Nā ētahi āhuatanga hauora, inā koa ngā raruraru o te whekau nui, me pokanga hei tango i taua wāhanga. Kātahi ka hangaia he kōhao iti ki te kiri o te puku hei tuku i ngā paru kia puta i te tinana. Nō reira, ka kohia ngā paru ki roto i tētahi putea e piri ana ki tēnei kōhao. Tērā pea he āhua kore whakamarie te noho me tēnei putea mō ētahi tāngata. Tērā pea he arai i te wā e noho tahi ana, e mau kākahu ana, e mahi ana i ngā mahi o ia rā. Nā, me pēhea mēnā he huarahi hei kohi para i roto i te tinana me te kore he putea o waho, ā, ka whakawātea i ngā wā katoa e hiahia ana tātou? Ko te otinga mō tēnā ko te putea Kock e kōrerohia nei e tātou i tēnei rā.
He aha te tikanga o tēnei putea Kock (putea-K)?
Whakaarohia, kaua e iri he putea i waho o tō tinana, engari me hanga he putea iti hei kohi me te penapena para i roto i tō tinana? Koinei te putea Kock.
I muri i te tango i te puku, ka kawea te pito o tō whekau iti, te ileum, ki te mata o te kiri i roto i tō puku, ā, ka hangaia he kōhao iti. Ka kiia tēnei he ileostomy. Ka kiia tēnei kōhao he stoma. Ko te tikanga ka mahia tēnei mā te tāpiri i tētahi pēke o waho ki te stoma.
Engari i roto i te tikanga putea Kock, ka whakamahia e te taote pokanga tētahi wāhanga o tō ake whekau iti hei hanga i tētahi putea iti i roto i tō tinana . Ka honoa tika tēnei putea ki te pūaha (stoma) i roto i tō puku. Nō reira, kāore koe e hiahia ki tētahi putea o waho hei kohi i tō paru. Ina hiahiatia, ka taea te whakauru i tētahi ngongo iti (catheter) mā roto i tēnei pūaha, ā, ka taea te whakakore i ngā para kua kohia i roto i te putea.
He rite tēnei ki te "papaku o roto" i roto i te tinana ka taea e tātou te whakawātea i ngā wā katoa. I tapaina tēnei i muri i te taote pokanga a Nils Kock.
He aha ngā whakamahinga o te putea Kock?
Ko te tikanga tēnei e whakamahia ana mō te hunga e noho ana me te 'ileostomy' tuturu engari kāore e hiahia ki te whakamahi i te putea tūtae o waho. Ko te painga nui o tēnei ko te taea e rātou te whakahaere i te haerenga o te tūtae.
I roto i te ileostomy noa, ka taea e te paru te kohi i roto i te putea i ngā wā katoa. Kāore e taea e tātou te whakahaere. Engari ko te ileostomy me te putea Kock ka kiia he ileostomy continence. Ko te tikanga o tēnā ko te "ka taea te whakahaere." I tēnei wā, ka kohia te paru i roto i te putea i roto, kaua e turuturu ki waho, nō reira kei a koe te mana ki te whakawātea i te wā e hiahia ana koe.
- Ngā kōrero tāpiri: I hangaia te putea Kock hei putea ā-roto hei kohi mimi mō ngā tūroro kua tangohia ā rātou pūkahukahu. Kei te whakamahia tonutia taua tikanga i ēnei rā, engari he maha ngā tikanga hou kua whakawhanakehia.
Me pēhea te mahi i tēnei pokanga?
Ka taea e tō taote pokanga te hanga i te putea Kock i te wā kotahi me tō ileostomy, ka taea rānei e rātou te mahi i tētahi atu pokanga i tētahi wā i muri mai. Ko te tikanga, mēnā kua whai ileostomy koe, ka taea tonu e koe te huri ki tētahi putea Kock i tētahi wā i muri mai.
