Ua emi anei ke kahe o ke koko i kou mau wāwae? E kamaʻilio kākou e pili ana i ke ʻoki ʻana o Aortobifemoral Bypass

Ke manaʻo nei ʻoe i ka ʻeha nui a i ʻole ka paʻa ʻana i kou mau wāwae, ʻoi aku hoʻi ma nā ʻūhā a me nā puʻupuʻu, ke hele ʻoe no kahi mamao pōkole? Nalo ka ʻeha ma hope o kekahi manawa, akā hoʻi hou mai ke hoʻomaka hou ʻoe e hele? A i ʻole e loaʻa iā ʻoe nā ʻeha ma kou mau wāwae me ke kumu ʻole a lōʻihi ka manawa e ho'ōla ai? Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​ua kamaʻilio paha kāu kauka iā ʻoe e pili ana i ke ʻoki kino. Ua makaʻu iki paha ʻoe i kou lohe ʻana i ka inoa. I kēia lā ke kamaʻilio nei mākou e pili ana i kēlā, kahi ʻoki kino i kapa ʻia ʻo Aortobifemoral Bypass. Mai hopohopo, e wehewehe maʻalahi kākou i kēia.

I ka ʻōlelo maʻalahi, he aha ka Aortobifemoral Bypass?

E noʻonoʻo ua ālai loa ʻia kekahi alanui nui ma ke kūlanakauhale ma muli o ke kaʻa. ʻAʻohe ala no nā kaʻa e hele ai. He aha kāu e hana ai? Hōʻalo mākou i kēlā wahi ālai ʻia a kūkulu i alanui 'bypass' hou e hiki ai i kēlā ʻaoʻao, ʻeā? ʻO ia ka hana a kēia ʻoki kino.

ʻO ka Aortobifemoral bypass kahi hana ʻoki e pili ana i nā kīʻaha koko i loko o ko mākou kino. Ma kēia, hana nā kauka ʻoki i kahi ala hou, i kapa ʻia he bypass , e kāpae i nā wahi i ālai ʻia a i ʻole nā ​​wahi i haiki ʻia o nā kīʻaha koko nui i loko o ko mākou ʻōpū. Hoʻihoʻi kēia i ke kahe koko i ko mākou mau wāwae.

Ma kēia ʻoki kino, hoʻohana nā kauka i kahi kīʻaha koko hana, i kapa ʻia he graft . Hana pinepine ʻia kēia me kahi mea e like me ka polyester. E hoʻomaopopo kākou pehea i loaʻa ai kona inoa:

• ʻO "Aorto" ke kīʻaha koko nui loa i loko o ko kākou kino, ʻo ia hoʻi ka aorta . Hoʻomaka ia ma ka puʻuwai a laila hele ma waena o ka umauma a i loko o ka ʻōpū.
• ʻO "Femoral" e pili ana i nā aʻa femoral, e hoʻomaka ana ma ko mākou ʻūhā a holo ma ko mākou mau ʻūhā a hiki i hope o ko mākou mau kuli.
• ʻO ke ʻano o "Bi" ʻo ia hoʻi ʻo 'ʻelua'. ʻO ia hoʻi, pili kēia graft i nā aʻa femoral ʻelua ma kou mau wāwae ʻelua.

Ua like kēia kāpili me kahi "Y" i luna. Hoʻopili ʻia ka hopena hoʻokahi ma luna i ka ʻaoʻao haʻahaʻa o ka aorta i loko o ka ʻōpū. Hoʻopili ʻia nā wāwae ʻelua o ka Y i nā aʻa femoral i loko o nā wāwae. Ma kēia ʻano, hiki i ke koko ke kāpae i ke ālai ʻana a kahe maʻalahi i nā wāwae.

No ke aha mākou e pono ai i kēia ʻano hana ʻoki kino?

