He haʻahaʻa anei kou mau platelets i loko o kou koko? E kamaʻilio kākou e pili ana i kēia (Thrombocytopenia)!

Pehea ʻoe? I kēia lā, e kamaʻilio mākou e pili ana i kahi maʻi e kani iki paha he koʻikoʻi, akā inā maopopo pono, hiki ke kāohi ʻia i kahi nui. ʻO ia ka emi ʻana o nā platelets i loko o ke koko, kahi kūlana i kapa ʻia ʻo (Thrombocytopenia) ma nā huaʻōlelo lapaʻau. Ua lohe paha ʻoe i kēia huaʻōlelo mai ke kauka mai, a ua ʻike paha ʻoe iā ia ma kahi hōʻike koko. Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

ʻO ka mea mua, e nānā kākou i ke ʻano o kēia mau platelets koko a no ke aha lākou i mea nui ai iā kākou?

E noʻonoʻo i kēia ʻano: ʻo nā platelets nā ʻano liʻiliʻi e like me ke koa e holo ana ma o ko mākou mau kīʻaha koko. I ka pololei, he ʻano lākou o kahi cell liʻiliʻi loa, ʻaʻohe kala. E like me nā cell ʻē aʻe i loko o ko mākou koko, hana ʻia nā platelets i loko o nā ʻiʻo palupalu i loko o ko mākou mau iwi i kapa ʻia ʻo ka iwi iwi.

I kēia manawa ke nīnau nei ʻoe, no ke aha lā mākou e pono ai i kēia mau koa liʻiliʻi? Eia ka mea nui: Ke ʻeha mākou i kekahi wahi a hoʻomaka ke kahe ʻana o ke koko, e like me ka wā e hele ana mākou i ke kaua, ʻo kēia mau platelets ka mea mua e holo wikiwiki i laila a hui pū e hana i kahi ʻūpā koko (`(clot)`) e hoʻōki i ke kahe ʻana o ke koko. Ua like ia me ka wā e kau ai ʻoe i kahi sima i loko o kahi lua i loko o ka paia. No laila, me ka ʻole o nā platelets, ʻoiai he ʻeha liʻiliʻi ʻaʻole hiki ke hoʻōki i ke kahe ʻana o ke koko. Maopopo iā ʻoe ke koʻikoʻi o ia mea?

No laila, he aha kēia helu platelet haʻahaʻa, a i ʻole thrombocytopenia?

I ka ʻōlelo maʻalahi, ʻo ka thrombocytopenia ka wā e emi ai ka nui o nā platelets ma kou koko ma mua o ka helu maʻamau o ke koko. ʻO ka maʻamau, aia ma waena o 1.5 a me 4.5 miliona mau platelets i kēlā me kēia microliter o ke koko o ke kanaka olakino. Ke hāʻule kēia helu ma lalo o kēia, kapa mākou ia he thrombocytopenia.

Akā eia ka mea: ʻaʻole ia he mea nui ka emi iki ʻana o nā platelets. Aia ia i kona haʻahaʻa, ke kumu i emi ai, a me ka wikiwiki o kona emi ʻana. No laila he mea nui e ʻimi i ka ʻōlelo aʻo a ke kauka.

No ke aha i haʻahaʻa ai ko mākou helu platelet? He aha nā kumu?

Nui nā kumu no ke kiʻekiʻe o nā platelet koko. E hoʻokaʻawale kākou iā lākou i ʻekolu mau ʻano nui.

1. Inā emi ka hana ʻana o nā platelets koko e ka iwi iwi:

Ua kamaʻilio mua mākou e pili ana i ke ʻano o ka hana ʻana o nā platelets i loko o ka iwi iwi. No laila, inā he pilikia me kēia iwi iwi a emi iho ka hana ʻana o nā platelets, emi iho ka helu o nā platelets i loko o ke koko. Aia kekahi mau kumu kūpono no kēia:

• ʻO kekahi mau maʻi viral: No ka laʻana, ʻo nā maʻi e like me ka dengue fever, hepatitis C, a me HIV hiki ke hana i ka hāʻule ʻana o ka iwi iwi.
• ʻO kekahi mau lāʻau lapaʻau: ʻO nā lāʻau lapaʻau i hoʻohana ʻia e mālama i ka maʻi kanesa (Chemotherapy), kekahi mau antibiotics, a me nā diuretics hiki ke hoʻopilikia i ka iwi iwi.
• Ka inu nui ʻana i ka waiʻona: Hiki i kēia ke hōʻino i ka iwi iwi.
• Nā hemahema o ka wikamina: Inā ʻaʻole lawa ka wikamina B12 (`(Vitamin B12)`) a i ʻole ka folate (`(Folate)`) i ke kino, e emi paha ka hana ʻana o nā platelets koko.
• Nā maʻi ʻaʻai koko: Hiki i nā maʻi ʻaʻai koko e like me ka leukemia ke hoʻōki i ka iwi iwi i ka hana ʻana i nā pūnaewele maʻamau.
• Anemia Aplastic: ʻO kēia ka manawa ʻaʻole hana pono ka iwi iwi i nā hunaola koko.
• Nā Syndromes Myelodysplastic: He ʻano kēia kahi e hana pono ʻole ai ka iwi iwi.
• Nā kūlana genetic laha ʻole: I kekahi manawa, hiki ke hana ʻia ka hana platelet haʻahaʻa e nā kumu genetic i loaʻa i ka wā hānau.

2. Inā luku koke ʻia nā platelets i hana ʻia a i ʻole inā hoʻohana nui ʻia i loko o ke kino:

I kekahi manawa, ʻoiai inā hana ka iwi iwi i nā platelets lawa, inā e luku koke ʻia lākou i loko o ke kino, a inā paha e hoʻohana nui ʻia lākou ma muli o ke kahe koko nui, hiki ke emi ka helu o nā platelet.

• ITP (Immune Thrombocytopenic Purpura): ʻO kēia ka manawa e hoʻouka hewa ai kā mākou ʻōnaehana pale a luku i kā mākou mau platelets koko ponoʻī. Hiki ke hana kēia i nā keiki ʻōpio ma hope o ke kuni viral, akā hiki nō hoʻi ke hana i nā pākeke.
• Hiki i kēia ke hana i nā maʻi autoimmune ʻē aʻe, e like me ka lupus a me ka rheumatoid arthritis.
• Kekahi mau lāʻau lapaʻau: Hiki i kekahi mau lāʻau lapaʻau ke hoʻopau i ka ʻōnaehana pale i nā platelets koko, ʻoiai he hopena aleri.
• Nā maʻi koʻikoʻi (sepsis): I nā maʻi koʻikoʻi, hiki ke loaʻa nā kūlana e like me DIC (Disseminated Intravascular Coagulation), e hoʻopau koke ai i nā platelets koko.
• ʻO TTP (Thrombotic Thrombocytopenic Purpura) (`(Thrombotic Thrombocytopenic Purpura)`) a me HUS (Hemolytic Uremic Syndrome) (`(Hemolytic Uremic Syndrome)`): He mau kūlana kakaikahi kēia akā weliweli. I kēia kūlana, hana ʻia nā ʻōpū koko liʻiliʻi i loko o nā kīʻaha koko a hoʻohana ʻia nā platelets.

3. Inā e hoʻonui ʻia ka spleen a hōʻiliʻili nā platelets ma laila:

ʻO ka spleen kahi ʻōkana i loaʻa ma ka ʻaoʻao hema o luna o ko kākou ʻōpū. Hoʻokāna ia i ke koko a wehe i nā hunaola koko kahiko. Inā hoʻonui ʻia ka spleen ma muli o kekahi mau maʻi (e laʻa me ka maʻi akepaʻa - cirrhosis, kekahi mau maʻi, ke kanesa koko), hiki iā ia ke hōʻiliʻili i nā platelets ma mua o ka maʻamau, e hoʻemi ana i ka helu o nā platelets i loko o ke koko.

He aha nā hōʻailona e hiki mai ana ke emi iho ka nui o nā platelets koko?

Hiki ke ʻokoʻa nā hōʻailona o nā platelets haʻahaʻa mai kēlā kanaka a kēia kanaka. Aia nō hoʻi ia i ka haʻahaʻa o kāu mau platelets a me ka wikiwiki o ko lākou hāʻule ʻana. I kekahi manawa, ʻaʻole paha e loaʻa i ka poʻe me ka helu platelet haʻahaʻa kekahi mau hōʻailona. Eia nō naʻe, eia kekahi o nā hōʻailona maʻamau:

• Nā Palapū: He mau kiko nui, polū a poni paha nā palapū ma ka ʻili. ʻOiai he puʻupuʻu liʻiliʻi ma kekahi wahi hiki ke hana i kahi palapū nui.
• Nā kiko ʻulaʻula liʻiliʻi ma ka ʻili:I kekahi manawa, ʻike ʻia nā kiko liʻiliʻi ʻulaʻula a poni paha (`(petechiae)`) ma ke kino holoʻokoʻa, e like me nā ʻanuʻu liʻiliʻi, ma nā wāwae a me nā lima. ʻAʻole nalowale kēia mau mea ke nānā ʻoe iā lākou.
• He lōʻihi ka manawa e oki ai ke kahe ʻana o ke koko ma hope o kahi ʻeha.
• Nā ʻāʻī koko, kahe pinepine ke koko ihu.
• Ke kahe ʻana o ke koko i loko o ka mimi a i ʻole ka ʻōpala (hiki ke ʻulaʻula ka mimi, ʻeleʻele a koko paha ka ʻōpala).
• No nā wahine, ʻoi aku ke kaumaha o ka wā menstrual a ʻoi aku ka lōʻihi o nā lā ma mua o ka maʻamau.
• Manaʻo luhi, luhi.
• I kekahi manawa, inā pili ia i ka pilikia o ke akepaʻa, e melemele paha nā maka (jaundice).

