Kei te uaua hoki tō manawa i ia rā, i ia rā nā te mate pukupuku nui? Kei te ngoikore tonu koe ahakoa te mahi i ngā mahi iti? Ahakoa te tango rongoā me te haere ki ngā kaupapa whakaora, kāore tō uauatanga manawa e heke? Mena koinā, tera pea ka taea e tō tākuta te kōrero ki a koe mō tētahi pokanga motuhake. Koinei tā tātou e kōrero nei i tēnei rā. Ko te ingoa o tēnei ko te Pokanga Whakaiti i te Rōrahi o te Hunga Manu, ko te LVRS rānei te poto.
He aha te tikanga o te pokanga LVRS?
Whakaarohia ō pūkahukahu he rite ki ngā hautai e rua. Ina nui te mate emphysema, ka puta he mirumiru hau i ētahi wāhanga o tēnei hautai, ka pupuhi. Kāore e taea e ēnei wāhi kua pakaru te manawa, ā, kāore e taea e rātou te mimiti i te hāora ki roto i te toto. Ehara i te mea koinā anake, engari ka āraihia hoki e ēnei wāhi pupuhi, koretake, ngā wāhanga hauora o ngā pūkahukahu, ka kore e taea e rātou te mahi tika.
Ko te pokanga LVRS he tapahi me te tango i ngā wāhanga kua pakaru, kua pupuhi, kua kore e whai hua o te pukahukahu.
Arā, ka whakaitihia te rahi o ngā pukahukahu. He aha te mea ka tupu ina mahi koe i tēnei? Ka tukuna ngā wāhanga hauora e toe ana o ngā pukahukahu kia whānui, kia mahi tika. Kātahi ka taea te mimiti tika i te hāora i te hau e manawahia ana e koe ki roto i te toto, ka tukuna puta noa i te tinana.
Ko te mea nui, kāore tēnei pokanga e whakaora katoa i te emphysema. Ā, kāore hoki e taea te whakaroa i tō oranga. Ko te whāinga matua o tēnei pokanga he whakaiti i ō uauatanga manawa me te whakapai ake i te kounga o tō oranga.
Ko wai ka taea te mahi i tēnei pokanga? Kāore ianei e taea e te katoa?
Kāo, kāore tēnei pokanga e pai mō te katoa. Kua kitea e ngā rangahau he pai anake te mahi a tēnei pokanga mō ngā tūroro e tutuki ana i ētahi paearu. Ka tirotirohia koe e tō tākuta kia mōhio ai mēnā he pai koe mō tēnei tikanga. Ko ēnei paearu ka whakaarohia i te nuinga o te wā:
- Kei raro iho i te 75 tau te pakeke.
- He poto rawa te manawa (dyspnea) e mau tonu ana ahakoa te rongoā me te whakaora i ngā pūkahukahu.
- Ko te nuinga o ngā pakaru o ngā pukahukahu me noho ki ngā wāhanga o runga. Ko te tikanga, me noho pai te toenga o ngā pukahukahu.
- He taunakitanga mō te pupuhi nui o ngā pukahukahu me te mau o te hau.
- Me mutu rawa tō kai paipa mō te iti rawa i te 4 marama. Kāore tēnei pokanga e mahia ki te tangata e kai paipa tonu ana.
- Kia kaha te tinana me te hinengaro ki te whai wāhi atu ki tētahi kaupapa whakaora pūkahukahu mō ngā wiki 6-10 i mua i te pokanga me ngā wiki 10-12 i muri i te pokanga.
He aha ngā tikanga pokanga?
E rua ngā tikanga matua mō te tango i ngā wāhanga kua pakaru o te pukahukahu. Mā tō taote pokanga e whakatau ko tēhea tikanga te mea pai mōu i runga i tō āhua.
| Tikanga pokanga | He whakamārama ngāwari noa iho |
|---|---|
| Te tirotiro i te uma | Ko te tikanga o tēnei ko te hanga i ētahi tapahi iti rawa e 3, e 5 rānei i waenganui i ngā rara, kaua ki tētahi tapahi nui i te uma. Ka whakauruhia he kāmera (videoscope) mā roto i tētahi tapahi hei tirotiro i ngā pukahukahu, ā, ka whakauruhia ngā taputapu pokanga mā roto i ētahi atu tapahi hei tango i ngā wāhanga kua pakaru. Ka kiia hoki tēnei tikanga ko te VATS (Video-Assisted Thoracic Surgery) . Nā te mea kāore he tapahi nui, tera pea ka tere ake te wā whakaora. |
| Te tango i te uaua o te hope | He pokanga tuwhera tēnei. Mā te tapahi i te wheua uma kia roa i waenganui o te uma ka whakatuwhera i te uma. Ko te painga o tēnei tikanga he ngāwari te toro atu ki ngā pukahukahu e rua mā te tapahi kotahi. |
Hei tāpiritanga, i ētahi wā, he tikanga e kiia nei ko te Bronchoscopic Lung Volume Reduction (BLR), arā, ko te whakauru i ngā takirere iti ki roto i ngā pukahukahu mā te whakamahi i te bronchoscope hei tuku i te hau kia puta mai i ngā wāhi kua pakaru, me te kore e pokanga. Engari he kaupapa motuhake tēnā.
He aha ngā whakamātautau e mahia ana i mua i te pokanga?
Hei whakatau mēnā he pai koe mō tēnei pokanga, ka tono tō tākuta kia whakamātauria koe i ētahi whakamātautau. Kaua e manukanuka, ko ēnei whakamātautau katoa he mea whakarite mō tō haumaru, kia whiwhi ai hoki i ngā hua pai rawa atu mai i te pokanga.
- Ngā Whakamātautau Whakaahua: Ka taea e ngā hihi-X o te uma me ngā karapa CT teitei te whakaatu i te nui o te hau e mau ana i roto i ngā pukahukahu me te wāhi e tino kino ana.
- Ngā Whakamātautau Mahi Pūkahukahu (PFT): Ka whakamahia ēnei hei ine i te pai o te mahi a ō pūkahukahu. Ka tirohia ngā mea pēnei i te uara o tō FEV1 hei matapae i te nui o te painga ka riro i a koe mai i te pokanga.
- Ngā Whakamātautau Whakakorikori Tinana: Ko ngā mea pēnei i te whakamātautau hikoi ono meneti ka ine i te tawhiti ka taea e koe te whakakorikori tinana.
- Whakamātautau Horopaki Pūkahukahu (DLCO): Ka whakamātautau tēnei i te pai o te mimiti o te hāora ki roto i ō pūkahukahu.
- Ngā Whakamātautau Manawa: Ka mahia ngā mahi pēnei i te EKG, te echocardiogram, me te whakamātautau ahotea hei whakarite kei te tika te mahi a tō manawa.
- Ētahi atu whakamātautau: Mā ngā mahi pēnei i te matawai V/Q me te whakamātautau hau toto uaua ka nui ake ngā kōrero mō te pūnaha manawa.
Ngā painga me ngā mōrearea o te pokanga
Pērā i ngā pokanga katoa, he painga, he mōrearea hoki tō tēnei pokanga. He mea nui kia kōrero noa koe mō tēnei mea ki tō tākuta, kia mārama ai koe ki a ia.
He aha ngā painga?
- Kua tino pai ake te kounga o te oranga.
- Te poto o te manawa kua heke.
- Te whakapai ake i te mahi a ngā pukahukahu.
- Te kaha ake ki te whakakori tinana.
- Ngāwari ake te tukanga manawa.
He aha ngā mōrearea?
He mōrearea kei ia pokanga, ā, ka whakapau kaha ngā tākuta ki te whakaiti i aua mōrearea.
- Ngā urupare kino ki te rongoā whakamoe.
- Te pūkahukahu kua hinga (pneumothorax).
- Te turuturu o te hau mai i ngā tuitui.
- Ngā mate pāwera pērā i te niumōnia.
- He whakaeke ngakau (myocardial infarction).
He pokanga nui tēnei. E ai ki ngā tatauranga, ko te mōrearea o te mate mai i tēnei pokanga kei waenga i te 3% me te 5%. Koia te mea nui o te whiriwhiri i te tūroro tika.
Kia pēhea te roa o te wā e ora ai?
I muri i te pokanga, me noho koe ki te hōhipera mō te 3 ki te 7 rā. I muri i tō hokinga ki te kāinga, ka tonoa koe kia tīmata anō i tētahi kaupapa whakaora pūkahukahu i roto i ngā wiki tuatahi. He mea tino nui tēnei nā te mea he mea nui ēnei mahi whakakori tinana hei whiwhi i te hua pai rawa atu o tō pokanga.
