Ua ʻike paha ʻoe i ka wā e ʻelemakule ai nā paipu wai i loko o ko kākou mau hale, ua paʻa lākou i ka lepo a me ka popo. Pēlā nō, hiki i nā kīʻaha koko i loko o ko kākou kino, nā ʻōmole e lawe ana i ke koko, ke paʻa i nā mea like ʻole i ka hala ʻana o ka manawa. Ke paʻa kahi kīʻaha koko, ua hoʻopilikia ʻia ke kahe o ke koko. I ia mau hihia, ʻo ke kaʻina hana e wehe i nā mea i paʻa ma o ke ʻoki ʻana a hoʻomaʻemaʻe i ke kīʻaha koko ua kapa wale ʻia ʻo "Endarterectomy".
He aha ka Endarterectomy? He aha ka mea e hana nei?
I ka ʻōlelo maʻalahi, ʻo ka endarterectomy kahi hana ʻoki e wehe hou i nā aʻa i paʻa a i ʻole i haiki ʻia. ʻO ka plaque kahi papa paʻakikī a pipili o ka momona a me ka calcium e hōʻiliʻili ana i loko o ko mākou mau kīʻaha koko. Ua like ia me ka ʻōpala e hana ana ma luna o kahi paipu wai. Ma kēia ʻoki ʻana, wehe nā kauka i ke kīʻaha koko a ʻokiʻoki i ka plaque i hōʻiliʻili ʻia i loko.
Ke wehe ʻia ka palaki ma kēia ʻano, hoʻonui ʻia ka hakahaka i loko o ke kīʻaha koko. ʻAe kēia i ke koko e kahe pono hou. Hiki i kēia ke hōʻemi nui i ka pilikia o nā ʻōpū koko a me nā maʻi koʻikoʻi e like me ka hahau ʻana .
Hana pinepine ʻia kēia ʻoki kino i ka wā e lilo ai ke ʻano i ʻike ʻia ʻo atherosclerosis, ʻo ia hoʻi ka hōʻiliʻili ʻana o ka plaque i loko o nā kīʻaha koko, i mea koʻikoʻi, ʻoiai hoʻi i ka poʻe e hōʻike nei i nā hōʻailona.
ʻO nā kūlana nui i mālama ʻia me kēia ʻoki kino:
- ʻO ka maʻi ʻaʻai Peripheral (PAD): ʻO kēia ka wā e hōʻiliʻili ai ka palaki i loko o nā aʻa e lawe ana i ke koko i kou mau wāwae a i ʻole nā lima, e ālai ana iā lākou. Hiki i kēia ke hōʻeha i kou mau wāwae i kou hele ʻana, nā ʻeha i ho'ōla ʻole ʻia, a i nā hihia ʻino loa, ka make ʻana o nā ʻiʻo (gangrene).
- ʻO ka maʻi Carotid Artery: ʻO kēia ka hōʻiliʻili ʻana o ka plaque ma nā aʻa nui ʻelua i loko o ko kākou ʻāʻī e lawe ana i ke koko i ka lolo. Inā e haiki kēia mau aʻa, hiki ke ʻoki ʻia ke kahe koko i ka lolo, e alakaʻi ana i ka hahau ʻana, ka transient ischemic attack (TIA), a i ʻole ka nalowale ʻana o ka ʻike no ka manawa pōkole.
He aha nā ʻano o ke ʻoki ʻana o ka endarterectomy?
Aia kekahi mau ʻano o kēia ʻoki kino ma muli o kahi i hana ʻia ai. I mea e maʻalahi ai iā ʻoe ke hoʻomaopopo, e nānā kākou i kēia ʻano.
| ʻAno o ke ʻoki kino | Wahi wehe ʻana i ke ālai ʻana | Koʻikoʻi |
|---|---|---|
| ʻO ka Endarterectomy Carotid | Ke aʻa e lawe ai i ke koko i ka lolo ma o ka ʻāʻī. | He ʻoki kino i hana pinepine ʻia. Hoʻēmi i ka pilikia o ka maʻi lolo. |
| ʻO ka Endarterectomy Aortic a me Iliac | ʻO nā aʻa nui i loko o ka ʻōpū a me ke pelvis. | He hana ʻoki maʻamau ia. |
| ʻO ka Endarterectomy Femoral | Nā aʻa e holo ana mai ka ʻāpana groin a i nā wāwae. | Hoʻihoʻi i ke kahe koko i nā wāwae. |
| ʻO ka Endarterectomy Coronary | ʻO nā aʻa coronary, e hoʻolako i ke koko i ka puʻuwai. | Hoʻohana pinepine ʻia ke ʻoki ʻana me ka bypass. |
| ʻO ka Endarterectomy Pulmonary | Nā aʻa puʻuwai. | He hana ʻoki kino kākaʻikahi ia e hana ʻia. |
Pehea ʻoe e hoʻomākaukau ai ma mua o ke ʻoki kino?
Ma mua o kou hana ʻana i kēia ʻoki kino, e hana ke kauka i kekahi mau hoʻokolohua e hoʻoholo pono ai i ka nui a me kahi o ka paʻa ʻana o ke kīʻaha koko.
- ʻO Doppler ultrasound: He scan e hoʻohana ana i nā nalu kani e nānā i ke kahe koko a me nā poloka.
- ʻO ka angiography CT: Hoʻohana i nā kukuna X kūikawā a me kahi kala hoʻohālikelike e hana i nā kiʻi ʻekolu-dimensional (3D) o nā kīʻaha koko.
- Angiography: Hoʻokomo pololei ʻia kahi kala i loko o ke aʻa a hoʻohana ʻia nā kukuna X e kiʻi i nā kiʻi o nā kīʻaha koko.
- MRA (Magnetic Resonance Angiography - MRA):Loaʻa nā kiʻi kikoʻī o nā kīʻaha koko me ka hoʻohana ʻana i nā magnet a me nā nalu lekiō.
Ma hope o kēia mau hoʻokolohua, e hāʻawi kāu kauka iā ʻoe i nā kuhikuhi no ke ʻano o ka hoʻomākaukau ʻana no ke ʻoki kino. Hiki ke noi ʻia ʻoe e hoʻōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau, e like me nā mea hoʻokahe koko. Hiki ke noi ʻia ʻoe e hoʻomaka e lawe i kekahi mau lāʻau lapaʻau, e like me ka aspirin. Pono ʻoe e hana i kēia mau mea a pau e like me ka ʻōlelo a kāu kauka iā ʻoe.
Pono nō hoʻi ʻoe e hoʻokē ʻai (ʻaʻole e ʻai a inu paha i kekahi mea) no kekahi mau hola ma mua o ke ʻoki kino. E hāʻawi ka hui anesthesia iā ʻoe i nā ʻōlelo kikoʻī e pili ana i kēia.
Pehea e hana ʻia ai ke ʻoki kino?
E hāʻawi ʻia ʻoe i ka anesthesia e pale aku iā ʻoe mai ka ʻeha ʻana i ka wā o ke ʻoki ʻana. Hāʻawi ʻia ka hapa nui o ka poʻe i ka anesthesia laulā. ʻO ke ʻano kēia e hiamoe ana ʻoe i ka wā o ke ʻoki ʻana. Eia nō naʻe, i kekahi manawa, ʻoiai i loko o kahi ʻoki e like me ka carotid endarterectomy, hiki ke mālama ʻia ʻoe e ala a ʻo ka wahi wale nō i nīnau ʻia e hoʻomānoanoa ʻia (local anesthesia) e maʻalahi ai ka nānā ʻana i ka hana o ka lolo.
Eia kahi wehewehe ʻanuʻu o nā mea e hana ʻia i ka wā o ke ʻoki kino:
1. ʻOki ʻili: Hana ʻia kahi ʻoki liʻiliʻi ma ka ʻili ma luna pono o ke aʻa i paʻa.
2. Ka wehe ʻana i ka plaque: Ua wehe ʻia ke aʻa a ua ʻeli pono ʻia ka papa o ka plaque i waiho ʻia i loko.
3. Ke pani ʻana i ke aʻa: A laila ua humuhumu ʻia ke aʻa. I kekahi manawa, ua humuhumu ʻia kahi ʻāpana liʻiliʻi i kahi e pale ai i ke aʻa mai ka ʻūmiʻi hou ʻana. Hiki ke hana ʻia kēia ʻāpana ma ke ʻano hana a i ʻole he ʻāpana ʻiʻo i lawe ʻia mai kahi aʻa ʻē aʻe i loko o kou kino ponoʻī.
4. Pani ʻili: ʻO ka hope loa, ua pani ʻia ka ʻoki ʻili me nā humuhumu.
ʻO ka maʻamau, hoʻokahi a ʻelua paha hola ka lōʻihi o ka Carotid Endarterectomy. Hiki ke ʻokoʻa ka manawa no nā ʻano ʻoki ʻē aʻe.
He aha nā pōmaikaʻi a me nā pilikia kūpono o ke ʻoki kino?
ʻO ka mea nui loa, inā ʻōlelo ke kauka e hana ʻoe i kēia ʻoki kino, ʻo ia hoʻi, ʻoi aku ka nui o nā pono o ka hana ʻana i ke ʻoki kino ma mua o nā pilikia o ka hana ʻole ʻana i ke ʻoki kino.