I roto i ngā kupu ngāwari, ko te tukanga e whai ake nei:
1. Te hanga i te pēke: Ka tangohia e te tākuta te 18 inihi o te pito o tō ake whekau iti, ka whakapikohia kia rite ki te āhua "U". Kātahi ka whakatuwheratia te whekau ki waenganui o tēnei whakapiko, ā, ka tuia ngā taha. Mā tēnei ka hangaia te pēke.
2. Te Hanga i te Takirere: Koinei te wāhanga tino nui. Mā te whakamahi i te toenga o te whekau i te pito o te putea, ka hangaia he takirere motuhake ('takirere kotahi-ara'). He rite ki te tatau e tuwhera ana i te taha kotahi anake. Ina whakakīia te para ki roto, ka kati aunoa tēnei takirere. Nō reira, kāore e turuturu ki waho ngā paru, ngā wai, te hau rānei.
3. Hononga: Hei whakamutunga, ka tāpirihia te pito o te takirere ki te pūaha (stoma) i hangaia i roto i tō puku. Ka tirohia e te tākuta kia tika ai te mahi o ngā mea katoa, ā, kāore he turuturu.
He aha ngā mea ka tupu i muri i te pokanga? Kia pēhea te roa o te wā e ora ai?
I muri i te pokanga, me noho koe ki te hōhipera mō te toru ki te rima rā pea. I tēnei wā, ka tāpirihia ngā ngongo ki tō tinana hei āwhina i a koe kia tere te ora.
- ngongo `IV` mō te hoatu tote
- `Kaiora IV` mō te kaiora
- Ngā paipa wai patunga e tango ana i ngā paru mai i te patunga
- Te kātene mimi
- He 'pamu mamae' hei whakahaere i te mamae
Kaua e manukanuka ki ēnei mea, he rangitahi noa iho ēnei.
Ka waiho te catheter e whakanohoia ana ki roto i tō stoma ki tōna tūranga mō ētahi wiki. Mā tēnei ka taea te rere o te paru i roto i te putea hou kua hangaia kia ora rā anō te patunga. Mā te nēhi koe e ako ki te tiaki i te catheter.
I muri i tō hokinga ki te kāinga me te okioki mō ētahi wiki, ka tangohia e tō tākuta tēnei ngongo. Kātahi, ka akona koe e te nēhi ki te whakawātea i te pēke māu ake mā te whakamahi i tētahi ngongo noa (catheter).
I te tīmatanga, me whakawātea pea tō pūkahukahu i te 8 ngā wā i te rā. Kaua e manukanuka, i roto i ngā marama e whai ake nei, ka nui haere te pēke hou i roto i tō tinana. Whai muri i tēnā, e 2-4 noa iho ngā wā e hiahiatia ana kia whakawāteahia i te rā.
Ngā painga me ngā raruraru pea o te putea Kock
Pērā i ngā tikanga hauora katoa, he painga, he mōrearea hoki. Me titiro tātou ki ēnei.
