Kua pāngia koe e te uaua ki te manawa, kua pāngia rānei koe e te mamae nui i roto i tō uma i te wā e manawa hōhonu ana koe? Kua pāngia rānei koe e te tere o te pao o tō ngākau, te werawera, me te manukanuka, kāore he take? Ahakoa he maha ngā wā ka whakaarohia tēnei he mate ngākau, he rerekē rawa atu pea, ā, he tino morearea pea. I tēnei rā ka kōrero tātou mō tētahi mate kino engari he whakaora ora e kiia nei ko te 'Pulmonary Embolism'.
He aha te Pulmonary Embolism?
Ko te Pulmonary Embolism (PE) he toto totoka e puta mai ana i roto i tētahi uaua toto (uaua) e tuku toto ana ki ō pūkahukahu. Tērā pea kei te whakaaro koe, "Me pēhea te puta o tētahi totoka i roto i ngā pūkahukahu?" Ko te pono, kāore tēnei totoka e puta mai i roto i ngā pūkahukahu. I te nuinga o te wā, ka puta mai i tētahi atu wāhi o tō tātou tinana, inā koa i roto i ngā uaua hohonu o ō tātou waewae, o ō tātou ringa rānei. Ka kiia tēnei ko te Deep Vein Thrombosis (DVT).
Whakaarohia ngā uaua toto o tō tinana he whatunga rori. Ko tēnei toto toto e hanga ana i roto i tō waewae, he rite ki te motuka, ka haere i taua rori me te toto, ka haere mā te ngākau, ā, ka mutu ka mau ki roto i tētahi uaua toto iti i roto i ngā pukahukahu. He rite ki tētahi motuka nui e mau ana i runga i tētahi rori iti.
Ina noho te toto totoka ki roto i ngā pukahukahu, e toru ngā mea matua ka puta:
1. Kua herea te rere o te toto ki ngā pukahukahu.
2. Ka heke te nui o te hāora i roto i ngā pukahukahu.
3. Ka piki ake te toto toto i roto i ngā uaua toto e hono ana ki ngā pukahukahu.
He āhuatanga ohorere hauora tēnei. Ki te kore e tere te rongoā, ka pāngia te ngākau, te pukahukahu rānei, tae atu ki te mate. E whakaatu ana ngā rangahau e tata ana ki te hautoru (33%) o te hunga whai mate pēnei ka mate i mua i te tātaritanga me te rongoā.
Engari ko te rongo pai , ki te kitea wawetia te mate, ā, ki te rongoatia tika, he onge te mate o tēnei mate.
He aha ngā tohu o tēnei mate? Kia tūpato tonu!
Ka rerekē pea ngā tohu o te pulmonary embolism (PE) i ia tangata, i ia tangata. Kei te rahi o te toto totoka me ōna pānga. Tērā pea kāore he tohu o ētahi tāngata. Heoi, ka pāngia te nuinga e te kotahi, neke atu rānei ngā tohu.
Ko ngā tohu matua me ngā tohu tōmua ko te poto ohorere o te manawa me te mamae o te uma e kaha ake ana i te manawa hohonu, i te whakapau kaha rānei.
Mena kei a koe tētahi, ētahi rānei o ēnei tohu, rapua tonutia he tohutohu hauora. He pai ake te haere ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera. Mā te maimoatanga tere ka tino whakaiti i te tūponotanga o te mate.
Kei te ripanga i raro nei ngā tohu tino kitea o tēnei mate.
| Tohu | Whakaahuatanga |
|---|---|
| Te uaua ohorere ki te manawa | Ahakoa kei te noho noa koe i reira me te kore mahi, ka pā whakarere pea te manawa poto. |
| Te mamae nui o te uma | Ka piki ake tēnei mamae i te wā e manawa ana, e maremare ana, e piko ana rānei. I ētahi wā ka rite ki te mamae o te mate manawa. Ka pā pea ki te uma, ki te ringa, ki te pakihiwi, ki te kaki, ki te kauae rānei. |
| Maremare | Tērā pea ka puta mai te toto me te hūpē. |
| Ngā tere o te ngakau | Tērā pea ka piki ake te tere o te manawa. |
| Pōuriuri, ngoikore rānei | Tērā pea ka pā te whanoke , te hemo o te kiri, te ngaro rānei o te māramatanga. |
| Ētahi atu āhuatanga | Te werawera nui, te kiri mā, kikorangi rānei, te whewhe, me te manukanuka kāore e taea te whakamārama. |
Mō ētahi tāngata, ka puta mārire ēnei tohu i roto i ngā rā, i ngā wiki rānei. Ka kaha haere ngā tohu i roto i te wā. Heoi, mō ētahi tāngata, ka puta ngā tohu kino i roto i ngā meneti o te tīmatanga o te mate.
