He aha mēnā he mate kino tōu, he aukati, he mate pukupuku rānei kei roto i ō whekau, ā, me pokanga nui? I ētahi wā, me tere tonu te mahi a ngā tākuta i tētahi pokanga whakaora ora. Ko tētahi tikanga motuhake e whakamahia ana i roto i ēnei momo take ko te Tikanga a Hartmann. Tērā pea he ahua whakamataku te ingoa, engari me kōrero mārama, me te ngāwari hoki mō ngā mea e tupu ana, te take e mahia ai, me ngā mea e tupu ana i muri i te pokanga.
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He aha te tikanga o Hartmann?
He pokanga te tikanga Hartmann e mahia ana i runga i te whekau nui (koroni). Ina koa, ko te tapahi me te tango i te wāhanga mate o te whekau nui, inā koa te wāhanga whakamutunga e puta ai te paru, arā , te koroni sigmoid, me te wāhanga o runga o te rectum i ētahi wā.
Whakaarohia i muri i te tango i te wāhanga mate o te whekau, me hono anō ngā wāhanga hauora e rua e toe ana. Heoi, he tino mōrearea te hono anō i ngā wāhanga e rua i te wā kotahi ina he mate kino, he pupuhi, he raruraru rānei. Mā te mahi pēnā ka horapa anō te mate, ka waiho hei raruraru nui.
Koia te take e hoatu ana e ngā tākuta he wā ki ngā wāhanga e rua e toe ana o te whekau kia ora ai.
1. Ka tuia te pito o te whekau e hono ana ki te nono (te pūtake rekereke) mō te wā poto.
2. Ko te pito hauora o te whekau nui, kei runga, e piri ana ki tētahi kōhao iti (stoma) i hangaia i roto i te pakitara o te puku.
Koinei te wāhi e puta mai ai te tūtae mā roto i tēnei pūaha hou i roto i te puku. Ka kiia tēnei he colostomy . Hei kohi i tēnei tūtae, ka tāpirihia he putea motuhake (pēke colostomy) ki waho o taua pūaha.
Ahakoa he panoni nui tēnei, kia maumahara, he otinga rangitahi noa iho tēnei. Kia ora pai te whekau (mō te 6-12 marama pea), ka taea te mahi i tētahi atu pokanga hei hono anō i ngā wāhanga e rua o te whekau i āraia, hei kati i te colostomy.
He aha koe i hiahia ai ki tēnei pokanga?
He maha ngā take matua mō te mahi i te tikanga Hartmann. He maha ngā take mō te tango i tētahi wāhanga o te whekau me te whakatakoto i te colostomy.
He aha i tangohia ai tetahi wāhanga o te whekau?
- Ārai: Mena he ārai kei roto i te whekau e kore ai e neke te tūtae.
- Pūhao: Ki te puta he kōhao i te pakitara o te puku, ā, ka turuturu te paru ki roto i te kōhao puku, ka horapa te mate puta noa i te kōhao puku (peritonitis).
- He mate urutā, he mate rānei kāore e taea te whakahaere: Ko ētahi mate urutā (hei tauira, te diverticulitis uaua) me ngā mate pēnei i te mate pukupuku, me tango pea te wāhanga mate hei ārai i te horapa atu.
He aha i whakatakotoria ai he colostomy?
E ai ki te kōrero i runga ake nei, ina mahia te pokanga i roto i te wā ohorere, ka ngoikore te tinana o te tūroro, ā, he tino teitei te tūponotanga o te mate. I roto i tēnei āhuatanga, he tino mōrearea te hono i ngā wāhanga e rua o te whekau (anastomosis). Nō reira, ko te whāinga tuatahi a ngā tākuta ko te whakaora i te ora o te tūroro. Mā te colostomy ka whai wā te whekau ki te ora, ā, ka taea te pokanga anō kia tika ake, kia iti ake te mōrearea, kia whakahokia mai ai te āhua noa.
| Ngā āhuatanga hauora matua e arahi ana ki te pokanga a Hartmann | |
|---|---|
| Ngā take tino noa |
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| Ētahi atu take | |
Te āhua o te pokanga me te tukanga
E rua ngā huarahi matua e taea ai tēnei pokanga:
1. Pokanga Tuwhera: Ka mahia te pokanga mā te whakatuwhera i te kōhao puku mā roto i tētahi tapahi nui i te puku. Ko tēnei tikanga te mea e whakamahia ana i ngā wā ohorere me ngā wā uaua.
2. Pokanga Laparoscopic: Ka mahia te pokanga mā roto i ētahi tapahi iti i roto i te puku, mā te whakamahi i tētahi kāmera me ngā taputapu motuhake. Ahakoa he tere ake te whakaoranga, kāore tēnei tikanga e pai mō ngā tūroro katoa.
I mua i te pokanga
Mena kei te whakaritehia koe mō te pokanga, ka tonoa koe kia nohopuku mō ngā haora 6-12. Tērā pea ka hoatu he wai motuhake ki a koe (te whakarite puku) hei horoi i ō whekau. I muri i tō whakaurunga ki te hōhipera, ka whakaurua he cannula tote ki roto i te uaua i tō ringa, ā, ka hoatu he wai me ngā rongoā ki a koe.
I te wā o te pokanga
Ka mahia te pokanga i raro i te mate whakamoe whānui. Ka tangohia e te taote pokanga te wāhanga mate o te whekau, ka kati i te pito o te pūkahukahu, ā, ka herea te pito kē atu ki te puku.Ka tāpirihia te stoma ki te pūaha. Hei whakamutunga, ka tāpirihia te putea colostomy, ā, ka tuia ngā patunga pokanga. E rua ki te whā hāora pea te roa o tēnei tukanga katoa.
I muri i te pokanga
I muri i te pokanga, ka haria koe ki te rūma whakaora, kātahi ka whakawhitia ki te wāhanga ina tau tō āhua. Me noho koe ki te hōhipera mō te 7-10 rā pea.
- I ngā rā tōmua, ka hoatu ngā rongoā whakamamae, ngā paturopi, me ngā wai mā te tote.
- Tērā pea ka roa ētahi rā ka mahi anō ngā whekau.
- Tuatahi, ka hoatu he kai wai ki a rātou, kātahi ka whakaurua mārire ki ngā kai totoka.
- Mā te nēhi whakangungu motuhake koe me tō whānau e ako ki te horoi me te whakawhiti i te putea colostomy, me pēhea hoki te tiaki i te stoma (tiaki stoma).
He aha ngā mōrearea me ngā pānga taha ka pā mai?
Pērā i ngā mahi pokanga katoa, he tūponotanga kei reira, engari e kiia ana he tikanga haumaru.
- Ngā tūponotanga pea: te mate patunga, te mate pūkahukahu (niumōnia), te toto o roto, te turuturu o te puku, te kino o ngā whekau e karapoti ana, te hanganga hernia.
- Ngā pānga taha pea:
- Te ileus rangitahi: Ka roa te wā ka tīmata anō te mahi a ngā whekau i muri i te pokanga.
- Puta i te pūwero: Ahakoa kāore koe e puku ana, ka puta mai pea he wai rite ki te hūpē i te toenga o te pūwero. He mea noa tēnei.
- Te ngoikore o te moepuku: He tino onge te wā ka pakaru ngā io e pā ana ki te mahi moepuku. Kōrero ki tō tākuta mēnā he āwangawanga āu mō tēnei.
Te whakaoranga me te whakaoranga
He wā te roa hei whakaora katoa.
- Wiki 4-6: Whakaitihia te whakamahinga o ngā rongoā mamae, hoki ki te kai noa, ka tīmata anō ki te whakakori tinana māmā.
- 3-6 marama: Te taunga ki te noho me te pēke colostomy, te āhua kua tino ora te tinana.
Ka taea te whakakore i te colostomy? (Whakahokinga)
Koinei te raruraru nui rawa atu mō te tini o te tangata. Ae, i te nuinga o te wā ka taea te whakakore.
Tata ki te 6-12 marama i muri i tō pokanga tuatahi, ka arotakehia anō tō hauora e tō taote pokanga. Mena kei te pai tō hauora, kua ora pai tō whekau, ā, ka taea e koe te manawanui ki tētahi atu pokanga, ka taea e koe te whiriwhiri kia whai pokanga whakahuri .
Heoi, mēnā kua horapa te mate pukupuku puta noa i te tinana, mēnā he mate pūnaha kino, mēnā rānei he tino ngoikore te tūroro, kāore pea te tākuta e tūtohu kia pokanga tuarua. Ka taea e koe te kōrero māhorahora ki tō tākuta mō ēnei mea katoa.
Karere Tangohia ki te Kāinga
- He tino nui te pokanga whakaora ora te tikanga Hartmann, e mahia ana i ngā wā ohorere.
- Ko tēnei pokanga he hanga i tētahi pūaha rangitahi i roto i te puku hei wāhi e puta ai te tūtae. Ka kiia tēnei he colostomy , ā, me ako koe ki te noho tahi me tēnei.
- Mō te nuinga o ngā tūroro, he rangitahi noa iho tēnei colostomy, ā, ka taea te whakaora anō mā tētahi atu pokanga i muri i ngā marama 6-12.
- He roa te wā e pau ana ki te whakaora. Me tautoko koe me tō whānau kia urutau ai ki tēnei huringa, ā-tinana, ā-hinengaro hoki.
- He mea tino nui kia kōrero noa koe ki tō tākuta mō ō pātai, ō wehi rānei.
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