Ua pehu koke kekahi o kou mau wāwae a wela i ka pā? Ua ʻeha anei ke hele a kū paha? Malia paha he ʻulaʻula ka ʻili ma kou wāwae? Manaʻo ka poʻe he
ʻeha wale nō ia a he kuʻekuʻe wāwae paha. Akā i kekahi manawa hiki ke lilo i mea koʻikoʻi loa a pono e nānā koke ʻia. I kēia lā, ke kamaʻilio nei mākou e pili ana i
kahi ʻōpū koko i loko o kahi aa koko hohonu, a i ʻole ka mea i ʻike ʻia ma ke ʻano lapaʻau ʻo
Deep Vein Thrombosis (DVT) .
I ka ʻōlelo maʻalahi, he aha ka DVT?
ʻElua ʻano o nā kīʻaha koko i loko o ko kākou kino. ʻO kekahi, ʻo ia nā aʻa koko ma luna e ʻike ʻia ma lalo o ka ʻili. ʻO kekahi, ʻo ia nā aʻa koko nui e holo hohonu ana i loko o ke kino. ʻO
ka Deep Vein Thrombosis (DVT) ka
wā e hana ʻia ai kahi clot koko (thrombus) i loko o kēia mau aʻa koko hohonu. E noʻonoʻo e like me kahi ʻāpana lepo e paʻa ana i loko o kahi paipu wai, e ālai ana i ke kahe ʻana o ka wai. Hiki i kēia clot koko ke ālai loa a hapa paha i
ke kahe ʻana o ke koko i loko o ke aʻa koko. ʻO kēia kūlana ka mea maʻamau i nā aʻa koko o nā wāwae (ʻoi aku hoʻi nā ʻūhā a i ʻole nā puʻupuʻu), a me ke pelvis. Eia naʻe, i kekahi manawa, hiki ke hana ʻia nā clots koko i loko o nā aʻa koko o nā lima, ka lolo, nā ʻōpū,
ke akepaʻa , a i ʻole nā puʻupaʻa.
No ke aha e hiki ai i ka DVT ke lilo i mea weliweli?
Inā mau ke kūlana DVT e like me ia, ʻaʻole ia he mea hoʻoweliweli i ke ola. Eia nō naʻe,
ʻo ka pōʻino nui inā e haki ke koko i hana ʻia i loko o kēia aʻa koko mai laila aku a hoʻomaka e hele ma ke kahe koko. E noʻonoʻo, he aha ka mea e hana ai inā e hele pololei kahi koko i haki (kapa mākou i kēia 'emboli') i kahi kīʻaha koko i loko o nā māmā a paʻa? ʻO ia ka mea a mākou e kapa nei he
Pulmonary Embolism (PE) . He pilikia weliweli loa kēia a hoʻoweliweli i ke ola. No laila, he mea nui e ʻike a mālama i ka maʻi i ka wā e manaʻo ai ʻoe he DVT kāu.
Eia kekahi, ma kahi o ka hapalua o ka poʻe i loaʻa ka DVT e hoʻomohala i nā pilikia lōʻihi i kapa ʻia ʻo
Post-Thrombotic Syndrome .ʻO kēia ka wā e hōʻino ai kahi ʻūpā koko i nā kiwikā palupalu i loko o nā aʻa koko, e hoʻoulu ai i ke koko e hōʻiliʻili i nā wāwae ma kahi o ka pume pono ʻana. Hiki i kēia ke hana i ka pehu ʻana, ka ʻeha, ka hoʻololi ʻana o ke kala (browning) o ka ʻili, a me nā ʻeha i paʻakikī ke ho'ōla (venous stasis ulcers) no nā mahina a i ʻole nā makahiki.
Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka DVT? He aha nā hōʻailona?
ʻAʻole nā kānaka a pau me ka DVT e loaʻa nā hōʻailona. Ma kahi o 30% o ka poʻe e loaʻa paha ka DVT me ka ʻole o nā hōʻailona. Loaʻa paha i kekahi poʻe nā hōʻailona he ʻoluʻolu loa a ʻaʻole lākou e ʻike. Eia nō naʻe, aia kekahi mau hōʻailona maʻamau. Inā loaʻa iā ʻoe kēia mau hōʻailona, ʻoiai inā loaʻa wale lākou ma kekahi wāwae, pono ʻoe e hopohopo.
