E kamaʻilio anei kākou e pili ana i ka Acute Tubular Necrosis, ka mea e hoʻopilikia ai i nā puʻupaʻa?

ʻO nā puʻupaʻa kekahi o nā ʻōkana koʻikoʻi loa i loko o ko kākou kino. E like me ke kānana, ʻo ka hana nui o nā puʻupaʻa, ʻo ia ka hoʻomaʻemaʻe ʻana i ko kākou koko a wehe i nā mea pono ʻole e like me ka mimi. Akā i kekahi manawa hiki ke hōʻino ʻia kēia mau puʻupaʻa. ʻO ka Acute Tubular Necrosis (ATN) kahi maʻi e hoʻopilikia ai i nā puʻupaʻa a hiki ke koʻikoʻi loa. E kamaʻilio kākou e pili ana i kēia ma nā ʻōlelo maʻalahi i kēia lā.

He aha ka Acute Tubular Necrosis?

I ka ʻōlelo maʻalahi, ʻo Acute Tubular Necrosis ka wā e hōʻino ʻia ai ko mākou mau puʻupaʻa ma muli o ka loaʻa ʻole o ka oxygen a me ke kahe koko. I loko o ko mākou mau puʻupaʻa, aia nā ʻano liʻiliʻi e like me ka paipu, a mākou e kapa nei he tubules . E like me ke kānana, ʻo kēia mau tubules ka mea e kānana i nā huahana ʻōpala a me nā wai keu i loko o ko mākou kino a hoʻokuʻu iā lākou ma ke ʻano he mimi. No laila, ma kēia kūlana i kapa ʻia ʻo ATN, ʻo ia mau tubules i hōʻino ʻia.

E noʻonoʻo, inā paʻa a haki paha nā ʻāpana kānana liʻiliʻi i loko o kahi kānana wai, ʻaʻole e hoʻomaʻemaʻe pono ʻia ka wai, ʻeā? Pēlā nō ia me kēia. Ke hōʻino ʻia kēia mau tubules, ʻaʻole hana pono nā puʻupaʻa. A laila, hoʻomaka nā electrolytes (ʻo ia hoʻi nā paʻakai e like me ka sodium a me ka potassium) a me nā wai i loko o ko kākou kino e hōʻiliʻili i loko o ke kino ma kahi o ka hele ʻana i waho. Hiki i kēia ke piʻi i nā pae weliweli. Hiki i kēia ke alakaʻi i ka hāʻule ʻana o nā puʻupaʻa koke , kahi kūlana e pau koke ai ka hana ʻana o nā puʻupaʻa.

No ke aha lā e kū mai ai kēia kūlana?

ʻAe, i kēia manawa he nīnau kāu e pili ana i ke kumu e kū ai kēia kūlana i kapa ʻia ʻo ATN. Aia paha kekahi mau kumu.

Nā kumu nui:

ʻO nā kumu maʻamau ka emi ʻana o ka nui o ka oxygen e hiki ana i nā puʻupaʻa.

• Inā loaʻa iā ʻoe kahi hāʻule puʻuwai , e emi iho paha ka nui o ke koko e kahe ana i nā puʻupaʻa no ka mea ʻaʻole e pamu pono ana ka puʻuwai i ke koko.
• Pēlā nō ia me ka hahau ʻana . I kēia manawa, hiki ke hoʻopilikia ʻia ke kahe o ke koko i ka lolo a me nā puʻupaʻa.

I ia mau hihia, ʻaʻole loaʻa i nā pūnaewele i loko o nā puʻupaʻa ka oxygen e pono ai a hoʻomaka e make. Pēlā e hōʻino ʻia ai nā tubules i ʻōlelo ʻia ma mua.

Ma muli o nā kemika:

Hiki i kekahi mau kemika ke hōʻino i kēia mau tubules.

• Eia kekahi laʻana, ʻo ka dye contrast i hoʻohana ʻia i kekahi mau hoʻokolohua X-ray . Ua ʻike paha ʻoe i kekahi manawa hāʻawi lākou iā ʻoe i kahi injection ma mua o ka hana ʻana i kahi mea e like me ka CT scan? Nā mea like me ia.
• ʻO kekahi mau lāʻau anesthesia .
• ʻO kekahi mau lāʻau antibiotic , ʻoiai inā hoʻohana hewa ʻole ʻia me ka ʻole o ke aʻoaʻo lapaʻau.
• Nā kemika ʻawahia ʻē aʻeHiki i nā ʻōpū momona ke hana i kēia.

ʻO ia ke kumu e noʻonoʻo ai nā kauka i ke kūlana o kou mau puʻupaʻa ma mua o ke kau ʻana i kekahi lāʻau lapaʻau a hana paha i kekahi hoʻokolohua.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i kēia?

ʻOiai hiki i kekahi ke loaʻa i kēia maʻi, aia kekahi poʻe i kahi pilikia kiʻekiʻe iki aʻe.

• ʻO ka poʻe i hōʻemi a ālai loa paha i ke kahe koko i nā puʻupaʻa, no ka laʻana, ma muli o nā ʻūpā koko .
• No ka poʻe i loaʻa i ke koko haʻahaʻa loa no ka manawa lōʻihi, a i ʻole no ka poʻe i loko o ka haʻalulu .
• Inā nui ke koko i nalowale i ka wā o ke ʻoki kino nui, a inā paha he nui ke koko i nalowale mai ke kino ma muli o kahi ʻeha nui (trauma) .
• Ka pōʻino nui o nā ʻiʻo . I kekahi manawa hiki ke like ka ʻino me kahi ulia nui.
• ʻOi aku ke kiʻekiʻe o kēia pilikia no ka poʻe me ka maʻi akepaʻa .

Inā loaʻa iā ʻoe nā maʻi e like me kēia, he mea nui loa ia e mālama pono i kou mau puʻupaʻa.

He aha nā hōʻailona o kēia?

ʻAʻole paha e ʻike koke ʻia nā hōʻailona o ATN, akā hiki ke ulu mālie lākou i:

• Ka emi nui ʻana o ka mimi i hoʻopuka ʻia: E ʻike ʻoe ua emi ka nui o ka mimi āu e hoʻokuʻu ai i kēlā me kēia lā.
• Ka pehu ʻana a me ka paʻa ʻana o ka wai: ʻO nā wahi e like me nā wāwae, nā lima, a me ka maka e pehu paha ma muli o ka hōʻiliʻili ʻana o ka wai i loko o ke kino.
• Ka luaʻi a me ka luaʻi ʻana: Hiki ke nalowale ka makemake e ʻai a me ka manaʻo e luaʻi.
• Pilikia i ke ala ʻana/hiamoe: Hiki paha iā ʻoe ke manaʻo i ka hiamoe mau.
• Manaʻo palaualelo: He manaʻo o ka palaualelo, nele i ka hoihoi e hana i kekahi mea.
• Huikau: Paʻakikī i ka noʻonoʻo ʻana, hiki ke manaʻo iki i ka pīhoihoi.

Mea nui: Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau hōʻailona, ​​ʻoiai inā ʻaʻole ʻoe e mimi nui ana, e ʻike koke i ke kauka, no ka mea, he pilikia paha kēia no ka puʻupaʻa.

Pehea ʻoe e ʻike ai i kēia?

Inā loaʻa iā ʻoe nā hōʻailona i ʻōlelo ʻia ma luna nei, a manaʻo kāu kauka he ATN kou, hiki iā lākou ke hana i kekahi mau hoʻokolohua e hōʻoia iā ia.

He aha nā hoʻokolohua?

• Nā hoʻāʻo koko: Nānā nui kēia i ka nui o nā huahana ʻōpala i loko o kou koko.
• Ka pae o ka naikokene Urea koko (BUN) .
• Ka pae Creatinine .
• Eia kekahi, nā pae electrolyte , ʻoi aku hoʻi nā pae potassium plasma .

Inā loaʻa kēia mau mea i ke koko me ka nui, ʻo ia hoʻi ʻaʻole hana pono nā puʻupaʻa.

• Nā hoʻāʻo mimi: Lawe ʻia kahi hāpana o kāu mimi a nānā ʻia ma lalo o kahi microscope ( hoʻokolokolo microscope o kāu mimi ). Hiki i kēia ke hāʻawi i kahi manaʻo o ka hōʻino ʻia o kou mau puʻupaʻa.

