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He aha te cholecystitis?
Ki te kī māmā noa, ko te cholecystitis he mumura, he pupuhi rānei o tō pūkahukahu . Whakaarohia he pēke iti āhua pea i raro i tō ate . Ka rongoa te pūkahukahu i te au , he wai i hangaia e te ate mō te wā poto. I muri i tā tātou kai, inā koa ngā kai momona, ka tukuna tēnei au ki te whekau iti hei āwhina i te nakunaku kai. Ka haere tēnei au mā roto i ngā ara iti rite ki te ngongo e kiia nei ko ngā awa au . Nō reira, ki te mea he mate, he aukati rānei kei roto i te pūkahukahu, i ngā awa au rānei e hono ana ki reira, ka puta te mumura, te mamae, me te pupuhi.He rerekē ngā momo cholecystitis?
Ae, ka taea te wehewehe i tēnei ki ētahi wāhanga matua:- Mumura whakapeka: He āhua ohorere, he kino hoki tēnei.
- Mumura mau tonu: He mate tēnei e āta whanake haere ana i roto i te wā, ā, kāore i te tino kino engari ka mau tonu.
- Mumura konutea: Koinei te momo mumura tino noa. He mumura i puta mai i ngā kōhatu o te pūkahukahu.
- Mumura acalculous: He mumura tēnei e puta mai ana i ētahi atu take ehara i te kohatu o te pūkahukahu.
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E kiia ana tata ki te 15% o te taupori o te ao he kohatu pūkahukahu. Tata ki te 20% o rātou ka pāngia e ngā raruraru nā ngā kohatu pūkahukahu, pērā i te cholecystitis . Kaua e miharo, 95% o ngā take cholecystitis nā ngā kohatu pūkahukahu!He aha ngā tohu o te cholecystitis?
Tērā pea ka rerekē paku ēnei tohu i runga i te momo mumura.Ngā tohu o te mumura tere:
- Te mamae nui i te puku o runga, ina koa i te taha matau:Ka taea e tēnei mamae te piki haere ohorere, ā, kāore e taea te whakamanawanui. I ētahi wā ka horapa tēnei mamae ki te pakihiwi matau, ki te tuara rānei. Ka rite te mamae ki te werohanga ngira, ki te mamae puhoi, ki te takahuri rānei o ngā uaua o te puku. Ka piki ake pea te mamae ina manawa hōhonu koe. E whakaaro ana ētahi he mamae uma, he mate manawa rānei tēnei. Ka kiia hoki tēnei mamae ohorere ko te "Whakaeke Pūkahukahu ".
- Whakapairuaki me te ruaki : He tohu noa anō hoki tēnei e haere tahi ana me te "whakaekenga o te pūkahukahu".
- Kirika: Ko te kirika neke atu i te 100 nekehanga Fahrenheit (37.8 Celsius) he tohu pea kei te pāngia koe e te mate, e te mumura nui rānei.
He mea nui: Tērā pea he rerekē paku ēnei tohu mō te kaumātua. Tērā pea ka ngaro noa iho te hiahia kai , ā, ka ngenge noa iho. Kāore hoki i te tino kitea te kirika i waenga i te kaumātua.
Ētahi atu āhuatanga tāpiri:
- Te pupuhi me te ngawari .
- Te pakari o ngā uaua i te taha matau o te puku.
- Te ngoikore me te ngenge , inā koa mō te hunga kaumātua.
Ngā tohu o te mumura mau tonu:
He iti ake te kaha o ngā tohu i ērā o ngā mate ohorere , ā, ka haere mai, ka haere noa. Tērā pea ka pāngia koe e te mamae o te puku me te whakapairuaki e kiia nei ko te "biliary colic" i muri i te kai i tētahi kai momona, taumaha. Nā te mea he nui ake te au e hiahiatia ana e ngā kai momona hei nakunaku. Kātahi ka tukuna he tohu e tō pūnaha nakunaku ki te pūkahukahu kia tukuna he au nui ake. Mā tēnei ka kaha ake te whakawhāiti o te pūkahukahu, ka piki ake te pēhanga ki roto. Ka roa pea tēnei mamae mō ētahi hāora.He aha te take matua mō tēnei?
