Kua rongo koe i te mea kei te pā te manawa o tō ngākau, kei te tere te pā, ā, kei te pēhia tō uma e tetahi mea rerekē? Koinei te mea e kiia nei e mātou ko te Atrial Fibrillation (AFib) i roto i te rongoā. He mate manawa tēnei e tino kitea ana. I te nuinga o te wā, ka taea te whakahaere i tēnei āhuatanga mā te rongoā. Engari mō ētahi tāngata, he uaua ki te whakahaere mā te rongoā anake. I ēnei wā, ka kōrero tātou mō tētahi pokanga tino angitu e taunakihia ana e ngā tākuta. Ko te Maze Procedure te ingoa. Ahakoa he ahua rerekē te ingoa, kua taea e ia te whakaora i te oranga o te tini o te hunga e pāngia ana e te AFib.
He aha te tikanga o tēnei Maze Procedure?
Whakaarohia tētahi kēmu maze. Kotahi anake te ara tomo, kotahi te ara puta, kotahi anake te ara tika i waenganui. Engari he maha anō hoki ngā ara hē e anga whakamua ana ki roto, ki muri hoki. Ko te mea anō tēnei e tupu ana i roto i te Tukanga Maze.
I roto i tēnei tikanga, ka hangaia e te taote pokanga he tauira kiko whara tino ātaahua, kua whakaritea, ki runga i te kiko o tō ngākau. He rite ki te hanga i tētahi arai i roto i te ngākau.
Nā, tirohia, ko te mea e tupu ana i roto i te ngākau o te tangata e pāngia ana e te Atrial Fibrillation, ko ngā tohu hiko e whakahaere ana i te manawa o te ngākau ka tīmata i te āhua pōrearea, ka tīmata i te wāhi kotahi ka horapa ki ngā ringa e whā. Koinei te take e ngaro ai te manawataki o te ngākau, ka tīmata te tere o te patu.
Ka ārai te tauira kiko whara i hangaia i roto i te Tukanga Maze i ngā ara mō ngā tohu hiko hē, koretake, kia haere whakamua, kia hoki whakamuri . I taua wā anō, ka whakatuwheratia te ara anake mō te tohu hiko tika kia whiua . Pērā i te ara tika i roto i te maze. Ka ārai tēnei i ngā tohu hē katoa, ā, ka taea anake ngā tohu tika te haere. Hei te mutunga, ka hoki tō tere manawa ki tētahi auau hauora, noa iho.
E rua ngā tikanga e whakamahia ana e ngā tākuta hei whakatika i tēnei kiko koha:
- Cryoablation: Ka whakamahia te makariri rawa (hukapapa) hei kino i te kiko me te whakaputa i te whara.
- Pūngao auau irirangi: Ka whakamahia te pūngao auau irirangi hei whakamahana i te kiko, hei whakaputa i te whara.
Ka taea te mahi i tēnei tikanga i ētahi wā i te wā kotahi me ētahi atu pokanga ngākau (pēnei i te pokanga bypass). Ka taea rānei te mahi takitahi. I ēnei rā, ko te momo pokanga hou me te tino matatau, ko te tikanga Cox-maze IV , e kiia ana ko te "paerewa koura" mō te atrial fibrillation.
I roto i ēhea āhuatanga ka mahia ai tēnei pokanga?
Kāore te Tukanga Maze i te tūtohutia mō ngā tūroro AFib katoa. Ka kōrero tō tākuta ki a koe mō tēnei tikanga mēnā:
- Kua tonoa māuMena kāore e taea e ngā rongoā te whakahaere i te manawataki o tō ngakau, ki te kore rānei e taea e koe te whakamahi i ētahi rongoā nā ngā pānga taha.
- Mena kei a koe te atrial fibrillation, nā tēnei i puta ai ngā toto totoka i roto i tō tinana, ā, kua puta ai ngā āhuatanga kino pēnei i te whiu .
