He kīʻaha koko paʻa ko kou ʻāʻī? E aʻo kākou i nā mea āpau e pili ana i ka Carotid Artery Stenosis!

ʻAuē, ua noʻonoʻo paha ʻoe i ke koʻikoʻi o ka pilikia inā e ālai ʻia nā kīʻaha koko nui ma nā ʻaoʻao ʻelua o ko kākou ʻāʻī? I kekahi manawa hiki ke hana ʻia kēia me ka ʻole o nā hōʻailona. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi e hiki ke ulu mālie a hoʻomākaukau koke i ke ala no kahi maʻi hoʻoweliweli ola e like me ka hahau . ʻO kēia ka mea a mākou e kapa nei ʻo Carotid Artery Stenosis .

He aha ka Carotid Artery Stenosis?

I ka ʻōlelo maʻalahi, ʻo Carotid Artery Stenosis kahi kūlana kahi e ālai ʻia ai nā Carotid Arteries ma nā ʻaoʻao ʻelua o kou ʻāʻī, nā kīʻaha koko nui e lawe ana i ke koko i kou lolo, maka, a me ke poʻo, mai loko mai. E noʻonoʻo iā ia e like me ka paipu wai e pani ʻia ana e ka lepo a me ka ʻōpala, kahi e hoʻolohi ai i ke kahe ʻana o ka wai. ʻO ke kumu nui o kēia ālai ʻana, ʻo ia ka hōʻiliʻili ʻana o kahi mea i kapa ʻia ʻo ka plaque i loko o nā aʻa. ʻO kēia 'plaque' i hana nui ʻia me nā waihona cholesterol momona .

Loaʻa iā kākou ʻelua mau aʻa carotid ma nā ʻaoʻao ʻelua o ko kākou ʻāʻī. I ke kanaka olakino, ua like kēia mau aʻa me kahi paipu maʻemaʻe, me ke koko e kahe mālie ana me ke keʻakeʻa ʻole. ʻO kēia koko ka mea e lawe i ka oxygen a me nā meaʻai e pono ai ko kākou lolo. No laila, ke hōʻiliʻili ka plaque i loko o kekahi a i ʻole nā ​​​​​​aʻa koko ʻelua, e emi ana ka nui o ke koko e kahe ana i ka lolo. ʻO kēia ka mea a nā kauka e kapa nei he atherosclerosis . Hōʻiliʻili mālie kēia ʻano i ka hala ʻana o ka manawa, a inā ʻaʻole mālama ʻia, hiki iā ia ke alakaʻi i kahi hahau weliweli, a me ka make.

Pehea ka maʻamau o kēia ʻano?

Ua manaʻo ʻia aia ma kahi o 5% o ka heluna kanaka maʻamau e loaʻa ana i kēia maʻi. Wahi a ka American Stroke Association , ʻo ka hahau ke kumu nui ʻelima o ka make. ʻO ka pilikia o ka paʻa ʻana o ke aʻa carotid, a me ka hahau, e piʻi aʻe ana me ka makahiki. ʻO ia hoʻi, he mea ia e piʻi mālie ana i ka hala ʻana o ka manawa.

He aha nā kumu a me nā kumu pilikia no kēia?

Aia kekahi mau kumu e kōkua ai i ka stenosis o ke aʻa carotid. ʻO ka mea maikaʻi loa, hiki iā mākou ke kāohi i kekahi o lākou. Eia kekahi o lākou:

