Te Tukanga Whipple i ngā Hōhipera Apollo, Lucknow

He aha i whiriwhiri ai ngā tūroro i ngā Hōhipera Apollo, Lucknow mō te Tukanga Whipple

• He wāhanga nō tētahi o ngā rōpū hauora nui rawa atu o Āhia: I whakatūria a Apollo Hospitals i te tau 1983, ā, i tēnei rā kei te whakahaerehia e rātou he whatunga o ngā hōhipera neke atu i te 70 me ngā moenga neke atu i te 10,000 me ngā tākuta neke atu i te 12,000 puta noa i Īnia, e hoatu ana ki te wāhanga o Lucknow te urunga atu ki ngā tikanga ā-rōpū, ngā whakaaro o te poari pukupuku me ngā huarahi whakaaro tuarua.
• Ngā tīma pokanga gastroenterology me te GI oncology kua whakatapua: Ko te tikanga Whipple i ngā Hōhipera Apollo Lucknow i whakamaheretia e tētahi rōpū honohono o ngā taote pokanga GI me HPB (hepato-pancreato-biliary), ngā tohunga mate pukupuku hauora, ngā tohunga mate pukupuku iraruke, ngā tohunga gastroenterologist, ngā tohunga radiologist, ngā tohunga pathology me ngā tohunga tiaki nui, kaua e whakaritea e tētahi taote pokanga kotahi e mahi takitahi ana.
• Arotake i te poari pukupuku maha-mātauranga: Ka matapakihia ngā mate pukupuku repeure me ngā mate pukupuku periampullary i roto i tētahi hui tahi kia whakatauhia ai te whakatau i waenga i te pokanga i mua i te wā, te chemotherapy neoadjuvant i te tuatahi, te tiaki mamae rānei mā te whakaae tahi, ā, kia tuhia hoki mō te tūroro.
• Te whakawhirinaki nui me te tārua ICU: Me mātua tiaki nui i muri i te pokanga kia kore ai e tangohia te puku o te puku. Kei te hōhipera ngā moenga ICU maha-motuhake, te tautoko i te hihi-ira hei tango i ngā toto, ngā ratonga pēke toto me te tiaki ohorere 24-hāora - arā, ngā mea e toru e tino pā ana ki te haumaru i muri i tēnei pokanga.
• Te hohonutanga o te tātaritanga i mua i te pokanga: Te urunga atu ki te kawa repe taikaha-toru: CT, MRI/MRCP, ultrasound endoscopic me te biopsy ngira pai, ERCP me te stenting biliary me te PET-CT, kia taea ai te whakatau i te wāhi me te taea te tango i runga i ngā whakaahua me te kiko kaua ki te whakapae noa.
• Ngā kōwhiringa tuwhera me ngā kōwhiringa iti rawa te whakaekenga i kōrerohia: Ki te taea e te hanganga tinana, te taumata o te pukupuku me te hauora o te tūroro, ka taea te whakaaro ki ngā huarahi laparoscopic, ki te āwhina rānei a te karetao; he huarahi tino tika tonu te pokanga tuwhera, ā, he maha ngā wā e pai ake ana. He mea takitahi te kōwhiringa, ā, mā te taote pokanga e whakamārama ko tēhea e taunakitia ana me te take.
• Tautoko whakaora hanganga: Ngā tohunga kai haumanu mō te whakakapinga whākōkī repeure me te kai whai muri i te Whipple, te tiaki mate huka mō ngā raruraru huka toto hou, kino rānei, te whakaora tinana mō te whakaoho wawe me te tiaki uma, ngā tohunga mamae, me te tiaki stoma/patunga.
• Manaaki puta noa i ngā reanga: Kua whakarerekētia ngā tikanga mō ngā tūroro kaumātua he mate ngākau, he mate pūkahukahu, he mate tākihi rānei, mō ngā pakeke e mahi ana me whai mahere hoki-ki-te-mahi tūturu, ā, - i roto i ngā take onge o te pukupuku pseudopapillary totoka, te whara rānei i roto i ngā tamariki, i ngā taiohi rānei - me te whakauru pokanga me te whakamoe tamariki.
• Kei te papa āwhina inihua me te TPA: Āwhina mō te whakamanatanga mua kore moni, ngā tuhinga kaupapa CGHS/ECHS/Ayushman Bharat mēnā e tika ana, me ngā reta whakatau tata mō te inihua a te kaitukumahi, a te kamupene rānei.
• He wāhi pai mō te rawhiti me te pokapū o Uttar Pradesh: Ko Lucknow te tari korero mo nga turoro mai i Kanpur, Barabanki, Sitapur, Hardoi, Unnao, Rae Bareli, Sultanpur, Ayodhya, Gonda, Bahraich, Lakhimpur Kheri, Gorakhpur, Varanasi, Prayagraj, Jhansi me nga waahanga tata o Bihar, rohe rohe o Nepal me Uttarakhand.

Me tono tika mai i te tari i te wā e kōrerohia ai te nui o ngā kēhi, ngā wheako o ia taote pokanga me ngā tatauranga putanga o nāianei mō tēnei wāhanga. Ko ngā putanga o te pokanga repeure e whakawhirinaki nui ana ki te koiora pukupuku me te hauora o te tūroro, ā, kāore he hōhipera e taea te oati ka ora.

Overview

Ko te tikanga Whipple, e mōhiotia ana ko te pancreaticoduodenectomy, he mahi pokanga uaua e mahia ana hei rongoā i te mate pukupuku repeure me ētahi atu āhuatanga e pā ana ki te repeure, te awa waikura me te duodenum. I Apollo Hospitals Lucknow, ka aro nui mātou ki te kounga me te haumaru i roto i te tiaki pokanga, ma te whakamahi i ngā hangarau o nāianei me ngā tikanga kua whakapumautia hei mahi ki te whakatutuki i te putanga pai rawa atu mō ia tūroro. Ko tā mātou kapa o ngā taote pokanga me ngā tohunga hauora e whakapau kaha ana ki te whakarato tiaki whaiaro, koia te take e whakaarohia ai e te nuinga o ngā tūroro i te rohe a Apollo Hospitals Lucknow mō te tikanga Whipple. Me te arotahi ki te whakawhirinaki o te tūroro me te whakawhitiwhiti kōrero mārama, ko tā mātou whāinga he ārahi i a koe i roto i ia taahiraa o tō haerenga maimoatanga.

He aha te take e hiahiatia ai te tukanga Whipple

He mea nui te tikanga Whipple mō ngā tūroro kua kitea he mate pukupuku repeure, inā koa mēnā kei te rohe te puku, ā, kāore anō kia horapa ki ētahi atu whekau. Ko tēnei pokanga he tango i te pane o te repeure, te duodenum, tetahi wāhanga o te awaawa au, me te pūkahukahu i ētahi wā. Mā te tango i ēnei wāhi kua pāngia, ko te whāinga o te tikanga he tango i te kiko mate pukupuku me te whakapai ake i te matapae o te tūroro.

Haunga te mate pukupuku, ka tohua pea te tikanga Whipple mō ētahi atu āhuatanga pēnei i te pancreatitis mau tonu, ngā whēkau pancreatic, ngā pukupuku o te awaawa ampullary me te distal, ngā pukupuku duodenal, ngā pukupuku pai rānei. Ko ngā painga pea o tēnei pokanga ko te āheinga ki te whakahaere i te mate mō te wā roa, te whakaora i ngā tohu, me te whakapai ake i te kounga o te oranga. I Apollo Hospitals Lucknow, ka arotakehia e tā mātou tīma ia take me te tino tupato kia whakatauhia ai mēnā he mea tika, he mea tika hoki te tikanga Whipple mō taua tangata.

Nga Morearea o te Roa

Ka pā mai pea ngā hua kino ki te whakaroa i te tikanga Whipple. Nā te mea he maha ngā wā ka kitea te mate pukupuku repeure i te wā kua tino tawhito, mā te whakaroa i te pokanga ka taea te horapa haere o te mate, ka arahi pea ki te horapa o te mate me te whakaiti i te tūponotanga o te angitu o te maimoatanga. Hei tāpiri, ka kino haere ngā āhuatanga pēnei i te pancreatitis mau tonu i roto i te wā, ka piki ake te mamae me ngā raruraru.

He mea nui te wawaotanga wā tika. I Apollo Hospitals Lucknow, ka whakanuia e mātou te hiranga o te tautuhi wawe me te maimoatanga tere. Ka mahi tahi tā mātou tīma maha-mātauranga me ngā tūroro kia kore ai e whakaroahia te tiaki e tika ana, kia puta ai te tūponotanga pai rawa atu mō te putanga pai.

Nga Painga o te Tikanga Whiu

He maha ngā painga o te mahi Whipple, inā koa mō ngā tūroro e pāngia ana e te mate pukupuku repeure me te mate pukupuku periampullary. Ko ngā painga matua ko:

• Te tūponotanga pai rawa atu mō te whakahaere mō te wā roa: Mō te mate pukupuku repe taiaki ā-rohe, ko te tango katoa i te pukupuku me te chemotherapy te huarahi anake e ora ai mō te wā roa, ā, i ētahi wā ka ora anō hoki.
• Te whakaora tohu: He maha ngā wā ka rongohia e ngā tūroro te whakaoranga mai i ngā tohu pēnei i te jaundice, te mākati, te mamae o te puku, te ruaki mai i te aukati o te duodenum me te uaua ki te nakunaku i muri i te pokanga.
• Kua pai ake te oranga: He maha ngā tūroro e kī ana kua pai ake te kounga o te oranga i muri i te whakaoranga, kua hoki ki ngā mahi o mua, ā, kua pai ake hoki te hauora whānui.
• Tiaki matawhānui: I Apollo Hospitals Lucknow, ka whakaratohia e mātou he huarahi whānui tae atu ki te tautoko kai, te whakakapinga whākōkī, te tiaki mate huka me te whakaora i te tinana puta noa i te wā e ora ana.

Te Whakarite me te Whakaora

Ko te whakarite mō te tikanga Whipple he maha ngā mahi nui hei tautoko i te wheako pokanga maeneene me te whakaoranga.

Tohu Awhina

• Whakawhitiwhiti whakaaro: Whakaritea he hui kōrero hōhonu ki tā mātou tīma pokanga o Apollo Hospitals Lucknow hei matapaki i tō hītori hauora, tō āhua hauora o nāianei me ō āwangawanga katoa.
• Whakamātautau i mua i te pokanga: Me whakahaere i ngā whakamātautau e tika ana i mua i te pokanga, tae atu ki ngā rangahau whakaahua me ngā whakamātautau toto, hei aromatawai i tō hauora whānui me tō rite mō te pokanga.
• Ngā whakatikatika kai: Whāia ngā tohutohu kai a tō rōpū, tae atu ki tētahi kai iti-ngako, ētahi atu tāpiringa kai motuhake rānei.
• Te whakahaere rongoa: Kōrerohia ngā rongoā katoa o nāianei ki tō tākuta, i te mea me whakarerekē, me whakamutu rānei ētahi – inā koa ngā rongoā whakaiti toto, ētahi rongoā mate huka me ētahi tāpiringa otaota, ayurvedic rānei – i mua i te pokanga.

Tohu Whakaora

• Tiaki whai muri: Haere ki ngā wā tirotiro katoa kua whakaritea ki Apollo Hospitals Lucknow kia taea ai te aroturuki i te whakaoranga me te whakatika wawe i ngā āwangawanga.
• Te tīmatanga anō o ngā mahi: Tīmatahia ki ngā mahi māmā, kātahi ka whakanuia haeretia kia rite ki ngā tohutohu.
• Tautoko kai: Me mahi tahi me te tohunga kai hei whakarite i tētahi mahere kai i muri i te pokanga hei tautoko i te whakaora me te whakahaere i ngā huringa o te nakunaku.
• Tautoko kare-a-roto: Whakaarohia ngā rōpū tautoko, ngā rōpū tohutohu rānei hei āwhina i te taha kare ā-roto o te whakaoranga.

Ngā Aratohu Hauora o Nāianei kei Muri i Ēnei Whakataunga

Ko te whakamahere maimoatanga i Apollo Hospitals Lucknow e whai ana i ngā aratohu e whakaaetia ana e te ao whānui me te motu whānui, kaua ki te hiahia takitahi. Ko ngā tuhinga matua e whakamahia ana ko:

• Te Kaunihera Rangahau Hauora o Īnia (ICMR) ? He tuhinga whakaae mō te whakahaere i te mate pukupuku repeure (ICMR, raupapa tuhinga whakaaetanga ā-Motu mō te Mātiti Mate Pukupuku), e whakatakoto ana i te paerewa Īnia mō te whakarite i te wāhanga, te aromatawai i te āheinga ki te tango i te pukupuku, me te tuku atu ki ngā pokapū nui te rahinga.
• Ngā Aratohu Whakahaere mō te Mātū Mate Pukupuku ā-Motu (NCG) o Īnia, Mate Pukupuku Pancreas me te Periampullary, putanga 2024, e whakarōpū ana i ngā taunakitanga mā te taumata rauemi kia taea ai te whakamahi i roto i ngā hōhipera kāwanatanga me ngā hōhipera tūmataiti o Īnia.
• Te Rōpū Inia mō te Gastroenterology (ISG) me te Wāhanga Inia o te International Hepato-Pancreato-Biliary Association (IHPBA-Inia) ngā tauākī tūnga mō te pancreatitis mau tonu me te whakakotahitanga o te pokanga pancreatic ki ngā wāhanga he nui te rahinga me te tautoko ICU.
• Ngā Aratohu Mahi Hauora a te NCCN mō te Oncology? Pancreatic Adenocarcinoma, Putanga 1.2025, Me te Aratohu Mahi Haumanu a te ESMO mō te matepukupuku repeure (2023), e whakahuatia whānuitia ana i roto i ngā papa pukupuku o Īnia.
• Ngā aratohu a te ERAS Society mō te tiaki perioperative i muri i te pancreaticoduodenectomy (whakahoutia i te tau 2022), e tautoko ana i te whāngai wawe, te whakaoho wawe me te karo i te whakamahi i ngā ngongo nasogastric noa.
• Ngā whakamāramatanga a te Rōpū Rangahau ā-Ao mō te Pokanga Repeure (ISGPS) (ngā whakahoutanga o te tau 2016?2022) mō te fistula pancreatic i muri i te pokanga, te whakaroa i te takoto kau o te puku me te toto i muri i te tangohanga pancreatic, e whakamahia ana mō te pūrongo pono o ngā raruraru.

He aha ngā mea kua rerekē i ēnei wā tata nei

• He nui ake ngā mahi chemotherapy i mua i te pokanga: Mō ngā pukupuku tata ka taea te tango me ētahi pukupuku kua tohua ka taea te tango, e pai ake ana ngā aratohu inaianei ki te rongoā neoadjuvant chemotherapy (te FOLFIRINOX kua whakarerekētia, te gemcitabine α-nab-paclitaxel rānei mō ngā tūroro kāore i te tino ora) i mua i te mahi pokanga, kaua ki te mahi pokanga tuatahi i ia wā.
• Ngā tikanga āwhina kaha ake: Ko te FOLFIRINOX kua whakarerekētia i muri i te pokanga te mea e pai ake ana mō ngā tūroro hauora i runga i te whakamātautau PRODIGE 24/CCTG PA.6, hei whakakapi i te gemcitabine kotahi-kaihoko hei taunoa.
• Te whakamātautau ira me te whakamātautau ngota: E taunaki ana ngā aratohu ināianei kia whakamātauria te germline mō ngā tūroro katoa e pāngia ana e te adenocarcinoma pancreatic, ka taea e tēnei te whakarerekē i te kōwhiringa chemotherapy (hei tauira, te aro ki te platinum i roto i te mate e pā ana ki te BRCA) ā, he pānga anō hoki ki ngā whanaunga toto.
• He mea nui te rōrahi: Kei te piki haere te kī a ngā aratohu o Īnia me te ao whānui me mahi te pancreaticoduodenectomy i ngā pokapū he nui te nui o ngā rongoā ā-tau, he nui ngā hihi-X me ngā ratonga ICU, nā te mea ko te whakaoranga mai i ngā raruraru - ehara i te pokanga tonu - te mea e arahi ana i te mate.
• Whipple iti rawa te whakaekenga i roto i ētahi ringaringa anake: E whakaaetia ana te laparoscopic me te robotic pancreaticoduodenectomy engari he mea here noa ki ngā tīma mohio me ētahi pukupuku kua tohua; kāore te pokanga tuwhera e kiia ana he ngoikore ake.
• Te Whakaora me ngā ERAS: Ko te arotau i te kai, te whakatika i ngā raruraru e pā ana ki te kiriuhi kanohi, te whakamutu i te kai paipa me ngā mahi manawa hanganga i mua i te pokanga he wāhanga o ngā tikanga whaimana, ehara i te tohutohu kōwhiringa.

Ka huri ngā aratohu. Me matapakihia, me tuhi hoki te putanga e pā ana ki tō keehi, me ngā rerekētanga katoa i taua putanga i te wā e kōrero tahi ana koe.

Te Wā o te Pokanga me te Wāhanga o mua i te Tukanga

Kāore i te tino mahia te tikanga Whipple i te rā e whakaarohia ana. He maha ngā wā e hiahiatia ana te whakarite, arā, kotahi ki te ono wiki, ā, i ētahi wā he maha ngā marama mēnā ka tukuna tuatahitia te rongoā mate pukupuku.

Ngā Kōwhiringa Hangarau me ngā Huarahi kē atu i Whakatauritea

Ngā Tukanga e Mahihia Ana i te Wā Kotahi i Ētahi Wā

• Te laparoscopy tātaritanga, te laparoscopy whakarārangi rānei i mua tata i te whakatuwheratanga, hei whakakore i ngā putunga o te peritoneal, o te ate rānei e kore e kitea.
• Cholecystectomy ? ka tangohia te pūkahukahu hei wāhanga o te mahi noa.
• Te tango me te hanga anō i te uaua te wāhi e pā ai te puku ki te uaua mesenteric portal, ki te uaua mesenteric o runga rānei, i roto i te mate tata ka taea te tango.
• Te whakawāteatanga o ngā kōpuku lymph kua roa ake e ai ki ngā kitenga i te wā o te pokanga, i roto i ngā aratohu.
• Te koiora wāhanga-tio o ngā tawhā, ngā pona rānei i te wā pokanga hei ārahi i te nui o te mea ka tangohia.
• Te whāngai i te jejunostomy, te ngongo nasojejunal rānei i ngā tūroro e kore e kai pai ana kia taea ai te tīmata wawe i te kai.
• Te koiora ate o tētahi whara whakapae i kitea i te wā o te pokanga.
• Te whakatikatika i Hernia mēnā ka kitea he hernia pito, he hernia tapahi rānei e noho tahi ana, ā, he haumaru te whakatika.

Wāhanga-a-Waihanga Whakaora Wāhanga

He whānuitanga noa iho ēnei, ehara i te kupu whakaari. Ka taea e ngā raruraru pēnei i te turuturu o te repe taiaki, te whakaroa i te whakawātea o te puku, te mate rānei te roa ki ia wāhanga.

Te Hokinga ki te Mahi Noa, te Mahi me te Whakakorikori Tinana

Ka aromatawaihia te hokinga mai mā te mahi, ehara i te maramataka. Ngā paearu whaitake i mua i te tīmatanga anō o ia mahi:

• Te hikoi ki roto: mai i te rā tuatahi i muri i te pokanga, me te āwhina.
• Te hikoi me ngā arawhata o te whare: ina taea e koe te hikoi mō te 10-15 meneti me te kore e manawa pōuri, e whanoke rānei, i roto i te 2-3 wiki te nuinga.
• Te taraiwa i tētahi waka: ina mutu te rongoā mamae opioid kaha, ka taea te tū ohorere me te kore e tiaki i te patunga, ā, ka taea te tahuri ki te tirotiro i ngā wāhi matapo - he maha ngā wā e 4-6 wiki. Ko ngā waka wira-rua e hiahia ana kia roa ake, 6-8 wiki, nā te wiri me te mōrearea o te hinga.
• Mahi tēpu, mahi tirotiro rānei: e 6-8 wiki te roa, he wā-wāhanga i te tuatahi. Tērā pea ka taea te mahi i te kāinga i mua ake.
• Te mahi ā-ringa, te mahi mara rānei, te mahi pāmu, te utaina: ko te tikanga e 3 marama, neke atu rānei, ā, i muri i te whakawāteatanga o te pokanga anake, nā te mea he āwangawanga tūturu te whakaora o te pakitara o te puku me te mōrearea o te hernia tapahia.
• Hiki: kaua e neke atu i te 4.5 kg te taumaha mō ngā wiki e ono; kaua e whakamahia he peere wai, he ipu hau, he putea, he mokopuna rānei.
• Te tūpoupou, te noho whakawhiti waewae me te noho papa: Ka pēhia te pakitara o te puku e ēnei, ā, he maha ngā wā kāore e pai mō ngā wiki e 4-6. Whakamahia he wharepaku o te Hauāuru, he tūru wharepaku rānei i runga i te wharepaku ā-Inia mō ngā wiki tuatahi e 6-8; ka taea te reti, te hoko rānei i tētahi nohoanga teitei i te rohe.
• Te moe papa: Ko te ara ake i te moenga papa he tino kaha te whakamahi i ngā uaua o te puku. Moe i runga i te moenga mō te iti rawa o te 6 wiki, ka huri ki tō taha i mua i te ara ake kaua e noho tika.
• Ngā mahi whakapono: Me tatari te takoto i te wā karakia, te piki arawhata o te temepara, te nohopuku roa me te haereere i te karakia kia whakaaetia koe e tō taote pokanga. Ko te nohopuku roa he mea kore e haumaru i muri i te Whipple nā ​​te mea he raruraru whākōkī me te huka toto? Me tono mō tētahi mahere whaiaro.
• Te whare takaro tinana, te yoga me te kaukau: te totoro mārie me te yoga manawa mai i ngā wiki e 4; te mahi i te puku, te taumaha me te kaukau i muri i ngā marama e 3 anake, ā, i muri i te ora katoa o te patunga.
• Ngā mahi moepuku: ina pai, e 4-6 wiki te roa.
• Ngā tūroro chemotherapy: Ka huri ngā whāinga mahi nā te ngenge me te iti o te tatau toto; whai i ngā tohutohu a te tīma matepukupuku mō ngā mano tini, te mōrearea o te mate me te whakapau kaha.

Te Whakaiti i te Mōrearea o te Hokinga Mai me ngā Raruraru Wā Roa

• Me whakaoti katoa te akoranga chemotherapy adjuvant mēnā kua tūtohutia - ko te whakamutu i waenganui ko tētahi o ngā take tino noa mō te hokinga wawe mai o te mate.
• Kia mau ki te kaupapa tirotiro: te arotake haumanu, te CA 19-9 me ngā karapa CT i ngā wā kua tohua e tō tākuta mate pukupuku, i ia 3-6 marama mō ngā tau 2-3 tuatahi.
• Kati te tupeka i ngā āhua katoa, tae atu ki te bidi, te khaini, te gutkha me te paan masala; ko te tupeka te tino take mōrearea ka taea te whakarerekē mō te mate pukupuku repeure. Kati rawa te waipiro.
• Whakahaerehia te mate huka kia kaha. He mea noa te tīmatanga o te mate huka hou, te kino haere rānei i muri i te Whipple, ā, me tika te rongoā insulin, rongoā rānei, kaua ki ngā rongoā kāinga.
• Me tango he rongoā whakakapinga whākōkī repe taiaki i ia kai me ia paramanawa i te horopeta kua tohua - mā te iti o te horopeta ka heke te taumaha, ka mate korere, ka kore hoki he huaora, ā, e whakapaetia hētia ana ko te mate pukupuku te take.
• Kia mau tonu ki tētahi kai nui te pūmua, arā, te tāra, te paneer, te hua manu, te ika, te heihei, te soya rānei, kia wehea kia 5-6 ngā kai iti; i te tīmatanga, whakaitihia ngā kai tino hinuhinu, parai me ngā kai tino kinaki.
• Me tirotiro i te mātotoru o te huaora D, B12, rino me te kiato o te wheua i ia wā; he mea noa te korenga o te huaora i muri i tēnei pokanga.
• Mō ngā tūroro pancreatitis mau tonu, he mea nui te kore inu waipiro me te kai paipa mō te wā katoa hei tiaki i te toenga o te pancreas.
• Mena ka whakaatuhia e te whakamātautau ira tangata he whakarerekētanga ira tuku iho, me tohutohu ki ngā whanaunga tuatahi mō te tātaritanga; kōrerohia tēnei ki tētahi kaitohutohu ira, kaua e whai i ngā tohutohu ipurangi.
• Me tere tonu te ripoata mēnā he kiriuhi waikura hou, he mamae tuara, he hekenga taumaha kāore i te mārama te take, he ruaki tonu rānei, kaua e tatari mō te wā e whai ake nei.

Tamariki, Kaumātua me Ētahi Atu Āhuatanga Motuhake

Nga tamariki me nga taiohi

He mea onge te tikanga Whipple i roto i ngā tamariki. Tērā pea ka hiahiatia mō ngā neoplasm pseudopapillary totoka o te pancreas, te pancreatoblastoma, ētahi pukupuku neuroendocrine, te whara kino rānei o te upoko duodenal me te pancreas. Me whai rongoā whakamoe tamariki ēnei take, tautoko ICU rahi tamariki me te aroturuki tipu, kai me te endocrine mō te wā roa, ā, ka whakahaerehia ngātahitia me ngā tīma pokanga tamariki me te oncology.

Nga pakeke

Ehara te pakeketanga anake i te arai. Ko te hauora tinana, te kai totika, te mahi a te ngākau, te pūkahukahu me te whatukuhu, te hinengaro me te tautoko a te whānau te mea nui atu i te maha o ngā tau. Kua whakauruhia ki roto i te mahere te aromatawai i te ngoikore, te aromatawai i te ngākau, te whakahaere āta i te wai me te mamae, te whakaoho wawe me te aukati i te pōrangi. Mō ētahi tūroro kaumātua he nui te mate tāpiri, ko te chemotherapy anake, ko te stenting whakaora rānei te whiringa haumaru me te atawhai, ā, ka kī pono te tīma.

Te mate huka, te momona me ētahi atu mate pāwera

He nui te hunga mate pukupuku repeure e mate ana i te mate huka, ā, he maha ngā wā ka hiahiatia he insulin i te taha o te pokanga. Ko te momona, te ate momona, te toto toto iti, te hypothyroidism, te hītori o te mate kohi me te mate tākihi ka whakarerekē katoa i te mahere, ā, ka arohia i mua i te rā o te pokanga.

Te whakamahere tahi a te whānau me te kaitiaki

He mahi nui tēnei, ā, he roa te wā e ora ai, ā, ko ngā whānau Inia te tikanga he mahi tahi tā rātou tiaki. Tāutuhia kia rua, neke atu rānei, ngā kaimahi ka taea te huri, ko tētahi o rātou e mārama ana ki te tūtohi rongoā. Whakaingoatia he kaikōrero mō te whānau mō ngā whakahōutanga hauora kia kore ai e whakapohehetia ngā mōhiohio puta noa i ngā whanaunga. Whakamaherehia ko wai ka whakahaere i te tunu kai ki tētahi kai kua whakarerekētia, ko wai ka whakahaere i ngā pepa inihua, ā, ko wai ka haere tahi me te tūroro mō ngā huringa chemotherapy.

Ki te kore koe e whiriwhiri kia pokanga

He whakatau tika te whakakore, te whakaroa rānei i te pokanga, ā, me whai whakaaro pai. Ko ngā hua ka puta mai i te mate e pā ana ki tēnei:

• Te mate pukupuku repeure, te mate pukupuku periampullary rānei ka taea te tango: Ki te kore e tangohia te pukupuku, ka neke te whāinga tūturu mai i te oranga mō te wā roa ki te whakahaere i te mate me ngā tohu. Ka taea e te rongoā chemotherapy te whakaroa i te whanaketanga engari he onge te whakakore i te pukupuku.
• Te aukati haere tonu: Tērā pea ka puta te kiriuhi waikura, te mākūkū, te mimi pouri, te ngoikore o te ate, te ruaki i te aukati o te duodenum me te cholangitis, ā, me whakarerekē tonu pea te stent.
• Te mamae me te whakaheke taumaha: Ka kino haere te mamae o te tuara me te puku o runga; ka puta mai te koretake o te ngongo me te cachexia. Ka taea e te tiaki mamae, te aukati io me te tautoko kai te āwhina nui.
• Pancreatitis mau tonu: te mamae tonu, te whakawhirinaki ki ngā opioid, te mate huka, te kore mimiti me te mōrearea iti o te mate pukupuku mō te wā roa.
• Ngā pukupuku i mua i te mate kino, te IPMN rānei: He mea nui tētahi mahere aroturuki kua tuhia me te whakaahua mēnā ka whakakahoretia te pokanga, nā te mea ka huri ētahi whara i roto i ngā tau.

Ki te kore koe e whakaae ki te pokanga, tonoa he mahere tuhituhi kore-pokanga e kapi ana i te tika o te chemotherapy, te stenting, te whakahaere mamae, te kai totika me te tuku tiaki whakaora. Ko te whiriwhiri i te tiaki e aro ana ki te whakamarie ehara i te mea he tuku, ā, ka tautoko te tīma i taua whakatau.

Ngā Take e Huri ai te Utu

Ka tukuna e Apollo Hospitals Lucknow he whakatau tata tuhituhi i muri i te aromatawai haumanu. Kāore he tatauranga e whakahuatia ana i konei nā te mea he whānui te whānuitanga, ā, he motuhake ki ia take. Ko ngā taurangi i raro nei ngā mea e neke ana i te tau.

Mō te hanganga mōkihi o nāianei, ngā mea kei roto me ngā mea kāore i roto, me ngā utu kaupapa e pā ana ki a koe, kōrero ki te kaiwhiwhi manuhiri, ki te kaute nama, ki te tēpu inihua rānei i Apollo Hospitals Lucknow.

Inihuarangatia, Maimoatanga Kore Moni me te Tukanga TPA i Inia

• Te whakamahere me te ohorere: He whakaurunga whakamaheretia te tikanga Whipple, nō reira me tīmata te whakamanatanga i mua i te 3-7 rā mahi i mua i te rā. He onge noa iho te puta mai i te huarahi ohorere - te whara, te cholangitis kino rānei, ā, me whakamōhio atu ki te taote i roto i ngā haora 24 o te whakaurunga.
• Ngā wā tatari: Ko te nuinga o ngā kaupapa here inihua hauora Inia he wā tatari tuatahi mō te 30 rā mō te mate, ā, he wā tatari motuhake mō te 2-4 tau mō ētahi mate kua whakarārangihia. Ka whai mana anō hoki ngā wā tatari mō ngā mate kua pā mai i mua, arā, 2-4 tau. Ko te mate pukupuku i kitea i muri i te wā tatari ka hipokina i te nuinga o te wā; ko te mate kua tuhia i mua i te tīmatanga o te kaupapa here ka kore pea e whakaurua. Tirohia te kupu tika o tō kaupapa here, kaua ko te tohutohu whānui.
• Te tukanga kore moni: Tukuna mai tō nama kaupapa here me tō kāri hiko, he ID whakaahua me ngā tuhinga haumanu a te tākuta e rongoā ana ki te tēpu inihua. Ka tukuna e te hōhipera he tono whakamanatanga mua ki te kaiinihua, ki te TPA rānei, mā rātou e tuku he reta whakaae me te nui o te moni kua whakaaetia. Ko ngā hapa, ngā taonga kore-hauora me te utu tāpiri ka whakatauhia e te whānau i te wā e tukuna ana. Ka taea te tono whakarei ake mēnā ka roa te noho, ka puta rānei he raruraru.
• Ara whakahoki moni: Mena kāore e wātea ana te kore moni, utua, ā, keremehia i muri mai. Puritia te whakarāpopototanga o te tukunga, te pire whakamutunga me te wehenga, ngā rīhiti utu katoa, ngā pūrongo tirotiro, te pūrongo histopathology me ngā tapanga tāpiringa, ngā tapanga pau rānei.
• Kāore i te nuinga o te wā e hipokina ana: Te kai me te noho a te kaimahi, te waea me te horoi kakahu, ētahi utu rēhita me te utu whakahaere, ētahi taonga pau, me ngā tāpiringa kai. Ka taea e te herenga reti rūma e hangai ana ki te ōrau me ngā wāhanga tangohanga ōrite te whakaiti i tō utu - pātai atu ki te tēpu kia whakamārama mai me pēhea te pānga o tō kōwhiringa rūma ki tēnei.
• Kāwanatanga