Ke hoʻokahe nei anei kou kino i ka wai e like me kēia? E kamaʻilio kākou e pili ana i ka Capillary Leak Syndrome!

Ua lohe paha ʻoe i ka Capillary Leak Syndrome? He mea paʻakikī paha ke kani ʻana o ka inoa. Akā i ka ʻōlelo maʻalahi, he ʻano ia kahi e kahe ai ka ʻāpana wai o ke koko, i kapa ʻia ʻo plasma, mai loko mai o nā kīʻaha koko liʻiliʻi i loko o ko kākou kino, i kapa ʻia ʻo capillaries. Ke kahe nei kēia wai i loko o ko kākou mau ʻiʻo, nā ʻiʻo, nā ʻōpū, a me nā lua o ke kino. Hiki i kēia ke lilo i ʻano koʻikoʻi, no laila he mea nui e makaʻala iā ia.

He aha kēia mea i kapa ʻia ʻo ka capillary leak syndrome?

ʻAe, e wehewehe iki kākou. E noʻonoʻo he ʻōnaehana paipu wai ko kou kino. ʻO kēia mau paipu ko kākou mau kīʻaha koko. ʻO nā paipu liʻiliʻi loa i loko o kēia i kapa ʻia he capillaries. ʻO kēia nā paipu e hele ai ka oxygen a me nā meaʻai i nā ʻāpana āpau o ko kākou kino. No laila, i loko o ka `(Capillary Leak Syndrome)`, ʻo ka ʻāpana wai o ke koko, ʻo ia hoʻi , ka plasma , e liki ana ma o kēia mau capillaries liʻiliʻi. Ua like ia me ka wai e liki ana mai loko mai o kahi paipu wai.

ʻO kēia kahe ʻana o ka wai ke kumu o ka hōʻiliʻili ʻana o ka wai ma nā ʻāpana like ʻole o ke kino. No ka laʻana, hiki i kēia wai ke kahe i loko o nā ʻiʻo, nā ʻiʻo, nā ʻano kino like ʻole, a i ʻole nā ​​​​wahi (nā lua o ke kino) kahi i loaʻa ai nā ʻano kino.

Hiki ke loaʻa nā hanana o kēia `(Capillary Leak Syndrome)` i nā manawa he nui i ka makahiki, a i ʻole hoʻokahi wale nō manawa i ke ola. Eia nō naʻe, inā ʻaʻole ia e mālama koke ʻia, hiki i kou koko ke hāʻule koke, e alakaʻi ana i ka hāʻule ʻana o nā ʻōkana a i kekahi manawa make. No laila, ʻaʻole kēia he mea e lawe māmā ʻia.

ʻAʻohe lāʻau lapaʻau mau loa no kēia. Eia nō naʻe, he mea nui e ʻimi koke i ke kōkua lapaʻau e kāohi i nā hōʻailona. I kekahi manawa, hiki ke pale aku i nā hoʻouka kaua e hiki mai ana ma ka hoʻomau ʻana i ka hoʻohana ʻana i nā lāʻau lapaʻau a i ʻole ka loaʻa ʻana o nā infusions o ka saline.

Aia kekahi ʻano o kēia? Pehea lākou e ʻokoʻa ai?

ʻAe, ʻelua ʻano nui o ka `(Capillary Leak Syndrome)`. E nānā kākou i ke ʻano o lākou.

• ʻO ka Systemic Capillary Leak Syndrome: Ua kapa ʻia hoʻi ʻo "Primary Capillary Leak Syndrome" a i ʻole "Clarkson's disease", he ʻano kēia e hana pinepine ʻia ai nā hoʻouka ʻana , ʻoiai i loko o ke kanaka olakino maʻamau.
• ʻO ka Secondary Capillary Leak Syndrome: ʻO kēia ka wā e kū mai ai ka hoʻouka ʻana ma muli o kekahi maʻi, kūlana, a i ʻole lāʻau lapaʻau ʻē aʻe.

I ka ʻōlelo maʻalahi, ʻo kekahi mea e hiki ke hana mau ʻia, a ʻo kekahi mea e hana ʻia no kekahi manawa no kekahi kumu ʻē aʻe.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?

