Ua kau ʻia anei kahi stent no kahi maʻi puʻuwai? Ua manaʻo paha ʻoe i kahi manaʻo nui o ka hōʻoluʻolu ma hope o ka hana ʻana pēlā. Ua hala nā mea e like me ka ʻeha o ka umauma a me ka pōkole o ka hanu, a ua manaʻo paha ʻoe ua loaʻa iā ʻoe kahi hoʻolimalima hou ma ke ola. Akā, pehea inā, ma hope o kekahi manawa, i loko o kekahi mau mahina, hoʻomaka hou kēlā maʻi kahiko? Pehea inā hoʻomaka hou kou umauma e ʻeha? Pehea inā paʻakikī ʻoe i ka hanu? Hopohopo ka poʻe he nui i kēia manawa. Ke noʻonoʻo nei lākou, "No ke aha e hana nei kēia ʻoiai ua kau ʻia kahi stent?" ʻO ka pane i kēlā nīnau ʻo ia ke kūlana a mākou e kamaʻilio nei i kēia lā, i kapa ʻia ʻo 'In-Stent Restenosis'.
I ka ʻōlelo maʻalahi, he aha ka In-Stent Restenosis?
I mea e maopopo ai i kēia, e hoʻomaka kākou mai kinohi mai.
I ka ʻōlelo maʻalahi, ʻo ke ʻano o 'Stenosis' ʻo ia hoʻi ke ālai ʻia a i ʻole ka haiki ʻana o kekahi mea e like me ko kākou mau kīʻaha koko. Ke ālai ʻia nā aʻa coronary e hoʻolako ana i ke koko i ka puʻuwai ma muli o nā waihona momona (kapa mākou i kēia ʻo Atherosclerosis ) kapa mākou ia he Coronary Artery Disease (CAD) . ʻO Angioplasty kahi lāʻau lapaʻau a nā kauka e hoʻohana ai e wehe hou i kēia kīʻaha koko i ālai ʻia.
Ma kēia, hoʻokomo ʻia kahi pōpō liʻiliʻi i loko o ka wahi i paʻa a hoʻopiha ʻia e hoʻonui i ke kīʻaha koko. A laila, i mea e pale ai i ka hiolo ʻana a me ka pani hou ʻana o ka wahi i hoʻonui ʻia, ua kau ʻia kahi ʻōmole liʻiliʻi e like me ka ʻupena (ʻo ia ka mea a mākou e kapa nei he stent ) i loko o ke aʻa. ʻAe kēia i ke kahe koko e hoʻi hou.
ʻAe, ua maopopo iā ʻoe i kēia manawa. ʻO 'Restenosis' kahi huaʻōlelo i hana ʻia me nā huaʻōlelo 're' (hou) a me 'stenosis' (blockage). ʻO ia hoʻi, e ālai hou . No laila, ʻo In-Stent Restenosis ka wā e ālai hou ʻia ai ke kīʻaha koko kahi i kau ʻia ai ka stent, ma kahi pono o ka stent. ʻOiai he mea hoʻonāukiuki loa kēia, he mea nui loa ia e ʻike i ke kumu o kēia hana.
No ke aha i ālai hou ʻia ai ke aʻa ma hope o ke kau ʻia ʻana o kahi stent?
ʻAʻole kēia ma muli o kahi pilikia me ka stent. Penei ka pane ʻana o ko mākou kino. E noʻonoʻo i ka wā e loaʻa ai kahi ʻeha ma kou kino, e hana ʻia kahi ʻeha i ka wā e ho'ōla ai, ʻeā? ʻO ia ka mea e hana nei ma ʻaneʻi.
ʻO ka stent kahi mea e puka mai ana mai waho o ko mākou kino. No laila, mālama ke kino iā ia e like me ka 'ʻeha' a hoʻāʻo e ho'ōla iā ia. I loko o kēia kaʻina hana, ulu kahi papa hou o nā cell ma luna o ka stent. He mea maʻamau kēia. Hana kēia papa hou o nā cell i ka stent ʻāpana o ka paia o ke kīʻaha koko, e hoʻomaʻamaʻa ana i ke kahe ʻana o ke koko.
