Ua loaʻa anei iā ʻoe kahi ʻoki liʻiliʻi a me ke koko liʻiliʻi, a laila ua pau ia ma kāna iho? He ʻano pale kupaianaha ia i loko o ko mākou kino. No ka hoʻōki ʻana i ke kahe ʻana o ke koko, hana ʻia kahi ʻūpā koko i loko o ko mākou kino. He hana koʻikoʻi loa kēia a maʻamau. Akā, e noʻonoʻo i ka mea e hiki mai ana inā hana ʻia kēia ʻūpā koko me ka ʻole o ka ʻeha, i loko wale nō o kou kino, i loko o kou mau kīʻaha koko . ʻO ia ka mea a mākou e kapa wale ai he maʻi ʻūpā koko, a i ʻole ma nā huaʻōlelo lapaʻau `(Hypercoagulable State)` a i ʻole `( Thrombophilia )`.
I ka ʻōlelo maʻalahi, he aha kēia maʻi koko?
ʻO kēia ka manawa e ʻoi aku ka maʻalahi o ke kāpili ʻana o kou koko ma mua o ka maʻamau. Hoʻokumu ʻia kahi kāpili koko ke hui pū nā protein i hana ʻia e ko kākou akepaʻa ( nā mea hana kāpili ) a me nā platelets i loko o ko kākou koko. He mea nui kēia e hoʻōki i ke kahe ʻana o ke koko ke loaʻa kahi ʻeha. Akā inā lilo kēia kaʻina hana i mea ikaika loa, hiki ke lilo i pilikia.
Kāhea mākou i nā ʻūpā koko i makemake ʻole ʻia e hana ʻia i loko o nā aa koko he "thrombus" a i ʻole "embolus".
He mea weliweli maoli anei kēia kūlana?
ʻAe, hiki ke lilo kēia i mea weliweli inā ʻaʻole mālama ʻia. ʻO kēia no ka mea hiki ke hana ʻia nā ʻūpā koko ma nā wahi āpau o ko kākou kino. Hiki iā lākou ke hana nui ʻia ma nā aʻa e lawe ana i ke koko mai ka puʻuwai i nā ʻāpana ʻē aʻe o ke kino a ma nā aʻa e lawe ana i ke koko mai ke kino a i ka puʻuwai.
Inā kū mai nā ʻōpū koko i loko o nā aa ...
Hiki i kahi ʻūpā koko i hana ʻia i loko o kahi aʻa ke haki a hele pū me ke koko, e hana ana i ʻelua mau pilikia nui:
- ʻO ka Thrombosis Vein Deep (DVT): ʻO kēia ka wā e hana ʻia ai kahi ʻaʻa koko i loko o kahi aʻa koko hohonu, ʻoi aku hoʻi ma nā wāwae, pelvis, lima, akepaʻa, ʻōpū, a i ʻole nā puʻupaʻa. E noʻonoʻo ʻoe aia ʻoe ma luna o kahi mokulele no nā hola i ka manawa. ʻO ka mālama ʻana i kou mau wāwae i hoʻokahi kūlana hiki ke hoʻopaʻa ʻia ke kahe koko , a hiki ke hana ʻia kahi ʻaʻa koko i loko o kahi aʻa koko i kou wāwae. Ua kapa ʻia kēia ʻo DVT.
- ʻO ka Pulmonary Embolus: He pilikia kēia. Hana ʻia kēia kūlana i ka wā e haki ai kahi ʻūpā koko i hana ʻia ma ka wāwae, e like me ka DVT, a noho i loko o kahi aa koko i loko o nā māmā. Hiki i kēia ke hoʻoweliweli i ke ola.
Inā hana ʻia nā ʻōpū koko i loko o nā aʻa ...
ʻO nā aʻa koko nā kīʻaha koko e hoʻolako i ke koko i piha i ka oxygen i ko kākou lolo, ka puʻuwai, a me nā lālā. Inā kū kahi ʻūpā koko i loko o kekahi o kēia mau mea, hiki iā ia ke hōʻeha nui.
- Hahau: Inā ālai kahi ʻaʻa koko i kahi aʻa e hoʻolako ana i ke koko i ka lolo.