| Ngā Painga | Ngā raruraru pea |
|---|---|
| Kāore he hiahia mō tētahi putea o waho: Kāore koe e hiahia ki te mau, ki te whakahaere rānei i tētahi putea ileostomy o waho. | Ngā raruraru o te takirere: I ētahi wā ka wetekina te takirere, ka turuturu te tūtae. Tērā pea ka āraia te takirere, ā, kāore e taea te whakauru i te ngongo. He āhuatanga ohorere te aukati katoa o te puku. Mēnā ka puta tēnei, me haere tonu koe ki te ETU (Emergency Treatment Unit). |
| He nui ake te herekoretanga me te tūmataitinga: Ka taea te hipoki i te stoma ki tētahi mea iti, pērā i te tauera miro. Kāore tēnei e kitea mai i waho. | Ngā Pūwero: Ka puta pea ngā kauhanga kore e tika ana mai i te pēke ki te kiri, ki ētahi atu okana rānei. Ka mamae pea, ka pangia rānei tēnei. |
| Te Whakahaere: Ka taea e koe te whakawātea i tō pūkahukahu i ngā wā katoa e hiahia ana koe, i tētahi wāhi watea, me te kore e turuturu te tūtae puta noa i te rā. | Pōkākā: He mumura, he mate pāwera rānei o te pēke. He mate noa tēnei. He maha ngā wā ka taea te rongoā wawe mā te whakamahi i ngā rongoā paturopi. |
| Moe whakamarie: He tino ngāwari te moe i te pō. Kāore koe e hiahia ki te ara ake i waenganui pō ki te whakawātea i tō pēke. | Te whaiti o te pūaha (Stricture/stenosis): Ka taea e te koha te whakawhāiti i te stoma, ā, ka uaua hoki te whakauru i te ngongo. |
| Parastomal hernia: Ka puta tetahi wāhanga o te whekau mā roto i te stoma. Ka taea hoki e tēnei te ārai. |
Mena ka puta ēnei raruraru, tera pea ka hiahiatia he pokanga anō ('pokanga whakatikatika') hei whakatika. Mō te putea Kock, inā koa nā ngā raruraru takirere, he paku teitei ake te tere o taua pokanga whakatikatika i ētahi atu tikanga (tata ki te 30%). Engari mā tō tākuta ēnei mea katoa e whakamārama ki a koe.
He aha te rerekētanga i waenga i te putea Kock me te putea-J?
Ahakoa he momo pēke ēnei e rua i hangaia i roto i te tinana, he rerekē rawa te āhua o tā rāua mahi.
- Pēke Kock (Pēke-K): Ka hangaia tēnei mā te `ileostomy`, arā, he whakatuwheratanga (`stoma`) i roto i te puku. Ka ringihia te tūtae mā roto i tētahi ngongo (`catheter`) ka whakaurua mā roto i te whakatuwheratanga o te puku.
- J-Pouch: He huarahi kē tēnei hei whakakapi i te ileostomy. I konei, ka hangaia he putea mai i te pito o te whekau iti, ā, ka honoa tika ki te anus (awa anal). Mā tēnei ka kore e hiahiatia he stoma (te whakatuwheratanga o te puku). Ka taea e te tūroro te haere ki te wharepaku me te tūtae noa.
I te nuinga o te wā, ko ngā tūroro e hiahia ana kia tangohia te koroni me te pūhā ka whiriwhiri i te tikanga J-pouch. Heoi, kia angitu ai te J-pouch, me mahi tika ngā uaua o te pūhā. Mō te hunga kāore e taea te whai J-pouch mō tētahi take, mō te hunga rānei kua pakaru te J-pouch, he kōwhiringa pai te Kock pouch.
Kei te hiahia koe ki te hanga huringa ki tō kai?
Ae, he mea tino nui te kai i tētahi kai taurite, whai kiko hoki hei tere ake i tō oranga. Mena he matotoru rawa ō tūtae, he wai rawa rānei, ka taea e koe te whakarerekē i tō kai. He tino āwhina te rapu tohutohu mai i tētahi tohunga kai. Ka taea e tō tākuta te tuku i a koe ki tētahi e tika ana.
Karere Tangohia ki te Kāinga
- He kōwhiringa pai te putea Kock mō te hunga kāore e hiahia ki te noho tahi me te putea ileostomy o waho.
- Ma tenei koe e āwhina ki te whakahaere i ō nekehanga puku, ā, ka nui ake tō herekoretanga me tō whakamarie i te wā e noho tahi ana koe.
- Heoi, pērā i ngā pokanga katoa, he mōrearea me ngā raruraru kei reira, inā koa ngā raruraru o te takirere.
- I mua i te whakatau mēnā he tika tēnei tikanga māu, he mea tino nui kia kōrero koe ki tō tākuta , kia mārama hoki ki ngā painga me ngā huakore katoa.
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