| Hōʻailona | Wehewehena |
|---|
| Ka pehu ʻana o ka wāwae a i ʻole ka lima | Aia pinepine ia ma kekahi ʻaoʻao wale nō. I kekahi manawa hiki ke hiki koke mai kēia pehu. |
| ʻEha a ʻoʻoleʻa paha | ʻEha ka ʻeha ma ka wāwae a i ʻole ka lima. Hiki ke hoʻonui ʻia kēia ʻeha, ʻoiai ke kū a hele wāwae paha. |
| Wela ke pā | ʻOi aku ka wela o ka wahi pehu a ʻeha ma mua o nā wahi ʻē aʻe. |
| ʻOle ke kala ʻili | Hiki i ka ʻili ke lilo i ʻulaʻula a polū paha. |
| Nā aa koko i ʻike ʻia | Hiki ke ʻike ʻia aku nā aa koko ma lalo o ka ʻili he nui a ʻoi aku ka puʻupuʻu ma mua o ka maʻamau. |
| Nā hiʻohiʻona ʻē aʻe | Inā kū mai nā ʻūpā koko i loko o nā aa koko o ka ʻōpū, hiki ke ʻike ʻia nā hōʻailona e like me ka ʻeha o ka ʻōpū, a inā kū mai lākou i loko o nā aa koko o ka lolo, hiki ke ʻike ʻia nā hōʻailona e like me ke poʻo ʻeha nui a i ʻole ka hopu ʻana. |
E makaʻala i nā hōʻailona o ka Pulmonary Embolism (PE)!
ʻIke wale kekahi poʻe he DVT ko lākou ma hope o ka haki ʻana o ke koko a paʻa i loko o ko lākou mau māmā. No laila e makaʻala loa i nā hōʻailona ma lalo nei.
Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, mai noho wale i ka home a kali. He pilikia kēia. E hele i ka ʻOihana Pilikia o ka haukapila (ETU) i ka hikiwawe loa.
He aha nā kumu pilikia no ka DVT?
Hiki i kekahi ke loaʻa i ka DVT. Akā, ʻoi aku ka nui o ka pilikia o kekahi poʻe i ka loaʻa ʻana. E nānā kākou i ke ʻano o ia mau mea.
- Noho mālie no ka manawa lōʻihi: E noʻonoʻo e holo ana ʻoe i kahi kaʻa mai Colombo a i Jaffna, Sri Lanka, a i ʻole e holo ana i kahi mokulele no nā hola e hiki ai i ka ʻāina. I loko o ia mau huakaʻi lōʻihi, ʻo ka mālama ʻana i kou mau wāwae ma ke kūlana like hiki ke hoʻolohi i ke kahe koko a alakaʻi i nā ʻūpā koko. Pēlā nō hoʻi ma hope o ke ʻoki kino nui, a inā pono ʻoe e noho ma kahi moe no nā lā ma muli o ka maʻi.
- ʻO ke ʻoki kino a i ʻole nā ulia: Inā ua hōʻino ʻia nā aa koko ma muli o ke ʻoki kino a i ʻole kahi ulia, piʻi ka pilikia o ke koko ʻana.
- Ma luna o 40 mau makahiki: Piʻi mālie ka pilikia me ka makahiki.
- Hāpai a me ka postpartum: ʻOi aku ka nui o ka pilikia o DVT i ka wā hāpai a no kahi o 6 mau pule ma hope o ka hānau ʻana.
- Kaumaha Loa/Momona: ʻOi aku ka pilikia o ka poʻe momona.
- Puhipaka: Hoʻonui ka puhipaka i ka pilikia o ke kāpili ʻana o ke koko.
- Nā lāʻau lapaʻau no ke kanesa a me ke kanesa: ʻO kekahi mau ʻano lāʻau lapaʻau no ke kanesa a me ke kanesa (e like me ka chemotherapy) e hoʻonui i ka pilikia o DVT.
- ʻO nā pila hoʻomalu hānau a i ʻole ka lāʻau lapaʻau hormone: ʻO nā pila hoʻomalu hānau a me ka lāʻau lapaʻau hormone i loaʻa ka hormone estrogen e hoʻonui iki i ka pilikia o nā ʻaʻa koko.
- Moʻolelo ʻohana: Inā ua loaʻa i kekahi o kou ʻohana (makuahine, makuakāne, kaikaina) ka DVT, aia nō hoʻi ʻoe i ka pilikia.
- Nā kumu hoʻoilina: Hiki ke hānau ʻia kekahi poʻe me nā kūlana e maʻalahi ai ke koko.
