Ua loaʻa i kou puʻuwai ka maʻi? E kamaʻilio kākou e pili ana i ka (Endocarditis)!

Ua lohe paha ʻoe e hiki i ka puʻuwai ke loaʻa ka maʻi? I kekahi manawa hiki ke koʻikoʻi loa kēia. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi e hoʻopilikia ai i ka ʻili o loko o ka puʻuwai. Kāhea mākou i kēia ʻo '(Endocarditis)'. No ka mea hiki ke koʻikoʻi loa kēia, he mea nui loa ia e makaʻala i kēia.

No laila he aha kēia ʻano `(Endocarditis)`?

I ka ʻōlelo maʻalahi, ʻo ka Endocarditis kahi mumū a i ʻole ka pehu ʻana o ka uhi o loko o kou puʻuwai, ka membrane lahilahi e uhi ana i nā keʻena a ʻoi aku hoʻi i nā valves o ka puʻuwai - kapa mākou ia he endocardium. E like me nā paia o ka hale, he uhi lahilahi ko ka puʻuwai i loko. ʻO ia ke ʻano o ka endocardium.

Me kēia mumū, hoʻomaka nā ulu liʻiliʻi, e like me nā ʻōpuʻu, e hana ma ka ʻili o loko o ka puʻuwai. Kāhea mākou i kēia mau 'mea kanu'. I ka hoʻomau ʻana o kēia mau 'mea kanu', hoʻomaka mālie ka luku ʻia ʻana o nā ʻiʻo puʻuwai a puni. Ua like ia me kahi pepeke e ʻai ana i ka lau mai kahi lāʻau. Hiki i kēia ke hōʻeha nui i kou mau valves puʻuwai. Inā ʻaʻole mālama ʻia, hiki i ka '(Endocarditis)' ke make. No laila he mea nui loa ka makaʻala i kēia.

He aha nā ʻano nui o ka `(Endocarditis)`?

E nānā, ʻelua ʻano nui o ka `(Endocarditis)`.

1. ʻO ka Endocarditis maʻi

2. ʻO ka Endocarditis ʻaʻole maʻi

1. He aha ka Infective Endocarditis?

ʻO kēia ke ʻano maʻamau o ka endocarditis. ʻO ka mea e hana ʻia ma ʻaneʻi, ʻo ia ka pipili ʻana o nā germs - ʻo ka hapa nui o ka bacteria - i nā ʻiʻo i hōʻino ʻia o kou puʻuwai a hoʻoulu i kahi maʻi. I kekahi manawa kapa nā kauka i kēia bacterial endocarditis a i ʻole BE.

Ma kēia `(Infective Endocarditis)`, ua hoʻokumu ʻia nā `(mea kanu)` i ʻōlelo ʻia ma mua e nā mea aʻe:

• Nā meaola hoʻopilikia (e like me ka bacteria a i ʻole kekahi fungi)
• `(Fibrin)` (He protein kēia e kōkua ai i ke kāpili ʻana o ke koko)
• Nā Platelets (nā ʻāpana liʻiliʻi o nā cell i loko o ke koko)

E noʻonoʻo e pili ana i ia mea, e like me ke kau ʻana i kahi kāʻei ma kahi ʻeha, hui pū kēia mau germs, `(Fibrin)` a me `(Platelets)` e hana i kēlā mau `(mea kanu)` i loko o ka puʻuwai.

2. He aha ka Endocarditis Non-infective?

He mea kākaʻikahi loa kēia ʻano. Maanei hoʻi, hana ʻia kēlā mau '(mea kanu)' ma ka papa o loko o ka puʻuwai, akā ʻaʻole ke kumu he maʻi. ʻO ia ke kumu i kapa ʻia ai kēia mau mea he '(sterile vegetations)', ʻo ia hoʻi he '(mea kanu)' me ka ʻole o nā germs.

ʻO ka endocarditis non-infective kahi kūlana e pili ana i nā kūlana e maʻalahi ai ke koko (kahi `hypercoagulable state`). Eia kekahi laʻana:

• ʻO ka maʻi Antiphospholipid
• `(Lupus)` (Kāhea pū kekahi poʻe i kēia `(Systemic Lupus Erythematosus)`)

Hoʻohana nā kauka i kekahi mau inoa ʻē aʻe no kēia ʻano (Non-infective Endocarditis):

• ʻO ka maʻi ʻaʻai ʻo Libman-Sacks
• `(ʻO ka endocarditis thrombotic non-bacterial)` a i ʻole `(NBTE)`
• `(Endocarditis Marantic)`

He aha nā hōʻailona o ka `(Endocarditis)`? Pehea e ʻike ai?

