Ina kī atu tō tākuta me tango te puku, te APR rānei, tera pea kei te mataku koe, kei te manukanuka hoki. He maha ngā pātai kei roto i tō hinengaro, pērā i te "He aha te momo pokanga tēnei?", "Ka tino mamae?", "Ka pēhea tōku oranga i muri i te pokanga?" He mea noa iho. Nō reira, i tēnei rā, me kōrero tātou mō te tikanga o tēnei pokanga APR, me pēhea te whakarite mōna, me ngā mea ka tupu i muri i te pokanga. Mā te mōhio mārama ki ēnei mea ka āwhina i te whakaiti i tō mataku ki te nui.
He aha rawa te pokanga Abdominoperineal Resection (APR)?
Ki te whakarapopoto, ko te tango i tō pūkahukahu, tō pūkahukahu, me te wāhanga o raro o tō whekau nui (korone sigmoid) mā te pokanga. Ko te take matua mō tēnei pokanga he mate pukupuku e tupu ana i raro rawa i te pūkahukahu, e tata ana ki te pūkahukahu.
I te nuinga o te wā, kua maha pea ngā wā i whiwhi koe i te irahiko me/ranei te rongoā matū hei whakahaere i te mate pukupuku i mua i tēnei pokanga. Kia whakaitihia ngā pūtau mate pukupuku e ngā maimoatanga, ka tangohia e te taote pokanga te wāhi katoa mā tēnei pokanga.
Me pēhea taku whakarite mō te pokanga?
Mā tō tākuta koe e ārahi marie ki te whakarite mō tēnei. Ka pātai atu ia ki a koe mō tō hītori hauora katoa. Kia mahara ki te kōrero ki tō tākuta mō ngā rongoā, huaora, tāpiringa rānei e tangohia ana e koe i tēnei wā.
Me kōrero mai hoki ki a mātou mēnā he mate moe pōrearea tōu. Mēnā he mīhini CPAP tāu e whakamahi ana, me kawe mai ki te hōhipera i te rā o te pokanga.
He mea tino nui kia mutu rawa te momi hikareti me te inu waipiro i ētahi wiki i mua i te pokanga. Ka taea e ēnei tikanga te whakaroa i te whakaora o te patunga, me te whakanui ake i te tūponotanga o ngā raruraru nui, tae atu ki ngā raruraru pūkahukahu. Kia pono ki tō tākuta mō tēnei, ā, kaua e mangere ki te tono āwhina hei whakakore i ēnei tikanga mēnā e tika ana.
Me pēhea te mahi i te pokanga?
Ka mahia tēnei pokanga i roto i te hōhipera, i raro i te whakamoe whānui. Ko te tikanga o tēnei, kāore koe e rongo i tetahi mea i te wā o te pokanga, ā, ka moe katoa koe. He maha ngā mahi matua o te pokanga.
1. Te whakarite ki te tango i ngā wāhanga o te puku
Tuatahi, ka tapahia e te taote pokanga ētahi tapahi iti i roto i te puku (laparoscopy), ka tautuhia, ka tapahia hoki ngā uaua toto matua e tuku toto ana ki ngā wāhanga o te koroni hei tango. Kātahi, ka wetekina te wāhanga o raro o te koroni (sigmoid colon) me te rectum mai i ngā kiko e karapoti ana. Muri iho, ka wehea te wāhanga hei tango mai i te wāhanga hauora e toe ana o te koroni.
2. Te tango i te nono
Muri iho, ka tapahia anō e te taote pokanga te rohe perineal, ka tangohia te nono. Ka tangohia katoatia te nono, te rectum, me te colon. Kātahi ka tuia te kiri i runga ake i te nono kia kati.
3. Te Waihanga i tētahi Colostomy
Tērā pea koe e whakaaro ana, "Me pēhea te puta o te tūtae i muri i te tangohanga o te nono me te pūkahukahu?" Koia te take e hangaia ai he colostomy tuturu.
I te whakarapopototanga, ko te kawe mai i tētahi wāhanga hauora o te taha whakarunga o tō koroni ki te mata o te kiri o tō puku, me te hanga i tētahi kōhao hou e tuwhera ana ki waho. Ka kiia tēnei kōhao hou he 'stoma' . He kōhao māwhero te nuinga o te wā, kei waenganui i te 1 me te 1 ½ inihi te rahi.
Inaianei ka puta mai ngā paru o tō tinana, arā, ngā paru me te hau, i tēnei stoma. Me mau koe i tētahi putea motuhake (pukoro ostomy) ki runga. Mā tēnei putea ka kohia ngā paru. Nā te mea kāore he nono āu, kāore e taea e koe te whakahaere i te haere o ngā paru. Nō reira, me mau tonu koe i tēnei putea.
He pēhea te roa o te wā whakaora i muri i te pokanga?
I muri i te pokanga, me noho koe ki te hōhipera mō ētahi rā. Ka whakatakotoria he putea ostomy ki runga i tō stoma i muri tonu i te pokanga. Heoi, ka roa pea ētahi rā kia mahi anō tō pūnaha nakunaku. Nō reira, ka hoatu he wai hei inu māu i te tuatahi. I te tīmatanga o te mahi a ō whekau, ka āta whakaurua koe ki ngā kai totoka.
I a koe i te hōhipera, ka ako ngā tākuta me ngā nēhi i a koe ki te tiaki i tō stoma, ki te whakawhiti i tō pēke, me te pupuri i tō kiri kia ma. Nō reira, kāore he mea hei manukanuka ina hoki koe ki te kāinga. Ko te mea nui ko te whai i ā rātou tohutohu.
He aha ngā painga o te mahi i tēnei pokanga laparoscopic?
He maha ngā painga o te mahi i tēnei pokanga mā te tikanga pokanga kī, te tikanga laparoscopy rānei, i te pokanga tuwhera tuku iho.
- He iti rawa ngā tapahi: He torutoru noa ngā tapahi iti ka whakamahia hei utu mō te tapahi nui kotahi.
- Te whakaiti i te mamae: He iti noa iho te mamae e pā ana i muri i te pokanga.
- Te whakahekenga o te toto: He iti ake te toto e ngaro ana i te tinana i te wā e pokanga ana.
- Te whakaiti i te mōrearea o ngā raruraru:He iti ake te tūponotanga o ngā mea pēnei i te pangia o te patunga.
- Te tere ake o te whakaoranga: He poto ake te noho hōhipera, ā, ka taea e koe te hoki wawe ki te oranga noa.
He aha ngā raruraru ka pā mai i tēnei pokanga?
Pērā i ngā pokanga katoa, he iti noa ngā mōrearea, engari kāore i te tino kitea.
- Ka puta he hernia perineal ina hutia te kiri ki muri i muri i te tangohanga o te nono. Mēnā e tika ana, ka taea te whakatika mā tētahi atu pokanga.
- Te toto nui rawa.
- Ngā raruraru e pā ana ki ngā tapahi (ngā patunga e pīrori ana, kāore e ora).
- Ina ora te patunga, ka mahue he kōhao iti ki te kiri (perineal sinus).
Ki te puta he mea pēnei, ka rongoātia e ngā tākuta mā te whakamahi i ngā maimoatanga pēnei i te hoatu paturopi, te mahi pokanga iti rānei mēnā e tika ana, i runga i tōna kaha.
E toru ki te ono wiki te roa hei whakaora katoa i tēnei pokanga. Heoi, ka rerekē pea tēnei wā i runga i ngā āhuatanga pēnei i tō hauora whānui. Pātai atu ki tō tākuta āhea koe ka taea te hoki ki te mahi.
| Ki te puta mai ēnei tohu, waea atu ki tō tākuta tonu atu. | |
|---|---|
| Tohu | Whakaahuatanga |
| Mamae nui o te puku | He mamae e nui atu ana i te mea noa, e kore e taea te whakamanawanui. |
| Whakapairuaki me te ruaki | Te whakapairuaki me te ruaki tonu. |
| Ngā huringa o ngā ara tapahi | Te whero, te pupuhi, te mamae nui, te pupuhi rānei o te wai i ngā wahi i tapahia. |
| Ngā para kāore e uru ki te putea ostomy | Kaua tetahi para, tetahi hau rānei e puta ki roto i te putea ostomy mō ngā rā e toru. |
| Kirika | Te kirika neke atu i te 38°C (100.5° F). |
| Te uaua ki te mimi | Te uaua, te mamae rānei i te wā e mimi ana. |
He mea noa te manukanuka me te āwangawanga mō te pokanga nui pēnei. Nō reira, kia tuwhera ki tō tākuta ngā pātai, ngā āwangawanga rānei kei a koe. Waihoki, ki te taea e koe te whakauru atu ki ngā rōpū tautoko me te hunga kua pokanga pēnei, ā, kei te ora ake, ka nui te kaha hinengaro me te maia e riro mai i a koe mai i ō rātou wheako.
Karere Tangohia ki te Kāinga
- He tikanga pokanga te APR e tango ana i te nono, te pūkahukahu, me te wāhanga o te koroni. Ko te nuinga o te wā ka mahia mō te mate pukupuku o te pūkahukahu o raro.
- Whai muri i tēnei pokanga, ka hangaia he pūaha tuturu ki te puku, e kiia nei ko te stoma, hei putanga mō te paru.
- He iti ake te mamae o te pokanga laparoscopic, he iti ake ngā tapahi, ā, ka tere ake te ora.
- He mea tino nui te whai i ngā tohutohu a te tākuta (ina koa te momi hikareti, te whakamutu waipiro, me te kai paipa) i mua tonu atu me muri i te pokanga.
- Kaua e wehi i ngā tohu rerekē ka puta i muri i te pokanga, ā, me whakamōhio tonu atu ki tō tākuta.
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