• Ka hoʻohana ʻana i ka paka a me ka cigarette: He mea nui kēia i nā maʻi he nui. Hoʻopōʻino ka puhipaka i nā kīʻaha koko a hoʻonui i ka pilikia o ka hōʻiliʻili ʻana o ka plaque.
• Momona: E like me nā maʻi ʻē aʻe e hele mai me ka momona o ke kino , hoʻopilikia pū ka momona i kēia.
• He nohona noho wale: ʻOi aku ke kiʻekiʻe o kēia pilikia no kekahi e hana ana ma ka noho i ka lā a pau a ʻaʻole hoʻi e hoʻoikaika kino.
• Ke koko kiʻekiʻe (Ke koko kiʻekiʻe / Hypertension):Ke piʻi aʻe ke kaomi, hiki ke hōʻino ʻia nā paia o nā kīʻaha koko, e maʻalahi ai ka hōʻiliʻili ʻana o ka plaque.
• ʻO ke kolesterol kiʻekiʻe: Inā kiʻekiʻe ka pae kolesterol i loko o ke koko, loaʻa ka mea nui no ka hoʻokumu ʻia ʻana o ka 'plaque' a mākou i ʻōlelo ai.
• ʻO ka maʻi diabetes Mellitus: ʻOi aku ka nui o ka poʻe me ka maʻi diabetes i ka loaʻa ʻana o nā pilikia kīʻaha koko. Hoʻololi ka maʻi diabetes i nā paia o nā kīʻaha koko, e maʻalahi ai ka hōʻiliʻili ʻana o ka plaque.
• Makahiki: I kou wā ʻelemakule, piʻi maoli kou pilikia no nā maʻi he nui. ʻAʻole kēia he ʻokoʻa.

Ke hui pū ʻia kekahi a ʻoi aku paha o kēia mau mea, piʻi nui aʻe ka pilikia o ka paʻa ʻana o ke aʻa carotid.

He aha nā hōʻailona o kēia maʻi?

ʻO ka pinepine, ʻaʻole hōʻike nā poloka o ke aʻa carotid i nā hōʻailona a hiki i ka wā e loaʻa ai ka hahau . Loaʻa ka hahau i ka wā e haki ai ka plaque i loko o ke aʻa, a i ʻole e hana ʻia kahi clot koko ma luna o ka plaque a hele i ka lolo, e ālai ana i kahi kīʻaha koko liʻiliʻi i loko o ka lolo. Ua kapa ʻia hoʻi kēia he ischemic stroke . Ke ʻoki ʻia ke kahe koko ma kēia ʻano, ua nele nā ​​​​​​pūnaewele o ka lolo i ka oxygen a me nā meaʻai a hoʻomaka e make.

Loaʻa paha i kekahi poʻe kahi hoʻouka kaua ischemic transient (TIA) ma mua o ka hahau nui. Ua like kēia me ka "mini-stroke." ʻO kēia ka wā e ālai ʻia ai kahi kīʻaha koko i loko o ka lolo no kekahi manawa a laila wehe hou. He hōʻailona koʻikoʻi ka TIA e hōʻike ana he hahau nui e hiki mai ana.

He mea nui: ʻOiai inā e nalowale nā ​​​​hōʻailona o ka TIA i loko o kekahi mau minuke, mai hoʻowahāwahā iā ia. ʻO ka ʻimi koke ʻana i ke kōkua lapaʻau e hiki ke kōkua i ka pale ʻana i kahi hahau nui.

He aha nā hōʻailona o ka stroke a i ʻole TIA?

Hiki ke hiki koke mai kēia mau hōʻailona. Inā loaʻa iā ʻoe kekahi o kēia mau mea , pono ʻoe e hele koke i ka haukapila :

• Kūlou kekahi ʻaoʻao o ka maka: Ke noi ʻia e minoʻaka, ʻaʻole hiki i kekahi ʻaoʻao o ka maka ke minoʻaka pono.
• Paʻakikī i ka ʻōlelo ʻana a i ʻole ka ʻōlelo ʻana i nā huaʻōlelo: He paʻakikī i nā poʻe ʻē aʻe ke hoʻomaopopo i ka mea e ʻōlelo ʻia nei, a ua ʻōlelo ʻia nā huaʻōlelo.
• Poho a pohihihi paha ka ʻike ma kekahi maka: Manaʻo paha ia e like me ka hāʻule ʻana o kahi pale ʻeleʻele i mua o kekahi maka.
• Ka mae a i ʻole ka nalowale o ka manaʻo ma kekahi ʻaoʻao o ke kino.
• Ka nāwaliwali o nā ʻiʻo a me ka nalowale o ka ikaika ma kekahi ʻaoʻao o ke kino: hiki ʻole ke hāpai i ka lima a i ʻole ka wāwae, ka paʻakikī ke hele.

