Ke manaʻo nei hoʻi ʻoe i ka ʻeha ʻoi a i ʻole ka ʻeha ʻana i kou mau wāwae ke hele ʻoe no kahi mamao pōkole? Ke emi nei anei ia ma hope o kou kū ʻana a hoʻomaha no kekahi manawa, a laila hoʻi hou mai ka ʻeha ke hoʻomaka hou ʻoe e hele? He pilikia kēia i loaʻa i nā poʻe he nui. ʻO ke kumu nui o kēia hiki ke lilo i kahi paʻa i loko o ke kīʻaha koko nui e lawe ana i ke koko momona oxygen i kou mau wāwae. I kēia lā, ke kamaʻilio nei mākou e pili ana i kahi ʻoki kino koʻikoʻi loa i hana ʻia ma ia ʻano kūlana.
He aha ka Aortobifemoral Bypass?
I ka ʻōlelo maʻalahi, he hana ʻoki kēia a nā kauka lapaʻau e hana ai ma kou ʻōpū. E like me ka wā e ālai ʻia ai ke alanui, hana ʻia kekahi alanui hou, i kapa ʻia he alanui 'bypass', hana kēia hana ʻoki i kahi ala hou e kāpae ai i nā kīʻaha koko i ālai ʻia a i ʻole nā arteries i loko o kou kino. ʻAe kēia i ke koko e kahe pono i kou mau wāwae.
Ma kēia kaʻina hana, hoʻokomo ke kauka lapaʻau i kahi kīʻaha koko hana, i kapa ʻia he graft, i loko o kou ʻōpū a hoʻopili iā ia i ke kīʻaha koko i ālai ʻia. Hana pinepine ʻia kēia kīʻaha koko hana me kahi mea e like me ka polyester. ʻO ka huaʻōlelo "aortobifemoral" ponoʻī e hōʻike ana i kēia.
- ʻO "Aorto" ke kīʻaha koko nui loa i loko o ko kākou kino, ʻo ia hoʻi ka aorta . Hoʻomaka ia mai ka puʻuwai a holo ma waena o ka umauma a i ka ʻōpū.
- ʻO "Femoral" e pili ana i nā aʻa i loko o kou mau ʻūhā . Hoʻomaka kēia ma ka ʻāpana groin a holo i lalo i ke kua o ke kuli.
- ʻO ke ʻano o "Bi" ʻo ia hoʻi "ʻelua." ʻO ia hoʻi, pili kēia kīʻaha koko hana i nā aʻa femoral ʻelua ma kou mau wāwae ʻelua.
E noʻonoʻo i kēia kāpili ʻana, ""(Graft),"" e like me kahi "Y" i luna. Hoʻohui ka ʻaoʻao luna hoʻokahi i ka aorta i loko o ka ʻōpū, a hoʻohui nā lālā ʻelua o ka "Y" i nā aʻa femoral i nā wāwae.
He aha ke ʻano o ke kūlana e hana ʻia ai kēia ʻoki kino?
Hana nui ʻia kēia ʻoki kino no ka mālama ʻana i kahi maʻi i kapa ʻia ʻo ka maʻi aortoiliac occlusive . ʻO kēia ka wā e hōʻiliʻili ai ka momona a me nā mea ʻē aʻe (e like me ka plaque) ma nā paia o loko o nā kīʻaha koko nui i loko o kou ʻōpū a me ka pelvis i ka hala ʻana o ka manawa. Kāhea mākou i kēia '(Plaque)'. Hana ʻia kēia hōʻiliʻili ʻana ma nā ʻano penei:
- ʻO ka aorta ʻōpū: ʻO kēia ka ʻāpana o ka aorta e iho i lalo ma ka ʻōpū.
- Nā aʻa iliac: ʻO kēia nā aʻa e lālā ana mai ka aorta ma ka piko (umbilicus) a hele i nā wāwae.
Ke emi a paʻa loa paha nā kīʻaha koko e kēia hōʻiliʻili ʻana o ke wai, ua nele kou kino haʻahaʻa, ʻoiai kou mau wāwae, nā wāwae, a me nā ʻōpū pelvic, i ke koko momona i ka oxygen a lākou e pono ai. Hiki i kēia ke alakaʻi i nā pilikia koʻikoʻi.
ʻOiai ʻaʻole hiki i kēia ʻoki kino ke ho'ōla loa i ka maʻi, hiki iā ia ke hoʻihoʻi i ke kahe koko maikaʻi i nā wāwae, kaohi i nā hōʻailona, a hōʻemi nui i ka pilikia o nā pilikia koʻikoʻi.
| Nā pilikia ma muli o ka emi ʻana o ke kahe koko |
|---|
| ʻEha ma nā wāwae i ka wā e hele ana (Intermittent claudication) |
| ʻEha nui ma nā wāwae ʻoiai i ka wā e hoʻomaha ai |
| Ka make ʻana o nā ʻiʻo ma ka wāwae (Gangrene) |
| ʻOki ʻana |
He ʻoki kino koʻikoʻi anei kēia? Aia kekahi mau koho ʻē aʻe?
