Ua kau ʻia anei kahi stent i loko o kou puʻuwai ma muli o kahi aʻa paʻa? Loaʻa i ka nui o ka poʻe ka hōʻoluʻolu ma hope o ka loaʻa ʻana o hoʻokahi. Akā i kekahi manawa, hoʻomaka hou ke aʻa e haiki ma kahi i kau ʻia ai ka stent. Me he mea lā e hoʻi mai ana ka maʻi kahiko. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau kūikawā ʻokoʻa iki i hoʻohana ʻia i ia mau hihia.
I ka ʻōlelo maʻalahi, he aha ka Coronary Brachytherapy?
ʻOiai he inoa paʻakikī kēia, he maʻalahi loa ka moʻolelo. ʻO ka brachytherapy coronary kahi lāʻau lapaʻau radiation kūikawā i hāʻawi ʻia i nā aʻa coronary o ka puʻuwai.
E noʻonoʻo i nā aʻa e hoʻolako ana i ke koko i ka puʻuwai e like me kahi paipu. Ke hōʻiliʻili ka palaki i loko o kēia mau paipu a haiki, kapa mākou i kēia maʻi coronary artery (CAD). Ma ke ʻano he lāʻau lapaʻau no kēia, hoʻokomo nā kauka i kahi stent, kahi paipu mesh liʻiliʻi, i loko o ke aʻa e hoʻonui hou iā ia.
Akā i kekahi poʻe, hoʻomaka ka ʻiʻo ʻeha e hana a puni ka stent. E like me ka hana ʻana o kahi ʻeha i ka wā e loaʻa ai iā mākou kahi ʻeha. ʻO kēia ʻiʻo ʻeha ke kumu o ka ʻūlū ʻana o ke aʻa i hoʻonui ʻia e wili mālie a pani hou ʻia. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia he in-stent restenosis (ISR) .
Pēlā nō, hoʻohana ʻia ka brachytherapy coronary e pale aku i ka ʻiʻo ʻeha mai ka hoʻokumu ʻana a puni kahi stent a me ke kumu e hoʻohaiki hou ai ke aʻa. Pili kēia i ke kuhikuhi ʻana i kahi liʻiliʻi loa o ka radiation, ma ke ʻano i kāohi ʻia, i ka wahi i haiki ʻia, e luku ana i nā cell e hana ana i ka ʻiʻo ʻeha.
ʻO wai ka mea e pono maoli ai kēia lāʻau lapaʻau?
ʻAʻole kēia he lāʻau lapaʻau no nā kānaka a pau. Paipai wale nā kauka iā ia i kekahi mau hihia kikoʻī. Inā ua kau ʻia kahi stent iā ʻoe a ua ālai hou ʻia (ISR), kūpono paha kēia lāʻau lapaʻau iā ʻoe.
E nānā i ka papa ma lalo nei e ʻike ai i ka mea kūpono loa i kēia.
| ʻO nā kānaka i kūpono paha no ka brachytherapy | |
|---|---|
| Ka pani hou ʻana o ka stent (ISR hou) | Inā haiki pinepine ka wahi i kau ʻia ai ka stent. |
| Nā stents he nui a i ʻole nā stents lōʻihi | Inā he nui kāu mau stents i loko o kou mau aʻa coronary a inā he stent lōʻihi loa kāu. |
| Nā maʻi ʻē aʻe e like me ka maʻi diabetes | No ka poʻe i ʻoi aku ka nui o ka pilikia o nā pilikia i ka wā o nā lāʻau ʻē aʻe (e like me ke ʻoki bypass) ma muli o nā kūlana olakino ʻē aʻe e like me ka maʻi diabetes. |
| Nā kīʻaha koko liʻiliʻi | No ka poʻe i liʻiliʻi loa nā kīʻaha koko o ka puʻuwai no nā lāʻau lapaʻau ʻē aʻe. |
Aia kekahi poʻe i pono ʻole ke hana i kēia lāʻau lapaʻau?
ʻAe, ʻaʻole kūpono kēia no nā kānaka a pau. No ka laʻana, inā ua loaʻa iā ʻoe ka radiation therapy no ka maʻi ʻaʻai umauma a i ʻole kekahi maʻi ʻaʻai ʻē aʻe ma ka ʻāpana umauma, ʻaʻole hana pinepine ʻia kēia lāʻau. Eia kekahi, inā ua ālai ʻia ka stent ʻaʻole ma muli o ka ʻiʻo ʻeha, akā ma muli o kahi pilikia me ka balloon i hoʻohana ʻia e kau i ka stent, ʻaʻole pono kēia lāʻau. Na kāu cardiologist e hoʻoholo i ka hoʻoholo maikaʻi loa e pili ana i kēia.
Pehea e hana ai ka lāʻau lapaʻau - ma kēlā me kēia ʻanuʻu
ʻAʻole kēia he hana ʻoki kino nui. Kāhea mākou iā ia he hana minimally invasive. ʻAʻole ʻoe e ʻeha nui. ʻO ka maʻamau, he 10 mau minuke ka lōʻihi o ke kaʻina hana holoʻokoʻa, akā pono ʻoe e noho i ka haukapila no kekahi mau hola.
| Nā ʻanuʻu | He aha ka mea e hana nei? |
|---|---|
| 1. Hoʻomākaukau | Ma mua o ka mālama ʻana, e hana ke kauka i kahi scan, e like me ka ultrasound intravascular, e ʻike pono i kahi i hoʻololi ʻia ai ke aʻa. |
| 2. Hoʻomaʻamaʻa ʻana | ʻAʻole ʻoe e nalowale loa i ka ʻike. E hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e hoʻohiamoe ai a hoʻomānoino ai iā ʻoe. E ʻike nō ʻoe, akā, ʻaʻole ʻoe e manaʻo i kekahi mea. |
| 3. Ke hoʻokomo nei i ka catheter | Hoʻokomo ʻia kahi ʻōmole lahilahi loa (catheter) ma o kahi aʻa koko nui ma ka lima a i ʻole ka wāwae, a me ke kōkua o nā kukuna X, alakaʻi ʻia ia i ke aʻa koko i haiki i loko o ka puʻuwai. |
| 4. Ke hoʻonui nei i ka pōpō | Hoʻopiha ʻia kahi pōpō liʻiliʻi i loko o ke aʻa, e hana ana i kahi no ka hoʻokele ʻana i ka radiation therapy ma kahi i haiki. Ua kapa ʻia kēia he balloon angioplasty. |
| 5. Ke hāʻawi nei i ka radiation | ʻO ka mea aʻe, ma o kēlā catheter, ua kuhikuhi ʻia kahi mahele radiation i kāohi maikaʻi ʻia i ka wahi i haiki ʻia no kekahi mau minuke. Hoʻopau kēia radiation i nā cell e hana ana i nā ʻiʻo scar. ʻAʻole ia e hoʻopilikia i nā wahi ʻē aʻe. |
| 6. Hoʻopau ʻana | Ua wehe pono ʻia ka mea hana radiation a me ke catheter. |
He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?
E like me nā lāʻau lapaʻau āpau, aia nā pono a me nā pōʻino liʻiliʻi.
Nā pono nui
- Hiki ke pale ʻia ka hoʻopaʻa hou ʻana o ka stent (ISR).
- Hoʻemi ia i ka manawa kūpono o ka loaʻa ʻana o ka hāʻule puʻuwai i ka wā e hiki mai ana.
- Hiki ke hoʻopau ʻia nā hōʻailona e like me ka ʻeha hou o ka umauma (angina), ka pōkole o ka hanu (dyspnea), a me ka dizziness.
- Hiki ke loaʻa kahi hopena me ka ʻole o ka hana ʻoki bypass nui.
Nā pilikia hiki ke loaʻa
He haʻahaʻa loa kēia mau pilikia. He mau pilikia maʻamau kēia e pili ana i kekahi kaʻina hana catheterization cardiac.
