Kua whakaarohia e koe te uaua toto nui rawa atu o tō tātou tinana? Pērā i te paipa wai matua e kawe mai ana i te wai ki tō tātou whare, ko te uaua toto matua e kawe ana i te toto ki ngā okana me ngā pūtau katoa o tō tātou tinana ko te aorta, e kīia nei ko te aorta . He uaua tino kaha tēnei. Engari i ētahi wā, pērā i te taha o te potae motuka tawhito ka ngoikore, ka pupuhi pērā i te mirumiru, ka ngoikore hoki te pakitara o tēnei aorta ka pupuhi i te wāhi kotahi. Ka pakaru rānei tōna paparanga o roto. He tino morearea ēnei āhuatanga. Kaua e manukanuka, nā te whanaketanga o te pūtaiao hauora, kei reira ngā maimoatanga tino whai hua mō tēnei. Koinei tā tātou e kōrero nei i tēnei rā.
He aha tēnei pokanga TEVAR?
Ki te kī māmā noa, he tikanga pokanga iti rawa te whakaekenga a TEVAR (Thoracic Endovascular Aortic Repair) e whakamahia ana hei whakatika i ngā pakaru o te thoracic aorta.
Whakaarohia te āhua o te rongoā i tēnei momo mate i ngā wā o mua. I tino whakatuwherahia e ngā tākuta te uma, ā, i mahia he pokanga nui hei whakatika i tēnei kino. He tino uaua, he roa te wā e ora ai, ā, he tino mōrearea.
Engari i roto i te tikanga TEVAR, kāore e mahia he tapahi nui pēnei. Engari, ka mahia he tapahi iti rawa ki te hope, ka whakauruhia he ngongo angiangi (catheter) mā roto, ā, ka tukuna he taputapu motuhake mā roto i taua ngongo hei whakatika i te wāhanga ngoikore o te aorta. He rite tēnei ki te pakaru o te paipa e rere ana i roto i te pakitara o te whare, ā, ka whakauruhia he paipa iti ake ki roto i te paipa me te kore e pakaru te pakitara. Ko te hua o tēnei he poto rawa te wā whakaora, he iti ake te mamae, ā, he iti ake te mōrearea.
I roto i ēhea āhuatanga e hiahiatia ai te pokanga TEVAR?
Ko te nuinga o te wā ka whakamahia tēnei pokanga e ngā tākuta hei rongoā i ētahi mate kino e pā ana ki te aorta. Me titiro tātou ki ēnei mate.
| Āhuatanga hauora | He whakamārama ngāwari noa iho |
|---|---|
| Te Aneurysm Aorta o te Uma | Koinei taku i kōrero ai i mua ake nei, he wāhi ngoikore i te pakitara o te aorta e pupuhi ana pērā i te poihau. Ka taea e ia te nui haere, ā, ka pakaru. Ki te tupu tēnā, ka tino morearea ki te ora. |
| Te Wetewete Aorta | Koinei te wā e haehae ai te paparanga o roto o te pakitara o te aorta. Kātahi ka turuturu te toto i waenganui i ngā paparanga e rua o te pakitara, ka wehe i ngā paparanga e rua. He mate kino anō hoki tēnei e hiahia ana kia rongoatia wawetia. |
| Te Whakawhitinga Aorta | Mā te whara kino ki te uma, pērā i te aituā motuka, ka pakaru, ka pakaru rānei te aorta. |
Ko te mea nui, ahakoa he tino morearea ēnei āhuatanga, kua whakaorangia e ngā maimoatanga hou pēnei i a TEVAR te tini o ngā oranga.
Me pēhea te whakarite i mua i te pokanga?
Ki te whakatau koe ki te mahi i tēnei momo pokanga, ka whakamārama mārama mai tō tākuta ki a koe me pēhea te whakarite mōna. Tērā pea ka tonoa koe kia mahi i ngā mea pēnei i:
- Te whakahaere i te toto toto me te cholesterol: Tērā pea ka hoatu he rongoā ki a koe hei āwhina i te whakahaere i ēnei.
- Kaua e kai paipa: Ki te mea he kai paipa koe, me mutu rawa atu.
- Ngā whakarerekētanga rongoā: Tērā pea ka tonoa koe kia mutu, kia whakarerekē rānei i ētahi o ngā rongoā e tangohia ana e koe mō tētahi wā i mua i te pokanga.
- Ngā whakamātautau motuhake: Me mahi e te tākuta ētahi whakamātautau hei whakamahere i te pokanga.
Ngā whakamātautau i mua i te pokanga
Ko te mea tino nui o ēnei whakamātautau ko te CT Angiogram . He matawai CT motuhake tēnei. Ka taea te kite mārama i te rahi me te āhua o tō aorta me ētahi atu uaua toto e whakamahia ana mō te pokanga.
Whakaarohia, ka whakauruhia te ngongo pokanga mā roto i tētahi oko toto i roto i te hope. Mena he kuiti rawa taua oko toto, he ārai rānei i ngā putunga cholesterol, kāore e taea te tuku i te ngongo mā roto. Mā tēnei matawai ka kitea wawetia ēnei mea.
He mea tino nui anō hoki ngā inenga mai i tēnei matawai hei whiriwhiri i te rahi tika o te tākai stent mō te wāhi kua pakaru i roto i tō aorta.
He aha te tārai stent?
Koinei te toa o tēnei pokanga. He ngongo te tākai stent i hangaia ki tētahi mea rite ki te papanga. He mata whakarewa kei roto. Ka whakapikohia, kātahi ka tukuna mā roto i te aorta. Ina tae ki te wāhi tika, ka tuwhera pērā i te puna ka piri pūmau ki te pakitara o te aorta.
Ko te mea ka tupu, ka rere te toto mā roto i tēnei ngongo hou. Kāore te pakitara ngoikore, pupuhi o te aorta e pēhi i te toto. Nō reira ka mutu te pupuhi. He rite ki te whakatakoto i tētahi arai hou ki roto i te aorta.
Me pēhea te mahi i te pokanga?
Me tino hiahia koe ki tēnei. Me titiro tātou ki ngā mahi ngāwari e whai wāhi ana ki te pokanga.
1. Whakamarie: Tuatahi, ka tukuna koe ki raro i te rongoā whakamoe whānui, ki te kore ko te wāhi anake e mahia ai te pokanga ka whakangā, kātahi ka hoatu he rongoā hei whakangā i a koe.
2. Tapahi iti: Muri iho, ka tapahia he tapahi iti ki te kiri, ko te nuinga ki te rohe o te hope, ā, ka uru atu ki te uaua toto (te uaua femur) kei reira.
3. Waea ārahi: Ka tukuna he waea angiangi (waea ārahi) ki roto i tēnei oko toto, mā tua atu i te wāhi kua pakaru o te aorta, kātahi ka whakamutua.
4. Te katita me te stent: Kātahi ka tukuna he ngongo (katita) mā te waea. Kei roto i tēnei ngongo te hononga stent kua whakapikohia. Ka mahia katoatia tēnei i raro i te arataki a tētahi mīhini hihi-X motuhake (fluoroscopy).
5. Te whakatakotoranga o te stent: Kia tika te tūnga o te ngongo, ka āta whakaurua e te tākuta te stent graft. Kātahi ka whānui aunoa, ka piri ki te pakitara o te aorta.
6. Whakaoti: Whai muri i tēnā, ka tangohia te ngongo me te waea, ā, ka tuituia te tapahi iti i mahia ki te hope ki ngā tuitui.
I te nuinga o te wā, e rua hāora te roa o tēnei tukanga katoa.
He aha ngā painga me ngā mōrearea o te pokanga TEVAR?
Pērā i ngā tikanga hauora katoa, he painga me ngā mōrearea kei reira, engari he nui ake ngā painga o te pokanga TEVAR i ngā mōrearea.
| Ngā Painga | Ngā Tūponotanga |
|---|---|
| He poto te wā whakaora. | Te turuturu toto huri noa i te stent (Endoleak). |
| Kua whakaitihia te maha o ngā rā e noho ana i te hōhipera. | Te mate urutā. |
| Ka iti ake te mamae me te toto. | Kei te neke haere te stent i tōna tūranga. |
| Kāore e waiho he koha nui. | Te pararutiki o ngā waewae (te pararutiki o ngā waewae) nā te heke o te rere o te toto ki te taurakira - he tino onge tēnei. |
| He iti te mōrearea o ngā raruraru nui. | Te whakaeke ngakau, te whiu rānei. |
Ka whakamāramahia e tō tākuta ēnei mōrearea ki a koe, ā, ka mahia e ia ngā mahi katoa hei whakaiti i aua mōrearea.
He pēhea te roa o te wā whakaora i muri i te pokanga?
I muri i te pokanga, ka puritia koe ki te wāhanga tiaki nui (ICU) hei tirotiro mā te tangata mō te rā kotahi, e rua rānei, kātahi ka whakawhitia ki te wāhanga whānui. Mēnā ka pai ngā mea katoa, ka taea e koe te hoki ki te kāinga i roto i ētahi rā. Anei ētahi mea hei maumahara māu i muri i tō hokinga ki te kāinga:
- Te taraiwa: Kaua e taraiwa mō te kotahi ki te rua wiki.
- Kaukau: Kaua e rumakina ki roto i te kaukau wai kia ora rā anō te patunga o te hope. He pai te kaukau.
- Te hiki taumaha: Kaua e hiki i te neke atu i te 10 pauna (tata ki te 4.5 kg) mō te kotahi ki te rua wiki.
He mea nui te aroturuki i te manawanui mō te wā katoa!
Koinei te mea tino nui . I muri i te pokanga TEVAR, he mea nui kia tirohia tō tākuta mō ngā tirotiro hauora puta noa i tō oranga. I te nuinga o te wā,
- Kotahi marama i muri i te pokanga
- Kātahi i roto i ngā marama e ono (mēnā he raruraru i te tirotiro tuatahi)
- Kotahi tau i muri mai
- Kātahi ka kotahi i ia tau
Me whai matawai koe. Ka mahia tēnei hei tirotiro mēnā kei te wāhi tika te stent, mēnā he raruraru kei roto, mēnā he turuturu toto. Kaua e mahue tēnei. He mea tino nui tēnei mō tō haumaru.
Ahea te wā me waea atu ahau ki te tākuta?
Mena he pātai, he āwangawanga rānei āu mō tō maimoatanga, mō te wā whakaora rānei, kaua e wehi ki te kōrero ki tō tākuta. Waihoki, ki te pāngia koe e ngā tohu ohorere o te mate manawa, te whiu rānei (hei tauira, te mamae nui o te uma, te poto o te manawa, te uaua ki te kōrero, te ngoikore rānei o te taha kotahi o te tinana), haere tonu ki te Tari Ohotata o te hōhipera (ETU) .
He whanaketanga whakamiharo a TEVAR i roto i te pūtaiao hauora. Kua āwhina i te rongoā i ngā mate i mua he morearea ki te ora, i ēnei rā, me te iti ake o te mōrearea me te iti ake o te mōrearea. Mena kei a koe, kei tētahi rānei e mōhio ana koe he mate pēnei, kaua e wehi ki te kōrero ki te tākuta me te whakatau i te kōwhiringa maimoatanga pai rawa atu māu.
Karere Tangohia ki te Kāinga
- He tikanga pokanga hou a TEVAR, he iti noa te whakaekenga e rongoā ana i ngā mate kino pēnei i te aneurysms, te tapahi rānei i te aorta thoracic.
- He iti ake te mamae o tēnei, he poto ake te wā whakaora, ā, he iti ake te mōrearea i te pokanga tuwhera uma tuku iho.
- Ka whakahaerehia te pokanga mā te whakauru i tētahi taputapu motuhake e kiia nei ko te stent graft mā roto i tētahi tapahi iti i hangaia ki te hope.
- Ahakoa he tere te ora i muri i te pokanga, he mea whakahau kia whakahaerehia ngā tirotiro hauora ā-tau me ngā matawai puta noa i te oranga .
- Kaua e mangere ki te kōrero ki tō tākuta mō ō raruraru, ō āwangawanga rānei.
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