I te nuinga o te wā, ko ngā mumura whakapeka me ngā mumura mau tonu e puta mai ana i ngā kōhatu pūkahukahu e aukati ana i ngā awaawa au . Ko ngā kōhatu pūkahukahu he matū totoka i roto i te au kua kohia i roto i te wā, ā, ka rite ki ngā kōhatu. I te nuinga o te wā ka hangaia ki raro o te auawa au, engari ka taea e rātou te neke haere i ētahi wā. I a rātou e neke ana, ka mau ki roto i te awaawa au, ki te waha rānei o te auawa au. Mā tēnei ka hoki te au ki roto i te auawa au, ka arahi pea ki te mate.- Mumura whakapeka:Ka puta tēnei ina āraia rawatia te rere o te au mai i te pūkahukahu e te kōhatu. Ka pupuhi haere te pūkahukahu, ā, ka kino haere te āhua.
- Mumura mau tonu: I ētahi wā, kāore pea te kōhatu e ārai katoa i te awaawa, engari ka mau pea mō tētahi wā, kātahi ka hemo anō. Hei tauira, ka mamae pea koe ina kōpiri te puku o te puku i muri i te kai nui. Koinei te take o te mumura mau tonu .
He aha atu ngā take i tua atu i ngā kōhatu o te kapia?
Ahakoa ko te aukati i ngā awaawa au e ngā kohatu au te tino take, ka pupuhi pea te au o te au, ka aukati hoki i te rere o te au e ētahi atu āhuatanga. Anei ētahi tauira:- Te Whakaiti i te Korokoro o te Wai Au : Ka taea e te mumura mau tonu o ngā awa au te hanga i te kiko koha me te whakawhāiti i ngā awa au, ka aukati i te rere o te au.
- Te Tākirikiri o te Puku Wai: He āhuatanga tēnei e pā ana ki te mahi a ngā uaua o te pūkahukahu . Ina koa, kāore te pūkahukahu e kōpiri pai ana, nō reira kāore te pūkahukahu e rere ki waho.
- Te Tūnga o te Aute: Ka raru pea te rere o te aute nā te mate ate mau tonu, nā te kai roa rānei (intravenous nutrition/IV). Kia maumahara, ki te kore koe e kai mā te waha engari kei te whāngaihia koe ki te aute, kāore koe e hiahia ki te aute.
- Matepukupuku: Ahakoa he onge, ka taea e te pukupuku matepukupuku i roto i te pūkahukahu, i ngā awa wai rānei te aukati i te rere o te wai wai.
- Ischemia: Ina heke te rere o te toto ki te pūkahukahu, ka taea te arahi ki te mumura whakapeka , ki te mumura mau tonu rānei, i runga i te kaha o te mumura. He maha ngā wā ka puta tēnei hei whakautu i tētahi mate kino, i tētahi aituā rānei. Ka taea hoki te puta mai i te aukati o ngā oko toto (te aukati toto) i te vasculitis rānei.
- Mate urutā: Ka pā he mate huakita ki roto i te pūkahukahu, ki ngā awa rānei o te pūkahukahu, ahakoa kāore he aukati. He onge tēnei. He nui ake te tūponotanga ka pā tēnei ki te hunga he ngoikore te pūnaha ārai mate. Ka taea hoki e te mate urutā te kino i te kiko o te pūkahukahu.
Ko wai kei te nui ake te mōrearea ki te whakawhanake i tēnei?
Mena he kohatu pūkahukahu tōu, he nui ake te tūponotanga ka pāngia koe e te cholecystitis. Ko te hunga e nui ake te tūponotanga ka pāngia koe e ngā kohatu pūkahukahu ko:- Mō ngā wāhine
- Mō ngā wāhine hapu
- Mō te hunga momona
- Mō te hunga mate huka
- Mō te hunga he nui te cholesterol
- Mō te hunga kua tere te heke o te taumaha (Te whakahekenga taumaha tere)
- Mō te hunga neke atu i te 40 tau te pakeke
- (Tērā pea he pānga anō tō ētahi awe ira me te āhua noho)
He pēhea te kino o tēnei mate koririti?
