E kī ana koe i a koe e kai ana? E ruaki pinepine ana rānei koe? Ko tētahi take mō tēnei he raruraru pea kei te takirere uaua i te pito o tō puku, arā, te wāhi e haere ai te kai mai i te puku ki te whekau iti. Ka kiia tēnei takirere ko te 'pylorus'. Ki te kore e tuwhera tika tēnei kuaha, ka piri te kai ki reira. He pokanga te Pyloroplasty e āwhina ana i ēnei wā. Me kōrero noa tātou mō tēnei i tēnei rā.
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He aha te Pyloroplasty?
Whakaarohia tō puku hei pēke. Ka rongoatia te kai e kainga ana e tātou ki roto i tēnei pēke, ka nakunakuhia, kātahi ka tukuna ki te whekau iti. I te pito o tēnei pēke puku, he mowhiti uaua e mahi ana pērā i te kēti. Ko te pylorus te ingoa. Ka tuwhera tēnei kēti ina hiahiatia, ka taea ai te kai kua nakunaku te haere ki roto i te whekau iti, kātahi ka kati.
Nō reira, ki te āraia tēnei pūaha, ki te whaiti, ki te kore rānei e tuwhera tika, kāore e taea e te kai te puta i te puku. I taua wā, ka kiia tēnei pūaha ko te pylorus he tikanga pokanga e whakamahia ana hei hanga anō me te whakawhānui. I ētahi wā, ki te pakaru tēnei wāhanga nā tētahi atu pokanga, ka mahia anō hoki tēnei pokanga hei whakatika.
I roto i ēhea ngā wā e hiahiatia ana te pokanga pyloroplasty?
Mena kāore tō pylorus e mahi tika ana, arā, kua roa te whakawātea o te puku, tera pea he āwhina tēnei pokanga. Ko te pyloroplasty te mea nui e whakaarohia ana i roto i ēnei āhuatanga e whai ake nei:
1. Ngā mate puku (Te mate puku peptic)
Ko ētahi mate puku kino me pokanga. Hei tauira, ki te mea he mate puku tonu tōu e toto tonu ana, e kore rānei e ora i te rongoā, ka tūtohu pea tō tākuta i tētahi tikanga e kiia nei ko te vagotomy hei whakaiti i te hanga waikawa o te puku. Ko te tikanga o tēnei ko te tapahi i ētahi o ngā io e haere ana ki te puku.
Engari he mea iti tēnei. Ahakoa ka whakaitihia e tēnei pokanga vagotomy te waikawa o te puku, ka kore pea e mahi ngā io e tohu ana i te pylorus kia tuwhera, kia kati hoki. Kātahi ka kore e tuwhera te kēti. Koia te take, ki te mahi koe i te pokanga vagotomy, ka mahi anō koe i te pokanga pyloroplasty hei whakawhānui ake i te kēti.
Hei tāpiritanga, i ētahi wā ka mumura te mate pukupuku, ka puta rānei he kiko koha, ka aukati katoa i te ara mā roto i te pylorus. I roto i ēnei āhuatanga ohorere, me mahi anō hoki tēnei pokanga.
2. Te mate puku
Koinei te wā kāore e mahi tika ana ngā uaua o te puku, tae atu ki te pylorus. Me te mea kua pararutiki ngā uaua o te puku. Ka roa te nakunaku me te tango kai mai i te puku. Ina kino rawa tēnei, ka piki ake te whakapairuaki me te ruaki, ā, kāore e taea te kai. Mena kāore ētahi atu maimoatanga e angitu, ka tūtohu pea tō tākuta kia whakatuwheratia te pylorus mā te pokanga pyloroplasty.
3. Te Mate Pūngāwerewere o te Pyloric
Ko tēnei mate ka kitea nuitia i roto i ngā pēpi whānau hou . I roto i tēnei mate, ka matotoru ngā pakitara o te pylorus o te pēpi, ka whaiti, ka ārai i te ara kai. Nō reira, kāore e taea e te pēpi te whakaputa i te waiū i inumia e ia, ā, ka ruaki tonu. Mō ēnei pēpi, he mea nui tēnei pokanga mēnā e hiahia ana rātou kia tika te whakauru o te kai ki roto i ō rātou tinana.
Me pēhea te mahi i tēnei pokanga, ā, he aha ngā tikanga?
E rua ngā huarahi e taea ai tēnei pokanga. Ko tētahi he pokanga tuwhera, arā, ko te tapahi i te puku. Ko tētahi he pokanga laparoscopic , arā, ko te tapahi i ētahi tapahi iti ki te puku me te whakamahi i tētahi kāmera me ngā taputapu ngawari. Ahakoa pēhea, ka noho koe i raro i te mate whakamoe whānui, nō reira kāore koe e rongo i tetahi mea.
He maha ngā tikanga matua mō te pokanga pyloroplasty. Ka whiriwhiria e te tākuta te tikanga tino tika i runga i te āhua o te tūroro.
| Tikanga Pokanga | Whakaahuatanga noa iho |
|---|---|
| Te Whakatō Pyloroplasty o Heineke-Mikulicz | Koinei te tikanga tino noa. Ka tapahia e te taote te pylorus kia roa, kātahi ka tuituia kia whakawhiti. Ka whānui ake te whakatuwheratanga, ka whakangāwari hoki i te uaua. |
| Te tango i te kiko o te waewae (Pyloroplasty Ramstedt) | He tikanga tēnei e whakamahia ana mō ngā pēpi whānau hou. I konei, ko ngā paparanga uaua o waho anake o te pylorus ka tapahia, ka waiho ko te arai o roto (mucosa) he mea angiangi. Mā tēnei ka pupuhi te arai o roto ki waho, ka nui ake te ātea i roto. |
| Te Whakawhanuitanga o te Pyloric | Ehara tēnei i te pokanga. He rite ki te endoscopy , arā, ka whakaurua he ngongo mā te waha, ā, ka whakawhanuitia te pylorus ki tētahi taputapu motuhake. |
| Te Tātaritanga o Jaboulay/Finney Pyloroplasty | Ehara ēnei i te tikanga tino noa. Ka whakamahia mēnā he mumura nui, he koha rānei kei roto i te pylorus. Ko te tikanga o tēnei ko te karo i te pylorus me te hanga hononga hou i waenga i te puku me te whekau iti (gastroduodenostomy) . |
He aha ngā mea ka tupu i muri i te pokanga?
I muri i te pokanga, mēnā i mahia he pokanga laparoscopic ki a koe, tera pea ka taea e koe te hoki ki te kāinga i taua rā anō. Mēnā i mahia he pokanga tuwhera ki a koe, me noho koe ki te hōhipera mō ētahi rā nā te mea he nui te motu. Kāore koe e hoatu he kai mārō ki a koe mō ngā rā tuatahi. Ka hoatu he kai mā te ngongo i whakanohoia ki roto i tō ihu, mā te tote rānei i hoatu ki roto i te uaua.
He aha ngā raruraru ka pā mai i te pokanga?
Pērā i ngā pokanga katoa, he maha ngā tūponotanga kei roto, engari he iti te tūponotanga ka puta ēnei.
- Te toto
- Ngā mate urutā
- Te toto totoka
- Te kino ki ngā whekau e karapoti ana
Haunga ēnei mōrearea whānui, he maha atu anō ngā raruraru e pā ana ki te pokanga pyloroplasty.
1. Te Mate Putunga
Koinei te pānga taha tino kitea i muri i tēnei pokanga. He rerekē rawa atu tēnei i te raruraru i puta ai te pokanga. Arā, ka tere ake te neke o te kai mai i te puku ki roto i te whekau iti. He wā poto noa iho tēnei.
E rua ngā wāhanga o ngā tohu o te mate tuku kai. I muri tata i te kai, ka pāngia pea koe e te mamae o te puku, te whakapairuaki, me te mate korere. I muri i ētahi haora, ka heke ohorere te taumata o te huka toto, ka puta ngā tohu pēnei i te ngoikore, te whanoke, te werawera, me te tere o te pao o te ngakau.
Ahakoa he ahua hoha pea tēnei i te tīmatanga, ka taea te whakahaere mā te whakarerekē i te kai , me te rongoā hoki mēnā e tika ana i whakaritea e tō tākuta.
2. Te rerenga o te au
Ina whakarerekētia te takirere pyloric, kāore e kati tika, ka tukuna ngā ihirangi o te whekau iti, inā koa te au , kia hoki ki roto i te puku. He mea whakapataritari te au ki te arai o te puku. Ki te haere tonu tēnei, ka pā te gastritis .
Te tukanga whakaora me te angitu
Ko te nuinga o te tangata, inā koa ko te hunga kua pokangahia ki te laparoscopy, ka tere te ora. Ka taea e rātou te hoki ki ā rātou mahi me ā rātou kai noa i roto i ētahi wiki. Mena kei a koe ngā tohu o te mate dumping syndrome, me tūpato koe ki tō kai kia ngaro ra ano (tērā pea i roto i ētahi marama).
He maimoatanga tino whai hua te Pyloroplasty mō te gastroparesis me te aukati puku, me te angitu tae atu ki te 90%.
Hei whakamutunga, ka taea e te aukati iti i roto i te pylorus te whakararuraru i tō pūnaha nakunaku katoa. He maimoatanga kore-pokanga mō tēnei, engari ki te kore e whai hua, he otinga pai, he haumaru hoki te pokanga.
Karere Tangohia ki te Kāinga
- He pokanga te pyloroplasty e whakawhanui ana i te whakatuwheratanga o te puku (pylorus), kia māmā ake ai te uru o te kai ki roto i te whekau iti me te kore e mau.
- Ko te nuinga o tēnei pokanga ka mahia mō ngā mate puku kino, te gastroparesis, me te pyloric stenosis i roto i ngā pēpi hou.
- Ka taea tēnei te mahi hei pokanga tuwhera, hei pokanga laparoscopic rānei. Mā tō tākuta e whakatau ko tēhea te tikanga pai mōu.
- Ko te pānga taha tino kitea i muri i te pokanga ko te dumping syndrome, arā, ko te tere rawa o te wehenga atu o te kai i te puku. Heoi, he wā poto noa iho tēnei, ā, ka taea te whakahaere mā te whakarerekē i tō kai.
- I mua i tētahi pokanga, he mea tino nui kia kōrerohia ngā painga me ngā huakore katoa me tō tākuta, kātahi ka whakatau.
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