Inā pono ʻoe a i ʻole kekahi āu i ʻike ai e hana i ke ʻoki kino, ua lohe paha ʻoe i ka huaʻōlelo anesthesia. ʻO ia hoʻi, ua hoʻomoe ʻia mākou i ka wā o ke ʻoki kino. Akā, ua manaʻo paha ʻoe he hiki i kekahi poʻe ke loaʻa i kahi hopena weliweli loa, a hiki i ke ola i kēia mau lāʻau anesthetic? ʻO ia kekahi o nā maʻi kakaikahi, akā koʻikoʻi loa i kapa ʻia ʻo Malignant Hyperthermia. He mea weliweli iki paha ka inoa, akā inā ʻike pono ʻia ʻoe e pili ana i ia mea, hiki ke pale ʻia nā pilikia he nui. No laila, e kamaʻilio kākou e pili ana i kēia lā me nā kikoʻī.
He aha ka Malignant Hyperthermia?
I ka ʻōlelo maʻalahi, ʻo ka 'Malignant Hyperthermia' he maʻi hoʻoilina . ʻO ia hoʻi, ua hoʻokumu ʻia e kahi mutation i loko o kā mākou mau genes. Ke hāʻawi ʻia kekahi mau lāʻau anesthesia i kekahi kanaka me kēia maʻi, pane maikaʻi ʻole ko lākou kino. He pilikia kēia e hiki ai ke hoʻoweliweli i ke ola.
ʻO ka mea maikaʻi loa, ʻoiai he mea kēia i hoʻoili ʻia mai kēlā hanauna a i kēia hanauna, aia nā lāʻau lapaʻau no ia . A, inā ʻike mua ʻoe e pili ana i kēia pilikia, hiki iā ʻoe ke pale iā ʻoe iho mai ia mea.
Ua ʻike mākou i ka wā e hāʻawi ʻia ai iā mākou ka anesthesia laulā, ʻaʻole hiki iā mākou ke manaʻo i kekahi mea i ka wā o ke ʻoki ʻana. Nui nā ʻano lāʻau lapaʻau e hāʻawi i kēia anesthesia. Eia nō naʻe, he kakaikahi wale nō o kēlā mau lāʻau lapaʻau e hoʻoulu ai i kēia kūlana i kapa ʻia ʻo 'Malignant Hyperthermia'. ʻAʻole hana ka hapa nui o nā lāʻau anesthetic i kēia.
ʻO kekahi mea nui, i kekahi manawa, ʻaʻole paha e ʻike kekahi kanaka he loli ko lākou ʻano genetic e hiki ai ke hoʻoulu i ka Malignant Hyperthermia, no ka mea, ʻaʻole paha lākou e hōʻike i kekahi mau hōʻailona a hiki i ka wā e loaʻa ai iā lākou nā lāʻau lapaʻau i ʻōlelo ʻia.
ʻO wai ka mea i ʻoi aku ka paʻakikī ke hoʻomohala i kēia?
E nānā kākou i ka mea i ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o kēia maʻi 'Malignant Hyperthermia'.
ʻO ke kumu, inā ua loaʻa i kekahi o kou ʻohana kahi hihia mua o 'Malignant Hyperthermia' , a laila hiki i nā lālā ʻē aʻe o kēlā ʻohana ke pilikia. ʻOi aku hoʻi, inā ua loaʻa i kahi hoahānau mua (ʻo ia hoʻi ka makuahine, ka makuakāne, nā kaikaina, nā keiki) ke ʻano, ua manaʻo ʻia ʻoe he 'hiki ke maʻalahi'.
No laila, inā pono ʻoe e hana i ke ʻoki kino, he mea nui loa ia e hoʻomaopopo i ke kauka anesthesiologist inā ua hana ʻia kekahi mea e like me kēia i kekahi o kou ʻohana.
E noʻonoʻo, e ʻōlelo kākou ʻaʻole i loaʻa i kou ʻohana kahi hopena `Malignant Hyperthermia` e like me kēia. Eia nō naʻe, hiki i ka poʻe me kekahi mau maʻi ʻiʻo ke piʻi aʻe ka pilikia. ʻO kekahi o kēia mau maʻi:
- ʻO ka maʻi waena
- ʻO ka maʻi Multiminicore
- ʻO ka maʻi King-Denborough
- ʻO ka maʻi STAC3
ʻOiai paha he mea paʻakikī iki kēia, he mea maikaʻi no ka poʻe me kēia mau kūlana e ʻike i kēia.
Pehea ka maʻamau o kēia ʻano?
Pehea ka maʻamau o kēia 'Malignant Hyperthermia'? ʻOiai ua huikau iki nā helu helu, ua manaʻo ʻia e hiki ke loaʻa kēia ʻano ma kahi o hoʻokahi i loko o 100,000 mau ʻoki kino i nā pākeke. Ma waena o nā keiki, ʻo kēia helu ma kahi o hoʻokahi i loko o 30,000 mau ʻoki kino. He mea kūpono hoʻi e hoʻomaopopo ʻia ʻo ka hapalua o nā maʻi i ʻike ʻia aia ma lalo o 19 mau makahiki.
Akā, manaʻo nā kānaka ʻepekema ʻo ka poʻe i maʻa i kēia kūlana 'Malignant Hyperthermia' e ʻoi aku ka nui o ko lākou noho ʻana i loko o ke kaiāulu. No ka mea, ʻaʻole i loaʻa i ka nui o ka poʻe nā lāʻau lapaʻau kikoʻī e hoʻoulu ai i ko lākou ola a pau, ʻaʻole paha lākou e ʻike ua pilikia lākou.
He aha nā hōʻailona o kēia?
Hiki ke ʻokoʻa iki nā hōʻailona o ka 'Malignant Hyperthermia' mai kēlā kanaka a kēia kanaka. Hiki iā lākou ke ʻike ʻia i ka wā o ke ʻoki kino a i ʻole ʻoe e hoʻōla ana mai ke ʻoki kino. No ka laʻana, inā ʻoe ma lalo o ka anesthesia a ʻike ʻia kēia mau hōʻailona i ka wā o ke ʻoki kino, ʻaʻole ʻoe e ʻike. Eia nō naʻe, ua makaʻala loa kāu anesthesiologist a i ʻole kahu maʻi anesthesia e pili ana i kēia. Nānā pono lākou i nā mea a pau ma lalo o ka anesthesia. I ka wā e ʻike ai lākou i kēia mau hōʻailona, e hoʻomaka koke lākou i ka mālama ʻana no ka 'Malignant Hyperthermia'.
Nā hōʻailona mua
Eia nā hōʻailona mua āu e ʻike ai:
- Ka piʻi ʻana o ka puʻuwai me ka ʻike ʻole ʻia (tachycardia). Piʻi koke ka puʻuwai.
- Ka piʻi koke ʻana o ka nui o ke kalapona ʻokikene i hoʻokuʻu ʻia mai ke kino . Hiki ke mālama ʻia kēia me nā lako lapaʻau.
- Hoʻonui ʻia ka nui o ka hanu ʻana (tachypnea). Hoʻomaka ʻoe e hanu wikiwiki, me he mea lā e hanu ana ʻoe.
- ʻOʻoleʻa ka ʻiʻo, ʻoʻoleʻa (`muscle rigidity`). Lilo nā ʻiʻo o ke kino i ʻoʻoleʻa me he mea lā e kuʻi ʻia ana e ka pōhaku.
- Piʻi koke ka mahana o ke kino . Hoʻomaka ke kino e wela.
Nā hōʻailona e ʻike ʻia ma hope
Ke hoʻonui nei ke kūlana, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:
- Ka piʻi ʻana o ka mahana o ke kino ma luna o ke kuni maʻamau .
- Mimi ʻeleʻele . Hiki ke lilo i ʻeleʻele.
- Hōʻike nā hoʻokolohua koko i ka haki ʻana o nā ʻiʻo .
- ʻAʻole kūpono ke ʻano o ka puʻuwai.
- Ke kahe ʻana o ke koko .
- Nā kūlana e like me ke kuʻi ʻana .
No ke aha e kū mai ai ka hyperthermia malignant?
I kēia manawa, e nānā kākou i ke kumu e kū ai kēia ʻano i kapa ʻia ʻo 'Malignant Hyperthermia'.
He protein ʻano ʻē ko ka poʻe me kēia maʻi i loko o ko lākou mau ʻiʻo. Ma muli kēia o kahi loli i loko o ko lākou mau genes, i kapa ʻia he mutation genetic .
I ka ʻōlelo maʻalahi, ua like ko kākou DNA me kahi "puke kuhikuhi" e loaʻa ana ka ʻike e pono ai nā cell i loko o ko kākou kino e hana i kā lākou hana. Inā he ʻike iki i nalowale ma kekahi wahi o kēia DNA, a inā he hōʻino i kekahi mea, ʻo ia ka manawa e kū mai ai nā maʻi genetic e like me kēia.
ʻAʻole kēia hoʻololi ʻana o ka genetic e hōʻike i kekahi mau hōʻailona i ke ola maʻamau. Eia nō naʻe, inā ua hoʻopili ʻia kekahi kanaka me kēia hoʻololi ʻana i nā lāʻau anesthetic kikoʻī i ʻōlelo ʻia ma luna - a i ʻole, kakaikahi loa, inā i hoʻopili ʻia i nā mahana kiʻekiʻe a inā paha lākou e komo i ka hoʻoikaika kino nui - hoʻomaka kā lākou mau ʻiʻo e hoʻokuʻu i ka calcium ma ke ʻano ʻē.
ʻO ka hopena, hoʻomau nā ʻiʻo i ka ʻūmiʻi a lilo i ʻūmiʻi a paʻakikī paha, piʻi ka metabolism o ke kino a me ka mahana o ke kino i ke ʻano ʻē. I ka hopena, make nā hunaola ʻiʻo, a hōʻiliʻili ka nui o ka potassium i loko o ke koko. Hiki i kēia ke alakaʻi i nā hōʻailona hou aʻe a me nā pilikia.
Hiki i nā lāʻau anesthetic ke hana i kēia ʻano.
ʻO ke kanaka i loaʻa i ke ʻano genetic i ke kūlana 'Malignant Hyperthermia' hiki ke loaʻa i kēia hopena inā hāʻawi ʻia iā lākou nā lāʻau hoʻomaha anesthetic penei:
Nā lāʻau lapaʻau i hanu ʻia:
- ʻO Halotāne
- ʻO ka Desflurane
- ʻO Sevoflurane
- ʻIsoflurane
Nā lāʻau lapaʻau intravenous:
- ʻO Succinylcholine - He lāʻau hoʻomaha māmā kēia e hana wikiwiki ana.
Pehea ʻoe e ʻike ai i kēia?
Inā hana ʻia ʻoe i ke ʻoki kino me ka hoʻohana ʻana i kahi anesthetic weliweli me ka ʻike ʻole he predisposition kou i ka 'Malignant Hyperthermia', ʻaʻole ʻoe a me ke kauka anesthesiology e ʻike ua loaʻa iā ʻoe a hiki i ka wā e hana ʻia ai ka hopena.
Eia nō naʻe, ke hāʻawi ʻia ʻoe a i ʻole kekahi mea ʻē aʻe i ka anesthesia, e nānā pono ke kauka anesthesiologist a kahu maʻi paha i kāu mau hōʻailona koʻikoʻi a me kou olakino i ka wā a ma hope o ke ʻoki ʻana. Inā loaʻa iā ʻoe ka 'Malignant Hyperthermia', e ʻike lākou iā ia ma o nā hōʻailona koʻikoʻi a me nā hopena i ʻōlelo ʻia ma mua. ʻO ia hoʻi:
- Hoʻonui ʻia ka helu o ka puʻuwai no ke kumu ʻole.
- Piʻi wikiwiki o ka mahana o ke kino.
- Ka piʻi koke ʻana o ka nui o ke kalapona ʻokikene i hoʻokuʻu ʻia mai ke kino.
- Paʻa nā ʻiʻo.
Ua hoʻomaʻamaʻa ʻia nā anesthesiologists e ʻike koke i kēia mau loli . A laila hiki iā lākou ke pane koke i kēia pilikia. ʻO ka wikiwiki o ka hōʻoia ʻana, ʻo ka nui o ka mālama ʻana a me ka kaohi ʻana i ke kūlana e hiki ke hoʻokō ʻia.
Pehea ʻoe e ʻike ai ma mua inā loaʻa iā ʻoe kēia pilikia?
Inā manaʻo ʻoe a i ʻole kāu kauka e pilikia paha ʻoe no ka Malignant Hyperthermia, inā paha ma muli o kou mōʻaukala ʻohana a i ʻole no nā kumu ʻē aʻe, aia kekahi mau hoʻokolohua kūikawā e hiki ke hana ʻia e hōʻoia i kēia:
- Hoʻāʻo ʻaelike caffeine halothane (CHCT) : No kēia hoʻāʻo, lawe ʻia kahi ʻāpana liʻiliʻi o kou ʻiʻo (biopsy ʻiʻo) a hōʻike ʻia ka hāpana ʻiʻo i nā hopena o ka halothane a me ka caffeine e ʻike ai inā pane ia i kahi kinoea anesthetic.
- Hoʻāʻo ʻana i ka genetics : Hiki i kēia mau hoʻokolohua ke ʻike i nā mutations i loko o nā genes i loko o ka DNA i kapa ʻia ʻo RYR1, STAC3, a me CACNA1S. Ua ʻike ʻia ma mua o 45 mau mutations e hiki ai ke hoʻoulu i ka Malignant Hyperthermia.
Eia nō naʻe, he pipiʻi loa kēia mau hoʻāʻo e ʻike i kahi predisposition i ka 'Malignant Hyperthermia', a hiki ke hana ʻia i loko o kekahi mau keʻena hoʻokolohua kūikawā. No ka laʻana, loaʻa wale ka hoʻāʻo 'CHCT' ma nā wahi ʻehā ma ʻAmelika Hui Pū ʻIa. No laila, inā pono ʻoe e hana i ke ʻoki kino ulia pōpilikia a ua loaʻa mua i kahi hoahānau pili loa ka 'Malignant Hyperthermia', hoʻohana pinepine nā anesthesiologists i nā anesthetics palekana ma kahi o kēlā mau lāʻau lapaʻau weliweli.
He aha nā lāʻau lapaʻau no kēia?
ʻO ka lāʻau lapaʻau nui no ka hyperthermia malignant ʻo ia ka lāʻau dantrolene (inoa inoa ʻo Dantrium®).
I ka manawa koke e kānalua ai nā kauka anesthesiology i kahi maʻi i kapa ʻia ʻo 'Malignant Hyperthermia', hāʻawi lākou i kēia lāʻau 'dantrolene'. I ka manawa like, hoʻōki lākou i ka hāʻawi ʻana i ka lāʻau anesthetic i hoʻoulu ai i ka hopena, a hoʻopau koke ke kauka ʻoki i ke ʻoki ʻana.
Eia kekahi, mālama pū ka hui anesthesia a me ke kime ʻoki kino i nā hōʻailona ʻē aʻe a me nā pilikia i hoʻokumu ʻia e ka `Malignant Hyperthermia`. ʻO kekahi o kēia mau lāʻau lapaʻau:
- Hoʻōla ʻia ka Hyperthermia me nā ʻano hoʻomaʻalili , e like me ka hāʻawi ʻana i nā wai IV anu a me ka hoʻopili ʻana i nā ʻeke hau.
- Hāʻawi ʻia ka oxygen ma o ka pale maka a i ʻole kahi paipu i kau ʻia i loko o ka trachea.
- Inā he puʻuwai kūpono ʻole (arrhythmia), hāʻawi ʻia ka lāʻau lapaʻau no ia mea.
Ke kūpaʻa kou kūlana, e mālama ʻia ʻoe i loko o ka ʻāpana mālama koʻikoʻi (ICU) no hoʻokahi lā ma ka liʻiliʻi no ka nānā ʻana . E hana ke kime lapaʻau i nā hoʻokolohua hou aʻe (e like me nā hoʻokolohua koko) a hāʻawi i ka lāʻau lapaʻau hou aʻe inā pono.
Hiki ke pale ʻia kēia?
He mea paʻakikī iki ke pale aku i ka Malignant Hyperthermia, ke ʻole ʻoe e ʻike he loaʻa iā ʻoe ka mutation genetic e hoʻokumu ai , a i ʻole kekahi o kou ʻohana i loaʻa i ke ʻano a ua haʻi aku ʻoe i kāu anesthesiologist. I kēlā hihia, ʻaʻole e hoʻohana ka anesthesiologist i kēlā mau lāʻau weliweli i kāu hoʻolālā anesthesia.
