ʻImi kūwaho a i ʻole ka pani ʻana

Ke loaʻa ʻoe i kahi kīʻaha puʻuwai hāmama, hana ke kaukaʻi i kahi ʻoki (incision) e holo i lalo ma waena o kou iwi iwi (sternum). Hoʻola pinepine ka ʻokiʻoki iā ia iho. Akā i kekahi manawa, aia nā pilikia e koi ai i ka lāʻau.

ʻElua mau pilikia ʻeha e hiki ke hana ʻia ma loko o 30 mau lā o ke ʻoki puʻuwai puʻuwai.

• ʻO ka maʻi i ka ʻeha a i ʻole ka iwi umauma. Hiki i nā ʻōuli ke lilo i pus ma kahi ʻokiʻoki, ke kuni, a i ʻole ke luhi a maʻi hoʻi.
• Hoʻokaʻawale ka sternum i ʻelua. Ua kūpaʻa ka sternum a me ka umauma. Lohe paha ʻoe i kahi kani kaomi ʻana i ka sternum ke hanu, ʻū, a neʻe paha.

No ka mālama ʻana i ka pōpilikia, wehe hou ka mea lapaʻau i ka wahi i hana ʻia. Hana ʻia ke kaʻina hana i ka lumi lumi. ʻO ke kauka

• Wehe i nā kaula e hoʻopaʻa pū ana i ka sternum.
• Hana i nā hoʻokolohua o ka ʻili a me nā kiko i ka ʻeha e nānā i nā hōʻailona o ka maʻi.
• Lawe i ka mea make a maʻi paha i ka ʻeha (ʻānai i ka ʻeha).
• E holoi i ka ʻeha me ka wai paʻakai (saline).

Ma hope o ka hoʻomaʻemaʻe ʻia o ka ʻeha, hiki paha i ke kaukipō ke pani i ka ʻeha a i ʻole. Hoʻopili ʻia ka ʻeha me kahi lole. E hoʻololi pinepine ʻia ka lole.

A i ʻole hiki i kāu kauka lāʻau ke hoʻohana i ka ʻaʻahu VAC (pani pani ʻia). He lole puʻupuʻu maikaʻi ʻole. Hoʻonui ia i ke kahe o ke koko a puni ka sternum a hoʻomaikaʻi i ka hoʻōla.

ʻO nā ʻāpana o ka lole VAC:

• Pahu holo
• Hoʻokiʻoki ʻia ka ʻāpana hua e kūpono i ka ʻeha
• Pahu holo
• Wehe lole i hoʻopaʻa ʻia ma luna

Hoʻololi ʻia ka ʻāpana hua i kēlā me kēia 2 a 3 mau lā.

E kau paha kāu kauka lāʻau i ka umauma ma luna ou. ʻO kēia ka mea e paʻa ai nā iwi o ka umauma.

Lawe ʻia paha he mau lā, mau pule, a i ʻole mau mahina no ka hoʻomaʻemaʻe o ka ʻeha, maʻemaʻe o ka maʻi, a me ka hoʻōla hope loa.

Ke hiki mai kēia, hiki i ke kaukipona ke hoʻohana i kahi paʻa o ka puʻupuʻu e uhi a hoʻopau i ka ʻeha. Hiki ke lawe ʻia i ka pale mai kāu puʻupuʻu, poʻohiwi, a i ʻole luna.

Loaʻa paha iā ʻoe ke mālama i ka ʻeha a me ka mālama ʻana a me nā lāʻau ʻaloʻalo.

Aia he mau kumu nui ʻelua no ka hana ʻimi ʻana a me nā kaʻina pani no ka ʻeha o ka umauma ma hope o ke kahakaha ʻana o ka puʻuwai.

• E hoʻopau i ka maʻi
• E hoʻokūpaʻa i ka sternum a me ka umauma

Inā manaʻo ka kaukōkō he maʻi kou i loko o ka ʻoki o kou umauma, hana pinepine ʻia kēia mau mea:

• Lawe ʻia nā laʻana mai ka hoʻokahe ʻana, ka ʻili, a me nā mea kiko
• Lawe ʻia kahi laʻana o ka umauma no kahi biopsy
• Hana ʻia nā hōʻike koko
• E loiloi ʻia ʻoe no ka maikaʻi o kāu ʻai ʻana a me ka loaʻa ʻana o ka momona
• Hāʻawi ʻia ʻoe i nā lāʻau ʻaloʻalo

E hoʻolōʻihi paha ʻoe i kekahi mau lā i ka haukapila. Ma hope o kēlā, e hele paha ʻoe:

• ʻO ka home a me ka ukali me kāu kauka. Hele mai paha nā kahu maʻi i kou home e kōkua me ka mālama.
• I kahi kahu hānai no ke kōkua hou ʻana e ola hou ana.

Ma kēlā me kēia wahi, loaʻa paha iā ʻoe nā lāʻau ʻalopiko no kekahi mau pule i kou neʻe (IV) a i ʻole ma ka waha.

Hiki i kēia mau pilikia ke hoʻopilikia i nā pilikia e like me:

• He paia umauma nāwaliwali
• Lōʻihi lōʻihi (mau) ʻeha
• Hoʻoemi i ka hana māmā
• Hoʻonui i ka makaʻu o ka make
• ʻO nā maʻi hou aʻe
• Pono e hana hou a hoʻoponopono hou paha i ke kaʻina hana

VAC - pani pani hakahaka - ʻeha sternal; Hoʻoiho kūlohelohe; Maʻi maʻi kūlohelohe

Kulaylat MN, Dayton MT. Nā pilikia ʻoki kino. I: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ʻO Sabiston Textbook of Surgery. 20 ouk. Piladelapia, PA: Elsevier; 2017: chap 12.

Lazar HL, Salm TV, Engelman R, Orgill D, Gordon S. Kāohi a me ka mālama ʻana i nā maʻi ʻeha sternal. ʻO J Thorac Cardiovasc Surg. 2016; 152 (4): 962-972. PMID: 27555340 pubmed.ncbi.nlm.nih.gov/27555340/.