Ko te whakamarie o te manawa e puta mai ana i te pokanga e rua ki te rima tau te roa. Nō reira, he mea tino nui kia mutu rawa te kai hikareti me te whai i ngā tohutohu a te tākuta i tēnei wā.
Āhea ahau me toro atu ki te tākuta?
Mena ka puta tētahi o ngā tohu e whai ake nei i muri i te pokanga, me haere tonu koe ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera .
- Te kirika.
- Te mamae nui o te uma.
- Te uaua nui ki te manawa.
- Te tae kikorangi o te kiri, o ngā ngutu, o ngā maikuku rānei (cyanosis).
Karere Tangohia ki te Kāinga
- He pokanga te LVRS e mahia ana i runga i tētahi rōpū tūroro kua tohua he nui te mate emphysema.
- Mena kei te whakaaro koe ki te mahi i tēnei pokanga, he mea nui kia mutu rawa te kai paipa.
- Ehara tēnei i te pokanga whakaora, ko tana whāinga matua he whakaiti i ngā uauatanga manawa me te whakapai ake i te kounga o te oranga.
- Ka roa te mahi a te pokanga mō ngā tau maha, ā, he mea nui te whakaora i ngā pūkahukahu kia tino whai hua ai.
- I mua i te whakatau, kōrerohia ngā painga, ngā huakore me ngā mōrearea o tēnei pokanga ki tō tākuta kia mārama ai koe.
👩🏽⚕️ Ngā pātai tāpiri (FAQs)
💬 He aha te pupuhi o te waewae / te edema o te taha?
Ehara i te mea ko ō waewae anake ka pakari haere i a koe e taumaha ana/ka pakeke haere ana! Ko te 'Pupuhi Waewae' he āhuatanga e nui haere ai tētahi o ō waewae (engari he maha ngā wā ko ngā waewae e rua), ngā pona waewae me ngā kapu waewae nā te nui o te wai e kohia ana (Edema) i raro i te kiri, ā, he uaua ki te mau hu/haere. Ina pēhia e koe tēnei wāhi pupuhi ki tō maihao, ka heke ki raro pērā i te poka mō tētahi wā (Pitting edema). He tohu tēnei mō te kino nui, whakamate ki te 'ngākau, ki ngā whatukuhu rānei' o te tinana!
💬 He aha ngā tino take whakamate o te pupuhi o ngā waewae me ngā waewae (Leg Swelling)?
E whā ngā tino take o tēnei: 1) 'Te ngoikore o te ngākau' - Ina kore e taea e te ngākau te pupuhi toto/he ngoikore (pēnei i te wā e mau ana koe i roto i te waka rererangi), ka kohia taua toto ki roto i ngā waewae nā te kaha o te kaha ā-papa, ā, ka pupuhi. 2) 'Te ngoikore o te whatukuhu/Te mate pukupuku toto' - Ina kore e taea e ngā whatukuhu te whakaputa mimi/ka ngaro te pūmua i ngā whatukuhu, ā, ka kī tonu i te wai. 3) Ngā pānga taha o ētahi pire toto toto me ngā rongoā mate pukupuku ū. 4) Te mate ate - I tēnei wā, ka kī katoa te puku i te wai, ā, ka nui haere pērā i te poihau.
💬 Ina pupuhi te waewae, he aha ngā 'āhuatanga morearea/ohorere' me haere tonu koe ki te hōhipera/wāhanga ohorere, me te kore e pania noa te hinu/te paninga?
He mea noa te pupuhi o ngā waewae i te wā e hapu ana, me te pupuhi i muri i te tū roa (Te pupuhi ngawari o te waewae - kia teitei ake ō waewae). Engari koinei te mōrearea nui rawa atu! Haunga ngā waewae pupuhi, 1) 'Mēnā kotahi anake te waewae (kotahi anake te taha) e pupuhi ana, e whero ana, e wera ana (Te Mahana/Te Whero/Te Mamae Nui - DVT/Te toto totoka)', 2) Mēnā ka pāngia koe e te uaua o te manawa me te kikī o te uma me te maremare/ruaki (Te Pūkahukahu / Te ngoikore o te ngākau), ka mate pea koe i roto i ngā meneti, me haere tonu koe ki te tari ohorere o te hōhipera (Te Āwhina Hauora)!
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