Eia nō naʻe, pane nui ke kino o kekahi poʻe i kēia. A laila, ʻo ka papa o nā cell e hana ʻia ma luna o ka stent, i kapa ʻia ʻo scar tissue, e lilo i ʻoi aku ka mānoanoa ma mua o ka mea i manaʻo ʻia . E like me ka limu e ulu ana i loko o kahi paipu wai a pani i ka lua o ka paipu, hoʻohaiki hou kēia ʻiʻo mānoanoa i ke ala koko. ʻO ia ka mea a mākou e kapa nei ʻo In-Stent Restenosis.
ʻO ka mea nui loa, ʻo kēia ʻano maʻamau ka hana ʻia ma hope o 3 a 6 mau mahina ma hope o ke kau ʻia ʻana o ka stent.I kēia manawa. Ma hope o hoʻokahi a ʻelua paha makahiki, ua haʻahaʻa loa ka manawa e hana ʻia ai kēia.
ʻO wai ka mea i pilikia nui no kēia maʻi?
ʻOiai hiki ke loaʻa kēia ʻano maʻi i kekahi kanaka nona ka stent, ʻoi aku ka nui o ka pilikia o kekahi poʻe. E nānā e ʻike inā loaʻa iā ʻoe kēia mau ʻano.
| Kumu pilikia | Wehewehena |
|---|---|
| Maʻi diabetes | ʻOi aku ka pilikia o ka poʻe me ka maʻi diabetes i kāohi pono ʻole ʻia. Hiki i nā pae kō koko kiʻekiʻe ke hoʻoulu i ka ulu ʻana o nā ʻiʻo ma ke ʻano ʻē. |
| Maʻi puʻupaʻa | He kiʻekiʻe nō hoʻi kēia pilikia no ka poʻe me ka maʻi puʻupaʻa mau loa. |
| Kolesterol kiʻekiʻe | No nā poʻe e mālama ana i nā pae cholesterol koko kiʻekiʻe. |
| Ke koko kiʻekiʻe (Hypertension) | He mea pilikia nō hoʻi ke koko kiʻekiʻe i kaohi ʻole ʻia. |
| Puhipaka | Hoʻonui ka puhipaka i ka pilikia no ka mea hōʻino ia i nā kīʻaha koko a keakea i ke kaʻina hana ho'ōla. |
He mau mea hou aʻe...
Eia kekahi, hiki ke hoʻonui ʻia kēia pilikia inā he liʻiliʻi loa ke kīʻaha koko i paʻa ʻia a inā he lōʻihi loa ke kīʻaha . Eia kekahi, inā e hoʻonui ʻia ke kīʻaha me kahi balloon me ka ʻole o kahi stent (Balloon Angioplasty), ʻoi aku ka kiʻekiʻe o ka pilikia o ka pani hou ʻana.
He aha nā hōʻailona o kēia?
ʻO kekahi o nā pilikia nui ma ʻaneʻi, ʻo ka hapa nui o ka poʻe me In-Stent Restenosis ʻaʻole lākou e ʻike i kekahi mau hōʻailona . ʻAʻole paha ʻoe e manaʻo i kekahi mea a hiki i ka wā e emi loa ai ke aʻa. ʻO ia ke kumu he mea nui e hele no nā nānā mau e like me ke kuhikuhi a kāu kauka ma hope o ka loaʻa ʻana o kahi stent.
Eia nō naʻe, loaʻa i kekahi poʻe nā hōʻailona e like loa me nā hōʻailona o ka maʻi ʻaʻa coronary (CAD) i loaʻa iā ʻoe ma mua o kou loaʻa ʻana o ka stent.
- ʻEha a ʻeha paha ka umauma (Angina): He manaʻo o ka paʻa a i ʻole ka ʻūmiʻi i loko o ka umauma. Hiki ke ʻoi aku ka ʻino o kēia ke hoʻoikaika kino ʻoe a piʻi paha i nā alapiʻi.
- Pōkole o ka hanu: Paʻakikī ka hanu ʻana ʻoiai me ka hoʻoikaika iki.
- Manaʻo luhi loa: Manaʻo nui i ka luhi ʻaʻole hiki iā ʻoe ke hana i nā mea āu i hana maʻalahi ai.
- ʻEha poʻohiwi a lima paha: ʻEha umauma e hele pū me ka ʻeha e pālahalaha ana i ka poʻohiwi hema a lima paha.
- Hiki nō hoʻi ke ʻike ʻia nā hōʻailona e like me ka dizziness, ka hou ʻana, a me ka nausea .
ʻO ka mea nui loa: Inā ʻike hou ʻoe i kekahi o kēia mau hōʻailona ma hope o ka loaʻa ʻana o kahi stent, mai poina he mea ʻē aʻe paha . E hoʻomaopopo koke i kāu kauka.
Pehea e ʻike ai inā loaʻa kēia?
Ke haʻi mai ʻoe iā mākou e pili ana i kāu mau hōʻailona, e kuhikuhi ke kauka i kekahi mau hoʻokolohua e hōʻoia iā ia.
- Hoʻāʻo Koʻikoʻi Hoʻoikaika Kino (Hoʻāʻo Treadmill): Ua hana ʻia ʻoe e hele a holo paha ma luna o ka treadmill a hoʻohana ʻia kahi ECG e nānā i ke ʻano o ka hana ʻana o kou puʻuwai ke kaumaha ʻoe.
- Ka Catheterization o ka Puʻuwai (Angiogram): ʻO kēia ka hoʻāʻo paʻa loa. E like me ke kau ʻana o ka stent, hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o kahi kīʻaha koko i loko o ka puʻuwai, hoʻokomo ʻia kahi kala kūikawā, a lawe ʻia kahi X-ray e ʻike inā he mea paʻa i loko o ka stent.
- Nā hoʻokolohua ʻē aʻe: I kekahi manawa, hiki ke hoʻohana ʻia nā ʻano hana scan e like me Intravascular Ultrasound (IVUS) e nānā i loko o ke kīʻaha koko a ana pololei i ka nui o ka poloka.
Pehea e mālama ʻia ai?
Na ke kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa ma muli o ke ʻano o ka paʻa ʻana a me kou kūlana.
| ʻAno lapaʻau | He aha ka mea e hana ʻia nei |
|---|---|
| Nā lāʻau lapaʻau | Pono paha ʻoe e hoʻololi i ka nui o kāu mau lāʻau lapaʻau o kēia manawa a i ʻole e hoʻohui i nā lāʻau lapaʻau hou. |
| Hana hou i ka Angioplasty | ʻO kēia ka lāʻau lapaʻau maʻamau. Hoʻokomo ʻia kekahi pōpō ʻē aʻe ma o ka stent i ālai ʻia e hoʻonui iā ia, a i kekahi manawa ua kau ʻia kekahi stent ʻē aʻe i loko. |
| ʻO ke ʻoki puʻuwai (CABG) | Inā koʻikoʻi ka paʻa ʻana a i ʻole he mau pilikia me kekahi mau kīʻaha koko, hiki ke kuhikuhi ʻia ʻoe no kahi ʻoki kino Coronary Artery Bypass Grafting (CABG). Pili kēia i ke kāpae ʻana i ka wahi i paʻa ʻia a me ka hana ʻana i kahi aʻa koko hou me ka hoʻohana ʻana i kahi kīʻaha koko i lawe ʻia mai kahi ʻē aʻe. |
| Lapaʻau radiation (Vascular Brachytherapy) | He lāʻau lapaʻau kākaʻikahi kēia. Maanei, ua hāʻawi ʻia kahi liʻiliʻi loa o ka radiation i loko o ka stent e hoʻōki i ke kūkulu ʻia ʻana o nā ʻiʻo scar. |
ʻAʻohe ala e pale aku ai i kēia?
