Te Whakatuwheratanga o te Uma mō te Pokanga Manawa (Sternotomy): Ngā Mea Me Mōhio Koe

Ina kī atu tō tākuta me pokanga koe ki te ngākau, ā, me whakatuwhera tō uma, tera pea ka mataku koe, ka āwangawanga hoki. He mea noa tēnā. Kāore he tangata e pai ana ki te pokanga. Engari he mea tēnei e mahia ana e ngā taote ngākau i te nuinga o te wā, ā, he angitu hoki. Nō reira, kāore he take e mataku ai koe. I roto i tēnei tuhinga, ka kōrero noa mātou mō te sternotomy, te take e mahia ai, te āhua o te mahi, me ngā mea me mōhio koe i muri i te pokanga.

He aha te sternotomy, i te whakarapopototanga?

I te whakarapopototanga, ko te sternotomy he pokanga e tapahia ai te wheua papatahi i waenganui o tō uma, te sternum, kia rua hei pokanga. E kīia ana tēnei e ētahi he "median sternotomy".

Whakaarohia, kei reira tēnei sternum me ngā rara hei tiaki i ngā whekau tino nui o roto i tō tātou uma, pērā i te ngākau me ngā pukahukahu. He rite ki tētahi whare herehere haumaru. Nō reira, ina he raruraru kei tō ngākau, ā, me whakatika e koe mā te pokanga, ko te huarahi pai me te huarahi māmā rawa atu mā te taote pokanga ki te tae atu ki te ngākau ko te tapahi i tēnei sternum ki waenganui, ka hanga he ara ki ngā taha e rua.

Tērā anō tētahi tikanga e kīia nei ko te "mini sternotomy" e kore ai e tapahia te sternum katoa, engari ka tapahia he tapahi iti. I roto i tēnei, ka tapahia he tapahi iti, tata ki te 2-3 inihi te whānui.

Koinei te mahi a te pokanga ngākau tuwhera? He pokanga nui tēnei?

He mea tēnei e whakapoauau ana i te tini o te tangata. Ko te sternotomy he tikanga e whakatuwhera ana i te ara mō te pokanga ngākau tuwhera . He rite ki te hiahia koe ki te whakatika i tētahi mea i roto i tō whare, me whakatuwhera tuatahi koe i te tatau. Koia te āhua. Ko te sternotomy he tikanga e "whakatuwhera ana i te tatau" kia tae atu ki te ngākau. Ko te pokanga ngākau tuwhera he tikanga e whakatika ana i te ngākau mai i roto.

Āe, e kiia ana tēnei he pokanga nui . Nā te mea e rua marama pea te roa kia ora katoa te wheua, kia piri anō hoki i muri i te motu. Ā, nā te mea ka mahia hei wāhanga o tētahi atu pokanga nui, pērā i te pokanga ngākau tuwhera, he pokanga nui tēnei ina honoa ngā mea e rua.

He aha koe i hiahia ai ki tēnei momo pokanga?

Ka whakamahia tēnei tikanga e te tākuta hei toro atu ki ngā whekau e tiakina ana e te sternum me ngā rara. Ko te nuinga:

• Manawa: Mō ngā mahi pēnei i te whakatika i ngā takirere manawa me te mahi pokanga bypass uaua coronary.
• Aorta: Mō ngā raruraru o te aorta, te oko toto matua e puta ana i te ngākau.
• Ngā uaua pūkahukahu: Ko ngā uaua e kawe ana i te toto mai i te ngākau ki ngā pukahukahu.

Ehara te sternotomy i te rongoā mō tētahi mate. He tikanga e mahia ana hei whakawātea i te wāhi mō ngā whekau kia ngāwari ake ai te mahi a te taote pokanga. I tētahi whenua pērā i Amerika, neke atu i te 700,000 o ēnei pokanga e mahia ana i ia tau. He mea noa tēnei.

He aha ngā mea ka tupu i mua i te pokanga?

I mua i tō pokanga, ka hoatu e te tīma hauora ētahi tohutohu ki a koe, pēnei i:

• Ko tā rātou he kaukau pai, kia whakapai tinana hoki i mua i te haerenga mai ki te hōhipera.
• Mena he huruhuru kei tō uma, ka ata tangohia.
• Ka hoatu ngā rongoā paturopi hei ārai i te mate i muri i te pokanga.
• Ka horoia pai te uma e mahia ai te pokanga ki ngā wai patu paturopi.

Me pēhea te mahi i te pokanga i te taahiraa i te taahiraa

Tērā pea he āhua whakamataku tēnei ki a koe, engari kia mahara , ka oti katoa ēnei mahi i muri i te hoatutanga o te rongoā whakamoe, ā, kua moe pai koe. Nō reira, kāore koe e rongo i tetahi mea.

1. Tuatahi, ka tapahia e te taote pokanga te kiri, ka tīmata i waenganui i ō pakihiwi ka toro atu ki raro i te sternum.

2. Kātahi ka whakamahia he taputapu hauora motuhake e kiia nei ko te "sternal saw" hei tapahi i te sternum i tētahi rārangi ma, mai i runga ki raro.

3. Ka whakatakotoria ngā kongakonga wheua e rua kua tapahia kia taha, ā, ka whakaurua he taputapu e kiia nei ko te "retractor" hei hanga urunga ki te ngākau.

4. Muri iho, ka huakina te kiriuhi tiaki e karapoti ana i te ngākau, te pericardium .

5. Inaianei ka taea e te taote pokanga te kite mārama i te ngākau. Kātahi ka mahia e rātou te pokanga nui e hiahia ana rātou ki te mahi (hei tauira, te pokanga whakawhiti).

6. Kia oti te pokanga matua, ka honoa anō ngā wāhanga e rua o te sternum i tapahia, ā, ka whakamaua mā te whakamahi i te 8, 12 rānei o ngā waea maitai (waea sternotomy) . He rite ki te here i tētahi mea kua whati.

7. Hei whakamutunga, ka tuia anō te kiko o te uma me te kiri, ā, ka pania he hinu paturopi ki te patunga.

He aha tāu e tumanako ai i muri i te pokanga?

I muri i te pokanga, ka noho koe ki te wāhanga tiaki nui (ICU) mō te rā kotahi, e rua rānei, kātahi ka whakawhitia ki te wāhanga noa.

• Mamae: Tērā pea ka pāngia koe e te mamae i muri i te pokanga, engari ka hoatu e tō tākuta he rongoā whakamamae hei āwhina i a koe ki te whakahaere. Ka taea e te nuinga o te tangata te whakahaere i te mamae mā te whakamahi i ngā rongoā whakamamae ka taea te hoko kore utu pērā i te Paracetamol.
• Ngā ngongo uma: Tērā pea ka whakanohoia tētahi, neke atu rānei, ngā ngongo ki roto i te uma hei tango i te wai me te toto nui mai i te patunga. Ka tangohia ēnei i roto i ētahi rā.
• He tohutohu motuhake mā ngā wāhine: Mena he nui ō ū, ka kī atu ngā tākuta kia mau koe i tētahi pōtae tautoko pai mō ngā hāora 24 o te rā, mō te kotahi ki te rua wiki i muri i te putanga mai i te hōhipera hei whakaiti i te taumaha me te pēhanga ki te patunga.

He aha ngā painga me ngā mōrearea o tēnei pokanga?

Pērā i ngā pokanga katoa, he painga, he iti noa hoki ngā mōrearea o tēnei pokanga.

Kia pēhea te roa o te wā e ora ai ahau? Me pēhea taku tiaki i ahau anō i te kāinga?

E waru wiki pea te roa kia tino ora ai te sternum. I tēnei wā, me whakawhāiti e koe te nekehanga o tō tinana o runga. He mea tino nui kia tino whai i ngā tohutohu a tō tākuta.

• Kaua e hiki i ngā mea taumaha: Kaua e hiki i tētahi mea taumaha atu i te 10 pauna (tata ki te 4.5 kirokaramu). He māmā noa iho, he rite tēnā ki te taumaha o te 4 rita miraka.
• Whakamahia ngā ringa e rua: Ina hiki i tētahi mea, whakamahia ngā ringa e rua hei hiki ōrite. Kaua e hiki i te taumaha ki te ringa kotahi anake.
• Kia tata ō ringaringa ki tō tinana: Ina hapai koe i tētahi mea, kia tata ō ringaringa ki tō tinana.

Mō te taraiwa

Ka taea e koe te taraiwa anō i te marama i muri i te pokanga. Engari i mua i tērā, me tono whakaaetanga koe ki tō tākuta. Kia ora rā anō tō sternum, he pai ake te noho ki te nohoanga o mua o te pāhihi ina haere ana i roto i te motuka. Ahakoa ka kore koe e pai ki te pēhi i te whitiki nohoanga ki tō uma, kia mau tonu te whitiki nohoanga nā te mea ka tiaki i a koe mēnā ka pā mai he aituā.

He aha ngā wā pai rawa atu hei toro atu ki te tākuta?

Ka whai wā tirotiro anō koe me tō tākuta i ia wā. Heoi, ki te pāngia koe e tētahi o ngā tohu e whai ake nei, me whakamōhio tonu koe ki tō tākuta.

Ko te whiriwhiri i te huarahi pai rawa atu mō tō pokanga ngākau he whakatau mā tō tākuta i runga i tō āhuatanga. I te nuinga o te wā, ko te sternotomy te huarahi pai ki te tango i te ngākau. Mena he pātai āu mō tēnei, kaua e mangere ki te pātai ki tō tākuta.