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.

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!

ʻO ka Thrombosis Vein Deep, DVT, nā ʻūpā koko, nā aʻa koko, Pulmonary Embolism, PE, pehu wāwae, nā lāʻau hoʻokahe koko, nā kāmaʻa hoʻopaʻa, nā ʻūpā koko, thrombosis venous