He aha te Tukanga Mitrofanoff? Me kōrero māmā noa iho.

I ētahi wā ka pā mai ngā raruraru hauora kāore e taea te whakaaro. Ina koa ka pā mai ngā raruraru pūkahukahu, he tino uaua te kore e taea te mimi noa. He wero nui te noho me ēnei āhuatanga mō te tamaiti me te pakeke. Hei āwhina i ēnei tāngata, i tēnei rā ka kōrero tātou mō tētahi pokanga motuhake hei whakahaere i ō rātou oranga. Ko te tikanga Mitrofanoff tēnei. Ahakoa he ahua rerekē te ingoa, he tino whai hua ngā painga o tēnei.

He whakarāpopototanga, he aha tēnei pokanga Mitrofanoff?

He tikanga pokanga te Mitrofanoff e hanga ana i tētahi pūaha iti (e kiia nei ko te stoma ) i roto i te puku kia rere ai te mimi mai i te pūhā. He tikanga tino motuhake tēnei nā te mea ka whakamahia e ngā taote pokanga tētahi wāhanga o tō tinana ake hei hanga i tēnei pūaha. Ko tō apenihana tēnā.

Whakaarohia, mā te whakamahi i tō kiriuhi, ka hangaia e koe he ara iti rite ki te ngongo mai i tō pūkahukahu ki tō puku. Kātahi, ina hiahia koe ki te mimi, ka taea e koe te whakauru i tētahi catheter , he ngongo ngāwari, mā roto i tēnei pūaha (stoma) hei whakawātea i tō pūkahukahu.

I te tau 1976 i whakaurua tuatahitia ai tēnei tikanga e tētahi ahorangi ko Paul Mitrofanoff tōna ingoa. Koia anō te ingoa o tēnei tikanga ko te 'appendicovesicostomy'.

Kia mārama tātou i te tuatahi he iti nei ngā kōrero mō ēnei wāhanga o te tinana.

Hei mārama katoa ki tēnei pokanga, he mea āwhina kia mārama ki te mahi a te pūnaha mimi me te ureter o tō tātou tinana.

• Pūngāwerewere: He pēke uaua tēnei e rite ana ki te poihau. Ka rere te mimi e hangaia ana e ō tātou whatukuhu mā te tātari toto mā roto i ngā ngongo iti e rua (ngā ureter) ka kohia ki roto i tēnei pūngāwerewere. Ina kī, ka hiahia tātou ki te mimi. Kātahi ka puta te mimi i te tinana mā roto i te urethra.
• Āpitihanga: He wāhanga tēnei o tā tātou pūnaha nakunaku. He ngongo iti tēnei kei te taha matau o raro o tō puku, e piri ana ki te wāhanga tuatahi o tō whekau nui. Kāore anō kia mōhiotia e ngā tākuta he aha atu āna mahi. Engari ka taea e tātou te ora hauora me te kore. He maha ngā tāngata ka tangohia mā te pokanga ina pāngia rātou e te apendicitis. Nō reira, kāore he raruraru ki te whakamahi mō ētahi atu whakamahinga whai hua.

Whakaarohia mēnā kāore he āpitihanga i a koe, arā, i tangohia i tētahi pokanga o mua, me aha koe? He otinga anō hoki mō tēnā. Mēnā koinā, ka tangohia e te taote pokanga te āpitihanga mai i tō whekau iti.Ka tangohia e rātou tētahi wāhanga iti, ka hangaia tēnei ara. Ko te tikanga Monti, ko Monti-Yang rānei te ingoa.

He aha tonu te mea ka tupu i te wā e pokangahia ana a Mitrofanoff?

Mā tēnei ka taea e koe te whakawātea i tō pūkahukahu mā te whakauru i tētahi catheter mā roto i tētahi kōhao i roto i tō puku (stoma). Ka kiia tēnei ko te self-catheterization .

I te roanga o te rā, i ngā wā motuhake (ia 3-4 hāora te nuinga), me mahi e koe ēnei e whai ake nei:

1. Ka whakaurua he ngongo ngāwari (catheter) mā te pūaha (stoma) i roto i te puku, ā, ka arahina i te ara kua hangaia ki te pūkahukahu.

2. Ka ringihia te mimi katoa ki roto i te wharepaku, ki roto rānei i tētahi ipu i te taha o te paipa.

3. Kia takoto kau rawa te mimi, ka tangohia te catheter. Kātahi ka kati aunoa te pūaha (stoma). Kāore he mimi e turuturu mai i reira.

He māmā ake tēnei tikanga, he iti ake te mamae, ā, he pai ake hoki mō te tini o te tangata i te whakauru i tētahi catheter mā roto i te urethra noa.

Ko wai e hiahia ana ki tēnei pokanga?

Tērā pea e hiahiatia te pokanga Mitrofanoff mō ngā tamariki me ngā pakeke. Ka tirohia motuhaketia e mātou ngā mea e rua.

He aha te take e hiahiatia ai te pokanga Mitrofanoff mō te tamaiti?

Ka whānau mai ētahi tamariki me ētahi ngoikoretanga o ō rātou pūnaha io. Nā tēnei ka kore e taea e rātou te whakahaere i ngā uaua o ō rātou pūkahukahu. Ka kiia tēnei he pūkahukahu neurogenic . Waihoki, ko ngā tamariki he mate whānau tō rātou pūnaha mimi, me mahi pea tēnei pokanga.

Ko ngā take noa e hiahiatia ai tēnei pokanga mō ngā tamariki:

• Spina Bifida: He ngoikore o te tuaiwi e kitea ana i te whānautanga mai.
• Te exstrophy pūkahukahu, te exstrophy cloacal rānei: Te kitea o te pūkahukahu ki waho nā te mea kāore anō kia oti te hanganga o te pakitara puku i te whānautanga.
• Te Pararutiki Hinengaro: He āhuatanga e pā ana ki ngā nekehanga o te tinana me te whakahaere uaua nā te kino o te roro.
• Te agenesis sacral: Ko te ngaronga whānau mai o te wāhanga o raro rawa o te tuaiwi.
• Te whara o te taurakira.

He aha te take e hiahiatia ai te pokanga Mitrofanoff mō te pakeke?

Tērā pea kāore e taea e ngā pakeke te whakahaere i ō rātou pūkahukahu mō ngā take maha.

• Ngā āhuatanga mate pukupuku: Ngā āhuatanga pēnei i te mate pukupuku tōngāmimi, te mate pukupuku repeure, te mate pukupuku koroni rānei.
• Te kore e taea te whakahaere i te mimi: Te kore e taea te pupuri i te mimi.
• Te mumura o te pūkahukahu (Cystitis).
• Ngā mate o te pūnaha io: Ko te pūkahukahu neurogenic e hua mai ana i ngā āhuatanga pēnei i te sclerosis maha, te mate a Parkinson rānei.
• Ngā whara o te tuaiwi, te pararutiki, ngā pukupuku tuaiwi rānei.
• Te whiu.

He aha ngā mea ka tū i mua, i te wā, me muri i te pokanga?

He mea noa te mataku i te wā e kōrero ana mō tētahi pokanga nui pēnei. Engari mā te mōhio ki te āhua o ēnei mea ka āwhina i te whakaiti i taua mataku.

I mua i te tikanga

Hei whakaiti i te tūponotanga o te mate i te wā e pokanga ana, me noho kau ō whekau. Me whai i ngā tohutohu a tō tākuta. Kei roto i ēnei ko:

• Te nohopuku i te rā i mua i te pokanga.
• Te inu i tētahi inu motuhake hei horoi rawa i ngā whekau (te horoi i te puku).

I te wā o te tukanga

Ka mahia tēnei pokanga i raro i te rongoā 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.

Ka whai te taote pokanga i ēnei mahi:

1. Ka tapahia tō puku.

2. Kua wehea te apitihanga mai i te whekau nui.

3. Ka honoa tetahi pito ki tētahi tapahi iti i mahia ki te pūkahukahu, ā, ka honoa tetahi pito ki tētahi kōhao iti (stoma) i hangaia ki te kiri o te puku.

4. Ka hangaia he hanganga rite ki te takirere ki te wāhi e hono ai te ureter ki te pūkahukahu hei ārai i te rere whakamuri o te mimi. Ka whakawhāitihia, ka katihia hoki tēnei takirere ina kī te pūkahukahu, ā, ka ārai i te turuturu o te mimi mā roto i te ara kua hangaia.

5. Hei āwhina i a koe ki te mimi kia ora rā anō tō pūhā, ka whakanohoia he ngongo rangitahi (ngā ngongo suprapubic) ki roto tonu i tō pūhā. Mā tēnei ka kohia te mimi ki roto i tētahi pēke i waho o tō tinana.

6. I ētahi wā, ka taea te whakanoho i ngā ngongo iti (ngā stent ureter) ki roto i ngā ngongo e kawe ana i te mimi mai i ngā whatukuhu ki te pūhā (ngā ureter). Kāore tēnei e hiahiatia ana mō te katoa.

7. Hei whakamutunga, ka katihia te tapahi matua mō te pokanga ki ngā tuitui ka taea te rewa.

I muri i te tikanga

I muri i te pokanga, me noho koe ki te hōhipera mō te wiki pea. I roto i tēnei wā:

• Kāore koe e whakaaetia kia kai mō ētahi rā. Engari, ka hoatu he wai ki a koe i roto i te IV. Hei hoatu i te wā ki ō whekau kia ora ai.
• Mō te rā tuatahi, e rua rānei, me takoto papatahi koe i runga i te moenga. Ka taea e koe te huri me te neke i ō waewae, engari kāore koe e whakaaetia kia noho ake.
• Ina hoki koe ki te kāinga, ka whakanohoia he catheter me te ngongo 'suprapubic' rangitahi ki roto i te ara hou i hangaia (te kauhanga Mitrofanoff) hei ārai i tōna kati. Me waiho tēnei catheter ki tōna tūranga mō te 4 wiki pea.
• Ki te tāutahia aua 'stent ureteral', me mahi tētahi atu tikanga iti hei tango i aua mea i roto i te 6-8 wiki.
• I te rā e akona ai koe ki te whakauru i te kātene ki a koe anō, ka tangohia e te tākuta ngā ngongo rangitahi e rua i te tari. Kāore e hiahiatia he pokanga anō mō ​​tēnei.

He aha ngā painga me ngā mōrearea o tēnei pokanga?

Pērā i ngā tikanga hauora katoa, he painga, he mōrearea anō hoki.

Te whakaoranga me te oranga i muri i te pokanga

I ngā wiki tuatahi i muri i te pokanga, ka pā pea ki a koe:

• He iti noa te toto i roto i te mimi (hematuria).
• Te mamae o ngā uaua o te pūhā (te pupuhi o te pūhā).

Ka tohua e tō tākuta ngā rongoā whakamamae mamae me ngā rongoā whakangāwari uaua mō ēnei.

I muri i te ono wiki pea, me toro atu koe ki tō tākuta kia ako ai koe ki te whakauru i te catheter māu ake (te whakaurunga catheter-ake).

Heoi anō, me aro tonu koe ki te mahi a tō pūnaha mimi. Me whakahaere ngā whakamātautau e whai ake nei i ia tau:

• Ngā whakamātautau toto hei tirotiro i te taumata o ngā electrolytes i roto i te toto me te mahi a ngā whatukuhu.
• Cystoscopy (tirotiro i te roto o te pūkahukahu).
• Ngā matawai ultrasound o ngā whatukuhu me te pūkahukahu.
• Ngā whakamātautau X-ray o ngā whatukuhu, te pūkahukahu, me te urethra.

Āhea te wā tika kia kite tonu i te tākuta

Mena ka pāngia koe e tētahi o ēnei tohu, me waea atu koe ki tō tākuta tonu :

• Te kore e taea te whakakore katoa i te pūkahukahu.
• Te toto nui rawa, te pupuhi, te maru rānei.
• Whakapairuaki me te ruaki.
• Mamae nui.
• Ngā tohu o te mate pukupuku, pērā i te rere o te ihu kakara kino, te kirika rānei.

He aha te rerekētanga i waenga i te Mitrofanoff me te Urostomy?

Ko ēnei tikanga e rua ko te tuku mimi mā roto i tētahi kōhao i roto i te puku. Heoi, mā te urostomy , ka hangaia he ara hei karo i te pūkahukahu, hei tango tika i te mimi mai i ngā whatukuhu. Ko ētahi tāngata whai urostomy me mau tonu i tētahi putea kohikohi mimi. Ko te tikanga tēnei kāore e taea e rātou te whakahaere i te rere o ō rātou mimi. Heoi, mā te Mitrofanoff, he nui ake tō herekoretanga nā te mea ka taea e koe te whakawātea i tō pūkahukahu mā te whakamahi i tētahi catheter ina hiahiatia.

He mahi tuturu tēnei pokanga?

Ka taea tēnei te huri. Arā, ka taea te tango i te kauhanga mā te pokanga. Heoi, kāore te apenipiti i honoa anō ki te whekau, nā te mea ehara i te okana nui. I muri i te tangohanga o te Mitrofanoff, me mimi pea koe mā te urethra, me whakauru rānei he catheter mā roto hei whakawātea i tō pūkahukahu, me mahi rānei i te urostomy. He mea tēnei me kōrero koe ki tō tākuta.