ʻO ke kīʻaha koko nui loa e lawe ana i ke koko ma loko o ko kākou kino, ʻo ia ka aorta, a i ʻole aorta. E noʻonoʻo e like me ka paipu wai nui e lawe mai ana i ka wai i ko kākou hale. He aha ka mea e hana ai inā e nāwaliwali kekahi o nā paia o kēia paipu ma kahi hoʻokahi a hoʻomaka e puʻupuʻu ma lalo o ke kaomi o ka wai? ʻO ia ke ʻano o ka Thoracic Aortic Aneurysm. ʻO ka mea e hana ai ma kēia hihia, ʻo ka nāwaliwali o ka paia o kahi ʻāpana o ka aorta e holo ana ma ko kākou umauma a puʻupuʻu e like me ka pōpō ma lalo o ke kaomi o ke koko. I kēia lā, e kamaʻilio mākou e pili ana i kēia kūlana, ka mea e hana pinepine ʻia me ka ʻole o nā hōʻailona, i loko o ke kino.
He aha ka Thoracic Aortic Aneurysm?
I ka ʻōlelo maʻalahi, he pehu a he puʻupuʻu paha kēia (aneurysm) i loko o ka aorta, ke aʻa nui e holo ana ma ko kākou umauma (thorax). Ua like kēia aorta me kahi paipu. Akā i ka wā e hana ʻia ai kahi aneurysm, loli ke ʻano o kēlā paipu, a puka mai kekahi wahi e like me ka pōpō. ʻO ka maʻamau, kapa nā kauka i kēia kūlana he aneurysm i ka wā e lilo ai kēlā ʻāpana o ke aʻa i ka liʻiliʻi he 50% ka laulā ma mua o kona laulā maʻamau.
Hiki i kēia ʻano aneurysm ke hana ʻia ma nā wahi āpau o ko kākou aorta. Akā, ʻo ka hapa nui o ia mea e hana ʻia ma ka ʻōpū. Kapa mākou ia he Abdominal Aortic Aneurysm. Akā, hoʻokahi o kēlā me kēia ʻehā aneurysms e hana ʻia ana ma ka umauma. Kapa mākou ia he Thoracic Aortic Aneurysm.
Inā he aneurysm liʻiliʻi kou e like me kēia, ʻaʻole paha e pono ka nui o ka lāʻau lapaʻau. ʻOiai ʻoe e lawe ana i ka lāʻau lapaʻau e kāohi i nā mea e like me ke koko kiʻekiʻe, e nānā pinepine kāu kauka iā ʻoe e ʻike inā e nui ana. Akā inā nui ka aneurysm, a i ʻole e ulu wikiwiki ana, pono paha ke ʻoki ʻana ma mua o ka ulu ʻana o nā pilikia koʻikoʻi e hoʻoweliweli i ke ola.
Pehea ka maʻamau o kēia ʻano?
Wahi a nā helu helu, pili kēia maʻi ma waena o 6 a me 10 mau kānaka i kēlā me kēia 100,000. Eia nō naʻe, ʻoi aku paha ka nui maoli. ʻO kēia no ka mea ʻaʻole hōʻike ka nui o ka poʻe i kekahi mau hōʻailona a ola me ka ʻike ʻole ua loaʻa iā lākou kēia maʻi. Ma kahi o 20% o nā maʻi i hōʻoia ʻia he mau ʻohana ko lākou i loaʻa pū kekahi, ʻo ia hoʻi he hoʻoilina paha.
He aha nā hōʻailona o kēia?
ʻO ka pōʻino nui o kēia ʻano, ʻo ia ka hapa nui o ka manawa ʻaʻohe hōʻailona. Eia nō naʻe, i kekahi manawa, ke ulu nui ka aneurysm a kaomi i nā ʻōpū a puni, hiki ke ʻike ʻia kekahi mau hōʻailona.
