He mea noa te mataku me te manukanuka ina kōrero mai tō tākuta mō te pokanga ngākau, inā koa te whakatikatika i te takirere mitral. "He aha tēnei pokanga?", "He aha ahau me mahi ai i tēnei?", "He morearea?", me ētahi atu. He maha ngā pātai ka puta ake pea ki te hinengaro. I tēnei rā, ka kōrerohia e tātou ēnei mea katoa i roto i tētahi huarahi tino māmā ka taea e koe te mārama.
He aha tēnei takirere mitral? He aha te tikanga o te whakatikatika?
Whakaarohia tō ngākau he whare e whā ngā rūma. Ko te "tatau" kei te taha maui o te ngākau i waenganui i te rūma o runga (atrium maui) me te rūma o raro (ventricle maui) e kiia ana ko te Mitral Valve . Ka tuwhera tēnei tatau kia uru ai te toto whai hāora mai i ngā pukahukahu ki te ventricle maui. Kātahi ka pupuhi te ventricle maui i te toto ki te toenga o te tinana.
Nō reira ka tīmata ngā raruraru ina kore e mahi tika tēnei takirere, te takirere mitral. I roto i te wā, ka kino pea te ngākau me ngā pukahukahu. Ko te whakatikatika i te takirere mitral he pokanga ngākau tuwhera hei whakatika i te hapa o tēnei takirere. Ka ngana tonu ngā tākuta ki te whakatika i tō ake takirere kaua ki te whakakapi katoa. Nā te mea he nui ake ngā painga me ngā mōrearea iti iho.
I roto i ēhea āhuatanga e hiahiatia ai tēnei pokanga?
Ka whakaarohia pea tēnei pokanga e te tākuta i roto i ngā āhuatanga hauora matua e toru.
| Āhuatanga hauora | Hei whakarāpopototanga... |
|---|---|
| Te Regurgitation o te Takirere Mitral | Kāore e kati tika ngā taupoki e rua o te takirere, ka "tātari" te toto ki te taha hē, arā, ki muri. Mena he nui tēnei turuturu, he tohu rānei, me mahi pokanga pea. |
| Te Stenosis o te Takirere Mitral | Ka āraia, ka whaiti hoki te whakatuwheratanga o te takirere, ā, ka kore e nui te toto e rere mā roto. Mēnā he kino rawa tēnei, ka whakamātau tuatahi te tākuta i ētahi atu maimoatanga (hei tauira, te valvotomy mitral balloon) ā, ki te kore e pai, ka tukuna koe ki te pokanga. |
| Te Porowhita o te Takirere Mitral | Ka tino wetekina, ka piko hoki ngā rau e rua o te takirere. Ka taea hoki e tēnei te turuturu whakamuri o te toto. E 60% anake o ngā pokanga takirere mitral e mahia ana nā tēnei āhuatanga. |
Mena kua heke te rere o te toto ki tō tinana i te taha maui o tō ngākau (te ventricle maui) (te ngoikore o te ngākau i te taha maui) mehemea rānei kua rahi tō ngākau, me mahi pea tēnei pokanga. Heoi, mena kei te tīmatanga tonu te mate, ka taea te whakahaere mā te rongoā. He maha ngā wā ka whakahaerehia e tō tākuta he echocardiogram hei aroturuki i te āhua o tō ngākau.
Me pēhea te whakarite i mua i te pokanga?
He mea tino nui kia whai i ngā tohutohu a tō tīma hauora i mua i te pokanga. Tērā pea ka kōrero atu rātou ki a koe i ēnei mea:
- Ka tonoa koe kia mutu te tango i ētahi rongoā, inā koa ko ngā rongoā whakakore toto (hei tauira, te aspirin, te warfarin), i ētahi wiki i mua i te pokanga.
- Ki te kai paipa koe, ka āwhina i a koe ki te whakamutu .
- I te pō i mua i te pokanga, ka tonoa koe kia horoi i tō tinana ki te hopi paturopi.
- Mā rātou koe e kī atu he aha ngā rongoā me tango e koe i te ata o te pokanga.
- Ka tonoa koe kia mutu te kai me te inu i muri i tētahi wā kua whakaritea i te rā o te pokanga.
He aha tonu te mea e tupu ana i te wā o te pokanga?
Nā te mea he pokanga ngākau tuwhera tēnei, ka hoatu he rongoā whakamoe ki a koe, ā, ka meinga koe kia moe. Nō reira, kāore koe e rongo i tetahi mea. Anei ngā mea ka tupu i te wā o te pokanga:
1. Whakamoemiti: Mā tēnei ka moe hōhonu koe, kāore he mamae e pā ana.
2. Mīhini karo: I te wā o te pokanga, ka honoa koe ki tētahi mīhini motuhake e kiia nei ko te "Mīhini Karo Cardiopulmonary" hei mahi i ngā mahi a tō ngākau me ō pukahukahu mō tētahi wā poto.
3. Tapahi: Ka tapahia e te taote pokanga te uma. Ka rerekē te rahi o tēnei tapahi i runga i te momo pokanga e mahia ana.
4. Te whakatikatika i te takirere: Kātahi ka whakamahia e te taote pokanga ngā tikanga maha hei whakatika i te hapa o tō takirere mitral. He maha ngā wā, ka whakatakotoria he mowhiti i hangaia ki te papanga (mowhiti annuloplasty) ki te taha o te takirere hei tautoko i a ia. Mā tēnei ka whakahokia te takirere ki tōna tūranga noa.
5. Tirotiro: Ka tirohia te takirere kia tino tika ai te whakatikatika. Mēnā e tika ana, ka mahia ētahi atu whakatikatika.
6. Whakaoraora: Ka momotuhia tō hononga mai i te mīhini karo, ā, ka mahi anō tō ngākau me ō pukahukahu.
7. Tirotiro whakamutunga:Ka whakamahia he whakamātautau motuhake e kiia nei ko te Transesophageal Echocardiogram (Echocardiogram) hei tirotiro i te takirere me te whakaū mēnā i angitu te pokanga.
He aha ngā tikanga e whakamahia ana mō te pokanga?
He rerekē ngā tikanga e whakamahia ana e ngā taote pokanga mō tēnei. Hei tauira, ahakoa te tapahi i te uma, tera pea he rerekē.
- He tapahi nui i waenganui o te uma (Full Sternotomy)
- sternotomy wāhanga (tapahia he wahi iti ki tetahi wāhanga o te uma)
- He tapahi iti i waenganui i ngā rara e rua (Te tango i te uma matau)
- Ka mahia te pokanga karetao mā te hanga i ētahi tapahi iti rawa i waenganui i ngā rara.
He maha ngā huarahi hei whakatika i te takirere. Kei roto i ēnei ko te tapahi i ngā wāhanga pakaru me te tuitui i ngā wāhanga e toe ana, te whakakapi rānei i ngā chordae ki ngā miro hangai motuhake pērā i te Gore-Tex® mēnā he wetekina ngā chordae. Mā tō tākuta tēnei e whakamārama atu ki a koe me ētahi atu taipitopito.
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 wāhanga tiaki nui (ICU) mō te rā kotahi, e rua rānei. I reira, ka aro turukihia e te tīma hauora tō manawa me tō manawa. Whai muri i tēnā, ka noho koe ki te wāhanga noa mō ētahi atu rā i mua i tō hokinga ki te kāinga. E whā ki te waru wiki pea te roa ki te ora katoa. Tērā pea ka roa ake te wā mō ētahi tāngata.
Kia maumahara ki tēnei mea tino nui: He mea motuhake tō haerenga whakaora ki a koe. Ahakoa ka ora katoa tō hoa noho i roto i te marama kotahi, tera pea ka roa pea ētahi marama. He mea noa tēnā. Nō reira kaua e whakarite i a koe ki ētahi atu. Kaua e pēhi i a koe anō kia tere te ora.
He maha ngā āhuatanga e pā ana ki te tere o tō whakaoranga:
- Te kaha o tō mate ngakau i mua i te pokanga.
- Tō hauora whānui i mua i te pokanga.
- Te tikanga pokanga i whakamahia mō te pokanga.
Kia hoki koe ki te kāinga, whakatakotohia he whāinga iti, ā, hoki mārire ki ō mahi o ia rā. Kia nui te okiokinga. Mā tō tākuta koe e kī atu āhea koe ka taea te tīmata ki te taraiwa, te hiki taumaha, me te whakakorikori tinana.
He aha ngā painga o te whakahoutanga? He tūponotanga kei reira?
He maha ngā painga o te whakatika i te takirere i runga i te whakakapi.
- Ka nui ake te tūponotanga o te oranga me te oranga mō te wā roa i muri i te pokanga.
- He pai ake te tiaki i te mahi a te ngākau.
- Ka whakaiti i te mōrearea o ngā raruraru pēnei i te whiu me te endocarditis.
- Kāore he take ki te tango i ngā rongoā anticoagulant mō te toenga o tō oranga.
Pērā i ngā pokanga katoa, he tūponotanga kei reira. Hei tauira, ka puta pea ngā manawataki o te ngākau rerekē (arrhythmias), te toto, me te mate. Heoi, ka tūtohu pea tō tākuta i tēnei pokanga mēnā he nui ake ngā painga o te pokanga i ngā tūponotanga.Nā te mea e whakapono ana rātou ki tēnā. E ai ki ngā pūrongo, ahakoa 10 tau i muri i tēnei pokanga, tata ki te 94% o te iwi kāore he raruraru nui o te takirere anō. Ko te tikanga he otinga tino angitu tēnei, ā, he roa te wā e mau ana.
Āhea ahau me toro atu ki te tākuta i muri i te pokanga?
He mea noa te pāngia e te mamae i te wā e ora ana. Heoi, ki te pāngia koe e tētahi, e ētahi rānei o ngā tohu e whai ake nei, he tohu pea tēnei mō tētahi raruraru. Mēnā ka pāngia koe e tēnei āhuatanga, waea atu ki tō tākuta, haere rānei ki te hōhipera tonu atu.
| Ngā tohu whakatūpato hei tirotiro māu | |
|---|---|
| • Mamae o te uma | • Te kirika, te makariri rānei |
| • Maremare me te hūpē kōwhai, kākāriki rānei | • Te whanoke, te māuiui rānei |
| • Te pupuhi, te whero, me te pupuhi huri noa i te wāhi i tapahia | • Te uaua ki te manawa |
| • He pāorooro rerekē (tere rawa, puhoi rawa rānei ) | • Te kōrero pōturi, te tohu rānei o te whiu |
| • Whakapairuaki me te ruaki | • Te mamae, te whero, te pupuhi rānei i te waewae o raro |
Ki te mea he āwangawanga āu mō tētahi tohu, kaua e wehi ki te pātai ki tō tākuta mōna. He mea whakamarie te mōhio ehara i te mea nui.
Karere Tangohia ki te Kāinga
- He pokanga te whakatikatika i te takirere mitral hei whakatika i tētahi hapa i roto i tō ake takirere ngākau. He pai ake tēnei i te whakakapi i te takirere.
- E 4-8 wiki pea, neke atu rānei, te roa hei whakaora katoa i tēnei pokanga. Kaua e whakarite i tō haerenga whakaora ki ētahi atu.
- Kia ata whai i ngā tohutohu a te tākuta i mua atu, ā, i muri mai hoki i te pokanga. He mea tino nui tēnei mō tō oranga.
- Kia tūpato ki ngā tohu whakatūpato pēnei i te mamae o te uma, te uaua ki te manawa, te kirika, me ngā tohu o te mate i te wāhi i tapahia. Mēnā kei te ruarua koe, rapua tonutia he tohutohu hauora.
- He otinga tino angitu tēnei pokanga, he otinga roa hoki. Kaua e mangere ki te kōrero ki tō tākuta mō ō pātai, ō āwangawanga, ō ruarua rānei mō tēnei.
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