He maʻi laha ʻole ka "Systemic Capillary Leak Syndrome".Ua hōʻike ʻia ma lalo o 500 mau kānaka ma ka honua holoʻokoʻa ua loaʻa kēia maʻi. ʻOi aku ka maʻamau i ka poʻe waena o ka makahiki. He mea kākaʻikahi loa ia i nā keiki ʻōpio. Eia nō naʻe, no ka mea, i kekahi manawa ua kuhihewa ʻia ka poʻe me kēia maʻi he maʻi ʻē aʻe ko lākou, ʻoi aku ka nui o ka poʻe me kēia maʻi.

Eia nō naʻe, hiki ke loaʻa ka Secondary Capillary Leak Syndrome i kēlā me kēia makahiki. Hiki i kekahi mau maʻi, nā kūlana olakino, a me nā lāʻau lapaʻau ke hana iā ia.

He aha ka mea e hana ʻia i ke kino ke hana ʻia kēia? (ʻEkolu mau pae)

Hiki ke hoʻokaʻawale ʻia nā mea e hana ʻia ana i loko o ko kākou kino i kēia hoʻouka ʻana o ka `(Capillary Leak Syndrome)` i ʻekolu mau pae. E nānā kākou i ke ʻano o ia mau mea.

Pae mua: Ma mua o ka ʻike ʻia ʻana o nā hōʻailona (pae Prodromal)

ʻO kēia ka manawa hoʻokahi a ʻelua paha lā ma mua o ka hoʻouka ʻana. I loko o kēia manawa, e hoʻomaka paha ʻoe e ʻike i kekahi mau hōʻailona.

• Manaʻo luhi
• Hoʻonui ʻia ka make wai no ka wai
• Hiki ke hana ʻia nā mea e like me ka piʻi koke ʻana o ke kaumaha .

Pae ʻelua: Pae leak a i ʻole pae resuscitation

ʻO kēia ka manawa e hana maoli ai ka hoʻouka kaua. ʻO ka mea e hana ʻia, ʻo ia ka wai a me ka albumin (kahi ʻano protein i loko o ke koko) e kahe ana mai kou mau capillaries i loko o nā hakahaka ma waena o kou mau ʻiʻo. Hoʻemi kēia i ka nui o ke koko e lawe ana i ka oxygen. Hāʻule kou koko, a hui pū nā hunaola koko ʻulaʻula, e hoʻomānoanoa ana i kou koko. ʻO kēia kahe wai e hoʻemi ai i ka nui o ke koko, i kapa ʻia ʻo hypovolemia .

Pae ʻekolu: Ma hope o ka hoʻouka ʻana `(Papa ma hope o ka leaka a i ʻole ka pae hoʻolimalima)`

ʻO kēia ka manawa ma hope o ka pau ʻana o ka hoʻouka kaua. ʻO ka mea e hana ʻia, hoʻomaka hou kou mau capillaries e omo i ka wai a me ka albumin mai nā ʻiʻo. Eia nō naʻe, i loko o kēia manawa, hiki i kou kino ke hōʻiliʻili i ka wai nui loa (fluid overload) . ʻO ka hopena, hiki i kou kino ke hana i ka mimi nui loa (polyuria) a hiki i kou mau māmā ke piha i ka wai (pulmonary edema).

E noʻonoʻo e pili ana i ia mea, ua like ia me ka huʻa e omo ana i ka wai. ʻO ka mua, puka mai ka wai mai ke kino mai, a laila ke omo hou ia me ka wikiwiki loa, omo ia ma mua o ka mea e pono ai.

He aha ke kumu o kēia?

E nānā kākou i ke kumu o kēia `(Capillary Leak Syndrome)`.

Nā kumu o ka `(Systemic Capillary Leak Syndrome)`

ʻO kaʻoiaʻiʻo, ʻaʻole ʻike ʻia ke kumu kikoʻī o ka Systemic Capillary Leak Syndrome. Manaʻo nā kānaka noiʻi ua hiki ke hana ʻia e ka pane a kā mākou ʻōnaehana pale i kekahi maʻi a i ʻole ka maʻi ahulau.

