Ua loaʻa anei iā ʻoe nā ʻūpā koko i loko o kou mau aa wāwae? E kamaʻilio kākou e pili ana i ka (Deep Vein Thrombosis - DVT)!

Ua lohe paha ʻoe i kēia maʻi i kapa ʻia ʻo (Deep Vein Thrombosis) a i ʻole DVT? Malia paha ua loaʻa koke iā ʻoe a i ʻole kekahi āu i ʻike ai kahi wāwae pehu a ʻeha a hele akula e ʻike i ke kauka. I kēia lā, e kamaʻilio kākou e pili ana i ke ʻano maoli, no ke aha e hana ai, he mea weliweli anei, a me ka mea e hana ai, ʻae?

He aha maoli ka DVT?

I ka ʻōlelo maʻalahi, ʻo DVT ((Deep Vein Thrombosis)) ka hoʻokumu ʻia ʻana o kahi clot koko ((thrombus)) i loko o nā aa koko, i loko loa o ko kākou kino. E noʻonoʻo e like me kahi ʻāpana lepo e paʻa ana i loko o kahi paipu wai. ʻElua mau kumu nui no ka hoʻokumu ʻia ʻana o kēia mau clots koko. ʻO kekahi, ua hōʻino ʻia nā aa koko ma kekahi ʻano. ʻO kekahi, ua emi ka wikiwiki o ke kahe ʻana o ke koko i loko o nā aa koko, ʻo ia hoʻi, ua lohi loa ka hele ʻana o ke koko.

Ke hana ʻia kahi ʻūpā koko, hiki iā ia ke ālai piha a hapa paha i ke kahe ʻana o ke koko ma o kahi aa koko. ʻO ka hapa pinepine, loaʻa ka DVT ma nā aa koko o ka wāwae haʻahaʻa (kuʻekuʻe wāwae), ʻūhā, a i ʻole ka ʻūhā. Eia nō naʻe, hiki ke loaʻa ka DVT ma nā aa koko hohonu ʻē aʻe i loko o ke kino, e like me ka lima, ka lolo, nā ʻōpū, ke akepaʻa, a me nā puʻupaʻa.

Pehea ka weliweli o ka DVT?

I kēia manawa ke noʻonoʻo nei paha ʻoe, he ʻūpā koko wale nō ia, no laila no ke aha e weliweli ai? ʻĀ, inā noho ka DVT ma kona wahi, ʻaʻole paha ia e hana i kahi ulia nui. Akā ʻo ka mea weliweli loa, ʻo ia ka hiki i ke ʻūpā koko e hana ʻia ana i loko o kēia mau aa ke haki a hele i loko o ke kino me ke koko.

E noʻonoʻo inā paʻa kahi ʻōpū koko (embolus) i haki i loko o kahi kīʻaha koko i loko o nā māmā, he kūlana weliweli loa ia. I ka lāʻau lapaʻau, kapa mākou iā ia he "Pulmonary Embolism" a i ʻole PE. No ka mea hiki i kēia ke hoʻoweliweli i ke ola, he mea nui e ʻike i nā hōʻailona, ​​​​hana i kahi hōʻailona, ​​​​a hoʻomaka koke i ka lāʻau.

ʻAʻole wale ia, akā ma kahi o ka hapalua o ka poʻe i loaʻa ka DVT i ko lākou mau wāwae, a i ʻole hoʻokahi i loko o ʻelua, e loaʻa paha ka ʻeha a me ka pehu ʻana i ko lākou mau wāwae no nā mahina, a i ʻole nā ​​makahiki. Ua kapa ʻia kēia ʻano he "post-thrombotic syndrome". Hana ʻia kēia i ka wā e hōʻino ai ka DVT i nā valves palupalu i loko o nā aʻa a me ka paia o loko o nā aʻa, e hoʻoulu ai i ke koko e hōʻiliʻili ma kahi hoʻokahi ma kahi o ka neʻe ʻana i luna pono. Hoʻokumu ʻia kēia ʻeha a me ka pehu ʻana e ka hoʻonui ʻia o ke kaomi i loko o nā aʻa.

Hiki i ka maʻi post-thrombotic ke komo pū me kēia mau hōʻailona:

• Ke hōʻiliʻili ʻana o ke koko ma ka wāwae.
• ʻO ka ʻoiaʻiʻo e hoʻomau nei ka pehu ʻana o nā wāwae.
• Hoʻonui ʻia ke kaomi i loko o nā aa koko.
• Ka loli ʻana o ke kala o ka ʻili ma nā wāwae, i kekahi manawa e lilo i ʻeleʻele.
• ʻO nā ʻeha stasis venous he mau ʻeha paʻakikī ke ho'ōla ʻia ma nā wāwae.

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He aha ka ʻokoʻa ma waena o ka DVT a me ka thrombosis vein hohonu?

Ua lohe paha ʻoe i kahi aa koko i pehu, uliuli, a ʻeha ke pā. Ua kapa ʻia ʻo ia ʻo (Superficial Venous Thrombosis) (ua kapa pū kekahi poʻe iā ia ʻo (phlebitis) a i ʻole (superficial thrombophlebitis)). Aia ia ma lalo pono o kou ʻili,Hoʻokumu ʻia kahi ʻūpā koko i loko o kahi aʻa koko kokoke. He mea kākaʻikahi loa ka hemo ʻana o kahi ʻūpā koko e like me kēia a hele i nā māmā. Eia nō naʻe, inā hele ka ʻūpā koko i ka ʻōnaehana aʻa koko hohonu, aia kahi manawa liʻiliʻi e hiki ai ke hana.

Hiki i ke kauka ke ʻike maʻamau inā he mau ʻūpā koko i loko o nā aa koko kokoke i ka ʻili ma ka pā ʻana a me ka nānā ʻana i ke kino. Eia nō naʻe, no ka maopopo loa e pili ana i ka DVT, ʻo ia hoʻi, he ʻūpā koko i loko o kahi aa koko hohonu, pono maoli kahi hoʻāʻo ultrasound.

Pehea ka maʻamau o kēia DVT?

He mea nui hoʻi e ʻike i kēia. Inā ʻoe e nānā i nā helu helu ma kahi ʻāina e like me ʻAmelika, ua ʻōlelo ʻia ma waena o hoʻokahi a ʻekolu o kēlā me kēia 1,000 mau mākua e loaʻa i ka DVT a i ʻole ka hopena (Pulmonary Embolism) (PE) i kēlā me kēia makahiki. Ua ʻōlelo ʻia hoʻi he ʻekolu haneli tausani mau kānaka e make ana i kēlā me kēia makahiki ma muli o DVT/PE. E noʻonoʻo, ʻo DVT/PE ke kolu o nā maʻi vascular maʻamau ma hope o ka hōʻeha puʻuwai a me ka hahau.

ʻOiai hiki ke loaʻa ka DVT/PE i kēlā me kēia makahiki, he mea kakaikahi ia i nā keiki a me nā ʻōpio. ʻOi aku ka maʻamau i nā poʻe ma luna o 60 mau makahiki. ʻO kekahi mea nui ʻē aʻe, ʻoi aku ma mua o ka hapalua o nā DVT āpau e loaʻa i ka wā e mālama ʻia ai ma ka haukapila no kahi maʻi a ma hope paha o kahi ʻoki ʻana. ʻO ke kumu nui o kēia, ʻoiai mākou i loko o ka haukapila, ʻaʻole mākou e neʻe nui e like me ka mea maʻamau a ua hoʻopaʻa ʻia i kahi moe no ka manawa lōʻihi, kahi e hōʻemi ai i ke kahe koko i nā wāwae.

He aha nā hōʻailona o ka DVT?

ʻO ka maʻamau, loaʻa ka DVT i nā aa koko o nā wāwae a i ʻole nā ​​​​lima. ʻO ka mea kupanaha, ma kahi o 30% o ka poʻe me DVT, a i ʻole hoʻokahi i loko o ʻekolu mau kānaka, ʻaʻohe o lākou mau hōʻailona! I kekahi manawa, he palupalu loa nā hōʻailona a ʻaʻole paha e ʻike kekahi poʻe.

Eia nō naʻe, hiki i nā hōʻailona o kahi DVT koke (acute) ke komo pū me:

• Ka pehu ʻana o kahi wāwae a lima paha (i kekahi manawa hiki koke kēia).
• ʻEha a palupalu paha ma ka wāwae a lima paha (hiki ke ʻike ʻia kēia i ke kū ʻana a i ʻole ke hele ʻana).
• Ke manaʻo nei ua ʻoi aku ka wela o ka ʻāpana pehu a ʻeha o ka wāwae a i ʻole ka lima ma mua o ke koena.
• ʻUlaʻula a ʻeleʻele paha o ka ʻili ma ia wahi.
• ʻIke ʻia nā aa koko kokoke i ka ʻili he nui aʻe ma mua o ka maʻamau a me ka puʻupuʻu.
• ʻEha ʻōpū a ʻeha paha ma ka ʻaoʻao o ka ʻōpū (hana ʻia kēia inā hana ʻia nā ʻūpā koko i loko o nā aa koko hohonu i loko o ka ʻōpū).
• ʻO ke poʻo ʻeha nui (ʻo ka pinepine koke ka hoʻomaka ʻana) a/a i ʻole nā ​​​​​​hōʻeha (hana ʻia kēia inā hana ʻia kahi ʻūpā koko i loko o ka lolo).

