E ʻike e pili ana i kou kāpili ʻana o ke koko me ka hoʻāʻo D-Dimer!

Ua lohe paha ʻoe i kēia hoʻāʻo i kapa ʻia ʻo D-Dimer. A i ʻole ua haʻi aku kāu kauka iā ʻoe e hana ia mea. No laila, he aha ka D-Dimer? No ke aha he mea nui kēia hoʻāʻo? E kamaʻilio kākou e pili ana i kēia mau mea āpau me ka kikoʻī, me ka maʻalahi loa, i kēia lā. E wehewehe wau iā ia ma ke ʻano e hiki ai iā ʻoe ke hoʻomaopopo.

He aha ka D-Dimer? I ka pōkole...

E noʻonoʻo i kēia ʻano: ʻO D-Dimer kahi ʻāpana liʻiliʻi o ka protein i hana ʻia i ka wā e heheʻe ai kahi ʻūpā koko i loko o kou kino. ʻO ka maʻamau, inā ʻaʻole nui nā ʻūpā koko e hana ana i loko o kou kino, a inā ʻaʻole e heheʻe nā ʻūpā e hana ana, ʻaneʻane ʻaʻohe D-Dimer i loko o kou koko. A i ʻole aia ia i nā nui liʻiliʻi loa.

I kēia manawa, inā maikaʻi ka hopena o kāu hoʻāʻo D-Dimer a i ʻole inā kiʻekiʻe kou pae D-Dimer, hiki ke hōʻike he maʻi koko ʻoe. Eia naʻe, ʻaʻole ia he manaʻo he maʻi koko kou . Eia kekahi, ʻaʻole hiki i kahi hoʻāʻo D-Dimer wale nō ke haʻi pololei iā ʻoe i ke ʻano o ke ʻano koko ʻoe a i ʻole kahi o ke koko ʻōpū i loko o kou kino. Pono nā hoʻāʻo hou aʻe e hoʻoholo i kēlā.

Pehea e hana maoli ai ke kāpili ʻana o ke koko?

E hoʻomaopopo mua kākou i ke kaʻina hana maʻamau o ke kāpili ʻana o ke koko. ʻOiaʻiʻo, he mea nui loa ke kāpili ʻana o ke koko. Ke ʻeha ʻoe, kōkua kēia kaʻina hana i ka hoʻōki ʻana i ke kahe ʻana o ke koko. E noʻonoʻo, ke loaʻa iā ʻoe kahi ʻeha i kahi kīʻaha koko a i ʻole nā ​​​​ʻiʻo a hoʻomaka ke kahe ʻana o ke koko, hoʻomaka kou kino i kahi kaʻina hana i kapa ʻia ʻo "hemostasis". ʻO kēia ka mea e kaupalena ai i ke kahe ʻana o ke koko a hana i kahi kāpili koko e hoʻōki ai.

I loko o kēia kaʻina hana o ka "hemostasis," hana kou kino i nā kaula o kahi protein i kapa ʻia ʻo "fibrin," e hana ana i kahi ʻupena. ʻO kēia ʻupena, me kahi ʻano cell i kapa ʻia ʻo "platelet," kōkua i ka mālama ʻana i ke koko a hiki i ka wā e ho'ōla ai ka ʻeha. I kekahi manawa hiki ke ʻike ʻia kēia mau ʻupena ma ke ʻano he ʻili ma kou ʻili a i ʻole he puʻupuʻu ma lalo o kou ʻili.

Ma hope o ka ho'ōla ʻana o kou ʻeha, a ʻaʻole pono hou kou kino i ke koko, hana kou kino i kahi enzyme i kapa ʻia ʻo "plasmin" e wāwahi i ke koko i mau ʻāpana liʻiliʻi a wehe iā lākou. Ua kapa ʻia kēia mau ʻāpana he "fibrin degradation products" a i ʻole "fibrin split-products". ʻO kekahi o kēlā mau ʻāpana ua kapa ʻia ʻo D-Dimer.