- Nā hewa o ka puʻuwai (Arrhythmia)
- Nā ʻūpā koko
- ʻEha a maʻi paha ma kahi i hoʻokomo ʻia ai ka catheter
- Ka pōʻino iki i kahi kīʻaha koko
ʻO ka mea nui loa, ʻo ka radiation i hoʻohana ʻia i kēia lāʻau lapaʻau he palekana loa ia.Hoʻokele ʻia ia ma ke ʻano i kāohi pono ʻia, i kahi kūpono wale nō, no laila ʻaʻole ia e hōʻeha i kekahi ʻāpana ʻē aʻe o ke kino.
He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau? A i ka manawa hea e pono ai iaʻu e ʻike i ke kauka?
Hiki i ka hapa nui o ka poʻe ke hoʻi i ka home i ka lā hoʻokahi me ke kaʻina hana. Pono paha ʻoe e noho i ka haukapila i ka pō. He mea nui e pale i ka hana ikaika no kekahi mau lā ma hope o kou hoʻi ʻana i ka home. E kuhikuhi kāu kauka i ka lāʻau lapaʻau e pale aku i nā ʻūpā koko.
ʻO kou kuleana ka mālama ʻana i ke olakino o kou puʻuwai ma hope o ka lāʻau lapaʻau.
- E ʻai i ka meaʻai haʻahaʻa momona a olakino hoʻi.
- E hoʻōki loa i ka puhipaka.
- E hoʻoikaika kino i nā manawa a pau.
- E kāohi i kāu inu ʻona.
Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, pono ʻoe e kāhea koke i kāu kauka a i ʻole e hele i ka haukapila kokoke loa i ka Emergency Department (ETU).
- Inā loaʻa iā ʻoe ke kuni kiʻekiʻe.
- Inā he ʻeha nui kou ma kou umauma, ʻauwae, lima, a poʻohiwi paha .
- Inā pilikia ʻoe i ka hanu ʻana.
- Inā he pus e puka mai ana mai kahi i hoʻokomo ʻia ai ke catheter, inā he pilau maikaʻi ʻole, a inā he pehu a ʻulaʻula paha.
ʻOiai ʻaʻole hoʻohana nui ʻia kēia lāʻau lapaʻau (no ka mea, ua hōʻemi nui nā ʻano stents hou - nā stents drug-eluting - i ka pilikia o ka reocclusion), hiki iā ia ke lilo i hopena kūpono a waiwai nui no nā poʻe maʻi me nā kūlana paʻakikī e ʻike nei i nā occlusions stent pinepine.
Leka Lawe-Home
- ʻO ka brachytherapy Coronary kahi lāʻau lapaʻau radiation i hoʻohana ʻia e pale i ka ʻiʻo scar mai ka hoʻokumu ʻana a puni kahi stent a me ke kumu e hoʻohāiki hou ai ke kīʻaha koko (in-stent restenosis).
- ʻAʻole kēia he lāʻau lapaʻau no nā kānaka a pau, akā kūpono loa ia no ka poʻe i loaʻa i nā poloka stent hou, nā maʻi ʻē aʻe e like me ka maʻi diabetes, a i ʻole nā maʻi puʻuwai paʻakikī.
- ʻAʻole kēia he ʻoki kino nui, a pili ia i kahi ʻōmole liʻiliʻi (catheter) e hele ana i loko o ka puʻuwai a hāʻawi i kahi mahele lāʻau i kāohi ʻia.
- He liʻiliʻi loa a palekana ka nui o ka radiation i hoʻohana ʻia, a ʻaʻole ia e hoʻopilikia i nā ʻāpana ʻē aʻe o ke kino.
- He mea nui loa ka hahai ʻana i kahi nohona olakino no ka puʻuwai ma hope o ka mālama ʻana. E ʻimi koke i ke kōkua lapaʻau inā ʻike ʻoe i nā hōʻailona e like me ka ʻeha o ka umauma a i ʻole ka pōkole o ka hanu.
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