I kekahi manawa, hiki iā ʻoe ke loaʻa nā pilikia nui i loko o kou kino me ka ʻike ʻole. ʻO kekahi o ia mau pilikia he aneurysm artery femoral. I ka ʻōlelo maʻalahi, ua puʻupuʻu kahi kīʻaha koko nui (artery) i loko o kou ʻūhā, kokoke i ka hui ʻūhā, e like me ka pōpō, i kapa ʻia ʻo "Femoral Artery Aneurysm". He mea kēia e hopohopo ai, no ka mea, i kekahi manawa hiki iā ʻoe ke loaʻa i kēia maʻi
me ka ʻole o nā hōʻailona .
He aha maoli ka aneurysm o ke aʻa femoral?
E noʻonoʻo i kahi paipu wai. Hoʻonāwaliwali ka paia o kēia paipu i kekahi manawa a puʻupuʻu mālie. Pēlā ia. ʻO ke kīʻaha koko nui ma kou ʻūhā (i kapa ʻia ʻo 'femoral artery')
e puʻupuʻu a hiki i ka pālua o kona nui maʻamau. Hana ʻia kēia no ka mea ua kīkoʻo ʻia nā papa āpau o ka paia o ke kīʻaha koko. Ke nāwaliwali ka paia o ke kīʻaha koko ma kēia ʻano,
ʻoi aku ka nui o ka pahū ʻana . Inā pahū, he kīʻaha koko nui kēia, no laila hiki ke nalowale ka nui o ke koko mai ke kino i ka manawa hoʻokahi. He kūlana weliweli loa kēlā. Eia kekahi, aia kahi manawa e hiki ai ke hana ʻia kahi ʻūpā koko i loko o kēia puʻupuʻu a paʻa i loko o ke aʻa, a i ʻole hiki ke haki a ālai i kahi aʻa ma kahi ʻē aʻe.
Aia kekahi ʻano o kēia mau pehu ma muli o ko lākou wahi i loaʻa ai?
ʻAe, hoʻokaʻawale nā kauka i kēia "Femoral Artery Aneurysm"
e like me kahi kikoʻī . ʻO ke kīʻaha koko nui i loko o kou ʻūhā, e kapa kākou iā ia ʻo "common femoral artery", māhele ʻia i mau lālā liʻiliʻi ma kekahi mau wahi.
- Hiki ke ʻike ʻia kekahi mau pehu ma mua o nā lālā o kēia aa nui .
- Hiki ke loaʻa kekahi ma kahi e māhele ai nā lālā , a i ʻole ma nā lālā e māhele ana, ʻo ke "profunda femoral artery" a i ʻole ke "superficial femoral artery".
Hana ʻia kēia hoʻokaʻawale ʻana ma ka wahi no ka mea i kekahi manawa hiki ke ʻokoʻa iki ka lāʻau lapaʻau ma muli o ka wahi kikoʻī o ka pehu ʻana.
ʻO wai ka mea kūpono loa e loaʻa i kēia maʻi?
ʻOiai hiki i kekahi ke loaʻa i kēia kūlana, i kapa ʻia ʻo "Femoral Artery Aneurysm," aia kekahi poʻe i kahi pilikia kiʻekiʻe iki aʻe.
- ʻOi aku ka nui o ka loaʻa ʻana o ia mea i nā kāne ma mua o nā wahine.
- He kiʻekiʻe loa kēia pilikia no ka poʻe ma luna o 70 mau makahiki .
Eia kekahi, hiki paha iā ʻoe ke pilikia inā loaʻa iā ʻoe kēia mau mea:
- Ke koko kiʻekiʻe : Inā kiʻekiʻe mau kou koko .
- ʻO ka cholesterol kiʻekiʻe : ʻO ka cholesterol kiʻekiʻe ka mea momona i loko o ke koko.Inā he kiʻekiʻe kou mau pae cholesterol .
- Nā maʻi pili pili : Aia kekahi mau maʻi laha ʻole e hoʻopilikia i nā ʻiʻo o ke kino, no ka laʻana, ʻo Ehlers-Danlos syndrome a i ʻole Marfan syndrome. Loaʻa pū kekahi i ka pilikia o ka poʻe me kēia mau maʻi.
- Ka hoʻohana ʻana i ka huahana paka : ʻOi aku ke kiʻekiʻe o kēia pilikia no ka poʻe e puhipaka ana i nā cigarette, beedis, betel nuts, a i ʻole nā ʻano paka ʻē aʻe.
- Atherosclerosis : ʻO kēia ke kumu nui. ʻO Atherosclerosis ka hōʻiliʻili ʻana o nā waihona momona ma nā paia o nā kīʻaha koko , e hoʻohaiki mālie ana iā lākou. Inā ua loaʻa iā ʻoe kahi hōʻeha puʻuwai ma mua, a inā he mau pilikia kou me nā kīʻaha koko i kou mau wāwae, e like me ka maʻi artery peripheral, hiki iā ʻoe ke pilikia no ka atherosclerosis.
- Moʻolelo ʻohana : Inā ua loaʻa i kekahi o kou ʻohana, e like me kou makuahine, makuakāne, a i ʻole nā kaikaina, kahi aneurysm e like me kēia ma mua, hiki paha iā ʻoe ke emi iho ka pilikia.
Pehea ka maʻamau o kēia ʻano?
ʻOiaʻiʻo,
he maʻi laha ʻole kēia `(Femoral Artery Aneurysm)`. ʻO ia hoʻi, ʻaʻole ia he maʻi maʻamau. Eia naʻe, ʻoiai he laha ʻole, hiki i kekahi poʻe ke loaʻa kēia mau pehu ma nā wāwae ʻelua. Hiki i kekahi ke loaʻa kēia mau pehu (aneurysms) ʻaʻole wale ma kēia aʻa femoral, akā ma nā kīʻaha koko ʻē aʻe o ke kino (no ka laʻana, ma ka aorta i loko o ka ʻōpū) i ka manawa like. Wahi a nā helu helu, pili wale kēia maʻi i ka 0.007% o nā kāne. I waena o nā wahine, ʻoi aku ka haʻahaʻa o kēia pakeneka. No laila, mai makaʻu e manaʻo he mea laha ʻole kēia, akā he mea nui loa ka makaʻala i kēia.
He aha ka mea e hana ʻia i ke kino ke hoʻonui ʻia kēia mau kīʻaha koko?
Inā loaʻa iā ʻoe kahi `(Femoral Artery Aneurysm)`, aia ʻelua mau pilikia nui. 1.
ʻAʻa koko : Hiki ke hana ʻia kahi ʻaʻa koko ma kahi o ka aneurysm a paʻa i loko o kēlā aa koko. A i ʻole, hiki i ke ʻaʻa koko ke haki a hele ma ke kahe koko e ālai i kahi kīʻaha koko liʻiliʻi ma kahi ʻē aʻe (no ka laʻana, ma ka wāwae haʻahaʻa a i ʻole ka wāwae). Hiki i kēia ke ʻoki i ke kahe koko i kēlā wahi a hoʻoulu i nā pilikia. 2.
Nahā : ʻO kēia ka mea weliweli loa. Hiki i ka paia nāwaliwali o ke aʻa ke puʻupuʻu a pohā koke. Inā hana ʻia kēlā, e like me ka mea i ʻōlelo ʻia ma mua, hiki ke hoʻoulu i ke kahe koko nui a me ka make.
He aha nā hōʻailona o kēia?
ʻO ka hapa nui o ka manawa,
Ma kahi o 40% o ka poʻe me kēia maʻi ʻaʻohe o lākou hōʻailona! ʻO ia ka mea weliweli. Eia naʻe, inā ʻike ʻia nā hōʻailona, hiki iā lākou ke komo pū me:- He puʻupuʻu ma kou ʻūhā : Hiki paha iā ʻoe ke manaʻo i kahi puʻupuʻu ma kou ʻāpana ʻūhā. I kekahi manawa, hiki i kēia puʻupuʻu ke manaʻo e like me ke kuʻi ʻana (pulsating).
- Pehu ʻana o ka wāwae lalo : Hiki ke pehu ka wāwae lalo.
- ʻEha a kaomi paha ma ka ʻūhā a i ʻole ka wāwae : Hiki iā ʻoe ke ʻike i ka ʻeha ma ka ʻūhā, ka ʻūhā, a i ʻole ka wāwae, a i ʻole ka manaʻo o ke kaomi.
- Nā ʻūpā koko : E like me ka mea i ʻōlelo ʻia ma mua, hiki ke loaʻa nā hōʻailona o nā ʻūpā koko (e.g., ke anu koke, ka maeʻele, ka ʻeha nui).
- Pehu : He mea kākaʻikahi loa kēia, akā inā hana ia, hiki iā ia ke hana i kahi pilikia koʻikoʻi me ka ʻeha koke a koʻikoʻi.
E hoʻomanaʻo, hiki ke loaʻa me ka ʻole o nā hōʻailona, no laila he manaʻo maikaʻi e kamaʻilio me ke kauka inā he mau kumu pilikia kou.
He aha ke kumu o kēia?
Aia kekahi mau kumu e hoʻonāwaliwali ai ka paia o ke aʻa femoral a hoʻoulu i kēia ʻano pehu (aneurysm).- Atherosclerosis : ʻO kēia ke kumu nui a maʻamau . Ke hōʻiliʻili ka momona i loko o nā kīʻaha koko, mānoanoa mālie nā paia o nā aʻa koko a nalowale ko lākou elasticity, ʻaʻole hiki iā lākou ke kū i ke kaomi o ke koko a hiki ke nāwaliwali a puʻupuʻu i kekahi mau wahi.
- Ke koko kiʻekiʻe : Ke kiʻekiʻe ke koko no ka manawa lōʻihi, aia mau nā kīʻaha koko ma lalo o ke kaomi nui. Hiki i kēia ke hoʻonāwaliwali i nā paia o nā aʻa koko.
- ʻEha : Inā ua hōʻino ʻia kekahi kīʻaha koko ma ka ʻūhā e kahi ulia a i ʻole kahi ʻeha koke, hiki i ka ʻāpana ke pehu ma hope. No ka laʻana, ʻo nā ʻeha liʻiliʻi mai kekahi mau kaʻina hana lapaʻau (e like me ke kau ʻana i kahi catheter) i kekahi manawa ke kumu.
- Nā maʻi pili ʻiʻo : E like me ka mea i ʻōlelo ʻia ma mua, ʻo ka poʻe me nā maʻi laha ʻole e hoʻopilikia i nā ʻiʻo pili o ke kino, e like me ka Ehlers-Danlos syndrome, Marfan syndrome, a i ʻole ka maʻi cystic adventitial, hiki ke loaʻa i ka nāwaliwali hānau ʻana o nā paia o ke kīʻaha koko.
- ʻO ka maʻi ʻo Behçet : Hiki i ka maʻi ʻo Behçet ke hoʻoulu i ka mumū o nā kīʻaha koko a alakaʻi i ka pehu e like me kēia.
ʻO kēia ke kumu e nāwaliwali ai ka paia o kou aʻa femoral a kīkoʻo mālie ma lalo o ke kaomi o ke koko, e hana ana i kahi aneurysm e like me kēia. Pehea e ʻike ai nā kauka i kēia?
Ke hele ʻoe e ʻike i ke kauka, hiki iā lākou ke ʻike i kahi puʻupuʻu ma kou ʻūhā i ka wā o ka hoʻokolokolo kino. Akā, ʻaʻole nā puʻupuʻu a pau ma kou ʻūhā he aneurysm. I kekahi manawa hiki ke lilo i hernia. No laila, no ka ʻike pono ʻana i ke ʻano o ia mea, a no ka ʻike pono ʻana i ka nui o ka puʻupuʻu, kahi o ia mea, a me ke ʻano o ia mea, e noi aku kāu kauka iā ʻoe e hana i kekahi mau hoʻokolohua e like me:- ʻO ke scan Ultrasound : He hoʻāʻo maʻalahi kēia, ʻeha ʻole e hiki ke nānā i loko o ke kīʻaha koko, kahi o ka pehu, a pehea kona nui.
- ʻO ka angiogram CT : He ʻano kūikawā kēia o ka scan CT. Ma kēia hoʻāʻo, ua hoʻokomo ʻia kahi dye kūikawā (contrast dye) i loko o kou mau kīʻaha koko, a lawe ka scanner CT i nā kiʻi kikoʻī ʻekolu-dimensional (3D) o nā kīʻaha koko. Hiki i kēia ke hāʻawi i ka ʻike he nui e pili ana i ka paʻa ʻana.
- M.R. Angiogram (Magnetic Resonance Angiogram - MRA) : He kiʻi MRI kūikawā kēia e nānā ana i nā kīʻaha koko, e like me ka CT angiogram.
Na ke kauka e hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe ma muli o ka ʻike i loaʻa mai kēia mau hoʻokolohua. Pehea ʻoe e mālama ai i kēia mau kīʻaha koko pehu i kou mau wāwae?
He haʻahaʻa iki ka pilikia o ka haki ʻana o ka "Femoral Artery Aneurysm" (ma kahi o 1% a 14%). No laila, ʻaʻole pono nā kānaka a pau i ke ʻoki koke ʻana . Eia nō naʻe, hiki i kāu kauka ke ʻōlelo aku i ke ʻoki ʻana e hoʻoponopono i ka aneurysm i nā hihia aʻe:- Inā loaʻa iā ʻoe nā hōʻailona (e like me ka ʻeha, ka pehu ʻana, ke koko ʻūlū).
- Inā pahū ka pehu (he pilikia kēia a pono e ʻoki koke ʻia).
- Inā e nui ana ka pehu (e nānā mau ke kauka iā ia).
- Inā ʻoi aku ke anawaena o ka puʻupuʻu ma mua o 2.5 kenimika (ma kahi o hoʻokahi ʻīniha) .
No ka hoʻoponopono ʻana i kēia puʻupuʻu, hana pinepine nā kauka i kahi 'ʻoki hāmama' . ʻO ia hoʻi, ʻoki lākou i ka ʻili a nānā pololei i ke kīʻaha koko. ʻAʻole kēia ke ʻoki 'laparoscopic' i hana pinepine ʻia ma o nā ʻoki liʻiliʻi me kahi kāmela. Wehe ke kauka i ka ʻāpana pehu a nāwaliwali o ke kīʻaha koko a hoʻololi iā ia me kahi ʻōmole hana, i kapa ʻia ʻo 'fabric graft' (kahi ʻōmole i hana ʻia me kahi ʻano lole kūikawā). Ua like kēia me ke ʻoki ʻana i kahi nāwaliwali o ka hose ahi a hoʻololi iā ia me kahi ʻāpana hou a ikaika aʻe. A laila hiki ke hoʻi hou ke kahe koko me ka mālie a me ke keakea ʻole.
He aha nā pilikia e hiki ke hana ma hope o kēia ʻoki kino?
E like me nā ʻoki kino āpau, aia kahi manawa liʻiliʻi o kekahi mau pilikia ma hope o kēia ʻoki kino bypass femoral artery. Akā, akahele loa nā kauka e pili ana i kēia mau mea.- Maʻi : Hiki i ka ʻeha ʻoki ke pehu a lilo i maʻi.
- Ke kahe ʻana o ke koko : Hiki ke kahe ke koko ma hope o ke ʻoki kino.
- Nā ʻūpā koko: Hiki ke hana ʻia nā ʻūpā koko ma nā wāwae.
ʻO kēia mau mea maʻamau e hiki ke kāohi ʻia. Inā manaʻo ʻoe i kekahi mea ʻē, pono ʻoe e haʻi koke i kāu kauka . ʻEhia ka lōʻihi e hoʻōla ai ma hope o kēia lāʻau lapaʻau?
Ma hope o ke ʻoki kino, pono ʻoe e noho ma ka haukapila no kahi o ʻekolu a ʻumi lā. Hiki ke hala i hoʻokahi mahina a ʻoi aku paha e hoʻōla piha ai a hoʻi i nā hana maʻamau. No laila, he mea nui loa e hahai pololei i nā ʻōlelo a ke kauka a e hoʻomanawanui i kēia manawa. He aha kaʻu e hana ai e hōʻemi i kēia pilikia?
E like me kā mākou i kūkākūkā ai ma mua, ʻo ke kumu nui o kēia `(Femoral Artery Aneurysm)` ʻo ia ka `(Atherosclerosis)`, kahi hōʻiliʻili ʻana o ka momona i loko o nā kīʻaha koko. No laila, ʻo ka kaohi ʻana iā ia hiki ke hōʻemi i ka pilikia o kēia mau aneurysms.- E kāohi i kou pae cholesterol a me ke koko . E lawe i nā lāʻau lapaʻau i kauoha ʻia e kāu kauka.