Nā kumu o ka `(Secondary Capillary Leak Syndrome)`

Aia kekahi mau kumu no kēia. ʻO ke kumu maʻamau ka maʻi i kapa ʻia ʻo sepsis . ʻO ia hoʻi, he pilikia hoʻoweliweli ola i hoʻokumu ʻia e kahi maʻi. Eia kekahi, aia kekahi mau kumu ʻē aʻe:

• Nā maʻi autoimmune:ʻO ka mea e hana ʻia ana ma kēia, ʻo ia ka hoʻouka ʻana o ko kākou ʻōnaehana pale ponoʻī i ko kākou mau hunaola olakino ponoʻī.
• ʻO ka maʻi ʻokoʻa: He pilikia e hiki ke hana i ka wā o ka mālama ʻana no kekahi mau ʻano leukemia (acute promyelocytic leukemia a i ʻole acute myeloid leukemia).
• ʻO ka maʻi Engraftment: He pilikia e hiki ke hana ma hope o ka hoʻoili ʻana o ka iwi iwi.
• Hemophagocytic lymphohistiocytosis: He maʻi hoʻoweliweli paha i ke ola i hana ʻia e kahi ʻōnaehana pale kino overactive.
• ʻO ka maʻi Ovarian hyperstimulation: He pilikia e hiki ke hana i ka wā o nā mālama ʻana i ka momona.
• Ka lāʻau make ʻana o Ricin.
• Nā nahu ʻana o ka nahesa.
• Nā kuni hemorrhagic viral: He hui o nā maʻi lele i hoʻokumu ʻia e nā virus.

ʻO kekahi mau lāʻau lapaʻau, e like me nā lāʻau anti-cancer gemcitabine (gemcitabine - Gemzar®) a me tagraxofusp (tagraxofusp - Elzonris®) , hiki ke hana i kēia (Secondary Capillary Leak Syndrome).

He aha nā hōʻailona e kū mai ana ma mua o ka hoʻomaka ʻana o kēia maʻi?

ʻO ka maʻamau, hoʻokahi a ʻelua paha lā ma mua o ka hoʻouka ʻana o ka "Capillary Leak Syndrome", ʻo ia hoʻi, i ka wā o ka "prodromal phase", hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• ʻEha ʻōpū a ʻeha paha nā ʻiʻo (myalgia).
• Ka luhi nui a i ʻole ka nāwaliwali.
• ʻEha poʻo .
• Hoʻonui ʻia ka make wai no ka wai.
• Hoʻonāukiuki, hoʻonāukiuki.
• Ka luaʻi.
• Piʻi koke ke kaumaha.
• Nā hōʻailona o kahi maʻi viral a i ʻole ka maʻi ʻōpū hanu luna.

Inā ʻike ʻoe i nā hōʻailona e like me kēia, mai lawe māmā ʻoe me ka ʻōlelo ʻana, "ʻĀ, he anu wale nō paha," ʻoiai inā ua loaʻa iā ʻoe nā ʻike like ma mua.

He aha nā hōʻailona e kū mai ana ke loaʻa iā ʻoe kahi maʻi?

I ka wā o ka hoʻouka ʻana o ka `(Capillary Leak Syndrome)`, ʻo ia hoʻi, i ka wā `(leak a i ʻole resuscitation phase)`, ʻokoʻa paha nā hōʻailona mai kēlā kanaka a kēia kanaka. Eia nō naʻe, eia nā hōʻailona maʻamau e ʻike ʻia:

• Ka pehu ʻana o ke kino, ʻoiai nā lālā (peripheral edema).
• Ka maʻi pākī.
• Ke koko haʻahaʻa (hypotension).
• ʻO ke kāpili ʻana o ke koko (hypercoagulability) - Hiki ke hana ʻia kēia e ka piʻi ʻana o ka helu o nā hunaola koko ʻulaʻula (hematocrit) a i ʻole ka piʻi ʻana o ka helu o nā hunaola koko keʻokeʻo (leukocytosis).

Pehea e ʻike ai nā kauka i kēia?

E ʻike ke kauka i ka Capillary Leak Syndrome ma ka nīnau ʻana e pili ana i kou mōʻaukala olakino a me ka hana ʻana i kahi hoʻokolokolo kino. E nānā lākou e ʻike inā haʻahaʻa kou koko.

Eia kekahi, ma mua o ka hōʻoia ʻana he Capillary Leak Syndrome kēia, pono e kāpae ʻia nā kūlana ʻē aʻe. Hiki iā lākou ke hana i kekahi mau hoʻāʻo koko e hana i kēia:

• E nānā inā kiʻekiʻe ka hematocrit (ka helu o nā hunaola koko ʻulaʻula i loko o ke koko).
• E nānā i nā pae hemoglobin kiʻekiʻe (kahi protein i loaʻa i loko o nā hunaola koko ʻulaʻula).
• E nānā inā haʻahaʻa ka protein i loko o ke koko (hypoalbuminemia).

Eia kekahi, hiki ke hana ʻia kahi hoʻāʻo koko e nānā i kahi protein pale ʻē i kapa ʻia ʻo "monoclonal gammopathy, a i ʻole M protein" i loko o ke koko. ʻO ka poʻe me ka "Capillary Leak Syndrome" hiki ke loaʻa kēia "M protein" ʻē i loko o ko lākou koko.

Pehea e mālama ʻia ai? Hiki ke ho'ōla ʻia?

ʻO ka mea pōʻino, ʻaʻohe lāʻau lapaʻau mau loa no ka Capillary Leak Syndrome. Hoʻāʻo nā kauka e kāohi i nā hōʻailona a pale i nā pilikia.

I ka wā o ka hoʻouka ʻana o ka "Capillary Leak Syndrome", hoʻāʻo nā kauka e kāohi i ke koko a mālama i ke kahe koko kūpono i nā ʻōpū. Hoʻāʻo pū lākou e pale i ka pehu nui a me ka hōʻiliʻili ʻana o ka wai. Hiki iā lākou ke hoʻohana:

• Glucocorticoids: He ʻano steroid kēia e kōkua ai i ka hōʻemi ʻana i ka leakage wai mai nā capillaries.
• Nā wai intravenous: Hāʻawi ʻia nā mea e like me ka saline e hoʻonui i ke kahe koko i nā ʻōpū e like me nā puʻupaʻa.

ʻO ka maʻamau , pono ʻoe e hoʻokomo ʻia i ka haukapila ma hope o kahi hoʻouka kaua. I ka wā o ka mālama ʻana, e hoʻomau kāu kauka i ka nānā ʻana i kou koko a me ke koko e hōʻoia ʻaʻole nui ka wai i loko o kou kino, hiki ke alakaʻi i nā pilikia ʻē aʻe, e like me ka edema pulmonary a me ka hopu koke ʻana o ka puʻuwai.

Ma hope o ka hoʻouka ʻana o ka Capillary Leak Syndrome, i ʻike ʻia ʻo ka post-leak phase a i ʻole ka recruitment phase, hiki i ke kauka ke kuhikuhi i kahi diuretic (kahi lāʻau lapaʻau e hoʻoulu ai iā ʻoe e hana hou i ka mimi) e hōʻemi i ka nui o ka wai keu i loko o kou kino.

Hiki ke pale ʻia ka hoʻi hou ʻana o ka Systemic Capillary Leak Syndrome (SCLS)?

ʻAʻole hiki iā ʻoe ke pale aku i ka Systemic Capillary Leak Syndrome mai ka ulu ʻana ma kahi mua. Akā, i ka wā e loaʻa ai iā ʻoe kahi hoʻouka kaua, ʻike ʻoe ua loaʻa iā ʻoe ke ʻano.

Eia nō naʻe, ʻo ka lawe mau ʻana i ka lāʻau lapaʻau a i ʻole ka loaʻa ʻana o nā infusions o ka saline hiki ke kōkua i ka pale ʻana i nā hoʻouka kaua e hiki mai ana a hōʻemi i ko lākou koʻikoʻi. Hiki i kēia mau lāʻau lapaʻau ke komo pū me:

• ʻO ka loaʻa ʻana o ka intravenous immune globulin (IVIG) i kēlā me kēia mahina.
• Nā lāʻau lapaʻau waha no ka hānō, e like me theophylline (theophylline - Elixophyllin®), terbutaline (terbutaline - Brethine®), a me montelukast (montelukast - Singulair®) .
• E hōʻemi i ka mumūNā steroid.

He aha ka wā e hiki mai ana no ka poʻe e noho nei me kēia maʻi? `(Outlook)`

Hiki ke mālama ʻia ka Systemic Capillary Leak Syndrome me nā lāʻau pale. ʻOi aku ka holomua o ka lāʻau ke ʻike mua ʻia ke ʻano a liʻiliʻi nā pilikia. ʻO kekahi o nā pilikia koʻikoʻi e hiki ke hana me ka Capillary Leak Syndrome:

• ʻO ka maʻi ʻāpana: Hoʻonui ʻia ke kaomi i loko o ka ʻiʻo a me ka emi ʻana o ke kahe koko.
• Ka hōʻiliʻili ʻana o ka wai a puni ka puʻuwai a me nā māmā (cardiac tamponade, pericardial effusion, a me ka pleural effusion).
• Ka hāʻule ʻana o ka puʻuwai.
• Ka hāʻule ʻana o nā puʻupaʻa.
• ʻO ka maʻi ʻaʻai.
• ʻEdema puʻuwai.
• Rhabdomyolysis: Ka hāʻule ʻana o ka puʻupaʻa ma muli o ka hōʻino ʻana o nā ʻiʻo.
• Hahau.

He mea weliweli paha kēia, akā e like me ka mea i ʻōlelo ʻia ma mua, he mea nui loa ka mālama koke ʻana a me ka hoʻokele kūpono.

Āhea wau e ʻike ai i ke kauka?

Inā manaʻo ʻoe e loaʻa ana iā ʻoe kahi hoʻouka ʻana o ka Capillary Leak Syndrome, e ʻike koke i ke kauka. Hiki iā lākou ke kōkua i ka hoʻokele ʻana i kāu mau hōʻailona a hāʻawi iā ʻoe i ka hōʻoluʻolu.

E hoʻomanaʻo, ʻoiai he mea kakaikahi kēia, he mea nui e makaʻala i nā hōʻailona a e ʻimi koke i ke kōkua lapaʻau inā kānalua.

Leka Lawe-Home

ʻAe, e hōʻuluʻulu kākou i nā kumu nui a mākou i kamaʻilio ai:

• ʻO kēia ka manawa e kahe ai ka ʻāpana wai o ke koko (plasma) mai loko mai o nā kīʻaha koko liʻiliʻi (capillaries) i loko o ko mākou kino.
• Hiki ke hana i kēia i hoʻokahi manawa a i ʻole pinepine.
• Inā ʻaʻole mālama ʻia, hiki ke loaʻa nā pilikia koʻikoʻi, no laila he mea nui ka nānā koke ʻana i ke kauka.
• ʻOiai ʻaʻohe lāʻau lapaʻau mau loa, aia nā lāʻau lapaʻau e kaohi i nā hōʻailona a pale i nā hoʻouka kaua e hiki mai ana.
• Inā kānalua ʻoe i kekahi o kēia mau hōʻailona, ​​e ʻike koke i ke kauka. ʻO ka wikiwiki o kou ʻike ʻana i ka maʻi a hoʻomaka i ka mālama ʻana, ʻoi aku ka maikaʻi o kou manawa e hoʻōla ai.

No laila, ke lana nei koʻu manaʻo he mea pono kēia ʻike iā ʻoe. E noho olakino!

ʻO ka Capillary Leak Syndrome, Plasma Leak, Haʻahaʻa o ke Koko, Maʻi Clarkson, Edema, Ke kahe ʻana o ka wai i loko o ke kino