• ʻO ka Biopsy Kidney: I kekahi mau hihia, ʻoiai inā ʻaʻole maopopo ka hōʻailona, ​​​​lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka puʻupaʻa no ka hoʻokolokolo ʻana. Ua kapa ʻia kēia he biopsy .

ʻO ka maʻamau, ʻike ʻia ʻo ATN e kahi nephrologist , he kauka loea i nā maʻi puʻupaʻa. E nānā ʻo ia i kāu mau hōʻailona a me nā hopena hoʻāʻo e hoʻoholo pono i ka mea e hana nei.

Pehea e mālama ʻia ai kēia?

I ka mālama ʻana i ka ATN, ʻo ka mea nui loa ka mālama ʻana i ke kumu kumu . ʻO ia hoʻi, inā ma muli o ka hōʻeha puʻuwai, e mālama iā ia, inā ma muli o ke koko haʻahaʻa, a inā ma muli o kahi lāʻau lapaʻau, e hoʻōki i ka lawe ʻana i kēlā lāʻau lapaʻau.

ʻO ka mālama maʻamau a me nā hoʻololi o ke ʻano o ka nohona:

• Ke ʻae nei i nā puʻupaʻa e ho'ōla: I ka hapanui o nā hihia, hiki i nā puʻupaʻa ke ho'ōla iā lākou iho i kekahi ʻano, akā he manawa iki ka lōʻihi.
• ʻAi: I loko o kēia manawa, e haʻi aku kāu kauka iā ʻoe e hahai i kekahi mau kapu meaʻai.
• Ka palena ʻana i nā wai: Pono ʻoe e kaupalena i ka nui o ka wai, ke kī, ke kofe, a me ka sopa āu e inu ai.
• E kaupalena i ka sodium (paʻakai): E hōʻemi i ka nui o ka paʻakai āu e hoʻohui ai i kāu mau meaʻai.
• Ka palena o ka potassium: E kaupalena i nā meaʻai waiwai i ka potassium (maiʻa, ʻalani, kekahi mau mea kanu).

Hana ʻia kēia e pale aku i ka hōʻiliʻili ʻana o kēia mau mea i loko o ke kino a hiki i ka wā e ola ai nā puʻupaʻa.

• Nā lāʻau lapaʻau:
• Nā Diuretics: Nā lāʻau lapaʻau e hoʻonui ai i ka hoʻopuka ʻana o ka mimi. Kōkua kēia i ka wehe ʻana i ka wai keu mai ke kino.
• Nā lāʻau lapaʻau e kāohi ana i ka potassium: Hiki ke kuhikuhi ʻia ka lāʻau lapaʻau e kāohi i nā pae potassium i loko o ke koko.

E pono anei ka dialysis?

Pono paha kekahi poʻe i ka dialysis a hiki i ka wā e maikaʻi ai ko lākou mau puʻupaʻa. He mīkini ka Dialysis e hoʻomaʻemaʻe hana i ke koko mai nā puʻupaʻa. He manawa pōkole paha kēia a hiki ke hoʻōki ʻia ke hoʻi hou nā puʻupaʻa i ke ʻano maʻamau.

Hiki ke pale ʻia kēia?

ʻOiai ʻaʻole hiki ke pale loa ʻia ka ATN, aia kekahi mau mea hiki iā mākou ke hana e hōʻemi i ka manawa kūpono o ia hanana.

• Ka mālama ʻana i kou mau puʻupaʻa i ka oxygen a me ke kahe maikaʻi ʻana o ka wai: ʻO kēia ka mea nui loa. ʻO ia hoʻi ke kāohi ʻana i nā mea e like me kou koko a me nā maʻi puʻuwai.
• Inā ʻoe e hana ana i kahi hoʻāʻo e hoʻohana ana i ka dye contrast: E inu i ka wai he nui ma mua a ma hope o ia ʻano hoʻāʻo. Kōkua kēia i ka dye e hoʻokahe koke ʻia mai kou mau puʻupaʻa.
• Ma mua o ka loaʻa ʻana o ke kāpili koko: E hōʻoia i ka kūlike o kou ʻano koko.
• Ke kāohi ʻana i nā maʻi e hiki ke hōʻino i nā puʻupaʻa:
• Ke koko kiʻekiʻe
• ʻO ka maʻi diabetes
• Maʻi akepaʻa
• Maʻi puʻuwai

Inā loaʻa iā ʻoe kekahi o kēia mau maʻi, e kaohi pono iā lākou e like me ke aʻo ʻana a ke kauka.

• E makaʻala me nā lāʻau ʻeha: E pale i ka hoʻohana ʻana i nā lāʻau ʻeha ma luna o ke kauka, e like me ka ibuprofen a me ka naproxen sodium , pinepine a me ka ʻole o ke aʻo ʻana a ke kauka. He mea nui loa kēia inā loaʻa iā ʻoe nā pilikia puʻupaʻa.

ʻEhia ka lōʻihi e ola ai mai kēia maʻi?

Hiki i ka necrosis tubular koʻikoʻi ke mau mai kekahi mau lā a i kekahi mau pule.

• I ke kanaka olakino maʻamau, hiki ke hoʻihoʻi ʻia kēia ʻano, ʻo ia hoʻi, hoʻomaka hou nā puʻupaʻa e hana pono.
• Eia nō naʻe, no kekahi me nā pilikia olakino ʻē aʻe, e like me ka maʻi diabetes a i ʻole ka maʻi puʻuwai, ʻoi aku ka lōʻihi o ka manawa hoʻōla. I kekahi manawa, ʻaʻole paha e hoʻōla piha nā puʻupaʻa, e waiho ana i kekahi nāwaliwali.

ʻO ia ke kumu he mea nui ka ʻike ʻana i nā hōʻailona a me ka ʻimi ʻana i ka lāʻau lapaʻau i ka wā mua. E hōʻemi kēia i ka hōʻino ʻana i nā puʻupaʻa a hoʻonui i nā manawa kūpono o ka ho'ōla wikiwiki ʻana.

Leka Lawe-Home

ʻAe, ke lana nei koʻu manaʻo ua loaʻa iā ʻoe kahi manaʻo maikaʻi e pili ana i ka Acute Tubular Necrosis a mākou i kamaʻilio ai i kēia lā.

• ʻO ka ATN kahi kūlana i hōʻino ʻia ai nā tubules i loko o nā puʻupaʻa ma muli o ka nele o ke koko a me ka oxygen i nā puʻupaʻa.
• Hiki i nā hōʻeha puʻuwai, nā hahau, kekahi mau lāʻau lapaʻau, a me nā kemika ke hana i kēia.
• Hiki i nā hōʻailona ke komo pū me ka emi ʻana o ka mimi ʻana, ka pehu ʻana, ka nausea, a me ka hiamoe.
• ʻIke ʻia kēia ma o nā hoʻāʻo koko a me ka mimi.
• ʻO ka mālama ʻana e pili ana i ka mālama ʻana i ke kumu kumu, ka kaohi ʻana i ka ʻai, a me ka hana ʻana i ka dialysis inā pono.
• ʻO ka noho ʻana i kahi nohona aloha i nā puʻupaʻa a me ka mālama ʻana i nā maʻi maʻi mau e hiki ke kōkua i ka pale ʻana i kēia.

ʻO ka mea nui loa, ʻo ia ke ʻimi koke i ke kōkua lapaʻau inā ʻike ʻoe i kekahi mea ʻē e pili ana i kou mau puʻupaʻa (ʻoi aku ka emi ʻana o ka mimi). Ma kēia ʻano, hiki iā ʻoe ke mālama iā ia ma mua o ka lilo ʻana i pilikia nui aʻe.

Inā he mau nīnau hou aku kāu e pili ana i kēia, mai kānalua e kamaʻilio me kāu kauka. E noho olakino!

ʻO ka puʻupaʻa, ka necrosis tubular acute, ka maʻi puʻupaʻa, ka hāʻule ʻana o ka puʻupaʻa, ke koko, ka oxygen, ka dialysis, ka mimi