E noʻonoʻo ʻoe e ʻoki ana i nā mea kanu i loko o ka lumi kuke a ʻoki hewa i kou lima. A i ʻole e ʻōlelo kākou ua hāʻule kekahi keiki liʻiliʻi i ka wā e pāʻani ana a ʻūlū kona kuli. I ka wā mua, aia kahi koko liʻiliʻi, akā ma hope o kekahi manawa, ʻoiai inā ʻaʻohe a mākou hana, pau ke kahe ʻana o ke koko, ʻeā? ʻAʻole kēia he mea ʻē aʻe. He ʻano pale kupaianaha kēia i loko o ko mākou kino. I ka lāʻau lapaʻau, kapa mākou i kēia he hemostasis . I ka ʻōlelo maʻalahi, ʻo ia ke kaʻina hana kūlohelohe e hoʻōki ai i ke kahe ʻana mai kahi ʻeha a hoʻomākaukau i ke kino e ho'ōla i kēlā ʻeha.
No laila, pehea e hana ʻia ai kēia kaʻina hana i kapa ʻia ʻo hemostasis?
He moʻolelo hoihoi loa kēia. ʻO ka huaʻōlelo hemostasis he ʻelua ʻāpana. ʻO "Hemo" ke ʻano o "ke koko" a ʻo "stasis" ke ʻano o "e hoʻōki" a i ʻole "e paʻa." I nā huaʻōlelo maʻalahi, ʻo ia hoʻi "e hoʻōki i ke kahe o ke koko." Hoʻomaka kēia kaʻina hana i loko o kekona o kahi ʻeha. He mea maʻamau ke kahe ʻana o ke koko mai kahi ʻeha no ʻelua a ʻehiku mau minuke.
ʻAʻole kēia he hana hoʻokahi wale nō. Hana ʻia ia ma kekahi mau ʻanuʻu, e like me kahi hui o nā mea hana lima akamai e hana pū ana e hoʻopau i kahi papahana. E nānā kākou i nā ʻanuʻu nui ʻehā.
| Nā ʻanuʻu | He aha ka mea e hana nei (ma nā huaʻōlelo maʻalahi) |
|---|---|
| KaʻAnuʻu Hana 1: Ka hoʻopaʻa ʻana o ke kīʻaha koko | Hoʻopaʻa nā kīʻaha koko (nā kīʻaha koko) ma kahi o ka ʻeha, e like me ke ʻūmi ʻana i kahi paipu wai. Hoʻolohi kēia i ke kahe ʻana o ke koko. |
| KaʻAnuʻu Hana 2: Ke hana ʻana i kahi plug manawa pōkole | ʻO nā platelets, kahi ʻano huna liʻiliʻi e lana ana i loko o ko kākou koko, e holo wikiwiki i kahi o ka ʻeha a pipili iā ia. Hoʻopili pū lākou a hoʻopaʻa i ka ʻeha no kekahi manawa. Ua like ia me ke kau ʻana i kahi pāpale ma luna o kahi ʻōmole. Ua kapa ʻia kēia he hemostasis mua . |
| KaʻAnuʻu Hana 3: Hoʻomaka i ke kaulahao coagulation | I kēia manawa, hoʻomaka ka hana maoli. He aha ka mea i loko o ke kokoHoʻāla ʻia nā protein i kapa ʻia ʻo nā mea coagulation kekahi ma hope o kekahi, e hoʻoikaika hou ana i kēlā sila manawa pōkole. Ua like kēia me kahi hopena kaulahao. Ua kapa ʻia kēia he hemostasis lua . |
| KaʻAnuʻu Hana 4: Ka Hoʻokumu ʻana i kahi ʻōpū koko mau loa | I ka hopena, hui pū nā platelets a me kahi protein kūikawā i kapa ʻia ʻo fibrin e hana i kahi ʻūpā koko ikaika a mau loa, e like me nā piliki a me ka sima e kūkulu ana i kahi pā. Hoʻopau loa kēia i ka ʻeha. Ma hope mai, i ka wā e ho'ōla ai ka ʻeha, hoʻoheheʻe ʻia kēia ʻūpā koko a hana ʻia ka ʻili hou. |
I ka ʻōlelo maʻalahi, ʻo ka hemostasis ka "plaster" maoli o ko mākou kino. Inā ʻaʻohe o ia mea, hiki i kahi ʻōpala liʻiliʻi ke hoʻokahe nui i ke koko a hiki ke hoʻoweliweli i ke ola.
He aha ka mea e hana ai inā hewa kēia kaʻina hana?
ʻOiai ke hana maikaʻi nei kēia kaʻina hana, i kekahi manawa hiki ke hele hewa. A laila hiki ke kū mai ʻelua mau pilikia:
1. Hypocoagulability: ʻO kēia ka manawa ʻaʻole e paʻa pono ke koko i ka wā e pono ai. ʻOiai kahi ʻeha liʻiliʻi hiki ke hoʻoulu i ke kahe koko lōʻihi, e hopena ana i nā palapū a me nā ʻeha.
2. Hypercoagulability: ʻO kēia ka wā e hana ʻia ai nā ʻūpā koko i loko o ke kino ke ʻole lākou e pono ai. Hiki i kēia ke lilo i mea weliweli loa.
Inā piʻi nui ke koko i loko o ke koko (Hypercoagulability)
He mea weliweli kēia no ka mea hiki i nā ʻūpā koko i makemake ʻole ʻia e hana ʻia i loko o ke kino (ka mea a mākou e kapa nei he thrombosis ) ke hele ma o nā kīʻaha koko a hoʻopaʻa ʻia i loko o nā ʻōpū koʻikoʻi e like me ka lolo, ka puʻuwai, a me nā māmā. ʻO ia ka mea e hana ʻia.
- Hahau: Inā ālai kahi ʻūpā koko i kahi kīʻaha koko e lawe ana i ke koko i ka lolo.
- Hoʻouka Puʻuwai: Inā ālai kahi ʻaʻa koko i kahi kīʻaha koko e hoʻolako ana i ke koko i ka puʻuwai.
- ʻO ka Pulmonary Embolism: Hiki ke hana kēia i ka wā e haki ai kahi ʻaʻa koko ( Deep Vein Thrombosis - DVT ), ka mea maʻamau e hana ʻia i loko o kahi aʻa koko hohonu i ka wāwae, a paʻa i loko o kahi aʻa koko i loko o nā māmā.
Hiki i kekahi ʻano maʻi kanesa, nā kūlana hoʻoilina (e like me Factor V Leiden , Protein C deficiency ), a me nā kūlana olakino ʻē aʻe (e like me Antiphospholipid syndrome , nā maʻi koʻikoʻi - sepsis ) ke hoʻonui i ke kāpili ʻana o ke koko ma kēia ʻano.
Inā emi nui ke koko i loko o ke koko (Hypocoagulability)
ʻO ke kū'ē kēia. No ka mea, ʻaʻole i paʻa pono kou koko, hiki i kekahi ʻeha ke lilo i mea weliweli. ʻOiai kahi ʻoki liʻiliʻi hiki ke hoʻoulu i ke kahe nui ʻana o ke koko. Hiki nō hoʻi ke kahe ʻike ʻole ʻia i loko o ke kino.
ʻO nā hiʻohiʻona nui o kēia:
- Hemophilia: He maʻi hoʻoilina kēia kahi i hana ʻole ai ke kino i hoʻokahi a ʻoi aku paha o nā mea e pono ai no ke kāpili ʻana o ke koko.
- ʻO ka maʻi Von Willebrand: He maʻi hoʻoilina maʻamau kēia e like me ka hemophilia.
- Thrombocytopenia: Ka emi ʻana o ka helu o nā platelets, ʻo ia nā pūnaewele koko mua. Hiki ke ʻike ʻia kēia ʻano ma kekahi mau ʻano maʻi kanesa (e.g., leukemia ).
Pehea ʻoe e ʻike ai inā he mau pilikia e like me kēia?
Inā loaʻa iā ʻoe kēia mau hōʻailona, e kuhikuhi aku kāu kauka iā ʻoe i kahi hematologist. E nīnau ʻo ia e pili ana i kāu mau hōʻailona a kauoha i nā hoʻokolohua koko e pono ai.
ʻO kekahi o kēlā mau hoʻokolohua:
- Helu Koko Piha (CBC)
- Helu Platelet
- Ka Manawa Koko
- Ka Manawa Prothrombin (PT)
- Ka Manawa Thromboplastin hapa i hoʻāla ʻia (aPTT)
- Pae Fibrinogen
Āhea ʻoe e ʻike ai i ke kauka?
Inā loaʻa iā ʻoe kekahi mau hōʻailona, ʻaʻole pono ʻoe e hoʻowahāwahā iā lākou. He mau pilikia paha kēia.
| Māhele hōʻailona | Nā mea e pono ai ke nānā aku |
|---|---|
| Nā hōʻailona o ka hoʻonui ʻia o ke koko (Hypercoagulability) - He mau pilikia kēia, e hele koke i ka ETU! | |
| Lolo (maʻi lolo) | Manuʻa ma kekahi ʻaoʻao o ke kino, paʻakikī ke ʻōlelo, kūlou ma kekahi ʻaoʻao o ka maka, ʻeha nui ka ʻeha poʻo. |
| Puʻuwai (maʻi puʻuwai) | ʻEha ka umauma, paʻakikī ka hanu ʻana, nāwaliwali, puʻuwai wikiwiki, maule. |
| I loko o nā māmā (Pulmonary Embolism) | Ka pōkole koke o ka hanu, ka ʻeha o ka umauma, ke kuʻi ʻana i ke koko, nā lehelehe polū a i ʻole nā manamana lima, a me ka maule ʻana. |
| Ma ka wāwae (DVT) | ʻEha, pehu, a me ka ʻulaʻula ma ka ʻāpana ʻūhā a i ʻole ma kahi ʻē aʻe o ka wāwae. |
| Nā hōʻailona o ka hypocoagulability - e kamaʻilio me kāu kauka inā loaʻa iā ʻoe kēia mau mea. | |
| Nā hiʻohiʻona maʻamau | • Ke kahe pinepine ʻana o ke koko ihu a me ka paʻakikī ke hoʻōki iā lākou. • Ke kahe ʻana o ke koko o nā ʻāʻī i ka wā e palaki ai i kou mau niho. • ʻOiai kahi ʻeha liʻiliʻi e kahe ana ke koko no ka manawa lōʻihi. • ʻEha (nā kiko polū/poni) ma ke kino me ke kumu ʻole. |
Leka Lawe-Home
- He hana kūlohelohe a koʻikoʻi ka hemostasis e hoʻōki ai ko mākou kino i ke kahe koko mai kahi ʻeha.
- He hana paʻakikī kēia e pili ana i kekahi mau ʻanuʻu.
- I kekahi manawa hiki ke hele hewa kēia kaʻina hana. Hiki i nā kūlana ʻelua, i kapa ʻia ʻo hypercoagulability a i ʻole hypocoagulability, ke lilo i mea weliweli.
- ʻO nā hōʻailona e like me ka ʻeha koke o ka umauma, ka paʻakikī o ka hanu ʻana, a i ʻole ka nalowale o ka ʻike ma kekahi ʻaoʻao o ke kino, he hōʻailona paha ia o kahi ʻūpā koko. I kēlā mau hihia, e hele koke i ka ʻOihana Pilikia o ka haukapila (ETU) .
- Inā ʻeha ʻoe me ke kumu ʻole, a inā ʻoe e kahe nui ana ke koko mai nā ʻeha liʻiliʻi, mai hoʻowahāwahā iā ia a e kamaʻilio pono me kāu kauka .
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