Whakaarohia te mea ka tupu mēnā ka āraia ohoreretia tētahi oko toto nui e ahu atu ana ki tō ngākau, roro, pukahukahu rānei e te toto totoka? Mā tēnei ka aukati i te rere o te toto ki aua whekau, ā, ka pāngia. He āhuatanga morearea tēnei. I roto i tētahi āhuatanga ohorere, ka whakamahia e ngā tākuta tētahi maimoatanga motuhake hei whakaora i ngā oranga. I tēnei rā, e kōrero ana tātou mō tētahi maimoatanga e whakarewa ana, e tango ana hoki i aua toto totoka, e kiia nei ko te 'Thrombolytic Therapy'.
He aha te Whakaora Thrombolytic?
Ahakoa he ahua uaua te ingoa, he tino māmā te ariā. Ki te kī māmā, ko te whakamahi i tētahi momo rongoā motuhake hei whakarewa me te tango i ngā toto totoka kino kua puta i roto i ngā uaua toto i roto i ō tātou tinana. He rite ki te whakarewa me te tango i tētahi mea kua āraia i roto i te paipa wai mā te whakamahi i tētahi matū.
Ko te whāinga matua o tēnei maimoatanga he whakahoki mai i te rere o te toto kua āraia e te toto totoka. Mā tēnei ka taea te whakaiti i te kino ki ngā whekau (pērā i te ngākau me te roro) e tukuna ana e taua oko toto. He maimoatanga tēnei e hoatu ana i roto i ngā āhuatanga ohorere. Ka taea e tēnei maimoatanga te whakaora ora, inā koa i roto i ngā take pēnei i te whakaeke ngākau (`(Myocardial Infarction)`), he whiu i puta mai i te aukati i roto i te oko toto i roto i te roro (`(Ischemic Stroke)`), he toto totoka rānei i roto i ngā pukahukahu (`(Pulmonary Embolism)`).
Ko te mea nui ko te tīmata wawe i tēnei maimoatanga. Ko te tere o te tīmatanga o te maimoatanga i muri i te tīmatanga o ngā tohu, ko te pai ake o ngā hua.
Ko wai e hiahia ana ki tēnei maimoatanga? Ā, ko wai kāore e tika kia whiwhi?
Ehara tēnei i te maimoatanga e taea te hoatu ki te katoa. He maha ngā āhuatanga ka whakaarohia e ngā tākuta i mua i te hoatutanga o tēnei maimoatanga ki tētahi. Nā te mea he tūponotanga kei roto. Kia kite tātou i te wā e tika ana tēnei maimoatanga, me te wā kāore e tika ana.
| Ngā āhuatanga e hiahiatia ai te maimoatanga | Ngā take kāore e tika ana kia tukuna he maimoatanga (nā te nui o te mōrearea) |
|---|---|
| Mena ka āraia ohoreretia tētahi oko toto nui (te uaua, te uaua rānei) e te toto totoka. | Mena kei te toto haere tonu te toto i roto i te tinana. |
| I ngā take pēnei i te deep vein thrombosis (DVT) me te pulmonary embolism (PE), kāore e taea te whakahaere me ngā rongoā whakangawari toto noa (anticoagulants). | Mena kua pāngia koe e te toto o te roro (Intracranial Hemorrhage). |
| I ngā haora tuatahi i muri i te whakaeke ngakau, i te whiu rānei. | Mena kua oti kē te pokanga roro, te pokanga tuaiwi rānei i a koe i ngā wā tata nei. |
| Mena ka puta he āhuatanga ohorere nā te aukati o ngā oko toto i roto i ngā peka (Peripheral Arterial Disease - PAD). | Mena he toto toto tiketike tōu kāore i te taea te whakahaere (te toto toto tiketike). |
| Mena ka āraia he katitere e werohia ana ki roto i te tinana e te toto totoka. | Mena he mate whatukuhu nui tōu. |
| Mena kua whara nui tō upoko i ngā wā tata nei. |
Hei tāpiritanga, e tino āwangawanga ana ngā tākuta mō te mōrearea o ngā raruraru ina tukuna ana tēnei maimoatanga ki ngā whaea hāpu me ngā kaumātua.
He aha ngā momo matua o tēnei maimoatanga?
He maha ngā huarahi hei hoatu i tēnei rongoā whakaheke toto. Ka whiriwhiria e te tākuta te tikanga tino tika i runga i te āhua o te tūroro me te wāhi o te toto totoka.
1. Te Whakatōtōtanga Pūnaha
Koinei te tikanga e whakamahia whānuitia ana. I konei, ka whakauruhia he ngongo IV ki roto i te uaua i te ringa, pērā i te pata tote, ā, ka tukuna te rongoā mā roto. Ka haere tēnei rongoā puta noa i te pūnaha tohanga toto, ka whakarewa i te toto totoka. He maha ngā wā ka whakamahia tēnei tikanga i ngā āhuatanga ohorere pērā i te whakaeke ngakau, te whiu, me te toto totoka i roto i ngā pukahukahu.
2. Te Thrombolysis e whakahaerehia ana e te catheter
He rerekē te tikanga nei. I konei, ka whakauruhia he ngongo tino angiangi, roa (e kiia ana tēnei he catheter) ki roto i te tinana mā roto i te uaua i te hope, i te kaki, i te ringa rānei. Kātahi, mā te whakamahi i tētahi tikanga pēnei i te hihi-X, ka arahina te pito o tēnei catheter ki te wāhi tika o te toto totoka. Kātahi, hei utu mō te hoatu i te rongoā ki te tinana katoa, ka werohia tika ki roto i te toto totoka mā roto i te catheter. Mā tēnei ka taea te hoatu i te rongoā i roto i te āhua kukū ake, tika ki te ūnga. Ko tēnei tikanga te nuinga o te wā e whakamahia ana mō ngā āhuatanga pēnei i te DVT me te PAD. I te nuinga o te wā ka mahia tēnei i mua i te wā.
3. Te tango i te toto i roto i te mīhini
I tēnei wā, hei tāpiritanga ki te hoatu rongoā, ka pakaruhia te toto totoka, ka tangohia mā te mīhini. Ka whakamahia he taputapu motuhake (he taputapu e wiri ana, e hurihuri ana, e ngotea ana rānei te totoka) i te pito o te katitere hei wawahi i te totoka, hei tango atu hoki. I ētahi wā ka whakamahia tēnei tikanga me te tikanga e ārahihia ana e te katitere.
He aha ngā mea ka tupu i te wā e rongoatia ana, ā, i muri hoki i te rongoā?
Ka rerekē te huarahi e tukuna ai tēnei maimoatanga i runga i te momo e whiwhi ai koe.
Mēnā he āhuatanga ohorere
Mena ka pāngia koe e tētahi āhuatanga ohorere, pērā i te mate manawa, te whiu rānei, ka ngana ngā tākuta ki te tīmata i te maimoatanga i te wā e taea ai i muri i tō whakaurunga ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera. Mō ngā hua pai rawa atu, he mea nui kia tīmata te maimoatanga i roto i ngā haora e rua o te tīmatanga o ngā tohu, i roto rānei i ngā meneti 30 o te taenga ki te hōhipera.
Te āhua o te maimoatanga
Kia titiro tātou ki ngā mea ka puta i roto i ēnei tikanga matua e rua.
| Te whakaheke toto pūnaha (mā te IV) | Te whakaheke toto e whakahaerehia ana e te catheter (mā te catheter) |
|---|---|
| I te nuinga o te wā ka mahia tēnei i roto i te wāhanga tiaki nui (ICU). | He mahi anō hoki tēnei e mahia ana i roto i tētahi wāhanga motuhake i roto i te hōhipera. |
| Ka hoatu e rātou he rongoā whakamoe hei whakamarie i a koe. Ka whakangāwari i te wāhi e werohia ana te IV. | Ka hoatu he rongoā whakamoe ki a koe hei whakamarie i a koe. Ka whakangāwarihia te wāhi e whakaurua ai te catheter (te hope, te ringa). |
| Ka whakauruhia he ngongo IV ki roto i te uaua i te ringa, ā, ka tukuna te rongoā mā roto i taua ngongo ki roto i te tinana. | Ka tapahia he tapahi iti, ka whakaurua he catheter ki roto i te uaua, kātahi ka haria te toto totoka ki te wāhi i puta ai te toto totoka. |
| Ka haere te rongoā puta noa i te tinana me te toto, ā, ka tae ki te toto totoka. | Ka werohia tika te rongoā ki roto i te toto totoka. I ētahi wā ka wahia te toto totoka ki tētahi taputapu miihini. |
| E tata ana ki te haora te roa o tēnei tukanga. | E 48 hāora pea (e rua rā) ka memeha rawa te toto totoka. I taua wā, ka tirotirohia koe i te hōhipera. |
I te wā e rongoatia ana, ka aroturuki tonu te tīma hauora i ngā mea pēnei i te tere o tō manawa, te mahi a tō pukahukahu, me te toto toto tiketike.
I muri i te maimoatanga
Ka whakahaerehia e te tākuta ētahi whakamātautau kia kitea ai kua memeha katoa te toto totoka.
- Angiogram
- Matawai CT
- Te Echocardiogram
I muri i te maimoatanga, me noho koe ki te wāhanga tiaki nui (ICU) mō te kotahi rā pea. Whai muri i tēnā, me noho koe ki te hōhipera mō tētahi atu rā, e toru rānei, i raro i te tirotiro. Ahakoa kua hoki koe ki te kāinga, me haere tonu te tango i ngā rongoā whakangawari toto hei ārai i te hanganga anō o ngā toto totoka.
He aha ngā painga me ngā mōrearea o tēnei maimoatanga?
Pērā i ngā maimoatanga hauora katoa, he painga, he mōrearea hoki tō tēnei.
Ngā painga matua:
- Te pūmanawa whakaora ora: Koinei te painga nui rawa atu. Ka taea e tēnei maimoatanga te āwhina ki te ārai i te mate i roto i ngā take pēnei i te whakaeke ngakau me te whiu.
- Te ārai i ngā hauātanga tuturu: Mā te whakaiti i te kino o te roro, ka taea te ārai i ngā uauatanga kōrero me te ngaronga o ngā waewae i muri i te whiu.
- Te ārai i te tapahi: Ki te aukatia tētahi uaua nui i roto i te ringa, i te waewae rānei, ka mate pea taua wāhanga o te tinana me te kore e rere te toto. Mā tēnei maimoatanga ka whakaitihia taua mōrearea.
Ngā mōrearea matua:
Ko te mōrearea nui rawa atu, me te mōrearea tino kino rawa atu o tēnei maimoatanga ko te tūponotanga o te toto o roto.
- Te toto o te roro: Koinei te raruraru tino morearea. Tata ki te 1% o te hunga e whiwhi ana i tēnei maimoatanga ka pāngia pea e te whiu nā te toto o te roro.
- Ētahi atu toto: Tērā pea ka toto koe i te ihu, i roto i tō tūtae, i roto rānei i tō mimi. Tērā pea he marō, he toto rānei kei te wāhi i werohia ai te IV, te catheter rānei.
- Ētahi atu mōrearea:
- Ngā uruparenga mate pāwera
- Te pakaru o te whatukuhu (ina koa mō te hunga mate huka)
- Te toto toto iti (`(Te toto toto tiketike)`)
- Ka whati te toto totoka ka haere ki tētahi atu wāhi ka piri.
- Ngā mate manawa o te ngākau (`(Arrhythmia ventricular)`)
Nā ēnei mōrearea, he maha ngā āhuatanga ka whakaarohia e ngā tākuta i mua i te hoatutanga o tēnei maimoatanga ki tētahi tangata.
Āhea ahau me toro atu ki te tākuta i muri i te maimoatanga?
Kia hoki koe ki te kāinga, he mea nui kia tūpato koe ki ētahi tohu. Mēnā ka pāngia koe e tētahi o ngā tohu i raro nei, me whakamōhio tonu koe ki tō tākuta.
| Ngā tohu hei tūpato | Whakaahuatanga |
|---|---|
| Mamae o te uma | Te mamae ohorere, te mamae nui haere rānei o te uma. |
| Ngā huringa o te whakatakotoranga IV/catheter | Mena ka toto tonu te wāhi, ka turuturu rānei, ka whero, ka wera, ka piki ake rānei te pupuhi/mamae. |
| Kirika | Ki te pāngia koe e te kirika, kāore he take. |
| Te ānini, te whakapairuaki rānei | Mena kei te kino haere tō mamae upoko, te whakapairuaki rānei, te mamae nui rānei. |
| Te ngoikore o ngā peka | Mena ka rongo koe i te ngau, i te mākūkū rānei i ō ringaringa, i ō waewae rānei. |
Tērā pea he tohu ēnei tohu mō tētahi raruraru, nō reira kaua e warewarehia.
Karere Tangohia ki te Kāinga
- He maimoatanga tino nui te whakaora toto mā te whakarewa i ngā totoka i roto i ngā āhuatanga ohorere pērā i te whakaeke ngakau me te whiu.
- He mea nui te wā kia angitu ai tēnei maimoatanga. Mā te haere ki te hōhipera i te wā tonu e puta mai ai ngā tohu ka nui ake te pai o ngā putanga.
- I te mea ko te toto te tino mōrearea o tēnei, ka whakatau ngā tākuta ki te hoatu i tēnei maimoatanga ki a koe i muri i te tirotiro tika i tō āhua.
- I muri i te maimoatanga, he mea tino nui kia tino whai i ngā tohutohu a tō tākuta, inā koa te tango i ngā rongoā whakangawari toto, hei ārai i ngā totoka toto a muri ake nei.
- Ina hoki koe ki te kāinga i muri i te maimoatanga, me whakamōhio tonu atu ki tō tākuta mō ngā tohu rerekē katoa e pā ana ki a koe.
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