He mahi whakamiharo tā te pūnaha nakunaku hei nakunaku me te mimiti i te kai e kainga ana e tātou. Engari whakaarohia, he aha te mea ka tupu mēnā he arai kei tētahi wāhi i tēnei haerenga, pērā i te rori kua āraia? Kāore e taea e te kai te neke whakamua. I roto i ēnei āhuatanga, ka kiia he pokanga motuhake he Gastrojejunostomy, e whakamahia ana hei karo i taua arai me te waihanga i tētahi ara hou mō te kai kia haere. Tērā pea kua kōrerotia tēnei e te tākuta ki a koe, kua rongo rānei koe mō tēnei mea, ā, ka hiahia koe ki te mōhio. Me kōrero ngāwari tātou mō tēnei, i roto i tētahi huarahi e mārama ai koe.
He aha te tikanga o te pokanga Gastrojejunostomy?
He pokanga te gastrojejunostomy e hanga hononga hou ana i waenganui i tō puku me te wāhanga waenga o tō whekau iti, e kiia nei ko te jejunum. Arā, ka taea e te kai te haere tika mai i te puku ki te wāhanga waenga o te whekau iti, e kiia nei ko te duodenum, kaua ki te haere ki te duodenum. Ka kiia tēnei hononga hou he anastomosis i roto i ngā kupu hauora.
Whakaarohia te keri i tētahi kōhao nui i te rori, ā, kāore e taea e ngā waka te haere. Kātahi ka tapahia he rori hou ki tērā taha o te kōhao, ka tukuna ngā waka kia haere, tika? Koinei te mahi a tēnei pokanga.
Engari kotahi te mea hei maumahara. Tērā tētahi atu mea e kiia ana ko te mea kotahi. He ngongo whāngai tēnā, he ngongo e whakaurua ana ki roto i te whekau iti hei whāngai i te tangata e uaua ana ki te kai. Ka haere hoki mā roto i te puku, ka uru ki roto i te jejunum, nō reira ka kiia he ngongo gastrojejunostomy. Engari ehara tēnā i te pokanga nui e kōrerohia ana e tātou. He tikanga motuhake tēnā.
He aha tātou i hiahia ai ki tēnei momo pokanga?
Ko te take matua mō tēnei pokanga he ārai kei te haere o te kai mai i te puku, i te wāhanga tuatahi rānei o te whekau iti. Mā tēnei ārai ka kore e neke whakamua te kai. He maha ngā āhuatanga pēnei.
| Āhua | He Whakamārama Māmā |
|---|---|
| Te Ārai Putanga Puku (GOO) | Ka āraia te wāhanga o raro o te puku, te tomokanga ki te whekau iti (pylorus), mō tētahi take. |
| Te aukati o te duodenum | Kāore te aukati i roto i te puku, engari kei te wāhanga tuatahi o te whekau iti e whai ake ana i reira (duodenum). |
| Te Matepukupuku Puku, te Matepukupuku Duodenal rānei | Te aukati i te korokoro nā te pukupuku matepukupuku, hei wāhanga rānei o te pokanga hei tango i te pukupuku. |
| Te Mate Pukupuku Peptic | Ngā raruraru pērā i te toto mai i ngā patunga kāore e ora, te kiriuhi rānei o ngā patunga ka ārai i te ara nakunaku. |
Hei tāpiritanga, i ētahi wā ka mahia hoki tēnei pokanga hei ārai i tētahi raruraru pea ā muri ake nei .
- Te whara ki te whekau iti: Mena ka tino pakaru te wāhanga tuatahi o te whekau iti, pērā i te aituā, ka mahia tēnei pokanga hei aukati i te kai kia haere mā roto kia ora rā anō. Ki te kore, ka puta he kōhao rerekē (fistula) mā roto i te whara, ka kino ai ngā whekau tata pērā i te repe taiaki.
- Matepukupuku Repeure: Mena kei te taha tonu o te whekau iti te matepukupuku repeure, ā, kāore e taea te tango mā te pokanga, tera pea ka tipu, ka aukati i te paipa kai a muri ake nei. I mua i tērā, ka whakatau pea ngā tākuta ki te mahi i tēnei pokanga hei ārai.
He aha ngā mea ka mahia i mua i te pokanga? Kei te pēhea te whakarite?
Ka ngana te tīma hauora ki te whakaora i a koe i mua i te pokanga. Whakaarohia, he tangata kua purua te korokoro, kāore e taea te kai, ā, e ruaki tonu ana. Ka arahi pea tēnei ki te matewai me te kore kai pai . Nō reira, me whakatika ēnei mea i mua i te pokanga.
Tērā pea ka mahi tō rōpū hauora i ngā mea penei:
- Tote (wai IV): Ka tukuna te tote ki roto i te uaua hei whakatika i te pupuri wai me te kore taurite o ngā electrolytes.
- Kai mā te werohanga IV: Nā te mea kāore e taea te kai mā te waha, ka tukuna tika atu ngā kai e tika ana ki roto i te uaua.
- Te whakawhiti toto: Mena he anemia tōu, me whiwhi pea koe i te whakawhiti toto.
- Paturopi: Ka hoatu ngā paturopi i mua i te pokanga hei ārai i te mate i muri i te pokanga.
- Te whakaiti i te pēhanga o te puku:Ka whakaurua he ngongo mā te ihu ki roto i te puku, ā, ka tangohia ētahi o ngā mea o roto hei whakaiti i te pēhanga. Ka piki ake te haumaru o te rongoā whakamoe.
He aha ngā mea ka tupu i te wā o te pokanga?
Ahakoa he maha ngā huarahi hei mahi i tēnei pokanga, koinei ngā mahi e mahia ana i te nuinga o te wā.
1. Whakamoemoe: Tuatahi, ka tukuna koe kia moe rawa (whakamoemoe whānui). Kāore koe e rongo i tetahi mea.
2. Te whakawātea i te puku: Ka whakaurua he ngongo mā te ihu, mā te waha rānei hei tango i ngā mea o roto i te puku, hei whakaiti hoki i te pēhanga.
3. Te tomo ki te kōhao puku: Ka tomo te taote pokanga ki te kōhao puku. E rua ngā huarahi e taea ai tēnei. Ko tētahi he pokanga tuwhera , arā, ko te tapahi i tētahi wahi iti ki te puku. Ko tētahi atu he pokanga laparoscopic, arā, ko te tapahi i ētahi wahi iti ki te puku me te whakauru i tētahi kāmera me ngā taputapu angiangi. Ka kiia hoki tēnei ko te "pokanga kī-pōro".
4. Te tautuhi i te wāhi o te raruraru: Ka kitea te wāhi tuturu o te aukati i roto i te puku, i te whekau iti rānei.
5. Te whakarite i te whekau iti: Ka hangaia he koropiko mai i te wāhanga waenga (jejunum) kia 10 henimita te tawhiti mai i te pito o te wāhanga tuatahi o te whekau iti (duodenum).
6. Te waihanga i tētahi hononga hou: Ka honoa te wāhanga whekau iti kua hangaia ki te puku kia 5 henimita te iti rawa i runga ake i te ārai. Koinei te ara 'takahi' hou i kōrerotia i mua ake nei.
7. Tirotiro: Ka tirohia te anastomosis hou kua hangaia mā te whakamahi i ngā tikanga maha hei whakarite kei te hono tika, ā, kāore he turuturu.
8. Te otinga o te pokanga: Ki te pai ngā mea katoa, ka katihia ngā tapahi/kōhao i mahia, ā, ka oti te pokanga.
I te nuinga o te wā, ka roa pea tēnei pokanga mō te rua ki te whā hāora .
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka haria koe ki te hōhipera. Tērā pea kāore e taea e koe te kai tonu i te āhua o te tinana. Tērā pea ka paku whakapairuaki koe i ngā rā tuatahi. I ētahi wā, i muri i te pokanga, ka paku "mangere" ō whekau (paralytic ileus). Ko te tikanga tēnei ka paku puhoi te mahi a te whekau.
I te tīmatanga, ka hoatu pea he tote me te kai mā roto i te uaua. Kātahi ka tīmata koe ki te kai wai mārama , ka neke haere ki te kai ngawari, kātahi ka whakauru haere i ngā kai noa i mua i tō hokinga ki te kāinga. Tērā pea ka roa ētahi wiki kia taunga ai ētahi tāngata ki te hononga hou i roto i ō rātou puku. I tēnei wā, me whāngai tonu pea koe mā roto i te ngongo, mā roto rānei i te uaua.
He aha ngā mōrearea me ngā raruraru ka pā mai i tēnei pokanga?
