Kua kī atu tō tākuta ki a koe, ki tētahi rānei o tō whānau, me whai pokanga koe e kiia nei ko te "Hartmann's Procedure"? Tērā pea i mataku koe i tō rongonga i taua ingoa. He mea noa iho. Engari he pokanga tino nui tēnei e mahia ana hei whakaora i ngā oranga. Nō reira, i tēnei rā, me kōrero tātou mō tēnei mea kia māmā noa iho, kia kore ai e puta ngā pātai me ngā mataku katoa kei a koe mō tēnei mea.
He aha te tikanga a Hartmann?
Whakaarohia tō tātou pūnaha nakunaku he ngongo roa. Ko te pito o tēnei ngongo te mea e kiia nei e tātou ko te koroni. I roto i te tikanga Hartmann, ka tangohia te pito mate me te pakaru o te koroni (e kiia nei ko te koroni sigmoid) me ētahi wāhanga o te rectum, te wāhi e rongoa ai te paru.
He whakarāpopototanga noa iho tēnei, he pokanga e tango ana i tētahi wāhanga o te whekau nui (colectomy). Heoi, ko te mea motuhake, i muri i te tangohanga o tētahi wāhanga, kāore e honoa anō ngā wāhanga e rua e toe ana o te whekau.
Engari, ka mahi te taote pokanga i tētahi mea pēnei:
1. Ka tuia kia kati te pito o te whekau e hono ana ki te pūkahukahu.
2. Ko te wāhanga hauora o tō koroni e puta mai ana i te tihi e hono ana ki tētahi pūaha iti (e kiia nei ko te stoma) i hangaia i roto i te kiri o tō puku.
Kātahi ka whakatakotoria he pēke colostomy ki waho o tēnei pūaha. Ka puta tō paru i roto i tō tinana ki roto i tēnei pēke. Ahakoa he ahua nui tēnei, he wā poto noa iho. I muri i te ora o tō puku, tata ki te 6 ki te 12 marama i muri mai, ka taea te mahi i tētahi atu pokanga hei tango i te pēke me te hono anō i ngā wāhanga e rua o tō puku.
He aha i tika ai kia mahia tēnei momo pokanga?
E rua ngā take matua mō te mahi i te tikanga Hartmann. Ko tētahi he tango i tētahi wāhanga o te whekau. Ko tētahi he whakatakoto i tētahi putea colostomy. Me titiro tātou ki ngā take mō ia o ēnei.
He aha i tapahia ai tetahi wāhanga o te whekau, ā, i tangohia atu ai?
Tērā pea me tango tetahi wāhanga o te koroni o te tangata mō ēnei take e whai ake nei:
- Te aukati i te puku: Mena kua tino aukatia tetahi wāhanga o te puku nā te pukupuku, te mate pukupuku, tetahi atu take rānei, me tango taua wāhanga.
- Te Pūngao o te Puku: Ki te puta he kōhao i roto i te puku nā te mate, nā te aituā rānei, ka turuturu te paru ki roto i te puku, he mea morearea ki te ora. Nō reira, me tango tonu te wāhanga kua pakaru.
- He mate urutā, he mate rānei kāore e taea te whakahaere: Hei aukati i te horapa o ētahi mate urutā (hei tauira, te diverticulitis kino) me ngā mate pēnei i te mate pukupuku, me tango katoa te wāhanga mate.
He aha i whakanohoia ai he putea colostomy?
Ko te tango i tētahi wāhanga o te whekau me te hono anō i ngā wāhanga e rua e toe ana i roto i te pokanga kotahi ka kiia he "anastomosis tuatahi." Heoi, kia taea ai tēnei, me tino pai te āhua o te tūroro, ā, me kore he mōrearea o te mate.
Engari he maha ngā wā ka mahia te tikanga Hartmann i roto i ngā āhuatanga ohorere.Arā, ina pāngia te tūroro e te mate kino, e te mumura rānei i roto i te kōhao puku. I roto i tēnei āhuatanga mōrearea, ki te hono ngā wāhanga e rua o te whekau tetahi ki tetahi, kāore pea ngā tuitui e ora tika, ā, ka turuturu anō te paru, ka kino rawa atu te āhuatanga.
