He aha ka endarterectomy? E kamaʻilio kākou e pili ana i ia mea!

Ua manaʻo paha ʻoe ua like nā kīʻaha koko i loko o ko kākou kino me nā paipu wai i loko o kahi hale? E like me ka hala ʻana o ka manawa, e hōʻiliʻili ana ka lepo a me ka ʻōpala i loko o nā paipu wai a ālai i ke kahe ʻana o ka wai, hiki i nā mea e like me ka ʻaila a me ka momona ke hōʻiliʻili i loko o ko kākou mau kīʻaha koko a ālai i ke kahe ʻana o ke koko. ʻO ia ka mea a mākou e kapa nei ʻo 'Endarterectomy', he hana ʻoki kino e hoʻomaʻemaʻe i kēlā kīʻaha koko i ālai ʻia. I kēia lā, e kamaʻilio mākou e pili ana i kēia ma nā ʻōlelo maʻalahi.

I ka ʻōlelo maʻalahi, he aha ka endarterectomy?

ʻO ka Endarterectomy (puana ʻia: en-da-te-rek-to-me) he hana ʻoki kino e wehe hou ai i nā aʻa i paʻa a i ʻole i haiki. Ma kēia kaʻina hana, wehe nā kauka i ka plaque , kahi papa mānoanoa o ka momona, ka calcium, a me ka plaque i kūkulu ʻia i loko o kou mau aʻa.

E like me ka hoʻomaʻemaʻe ʻana i ka lepo i loko o kahi paipu wai a me ka ʻae ʻana i ka wai e kahe mālie hou, ma hope o kēia ʻoki kino, hoʻihoʻi ʻia ke kahe koko i loko o nā kīʻaha koko. Hoʻemi nui kēia i ka pilikia o nā kūlana weliweli e like me nā ʻōpū koko a me ka hahau ʻana .

Hana pinepine ʻia kēia ʻoki kino ma ke ʻano he lāʻau lapaʻau no kahi maʻi i kapa ʻia ʻo atherosclerosis. ʻO kēia ka wā e hōʻiliʻili ai ka plaque i loko o nā kīʻaha koko, e hoʻopaʻakikī mālie ai a ololi. Manaʻo pinepine ʻia kēia ʻoki kino no nā hihia hōʻailona, ​​​​​​nā hihia koʻikoʻi o nā aʻa i paʻa.

ʻElua mau kūlana nui i mālama ʻia me kēia ʻoki kino:

• ʻO ka maʻi ʻaʻai Peripheral (PAD): He hōʻiliʻili ʻana kēia o ka palaki i loko o nā aʻa e hoʻolako ana i ke koko i kou mau wāwae a i ʻole nā ​​​​lima. Hiki i kēia ke hōʻeha i kou mau wāwae i kou hele ʻana, nā ʻeha e ho'ōla lohi, a i kekahi manawa make nā ʻiʻo (gangrene).
• ʻO ka maʻi Carotid Artery: He maʻi koʻikoʻi kēia. Hoʻokumu ʻia ia e ka hōʻiliʻili ʻana o ka plaque ma nā aʻa nui ʻelua ma ka ʻāʻī e lawe ana i ke koko i ka lolo. Inā ʻaʻole mālama ʻia, hiki iā ia ke alakaʻi i ka hahau ʻana a i ʻole ka transient ischemic attack (TIA).

He aha nā ʻano o ke ʻoki ʻana o ka endarterectomy?

ʻOkoʻa ke ʻano o ke ʻoki kino ma muli o kahi o kou kino i ālai ʻia ai ke kīʻaha koko. E nānā i ka papa ma lalo nei e maʻalahi ai kēia iā ʻoe.

Pehea e hoʻomākaukau ai ma mua o ke ʻoki kino?

Ma mua o kēia ʻoki kino, e hana ke kauka i kekahi mau hoʻokolohua e ʻike pono ai i ke ʻano o ka paʻa ʻana o kou kīʻaha koko.

• Doppler Ultrasound: Hoʻohana kēia i nā nalu kani e ʻike i kahi i ālai ʻia ai nā kīʻaha koko a me ka nui o ke koko e kahe ana.
• CT Angiography: Ma kēia, ua hoʻokomo ʻia kahi wai kūikawā (contrast dye) i loko o kahi aa koko i kou lima, a hoʻohana ʻia kahi CT scan e lawe i kahi kiʻi ʻekolu-dimensional (3D) o kou mau kīʻaha koko.
• Angiography: Ma kēia kaʻina hana, hoʻokomo pololei ʻia kahi wai kūikawā i loko o ke kīʻaha koko a lawe ʻia nā kiʻi X-ray.
• Magnetic Resonance Angiography (MRA): Hoʻohana i nā magnet a me nā nalu lekiō e kiʻi i nā kiʻi o nā kīʻaha koko.

Eia kekahi, e hāʻawi kāu kauka iā ʻoe i nā ʻōlelo aʻoaʻo no ka hoʻomākaukau ʻana no ke ʻoki ʻana. Hiki ke noi ʻia ʻoe e hoʻōki i ka lawe ʻana i kekahi mau lāʻau lapaʻau, e like me nā mea hoʻokahe koko (anticoagulants). I kekahi manawa, hiki ke noi ʻia ʻoe e hoʻomaka e lawe i nā lāʻau lapaʻau e like me ka aspirin.

Pono nō hoʻi ʻoe e hoʻokē ʻai no kekahi mau hola ma mua o ke ʻoki kino. E haʻi pololei aku ka hui anesthesiology iā ʻoe i ka mea e hana ai. Hiki paha iā ʻoe ke loaʻa nā hoʻokolohua e like me ka `Echocardiogram` a i ʻole `Stress Test` e nānā i ke olakino o kou puʻuwai.

