Te Whakapaipai mō te Empyema - Te Utu, Ngā Tohu, Te Whakarite, Ngā Mōrearea, me te Whakaora

Ko te decortication mō te empyema he tikanga pokanga e aro ana ki te rongoā i tētahi āhuatanga e mōhiotia ana ko te empyema, arā, ko te kohikohinga o te pupuhi i roto i te wāhi pleural—te rohe i waenganui i ngā pukahukahu me te pakitara o te uma. He maha ngā wā ka puta mai tēnei āhuatanga hei raruraru o te niumōnia, te whēwhe pukahukahu, te whara rānei o te uma, ka arahi ki te mate me te mumura. Ko te whāinga matua o te decortication ko te tango i te paparanga matotoru, muka o te kiko (te "kiri") e hanga ana i te taha o te pukahukahu nā te mate, kia taea ai e te pukahukahu te whānui katoa me te mahi tika anō.

I te wā o te tukanga tango i te kiri, ka tapahia e te taote pokanga te pakitara o te uma hei uru atu ki te wāhi pleural. Kātahi ka tangohia marietia e te taote pokanga te mea kua pangia me te kiko muka kua whanake. Ehara i te mea ka āwhina noa tēnei ki te whakakore i te mate engari ka whakahokia mai anō hoki te kaha o te pukahukahu ki te whānui me te whakawhāiti, he mea nui mō te manawa noa. Ka taea te mahi i te tukanga mā te whakamahi i te pokanga tuwhera tuku iho, i ngā tikanga iti rawa rānei e whakaeke ana, i runga i te āhua o te tūroro me te tohungatanga o te taote pokanga.

Ko te tango i te empyema i roto i te puku ka mahia i te nuinga o te wā ina kore e taea e ētahi atu maimoatanga, pērā i ngā paturopi, te tango rānei i te wai pleural, te whakatau i te mate. Mā te aro atu ki ngā take matua e puta ai te empyema, ka taea e tēnei tikanga te whakapai ake i te kounga o te oranga me te mahi manawa o te tūroro.
 

Why is Decortication for Empyema Done?

E taunakihia ana te tango i ngā rongoā mō te empyema ina kitea he tohu o te empyema kāore e pai ake i ngā maimoatanga matawhānui. Ko ngā tohu noa ko te maremare tonu, te mamae o te uma, te kirika, te uaua ki te manawa, me te ngenge. Ka pā nui ēnei tohu ki te oranga o te tūroro i ia rā, me te oranga whānui.

He maha ngā wā ka puta te empyema hei raruraru o te niumōnia, ka horapa te mate ki te wāhi pleural, ka hua ake te kohikohinga o te pus. Ko ētahi atu take ko ngā whēwhe o te pukahukahu, te mate kohi, ngā raruraru rānei i muri i te pokanga. Ina ngana te tinana ki te whawhai ki te mate, ka hua ake he paparanga matotoru, he muka e karapoti ana i te pukahukahu, ka aukati i tōna nekehanga, ā, ka puta ake ngā raruraru anō.
 

Ko te whakapaipai i te nuinga o te wā ka tūtohutia ina:

• Kāore i angitu ngā maimoatanga matawhānui: Mena kāore e ranea te mate i ngā paturopi me ngā tikanga tango wai, pērā i te thoracentesis, te whakatakotoranga ngongo uma rānei, ki te hoki mai anō te empyema, me pokanga pea.
• Te Empyema Mau tonu: Ki te pāngia ngā tūroro e te empyema mau tonu, arā, kua roa te mate e pāngia ana, tērā pea ka matotoru te kiri pleural e hiahiatia ana te tango pokanga hei whakaora i te mahi a ngā pukahukahu.
• Nga Tohu Nui: Ko ngā tūroro e pāngia ana e te uaua o te manawa, e te ngoikore nui rānei o te mahi a ngā pukahukahu, ka whai hua pea i te rongoā whakakore i ngā tohu me te whakapai ake i te kounga o ō rātou oranga.
• Nga kitenga whakaahua: Tērā pea ka kitea he empyema kua kitea i roto i te uma mā te hihi-X, mā te matawai CT rānei, e tohu ana kei te mau te pūkahukahu i roto i ngā pute i roto i te wāhi pleural. Tērā pea ka hiahiatia he pokanga hei whakakore i te mate.

Mā te tango i te empyema, ko te whāinga a ngā kaiwhakarato hauora he whakakore i te pūtake o te mate, he whakaora i te mahi a ngā pukahukahu, ā, hei whakapai ake i te hauora me te oranga whānui o te tūroro.
 

Indications for Decortication for Empyema

He maha ngā āhuatanga haumanu me ngā kitenga tātaritanga e tohu ana i te hiahia mō te tango i te empyema. He mea nui te mārama ki ēnei tohu mō ngā tūroro me ngā kaiwhakarato hauora ki te whakatau i te huarahi mahi tika. Anei ngā tohu matua mō tēnei tikanga pokanga:

• Empyema pumau, e hokihoki ana rānei: Mena kua tāpaetia he empyema kei te tūroro, ā, kāore e pai ki te rongoā paturopi, ki ngā tikanga tango wai rānei, me tango pea he rongoā whakakore i te paitini. He pono rawa tēnei mō ngā tūroro e pāngia ana e ngā wā empyema ana ahakoa te maimoatanga.
• Nga Tohu Maamaa: Ko ngā tūroro e pāngia ana e ngā tohu mau tonu e pā ana ki te empyema, pērā i te maremare tonu, te mamae o te uma, me te uaua ki te manawa, ka taea te whakamahi hei rongoā mō te decortication. Ka pā kino pea ēnei tohu ki te kounga o te oranga o te tūroro, ā, ka tohu pea kāore anō kia ea te mate.
• Hua Atahanga: Mā ngā whakaahua tātaritanga, pērā i ngā hihi-X o te uma, ngā karapa CT rānei, ka kitea te kiri pleural matotoru, te empyema rānei kua kitea. E whakaatu ana ēnei kitenga kāore i te kitea noa te mate engari he uaua hoki nā te hanganga o te kiko muka e aukati ana i te whānui o te pukahukahu.
• Te korenga o ngā wawaotanga kore-pokanga: Mena kāore i taea e ngā wawaotanga kore-pokanga, pērā i te tango i te wai i roto i te ngongo o te uma, te thoracentesis rānei, te tango tika i te empyema, ki te kohia anō rānei te wai, me tango pea te kiko muka hei tango i te kiko me te whakahaere i te mahi tika o ngā pukahukahu.
• Te mamae o te manawa: Ko ngā tūroro e pāngia ana e te uaua o te manawa nā te empyema, me pokanga wawe pea. Ka taea e te decortication te āwhina i te whakamamae i ngā tohu me te whakapai ake i te mahi a ngā pukahukahu, ka whakaora i te tūroro.
• Nga Tikanga o raro: Ko ētahi āhuatanga hauora matua, pērā i te ngoikore o te pūnaha ārai mate, ngā mate pūkahukahu mau tonu rānei, ka piki ake te mōrearea o te whakawhanake i te empyema me te whakauaua i tōna maimoatanga. I roto i ēnei āhuatanga, ka whakaarohia pea te tango i te rongoā hei ārai i ngā raruraru anō me te whakapai ake i te hauora whānui o te tūroro.

Mā te tautuhi i ēnei tohu, ka taea e ngā kaiwhakarato hauora te whakatau whai whakaaro mō te hiahia o te tango i te empyema, kia mōhio ai ka whiwhi ngā tūroro i te tiaki tika me te wā tika.
 

Types of Decortication for Empyema

Ahakoa kāore anō kia tautuhia he momo momo decortication mō te empyema, ka taea te whakatata atu ki te tikanga i roto i ngā huarahi rerekē i runga i te āhua motuhake o te tūroro me te tohungatanga o te taote pokanga. Ko ngā tikanga matua e rua e whakamahia ana i roto i te decortication ko:

• Whakatuwheratanga Whakapaipai: Ko tēnei tikanga tuku iho ko te tapahi i tētahi tapahi nui ake i te pakitara o te uma kia uru tika atu ai ki te wāhi pleural. Ka tangohia e te taote pokanga te rauemi pangia me te kiko muka e karapoti ana i te pukahukahu. Mā te whakakorenga tuwhera ka taea te tiro whānui i te kōhao pleural, ā, he maha ngā wā ka whakamahia i roto i ngā take uaua ake e hiahiatia ana te tango whānui i te kiko.
• Te Whakapaipai i te Pokanga Uma Āwhina Ataata (VATS): Ka whakamahia e tēnei tikanga iti rawa te whakaekenga he tapahi iti me te kāmera hei ārahi i te taote pokanga ki te tango i te kiko pangia. Ko te tikanga, he iti ake te mamae i muri i te pokanga, he poto ake te wā whakaora, ā, he iti ake te kiriuhi i te wā e whakamahia ana te VATS decortication, ki te whakatauritea ki te decortication tuwhera. He pai ake tēnei tikanga mō ngā tūroro he iti ake te horapa o te mate, mēnā rānei he wheako tō te taote pokanga ki tēnei tikanga.

Ko te whāinga o ngā huarahi e rua ko te tango i te kiko muka me te pupuhi mai i te wāhi pleural, kia taea ai e te pukahukahu te whānui anō me te mahi tika. Ko te whiriwhiri i te tikanga e whakawhirinaki ana ki ngā āhuatanga maha, tae atu ki te whānuitanga o te empyema, te hauora whānui o te tūroro, me te hiahia o te taote pokanga.

Hei whakamutunga, he tikanga pokanga nui te tango i te paru mai i te empyema, e aro ana ki ngā raruraru e puta mai ana i te empyema, e whakaora ana i te mahi a ngā pukahukahu, e whakapai ake ana hoki i te kounga o te oranga o ngā tūroro. Mā te mārama ki te tikanga, ōna tohu, me ngā huarahi rerekē ka taea e ngā tūroro te whakatau whai whakaaro mō ā rātou whiringa maimoatanga.
 

Contraindications mo Whakapaipai mo Empyema

Ko te decortication mō te empyema he tikanga pokanga e aro ana ki te tango i te kiriuhi pleural matotoru ka puta mai i te mate, i te mumura rānei i roto i te wāhi pleural. Ahakoa he whakaora ora tēnei tikanga, ā, he whakapai ake i te kounga o te oranga mō te tini o ngā tūroro, tera pea ētahi āhuatanga me ngā āhuatanga e kore ai e tika te tango decortication mō te tūroro. He mea nui te mārama ki ēnei contraindications mō ngā tūroro me ngā kaiwhakarato hauora.

• Nga mate kino: Kāore pea ngā tūroro e pāngia ana e ngā raruraru hauora nui, pērā i te mate manawa kino, te mate huka kāore i te taea te whakahaere, te mate pūkahukahu kua horapa haere rānei, e aro atu ki te ahotea o te pokanga. Ka taea e ēnei āhuatanga te whakanui ake i te mōrearea o ngā raruraru i te wā me muri i te pokanga.
• Te Mahi Kino o te Pūkahukahu: E ai ki ngā whakamātautau mahi a ngā pūkahukahu, ko te hunga kua tino ngoikore te mahi a ō rātou pūkahukahu, kāore pea i te pai mō te whakakore i te manawa. Ka taea e te pokanga te whakararu i te mahi manawa, ka puta ai ngā raruraru pēnei i te ngoikore o te manawa.
• Mate Kore-Whakahaeretia: Mena he mate puku hohe, kāore i te whakahaeretia, kua horapa ki tua atu i te wāhi pleural, kāore pea e tika ana te mahi tango i te waikura. Ka uaua ake te whakaora i te noho mai o te mate pūnaha, ā, ka nui ake te tūponotanga o te sepsis.
• Te kino: Kāore pea ngā tūroro e mōhiotia ana he mate pukupuku kei roto i te wāhi pleural, i ngā hanganga huri noa rānei, e whai hua mai i te decortication. I roto i ēnei āhuatanga, me huri pea te arotahi ki te tiaki mamae kaua ki te pokanga.
• Ngā Piringa, te Fibrosis rānei: Ka uaua pea te mahi mēnā he nui ngā piri, he nui rānei te fibrosis i roto i te wāhi pleural. Mēnā he matotoru rawa te pleura, he piri rānei ki ngā hanganga e karapoti ana, tera pea he uaua ki te mahi haumaru i te tango i ngā paitini.
• Manakohanga Tūroro: Tērā pea ētahi tūroro e whiriwhiri kia kaua e pokangahia nā runga i ō rātou ake whakapono, i te wehi mō te tikanga, i ngā āwangawanga rānei mō te whakaoranga. He mea nui te whakaae whai muri i te mōhio, ā, me whakaute te mana motuhake o te tūroro.
• Whakaarohia te pakeke: Ahakoa ehara te pakeketanga anake i te mea tino ārai, tera pea he nui ake te tūponotanga o ngā raruraru ki ngā tūroro kaumātua. Me arotake pai tō rātou hauora whānui me te āhua mahi i mua i te haere tonu.
• Te nui: Ka taea e te momona nui te whakararuraru i te urunga ki te pokanga, me te whakanui ake i te mōrearea o ngā raruraru muri i te pokanga, pērā i ngā mate pukupuku me ngā raruraru manawa.
• Nga mate o te Coagulation: Tērā pea ka nui ake ngā mōrearea o ngā tūroro e pāngia ana e te mate toto, e te hunga rānei e rongoā ana ki te rongoā ārai toto i te wā e pokanga ana. He mea nui kia ata whakahaerea ēnei āhuatanga i mua i te whakaaro ki te tango i te rongoā ārai toto.

Mā te tautuhi i ēnei ārai, ka taea e ngā kaiwhakarato hauora te aromatawai pai ake i ngā mōrearea me ngā painga o te tango i te rongoā mō te empyema, kia mōhio ai ka whiwhi ngā tūroro i te tiaki tino tika e rite ana ki ō rātou āhuatanga takitahi.
 

Me pēhea te whakarite mō te whakapaipai i te empyema

He maha ngā mahi nui hei whakarite mō te tango i te empyema kia pai ai te putanga. Me mōhio pai ngā tūroro, ā, me whai wāhi kaha hoki ki ngā whakaritenga o mua i te tikanga. Anei ngā mea hei tumanako atu:

• Whakawhitiwhitinga Mahi-mua: Ka whai kōrero taipitopito ngā tūroro ki tā rātou taote pokanga. He wāhi tēnei ki te matapaki i te tikanga, ōna painga, ngā mōrearea, me ngā mea hei tumanakohia i te wā e ora ana. Me wātea ngā tūroro ki te pātai me te whakapuaki i ō rātou āwangawanga.
• Te arotake i nga hitori o te rongoa: Ka arotakehia te hītori hauora o te tūroro. Kei roto i tēnei ko te matapaki i ngā pokanga o mua, ngā rongoā o nāianei, ngā mate pāwera, me ngā āhuatanga hauora o nāianei. He mea nui kia whakaratohia ngā mōhiohio katoa me te tika.
• Te whakamātautau tinana: Ka whakahaerehia he whakamātautau tinana whānui hei aromatawai i te hauora whānui o te tūroro me te pai mō te pokanga. Kei roto pea i tēnei ko te tirotiro i ngā tohu ora, te mahi a ngā pukahukahu, me te āhua tinana whānui.
• Whakamātautau Tātaritanga: Ka taea e ngā tūroro te whai i ētahi whakamātautau hei aromatawai i tō rātou hauora me te whānuitanga o te empyema. Ko ngā whakamātautau noa ko:
  • X-ray o te uma, te matawai CT rānei: Mā ēnei rangahau whakaahua ka taea te tirotiro i te āputa pleural me te aromatawai i te whānuitanga o te empyema.
  • Ngā Whakamātautau Toto: Mā ngā whakamātautau toto o ia rā ka tirohia te mate, te mahi a te ate me te whatukuhu, me te kaha ki te totoka.
  • Ngā Whakamātautau Mahi a te Pūkahukahu: Ka ine ēnei whakamātautau i te kaha me te mahi a te pūkahukahu, hei āwhina i te whakatau mēnā ka taea e te tūroro te aro ki te pokanga.
• Whakahaere rongoa: Me whakarerekē pea ngā tūroro i ā rātou rongoā i mua i te tikanga. Kei roto i tēnei ko te whakamutu i ngā rongoā whakaiti toto, i ētahi atu rongoā rānei ka piki ake te mōrearea o te toto. He mea nui kia whai i ngā tohutohu a te taote pokanga mō te whakahaere rongoā.
• Nga tohutohu nohopuku: Ko te tikanga ka tohutohuhia ngā tūroro kia nohopuku mō tētahi wā i mua i te pokanga, ka tīmata i te pō i mua. Ko te tikanga kia kaua e kai, e inu rānei, tae atu ki te wai, hei whakaiti i te tūponotanga o te mimiti i te wā e whakamoea ana.
• Te Whakaritenga Waka: I te mea ko te tango i ngā niho i raro i te mate whakamoe whānui te tikanga, me whai tangata hei kawe i a rātou ki te kāinga i muri i te tikanga. He mea nui kia whakaritea he pakeke whai kawenga hei āwhina.
• Whakamahere Tiaki Whaimuri-Operative: Me kōrero ngā tūroro ki tā rātou tīma hauora mō te tiaki i muri i te pokanga. Kei roto i tēnei ko te mārama ki te whakahaere mamae, te tiaki patunga, me ngā wā whakarite whai muri. Mā te whai mahere ka taea te whakamama i te manukanuka, ā, ka pai ake te whakaoranga.
• Whakarerekētanga o te oranga: Ka tohutohuhia pea ngā tūroro kia huri i te āhua noho i mua i te pokanga, pērā i te whakamutu i te kai paipa, te whakapai ake rānei i te kai totika, hei whakapai ake i tō rātou hauora whānui me te kaha ki te whakaora.

Mā te whai i ēnei mahi whakarite, ka taea e ngā tūroro te whakarite kia rite rātou mō te tango i te puku mai i te empyema, ā, ka angitu ake te mahi pokanga me te whakaoranga.
 

Te Whakapaipai mō te Empyema: Te Tukanga Hipanga-i-te-Taumata

Mā te mārama ki te tukanga taahiraa-i-te-taahiraa o te tango i te empyema ka āwhina i te whakaiti i te manukanuka me te whakarite i ngā tūroro mō ngā mea ka tūpono mai. Anei te whakamāramatanga o te tukanga:

• Whakaritenga i mua i te mahi: I te rā o te pokanga, ka tae atu ngā tūroro ki te hōhipera, ki te pokapū pokanga rānei. Ka tirohia rātou, ā, ka arotakehia e te nēhi ō rātou hītori hauora, ka whakaū i te tikanga. Ka whakatakotoria he raina werohanga (IV) hei hoatu rongoā me ngā wai.
• Whakahaere Whakamaoritanga: I mua i te tīmatanga o te tikanga, ka tūtaki te tohunga whakamoe ki te tūroro ki te matapaki i ngā kōwhiringa whakamoe. Ka whiwhi te nuinga o ngā tūroro i te whakamoe whānui, arā, ka moe rātou, ā, ka kore e mōhio i te wā e pokangahia ana. Ka aroturukihia e te tohunga whakamoe ngā tohu ora o te tūroro puta noa i te tikanga.
• Whakatūnga: Kia whakamoea te tūroro, ka whakanohoia ia ki runga i te tēpu pokanga, me te takoto ki tōna taha. Mā tēnei tūranga ka taea e te taote pokanga te uru atu ki te taha o te uma e pāngia ana.
• Werohanga: Ka tapahia e te taote pokanga te pakitara o te uma, i waenganui i ngā rara i te nuinga o te wā, kia uru atu ai ki te wāhi pleural. Ka rerekē pea te rahi me te wāhi o te tapahi i runga i te whānuitanga o te empyema me te hiahia o te taote pokanga.
• Te Tūhuratanga o te Wāhi Mamae: I muri i te tapahi, ka āta tirotirohia e te taote pokanga te wāhi pleural. Ka arotakehia e rātou te whānuitanga o te empyema, me te rapu mēnā he pleura matotoru me tetahi wai pangia e tika ana kia ringihia.
• Whakapaipai: Ko te whāinga matua o te tikanga he tango i te pleura matotoru (decortication). Ka wehea marietia e te taote pokanga te pleura mai i te kiko o raro o te pukahukahu, me whakamahi pea i ngā taputapu motuhake. He mea nui tēnei taahiraa kia taea ai e te pukahukahu te whānui me te mahi tika i muri i te tikanga.
• Te Whakatakotoranga o te Wairere: I muri i te tango i te paru, ka whakanohoia pea e te taote pokanga he ngongo uma hei āwhina i te tango i te wai me te hau e toe ana mai i te wāhi pleural. Ka noho tonu tēnei ngongo ki tōna wāhi mō ētahi rā hei whakahaere i te whakaora me te ārai i te kohikohinga wai.
• Ko te kopiri: Kia oti te mahi, ka kati te taote pokanga i te tapahi mā te whakamahi i ngā tuitui, i ngā staples rānei. Ka tāpirihia he takai parakore hei tiaki i te wāhi i pokangahia.
• Rūma Whakaora: I muri i te pokanga, ka haria ngā tūroro ki te rūma whakaora, ā, ka tirotirohia rātou i te oho ake i te wā i muri i te rongoā whakamoe. Ka tirohia ngā tohu ora i ia wā, ā, ka tīmatahia te whakahaere mamae.
• Noho hōhipera: Ka noho te nuinga o ngā tūroro ki te hōhipera mō ētahi rā i muri i te tikanga. I tēnei wā, ka aroturukihia e ngā kaiwhakarato hauora te whakaoranga, ka whakahaere i te mamae, ā, ka whakarite kia tika te mahi a te ngongo uma.
• Nga Tohutohu Tukunga: Kia tau te tūroro, kia tangohia hoki te ngongo o te uma, ka whiwhi rātou i ngā tohutohu tuku i te patunga. Kei roto i tēnei ko ngā mōhiohio mō te tiaki i te patunga, ngā here mahi, me ngā wā whakarite whai muri.

Mā te mārama ki te tukanga taahiraa-i-te-taahiraa o te tango i te empyema, ka taea e ngā tūroro te noho rite ake, me te mōhio ake ki ō rātou wheako pokanga.
 

Ngā Tūponotanga me ngā Āhuatanga Raruraru o te Decortication mō te Empyema

Pērā i ngā tikanga pokanga katoa, he tūponotanga me ngā raruraru pea kei te tango i te empyema. Ahakoa he maha ngā tūroro e mahi ana i te tikanga me te kore raruraru, he mea nui kia mōhio ki ngā tūponotanga noa me ngā tūponotanga onge. Anei tētahi tirohanga whānui:
 

• Mōrearea noa:
  • Mamae: He mea noa te mamae i muri i te pokanga, ā, ka taea te whakahaere mā te rongoā. Me kōrero ngā tūroro ki tā rātou tīma hauora mō te nui o te mamae.
  • Mate urutā: Tērā pea ka pāngia te wāhi i pokangahia ai, i te wāhi pleural rānei. Tērā pea ka tohua he rongoā paturopi hei whakaiti i tēnei mate urutā.
  • Te toto: E matapaetia ana he toto iti, engari me wawao atu pea mēnā he toto nui rawa. Ka mahi ngā taote pokanga i ngā mahi ārai hei whakaiti i tēnei mōrearea.
  • Ngā raruraru manawa: Tērā pea ka pāngia ngā tūroro e ngā uauatanga manawa mō te wā poto i muri i te pokanga, inā koa mēnā kua pāngia rātou e ngā mate pūkahukahu. Mā ngā mahi manawa me te whakaora tinana ka āwhina i te whakapai ake i te mahi a ngā pūkahukahu.
     
• Morearea Iti Ake:
  • Pneumothorax: Ka puta tēnei ina turuturu te hau ki roto i te wāhi pleural, ka pakaru pea ngā pukahukahu. Tērā pea me whai maimoatanga tāpiri, pērā i te whakatakotoranga ngongo uma.
  • Te Hanganga o te Fistula: I ētahi wā onge, ka puta pea he hononga rerekē (fistula) i waenga i te wāhi pleural me ngā hanganga e karapoti ana, ka arahi atu ki ngā raruraru.
  • Ngā raruraru o te rongoā whakamoe: Ahakoa he onge, ka puta pea ngā raruraru mai i te rongoā whakamoe, tae atu ki ngā mate pāwera, ngā raruraru manawa rānei. Ka tirotirohia paitia ngā tūroro e te tohunga rongoā whakamoe mātau.
  • Te Kotinga, te Fibrosis rānei: Tērā pea ka puta he kotinga ki ētahi tūroro i te wāhi pleural, ka pā kino ki te mahi a ngā pukahukahu, ā, me whai atu maimoatanga.
     
• Morearea onge:
  • Whara o ngā whekau: He iti noa te mōrearea o te whara o ngā whekau e karapoti ana, pērā i te pukahukahu, te ngākau, te diaphragm rānei, i te wā e whakahaerehia ana te mahi. Ka tino tupato ngā taote pokanga kia kore ai e pāngia e tēnei.
  • Te Hinga o te Mahi a ngā Pūkahukahu mō te Wā Roa: I ētahi wā, ka pāngia pea ngā tūroro e te hekenga o te mahi a ngā pūkahukahu i muri i te pokanga, inā koa mēnā he mate pūkahukahu nui tō rātou i mua.

Ahakoa he mea nui kia whakaarohia ngā mōrearea e pā ana ki te tango i te pokanga mō te empyema, he maha ngā tūroro e kite ana i ngā whakapainga nui i roto i ō rātou tohu me te kounga o te oranga i muri i te tikanga. Mā te whakawhitiwhiti kōrero tuwhera ki ngā kaiwhakarato hauora ka āwhina i te aro atu ki ngā āwangawanga me te whakarite kia mōhio pai ngā tūroro ki tā rātou haerenga pokanga.
 

Te Whakaora i muri i te Whakapaipai mō te Empyema

He wāhanga nui te whakaoranga mai i te tango i te pokanga mō te empyema, ā, he pānga nui tēnei ki te putanga whānui o te tikanga. Ka rerekē pea te roanga o te wā whakaora e tumanakohia ana i ia tūroro, i ia tūroro, engari i te nuinga o te wā, ka taea e ngā tūroro te tumanako kia noho ki te hōhipera mō te 5 ki te 7 rā i muri i te pokanga. I tēnei wā, ka aroturukihia e ngā kaiwhakarato hauora ngā tohu ora, ka whakahaere i te mamae, ā, ka whakarite kia tika te mahi a ngā pukahukahu.

Kia tukuna ki te hōhipera, ka haere tonu te whakaora a ngā tūroro ki te kāinga. He mea nui ngā wiki tuatahi mō te whakaora, ā, me ata noho ngā tūroro. Ko te nuinga o te tangata ka hoki ki ngā mahi māmā i roto i ngā wiki e 2 ki te 4, engari me karo i ngā mahi uaua ake, pērā i te hiki taumaha, te whakakori tinana kaha rānei, mō te iti rawa o te 6 ki te 8 wiki.
 

Ko nga tohutohu tiaki muri ko:

• Whakahaere mamae: Whaia te mahere whakahaere mamae kua whakaritea. Ka tūtohuhia nga rongoa mamae i runga i te kaute, engari me korero tonu ki to taakuta i mua i te tango rongoa.
• Tiaki Taonga: Kia ma, kia maroke hoki te wāhi i pokangahia. Whāia ngā tohutohu a tō taote pokanga mō ngā whakawhiti kakahu me ngā tohu o te mate hei tirotiro māu, pērā i te whero haere, te pupuhi, te rere rānei o te wai.
• Nga Mahi Manawa: Whakamātauria ngā mahi manawa hōhonu e ai ki ngā tohutohu a tō kaiwhakarato hauora. Ka āwhina tēnei ki te whakawhānui i ngā pukahukahu me te ārai i ngā raruraru pēnei i te niumōnia.
• Kaikai: Kia mau ki te kai taurite te nui o te pūmua, te huaora, me te kohuke hei tautoko i te whakaora. He mea nui ano te noho wai.
• Whakaritenga Whaiwhai: Haere ki ngā wā tirotiro katoa kua whakaritea hei aroturuki i te ahunga whakamua o te whakaora me te aro turuki i ngā āwangawanga e pā ana ki tēnā.
• Nga Rahui Mahi: Āta karohia ngā mahi ka taea te whakararu i te uma, pērā i te hiki taumaha, ngā hākinakina taumaha rānei, kia whakaaetia rā anō e tō tākuta.

Mā te piri ki ēnei aratohu, ka taea e ngā tūroro te whakahaere i te tukanga whakaora maeneene ake, me te hoki mārire ki ā rātou mahi o ia rā.
 

Ngā Hua o te Whakapaipai mō te Empyema

He maha ngā whakapainga hauora matua me ngā putanga kounga o te oranga ka tukuna e te decortication mō te empyema. Ko te whāinga matua o tēnei pokanga ko te tango i te paparanga pleural matotoru e aukati ana i te whānui o te pukahukahu, kia pai ake ai te mahi a te pukahukahu. Anei ētahi o ngā painga nui:

• Kua Pai ake te Mahi Pukahukahu: Mā te tango i te paparanga muka e karapoti ana i te pukahukahu, ka taea e te decortication te whānui katoa o te pukahukahu, ka whakapai ake i te mahi manawa. He maha ngā wā ka pāngia ngā tūroro e te hekenga nui o te manawa poto me te pikinga o te kaha o te pukahukahu whānui.
• Te mamae mamae: He maha ngā tūroro e kī ana kua heke te mamae o te uma i muri i te tikanga. Mā te tango i te kiko pleural kua pangia ka whakaiti i te pēhanga ki runga i ngā pukahukahu me ngā hanganga e karapoti ana, ā, ka pai ake te whakaoranga.
• Kua Whakaitihia te Morearea o nga Poauauautanga: Ka āwhina te decortication ki te ārai i ngā raruraru anō e pā ana ki te empyema, pērā i te mate pūmau, te whanaketanga rānei o ngā whewhe pūkahukahu. Mā te aro ki te take matua, ka taea e ngā tūroro te karo i ngā raruraru hauora kino ake ā muri ake nei.
• Te Kounga o te Ora: I te pai ake o te mahi a ngā pukahukahu me te whakaiti i te mamae, ka kitea e ngā tūroro he tino pai ake te kounga o ō rātou oranga whānui. Ka taea e rātou te whai wāhi atu ki ngā mahi o ia rā me te ngāwari ake, me te whai oranga kaha ake.
• He poto ake te noho i te hohipera: Ki te whakaritea ki ētahi atu maimoatanga mō te empyema, ka roa ake pea te noho hōhipera me te tere ake te wā whakaora nā te decortication, ā, ka taea ai e ngā tūroro te hoki wawe ki ō rātou oranga noa.

