He aha inā komo kahi germ i loko o ka puʻuwai? E aʻo kākou e pili ana i ka endocarditis ma nā ʻōlelo maʻalahi

He ʻōkana kupaianaha kou puʻuwai , ʻeā? Akā i kekahi manawa, hiki i kahi hua liʻiliʻi mai kahi ʻē aʻe o ko kākou kino ke hele ma ke kahe koko a hōʻino i ka puʻuwai ponoʻī. ʻO ia kekahi kūlana koʻikoʻi, a hiki ke hoʻoweliweli i ke ola a kākou e kamaʻilio nei i kēia lā, i kapa ʻia ʻo endocarditis. He mea nui loa ia e ʻike pono i kēia a loaʻa koke ka lāʻau lapaʻau.

He aha ka Endocarditis maʻalahi?

I ka ʻōlelo maʻalahi, ʻo ka endocarditis kahi maʻi a me ka mumū o ka uhi o loko o kou puʻuwai (ka mea a mākou e kapa nei ma ke ʻano lapaʻau ʻo endocardium) a me nā valves o ka puʻuwai. Hoʻokumu pinepine ʻia ia e kahi germ, e like me ka bacteria .

E noʻonoʻo, komo kahi germ mai kou waha, ʻili, a i ʻole kekahi wahi o kou ʻōnaehana hanu i loko o kou koko. A laila, hele pū kēia germ me ke koko a hele i kou puʻuwai. ʻAʻole maʻalahi ka maʻi o ka puʻuwai olakino. Akā inā he pōʻino a nāwaliwali paha i loko o kou mau valves puʻuwai, hele ka germ a pipili i kēlā mau wahi nāwaliwali, ulu ke aʻa ma laila, a hoʻomaka e hoʻonui.

I ka ulu ʻana o kēia mau germs ma laila, hana lākou i nā ulu liʻiliʻi, e like me nā ʻūpā koko a me nā ʻiʻo fibrous. Kāhea mākou i kēia mau 'mea kanu'. Hiki i kēia mau 'mea kanu' ke hōʻeha nui i nā valves o ka puʻuwai. Hiki i kēia ke kumu i ka pani pono ʻole ʻana o nā valves, ke kahe ʻana o ke koko, a i ʻole ke kumu i ka pau ʻana o ka hana a ka puʻuwai.

ʻElua ʻano nui o kēia.

Hiki ke hoʻokaʻawale ʻia ka endocarditis i ʻelua mau ʻano nui.

1. Infective Endocarditis: ʻO kēia ke ʻano maʻamau. E like me ka inoa e hōʻike nei, ua hoʻokumu ʻia e kahi germ, e like me ka bacteria a i ʻole fungi, e komo ana i ka puʻuwai. I kekahi manawa kapa ʻia e nā kauka ʻo `(Bacterial Endocarditis - BE)`.

2. ʻO ka Endocarditis ʻaʻole maʻi: He mea kākaʻikahi loa kēia. Maanei, ʻaʻole i hoʻokumu ʻia nā 'mea kanu' i loko o ka puʻuwai e kahi germ. Kāhea mākou i kēia mau mea '( sterile vegetations)'. ʻO ka maʻamau, loaʻa kēia ʻano me nā maʻi e hoʻoulu ai i ke koko e maʻalahi. No ka laʻana, hiki ke ʻike ʻia me nā kūlana e like me ka maʻi '( lupus )' a me ka '(Antiphospholipid syndrome)'.

He aha nā hōʻailona o ka endocarditis? Pehea ʻoe e ʻike ai iā lākou?

He paʻakikī iki nā hōʻailona o kēia maʻi, no ka mea, hiki ke ʻike koke ʻia, a i ʻole hiki ke ʻike mālie ʻia i loko o nā pule.

Hiki i ka endocarditis infective ke hele mai i ʻelua mau ʻano:

• ʻOi: Hoʻomaka koke kēia. Hiki ke lilo i mea hoʻoweliweli i ke ola i loko o kekahi mau lā, me nā hōʻailona e like me ke kuni nui a me ka puʻuwai wikiwiki.
• Subacute: Hoʻomaka mālie kēia, i loko o nā pule a i ʻole nā ​​​​mahina.ʻO nā hōʻailona e like me ka manaʻo o ka nāwaliwali a me ke kuni iki nā mea mua e ʻike ʻia.

ʻO ka maʻamau, ʻaʻole hōʻike ka endocarditis non-infective i nā hōʻailona. ʻO nā hōʻailona o ka maʻi kumu (e like me ka lupus) ke kumu o ia mea.

ʻO wai ka mea i ʻoi aku ka nui o ka pilikia o ka hoʻomohala ʻana i kēia?

ʻAʻole maʻi maʻamau ka endocarditis, akā ʻoi aku ka nui o ka pilikia o kekahi poʻe i ka loaʻa ʻana.

• ʻO nā kānaka me nā kiwikā puʻuwai hana, nā pacemakers, a i ʻole nā ​​​​defibrillators : ʻOi aku ka maʻalahi o kēia mau mea hana e haumia me nā germs.
• ʻO ka poʻe i loaʻa i ka endocarditis ma mua: Inā ua loaʻa iā ʻoe i hoʻokahi manawa, aia kahi pilikia e hana hou ʻia.
• ʻO nā kānaka me kekahi mau maʻi puʻuwai: ʻoi aku ka maʻi valve puʻuwai a me ka cardiomyopathy hypertrophic.
• Nā mea hoʻohana lāʻau lapaʻau IV: Hiki i nā germs ke komo pololei i ke kahe koko ma o nā nila inikini lepo.
• ʻO nā kānaka me ka maʻemaʻe waha a me nā niho maikaʻi ʻole: Hiki i nā bacteria i loko o ka waha ke komo maʻalahi i ke kahe koko ma muli o ka pala o nā niho a me nā maʻi ʻāʻī.
• Nā kānaka me ka ʻōnaehana pale maʻi nāwaliwali: Nā kānaka me nā maʻi e like me ka maʻi diabetes a i ʻole ka poʻe e lawe ana i nā lāʻau lapaʻau e hoʻopau ana i ka ʻōnaehana pale maʻi.
• ʻO nā kānaka i hana mua ʻia i ke ʻoki ʻana o ka valve puʻuwai.

He aha nā pilikia inā ʻaʻole mālama ʻia?

He aha ka mea e hiki ke hana inā hoʻopaneʻe ʻia ka mālama ʻana:

• Ua luku loa ʻia nā kiwikā o ka puʻuwai, e hoʻokahe ana i ke koko (Leaky heart valve)
• Ka hāʻule ʻana o ka puʻuwai
• Nā ʻōpū a puni ka puʻuwai
• Puʻuwai puʻuwai kūpono ʻole (Arrhythmia)
• Hiki i nā ʻāpana liʻiliʻi o kēlā mau mea kanu ke haki a ālai i kahi kīʻaha koko i loko o ka lolo, e hana ana i ka hahau ʻana.
• Hoʻolaha ka maʻi i loko o ke kino, e hana ana i kahi maʻi make i kapa ʻia ʻo sepsis.
• I ka hopena, hiki nō paha ke make.

Pehea e ʻike ai nā kauka i kēia?

Inā loaʻa iā ʻoe nā hōʻailona a me nā kumu pilikia, e hana kāu kauka i kahi hōʻailona i ka hikiwawe loa. E pili nui kēia i kekahi mau hoʻokolohua.

• Nā hoʻāʻo koko:
• Hoʻāʻo moʻomeheu koko:Penei ʻoe e ʻike ai i ke ʻano o ka bacteria i loko o ke koko.
• Helu koko piha: E nānā no ka maʻi.
• Hoʻāʻo protein C-reactive: Nānā i ka pehu ʻana i loko o ke kino.

• Nā hoʻāʻo kiʻi o ka puʻuwai:
• Echocardiogram: He scan kēia o ka puʻuwai. Hiki iā ia ke ʻike maopopo i ke ʻano o ka hana ʻana o ka puʻuwai, nā pōʻino i nā valves, a inā he 'mea kanu'.
• Transesophageal echocardiogram: He ʻano echo nō hoʻi kēia. Eia nō naʻe, hoʻokomo ʻia kahi ʻōmole liʻiliʻi ma o ka ʻāʻī a scan ʻia kokoke i ka puʻuwai. Hiki i kēia ke hana i nā kiʻi ʻoi aku ka maopopo.
• ʻO ke nānā ʻana i ka MRI puʻuwai: I kekahi mau hihia, pono paha kēia hoʻāʻo.

He aha nā lāʻau lapaʻau?

He kūlana ka Endocarditis e pono ai ka mālama ʻia ʻana ma ka haukapila a me ka mālama ʻana. ʻO ka lāʻau lapaʻau nui he mau antibiotic intravenous (IV antibiotics).

E hoʻomau ʻia kēia lāʻau lapaʻau no kekahi mau pule, i kekahi manawa he 6 a 8 paha pule. Ke ʻike ʻia ke ʻano o ka bacteria i loko o kou koko, e koho kāu kauka i ka antibiotic kūpono no ia. I ka wā o kāu lāʻau lapaʻau, e nānā mau ʻia kāu mau hōʻailona, ​​a e hana hou ʻia kāu mau hoʻāʻo koko e hōʻoia i ka hala ʻana o ka maʻi.

Hiki ke pale ʻia kēia kūlana?

ʻOiai ʻaʻole hiki ke pale loa iā ia, aia kekahi mau mea hiki iā mākou ke hana e hōʻemi i ka pilikia. Pono ʻoe e makaʻala loa e pili ana i kēia mau mea inā ʻoe i loko o kahi māhele pilikia kiʻekiʻe.

• E mālama i ka maʻemaʻe o ka waha a me nā niho: E palaki pono i kou mau niho i kēlā me kēia lā. E hoʻomaʻemaʻe ma waena o kou mau niho. E kipa pinepine i kāu kauka niho e nānā i kou olakino waha. ʻO kēia ka mea nui loa.
• ʻŌlelo aʻoaʻo kūikawā no nā poʻe pilikia kiʻekiʻe: Inā he valve prosthetic kou, ua loaʻa iā ʻoe ka endocarditis ma mua, a i ʻole he mau maʻi puʻuwai pilikia kiʻekiʻe ʻē aʻe, hiki i kāu kauka ke ʻōlelo aku iā ʻoe e lawe i nā antibiotics prophylactic ma mua o kekahi mau kaʻina hana niho (e laʻa, ka unuhi ʻana i nā niho, ke ʻoki ʻana i nā ʻāʻī). ʻO kēia ke pepehi ʻana i nā bacteria e komo i ke koko i ka wā o nā kaʻina hana niho ma mua o ko lākou hiki ʻana i ka puʻuwai.
• E hoʻomaopopo i kāu mau kauka:E hoʻomaopopo mau i kāu kauka ʻohana a me kāu kauka niho e pili ana i kou maʻi puʻuwai a me ka pilikia o ka endocarditis.