| Hōʻailona | Kumu |
|---|---|
| ʻEha ma ka ʻauwae, ka ʻāʻī, ka umauma, a i ʻole ke kua i luna. | Ma muli o ke kaomi mai ka aneurysm. |
| Ka paʻakikī i ka moni ʻana a i ʻole ka ʻeha i ka moni ʻana. | Hoʻokumu ʻia kahi aneurysm e kahi puʻupuʻu i loko o ka esophagus. |
| Ka leo palahalaha. | Ma muli o ke kaomi ʻana o nā aʻalolo e kaohi ana i ka leo. |
| ʻŪhū a paʻakikī paha ka hanu ʻana. | Hoʻokumu ʻia kahi aneurysm e ke kaomi ʻana o ka trachea. |
Nā hōʻailona ulia pōpilikia e kū mai ana inā haki kahi aneurysm (ruptures) a dissection paha (dissection)
ʻO kēia ke kahua weliweli loa o ka maʻi. Hiki i ka paia o kahi aneurysm ke hoʻonāwaliwali a pohā koke (rupture) a haehae paha i ʻelua papa o ka paia (dissection). He kūlana koke loa kēia a hoʻoweliweli i ke ola. ʻIke pinepine ʻia kēia mau hōʻailona me ka koke a me ke koʻikoʻi loa.
Inā ʻike ʻoe a i ʻole kekahi mea ʻē aʻe i kekahi o kēia mau hōʻailona, mai hoʻokaʻulua i hoʻokahi minute. E hele koke i ka Emergency Treatment Unit (ETU) o ka haukapila. He mea nui kēlā me kēia kekona e hoʻopakele i ke ola.
| Nā hōʻailona e pono ai ke kōkua lapaʻau koke | |
|---|---|
| ʻEha nui | Ka ʻeha ʻō koke, ʻaʻole hiki ke hoʻomanawanui, ʻeha hou, ʻeha hou i ka umauma a i ʻole ke kua. |
| Pōʻino | Pōniuniu, ʻike maka pohihihi, a i ʻole ka nawaliwali. |
| Paʻakikī ka hanu ʻana | Ka manaʻo koke o ka pōkole o ka hanu. |
| Nā palpitations o ka puʻuwai | Manaʻo e kuʻi wikiwiki ana kou puʻuwai. |
| Ka hou nui ʻana | Ka hou nui ʻana me ke kumu ʻole. |
| Nā hiʻohiʻona ʻē aʻe | Huikau, paʻakikī i ka ʻōlelo ʻana, nalowale o ka ʻike, mae a nāwaliwali paha ma kekahi ʻaoʻao o ke kino. |
No ke aha lā e hana ʻia ai kekahi mea e like me kēia?
ʻO ka maʻamau, he ikaika a palupalu nā paia o ko kākou mau aʻa. Pono lākou e hiki ke ʻūlū a kīkoʻo ma lalo o ke kaomi o ke koko e komo mai ana me kēlā me kēia puʻuwai. Akā inā nāwaliwali kēia mau paia, ʻaʻole hiki iā lākou ke hoʻomanawanui i ke kaomi a hoʻomaka e puʻupuʻu.
ʻO ke kumu nui o kēia, he maʻi i kapa ʻia ʻo Atherosclerosis . I ka ʻōlelo maʻalahi, ua waiho ʻia nā mea momona e like me ka cholesterol i loko o nā kīʻaha koko (kapa mākou i kēia plaque), e mānoanoa mālie ana a hoʻonāwaliwali i nā paia o nā kīʻaha koko. E like me ka ʻōpala e hōʻiliʻili ana i loko o kahi paipu wai kahiko. Hoʻonāwaliwali kēia i nā paia o nā kīʻaha koko a hoʻonui i ka manawa kūpono e loaʻa ai kahi aneurysm.
He aha nā kumu e hoʻonui ai i ka pilikia?
Ma waho aʻe o ka atherosclerosis, ʻo nā mea āpau e hoʻonāwaliwali ai i nā paia o ka aorta e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i kahi aneurysm.
| Kumu pilikia | Wehewehena |
|---|---|
| Ke koko kiʻekiʻe | Hoʻokau mau i ke kaomi hou aʻe ma nā paia o nā aa koko. |
| Ka puhipaka a me ka hoʻohana ʻana i ka paka | Hoʻopōʻino pololei ia i nā paia o ke aʻa a hoʻolalelale i ka hoʻokumu ʻia ʻana o ka atherosclerosis. |
| Moʻolelo ʻohana | Inā ua loaʻa i kekahi o kou ʻohana pili kahi aneurysm, ua ʻoi aku kou pilikia. |
| Ka ʻelemakule ʻana | Ma keʻano laulā, ʻoi aku ka nui o ka pilikia o ka poʻe ma luna o 65 mau makahiki. |
| ʻO kekahi mau kūlana genetic | ʻO nā kūlana e like me ka Marfan syndrome, Loeys-Dietz syndrome, Vascular Ehlers-Danlos syndrome, a me Turner syndrome e hoʻonui i ka pilikia no ka mea hoʻonāwaliwali lākou i nā ʻiʻo pili o ke kino. |
| Nā kūlana olakino ʻē aʻe | ʻO nā kūlana e like me ka aortitis (ka mumū o ka aorta), ka maʻi valve aortic bicuspid (kahi maʻi valve puʻuwai), a me ka maʻi artery coronary (CAD). |
Pehea e ʻike ai nā kauka i kēia?
ʻO ka hapa nui o ka manawa, ʻike ʻia kēia ma ka ulia. Kāhea mākou iā ia he "diagnosis ulia." ʻO ia hoʻi, ke hana ʻia kahi X-ray umauma no kekahi kumu ʻē aʻe, ʻike paha ke kauka ua ʻoi aku ka laulā o ka ʻaoʻao waena o ka umauma (mediastinum) ma mua o ka maʻamau. ʻO ia ka manawa e kānalua ʻia ai he aneurysm.
Inā kū mai kēlā kānalua, e kauoha ke kauka i nā hoʻokolohua e like me kēia e hōʻoia iā ia:
- ʻO ka computed tomography (CT) angiogram: Hiki i kēia ke hana i nā kiʻi ʻekolu-dimensional maopopo loa o ka aorta.
- Echocardiogram (echo): He scan ultrasound e nānā i ka hana o ka puʻuwai a me ka hapa mua o ka aorta.
- ʻO ka angiogram resonance magnetic (MRA): He hoʻāʻo like me ka CT scan, akā me ka hoʻohana ʻole ʻana i ka radiation.
- ʻO ka ultrasound ʻōpū: Hiki i ka poʻe me ka aneurysm thoracic ke loaʻa i kahi aneurysm ʻōpū, no laila e nānā pū i kēlā.
He aha nā lāʻau lapaʻau i loaʻa?
ʻO ke ʻoki kino wale nō ka lāʻau lapaʻau hope loa no ka aneurysm aortic thoracic. Eia nō naʻe, i ka manawa a me ke ʻano o ke ʻoki kino e hana ʻia ai, pili ia i ka nui o ka aneurysm, kona wahi, pehea ka wikiwiki o kona ulu ʻana, a me kou olakino holoʻokoʻa.
Āhea e pono ai ke ʻoki kino?
Inā liʻiliʻi ka aneurysm, hiki i ke kauka ke hoʻoholo e kali me ke ʻoki ʻole ʻana. Kāhea mākou i kēia "kali makaʻala." ʻO ke ʻano kēia e nānā lākou i ka aneurysm i kēlā me kēia 6 a 12 mau mahina e ʻike inā e nui ana, a e hāʻawi lākou iā ʻoe i ka lāʻau lapaʻau e kāohi i kou koko.
Akā,
- Inā he 2 ʻīniha (ma kahi o 5.5 kenimika) a ʻoi aku paha ka nui o ka aneurysm,
- Inā ʻoi aku ka wikiwiki o ka ulu ʻana o ka aneurysm ma mua o 0.5 cm i kēlā me kēia makahiki .
- Inā ʻo ka aneurysm ke kumu o nā hōʻailona ,
ʻO ka maʻamau, ʻōlelo ʻia ke ʻoki ʻana no ka mea ʻo ka nui o ka aneurysm, ʻo ka nui o ka pilikia o ka pahū ʻana.
Nā ʻano hana nui
Aia kekahi mau ʻano hana nui i hoʻohana ʻia i kēia manawa.
1. ʻO ke ʻoki kino kuʻuna: Hana ʻia kahi ʻoki ma waenakonu o ka umauma, wehe ʻia ka ʻāpana nāwaliwali o ka aorta me ka aneurysm, a hoʻokomo ʻia kahi graft ma kona wahi.
2. Hoʻoponopono ʻana i ka ʻōpū endovascular aortic thoracic (TEVAR): He hana hoʻopilikia iki kēia. Hana ʻia kahi ʻoki liʻiliʻi ma ka ʻūhā, a hoʻokomo ʻia kahi stent graft ma o ka ʻoki me ka hoʻohana ʻana i kahi catheter i ka aneurysm a hoʻopaʻa ʻia mai loko mai.
3. Hoʻololi aʻa aortic: Hana ʻia kēia ʻoki kino inā aia ka aneurysm ma ke aʻa o ka aorta, kahi e pili ana i ka puʻuwai. Pono paha e hoʻololi i ka valve puʻuwai.
Na kāu kauka e hoʻoholo i ke ʻano lapaʻau kūpono loa iā ʻoe.
ʻAʻole anei hiki ke pale ʻia kēia?
ʻAʻohe ala e pale aku ai i ka ulu ʻana o kahi aneurysm. Eia nō naʻe, ʻo ka kaohi ʻana i ke kumu nui, ʻo ia hoʻi ka atherosclerosis, hiki ke hōʻemi nui i ka pilikia.
- E kāohi i kou koko a me nā pae cholesterol ma ka lawe ʻana i nā lāʻau lapaʻau a kāu kauka i kauoha ai.
- E hoʻohana i kahi ʻano ʻai olakino no ka puʻuwai, e like me ka Mediterranean Diet.
- E haʻalele loa i ka puhipaka a me nā huahana paka āpau.
- Hoʻoikaika kino. E hana i ka hana kino kaulike, e like me ka hele wāwae, no ka liʻiliʻi he 150 mau minuke i ka pule. Akā e kamaʻilio me kāu kauka ma mua o ka hoʻomaka ʻana i kahi papahana hoʻoikaika kino hou.
- E hana i kahi hoʻokolohua olakino makahiki.
Inā loaʻa iā ʻoe kēia maʻi, pehea ʻoe e mālama ai iā ʻoe iho?
Inā haʻi aku kāu kauka iā ʻoe he aneurysm aortic thoracic kou, mai hopohopo. E hāʻawi ʻo ia iā ʻoe i nā ʻōlelo aʻoaʻo no ka mālama ʻana iā ʻoe iho ʻoiai ʻoe e ola nei me ia.
- E pale i nā mea e like me ka hāpai kaumaha a me ka hoʻomaʻamaʻa waena kiʻekiʻe (HIIT). Hiki i kēia ke kau i ke kaomi pono ʻole ma ka aorta. E nīnau i kāu kauka i nā hoʻomaʻamaʻa kino kūpono iā ʻoe.
- E hōʻalo loa i ka hoʻohana ʻana i ka paka.
- E hōʻemi i ka paʻakai i ka meaʻai.
- E lawe i ka lāʻau lapaʻau i kauoha ʻia e ke kauka me ka pololei a me ka manawa kūpono.
- E hōʻalo i nā lāʻau lapaʻau e hoʻonui ai i ka puʻuwai (cocaine, amphetamines) a me kekahi mau mea kanu.
- E hoʻomau i ka launa pū ʻana me kāu kauka. Inā loaʻa iā ʻoe kekahi mau hōʻailona hou a i ʻole he mau hopena ʻaoʻao mai kāu lāʻau lapaʻau, e hoʻomaopopo koke iā lākou.
Leka Lawe-Home
- ʻO ka Thoracic Aortic Aneurysm kahi puʻupuʻu e like me ka pōpō pehu i loko o ke kīʻaha koko nui o ka umauma.
- ʻO ka hapa nui o ka manawa, ʻaʻohe ona hōʻailona, no laila inā he mau kumu pilikia kou (ke koko kiʻekiʻe, ka puhipaka, ka mōʻaukala ʻohana), e makaʻala i ia mea.
- He pilikia koʻikoʻi ka ʻeha koke a koʻikoʻi o ka umauma a i ʻole ke kua, ka paʻakikī o ka hanu ʻana, a i ʻole ka hāʻule ʻana. E hele koke i ka ʻOihana Pilikia o ka haukapila (ETU).
- Inā liʻiliʻi ka aneurysm, hiki ke mālama ʻia me ka lāʻau lapaʻau a me ka nānā mau ʻana. Inā nui, hiki ke mālama ʻia me ke ʻoki ʻana.
- Me ka mālama lapaʻau kūpono a me nā hoʻololi ʻana i ke ʻano o ka nohona, hiki iā ʻoe ke ola i kahi ola lōʻihi a olakino hoʻi me kēia maʻi. E hahai mau i ka ʻōlelo aʻo a kāu kauka.
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