- Hoʻouka Puʻuwai: Inā ālai kahi ʻaʻa koko i kahi aʻa coronary e hoʻolako ana i ke koko i ka puʻuwai.
- ʻEha nui ka wāwae a me ka paʻakikī i ka hele wāwae.
- I kekahi mau hihia, pono paha e wehe i kahi lima a i ʻole ka wāwae.
Hiki i kēia kūlana ke alakaʻi i ka hāʻule ʻana o ka hāpai keiki i ka wā hāpai. He kiʻekiʻe loa kēia pilikia i ka poʻe me ke ʻano e like me ka "Antiphospholipid Syndrome." Ma keʻano laulā, piʻi ka pilikia o nā ʻūpā koko ma kahi o ʻelima mau manawa i ka wā hāpai ma muli o ka hoʻonui ʻia o ka nui o ke koko a me ke kaomi i loko o ke kino.
Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe kēia maʻi? He aha nā hōʻailona?
Pili nā hōʻailona i kahi o ke kino i hana ʻia ai ke koko. Hiki ke ʻokoʻa nā hōʻailona mai kēlā kanaka a kēia kanaka.
| Hōʻailona | He aha ka mea i hōʻike pinepine ʻia? |
|---|---|
| Ka pehu ʻana, ka ʻulaʻula, ka ʻeha, a me ka mehana ma ka wāwae | Hiki ke loaʻa nā ʻūpā koko i loko o nā aʻa hohonu (Deep Vein Thrombosis - DVT) . |
| ʻEha koke ka umauma a me ka paʻakikī o ka hanu ʻana | Hiki ke loaʻa kahi ʻūpē koko i loko o nā māmā (pulmonary embolism) . He pilikia kēia. |
| Ka mae koke ʻana o ka maka, ka lima, a i ʻole ka wāwae (ʻoi aku ma kekahi ʻaoʻao), ka paʻakikī o ka ʻōlelo ʻana, a i ʻole nā loli o ka ʻike | He hahau paha ia. He pilikia kēia. |
| Paʻa ma waenakonu o ka umauma, ʻeha e pālahalaha ana i ka lima hema, ka ʻāwae, a i ʻole ke kua, e hou ana | He hōʻeha puʻuwai paha ia. He pilikia kēia. |
No ke aha e loaʻa ai kēia mau maʻi? He aha nā kumu?
Hiki ke hoʻokaʻawale ʻia nā maʻi koko koko i ʻelua mau ʻāpana nui: nā kumu hānau (genetic) a me nā kumu i loaʻa.
| ʻAno kumu | Ka wehewehe a me nā laʻana |
|---|---|
| 1. Nā kumu hoʻoilina / genetic | |
| Nā kīnā hoʻoilina | He mau mea kēia a mākou e hoʻoilina ai mai ko mākou mau mākua mai. ʻAʻole nā kānaka a pau i loaʻa i kēia mau mea e loaʻa i nā ʻūpā koko, akā ʻoi aku ke kiʻekiʻe o ka pilikia.
|
| 2. Nā kumu i loaʻa | |
| Nā kūlana olakino ʻē aʻe |
|
| ʻO ke ʻano o ka nohona a me nā kumu ʻē aʻe | |
Pehea e ʻike ai nā kauka i kēia maʻi?
ʻOiai he ʻūpā koko kou, ʻaʻole ia he manaʻo he maʻi hoʻoilina kou, no laila e nānā pono kāu kauka i kou mōʻaukala olakino pilikino a me kou ʻohana.
ʻO ka maʻamau, ua kuhikuhi ʻia nā poʻe me nā kumu pilikia e hiki mai ana no ia mau hoʻokolohua:
- Inā he moʻolelo ko kekahi o ka ʻohana no kēia ʻano ʻūpā koko.
- Inā loaʻa i kahi ʻōpio ma lalo o 50 mau makahiki he ʻūpā koko.
- Inā kū nā ʻūpā koko ma nā wahi ʻē, e like me nā lima, ke akepaʻa, a i ʻole ka lolo.
- Inā kū mai nā ʻūpā koko no ke kumu ʻole.
- Inā loaʻa iā ʻoe nā ʻūpā koko e hana hou ʻia.
- Inā pinepine ka hāʻule ʻana o nā keiki.