ʻAʻole ʻike kekahi poʻe he DVT ko lākou a hiki i ka wā e hemo ai ke koko mai ko lākou wāwae a lima paha a hele i ko lākou mau māmā. ʻO ia ka manawa e hoʻomaka ai lākou e ʻike i nā hōʻailona o ka pulmonary embolism (PE), hiki ke komo pū me ka ʻeha koke o ka umauma, ka pōkole o ka hanu, ke kuʻi ʻana i ke koko, ka manaʻo poniuniu, a me ka nalowale paha o ka ʻike.

Eia kekahi mea e hoʻomanaʻo ai: Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o nā hōʻailona o ka DVT, mai kali a emi nā hōʻailona. E kāhea koke aku i ke kauka, a i ʻole e hele i ka lumi pilikia o ka haukapila kokoke loa iā ʻoe. Hiki i ka mālama koke ke pale aku i nā pilikia koʻikoʻi.

He aha nā kumu o ka DVT?

I kēia manawa, e nānā kākou i nā kumu maʻamau, a i ʻole nā ​​kumu pilikia, o ka DVT. Inā pili kēia mau mea iā ʻoe, he manaʻo maikaʻi e makaʻala iki e pili ana i ka DVT:

• Loaʻa kahi moʻolelo ʻohana o nā kūlana genetic e hoʻonui ai i ka pilikia o nā ʻūpā koko.
• ʻO ke kanesa a me kekahi o kāna mau lāʻau lapaʻau (e like me ka chemotherapy).
• Inā ua loaʻa iā ʻoe a i ʻole kekahi o kou ʻohana ka DVT ma mua.
• Ka palena o ke kahe ʻana o ke koko i loko o kahi aa koko hohonu ma muli o ka ʻeha, ke ʻoki kino, a i ʻole ka noho paʻa ʻole no ka manawa lōʻihi.
• Ke noho nei ma ke kūlana hoʻokahi, me ka neʻe ʻole ʻana, no ka manawa lōʻihi. E like me ka wā e holo ana ma kahi kaʻa lōʻihi, kaʻaahi, a mokulele paha, a i ʻole ke noho ʻana ma kahi moe ma hope o ke ʻoki ʻana a i ʻole kahi ʻeha nui.
• Ke hāpai nei a i ʻole ka hānau ʻana i kahi pēpē (ʻoi aku ka nui o ka pilikia i loko o nā pule 6 mua).
• ʻOi aku ma mua o 40 mau makahiki (akā e hoʻomanaʻo e hiki i ka DVT ke ulu i kēlā me kēia makahiki).
• Kaumaha loa/momona nui .
• Loaʻa kahi maʻi autoimmune e like me lupus, vasculitis, a i ʻole ka maʻi ʻōpū mumū (IBD).
• Ka hoʻohana ʻana i nā huahana paka (e like me nā cigarettes, beedis).
• ʻO ka poʻe me nā aʻa varicose e piʻi aʻe ka pilikia o DVT.
• Ke lawe nei i nā pila hoʻomalu hānau a i ʻole kekahi mau lāʻau lapaʻau hormone .
• Ke hoʻokomo ʻia nei kahi catheter venous waena (kahi paipu i hoʻokomo ʻia i loko o kahi aa nui) a i ʻole kahi pacemaker (kahi mea e kaohi ai i ka helu o ka puʻuwai) i loko o ke kino.
• ʻO ka loaʻa ʻana o ka maʻi COVID-19 i kēia manawa koke nei e hoʻonui pū i ka pilikia o ka DVT.

Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka DVT?

Ke ʻike ʻoe i ke kauka me nā hōʻailona o DVT, e nīnau mua lākou iā ʻoe e pili ana i kāu mau hōʻailona, ​​​​kou mau kūlana olakino ʻē aʻe, a inā paha ua loaʻa i kekahi o kou ʻohana nā kūlana like. A laila e nānā lākou iā ʻoe. Ma hope o kēlā, hiki iā lākou ke hana i hoʻokahi a ʻoi aku paha o nā hoʻokolohua aʻe e hōʻoia inā loaʻa iā ʻoe ka DVT:

