Ua kuhikuhi anei kāu kauka iā ʻoe i kahi lāʻau lapaʻau e pale aku ai i nā ʻūlū koko? Ua kapa kekahi poʻe i kēia he 'mea hoʻomāmā koko'. He mea maʻamau ke manaʻo iki i ka makaʻu a me ka hopohopo ke lohe ʻoe e pili ana i kēia lāʻau lapaʻau. Hiki paha i nā nīnau e like me "E pau anei ke kahe koko inā ʻoki au i koʻu lima a i ʻole koʻu wāwae?" ke noʻonoʻo. Akā, ʻo kēia lāʻau lapaʻau kekahi mea e hiki ai ke hoʻopakele i kou ola. I kēia lā, e kamaʻilio mākou e pili ana i kēia mau lāʻau hoʻomāmā koko, a i ʻole 'Anticoagulants', ma ke ʻano maʻalahi hiki iā ʻoe ke hoʻomaopopo.
I ka ʻōlelo maʻalahi, he aha kēia mau anticoagulants?
ʻO nā anticoagulants kahi papa o nā lāʻau lapaʻau e hōʻemi ana i ka hiki o kou koko ke kāpili. Kōkua lākou i kou kino e hoʻoheheʻe i nā clots koko e kū nei, a i ʻole e pale aku i nā clots hou mai ka hoʻokumu ʻana. ʻAʻole kēia he mau pila wale nō.
- Nā lāʻau lapaʻau waha
- Ma ke ʻano he inikini (Injections)
- Ma ke ʻano he wai i hāʻawi ʻia i loko o kahi aʻa (Intravenous - IV)
Loaʻa kēia mau lāʻau lapaʻau i nā ʻano he nui, e like me: Hoʻohana pinepine ʻia kēia mau lāʻau lapaʻau e pale a mālama i nā maʻi koʻikoʻi e hoʻoweliweli ana i ke ola e like me nā hahau ʻana, nā hōʻeha puʻuwai, a me nā embolisms pulmonary.
No ke aha mākou e pono ai i kēia ʻano lāʻau lapaʻau?
E noʻonoʻo ʻoe he ʻoki liʻiliʻi kou ma kou lima a i ʻole kou wāwae. Ma hope o kekahi manawa, e pau ke kahe ʻana o ke koko. Pehea lā e hana ai kēlā? No ka mea, ua paʻa ke koko. He ʻano pale maikaʻi loa kēia i loko o ko kākou kino. Hoʻōki kēia kaʻina hana i ke kahe nui ʻana mai kahi ʻeha a hoʻomaka ka ʻeha e ho'ōla.
Eia nō naʻe, hoʻomaka ka pilikia ke hana ʻia kēia mau ʻūpā koko me ke kumu ʻole, ma nā wahi kūpono ʻole, ʻo ia hoʻi, i loko o nā kīʻaha koko. He aha ka mea e hana ai inā hele pū kahi ʻūpā koko i hana ʻia ma kēia ʻano me ke koko a paʻa i loko o kahi kīʻaha koko lahilahi i loko o ka lolo, ka puʻuwai, a i ʻole nā māmā? A laila e pau ke kahe ʻana o ke koko i ka ʻōkana i hoʻolako ʻia e kēlā kīʻaha koko, a hoʻomaka kēlā ʻōkana e hana hewa a hōʻino ʻia. ʻO kēia ka mea weliweli loa.
ʻO kēia kekahi o nā kūlana koʻikoʻi loa e hiki ke kū mai ma muli o nā ʻūpā koko ma kēia ʻano.
| Kūlana weliweli | ʻO ka mea e hana wale ʻia |
|---|---|
| Hahau | Hele kahi ʻūpā koko i ka lolo a ālai i kahi kīʻaha koko liʻiliʻi ma laila. Hiki i kēia ke make ai nā hunaola o ka lolo. |
| ʻO ka Embolism Pulmonary (PE) | Hoʻopili kahi ʻūpā koko i kahi kīʻaha koko nui e alakaʻi ana i nā māmā. He kūlana koʻikoʻi loa kēia a hiki ke make. |
| Maʻi hohola | Hoʻopili kahi ʻūpā koko i nā aʻa coronary e hoʻolako ana i ke koko i ka puʻuwai. Hōʻino pū kēia i ka ʻiʻo o ka puʻuwai. |
ʻO wai ka mea i kuhikuhi nui ʻia ai kēia lāʻau lapaʻau?
Kuhikuhi nā kauka i kēia mau 'Anticoagulants' i ka poʻe i pilikia i ka loaʻa ʻana o nā kūlana weliweli i ʻōlelo ʻia ma luna. Eia kekahi o nā kūlana olakino e hoʻoweliweli iā lākou:
- ʻO ka Fibrillation Atrial: ʻO kēia ka manawa ʻaʻole e ʻūlū pono nā keʻena ʻelua o luna o ka puʻuwai (atria), akā e kuʻi kū ʻole ana, me he mea lā e haʻalulu ana. Ke hana ʻia kēia, ʻaʻole e holo pono ke koko, a ʻoi aku ka nui o ka manawa e hana ʻia ai nā ʻōpū koko i loko o kēlā mau keʻena. Inā haki kēia mau ʻōpū koko mai ka puʻuwai a hele i ka lolo, hiki iā lākou ke hana i ka hahau.
- ʻO ke ʻoki ʻana i ka valve o ka puʻuwai: Ke hoʻololi ʻia nā valve o ka puʻuwai, ʻoiai me kahi valve mechanical, aia kahi pilikia o ka hoʻokumu ʻia ʻana o nā ʻōpū koko ma ka ʻili o ka valve. He mea nui kēia lāʻau lapaʻau e pale aku i kēia.
- Hoʻololi ʻūhā a kuli paha: Ma hope o nā ʻoki kino nui e like me kēia, aia kahi pilikia o ke koko e hana ʻia ana i loko o nā aa hohonu o nā wāwae. Kāhea mākou i kēia kūlana ʻo 'Deep Vein Thrombosis (DVT).' Hana ʻia ka Pulmonary Embolism i ka wā e haki ai kahi koko i hana ʻia ma ka wāwae a noho i loko o nā māmā.
- Nā Maʻi ʻAʻa Koko: Loaʻa i kekahi poʻe kahi predisposition genetic i ka ʻaʻa koko. Pono pū kekahi poʻe i kēia lāʻau lapaʻau.
Nā ʻano o nā anticoagulants a me kā lākou hana
Aia kekahi mau ʻano anticoagulants. Hoʻopilikia kēlā me kēia ʻano i ke kaʻina hana coagulation koko ma nā ʻano like ʻole. E nānā kākou i nā ʻano nui.
Nā lāʻau lapaʻau waha
1. Warfarin
He lāʻau lapaʻau lōʻihi kēia e hana ana ma ke ālai ʻana i ka hiki o ke kino ke hoʻohana i ka wikamina K, kahi wikamina e pono ai no ke kāpili ʻana o ke koko.
ʻO ka pilikia nui me warfarin, ʻo ia ka ʻokoʻa loa o kona nui mai kēlā kanaka a kēia kanaka a pono e kaohi pono ʻia.Inā hoʻonui iki ʻia ka nui o ka lāʻau, piʻi ka pilikia o ke kahe ʻana o ke koko, a inā e hoʻemi ʻia, ʻaʻole i pale pono ʻia nā ʻūpā koko. No laila, pono i ka poʻe e lawe ana i ka 'Warfarin' ke hana mau i kahi hoʻāʻo koko ('INR test') e nānā inā pololei ka nui o ka lāʻau.
2. Nā lāʻau lapaʻau hou (Direct Oral Anticoagulants - DOACs)
He mau lāʻau lapaʻau hou kēia. No kēia hui nā lāʻau lapaʻau e like me 'Dabigatran', 'Rivaroxaban', 'Apixaban'. ʻO ka pōmaikaʻi nui o kēia mau mea, ʻaʻole pono lākou i nā hoʻāʻo koko pinepine e like me 'Warfarin'. Hoʻopili lākou i nā enzyme kikoʻī e pili ana i ke kaʻina hana koko (e.g. 'Thrombin' a i ʻole 'Factor Xa') a hoʻōki i kā lākou hana.
Nā lāʻau lapaʻau injectable a me IV
ʻO Heparin a me nā lāʻau lapaʻau e pili ana
Hoʻohana pinepine ʻia kēia mau mea ma nā haukapila ke pono nā hopena wikiwiki. Hana ʻo 'Heparin' ma ka hoʻoulu ʻana i kahi protein kūlohelohe ('Antithrombin') i loko o ko mākou kino e pale ai i ke kāpili ʻana o ke koko, a hoʻōki i ke kaʻina hana kāpili koko. ʻO 'Low-Molecular-Weight Heparin (LMWH)' kahi mana holomua o kēia, maʻalahi ke lawelawe, a i kekahi manawa hoʻohana ʻia ma ka home.
He aha nā hopena ʻaoʻao a me nā pilikia?
ʻO ke kumu nui a i manaʻo ʻia o kekahi anticoagulant, ʻo ia ke kahe koko . ʻO kēia no ka mea ke kāohi nei kēia mau lāʻau lapaʻau i ke kāpili ʻana o ke koko. No laila, ʻoiai kahi ʻeha liʻiliʻi hiki ke hoʻoulu i ke kahe koko hou aʻe ma mua o ka maʻamau.
Eia nō naʻe, hiki i kekahi mau lāʻau lapaʻau ke loaʻa nā hopena ʻaoʻao ʻē aʻe e pili pono ana iā lākou.
| ʻAno lāʻau lapaʻau | Nā hopena ʻaoʻao kūikawā koʻikoʻi |
|---|---|
| ʻO Warfarin |
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| Heparin |
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| Nā DOAC (nā lāʻau lapaʻau hou) |
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Āhea ʻoe e ʻike ai i ke kauka? - He mea kēia e pono ai ʻoe e ʻike!
Ma ke ʻano he kanaka e lawe ana i kēia lāʻau lapaʻau, pono ʻoe e makaʻala loa. No ka mea, ʻaʻole paha ʻoe e ʻike i kekahi kahe koko i loko. No laila e makaʻala loa i nā mea aʻe.
| Nā pilikia a me nā kūlana e pono ai ke ʻimi ʻia ke aʻo lapaʻau | |
|---|---|
| Inā loaʻa iā ʻoe kēia mau hōʻailona, e kamaʻilio me kāu kauka. | |
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| Inā loaʻa iā ʻoe kēia mau hōʻailona, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila! | |
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ʻO ka mea nui loa, ʻo ia ka haʻi ʻana i kēlā me kēia kauka a me nā kauka niho e mālama iā ʻoe e lawe ana ʻoe i ka lāʻau anticoagulant. He mea nui e hoʻomaopopo i kēia ma mua o ka unuhi ʻana i ka niho.
Leka Lawe-Home
- ʻO nā anticoagulants kahi ʻano lāʻau lapaʻau e hoʻōla ola ai e pale iā ʻoe mai nā maʻi koʻikoʻi e like me ka hahau ʻana a me ka hōʻeha puʻuwai. No laila, mai makaʻu i kēia mau lāʻau lapaʻau.
- E hōʻoia e lawe i ka nui i kuhikuhi ʻia, i ka manawa i kuhikuhi ʻia, e like me ka ʻōlelo a kāu kauka iā ʻoe. Mai hoʻokuʻu i hoʻokahi lā.
- Ma muli o ka pilikia o ke kahe ʻana o ke koko i ka wā e lawe ana i kēia lāʻau lapaʻau, e akahele e like me ka hiki e pili ana i nā hana e hiki ai ke hāʻule a me nā ʻeha, a e pili ana i nā haʻuki weliweli.
- Inā loaʻa ke kahe koko ʻano ʻē, ka palapū, a i ʻole ka ʻeha poʻo, e ʻimi koke i ke kōkua lapaʻau me ka hoʻokaʻulua ʻole .
- Ma mua o ka hoʻomaka ʻana i kekahi lāʻau lapaʻau ʻē aʻe (me nā painkillers), e haʻi i kāu kauka e lawe ana ʻoe i nā anticoagulants, no ka mea hiki i kekahi mau lāʻau lapaʻau ke launa pū me kēia.
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