- Inā loaʻa iā ʻoe ka hahau ʻana i ka wā ʻōpiopio.
He aha nā hoʻokolohua e hana ʻia?
E hana ʻia kekahi mau hoʻāʻo koko e loiloi i kou kūlana.
- PT-INR: Inā ʻoe e lawe ana i ka lāʻau 'Warfarin', hana ʻia kēia hoʻāʻo e nānā i ka wikiwiki o ke kāpili ʻana o kou koko.
- aPTT: Hana ʻia kēia hoʻāʻo e ʻike i ke ʻano o ka pane ʻana o ke koko i ka lāʻau 'Heparin' inā ʻoe e lawe ana.
- Helu Koko Piha (CBC): He helu koko piha.
- Hoʻāʻo Fibrinogen
Hana ʻia nā hoʻokolohua genetic kikoʻī e ʻike ai i nā kūlana hānau. Hana pū lākou i nā hoʻokolohua e nānā i nā pae protein e like me `Protein C`, `Protein S`, a me `Antithrombin`.
Ma muli o ka maʻalahi loa o kēia mau hoʻokolohua, he mea nui loa e hana ʻia ma kahi keʻena hoʻokolohua kūikawā a wehewehe pololei ʻia e ke kauka me ka ʻike kūikawā.
Pehea e mālama ʻia ai?
ʻO ka hapa nui o ka manawa, pono wale ka lāʻau lapaʻau inā e hana ʻia kahi ʻūpā koko i loko o kahi aa koko. ʻO ka pahuhopu nui o ka lāʻau lapaʻau, ʻo ia ke pale aku i ka hana ʻana o nā ʻūpā koko hou aʻe a me ka pale ʻana i ka nui o nā ʻūpā koko e kū nei.
Hoʻohana ʻia nā lāʻau hoʻokahe koko no kēia. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia mau mea he 'Anticoagulants'.
Nā lāʻau lapaʻau i hoʻohana nui ʻia:
- ʻAspirina
- ʻO Warfarin (kahi ʻano pila waha)
- ʻO Heparin (kahi inikini i hāʻawi ʻia i loko o kahi aʻa a i ʻole ma lalo o ka ʻili ma ka haukapila)
- ʻO ka heparin kaumaha haʻahaʻa-molecular (kahi inikini hiki ke hoʻokomo ʻia ma lalo o ka ʻili ma ka home i hoʻokahi a ʻelua paha i ka lā)
- Fondaparinux (ʻōmole)
- Nā anticoagulants waha pololei (DOAC) - ʻo ia ka hanauna hou o nā pila waha (e.g. Rivaroxaban, Apixaban)
Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe, pehea ka lōʻihi o kou lawe ʻana, a me ke ʻano o ka nānā ʻana e pono ai.
He mea nui loa: Inā ʻoe e lawe ana i kahi lāʻau lapaʻau e like me 'Warfarin', mai hoʻōki i ka lawe ʻana a hoʻololi paha i ka nui me ka ʻole o ke kūkākūkā ʻana me kāu kauka no kekahi kumu. Eia kekahi, ʻaʻole kūpono ʻo 'Warfarin' inā hāpai ʻoe a i ʻole e hoʻolālā ana e hāpai. E hōʻoia e hoʻomaopopo i kāu kauka e pili ana i kēia.
Pono anei iaʻu e makaʻala i kaʻu meaʻai a me kaʻu mea inu i ka wā e lawe ana iā Warfarin?
ʻAe. ʻO nā meaʻai i waiwai i ka wikamina K, ʻoi aku hoʻi, hiki ke hoʻopilikia i ka pono o Warfarin. No laila, he mea nui loa e hahai i nā ʻōlelo kuhikuhi i hāʻawi ʻia e kāu kauka i ka wā e lawe ai i kēia lāʻau.
ʻO kekahi mau meaʻai i waiwai i ka wikamina K
- ʻŌpuʻu Brussels
- ʻO ka palaina
- Broccoli
ʻAʻole kēia e ʻōlelo ʻaʻole pono ʻoe e ʻai i kēia mau meaʻai, akā he mea nui e mālama mau i kāu ʻai i kēlā me kēia lā. E kamaʻilio me kāu kauka e pili ana i kēia.