I kēia manawa, e nānā kākou i nā hōʻailona e hiki ke kū mai i kēia maʻi '(Endocarditis)'. Pono ʻoe e makaʻala loa i kēia mau hōʻailona.

Nā hōʻailona o ka Endocarditis maʻi:

ʻO kēia nā hōʻailona i ʻike pinepine ʻia:

• ʻEha umauma
• He kani puʻuwai ʻē aʻe (he "murmur puʻuwai" a ke kauka e lohe ai i ka wā e hoʻolohe ai me ka "stethoscope")
• Hoʻonui ʻia ka helu o ka puʻuwai (Tachycardia)
• Luhi
• Kuni (hiki ke ʻoi aku ma mua o 38.4°C a i ʻole 100°F)
• Nā anu a me ka hou o ka pō
• Ka nalowale o ka makemake a me ka pohō kaumaha
• ʻEha nā ʻiʻo a me nā hono
• Paʻakikī ka hanu ʻana (`(Dyspnea)`)
• He ʻili ʻulaʻula, ʻo ia hoʻi, he ʻili e like me ka ʻili ʻulaʻula.
• ʻO ka pehu ʻana i kou ʻōpū a i ʻole kou mau wāwae
• Ke koko i loko o ka mimi (`(Hematuria)`)

ʻO ka mea nui loa, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​pono ʻoe e hele koke i ka lumi pilikia o ka haukapila. He maʻi hoʻoweliweli ka Infective Endocarditis.

Hiki i ke kūlana `(Infective Endocarditis)` ke hoʻopilikia 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: He hana mālie kēia. Hiki ke ʻike mālie ʻia nā hōʻailona ma luna o kekahi mau pule a i ʻole nā ​​​​mahina.

Nā hōʻailona o ka Endocarditis Non-infective:

ʻAʻohe mau hōʻailona kikoʻī e pili ana i kēia ʻano endocarditis. Eia nō naʻe, loaʻa paha iā ʻoe nā hōʻailona o kahi maʻi olakino (e like me lupus) ke kumu o ia mea. ʻAʻole ʻike ka hapa nui o ka poʻe me ka endocarditis non-infective ua loaʻa iā lākou ia, a ua ʻike ʻia ia ma ke ʻano ulia i ka wā o kahi hoʻāʻo kiʻi o ka puʻuwai (e like me ka echocardiogram) no kekahi kumu ʻē aʻe. I kekahi manawa, ʻike ʻia ke ʻano ma ka autopsy.

He aha nā kumu o ka Endocarditis?

ʻO ka hapa pinepine, ʻo ke kumu nui o ka endocarditis he maʻi bacteria . Komo kēia mau bacteria i kou koko mai kahi ʻē aʻe o kou kino - no ka laʻana, kou waha, ʻili, a i ʻole ka ʻōnaehana hanu - a hele ma ke koko a hiki i kou puʻuwai.

E noʻonoʻo wale, inā he ʻeha ma ko kākou waha, inā he mau huakini ma hope o ko kākou mau niho, inā huki kākou i kahi niho, i kekahi manawa hiki i kēlā mau huakini ke komo i loko o ke koko.

ʻO ka maʻamau, kūpaʻa ka ʻiʻo puʻuwai olakino i ka maʻi. ʻO ia hoʻi, ʻaʻole ia e maʻalahi ke loaʻa i ka maʻi. Eia nō naʻe, inā he pōʻino a nāwaliwali paha i loko o ka puʻuwai, kiʻekiʻe ka manawa e loaʻa ai ka `(Endocarditis)`. Hele mai kēlā mau bacteria a pipili i ka ʻiʻo i hōʻino ʻia a hoʻomaka e ulu ma laila. E like me ka mea i ʻōlelo ʻia ma mua, hana lākou i ka mea i kapa ʻia ʻo `(mea kanu)`, a hana pū lākou i nā enzymes like ʻole. Ma muli o kēia kaʻina hana, hoʻomaka ka luku ʻia ʻana o nā ʻiʻo a puni ka puʻuwai. I ka pololei, ʻo nā valves puʻuwai nā mea i hōʻino nui ʻia.

He aha nā mea e hoʻonui ai i ka pilikia o ka loaʻa ʻana o ka `(Endocarditis)`?

Ma keʻano laulā, ʻaʻole maʻamau ka maʻi ʻo `(Endocarditis)`. Eia nō naʻe, aia kekahi mau mea e hoʻonui ai i kou pilikia o ka loaʻa ʻana o kēia maʻi. E nānā kākou i ke ʻano o lākou:

• Inā loaʻa iā ʻoe kahi valve puʻuwai hana, pacemaker, a i ʻole defibrillator i hoʻokomo ʻia i loko o kou puʻuwai, he mea maʻalahi i ka bacteria ke hoʻopili i kēia mau mea hana.
• Inā loaʻa iā ʻoe ka maʻi diabetes. Hiki i ka maʻi diabetes ke hōʻemi i ka hiki o ke kino ke hakakā i nā maʻi.
• ʻO kekahi mau maʻi puʻuwai, ʻoiai ka maʻi valve puʻuwai a me ka hypertrophic cardiomyopathy (ka mānoanoa kūpono ʻole o ka ʻiʻo puʻuwai).
• Ka hoʻohana ʻana i nā lāʻau lapaʻau intravenous (ka hoʻohana ʻana i nā mea IV). Hiki i kēia ke hoʻokomo pololei i nā germs i loko o ke kahe koko ma ka hoʻohana ʻana i nā nila haumia.
• ʻO ke olakino niho maikaʻi ʻole a me ka maʻi ʻāʻī. Hiki i nā bacteria i loko o ka waha ke komo i ke kahe koko a hele i ka puʻuwai.
• Inā ua loaʻa iā ʻoe ka maʻi ʻeha (Bacterial Endocarditis) ma mua.
• Inā ua hana mua ʻoe i ke ʻoki ʻana i ka valve puʻuwai.
• Inā nāwaliwali ka ʻōnaehana pale kino, hiki i nā maʻi e like me ka HIV/AIDS, nā lāʻau lapaʻau maʻi kanesa, a i ʻole kekahi mau lāʻau lapaʻau ke hoʻonāwaliwali i ka ʻōnaehana pale kino.

He aha nā pilikia e hiki mai ana o ka `(Endocarditis)`?

ʻAʻole he mea e lawe māmā ʻia ka Endocarditis. Inā ʻaʻole i ʻike ʻia a mālama ʻia i ka wā mua, hiki iā ia ke alakaʻi i nā pilikia koʻikoʻi. Eia nā mea e hiki ke hana:

• Nā ʻano ʻē i loko o ka puʻuwai puʻuwai (Arrhythmia)
• Nā abscesses a puni nā valves puʻuwai
• Ka poloka o ka puʻuwai ( ka haki ʻana o nā hōʻailona uila o ka puʻuwai)
• Ka hāʻule ʻana o ka puʻuwai (ka hāʻule ʻana o ka puʻuwai)
• Ka puka o ka valve puʻuwai
• Sepsis (kahi maʻi koʻikoʻi e laha ana ma ke kino holoʻokoʻa)
• ʻO ka hahau ʻana (inā haki nā ʻāpana o nā mea kanu a ālai i kahi kīʻaha koko i loko o ka lolo)
• Hiki ke make.

ʻO ia ke kumu a mākou e ʻōlelo nei e ʻimi koke i ke kōkua lapaʻau inā loaʻa iā ʻoe nā hōʻailona, ​​​​no ka mea, inā loaʻa kēia mau pilikia, hiki i ke kūlana ke koʻikoʻi loa.

Pehea e ʻike ai nā kauka i ka Endocarditis?

Inā loaʻa iā ʻoe nā hōʻailona o `(Endocarditis)` a he mau kumu pilikia kou, e hoʻāʻo kāu kauka e ʻike i ka maʻi i ka wā hikiwawe loa, no ka mea, he mea nui loa ka hoʻomaka koke ʻana i ka lāʻau.

Hana ʻia nā hoʻokolohua e like me kēia no ka ʻike ʻana i ka Endocarditis:

Nā hoʻāʻo koko:

• Nā hoʻāʻo moʻomeheu bacteria: Hiki i kēia ke hoʻoholo pololei i ke ʻano o ka bacteria i loko o kou koko. He mea nui loa kēia no ke koho ʻana i ka lāʻau lapaʻau.
• Helu koko piha (CBC): Hiki ke hoʻohana ʻia kēia e nānā i ka helu o nā cell i loko o ke koko a hāʻawi i kahi manaʻo o kahi maʻi.
• Hoʻāʻo protein C-reactive (CRP): Hōʻike kēia inā he mumū i loko o ke kino.

Nā hoʻāʻo kiʻi:

Hiki i kēia mau hoʻokolohua ke nānā i nā 'mea kanu' o ka puʻuwai a me ka hōʻino ʻana i ka puʻuwai. Hiki i kāu kauka ke paipai i hoʻokahi a ʻoi aku paha o kēia mau hoʻokolohua:

• Echocardiogram: Ua like kēia me kahi scan ultrasound o ka puʻuwai. Hiki iā ia ke nānā i ka hana o ka puʻuwai, ke kūlana o nā valves, a inā he mau mea kanu.
• ʻO ka echocardiogram Transesophageal (TEE): ʻO kēia ke komo ʻana i kahi ʻōmole liʻiliʻi i lako me ke kāmela i lalo o ka puʻu e kiʻi i kahi ʻike maopopo o ka puʻuwai ma o ka esophagus. Hiki iā ia ke hana i nā kiʻi ʻoi aku ka maopopo ma mua o ka echocardiogram maʻamau.
• MRI Puʻuwai: Hiki i kēia ke hāʻawi i nā kiʻi kikoʻī o ka puʻuwai.

He aha nā lāʻau lapaʻau no ka `(Endocarditis)`?

He maʻi ola ko Endocarditis. Pono ka mālama koke ʻana e hoʻōki i ka hōʻino ʻana i kou mau valves puʻuwai a pale i nā pilikia koʻikoʻi.

Nā lāʻau antibiotic:

Pono paha ʻoe e lawe i nā lāʻau antibiotic intravenous (IV antibiotics) no kekahi mau pule - ma kahi o ʻeono pule . ʻO kēia ka mea e ho'ōla loa ai i ka maʻi. Ke ʻike ʻia ke ʻano kikoʻī o ka bacteria i loko o kou koko, hiki i kāu kauka ke hoʻololi i nā lāʻau antibiotic e kūpono.

Ma loko o kāu lāʻau lapaʻau ʻana, e nānā mau ana kāu kauka i kāu mau hōʻailona e ʻike ai inā e holo pono ana ka lāʻau lapaʻau. E hana hou lākou i nā hoʻokolohua moʻomeheu bacteria.

ʻO ke ʻoki kino:

Inā ua hōʻino ka endocarditis i kekahi o nā kiwikā o kou puʻuwai a i ʻole kekahi ʻāpana ʻē aʻe o kou puʻuwai, pono paha ʻoe e hana ʻoki kino. Eia kekahi laʻana, pono paha ʻoe e hoʻoponopono i kahi kiwikā i hōʻino ʻia a i ʻole e hoʻokomo ʻia kahi kiwikā hou.

Hiki ke pale ʻia kēia maʻi?

ʻAʻole hiki ke pale ʻia ka Endocarditis i nā manawa a pau. Eia nō naʻe, inā ʻoe i ka pilikia nui no ka loaʻa ʻana o kēia maʻi (e hoʻomanaʻo i nā kumu pilikia i ʻōlelo ʻia ma mua?), a inā ua loaʻa iā ʻoe ka endocarditis ma mua, hiki i kāu kauka ke ʻōlelo aku iā ʻoe e lawe i nā antibiotics prophylactic ma mua o kekahi mau kaʻina hana niho. ʻO nā hiʻohiʻona o ia mau kaʻina hana niho:

• Ka lāʻau lapaʻau no kou mau ʻāʻī
• Nā lāʻau lapaʻau e pili ana i ka ʻāpana periapical o kou mau niho
• Nā lāʻau lapaʻau e pili ana i ka mucosa waha

He mea nui loa ia e hoʻomaopopo i kāu mau kauka (nā kauka lapaʻau laulā a me nā kauka niho) he maʻi puʻuwai kou e hoʻolilo iā ʻoe i ka pilikia nui o ka loaʻa ʻana o ka `(Endocarditis)`. Eia kekahi, e mālama i kahi mea e like me ke kāleka ID i loko o kāu ʻeke e komo pū ana me nā alakaʻi antibiotic e pono ai. Hāʻawi ka `(American Heart Association)` i kēlā mau kāleka (ma Sri Lanka, hiki iā ʻoe ke nīnau i kāu kauka e pili ana i kēia).

Inā loaʻa iaʻu ka `(Endocarditis)`, he aha kaʻu e manaʻo ai?

Hiki iā ʻoe ke manaʻo e lawe i nā lāʻau antibiotic no ʻelua a ʻewalu pule e hoʻomaʻemaʻe i ka maʻi. Hoʻōla ka hapa nui o ka poʻe mai ka endocarditis me ka mālama maikaʻi a wikiwiki. Eia nō naʻe, ʻo ka pilikia o nā pilikia koʻikoʻi a i ʻole ka make e pili ana i nā mea e like me:

• kou mau makahiki
• Inā paha he valve puʻuwai hana kou a ʻaʻole paha
• Pehea ka lōʻihi o ka loaʻa ʻana o ka maʻi
• He aha ke ʻano meaola (ʻano bacteria) i hoʻomaʻi iā ʻoe?
• ʻEhia ka nui o ka pōʻino i hana ʻia i kou kiwikā puʻuwai?

Hiki i kāu kauka ke hāʻawi iā ʻoe i kahi manaʻo maikaʻi aʻe o ka mea e manaʻo ai ma muli o kou kūlana.

Me ka mālama maikaʻi ʻana, hoʻōla ka hapa nui o ka poʻe mai ka `(Endocarditis)`. E makaʻala i nā hōʻailona o `(Endocarditis)` a e hele koke i ka lumi pilikia inā manaʻo ʻoe he loaʻa iā ʻoe. Eia kekahi, ʻo ka mālama ʻana i kou mau niho a me kou waha i ka maʻemaʻe hiki ke hōʻemi i kou pilikia o ka loaʻa ʻana o `(Endocarditis)`. ʻO kēia ka palaki ʻana i kou mau niho i kēlā me kēia lā a me ka ʻike pinepine ʻana i kāu kauka niho no nā nānā ʻana.

No laila, he aha nā mea nui e pono ai kākou e hoʻomanaʻo mai kēia moʻolelo?

ʻAe, ua kamaʻilio nui mākou e pili ana i ka `(Endocarditis)`. I ka hōʻuluʻulu manaʻo, he mea kūpono ke hoʻomanaʻo i kēia mau manaʻo:

• ʻO ka Endocarditis kahi mumū o ka uhi o loko o ka puʻuwai, ʻoiai nā valves. ʻO ke kumu nui o kēia he maʻi bacteria.
• Inā loaʻa iā ʻoe nā hōʻailona e like me ke kuni, ke anu, ka luhi, ka hanu pōkole, a i ʻole ka ʻeha o ka umauma , mai lawe māmā iā lākou. E makaʻala loa i kēia mau hōʻailona inā loaʻa iā ʻoe ka maʻi puʻuwai, kahi valve puʻuwai prosthetic, a i ʻole kahi mea pilikia e like me ka maʻi diabetes.
• Inā ʻike ʻia nā hōʻailona,Mai hoʻonele i ka manawa a e ʻimi koke i ke kōkua lapaʻau. Hiki i ka lāʻau lapaʻau koke ke hoʻopakele i nā ola a pale i nā pilikia koʻikoʻi.
• He mea nui loa ka mālama ʻana i kou olakino waha. E palaki maikaʻi i kou mau niho i kēlā me kēia lā a e ʻike mau i ke kauka niho. E kōkua kēia i ka pale ʻana i ka `(Endocarditis)`.
• Inā he kiʻekiʻe kou pilikia no ka endocarditis, e kamaʻilio me kāu kauka e pili ana i ka pono e lawe i nā antibiotics prophylactic ma mua o ka mālama ʻana i nā niho.

E hoʻomanaʻo, ʻo kēia ʻike e hoʻonaʻauao iā ʻoe, ʻaʻole e hoʻoweliweli iā ʻoe. He mea nui loa ka ʻike no ke ola olakino. Inā he mau hopohopo kāu, mai makaʻu e kamaʻilio me ke kauka.

ʻO ka Endocarditis, nā maʻi puʻuwai, nā valves puʻuwai, bacteria, kuni, pōkole o ka hanu, olakino niho