Kei te rite tō puku ki te kōhatu? Me ako tātou mō tēnei mate onge (Ogilvie Syndrome)

Kua rongo koe i te mea kei te mau tetahi mea i roto i tō puku, kei te rahi haere tō puku, ā, kei te pēhia koe e te mea kei te tata te pahū? Me te mea kua tino āraihia ō whekau. I te nuinga o te wā, ka puta tēnei ina kua āraihia tetahi mea i roto i ō whekau. Heoi, he āhuatanga rerekē, he āhuatanga onge hoki, ka mutu ohorere te mahi a ō whekau, kāore he mea e mau ana i roto. I tēnei rā, ka kōrero tātou mō tētahi āhuatanga kāore anō kia rangona e te nuinga o te tangata. I roto i ngā kupu hauora, ka kiia tēnei ko te Ogilvie Syndrome , ko te Acute Colonic Pseudo-obstruction rānei (ACPO) .

He aha te Ogilvie Syndrome?

Whakaarohia, he nui ngā waka, engari kāore he aituā, he arai rānei i te rori. Kei te tū noa ngā waka. He rite tonu te mate Ogilvie Syndrome ki tēnā. Ka mutu ohorere te nekenekehanga o te kai me te para i roto i tō koroni. Me te mea kei te mau tetahi mea i roto i tō koroni, engari kāore he arai tinana. Ko te raruraru kei roto i te pūnaha io e whakahaere ana i ngā uaua o tō koroni. Nā te mea kāore e mahi tika ana, ka mutu te nekenekehanga o te koroni (e kiia ana tēnei ko te "peristalsis"), ā, ka mau ngā mea o roto ki te wāhi kotahi. Mā tēnei ka whānui haere te koroni, ka pupuhi rānei.

Ko te tikanga o te kupu "pseudo-obstruction" i roto i tōna ingoa he "arai teka." Ko te tikanga o tēnei he tohu kei te puta mai me te mea he arai, ahakoa kāore he arai.

He aha te rerekētanga o tēnei i ētahi atu mate puku?

He rerekē ngā āhuatanga e whakararu ana i te mahi a te puku. Nō reira, me titiro tātou ki te rerekētanga o te Mate Ogilvie i ērā.

• Ki te whakatauritea ki ētahi atu mate 'Pūrākau Ārai' o te Whekau: He mate 'whakamataku' te Ogilvie Syndrome. Arā, ka puta ohorere mai, ā, he wā poto noa iho . Ā, ka pā noa ki te whēkau nui . Heoi, ka pāngia pea ētahi tāngata e te 'pūrākau ārai' mau tonu. Ko te tikanga ka puta mai i tētahi atu mate mau tonu, i tētahi mate whānau rānei.
• Te rerekētanga ki te 'Paralytic Ileus': Kua rongo pea koe i te kupu 'Paralytic Ileus'. E whakamahia ana hei whakaahua i tētahi āhuatanga ka mutu te mahi a ngā whekau mō tētahi wā, inā koa i muri i te pokanga puku. He mea tino noa. Ka pā ki te whekau iti me te whekau nui ka mutu te mahi mō tētahi wā, kātahi ka ora ake i roto i ētahi rā. Heoi, he āhuatanga uaua ake, he onge ake hoki te Ogilvie Syndrome. Ko te whekau nui te nuinga e pā ana, inā koa te cecum.

Ko wai te mea tino mōrearea ki te whakawhanake i tēnei mate?

Ahakoa ka taea e te tangata te pāngia e te mate, he mea tino noa tēnei mō te hunga kaumātua neke atu i te 60 tau te pakeke, ā, he maha atu anō hoki ō rātou raruraru hauora.E pūrongohia ana tēnei āhuatanga mō te kotahi i roto i te 1,000 tūroro e mau ana ki te hōhipera.

Hei whakarāpopototanga, ka taea tēnei te tupu i ngā wā katoa e tino pāngia ana te tinana e te ahotea nui. Whakaarohia he pokanga nui, he aituā nui, he mate manawa, he mate kino rānei. Ka pāngia ēnei mea e te mahi a tō tātou pūnaha io. Ko tēnei pūnaha io te mea e kī ana ki ngā uaua o roto i ngā whekau kia "neke." Nō reira, ina kore e taurite te taurite o reira, ka mutu te mahi a ngā whekau, ā, ka puta te Mate Ogilvie.

He aha ngā tohu o te Mate Ogilvie?

Ina mau te hau, te wai, me te kai kāore anō kia nakunaku ki roto i ō whekau, ka pāngia pea koe e ēnei tohu. Ka tīmata ohorere pea ēnei, ā, ka piki haere haere.

He aha ai tēnei? Kia tirohia hohonutia ngā take.

Ahakoa kāore anō kia tino mārama te tino take o tēnei, e whakapono ana ngā kaipūtaiao nā te hapa o roto i tō tātou pūnaha io ā-motuhake i puta ai. Whakaarohia, ko ngā mea e tupu aunoa ana i roto i tō tātou tinana, pērā i te manawa, te nakunaku, e whakahaerehia ana e tēnei pūnaha io, e mahi ana pērā i te "aunoa-pairati". Nō reira, nā te nui o te taumahatanga ki te tinana, ka kore e taurite tēnei pūnaha "aunoa-pairati", ā, ka whakararuraruhia ngā tohu e whakahaere ana i ngā nekehanga o te puku.

Ko ngā take matua e whai wāhi ana ki tēnei āhuatanga ka taea te wehewehe ki ētahi wāhanga maha.

He kino rawa atu pea tēnei? He aha ngā raruraru?

Āe, ki te kore tēnei e tātaritatia, e rongoatia tikatia, ka arahi pea ki ngā raruraru tino kino, ā, ka morearea hoki te ora . Whakaarohia, he aha ka tupu mēnā ka pupuhi tonu koe i te hau ki roto i te poihau? Ka pahū. Pērā anō hoki ngā whekau.

Ko te whānui noa o te koroni he tata ki te 8 henimita. Heoi, i roto i te Mate Ogilvie, ki te nui ake i te 12 henimita, ka nui ake te tūponotanga o ngā raruraru.

Ko ngā raruraru matua ka puta ko:

• Ischemia: Mā te totoro nui o ngā pakitara o te whekau ka whakawhāitihia ngā oko toto ngawari e tuku toto ana ki a rātou, ka whakaitihia te rere o te toto . Ka puta te mumura o te whekau (ischemic colitis), ā, ki te kore e rongoatia, ka mate pea ngā kiko (necrosis).
• Pūhao: Ina mate te kiko, ka ngoikore te pakitara o te puku, ā, ka puta he kōhao iti . He tino morearea tēnei nā te mea ka turuturu ngā huakita me ngā para mai i te puku ki roto i te kōhao puku, ka puta he mate kino (peritonitis).
• Sepsis: Kāore e mutu i reira te mate kua horapa ki te puku. Ka taea e ia te uru ki roto i te toto ka horapa puta noa i te tinana.He mate morearea tēnei e hiahia ana kia rongoatia wawetia. Ka taea hoki e ia te arahi ki te ngoikore o ngā okana, takitahi.

Me pēhea te tautuhi tika i tēnei mate?

E rua ngā mea e tino āwangawanga ana ngā tākuta ina tātaritangahia ana tēnei mate.

1. Tuatahi, ka tirohia mēnā he ārai tinana kei roto i te whekau.

2. Mena kāore he ārai pēnei, ka whakatauhia mēnā ko te Mate Ogilvie te take o ēnei tohu, he mea kē atu rānei.

Kei te whakahaerehia ngā whakamātautau maha mō tēnei.

• Ngā hihi-X me ngā matawai CT: Mā te hihi-X o te puku, mā te matawai CT rānei ka kitea mārama te whekau nui, kua pupuhi, kua kī tonu i te hau. I ētahi wā, ka hoatu he wai motuhake (he 'mea ārai') hei inu, hei werohanga rānei hei tiki whakaahua mārama ake.
• Enema Gastrografin: He whakamātautau tino motuhake tēnei. Nā te mea he whakamātautau, he maimoatanga hoki i ētahi wā. I konei, ka whakaurua he wai wairewa-wai e kiia nei ko te 'gastrografin' ki roto i te whekau mā te rectum, ā, ka mātakihia te huarahi e neke ai i te whekau mā te ataata X-ray `(fluoroscopy)`. Ka taea e tēnei te whakatau tika mēnā he ārai kei roto i te whekau. Waihoki, he āhuatanga whakawaiwai tēnei wai 'gastrografin'. Nō reira, i ētahi wā ka āwhina tōna pānga ki te tīmata anō i te mahi a te whekau kua mutu.

He aha ngā maimoatanga mō tēnei?

Ko te maimoatanga e whakawhirinaki ana ki te pupuhi o tō kōpū me te mea kei te tūpono koe ki ngā raruraru. I ngā wā katoa e taea ai, ka ngana ngā tākuta ki te rongoā mā te whakamahi i ngā maimoatanga tautoko māmā ('maimoatanga ā-pūmau') kaua ki te whakamahi i ngā mea pēnei i te pokanga.

Maimoatanga Tūpato

I te tīmatanga, ka whakahaerehia tēnei maimoatanga me te aroturuki tupato i te āhua o te tūroro.

• Te rongoā i ngā mate pūtake: Mena he mate pūtake, pērā i te mate pāwera, te mate ngakau rānei, ka rongoāhia tuatahitia.
• Te whakamutu i te rongoā: Ka whakamutua mō te wā poto ngā rongoā e whakapaetia ana kei te take te Ogilvie Syndrome.
• Te okioki i te puku: Kati rawa te kai me te inu wai.
• Tote IV: Ka tukuna te nui o ngā wai me ngā tote e hiahiatia ana e te tinana mā roto i tētahi uaua (ngā wai IV).
• Te hikoi me te huri i ngā tūranga: Ki te taea, whakatenatenahia te tūroro kia hikoi haere me te huri i ngā tūranga i runga i te moenga. Ka taea e tēnei te whakaoho i te nekenekehanga o te puku.
• Te whakaurunga o te ngongo: Ka whakauruhia he ngongo (`Tube Nasogastric`) mā te ihu ki roto i te puku hei tango i te hau me te wai taikaha. Ka whakauruhia hoki he ngongo (`Tube Rectal`) mā te nono hei tuku i te hau kia puta.

I te wā e rongoatia ana, ka whakahaerehia e ngā tākuta he hihi-X me ngā whakamātautau toto hei aroturuki i te āhua o ngā whekau me ngā raruraru katoa.

A, mehemea kāore e angitu te maimoatanga tautoko?

Ki te kore te āhua e pai ake i muri i te 72 hāora, ki te nui atu rānei te whānui o te whekau i te 12 henimita, ka neke atu ngā tākuta ki te mahi e whai ake nei.

• Te Whakaiti i te Kōpuku o te Kōnkoro: I tēnei mahi, ka whakaurua he ngongo me te kāmera e piri ana (he 'koronoscope') mā te nono, ā, ka mimitihia te hau kua kohia i roto i te kōnkoro mā te ngongo. Ka whakaitihia tonutia te pēhanga i roto i te kōnkoro. Heoi, nā te mea he mahi whakararuraru tēnei, ā, i ētahi wā he iti noa te mōrearea o te poka o te kōnkoro, ka tino tupato te mahi.
• Werohanga Neostigmine: He tino kaha te whakaohooho uaua o tēnei. He mea whakamahi noa hei āwhina i ngā uaua kia ora ake i muri i te whakamoe. Ina hoatu tēnei rongoā hei werohanga ā-uaua (IV) ki te hunga whai mate Ogilvie Syndrome, ka tīmata anō te mahi a ngā uaua puku, ā, kua puta he hua pai. Heoi, nā te mea ka taea e tēnei rongoā te whakaroa i te tere o te manawa, ka hoatu noa i raro i te tirotiro tata a te tākuta i te wāhanga tiaki nui (ICU) .
• Pokanga (Colectomy / Colostomy): Ahakoa ēnei maimoatanga katoa, ki te pupuhi tonu te whekau, ki te puta rānei he raruraru nui pēnei i te pokanga, ko te pokanga pea te huarahi whakamutunga. I tēnei wā, ka tapahia te wāhanga kua pakaru o te whekau, ka tangohia (Colectomy). I ētahi wā, me hanga he whakatuwheratanga rangitahi, he whakatuwheratanga tuturu rānei i roto i te puku kia puta ai te paru. Ka kiia tēnei he Colostomy.

Ka taea e tēnei āhuatanga te whakararu i te ora?

Ki te kore he raruraru, ko te mōrearea o te mate mō te tangata e pāngia ana e te Ogilvie Syndrome he tata ki te 15%. Heoi, kei roto hoki i tēnei ōrau ngā pānga o ētahi atu mate hauora e pā ana ki te tūroro.

Heoi, ki te puta he raruraru nui pēnei i te poka o te puku, ka eke te ōrau mate ki te 40%. E whakaatu ana tēnei i te kino o tēnei mate.

Ko te mea nui ko te aro tonu ki ngā tohu ina puta mai, te tautuhi wawe i te mate, me te tīmata i te maimoatanga. Ki te pērā, ka taea e koe te ārai i ngā raruraru nui me te ora wawe mā ngā maimoatanga ngāwari.