He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke haʻi aku ke kauka iā ʻoe a i ʻole kekahi o kou ʻohana he "aneurysm" a pono ʻoe e hana i kahi ʻoki no ia mea. Ke lohe ʻoe i kēia huaʻōlelo, nui nā mea e hiki mai ana i ka noʻonoʻo. No laila i kēia lā, e aʻo hou kākou e pili ana i kēia, ʻo ia hoʻi, kēia ʻoki aneurysm. E wehewehe wau i nā mea āpau iā ʻoe me ka maʻalahi a me ka maopopo, e like me kāu e kamaʻilio ai me kahi hoaaloha.
He aha maoli ke ʻano o ke ʻoki ʻana o ka aneurysm?
I ka ʻōlelo maʻalahi, ʻo ke ʻoki ʻana o ka aneurysm kahi lāʻau lapaʻau no ka nāwaliwali o ka aorta, ke kīʻaha koko nui i loko o ko kākou kino. E noʻonoʻo i kahi paipu wai e nāwaliwali ana i kekahi manawa a puʻupuʻu e like me ka pōpō. Ma ke ʻano like, i ka wā e nāwaliwali ai ka aorta i kekahi manawa a puʻupuʻu, kapa mākou ia he aneurysm aortic. He mea weliweli kēia no ka mea hiki i kēia puʻupuʻu ke pahū (rupture) a haehae paha (dissection) i kēlā me kēia manawa. Inā hana ʻia kēlā, hiki ke lilo i mea weliweli loa no ke ola.
No laila, ʻo ka pahuhopu nui o kēia hana, ʻo ia ka wehe ʻana i ke kīʻaha koko pehu a nāwaliwali ma mua o ka pahū ʻana a hoʻololi iā ia me kahi paipu lole synthetic ikaika. Kāhea mākou i kēia he graft . Hana kēia graft e like me ke kīʻaha koko hou. A laila kahe ke koko ma o ia me ka ʻole o ka pilikia.
Ua manaʻo ʻia kēia he ʻoki nui. Hana pinepine ʻia ia e ke kauka ʻoki thoracic a i ʻole vascular i loko o ka lumi hana o ka haukapila. Ma muli o ka wahi o ka aneurysm, pono paha ke kauka e hana i kahi ʻoki nui ma ka umauma a i ʻole ka ʻōpū.
- Kāhea mākou i kahi aneurysm ma ka ʻāpana umauma he Thoracic Aortic Aneurysm .
- ʻO kahi haʻahaʻa iki, ʻo ia hoʻi, ma ka ʻōpū, ua kapa ʻia ʻo Abdominal Aortic Aneurysm .
He mea nui kēia ʻoki kino e pale aku i nā pilikia nui. E like me nā ʻoki kino nui a pau, aia kekahi mau pilikia liʻiliʻi, akā ʻoi aku ka nui o nā pono ma mua o lākou. E nānā pono kāu kauka i kou kūlana a hoʻoholo inā pono ʻoe i ke ʻoki kino a i ʻole.
ʻO wai ka mea e pono ai kēia ʻoki kino?
Hiki ke māhele ʻia kēia i ʻelua ʻāpana. ʻO kekahi he pilikia. ʻO kekahi he kūlana kahi āu e hoʻolālā ai ma mua o ka hiki ʻana mai o kahi pilikia.
1. ʻO ka poʻe i loaʻa i kahi aneurysm i haki a haki paha (he pilikia)
ʻO kēia ke kūlana weliweli loa a wikiwiki hoʻi. Inā pahū a haki paha kahi aneurysm, pono ke ʻoki koke ʻana. ʻO kēia wale nō ke ala e hoʻopakele ai i ke ola. Inā ʻike koke ʻia nā hōʻailona ma lalo nei, pono ʻoe e hele koke i ka Emergency Department (ETU) o kahi haukapila .
| Nā hōʻailona i ka wā pilikia | |
|---|---|
| ʻEha ʻoi, ʻaʻole hiki ke hoʻomanawanui, koke, ʻeha nui (ma ka umauma, ke kua, ka ʻōpū, a i ʻole nā wāwae) | Pōʻino a me ka nawaliwali |
| Ke anu nei a me ka hou ʻana | Paʻakikī ka hanu ʻana |
| Nā palpitations o ka puʻuwai | Ka luaʻi a me ka luaʻi |
2. ʻO ka poʻe me kahi aneurysm i pilikia o ka pahū ʻana
Inā ua ʻike kāu kauka he aneurysm kou, ʻoiai inā ʻaʻole i pahū, he mea nui e ʻike pinepine i kāu kauka e nānā i kona kūlana. E nānā kāu kauka i kona nui a me ka wikiwiki o kona ulu ʻana e hoʻoholo ai i ka manawa kūpono e hana ai i ke ʻoki kino. Pono paha ʻoe i ke ʻoki kino inā loaʻa iā ʻoe kekahi o kēia mau kūlana:
- Inā ʻoi aku ka nui o ka aneurysm ma mua o 5 kenimika ke anawaena .
- Inā e ulu wikiwiki ana (no ka laʻana, ʻoi aku ma mua o 1 kenimika i kēlā me kēia makahiki).
- Inā loaʻa iā ʻoe ka ʻeha pinepine ma nā wahi e like me ka ʻōpū, ke kua, ka umauma, a i ʻole ka ʻūhā.
- Inā ʻoe e manaʻo nei i kahi manaʻo pulsing i loko o kou ʻōpū.
- Inā he ʻū, he leo honi, a he paʻakikī paha ka hanu ʻana.
ʻO ka mea nui, ʻaʻole like ka mālama ʻia ʻana o nā kānaka a pau. E noʻonoʻo kāu kauka i nā kumu he nui, e like me kou olakino holoʻokoʻa, ka makahiki, a inā he mau maʻi ʻē aʻe kou, e hoʻoholo ai i ka lāʻau lapaʻau maikaʻi loa nāu.
Eia kekahi laʻana, inā loaʻa iā ʻoe kahi maʻi genetic e like me Marfan syndrome , hiki i kahi aneurysm liʻiliʻi ke lilo i mea weliweli iā ʻoe. No laila, hiki ke ʻōlelo ʻia e hana ʻoki ma mua o kekahi.
I kekahi manawa, ma muli o nā pilikia olakino ʻē aʻe, hiki ke pilikia ke hana i kahi ʻoki kino nui e like me kēia. I ia mau hihia, hiki i kāu kauka ke ʻōlelo aku i kahi kaʻina hana maʻalahi i kapa ʻia ʻo EVAR (Endovascular Aneurysm Repair) , kahi e hoʻokomo ʻia ai kahi paipu ma o kahi ʻoki liʻiliʻi i loko o ke kīʻaha koko.
Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki ʻana?
Hoʻomaka ka hoʻomākaukau ʻana no kahi ʻoki kino nui e like me kēia i kekahi mau pule ma mua. E nānā pono kāu kauka iā ʻoe a hana i kekahi mau hoʻokolohua e hōʻoia i kou kino i ke kūlana kūpono no ke ʻoki kino. I loko o kēia manawa, pono ʻoe e kamaʻilio me kāu kauka e pili ana i kēia mau mea:
- Pono ʻoe e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei: nā lāʻau lapaʻau i kauoha ʻia, nā lāʻau lapaʻau ma luna o ke kauka, nā huaora, nā lāʻau lapaʻau lāʻau, a me nā mea āpau āu e lawe nei. Hiki ke noi ʻia ʻoe e hoʻōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau ma mua o ke ʻoki ʻana. He mea nui loa ia e hahai pono i nā ʻōlelo a kāu kauka e like me ka mea i hāʻawi ʻia.
- E pili ana i nā kūlana olakino ʻē aʻe āu i loaʻa ai: Inā loaʻa iā ʻoe kekahi mau kūlana olakino e like me ke koko kiʻekiʻe a i ʻole ka maʻi diabetes, pono e kaohi maikaʻi ʻia ma mua o ke ʻoki ʻana.
- E pili ana i kou olakino kino: E haʻi i kāu kauka inā loaʻa iā ʻoe ke anu, ka maʻi palū, ka herpes, a i ʻole kekahi maʻi ʻē aʻe. ʻAʻole ia he manaʻo maikaʻi e hana i ke ʻoki kino ke maʻi ʻoe.
- Inā ʻoe e puhipaka: Pono ʻoe e hoʻōki loa i ka puhipaka ma ka liʻiliʻi hoʻokahi mahina ma mua o ke ʻoki kino. Inā makemake ʻoe i ke kōkua me kēia, e nīnau i kāu kauka, e hiki iā ia ke kōkua iā ʻoe.