Hiki iā ʻoe ke hoʻohana i ka acronym FAST e hoʻomanaʻo i kēia mau ʻano:

• F - Ke kūlou nei ka maka
• A - Nāwaliwali o ka Lima
• S - Paʻakikī ʻŌlelo
• T - Ka manawa e kāhea aku ai i nā lawelawe ulia pōpilikia (e hoʻokomo koke i ka haukapila)

ʻOiai inā he poloka i loko o ke aʻa carotid, hiki iā ia ke hoʻoulu i ka maʻi lolo.Inā ʻaʻohe ou anu, ʻaʻole paha ʻoe e ʻike i kekahi mau hōʻailona. ʻO ia ke kumu he mea hopohopo iki kēia.

Pehea e ʻike ʻia ai kēia maʻi?

ʻO ka hapa nui o ka manawa, ʻike ʻia ka stenosis o ke aʻa carotid ma hope o kou loaʻa ʻana o nā hōʻailona o ka hahau ʻana. ʻIke wale ʻia ia ke hana nā kauka i nā hoʻokolohua e ʻike ai i ke kumu o ka stenosis.

I kekahi manawa, ke nānā ke kauka i kou ʻāʻī me ka stethoscope no kekahi kumu ʻē aʻe, lohe paha lākou i kahi leo ʻē, he leo hū (bruit) e puka mai ana mai loko mai o nā kīʻaha koko. Hiki i kēlā ke hoʻāla i ka kānalua e pili ana i kēia maʻi.

Hoʻohana nā kauka i kekahi mau hoʻokolohua e hōʻoia i kēia maʻi a hoʻoholo pono i ka nui a me kahi o ka poloka:

• ʻO ke kiʻi ʻana i ka ultrasound (Ultrasound / Duplex Ultrasound): Hoʻohana kēia i nā nalu kani e hana i nā kiʻi o nā kīʻaha koko i loko o ke kino. He hoʻāʻo maʻalahi a ʻeha ʻole kēia e hana ʻia ma ka ʻili o ka ʻili. Hiki iā ia ke nānā i ke ʻano o ke kahe ʻana o ke koko i loko o nā kīʻaha koko a inā he mea e ālai ana a i ʻole e haiki ana.
• ʻO CT Angiography (Computed Tomography Angiography - CTA): Hoʻohana kēia hoʻāʻo i kahi mīkini i kapa ʻia he scanner `CT` (kahi mea e hoʻohana ana i nā kukuna X e lawe i nā kiʻi kikoʻī o loko o ke kino) e lawe i nā kiʻi kikoʻī o nā aʻa carotid. I loko o kēia hoʻāʻo, hoʻokomo ʻia kahi kala kūikawā i loko o nā kīʻaha koko. Hoʻomaopopo kēia kala i nā wahi i ālai ʻia i nā kiʻi. Hiki ke hana ʻia kēia hoʻāʻo no ka poʻe i hoʻokomo ʻia kahi `pacemaker` a i ʻole i hoʻokomo ʻia nā `stent` no nā maʻi ʻē aʻe.
• ʻO ka Angiography Cerebral: He hoʻāʻo diagnostic nō hoʻi kēia. Eia nō naʻe, ma kēia hoʻāʻo, ua hoʻokomo ʻia kahi catheter liʻiliʻi (ʻōmole lahilahi) ma o kahi kīʻaha koko a ua nānā ʻia ka mea i paʻa. Ma kēia hoʻāʻo, ua hoʻokomo ʻia kahi kala like i loko o nā kīʻaha koko e ʻike maopopo i nā kikoʻī o nā aʻa koko. He hoʻāʻo paʻakikī iki kēia.
• MR Angiography (Magnetic Resonance Angiography - MRA): Ua like kēia me ka CT scan, akā ʻaʻole ia e hoʻohana i nā kukuna X. Lawe ʻia nā kiʻi me ka hoʻohana ʻana i nā kahua magnetic a me nā nalu lekiō. Hiki i kēia ke hana i nā kiʻi kikoʻī o nā kīʻaha koko. He hoʻāʻo ʻeha ʻole kēia.

Pehea ʻoe e hoʻokaʻawale ai i kēia ālai ʻana?

I ka hana ʻana i kahi hōʻailona, ​​​​nānā nā kauka inā loaʻa iā ʻoe ke ʻano, pehea kona koʻikoʻi, a me kona wahi. ʻO ka stenosis o ke aʻa Carotid ma ke ʻano laulā ua māhele ʻia i ʻekolu mau ʻāpana nui: ʻoluʻolu, waena, a koʻikoʻi.

• ʻO kahi ālai iki ka mea kahi i emi ai ke ālai ma mua o 50%, ʻo ia hoʻi, ʻaʻole i piha ma mua o ka hapalua.
• ʻO ke kūlana paʻapū kūpono ma waena o 50% a me 79% o ke kūlana paʻapū.
• ʻO ka paʻa nui ma waena o 80% a me 99% ka paʻa ʻana, ʻo ia hoʻi, ua paʻa ka nui. ʻO kēia ka pae weliweli loa.

Pehea e mālama ʻia ai kēia?

ʻO ka pahuhopu nui o ka mālama ʻana i ka stenosis o ke aʻa carotid ʻo ia ke kāohi i ka maʻi mai ka ʻino ʻana. Hoʻomaka kēia me nā hoʻololi ʻana i ke ʻano o ka nohona :

• Ka ʻai ʻana i kahi meaʻai olakino maikaʻi.(Nā meaʻai haʻahaʻa i ka ʻaila, ka paʻakai, a me ke kō, kiʻekiʻe i nā huaʻai a me nā mea kanu)
• Hoʻoikaika kino mau .
• E ho'ōki loa i ka puhi paka.

Eia kekahi, hiki i nā kauka ke ʻōlelo aku i ka aspirin i kēlā me kēia lā, kahi lāʻau pēpē o nā lāʻau hoʻokahe koko, nā lāʻau koko, a me nā lāʻau hoʻohaʻahaʻa cholesterol.

Eia nō naʻe, inā koʻikoʻi ka paʻa ʻana, a inā ʻoe e hōʻike nei i nā hōʻailona o ka TIA a i ʻole ka hahau ʻana, hiki i nā kauka ke ʻōlelo aku i ke ʻoki ʻana.

• ʻO Carotid Endarterectomy: Pili kēia i ka hana ʻana i kahi ʻoki liʻiliʻi ma ka ʻāʻī, ka wehe ʻana i ke kīʻaha koko, a me ka wehe ʻana i ka palaki i kūkulu ʻia i loko.
• Ke kau ʻana i ka stenting: ʻO kēia ke kau ʻana i kahi stent liʻiliʻi e like me ka ʻupena i loko o ke kīʻaha koko i paʻa me ka hoʻohana ʻana i kahi mea e like me ke nila, e hoʻonui ana i ke kīʻaha koko mai loko mai. A laila paʻa ka plaque ma waena o ka stent a me ka paia o ke kīʻaha koko, e ʻae ana i ke kahe koko e hoʻomau me ke keakea ʻole.

Na ke kauka ʻoki koko a loea paha e hoʻoholo i kahi o kēia mau ʻoki ʻelua e kūpono iā ʻoe.

ʻAʻole pono nā ʻoki aʻa carotid āpau i ke ʻoki kino a i ʻole ke stenting. Loaʻa i kēia mau lāʻau lapaʻau nā pilikia. Paipai nā kauka i kēia mau lāʻau lapaʻau inā ʻoi aku ka nui o ka pilikia o ka lolo mai ka paʻa ʻana ma mua o nā pilikia o ke ʻoki kino.

He aha ka mea e hana ʻia ma hope o kēia mau ʻoki kino? Pehea ka lōʻihi e hoʻōla ai?

