He aha te Whakatikatika me te Whakakapi i te Pūwāhi Pūkahukahu? Te Whāinga, te Hātepe & ngā Hua

Ko te whakatikatika me te whakakapi i te pūwāhi pūkahukahu he pokanga ngākau hei whakatika i ngā raruraru o te pūwāhi i waenga i te pūkahukahu matau o tō ngākau me te uaua pūkahukahu. Ko te tikanga ka tuwhera, ka kati tēnei pūwāhi hei whakahaere i te rere o te toto mai i tō ngākau ki ō pūkahukahu, engari i ētahi wā kāore e pai te mahi nā te hē i te whānautanga, te mate, te mau rānei i te wā.

Inā kāore e pai te mahi o tō pūwāhi pūkahukahu, me kaha ake tō ngākau ki te papu toto ki ō pūkahukahu mō te hāora. Ka taea e ēnei hātepe te whakahoki mai i te rere toto noa me te āwhina i tō ngākau kia pai ake te mahi, he maha ngā wā ka tino pai ake tō kounga o te ora.

He aha te whakatikatika me te whakakapi i te pūwāhi pūkahukahu?

Ko te whakatikatika i te pūwāhi pūkahukahu te tikanga ka whakatikahia e tō tākuta pokanga tō pūwāhi o nāianei kia pai ake ai te mahi. Mā tēnei pea e whakahāngai anō ngā rau o te pūwāhi, te tango i ngā kiko kōpiko, te whānui rānei i tētahi wāhi kuiti. He maha ngā wā ka pai ake te whakatikatika inā taea, nā te mea ka pupuri koe i ō kiko pūwāhi taketake.

Ko te whakakapi i te pūwāhi pūkahukahu e hāngai ana ki te tango i tō pūwāhi kua pakaru me te whakauru i tētahi mea hou. Ka taea e te pūwāhi whakakapi te mīhini (i hangaia mai i ngā rauemi roa) te koiora rānei (i hangaia mai i ngā kiko kararehe, tangata rānei). Ka tūtohu tō tākuta pokanga i te kōwhiringa pai rawa atu i runga i tō tau, tō oranga, me tō āhuatanga ngākau motuhake.

E whai ana ngā hātepe e rua ki te whakahoki mai i te rere toto noa i waenga i tō ngākau me ō pūkahukahu. Ko te kōwhiri i waenga i te whakatikatika me te whakakapi e whakawhirinaki ana ki te nui o te pakaru o tō pūwāhi me te mōhiotanga ka taea te whakatika pai.

He aha te take ka mahia ai te whakatikatika me te whakakapi i te pūwāhi pūkahukahu?

Ka mahia ēnei pokanga inā kāore e tuwhera, e kati rānei tō pūwāhi pūkahukahu, e kaha ake ai tō ngākau i te mea e tika ana. Ko ngā take tino noa ko ngā hē ngākau i te whānautanga i whānau mai koe, ngā mate i pakaru ai te pūwāhi, ngā raruraru rānei mai i ngā pokanga ngākau o mua.

Me hiahia pea koe ki tēnei pokanga mēnā he stenosis pūkahukahu tō, arā, he whāiti rawa te tūwhera, ā, e aukati ana i te rere o te toto ki ō pūkahukahu. Ko tētahi atu take noa he regurgitation pūkahukahu, arā, kāore te tūwhera e kati katoa, ā, ka rerere whakamuri te toto ki tō ngākau.

Ka tohutohu te tākuta i te pokanga i te wā e tīmata ana ngā tohumate pēnei i te poto o te manawa, te ngenge, te mamae o te uma rānei ki te pā ki āu mahi o ia rā. Ka tohutohu pea rātou i te pokanga mēnā e whakaatu ana ngā whakamātautau kei te whānui, kei te ngoikore rānei tō ngākau, ahakoa kāore anō koe i te mōhio ki ngā tohumate.

He aha te tikanga mō te whakatikatika me te whakakapi i te tūwhera pūkahukahu?

Ko te tikanga nei ka mahia i roto i te rūma whakahaere i te hōhipera i raro i te rongoā whānui, arā, ka moe katoa koe i te wā o te pokanga. Ka aroturuki tō rōpū pokanga i tō ngākau, tō manawa, me ētahi atu tohu nui i te wā o te mahi.

Ko te nuinga o ngā pokanga tūwhera pūkahukahu ka mahia mā te pokanga tuwhera-ngākau, arā, ka hanga e tō tākuta pokanga tētahi tapahi i tō uma kia uru tika atu ki tō ngākau. Koinei te mea e pā ana i te wā o te tikanga:

1. Ka whakatuwherahia e tō tākuta pokanga tō uma mā te wheua uma
2. Ka whakamutua tō ngākau mō tētahi wā, ā, ka whakahaere tētahi mīhini ngākau-pūkahukahu i te rerenga toto
3. Ka uru atu ki te tūwhera pūkahukahu, ā, ka whakatikahia, ka whakakapia rānei
4. Ka whakamātauria ngā hononga katoa kia mōhio ai kei te tika te mahi
5. Ka tīmata anō tō ngākau, ā, ka katia te uma

Ko ētahi tāngata ka tūpono pea ki ngā huarahi iti ake te whakaeke, pēnei i te whakakapinga tūwhera pūkahukahu transcatheter, arā, ka whakauruhia te tūwhera hou mā tētahi katita i tō waewae. Ko tēnei kōwhiringa e wātea ana mō ngā tāngata kua pokangahia i tō rātou ngākau i mua, ā, e tutuki ana i ngā paearu motuhake.

Ko te tikanga katoa e 3 ki te 5 hāora te roa, i runga i te uaua o tō keehi me te hiahia ki ētahi atu whakatikatika ngākau i te wā kotahi.

Me pēhea te whakarite mō tō whakatikatika me te whakakapi i te tūwhera pūkahukahu?

Ka tīmata tō whakarite i ngā wiki i mua i te pokanga mā te whakamātau whānui kia mōhio ai kua rite koe mō te mahi. Ko te tikanga, kei roto i tēnei ko ngā whakamātautau toto, ngā hihi-X o te uma, he electrocardiogram, me ngā whakaahua taipitopito o te ngākau hei āwhina i tō tākuta pokanga ki te whakamahere i te huarahi pai.

Ka arotake tō rōpū hauora i ō rongoā katoa o nāianei, ā, ka tono pea kia whakamutua e koe ētahi, ina koa ngā rongoā whakaheke toto, tata ki te wiki i mua i te pokanga. Ka tūtaki anō koe ki tō tākuta rongoā whakamoe ki te kōrero mō tō hītori hauora me ō āwangawanga mō te rongoā whakamoe.

I ngā rā e tata ana ki te pokanga, me whai koe i ngā tohutohu motuhake hei whakaiti i te tūponotanga o te mate:

• Horoi ki te hopi patu huakita i te pō i mua i te pokanga me te ata o te pokanga
• Kaua e kai, e inu rānei i tētahi mea i muri i te pō waenga i mua i tō mahi
• Whakaritea kia haria koe e tētahi ki te hōhipera, ā, noho tahi me koe i muri mai
• Whakakīa ngā kākahu pai me ngā taonga whaiaro mō tō noho i te hōhipera

Ka kōrero anō tō rōpū hauora mō te aha e tūmanakohia ana i te wā whakaora, ā, ka whakarite i ngā ratonga tautoko e hiahia ana koe i te kāinga. Mā tēnei whakarite e āwhina kia pai te haere o te wheako me te whakaora.

Me pēhea te pānui i ngā hua o tō whakamātautau tūāwhiorangi?

I mua i te pokanga, ā, i muri mai, ka whakamahi ngā tākuta i ētahi whakamātautau hei tirotiro i te pai o te mahi a tō tūāwhiorangi. Ko te echocardiogram te whakamātautau tino noa, e whakamahi ana i ngā ngaru oro hei hanga pikitia neke o tō ngākau me te ine i te rere o te toto mā te tūāwhiorangi.

Ka whakaatu ō hua echo i te pākēneke tūāwhiorangi, e ine ana i te rerekētanga pēhanga puta noa i tō tūāwhiorangi. Ko ngā pākēneke pēhanga noa te tikanga he iti iho i te 25 mmHg, i te wā e tohu ana ngā pākēneke neke atu i te 50 mmHg i te whāiti nui pea e hiahia ana ki te rongoā.

Ka inea hoki e te whakamātautau te regurgitation, te nui rānei o te toto e turuturu whakamuri ana i te tātā. Ko te tikanga ka whakaahuahia tēnei he kore, he iti noa, he ngawari, he āhua, he kaha rānei. Mā tō tākuta e whakamārama te tikanga o ēnei inenga mō tō āhuatanga motuhake me te hauora o tō ngākau.

Ko ētahi atu inenga nui ko te rahi me te mahi o tō pūkahukahu matau, nā te mea ka taea e ngā raruraru tātā hākinakina te whānui, te ngoikore rānei o te taha matau o te ngākau i te roanga o te wā. Mā tō tākuta e whai i ēnei inenga hei whakatau i te wā pai mō te pokanga me te aroturuki i tō ahunga whakamua i muri mai.

Me pēhea te whakahaere i tō hauora i muri i te pokanga tātā pūkahukahu?

I muri i tō pokanga, ko te whakahaere i tō hauora ko te whai i ngā tohutohu a tō tākuta me te haere ki ngā pōti whai muri katoa. Ka haere haere tō whakaora, ā, ka hoki te nuinga o te tangata ki ngā mahi noa i roto i te 6 ki te 8 wiki, ahakoa ka ora te katoa i runga i tō rātou ake tere.

Mēnā i whiwhi koe i tētahi tātā mīhini, me tango koe i te rongoā whakaheke toto mō te ora hei ārai i ngā pūtau toto. E hiahia ana tēnei ki ngā whakamātautau toto i ngā wā katoa kia mōhio ai kei te tika te taumata rongoā. Ko te tikanga kāore ngā tātā koiora e hiahia ana ki ngā whakaheke toto mō te wā roa.

Me haere hoki koe ki ngā arowhai i ngā wā katoa me tō kairangahau ngākau ki te aroturuki i te pai o te mahi a tō tātā kua whakatikahia, kua whakakapingia rānei. Ko te tikanga ka uru ēnei haerenga ki ngā echocardiograms, ā, ka iti ake pea te auau i te roanga o te wā mēnā kei te pai ngā mea katoa.

Ko te pupuri i tētahi oranga hauora ngākau ka āwhina i tō tātā hou, kua whakatikahia rānei kia roa te roa e taea ana. Kei roto i tēnei ko te kai i te kai taurite, te noho kaha tinana i runga i te tohutohu a tō tākuta, me te karo i te kai paipa.

He aha ngā āhuatanga mō ngā raruraru tātā pūkahukahu?

Ko te nuinga o ngā raruraru tātā pūkahukahu kei te noho mai i te whānautanga hei hē ngākau whānau, te tikanga i whānau mai koe me rātou. Ka puta ēnei hē i te wā o te whanaketanga o te pēpi, ā, kāore i puta mai i ngā mea i mahia e ngā mātua, i kore rānei i mahia i te wā o te hapū.

Heoi anō, he tūāhua ka piki ake te tūponotanga ki te whanake i ngā raruraru o te pūkahukahu i muri mai i te wā. Ko ngā mate o te ngākau i mua, otirā ko te kirika rūmātiki, te endocarditis rānei, ka pā ki te kiko o te pūkahukahu, ka pā ki te pai o tōna mahi i te wā.

Ko ngā tāngata i pātia i te pokanga ngākau i mua, otirā i te tamarikitanga, ka whanake pea i ngā raruraru o te pūkahukahu i te wā e pakeke ana. He mea noa tēnei ki ngā tāngata i whānau mai me ngā hē o te ngākau uaua i hiahiatia ai ngā pokanga maha.

I te nuinga o te wā, ko ētahi āhuatanga hauora pēnei i te mate carcinoid, ētahi mate autoimmune rānei, ka pā ki te pūkahukahu. Ka pā pea te rongoā iraruke ki te wāhi o te uma i ētahi wā ki ngā pūkahukahu i ngā tau i muri i te rongoā.

He pai ake te whakatika, te whakakapi rānei i te pūkahukahu?

Ko te whakatika te mea e pai ana i te nuinga o te wā ka taea, nā te mea ka pupuri koe i tō kiko pūkahukahu taketake, e roa ana te wā, e mahi ana i te āhua māori atu i ngā pūkahukahu hanga. Kāore hoki ngā pūkahukahu kua whakatikahia e hiahiatia te rongoā whakaheke toto i te nuinga o ngā wā.

Heoi anō, kāore e taea te whakatika i ngā wā katoa mēnā kua nui rawa te kino, te hē rānei o te pūkahukahu. I ēnei wā, ka hiahiatia te whakakapi hei whakahoki i te mahi tika o te ngākau. Ka āta arotake tō tākuta pokanga i tō āhuatanga motuhake hei whakatau ko tēhea kōwhiringa e whai hua ana i te wā roa.

Ka whakawhirinaki hoki te whakatau ki tō tau, tō oranga, me ētahi atu āhuatanga hauora. Ka nui ake pea te hua o ngā tāngata e tamariki ana i te whakatika ka taea, i te wā e pai ana pea ngā tāngata pakeke ki tētahi kōwhiringa i runga i ō rātou āhuatanga.

Ka kōrero tō rōpū pokanga i ngā painga me ngā ngoikoretanga o ia huarahi i runga i tō keehi takitahi. He pai rawa ngā reiti angitu o ngā tikanga e rua ka mahia e ngā tākuta pokanga ngākau whai wheako.

He aha ngā raruraru ka puta mai i ngā raruraru o te pūkahukahu?

Ki te kore e rongoatia ngā raruraru o te pūwaha pūkahukahu, ka puta he raruraru nui i te roanga o te wā. Ko te raruraru tino noa ko te rahunga o te ngākau matau, ka whānui, ka ngoikore te taha matau o tō ngākau i te kaha o te mahi ki te pūhi i te toto mā te pūwaha hē.

Ka puta pea ngā manawataki hē o te ngākau e kīia ana ko te arrhythmia, ka puta ai te pā o te ngākau, te whanoke, te ngaro rānei. Ka puta ēnei raruraru manawataki nā te mea ka pōuri te uaua o te ngākau, ka raru te pūnaha hiko.

Ko ētahi atu raruraru ka puta:

• Te kore e kaha ki te whakakori tinana me te tino ngenge
• Te kohikohi wai i ō waewae, te puku, te pūkahukahu rānei
• Te hanga o ngā toto toto i roto i ngā ruma ngākau kua whānui
• Te mate ohorere o te ngākau i ngā wā onge, tino nui

Ko te rongo pai, ka taea te ārai, te whakahoki rānei i ēnei raruraru mā te rongoā i te wā tika. Mā te aroturuki i ngā wā katoa e tō tākuta ngākau e āwhina ana ki te hopu i ngā raruraru i te wā wawe, i te wā e taea ana te rongoā.

He aha ngā raruraru ka puta i te pokanga pūwaha pūkahukahu?

Pērā i ngā pokanga nui katoa, he tūponotanga kei roto i ngā mahi pūwaha pūkahukahu, ahakoa he onge noa ngā raruraru nui ina mahia e ngā tākuta whai wheako. Ko ngā tūponotanga tonu ko te toto, te mate, me ngā urupare ki te rongoā whakamoe.

Ka pā pea te manawataki hē o te ngākau ki ētahi tāngata i muri i te pokanga, ā, ka ngaro i te wā e ora ana te ngākau. He tūponotanga iti anō o te whiu, te whakaeke ngākau rānei, ina koa ki ngā tāngata he raruraru ngākau ētahi atu, he āhuatanga tūpono rānei.

Ngā raruraru i te wā roa ka puta:

• Te kino o te pūwaha i te roanga o te wā, ina koa ki ngā pūwaha koiora
• Ngā toto toto me ngā pūwaha mīhini ki te kore e whakahaere tika ngā rongoā whakaheke toto
• Te mate o te pūwaha hanga, e kīia ana ko te endocarditis
• Te hiahia mō te pokanga anō i te wā e haere ake nei

Ka kōrerohia e tō rōpū tākuta ngā tūponotanga nei ki a koe, ā, ka whakamāramahia me pēhea te pānga ki tō āhuatanga motuhake. Ko te nuinga o te tangata e pai ana i muri i te pokanga, ā, ka kite i te whakapai ake i ō rātou tohumate me te kounga o te oranga.

Āhea au e kite ai i te tākuta mō ngā raruraru o te pūkahukahu?

Me kite koe i te tākuta mēnā ka pā ki a koe ngā tohumate e tohu ana i ngā raruraru o te pūkahukahu, ina koa he koha ngākau tūturu tō, he hītori pokanga ngākau rānei. Ko ngā tohumate noa ko te pōturi o te manawa i ngā mahi noa, te ngenge rerekē, te mamae rānei o te uma.

Ko ētahi atu tohu whakatūpato ko te ngaro o te mahara, te tata rānei ki te ngaro o te mahara, ina koa i te wā e whakakori tinana ana, e mahi ana rānei i ngā mahi tinana. Ko te pūhi i ō waewae, ō pūwaha, ō puku rānei ka tohu hoki kei te kore tō ngākau e pōmpu pai ana, ā, me arotake.

Mēnā he raruraru pūkahukahu tō, me rapu tonu koe i te āwhina hauora mēnā ka puta:

• Te pōturi o te manawa nui, te uaua rānei ki te manawa
• Te mamae o te uma e kore e ngaro i te okiokinga
• Ngā manawataki ngākau rerekē, tino tere rānei
• Ngā tohu o te mate, pēnei i te kirika, ina koa he tātāi tō

Me pupuri e te hunga whai koha ngākau tūturu te whai-a-roto i te tākuta ngākau i ngā wā katoa ahakoa e pai ana te āhua, nā te mea ka puta ngā raruraru i te wā. Ko te kitenga me te rongoā wawe ka arahi ki ngā putanga pai rawa atu.

Ngā pātai e pātai pinepine ana mō te whakatikatika me te whakakapi i te pūkahukahu

Q.1 He pai te pokanga pūkahukahu mō te manawanui ki te whakakori tinana?

Āe, ko te pokanga pūkahukahu te nuinga ka tino whakapai ake i te manawanui ki te whakakori tinana me te taumata pūngao whānui. He maha ngā tāngata ka kite ka taea e rātou te hoki ki ngā mahi kāore i taea e rātou mō ngā tau, tae atu ki ngā hākinakina me te whakakori tinana.

Whai muri i te pokanga angitu, ka kaha ake te papu o tō ngākau i te toto ki ō pūkahukahu, ko te tikanga ka whiwhi tō tinana i te hāora e hiahiatia ana i te wā e whakakorikori ana. Ko te nuinga o te tangata ka kite i te pai ake o te kaha ki te whakakorikori i roto i ngā marama torutoru i muri i te pokanga i te wā e ora ana tō rātou ngākau, ā, ka urutau ki te pai ake o te mahi o te tākawa.

Q.2 Ka pā te korenga o te tākawa pūkahukahu ki te korenga o te ngākau matau?

Āe, ka taea e te korenga o te tākawa pūkahukahu te arahi ki te korenga o te ngākau matau i te roanga o te wā ki te kore e rongoatia. Ki te kore te tākawa e kati tika, ka turuturu te toto ki muri ki roto i te pūpū matau, ka kaha ake te mahi, ā, ka whānui, ka ngoikore hoki.

Heoi, he tau te roa o tēnei tukanga ki te whakawhanake, ā, ka taea e te pokanga te ārai, te whakahoki rānei i ngā raruraru o te ngākau matau i te wā e mahia ana i te wā tika. Koinei te take he mea nui te aroturuki i ngā wā katoa me ngā echocardiograms mō te hunga e pā ana ki te korenga o te tākawa pūkahukahu.

Q.3 Kia pēhea te roa o te whakakapinga o te tākawa pūkahukahu?

Kei te momo tākawa i whakamahia te roanga o te whakakapinga o te tākawa pūkahukahu. Ka taea e ngā tākawa mīhini te roa i te 20-30 tau, neke atu rānei, i te wā e roa ana ngā tākawa koiora i te 10-20 tau, ahakoa he rerekē tēnei i waenga i ngā tāngata.

Me whai whakakapinga tākawa maha ngā tūroro tamariki i roto i tō rātou oranga, i te wā e hiahia ana ngā tūroro pakeke kotahi anake te whakakapinga. Ka kōrero tō tākuta i te roanga e tūmanakohia ana i runga i tō tau me te momo tākawa e tūtohutia ana mō tō āhuatanga.

Q.4 Ka taea e au te whai tamariki i muri i te pokanga tākawa pūkahukahu?

He maha ngā wāhine ka taea te whai tamariki i muri i te pokanga tākawa pūkahukahu, ahakoa me āta aroturuki te hapū e tō tākuta ngākau me tō tākuta whakawhānau. Ko ngā mea nui ko te pai o te mahi o tō tākawa me te tango rānei koe i te rongoā whakaheke toto.

Mēnā he tūāpapa miihini tō, ā, e tango ana koe i ngā rongoā whakaheke toto, ka uaua ake te whakahaere rongoā i te wā e hapū ana koe. Ka mahi tahi tō rōpū hauora kia noho hauora ai koe me tō pēpi i te wā e hapū ana koe, tae noa ki te wā whānau.

Q.5 He aha ngā mahi me karo e au i muri i te pokanga tūāpapa pūkahukahu?

I muri i te whakaoranga, ka hoki te nuinga o te tangata ki ā rātou mahi noa, tae atu ki te whakakori tinana me ngā hākinakina. Heoi, mēnā he tūāpapa miihini tō, me karo e koe ngā mahi e mōrearea ana te whara ka puta te toto nui, pērā i ngā hākinakina whakapā, i ngā mahi rānei e mōrearea ana te hinga.

Ka hoatu e tō tākuta ngā aratohu motuhake i runga i tō āhuatanga takitahi me te momo tūāpapa. He ramai te nuinga o te tangata i te iti o ngā here i te wā kua ora katoa rātou i te pokanga.