Akā, ʻo ka mea kaumaha, ʻo ka hapa nui o ka manawa e ʻike wale ai ka poʻe ua pilikia lākou no ka Malignant Hyperthermia ma hope o ka hiki ʻana iā lākou.
He aha ka mea e hana ʻia ma hope o kēia maʻi? Hiki ke ho'ōla ʻia?
Inā ʻike mua ʻia nā hōʻailona o ka 'Malignant Hyperthermia' a mālama pono ʻia, hiki ke ho'ōla piha ʻia . He mea nui loa ka hana koke a ka hui anesthesia a me ke kime ʻoki ma ʻaneʻi.
Eia nō naʻe, pono kākou e hoʻomanaʻo i kekahi manawa, ʻoiai me ka mālama koke ʻana, hiki ke hāʻule nā ʻōkana he nui a me ka make.
He aha nā pilikia ʻē aʻe e hiki ke kū mai ma muli o ka hyperthermia malignant?
ʻO ka hyperthermia maʻamau hiki ke hana i nā pilikia koʻikoʻi e like me:
- Ka pōʻino o nā ʻiʻo
- Ka hāʻule ʻana o ka puʻupaʻa
- Ka hemahema o ke akepaʻa
- Ke kahe ʻana o ke koko
- Hoʻopau ʻia ka puʻuwai
- Nā hopu ʻana
- Koma
- Make
He mea make anei kēia?
Inā ʻaʻole mālama ʻia, he maʻi make paha ka `Malignant Hyperthermia`. ʻOiai me ka mālama pono ʻana, ʻo ka nui o ka make i hōʻike ʻia ma waena o 3% a me 5%. No laila, ʻaʻole kēia he mea e lawe māmā ʻia.
Āhea wau e ʻike ai i ke kauka e pili ana i kēia?
Inā ʻoe e hoʻomākaukau ana no ke ʻoki kino, he mea nui loa ia e haʻi aku i nā kauka inā ua loaʻa i kekahi o kou ʻohana kekahi mau pilikia me ka anesthesia ma mua .
Eia kekahi, inā ua ʻike hou ʻia ʻoe me kahi loli genetic e hoʻoulu ai i ka Malignant Hyperthermia i loko o kahi hoahānau koko (hoahānau biological), a inā ʻike ʻoe ua loaʻa i kēlā kanaka kahi maʻi i kapa ʻia ʻo Malignant Hyperthermia, he mea nui loa ia e hoʻomaopopo i kāu kauka a hoʻopaʻa i kēia ma kāu mau moʻolelo lapaʻau.
ʻO nā mea nui e pono ai ʻoe e hoʻomanaʻo ma kēia ʻatikala
He hopena koʻikoʻi ka Malignant Hyperthermia a he mea hoʻoweliweli paha i ke ola i kekahi mau lāʻau hoʻomāmā.
ʻO ka nūhou maikaʻi, hiki ke mālama ʻia, a inā ʻike ʻoe ua pilikia ʻoe, hiki ke pale ʻia.
Inā hiki, e ʻike i nā kikoʻī āpau e pili ana i ka mōʻaukala lapaʻau o kou mau hoahānau koko. E kaʻana like i kēlā ʻike me kāu kauka. ʻOiai ʻo ka 'Malignant Hyperthermia' ke kumu o kahi hoʻololi genetic i hoʻoili ʻia ma nā hanauna, inā loaʻa i kekahi o kou ʻohana, ʻoi aku kou pilikia.
Inā he mau nīnau a hopohopo paha kāu e pili ana i ke ʻoki kino a me ka anesthesia āu e loaʻa ai, mai kānalua e nīnau i kāu kauka. Aia lākou ma laila e kōkua iā ʻoe. ʻO kou ʻike a me ke kamaʻilio ākea me kāu hui lapaʻau ka pale maikaʻi loa iā ʻoe.
ʻO ka hyperthermia malignant, anesthesia, ʻoki kino, nā maʻi genetic, ka mōʻaukala ʻohana, nā pilikia anesthesia, ke kiʻekiʻe o ke kino
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo