Hoʻoponopono aneurysm aorta ʻōpū - wehe

Wehe i ka ʻōpū aortic aneurysm (AAA) kahi hoʻoponopono e hoʻoponopono i kahi ʻāpana ākea i kāu aorta. Kapa ʻia kēia he aneurysm. ʻO ke aorta ka aʻa nui e hāpai i ke koko i kou ʻōpū (ʻōpū), pelvis, a me nā wāwae.

ʻO kahi aneurysm aortic ke hele a nui a ʻāpana o kēia aʻa a i waho o nā pāʻū.

E mālama ʻia ke kaha ʻana i kahi keʻena hana. Hāʻawi ʻia ʻoe i ka anesthesia laulaha (e hiamoe ʻoe a ʻaʻohe ʻeha).

Wehe ʻia kāu ʻōpū iā ʻoe a hoʻololi i ka aneurysm aortic me kahi mea like me ka lole a ke kanaka i hana ai.

Eia pehea e hiki ai ke hana:

• I hoʻokahi ala, e moe ʻoe ma kou kua. E ʻokiʻoki ke kaukipoki ma waena o kou ʻōpū, mai lalo pono o ka umauma a i lalo o ka pihi ʻōpū. Kākaʻikahi, hele ka ʻoki ma ʻō o ka ʻōpū.
• I kahi ala ʻē aʻe, e moe iki ʻoe i kou ʻaoʻao ʻākau. E ʻokiʻoki ke kaukipō i kahi ʻelima a ʻeono ʻīniha (13 a 15 mau kenimika) e ʻoki ʻia mai ka ʻaoʻao hema o kou ʻōpū, e hoʻopau iki ma lalo o kāu ʻōpū.
• E pani ana kāu kaukukō i ka aneurysm me kahi ʻōmole lōʻihi i hana ʻia i ke kapa kanaka (synthetic). Humuhumu ʻia me nā humuhumu.
• I kekahi mau hihia, e hoʻoneʻe ʻia nā wēlau o kēia pahu (a i ʻole ka graft) ma o nā kīʻaha koko i kēlā me kēia ʻūlū a hoʻopili ʻia i kēlā mau mea i ka wāwae.
• Ke hoʻopau ʻia ke ʻoki, e nānā ʻia kou mau wāwae e ʻike pono he lāʻau kaʻi. ʻO ka hapanui pinepine ka hoʻāʻo ʻana o ka waihoʻoluʻu e hoʻohana ana i nā kukuna x i mea e hōʻoia ai aia ke kahe maikaʻi o ke koko i nā wāwae.
• Hoʻopili ʻia ka ʻoki me nā sutures a i ʻole staples.

ʻO ke kaha no ke kūpikipiki aneorysm aortic e lilo i 2 a 4 mau hola. Hoʻomaha hou ka hapanui o ka poʻe i loko o ke keʻena mālama nui (ICU) ma hope o ke kaha ʻana.

Hana ʻia kahi ʻoki ākea e hoʻoponopono i kahi AAA i kekahi manawa ma ke ʻano he hanana pilikia ke loaʻa ke kahe ʻana i loko o kou kino mai ka aneurysm.

Loaʻa iā ʻoe he AAA i kumu ʻole i kekahi ʻōuli a i ʻole nā ​​pilikia. Ua loaʻa paha i kāu kauka olakino ka pilikia ma hope o kāu hana ʻana o kahi ultrasound a i ʻole CT scan i hana ʻia no kekahi kumu ʻē aʻe. Aia kekahi pilikia e haki paha kēia aneurysm (haki) inā ʻaʻohe ou ʻoki e hoʻoponopono ai. Eia nō naʻe, he mea weliweli paha ke ʻoki ʻana e hoʻoponopono i ka aneurysm, kaukaʻi ʻia i kou olakino holoʻokoʻa.

Pono ʻoe a me kāu mea lawelawe e hoʻoholo inā ʻoi aku ka liʻiliʻi o ka hopena o kēia ʻoki ma mua o ka makaʻu no ka haki. ʻOi aku paha ka manaʻo o ke ʻoki kino inā ʻo ka aneurysm:

• ʻOi aku ka nui (ma kahi o 2 ʻīniha a 5 cm paha)
• Ke ulu nei me ka wikiwiki (kahi liʻiliʻi ma mua o 1/4 iniha ma luna o 6 a 12 mau mahina i hala.

ʻOi aku ka makaʻu o kēia ʻoki inā loaʻa iā ʻoe:

• Maʻi maʻi puʻuwai
• Hewa ʻole nā ​​hakuʻala
• Maʻi maʻi
• Hapa i hala
• Nā pilikia olakino ʻē aʻe

ʻOi aku ka kiʻekiʻe o nā pilikia no ka poʻe ʻelemākule.