ʻAe, ua manaʻo ʻia kēia he ʻoki nui no ka mea he pono ia i kahi ʻoki nui ma ka ʻōpū.
Akā aia kekahi koho ʻē aʻe minimally-invasive i kapa ʻia ʻo aortoiliac stenting me ka bifurcation reconstruction (AISBR) . Pili kēia i ke kau ʻana i kahi ʻōmole mesh liʻiliʻi i kapa ʻia he stent i loko o ke aʻa i paʻa a hoʻopiha iā ia e wehe hou i ke aʻa. Ua hōʻike kekahi mau noiʻi he emi nā pilikia o kēia ʻano hana a he pōkole ka noho ʻana ma ka haukapila.
Na kāu kauka e hoʻoholo inā kūpono ke ʻoki hāmama a i ʻole ke stenting iā ʻoe. ʻOiai ʻo ka stenting maʻamau i mālama ʻia no ka poʻe hiki ʻole ke ʻae i ke ʻoki nui, me ka holomua o ka ʻenehana, hoʻohana pinepine ʻia ia ma kahi o ke ʻoki hāmama. Eia nō naʻe, i kekahi manawa, inā ʻaʻole maikaʻi ke koho stenting iā ʻoe, a inā ua hāʻule kahi stent ma mua, pono paha ke ʻoki hāmama.
Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki kino?
E aʻo aku kāu hui lapaʻau iā ʻoe pehea e hoʻomākaukau ai no ke ʻoki kino. ʻO kēia nā mea āu e mālama ai.
- E hoʻōki loa i ka puhipaka: ʻO ka hoʻōki ʻana i ka puhipaka ma ka liʻiliʻi he 3-4 mau pule ma mua o ke ʻoki ʻana e hiki ke kōkua iā ʻoe e hoʻokō i nā hopena maikaʻi loa. He mea nui e hoʻomau i ka hoʻōki ʻana i ka puhipaka ma hope o ke ʻoki ʻana no ke olakino o kou puʻuwai a me nā kīʻaha koko.
- E kamaʻilio me kāu kauka e pili ana i nā lāʻau lapaʻau: Pono ʻoe e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āu e lawe nei. Hiki iā ia ke noi iā ʻoe e hoʻōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau a hoʻololi paha i ka nui ma mua o ke ʻoki ʻana.
- ʻO ka hoʻokē ʻai ʻana: E aʻo ʻia ʻoe e kāohi i ka ʻai ʻana a i ʻole ka inu ʻana mai ke aumoe o ka lā ma mua o ke ʻoki ʻana.
- Nā hoʻokolohua lapaʻau: E noi ʻia ʻoe e hana i kekahi mau hoʻokolohua ma mua o ke ʻoki ʻana.
- Kuhikuhi kuʻekuʻe wāwae-brachial
- ʻO ka ultrasound vascular (kahi scan ultrasound o nā aʻa)
- Nā scan e nānā i ke olakino o ka puʻuwai a me nā aʻa coronary.
He aha ka mea e hana ʻia i ka wā o ke ʻoki kino?
Hiki i ke ʻoki kino ke hala ma waena o 2 a me 6 mau hola. Eia nā hana aʻe e hana ʻia i loko o kēia kaʻina hana.
1. E hāʻawi ʻia ʻoe i ka anesthesia laulā e hoʻohiamoe loa iā ʻoe.
2. Hana ʻia kahi ʻoki nui (laparotomy) ma ka lōʻihi o kou ʻōpū i hiki i ke kauka lapaʻau ke hiki i ka aorta.
3. Hana ʻia ʻelua ʻoki ma nā ʻūhā ʻelua e hiki ai i nā aʻa femoral.
4. Ua hoʻokomo ʻia ke kīʻaha koko hana "Y" i ʻōlelo mua ʻia ʻo `(Graft)` , ua hoʻopili ʻia ka ʻaoʻao o luna i kahi i paʻa ʻia o ka aorta mai luna mai, a ua hoʻopili ʻia nā ʻāpana ʻelua o lalo i nā wahi i paʻa ʻia o nā aʻa femoral ʻelua mai lalo mai, a ua humuhumu ʻia.
5. ʻO ka hope loa, ua pani ʻia nā ʻoki ma ka ʻōpū a me ka ʻūhā me nā humuhumu a i ʻole nā staples.
He aha ka mea e hana ʻia ma hope o ke ʻoki ʻana a ke hoʻi ʻoe i ka home?
Pono ʻoe e noho ma ka haukapila no 4 a 7 mau lā. I loko o kēia manawa, e mālama pono ke kime lapaʻau iā ʻoe. Eia kekahi, hiki ke hala ma kahi o 2 a 3 mau mahina e hoʻōla piha ai. Eia naʻe, ma hope o 4 a 6 mau pule, hiki iā ʻoe ke hoʻi mālie i kāu mau hana maʻamau.
E mālama i kēia mau mea ke hoʻi ʻoe i ka home.
- E lawe i nā ʻeha hoʻoluhi a me nā lāʻau lapaʻau ʻē aʻe i kauoha ʻia e kāu kauka i ka manawa kūpono.
- E mālama i nā ʻoki i maʻemaʻe a mālama iā lākou e like me ke kuhikuhi a ke kauka.
- E hoʻoikaika kino e like me ke kuhikuhi a kāu kauka. ʻO ka hoʻonui mālie ʻana i ka mamao āu e hele ai e kōkua i ke kaʻina hana ho'ōla. Akā, mai hana nui.
- E nīnau i kāu kauka e pili ana i ka manawa kūpono e hoʻomaka hou ai i nā hana e like me ka hoʻokele kaʻa ʻana, ka hele ʻana i ka hana, a me ka hāpai ʻana i nā mea kaumaha.
I ka manawa hea e ʻike koke ai i ke kauka a hele i ka Emergency Treatment Unit (ETU)
He mea nui loa ia e makaʻala inā loaʻa kekahi mau pilikia i ka wā e hoʻōla ai.
| Inā loaʻa iā ʻoe kēia mau hōʻailona, e kāhea koke aku i kāu kauka. | |
|---|---|
| kuni | Ka luaʻi a me ka luaʻi |
| ʻEha, ʻulaʻula, a mehana paha a puni nā ʻoki | Ke kahe nei ka wai mai nā ʻoki |
| ʻUlaʻula a pehu paha ma ka ʻāpana groin a i ʻole ka wāwae | ʻEha wāwae, ʻeha, a nalowale paha ka manaʻo |
| ʻIli anu, keʻokeʻo, a polū paha ma nā wāwae a i ʻole nā wāwae | Nā ʻeha wāwae i ho'ōla ʻole a lilo i mea ʻino |
Inā ʻike ʻia nā hōʻailona o ka hōʻeha puʻuwai a i ʻole ka hahau ʻana, e kāhea koke aku i kahi lawelawe ambulance ulia pōpilikia a i ʻole e hele i ka Emergency Treatment Unit (ETU) kokoke loa.
Nā hōʻailona o ka hōʻeha puʻuwai:
- ʻEha a ʻeha paha ka umauma
- Paʻakikī ka hanu ʻana
- Ka luaʻi, ka ʻeha o ka ʻōpū
- Nā palpitations o ka puʻuwai
- ʻO ka poʻo hina (vertigo) a i ʻole ka nāwaliwali
Nā hōʻailona o ka hahau ʻana:
- Ka nawaliwali a ka ʻeha paha ma kekahi ʻaoʻao o ke kino
- Paʻakikī i ka ʻōlelo ʻana (Aphasia) a i ʻole ka haʻalulu
- Ka nalowale ʻana o ke kaohi ʻana o nā ʻiʻo ma kekahi ʻaoʻao o ka maka
- Ka nalowale koke a i ʻole ka pohihihi o ka ʻike a i ʻole ka lohe
Leka Lawe-Home
- He hana nui ka Aortobifemoral Bypass, akā he holomua loa ia, i hana ʻia i ka wā e ālai nui ʻia ai ke aʻa nui e lawe ana i ke koko i nā wāwae.
- ʻO kēia ʻoki kino e pili ana i ka hana ʻana i kahi ala hou me ka hoʻohana ʻana i kahi kīʻaha koko hana ʻano 'Y' e kāpae i ke kīʻaha koko i ālai ʻia.
- ʻO nā hoʻomākaukau e like me ka haʻalele ʻana i ka puhipaka ma mua o ke ʻoki ʻana hiki ke hoʻonui i ka holomua o nā hopena.
- He mau mahina ka lōʻihi e ho'ōla piha ai ma hope o ke ʻoki ʻana, a he mea nui loa e hahai i nā ʻōlelo aʻoaʻo lapaʻau i loko o ia manawa.
- Inā ʻike ʻoe i kekahi mau hōʻailona ʻē i kou wā e hoʻōla ai, e like me ke kuni, ka maʻi ʻeha, a i ʻole ka ʻeha nui o ka wāwae, e hoʻomaopopo koke i kāu kauka.
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