Hiki i ka stenosis o ke aʻa Carotid ke lilo i mea weliweli inā ʻaʻole i ʻike ʻia a mālama koke ʻia. Hiki iā ia ke alakaʻi i ka maʻi lolo , ka make, a i ʻole ke kīnā mau loa. No laila, he mea nui e makaʻala i nā hōʻailona o ka hahau ʻana a hana koke inā ʻike ʻoe a i ʻole kekahi i kēlā hōʻailona.

Hiki i ka mālama mua ʻana i ka stenosis o ke aʻa carotid ke hoʻopakele i nā ola. I ka wā e pono ai, loaʻa nā hopena maikaʻi loa i ke ʻoki ʻana a me ka stenting. Noho ka hapa nui o ka poʻe i ka haukapila i ka pō a hoʻōla koke.

I kou wā ʻelemakule, piʻi aʻe kou pilikia o ka loaʻa ʻana o ka maʻi carotid artery. ʻO ka mea nui loa hiki iā ʻoe ke hana e pale aku i kēia maʻi, a e pale aku i nā pilikia e like me ka hahau ʻana, ʻo ia ka mālama ʻana i kahi nohona olakino . ʻO nā laʻana e komo pū me ka hoʻoikaika kino, ka ʻai ʻana i ka meaʻai olakino, a me ka puhi ʻole ʻana. E ʻike pinepine i kāu kauka ʻohana a me kāu kauka cardiologist a e hahai i kā lākou ʻōlelo aʻo. E kamaʻilio me kāu kauka e pili ana i nā ala e mālama ai i kou puʻuwai a me ke olakino o ke kaʻapuni koko.

Leka Lawe-Home

ʻAe, no laila, mai nā mea a mākou i kamaʻilio ai, eia nā mea nui loa e pono ai ʻoe e hoʻomanaʻo:

• ʻO ka Carotid Artery Stenosis kahi kūlana kahi e ālai ʻia ai ke kīʻaha koko nui ma ka ʻāʻī e nā waihona momona (plaque). ʻO kēiaHiki ke loaʻa ka hahau ʻana .
• ʻO ka puhipaka, ka momona, ke koko kiʻekiʻe, ka cholesterol kiʻekiʻe, ka maʻi diabetes, a me ka ʻelemakule nā ​​​​kumu nui no kēia.
• I ka hapanui o ka manawa, hiki ke hana ʻia kēia me ka ʻole o nā hōʻailona . Eia nō naʻe, inā loaʻa iā ʻoe kahi `TIA` (mini-stroke) a i ʻole nā ​​​​hōʻailona o ka hahau ʻana (kūlou ke alo, paʻakikī i ka ʻōlelo ʻana, nāwaliwali o ka lima a i ʻole ka wāwae), e hele koke i ka haukapila .
• Hiki ke ʻike ʻia kēia ma o nā hoʻokolohua e like me ka ultrasound, CTA, a me MRA .
• ʻO ka lāʻau lapaʻau e pili ana i nā hoʻololi ʻana i ke ʻano o ka nohona, nā lāʻau lapaʻau, a inā pono, ke ʻoki ʻana (Carotid Endarterectomy) a i ʻole ke kau ʻana o ka stent .
• ʻO ke ala maikaʻi loa e pale aku ai i kēia, ʻo ia ke ola i kahi nohona olakino .

Ua maopopo? Inā he mau nīnau hou aku kāu e pili ana i kēia, mai makaʻu e kamaʻilio me kāu kauka. E noho olakino!

ʻO ka Stenosis o ke Alanui Carotid, ka Paʻa ʻana o nā Kiko Koko ma ka ʻĀʻī, ka Maʻi Holoholona, ​​ka Hahau ʻana, ke Kahe ʻana o ke Koko i ka Lolo, nā Waihona Momona, Kolesterol Kiʻekiʻe, ke Koko Kiʻekiʻe, ka Puhipaka, nā Hōʻailona, ​​ka Lāʻau, ʻO ka Stenosis o ke Alanui Carotid Sinhala