He aha te Tukanga a Hartmann? Me ako ngāwari tātou.

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.

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.

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.

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.