Ke manaʻo nei ʻoe i kekahi manawa i ka ʻūlū a i ʻole ka ʻeha i loko o kou umauma ke luhi iki ʻoe, a i ʻole ke piʻi ʻoe i kahi alapiʻi? A i ʻole he paʻakikī kou hanu ʻana? Hiki i kēia ke lilo i luhi maʻamau, akā i kekahi manawa hiki iā lākou ke lilo i pilikia me kahi aa koko e lawe ana i ke koko i ko kākou puʻuwai. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi koʻikoʻi iki, akā he mea nui loa ia e makaʻala. ʻO ia ke ʻano i kapa ʻia ʻo CTO, a i ʻole Chronic Total Occlusion.
I ka ʻōlelo maʻalahi, he aha ka CTO (Chronic Total Occlusion)?
E noʻonoʻo ʻoe he paipu nui kāu e lawe mai ana i ka wai i kou hale. I ka hala ʻana o ka manawa, e paʻa ana kēia paipu i ka ʻōpala a me ka lepo, a i ka hopena e paʻa loa ia, e pale ana i kahi kulu wai mai ke kahe ʻana.
ʻO ia hoʻi ka mea like e hana ʻia i loko o ko kākou puʻuwai. Loaʻa iā kākou nā kīʻaha koko (kapa mākou i kēia mau aʻa coronary) e hoʻolako i ke koko maʻemaʻe i ko kākou puʻuwai. Inā waiho ʻia nā mea e like me ka ʻaila a me ka cholesterol i loko o kēia mau aa koko i loko o kekahi manawa, a paʻa loa ke aa koko (100%), ʻo ia hoʻi inā mau kēia paʻa no ʻekolu mahina a ʻoi , kapa mākou i kēlā ʻano he Chronic Total Occlusion (CTO) .
Ke paʻa loa kahi aʻa koko ma kēia ʻano, ʻaʻole loaʻa i ka ʻāpana o ka puʻuwai i hoʻopilikia ʻia ka oxygen a me nā meaʻai e pono ai. Hiki i kēia ke hana i nā hōʻailona e like me ka ʻeha o ka umauma a me ka paʻakikī o ka hanu ʻana. I kekahi mau hihia, hiki ke koʻikoʻi kēia, a hiki i ka hōʻeha puʻuwai.
ʻO wai ka mea i pilikia nui i ka loaʻa ʻana o kēia kūlana CTO?
ʻIke pinepine ʻia ka CTO i nā poʻe me ka maʻi puʻuwai, ʻoiai ka maʻi coronary artery (CAD). Ua manaʻo ʻia he hoʻokahi i loko o ʻekolu poʻe me CAD e loaʻa pū kekahi CTO.
ʻO nā mea pilikia like e kōkua nui ai i ka maʻi puʻuwai e kōkua pū i ka CTO. E nānā e ʻike inā loaʻa iā ʻoe kēia mau mea pū kekahi.
| Kumu pilikia | He wehewehe maʻalahi |
|---|---|
| Puhipaka | ʻO kēia ka ʻenemi nui. Hoʻopōʻino ka puhipaka i nā kīʻaha koko a hoʻolalelale i ke kūkulu ʻia ʻana o nā waihona i loko o lākou. |
| Ke koko kiʻekiʻe (Hypertension) | I ka piʻi ʻana o ke kaomi, ua hōʻino ʻia nā paia o nā aʻa koko a piʻi aʻe ka manawa kūpono o ka waiho ʻana o ka cholesterol. |
| ʻO ke kolamu kiʻekiʻe (Hyperlipidemia) | Ke piʻi ka nui o ka cholesterol ʻino (LDL) i loko o ke koko, hoʻomaka ia e waiho pololei ma nā paia o nā aʻa. |
| Maʻi diabetes | Inā ʻaʻole i kāohi ʻia nā pae kō, hōʻino ia i nā kīʻaha koko a hoʻonui i ke kūkulu ʻia ʻana o kēia mau waihona. |
| Momona | Ua pili ke kaumaha o ke kino i ka maʻi puʻuwai. ʻOi aku ka nui o ka pilikia o ka BMI ma mua o 30. |
| Moʻolelo ʻohana o ka maʻi puʻuwai | Inā loaʻa i kou makuahine, kou makuakāne, a i ʻole kou mau kaikaina ka maʻi puʻuwai, aia paha ʻoe i ka pilikia. |
| Ka nele o ka hoʻoikaika kino | ʻO ka hoʻoikaika ʻole ʻana i kou kino ua like ia me ka hoʻoulu ʻana i ka maʻi puʻuwai. |
| ʻO ka hōʻeha puʻuwai ma mua a i ʻole ke ʻoki bypass | Inā ua loaʻa iā ʻoe kahi hōʻeha puʻuwai ma mua a i ʻole ke ʻoki bypass, aia ʻoe i ka pilikia o ka loaʻa ʻana o kahi CTO ma kekahi aʻa ʻē aʻe. |
ʻO ka mea nui loa, ʻo ia ka piʻi ʻana o ka pilikia o ka loaʻa ʻana o CTO me ka makahiki. No laila, i ko kākou ʻelemakule ʻana, pono kākou e mālama pono i ko kākou puʻuwai.
He aha nā hōʻailona o kahi CTO?
Hiki ke ʻokoʻa nā hōʻailona o ka CTO mai kēlā kanaka a kēia kanaka. ʻAʻole paha i loaʻa i kekahi poʻe kekahi mau hōʻailona. Eia naʻe, ʻo nā hōʻailona maʻamau:
- ʻEha ka umauma, paʻa, a i ʻole ke kaomi: Hiki paha iā ia ke manaʻo e like me kekahi e ʻomi ana i kou umauma.
- Paʻakikī ka hanu ʻana (Dyspnea):Ka pōkole o ka hanu ke hoʻoikaika ʻoe, e like me ka hele wāwae ʻana i kahi mamao pōkole a i ʻole ke piʻi ʻana i luna o nā alapiʻi.
- Luhi loa: Manaʻo luhi i nā manawa a pau, ʻoiai me ka hana ʻole ʻana i kekahi hana.
- Manaʻo puni.
- Puʻuwai kūpono ʻole.
- Ka luaʻi.
- ʻEha ma ka lima luna: ʻoi aku hoʻi ma ka lima hema.
ʻO ka mea nui, ʻo ia ka mea maʻamau o kēia mau hōʻailona ke luhi ʻoe. Hoʻomaha lākou ke hoʻomaha ʻoe. Eia nō naʻe, i kekahi manawa hiki ke loaʻa kēia mau hōʻailona ʻoiai ʻaʻole ʻoe luhi iki.
Pehea e ʻike ai ke kauka i kēia?
Inā loaʻa iā ʻoe kēia mau hōʻailona, pono ʻoe e ʻike i ke kauka. E nānā ʻo ia iā ʻoe a, inā pono, e kuhikuhi iā ʻoe no kekahi mau hoʻokolohua.
ʻO ka hoʻāʻo nui e hōʻoia inā he CTO kāu, he angiogram coronary . Ma kēia, ua hoʻokomo ʻia kahi ʻōmole lahilahi loa ma o kahi aʻa koko ma kou lima a wāwae paha i nā aʻa koko o ka puʻuwai, a ua hoʻokomo ʻia kahi wai kūikawā (contrast dye). A laila, ua lawe ʻia kahi X-ray e ʻike pehea e kahe ai kēia wai ma o nā aʻa koko o ka puʻuwai. Inā he poloka i loko o kahi aʻa koko, e ʻike maopopo ʻia kēia wai no ka mea ʻaʻole ia e kahe hou aku.
Eia kekahi, hiki i ke kauka ke ʻōlelo i nā hoʻokolohua ʻē aʻe e like me:
- ECG (Electrocardiogram): Nānā i ka hana uila o ka puʻuwai.
- Echocardiogram (Echo): He scan e nānā i ka hana o ka puʻuwai a me ke kahe o ke koko.
- Hoʻāʻo Koʻikoʻi: E ʻike pehea e pane ai kou puʻuwai ke hoʻoikaika iki ʻoe (e like me ka holo ʻana ma luna o ka treadmill).
- MRI Puʻuwai: E kiʻi i kahi kiʻi maopopo o ke ʻano o ka puʻuwai a me ke kahe o ke koko.
He aha nā lāʻau lapaʻau no CTO?
Inā ua ʻike ʻia ʻoe me ka CTO, mai hopohopo. Nui nā lāʻau lapaʻau kūpono no kēia. E hilinaʻi ka hoʻolālā lapaʻau i ke koʻikoʻi o kāu mau hōʻailona, kahi o ke aʻa i paʻa, a me kou olakino holoʻokoʻa. ʻElua ʻano nui o ka lāʻau lapaʻau.
1. Ke komo ʻana o ka coronary Percutaneous (PCI)
ʻO kēia ka lāʻau lapaʻau i hoʻohana pinepine ʻia, ʻaʻohe ʻoki ʻana. Hana ʻia ia ma ke ʻano like me ka angiogram.
- Hoʻokomo ʻia kahi ʻōmole lahilahi loa (catheter) ma o kahi aʻa koko ma ka lima a i ʻole ka wāwae i ka puʻuwai kahi i loaʻa ai ke aʻa i paʻa.
- Hoʻokomo ʻia kahi pōpō liʻiliʻi ma o kēlā ʻōmole a hoʻopiha ʻia ma kahi o ka paʻa. A laila kaomi ʻia ka papa o ka ʻaila i hōʻiliʻili ʻia i loko o ke aʻa koko i nā ʻaoʻao, e wehe ana i ke aʻa koko.
- A laila, ua kau ʻia kahi ʻōmole mesh liʻiliʻi i kapa ʻia he stent ma luna o ka puka. Kōkua ka stent i ka wehe ʻana o ke aʻa a pale iā ia mai ka pani hou ʻia.
Ua hōʻike ʻia nā noiʻi ua holomua kēia ʻano hana no kahi o 86% o nā maʻi.
2. ʻO ke kāpili ʻana o ke aʻa coronary (CABG)
He ʻoki puʻuwai hāmama kēia. Manaʻo wale ʻia inā ua ālai ʻia nā aʻa he nui, a inā paʻakikī loa ka ālai ʻana e wehe ʻia me ka PCI.
I ka ʻōlelo maʻalahi, pili kēia i ka hana ʻana i kahi "bypass" no kahi aa koko i paʻa. ʻO ia hoʻi, ua lawe ʻia kahi ʻāpana aa koko mai kahi ʻāpana ʻē aʻe o kou kino (mai kou umauma a i ʻole kou wāwae) a ua hana ʻia kahi ala hou no ke kahe ʻana o ke koko a puni ka ʻāpana i paʻa.
Hāʻawi kēia hana i nā hopena holomua no kahi o 60% o nā maʻi.
E wehewehe pono ana kāu kauka cardiologist iā ʻoe i ke ʻano lapaʻau kūpono loa iā ʻoe.
Nā nīnau e nīnau aku ai i kāu kauka
Inā ua ʻike ʻia ʻoe me CTO, he mea maʻamau ka loaʻa ʻana o nā nīnau he nui i loko o kou manaʻo. Mai makaʻu a kānalua paha e nīnau i kēia mau nīnau i kāu kauka.
- "E ke kauka, he aha nā hōʻailona mua o kēia CTO?"
- "He aha nā hoʻokolohua e pono ai iaʻu e hana e hōʻoia i kēia?"
- "He aha nā hoʻololi e pono ai iaʻu e hana i koʻu nohona e pale aku ai i kēia maʻi mai ka hanana ʻana?"
- "He aha nā koho lapaʻau e loaʻa iaʻu? He aha ka mea maikaʻi loa iaʻu?"
- "Ma hope o ka lāʻau lapaʻau, he aha ka manawa kūpono e hiki hou mai ai kēia maʻi?"
Leka Lawe-Home
- ʻO ka CTO (Chronic Total Occlusion) kahi maʻi koʻikoʻi kahi i ālai piha ʻia ai (100%) kahi kīʻaha koko e hoʻolako ana i ke koko i ka puʻuwai no nā mahina ʻekolu a ʻoi.
- ʻO ke kumu nui o kēia, ʻo ia ka waiho ʻana o nā mea e like me ka cholesterol a me ka ʻaila ma nā paia o nā aʻa.
- ʻO ka puhipaka, ke koko kiʻekiʻe, ka maʻi diabetes, a me ke kolamu kiʻekiʻe nā kumu pilikia nui. He mea nui loa ka kaohi ʻana i kēia mau mea.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha o ka umauma, ka paʻakikī o ka hanu ʻana, a i ʻole ka luhi nui , mai hoʻowahāwahā iā lākou a e ʻimi koke i ke kōkua lapaʻau.
- Mai hopohopo, aia i kēia manawa nā lāʻau lapaʻau holomua loa e like me ka PCI (hoʻokomo stent) a me ka CABG (ʻoki bypass).
- ʻO kahi nohona olakino (ʻai maikaʻi, hoʻoikaika kino) a me ka lawe ʻana i ka lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka e kōkua nui i ka mālama ʻana i kēia maʻi.
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo