Kāore pea koe i rongo mō tētahi tohunga e tirotiro ana mēnā kei te mahi tika tō pūnaha io, tae atu ki tō roro, tō taurakira, me te whatunga io e rere ana puta noa i tō tinana. Pērā i tētahi tohunga e tirotiro ana mēnā kei te mahi tika ngā waea i roto i tō whare, kei te poto rānei tetahi wāhi, kei te iti rānei te iahiko, ka tirohia anō hoki e tēnei tākuta te "pūnaha hiko" o tō tinana. I tēnei rā kei te kōrero tātou mō tēnei tohunga, he Kairangahau Hinengaro.
Hei whakarāpopototanga, ko wai te tohunga roro?
He tohunga te tohunga roro e rangahau ana i te mahi a tō tātou pūnaha io, inā koa ko tōna ngohe hiko , ā, e whakahaere ana i ngā whakamātautau me te tautuhi i ngā mate e pā ana.
Whakaarohia, he mīhini tino uaua tō tātou tinana. Ko te rūma whakahaere o tēnei mīhini ko te pūnaha io. Arā, ko te roro, ko te taurakira, me ngā io e kawe ana i ngā kōrero puta noa i te tinana. Ko ngā mea katoa e whakaarohia ana e koe, e pā ana ki a koe, e mahia ana e koe, e whakahaerehia ana e tēnei pūnaha. Mai i te wā e ara ake ai tō ringa ki te wā e pā ai tō ngākau, he wāhanga katoa tēnei o taua mea.
Nō reira, ki te mea he raruraru kei tēnei pūnaha, ahakoa he raruraru kei te rere o ngā kōrero, he raruraru rānei kei ngā tohu hiko, ka āwhina te tohunga roro ki te kimi.
Tohunga roro me te tohunga roro - He aha te rerekētanga i waenganui i ēnei e rua?
He maha ngā wā ka pōhēhētia ēnei ingoa e rua. He tākuta rāua e mahi ana i te pūnaha io. Engari he rerekētanga iti. Me whakamārama tātou i tēnei mā te whakamahi i tētahi tauira.
Whakaarohia he raruraru kei roto i te pūnaha rama i roto i tō whare. Tuatahi, me kōrero koe ki tētahi tohunga hiko noa. Ka taea e ia te tirotiro i te pūnaha waea katoa o te whare, te tirotiro mēnā kua pakaru te fuse, kua hē te pana, kua pau te pūangi, ā, ka whiwhi i tētahi tirohanga whānui. Koinei te āhua o tētahi Tohunga Niho . He tākuta ia e mōhio whānui ana ki ngā āhuatanga katoa o te pūnaha io, arā, tōna hanganga, tana mahi, me ngā mate katoa e pā ana ki a ia. Ka tohua e te Tohunga Niho tō rongoā, ā, ka whakamahere i tō maimoatanga.
Whakaarohia he raruraru tino uaua kāore e kitea e te kaihikohiko. Ka heke te ngaohiko o te iahiko, me te mea he turuturu iti kei hea. Kātahi ka kawea mai e ia tētahi e whakamahi ana i ngā mita motuhake, he tohunga ki te rere o te iahiko. Koinei te āhua o tētahi Kairangahau Niho . He tohunga ia ki te mahi a te pūnaha io, inā koa te huarahi e haere ai ngā tohu hiko. Ko tāna mahi he whakahaere i ngā whakamātautau maha, he tātari i ngā hua, me te kimi i te raruraru o te mahi a ngā io.
He māmā noa iho, ka tātaritanga me te rongoāhia e te Kairangahau Niho ngā mate. Ka whakahaerehia e te Kairangahau Niho ngā whakamātautau motuhake, ā, ka whakaratohia ngā raraunga nui e hiahiatia ana mō taua tātaritanga. Engari kāore rātou e tohu rongoā i te nuinga o te wā.
Ngā tūranga matua e rua o te tohunga roro
Ka taea e tātou te wehewehe i ngā tohunga roro kia rua ngā wāhanga matua, i runga i te āhua o tā rātou mahi.
1. Te hunga e mahi ana i roto i te pokanga (Ngā Tohunga Pokanga Neurophysiology)
2. Te hunga e tātaritanga mate ana i ngā wāhi rongoā (Ngā Tohunga Hinengaro Hauora)
Kia tirohia takitahitia te tūranga o ia tangata.
1. Te Tūranga o te Kairangahau Pūnaha io i roto i te Pokanga
He wāhanga tino nui tēnei. Whakaarohia kei te whakahaerehia he pokanga nui ki tōna tuaiwi, ki tōna roro rānei. I a ia e mahi ana i te pokanga, me aroturuki ngā taote pokanga mō te kino o ngā io. Mena he hapa iti noa iho, ka taea e te tangata te pararutiki, te ngaro te rongo, te pāngia rānei e te whiu.
Koinā te wā e uru atu ai te tohunga roro ki te tīma pokanga. Ka whakamahia e ia ngā taputapu motuhake hei aroturuki i te mahi hiko o te pūnaha io o te tūroro puta noa i te pokanga. Ka kiia tēnei ko te Intraoperative Neurophysiology Monitoring (IONM) . Ina pāngia te io, ahakoa he iti noa iho, ka huri ōna tohu hiko. Ina kite tonu te tohunga roro i taua huringa, ka whakatūpato ia i te taote pokanga. Kātahi ka taea e te taote pokanga te mahi i ngā mahi e tika ana i mua i te pakaru.
| Momo pokanga | Te tūranga o te tohunga roro |
|---|---|
| Pokanga tuaiwi | Hei aroturuki i ngā pakaru o te taurakira me ngā io e puta mai ana i reira. Hei āwhina i te ārai i te ngaronga o ngā peka. |
| Pokanga roro | Hei tirotiro mēnā kua pakaru ngā wāhanga nui o te roro, hei tauira, ngā wāhanga e pā ana ki te kōrero, te tirohanga, me te nekehanga. |
| Ngā pokanga taringa, ihu, me te korokoro (ngā tikanga ENT) | Te ārai i te ngaronga o te rongo nā te kino o te io whakarongo, inā koa i te wā e pokangahia ana te taringa. |
| Ngā pokanga toto | Te aroturuki i ngā mahi a te roro hei ārai i ngā kino i puta mai i te hekenga o te rere o te toto ki te roro (ischemia). |
2. Te tohunga roro e whakatau ana i ngā mate haumanu
Koinei te Kairangahau io e kitea ana e tātou, ko ia te mea e tohua mai ana e tā tātou tākuta. Kei ngā hōhipera, kei ngā whare hauora rānei rātou. He maha ā rātou whakamātautau hei tirotiro i te mahi a te pūnaha io. I runga i ngā hua o ēnei whakamātautau ka whakatauhia e tō Kairangahau io te āhua o tō mate.
Koinei ētahi o ngā whakamātautau matua e mahia ana e rātou:
- EMG (Electromyography): Ka tirohia e tēnei whakamātautau te hauora o ō uaua me ngā io e whakahaere ana i aua uaua. Mena he ngoikore, he mākūkū, he ngoikore rānei tō ringa, ka taea e tēnei whakamātautau te āwhina ki te whakatau mena kei roto i te uaua tonu te raruraru, kei roto rānei i ngā io e whakarato ana i a ia. He mea nui tēnei mō te tautuhi i ngā mate pēnei i te Carpal Tunnel Syndrome (he uaua kua pēhia i te ringaringa) me te Peripheral Neuropathy (he kino ki ngā io i ngā ringa me ngā waewae nā ngā mate pēnei i te mate huka).
- NCS (Rangahau Whakahaere Io): Ka ine tēnei i te roa o te wā e haere ai te tohu hiko i roto i te io, me tōna tere hoki. Mēnā ka pakaru te io, ka heke te tere o te haere o taua tohu. He maha ngā wā ka mahia ngātahitia ngā whakamātautau EMG me te NCS.
- EEG (Electroencephalogram): Kua rongo pea koe i tēnei. Ko te tikanga o tēnei ko te tāpiri i ngā irahiko iti ki te tumuaki me te tuhi i ngā mahi hiko o te roro . He mea nui tēnei whakamātautau hei tātaritanga i ngā mate pēnei i te mate haurangi me te kimi i te pūtake o te mate i roto i te roro.
- Whakamātautau Pūmanawa Whakaoho: Kei roto i tēnei ko te tuku i tētahi whakaohooho, pērā i te mārama ki ngā kanohi, te tangi rānei ki ngā taringa, me te ine i te ngohe hiko i roto i te roro me te taurakira hei whakautu ki tēnā. Arā, ka ine i te tere o te taenga atu o ngā mea e kitea ana e ō kanohi ki te roro, me te tere o te taenga atu o ngā mea e rangona ana e ō taringa ki te roro.
- Te ako moe (Te ako moe / Te polysomnography):He raruraru kei ētahi tāngata pērā i te ngongoro, te hikoi moe, me te ngongoro i te wā e moe ana. Hei tautuhi i ēnei mate moe, ka haria te tūroro ki te hōhipera, ā, ka tirotirohia ngā mahi a te tinana (ngā ngaru roro, te manawa, me te tere o te ngakau) i te pō. Ka mahia hoki tēnei e te Kairangahau Pūnaha io.
Me pēhea te noho hei tohunga hinengaro?
He haerenga roa, he haerenga whakatapua hoki tēnei. He tākuta te tohunga roro. Nō reira, me whakauru tuatahi koe ki te kura hauora, ā, me whakaoti i tētahi tohu hauora (MD/MBBS).
Kātahi:
- Me whakaoti e koe tētahi mahi tauira kotahi tau te roa.
- Whai muri i tēnā, me whai koe i ētahi tau o te whakangungu paerua (Residency/MD) kia whiwhi ai koe i te mātauranga motuhake ki te neurology.
- I muri i taua whakangungu, ka ako hōhonu koe i te mahi a te pūnaha io, ā, ka whiwhi whakangungu i roto i tētahi wāhanga motuhake e kiia nei ko te Neurophysiology.
He nui te wā, te ako, me te whakapau kaha e hiahiatia ana mō tēnei.
Nō reira, ki te tukuna koe e tō tākuta mō tētahi whakamātautau pēnei i te EMG, i te EEG rānei, kua mōhio koe ka haere koe ki te kite i tētahi Kaimātai Hinengaro. Māna koe e tirotiro hohonu i tō pūnaha io, ā, ka āwhina i a koe ki te whakatau i te tātaritanga tika mō tō āhua. Nō reira, kaua e mataku, pātai atu ki taua tākuta mō ngā pātai, ngā āwangawanga rānei kei a koe. Kei reira rātou hei āwhina i a koe.
Karere Tangohia ki te Kāinga
- He tākuta te tohunga roro e tohunga ana ki ngā mahi hiko o te pūnaha io (te roro, ngā io).
- Ka rongoāhia e te tākuta roro ngā mate pūnaha io, ā, ka āwhina te tākuta roro ki te tautuhi i aua mate mā roto i ngā whakamātautau motuhake (pēnei i te EMG, EEG).
- I ngā wā pokanga nui (tuarā, roro), he mea nui te āwhina a te tohunga roro kia kore ai e pakaru ngā io.
- Mena ka tukuna koe mō tētahi whakamātautau pēnei i te EMG, NCS, EEG rānei, ka tirotirohia koe e tētahi Kairangahau io. Kaua e wehi ki te pātai ki tō tākuta mō tēnei mea.
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