Inā loaʻa iā ʻoe kēia maʻi, pehea ʻoe e mālama ai iā ʻoe iho?
- Inā ʻoe e lawe nei i nā lāʻau lapaʻau e like me Warfarin, e kau ana i kahi kūpeʻe lima lapaʻau e ʻōlelo ana e kōkua kēia iā ʻoe e loaʻa ka lāʻau kūpono i ka wā pilikia.
- Hiki i kekahi mau lāʻau lapaʻau kūʻai ʻole ʻia, e like me nā lāʻau ʻeha, ke launa pū me kēia mea hoʻokahe koko. No laila e kamaʻilio me kāu kauka ma mua o ka lawe ʻana i kekahi lāʻau lapaʻau ʻē aʻe.
- E hana i nā hoʻāʻo koko maʻamau (e like me PT-INR). Pono paha e hoʻoponopono ʻia ka nui o kāu lāʻau lapaʻau ma muli o nā hopena.
- Inā ʻoe e hana ʻoki kino a i ʻole e hoʻolālā ana e hāpai, e hoʻomaopopo i kāu kauka ma mua.
Āhea wau e ʻike ai i ke kauka?
Ke lawe ʻoe i nā lāʻau hoʻokahe koko, ʻoiai he ʻoki liʻiliʻi paha e hoʻonui iki i ke kahe ʻana o ke koko, a i ʻole e loaʻa paha iā ʻoe nā palapū. He mea maʻamau kēia.
Eia nō naʻe, inā ʻoe e kahe koko nui ana a ʻike paha i nā kiko koko nui, e kāhea koke aku i kāu kauka.
Eia kekahi, inā manaʻo ʻoe he mau hōʻailona kou o DVT (pehu wāwae, ʻeha), e ʻimi koke i ke kōkua lapaʻau.
Āhea ʻoe e hele ai i ka Emergency Treatment Unit (ETU)?
Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o nā hōʻailona ma lalo nei, he pilikia olakino ia. E hele koke i ka haukapila kokoke loa i ka Emergency Department (ETU).
* ʻEha koke ka umauma a me ka paʻakikī o ka hanu ʻana (he hōʻailona paha ia o ka pulmonary embolism).
* Nā hōʻailona o ka hōʻeha puʻuwai a i ʻole ka hahau.
Hiki ke paʻakikī ke ola me kēia maʻi. Akā me ka lāʻau lapaʻau kūpono a me ka ʻōlelo aʻoaʻo a ke kauka kūpono, hiki iā ʻoe ke ola i kahi ola maʻamau. Aia kāu kauka ma laila e kōkua iā ʻoe. No laila, mai kānalua e kamaʻilio me ia e pili ana i nā nīnau a hopohopo paha āu e loaʻa ai.
Leka Lawe-Home
- ʻO ka maʻi ʻaʻa koko kahi kūlana kahi e piʻi ai ka pilikia o ka hoʻokumu ʻia ʻana o nā ʻaʻa koko me ke kumu ʻole a me ka maʻalahi i loko o nā kīʻaha koko o ke kino.
- ʻO nā kumu o kēia hiki ke hānau ʻia (genetic) a i ʻole nā mea e kū mai ana i ka wā o ke ola (e like me ke kanesa, ke ʻoki kino, ka hāpai ʻana).
- ʻOkoʻa nā hōʻailona ma muli o kahi o ke koko i loko o ka māmā, ka lolo, a i ʻole ka puʻuwai he mau pilikia hoʻoweliweli i ke ola.
- ʻO ka lāʻau lapaʻau nui, ʻo ia nā lāʻau hoʻokahe koko (anticoagulants). Pono e lawe ʻia kēia mau mea e like me ke kuhikuhi a ke kauka.
- Inā ʻoe e lawe ana i nā lāʻau hoʻokahe koko, e hoʻomaopopo pono i kāu kauka ma mua o ka lawe ʻana i nā lāʻau lapaʻau ʻē aʻe, ma mua o ke ʻoki ʻana, a ma mua o ka hāpai ʻana.
- Inā ʻike ʻoe i ke kahe nui ʻana o ke koko a i ʻole nā hōʻailona ʻē aʻe, e ʻimi koke i ke kōkua lapaʻau.
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo