate urutā: Mate urutā i te wāhi i whara ai.
- Te ngoikore o te whatukuhu
- Te whakaekenga o te ngakau
- Te toto nui rawa
He tino iti ēnei mōrearea. Mā tō tākuta ēnei mea katoa e whakamārama ki a koe i mua i te pokanga.
Me pēhea te mahi i te pokanga?
Āe, me titiro tātou ki ngā mahi e whai wāhi ana ki tēnei pokanga.
1. Tuatahi, ka hoatu he rongoā whakamoe ki a koe hei whakamoe i a koe, hei whakamoe māmā rānei. Nō reira, kāore koe e mamae.
2. Muri iho, ka uru atu te tākuta ki te aneurysm i roto i tō puku mā roto i ngā uaua femoral i roto i tō hope.
3. Mā te whakamahi i ngā ngira angiangi e rua, ka whakauruhia he catheter , he ngongo angiangi, ngāwari, ki roto i ēnei uaua e rua. Ka whakapikohia te stent graft i kōrerotia i mua ake nei ki roto i tēnei catheter.
4. I a ia e tirotiro ana i tētahi mata motuhake rite ki te hihi-X, ka ārahi te tākuta i tēnei catheter i te taha o te uaua toto ki te wāhi o te aneurysm.
5. Kia tae ki te wāhi tika, ka whakawhanuitia te ngongo stent i roto i te catheter. Kātahi ka whakawhanuitia ki roto i te uaua toto, ka hanga he ara hou, he ara kaha ake mō te rere o te toto.
6. Kua piri pūmau tēnei ngongo stent ki te pakitara o te uaua toto, kia kore ai te toto e uru ki te aneurysm.
7. Kia oti te tikanga, ka tangohia marietia te katitere. He iti rawa ngā poka, kāore e hiahiatia he tuitui. Ka tāpirihia he paraikete iti ki te patunga hei āwhina i te whakaora.
He pēhea te roa o te wā whakaora i muri i te pokanga?
I te nuinga o te wā, e torutoru ngā rā ki te kotahi marama ka tino ora ai koe.
- Me noho koe ki te hōhipera mō ngā rā e rua, e toru rānei.
- Ka taea e koe te tīmata kai me te inu tonu i muri i te rongoā whakamoe.
- Ka taea e koe te ara ake i te moenga ka hikoi me te awhina a ngā nēhi.
- Tērā pea ka paku ngenge koe, ka mamae hoki mō ētahi rā i muri i tō hokinga ki te kāinga. Me whakamahi tika koe i ngā rongoā whakamamae mamae i hoatu ki a koe.
- Kaua e taraiwa kia tangohia rā anō e koe ngā rongoā whakamamae mamae.
- Ka taea e te nuinga o te tangata te hoki ki te mahi i roto i te marama.
- Me karo koe i te hiki i ngā mea taumaha mō ngā wiki e 4 ki te 6.
| Ki te pā mai ēnei tohu ki a koe, me toro atu ki tō tākuta tonu. | |
|---|---|
| Āhuatanga | Whakaahuatanga |
| Pupuhi waewae, mamae | He tohu pea ēnei o te toto toto hohonu (DVT) i roto i ngā waewae. Kei roto i tēnei ko te kiri makariri o ngā waewae. |
| Pōuriuri, ngoikore rānei | He tohu pea tēnei nō tētahi raruraru kei roto. |
| Mamae tuara, uma, puku rānei | He raruraru pea tēnei nō te stent, nō te aneurysm rānei. |
| Ngā tere o te ngakau | Te tere ohorere o te ngakau (Palpitasi o te ngakau). |
| Te whero, te mamae rānei i te rohe o te hope | He tohu pea tēnei nō te mate urutā i te wāhi i pokanga ai. |
Karere Tangohia ki te Kāinga
- He huarahi pai rawa atu a EVAR, he iti rawa te whakaekenga, hei whakakapi i te pokanga tuwhera tuku iho.
- I muri i tēnei maimoatanga, ka tere tō ora ake, ā, ka taea e koe te hoki wawe ki te kāinga.
- Ahakoa kua ora koe, me tiaki tonu tō ngākau me ō uaua toto. Mā ngā mahi pēnei i te whakakori tinana me te whakaiti i te tote i roto i ō kai ka āwhina i te ārai i ngā raruraru a muri ake nei.
- Ko te mea nui ko te kite anō i te tākuta i te wā kua whakaritea mō ngā whakamātautau whai muri. Pērā ai, ka taea e koe te tirotiro mēnā kei te mahi tika te stent i whakaurua e koe, me te mea he raruraru kē atu.
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