Ua manaʻo paha ʻoe ua pehu wale kou ʻōpū, kaumaha loa, a ua paʻa koke nā lole āu e ʻaʻahu ai? Malia paha ua piʻi koke ke kaumaha o kou kino i hoʻokahi a ʻelua paha paona i loko o kekahi mau lā. ʻAʻole kēia he piʻi maʻamau, ma muli paha kēia o kahi maʻi i kapa ʻia ʻo 'ascites', ʻo ia hoʻi ke ʻano e piha ai ka ʻōpū i ka wai. ʻIke pinepine ʻia kēia ma ke ʻano he hōʻailona o kahi maʻi koʻikoʻi ʻē aʻe i loko o ko kākou kino. No laila e kamaʻilio wale kākou e pili ana i kēia i kēia lā.
He aha maoli ka Ascites?
I ka ʻōlelo maʻalahi, ʻo ka ascites ka hōʻiliʻili ʻana o ka wai keu i loko o kou lua ʻōpū, a i ʻole ka ʻōpū. Hiki ke hana mālie kēia, a i ʻole hiki ke hana koke ʻia.
E noʻonoʻo, aia kahi membrane lahilahi a puni nā ʻōpū i loko o ko kākou ʻōpū, e like me ka ʻōpū, nā ʻōpū, ke akepaʻa, a me nā puʻupaʻa. Kāhea mākou i kēia ʻo ka peritoneum. He ʻelua papa kona. ʻO ka maʻamau, he liʻiliʻi loa ka wai ma waena o kēia mau papa ʻelua, i hiki ai i nā ʻōpū ke neʻe maʻalahi me ka ʻole o ke kuʻi ʻana kekahi i kekahi. Akā i ke ʻano o ka ascites, hōʻiliʻili kahi nui o ka wai ma waena o kēia mau papa ʻelua. ʻO ia ka manawa e hoʻonui ʻia ai ka ʻōpū a manaʻo ʻia he pōpō wai i loko o ka ʻōpū.
E nānā inā loaʻa iā ʻoe kēia mau ʻano.
ʻO nā hōʻailona nui o ka ascites ka piʻi koke ʻana o ka nui o ka ʻōpū a me ka piʻi koke ʻana o ke kaumaha o ke kino i loko o ʻelua a ʻekolu mau lā. Hiki i kekahi poʻe ke ʻike i ka pehu ʻana o nā wāwae (edema).
| Hōʻailona | Wehewehena |
|---|---|
| Paʻakikī ka hanu ʻana | I ka piʻi ʻana o ka nui o ka wai i loko o kou ʻōpū, kaomi ia ma luna o kou mau māmā, e paʻakikī ai ka hanu ʻana. |
| Ka paʻakikī e neʻe a puni a noho i lalo | ʻAʻole ʻoluʻolu ke kino i ka ulu ʻana o ka ʻōpū. Lilo ia i mea paʻakikī ke hana i nā mea e like me ka noho ʻana, ka hele ʻana, a me ke kūlou ʻana. |
| Nā pilikia hoʻoheheʻe | Hiki ke ʻōhū, ʻeha ka ʻōpū, nalowale ka makemake e ʻai, a me ka paʻa ʻana o ka ʻōpū. |
| ʻEha hope | Hiki i ke kaumaha nui i loko o ka ʻōpū ke kau i ke kaomi hou ma ke kua a hoʻoulu i ka ʻeha o ke kua. |
| Manaʻo luhi | Hiki iā ʻoe ke luhi i nā manawa a pau ma muli o ke ʻano ʻeha o ke kino a me ka maʻi. |
No ke aha i piha ai koʻu ʻōpū i ka wai? He aha nā kumu nui?
ʻO ke kumu nui a maʻamau o ka ascites ʻo ia ka cirrhosis o ke akepaʻa . ʻO ke ʻano kēia, ua luku ʻia nā hunaola akepaʻa a ua pani ʻia me nā ʻiʻo fibrous (nā ʻōpala) e pale ai i ke akepaʻa mai ka hana pono ʻana. Akā, ʻaʻole kēia wale nō ke kumu.
Aia paha he mau kumu ʻē aʻe:
- Ka hāʻule ʻana o ka puʻuwai paʻa
- Ka hāʻule ʻana o ka puʻupaʻa
- Nā maʻi ʻaʻai o nā ʻōpū a me nā ʻōpū pelvic
- ʻO ka maʻi puʻupuʻu
- ʻAʻole pinepine loa, hiki i kahi maʻi puʻupaʻa i kapa ʻia ʻo nephrotic syndrome ke kumu.
Pehea e ulu ai nā ascites ma muli o ka cirrhosis o ke akepaʻa?
Pono kēia i kahi wehewehe iki. E noʻonoʻo aia kekahi aa nui e lawe ana i ke koko ma o ko kākou ake, i kapa ʻia ʻo ka aa portal. Ke lilo ke ake i cirrhotic, ʻo ia hoʻi, ke lilo ke ake i ʻeha, e ālai ʻia kēia mau kīʻaha koko. A laila piʻi nui ke koko i loko o kēia aa. I ka lāʻau lapaʻau, ua kapa ʻia kēia he portal hypertension .
Ke piʻi aʻe kēia kaomi, loaʻa i ko kākou mau puʻupaʻa ka hōʻailona hewa e mālama i ka paʻakai (sodium) a me ka wai i loko o ke kino. I ka hala ʻana o ka manawa, ʻo ka paʻakai a me ka wai i mālama ʻia ma kēia ʻano, ma muli o kēlā kaomi i hoʻonui ʻia, e hoʻomaka e kahe mai loko mai o nā kīʻaha koko a hōʻiliʻili i loko o ka lua ʻōpū. Penei ka piha ʻana o ka ʻōpū me ka wai.
ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i nā ascites?
ʻO kēlā me kēia kanaka i loaʻa i ka hōʻino ʻia o ke akepaʻa e hiki ai ke alakaʻi i ka cirrhosis, aia i ka nui o ka pilikia o ka loaʻa ʻana o ka ascites. ʻO ia mau kūlana:
- Nā maʻi e pili ana i ke akepaʻa momona (Metabolic dysfunction-associated steatohepatitis - MASH)
- Ka maʻi hoʻohana ʻona
- Nā maʻi viral Hepatitis B a me Hepatitis C
- Nā maʻi i hoʻouka ai ka ʻōnaehana pale o ke kino i ke akepaʻa (Autoimmune hepatitis)
- Nā maʻi akepaʻa genetic e like me ka hemochromatosis a me ka maʻi Wilson
He aha nā pilikia e hiki ke loaʻa mai ka ascites?
ʻAʻole wale ka ascites he pehu o ka ʻōpū. Hiki iā ia ke hana i nā pilikia olakino koʻikoʻi ʻē aʻe.
He hōʻailona koʻikoʻi ka ascites e hana pono ʻole ana ke akepaʻa, no laila mai hoʻowahāwahā iā ia.
