Kei a koe tēnei momo mamae o te uma? (Mediastinitis) Me ako tātou mō tēnei.

Kua pāngia koe e te mamae rerekē, te taumaha, te kore whakamarie rānei i waenganui o tō uma, te wāhi kei reira tō ngākau? Tērā pea ka whakaaro koe kāore he mea nui. Heoi, i ētahi wā, ko ēnei tohu he tohu pea mō tētahi mate hauora kino ake. Koia mātou ka kōrero ai i tēnei rā mō tētahi mate e kiia nei ko te `(Mediastinitis)` ka puta pea i roto i te uma, engari he tokomaha kāore i te mōhio. Ahakoa he ahua uaua tēnei ingoa, kia mārama noa tātou.

He aha tēnei `(Mediastinitis)`?

Ki te whakarāpopototanga, ko te `(Mediastinitis)` he mumura, he mate rānei e puta ana i te wāhi e kiia nei ko `(mediastinum)` i waenganui o tō tātou uma. Tērā pea kei te whakaaro koe he aha te `(mediastinum)`. Whakaarohia, he kōhao nui tō tātou uma, e kiia nei e tātou ko `(thoracic cavity)` . Kei ia taha o tēnei `(thoracic cavity)` ngā `(pleural cavities)` kei reira ō tātou pūkahukahu. Ko te wāhi nui i waenganui o te uma, i waenganui i ngā pūkahukahu e rua, e kiia nei ko `(mediastinum).`

Kei tēnei wāhanga o te `(mediastinum)` te wāhi e noho ai ngā whekau me ngā hanganga nui, pērā i te ngākau , te wāhanga o te paipa kai (`(esophagus)`) , me ngā uaua toto matua e hono ana ki te ngākau. Nō reira, ka taea e koe te mārama ki te kino o te pānga mēnā ka puta te mumura, te mate rānei i tētahi wāhi nui. Koia te take ka taea ai e te mate `(Mediastinitis)` te whakararu i te ora.

Ka taea e tēnei mate (Mediastinitis) te pāngia e te mate koi (ka puta ohorere) te mate pūmau rānei (ka āta whanake haere i roto i te wā) .

Ka aha te tinana mēnā ka pāngia koe e te `(Mediastinitis)`?

He mate morearea te mediastinitis. Ka taea e tēnei mumura te whakararuraru i te mahi noa o ō tātou whekau nui me ngā oko toto i roto i te uma. Ka taea e tēnei te arahi ki ngā raruraru nui. Nō reira, mā te whiwhi maimoatanga i te wā e taea ai ka nui ake te tūponotanga o te ora me te whakaora i tō oranga.

Ko ētahi o ngā raruraru ka puta mai i te mediastinitis ko:

• Te aukati i te ara manawa e uaua ai te manawa.
• Te pericarditis constrictive (te whakapakeketanga o te kiriuhi e karapoti ana i te ngākau).
• Te niumōnia auau.
• Te ngoikore o te ngakau o te taha matau .
• Te paihana toto, arā, te `(Sepsis)` .
• Te toto toto nui.
• Te mate pūkahukahu o te uaua nui (te pēhanga ki te uaua nui e kawe ana i te toto ki te ngākau).

Whakaarohia, ki te puta he āhuatanga pēnei, ka pā ki te pūnaha tinana katoa. Koia te take kāore e pai kia māmā noa te whakaaro ki tēnei.

He pēhea te noa o tēnei āhuatanga?

E ai ki ngā tākuta, he mate onge te "Mediastinitis". Heoi, ko te whānuitanga o tōna pānga i waenga i te tangata ('prevalence') me te hunga e tino pāngia ana, ka rerekē i runga i te āhua o te mate ('acute', 'chronic' rānei).

Ko te mediastinitis whakapeka e kitea whānuitia ana he raruraru o te pokanga uma, inā koa he tikanga e kiia nei ko te median sternotomy . Ko te median sternotomy he tikanga pokanga e tapahia ai e te taote tō wheua uma (sternum) kia rua hei uru atu ki tō ngākau, ki ō oko toto rānei. I waenga i te 0.25% me te 5% o te hunga e pāngia ana e tēnei momo pokanga ka pāngia e te mediastinitis whakapeka. Ka rerekē pea tēnei auau i ia hōhipera ki ia hōhipera, i ia rohe ki ia rohe.

He onge ake te mate mediastinitis mau tonu . I te nuinga o te wā ka kitea i ngā wāhi e kitea whānuitia ana te momo harore e kiia nei ko te Histoplasma capsulatum (endemic). Heoi, kāore te katoa e pāngia ana e tēnei harore ka pāngia e te mate. E ai ki ngā kairangahau he iti iho i te 1% o te hunga e pāngia ana ka pāngia e te mate harore (histoplasmosis). I roto i a rātou, he iti noa iho te tokomaha ka pāngia e te mate mediastinitis mau tonu. E ai ki ngā rangahau he rau tonu ngā tūroro i te United States e pāngia ana e te mate fibrosing mediastinitis (he momo mate mediastinitis mau tonu).

He aha te rerekētanga i waenga i te 'Acute Mediastinitis' me te 'Chronic Mediastinitis'?

E rua ngā momo `(Mediastinitis)`. Ko tētahi ko te `Acute Mediastinitis` . Ko tētahi ko te `Chronic Mediastinitis` . He rerekētanga nui i waenganui i ēnei e rua.

Ko te mediastinitis whakapeka he āhuatanga ka puta ohorere mai, me ngā tohu kino . Hei tauira, ki te mea he poka i roto i te korokoro, ka taea e te mediastinitis whakapeka te puta i roto i ētahi haora. Ka taea hoki te puta mai ina he mate kei roto i te korokoro, i te waha rānei. Hei raruraru o te pokanga uma, ka puta i roto i te marama tuatahi. He onge, ka puta i muri mai, ahakoa i roto i te tau tuatahi. He āhuatanga ohorere hauora te mediastinitis whakapeka. Me tīmata tonu te maimoatanga hei whakaora i tō ora.

He mate kino anō hoki te mediastinitis mau tonu , engari ka āta whanake haere i roto i ngā marama, i ētahi wā ka roa pea ngā tau . Ka taea e tēnei te hanga kiko whara i roto i tō mediastinum. Ka kiia tēnei mate ko te fibrosing mediastinitis , ko te mediastinal fibrosis rānei. Ko te tino take o te mediastinitis mau tonu he mate harore.

Tērā pea kāore he tohu o te tangata e pāngia ana e te mate pāwera mau tonu, kāore rānei he tohu o te mate. Mēnā he tohu kei a rātou, pērā i te poto o te manawa, ka tīmata pea me te ngawari, ā, ka kino haere i te roanga o te wā. Ka puta ngā tohu nā te mea ka nui haere te kiko whara i roto i tō uma, ka pēhi i tō puku manawa (trachea) i te vena cava nui rānei, he uaua nui e kawe ana i te toto ki tō ngākau. Ko te whāinga matua o te maimoatanga he whakaiti i ngā tohu me te whakapai ake i te kounga o te oranga.

He aha ngā tohu o te `(Mediastinitis)`?

Ka rerekē anō hoki ngā tohu i runga i te mea he 'kōkī' te mate, he 'pūmau' rānei.

Ngā tohu o te 'Acute Mediastinitis':

• Te mamae ohorere, te mamae nui o te uma.
• Ngā makariri.
• Mena i tangohia te sternotomy o te puku o waenganui, tera pea ka puta he wai rite ki te pulu i te patunga.
• Te kirika.
• Te poto o te manawa.

Ngā tohu o te 'Mediastinitis Mau tonu':

Kāore pea he tohu e puta mai i te mate pukupuku mau tonu. Heoi, ka pāngia pea te hunga whai mate pukupuku fibrosing e ngā tohu pēnei i:

• Mamae o te uma.
• Te maremare, tera pea ka maremare toto.
• Te uaua ki te manawa.
• Ngā tohu tāpiri e pā ana ki te "Superior vena cava syndrome" (hei tauira, te pupuhi o te mata, te kaki, ngā ringaringa).

He aha ngā take o te `(Mediastinitis)`?

He rerekē anō hoki ngā take mō tēnei āhua i runga i te momo.

Ngā Take o te 'Acute Mediastinitis':

Ka puta te mate pāwera whakapeka ina pāngia ohorere ngā kiko o roto i tō uma. Ka puta pea ēnei mate i:

• Ngā raruraru o te pokanga sternotomy median: Ko te nuinga o ngā mate i muri i tēnei momo pokanga ka puta mai i te huakita e kiia nei ko Staphylococcus aureus . Ka pangia pea tō kiko uma, tō patunga pokanga rānei i te wā o te pokanga, i muri tata mai rānei. Hei tauira, ki te kore te patunga e ora pai, ki te tomo mai rānei ngā iroriki mā roto i te patunga.
• Te poka o te korokoro: He maha ngā take ka pā mai ai tēnei. Hei tauira, ko ngā raruraru i te wā o ngā tikanga endoscopic (ngā whakamātautau mā te whakamahi i te kāmera hei tirotiro i roto i te korokoro) me te ruaki nui, kaha hoki ( Boerhaave syndrome) ka pakaru ai te korokoro.
• Te horapa o te mate mai i te māhunga, i te kaki rānei: Ka kiia tēnei e ngā tākuta ko te "descending necrotizing mediastinitis." Ko te tikanga o tēnei ko te mate i tīmata i te wāhanga o runga o te uma ka horapa ki raro ki roto i te uma, ka kino ai ngā kiko o reira. Ka horapa pea ngā mate i roto i tō waha (pēnei i te niho kua pūngā) me ngā mate korokoro i tēnei ara.

Ngā Take o te Mediastinitis Mau tonu:

Ka puta anō hoki te mate pāwera i te mediastinitis mau tonu. Heoi, i tēnei wā, kāore te mumura i roto i ō kiko e puta tonu mai i muri i te pānga ki ngā huakita, engari ka puta mārire. Ka puta pea te mediastinitis mau tonu i:

• He mate harore (koinei te tino take).
• Te mate kohi.
• Te rongoā irahiko.
• Te silicosis (he mate pūkahukahu e puta mai ana i te hongi i ngā matūriki silica).
• Te Sarcoidosis (te hanganga o ngā tautau iti o ngā pūtau mumura i roto i ngā momo whekau o te tinana).

I ētahi wā, kāore e kitea he tino take mō te mate pāwera mau tonu. Ka kiia tēnei he idiopathic .

Ko te mate harore tino noa e puta ai te mediastinitis mau tonu ko te Histoplasma capsulatum . I te Hononga o Amerika, ko te nuinga o tēnei harore kei te Ohio River Valley me te Mississippi River Valley. I ētahi atu wāhi o te ao, ka kitea i Āwherika, Āhia, Ahitereiria, Amerika Waenganui, me ētahi wāhanga o Amerika ki te Tonga.

Kei roto i te oneone tēnei harore e noho ana. Kāore e kino ki te kore e uru ki te hau, ā, ka manawahia e koe. Ehara i te mea ka pāngia te katoa e te mate. Inaa, ko te nuinga o te hunga e pāngia ana e tēnei harore e kore e pāngia e te mate, he mate ngawari noa iho rānei, kāore he tohu. Heoi, he iti noa te tūponotanga ka nui rawa te urupare a tō pūnaha ārai mate ki tēnei harore i muri i te pāngia (he maha ngā tau i muri mai). Ka taea e tēnei te mumura o ngā kiko i roto i tō "mediastinum", ka arahi pea ki ngā raruraru.

He aha ngā āhuatanga mōrearea e pā ana ki te whanaketanga o te `(Mediastinitis)`?

Nā, me titiro tātou ko wai ka nui ake te tūponotanga ki te pāngia e tēnei mate. Mena kei te pokanga koe e hiahia ana ki te `(median sternotomy)`, pērā i te pokanga ngākau tuwhera, tera pea ka āwangawanga koe mō ngā raruraru. Kōrero ki tō tākuta mō tō tūponotanga. I te nuinga o te wā, he nui ake te tūponotanga ki te pāngia koe e te `acute mediastinitis` i muri i te `(median sternotomy)` mena kei a koe tētahi o ēnei āhuatanga e whai ake nei:

• Mena he mate hauora tōu e ngoikore ai tō pūnaha ārai mate .
• Te mate pūkahukahu ārai mau tonu (COPD) .
• Mate huka.
• Te ngoikore o te whatukuhu.
• Te momonatanga.
• Te mate o te uaua taha (PAD) (te angiangi o ngā oko toto i roto i ngā ringa me ngā waewae).

Ka piki ake hoki te mōrearea o ngā raruraru i muri i te pokanga i te momi hikareti me te whakamahi tupeka .

Ko ētahi āhuatanga e pā ana ki te pokanga tonu ka whakanui ake i te mōrearea o te mediastinitis. Ko ētahi o ēnei:

• I roa rawa te pokanga , i roa rawa rānei te wā i runga ai te tūroro i te cardiopulmonary bypass.
• Te pokanga anō (mēnā kua oti kē te pokanga o tō uma).

Ko koe `(Histoplasma capsulatum)`Mena kei te noho koe i tētahi rohe e horapa ana te harore, he nui ake tō tūponotanga ki te pāngia e te mediastinitis mau tonu.

Me pēhea te tātaritanga o te `(Mediastinitis)`?

I te nuinga o te wā ka tātaritatia e ngā tākuta te mediastinitis mā te whakamātautau tinana me ngā whakamātautau tāpiri.

I a koe e whakamātautau tinana ana, ka pātai atu te tākuta ki a koe mō:

• Ō tohumate.
• Tō hītori hauora (ngā mate o mua, ngā rongoā, me ētahi atu).
• Mō ngā pokanga, ngā tikanga hauora rānei i mahia ki a koe i ēnei wā tata nei .
• Mō ngā rohe kua haerea e koe (ina koa ngā rohe e kitea whānuitia ana te `(Histoplasma capsulatum)`).

Ka taea hoki e tō tākuta te tono i ētahi atu whakamātautau hei whakaū i te mate.

He aha ngā whakamātautau e whakamahia ana hei tautuhi i te `(Mediastinitis)`?

Ko te matawai rorohiko (CT) me te contrast te paerewa koura mō te tautuhi i te mediastinitis. Hei tāpiri, ka tono pea tō tākuta i tētahi hihi-X o te uma , i tētahi koiora ngira rānei .

Me pēhea te rongoā i te Mediastinitis?

Āe, he rongoā kei reira mō tēnei? Āe, kei reira. Engari he rerekē i runga i te āhua o te mate (ahakoa he 'whakapeka', he 'mau tonu' rānei) me te pūtake.

Ko te mediastinitis whakapeka i muri i te sternotomy median ka hiahiatia pea ngā maimoatanga e whai ake nei:

• Ngā paturopi , e hoatu ana mā roto i te uaua (IV) mā roto i te wai tote.
• He pokanga hei tango i ngā kiko mate me te tango i te wai kua kohia.

Ko te mediastinitis whakapeka i puta mai i te roimata esophageal ka hiahiatia pea ngā maimoatanga e whai ake nei:

• Ngā rongoā paturopi.
• He pokanga hei whakatika i te kōhao, hei tango i te kiko mate, me/ranei hei tango i te wai kua kohia.

Mena kei a koe te mate pāwera nui (acute mediastinitis), ka whakaurua koe e tō tīma hauora ki te wāhanga tiaki nui (ICU) . I reira, ka aro turukihia e te tīma hauora ō tohu me tō whakaoranga.

Tērā pea ka uru atu ki te maimoatanga mō te mediastinitis mau tonu te pokanga hei whakamama i ngā tohu. Tērā pea ka tūtohu tō tākuta i ngā tikanga hei whakatuwhera i tō ara manawa, hei whakapai ake rānei i te rere o te toto i roto i ngā oko toto i roto i tō uma. Kei te rapu tonu ngā kairangahau i ngā huarahi maimoatanga mō te hunga e pāngia ana e te mediastinitis mau tonu.

Kōrero ki tō tākuta mō ngā kōwhiringa maimoatanga e wātea ana ki a koe me ngā mea ka taea e koe te tumanako.

Ka taea te ārai i te Mediastinitis?

He pai ake te ārai i tēnei āhuatanga i mua i te puta. He raruraru noa te mediastinitis o ngā tikanga hauora. Mena kei te pokanga uma koe, kei te pokanga endoscopic rānei, kōrero ki tō tākuta mō ngā huarahi hei whakaiti i te tūponotanga o ngā raruraru. Pātai atu ki ngā mahi ka mahia e tō rōpū hauora hei whakaiti i te tūponotanga o te mate. Me pātai hoki me pēhea te tiaki i tō patunga i te kāinga i muri i te pokanga.

Mā te ārai i ngā mate me te rongoā i te wā tonu ka puta mai ka āwhina i te whakaiti i te mōrearea o te mediastinitis acute. Ka horapa pea ngā mate i roto i tō waha me tō korokoro ki tō uma, ā, ka puta he raruraru nui. Anei ētahi mea ka taea e koe te mahi hei āwhina i te ārai i ēnei momo mate:

• Kia tiakina ō niho me ō kapia (`(waha akuaku)`) hei ārai i ngā mate niho.
• Tirohia te tākuta niho i ia ono marama kia horoia ō niho , kia whai rānei i ngā tohutohu a tō tākuta niho.
• Tirohia te tākuta kotahi i te tau hei tirotiro i tō hauora whānui.
• Ki te puta mai ngā tohu o te mate urutā, me toro atu ki te tākuta tonu , ka tango i ngā rongoā kua tohua hei rongoā i te mate urutā kia rite tonu ki te mea kua tohua.

Ka taea te whakamate i te Mediastinitis?

He take nui tēnei. Ae, ka taea e tēnei mate te whakararu i te ora, arā, ka mate pea. Ko te tautuhi me te maimoatanga wawe ngā huarahi pai hei whakaora i ngā ora. Me titiro tātou ki ngā mea e mōhiotia ana e ngā kairangahau mō te reiti mate o te mediastinitis:

• Ko te reiti mate mō te hunga e pāngia ana e te mediastinitis whakapeka i muri i te tango i te sternotomy waenga kei waenga i te 1% me te 14% . He pai ake tēnei i tōna āhua o mua (12% ki te 50%). Nā ngā whakapainga o te whakahaere pokanga tēnei. Tērā pea ka miharo koe he aha i whānui ai ēnei awhe. Nā te mea he rerekē ngā rangahau e whakamahi ana i ngā rōpū taupori rerekē hei ako i ngā reiti mate. Nō reira, ka whakawhirinaki tō putanga ki ngā āhuatanga maha, pērā i te wāhi e pokangahia ai koe, tō tau, me tō hauora whānui.
• He rerekē te auau mate mō te hunga e pāngia ana e te mate pāwera nui nā te haehae o te korokoro. Kei te tere o te maimoatanga. Neke atu i te 10% o te hunga e rongoatia ana i roto i ngā haora 24 i muri i te haehae ka mate. Ka piki ake taua tau ki te 30% ki te 40% i roto i te hunga e rongoatia ana i muri i ngā haora 24. Ka piki ake hoki te mōrearea o tētahi putanga kino atu i te kaumātuatanga.
• Ko te hunga e pāngia ana e te "Descending necrotizing mediastinitis" ka tere te pāngia e te "Sepsis" (te paihana toto) me te ngoikore o ngā okana. Nō reira, ko te reiti mate kei waenga i te 11% me te 40% .

Ahakoa te āhua whakamataku o ēnei tatauranga, he take anō kei reira hei tumanako.Mā te mōhio ki ngā take me ngā tohu o te `(Mediastinitis)` ka āwhina i a koe ki te mōhio āhea me rapu āwhina hauora mēnā e tika ana. Waihoki, me ngā whanaketanga o te ao hauora, kei te haumaru haere ngā pokanga, ā, ka rongoatia hoki ngā raruraru.

Āhea koe me toro atu ki te tākuta?

Ko te 'Acute mediastinitis' he mate e puta ohorere mai ana. Mēnā ka puta mai ēnei tohu (hei tauira, te mamae ohorere o te uma, te kirika, te uaua ki te manawa), waea atu ki te 911 tonu, ki tō nama urupare ā-rohe rānei, haere rānei ki te hōhipera tata. Ko te tere o te whiwhi maimoatanga, ko te pai ake o te putanga whakaora.

Me kōrero anō hoki koe ki te tākuta i roto i ēnei āhuatanga e whai ake nei:

• Mena kei te tata koe ki te pokanga ngākau tuwhera, ki tētahi atu tikanga hauora rānei e whakanui ake ai i tō mōrearea ki te mediastinitis, pātai atu me pēhea e taea ai e koe te whakaiti i tō mōrearea.
• Mena kei a koe ngā tohu o te mediastinitis mau tonu , kei te āwangawanga rānei koe mō tō mōrearea.

Hei whakamutunga, he karere hei kawe ki te kāinga

Kua mārama pea koe ināianei he mate kino te `(Mediastinitis)`, ā, i ētahi wā ka morearea te ora. Kaua e mataku. Ko te mea nui kia mōhio koe ki tēnei.

Kia maumahara:

* I muri i te pokanga o te uma, inā koa te pokanga o te ngākau, tiakina te patunga. Me whai i ngā tohutohu a tō tākuta.

* Kaua e warewarehia ngā mate o te waha me te korokoro. Ka horapa pea, ā, ka pā mai he mate kino.

* Ki te pāngia koe e te mamae ohorere o te uma, te kirika, te uaua rānei ki te manawa , rapua tonutia he awhina hauora.

* Mena kei roto koe i ngā rohe e kitea whānuitia ana ngā harore pēnei i te `(Histoplasma capsulatum)`, kia tūpato hoki ki tēnā.

* Ko te wawe o te tautuhi me te rongoā i te mate, ko te nui ake o te tūponotanga kia ora. Nā te whanaketanga o te pūtaiao hauora, ka taea inaianei te whakatau angitu i ēnei āhuatanga.

Mena kei te pāngia koe e te mate mediastinitis, tera pea ka manukanuka koe, ka kore hoki e taea te āwhina. Mā te ako mō tēnei mate ka āwhina i a koe kia whai mana whakahaere. Mā tēnei mōhiotanga koe e āwhina ki te kōrero ki te tīma hauora o tō hoa aroha mō ngā mea e pā ana. Pātai atu ki a rātou me pēhea e taea ai e koe te āwhina i a rātou i a rātou e ora ana.

` mediastinitis, mamae o te uma, mate o te uma, ngā raruraru pokanga ngākau, pakaru o te korokoro, mate harore, mediastinum