E hāʻawi ʻia aku nō hoʻi iā ʻoe kekahi mau kuhikuhi kūikawā e hoʻomākaukau ai no ka lā o ke ʻoki kino. ʻO kekahi o lākou:
- I ka pō ma mua o ke ʻoki ʻana, ua ʻōlelo ʻia ʻoe ʻaʻole e inu i ka wai ma hope o ke aumoe.
- He aha ka lāʻau lapaʻau e pono iaʻu ke lawe i ke kakahiaka o ke ʻoki kino?
- Ke noi nei e hoʻonohonoho i kekahi e kiʻi iā ʻoe ke hoʻi ʻoe i ka home mai ka haukapila.
E hahai pono i kēia mau kuhikuhi a pau. Inā he mea āu e kānalua ai, e nīnau i kāu kauka a kahu maʻi paha.
He aha ka mea e hana maoli ana i loko o ka hana?
Hiki paha iā ʻoe ke hoihoi loa a makaʻu hoʻi i kēia. Akā, mai hopohopo. E mālama pono kāu hui lapaʻau iā ʻoe. Ma mua o ka hoʻomaka ʻana o ke ʻoki kino, e hāʻawi ʻia ʻoe i ka anesthesia laulā . A laila e hiamoe loa ʻoe a ʻaʻole ʻoe e manaʻo i kekahi mea. A laila e hana ʻia ke ʻoki kino e like me kēia mau ʻanuʻu:
1. ʻOki ʻana: Hana ke kauka lapaʻau i kahi ʻoki lōʻihi ma ka ʻili o kou umauma a i ʻole ka ʻōpū e hiki ai i kahi o ka aneurysm.
2. Ke hoʻopaʻa ʻana: ʻO ka mea aʻe, ua pani ʻia ke aʻa nui ma luna a ma lalo o ka aneurysm me ka hoʻohana ʻana i nā mea hana kūikawā (clamps). I kēia manawa, ʻae ʻia ke kahe koko i ke koena o ke kino e hoʻomau, a hiki ke hoʻopili ʻia ʻoe i kahi mīkini puʻuwai-māmā . Lawe kēia i ka hana o kou puʻuwai a me kou māmā no kekahi manawa i ka wā o ke ʻoki ʻana.
3. Hoʻokomo ʻana i ke kāpili: ʻO kēia ka ʻāpana koʻikoʻi loa o ke ʻoki kino. ʻOki ke kauka i ke kīʻaha koko pehu a nāwaliwali a hoʻololi iā ia me ka paipu hana i ʻōlelo ʻia ma mua, ʻo ia hoʻi ke kāpili. Hana ʻia kēia kāpili me kahi mea synthetic ikaika e like me ka polyester.
4. Pani ʻana o ka ʻoki ʻana:Ma hope o ke kau ʻia ʻana o ke kīʻaha koko hou, e pani ke kauka ʻoki i ka ʻoki ma kou umauma a i ʻole ka ʻōpū me nā humuhumu a i ʻole nā staples.
ʻO ka maʻamau, ʻekolu a ʻehā hola ka lōʻihi o kēia hana holoʻokoʻa.
He aha ka mea e hana ʻia ma hope o ke ʻoki ʻana?
Ma hope o ke ʻoki kino, e lawe ʻia ʻoe i ka ʻāpana mālama koʻikoʻi (ICU) . Ma laila, e nānā pono ʻia kou kūlana no kekahi mau lā. A laila e hoʻoneʻe ʻia ʻoe i kahi keʻena maʻamau. I ka huina, pono ʻoe e noho ma ka haukapila no kahi o ʻekolu a ʻumi lā.
ʻOiai ʻoe ma ka haukapila, e kū ʻoe i nā pilikia e like me:
- He catheter mimi.
- He ʻōmole i hoʻokomo ʻia ma ka ihu e wehe ai i ka wai mai loko mai o ka ʻōpū.
- Nā lāʻau lapaʻau e pale ai i ke kāpili ʻana o ke koko (nā anti-coagulants).
- ʻO nā kāmaʻa hoʻopaʻa (compression socks) kahi ʻano kūikawā o nā kāmaʻa e hoʻohana ʻia e pale aku ai i ke koko i loko o nā wāwae.
- He mīkini e kōkua iā ʻoe e hanu.
- Nā lāʻau hoʻopau ʻeha no ka ʻeha i ka wā e hoʻōla ai.