- Mena kua whakaritea kia pokangahia koe mō tētahi atu mate ngākau (hei tauira, te whakatika i te takirere ngākau, te pokanga bypass) , ka taea te whakamahi i tēnei tikanga hei rongoā i tō atrial fibrillation i te wā kotahi e pokangahia ai.
- Mena kua oti i a koe te maimoatanga e kiia nei ko te Catheter Ablation i mua, ā, kāore i angitu.
Ki te kore e rongoatia, ka taea e te mate e kiia nei ko te atrial fibrillation te whakaneke rua i te mōrearea o te mate, me te whakanui ake i te mōrearea o te whiu mā te rima ki te whitu ngā wā. Ka taea hoki e ia te arahi ki te ngoikore o te ngakau. Nō reira, he mea tino nui kia whiwhi maimoatanga tika mō tēnei mate.
He aha ngā mea ka tupu i mua i te pokanga?
Kāore e taea te pokanga pēnei i te wā kotahi. I mua i tēnā, me tirotirohia e koe te āhua o tō tinana. He maha ngā whakamātautau me ngā haerenga ki te tākuta.
- Te Echocardiogram Transthoracic: He rite tēnei ki te matawai ultrasound o te ngākau. Ka tirohia te rahi o tō atrium maui me te mea he raruraru kei roto i te takirere ngākau.
- Matawai CT (Tomography Rorohiko) o te Uma: Ka mahia he matawai CT o te uma. I ētahi wā, ki te mea he iti noa te pokanga e hiahiatia ana, me whai matawai CT anō hoki koe o te puku me te hope.
- Te tūtaki ki ngā tākuta: Ka tūtaki tō tākuta ngakau, tō taote pokanga, me tō tākuta whakamoe ki a koe ki te whakamārama i te pokanga, ōna mōrearea, me te āhua o te tuku whakamoe. Pātaihia ō pātai i tēnei wā.
- Te whakarato tohutohu: Ka hoatu he tohutohu mārama ki a koe mō ngā mea hei kai, hei inu, hei whakamutu i te tango, me ngā rongoā hei tango i ngā rā i mua i te pokanga.
Me pēhea te mahi i te pokanga?
E rua ngā huarahi matua e taea ai te mahi i te Tukanga Maze. Mā tō taote pokanga e whakatau ko tēhea te tikanga e pai ana mōu.
| Tikanga pokanga | He māmā noa te huarahi ki te mahi. |
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| Pokanga tuwhera (tikanga Sternotomy) |
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| Pokanga poka kī (tikanga torokopiko) |
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Nā te mea he tino iti ngā tapahi e mahia ana i te pokanga kōhao kī (Thoracoscopic), he iti ake ngā raruraru me te poto ake o te noho hōhipera.
He aha te mea e mahia ana ki te Tāpiringa Atrial Mauī?
He wāhanga tino nui tēnei o te Tukanga Maze. Ko te Tāpiringa Atrial Mauī he pēke kiko iti, āhua taringa, e piri ana ki te atrium maui o te ngākau. Koinei te wāhi matua o te hanganga toto totoka i roto i te hunga e pāngia ana e te fibrillation atrial.
Kua kitea e ngā rangahau e 90% o ngā toto totoka e puta ai ngā whiu i roto i ngā tūroro AFib ka puta i tēnei wāhi iti.
Ina whakararuraruhia te manawataki o te ngākau, ka noho pūmau te toto e tomo ana ki tēnei hononga, ā, ka nui ake te tūponotanga o te puta o ngā toto totoka. Mēnā ka pakaru te toto ka puta pēnei, ka haere i roto i ngā oko toto, ka mau ki roto i te uaua o te roro, ka pā mai he whiu.
Nō reira, i te wā o te Tukanga Maze, ka kati te taote pokanga i tēnei Āpitihanga Atrial Mauī mā te whakamahi i ngā tuitui, i ngā tāpa, i tētahi taputapu motuhake rānei, ka tapahia katoatia rānei. Ka taea e tēnei te whakaiti i tō tupono ki te pāngia e te whiu ā muri ake nei.
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, ka puritia koe ki te wāhanga tiaki nui (ICU) hei tirotiro mā te rā kotahi, e rua rānei, kātahi ka whakawhitia ki tētahi wāhanga noa. Mena kua pokanga kē atu koe, tera pea ka roa ake tō noho ki te hōhipera. I te nuinga o te wā, ka taea e te tangata kua pokangahia te pokanga kī te hoki ki te kāinga i roto i ngā rā e whā. Mena kua pokanga tuwhera koe, me noho pea koe mō te wiki pea.
Ahakoa kua hoki koe ki te kāinga, me tango tonu e koe ētahi rongoā mō ētahi marama.
- Ngā rongoā ārai toto (ngā rongoā whakaiti toto): Me tango e koe ēnei rongoā (hei tauira, warfarin, apixaban) mō te iti rawa i te toru marama hei ārai i te toto e pupuhi ana. Whai muri i tēnā, ka whakatau tō tākuta mēnā me haere tonu te tango i ēnei rongoā.
- Ngā rongoā whakahaere i te tere o te ngakau: Tērā pea ka hiahiatia ēnei hei whakahaere i ngā pāorooro ngakau kāore i te tika, ka puta pea i ngā wāhanga tōmua o te whakaoranga o te ngakau.
- Ngā rongoā diuretic: Ka hoatu ēnei rongoā hei whakaiti i te kohi wai koretake i roto i te tinana.
I ētahi wā, kāore e tino ea te AFib i muri i te Tukanga Maze. I ēnei āhuatanga, me tango pea he catheter . Nō reira, he mea nui kia whakapā atu koe ki tō tākuta ngakau i muri i te tikanga.
He aha ngā painga me ngā mōrearea o tēnei pokanga?
| Ngā Painga | Ngā Tūponotanga me ngā Āhuatanga Whakararuraru |
|---|---|
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Kia pēhea te roa o te wā e ora ai?
E toru ki te ono wiki te roa hei hoki atu ki ō mahi o ia rā. Mena kua pokangahia koe ki te pokanga kī, ka tere ake tō wā whakaora nā te mea kāore he tapahi nui i roto i tō uma.
Āhea koe me toro atu anō ki tō tākuta?
Ki te pāngia anō koe e ngā tohumate o te AFib i muri i te pokanga, me whakamōhio tonu atu ki tō tākuta ngakau. Hei tāpiri, me pupuri e koe he rārangi whakamātautau me ngā wā whakarite.
- I hoki ahau ki te kāinga i te hōhipera i roto i te wiki.
- Tirohia te tākuta ngakau i roto i te tata ki te kotahi marama.
- Ka whakamātauhia te electrocardiogram (EKG) i te 3, 6, me te 12 marama i muri i te pokanga, ā, kotahi i te tau.
- He whakamātautau Holter monitor (he taputapu e aroturuki ana i te mahi o te ngākau mō ngā hāora 24) i ngā marama 6 me te 12 i muri i te pokanga.
He mea tino nui kia tika te whakahaere i ēnei whakamātautau katoa kia pai ai tō hauora.
Karere Tangohia ki te Kāinga
- He tino angitu te Tukanga Maze mō te Atrial Fibrillation (AFib), he mate e uaua ana ki te whakahaere mā te rongoā.
- Ko te tikanga o tēnei ko te waihanga i tētahi tauira kiko koha, he rite ki te 'raiha', hei aukati i ngā tohu hiko hē i roto i te ngākau.
- Ka whakataurite tēnei pokanga i te tere o te manawa o tō ngakau, ā, ka tino whakaiti i te mōrearea o te whiu.
- E rua ngā tikanga: te pokanga tuwhera me te pokanga kōhao kī. He tere ake te wā whakaora i muri i te pokanga kōhao kī.
- Kōrerohia ki tō tākuta mēnā he tika tēnei pokanga māu, me ngā painga me ngā mōrearea hoki.
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