Hana nui ʻia kēia ʻoki kino ma ke ʻano he lāʻau lapaʻau no kahi maʻi i kapa ʻia ʻo ka maʻi occlusive Aortoiliac . ʻOiai paha he mea paʻakikī iki ka inoa, he maʻalahi loa ka moʻolelo. ʻO ka mea e hana ʻia ana, ʻo ia ka hōʻiliʻili ʻana o ka cholesterol a me nā waihona momona ʻē aʻe (plaque) i ka hala ʻana o ka manawa i loko o nā kīʻaha koko nui i loko o ko kākou ʻōpū a me ka pelvis. ʻO nā kīʻaha koko nui i hoʻopilikia ʻia ma kēia ʻano:

• ʻAorta ʻōpū: ʻO kēia ka ʻāpana o ka aorta e iho i lalo mai loko mai o ko mākou ʻōpū.
• Nā aʻa Iliac:Hoʻomaka kēia ma kahi kokoke i ka ʻūhā kahi e māhele ai ka aorta i ʻelua. ʻO kēia nā mea e hele ana i ka ʻāpana ʻūhā a lilo i nā aʻa femoral.

Ke hōʻiliʻili ka palaki i loko o kēia mau kīʻaha koko a hoʻohaiki iā lākou, ʻaʻole loaʻa i nā ʻāpana haʻahaʻa o ko mākou kino, e like me nā wāwae, nā wāwae, a me nā ʻōpū ʻē aʻe i loko o ka pelvis, ka nui o ke koko oxygenated e pono ai. Ke lilo kēia ʻano i mea koʻikoʻi, hiki ke loaʻa nā pilikia like ʻole.

He ʻoki kino koʻikoʻi anei kēia? Aia kekahi mau koho ʻē aʻe?

ʻAe, ʻo ka aortobifemoral bypass kahi ʻoki hāmama i hana ʻia ma o kahi ʻoki nui ma ka ʻōpū. No laila, ua manaʻo ʻia he ʻoki nui, a he ʻoki nui paha.

Akā i kēia mau lā, me ka holomua o ka ʻenehana, aia nā lāʻau lapaʻau ʻē aʻe no kēia. ʻO kekahi o nā mea nui he ʻano hana i kapa ʻia ʻo aortoiliac stenting me ka bifurcation reconstruction (AISBR) . No kēia ka māhele o ke ʻoki endovascular .

I ka ʻōlelo maʻalahi, pili kēia i ke komo ʻana i kahi cannula i loko o ke kīʻaha koko ma o kahi lua liʻiliʻi ma ka ʻūhā, e hele ana i kahi i paʻa, a kau i kahi ʻōmole liʻiliʻi e like me ka mesh (stent) ma o ia mea e hoʻonui hou i ke kīʻaha koko. ʻOi aku ka liʻiliʻi o nā pilikia ʻokiʻoki a me ka noho pōkole ʻana i ka haukapila.

Na kāu kauka e hoʻoholo i ke koho kūpono loa iā ʻoe. ʻO ka maʻamau, ua ʻōlelo ʻia ke kau ʻana o ka stenting no ka poʻe i loaʻa i ka pilikia nui no ke ʻoki kino nui ma muli o nā kūlana olakino ʻē aʻe. Eia nō naʻe, i kekahi manawa, ma muli o ke koʻikoʻi o ka paʻa ʻana, pono paha ke ʻoki kino hāmama. No laila e kamaʻilio me kāu kauka e pili ana i kāu mau koho a me nā pono a me nā pōʻino.

Pehea mākou e hoʻomākaukau ai ma mua o ke ʻoki kino?

Pono ka nui o ka hoʻomākaukau ʻana no kahi ʻoki kino nui e like me kēia. E hāʻawi kāu hui lapaʻau iā ʻoe i nā kuhikuhi e pono ai. Ma keʻano laulā, pono ʻoe e mālama i kēia mau mea.