E hoʻomaka mālie ʻoe e hele a loaʻa ka ikaika. Akā e hoʻomanaʻo, ua hana ʻia ʻoe i kahi ʻoki kino nui. Pono ʻoe e hāʻawi i kou kino i ka manawa e ho'ōla ai. E hoʻolohe pono i ka ʻōlelo a ke kauka, mai wikiwiki. E hoʻomaha nui.
E like me nā ʻoki kino āpau, aia kekahi mau pilikia me kēia?
ʻAe. ʻOiai he mea hoʻōla ola kēia ʻoki kino, e like me nā ʻoki kino āpau, aia nā pilikia a me nā pilikia e hiki ke kū mai. ʻO kekahi o lākou:
- Ke kahe koko nui ʻana.
- Nā ʻūpā koko.
- Paʻakikī ka hanu ʻana.
- Ka hōʻino ʻana i nā ʻōpū a i ʻole nā kikowaena ʻē aʻe.
- Hōʻeha puʻuwai a i ʻole ka hahau.
- Ka maʻi o ke kāpili i hoʻokomo ʻia.
- Nā maʻi o ka māmā, ke ala mimi, a i ʻole ka ʻōpū.
- Ka hāʻule ʻana o nā puʻupaʻa.
- Ka pōʻino o ke aʻalolo.
Akā, mai hopohopo. E hana kāu hui lapaʻau i nā mea āpau e hiki ai iā lākou ke hōʻemi i kēia mau pilikia a e palekana a holomua ke ʻoki kino. E kamaʻilio me kāu kauka e pili ana i nā pilikia āu e kū nei.
Inā hoʻolālā ʻia a hana ʻia ke ʻoki ʻana ma mua o ka haki ʻana o kahi aneurysm , kiʻekiʻe loa ka manawa e ola ai, ma waena o 95% a me 98% .
Eia nō naʻe, i ka hanana o kahi ʻoki kino ulia pōpilikia ma hope o ka haki ʻana o kahi aneurysm , hiki i ka manawa e ola ai ke hāʻule i waena o 50% a me 70%. Akā, no ka mea, he mea maopopo ka make inā ʻaʻole mālama ʻia, ʻo ke ʻoki kino wale nō ka hopena maikaʻi loa.
Ka wā hoʻōla a me nā mea e pono ai ke nānā aku ma ka home
He ʻāpana nui kēia no nā kānaka he nui.
ʻEhia ka lōʻihi e ho'ōla ai?
ʻO ka maʻamau , he ʻehā a ʻeono pule e hoʻōla piha ai.He 10-20 mau lā ka lōʻihi. Akā, hiki i kekahi poʻe ke hele no ʻelua a ʻekolu mahina. He ʻokoʻa ia mai kēlā kanaka a kēia kanaka.
Nā mea pono ʻole e hana i kēia manawa
- Mai hoʻokele a hiki i ka wā e ʻae ai kāu kauka iā ʻoe (ʻo ka maʻamau hoʻokahi a ʻelua pule).
- Mai komo i loko o kahi ʻōmole wai a hiki i ka wā e ho'ōla ʻia ai ka ʻeha. Hiki iā ʻoe ke ʻauʻau, akā e makaʻala i ka ʻeha.
- Mai ʻauʻau a hiki i ka wā e ho'ōla ai ka ʻeha.
- Mai hāpai i nā mea kaumaha (ʻoi aku ma mua o 4-5 kg) no ka liʻiliʻi he 4-6 mau pule.
- Mai hoʻoikaika kino a pau kou hanu.
Pehea e mālama ai i ka ʻeha o ke ʻoki kino?
He mea nui loa ka mālama ʻana i kou ʻeha maʻemaʻe. E like me ka ʻōlelo a ke kauka, pono ʻoe e hoʻololi i ke kapa komo ma ka ʻeha i kēlā me kēia lā. Hiki ke ʻeha iki ke ʻeha ʻoe i ka wā e kihe ai a ʻū paha. I kēlā manawa , e lawe i kahi uluna a kau ma luna o ka ʻeha a kaomi iā ia . ʻO ia ka mea e hōʻemi ai i ka ʻeha a pale i ka ʻeha.
Ka makemake a me ka ikaika
I kou wā e hoʻōla ai, ʻaʻole paha ʻoe e makemake nui i ka ʻai. He mea maʻamau kēlā. Hiki paha iā ʻoe ke manaʻo luhi loa. He ʻāpana kēia o ke kaʻina hana hoʻōla.
Inā loaʻa iā ʻoe kēia mau hōʻailona, e kāhea koke aku i kāu kauka!
E makaʻala loa i kou kino ma hope o kou hoʻi ʻana i ka home. Inā loaʻa iā ʻoe kekahi o nā hōʻailona ma lalo nei, e hoʻomaopopo koke i kāu kauka.
| Pilikia | Nā hiʻohiʻona e nānā ai |
|---|---|
| Nā pilikia e pili ana i ka ʻoki ʻana | |
| A puni ka ʻeha | ʻUlaʻula, ʻeha, mehana, a pehu paha. |
| Ke kahe nei ka wai mai ka ʻeha | Ke pulu nei a hiki i kahi e puka mai ai ke koko a i ʻole ka wai moakaka mai loko mai o ke kāʻei. He wai ʻōmaʻomaʻo a melemele paha e like me ka pehu e puka mai ana. |
| Nā kihi ʻeha | Manaʻo e neʻe ana nā humuhumu a i ʻole nā lihi o ka ʻeha. |
| Nā pilikia koʻikoʻi ʻē aʻe | |
| ʻEha | ʻEha nui a mau loa ma ke kua a i ʻole ka ʻōpū. |
| Ka hanu ʻana a me ka puʻuwai | ʻEha ka umauma a i ʻole ka paʻakikī o ka hanu ʻana ʻoiai i ka wā e hoʻomaha ai. |
| Nā hiʻohiʻona kino ʻē aʻe | Pehu o nā wāwae, poniuniu, nalowale ka ʻike, luhi nui, kuni a i ʻole ke anu, koko i loko o ka ʻōpala. |
Nā hoʻololi o ke ola e pono ai ʻoe e hana ma hope o ke ʻoki ʻana
He hoʻopukapuka kālā nui kēia no kou olakino. Na ʻoe e mālama i kēlā hoʻopukapuka kālā.
- ʻAi olakino no ka puʻuwai: E hōʻemi i ka paʻakai, ke kō, a me ka ʻaila. E inu i ka wai he nui.
- Hoʻoikaika Kino: E nīnau i kāu kauka i nā hoʻoikaika kino kūpono iā ʻoe.
- Inā ʻoe e puhipaka, e hoʻōki i kēia manawa: He mea ʻino loa ka puhipaka i kou mau kīʻaha koko.
- E kāohi i ke koko kiʻekiʻe, ka cholesterol, a me ka maʻi diabetes: E lawe i kāu mau lāʻau lapaʻau i ka manawa kūpono.
He hana hoʻōla ola ke ʻoki ʻana o ka aneurysm e kōkua ai i kou mau kīʻaha koko e ho'ōla. No kekahi poʻe, he hana ulia pōpilikia ia. No kekahi poʻe, he mea ia i hoʻolālā ʻia i nā mahina ma mua. Eia naʻe, ʻaʻole ia me ka ʻole o nā pilikia. No laila, e kamaʻilio me kāu kauka e pili ana i ka lāʻau maikaʻi loa nāu. ʻO nā nānā mau ʻana ke ala maikaʻi loa e ʻike ai i kahi aneurysm ma mua o kona ulu nui ʻana a lilo i pilikia.
Leka Lawe-Home
- ʻO ke ʻoki ʻana o ka aneurysm kahi ʻoki ola e pili ana i ka wehe ʻana i kahi ʻāpana nāwaliwali a puʻupuʻu o ka aorta a hoʻololi iā ia me kahi ʻōmole hana (graft).
- ʻOi aku ka kiʻekiʻe o ka holomua o kahi ʻoki kino i hoʻolālā ʻia ma mua o ka haki ʻana o kahi aneurysm. No laila, he mea nui loa ia e makaʻala i nā hōʻailona a ʻike pinepine i kāu kauka.
- No ka mea he ʻoki kino nui kēia, hiki ke hala kekahi mau pule a i ʻole mau mahina e hoʻōla piha ai. E hoʻomanawanui a e hahai i nā ʻōlelo a kāu kauka e hāʻawi iā ʻoe iho i ka manawa e ho'ōla ai.
- ʻO ka hoʻohana ʻana i kahi nohona olakino (ʻai maikaʻi, hoʻoikaika kino, a me ka haʻalele ʻana i ka puhipaka) ma hope o ke ʻoki ʻana kekahi o nā hoʻopukapuka kālā maikaʻi loa hiki iā ʻoe ke hana i kou olakino i ka wā e hiki mai ana.
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