ʻO nā mea e pono ai ʻoe e ʻike e pili ana i ka Hepatopulmonary Syndrome

Inā ʻoe a i ʻole kekahi āu i ʻike ai he maʻi akepaʻa, a inā loaʻa iā ʻoe iho ke ʻano, he mea nui e makaʻala i kēia ʻano hiki ke hoʻopilikia i ka hanu ʻana. Kapa mākou ia he Hepatopulmonary Syndrome. He paʻakikī iki paha ke kani ʻana o ka inoa, akā e mālama kākou i ka maʻalahi, ʻeā? No ka mea, he pilikia ia e hele ana mai ke akepaʻa a i nā māmā.

He aha maoli ka Hepatopulmonary Syndrome?

I ka ʻōlelo maʻalahi, ʻo ka maʻi hepatopulmonary he mea laha ʻole akā he pilikia koʻikoʻi o ka maʻi akepaʻa e hiki ke hoʻopilikia i nā māmā. ʻO ke ʻano o ka huaʻōlelo "hepato" ʻo ia hoʻi "e pili ana i ke akepaʻa." ʻO ke ʻano o "pulmonary" ʻo ia hoʻi "e pili ana i nā māmā." Ua ʻike anei ʻoe ua pili ko kākou akepaʻa a me nā māmā e nā kīʻaha koko?

E noʻonoʻo, i ka wā e loaʻa ai i kekahi ka maʻi akepaʻa, ʻoiai ke ʻano e like me ka cirrhosis, kahi e paʻakikī ai ke akepaʻa a emi iho, e ākea kekahi o nā kīʻaha koko e pili ana i nā māmā me ke kumu ʻole. E like me ka pehu ʻana o ka baluna. I ka lāʻau lapaʻau, kapa mākou i kēia he "Vasodilation" . Ke ākea nā kīʻaha koko ma kēia ʻano, loli ke ʻano maʻamau o ke kahe koko i loko o nā māmā. I kekahi manawa, ʻaʻole hui pono ke koko me ka oxygen i loko o nā māmā, akā hele pololei ma o lākou. Ua kapa ʻia kēlā mau kahe koko ʻano ʻole he "Shunts" . ʻO ka ākea o nā kīʻaha koko i loko o nā māmā ma muli o ka "Vasodilation", a emi ka pae oxygen i loko o ke koko ma muli o kēlā mau "Shunts". Kapa mākou i kēia he "Hypoxemia" . Maopopo iā ʻoe?

Pehea ka hopena o kēia maʻi iā ʻoe? Ke pilikia nei ʻoe i ka hanu ʻana?

I kēia manawa, ke noʻonoʻo nei paha ʻoe, "ʻAe, pehea kēia e pili ai iaʻu?" ʻO ka mea nui e pili ana i kēia, ʻo ia ka paʻakikī o ka hanu ʻana (dyspnea) . ʻAʻole hiki koke mai kēia, e ʻoi aku ka ʻino. ʻAʻole paha e ʻike kekahi poʻe i ka wā mua. Akā i ka hala ʻana o ka manawa, hiki i kēia ʻano ke lilo i mea koʻikoʻi loa a lilo i mea paʻakikī ke hanu ʻoiai ke kū mālie.

He paʻakikī i kekahi poʻe ke hanu i ka wā e noho ana a kū ana paha, akā ʻoi aku ka maikaʻi o ko lākou ʻano ke moe lākou i lalo. No kekahi poʻe, ʻo ke ʻano ʻē aʻe ia; he pilikia ko lākou hanu ʻana i ka wā e moe ana, a ʻoi aku ka maikaʻi o ko lākou ʻano ke noho lākou i luna. Eia naʻe, no ka mea, e ʻoi aku ka ʻino o kēia pōkole o ka hanu i ka hala ʻana o ka manawa, kapa mākou iā ia he Chronic Respiratory Failure. ʻO ke ʻano kēia, ʻaʻole e pau koke nā mea āpau, akā, ʻaʻole lawa ka oxygen i nā ʻōpū a me nā ʻiʻo o kou kino. Kapa mākou i kēia he hypoxia .

He kūlana weliweli loa kēia. ʻIke anei ʻoe i ke aha? He mea nui ka oxygen no ko kākou kino. Ke nalowale loa ia, hiki iā ia ke hōʻeha mau loa i nā ʻōpū koʻikoʻi e like me ka lolo a me ka puʻuwai. Inā ʻaʻole mālama pono ʻia, hiki i kēia kūlana ke hoʻoweliweli i ke ola.

ʻO wai ka mea i ʻoi aku ka paʻakikī ke loaʻa i ka maʻi hepatopulmonary?

Ua ʻike ʻia ma kahi o ka hapaha, a i ʻole 25%, o ka poʻe me ka maʻi akepaʻa mau loa e loaʻa i ka maʻi hepatopulmonary. Hiki nō hoʻi ke hana ʻia i nā hihia o ka hāʻule koke ʻana o ke akepaʻa, i kapa ʻia ʻo ka hāʻule ʻana o ke akepaʻa koke, akā ʻaʻole ia he mea maʻamau.

ʻO ka hapa nui o ka manawa, ʻo kēia ka mea e hana ʻia: ʻO ka cirrhosis o ke akepaʻa ke kumu o ka hoʻonui ʻia o ke kaomi i loko o nā kīʻaha koko e pili ana i ke akepaʻa. I ka lāʻau lapaʻau, kapa mākou iā ia he "Portal Hypertension" . ʻO kēlā kūlana "Portal Hypertension" ke kumu e ākea ai nā kīʻaha koko i loko o nā māmā i kekahi poʻe, e hana ana i kēia maʻi hepatopulmonary. Eia naʻe, he mea kakaikahi loa, hiki ke hana ʻia ka "Portal Hypertension" ma muli o nā kumu ʻē aʻe, e like me nā ʻōpū koko, a hiki nō hoʻi kēia maʻi ke hana ʻia ma o ia mea.

He aha ke kumu maoli o kēia?

ʻO kaʻoiaʻiʻo, ʻaʻole maopopo loa i nā kānaka ʻepekema ke kumu o kēia kūlana, i kapa ʻia ʻo portal hypertension, e hoʻonui ai i nā kīʻaha koko i loko o nā māmā (vasodilation) i kekahi poʻe. Nui nā kumumanaʻo a me nā manaʻo e pili ana i ia mea. ʻAʻole maopopo loa ke kumu e hiki ʻole ai i nā kānaka a pau, akā i kekahi poʻe wale nō. ʻAʻole like me ka pili pono ʻana i ke koʻikoʻi o ka maʻi akepaʻa.

Akā hoʻokahi mea i maopopo. ʻO ka vasodilation i loko o nā māmā ke kumu o ka emi ʻana o nā pae oxygen i loko o ke koko (Hypoxemia). I ka ʻōlelo maʻalahi, aia kahi kaulike ʻole ma waena o ka nui o ka ea e komo ana i loko o nā māmā a me ka nui o ke koko e hele ana ma o nā māmā. ʻO ia ke kumu i loaʻa ʻole ai i ke kino ka nui o ka oxygen e pono ai.

He aha nā hōʻailona? Pehea mākou e ʻike ai i kēia?

Inā ʻaʻole koʻikoʻi loa ke kūlana o ka Hepatopulmonary Syndrome, ʻaʻole paha ʻoe e ʻike i kekahi mau hōʻailona. ʻO ka hōʻailona mua a ka poʻe he nui e manaʻo ai, e like me ka mea i ʻōlelo ʻia ma mua, ʻo ia ka paʻakikī o ka hanu ʻana (Dyspnea) . Eia nō naʻe, he nui nā kumu e paʻakikī ai ka hanu ʻana. Hiki i ke kanaka me ka maʻi akepaʻa ke loaʻa ka paʻakikī o ka hanu ʻana ma nā ʻano like ʻole. No laila, i kekahi manawa, ʻaʻole paha e ʻike koke nā mea maʻi a me nā kauka i kēia ma ke ʻano he hōʻailona o ka Hepatopulmonary Syndrome.

Ke hoʻonui nei ke kūlana, hiki iā ʻoe ke ʻike i nā hōʻailona ʻē aʻe e like me:

• Platypnoea: ʻO kēia ka wā e paʻakikī ai iā ʻoe ke hanu i kou noho ʻana a kū paha, akā e ʻike iki ʻoe i ka hōʻoluʻolu ke moe ʻoe i lalo.
• Orthopnea: ʻO kēia ke ʻano ʻē aʻe. He paʻakikī ke hanu i ka wā e moe ana, akā ʻoi aku ka maikaʻi i ka wā e noho ana i luna.
• Cyanosis: He ʻano polū ke kala o nā lehelehe, nā kui lima, a i kekahi manawa ka ʻili ma muli o ka nele o ka oxygen i ke kino. He hōʻailona ʻike ʻia kēia.
• Nā manamana lima i hoʻopaʻa ʻia:ʻIke ʻia nā wēlau o nā manamana lima a i ʻole nā ​​manamana wāwae e pehu a puʻupuʻu ana, e like me nā wēlau o ka lāʻau pahu. He hōʻailona kēia o ka hypoxemia.