He aha tēnei e tupu ai? He aha ngā āhuatanga mōrearea?
E ai ki taku kōrero i mua ake nei, ko te Pulmonary Embolism (PE) ka puta mai i te toto totoka (DVT) e puta mai ana i ētahi atu wāhi o te tinana, inā koa i ngā waewae, ka pakaru mai, ka mau ki roto i ngā pukahukahu. Nō reira, ko ngā mea katoa ka puta ai ēnei toto totoka ka puta ai hoki te PE.
Ko ētahi take matua:
- Te pupuri i te tinana kia marino mō te wā roa: Ina noho koe i te moenga i muri i te pokanga, ina noho tonu rānei koe i te tūranga kotahi i te wā roa o te rererangi, o te eke pahi rānei, ka puhoi te rere o te toto i roto i ngā waewae, ā, ka puta he toto totoka.
- Te kino o ngā uaua: Ka taea e ngā aituā, ngā whatiwhatinga (ina koa ko te hope, te turi, te waewae rānei), me ngā pokanga nui te kino o ngā uaua me te whakanui ake i te mōrearea o te toto totoka.
- Ētahi atu āhuatanga hauora: Ngā āhuatanga pēnei i te ngoikore o te ngākau, te mate pukupuku, me te whiu.
- Ngā panonitanga o te toto totoka: Tērā pea he mate toto totoka ira kei ētahi tāngata. Waihoki, tera pea ka paku piki ake tēnei mōrearea i roto i te hunga e tango ana i ngā pire ārai whānau, i te rongoā whakakapinga homoni rānei.
Kei raro nei ētahi o te hunga he nui ake te mōrearea ki tēnei mate. Mena kei a koe tētahi, neke atu rānei o ēnei āhuatanga mōrearea, he mea nui kia kōrero koe ki tō tākuta mō tēnei mea.
- He toto totoka kei roto i te waewae, kua pāngia rānei e te toto totoka (Deep Vein Thrombosis - DVT).
- E pokangahia ana, e takoto roa ana rānei i te moenga.
- Te momi hikareti.
- Neke atu i te 60 tau te pakeke.
- Te haputanga, te ono wiki rānei i muri i te whānautanga.
- He mate pukupuku tō te tinana.
- Te whakamahi i ngā rongoā homoni pēnei i ngā pire ārai whānau.
- Momona - Taupū Papatipu Tinana (BMI) neke atu i te 30.
- He hītori whānau mō ngā toto totoka.
- Kei a koe ētahi atu mate pūmau pērā i te mate huka me te mate ngakau.
- Te whai i tētahi catheter uaua pokapū mō te wā roa (he ngongo e whakaurua ana ki roto i tētahi uaua i te ringa, i te waewae rānei) hei tuku i ngā mea pēnei i te saline.
Me pēhea te tautuhi i te mate? (Tautuhinga)
Ina haere koe ki te hōhipera, ka tirotirohia e te tākuta ō tohu me ō tūponotanga. Kātahi ka whakaritea e ia ētahi whakamātautau hei whakaū i te mate.
| Whakamātautau | Hei whakarāpopototanga, he aha tāna mahi? |
|---|---|
| Ngā Whakamātautau Toto | Anei te whakamātautau D-dimerHe mea motuhake te whakamātautau. Ka ine i te pūmua e puta ana i te wā e memeha ai te toto totoka i roto i te tinana. Mena he iti tēnei taumata, he iti te tūponotanga ka pāngia koe e te PE. |
| Angiogram CT | He matawai CT motuhake tēnei. Ka werohia he tae motuhake (whakawhitinga) ki roto i tētahi uaua i roto i tō ringa, ā, ka tangohia he whakaahua toru-ahu (3D) o ngā uaua toto i roto i ō pukahukahu. Mena he toto totoka, ka kitea mārama. |
| Matawai Ultrasound o ngā Waewae | Ka mahia tēnei matawai hei tirotiro mō ngā toto totoka (DVT) i roto i ngā uaua hohonu o ngā waewae. Mena he DVT, tera pea koinei te take o ngā tohu o te pukahukahu. |
| Ētahi atu whakamātautau | Hei tāpiritanga, ka mahia hoki he hihi-X o te uma, he echocardiogram hei tirotiro i te mahi a te ngākau, me te pulse oximeter hei ine i ngā taumata hāora. |
Me pēhea te rongoā?
Ko te maimoatanga mō te PE ka mahia i te hōhipera, nā te mea me aro turukihia tō āhua. Ko te roa o te maimoatanga ka whakawhirinaki ki te kaha o te toto totoka.
Ko te maimoatanga matua ko te hoatu i ngā rongoā hei aukati i te toto totoka . Ka kiia ēnei he rongoā ārai toto , he rongoā whakangawari toto rānei.
Ko te mea nui, kāore ēnei rongoā e whakarewa i ngā toto toto kua totohu. Ka ārai noa i te hanganga o ngā toto toto hou, me te nui haere o ngā toto toto kua totohu. Ka memeha haere ngā toto toto kua totohu i roto i ngā tukanga taiao o te tinana.
- Ngā rongoā ārai toto totoka: Ka hoatu ēnei hei werohanga, hei pire rānei. Me tango pea koe i ēnei rongoā mō te 3-6 marama, i ētahi wā ka roa atu rānei. Kaua e mutu te tango i ēnei rongoā mō tetahi take ki te kore koe e tohutohuhia e tō tākuta.
- Whakaora Thrombolytic: He maimoatanga tēnei e hoatu ana i roto i ngā take tino kino, e morearea ana ki te ora. Ko te mahi a ēnei rongoā mā te whakarewa tere i te toto totoka. Ka hoatu i raro i te tirotiro tata a ngā tākuta i te wāhanga tiaki nui (ICU).
- Ētahi atu tikanga:I ētahi wā, ki te kore e ranea te rongoā, me pokanga, me whakamahi rānei i te catheter hei tango i te toto totoka. Ko tētahi atu kōwhiringa ko te whakauru i te Tātari Vena Cava. Ka whakamahia tēnei hei tātari me te hopu i ngā toto totoka mai i ngā waewae i mua i te taenga ki ngā pukahukahu.
- Tōkena Kōpeke: Ka tohutohu pea tō tākuta kia mau koe i ēnei momo tōkena motuhake hei pupuri i te rere pai o te toto i roto i ō waewae.
Ka taea te karo i tēnei āhuatanga?
Āe, he nui te wā ka taea. Ko te mea nui i konei ko te whakaiti i te mōrearea o te toto totoka.
- Kia kaha te mahi: Whakakorikori tinana i ia rā. Ki te noho roa koe (i runga waka rererangi, i runga pahi, i runga mahi tari), whakatika, ka hikoi haere i te iti rawa i te kotahi i te haora, me te neke i ō waewae me ō ringa.
- Āta karohia ngā kākahu piripono: Ka taea e te mau kākahu piripono te aukati i te rere o te toto.
- Kaua e whiti i ō waewae: Kaua e noho roa me ō waewae e whiti ana.
- Kia mau tonu te taumaha hauora.
- Āta karohia te momi hikareti.
- Inumia he nui te wai: Ka matotoru te toto i te matewai.
- Kia tūpato ki ngā āhuatanga mōrearea: Mena kua pokaina koe, kei te hapu koe, kei a koe rānei ētahi atu āhuatanga mōrearea, kōrero ki tō tākuta mō ngā mahi ka taea e koe te mahi hei ārai i te toto e pupuhi ana.
Me tīmata koe ki te pai ake i roto i te wiki kotahi o te maimoatanga. Heoi, ka roa pea ngā marama, ngā tau rānei kia memeha rawa te toto totoka. I tēnei wā, he mea nui kia ata whai i ngā tohutohu a tō tākuta.
Karere Tangohia ki te Kāinga
- Ko te embolism pūkahukahu (PE) he toto totoka e puta ana i roto i te oko toto i roto i ngā pūkahukahu. He āhuatanga ohorere hauora tēnei ka tūpono ki te ora.
- Ko te poto ohorere o te manawa, te mamae o te uma i te manawa hōhonu, me te tere o te papā o te ngakau ngā tohu matua. Mēnā ka puta ēnei, haere tonu ki te Tari Ohotata o te hōhipera (ETU).
- He maha ngā wā ka puta ēnei toto totoka i roto i ngā waewae (DVT). Ko te kore e nekeneke mō te wā roa, te pokanga, te momi hikareti, me te momonatanga ngā tino take mōrearea.
- He tino nui te pūmanawa hei whakaora ora ina kitea te mate i te wā tika, ā, ina rongoatia ki ngā rongoā ārai toto.
- He mea tino nui kia tangohia te rongoā i tohua e tō tākuta mō te roanga katoa o te wā, me te whai i ngā tohutohu kua hoatu hei ārai i te hokinga mai o tēnei mate.
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