Nā hoʻokolohua ʻike DVT

• ʻO ka ultrasound venous Duplex : ʻO kēia ka hoʻāʻo maʻamau, ʻeha ʻole, a maʻalahi hoʻi e hana e ʻike i ka DVT.Hoʻohana kēia i nā nalu kani i kapa ʻia ʻo ultrasound e nānā i ke kahe o ke koko i loko o nā aa koko a e ʻike inā he mau ʻūlū koko. Hoʻokomo ke kanaka e hana ana i kēia hoʻāʻo i kahi probe ultrasound ma kou wāwae a lima paha a kau i ke kaomi mālie. Inā ʻaʻole e ʻūlū pono ke aa koko i kou wā e kaomi ai, manaʻo paha ke kauka he ʻūlū koko paha ma laila. Inā ʻaʻole maopopo loa nā hopena o kēia ultrasound, hiki i ke kauka ke hana i kahi hoʻāʻo ʻē aʻe.
• (Venography) : He hoʻāʻo kēia i hana ʻia i loko o ke kino. Hoʻohana pinepine ʻia i kēia mau lā. Maanei, hana ʻia kahi ʻoki liʻiliʻi ma ka ʻili o ka ʻāʻī a i ʻole ka ʻūhā, hoʻokomo ʻia kahi ʻōmole lahilahi ("catheter)) ma o ia mea i loko o kahi aʻa, a hoʻokomo ʻia kahi wai kūikawā (mea hoʻohālikelike) i loko o nā aʻa. A laila, lawe ʻia nā kiʻi X-ray e ʻike inā ua ālai ʻia ke kahe koko i loko o nā aʻa ma muli o nā ʻūpā koko.
• ʻO ke Kiʻi Resonance Magnetic (MRI) a i ʻole Magnetic Resonance Venography (MRV) : Hiki i ka MRI ke kiʻi i nā kiʻi maopopo loa o nā ʻōpū a me nā ʻano i loko o ke kino. Hiki i ka MRV ke kiʻi i nā kiʻi o nā aa koko, ʻoi aku hoʻi ma nā wahi kikoʻī o ke kino. Hiki i ka MRI a me MRV ke hāʻawi pinepine i ka ʻike kikoʻī ma mua o ka ultrasound a i ʻole CT scan.
• ʻO ke kiʻi ʻikepili i helu ʻia (CT) : ʻO kēia kekahi ala e lawe ai i nā kiʻi ʻokiʻoki o loko o ke kino me ka hoʻohana ʻana i ka ʻenehana X-ray. Hiki i ke kauka ke hoʻohana i kahi CT scan e ʻike i kahi DVT i loko o ka ʻōpū, pelvis, a i ʻole ka lolo, a me ka nānā ʻana i nā ʻōpū koko i loko o nā māmā (pulmonary embolism).

I kekahi manawa, inā kānalua kāu kauka he maʻi koko koko kou, inā he maʻi hoʻoilina a i loaʻa paha, e kauoha paha lākou i nā hoʻokolohua koko kūikawā e nānā iā ia. He mea nui loa kēia i nā hihia e like me kēia:

• Inā he mau ʻūpā koko kou i ka wā ma mua no kekahi kumu ʻē aʻe.
• Inā he ʻūpē koko kou i loko o kahi aa koko ma kahi ʻē, e like me kou ʻōpū, akepaʻa, puʻupaʻa, a lolo paha.
• Inā he moʻolelo ikaika ko kou ʻohana no nā ʻūpā koko.
• Inā ua ʻike mua ʻia kekahi o kou ʻohana me kahi maʻi koko hoʻoilina kikoʻī.

Pehea ke ola o kēlā me kēia lā me ka DVT?

Ke loaʻa iā ʻoe kahi DVT, hiki iā ʻoe ke loaʻa i kahi ʻeha a me ka pehu i kou wāwae no nā lā mua, e paʻakikī ai iā ʻoe ke neʻe a hana i kāu mau hana maʻamau. Akā , mai hopohopo, hiki iā ʻoe ke hoʻi mālie i kāu mau hana maʻamau .

Inā pehu kou mau wāwae a kaumaha, e hoʻāʻo e moe ma kahi moe me hoʻokahi a ʻelua paha uluna ma lalo o kou mau wāwae a e mālama i kou mau kuʻekuʻe wāwae ma kahi o 5-6 ʻīniha ma luna o kou poʻo. E kōkua kēia i ka hoʻomaikaʻi ʻana i ke kahe koko mai kou mau wāwae a i kou puʻuwai a hōʻemi i ka pehu.

Eia kekahi, e noʻonoʻo e pili ana i kēia mau mea:

• Inā pono ʻoe e noho no ka manawa lōʻihi (e laʻa, i ka wā e hana ana ma ke keʻena, e nānā ana i ke TV), e hana i nā hoʻomaʻamaʻa e pili ana i ka neʻe ʻana i kou mau ʻūhā i mua a i mua ma ka liʻiliʻi i hoʻokahi manawa i kēlā me kēia hapalua hola.
• E ala a hele wāwae no kekahi mau minuke ma ka liʻiliʻi i kēlā me kēia hola āu e ala ai. He mea nui loa kēia i kou wā e holo ana i kahi mokulele lōʻihi a i ʻole kahi huakaʻi lōʻihi i loko o kahi kaʻa e like me ke kaʻa ʻōhua, kaʻaahi, a i ʻole ke kaʻa.
• Inā kuhikuhi kāu kauka iā ia, e ʻaʻahu i nā kāmaʻa hoʻopaʻa kūikawā e piʻi aʻe i kou mau kuli. Ua ʻike ʻia ʻo ke komo ʻana i kēia mau mea i kēlā me kēia kakahiaka a me ke ahiahi e hōʻemi i ka ʻeha wāwae a me ka pehu a hiki i ka 50%.
• E hōʻalo i nā hana e hiki ai ke hōʻeha nui (e like me ka holo wikiwiki a i ʻole nā ​​​​haʻuki lele) no kekahi manawa.
• E inu mau i ka wai he nui, ʻoiai hoʻi i ka wā e hele ana, a mai hoʻokuʻu i kou kino e maloʻo.

He aha nā lāʻau lapaʻau no ka DVT?

Pono paha kekahi poʻe me DVT e noho i ka haukapila no ka mālama ʻana, akā hiki ke mālama ʻia ka hapa nui o ka poʻe ma ka home, e lawe ana i ka lāʻau lapaʻau e like me ke kauoha a kā lākou kauka, a e hele i nā keʻena lapaʻau (outpatient).

ʻO nā lāʻau lapaʻau nui no ka DVT:

• Ke hāʻawi nei i nā lāʻau hoʻokahe koko (anticoagulants) e pale i ke kāpili ʻana o ke koko.
• ʻO ka mea aʻu i ʻōlelo ai ma mua, ʻo ia ke komo ʻana i nā stockings compression.
• Ke hāpai nei i ka(nā) wāwae i hoʻopilikia ʻia i nā manawa he nui i ka lā.

He mea kākaʻikahi loa, inā ua pālahalaha nui ka DVT, pono paha nā lāʻau lapaʻau kūikawā (nā kaʻina hana e pili ana i ka catheter).

He nui nā pahuhopu nui o kēia mau lāʻau lapaʻau:

• ʻO ka pahuhopu ka hoʻōki ʻana i ke koko i paʻa i ka nui a me ka laha ʻana i nā aa koko ʻē aʻe a puni.
• Ke pale nei i ka haki ʻana o ke koko mai kahi aa koko a me ka hele ʻana me ke koko i nā māmā (e hana ana i ka embolism pulmonary).
• Hoʻemi i ka pilikia o ka hoʻomohala ʻana i kēia ʻano koko i ka wā e hiki mai ana.
• Ke pale ʻana i nā pilikia lōʻihi (e laʻa, ka lawa ʻole o ke koko venous, kahi kūlana e hoʻoulu ai i ka pehu ʻana o nā wāwae a me ka hoʻololi ʻana o ka ʻili) hiki ke hana ʻia e kēia ʻaʻa koko.

E hoʻomanaʻo i kēia mau mea e pili ana i ka lāʻau lapaʻau

Inā kuhikuhi kāu kauka i ka lāʻau no DVT, e makaʻala loa i kēia mau mea:

• E lawe i kāu lāʻau lapaʻau e like me ke kuhikuhi a kāu kauka, i ka manawa kūpono, ma ka nui kūpono. Mai poina i hoʻokahi lā.
• E hana i kāu mau hoʻāʻo koko e like me ka mea a kāu kauka e ʻōlelo ai iā ʻoe, a mai poina i kāu mau manawa lab. (Pono kekahi mau lāʻau hoʻokahe koko i nā hoʻāʻo koko maʻamau e nānā i kou hiki ke hoʻopaʻa koko.)
• Mai hoʻomaka i kekahi lāʻau lapaʻau hou (me nā lāʻau ʻeha ma luna o ke kauka, nā huaora, a me nā lāʻau Ayurvedic) a i ʻole e ho'ōki i ka lawe ʻana i kekahi lāʻau lapaʻau āu e lawe nei me ka ʻole o ka nīnau ʻana i kāu kauka.
• E kamaʻilio me kāu kauka e pili ana i kāu ʻai. Hiki i kekahi mau lāʻau hoʻokahe koko (e like me warfarin) ke kaupalena i ka nui o kekahi mau meaʻai āu e ʻai ai (e like me nā legumes). No laila e makaʻala i kēia.

He mea hou aʻe e pili ana i ka mālama ʻana i ka DVT

Nā Anticoagulants (nā mea hoʻokahe koko)

Pale nui kēia lāʻau lapaʻau i kou koko mai ka maʻalahi o ke kāpili ʻana. Hoʻōki pū ia i nā ʻōpū koko e kū nei mai ka nui ʻana, a pale pū ia iā lākou mai ka haki ʻana a me ka neʻe ʻana a puni.

ʻO ka mea nui, ʻaʻole "hoʻoheheʻe" kēia mau anticoagulants i nā ʻōpū koko. Hoʻoheheʻe mālie nā ʻano hana kūlohelohe o kou kino i nā ʻōpū. Eia nō naʻe, i kekahi manawa ʻaʻole e hoʻoheheʻe loa nā ʻōpū. Inā hana lākou, emi lākou a noho mau ma ke ʻano he "palapala" liʻiliʻi i loko o nā aa koko. I kekahi manawa hiki i kēia mau ʻōpū "kahiko" ke hoʻoulu i ka pehu mau o ka wāwae, akā ʻo ka hapa nui o ka manawa ʻaʻole lākou e hoʻoulu i nā hōʻailona nui.

Aia kekahi mau ʻano anticoagulants. No ka laʻana, ʻo warfarin (kūʻai ʻia ma lalo o nā inoa e like me Coumadin), heparin (hāʻawi ʻia ma ke ʻano he injection), a me nā anticoagulants waha pololei hou (DOACs) a i ʻole nā ​​​​​​anticoagulants waha hou (NOACs) (e.g. rivaroxaban, apixaban, dabigatran). E haʻi aku kāu kauka iā ʻoe i ke ʻano o ka lāʻau lapaʻau maikaʻi loa iā ʻoe a ʻoi aku ka palekana.

Inā pono ʻoe e lawe i kahi anticoagulant, pehea ka lōʻihi o kou lawe ʻana e pili ana i kou kūlana. Pono kekahi poʻe e lawe no kekahi mau mahina wale nō (ʻo 3-6 mau mahina paha), aʻo kekahi poʻe e pono paha e lawe no ke koena o ko lākou ola. Pili kēia i nā mea e like me:

• Ua loaʻa anei iā ʻoe nā ʻūpā koko e like me kēia ma mua?
• Inā ʻoe e mālama ʻia nei no kahi maʻi lōʻihi, e like me ke kanesa a i ʻole kahi maʻi autoimmune (inā pēlā, pono paha ʻoe e lawe i kahi anticoagulant no ka manawa lōʻihi, kahi e hoʻonui ai i kou pilikia o ka hoʻomohala ʻana i kahi ʻōpū koko).

ʻO ka hopena maʻamau o nā anticoagulants ka kahe koko. Inā loaʻa iā ʻoe ka ʻeha maʻalahi, ke kahe nui ʻana mai kou mau ʻāʻī i ka wā e palaki ai i kou mau niho, ke kahe ʻana o ka ihu, a i ʻole nā ​​​​​​ʻeleʻele ʻeleʻele i ka wā e lawe ana i kēia mau lāʻau lapaʻau, e kāhea koke i kāu kauka .

(Nā Kāmaʻa Paʻa) (Nā kāmaʻa paʻa kūikawā)

Hiki i kāu kauka ke kuhikuhi iā ʻoe e ʻaʻahu i nā kāmaʻa hoʻopaʻa kūikawā e hōʻemi a hoʻopau paha i ka pehu ʻana i kou mau wāwae. ʻO ke kumu nui o kēia pehu ʻana, ʻo ia ka hōʻino ʻia o nā valves palupalu i loko o kou mau aa i hoʻokumu ʻia e DVT. Hiki nō hoʻi ke pehu ʻana no ka mea ua ālai ʻia ke kahe koko i loko o kou mau aa e DVT.

ʻO ka hapa nui o nā stockings compression e hele mai ana i ke ʻano e ʻaʻahu ʻia ma lalo o ke kuli. ʻOi aku ka paʻa o kēia mau stockings ma ke kuʻekuʻe wāwae, a emi mālie ka paʻa i kou neʻe ʻana i luna o ka wāwae. Hoʻokumu kēia i kahi kaomi lohi a like (compression) ma ka wāwae, e hōʻemi ana i ka hōʻiliʻili koko a kōkua iā ia e neʻe i luna. Pono kekahi poʻe e ʻaʻahu iā lākou no ʻelua mau makahiki a ʻoi aku paha. Ua hōʻike ʻia nā haʻawina e hiki i ke komo ʻana i kēia mau stockings i kēlā me kēia lā mai ke kakahiaka a i ke ahiahi (a ʻaʻole i ka pō ke hiamoe ʻoe) ke hōʻemi i ka ʻeha a me ka pehu ʻana i ka wāwae a hiki i ka 50%.

I kekahi manawa, ma hope o ke ʻoki kino nui, ʻike paha ʻoe i nā kānaka e ʻaʻahu ana i nā mea hana kūikawā ("(intermittent pneumatic compression devices)") i kau ʻia a puni kou wāwae a hoʻopaʻa ʻia a wehe ʻia i kēlā me kēia manawa e pale aku i ka DVT i kou wā ma ka haukapila. ʻAʻole ʻōlelo ʻia kēia mau mea no ka hoʻohana ʻana ma waho o ka haukapila. Eia kekahi, ʻaʻole ʻōlelo ʻia kēia mau mea no kekahi mea i loaʻa mua ka DVT i ko lākou wāwae.

Nā kaʻina hana kikoʻī no ka DVT

Hiki ke mālama pinepine ʻia ka DVT me ka lāʻau lapaʻau. Eia nō naʻe, inā ʻaʻole hiki iā ʻoe ke lawe i nā lāʻau hoʻokahe koko no kekahi kumu, a inā hoʻomau ʻoe i ka hoʻomohala ʻana i nā ʻūpā koko ʻoiai ke lawe pololei ʻana iā lākou, pono paha i ke kauka lapaʻau ke hana i kahi hana e kau ai i kahi mea kūikawā (kahi kānana vena cava inferior a i ʻole kānana IVC) i loko o ke aʻa nui loa i kou kino (ka vena cava).

Hana pinepine ʻia kēia ma ka hoʻomāʻū ʻana i ka ʻāpana. Hoʻokomo ke kauka lapaʻau i kēia (kānana IVC) ma o kahi ʻōmole lahilahi ((catheter)) i loko o kahi aʻa nui ma kou ʻūhā a i ʻole ka ʻāʻī, a laila lawe iā ia a waiho i loko o ka (vena cava), ke aʻa nui e lawe i ke koko mai nā ʻāpana haʻahaʻa o ke kino a i ka puʻuwai. ʻO ke kumu o kēia kānana, ʻo ia ke pale aku i nā ʻōpū koko i loko o nā aʻa o kou mau wāwae mai ka haki ʻana a me ka hele ʻana i luna, a me nā ʻōpū koko nui ((emboli)) mai ka hele ʻana i kou mau māmā a me ke kumu ʻana i ka (pulmonary embolism). Akā e hoʻomanaʻo, ʻoiai ʻo ka (kānana IVC) e hōʻemi ana i ka pilikia o ka (pulmonary embolism), ʻaʻole ia e pale i nā ʻōpū koko hou mai ka hana ʻana i loko o kou mau aʻa.

Pehea e hiki ai iaʻu ke hōʻemi i koʻu pilikia o ka hoʻomohala ʻana i ka DVT?

ʻŌlelo lākou, "ʻOi aku ka maikaʻi o ka pale ʻana ma mua o ka ho'ōla." No laila he ʻoiaʻiʻo nō hoʻi kēlā e pili ana i ka DVT.

Inā ua loaʻa iā ʻoe kahi DVT a ua hoʻopau i ka lāʻau lapaʻau, pono ʻoe e hana i kēia mau mea e hōʻemi ai i kou pilikia o ka hoʻomohala ʻana i kahi ʻōpū koko DVT / PE i ka wā e hiki mai ana:

• E lawe i kāu lāʻau lapaʻau e like me ke kauoha a kāu kauka, no ka manawa i kauoha ʻia.
• Mai poina i nā manawa i koho ʻia e kāu kauka a me nā hoʻokolohua lab. ʻO kēia nā lā e hiki ai i kāu kauka ke hoʻoholo i ka maikaʻi o kāu lāʻau lapaʻau a inā pono e hoʻololi i ka nui o kāu lāʻau lapaʻau.
• E hana i nā hoʻololi i ke ʻano olakino, e like me ka ʻai ʻana i ka meaʻai kaulike, ka hoʻoikaika kino i kēlā me kēia lā, a me ka haʻalele loa i ka hoʻohana ʻana i ka paka.

Inā ʻaʻole ʻoe i loaʻa i ka DVT, akā loaʻa iā ʻoe kekahi a ʻoi aku paha o nā kumu pilikia i ʻōlelo ʻia ma luna, e mālama pono e pale aku i ka DVT ma o:

• Inā pono ʻoe e noho ma kahi hoʻokahi no ka manawa lōʻihi (e.g., ma ke keʻena, ma kahi huakaʻi lōʻihi), e hana i kekahi mau hoʻoikaika kino māmā, e like me ka hoʻoneʻe ʻana i kou mau pūhaka i luna a i lalo a me ka hoʻohuli ʻana i kou mau kuʻekuʻe wāwae, ma ka liʻiliʻi i hoʻokahi manawa i kēlā me kēia hapalua hola.
• Inā ʻoe ma kahi mokulele lōʻihi, e ala aʻe ma ka liʻiliʻi hoʻokahi manawa i kēlā me kēia hola a hele a puni ke alahele. Inā ʻoe ma kahi huakaʻi kaʻa lōʻihi (kaʻa, kaʻa), e puka i waho o ke kaʻa ma ka liʻiliʻi hoʻokahi manawa i kēlā me kēia hola a ʻelua paha a neʻe iki a puni, e kīkoʻo iki i kou mau wāwae.
• Ma hope o kahi maʻi a ʻoki kino paha, e ala aʻe mai kahi moe a hoʻomaka e hele wāwae i ka hikiwawe loa. ʻO ka wikiwiki o kou hoʻomaka ʻana e neʻe a puni, ʻo ka emi ʻana o ka loaʻa ʻana o ka DVT.
• Ma hope o ke ʻoki kino nui, inā kuhikuhi kāu kauka iā ia, e lawe i ka lāʻau lapaʻau (e laʻa me nā inikini heparin liʻiliʻi) a i ʻole e ʻaʻahu i nā kāmaʻa hoʻopaʻa e hōʻemi i ka pilikia o nā ʻūpā koko.
• E ʻike i kāu kauka i nā manawa i hoʻonohonoho ʻia a hahai pono i kāna mau kuhikuhi e hōʻemi i kou pilikia o DVT.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu kahi DVT?

Hiki ke hala i nā mahina a i hoʻokahi makahiki no ka hoʻoheheʻe loa ʻana o kahi ʻōpū koko mai kahi DVT. No laila, he mea nui e hoʻomau i ka lawe ʻana i kāu mau lāʻau hoʻokahe koko a me ke komo ʻana i nā kāmaʻa hoʻopaʻa, inā i kuhikuhi ʻia, a hiki i ka wā e ʻōlelo ai kāu kauka iā ʻoe e hoʻōki.

I ka wā e lawe ai i nā lāʻau hoʻokahe koko (ʻoi aku ka warfarin), pono ʻoe e loaʻa i nā hoʻokolohua koko maʻamau (nā hoʻokolohua INR) e hōʻoia i ka loaʻa ʻana o ka nui kūpono. Makemake paha kāu kauka e hana i nā ultrasounds hou aʻe ma hope e nānā inā aia nō kou ʻōpū koko, inā ua emi ka nui a i ʻole e nui ana, a pehea e neʻe ai kou mau aa koko.

Āhea wau e ʻike hou ai i kaʻu kauka?

Inā ʻaʻole e hoʻomaikaʻi a ʻoi aku paha ka ʻino o kāu mau hōʻailona (e like me ka ʻeha o ka wāwae a me ka pehu ʻana) i ka wā o ka mālama ʻana, e haʻi koke i kāu kauka . Eia kekahi, inā ʻoi aku ka maʻalahi o ka palapū ʻana i ka wā e lawe ana i nā lāʻau hoʻokahe koko, a inā he nui ke kahe koko o kou menstrual, e haʻi i kāu kauka.

Āhea wau e hele ai i ka ʻOihana Pōpilikia (ETU) ?

He mea nui loa nō hoʻi kēia. Inā ʻike ʻoe i kekahi o kēia mau mea i ka wā e lawe ana i nā lāʻau hoʻokahe koko, ʻo ia hoʻi ke hōʻike nei ʻoe i nā hōʻailona o ke kahe koko nui, e hele koke i ka lumi pilikia o ka haukapila:

• Inā he ʻulaʻula ʻōlinolino ka luaʻi me ke koko, a inā he ʻeleʻele ka luaʻi e like me ka lepo kofe.
• Inā he ʻulaʻula ʻōlinolino ka noho me ke koko, a inā he ʻeleʻele ʻeleʻele a pipili ka noho.
• Inā hoʻomau ʻoe i ke kahe ʻana o ke koko mai kou ihu, waha, a i ʻole ma kahi ʻē aʻe me ka ʻole o ka hoʻōki.
• Inā ʻike ʻoe i nā hōʻailona o ka hahau ʻana, e like me ka ʻeha poʻo koke, ka loli o ka ʻike, ka paʻakikī o ka ʻōlelo ʻana, a i ʻole ka nāwaliwali ma kekahi ʻaoʻao o ke kino.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

Ke ʻike ʻia ʻoe me ka DVT, he mea maʻamau ka nui o nā nīnau ma kou manaʻo. Mai makaʻu e nīnau i kāu kauka e pili ana i nā mea e like me:

• Pehea ka lōʻihi e pono ai iaʻu ke lawe i kēia lāʻau hoʻokahe koko?
• Āhea e hiki ai iaʻu ke hele hou ma ke ʻano maʻamau (ʻoi aku hoʻi nā huakaʻi lōʻihi, nā mokulele)?
• ʻEhia pinepine e pono ai iaʻu ke ʻike i ke kauka ((nā manawa hahai))?
• Pono anei iaʻu e hana i kekahi mau hoʻololi kūikawā i kaʻu papaʻai?
• He aha nā hana e pono iaʻu e pale aku i ka wā e lawe ana i kēia lāʻau lapaʻau?

No laila, he aha kā kākou e lawe ai i ka home mai kēia moʻolelo?

ʻAʻole ia he mea e makaʻu ai i ka DVT, akā, ʻaʻole ia he mea e lawe māmā ʻia. He kūlana ia e hoʻopilikia ana i nā poʻe he nui a puni ka honua a hiki ke mālama pono ʻia.

ʻO ka mea nui loa,Inā loaʻa iā ʻoe nā hōʻailona, ​​e ʻike koke i ke kauka a lawe i ka lāʻau lapaʻau e like me kāna i ʻōlelo ai. Inā ua kuhikuhi ʻia ʻoe i nā lāʻau hoʻokahe koko, e lawe iā lākou i ka manawa kūpono a loaʻa i nā hoʻokolohua a kāu kauka e ʻōlelo ai. ʻO kāu kauka ke kanaka maikaʻi loa e pane i nā nīnau a hopohopo paha āu e pili ana i kou olakino. No laila, e kamaʻilio ākea me ia a loaʻa ka lāʻau lapaʻau maikaʻi loa no kou kūlana. E noho olakino!