Nō reira, ko tā te taote pokanga he aro tuatahi ki te raruraru o nāianei (tangohia te wāhanga mate) me te tuku wā ki te puku kia ora. Koinā te mahi a te putea colostomy. Kātahi, ina ora katoa ngā mea, ka whai wāhi ki te mahi i tētahi atu pokanga hei whakahoki i te āhua ki te āhua noa i te wā tika.
He aha ngā take matua mō te mahi i te pokanga Hartmann?
He maha ngā āhuatanga hauora e hiahiatia ai tēnei pokanga.
| Āhuatanga hauora | He whakamārama māmā |
|---|---|
| Diverticulitis uaua | Ka pangia, ka pakū ngā pēke iti i roto i te pakitara o te whekau nui, ka horapa te mate puta noa i te kōhao puku (peritonitis). He mate tino kino tēnei. |
| Matepukupuku o te repeure | Ka taea tēnei pokanga te mahi i roto i tētahi āhuatanga ohorere, pērā i te wā e āraihia ai te puku e te pukupuku matepukupuku, e pokaia ana te puku, e nui rawa rānei te toto. |
| Ētahi atu take | Mēnā he aukati te puku nā ngā koha o tētahi pokanga o mua, he ngaronga o te rere o te toto ki te puku, he aituā kino, he turuturu rānei o ngā tuitui o tētahi pokanga o mua. |
Me pēhea te mahi i te pokanga?
E rua ngā huarahi e taea ai te mahi i te pokanga a Hartmann.
1. Pokanga Tuwhera: I tēnei, ka mahia te pokanga mā te tapahi i tētahi puku kia paku nui ake, ka huaki ai te kōhao o te puku.
2. Pokanga Laparoscopic:Ka kiia hoki tēnei ko te "pokanga kōhao kī". Ka mahia te pokanga mā roto i ētahi tapahi iti i roto i te puku, ā, ka whakauruhia he kāmera (laparoscope) me ngā taputapu motuhake. He iti ake te kiripaka e toe ana i tēnei tikanga, ā, he poto ake te wā whakaora.
Heoi, i runga i te kaha o tō mate, ka taea e koe te tīmata me te huarahi laparoscopic, kātahi ka huri ki te pokanga tuwhera i te wā e whakahaerehia ana. Mā tō taote pokanga tēnei e whakatau.
He aha ngā mea ka tupu i mua i te pokanga?
- Ka tonoa koe kia mutu te kai me te inu i ngā haora 6-12 i mua i te pokanga.
- I runga i tō āhua, ka hoatu pea he inu motuhake ki a koe hei horoi i ō whekau.
- Ina tae koe ki te hōhipera, ka whakauruhia he catheter IV ki roto i tētahi uaua i tō ringa.
- Mā te tākuta koe e whakamārama i mua i te wā e tika ana mō ngā rongoā whakamamae.
He aha ngā mea ka tupu i te wā o te pokanga?
Ka tukuna he rongoā whakamoe whānui ki a koe, nō reira kāore koe e rongo i tetahi mea. E rua ki te whā hāora pea te roa o te pokanga. Ka tangohia e te taote pokanga te wāhanga mate o te whekau, ka hangaia he colostomy e ai ki tā tātou i kōrero ai i mua ake nei, ā, ka tuitui i ngā tapahi.
He aha ngā mea hei tumanakohia i muri i te pokanga?
I muri i te pokanga, ka haria tuatahitia koe ki te rūma whakaora. Kia pumau tō āhua, ka whakawhitia koe ki te wāhanga.
- Noho hōhipera: I te nuinga o te wā, me noho koe ki te hōhipera mō te 7-10 rā.
- Kai: Ko te kai wai anake ka hoatu i ngā rā tōmua. Mā te āta haere, ka whakaurua rātou ki te kai noa.
- Mamae: Ka hoatu ngā rongoā whakamamae uaua mō ngā rā tuatahi, kātahi ka huri ki ngā papa.
