Ua lohe paha ʻoe i kahi maʻi kahi e piʻi koke ai ke kaomi i loko o nā kīʻaha koko liʻiliʻi i loko o nā māmā? Ua like ia me kahi mea e paʻa ana i loko o kahi paipu wai a piʻi ke kaomi. ʻO ia ke ʻano o CTEPH. ʻOiai ke kani lōʻihi iki paha ka inoa, maʻalahi ke hoʻomaopopo. He maʻi kakaikahi ia, akā he mea nui ia e pono ai kākou a pau e makaʻala.
I ka ʻōlelo maʻalahi, he aha ka CTEPH?
ʻO CTEPH ke koko kiʻekiʻe i loko o nā māmā. Ma ke ʻano lapaʻau, kapa mākou i kēia he '(Pulmonary Hypertension)'. Akā, he ʻokoʻa kēia mai ke koko kiʻekiʻe maʻamau. Aia kekahi kumu kikoʻī no ke kumu o ka CTEPH. ʻO ia hoʻi, ʻaʻole e hoʻoheheʻe pono ʻia nā ʻōpū koko i paʻa mua ʻia i loko o nā kīʻaha koko o nā māmā '(Pulmonary Embolism)'.
E noʻonoʻo he ʻūpā koko ko ke kanaka i loko o ko lākou mau māmā. ʻO ka maʻamau, hoʻoheheʻe nā ʻano hana ponoʻī o ko mākou kino i kēia mau ʻūpā koko i ka hala ʻana o ka manawa. Akā i kekahi poʻe, ʻaʻole e hoʻoheheʻe loa kēia mau ʻūpā koko. Akā, lilo lākou i ʻiʻo kahiko, e like me ka ʻōpala e noho ana i loko o nā kīʻaha koko. I ka hala ʻana o ka manawa, hoʻoemi kēia ʻiʻo ʻōpala i nā kīʻaha koko.
Ke haiki nā kīʻaha koko, pono ka puʻuwai e hana ikaika e pamu i ke koko ma o kēlā mau kīʻaha koko i haiki. ʻO kēia ke kumu o ke kaomi i loko o nā kīʻaha koko i loko o nā māmā e piʻi nui loa. ʻO ia ka mea a mākou e kapa nei ʻo CTEPH (Chronic Thromboembolic Pulmonary Hypertension) .
ʻO ka mea nui, ʻo kēia maʻi wale nō e loaʻa i ka poʻe i loaʻa ka mōʻaukala o ka pulmonary embolism. Inā kiʻekiʻe ke kaomi i loko o nā māmā me ka ʻole o ia mōʻaukala, hiki ke lilo i maʻi ʻē aʻe.
Pehea ka hopena o CTEPH i kou kino?
ʻO ka ʻaoʻao ʻākau o ko kākou puʻuwai e pamu i ke koko haumia a nele i ka oxygen i nā māmā no ka hoʻomaʻemaʻe ʻana. I kēia manawa, i ka wā e emi ai nā kīʻaha koko i loko o nā māmā ma muli o CTEPH a piʻi ke kaomi, pono ka ʻaoʻao ʻākau o ka puʻuwai e kū i kahi pilikia nui i ka hoʻokuke ʻana i kēia koko i nā māmā.
Hoʻopilikia kēia i ʻelua mau pilikia nui:
1. Ke hoʻouka nui nei i ka puʻuwai: Ke hana nui ʻoe e like me kēia i nā manawa a pau, hoʻomaka ka ʻaoʻao ʻākau o ka puʻuwai e nāwaliwali. Ua like kēia me ka pamu wai e hana ikaika ana e hoʻopiha i kahi hakahaka i paʻa. I ka hala ʻana o ka manawa, nāwaliwali ka pamu.
2. Ka emi ʻana o ka pae oxygen i loko o ke kino: ʻAʻole hiki i ke koko ke hele pono ma o nā māmā a lawe i ka oxygen. ʻO kēia ke kumu o ka emi ʻana o ka pae oxygen i loko o ke kino. ʻO kēia ka mea a mākou e ʻike ai ma ke ʻano he mau hōʻailona e like me ka luhi a me ka pōkole o ka hanu.
He aha nā kumu e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana o CTEPH?
E like me ka mea i ʻōlelo ʻia ma mua, ʻo ke kumu nui, ʻo ia ka hoʻoheheʻe ʻole ʻia o nā ʻūpē koko i hana ʻia i loko o nā māmā. Eia nō naʻe, ʻoi aku ka nui o ka loaʻa ʻana o kēia maʻi i kekahi poʻe. E nānā kākou i kēia mau mea pilikia.
| Kumu pilikia | Wehewehena |
|---|---|
| ʻAno koko | ʻOkoʻa ke ʻano koko o ka ʻano koko ʻo 'O'. |
| Nā maʻi koko | Inā loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana kahi maʻi koko koko (e like me ka Antiphospholipid Syndrome ). |
| Ka wehe ʻana i ka spleen | Splenectomy (wehe ʻoki ʻana i ka spleen) . |
| Nā maʻi lōʻihi | Nā maʻi lōʻihi e like me nā maʻi iwi (osteomyelitis) . |
| Nā kūlana olakino ʻē aʻe | ʻO kekahi mau ʻano maʻi kanesa a me nā maʻi e like me ka Inflammatory Bowel Disease . |
| Nā kumu ʻē aʻe | ʻOiai he wahine, he pacemaker ka puʻuwai, a me ka lawe ʻana i ka lāʻau hormone thyroid, he mau mea pilikia ia no nā maʻi. |
He aha nā hōʻailona o kēia maʻi?
ʻAʻole paha e ʻike maopopo ʻia nā hōʻailona o CTEPH i ka wā mua. Hoʻomohala mālie lākou. Manaʻo paha ʻoe he luhi maʻamau wale nō kēia. Akā, he mea nui loa ia e hoʻolohe i kēia mau hōʻailona.
| Hōʻailona | ʻIke hou aku |
|---|---|
| Paʻakikī ka hanu ʻana | Loaʻa ia i ka wā e hoʻoikaika ai ʻoe, e like me ka hele wāwae a i ʻole ke piʻi ʻana i nā alapiʻi. I ka holomua ʻana o ka maʻi, hiki ke loaʻa kēia ʻoluʻolu ʻole ʻoiai ʻoe e kū mālie ana. |
| Luhi nui a me ka paupauaho | Luhi mau ka manaʻo ʻoiai me ka hana ʻole ʻana i kekahi hana. |
| ʻEha a ʻeha paha ka umauma | Hiki ke hōʻea mai kēia ʻeha no ka mea pono ka puʻuwai e hana ikaika aʻe. |
| Ka pehu ʻana o nā wāwae a me nā kuʻekuʻe wāwae (Edema) | Ma muli o ka hana o ka puʻuwai i hoʻopilikia ʻia, hōʻiliʻili ka wai i loko o ke kino, e hoʻoulu ai i ka pehu ʻana o nā wāwae. |
| ʻO ka poniuniu a me ka nāwaliwali (Syncope) | Hiki ke hana kēia ke loaʻa ʻole ka oxygen i ka lolo. |
| Nā palpitations o ka puʻuwai | Manaʻo e like me hiki iā ʻoe ke lohe i kou puʻuwai ponoʻī. |
| Ka hoʻololi ʻana o ke kala polū (Cyanosis) | Polū nā lehelehe a me nā manamana lima ma muli o ka haʻahaʻa o ka oxygen i loko o ke koko. |
Inā loaʻa iā ʻoe kēia mau hōʻailona, ʻoiai inā he moʻolelo kou o nā ʻūpā koko ma mua i loko o nā māmā, e ʻoluʻolu e ʻike koke i kāu kauka.
Pehea e ʻike ʻia ai ka CTEPH?
Ke ʻike ʻoe i ke kauka, e nīnau ʻo ia e pili ana i kāu mau hōʻailona a nānā iā ʻoe. Inā he kānalua kou he CTEPH, e paipai lākou i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona.
- Nānā V/Q: Nānā kēia i ke kahe ʻana o ke koko i nā māmā a pehea e neʻe ai ka ea ma o lākou. Hiki i kēia nānā ke ʻike i nā wahi i loaʻa ai nā ʻūpē koko, ʻoiai e emi ana ke kahe o ke koko.
- Transthoracic Echocardiogram (TTE): Hiki i kēia ke nānā i ke kaomi ma ka ʻaoʻao ʻākau o ka puʻuwai a pehea ka nāwaliwali o ka puʻuwai.
- CT Pulmonary Angiogram: He scan CT kūikawā kēia e hiki ke ʻike maopopo i nā ʻūpā koko kahiko a me ka haiki ʻana o nā kīʻaha koko i loko o nā māmā.
Nā hoʻokolohua hou aʻe e hōʻoia
Ke hōʻoia ʻia ka maʻi, hiki ke hana ʻia kekahi mau hoʻokolohua hou aʻe e hoʻoholo ai i kona koʻikoʻi a hoʻolālā i ka mālama ʻana.
- Ka Hoʻokomo ʻana i ka Catheter o ka Puʻuwai ʻĀkau: ʻO kēia ke ala pololei loa e ana ai i ke kaomi o ka pulmonary. Hoʻokomo ʻia kahi ʻōmole liʻiliʻi (catheter) ma o kahi kīʻaha koko i loko o ke kino i loko o ka ʻaoʻao ʻākau o ka puʻuwai a me ke kīʻaha koko nui e alakaʻi ana i nā māmā, a ana ʻia ke kaomi.
- Hoʻāʻo Koʻikoʻi Hoʻoikaika Kino: Hana ʻia kēia hoʻāʻo e ʻike ai pehea e hana ai kou puʻuwai a me kou mau māmā i kou wā e hoʻoikaika kino ai.
He aha nā lāʻau lapaʻau no kēia?