ʻO wai ka mea hiki ʻole ke hana i kēia ʻoki kino?

ʻOi aku ka nui o ka pilikia o kekahi poʻe me kekahi mau kūlana olakino no kēia ʻoki kino, no laila ʻaʻole ʻōlelo nā kauka iā ia no lākou. Eia kekahi laʻana:

• Inā he maʻi puʻuwai koʻikoʻi kou i hiki ʻole ke kaohi ʻia (congestive heart failure).
• Inā ua loaʻa iā ʻoe kahi hāʻule puʻuwai i hala koke nei.
• Inā he mau hōʻailona kou o ka maʻi puʻuwai hiki ʻole ke mālama ʻia.
• Inā loaʻa iā ʻoe nā maʻi māmā koʻikoʻi e like me ka emphysema a i ʻole COPD.
• Inā ua loaʻa mua iā ʻoe ka lāʻau radiation i ka wahi e hana ʻia ai ke ʻoki ʻana.
• Inā he maʻi ma ia wahi.

Pehea e hana ʻia ai ke ʻoki kino?

E hāʻawi ʻia ʻoe i ka anesthesia i ʻole ʻoe e ʻeha i ka wā o ke ʻoki ʻana. ʻO ka hapa nui, e hāʻawi ʻia ʻoe i ka anesthesia laulā. ʻO ke ʻano kēia e nalowale ana kou ʻike. Eia nō naʻe, i kekahi mau hihia, ʻoiai i ka hoʻomaʻemaʻe ʻana i nā aʻa i kou ʻāʻī (carotid endarterectomy), hiki ke mālama ʻia ʻoe a make wale nō ma ia wahi (local anesthesia) i ka wā o ke ʻoki ʻana no ka mea he mea pono e nānā i ka hana o kou lolo.

I ka wā o ke ʻoki kino, ke kauka:

1. Hana ʻia kahi ʻoki ma ka ʻoki ʻana i ka ʻili ma luna o ke kīʻaha koko i ālai ʻia.

2. Ua wehe ʻia ke kīʻaha koko a ua wehe pono ʻia ka papa o ka `plaque` i loko.

3. Hoʻopili hou ʻia ke kīʻaha koko a pani ʻia. I kekahi manawa, i mea e pale ai i ka ʻūmiʻi hou ʻana o ka wahi, hoʻohana ʻia kahi ʻāpana hana (patch) a i ʻole kahi ʻāpana o ke aʻa koko olakino i lawe ʻia mai kahi ʻāpana ʻē aʻe o kou kino ponoʻī e hoʻonui iki i ka wahi.

4. ʻO ka hope loa, ua pani ʻia ka ʻoki ʻili a ua humuhumu ʻia.

Nā pono, nā pilikia, a me ka manawa ho'ōla

ʻO ka pōmaikaʻi nui o kēia ʻoki kino, ʻo ia ka wehe ʻana i ke kīʻaha koko i paʻa a hoʻihoʻi i ke kahe koko. Hoʻemi nui kēia i ka ʻeha o ka wāwae, nā ʻeha i hoʻōla ʻole ʻia, a ʻoi aku hoʻi ka pilikia o ka hahau ʻana. ʻO ka hopena o kēia ʻoki kino e mau ana no nā makahiki.

E like me nā hana ʻoki kino āpau, aia kekahi mau pilikia e pili ana, akā haʻahaʻa ka likelika o kēia mau mea.

• Ke kahe ʻana o ke koko
• ʻO ka maʻi puʻuwai, e like me ka hōʻeha puʻuwai
• Nā maʻi
• Ka pōʻino o ke aʻalolo (pinepine no ka manawa pōkole)
• Ka hoʻohaiki ʻana o ke aʻa like i hana ʻia ke ʻoki kino
• `Haʻihaʻi`

ʻEhia ka lōʻihi e ho'ōla ai?

ʻO ka lōʻihi o kou noho ʻana ma ka haukapila e pili ana i ke ʻano o ke ʻoki kino e hana ʻia.

• ʻO ke ʻoki ʻana o ka carotid (ʻāʻī): ma kahi o hoʻokahi lā.
• No ke ʻoki ʻana i nā aʻa femoral (wāwae): Ma kahi o ʻelua a ʻehā lā.
• ʻO ke ʻoki kino aortic (ʻōpū): ma kahi o hoʻokahi pule.

E noi ʻia ʻoe e hele mai no kahi nānā ʻana ma kahi o ʻehā pule ma hope o ke ʻoki ʻana. Hiki i ka hapa nui o ka poʻe ke hoʻi i ka hana ma hope o kēia nānā ʻana. Eia nō naʻe, inā he hana kāu e pono ai ka hāpai kaumaha, hiki ke hala i hoʻokahi a ʻelua paha mahina no kou hoʻōla piha ʻana.

I ka manawa hea e pono ai iaʻu ke kāhea aku i ke kauka?

Inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei ma hope o kāu ʻoki ʻana, pono ʻoe e kāhea koke i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) o ka haukapila kokoke loa iā ʻoe.

• ʻEha umauma
• Paʻakikī ka hanu ʻana
• Inā manaʻo ʻoe he kuni a he anu paha
• Inā manaʻo ʻoe i ka palupalu a i ʻole ka nāwaliwali ma kahi i ʻoki ʻia
• Inā he pehu, ʻulaʻula, a i ʻole ka wai e like me ka pus a puni ka ʻoki
• Nā loli i ka ʻike, ka ʻōlelo ʻole, a i ʻole ke kūlou ʻana o kekahi ʻaoʻao o ka maka
• Inā loaʻa ka nausea a i ʻole ka luaʻi ʻana