- Te mahi a te whekau: Tērā pea ka roa ētahi rā ka tīmata anō te mahi a ngā whekau i muri i te pokanga.
- Pēke Colostomy: Mā te nēhi whakangungu motuhake (nēhi stoma) koe e ārahi ki te whakamahi, ki te horoi, me te whakarerekē. Kaua e manukanuka, ka roa pea te wā e taunga ai koe.
Āhea ahau ka taea te hoki ki te kāinga?
- Ina hoki anō ngā mea pēnei i te tere o te manawa me te toto ki te āhua noa.
- Ina taea e koe te ara ake me te hikoi me te kore he awhina a tetahi.
- Ina tīmata te turuturu o te tūtae ki roto i te putea colostomy.
- Ina taea te whakahaere i te mamae ki ngā pire.
- Āhea ka taea e koe te whakarerekē i te putea colostomy māu ake.
He aha ngā mōrearea me ngā pānga taha ka pā mai?
Pērā i ngā pokanga katoa, he tūponotanga kei roto, ā, he mea nui kia kōrerohia ēnei ki tō tākuta.
- Ngā raruraru pea: Te mate o te patunga, te niumōnia, te toto o roto, te toto totoka, te hanganga hernia, me ētahi atu.
- Ngā pānga taha:
- Te ngoikore o te puku rangitahi (Ileus): Whai muri i te pokanga, tera pea ka roa te mahi a ngā whekau. Mō aua rā, ka whakaratohia te kai mā te tote.
- Puta mai i te tūtae: Ahakoa kāore te tūtae e puta mai ana, ka puta mai pea he wai rite ki te hūpē i te toenga o te tūtae.
- Ngā pānga ki te mahi ā-ira tangata: He tino onge, ka puta he panoni ki te aro, ki te mahi rānei o te taha ā-ira tangata i te pakaru o ngā io i te wāhi e pokangahia ana. Mena he āwangawanga āu mō tēnei, kōrero noa ki tō tākuta.
Ka taea te tango anō i te putea colostomy? (Pokanga Whakahurihuri)
Koinei te raruraru nui rawa atu o te tini tāngata. Ae, he tokomaha e taea te whakahoki i tēnei ki te āhua noa.
I waenganui i te 6 me te 12 marama i muri i te tikanga Hartmann, ka arotakehia anō tō hauora e tō tākuta. Mena kei te ora pai koe, ā, kāore he mate kino kē atu, ka mahia pea tētahi atu pokanga hei tango i te putea colostomy me te hono anō i ngā wāhanga e rua o tō whekau.
Heoi anō, kāore pea ētahi tāngata e āhei ki te mahi i tēnei pokanga tuarua. Hei tauira:
- Mena kua horapa te mate pukupuku ki ētahi atu wāhanga o te tinana.
- Mena kei a koe ētahi atu mate kino pēnei i te mate manawa, te mate pūkahukahu rānei.
- Mena kāore e taea e koe te utu mō tētahi atu pokanga nā te koroheketanga, nā te momona rawa rānei.
Ko tō taote pokanga te tangata pai rawa atu hei whakatau i tēnei.
Karere Tangohia ki te Kāinga
- Kāore he mea e wehi ai te Tikanga a Hartmann. He maha ngā wā ka mahia hei whakaora i a koe i tētahi mea e morearea ai te ora, pērā i te mate pukupuku, i tētahi mate kino rānei.
- He roa te wā e hiahiatia ana hei taunga ki te noho me te pēke colostomy, engari ka taea tonu. Ma te hōhipera koe e whakarato ki ngā tohutohu me te tautoko e hiahiatia ana e koe.
- Ko te mea nui , he āhua rangitahi noa iho tēnei mō te nuinga o te tangata. Tērā pea ka ora anō rātou i muri i tētahi atu pokanga i roto i ētahi marama.
- He tika tōu ki te kōrero tuwhera ki tō tākuta mō ngā pātai, ngā wehi, ngā ruarua rānei kei a koe.
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