| Ka hopena ʻaoʻao | Wehewehena |
|---|---|
| ʻO ka ʻeha mau o ka ʻōpū | ʻO ka ʻeha, ka ʻoluʻolu ʻole, a me ka paʻakikī o ka hanu ʻana i hoʻokumu ʻia e ka wai i loko o ka ʻōpū e hiki ai ke paʻakikī i ka hana ʻana i nā hana o kēlā me kēia lā e like me ka ʻai ʻana a me ka hele wāwae. |
| Nā maʻi | Hiki i ka wai e hōʻiliʻili ana i loko o ka ʻōpū ke lilo i maʻi me nā germs. Ua kapa ʻia kēia he peritonitis. Hiki i kēia ke hoʻoulu i ke kuni a me ka ʻeha nui o ka ʻōpū. Pono paha kēia i nā antibiotics IV. |
| ʻO ka wai a puni nā māmā (Hepatic hydrothorax) | Hiki i ka wai i loko o ka ʻōpū ke komo i loko o ka umauma a hōʻiliʻili a puni nā māmā. Hiki i kēia ke hana i ka paʻakikī o ka hanu ʻana, ka ʻū ʻana, a me ka haʻahaʻa o ka oxygen i loko o ke koko (hypoxemia). |
| ʻUluʻulu | Ma muli o ke kaomi nui ʻana i loko o ka ʻōpū, hiki i nā mea e like me nā ʻōpū ke puka mai ma o nā wahi nāwaliwali o ka ʻōpū. Ua kapa ʻia kēia he hernia. |
| Ka hāʻule ʻana o ka puʻupaʻa | Ke koʻikoʻi ka cirrhosis o ke akepaʻa, hiki iā ia ke hoʻopilikia i ka hana o nā puʻupaʻa a alakaʻi i ka hāʻule ʻana o nā puʻupaʻa. |
Pehea e ʻike ai ke kauka i kēia?
Ke hele ʻoe e ʻike i ke kauka, e nīnau mua ʻo ia iā ʻoe e pili ana i kāu mau hōʻailona a nānā i kou ʻōpū. Hiki iā ʻoe ke loaʻa kahi manaʻo maʻamau inā he wai i loko o ka ʻōpū ma ke kaomi ʻana me kou manamana lima.
A laila, e hōʻoia i ke kūlana pololei, hiki ke hana ʻia nā hoʻokolohua aʻe:
- ʻO ke kiʻi Ultrasound a i ʻole CT scan: Hiki i kēia ʻano scan ke ʻike maopopo i nā mea e like me ka nui o ka wai i loko o ka ʻōpū a me ke kūlana o ke akepaʻa.
- Paracentesis: Pili kēia i ke komo ʻana i kahi nila lahilahi loa i loko o ka ʻōpū a lawe i kahi wai liʻiliʻi mai ka ʻōpū. Hiki ke hoʻāʻo ʻia kēia wai e ʻike inā he mau hunaola kanesa a bacteria paha. He mea nui loa kēia hoʻāʻo e hoʻoholo i ke kumu pololei o ka ascites.
He aha nā lāʻau lapaʻau no ka ascites?
ʻO ka pahuhopu nui i ka mālama ʻana i nā ascites, ʻo ia ka hoʻemi ʻana i ka nui o ka wai e hōʻiliʻili ana i loko o ka ʻōpū a pale iā ia mai ka hōʻiliʻili hou ʻana.
Nā ʻano lapaʻau maʻamau
- Ka kaohi ʻana i ka paʻakai (sodium): ʻŌlelo mua nā kauka e hōʻemi i ka nui o ka paʻakai āu e ʻai ai. Hiki iā ʻoe ke ʻōlelo e pono ʻoe e ʻai ma lalo o 2000 milligrams o ka paʻakai i kēlā me kēia lā. ʻO ke ʻano kēia e pono ʻoe e hōʻemi i ka nui o ka paʻakai āu e hoʻohui ai i kāu meaʻai a pale loa i nā meaʻai me ka paʻakai huna, e like me nā hua maloʻo, nā pickles, nā mea ʻono, nā sausage, nā meaʻai i kūʻai ʻia ma ka hale kūʻai, a me nā meaʻai i hoʻopaʻa ʻia.
- Diuretics (nā pila wai): ʻO kēia mau lāʻau lapaʻau ke kumu o ka hoʻokuʻu ʻana o nā puʻupaʻa i ka wai nui a me ka paʻakai mai ke kino ma o ka mimi.
- Ka mālama ʻana i ka maʻi kumu: Inā ʻo ke kanesa ke kumu o ka ascites, ʻo ka mālama ʻana iā ia e hōʻemi pū i ka nui o ka wai i loko o ka ʻōpū.
I kekahi manawa, ʻaʻole lawa kēia lāʻau lapaʻau ...
He mea paʻakikī i kekahi poʻe ke kāohi i ka waikawa o ko lākou ʻōpū ma hope o ka kāohi ʻana i ka ʻai ʻana i ka paʻakai a me ka inu ʻana i nā pila wai. I ia mau hihia, pono lākou e hoʻohana i nā ʻano lapaʻau ʻē aʻe.
- Paracentesis: He hoʻāʻo a he lāʻau lapaʻau kēia. Hoʻoneʻe kēia kaʻina hana i ka nui o ka wai mai ka ʻōpū me ka hoʻohana ʻana i kahi nila. ʻOiai hāʻawi kēia i ka hōʻoluʻolu wikiwiki, pono paha e hana hou ʻia no ka mea hiki ke hōʻiliʻili hou ka wai.
- Ke kaʻina hana TIPS (Transjugular intrahepatic portosystemic shunt): He kaʻina hana paʻakikī iki kēia. Pili ia i ka hana ʻana i kahi bypass liʻiliʻi (shunt) ma waena o ke aʻa portal, kahi i hoʻonui ʻia ke kaomi, a me kekahi aʻa ʻē aʻe e lawe ana i ke koko mai ke akepaʻa. ʻAe kēia i ke koko e lawe i kahi ala hou ma o ke akepaʻa, e kāpae ana i ke kūpikipikiʻana, kahi e hōʻemi ai i ke kaomi a hoʻemi i ka nui o ka wai i loko o ka ʻōpū.
- Hoʻoili ʻana i ke akepaʻa: No nā poʻe me ka cirrhosis koʻikoʻi o ke akepaʻa, pono paha ka hoʻoili ʻana i ke akepaʻa ma ke ʻano he koho hope loa.
Āhea ʻoe e ʻike ai i ke kauka?
Inā loaʻa iā ʻoe kahi maʻi e like me ka cirrhosis o ke ake, e ʻike koke i kāu kauka inā ʻike ʻoe i kēia mau hōʻailona:
- Inā piʻi koke ke kaumaha o kou kino.
- Inā manaʻo ʻoe e ulu nui ana kou ʻōpū.
- Inā pilikia ʻoe i ka hanu ʻana.
Inā loaʻa nā hōʻailona ma lalo nei, e hele koke i ka Emergency Treatment Unit (ETU) o ka haukapila me ka hoʻokaʻulua ʻole:
- kuni
- ʻEha nui loa ka ʻōpū
Leka Lawe-Home
- ʻO ka Ascites ka hōʻiliʻili ʻana o ka wai i loko o ka ʻōpū. He kūlana koʻikoʻi kēia i hoʻoulu pinepine ʻia e ka cirrhosis, kahi maʻi ate.
- ʻO nā hōʻailona nui ka ʻōpū nui, ka piʻi ʻana o ke kaumaha, ka paʻakikī o ka hanu ʻana, a me nā wāwae pehu.
- ʻO ka kaohi ʻana i ka paʻakai a me ka lawe ʻana i nā diuretics (nā pila wai) nā koho lapaʻau mua.
- E kaupaona iā ʻoe iho i kēlā me kēia lā. Inā ʻoi aku kou piʻi ʻana ma mua o hoʻokahi kilokani i kēlā me kēia lā no ʻekolu mau lā i ka lālani, e hoʻomaopopo i kāu kauka.
- E pale loa i ka inu ʻana i ka waiʻona. Hoʻopōʻino hou kēia i ke akepaʻa.
- E pale i ka lawe ʻana i nā lāʻau hoʻomaha ʻeha NSAID (e.g., ibuprofen, aspirin) me ka ʻole o ke aʻo ʻana a ke kauka. Hoʻonui kēia i ka paʻa ʻana o ka wai a me ka paʻakai i loko o ke kino.
- Inā loaʻa iā ʻoe ke kuni a me ka ʻeha nui o ka ʻōpū, he hōʻailona paha ia o kahi maʻi. E hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila.
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