Kua rongo pea koe i tētahi kaumātua e mau ana ki te hōhipera me te "wai i roto i ngā pukahukahu." Tērā pea kua pā ki tētahi o tō whānau. He aha te tikanga o tēnei "wai i roto i ngā pukahukahu"? He mea tēnei hei wehi māu? I tēnei rā, me kōrero tātou mō tēnei āhuatanga, e kiia nei ko te "Pleural Effusion" i roto i ngā kupu hauora, i roto i tētahi huarahi tino māmā ka taea e koe te mārama.

He aha tonu te tikanga o te whakakī i ō pukahukahu ki te wai?

Whakaarohia kei roto i tētahi rūma tiaki i roto i te uma ō tātou pūkahukahu. Kei te taha o ēnei pūkahukahu, tae atu ki te taha o roto o te uma, e rua ngā kiriuhi angiangi. He rite ki tētahi poihau i roto i tētahi poihau. Ka kiia ēnei kiriuhi e rua ko te pleura.

I te nuinga o te wā, i roto i te tangata hauora, he iti noa te wai i waenganui i ēnei kiriuhi e rua. He rite ki te hinu iti i roto i te mīhini. Nā te nui o te wai, ina manawa tātou, ina kōpiri me te whānui o ō tātou pukahukahu, ka puta taua tukanga me te kore he uauatanga, he waku rānei. Koinei te ara tūturu.

Engari i roto i te āhuatanga e kiia nei ko te "Pleural effusion", ka nui ake te wai e kohia ana i roto i te wāhi takoto kau i waenganui i ēnei kiriuhi e rua. Koinei te mea e kiia nei e tātou ko te "wai i roto i ngā pukahukahu." Hei whakamārama, kāore tēnei wai e whakakī i ngā pukahukahu, engari i waenganui i ngā kiriuhi pleural e rua e karapoti ana i ngā pukahukahu.

E rua ngā take matua mō te kohikohinga wai i tēnei ara:

1. Tērā pea kei te nui rawa te wai e whakaputaina ana e te tinana.

2. Ki te kore, kāore pea e taea e te tinana te mimiti tika i te nui o te wai e whakaputaina ana.

Ahakoa pēhea, ko te mutunga mai ka nui haere te wai i te taha o ngā pukahukahu, ka pēhi i a rātou, ā, ka tīmata te uaua ki te manawa.

E rua ngā momo wai e huihui ana.

E rua ngā momo matua o te wai e kohia ana e ngā tākuta, e ai ki te āhua o te wai e kohia ana. Nā te mea ka taea e ngā wāhanga o te wai te whakaatu i te pūtake o te wai.

I te wā e rongoatia ana, he mea nui kia mōhiotia ko tēhea momo e rua kei a koe, me te aha hoki te pūtake.

He aha ngā tohu ka pā ki a koe?

Ka pāngia ētahi tāngata e te wai e puta mai ana i te pleural effusion engari kāore he tohu e puta mai ana. Ka kitea noa iho i te wā e tangohia ana te hihi-X o te uma mō tētahi atu take. Heoi, he maha ngā tāngata ka pāngia e ngā tohu, inā koa ka nui haere te wai.

• Te uaua ki te manawa: Koinei te tohu matua, te tohu tino kitea. Ina kī te wai i te taha o ngā pukahukahu, kāore e ranea te wāhi mō ngā pukahukahu ki te pupuhi tika. Ka uaua te manawa, ā, ka pōuri koe.
• Mamae o te uma: He mamae koi e tino pāngia ana ina mānu hōhonu, ina maremare rānei. Ka puta tēnei ina mirimiri ngā kiriuhi pleural e rua.
• Maremare maroke: Ka pāngia pea ētahi tāngata e te maremare maroke pumau.
• Orthopnea: He tohu āhua ahurei tēnei. Ka uaua ake te manawa ina takoto, engari ka māmā ake te manawa ina noho, ina tū rānei.
• Te kirika: Mena he mate pāwera te pūtake (pēnei i te niumōnia), ka puta pea ngā tohu pēnei i te kirika me te mamae o te tinana.

Me pēhea te mohio ki tēnei āhuatanga?

Ina haere koe ki te tākuta, ka pātai tuatahi ia ki a koe mō ō tohu me ētahi atu mate hauora kei a koe (pēnei i te mate ngakau, te mate huka rānei). Kātahi ka whakanohoia he stethoscope ki tō uma, ka whakarongo. Mena he wai kei te taha o ō pukahukahu, ka rerekē pea ngā oro ka rangona e koe ina manawa koe.

I muri i tēnā, ka whakaritea he maha o ngā whakamātautau hei whakaū i te mate me te kimi i te pūtake.

• X-ray o te uma: Koinei te whakamātautau tino māmā, tino māmā hoki. Ka taea e te X-ray te kite mārama mēnā he wai kei te taha o ngā pukahukahu, me te nui o te wai kei roto.
• Matawai CT: Ka taea e tēnei te whakaputa i tētahi whakaahua mārama ake, toru-ahu (3D) o ngā pukahukahu me te āputa pleural. He tino āwhina tēnei ki te kimi i te pūtake o te putunga wai (pērā i te pukupuku).
• Matawai ira-oro: Ka āwhina tēnei ki te tautuhi i te wāhi o te wai me te ine i te nui o te wai. Ka whakamahia hei ārahi i te ngira ki roto i te wāhi, inā koa ka mahia he tikanga e tango ana i te wai.
• Te Whakamātautau i te Tora: Ko tētahi o ngā whakamātautau tino nui tēnei. Ko te tikanga he tapahi iti i te uma, he werohanga i tētahi ngira iti ki waenganui i ngā rara e rua, ā, ka tangohia he tauira o te wai e karapoti ana i ngā pukahukahu. Kātahi ka tukuna tēnei tauira wai ki tētahi taiwhanga hei whakamātautau.