Ko te cholecystitis whakapeka te take o te aukati i te rere o te au. Ehara i te mea ko te pūkahukahu anake e pā ana. Ka pā pea ki tō pūnaha au katoa - te pūnaha o ngā whekau e kawe ana i te au mā roto i ngā awa au - ā, ka puta te mumura me te mate. Ka taea e te au kua kohia te waipuke ki roto i te toto ka meinga koe kia mate. Ka ārai hoki i tō pūnaha nakunaku kia kore e whiwhi i te au e hiahiatia ana. Ka taea e te mumura me te pupuhi nui te mate o te kiko (gangrene) . Ki te tupu tēnei, ka pakaru te whekau, ka pokaia rānei. Ka kiia tēnei ko te gangrenous cholecystitis . He iti ake te kino o te mumura mau tonu , engari ka taea hoki e te mumura roa te whakararu nui. Ka puta pea he kiko whara i roto i tō pūkahukahu, ā, ka ārai i te whakawhāiti tika. Ka taea hoki e tēnei te aukati i te rere o te au.Ngā raruraru o te Cholecystitis:
- Te kino ki tō ate, ki ngā awaawa au, ki te pancreas rānei (hei tauira, te pancreatitis ).
- Te ngoikore o te nakunaku me te mimiti o ngā matūkai i roto i te whekau iti.
- Ka puta he whara o te pūkahukahu (Gallbladder Fibrosis) me te ngoikore o te mahi a te puku mā te mumura roa.
- Te matenga o ngā kiko nā te pupuhi (necrosis) me te gangrenous cholecystitis .
- Te poka o te puku au , ka hua ake he mate o te kōhao puku (peritonitis).
- Ka taea e te peritonitis te arahi ki te whewhe , ki te paihana toto rānei ('Septicemia').
Ehara tēnei i te mea hei maka noa atu, nā te mea he nui rawa te kino ka pā mai.
Me pēhea te tautuhi i tēnei?
Ka pātai tuatahi te tākuta ki a koe mō ō tohumate. Mēnā kei te whakapae rātou he cholecystitis koe, ka tono rātou kia manawa hōhonu koe, ka pēhi i te taha matau o runga o tō puku. Mēnā ka pāngia koe e te mamae, he tohu rongonui tēnei mō te mate ( te Tohu a Murphy ). Kātahi ka whakahaerehia e rātou he whakamātautau whakaahua hei tirotiro i tō pūkahukahu me ngā awa waikura, me ngā whakamātautau toto hei rapu i ētahi atu mōhiohio. Ko ētahi o ngā whakamātautau e mahia ana mō tēnei ko:- Tatau Toto Katoa (CBC)
- Ngā Whakamātautau Mahi Ate
- Te Whakamātautau i te Puku
- Te Ultrasound Endoskopiko
- Matawai CT (Matawai CT - Matawai Tomography Rorohiko)
- Matawai HIDA (Matawai HIDA - Matawai Waikawa Iminodiacetic Hepatobiliary)
Ka ora ake tēnei mate pukupuku i a ia anō?
Kāo. Me rongoā ngā take katoa o te cholecystitis . I ētahi wā, ka memeha noa te kōhatu e ārai ana i te pūkahukahu, i te awa wai rānei, ā, ka ngaro atu ō tohumate. Engari, ehara i te mea pai te tatari kia puta mai tēnā - he mamae, he mōrearea hoki. Ahakoa pērā, e kore e ea ō raruraru. Tērā pea ka piri anō te kōhatu kotahi, tētahi atu kōhatu rānei.He aha te rongoā mō tēnei?
Ka rongoatia tonutia te mate cholecystitis i roto i te hōhipera. Ka tīmata te maimoatanga mā te whai i ēnei:- Te hoatu wai IV i a koe e whakangā ana i tō pūnaha nakunaku.
- Te hoatu paturopi ā-uaua (paturopi IV) hei ārai, hei rongoā rānei i ngā mate pāwera.
- Te whakaora i te mamae mā te werohanga IV, he mea e hiahiatia ana e te tini o te tangata.
- Te tango wai mai i te pūkahukahu me te whakaiti i te pēhanga: Ka taea e te tākuta te tapahi i tō puku me te whakauru i tētahi ngongo tango wai ki roto i tō pūkahukahu. Mēnā rānei, ka taea e rātou te whakamahi i tētahi ultrasound endoscopic hei ārahi i tētahi ngongo mā roto i tō waha hei tango wai mai i tō pūkahukahu ki roto i tō ara nakunaku.
- Te Tango Kōhatu Ā-roto: Ko te ERCP (Endoscopic Retrograde Cholangiopancreatography) he tikanga e whakamahi ana i te endoscope mā roto i tō waha hei tirotiro i tō pūnaha biliary mā te whakamahi i te hangarau hihi-X. Mā tēnei ka taea te whakauru i ngā taputapu iti mā roto i te endoscope hei tango i ngā kōhatu e piri ana ki ngā awaawa ā-roto. Ka taea e tēnei te whakaora i ō tohumate tonu.