Eia nō naʻe, inā he maʻi koko koko kou, hiki iā ʻoe ke loaʻa nā ʻōpū koko me ka ʻole o kahi ʻeha. A i ʻole, ʻaʻole paha e heheʻe nā ʻōpū i hana ʻia i ka wā e pono ai. I ka ʻōlelo maʻalahi, ʻaʻole hana pono ke kaʻina hana koko koko o kou kino. Hiki i kēia ʻano ʻōpū koko ke lilo i mea weliweli a hoʻoweliweli i ke ola.

No laila, ʻo ka pae kiʻekiʻe o ka D-Dimer i loko o kou koko hiki ke lilo i hōʻailona e hana nui ana kou kino a hoʻoheheʻe i nā ʻūpā koko. ʻO ia ke kumu he hōʻailona ia o kahi maʻi ʻūpā koko.

He aha ka hoʻāʻo D-Dimer i hoʻohana ʻia no ka ʻike ʻana?

Hoʻohana pinepine nā kauka i kahi hoʻāʻo D-Dimer e kōkua i ka ʻike ʻana i kahi maʻi koko koko. ʻO nā kūlana nui:

• ʻO ka Thrombosis Vein Deep (DVT) a i ʻole Venous Thrombosis: ʻO kēia ka wā e hana ʻia ai kahi clot koko i loko o kahi aa koko i loko o kou kino. Hiki i kēia clot ke ālai piha a hapa paha i ke kahe o ke koko ma o ka aa koko. ʻO ka hapa nui, ʻike pinepine ʻia ka DVT ma ka wāwae haʻahaʻa, ka ʻūhā, a i ʻole ka ʻūhā. Eia nō naʻe, hiki nō hoʻi ke hana ma nā wahi ʻē aʻe o ke kino, e like me ka lima, ka lolo, nā ʻōpū, ke akepaʻa, a i ʻole nā ​​puʻupaʻa.
• ʻO ka Pulmonary Embolism (PE): ʻO kēia ka wā e hele ai kahi ʻūpā koko i hana ʻia ma kahi ʻē aʻe o ke kino (ma ka wāwae a i ʻole ka lima) ma ke kahe koko a paʻa i loko o kahi kīʻaha koko i loko o nā māmā. He kūlana weliweli loa kēia.
• Hoʻolaha ʻia ka Coagulation Intravascular (DIC): Ma kēia kūlana, nui nā ʻōpū koko e hana ʻia i loko o kou kino . Hiki i kēia ke hōʻino i nā ʻōpū a hoʻoulu i nā pilikia koʻikoʻi ʻē aʻe. Hoʻohana ʻia ka hoʻāʻo D-Dimer ʻaʻole wale no ka ʻike ʻana i ka DIC, akā e ʻike pū i ka maikaʻi o ka hana ʻana o ka lāʻau no DIC.
• Hahau: Ma kēia kūlana, a mākou e kapa nei hoʻi he "ʻaʻa koko i loko o ka lolo," e ālai ʻia a pahū paha kekahi kīʻaha koko i loko o ka lolo.

No ke aha e pono ai iaʻu kahi hoʻāʻo D-Dimer?

Inā loaʻa iā ʻoe nā hōʻailona o ke ʻano o ke koko ʻana, hiki i kāu kauka ke kauoha i kahi hoʻāʻo D-Dimer. ʻO kēia nā hōʻailona o nā kūlana e like me `(DVT)`, `(PE)`, `(DIC)`, `(Stroke)` i ʻōlelo ʻia ma luna.

ʻO ka hapa nui o ka manawa, hana ʻia nā hoʻokolohua D-Dimer ma kahi lumi pilikia a i ʻole ka haukapila.

He aha nā hōʻailona o ka deep vein thrombosis (DVT)?

ʻO ka maʻamau, loaʻa kahi DVT i kou wāwae a lima paha. ʻAʻole loaʻa i nā kānaka a pau nā hōʻailona. Eia nō naʻe, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Ka pehu ʻana o ka wāwae a i ʻole ka lima (i kekahi manawa koke).
• ʻEha a palupalu paha ka wāwae (hiki ke ʻike wale ʻia i ke kū ʻana a i ʻole ke hele ʻana).
• He manaʻo pehu a ʻeha hoʻi ma ka wāwae a i ʻole ka lima.
• ʻUlaʻula a hoʻololi paha ke ʻano o ka ʻili.
• ʻIke ʻia nā kīʻaha koko ma lalo o ka ʻili he nui aʻe ma mua o ka maʻamau.