- Nā kūlana olakino ʻē aʻe: ʻO nā maʻi autoimmune e like me ka lupus, ka maʻi ʻōpū mumū, nā veins varicose (nā veins varicose i nā wāwae), a me ka maʻi COVID-19 hiki ke hoʻonui i ka pilikia o DVT.
E ke kauka, pehea ʻoe e ʻike pololei ai i ka DVT?
Inā loaʻa iā ʻoe nā hōʻailona o DVT, e nānā mua kāu kauka iā ʻoe, e nīnau e pili ana i kou mōʻaukala olakino a me nā mea pilikia, a laila e kauoha i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona.
- ʻO Duplex Venous Ultrasound: ʻO kēia ka hoʻāʻo nui a hoʻohana pinepine ʻia e ʻike i ka DVT. Ua like ia me ka scan pēpē. ʻAʻohe ʻeha. Hiki iā ia ke ʻike maopopo i ke kahe o ke koko i loko o nā aʻa a inā he mau ʻūpā koko.
- Venography: ʻAʻole hoʻohana nui ʻia kēia i kēia manawa. Pili kēia i ka hoʻokomo ʻana i kahi wai kūikawā (dye) i loko o kahi aa a me ka lawe ʻana i kahi X-ray.
- MRI a i ʻole CT scan: I kekahi manawa e hana ʻia kēia mau hoʻokolohua inā he kānalua no nā ʻōpū koko i loko o nā aa koko hohonu, e like me ka ʻōpū a i ʻole ka lolo.
- Nā hoʻāʻo koko kūikawā: Inā ua hoʻomohala ʻoe i ka DVT no ke kumu ʻole, a inā he moʻolelo ʻohana kou, hiki i kāu kauka ke hoʻoholo e hana i nā hoʻāʻo koko kūikawā e nānā i nā kūlana genetic e pili ana i ke kāpili ʻana o ke koko.
He aha nā lāʻau lapaʻau no ka DVT?
Aia kekahi mau pahuhopu nui i ka mālama ʻana i ka DVT.
- Ke kāohi nei i ka nui ʻana o ke koko.
- Ke pale nei i kēlā ʻūpā koko mai ka haki ʻana a hele i nā māmā.
- Ke kāohi nei i ke kūkulu ʻia ʻana o nā clots koko hou.
- Hoʻemi i ka pilikia o nā pilikia lōʻihi (Post-Thrombotic Syndrome).
Aia kekahi mau ʻano lapaʻau nui e hoʻokō ai i kēia mau pahuhopu.
1. Nā lāʻau hoʻokahe koko (Anticoagulants)
Ua kapa ʻia kēia he 'Anticoagulants' ma ka ʻōlelo Pelekania. Hana kēia mau lāʻau lapaʻau ma ka hoʻēmi ʻana i ka hiki o ke koko ke kāpili.
ʻO ka mea nui loa, ʻaʻole kēia mau lāʻau lapaʻau e 'hoʻoheheʻe' i kahi ʻūpā koko i hana mua ʻia. Akā, ke kāohi nei lākou iā ia mai ka nui ʻana a me ke kūkulu ʻana i nā ʻūpā hou. I ka hala ʻana o ka manawa, hiki i nā kaʻina hana kūlohelohe o ke kino ke hoʻoheheʻe mālie i ke ʻūpā koko. Hoʻohana ʻia nā lāʻau lapaʻau e like me 'Warfarin' a me 'Heparin' no kēia. Na kāu kauka e hoʻoholo i ka lāʻau lapaʻau kūpono iā ʻoe a me ka lōʻihi o kou lawe ʻana. ʻO ka maʻamau, pono ʻoe e lawe i kēia lāʻau lapaʻau no 3-6 mahina, a i ʻole no kekahi poʻe, no ke koena o kou ola.
ʻŌlelo Aʻo: ʻO ka hopena nui o ka lawe ʻana i kēia lāʻau lapaʻau ka hoʻonui ʻia o ka pilikia o ke kahe ʻana o ke koko. Inā loaʻa iā ʻoe kekahi ʻeha ʻē aʻe, nā ʻāʻī koko i ka wā e palaki ai i kou mau niho, a i ʻole kekahi kahe koko ʻē aʻe , e haʻi koke i kāu kauka.