- E hoʻoikaika kino mau . ʻOiai kekahi mea maʻalahi e like me ka hele wāwae no 30 mau minuke i ka lā he mea maikaʻi ia.
- E ʻai i ka meaʻai olakino a haʻahaʻa ka momona . E ʻai i nā huaʻai, nā mea kanu, a me nā meaʻai waiwai i ka fiber.
- Inā ʻoe e puhipaka, e hoʻōki loa . E hoʻōki hoʻi i ka hoʻohana ʻana i nā huahana paka. He mea nui loa kēia.
- No kekahi poʻe, ma waho aʻe o kēia mau hoʻololi ʻana i ke ʻano o ka nohona, hiki paha i ke kauka ke ʻōlelo aku e hoʻomau i ka lawe ʻana i nā lāʻau hoʻohaʻahaʻa cholesterol.
Inā loaʻa iaʻu ka pehu e like me kēia, he aha kaʻu e manaʻo ai?
ʻAʻole e nalowale kēia `(Femoral Artery Aneurysm)` ma kāna iho me ka ʻole o ka lāʻau lapaʻau. Inā haʻi aku kāu kauka iā ʻoe he hoʻokahi kou, e nānā mau ʻo ia iā ia (e haʻi iā ʻoe e hele mai no ka `follow-up`). ʻO ia hoʻi, e hana ʻo ia i nā hoʻokolohua e like me `(Ultrasound scan)` i kekahi mau manawa e ʻike ai inā e nui ana ka pehu a i ʻole he mau pilikia ʻē aʻe. Ma muli o kēlā, e hoʻoholo ʻo ia inā pono ke ʻoki ʻana a i ʻole e kali iki. ʻO ka hopena o kēia mau ʻoki ʻana he maikaʻi loa ia. He haʻahaʻa loa ka pilikia o ka make i ka manawa o ke ʻoki ʻana, ma waena o 1% a me 5%. ʻOiai ʻelima mau makahiki ma hope o ke ʻoki ʻana, ma kahi o 85% o nā kīʻaha koko i hoʻoponopono ʻia e hana maikaʻi ana, me ka ʻole o nā pilikia me ke kahe koko. He nūhou maikaʻi maoli kēia. Pehea e hiki ai iaʻu ke mālama iaʻu iho?
Inā loaʻa iā ʻoe kahi `(Femoral Artery Aneurysm)` a ua hana ʻia ke ʻoki kino, a i ʻole ke nānā ʻia nei e ke kauka me ka ʻole o ke ʻoki kino, pono ʻoe e nānā mau ʻia kou mau aʻa e ke kauka no ke koena o kou ola. Hiki i kēia nānā mau ke kōkua i ka ʻike ʻana i nā aneurysms hou ma mua o ko lākou nui ʻana a pahū. Inā puhipaka ʻoe, hiki iā ia ke hoʻonui i kēia mau aneurysms. No laila, e aʻo maoli kāu kauka iā ʻoe e hoʻōki i ka puhipaka. Eia kekahi, e hahai pono i nā ʻōlelo kuhikuhi i hāʻawi ʻia e kāohi i kāu cholesterol a me ke koko koko. Āhea wau e hele ai i ka mālama ulia pōpilikia?
Inā hōʻike koke kou wāwae a wāwae paha i hoʻokahi a ʻoi aku paha o kēia mau hōʻailona, pono ʻoe e hele koke i ka lumi pilikia o ka haukapila, me ka hoʻokaʻulua ʻole :- Inā nāwaliwali ka wāwae a manaʻo paha ua make.
- Inā pehu koke ka wāwae .
- Inā ʻoe e ʻeha nei i ka ʻeha hiki ʻole ke hoʻomanawanui.
- Inā he ʻeha kou wāwae.
- Inā ʻoi aku ke anu o kou wāwae ma mua o kekahi wāwae ke hoʻopā ʻoe iā ia.
- Inā ua keʻokeʻo ka wāwae a ua loli paha ke kala.
Hōʻike kēia mau hōʻailona i kahi pilikia koʻikoʻi me ke kahe koko i ka wāwae, ʻo ia hoʻi ke ʻano o ka pehu ʻana e hiki ai ke hoʻoulu i kahi ʻūlū koko a i ʻole e pahū ana ka pehu. No laila, ʻo ka loaʻa koke ʻana o ka lāʻau me ka hoʻonele ʻole i ka manawa hiki ke hoʻōla i ke ola. He aha nā nīnau e pono iaʻu e nīnau aku i ke kauka?
Inā he mau nīnau a hopohopo paha kāu e pili ana i kēia maʻi, mai kānalua e nīnau i kāu kauka. Eia kekahi laʻana, hiki iā ʻoe ke nīnau i nā nīnau e like me kēia:- "E ke kauka, he aha ke kumu o kēia pehu ʻana i loko o koʻu mau aa?"
- "Pono maoli anei au i ke ʻoki kino no kēia? ʻAʻohe anei he mau lāʻau lapaʻau ʻē aʻe?"
- "Hiki iaʻu ke loaʻa hou aku ka pehu e like me kēia ma nā wahi ʻē aʻe o koʻu kino?"
- "Hiki iā ʻoe ke hāʻawi mai iaʻu i kekahi mau ʻōlelo aʻoaʻo e pili ana i nā meaʻai e kōkua ai i ka hoʻohaʻahaʻa ʻana i koʻu pae cholesterol?"
He mea nui loa ka nīnau ʻana i nā nīnau e like me kēia e hoʻomaopopo maikaʻi ai i kou kūlana. He aha ka ʻokoʻa ma waena o ka 'Femoral Artery Aneurysm' a me ka 'Pseudoaneurysm'?
I kekahi manawa e lohe pū ʻoe i ka huaʻōlelo `(Pseudoaneurysm)`. ʻO ke ʻano kēia he "pūpū wahaheʻe". ʻOi aku ka maʻamau o kēia `(Pseudoaneurysm)` ma mua o ka `(Femoral Artery Aneurysm)` maoli a mākou i kamaʻilio ai. ʻO ka maʻamau, hana ʻia kahi `(Pseudoaneurysm)` ma hope o kahi hana lapaʻau ma kou kīʻaha koko (no ka laʻana, ke hana ʻia kahi `(angiogram)` a i ʻole ke hoʻokomo ʻia ʻana o kahi `(catheter)`), a ua hōʻino iki ʻia ka paia o kēlā kīʻaha koko, a kahe kekahi koko i waho a hōʻiliʻili a puni ke aʻa, e hana ana i puʻupuʻu. ʻO ka ʻokoʻa nui, ma kahi `(aneurysm)` maoli, e kīkoʻo a puʻupuʻu nā papa āpau o ka paia o ke kīʻaha koko. Akā ma kahi `(pseudoaneurysm)`, ʻaʻole ia e hana ʻia, he hōʻiliʻili koko ia e kahe ana ma o kahi lua i loko o ka paia o ke kīʻaha koko. He aha ka leka a mākou e makemake ai e lawe i ka home mai kēia moʻolelo?
No laila, ʻoiai he mea kakaikahi loa ka aneurysm o ke aʻa femoral a mākou i kamaʻilio nui ai, he mea nui loa ia iā ʻoe a me kou ʻohana e makaʻala i ia mea.- Hiki i kēia ke lilo pinepine i asymptomatic .
- Inā he mau kumu pilikia kou (ke koko kiʻekiʻe, ka cholesterol, ka puhipaka, ka mōʻaukala ʻohana), e ʻimi i ke kōkua lapaʻau .
- Inā ʻike kāu kauka ua loaʻa iā ʻoe kekahi, mai hopohopo. Aia kekahi mau lāʻau lapaʻau kūpono e hiki ke hoʻohana ʻia e wehe iā ia, ʻoiai ma ke ʻoki ʻana, ma mua o ka pahū ʻana .
- ʻO ka hālāwai ʻana me ke kauka i ʻike i ka mālama ʻana i kēia ʻano maʻi e lilo ia i mea hōʻoluʻolu nui iā ʻoe.
- E mālama mau i kou olakino, e ola i kahi nohona olakino, a e hahai pono i nā ʻōlelo a kāu kauka.A laila hiki iā ʻoe ke pale i nā pilikia olakino he nui e like me kēia a noho olakino.
Inā he mau nīnau hou aku kāu, e ʻoluʻolu e kamaʻilio me kāu kauka ʻohana a i ʻole kekahi loea.
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