Inā loaʻa iā ʻoe kēia mau hōʻailona o `(DVT)`, ʻoiai inā ʻaʻole ʻoe i loko o ka haukapila i kēia manawa, e ʻike koke i kāu kauka.

He aha nā hōʻailona o ka embolism pulmonary (PE)?

He pilikia kēia. ʻO nā ʻano o kahi `(PE)` penei:

• Ka paʻakikī koke o ka hanu ʻana (dyspnea) a i ʻole ka hanu wikiwiki.
• ʻEha nui o ka umauma (ʻoi aku ka ʻino i ka wā e ʻū ai a neʻe paha).
• ʻEha hope.
• ʻŪhū (i kekahi manawa me ka huʻa koko).
• Ke hou nui nei ma mua o ka maʻamau.
• Ka wikiwiki o ka puʻuwai (tachycardia).
• Ka poniuniu a i ʻole ka māʻule ʻana.

Mea nui: Inā loaʻa iā ʻoe kēia mau hōʻailona `(PE)`, pono ʻoe e kāhea i ka 911 a i ʻole e hele koke i ka lumi pilikia kokoke loa. ʻAʻole pono e hoʻopaneʻe ʻia kēia.

He aha nā hōʻailona o ka disseminated intravascular coagulation (DIC)?

Hiki i nā hōʻailona o DIC ke komo pū me:

• Nā ʻāʻī koko.
• Ka luaʻi a me/a i ʻole ka luaʻi ʻana.
• ʻEha nui o nā ʻiʻo a me ka ʻeha o ka ʻōpū.
• Nā ʻōhūhū.
• ʻEmi ka hoʻopuka ʻana o ka mimi ma mua o ka maʻamau.

Inā ua ʻike mua ʻia ʻoe me DIC a ke loaʻa nei ka lāʻau lapaʻau, hiki i kāu kauka ke kauoha i nā hoʻokolohua D-Dimer maʻamau e nānā inā ke hana pono nei kāu lāʻau lapaʻau.

He aha nā hōʻailona o ka hahau ʻana?

He pilikia nō hoʻi ka lolo. Eia nā hōʻailona:

• Ka mae koke ʻana a i ʻole ka nāwaliwali o ka maka, ka lima, a i ʻole ka wāwae (ʻoi aku hoʻi ma kekahi ʻaoʻao o ke kino).
• Ka huikau koke, ka paʻakikī i ka ʻōlelo ʻana, a i ʻole ka paʻakikī i ka hoʻomaopopo ʻana i ka mea a kekahi e ʻōlelo nei.
• Ka paʻakikī koke i ka ʻike ʻana i kekahi a i ʻole nā ​​​​maka ʻelua.
• Ka paʻakikī koke o ka hele wāwae.
• Ka poniuniu koke, ka nalowale o ke kaulike, a i ʻole ka nalowale o ka hoʻonohonoho ʻana.
• He ʻeha poʻo nui e hiki koke mai ana me ke kumu ʻole.

He mea nui loa: Inā ʻike ʻoe a i ʻole kekahi i kēia mau hōʻailona o ka hahau ʻana , pono ʻoe e kāhea i ka 911 a i ʻole e hele koke i ka haukapila kokoke loa. He mea nui ka manawa.

ʻO wai ka mea e hana i ka hoʻāʻo D-Dimer? Pehea e hana ʻia ai?

ʻO ka maʻamau, hana kahi phlebotomist i ke kaha koko, me ka hoʻāʻo D-Dimer. Eia nō naʻe, hiki i kekahi loea olakino i aʻo ʻia e kaha koko ke hana ia mea. A laila hoʻouna ʻia kāu hāpana koko i kahi keʻena hoʻokolohua. Ma laila, hoʻomākaukau kahi ʻepekema keʻena hoʻokolohua lapaʻau i ka hāpana a hoʻāʻo iā ia ma nā mīkini i kapa ʻia he mau mea kālailai.

Pono anei iaʻu e hana i kekahi mea ma mua o ka hoʻokolohua?

ʻAʻole, ʻaʻole pono ʻoe e hana i kekahi mea kūikawā ma mua o ka hoʻāʻo D-Dimer. Hiki iā ʻoe ke ola maʻamau.

He aha ka mea e hana ʻia i ka wā o ka hoʻāʻo?

He hoʻāʻo koko ka D-Dimer. No laila, ke lawe ʻoe i kahi hāpana koko, eia nā mea e hana ʻia:

• E noho ʻia ʻoe ma luna o kahi noho a moe paha ma luna o kahi moe. A laila e nānā ke limahana olakino i kou mau lima a loaʻa kahi aa koko maʻalahi e huki ai i ke koko. ʻO ka hapa pinepine, aia ia ma loko o kou lima, ma hope pono o kou kuʻekuʻe lima.
• Ke loaʻa kahi aʻa koko, hoʻomaʻemaʻe ʻia a disinfect ʻia.
• A laila hoʻokomo ʻia kahi nila liʻiliʻi i loko o kou aa koko a lawe ʻia kahi hāpana koko. E like kēia me kahi nahu ʻanuʻu liʻiliʻi.
• Ma hope o ke hoʻokomo ʻana i ka nila, e hōʻiliʻili ʻia kahi koko liʻiliʻi i loko o kahi ʻōmole hoʻāʻo.
• Ma hope o ka lawe ʻia ʻana o ke koko kūpono no ka hoʻāʻo ʻana, wehe ʻia ke kui a kau ʻia kahi ʻāpana pulupulu a gauze paha ma luna o ka wahi i hoʻōki ai i ke kahe ʻana o ke koko.
• A laila hoʻopili ʻia kahi plaster i ka wahi a ua pau ka hana.

ʻO ka maʻamau, ʻaʻole i ʻoi aku ma mua o ʻelima mau minuke kēia kaʻina hana holoʻokoʻa. Wikiwiki loa.

He aha ka mea e hana ʻia ma hope o ka hoʻāʻo?

Ma hope o ka lawe ʻia ʻana o kāu hāpana koko, hoʻouna ʻia ia i kahi keʻena hoʻokolohua. Ke loaʻa nā hopena o ka hoʻāʻo, e haʻi aku kāu kauka iā ʻoe i nā hopena.

Aia kekahi mau pilikia me ka hoʻāʻo D-Dimer?

He hoʻāʻo lapaʻau maʻamau a pono hoʻi nā hoʻāʻo koko. Haʻahaʻa loa nā pilikia o ka loaʻa ʻana o kahi hoʻāʻo koko. Hiki iā ʻoe ke manaʻo i kahi ʻeha iki a palapū paha ma kahi i huki ʻia ai ke koko. Akā e nalo koke ana kēlā. No laila, ʻaʻohe mea e hopohopo ai.

He aha ka manaʻo o nā hopena o ka hoʻāʻo D-Dimer?

ʻO kahi hōʻike hoʻāʻo koko, ʻoiai kahi hōʻike hoʻāʻo D-Dimer, loaʻa mau ka ʻike e like me kēia:

• ʻO ka inoa o ka hoʻāʻo koko, a i ʻole ka mea i ana ʻia i loko o kou koko.
• ʻO ka helu a i ʻole ke ana o kāu hopena hoʻāʻo koko.
• ʻO ka pae maʻamau no kēlā hoʻāʻo.
• ʻIke e hōʻike ana inā he maʻamau, ʻano ʻē, kiʻekiʻe, haʻahaʻa, maikaʻi, a maikaʻi ʻole paha kāu hopena.

He aha ka hopena maʻamau o ka D-Dimer?