2. Nā Kāʻei Hoʻopaʻa
ʻAʻole like kēia me nā socks maʻamau. He mau socks i hoʻolālā kūikawā ʻia kēia e kūpono pono a puni nā kuʻekuʻe wāwae. Hana ʻia lākou e paʻa loa a puni nā kuʻekuʻe wāwae a lilo mālie i mea paʻa ʻole i nā kuli. Kōkua kēia i ke kahe ʻana o ke koko i luna o nā wāwae me ka ʻole o ka kū ʻana. ʻO ke komo ʻana i kēia mau mea i ka lā a pau hiki ke hōʻemi i ka pehu a me ka ʻeha ma nā wāwae ma kahi o 50%.
3. Kānana IVC
ʻAʻole kēia he lāʻau lapaʻau no nā kānaka a pau. Paipai ʻia no ka poʻe hiki ʻole ke lawe i nā lāʻau hoʻokahe koko, a i ʻole ka poʻe e ulu ana i nā ʻūpā koko i ka wā e lawe ana iā lākou. Maanei, ua hoʻokomo ʻia kahi mea liʻiliʻi e like me ka ʻupena (he `kānana`) i loko o ke aʻa nui o ke kino, ʻo ia hoʻi ka `Vena Cava`. ʻO kēia ke hopu i kahi ʻūpā koko i haki ma ka wāwae ma mua o ka hiki ke hele i nā māmā.
Pehea e hiki ai iaʻu ke pale aku i ka hoʻi hou ʻana o ka DVT?
Ke loaʻa iā ʻoe kahi DVT, he mea nui e pale aku iā ia mai ka hana hou ʻana. Eia kekahi, inā ʻoe e pilikia ana no ka DVT, pono ʻoe e hana i nā hana e pale aku ai iā ia mai ka hana hou ʻana.
Inā ua loaʻa iā ʻoe ka DVT:
- E lawe i ka lāʻau lapaʻau i kuhikuhi ʻia e ke kauka me ka pololei a me ka manawa kūpono. Mai poina i hoʻokahi lā.
- E hele i nā keʻena lapaʻau a me nā hoʻāʻo koko i nā lā i hoʻonohonoho ʻia.
- E hoʻomau i kahi nohona olakino (ʻai maikaʻi, hoʻoikaika kino, a me ka pale ʻana i ka puhipaka).
Inā ʻoe i ka pilikia no DVT, e pale aku iā ia:
- Ma nā huakaʻi lōʻihi: E ala a hele a puni ma ka liʻiliʻi hoʻokahi manawa i ka hola. ʻOiai e noho ana, e hana i nā hoʻoikaika kino liʻiliʻi e like me ka hoʻohuli ʻana i kou mau kuʻekuʻe wāwae a me ka hoʻoneʻe ʻana i kou mau manamana wāwae i luna a i lalo.
- Ma hope o ke ʻoki kino: E ala aʻe mai kahi moe a hoʻomaka e hele wāwae i ka hikiwawe loa. E hana e like me ka ʻōlelo a kāu kauka.
- E inu mau i ka wai lawa.
- E kamaʻilio me kāu kauka a loaʻa ka ʻōlelo aʻoaʻo no nā ala e hōʻemi ai i kou pilikia.
Leka Lawe-Home
- ʻO ka Deep Vein Thrombosis (DVT) he ʻūpā koko e hana ʻia ana i loko o nā aʻa koko hohonu o ke kino. He maʻi koʻikoʻi kēia.
- ʻO ka pilikia weliweli loa o ka DVT he ʻūpā koko e haki a noho i loko o nā māmā (pulmonary embolism), hiki ke hoʻoweliweli i ke ola.
- ʻO ka pehu koke, ka ʻeha, ka mehana, a me ka ʻulaʻula ma kekahi wāwae nā hōʻailona nui o ka DVT. Mai hoʻowahāwahā i kēia mau mea.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha koke o ka umauma a me ka paʻakikī o ka hanu ʻana, e hele koke i ka Emergency Department (ETU) o ka haukapila.
- Hoʻohana nui ʻia nā lāʻau hoʻokahe koko a me nā kāmaʻa hoʻopaʻa no ka mālama ʻana. E hahai pono i nā ʻōlelo a kāu kauka.
- He mea nui ka noho ʻana a ʻaʻole e noho mālie i nā huakaʻi lōʻihi a ma hope o ke ʻoki ʻana e pale aku ai i ka DVT.
DVT, Thrombosis Vein Hohonu, Nā ʻAʻa Koko, Nā ʻAʻa Koko i loko o nā Veins, Pehu ʻana o ka Wāwae, Pulmonary Embolism, Nā Mea Hoʻomāmā Koko, Nā Anticoagulants, Nā Lāʻau Hoʻomāmā Koko, ʻEha Wāwae
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