Kua mutu ohorere te mahi a tō puku? Kia tūpato tātou ki tēnei mate morearea (Ogilvie Syndrome)!

Kua pāngia koe e te mākū o te puku, me te kikī o te puku? Me te mea kei te mau tetahi mea i roto i tō puku, engari ehara. Koinei te momo āhua rerekē, he āhua morearea pea ka kōrerohia e tātou i tēnei rā. Ko te ingoa o tēnei mate ko te Ogilvie Syndrome. Me titiro tātou ki te aha, te take e puta ai, me pēhea te mōhio ki a ia, me pēhea hoki te rongoā.

He aha te Mate Ogilvie?

Ki te kī ngāwari, ko te Ogilvie Syndrome te wā e mutu ohorere ai te mahi a tō koroni , kāore he take e kitea ana. Ka kiia hoki e ngā tākuta he aukati-pūāhua koroni acute (ACPO) . Ko te tikanga o te "whakararu-pūāhua" he rite te mahi a tō koroni ki te mea kua āraia e tetahi mea, engari i roto i te ao tūturu , kāore he mea e āraia ana e te tinana . Ko te raruraru kei roto i te pūnaha e whakahaere ana i te nekehanga o te koroni. Arā, ka mutu te pana i te kai me te inu ki mua i roto i te koroni. Kātahi ka kohikohi ngā mea pēnei i te kai me te hau ki roto i te koroni, ka whānui ake, ka pupuhi rānei ngā pakitara o te koroni. Whakaarohia he rite ki te waka e raru ai te haere o ngā waka, ka āraia te huarahi.

He aha te rerekētanga o te Mate Ogilvie i ētahi atu arai rūpahu o te puku?

He mate whakapeka te mate Ogilvy. Ko te tikanga ka puta ohorere mai, ā, he wā poto noa iho. Ka pā noa ki te koroni . Ko te kupu "pērā-aukati whekau" he kupu whānui ake. E pā ana ki tētahi mahi koretake e puta ana me te kore he aukati tinana i roto i ngā whekau. He mau tonu ngā āputa whekau o ētahi tāngata, i ētahi wā nā tētahi atu mate roa, nā tētahi mate whānau rānei.

He aha te rerekētanga i waenga i te Ogilvie Syndrome me te Paralytic Ileus?

He ārai puku pōuri anō hoki te ileus paralytic. Heoi, he maha ngā wā ka pā ki ngā whekau iti me ngā whekau nui. He tino noa tēnei āhuatanga i muri i te pokanga puku . Ka puta tēnei ina tīmata te mahi a ngā whekau i muri i te pokanga. I te nuinga o te wā ka ea i roto i ngā rā torutoru.

Heoi, ka pā te mate Ogilvy ki tō koroni , me te wāhanga o tō koroni e kiia nei ko te cecum , te wāhi e tīmata ai. Kāore i te rite te noa ki te paralytic ileus, ā, he uaua ake pea.

Ko wai te mea tino tūpono ka pāngia e te Ogilvie Syndrome?

Ahakoa ka pā tēnei ki te katoa, he mea noa iho tēnei mō te hunga kaumātua me te hunga he maha atu ngā raruraru hauora.Whakaarohia tētahi tangata kua pokanga nui, kua pāngia e tētahi aituā, kua pāngia e te mate ngākau, kua pāngia rānei e te mate kino. Ka taea e ēnei mea te whakararu i te mate Ogilvy. Waihoki, ko ngā kore taurite o ngā electrolyte , ngā mate pūnaha io , me te tango i ngā rongoā maha i te wā kotahi he āhuatanga mōrearea. Ka pāngia katoatia e ēnei tō tātou pūnaha io . Ko taua pūnaha io te mea e kī ana ki ngā uaua o tō tātou whekau nui kia panaia te kai ki mua.

He pēhea te noa o tēnei?

E ai ki ngā pūrongo, kotahi i roto i te 1,000 o ngā whakaurunga hōhipera ka pā te mate Ogilvy. Ko te tau toharite o te hunga e pāngia ana he 60 tau te pakeke.

He aha ngā tohu o te Mate Ogilvie?

Ina tīmata te kohikohi o te kai me te hau kāore i keria ki roto i tō whekau nui, ka pāngia pea koe e ēnei āhuatanga:

• Te pupuhi o te puku: Ko te ahua o te puku e pupuhi ana, e whakanuia ana hoki.
• Mamae puku: Tērā pea ka puta he mamae nui o te puku.
• Te ngaronga o te hiahia kai: Te ngaronga o te hiahia ki te kai.
• Whakapairuaki me te ruaki: Te māuiui me te ruaki.
• Te pupuhi me te hau: He kare ā-roto e kī ana i roto i te puku.
• Te korere me te/ranei te mate puku: Ka pāngia pea ētahi tāngata e te mate puku, ko ētahi ia ka pāngia e te mate puku.

Whakaarohia a Matua Nimal, e 65 ōna tau, he mate huka tōna, ā, he mate ngākau hoki. I pokangahia tōna hope. I muri i ngā rā e rua, e toru rānei, ka kī tonu tōna puku, ā, ka uaua ki a ia te manawa. I tana pā ki tōna puku, he pakeke pērā i te toka. I mea ia kāore ia i te hiahia ki te kai, ā, i whakapairuaki anō hoki. Nō te tirotiro a ngā tākuta i a ia ka mōhio rātou he mate Ogilvy.

He aha te take o te Mate Ogilvie?

Kāore anō kia tino mārama te tino take. Engari e whakapono ana ngā kaipūtaiao nā te hapa o roto i tō tātou pūnaha io ā-roto i puta ai. Ko tēnei pūnaha io ā-roto te wāhanga o tō tātou tinana e whakahaere ana i ngā nekehanga uaua kāore tātou e mōhio. E whakahaere ana hoki i te nekehanga ngaru (peristalsis) e pana ana i te kai ki mua i roto i ō tātou whekau. Nā te mea he mate ohorere tēnei, ka puta mai i tētahi taumahatanga rerekē ki te pūnaha io ā-roto. Heoi anō, tera pea ētahi atu āhuatanga hauora e whai wāhi ana ki tēnei.

He maha ngā āhuatanga hauora whakapeka ka taea te whakaoho i te mate Ogilvy:

• Te whakaekenga o te ngakau
• Te ngoikore o te ngākau (te ngoikore o te uaua o te ngākau nā te mate o te ngākau)
• Whara whara
• Ngā mate urutā kino (hei tauira, te niumōnia, te sepsis rānei)
• Pokanga puku tuwhera
• Pokanga ngākau tuwhera
• Te pokanga orthopedic (hei tauira, te whakakapinga hope)
• Whānautanga tākuta / Wāhanga-C

Ngā āhuatanga hauora o mua e whai wāhi ana ki te mate Ogilvy:

• Te ngoikore o te whatukuhu
• Te ngoikore o te manawa
• Mate pūnaha io
• Mate ngākau
• Matepukupuku
• Ngā mate pāwera
• Ngā taurite kore o te irahiko
• te pakeketanga
• He ngoikore te tinana
• Te tango i ngā rongoā maha i te wā kotahi

Ko ētahi rongoā e pā ana ki te mate Ogilvy:

• Ngā rongoā ārai hinengaro
• Ngā Amphetamine
• Ngā corticosteroids
• Ngā opioid (ngā rongoā mamae)
• Ngā rongoā ārai mate
• Te rongoā whakamoe tuaiwi

He aha ngā raruraru ka pā mai i te Ogilvie Syndrome?

I te nuinga o te wā, ka memeha noa te mate Ogilvy, ka memeha rānei mā te tiaki tautoko. Heoi, i ētahi wā ka hiahiatia he wawaotanga . Ki te kore e kitea mō te wā roa rawa, ka raru pea ngā raruraru nui mēnā ka kino haere te āhua. E whakaatu ana ngā rangahau he nui ake te tūponotanga ka puta ngā raruraru mēnā ka whānui te koroni (neke atu i te 12 henimita). Ko te whānui noa o te koroni he tata ki te 8 henimita.

Ka nui ake te whānui o te whekau, ka nui ake te mōrearea. Ngā Mōrearea Pea:

• Ischemia: Ka taea e te pēhanga nui rawa ki ngā pakitara o te koroni te aukati i te rere o te toto . Ka taea e tēnei te arahi ki te mumura nui, e kiia nei ko te ischemic colitis . Ki te kore e rongoatia, ka mate pea ngā kiko (necrosis) . Whakaarohia he rite ki te pēhi i tētahi paipa wai kia tino kaha rawa kia mutu ai te rere o te wai.
• Pūngao: Ka ngawari te haehae, te pakaru rānei o ngā wāhi kiko necrotic. Mēnā ka puta he pūngao o te puku, ka horapa ngā paitini me ngā huakita ki roto i te kōhao puku, ka puta he mate kino e kiia nei ko te peritonitis .
• Sepsis: Ka horapa ngāwari te peritonitis ki te toto (septicemia) . He āhuatanga ohorere tēnei! Ko te Sepsis te wā e horapa ai te mate puta noa i te tinana, ā,Tērā pea ka puta he āhuatanga e kīia nei ko te septic shock, ka arahi pea tēnei ki te ngoikore o ngā okana maha.

He tino morearea ēnei raruraru, koia te mea nui kia rapu tohutohu hauora i te wā tonu ka kite koe i ngā tohu o te mate Ogilvy.

Me pēhea te tautuhi i te mate Ogilvie Syndrome?

Ko te tautuhi mate ka whakawhirinaki ki ēnei āhuatanga:

• Mā ngā whakamātautau hihi-X kua whānui te koroni, ā, kāore he ārai tinana mō te whekau.
• Ngā whakamātautau motuhake hei whakakore i ētahi atu mate e pā ana ki tō āhua.

He aha ngā momo whakamātautau hihi-X hei tautuhi i tēnei?

Hei tirotiro taipitopito i roto i tō koroni, ka whakamahia e ngā tākuta tētahi tikanga e kiia nei ko te ātete whakahāngai ā-roto me te hihi-X. Ka pania tēnei rauemi whakahāngai ki te taha o roto o tō koroni, ā, ka kitea mārama i runga i ngā whakaahua hihi-X. Ka taea te hoatu i tēnei whakahāngai hei inu māu, hei enema, hei wai rānei e hoatu ana ki roto i te uaua (IV). Ko te matawai CT whakahāngai me te fluoroscopy whakahāngai he tikanga e rua e whakamahia ana mō tēnei.

He whakamātautau kei te kīia ko te gastrografin enema , ka taea te whakamahi hei rongoā i ētahi wā. Ko te whakauru i tētahi otinga rerekē wairewa-wai ko te gastrografin ki roto i tō koroni mā roto i tō rectum, me te tango i ngā hihi-X fluoroscopic. (He rite te fluoroscopy ki tētahi hihi-X ataata e taea ai te kite i te nekehanga o te otinga.) Hei pānga taha, ka taea hoki e te gastrografin te mahi hei rongoā whakawai i roto i te koroni, hei āwhina i ō whekau kia neke anō.

Me pēhea te rongoā i te Mate Ogilvie?

Ko te maimoatanga e whakawhirinaki ana ki te whānui o tō koroni me te mea kei te tūpono koe ki ngā raruraru. I ngā wā katoa e taea ana, ka ngana ngā tākuta ki te rongoā mā te manaaki tautoko me te tirotiro tata . Ko te tikanga o tēnā ko te āwhina i te tinana ki te whakaora i a ia anō me te kore he wawaotanga nui. Engari ki te tika, ka whakamahia e rātou ngā rongoā, ngā tikanga rānei hei whakaiti i te pēhanga o te koroni me te whakaiti i te tūponotanga o ngā raruraru. Mena ka puta he raruraru, me rongoā wawe.

Ko ngā maimoatanga ārai mate ka uru pea ki:

• Te rongoā i ngā mate pūtake e whai wāhi ana ki tēnei āhuatanga.
• Tērā pea ka whai wāhi atu te whakamutu i te rongoā ki tēnei āhuatanga.
• Okiokinga whekau: Te whakaiti i te pēhanga mā te kore e kai.
• Ngā wai werohanga uaua (ngā wai werohanga IV):Te pupuri i te makuku me te whakatika i ngā kore taurite o ngā electrolytes mā te hoatu i ngā mea pēnei i te tote ki roto i te uaua.
• Whakatenatenahia te nekehanga o te puku mā te hikoi, te huri rānei i ngā tūnga.
• Ngongo nasogastric: Hei tango i te hau me te wai taikaha mai i te puku.
• Ngongo rectal: He catheter e whakaurua ana mā roto i te rectum hei tango i te hau me te wai mā te kaha ā-papa.
• Te aro turuki i te āhua mā te whakaahua me ngā whakamātautau toto auau.

E rua, e toru rānei ngā rā e kitea ai tēnei āhuatanga (tata ki te 72 hāora). Heoi, mēnā kua whānui kē te koroni neke atu i te 12 henimita, kāore rānei he whakapainga i muri i ēnei maimoatanga ātaahua, ka whakatau pea te tākuta ki te wawao hei whakaiti i te pēhanga ki runga i te koroni.

Ko ngā wawaotanga ko:

• Te tango i te pēhanga o te koroni: He tikanga tātaritanga me te maimoatanga te koroni . Ko te whakaurunga o tētahi kāmera iti ki te pito o tētahi ngongo roa e kiia nei ko te koroni ki roto i te whekau nui mā te nono. Ko te whāinga o te koroni tango i te pēhanga ko te mimiti i te hau nui i roto i te whekau nui mā te ngongo, kātahi ka hoatu he enema mā te ngongo. Ka taea e tēnei tikanga te whakaora i tētahi aukati rūpahu mēnā ka kore e ranea te rongoā, kāore rānei e haumaru mōu. Heoi, ka whakamahia e ngā tākuta me te tūpato nā te mea he uaua ki te mahi, ā, he iti noa te mōrearea o ngā raruraru. I ētahi wā, ka puta he kōhao i roto i te koroni nā te koroni (te pakaru o te whekau).
• Werohanga Neostigmine: Ka hoatu tēnei rongoā mā te IV. He whakaoho uaua. He maha ngā wā ka whakamahia hei āwhina i ngā uaua kia marino i muri i te whakamoe. Kua whakaatuhia he whai hua ki te "whakaara" i ngā uaua o te koroni me te tīmata anō i te peristalsis i roto i te hunga whai mate Ogilvy. Heoi, nā te mea he rongoā tino kaha , ka hoatu noa i raro i te tirotiro tata i roto i te wāhanga tiaki nui (ICU) . Ka aroturukihia tō ngākau e ngā tākuta kia kore ai e tino puhoi te tere o tō ngākau i a koe e whiwhi ana i te neostigmine.
• Colectomy / Colostomy: Mena ka whānui tonu tō koroni ahakoa ēnei wawaotanga, ka puta rānei he raruraru pēnei i te pokanga, te necrosis rānei, me pokanga pea koe hei tango i te wāhanga e pāngia ana o tō koroni . Koinei te huarahi whakamutunga . Ki te colectomy, ka whai colostomy rangitahi, pumau rānei koe.Tērā pea me mahi tētahi. Arā, me hanga he kōhao motuhake hei putanga mō te tūtae. I ētahi wā, ka taea te whakakore i te colostomy i muri i te otinga o te pokanga.

Ka taea te whakamate i te Mate Ogilvie?

Ae, ka mate pea ngā raruraru . Mēnā he raruraru pēnei i te poka, te ischemia rānei, ka eke te reiti mate ki te 40%. Heoi, ka puta ēnei raruraru i raro iho i te 15% o te tangata. Mēnā kāore he raruraru, e tata ana te reiti mate mō te mate Ogilvy ki te 15%. Kāore pea tēnei tatauranga e tohu i te mate Ogilvy anake. Nā te mea he maha ngā tāngata e pāngia ana e te mate Ogilvy, he mate hauora anō ō rātou e pā ana ki tō rātou mate.

He āhuatanga ohorere te aukati-pūngoi kino o te koroni, ka taea te kawe mai i ngā raruraru hou ki te hunga kua raru kē ki ētahi atu mate hauora. Kāore tetahi e tumanako ana ki te mate Ogilvy, engari me mōhio te katoa ki ngā tohu . Ko te mōhio wawe te mea nui ki te ārai i ngā raruraru nui o te mate Ogilvy. Ki te kore he raruraru, tera pea ka ora mā te maimoatanga matawhānui.

Ngā mea tino nui hei maumahara mā tātou (Karere hei tango ki te kāinga)

Nō reira, he mate kino rawa atu te Ogilvie Syndrome i tō whakaaro. Engari kāore he mea hei manukanuka, ā, mā te mōhio ka taea te ārai i ngā raruraru maha.

• Tātaritanga: Ki te pāngia koe e ngā tohu pēnei i te pupuhi ohorere, te mamae nui o te puku, te kore hiahia kai, te whakapairuaki, te ruaki rānei, me toro atu koe ki te tākuta, inā koa kua kaumātua koe, he mate hauora kē atu rānei tōu, kua oti rānei te pokanga i ngā wā tata nei.
• Ngā Take: He maha ngā wā ka puta mai tēnei i tētahi atu mate, i tētahi pokanga, i tētahi rongoā rānei. Nō reira, he mea nui kia kōrerotia e koe tō hītori hauora katoa ki tō tākuta.
• Ngā raruraru: Ki te kore e rongoatia wawetia, ka taea e te hekenga o te rere o te toto ki te koroni te arahi ki te mate o ngā kiko, te pakaru o te koroni, me ngā mate kino. Ka taea e ēnei te whakararu i te ora.
• Maimoatanga: Ko te nuinga o ngā mate ka ea mā te tiaki tautoko, engari i ētahi wā ka hiahiatia he colonoscopy, he rongoā, he pokanga rānei hei whakamama i te pēhanga.
• Mā te kitenga wawe ka ora ngā tāngata: Kaua e warewarehia ēnei tohu mō tetahi take. Ko te mea nui ko te kite wawe i a rātou me te tīmata maimoatanga.

Mena kei a koe, kei tētahi atu rānei e mōhio ana koe, kaua e mangere ki te rapu tohutohu hauora. Kia ora tonu!

Te Mate Ogilvie, te aukati pōhewa o te koroni, te koroni, te koretake o te mahi a te puku, te pupuhi, te mamae o te puku, te aukati pōhewa