Pērā i ngā pokanga katoa, he tūponotanga kei roto. Ehara i te katoa ka pāngia e ēnei tūponotanga, engari he mea pai kia mōhio ki ēnei tūponotanga.
| Momo mōrearea | Whakaahuatanga |
|---|---|
| Ngā tūponotanga e pā ana ki tētahi pokanga |
|
| Ngā tūponotanga motuhake ki tēnei pokanga | Te turuturu o te hononga toto: He āhuatanga onge tēnei. Kāore te hononga hou i hiritia kia tika, ā, ka turuturu ngā ihirangi o te puku, o te puku rānei ki roto i te kōhao puku. Ka pā mai pea he mate kino. Ki te uru te mate ki roto i te toto, ka mate pea (sepsis). |
Ngā pānga taha ka puta pea i muri i te pokanga
Ahakoa ka angitu te pokanga, ka puta pea ētahi pānga taha i roto i te wā. Ko te nuinga o ēnei ka taea te whakahaere.
| Pānga taha | Ka ahatia? |
|---|---|
| Te Mate Putunga | Ka "tuku" ohorere, ka tere hoki te kai mai i te puku ki roto i te whekau iti. Ka puta ngā tohu pēnei i te whakapairuaki, te pupuhi, te mamae o te puku, me te werawera i muri i te kai. Ka memeha haere tēnei i muri i tētahi wā i te wā e taunga ana te tinana ki tēnei. |
| Te Mate Pukupuku o te Taha | I te nuinga o te wā, kei roto i te puku me te wāhanga tuatahi o te whekau iti ngā waikawa o te puku. Kua hangaia aua wāhanga kia tū atu ki a rātou. Engari nā tēnei arai, ka haere tika ngā waikawa o te puku ki te wāhanga waenga o te whekau iti (jejunum). Kāore e taea e taua wāhanga te tū atu ki ngā waikawa. Nō reira, ka puta he mate pukupuku ki reira. |
| Te Whakahokinga o te Au | I te nuinga o te wā, ka āraia ngā matū e āwhina ana i te nakunaku, pērā i te au, kia kaua e hoki ki roto i te puku. Engari nā tēnei hononga hou, ka taea e aua matū te hoki ki roto i te puku. Ka taea e tēnei te whakamumura i ngā pakitara o te puku. |
He pēhea te wā whakaora?
E ono wiki pea te roa hei whakaora katoa, engari ka rerekē pea tēnei i runga i te momo pokanga i mahia ki a koe (tuwhera, laparoscopic rānei) me tō āhua tinana.
Mā tō tīma hauora koe e tohutohu mō te tiaki i ō tapahi, te whakahaere i te mamae, me te wā ka taea e koe te hoki anō ki ngā mahi o ia rā i muri i tō hokinga ki te kāinga. Mā rātou anō hoki koe e tohutohu ki te kite anō i a koe i roto i ētahi wiki i muri i tō pokanga.
Me whai pea koe i tētahi kai motuhake mō ētahi marama i muri i te pokanga, inā koa te karo i ngā kai he nui te huka me te tango i ngā tāpiringa huaora.
Ki te pā mai ēnei tohu ki a koe, waea atu ki tō tākuta tonu atu.
Ki te puta mai tētahi o ngā tohu e whai ake nei i muri i tō hokinga ki te kāinga, me whakamōhio tonu atu ki tō tākuta, ki te hōhipera rānei i whiwhi ai koe i te maimoatanga .
- Ki te mea ka whero, ka mamae, ka pupuhi, ka mahana rānei te taha o te wahi i tapahia (he tohu mate ēnei).
- Mena he kirika tōu neke atu i te 38° Celsius (100° Fahrenheit).
- Mena he uaua te whakahaere i te mamae.
- Mena he uaua ki a koe te kai, te pupuri rānei i te kai kia iti.
- Mena he mate korere tonu tōu.
- Ki te huri tō kiri, te mā rānei o ō kanohi hei kōwhai .
Karere Tangohia ki te Kāinga
- He pokanga te Gastrojejunostomy e hanga ana i tētahi ara 'takahi' hou mai i te puku ki te korokoro.
- Ko te tikanga o tēnei he rongoā mō ngā āhuatanga pēnei i te aukati i te ara nakunaku, te mate pukupuku, ngā mate puku kino rānei.
- I mua i te pokanga, ka tukuna koe ki te maimoatanga e tika ana kia pai rawa atu tō āhua tinana.
- He roa te wā e ora ai, inā koa te taunga ki ngā huringa o te kai.
- Tērā pea ka puta ētahi pānga taha i muri i te pokanga, engari ko te nuinga ka taea te whakahaere.
- Kia tika te whai i ngā tohutohu a tō tākuta. Mēnā ka pāngia koe e ētahi tohu mōrearea, rapua tonutia he tohutohu hauora.
- He panonitanga nui tēnei mō tō ao, nō reira kaua e mangere ki te tiki i te āwhina me ngā tohutohu katoa e hiahiatia ana e koe mai i tō tīma hauora i a koe e haere ana.
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