Eia ka nūhou maikaʻi loa. ʻAe, hiki ke pale ʻia kēia i kēia manawa.
ʻO ke kumu o kēia, he ʻano stent hou i kapa ʻia ʻo Drug-Eluting Stents (DES) . ʻAʻole kēia he ʻupena metala wale nō. Loaʻa i kēia mau stent kahi lāʻau lapaʻau kūikawā e kāohi ana i ka hoʻokumu ʻia ʻana o kēlā ʻiʻo ʻeha a mākou i kamaʻilio ai. Ma hope o ke kau ʻia ʻana o ka stent i loko o ke kino, hoʻokuʻu mālie ʻia kēia lāʻau lapaʻau, e hoʻōki ana i nā cell mai ka ulu pono ʻole.
Ke hoʻohālikelike ʻia me nā stent metala ʻōlohelohe kahiko, haʻahaʻa loa ka pilikia o ka restenosis in-stent ke hoʻohana ʻia kēia mau stent drug-eluting . ʻOiai ma Sri Lanka i kēia lā, hoʻohana pinepine ʻia kēia ʻano stent hou.
Eia nō naʻe, aia kekahi mau mea e pono ai ʻoe e hana ma kāu ʻaoʻao.
- E lawe i kāu lāʻau lapaʻau e like me ke kauoha: E lawe i ka lāʻau lapaʻau i kauoha ʻia e kāu kauka, ʻoiai nā mea e pale ai i ke kāpili ʻana o ke koko (e.g., Aspirin, Clopidogrel), e like me ke kauoha, me ka ʻole o ka hala ʻana i hoʻokahi lā.
- E hoʻololi i kou nohona: Inā ʻoe e puhipaka, e hoʻōki koke.E kāohi i kāu cholesterol, ka maʻi diabetes, a me ke koko kiʻekiʻe. E ʻai i ka meaʻai olakino haʻahaʻa i ka ʻaila, ka paʻakai, a me ke kō, a kiʻekiʻe i nā huaʻai a me nā mea kanu. E hoʻoikaika kino e like me ke kuhikuhi a kāu kauka.
Leka Lawe-Home
- ʻO ka In-Stent Restenosis ka hoʻohaiki hou ʻana o ke kīʻaha koko ma hope o ke kau ʻia ʻana o kahi stent ma muli o ka ulu ʻana o nā ʻiʻo ʻeha. Hana pinepine ʻia kēia i loko o 3-6 mau mahina o ka mālama ʻana.
- Inā ʻike ʻoe i kekahi o nā hōʻailona like me ma mua, e like me ka ʻeha o ka umauma a i ʻole ka pōkole o ka hanu , ma hope o ka loaʻa ʻana o kahi stent, mai hoʻowahāwahā iā ia. E ʻike koke i kāu kauka.
- I ka hapa nui o ka manawa, ʻaʻole paha e hōʻike kēia ʻano i kekahi mau hōʻailona . No laila, he mea nui e ʻimi i ke kōkua lapaʻau i ka manawa kūpono, e like me ka ʻōlelo a kāu kauka.
- Ua hoʻemi nui ʻia ka pilikia o kēia ʻano ma muli o ka hoʻohana ʻana i nā Drug-Eluting Stents (DES) i kēia manawa.
- ʻO ka mea nui loa hiki iā ʻoe ke hana ma kāu ʻaoʻao, ʻo ia ke lawe i kāu mau lāʻau lapaʻau e like me ke kauoha, pale i ka puhipaka, a mālama i kahi nohona olakino . Hiki i kēia mau mea ke pale i kou puʻuwai i ka wā lōʻihi.
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