ʻO nā pōʻino no kēlā me kēia ʻoki kino:

• Hoʻopaʻa ke koko i nā wāwae e hele paha i nā akemāmā
• Nā pilikia hanu
• Ka hōʻeha puʻuwai a i ʻole hōʻeha
• ʻO ka maʻi, e komo pū ana me nā akemāmā (pulumonia), ka mimi, a me ka ʻōpū
• Nā hopena i nā lāʻau

ʻO nā pilikia no kēia ʻoki kino penei:

• Kahe i mua o a ma hope paha o ke kaha
• Hoʻopilikia i ke aʻalolo, e hōʻeha ana i ka ʻeha a i ʻole ka helu ʻana i ka wāwae
• Poino i kou ʻōpū a i ʻole nā ​​mea pili kokoke
• Loaʻa ka loaʻa ʻole o ke koko i kahi ʻāpana o ka ʻōpū nui e lohi ai ke kahe ʻana o ke kahe i ka pahu
• ʻO ka maʻi o ke kēpau
• ʻO ka ʻeha i ka ureter, ka paipu e lawe i ka mimi mai kou puʻupaʻa i kāu pūpū
• ʻO ke kōpaʻa kīnā ʻole e paʻa mau paha
• ʻO ka hoʻoneʻe moekolohe haʻahaʻa a i ʻole hiki ʻole ke kūkulu i kūkulu
• ʻO ke koko maikaʻi ʻole i kou mau wāwae, kou mau puʻupaʻa, a i ʻole nā ​​mea ʻē aʻe
• ʻEha ʻiwi
• Wāwahi hāmama
• Nā maʻi hōʻeha

E loaʻa i kāu hōʻike i kahi hōʻike kino a loaʻa i nā hoʻokolohua ma mua o kāu ʻoki ʻana.

E haʻi mau i kāu mea hoʻolako i nā lāʻau āu e lawe nei, a me nā lāʻau, nā mea hoʻopihapiha, a me nā mea kanu āu i kūʻai ai me ka ʻole o ka lāʻau.

Inā ʻoe he puhipaka, pono ʻoe e hōʻoki i ka puhipaka ma kahi o 4 mau pule ma mua o kou ʻoki ʻana. Hiki i kāu mea hāʻawi ke kōkua.

I loko o 2 mau pule ma mua o kou ʻoki kino:

E kipa aku ʻoe me kāu mea lawelawe e hōʻoia i ka mālama maikaʻi ʻana i nā pilikia olakino e like me ka maʻi kō, ke koko kiʻekiʻe, a me nā pilikia puʻuwai a i ʻole māmā.

• Nonoi ʻia paha ʻoe e haʻalele i ka lawe ʻana i nā lāʻau i mea e paʻakikī ai ke kō ʻana o kou koko. Hoʻopili kēia i ka aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), naprosyn (Aleve, Naproxen), a me nā lāʻau ʻē aʻe e like me kēia.
• E nīnau i nā lāʻau āu e lawe ai i ka lā o kou ʻoki ʻana.
• E haʻi mau i kāu mea hāʻawi inā loaʻa ʻoe i ke anu, flu, fever, breakout herpes, a i ʻole nā ​​maʻi ʻē aʻe ma mua o kou ʻoki ʻana.

Mai inu i kekahi mea ma hope o ke aumoe o ka lā ma mua o kou ʻoki ʻana, me ka wai.

I ka lā o kou ʻoki kino:

• Lawe i nā lāʻau i kauoha ʻia iā ʻoe e lawe me kahi wahi wai ʻuʻuku.
• E haʻi ʻia ʻoe i ka wā e hōʻea ai i ka haukapila.

Noho ka hapa nui o ka poʻe i ka haukapila no 5 a 10 mau lā. Ma kahi noho ma ka haukapila, e:

• E noho i kahi keʻena mālama mālama (ICU), kahi e nānā pono ʻia ai ʻoe ma hope pono o ke kaha ʻana. Pono ʻoe i kahi mīkini hanu i ka lā mua.
• Loaʻa i kahi catheter urinary.
• E loaʻa i kahi paipu e komo i loko o kou ihu i loko o kou ʻōpū e kōkua i ka hoʻoheheʻe ʻana i nā wai no 1 a i ʻole 2 mau lā. E hoʻomaka mālie ʻoe i ka inu ʻana, a laila ʻai.
• E loaʻa ka lāʻau e mālama lahilahi ai kou koko.
• E paipai ʻia e noho ma ka ʻaoʻao o kahi moe a laila hele wāwae.
• E komo i nā stocking kūikawā i mea e pale aku ai i nā kahe koko i kou mau wāwae.
• Nīnau ʻia e hoʻohana i ka mīkini hanu e kōkua i ka hoʻomaʻemaʻe i kou mau māmā.
• E loaʻa i nā lāʻau ʻeha i loko o kou mau uaua a i ʻole i ka ākea e hoʻopuni i kāu iwi kuamoʻo (epidural).

ʻO ke ola hou ʻana no ka ʻoki ākea e hoʻoponopono i kahi aneurysm aortic e lilo i 2 a 3 mau mahina. ʻO ka hapa nui o ka poʻe e hoʻōla piha i kēia ʻoki.

ʻO ka hapa nui o ka poʻe i hoʻomaʻemaʻe i kahi aneurysm ma mua o ka haki ʻana (ruptures) he nānā maikaʻi.

AAA - wehe; Hoʻoponopono - aneurysm aortic - wehe

• Hoʻoponopono aneurysm aorta ʻōpū - wehe - hoʻokuʻu
• Ke hele nei i waho o kahi moe ma hope o ke kaha ʻana

Lancaster RT, Cambria RP. Wehe i ka aneurysms aorta ʻōpū. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 12th ed. Piladelapia, PA: Elsevier; 2017: 899-907.

ʻO Tracci MC, Cherry KJ. ʻO ke aorta. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 61.

ʻO Woo EY, Damrauer SM. ʻO nā aneurysms aorta ʻōpū: wehe i ka lāʻau lapaʻau. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 71.