I te nuinga o te wā, he kōwhiringa pokanga whai hua te tango i ngā niho pakaru (decortication) mō te empyema, ā, ka taea e tēnei te whakapai ake i te hauora me te kounga o te oranga mō ngā tūroro e pāngia ana e tēnei mate.
 

Te Whakapaipai i te Empyema me te Pokanga Ataata-Āwhina mō te Tātaritanga o te Uma (VATS)

Ahakoa he tikanga noa te tango i ngā mea e hiahiatia ana mō te empyema, ko tētahi atu huarahi ko te Pokanga Ataata-Āwhina i te Tākihi (VATS). Ko te whāinga o ngā tikanga e rua he rongoā i te empyema, engari he rerekē te huarahi me te tikanga. Anei te whakataurite i ngā mea e rua:

Āhuahira	Te whakapaipai mō te Empyema	Taapiri Ataata-Awhina Thoracoscopic (VATS)
Tikanga Haparapara	Tuwhera tuwhera	Iti invasive
Te wa whakaora	Roa ake (5-7 ngā rā i te hōhipera)	Poto ake (2-4 rā i te hōhipera)
Taumata mamae	Te nui ake o te mamae i muri i te pokanga	Te mamae o raro i muri i te mahi
Tuiri	Te tapahi nui ake	Nga waahi iti ake
Ngā uaua	He nui ake te tupono o nga raruraru	He iti ake te tupono o nga raruraru
Tuhinga	Empyema kino me te pleura matotoru	Ngā mate empyema o te wā tōmua, ngā mate iti iho rānei te kino

 

Te utu mō te whakapaipai i te Empyema i Inia

Ko te utu mō te tango i te empyema i Inia kei waenganui i te ₹1,00,000 ki te ₹2,50,000. Ka rerekē pea tēnei utu i runga i te hōhipera, te tohungatanga o te taote pokanga, me te āhua motuhake o te tūroro. Mō te whakatau tata tika, whakapā mai ki a mātou i tēnei rā.
 

Ngā Pātai Auau mō te Whakapaipai i te Empyema

He aha taku e kai ai i mua atu, ā, i muri i te pokanga? 

I mua i te pokanga, arotahi ki tētahi kai taurite e whai kiko ana i ngā hua rākau, ngā huawhenua, me ngā pūmua kikokore. I muri i te pokanga, kia mau tonu ki tētahi kai ōrite, engari ko te mea nui ko ngā kai he nui te pūmua hei āwhina i te whakaora. Kia mau te wai, ā, karohia ngā kai taumaha, hinuhinu ka pā kino ki tō puku.

Kia pehea te roa ka noho ahau ki te hohipera? 

Ko te nuinga o ngā tūroro e noho ana i te hōhipera mō te 5 ki te 7 rā i muri i te tango i te rongoā. Tērā pea ka rerekē te roa o tō noho i te hōhipera i runga i te ahunga whakamua o tō whakaoranga me ngā raruraru ka puta mai.

Ka taea e au te tango i aku rongoa i mua i te pokanga? 

Kōrero ki tō tākuta mō ō rongoā auau. Me whakamutu, me whakarerekē rānei ētahi rongoā i mua i te pokanga, inā koa ngā rongoā whakaiti toto, ngā rongoā rānei e pā ana ki te toto toto.

He aha nga tohu o te mate me titiro ahau? 

Kia mataara ki te whero haere, ki te pupuhi, ki te rere rānei i te wāhi i pokangahia, ki te kirika, ki te makariri, ki te mamae kino rānei. Mēnā ka kite koe i tētahi o ēnei tohu, whakapā atu ki tō kaiwhakarato hauora tonu atu.

Ahea ahau ka hoki mai ki te mahi? 

Ka taea e te nuinga o ngā tūroro te hoki ki ngā mahi māmā i roto i ngā wiki e 2 ki te 4 i muri i te pokanga. Heoi, ki te mea he mahi taumaha, he mahi uaua rānei tāu mahi, me tatari pea koe mō ngā wiki e 6 ki te 8, kia whakaaetia rānei e tō tākuta.

He herenga mo te korikori tinana i muri i te pokanga? 

Āe, karohia te hiki taumaha, te whakakori tinana kaha, me ngā mahi taumaha mō te iti rawa 6 ki te 8 wiki i muri i te pokanga. E akiakihia ana te hikoi mārie me ngā mahi māmā hei whakatairanga i te tohanga toto me te whakaora.

Me pehea taku whakahaere i te mamae i muri i te pokanga? 

Whāia te mahere whakahaere mamae a tō tākuta, tae atu ki ngā rongoā kua tohua, ngā rongoā mamae rānei e hokona kore utu ana. Whakamahia he putea hukapapa ki te wāhi pokanga hei āwhina i te whakaiti i te pupuhi me te mamae.

Me aha ahau mēnā ka pāngia ahau e te poto o te manawa i muri i te pokanga? 

Ki te pāngia koe e te poto o te manawa, whakapā atu ki tō kaiwhakarato hauora tonu. He tohu pea tēnei o tētahi raruraru e tika ana kia arohia.

Ka taea e au te taraiwa i muri i te pokanga? 

Ko te tikanga kia kaua e taraiwa mō te iti rawa i te rua wiki i muri i te pokanga, kia mutu rā anō rānei te tango i ngā rongoā mamae ka pā kino ki tō kaha ki te taraiwa haumaru.

He haumaru te mahi i tēnei tikanga mō ngā tūroro kaumātua? 

Ae, ka taea e ngā tūroro kaumātua te tango i te rongoā mō te empyema me te kore e manukanuka, engari me whai aromatawai tāpiri i mua i te pokanga me te tiaki i muri i te pokanga kia pai ai te ora.

He aha te tukanga tukunga hōhipera noa? 

I mua i te tukunga atu ki te hōhipera, ka whakarite tō tīma hauora kei te ora tonu koe, ka hoatu he tohutohu mō te tiaki i te kāinga, ā, ka whakaritea he wā tirotiro. Ka whiwhi hoki koe i ngā mōhiotanga mō te whakahaere i te mamae me te kite i ngā tohu o ngā raruraru.

Kia pēhea te roa me tango e au ngā paturopi i muri i te pokanga? 

Ka rerekē te roa o te rongoā paturopi i runga i tō āhua me te mate. Ma tō tākuta e tohutohu te roa me haere tonu te tango i ngā paturopi.

Ka taea e ngā tamariki te tango i te rongoā horoi o te puku mō te empyema? 

Āe, ka taea e ngā tamariki te mahi i tēnei tikanga mēnā e tika ana. Tērā pea ka hiahiatia he tiaki motuhake me te aroturukitanga mō ngā tūroro tamariki i te wā o te pokanga, ā, i muri hoki i te pokanga.

He aha ngā mōrearea e pā ana ki te whakapaipai? 

Kei roto i ngā mōrearea ko te toto, te mate pāwera, me ngā raruraru e pā ana ki te rongoā whakamoe. Kōrerohia ēnei mōrearea ki tō kaiwhakarato hauora kia mārama ai koe ki te pānga ki tō āhuatanga.

Ka hiahia ahau ki te rongoa tinana i muri i te pokanga? 

Tērā pea ka whai hua ētahi tūroro i te whakaora tinana hei whakapai ake i te mahi a ngā pukahukahu me te whakaora whānui. Ka arotakehia e tō tākuta ō hiahia, ā, ka tukuna koe mēnā e tika ana.

Me pehea taku tautoko i taku whakaoranga i te kainga? 

Kia arotahi ki te kai totika, kia noho wai, kia whai i ngā tohutohu a tō tākuta, me te mahi i ngā mahi māmā e whakaaetia ana. He mea nui hoki te okiokinga mō te whakaora.

He aha mehemea he ahua o mua ahau? 

Me whakamōhio atu ki tō kaiwhakarato hauora mō ngā mate kua pā ki a koe, nā te mea ka pā pea ēnei ki tō pokanga me tō whakaoranga. Mā tō rōpū hauora e whakarite tō tiaki kia rite ki tēnā.

Ahea ahau e whakarite ai i taku hui whai ake? 

Ko ngā wā tirotiro whai muri ka whakaritea i roto i te 1 ki te 2 wiki i muri i te pokanga. Ka hoatu e tō tākuta he tohutohu motuhake mō te wā e hoki mai ai koe ki te aromatawai.

Ka taea e au te tango i ngā tāpiringa otaota i mua atu, i muri rānei i te pokanga? 

Me kōrero ki tō tākuta i mua i te tango i tētahi atu rongoā, nā te mea ka taunekeneke pea ētahi me ngā rongoā, ka pāngia rānei tō oranga.

Me aha ahau mēnā he āwangawanga kei ahau i te wā e ora ana? 

Mena he āwangawanga āu, he tohu rerekē rānei kei te pā mai i a koe i te wā e ora ana koe, kaua e mangere ki te whakapā atu ki tō kaiwhakarato hauora mō ngā aratohu me ngā tautoko.
 

Opaniraa

He tikanga pokanga nui te tango i te paru mai i te puku, ka taea ai te whakapai ake i te mahi a ngā pukahukahu, te whakaiti i te mamae, me te whakapai ake i te kounga o te oranga mō ngā tūroro. He mea nui te mārama ki te tukanga whakaora, ngā painga, me ngā mōrearea pea hei whakatau whai whakaaro mō tō hauora. Mena kei te whakaaro koe, kei te whakaaro rānei tētahi o tō whanaunga ki tēnei tikanga, he mea nui kia kōrero koe ki tētahi tohunga hauora ka taea te tuku tohutohu me te tautoko whaiaro e hāngai ana ki ō hiahia.