Kei te pēhia tō manawa e te tere rawa, te koretake hoki o te pā o tō ngākau i ētahi wā? Ko tēnei āhua, e rite ana ki te mea kei roto i tō uma te hē, e kiia ana ko te Atrial Fibrillation (Afib) . He rerekētanga tēnei i roto i te manawataki o te ngākau. Ki te kore koe e tiaki i tēnei, tera pea ka pāngia koe e ngā āhuatanga kino pēnei i te whiu i te wā roa. Nō reira, i tēnei rā kei te kōrero tātou mō tētahi huarahi tino angitu, hou hoki hei rongoā i tēnei āhua Afib.
He aha te Wehenga o ngā Uaua Pūkahukahu (PVI)?
Ki te whakarapopototanga, ko te Pulmonary Vein Isolation (PVI) he tikanga e whakamahia ana hei rongoā i te atrial fibrillation (Afib). He momo pokanga ngākau tēnei, engari ehara i te pokanga nui.
Whakaarohia, ko te mahi a tō tātou ngākau e whakahaerehia ana e tētahi pūnaha tohu hiko. I roto i te Afib, ka pōhēhē ēnei tohu hiko, ka haere ki te ngākau i roto i te āhua koretake. I te nuinga o te wā, ka tīmata ēnei tohu hapa i roto i ngā oko toto e whā e kawe ana i te toto whai hāora mai i ngā pukahukahu ki te atrium maui o te ngākau, e kiia nei ko ngā uaua pūkahukahu .
Nō reira, ko tā te maimoatanga PVI he tautuhi i ngā wāhi e puta mai ana aua tohu hiko hapa, ka hanga he kiko koha iti rawa i aua wāhi. Ka kiia tēnei ko te tango i te ngākau . He rite te mahi a tēnei kiko koha ki te pakitara, ā, ka aukati i aua tohu hiko hapa kei horapa ki ētahi atu wāhanga o te ngākau. Kātahi ka patupatu anō te ngākau i te āhua noa.
Mā wai tēnei maimoatanga e tika?
Ehara tēnei maimoatanga i te mea mā te katoa. Ko tō tākuta te tangata pai hei whakatau. Ko te tikanga, ka tūtohutia tēnei maimoatanga mā te hunga e:
- Mō te hunga kei te mau tonu ngā tohumate ahakoa te tango i ngā rongoā ārai mate pāwera hei whakahaere i tō rātou mate Afib.
- Mō te hunga kāore e taea e ō rātou tinana te aro atu ki aua rongoā, ki te hunga rānei e pāngia ana e ngā pānga taha o aua rongoā.
Kua kitea e ētahi rangahau he pai ake ngā hua o ētahi tūroro ina whakamahia te PVI hei maimoatanga tuatahi, i mua i te tīmatanga o te rongoā. Heoi, ehara tēnei i te maimoatanga paerewa, ā, kei te rangahauhia tonutia.
Me pēhea koe e mōhio ai mēnā he tika tēnei maimoatanga māu?
I mua i te whakatau mēnā he tika tēnei māu, ka tirotirohia koe e tō tākuta. Ka arotakehia e ia tō hītori hauora me ngā whakamātautau katoa kua mahia e koe. Ko ētahi o ngā whakamātautau e mahia ana mō tēnei kaupapa ko:
- Echocardiogram (Echo): He matawai ultrasound tēnei o te ngākau. Ka taea te tirotiro i te hanganga me te mahi a te ngākau.
- Electrocardiogram (EKG): He whakamātautau e hopu ana i te ngohe hiko o te ngākau.
- Aroturuki Holter:He taputapu iti tēnei ka mau ki tō tinana hei aroturuki i te tere o tō manawa mō te wā roa, pērā i te 24, 48 hāora rānei.
He aha ngā maimoatanga?
Ka mahia tēnei maimoatanga PVI mā te whakamahi i tētahi tikanga e kiia nei ko te catheter ablation . Arā, ka mahia tēnei maimoatanga mā te tuku i tētahi ngongo angiangi , ngāwari hoki e kiia nei ko te catheter mā roto i tētahi oko toto ki te ngākau. E rua ngā tikanga matua mō te whakatika i te kiko whara i kōrerotia i mua ake nei.
| Tikanga maimoatanga (Tikanga whakaweto) | Te āhua o tana mahi |
|---|---|
| Te Whakakorenga Auautanga Reo Irirangi | Koinei te tikanga e whakamahia whānuitia ana. Ka whakamahia te wera mai i ngā ngaru reo irirangi hei whakangaro i te kiko e hiahiatia ana. |
| Te Whakakānga | I konei, ka whakamahia te tino makariri hei whakatio mō te wā poto, hei whakangaro hoki i te kiko e hiahiatia ana mō ake tonu atu. |
Kāore e taea te kī he pai ake tētahi o ēnei tikanga e rua i tētahi atu. He tata rite tonu ngā hua o ngā mea e rua, ā, kāore he rerekētanga nui o te haumaru. Mā tō tākuta koe e whakamārama ko tēhea tikanga te mea pai mōu.
He aha ngā mea ka tupu i te wā e rongoatia ana?
I tēnei maimoatanga, ka whakamoea katoatia koe (whakamoea whānui), nō reira kāore koe e mamae, engari ka moe koe. I ētahi wā, ka whakamahia pea he whakamoea ā-rohe anake. Ka whakamōhiotia koe mō tēnei i mua i te wā.
Hei whakarāpopototanga, koinei te mea ka tupu:
1. Whai muri i te rongoā whakamoe, ka tapahia he tapahi iti rawa ki te rohe o te hope, ki te kaki rānei.
2. Mā roto i taua tapahi, ka tukuna ngā katitere e rua mā te uaua toto ki roto i te atrium maui o te ngākau.
3. Ka kitea tika te pūtake o ngā tohu hiko hapa e te katitere kotahi.
4. Ka tukuna e te katitere tetahi atu te wera, te makariri rānei hei hanga i ngā koha ki aua wāhi.
5. Kia oti te mahi, ka tangohia ngā katitere e rua, ā, ka katia te tapahi iti.
Me pēhea te aroturuki i tō ngākau i te wā e rongoatia ana?
I te roanga o te maimoatanga, ka whakamahia ētahi taputapu hei aroturuki i te mahi a tō ngākau me ētahi atu mahi a tō tinana. Kaua e manukanuka, hei tiaki i a koe tēnei katoa.
| Aroturuki | Whakamahinga |
|---|---|
| Cardioverter | Ka whakamahia hei whakahaere i te tere o te manawa mēnā ka heke, ka piki rānei. |
| Te hiko o te manawa (EKG) | Ka aro turukihia te mahi hiko o te manawa i runga i te mata mā roto i ētahi whakapiripiri e piri ana ki te uma. |
| Aroturuki Pēhanga Toto | Ka inehia tonutia te toto toto mā te whakamahi i tētahi poroporo e piri ana ki te ringa. |
| Aroturuki Oximeter | Ka inehia te taumata o te hāora i roto i te toto mā te topenga e piri ana ki te matihao. |
| Te tirotiro i te pūoro | Ka whakamahia he mea pēnei i te mīhini hihi-X hei tirotiro i te wāhi kei roto i te ngākau te catheter. |
| Te Echocardiography o roto i te ngākau | Ka kitea mārama te roto o te ngākau e tētahi taputapu ultrasound iti e tukuna ana mā te catheter. |
Kia pēhea te roa o te maimoatanga, ā, he aha ngā mōrearea?
Ko te tikanga ka roa tēnei maimoatanga i waenga i te 4 ki te 6 hāora.Tērā pea ka roa te wā. He mea pai kia mōhio tō whānau ka noho koe i te hōhipera i te rā katoa, nā te mea ka roa te wā ki te whakarite me te whakaora. Me noho koe i te hōhipera i te pō i muri i te maimoatanga.
Pērā i ngā tikanga ngākau katoa, he iti noa ngā mōrearea . Heoi, he tikanga tino haumaru. Ko ngā raruraru pea ko:
- Ngā mate urutā i te wāhi i tapahia.
- He iti noa te tūponotanga ka pakaru ngā io i te wā e cryoablation ana.
- Te poka o te ngākau (1% te mōrearea).
- Te kino ki ngā oko toto o te pūkahukahu (1% te mōrearea).
- Te whiu (0.5% te mōrearea).
- Te kino ki te korokoro (0.25% te mōrearea).
Te whakaora me te tiaki i muri i te
Tērā pea ka pāngia koe e te mamae, te ngenge, te mamae rānei o te uma i roto i ngā haora 48 tuatahi i muri i te maimoatanga. He mea noa tēnei. Ka taea e koe te hoki ki ngā mahi o ia rā i muri i ētahi rā. Heoi, ka roa pea ētahi wiki i mua i te tīmatanga o ngā mahi uaua pēnei i te whakakori tinana.
Ko te mea nui, i muri i te maimoatanga, ka puta te kiko whara, ā, ka roa pea ētahi wiki kia kitea ai ngā hua katoa. I taua wā, ka pāngia anō koe e te ngakau pōturi. I ētahi wā, ka rongo pea koe kei te kino haere ō tohu i mua i te pai haere. He mea noa tēnei, nō reira kaua e manukanuka.
Me tango e koe ētahi rongoā mō ētahi marama i muri i te maimoatanga.
- Ngā rongoā ārai arrhythmic: Whakahaerehia te tere o te manawa kia tino mahi rā anō te kiko koha hou.
- Ngā rongoā ārai toto (ngā rongoā whakangawari toto): He mea nui ēnei hei whakaiti i te mōrearea o te whiu.
Me haere koe ki ngā wā tirotiro i muri i ngā marama 3-4 me te tau.
Karere Tangohia ki te Kāinga
- He maimoatanga haumaru, whai hua hoki te Pulmonary Vein Isolation (PVI) mō te Atrial Fibrillation (Afib), inā koa mō te hunga e uaua ana ki te whakahaere i ō rātou āhua mā te rongoā.
- Ko te tikanga o tēnei he hanga i ngā koha iti ki te ngākau hei aukati i ngā ara e puta mai ai ngā tohu hiko hapa.
- He maimoatanga tēnei e mahia ana mā roto i tētahi catheter, kāore he tapahi nui.
- Tērā pea ka roa ētahi wiki kia ora katoa ai, kia kitea ai hoki ngā hua. He mea noa te hoki mai o ngā tohu i taua wā.
- Ahakoa ka taea e tēnei te whakahaere i ngā tohumate, ehara i te rongoā. He mea tino nui kia haere tonu te tango i ngā rongoā whakaiti toto e tohua ana e tō tākuta hei whakaiti i te tūponotanga o te whiu.
- Ki te pāngia koe e te mamae, te mamae o te uma, te uaua rānei ki te manawa, me toro atu ki tō tākuta tonu.
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