Ke ʻeha pinepine nei ʻoe ma kou kua hema a i ʻole ka ʻōpū haʻahaʻa? A i ʻole ua ʻike ʻoe i kahi koko liʻiliʻi i loko o kou mimi ? Inā loaʻa iā ʻoe nā hōʻailona e like me kēia, ʻo ke kumu paha he maʻi laha ʻole āu i lohe ʻole ai. I kēia lā ke kamaʻilio nei mākou e pili ana i kēia maʻi i kapa ʻia ʻo Nutcracker Syndrome. Mai makaʻu i ka lohe ʻana i kēia. ʻAʻole maʻamau kēia he mea koʻikoʻi, a hiki i kahi loea i ʻike e pili ana i kēia ke kōkua iā ʻoe.
I ka ʻōlelo maʻalahi, he aha ka Nutcracker Syndrome?
E noʻonoʻo i kahi nutcracker. Ua like ia me ka wāwahi ʻana i kahi nati me kahi nutcracker. Ma kēia kūlana, ʻo ke aʻa nui e lawe ana i ke koko mai kou puʻupaʻa hema, ʻo ka aorta, ua ʻūmiʻi ʻia ma waena o ʻelua mau kīʻaha koko nui i loko o kou ʻōpū. ʻO ia ke kumu i kapa ʻia ai ʻo Nutcracker Syndrome.
Ke ālai ʻia kahi aa koko ma kēia ʻano, lohi ke kahe ʻana o ke koko ma o ia mea, a piʻi aʻe paha ke koko a hoʻomaka ke koko e kahe i ke ala kūpono ʻole. ʻO kēia ke kumu o nā hōʻailona e like me ka ʻeha a me ke koko i loko o ka mimi .
ʻO ka hapa pinepine, ua paʻa kēia aʻa koko ma waena o ke aʻa nui e puka mai ana mai ko mākou puʻuwai (aorta) a me ke aʻa e hoʻolako ana i ke koko i ko mākou mau ʻōpū (superior mesenteric artery). Ua kapa ʻia kēia he anterior nutcracker syndrome . He mea kākaʻikahi loa, hiki i kēia aʻa koko ke paʻa ma waena o ke aʻa nui a me ka iwi kuamoʻo . Ua kapa ʻia kēia he posterior nutcracker syndrome .
"Mai hopohopo," wahi a Kauka Caitlin Hicks, he kauka lapaʻau vascular ma ke Kulanui ʻo Johns Hopkins. "He mea nui e ʻike i kahi loea i ʻike e pili ana i kēia a kamaʻilio e pili ana i kāu mau koho. Akā i ka hapa nui o ka manawa, e hoʻopau wale kēia mau hōʻailona i ka hala ʻana o ka manawa."
He aha nā hōʻailona o ka Nutcracker Syndrome?
I ka wā mua, ʻaʻole paha ʻoe e ʻike i kekahi mea nui. Akā inā paʻa ka aa koko no ka manawa lōʻihi, hiki ke ʻike ʻia nā hōʻailona like ʻole. E nānā kākou i kēia mau mea ma kahi papa.
| ʻAno o ka hōʻailona | Wehewehena |
|---|---|
| Nā hōʻailona maʻamau |
|
| Nā ʻano kikoʻī i nā wahine | |
| Nā ʻano kikoʻī i nā kāne |
Ke hiki ʻole ke kahe pono ke koko ma o ke aʻa renal, hiki i ke kaomi o kēlā koko ke hoʻopilikia i nā aʻa ʻē aʻe ma ke pelvis. ʻO ia ke kumu e ʻokoʻa ai nā hōʻailona ma muli o ke kāne.
ʻAʻole mau kēia ʻeha. I kekahi manawa hiki ke ʻoi aku ka ʻino i ka wā e neʻe ai, ma kekahi mau kūlana, a i ʻole i ka wā o ka menstruation i nā wahine.
ʻO ka ʻokoʻa ma waena o ka Nutcracker Phenomenon a me ka Nutcracker Syndrome
Pono kākou e hoʻomaopopo i kekahi mea ʻē aʻe ma ʻaneʻi. ʻO ia ka ʻokoʻa ma waena o kēia mau mea ʻelua.
- ʻO ka hanana Nutcracker: I kēia hihia, ʻoiai ua ālai ʻia ka aʻa renal i ʻōlelo ʻia ma luna, ʻaʻohe ou hōʻailona .
- ʻO ka Nutcracker Syndrome: I kēia hihia, ua ālai ʻia ke aʻa koko, a ke ʻike nei ʻoe i nā hōʻailona .
ʻAʻole mālama pinepine nā kauka i ka hanana. Akā inā ʻike ʻia nā hōʻailona ma hope, pono ʻoe e ʻike i kāu kauka a kamaʻilio e pili ana.
He aha nā kumu o kēia kūlana?
ʻAʻohe "hewa" ma kou ʻaoʻao no kēia. ʻO nā kumu maʻamau:
- Ka hāiki hānau ʻana o ke kihi kahi i loaʻa ai nā kīʻaha koko.
- Ka nalowale ʻana o ka momona o ka ʻōpū (ma muli o ka wīwī a i ʻole ka emi koke ʻana o ke kaumaha).
- Piʻi koke ke kiʻekiʻe (ulu wikiwiki, ʻoi aku hoʻi i ka wā ʻōpiopio).
I ka ʻōlelo maʻalahi, hoʻemi kēia mau mea i kahi no ke kīʻaha koko. ʻO ka maʻamau, aia kahi papa momona ma laila e pale i ke aʻa. Ke lahilahi kēlā, a i ʻole ke loli ke kūlana o nā kīʻaha koko, hiki ke ālai ʻia ke kīʻaha koko.
ʻO nā kumu ʻē aʻe i ʻike pinepine ʻole ʻia:
- Nā puʻupuʻu e kū ana ma kahi kokoke i ka pancreas a i loko paha o ka ʻōpū.
- Nā ʻōpū lymph pehu.
- ʻO ka aorta i hoʻonui ʻia.
- Hāpai (ma muli o ke kaomi ʻana o ka ʻōpū i nā aʻa a puni).
- Nā pilikia o ka ʻōiwi (e like me ka piʻi ʻana o ke kua i lalo).
Pehea e hana ʻia ai ka hōʻailona?
Hiki ke paʻakikī ke ʻike i ka Nutcracker Syndrome no ka mea ua like loa nā hōʻailona (ʻeha ʻōpū, koko i loko o ka mimi) me nā maʻi maʻamau ʻē aʻe, e like me nā pōhaku puʻupaʻa, nā maʻi ʻōpū mimi, a me ka endometriosis. No laila e nānā mua kāu kauka i nā kumu ʻē aʻe.
Ke kāpae ʻia kēlā mau kumu, inā kānalua ʻia ka Nutcracker Syndrome, hiki ke hana ʻia nā hoʻokolohua aʻe e nānā i ka renal vein occlusion:
- Urinalysis: Hiki i kēia ke ʻike i nā kulu koko liʻiliʻi loa i ʻike ʻia me ka maka ʻōlohelohe.
- ʻO ke kani ʻana o ka Doppler ultrasound: He hoʻāʻo ʻeha ʻole kēia e hoʻohana ana i nā nalu kani e ana i ka wikiwiki o ke kahe ʻana o ke koko ma o nā aʻa renal. ʻOiai ʻaʻole hiki i kēia wale nō ke hōʻoia i ka hōʻailona, hiki iā ia ke hāʻawi i nā hōʻailona koʻikoʻi.
- ʻO ka CT angiography (CTA) a i ʻole MR angiography (MRA): Hiki i kēia ʻano scan ke hana i kahi kiʻi ʻekolu-dimensional maopopo loa o nā kīʻaha koko i loko o ka ʻōpū. Hiki iā lākou ke ʻike pololei inā ua ālai ʻia kahi aa koko, inā e kahe ana ke koko i hope, a inā paha e hele ana i kahi ala ʻē aʻe.
- Venogram: Pili kēia i ke komo ʻana i kahi ʻōmole lahilahi i loko o ke aʻa a me ke ana ʻana i ke kaomi ma mua a ma hope o ke ālai ʻana. Inā he ʻokoʻa koʻikoʻi ke kaomi, he hōʻike ikaika kēia e loaʻa ana kēia kūlana. Hiki ke hoʻohana ʻia kahi ʻenehana i kapa ʻia ʻo IVUS (intravascular ultrasound) i kēia manawa e nānā i loko o ke aʻa.
He aha nā lāʻau lapaʻau?
Aia ka lāʻau lapaʻau i ka nui o ka hopena o kāu mau hōʻailona i kou ola o kēlā me kēia lā. Hoʻōla kekahi poʻe me nā lāʻau lapaʻau maʻalahi a i ka hala ʻana o ka manawa. Pono paha kekahi i ke ʻoki kino.
Ka nānā ʻana a me ka kaohi ʻana i nā hōʻailona
Inā ʻaʻole koʻikoʻi kou mau hōʻailona, hiki i kāu kauka ke paipai i ka kali makaʻala. ʻOi loa i nā keiki ʻōpio, e hoʻomaikaʻi paha kēia kūlana iā ia iho i ka ulu ʻana o ke kino. I loko o kēia manawa:
- Hiki ke hoʻohana i nā lāʻau ʻeha ʻeha (e.g. paracetamol).
- Hiki ke hāʻawi ʻia kekahi mau lāʻau lapaʻau e kōkua ai i nā puʻupaʻa (e like me nā ACE inhibitors).
- Inā ʻo ka pohō kaumaha ke kumu, e aʻo ʻia paha ʻoe e hoʻonui i ke kaumaha.
- Nānā mau ʻia ke kūlana me nā scan a i ʻole nā hoʻāʻo mimi.
ʻO ke ʻoki kino a me nā ʻano hana ʻē aʻe
Inā ʻaʻole e hoʻomaikaʻi nā hōʻailona a i ʻole e hoʻopilikia nui ana i kou ola o kēlā me kēia lā, pono paha ʻoe e noʻonoʻo i ke ʻoki kino. ʻO ke koho maikaʻi loa nāu e pili ana i kou makahiki, ke olakino, a me ke ʻano o kāu mau hōʻailona.
- ʻO ka hoʻololi ʻana o nā aʻa renal: Pili kēia i ka wehe ʻana i ke aʻa i paʻa a hoʻopili hou iā ia i kahi me ka hakahaka nui aʻe. ʻO kēia ke ʻoki maʻamau a holomua loa.
- Ke kau ʻana i ka stenting: Hoʻokomo ʻia kahi ʻōmole mesh liʻiliʻi (stent) i loko o ke aʻa i paʻa ʻia e wehe ai. Eia naʻe, ʻaʻole kēia ke koho maikaʻi loa no ka poʻe ʻōpio, no ka mea, ʻaʻole mau loa kēia mau stents.
- ʻO ka hoʻopili ʻana o nā aʻa Gonadal: Hoʻohana ʻia kēia e mālama i nā aʻa pehu i loko o ke pelvis. Hoʻopaʻa ia i ke kahe koko i kēlā mau aʻa. He mea kōkua paha kēia inā ʻo ka ʻeha pelvic ka pilikia nui.
- ʻO ke kāpili ponoʻī ʻana o ka puʻupaʻa: Wehe ʻia ka puʻupaʻa holoʻokoʻa a hoʻoili ʻia i kahi kūpono ʻē aʻe o ke kino. Hana ʻia kēia inā ʻaʻole holo pono nā mea ʻē aʻe.
Leka Lawe-Home
- He maʻi laha ʻole ka Nutcracker Syndrome i hoʻokumu ʻia e ke kaomi ʻana o kahi aʻa koko ma ka puʻupaʻa hema.
- ʻO nā hōʻailona nui ka ʻeha ma ka ʻaoʻao hema o ke kua/ʻōpū a me ke koko i loko o ka mimi.
- ʻIke pinepine ʻia kēia i nā poʻe ʻōpio a wiwi a hiki ke ho'ōla ponoʻī i ka ulu ʻana o ke kino.
- Mai hoʻowahāwahā i nā hōʻailona. Inā hoʻomau a lilo paha i mea koʻikoʻi, e ʻimi pono i ke kōkua lapaʻau.
- Loaʻa nā koho lapaʻau mai ka nānā ʻana a i ke ʻoki ʻana, a ua hoʻoholo ʻia e kāu kauka ma muli o kou kūlana.
ʻO ka Nutcracker Syndrome, ʻeha puʻupaʻa, koko i loko o ka mimi, ʻeha ʻaoʻao, hematuria, ʻeha ʻaoʻao hema
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