He aha ngā mea e rapua ana e koe ina whakamātautau ana i tētahi tauira wai?

Ka whakamātauhia te wai e te taiwhanga mō te pūmua, te huka, ngā momo pūtau (kei reira ngā pūtau matepukupuku?), me ngā moroiti pēnei i te huakita. Mā ēnei mōhiohio ka āwhina te tākuta ki te whakatau mēnā he "Transudative" he "Exudative" rānei, ā, mēnā he mate pukupuku, he matepukupuku, he aha atu rānei te take.

I ētahi wā, ki te kore e taea e ēnei whakamātautau te tautuhi i te pūtake, ka taea te mahi i tētahi tikanga e kiia nei ko te thoracoscopy, ko te VATS rānei. Ko te tikanga o tēnei ko te whakauru i tētahi kāmera mā roto i tētahi, i ētahi rānei tapahi iti i roto i te uma hei tirotiro tika i te pleura me ngā pukahukahu. Ka taea hoki te tango i tētahi tauira kiko mō te koiora.

He aha ngā maimoatanga?

E rua ngā whāinga matua mō te rongoā i te pleural effusion:

1. Te tango i te wai nui me te whakamama i ngā uauatanga manawa.

2. Te rongoā i te pūtake o tēnei pupū wai, me te ārai i te pupū wai anō.

1. Te rongoā i te pūtake o te mate

• Mena ka kohia te wai nā te ngoikore o te ngākau , ka hoatu he rongoā hei whakapai ake i te mahi a te ngākau me ngā rongoā whakaheke toto (ngā pire wai) hei tango i te wai nui mai i te tinana.
• Take: PneumoniaMena he mate kitakita, ka hoatu he paturopi.
• Mena he mate pukupuku te pūtake, me whiwhi koe i te rongoā chemotherapy me te radiation therapy.

2. Ngā tikanga mō te tango i te wai kua kohia

• Te Whakaora i te Thoracentesis: Koinei tonu te whakamātautau i kōrerotia i mua ake nei, engari hei utu mō te tango tauira, ka tangohia te nui o te wai e taea ana mā te ngira. Mā tēnei ka tere te whakaora i te tūroro.
• Ngongo Uma: Mena he nui rawa te wai, he matotoru rānei te wai (pērā i te pūkahukahu), ka taea te whakatakoto i tētahi ngongo iti e kiia nei ko te "ngongo uma" ki roto i te uma mō ētahi rā. Ka ringihia mārire te wai ki roto i tētahi pounamu mā roto i tēnei ngongo.
• Te Mate Pukupuku o te Uru: Ka whakamahia tēnei tikanga mēnā ka haere tonu te kohikohi wai nā tētahi take pēnei i te mate pukupuku. I roto i tēnei tikanga, ka whakaurua he rongoā motuhake (pēnei i te talc) mā roto i tētahi ngongo uma i waenganui i ngā kiriuhi uru e rua. Ka puta te mumura i waenganui i ngā kiriuhi e rua i tēnei rongoā, ka piri tahi. Kātahi ka whakakorea te wāhi ka taea te kohikohi anō i te wai.
• Pokanga: Mena kāore ētahi atu tikanga e angitu, mena rānei kua puta he paparanga matotoru huri noa i te pleura nā te mate, tera pea e tika ana te pokanga.
• VATS (Pokanga thoracoscopic āwhina-ataata): He pokanga e mahia ana mā te whakamahi i tētahi kāmera e whakaurua ana mā roto i ngā tapahi iti.
• Te pokanga o te uma: He pokanga tuku iho e whakatuwhera ana i te uma. Ka taea e tēnei te tango katoa i te kiko pangia.

Ngā raruraru ka puta mai i tēnei āhuatanga

Ki te kore e tika te rongoā, ka pā mai ngā momo raruraru maha i te pleural effusion.

• Mate urutā: Ka taea e ngā iroriki te tomo ki roto i te wai e karapoti ana i ngā pukahukahu, ka hanga he whewhe.
• Te whara i te taha o ngā pukahukahu: Mā te pupuri wai mō te wā roa ka matotoru te kiriuhi pleural, ka kore ai e pupuhi tika ngā pukahukahu.
• Te hinga o te pukahukahu/Pneumothorax: I ētahi wā ka pakaru ngā pukahukahu i te wā e tangohia ana te wai.

Nō reira, he mea tino nui kia rapu tohutohu hauora tonu atu mēnā ka puta ngā tohu.

Ka taea te karo i tēnei āhuatanga?

I te mea he hua te toto e puta mai ana i tētahi atu mate, ko tā tātou mahi he aukati i te whanaketanga o taua mate.

• Āta karohia te kai hikareti: Ko te kai hikareti tetahi o ngā tino take o te mate pukupuku o te pūkahukahu me te mate ngakau.
• Āta karohia te pānga o te asbestos: Ka pā mai pea ngā mate pūkahukahu.
• He momo noho hauora: Ko ngā mahi pēnei i te kai taurite, te whakakori tinana, me te whakaiti i te nui o te tote ka āwhina i te whakahaere i ngā mate pēnei i te mate ngakau me te mate tākihi.
• Mena kei a koe kē te mate manawa, te mate tākihi rānei, me tango te rongoā kia rite ki te whakahaunga a tō tākuta , ā, me haere ki te wāhi rongoā i te wā tika.