ʻO ka nūhou maikaʻi e pili ana iā CTEPH, he maʻi hiki ke ho'ōla ʻia. Hiki ke hoʻomaha ʻia ka hapa nui o nā maʻi me ke ʻoki ʻana a i ʻole nā lāʻau lapaʻau ʻē aʻe. ʻElua mau koho lapaʻau nui.
1. Ka Hoʻopau ʻana i ka Endarterectomy Pulmonary (PTE):
He ʻoki puʻuwai hāmama kēia. Ma kēia kaʻina hana, wehe nā kauka ʻoki i nā kīʻaha koko nui i loko o nā māmā a ʻeli i nā ʻōpū koko kahiko a me nā ʻiʻo ʻeha i kūkulu ʻia i loko. ʻOiai he ʻoki paʻakikī loa kēia, inā holomua, loaʻa iā ia kahi manawa kūpono e ho'ōla loa i ka maʻi.
2. ʻO ka Pulmonary Balloon Angioplasty (BPA):
Hoʻohana ʻia kēia lāʻau lapaʻau no ka poʻe i loaʻa nā ʻūpā koko i loko o nā aʻa koko liʻiliʻi loa e hiki ke ʻoki ʻia. Ma kēia lāʻau lapaʻau, hoʻokomo ʻia kahi ʻōmole liʻiliʻi (catheter) i loko o kahi aʻa koko ma ka wāwae a hoʻohana ʻia kahi pōpō liʻiliʻi ma ka hopena e hoʻopiha a hoʻonui i ke aʻa koko i haiki. ʻAʻole kēia he mea nui e like me ke ʻoki kino.
Hiki i kekahi o kēia mau lāʻau ke ho'ōla loa i ka CTEPH. Ma hope o ka lāʻau lapaʻau, hiki i ka hapa nui o ka poʻe ke ola i kahi ola maʻamau.
I kekahi manawa, no ka poʻe hiki ʻole ke hana ʻoki kino a i ʻole ka poʻe i loaʻa iki ke kaomi kiʻekiʻe i loko o ko lākou mau māmā ma hope o ke ʻoki kino, hāʻawi ʻia nā lāʻau lapaʻau kūikawā (e laʻa me Riociguat) e kaohi i kēlā kaomi.
Nā mea e ʻike ai i ka wā e noho pū ana me CTEPH
E hoʻomaikaʻi nui ʻia kou ola ma hope o ka lāʻau lapaʻau, akā aia kekahi mau mea e pono ai ʻoe e makaʻala.
- Nā lāʻau hoʻokahe koko no ke ola holoʻokoʻa: Pono ʻoe e lawe i nā lāʻau hoʻokahe koko no ke koena o kou ola e pale aku ai i nā ʻūpā koko hou aʻe. He mea nui e hahai pono i nā ʻōlelo a kāu kauka.
- ʻAi: Inā ʻoe e lawe ana i kahi lāʻau lapaʻau e like me 'Warfarin', pono ʻoe e makaʻala e pili ana i nā meaʻai waiwai i ka wikamina K (e like me ke kāpeti, spinach, broccoli). E kamaʻilio me kāu kauka e pili ana i kēia.
- E pale i ka puhipaka: He mea ʻino loa ka puhipaka i kou mau māmā. Inā he mea puhipaka ʻoe, he mea nui e hoʻōki loa.
- Hoʻoikaika kino māmā: Hiki i ka hoʻoikaika kino māmā, e like me ka hele wāwae, ke kōkua i ka hoʻonui ʻana i kou ikaika. Eia nō naʻe, e ʻoluʻolu e kūkākūkā me kāu kauka ma mua o ka hoʻomaka ʻana i kekahi papahana hoʻoikaika kino. Hiki ke kuhikuhi ʻia ʻoe i kahi papahana hoʻōla i mālama ʻia e ke kauka i kapa ʻia ʻo "Pulmonary Rehabilitation."
- Ola kino: ʻO ka noho ʻana me kahi maʻi lōʻihi e like me kēia hiki ke alakaʻi i nā manaʻo o ke kaumaha, ka hopohopo, a i ʻole ke kaumaha. Inā ʻoe e manaʻo nei i kēia ʻano, mai hilahila e kamaʻilio me kāu kauka a i ʻole kekahi mea kokoke iā ʻoe.
Leka Lawe-Home
- He maʻi koko kiʻekiʻe ʻo CTEPH i hoʻokumu ʻia e nā ʻūpā koko kahiko e paʻa ana i loko o nā kīʻaha koko o nā māmā.
- Mai huikau i kēia me ke koko kiʻekiʻe maʻamau.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka pōkole o ka hanu, ka luhi nui, a i ʻole ka pehu ʻana i kou mau wāwae, ʻoiai inā he moʻolelo kou o nā ʻūpā koko, e ʻike koke i ke kauka.
- Hiki ke ho'ōla loa ʻia kēia maʻi me ke ʻoki kino a i ʻole nā ʻano hana ʻē aʻe.
- ʻOiai ma hope o ka lāʻau lapaʻau, e hahai pono i nā ʻōlelo a kāu kauka, ʻoiai e pili ana i ka lawe ʻana i nā lāʻau hoʻokahe koko.
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