He mea noa te ahua whakapairuaki me te mataku ina rongo koe i te kupu "pokanga ate." Nā te mea ko te ate tētahi o ngā okana tino nui, tino nui hoki o roto i tō tātou tinana. Engari mō ētahi mate, inā koa ngā mate kino pēnei i te mate pukupuku, ko te tango i te wāhanga mate o te ate te otinga pai hei whakaora i tō oranga. Nō reira, i tēnei rā, me kōrero tātou mō tēnei 'hepatectomy', arā, te pokanga hei tango i tētahi wāhanga o te ate, i roto i tētahi huarahi māmā, mārama hoki, hei whakamārama i ō feaa katoa.
He aha koe i hiahia ai ki tēnei momo pokanga?
Āe, tuatahi, me titiro tātou ki ngā āhuatanga ka whakatauhia e ngā tākuta kia mahia tēnei pokanga. E rua ngā take matua. Ko tētahi hei rongoā mō te mate ate. Ko tētahi atu ko te tuku a te tangata hauora i tētahi wāhanga o tōna ate ki tētahi tangata mate (Te Whakatō Ate a te Kaituku Ora).
Mō ngā mate ate
He maha ngā wā ka mahia tēnei pokanga hei tango i ngā pukupuku kua puta i roto i te ate. Ka taea e ēnei pukupuku te mate pukupuku, te mate pukupuku o mua, te mate kino rānei. E rua ngā momo mate pukupuku ate.
1. Tuatahi: Ko te tikanga ka tīmata te mate pukupuku i roto i te ate.
2. Tuarua: Ko te tikanga kua tīmata te mate pukupuku ki tētahi atu wāhi o te tinana (hei tauira, te koroni) ā, kua horapa ki te ate.
Ko ngā momo mate pukupuku matua e rongoatia ana e tēnei pokanga ko:
- Te mate pukupuku ate - Koinei te momo mate pukupuku matua e tīmata ana i te ate.
- Cholangiocarcinoma - He mate pukupuku anō hoki tēnei e tīmata ana i roto i te ate.
- Matepukupuku koroni kua horapa - Te horapa o te matepukupuku koroni ki te ate.
Ehara i te mea mō te mate pukupuku anake tēnei pokanga, engari mō ētahi atu āhuatanga hauora anō hoki:
- Ngā kōhatu o te pūhā i roto i ngā awaawa au i roto i te ate (ngā awaawa intrahepatic).
- Ngā pukupuku noa pēnei i te adenoma.
- Ngā pūkahukahu ate.
Ka koha tetahi tangata hauora i tetahi wāhanga o tōna ate
He mea nui tēnei. Ina tata pakaru katoa te ate o tētahi, ā, me whakatō ate, ka taea e te tangata hauora te tuku i tētahi wāhanga o tōna ate ki taua tūroro. I roto i tēnei momo tuku, ka tangohia tētahi wāhanga o te ate o te kaituku mā te pokanga. Ko te mea whakamiharo ko te tipu anō o te ate e toe ana o te kaituku me te ate hou o te tūroro kua whakatōkia hei ate katoa.
He pēhea te kino o tēnei pokanga? He mōrearea kei reira?
Ae, he tino uaua te pokanga hei tango i tētahi wāhanga o te ate, ā, he tino uaua hoki.E kiia ana pērā. Ko te take matua mō tēnei he nui ngā oko toto e horapa ana puta noa i te ate. Nō reira, ka puta pea te toto nui i te wā e pokanga ana. Nō reira, me whai whakangungu motuhake ngā taote pokanga e mahi ana i ēnei pokanga kia kore ai e kino ngā oko toto, kia whakahaere hoki i te toto.
Engari kei reira tēnei:
- Te Tangohanga Iti: Ki te iti iho i te haurua o te ate ka tangohia, he iti te mōrearea. Ka taea te mahi i ēnei momo pokanga mā te whakamahi i ngā tikanga iti rawa te whakaekenga pērā i te laparoscopy , te pokanga robotic rānei.
- Te Tangohanga Nui: Mena he nui atu i te haurua o te ate e tika ana kia tangohia, he uaua ake, he mōrearea ake hoki.
Nō reira, ko te mea nui hei maumahara, ki te mea ka pokaina koe, he mea nui kia whiriwhiria he hōhipera kei a ia he tīma hauora tino mātau, he tohunga hoki .
He aha ngā mea ka tupu i mua i te pokanga?
I mua i tō pokanga, ka āta whakaarohia e te tīma hauora ētahi āhuatanga. Kātahi anō ka whakatau mēnā ko tēnei pokanga te maimoatanga tika māu.
Ngā mea e whakaarohia ana e ngā tākuta:
- He kaha tō hauora tinana ki te tu atu ki tētahi pokanga nui pēnei?
- Ka taea te tango i te pukupuku, i te wāhanga mate rānei o te ate mā te pokanga?
- Mena he mate pukupuku, kua horapa atu ki ētahi atu wāhanga o te tinana i tua atu i te ate?
I ētahi wā, mēnā he nui te pukupuku matepukupuku, ka taea te whakahaere i te pokanga kia māmā ake, kia haumaru ake hoki mā te hoatu maimoatanga pēnei i te radiotherapy , te chemotherapy rānei i mua i te pokanga hei whakaiti i te pukupuku.
Me whakatau anō hoki e ngā tākuta mēnā me whai whakawhitinga ate wāhanga, whakawhitinga ate katoa rānei. Ka pāngia taua whakatau e ēnei āhuatanga:
- Kia pēhea te horapa o te pukupuku?
- He pēhea te hauora o te toenga o tō ate?
- He rawaka te toenga o te ate i muri i te pokanga mō ngā mahi a te tinana?
Ngā whakamātautau i mua i te pokanga
Hei mōhio ki ēnei mea katoa, ka whakahau tō tākuta i ētahi whakamātautau, pēnei i:
- Ngā whakamātautau whakaahua: He matawai CT, he matawai MRI rānei.
- Ngā whakamātautau mahi ate: He whakamātautau toto noa ēnei.
- Kohikohi ate: Te tango i tētahi wāhanga iti rawa o te ate hei tirotiro.
He aha ngā tikanga matua mō te mahi i te pokanga?
E toru ngā huarahi matua e taea ai te mahi pokanga hepatectomy. Mā tō taote pokanga e whakatau te tikanga e pai ana mōu.
| Tikanga pokanga | Whakaahuatanga | He pai mō |
|---|---|---|
| Pokanga Tuwhera | Ka mahia te pokanga mā te tapahi i tētahi tapahi roa, nui ki te puku, kia huaki ai te kōhao o te puku. Ka taea e ngā tākuta te kite tika i te ate. | Mō ngā pukupuku nunui, matatini, ngā āhuatanga kino rānei. |
| Pokanga Laparoscopic | Ka mahia te pokanga mā te hanga i ētahi tapahi iti rawa e 4-6 ki te puku, ka whakauruhia he kāmera mā roto i tētahi, ā, ka whakauruhia he taputapu motuhake mā roto i ētahi atu. Ka whakahaerehia te pokanga e te tākuta i a ia e mātakitaki ana i te mata. | Mō ngā pokanga iti, māmā ake te uaua. He poto te wā whakaora. |
| Pokanga Robotic | He rite ki te laparoscopy, engari ka whakahaerea ngā taputapu pokanga e te ringa karetao e whakahaerehia ana e te tākuta. Mā tēnei ka taea te pokanga tika ake. | Ahakoa ngā pokanga tino uaua rawa atu ka taea te mahi mā te whakamahi i tēnei tikanga. |
Ka aha te wāhanga o te ate ka tangohia? Ka tupu anō?
Āe! Koinei te mea tino whakamiharo mō te ate. He kaha whakamiharo tō te ate ki te whakatika me te whakaora anō i a ia anō.
Whakaarohia, ahakoa e rua hautoru o te ate hauora ka tangohia, ka taea e te wāhanga hauora e toe ana te wehewehe anō, te tipu, me te tupu anō ki tōna rahi taketake i roto i ētahi wiki, i ētahi marama rānei. Pērā i te hiku o te mokomoko ka tupu anō ina whatiia. Engari ko te tere o tēnei tipu anō ka whakawhirinaki ki ētahi āhuatanga.
- Mena kua whiwhi koe i te rongoā chemotherapy i mua.
- Mena he kohi ngako kei roto i te ate (ate momona).
- Mena kei a koe te mate ate mau tonu pērā i te cirrhosis.
I roto i ēnei āhuatanga, ka pōturi ake pea te tere o te whakaora anō i te ate.
He aha ngā mahi o te pokanga?
Ahakoa he iti noa ngā rerekētanga i runga i te tikanga pokanga me te nui o te kiko i tangohia, ko te tikanga o te pokanga he penei:
1. Whakamoemoe: Ka meinga koe kia moe rawa (whakamoemoe whānui) i mua i te pokanga.
2. Te tapahi: I roto i te pokanga tuwhera, ka tapahia he tapahi roa ki te puku. I roto i te laparoscopy, ka tapahia he maha ngā tapahi iti.
3. Te whakarite i te ate: Ka tautuhia e te taote pokanga te wāhanga tika o te ate ka tangohia. Tērā pea ka whakamahia he tirotiro oro-oro i te wā o te pokanga. Mēnā kei te tata te wāhanga ka tangohia ki te pūkahukahu, me tango pea te pūkahukahu.
4. Te tango i te ate: Ka āta wehea e te tākuta te kiko o te ate, ka tautuhia ngā uaua toto me ngā awaawa au, ka hiritia ki ngā topenga, ki ngā tāpa rānei. Ka whakamahia ngā taputapu motuhake hei whakahaere i te toto.
5. Te tango i te wāhanga: Ka tangohia te wāhanga ate kua wehea mai i te tinana. I roto i te tikanga laparoscopy, me tapahi anō pea kia 2-5 inihi te roa hei tango i tēnei wāhanga.
I te nuinga o te wā, ka roa pea tēnei pokanga i waenga i te rua ki te ono hāora .
He aha ngā mea ka tupu i muri i te pokanga? I te hōhipera
I muri i te pokanga, ka puritia koe i roto i tētahi wāhanga motuhake (wāhanga muri i te whakamoe) kia oho ake rā anō koe i te whakamoe, kātahi ka whakawhitia ki tētahi wāhanga noa. Mena he tino uaua te pokanga, me noho pea koe ki te wāhanga tiaki nui (ICU) mō te rā kotahi, e rua rānei.
I ngā rā tōmua, ka whakauruhia he maha ngā ngongo ki roto i tō tinana. Mā ēnei ka mimiti i ngā wai, ka whakaora i tō puku, ā, ka whakarato kai. Ka aroturuki tonu te tīma hauora i tō toto toto, i ō taumata huka, me tō toto.
Kia tau tō āhua, tera pea ka noho koe ki te hōhipera mō ētahi atu rā, mō te wiki rānei. I tēnei wā:
- Mā te kai wai, ka tīmata mārire rātou ki te kai i ngā kai totoka.
- Ka ara ake ia i te moenga ka tīmata te hikoi.
- Ka tangohia mārire ngā paipa kua tāutahia.
- Ka hoatu ki a koe te rongoā e tika ana hei whakahaere i te mamae.
I tōku hokinga ki te kāinga i te hōhipera, i homai he rā ki ahau kia haere mai anō ahau ki te kite i te tākuta i roto i ngā wiki e rua.
Ngā Tūponotanga me ngā Āhuatanga o te Pokanga
Pērā i ngā pokanga nui katoa, tera pea ngā mōrearea me ngā raruraru ka pā mai, ā, he mea nui kia mōhio ki aua mōrearea.
| Ngā raruraru | He whakamārama māmā |
|---|---|
| Mate pāwera | Tērā pea ka pangia te motu e te niumōnia, e te mate mimi rānei. Ka taea e ngā paturopi te rongoā i tēnei. |
| Te toto | He nui te mōrearea o te toto i roto i te pokanga ate. Tērā pea me whakawhiti toto i muri i te pokanga. |
| Te turuturu o te au | Mena ka pakaru te awaawa o te au i te wā o te pokanga, ka turuturu pea te au ki roto i te kōhao puku. Me whakauru he ngongo anō hei tango i te au. |
| Te rerenga toto i roto i te pleural | Ka taea e te wai te kohikohi huri noa i ngā pukahukahu, ka mamae ai te uma me te uaua ki te manawa. |
| Ngā ascites | Te pupūnga wai i roto i te puku. Ka taea te rongoā i tēnei mā te rongoā, mā te whakauru rānei i tētahi ngongo hei tango i te wai. |
| Te toto totoka (te toto totoka o te uaua hohonu) | Ka puta pea ngā toto totoka i roto i ngā waewae nā te noho roa i runga i te moenga i muri i te pokanga. |
| Te ngoikore o te ate | Ka puta pea tēnei āhuatanga mēnā kāore e ranea te ate e toe ana hei mahi tika i roto i te tinana. I tēnei wā, me whai wāhi pea ki te whakawhitinga ate ohorere. |
E ai ki ngā tatauranga, tata ki te 2% o te hunga e pokangahia ana ka mate i ngā raruraru. Heoi, mō te tūroro matepukupuku, he nui ake ngā painga o te pokanga i ngā mōrearea e pā ana ki te matepukupuku.
Kia pēhea te roa o te wā e ora ai i muri i te hokinga ki te kāinga?
E whā ki te waru wiki pea te roa hei whakaora katoa i te kāinga. Me tango wā hararei koe mai i te mahi i tēnei wā.
- Āta karohia rawatia te hiki taumaha me te whakakori tinana kaha .
- E 12 wiki pea te roa hei tīmata anō i ngā mahi o ia rā.
- Mena i mahia te pokanga laparoscopic, te pokanga robotic rānei, tera pea ka tere ake te wā whakaora.
Hei tere ake i te tukanga whakaora, he mea nui kia kai i ngā kai whai pūmua me te mahi i ngā mahi whakakori tinana māmā (pēnei i te hikoi) . Ngāna kia hikoi mō te 30 meneti pea i te rā, engari okioki mēnā ka ngenge koe.
Ki te pā mai ēnei tohu ki a koe, me toro atu ki te tākuta tonu.
Ki te pā mai ētahi tohu rerekē i muri i te hokinga ki te kāinga, me whakamōhio tonu atu ki tō tākuta.
- He wai pērā i te toto, i te pūhā rānei e turuturu ana mai i te patunga.
- Te kirika pumau.
- Te ruaki, te korere rānei.
- Te koretake o te puku e roa ana mō te neke atu i te toru rā.
- Te pupuhi o te puku.
- Te kōwhai o ngā kanohi me te kiri (Jaundice).
Karere Tangohia ki te Kāinga
- He pokanga nui te tango i te ate mai i te ate, arā, te tango i tētahi wāhanga o te ate, engari he huarahi tino whai hua hei whakaora i ngā oranga mai i ngā mate pēnei i te mate pukupuku.
- He tino mīharo te kaha o tō tātou ate ki te whakaora anō i a ia anō, nō reira kaua e wehi i te wāhanga ka tangohia.
- He mea tino nui te whiriwhiri i tētahi taote pokanga me tētahi tīma hauora mātau mō te angitu o tēnei pokanga.
- He roa te wā e ora ai i muri i te pokanga, nō reira whakarongo ki tō tinana, ā, hoatu ki a ia te okiokinga e hiahiatia ana.
- Me whai tonu i ngā tohutohu a tō tākuta. Kaua e wehi ki te pātai mēnā he pātai āu.
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