• Ke haʻalele ʻana i ka puhipaka: Inā he mea puhipaka ʻoe, pono ʻoe e hoʻōki loa ma ka liʻiliʻi he 3-4 mau pule ma mua o ke ʻoki ʻana. He mea nui loa ka haʻalele ʻana i ka puhipaka no ka holomua o ke ʻoki ʻana, a no ke olakino o kou puʻuwai a me nā kīʻaha koko ma hope.
• E haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āu e lawe nei: Inā ʻoe e lawe nei i ka lāʻau lapaʻau no nā mea e like me ka maʻi diabetes a i ʻole ke koko kiʻekiʻe, pono ʻoe e haʻi i kāu kauka e pili ana i ia mea. Pono paha e hoʻōki ʻia kekahi mau lāʻau lapaʻau a hoʻololi paha i ka nui ma mua o ke ʻoki ʻana.
• Ka hoʻokē ʻai ʻana ma mua o ke ʻoki kino: E aʻo ʻia ʻoe e pale i ka ʻai ʻana a i ʻole ka inu ʻana ma hope o ke aumoe o ka pō ma mua o ke ʻoki kino. E hahai pono i kēia mau kuhikuhi.
• Ke kiʻi ʻana i nā hoʻokolohua e pono ai: Pono ʻoe e hana i kekahi mau hoʻokolohua e hōʻoia i kou olakino ma mua o ke ʻoki ʻana.
• ʻIkepili kuʻekuʻe wāwae-brachial (ABI): He hoʻāʻo e ana i ke koko ma nā wāwae.
• ʻO ke kani ʻana o ke koko (Doppler scan): He scan e nānā pono ai i ke kahe ʻana o ke koko i loko o nā kīʻaha koko a me nā mea i ālai ʻia.
• ʻO nā hoʻokolohua e like me ECG a me Echo e nānā i ke olakino o ka puʻuwai a me nā aʻa coronary.

He aha ka mea e hana maoli ana i ka wā o ke kaʻina hana?

ʻAʻole ʻoe e manaʻo i kekahi mea i ka wā o ke ʻoki ʻana, no ka mea, e noho ana ʻoe ma lalo o ka anesthesia laulā. E hahai ke kime ʻoki i kēia mau ʻanuʻu:

1. Anesthesia: Hoʻokomo ʻia ʻoe i loko o kahi hiamoe hohonu.

2. Ke hana ʻana i nā ʻoki: ʻO ka mua, hana ʻia kahi ʻoki nui (laparotomy) ma ka lōʻihi o ka ʻōpū e hiki ai i ka aorta. A laila, hana ʻia ʻelua mau ʻoki hou ma ka piko o ka ʻūhā e hiki ai i nā aʻa femoral.

3. Hoʻokomo ʻana i ka hoʻopili ʻana:Lawe ke kauka lapaʻau i ke kīʻaha koko hana "Y" a humuhumu i ka ʻaoʻao luna o ia mea ma luna o ka mea i paʻa i loko o ka aorta. Ua humuhumu ʻia nā wāwae ʻelua o lalo o ka Y ma lalo o ka mea i paʻa i loko o nā aʻa femoral.

4. Ke pani ʻana i nā ʻoki: Ma hope o ka hana ʻia ʻana o ke alahaka hou, ua pani ʻia nā ʻoki i hana ʻia ma ka ʻōpū a me ka ʻūhā me nā humuhumu a i ʻole nā ​​staples.

ʻO ka maʻamau, hiki i kēia ʻoki kino holoʻokoʻa ke hala ma waena o 2 a me 6 mau hola .

He aha ka mea e hana ʻia ma ka haukapila ma hope o ke ʻoki kino?

Ma hope o ke ʻoki kino, pono ʻoe e noho ma ka haukapila no 4 a 7 mau lā. I loko o kēia manawa, e mālama pono loa ke kime lapaʻau iā ʻoe.

• E mālama ʻia ʻoe ma ka ʻāpana mālama koʻikoʻi (ICU) a i ʻole kahi keʻena kūikawā a e nānā pono ʻia no nā pilikia, ʻoiai nā maʻi.
• Nānā pinepine au inā maikaʻi ke kahe koko ma kou mau wāwae .
• E kōkua lākou iā ʻoe e hele mālie. Ma kahi mamao pōkole mua, a laila e hoʻonui i ka mamao i kēlā me kēia lā.
• Hāʻawi ʻia nā lāʻau ʻeha e kāohi i ka ʻeha.

He aha nā holomua a me nā pilikia o kēia ʻoki kino?

He holomua nui kēia ʻoki kino. Wahi a nā helu helu, ma waena o 80% a me 95% o nā ʻoki kino e mālama pono i ke kahe koko no 5 mau makahiki. I ka 10 mau makahiki, ʻo ka helu holomua ma waena o 74% a me 86%.

E like me nā ʻoki kino nui a pau, aia nā pilikia a me nā pilikia e hiki ke kū mai. Ma mua o kou hopohopo ʻana, e hoʻomanaʻo e hana ka hui lapaʻau i kā lākou mea maikaʻi loa e hōʻemi i ka hiki ke hana ʻia kēia mau mea.

Nā pilikia e hiki mai ana:

• Maʻi hohola
• Hahau
• Ke kahe koko nui
• Nā ʻūpā koko
• Nā maʻi ʻeha ʻoki
• Maʻi hoʻopili
• Ka hāʻule ʻana o ka puʻupaʻa
• Ka hāʻule ʻana o ka māmā

E kamaʻilio ākea me kāu kauka e pili ana i kēia mau pilikia ma mua o ke ʻoki ʻana a e nīnau i kāu mau nīnau.

Hoʻōla hou a me nā hana palekana ma hope o ka hoʻi ʻana i ka home

Hiki ke hala he 2 a 3 mau mahina e hoʻōla piha ai, akā pono ʻoe e hiki ke hoʻi mālie i nā hana maʻamau i loko o 4 a 6 mau pule.

Hiki ke ʻeha nā ʻoki no nā pule mua. E hoʻohana i nā lāʻau hoʻomaha ʻeha a kāu kauka i kuhikuhi ai no kēia.

• E lawe i kāu lāʻau lapaʻau e like me ke kauoha: E lawe i nā lāʻau lapaʻau a pau i kauoha ʻia e kāu kauka i ka manawa kūpono a me ka nui kūpono.
• E mālama i nā ʻeha maʻemaʻe: E hahai pono i nā ʻōlelo a kāu kauka e pili ana i ka holoi ʻana a me ke kau ʻana i ka lāʻau lapaʻau.
• Hoʻomaʻamaʻa kino:ʻO ka hoʻoikaika kino maikaʻi loa e hana ai i nā pae mua, ʻo ia ka hele wāwae. E hoʻonui mālie i ka mamao āu e hele ai i kēlā me kēia lā. Akā, mai hele ikaika aʻe ma mua o ka ʻōlelo a kāu kauka.
• Mai hāpai i nā mea kaumaha: Mai hāpai piha i nā mea kaumaha no kekahi mau mahina.

E nīnau i kāu kauka i ka wā hiki iā ʻoe ke hoʻomaka hou e hoʻokele kaʻa, e hele i ka hana, a e hana i ka hoʻoikaika kino ikaika.

I ka manawa hea e pono ai iaʻu ke kāhea aku i ke kauka?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona ma hope o ka hoʻi ʻana i ka home, e kāhea koke aku i kāu kauka a i ʻole e hele i ka haukapila .

He aha e hana ai i ka wā pilikia? (Kūlana pilikia)

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona o ka hōʻeha puʻuwai a i ʻole ka hahau ʻana , e kāhea koke aku i ka lawelawe ambulance 1990 a i ʻole e hele i ka Emergency Treatment Unit (ETU) o ka haukapila kokoke loa.

Nā hōʻailona o ka hōʻeha puʻuwai

• ʻEha, ʻūmiʻi, a ʻoluʻolu ʻole paha ma waenakonu o ka umauma.
• Paʻakikī ka hanu ʻana.
• Luli, ʻeha ʻōpū.
• Nā palpitations o ka puʻuwai.
• Luhi loa.
• Pōʻino, nalowale ka ʻike.
• Ka hou nui ʻana.

Nā hōʻailona o ka hahau ʻana

• Ka maneʻo a nāwaliwali paha ma kekahi ʻaoʻao o ke kino (ka maka, ka lima, a i ʻole ka wāwae).
• Ka paʻakikī i ka ʻōlelo ʻana a i ʻole ka ʻōlelo ʻana me ka ʻole o ka pololei.
• Ka nalowale koke ʻana o ka ʻike, hoʻokahi a ʻelua paha mau ʻike.
• ʻEha poʻo koʻikoʻi koke.
• Ka paʻakikī o ka hele wāwae, ka nalowale o ke kaulike.

Hiki i ke alo ʻana i kahi ʻoki kino nui ke lilo i mea hoʻoluhi naʻau. He mea maʻamau kēlā. E kamaʻilio e pili ana i kou mau makaʻu a me kou hopohopo me kou ʻohana, a me kāu kauka a me ka hui lapaʻau. ʻO ka loaʻa ʻana o ka ʻike āpau āu e pono ai a me ke komo ʻana i loko me ka hoʻomākaukau noʻonoʻo maikaʻi e kōkua nui i ke kaʻina hana ho'ōla.