He raruraru anō tōu ki te gastritis kāore e ora mō te wā roa, arā, he mate puku (Peptic Ulcer Disease)? Ahakoa kua tangohia te rongoā, i ētahi wā ka mau tonu ēnei mate puku , kāore e ora. I roto i ēnei take kino, i tēnei rā ka kōrero tātou mō tētahi pokanga motuhake e taunakihia ana e ngā tākuta. Ko te ingoa o tēnei ko te Vagotomy. Kāore pea koe i rongo i tēnei ingoa. Engari he tikanga maimoatanga tino nui tēnei. Kia titiro tātou he aha te tikanga.
He aha te Vagotomy?
Whakaarohia he 'waea waea' motuhake e kawe ana i ngā mōhiohio i waenga i tō roro me te pūnaha nakunaku i roto i tō puku. I roto i te rongoā, ka kiia tēnei ko te Nerve Vagus. Ko tēnei nerve te mea e hoatu ana ki tō puku te tohu kia "hukahia te waikawa inaianei." Ina kai tātou, ko tēnei nerve Vagus te mea e tuku ana i te karere mai i te roro kia whakaputa i te waikawa e hiahiatia ana hei nakunaku i taua kai.
Ināianei, he nui rawa te waikawa e whakaputaina ana e ngā puku o ētahi tāngata. Ka kino pea te arai o te puku, ā, ka puta he mate pukupuku e kore e ora . Ko te vagotomy ko te tapahi i te wāhanga o te io vagus e tuku karere ana mai i te roro ki te puku hei whakaputa waikawa. Pērā i te tapahi i te waea waea hei aukati i te karere, ka whakaitihia te tohu ki te puku hei whakaputa waikawa mā te tapahi i tēnei io. Ka āwhina tēnei ki te whakahaere i te whakaputanga waikawa o te puku , ka āwhina ki te whakaora i ngā mate pukupuku me te aukati i te hanganga o ngā mate pukupuku hou.
Ehara tēnei i te mea e mahia ana mō te mate gastritis noa. He rongoā whakamutunga tēnei mō ngā mate puku kino, uaua hoki e kore e taea te whakaora mā te rongoā.
He aha ngā momo matua o te pokanga vagotomy?
He rite te io vagus ki te pūtake rākau e tīmata ana, ka peka atu. Ka taea te wehewehe i te pokanga vagotomy ki ngā momo matua e rua, i runga i te wāhi i tapahia ai tēnei io. He rerekē paku ngā pānga o ngā mea e rua.
| Momo pokanga | He whakamārama māmā |
|---|---|
| Te tango i te ngako o te waewae | Ko te tikanga o tēnei ko te tapahi i te pūtake matua o te io vagus. He rite tēnei ki te tapahi i te pūtake matua o te rākau. Ehara i te mea ko te puku anake te pānga o tēnei, engari ko ngā tohu ki te ate, te pūkahukahu, te repeure, me ngā whekau hoki. Ahakoa ka whakaitihia te waikawa e tēnei, ka pā anō hoki ki ētahi atu wāhanga o te pūnaha nakunaku (ngā pānga taha). |
| Te Vagotomy Tino Kōwhiri | I tēnei, kāore he mahi e mahia ana ki te pūtake io matua. Engari, ko ngā manga io tino iti anake e kawe ana i ngā tohu ki ngā pūtau whakaputa waikawa (ngā pūtau parietal) i roto i te puku ka tapahia, ka tangohia. He rite tēnei ki te tapahi i tētahi peka o te rākau me te kore e kino te pūtake. He iti noa ngā pānga taha ka puta mai i tēnei. Heoi, he mahi uaua tēnei mā te taote pokanga, ā, me nui ake te pūkenga e hiahiatia ana. |
I roto i ēhea ngā wā ka mahia ai tēnei pokanga?
I te nuinga o te wā, ka taea te rongoā i ngā mate puku. Heoi, tera ētahi wā ka kino rawa atu. Koinei te wā me whakaaro koe ki te pokanga vagotomy.
- Ngā Mate Pukupuku Toto: Mena ka toto tonu te mate puku, ā, kāore e taea te whakahaere mā ngā tikanga pēnei i te endoscopy, me pokanga pea hei whakatika i te mate puku. Tērā pea ka mahia he vagotomy hei ārai i te hanganga o ngā mate puku.
- Ngā Mate Puku: He āhuatanga ohorere tēnei. Mēnā he hohonu te mate ka puta he kōhao ki te pakitara, ka turuturu pea te waikawa o te puku me te kai ki roto i te kōhao puku, ka puta he mate kino. Mēnā he pēnei, me pokanga hei kati wawe i te kōhao. Tērā pea ka mahia he vagotomy. Mēnā he pēnei, ka whakaurua tonutia koe ki te Tari Ohorere (ETU) .
- Te Ārai Putanga Puku: Ka ārai pea te kiko ira mai i ngā whara roa i te rerenga o te kai mai i te puku ki te whekau iti. Ka taea e tēnei te piri o te kai ki roto i te puku, ā, ka ruaki . Tērā pea ka mahia he vagotomy i te wā o te pokanga hei tango i tēnei ārai.
Ko ētahi atu pokanga i mahia tahitia me te vagotomy
Ehara te vagotomy i te pokanga tūkotahi. Ka mahia ngātahitia me ētahi atu pokanga hei whakatika i ngā raruraru i puta mai i ngā whara.
1. Te tango i te uaua o te puku me te tango i te puku
I ētahi wā tino kino, me tango pea tētahi wāhanga o te puku. Ka kiia tēnei he gastrectomy. I te nuinga o te wā, ka tangohia te wāhanga o raro o te puku. Ka puta he homoni e kiia nei ko te gastrin i tēnei wāhanga. Ka āwhina hoki tēnei homoni ki te whakaputa waikawa. Nō reira, ina tangohia tētahi wāhanga o te puku, ka mahia hoki he vagotomy hei ārai i te whara anō.
2. Vagotomy me te Pyloroplasty
Ki te mahi tātou i te pokanga Truncal Vagotomy i kōrerotia e tātou i mua ake nei, me mahi tonu tātou i tēnei pokanga pyloroplasty i te wā kotahi. I te pito o te puku, he wāhanga uaua rite ki te takirere e kiia nei ko te pylorus. He rite tēnei ki tētahi kēti e tuwhera ana, e kati ana hoki, kia uru ai te kai ki roto i te whekau iti. Ina tapahia te pūtake matua o te io vagus i roto i te truncal vagotomy, ka ngaro ngā tohu e whakatuwhera ana, e kati ana i tēnei kēti. Kātahi ka mau te kai ki roto i te puku. Ka mahia te pokanga pyloroplasty hei whakatikatika i taua kēti kia tuwhera tonu ai. Kātahi ka ngāwari te uru o te kai ki roto i te whekau iti.
He aha ngā mea ka tupu i mua atu, ā, i te wā o te pokanga?
I mua i te pokanga, ka tukuna atu ki a koe te maimoatanga e tika ana hei pupuri i tō hauora kia pai tonu. Hei tauira, ka hoatu he tote ki a koe mēnā kua maroke koe i te ruaki, he toto rānei mēnā kua ngaro te toto i a koe. Ka hoatu hoki he paturopi ki a koe hei ārai i te mate me ngā rongoā hei ārai i te toto e pupuhi ana . Ka mahia te pokanga i raro i te rongoā whakamoe , arā, ka moe rawa koe.
E rua ngā huarahi hei mahi i te pokanga:
- Pokanga Tuwhera: Ko te tikanga tuku iho, ka mahia mā roto i tētahi tapahi nui i te puku.
- Pokanga Laparoscopic: E mōhiotia ana hoki tēnei ko te 'pokanga kōhao kī'. He tikanga tēnei e uru ana ki te hanga i ētahi tapahi iti noa iho ki te puku, me te whakauru i tētahi kāmera me ngā taputapu ngawari. Ko te mutunga iho he poto ake te wā whakaora me te iti ake o ngā koha.
Mā te taote pokanga e whakatau ko tēhea tikanga te mea pai mōu.
He aha ngā mea ka tupu i muri i te pokanga? Ngā tūponotanga me ngā pānga taha pea
I runga i te āhua o te pokanga, me noho pea koe ki te hōhipera mō ētahi rā. Ka tukuna koe ki te kāinga ina taea e koe te hikoi me te mahi takitahi anō. Tērā pea ka roa ētahi wiki kia tino ora ai koe. Ka tīmata koe me te kai wai, ā, ka āta urutau ki te kai noa.
Pērā i ngā pokanga katoa, he mōrearea anō hoki kei tēnei pokanga.
| Ngā tūponotanga me ngā pānga taha | Whakaahuatanga |
|---|---|
| Ngā tūponotanga i te wā pokanga | Te kino ki ngā whekau e karapoti ana, ki ngā oko toto, ki ngā io rānei, ki ngā mate pāwera, ki te toto nui, ki ngā toto totoka, me ētahi atu. |
| Korere | He pānga taha noa tēnei, inā koa i muri i te tango i te toto i roto i te puku. Ka puta tēnei āhuatanga ina turuturu ohorere te au ki roto i te whekau nā te hekenga o ngā tohu io ki te pūkahukahu. He wā poto noa iho tēnei i te nuinga o te wā. |
| Te Mate Putunga | Nā te pokanga pyloroplasty tēnei i puta ai. I te tere o te neke o te kai mai i te puku ki ngā whekau, ka puta pea te whakapairuaki, te mamae o te puku, me te mate korere i muri tonu i te kai. I ētahi wā, i muri i ētahi haora, ka heke ohorere te taumata huka toto, ā, ka ngoikore pea koe. Ka taea te whakahaere i tēnei mā te whakarerekē i tō kai. |
| Ngā kōhatu o te pūhā | I muri i te tango i te puku o te puku, ka kohikohi pea te au o te ate, ka hanga he kōhatu nā te ngoikore o te mahi a te puku o te puku. |
Kāore ēnei pānga taha e pā ki te katoa. Ā, ka hoatu e tō tākuta he rongoā me he tohutohu hei whakahaere i te nuinga o ēnei. Ko te mea nui, ko te painga matua o tēnei pokanga ko te kaha ki te whakaora katoa i ngā mate puku kua roa e kore e ora.
Karere Tangohia ki te Kāinga
- Ko te Vagotomy he pokanga motuhake e mahia ana mō ngā mate puku kino me te uaua (Peptic Ulcers) e kore e taea te whakaora ki te rongoā.
- I konei, ka tapahia ka tangohia te wāhanga e tika ana o te Nerve Vagus, e kawe ana i ngā tohu mai i te roro ki te puku hei whakaputa waikawa.
- E rua ngā momo matua o tēnei pokanga: te Truncal Vagotomy me te Highly Selective Vagotomy.
- He maha ngā wā ka mahia tēnei i te taha o tētahi atu pokanga, pērā i te tango i te puku, te tango rānei i te pyloroplasty.
- Tērā pea ka puta ngā pānga taha pēnei i te mate korere me te mate dumping syndrome i muri i te pokanga, engari ko te nuinga o ēnei ka taea te whakahaere.
- Me whakatau mēnā he tika tēnei pokanga māu i muri i te tirotiro hōhonu i tō āhua hauora, me te kōrero tahi me tō taote pokanga.
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