ʻO ka hoʻokaʻawale ʻana o ke koko - Ua ʻike anei ʻoe i kēia kūlana weliweli?

ʻO kou puʻuwai ke kikowaena nui o ka pamu ʻana no kou kino holoʻokoʻa. No laila, ʻo ke kīʻaha koko nui loa e puka mai ana mai ka puʻuwai a lawe i ke koko maʻemaʻe waiwai i ka oxygen ma loko o kou kino ua kapa ʻia ʻo ka aorta. E noʻonoʻo e like me ka paipu wai nui e hoʻolako ana i ka wai i kou hale. ʻO ka Aortic Dissection ka wā e haehae ai ka paia o kēia kīʻaha koko nui mai loko mai. He pilikia weliweli loa kēia, e hoʻoweliweli ana i ke ola e hana pinepine ʻia me ka koke ʻole, me ka ʻole o kahi ʻōlelo aʻo mua.

He aha ka Aortic Dissection? E hoʻomaopopo maʻalahi kākou

He kīʻaha koko ko kākou aorta i hana ʻia me ʻekolu papa. Ua like ia me ka paia ʻekolu papa. Inā no kekahi kumu, e kahe ana ka waimaka ma ka papa o loko o kēia paia, e komo ke koko e kahe ana ma lalo o ke kaomi kiʻekiʻe i loko o ka waimaka a hoʻomaka e kahe ma waena o nā papa ʻelua o ka paia. Ke hoʻopiha ʻia ke koko ma kēia ʻano, e hoʻokaʻawale nā ​​papa ʻelua kekahi i kekahi. ʻO ia ka mea a mākou e kapa nei he dissection.

E noʻonoʻo e like me ke alanui i pohā i ʻelua. Ke hana ʻia kēia, ua hoʻopilikia ʻia ke kahe maʻamau o ke koko i nā ʻāpana like ʻole o ke kino. A i kekahi manawa, hiki i kēia aʻa nui ke pohā loa (rupture).

He aha nā ʻano nui o ka dissection aortic?

Ua hoʻokaʻawale nā ​​kauka i kēia ʻano i ʻelua ʻano nui, i kapa ʻia ʻo ka hoʻokaʻawale ʻana o Stanford, kahi i hoʻokumu ʻia ma kahi e loaʻa ai ka haehae.

He aha nā hōʻailona o kēia? Pehea e ʻike ai?

ʻO ke ʻano nui o ka aortic dissection, ʻo ia ka hiki koke ʻana mai . ʻAʻohe hōʻailona hōʻike. Hiki ke hana ʻia i kēlā me kēia manawa, e like me ka wā e hiamoe ana ʻoe, e hoʻomaha ana, a i ʻole e hana ana i ka hana kaumaha.

Eia nā hōʻailona i ʻike ʻia ma ke ʻano laulā:

• ʻEha koke, ʻaʻole hiki ke hoʻomanawanui, ʻeha nui ma ka umauma a i ʻole ke kua o luna. Ua wehewehe ka poʻe he nui iā ia he manaʻo "hae" a "ʻūlū ʻia" . ʻO kēia ka hōʻailona nui a maʻamau.
• ʻEha nui o ka ʻōpū.
• Paʻakikī ka hanu ʻana (Dyspnea).
• Pōniuniu a vertigo paha.
• Ka emi koke ʻana o ke koko (kaomi koko haʻahaʻa).
• He nawaliwali a wikiwiki hoʻi ka puʻuwai.
• Ka hou nui ʻana.
• Ka huikau.
• Ka nalowale ʻana o ka ʻike.
• Nā hōʻailona o ka hahau ʻana. Eia kekahi laʻana, nāwaliwali ma kekahi ʻaoʻao o ke kino a i ʻole ka paʻakikī i ka ʻōlelo ʻana.

No ke aha e hana ʻia ai kēia? He aha nā kumu pilikia?

ʻO ke kumu nui o ka ʻoki ʻana o ka aortic ʻo ia ka nāwaliwali mālie o ka paia o ka aorta i ka hala ʻana o ka manawa. Hana malū ʻia kēia nāwaliwali no nā makahiki, a i ka hopena e haehae ma kahi nāwaliwali loa.

ʻO ke kumu pilikia nui a maʻamau no kēia, ʻo ia ke koko kiʻekiʻe i kāohi ʻole ʻia (Hypertension) . Hoʻopōʻino ke koko kiʻekiʻe i nā paia o nā kīʻaha koko, e hoʻolilo ana iā lākou i palupalu a nāwaliwali.

ʻO nā kumu pilikia ʻē aʻe:

• ʻO ka Atherosclerosis a i ʻole ke cholesterol kiʻekiʻe.
• Ka hoʻohana ʻana i nā huahana paka (puhipaka).
• ʻO ka aneurysm aorta.
• Nā maʻi o ka valve aortic o ka puʻuwai.
• ʻO nā kīnā puʻuwai hānau, no ka laʻana, ka valve aortic bicuspid (ʻelua mau valves ma kahi o nā ʻekolu maʻamau).
• Nā maʻi pili o nā ʻiʻo, e like me ka Marfan syndrome a me ka Ehlers-Danlos syndrome . He mau kūlana kēia i hiki ke hoʻoilina ʻia.
• Inā ua loaʻa i kekahi o ka ʻohana kahi dissection aortic ma mua.
• Nā ʻeha koʻikoʻi ma ka umauma (e like me kahi ulia kaʻa koʻikoʻi).
• Ma waena o 40 a me 70 mau makahiki.
• Ke koko kiʻekiʻe i ka wā hāpai.
• Ka hoʻohana ʻana i nā lāʻau lapaʻau e like me ka cocaine.

Pehea e ʻike ai ke kauka i kēia?

Ke hele ʻoe i ka haukapila, hiki i ke kauka ke kānalua i kēia kūlana ma muli o kāu mau hōʻailona. Eia nō naʻe, no ka mea ua like kēia mau hōʻailona me ka hōʻeha puʻuwai a i ʻole ka hahau ʻana, pono e hana koke ʻia kekahi mau hoʻokolohua e hōʻoia pono ai.

• CT scan (Computed Tomography): ʻO kēia ke ala maikaʻi loa a wikiwiki hoʻi e ʻike maopopo ai i ka aorta i kahi pilikia.
• Echocardiogram: He hoʻāʻo ultrasound kēia. Hiki i kahi echocardiogram transesophageal (TEE) ke hōʻike maopopo i ka aorta ma mua o ka echocardiogram transthoracic.
• X-ray o ka umauma: Hiki ke hāʻawi i kahi manaʻo maʻamau inā ua hoʻonui ʻia ka aorta.
• MRI (Magnetic Resonance Imaging): ʻOiai hiki i kēia ke hana i nā kiʻi maopopo loa, ʻaʻole i hoʻohana pinepine ʻia i nā pilikia no ka mea ʻoi aku ka lōʻihi ma mua o ka CT scan.

Pehea e mālama ʻia ai?

ʻO ke ʻano o ka mālama ʻana ma muli o kahi o ka haehae (ʻAno A a i ʻole ʻAno B) a me ke kūlana o ka mea maʻi.

ʻO ke ʻoki kino a me nā lāʻau lapaʻau ʻē aʻe

1. Hoʻololi i ke kāpili: He ʻoki puʻuwai hāmama kēia. Ma kēia ʻoki, wehe ke kauka ʻoki i ka ʻāpana i hōʻino ʻia o ka aorta a hoʻololi iā ia me kahi kāpili synthetic. Hana ʻia kēia ʻoki ma ke ʻano he lāʻau lapaʻau ulia pōpilikia no ka dissection Type A.

2. Hoʻoponopono ʻana i ka Endovascular Stent-Graft: Pili kēia i ka hana ʻana i kahi ʻoki liʻiliʻi i loko o kahi kīʻaha koko ma ka ʻūhā a me ka hoʻohana ʻana i nā uea a me nā catheters e hoʻokomo i kahi paipu metala (stent graft) i loko o ka ʻāpana nāwaliwali o ka aorta. Hoʻoikaika kēia i ka paia nāwaliwali mai loko mai. Hoʻohana pinepine ʻia kēia ʻano hana no ka dissection Type B paʻakikī.

3. Ke ʻAno Hana Hoʻohui: I kekahi mau hihia paʻakikī, pono e hoʻohana pū ʻia nā ʻano hana ʻoki hāmama a me nā ʻano hana stent-graft.

Nā lāʻau lapaʻau (nā lāʻau lapaʻau)

Hoʻohana nui ʻia nā lāʻau lapaʻau ma mua o ke ʻoki ʻana, ma hope o ke ʻoki ʻana, a ma nā hihia ʻAno B kahi i koi ʻole ʻia ai ke ʻoki ʻana.

• Hiki ke hāʻawi ʻia nā lāʻau lapaʻau e like me nā beta-blockers e hoʻohaʻahaʻa i ka helu o ka puʻuwai a me ke koko. Hoʻemi kēia i ke kaomi ma ka aorta a pale i ka laha ʻana o ka haehae.
• Pono ʻoe e lawe i ka lāʻau lapaʻau no ke koena o kou ola e kaohi i kou koko koko.

Hiki ke pale ʻia kēia?

ʻAʻole hiki iā mākou ke hoʻololi i kekahi mau mea pilikia (e like me nā maʻi hoʻoilina). Eia nō naʻe, aia kekahi mau mea hiki iā mākou ke kaohi.

• E mālama pono i kou koko.Inā he koko kiʻekiʻe kou, e lawe i ka lāʻau lapaʻau a kāu kauka i kuhikuhi ai a hoʻēmi i kāu ʻai ʻana i ka paʻakai.
• Inā ʻoe e puhipaka ana, e hoʻōki koke.
• E mālama i ke kaumaha o ke kino olakino.
• Inā loaʻa i kekahi o kou ʻohana (nā mākua, nā kaikaina) kēia maʻi, e kamaʻilio me kāu kauka e pili ana i ia mea a e hana i nā hoʻokolohua e pono ai.
• Hiki i ke kau ʻana i ke kāʻei noho ke pale i nā ʻeha o ka umauma i loko o kahi ulia kaʻa.