I ētahi wā, kua rongo pea koe mō tētahi tamaiti i whānau mai me tētahi momo raruraru ngākau i a ia e tamariki ana. Tērā pea i pokaina taua tamaiti i taua wā, ā, i whakatikatikaina te āhua. Engari ina pakeke haere taua tamaiti, ina tae ia ki te wā taitamariki, ka puta anō te raruraru ngākau i roto i taua tamarikitanga i tētahi ara rerekē. Mēnā he pērā te āhua, i tēnei rā ka kōrero tātou mō tētahi tikanga maimoatanga tino nui ka taea te homai he kaha nui ki te ora.
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Nā, he aha te TPVR?
Ki te whakarapopoto, ko te TPVR , te Transcatheter Pulmonary Valve Replacement rānei, he tikanga motuhake e whakakapi ana i te takirere pūkahukahu e kore e mahi tika ana i roto i tō ngākau, engari kāore e whakatuwhera i tō uma. He mea whakamiharo tēnei, kāore? I te nuinga o te wā, ina whakaaro tātou ki te whakakapi i te takirere ngākau, ka whakaaro tātou ki te pokanga ngākau tuwhera, arā, ko te tapahi nui i waenganui o te uma. Heoi, i roto i tēnei tikanga TPVR, ka tapahia e te taote pokanga he tapahi iti rawa ki te kiri o tō hope, ā, ka mahia te tukanga katoa mā roto.
Ko te takirere pūkahukahu te kuaha e whakahaere ana i te rere o te toto mai i te ngākau ki ō tātou pūkahukahu. Ki te kore e mahi tika, ka whakararuraruhia te rere o te toto ki te tinana katoa. Nō reira, mā tēnei tikanga, ina whakakapia te takirere ngoikore ki tētahi mea hou, ka tino piki ake tō roanga oranga me te kounga o te oranga. Waihoki, ka āwhina i te whakaroa, i te karo rānei i te hiahia mō ngā pokanga nui.
He aha te mea ka tupu me tēnei maimoatanga TPVR?
Whakaarohia i roto i te pokanga ngākau tuwhera tuku iho, ka tapahia e ngā tākuta te wheua o te uma, ka whakawhitihia te mahi a te ngākau ki tētahi mīhini whakawhiti ngākau-pūkahukahu), kātahi ka tangohia te takirere tawhito ka whakauruhia he mea hou. He roa te wā e pau ana ki tēnei, he roa ake te ora, ā, he tino mōrearea pea mō ētahi tūroro ki te mahi i tētahi pokanga nui pēnei.
Engari he tino rerekē te tikanga TPVR. He tikanga iti rawa te whakaekenga . Anei ngā mea ka tupu:
1. Ka tapahia e te tākuta ngakau he uaua iti ki roto i tētahi oko toto nui i roto i tō hope (uaua femoral) ka whakauruhia he ngongo angiangi, ngāwari, e kiia nei ko te catheter, mā roto.
2. Kei roto i tēnei katitere te takirere hou, he poihau iti kua whakapikoa ki runga.
3. Mā te whakamahi i ngā tikanga motuhake pēnei i te hihi-X, ka ārahi marie te tākuta i tēnei katitere mā roto i te uaua toto ki te wāhi kei reira te takirere pūkahukahu i roto i te ngākau.
4. Kia tau te pūnga, ka pupuhihia te poihau. Ka whānui te takirere hou, i whakapikoa, ka mau ki te wāhi i tū ai te takirere tawhito.
5. Mai i taua wā tonu, ka tīmata te mahi a te takirere hou. Ka hoki anō te rere o te toto mai i te ngākau ki ngā pukahukahu ki te āhua noa.
Ko tētahi o ngā painga nui o tēnei ko te nuinga o te hunga kua whiwhi i tēnei maimoatanga ka taea te hoki ki te kāinga tonu. He poto rawa te wā whakaora.
Nā, he aha te mea ka tupu mēnā kāore tēnei takirere pūkahukahu e mahi tika?
E rua ngā raruraru matua ka pā ki te takirere pūkahukahu.
| Āhuatanga hauora | Hei whakarāpopototanga... |
|---|---|
| Te Stenosis Pūkahukahu | Nā te mea kāore te takirere e tuwhera tika, ka whakaitihia te nui o te toto ka rere mā roto ki ngā pukahukahu. Ka nui te taumahatanga o te taha matau o te ngākau, ka raru pea taua wāhanga. |
| Te ruaki o te pūkahukahu | Nā te mea kāore te takirere e kati tika, ka turuturu te toto e pupuhihia ana ki ngā pukahukahu ki roto i te ngākau. Ka taea e tēnei te whakanui ake i te taumahatanga ki te ngākau, ā, ka pakaru te taha matau. |
Nā ēnei āhuatanga e rua, ka pāngia pea koe e ngā tohu pēnei i te poto o te manawa (dyspnea) , te pupuhi o ngā waewae me te puku (edema) , te mamae o te uma , me te pā o te ngakau kāore i te rite . Ka tino heke iho ēnei tohu i muri i te maimoatanga TPVR.
Mā wai tēnei maimoatanga e tino tika?
Mena i whānau mai koe me te mate manawa whānau , ā, i pokangahia koe i a koe e tamariki ana, tera pea ka pai tēnei maimoatanga mōu. Nā te mea ka kino haere te takirere i whakatōkia i te tamarikitanga (he homograft te nuinga o te wā). Kātahi ka puta ngā āhuatanga kua whakahuatia ake nei, pērā i te stenosis, te regurgitation rānei, i te wā taitamariki. Koia te take e taunaki ana ngā tākuta i te tikanga TPVR mō ēnei tāngata.
Ka whakamahia tēnei tikanga hei rongoā i ngā mate ngakau whānau e whai ake nei:
- Tetralogy o Fallot: He huinga o ngā hapa e whā, tae atu ki ngā kōhao i roto i te ngākau, e whakaranu ai te toto pai me te toto kino.
- Atresia Pūkahukahu: He āhuatanga kāore i hangaia te takirere pūkahukahu i te whānautanga.
- Truncus Arteriosus: Ko ngā oko toto matua e rua e ahu mai ana i te ngākau (aorta me te uaua pūkahukahu) e honoa ana hei hanga i te oko toto kotahi.
- Te Whakawhiti o ngā Uaua Nui: Ka whakawhitihia, ka honoa hoki ngā uaua toto nui e rua ki ngā taha hē.
Ko te mea nui, mā tō tākuta e whakatau mēnā he tika tēnei maimoatanga māu, i runga i tō hītori hauora, tō āhua hauora o nāianei, me ētahi whakamātautau motuhake.
He aha ngā mahi i mua atu, ā, i muri mai i te maimoatanga?
Te whakarite i mua i te maimoatanga
Hei tirotiro mēnā ka taea e koe te mahi TPVR, ka tirotirohia koe e tō tākuta, ā, ka whakahaerehia pea he whakamātautau ahotea whakakori tinana. Hei tāpiri, ka taea te mahi i ēnei whakamātautau e whai ake nei:
- Angiogram
- Matawai CT o te ngākau
- MRI o te ngākau
- Te Echocardiogram
- Whakamātautau ECG
I muri i te whakaaroaro i ēnei mea katoa, ka whakatau te tākuta ko tēhea te otinga pai rawa atu māu.
I te wā o te maimoatanga
Ka whakamoea koe i mua i te tīmatanga o te maimoatanga, nō reira kāore koe e mamae. E rua ki te toru hāora te roa o te tukanga katoa. Ka whakauruhia e ngā tākuta te catheter, ka whakanoho i te takirere, ka tirohia tana mahi, kātahi ka tangohia te catheter.
I muri i te maimoatanga
Ka puritia koe ki te hōhipera hei tirotiro māu i te pō, ā, i te nuinga o te wā ka tukuna koe ki te kāinga i te aonga ake. Ka taea e koe te hoki anō ki ō mahi o ia rā i roto i te wiki pea.
He aha ngā painga me ngā mōrearea?
Pērā i ngā maimoatanga hauora katoa, he painga, he mōrearea hoki ō tēnei.
| Ngā Painga | Ngā Tūponotanga |
|---|---|
| He poto te wā whakaora. | Te toto totoka. |
| He iti te mōrearea o te pangia. | Te kino ki ngā oko toto. |
| He poto ake te noho ki te hōhipera. | Te pāorooro o te manawa (Arrhythmia). |
| Kāore he koha nui e kitea. | Ngā mate o te ngākau (Endocarditis). |
| He iti iho te mamae. | Te toto ohorere. |
He tino onge te puta o ngā raruraru nui pēnei i te mate manawa, te whiu, te mate rānei. Nō reira, he mea nui kia kōrerohia ngā painga me ngā huakore o tēnei maimoatanga ki tō tākuta i mua i te whakatau.
Ētahi atu mea nui hei mōhio
Kia pēhea te roa o te ora o tētahi takirere hou?
Kei tō hauora whānui me te āhua o tō ngākau tēnei. Tērā pea me mahi anō he pokanga mō ētahi tāngata i muri i tētahi wā. Engari ko te rongo pai, ki te tika, ka taea te whakakapi i tētahi atu takirere mā te tikanga TPVR.
Me tūpato koe i te wā e mahi ana koe i ngā maimoatanga niho?
Ae, he mea tino nui tēnei. I roto i ngā mahi pēnei i te tango niho me te horoi niho, ka taea e ngā huakita i roto i te waha te uru ki roto i te toto ka haere mā roto i taua mea ka puta he mate kino e kiia nei ko te endocarditis , he mate o te takirere ngākau hou kua whakatōkia. Nō reira, i mua i tō maimoatanga niho, me whakamōhio atu koe ki tō tākuta niho kua pāngia koe e te TPVR. Tērā pea ka tonoa koe kia tango i ngā paturopi i mua i te maimoatanga.
He raruraru kei roto i te haumarutanga o te taunga rererangi?
Kāo. Kāore ngā hihi-X me ngā tirotiro haumaru o te taunga rererangi e pā kino ki a koe. Heoi, ki te mea kei te whakaaro koe ki te tirotiro MRI, kōrero ki tō tākuta i te tuatahi.
Karere Tangohia ki te Kāinga
- He maimoatanga hou te TPVR, he iti noa te whakaekenga e whakakapi ana i te takirere pūkahukahu o te ngākau mā te tapahi iti, me te kore e whakatuwhera i te uma.
- He otinga pai tēnei mō ngā raruraru takirere e pā mai ana i te wā taitamariki, inā koa mō te hunga i pokangahia i te tamarikitanga nā te mate manawa whānau.
- He poto ake te wā whakaora, he poto ake te noho ki te hōhipera, ā, he iti ake te mamae i tērā i te pokanga ngākau tuwhera tuku iho.
- Pērā i ngā maimoatanga katoa, he mōrearea anō hoki, nō reira me kōrero koe ki tō tākuta i mua i te whakatau mēnā he tika mōu.
- He mea tino nui kia ora ai koe, kia whai tonu i ngā tohutohu a tō tākuta i muri i te maimoatanga, me te toro atu ki tō tākuta i ngā rā kua whakaritea.
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