Nā pono nui:
- Hoʻopau ʻia ke ālai ʻia a hoʻihoʻi ʻia ke kīʻaha koko i ka maʻamau.
- Ke hoʻi hou ke kahe koko i ka maʻamau, hoʻomaka nā mea e like me ka ʻeha o ka wāwae a me nā ʻeha e ho'ōla ʻole ʻia e ho'ōla.
- Ua hoʻemi nui ʻia ka pilikia o ka hahau ʻana.
- I ka hapanui o nā hihia, mau nā hopena o ke ʻoki ʻana no nā makahiki.
Nā pilikia hiki ke loaʻa:
E like me nā ʻoki kino āpau, aia kekahi mau pilikia liʻiliʻi e pili ana.
- Ke kahe ʻana o ke koko
- Nā pilikia puʻuwai e like me ka hōʻeha puʻuwai
- Nā kūlana maʻi
- Ka pōʻino o ke aʻalolo (pinepine no ka manawa pōkole)
- Ka hoʻololi hou ʻana o ke aʻa ma hope o ke ʻoki ʻana
- Ka maʻi lolo
Akā no ka hapanui o nā kānaka, ua haʻahaʻa loa ka pilikia o nā pilikia koʻikoʻi.
ʻEhia ka lōʻihi e hoʻōla ai ma hope o ke ʻoki kino?
E loli ka lōʻihi o kou noho ʻana ma ka haukapila ma hope o ke ʻoki kino ma muli o ke ʻano o ke ʻoki kino i hana ʻia.
| ʻAno o ke ʻoki kino | Ka lōʻihi awelika o ka noho ʻana ma ka haukapila |
|---|---|
| ʻO ka Endarterectomy Carotid | 1 lā |
| ʻO ka Endarterectomy Femoral | 2-4 lā |
| ʻO ka Endarterectomy Aortic a i ʻole Visceral | Ma kahi o hoʻokahi pule |
| ʻO ka Endarterectomy Pulmonary | Ma kahi o 10 mau lā |
Ma hope o kou hoʻi ʻana i ka home, he mea nui loa ka hoʻomaha a lawe i kāu lāʻau lapaʻau e like me ke kauoha a kāu kauka. E noi ʻia ʻoe e hele mai i ke keʻena lapaʻau no kahi kipa ma hope o 4 mau pule. A laila e nānā ʻia ka ʻoki. Hiki i ka hapa nui o ka poʻe ke hoʻi i ka hana ma hope o kēia kipa keʻena lapaʻau.
Akā inā he kanaka ʻoe e hāpai kaumaha ana, pono ʻoe e hoʻomaha no hoʻokahi a ʻelua paha mahina a hiki i kou ho'ōla piha ʻana. ʻOiai inā ua hana ʻia ʻoe i ke ʻoki ʻōpū, ʻaʻole ia he manaʻo maikaʻi e hāpai ma mua o 5 paona no ʻelua mahina.
Āhea ʻoe e kāhea koke aku ai i ke kauka?
Inā ʻike ʻoe i kekahi o kēia mau hōʻailona ma hope o kāu ʻoki ʻana, e hoʻomaopopo koke i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa.
- ʻEha umauma
- Paʻakikī ka hanu ʻana
- Inā manaʻo ʻoe he kuni a he anu paha
- Inā he pehu, ʻulaʻula, a i ʻole ka wai e like me ka pus e puka mai ana mai ka wahi i ʻoki ʻia
- Inā ʻike ʻoe i ka palupalu a i ʻole ka nawaliwali i loko o kou kino
- Inā ʻike ʻoe i nā loli i ka ʻike, ka ʻōlelo ʻana me ka ʻole o ka ʻike, a i ʻole ke kūlou ʻana ma kekahi ʻaoʻao o kou alo
- Ka luaʻi a i ʻole ka luaʻi
Leka Lawe-Home
- ʻO Endarterectomy kahi hana ʻoki e wehe ai i nā waihona momona (plaque) i loko o nā kīʻaha koko a hoʻihoʻi i ke kahe koko.
- Hiki i kēia ʻoki kino ke hōʻemi nui i ka pilikia o nā maʻi koʻikoʻi e like me ka maʻi lolo.
- ʻOiai he hana ʻoki kino nui kēia, kiʻekiʻe loa nā pono ke hana ʻia ma ka mea maʻi kūpono.
- He mea nui loa e hahai pololei i nā ʻōlelo a kāu kauka, ma mua a ma hope o ke ʻoki ʻana.
- Inā ʻike ʻoe i kekahi mau hōʻailona hōʻailona ma hope o ke ʻoki ʻana, e ʻimi koke i ke kōkua lapaʻau. Inā he mau hopohopo kou e pili ana i kou olakino, mai makaʻu e kūkākūkā me kāu kauka.
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