Ua kuhikuhi ʻia anei ʻoe a i ʻole kekahi o kou ʻohana i kahi lāʻau hoʻokahe koko e ke kauka? Ua lohe paha ʻoe i nā "lāʻau hoʻokahe koko." ʻAʻole hoʻokahe maoli kēia mau lāʻau i ke koko, ke kāohi wale nei lākou i ke kaʻina hana clotting. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi papa lāʻau koʻikoʻi a hou loa i kapa ʻia ʻo Factor Xa Inhibitors.
I ka ʻōlelo maʻalahi, he aha kēia mau Factor Xa Inhibitors?
ʻO nā Factor Xa Inhibitors kahi ʻano lāʻau lapaʻau e pale ai i ko mākou koko mai ka nui o ke kāpili ʻana. Ua kapa ʻia lākou e nā kauka he "Direct Oral Anticoagulants - DOACs". I ka ʻōlelo maʻalahi, he mau lāʻau lapaʻau kēia e pale ai i ke kāpili ʻana o ke koko. Hoʻohana ʻia lākou e mālama i kahi ʻūpā koko i hana mua ʻia, a me kahi lāʻau lapaʻau lōʻihi e pale ai i nā ʻūpā koko i ka wā e hiki mai ana.
Aia kekahi mau ʻano lāʻau lapaʻau nui e pili ana i kēia māhele.
| Inoa Lāʻau Lapaʻau | Nā kiko kūikawā |
|---|---|
| ʻApixaban | He ʻano i hoʻohana pinepine ʻia. |
| ʻO Rivaroxaban | ʻO kekahi ʻano i hoʻohana pinepine ʻia. |
| ʻEdoxaban | Hoʻohana ʻia ma ke ʻōlelo aʻoaʻo lapaʻau. |
| ʻO Fondaparinux | ʻAʻole kēia he pila, akā, he inikini i hāʻawi ʻia ma o ka intravenous. |
He aha ke ʻano o nā kūlana olakino e hoʻohana ʻia ai kēia?
Hiki ke kuhikuhi ʻia kēia mau lāʻau lapaʻau no nā kumu like ʻole, ʻo ia hoʻi:
- E hōʻemi i ka pilikia o ka hahau ʻana: ʻOi aku hoʻi no ka poʻe me ka atrial fibrillation, kahi puʻuwai paʻakikī i ka atria o ka puʻuwai.
- E hōʻemi i ka pilikia o ke koko i loko o nā aa koko (Venous Thrombosis).
- E hōʻemi i ka pilikia o nā hanana cardiovascular i nā poʻe me nā maʻi puʻuwai a me nā kīʻaha koko, e like me ka maʻi artery coronary a me ka maʻi artery peripheral.
- E mālama i nā ʻūpā koko i loko o nā aʻa hohonu (Deep Vein Thrombosis - DVT). ʻO ka maʻamau, hana kēia ma nā wāwae.
- E mālama i nā ʻūpā koko i loko o nā māmā (Pulmonary Embolism - PE).
- E mālama i ka venous thromboembolism (VTE).
ʻO wai ka mea e pono ke lawe i kēia lāʻau lapaʻau?
Lawe kekahi poʻe i kēia mau lāʻau lapaʻau no ka mea ua loaʻa iā lākou kahi ʻūpā koko. No kekahi poʻe, kuhikuhi nā kauka iā lākou ma ke ʻano he hana pale no ka mea aia lākou i ka pilikia o ka loaʻa ʻana o nā ʻūpā koko.
E noʻonoʻo ua loaʻa i kekahi kahi pani ʻūhā holoʻokoʻa. Ma hope o ke ʻoki ʻana, pono ʻoe e noho ma kahi moe no kekahi manawa, no laila e emi ana ke kahe o ke koko i loko o nā aʻa koko i kou mau wāwae, e hoʻonui ana i ka pilikia o nā ʻūpā koko. ʻO ia ka manawa e kuhikuhi ai nā kauka i kēia mau lāʻau lapaʻau. Hāʻawi ʻia lākou ma hope o ke pani ʻana i ke kuli.
He aha ka ʻokoʻa ma waena o Warfarin, kahi lāʻau kahiko, a me kēia lāʻau hou?
Ma mua o ka hiki ʻana mai o Factor Xa Inhibitors, ʻo ka lāʻau lapaʻau i hoʻohana nui ʻia e pale aku i nā ʻūpā koko ʻo ia ʻo "Warfarin." He lāʻau lapaʻau maikaʻi loa ʻo Warfarin i hoʻohana ʻia no nā makahiki he nui.
Akā eia ka ʻokoʻa nui : Pono ke kanaka e lawe ana iā Warfarin e loaʻa i nā hoʻokolohua koko maʻamau (nā hoʻokolohua INR) e hōʻoia i ka hana pono ʻana o ka nui o ka lāʻau lapaʻau. Hiki ke hana ʻia kēia hoʻokolohua ʻelua i ka pule, a i ʻole hoʻokahi manawa i ka mahina.
Akā, ʻaʻole pono ka mea e lawe ana i nā Factor Xa Inhibitors e hana i kēia mau hoʻāʻo koko pinepine. Ua lawa ka lawe ʻana i ka mahele i kuhikuhi ʻia i kēlā me kēia lā. He mea maʻalahi loa kēia no nā maʻi.
Pehea e hana ai kēia lāʻau lapaʻau ma ke kino?
He mea maʻalahi loa kēia e hoʻomaopopo. E noʻonoʻo i ke kaʻina hana o ka hoʻokumu ʻana i kahi ʻūpā koko i loko o ko kākou kino e like me kahi laina hōʻuluʻulu ma kahi hale hana. Nui nā ʻanuʻu e pili pū ana.
He mea hana koʻikoʻi loa ʻo "Factor Xa" i kēia laina hana. Me ka ʻole o ia mea, ʻaʻole hiki iā mākou ke hele i ka hana aʻe. No laila, ʻo ka mea a mākou e hana ai me kēia lāʻau Factor Xa Inhibitor, ʻo ia ke kāohi ʻana i kēlā mea hana (ʻo ia ka protein) i kapa ʻia ʻo "Factor Xa" mai ka hana ʻana. A laila e pau ka laina hana i ka hapalua, ʻo ia hoʻi ke oki nei ke kūkulu ʻia ʻana o ke koko. He maʻalahi loa, ʻeā?
Pehea ka lōʻihi e pono ai iaʻu e lawe i kēia lāʻau lapaʻau?
ʻO ke kumu i kuhikuhi ʻia ai kēia lāʻau lapaʻau iā ʻoe e hoʻoholo ai i ka lōʻihi o kou lawe ʻana. Na kāu kauka e wehewehe i kēia iā ʻoe. ʻO kēia ka lōʻihi o ka manawa e lawe ai.
| Kūlana/Kumu | Ka awelika o ka manawa e lawe ai i ka lāʻau lapaʻau |
|---|---|
| Ka puʻuwai puʻuwai kūpono ʻole (Atrial Fibrillation) | Pinepine i loko o ke ola a pau. |
| Nā ʻūpā koko i loko o nā aʻa (VTE) | 3 a 6 mahina. |
| He ʻōpū koko ma ka wāwae (DVT) a i ʻole ka māmā (PE) | Ma kahi o 6 mahina. |
| Ma hope o ke ʻoki hoʻololi kuli | Ma kahi o 12 mau lā. |
| Ma hope o ke ʻoki pani ʻūhā | Ma kahi o 35 mau lā. |
He aha nā pilikia nui a me nā hopena ʻaoʻao?
ʻO ka pilikia nui me kēia mau lāʻau lapaʻau, ʻo ia ke kahe nui ʻana o ke koko . He mea maʻamau kēia, no ka mea, ʻo ke kumu holoʻokoʻa o kēia mau lāʻau lapaʻau, ʻo ia ke kāohi i ke kāpili ʻana o ke koko. ʻO ke ʻano kēia, ʻoiai he ʻeha liʻiliʻi hiki ke hoʻoulu i ka kahe ʻana o ke koko ma mua o ka mea maʻamau. ʻO ka pilikia weliweli loa, ʻo ia ke kahe ʻana o ke koko i loko o ka lolo a i ʻole ke ala ʻai.
ʻO ka mea nui loa, ʻo ia ke akahele e like me ka hiki ke pale aku i nā ulia a me nā ʻeha i ka wā e hoʻohana ai i kēia lāʻau.
ʻO nā hopena ʻē aʻe:
- ʻO ka palapū maʻalahi (bruising) ma ke kino.
- ʻŌhūhū ʻili.
ʻOiai aia nā lāʻau lapaʻau kūikawā e like me `(Andexanet Alfa)` hiki ke hoʻohuli i nā hopena o kēia mau lāʻau lapaʻau, he pipiʻi lākou a ʻaʻole paha e loaʻa i nā haukapila āpau. No laila ʻoi aku ka maikaʻi o ka makaʻala.
Nā mea hiki iā ʻoe ke hana e akahele
- E komo i nā mīkina lima a me nā kāmaʻa i ka wā e hana ana i loko o ka māla.
- E akahele loa i ka hoʻohana ʻana i nā mea ʻoi e like me nā pahi a me nā ʻūpā.
- E hoʻohana i ka pahi ʻumiʻumi uila ma kahi o ka pahi ʻumiʻumi ʻoi.
- E makaʻala i nā pilikia paheʻe a hāʻule paha (e like me nā moena palupalu) i loko o kou home. E hōʻemi i ka pilikia o nā ulia mai ia mau mea.
I ka manawa e ʻike koke ai i ke kauka
Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei, e kāhea koke aku i kāu kauka. I kekahi mau hihia, he mea nui e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa .
- Ke kahe koko nui ʻaʻole hiki ke hoʻōki (e laʻa me ka ihu, nā ʻāʻī, a i ʻole kahi ʻeha).
- ʻO ka hāʻule ʻana a i ʻole ka hahau ikaika ʻana i ke poʻo (ʻoiai inā ʻaʻohe kahe koko o waho).
- ʻEha nui ka ʻeha poʻo a i ʻole ka ʻeha umauma.
- Paʻakikī ka hanu ʻana.
- He ʻōhūhū maʻamau ʻole ma ka ʻili.
Ua hoʻokuʻu kēia mau lāʻau lapaʻau i nā poʻe he nui mai ka pilikia o nā hoʻāʻo koko pinepine, e like me nā mea i hoʻohana ʻia e nā maʻi e lawe ana iā Warfarin. Eia naʻe, ʻaʻole kūpono kēia mau lāʻau lapaʻau no nā mea āpau. No laila, e kamaʻilio me kāu kauka e hoʻoholo i ka lāʻau lapaʻau maikaʻi loa iā ʻoe. ʻAʻohe mea he lāʻau lapaʻau āu e lawe ai, he mea nui e hahai pololei i nā ʻōlelo a kāu kauka a noi i ka wehewehe inā he mea āu i maopopo ʻole ai.
Leka Lawe-Home
- He papa lāʻau koʻikoʻi loa nā mea hoʻopaʻa Factor Xa e pale ai i ke kūkulu ʻia ʻana o nā ʻūpā koko weliweli.
- E lawe mau i ka nui kikoʻī, i ka manawa kikoʻī, e like me ke kauoha a kāu kauka. Mai hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau a hoʻololi paha i ka nui ma kāu iho.
- ʻO kahi pōmaikaʻi nui o kēia lāʻau lapaʻau, ʻaʻole ia e koi pinepine i nā hoʻāʻo koko e like me Warfarin.
- ʻOiai ʻo ke kahe koko ke kumu nui o ka pilikia, e makaʻala mau e pale i nā ʻeha.
- Inā loaʻa ke kahe koko ʻē, ka ʻeha poʻo nui, ka ʻeha umauma, a i ʻole ka ʻeha poʻo mai ka hāʻule ʻana, e ʻimi koke i ke kōkua lapaʻau a i ʻole e hele i ka haukapila kokoke loa i ka Emergency Department (ETU).
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