Aia nā ʻano like ʻole e hoʻāʻo ai i kāu pae D-Dimer i loko o kou koko. No laila, ʻaʻohe pae honua e ʻōlelo ana "ʻo kēia ka pae maʻamau." E komo pū ana kāu hōʻike lab i ka ʻike e hōʻike ana inā he maʻamau, haʻahaʻa, kiʻekiʻe, maikaʻi, a maikaʻi ʻole paha kāu pae D-Dimer.

Inā ʻōlelo kāu hōʻike lab ua haʻahaʻa, maikaʻi ʻole, a maʻamau paha kāu pae D-Dimer, ʻo ia hoʻi ke ʻano ʻaʻole ou maʻi koko.

Inā ua ʻike ʻia ʻoe me ka Disseminated Intravascular Coagulation (DIC) a ke loaʻa nei iā ʻoe ka lāʻau lapaʻau, ʻo ka pae maʻamau a haʻahaʻa paha o ka D-Dimer i loko o kou koko ʻo ia hoʻi ke holo pono nei kāu lāʻau lapaʻau.

He aha ka manaʻo o ka hopena D-Dimer kiʻekiʻe?

Inā hōʻike kāu mau hopena ua ʻoi aku ke kiʻekiʻe o kou mau pae D-Dimer koko ma mua o ka maʻamau , hiki ke hōʻike ʻia he maʻi ʻūlū koko kou. Eia nō naʻe, e like me kaʻu i ʻōlelo ai ma mua, ʻaʻole hiki i kahi hoʻāʻo D-Dimer wale nō ke haʻi pololei iā ʻoe i ke ʻano o ke ʻūlū koko āu e loaʻa ai a i ʻole kahi o nā ʻūlū koko i loko o kou kino.

Inā ua ʻike ʻia ʻoe me ka Disseminated Intravascular Coagulation (DIC) a ke loaʻa nei ka lāʻau lapaʻau, ʻo ke kiʻekiʻe o ka D-Dimer i loko o kou koko ke ʻano paha ʻaʻole e holo pono ana kāu lāʻau lapaʻau.

Eia nō naʻe, aia kekahi mau hihia kahi e hiki ai ke hoʻokiʻekiʻe ʻia nā pae D-Dimer me ka ʻole o kahi maʻi koko. ʻO nā kumu ʻē aʻe e hiki ai ke kiʻekiʻe aʻe nā pae D-Dimer ma mua o ka maʻamau:

• Ka hāpai ʻana.
• Maʻi puʻuwai.
• He hana ʻoki kino hou loa.
• He ulia a ʻeha paha i ke kino (trauma).
• He maʻi.

Eia kekahi, piʻi pinepine nā pae D-Dimer me ka makahiki. Inā loaʻa iā ʻoe kahi maʻi e like me ka rheumatoid arthritis, hiki iā ʻoe ke loaʻa nā hopena maikaʻi ʻole.

No laila, inā hōʻike kāu mau hopena he ʻano ʻē kāu mau pae D-Dimer, e kauoha paha kāu kauka i nā hoʻāʻo koko hou a me/a i ʻole nā ​​​​hoʻokolohua kiʻi e hana i kahi hōʻailona.

Āhea e ʻike ai au i nā hopena o ka hoʻāʻo D-Dimer?

Hoʻomaʻamaʻa pinepine nā kauka i nā hoʻāʻo D-Dimer i nā kūlana pilikia, no ka mea, hiki i nā ʻūpā koko ke hoʻoweliweli i ke ola. Inā hana ʻia kēia hoʻāʻo i kahi pilikia, e loaʻa paha i kāu kauka nā hopena i loko o kekahi mau hola.

Inā loaʻa iā ʻoe kahi hoʻāʻo D-Dimer e ʻike ai i ka maikaʻi o kāu lāʻau lapaʻau i kou wā e mālama ʻia ai no ke ʻano o ke koko ʻana, e loaʻa paha iā ʻoe nā hopena i loko o hoʻokahi a ʻelua paha mau lā ʻoihana.

He aha ka mea e hiki mai ana? Inā he ʻano ʻē nā hopena...

Inā ʻaʻole kūpono kāu mau hopena hoʻāʻo D-Dimer, hiki i kāu kauka ke kauoha i hoʻokahi a ʻoi aku paha mau hoʻāʻo kiʻi e hoʻoholo ai inā he maʻi koko koko kou, a inā pēlā, kahi o nā clots. ʻO kēia mau hoʻāʻo:

• ʻO ke kani ʻana o Doppler: Hoʻohana kēia i nā nalu kani e hana i nā kiʻi o kou mau veins (nā kīʻaha koko).
• ʻO ka angiography tomography computed (CT): Ma kēia hoʻokolohua, hoʻokomo ke kauka i kahi kala kūikawā i loko o kekahi o kou mau aa koko. ʻIke ʻia kou mau kīʻaha koko ma kahi mīkini X-ray kūikawā.
• ʻO ka nānā ʻana i ka ventilation-perfusion (V/Q) o ka māmā: Pili kēia i kahi scan ventilation (V), e ana ana i ke kahe ʻana o ka ea i loko o kou mau māmā, a me kahi scan perfusion (Q), e nānā ana i kahi e kahe ai ke koko i loko o kou mau māmā. Ma nā scan ʻelua, hoʻohana ʻia kahi liʻiliʻi o kahi mea radioactive palekana e kōkua i ka scanner e ʻike i ke ʻano o ka neʻe ʻana o ka ea a me ke koko ma o kou mau māmā.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe nā hōʻailona o ka hahau ʻana a i ʻole ka pulmonary embolism (PE), e kāhea koke i ka 911 a i ʻole e hele i ka lumi pilikia kokoke loa. Mai hoʻokaʻulua.

Inā loaʻa iā ʻoe nā hōʻailona o ke koko ʻūlū i loko o kahi aʻa koko hohonu (Deep Vein Thrombosis - DVT), e ʻike koke i kāu kauka.

He aha nā kumu pilikia no ke koko?

ʻO nā mea pilikia e hiki ke kōkua i ke kūkulu ʻia ʻana o ke koko koko kūpono ʻole a kūpono ʻole paha:

• Loaʻa i ke ʻoki kino nui a i ʻole kahi ʻeha kino nui (trauma).
• Ke noho ʻana ma kahi hoʻokahi no ka manawa lōʻihi (e laʻa me ka noho ʻana ma nā huakaʻi lōʻihi, a i ʻole ka noho ʻana ma kahi moe no ka manawa lōʻihi).
• ʻO ka lawe ʻana i nā pila hoʻomalu hānau a i ʻole ka lāʻau hoʻololi hormone.
• Ka hāpai ʻana a i ʻole ka hānau keiki hou ʻana.
• Loaʻa kahi moʻolelo ʻohana o ke koko ʻana, a i ʻole he maʻi olakino kūikawā e like me ka maʻi Factor V Leiden, Antiphospholipid syndrome, a i ʻole Polycythemia vera.
• Loaʻa i kahi ʻano maʻi ʻaʻai.
• Ka hoʻomaka ʻana o ka maʻi Coronavirus 2019 (COVID-19).
• Loaʻa ka momona.
• Puhi paka.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

He mea maʻamau ka makaʻu a me ka hopohopo ke loaʻa iā ʻoe kahi hopena hoʻāʻo kūpono ʻole. Akā e hoʻomanaʻo, ʻo ka hopena hoʻāʻo D-Dimer kiʻekiʻe ʻaʻole ia he manaʻo he maʻi koko koko kou. Inā hōʻike kāu mau hopena ua kiʻekiʻe kou pae D-Dimer, e kauoha paha kāu kauka i nā hoʻokolohua hou aʻe e hana i kahi hōʻailona.

Inā he mau nīnau kāu, mai makaʻu e nīnau i kāu kauka. Aia nā kauka ma laila e kōkua iā ʻoe. E wehewehe lākou i nā mea āpau iā ʻoe.

Manaʻolana wau he mea pono kēia ʻike iā ʻoe. E ola kino!

ʻO D-Dimer, ke kāpili ʻana o ke koko, nā hoʻāʻo koko, DVT, PE, Stroke, DIC, nā ʻūpā koko