Ma waho aʻe o kēia mau hōʻailona, ​​​​hiki iā ʻoe ke loaʻa nā hōʻailona maʻamau i ka maʻi akepaʻa a me/a i ʻole ka portal hypertension. Eia kekahi laʻana:

• Nā angiomas spider: Nā kīʻaha koko liʻiliʻi, ʻulaʻula, e like me ka spider e ʻike ʻia ma lalo o ka ʻili.
• Nā aʻa Varicose: ʻIke ʻia nā kīʻaha koko i hoʻonui ʻia i loko o ka ʻōpū a i ʻole ka esophagus.
• He moʻolelo o ke kahe koko ʻana o ka ʻōpū ma mua.
• ʻO Ascites (pehu ʻana o ka ʻōpū)

Pehea e ʻike ai nā kauka i kēia?

Hoʻomaopopo nā kauka i kēia maʻi hepatopulmonary ke hui pū ʻia nā hōʻailona nui ʻekolu:

1. Portal Hypertension: Hana pinepine kēia me nā maʻi akepaʻa.

2. Nā hoʻonui ʻana o nā kīʻaha koko intrapulmonary: ʻO ke ʻano kēia, ua hoʻonui ʻia nā kīʻaha koko i loko o nā māmā.

3. Ka emi ʻana o ka nui o ka oxygen i loko o ke koko (Hypoxemia) .

ʻO ka hapa nui o ka manawa, ke loaʻa iā ʻoe kēia `(Hepatopulmonary Syndrome)`, ua ʻike mua kāu mau kauka he maʻi akepaʻa kou `(Liver Disease)` a i ʻole `(Portal Hypertension).` A i ʻole, e hana mua kāu hui lapaʻau i nā scan like ʻole a me nā hoʻāʻo koko e ʻike ai inā he hōʻino ʻia ke akepaʻa. A laila e nānā lākou i nā aa koko i loko o kou mau māmā a ana i ka nui o ka oxygen i loko o kou koko. Hiki i kēia mau hoʻāʻo ke hōʻike maopopo aku ua hoʻonui ʻia nā kīʻaha koko i loko o kou mau māmā `(Vasodilation)`, ka mea e hoʻohaʻahaʻa ai i ka oxygen i loko o kou koko `(Hypoxemia).`

He aha nā hoʻokolohua kūikawā i hana ʻia no kēia?

Hana nā kauka i kekahi mau hoʻokolohua e hōʻoia i kēia kūlana. ʻO kekahi o lākou:

• ʻO ka pulse oximetry: Ua hana mua ʻia paha kēia iā ʻoe. He hoʻāʻo maʻalahi loa ia a ʻeha ʻole. Hoʻopili ʻia kahi mea liʻiliʻi e like me ke clip ma ka piko o kou manamana lima. Hoʻomālamalama ia i kahi kukui ma o kou manamana lima a ana i ka nui o ke kukui e puka mai ana ma kēlā ʻaoʻao, kahi i hoʻohana ʻia e ana i ka nui o ka oxygen i loko o kou koko (Oxygen Saturation). He hoʻāʻo maʻamau kēia.
• ʻO ke Kinoea Koko Arterial (ABG): Inā hōʻike ka pulse oximetry ua haʻahaʻa ka oxygen o kou koko, ʻo ka hoʻāʻo aʻe āu e hana ai ʻo ia ka ABG. He kikoʻī iki kēia. Lawe ʻia kahi hāpana koko liʻiliʻi mai kahi aʻa i loko o kou pulima . Hoʻāʻo ʻia ka hāpana koko e hoʻoholo i ka nui o ka oxygen i hoʻoheheʻe ʻia i loko o kou koko (PaO2). He ana kēia o ka maikaʻi o ka omo ʻana o kou mau māmā i ka oxygen i loko o kou koko.
• ʻO ka Echocardiography Hoʻohālikelike:ʻO kēia ke ʻano radiological maikaʻi loa e ʻike ai i nā aʻa pulmonary i hoʻonui ʻia. He ultrasound ka echocardiogram. Hoʻohana ia i nā nalu kani alapine kiʻekiʻe e kiʻi i nā kiʻi o kou puʻuwai a me nā aʻa i loko o kou mau māmā. I loko o kahi ultrasound i hoʻonui ʻia me ka hoʻohālikelike ʻana, ua hoʻokomo ʻia kahi mea hoʻohālikelike, kahi wai kūikawā, i loko o kahi aʻa e ʻike nui ʻia ai nā aʻa. Ke loaʻa iā ʻoe kahi echocardiogram hoʻohālikelike, hoʻokomo kahi loea i kahi hopena saline i hoʻonāukiuki ʻia i loko o kou aʻa. He hopena kēia i hana ʻia ma ka hoʻohui ʻana i nā pehu ea liʻiliʻi i ka wai paʻakai. A laila nānā lākou e ʻike inā neʻe kēia mau pehu liʻiliʻi mai ka ʻaoʻao ʻākau o kou puʻuwai a i ka ʻaoʻao hema i ka hala ʻana o ka manawa (ʻākau a hema cardiac shunt). Hiki i kēia ke haʻi iā lākou inā loaʻa iā ʻoe ka `(Hepatopulmonary Syndrome)` a i ʻole.

Pehea e mālama ʻia ai kēia?

ʻO ka lāʻau lapaʻau wale nō o kēia manawa no ka maʻi hepatopulmonary ʻo ia ka oxygen supplemental . ʻO ka hoʻōla oxygen e pili ana i ka hanu ʻana i ka 100% oxygen e kōkua i kou kino. Pono paha ʻoe e loaʻa ka oxygen mai kahi keʻena i hoʻopaʻa ʻia i loko o kahi haukapila, i kapa ʻia ʻo hyperbaric oxygen therapy. A i ʻole, e hāʻawi ʻia paha ʻoe i kahi mea hiki iā ʻoe ke lawe i ka home, e like me ka mask oxygen. Hiki i ka oxygen ke kōkua i ka hōʻemi ʻana i nā hōʻailona, ​​​​ʻoi aku ka pōkole o ka hanu, a mālama i nā ʻiʻo o kou kino e hana pono ana ma ka hāʻawi ʻana iā lākou i ka oxygen a lākou e pono ai.

Ke hoʻi hou mai nei ka maʻi hepatopulmonary? Hiki ke ho'ōla loa ʻia?

ʻO ka lāʻau lapaʻau wale nō no kēia maʻi hepatopulmonary he hoʻoili ake . ʻAe, ua lohe pololei ʻoe iaʻu. Ma hope o ka hoʻoili ake kūleʻa, ʻo ka hoʻonui ʻia ʻana o nā kīʻaha koko i loko o nā māmā (vasodilation) a me ka nele o ka oxygen i loko o ke koko (hypoxemia) e hoʻohuli mālie. ʻO ia hoʻi, e maikaʻi ana. He ʻeono a ʻumikūmālua mahina e hoʻi ai ka hana o kou māmā i ka maʻamau.

Eia naʻe, ʻaʻole kūpono nā kānaka a pau no ka hoʻoili ʻana o ke akepaʻa. Nui nā kumu like ʻole no kēia. ʻOiai inā kūpono lākou, aia kekahi mau manawa e pono ai lākou e kali i kahi manawa lōʻihi no ka loaʻa ʻana o ke akepaʻa. No laila, ua like kēia hoʻōla ʻana me ka heihei kūʻē i ka manawa.

He mea make anei kēia? Pehea lā ka manawa e ola ai?

Inā loaʻa iā ʻoe ka Hepatopulmonary Syndrome, ua loaʻa paha iā ʻoe ka maʻi akepaʻa mau loa. ʻO ka maʻi akepaʻa hope loa kahi maʻi hiki ke make me ka ʻole o ka hoʻoili ʻana i ke akepaʻa. ʻO ka Hepatopulmonary Syndrome kekahi o nā hopena ʻaoʻao a me nā pilikia e hele pū me ia. ʻAʻole make ka nui o ka poʻe mai ka Hepatopulmonary Syndrome, ʻo ia ka nele o ka oxygen (hypoxemia), akā hāʻawi pū ia i ko lākou olakino holoʻokoʻa a hoʻopōkole i ko lākou ola.

ʻO ka lōʻihi o kou ola ʻana me ka Hepatopulmonary Syndrome e pili ana i nā mea he nui. Hoʻokomo pū kēia i ke koʻikoʻi o kou maʻi akepaʻa, kou olakino holoʻokoʻa, a inā he mau maʻi ʻē aʻe kou. Ma ka awelika, hiki i kekahi me ka cirrhosis o ke akepaʻa akā me ka ʻole o ka Hepatopulmonary Syndrome ke ola no kahi o ʻehiku mau makahiki me ka ʻole o ka hoʻoili ʻana i ke akepaʻa. Eia nō naʻe, no kekahi me ka cirrhosis a me ka Hepatopulmonary Syndrome, hiki ke hoʻemi ʻia ka awelika o ke ola me ka ʻole o ka hoʻoili ʻana i ke akepaʻa i ʻelua mau makahiki.

Loaʻa paha i kekahi poʻe ka maʻi hepatopulmonary palupalu, ʻaʻole ia he koʻikoʻi e like me ka maʻi akepaʻa. Hiki paha iā lākou ke ola lōʻihi me ka lāʻau lapaʻau kākoʻo. Eia kekahi, ʻaʻole paha e ola kekahi poʻe i kahi hoʻoili akepaʻa inā koʻikoʻi ko lākou maʻi. ʻO ka awelika o ka helu ola ʻelima makahiki no ka poʻe me ka maʻi hepatopulmonary i loaʻa kahi hoʻoili akepaʻa kūleʻa ma kahi o 70%. He haʻahaʻa iki kēia ma mua o ka helu ola holoʻokoʻa ma hope o kahi hoʻoili akepaʻa (75%).

Hoʻopilikia ka maʻi akepaʻa i kēlā me kēia kanaka i nā ʻano like ʻole. He maʻi laha ʻole ka Hepatopulmonary Syndrome a hiki ke make. ʻAʻole paha ʻoe i lohe e pili ana iā ia a hiki i ka wā e hiki mai ai iā ʻoe a i ʻole kekahi mea kokoke iā ʻoe.

He kakaikahi a ʻaʻohe paha o nā hōʻailona o ka poʻe he nui. Akā no kekahi poʻe, ʻoiai ka poʻe i loko o ke olakino maikaʻi ʻole, hiki i kēia ke manaʻo e like me ka "ʻōpala hope loa." E like me ka maʻi akepaʻa, ʻoi aku ka ʻino o ka maʻi hepatopulmonary (HPS) i ka hala ʻana o ka manawa. Inā aia ʻoe ma ka papa inoa kali no ka hoʻoili akepaʻa, e hoʻoneʻe ʻia ʻoe i luna ma ka papa inoa ke ʻike ʻia ʻoe me HPS. ʻO kēia no ka mea ua ʻike nā kauka hiki i kēia ʻano ke hoʻopōkole i kou ola a hoʻemi i kou ʻano o ke ola - a ua ʻike lākou hiki i ka hoʻoili akepaʻa ke ho'ōla iā ia. I kēia manawa, hiki i ka hoʻomau ʻana i ka lāʻau lapaʻau oxygen ke kōkua iā ʻoe e loaʻa kahi hōʻoluʻolu a kōkua iā ʻoe e ola lōʻihi.

ʻO ka mea hope loa, aia kekahi mau mea nui e pono ai ʻoe e hoʻomanaʻo

No laila, ke lana nei koʻu manaʻo ua loaʻa iā ʻoe kekahi mālamalama mai kā mākou i kūkākūkā ai e pili ana i ka Hepatopulmonary Syndrome. E hoʻomanaʻo i kēia mau manaʻo:

• He pilikia kakaikahi kēia akā hiki ke koʻikoʻi o ka maʻi akepaʻa .
• ʻO ka hōʻailona nui ka paʻakikī o ka hanu ʻana (dyspnea) , ʻoiai hoʻi i ka poʻe me ka maʻi akepaʻa.
• Inā pilikia ka hanu ʻana o kekahi me ka maʻi akepaʻa, pono e kānalua ʻia kēia ʻano (Hepatopulmonary Syndrome) a pono e haʻi ʻia i ke kauka e pili ana i ia mea.
• ʻO ka hoʻoili ʻana i ke akepaʻa wale nō ke ʻano lapaʻau e loaʻa ana i kēia manawa.
• A hiki i ka loaʻa ʻana o kēlā lāʻau lapaʻau, hiki i ka oxygen therapy ke kōkua i ka kaohi ʻana i nā hōʻailona a mālama i ke ola.
• Inā loaʻa iā ʻoe a i ʻole kekahi āu i ʻike ai kēia mau hōʻailona, ​​​​he mea nui loa ia e ʻike koke i ke kauka no ka ʻōlelo aʻo. No ka mea, inā ʻike mua ʻia, ʻoi aku ka maʻalahi o ka mālama ʻana a me ka hoʻolālā ʻana no ka mālama hou aku. Mai hopohopo, akā ʻoi aku ka maikaʻi o ka makaʻala.

ʻO ka maʻi hepatopulmonary, maʻi akepaʻa, maʻi māmā, paʻakikī ka hanu ʻana, nele i ka oxygen, cirrhosis, hoʻoili akepaʻa