Pokanga (Cholecystectomy)
Ahakoa kua ora tō cholecystitis o nāianei - arā, kua kore te kōhatu i piri e piri, ā, kua kore ngā tohu i arahi i tō haerenga ki te hōhipera - he mau tonu , he whakapeka hokiKa taea e ngā momo cholecystitis e rua te hoki mai anō. Ko ngā kōhatu pūkahukahu kua puta he mate i mua, he nui ake te tūponotanga ka puta anō. Ka taea e ngā mate pūkahukahu te arahi ki te mumura mau tonu, ā, ka taea e ēnei te whakararu i te kino mō te wā roa. Hei ārai i ngā pānga o te cholecystitis hoki mai anō, ka tūtohu ngā tākuta kia pokangahia te tango i te pūkahukahu (cholecystectomy) . He tikanga noa tēnei, he iti noa iho ngā pānga taha. Mō te tini o te tangata, ka taea tēnei te mahi mā te laparoscopic - mā roto i ētahi tapahi iti, e mōhiotia ana ko te "pokanga kōhao kī". I ngā take uaua ake, me pokanga tuwhera pea.He aha ngā mea ka tupu i muri i te pokanga?
Ka taea e tō pūnaha biliary me te pūnaha nakunaku te mahi pai me te kore tō pūkahukahu. Ko te pūkahukahu he wāhi penapena noa iho mō te au, e hangaia ana e te ate. Ina tangohia tō pūkahukahu e te taote pokanga, ka hurihia e ia ngā awa au kia rere tika ai te au mai i tō ate ki roto i tō whekau iti. Tērā pea ka roa pea ētahi wiki, ētahi marama rānei kia urutau tō tinana ki tēnei huringa. I tēnei wā, ka pāngia pea koe e ngā tohu rangitahi pēnei i:- Te pēhanga, te mamae rānei i roto i te pūnaha ate nā te puhoi o te rere o te ate.
- He uaua te nakunaku i ngā kai momona, ā, ka puta te mate korere i ētahi tāngata.
He aha te tirohanga mō te tangata e pāngia ana e te cholecystitis?
Ahakoa te momo, te take rānei, me rongoatia te cholecystitis ki te hōhipera. Ka whakaora tonu te hōhipera i te mamae, ā, ka rapu i te take. He kohatu pūhā te tikanga, ahakoa kāore i te wā katoa. I te nuinga o te wā, ka tūtohu ngā tākuta kia rongoatia mō te wā roa mā te pokanga. He tino pai ngā hua o te tini tāngata. Ki te kore e rongoatia, ka puta pea ngā raruraru kino.He āhuatanga ohorere hauora tonu te mamae nui o te puku. Mēnā he tohu mamae o te pūkahukahu — arā, mēnā ka puta ohorere, ka tino pā ki te taha matau o runga o te puku, me te whakapairuaki hoki — he mea whakaaro nui kia haere tika atu ki te rūma ohorere o te hōhipera.Ahakoa he iti tō pūkahukahu, ka tūpono pea tō pūnaha pūkahukahu katoa ki te mōrearea mēnā ka pēhia. Tērā pea ka ngaro ngā tohu o te cholecystitis, engari kei te mau tonu te pūtake. Tērā pea ka hoki mai ngā tohu, ā, ka haere tonu te kino o te cholecystitis ki tō pūkahukahu kia whiwhi rā anō koe i te maimoatanga e tika ana.
Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)
Nō reira, hei whakamutunga, ehara te cholecystitis i te mea hei takaro noa.- Mena kei a koe ngā tohu pēnei i te mamae nui i te taha matau o runga o tō puku, te whakapairuaki, te ruaki, me te kirika, me toro atu koe ki te tākuta. Kaua e whakaroa.
- I te nuinga o te wā, ka puta mai tēnei i ngā kohatu o te pūkahukahu, engari tera pea ētahi atu take.
- Mā te maimoatanga tika, ka taea te whakaora katoa i tēnei mate. He maha ngā wā, ko te tango pokanga i te pūkahukahu te otinga pai rawa atu.
- Ki te kore e rongoatia , ka puta pea ngā raruraru kino ka mōrearea ai te ora .
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