Mea nui: Inā ʻike ʻoe i nā hōʻailona e like me ke poʻo ʻeha, ka manaʻo palupalu, a i ʻole ka paʻakikī i ka ʻōlelo ʻana, pono ʻoe e hele koke i ka haukapila, no ka mea, he hōʻailona paha kēia o ke kahe ʻana o ke koko i loko o ka lolo!

Inā loaʻa iā mākou nā hōʻailona e like me kēia, he aha kā mākou e hana ai? Pono anei mākou e ʻike i ke kauka?

ʻAe, ʻoiaʻiʻo nō! Inā he kahe koko ʻē kou, nā kiko koko ma kou ʻili, a i ʻole ka luhi nui, mai hoʻowahāwahā a ʻike i ke kauka. Mai hopohopo, akā, mai hoʻokaʻulua. E nīnau ke kauka iā ʻoe, e nānā iā ʻoe, a e kuhikuhi iā ʻoe no nā hoʻokolohua inā pono.

Pehea e ʻike ai ke kauka i kēia? He aha ke ʻano o nā hoʻokolohua a lākou e hana ai?

Ke ʻike ʻoe i ke kauka, e nīnau mua lākou e pili ana i kāu mau hōʻailona, ​​​​nā lāʻau lapaʻau āu e lawe nei, a inā paha ua loaʻa i kekahi o kou ʻohana nā pilikia like. A laila e nānā lākou iā ʻoe a nānā i ke kahe ʻana o ke koko, ka hoʻololi ʻana o ka ʻili, a me ka spleen i hoʻonui ʻia.

Eia kekahi, hiki ke hana i nā hoʻokolohua e like me:

• Helu Koko Piha (FBC) : ʻO kēia ka hoʻāʻo nui e hoʻoholo ai i ka helu pololei o nā platelets i loko o ke koko. Hāʻawi pū ia i ka ʻike e pili ana i nā hunaola koko ʻulaʻula a me nā hunaola koko keʻokeʻo.
• ʻO ka Smear Koko Peripheral : Pili kēia i ka lawe ʻana i kahi hāpana koko a nānā i ke ʻano a me ka nui o nā platelets ma lalo o kahi microscope. I kekahi manawa, nānā pū lākou e ʻike inā ua paʻa pū nā platelets a i ʻole he mau cell ʻē.
• Nā hoʻāʻo koko ʻē aʻe: Aia kekahi mau hoʻāʻo ʻē aʻe e hiki ke kōkua i ka loaʻa ʻana o ke kumu. No ka laʻana, nā hoʻāʻo e nānā i ka hana o ke ake (nā hoʻāʻo hana o ke ake), nā hoʻāʻo hana o nā puʻupaʻa, nā hoʻāʻo e nānā i nā maʻi viral, a me nā hoʻāʻo e nānā i nā māka autoimmune.
• ʻO ka ʻume ʻana o ka iwi iwi a me ka Biopsy : I kekahi manawa, inā ʻaʻole hōʻike wale nā ​​​​hoʻokolohua koko i ke kumu, hana ʻia kēia hoʻokolohua e ʻike inā hana pono ka iwi iwi i nā platelets. Pili kēia i ka lawe ʻana i kahi liʻiliʻi o ka iwi iwi mai kahi wahi liʻiliʻi, e like me ka ʻūhā, ma lalo o ka anesthesia.

He aha nā lāʻau lapaʻau no nā platelets koko haʻahaʻa?

He pilikia kēia i loaʻa i nā poʻe he nui. ʻO ka mālama ʻana no nā platelets haʻahaʻa e hilinaʻi wale ʻia ma ke kumu o ia mea a me ke koʻikoʻi o ke kūlana. ʻAʻohe hopena hoʻokahi e kūpono i nā mea āpau.

• No ka poʻe me ka helu platelet haʻahaʻa iki: Inā ʻaʻole haʻahaʻa loa ka helu platelet a ʻaʻohe hōʻailona o ke kahe ʻana o ke koko, i kekahi manawa ʻaʻole pono ka lāʻau lapaʻau, nānā wale ʻia me nā hoʻāʻo koko maʻamau.
• Ke mālama nei i ke kumu kumu:
• Inā ua hoʻohaʻahaʻa kahi lāʻau lapaʻau i kāu helu platelet, e haʻi aku kāu kauka iā ʻoe e hoʻōki i ka lawe ʻana i ka lāʻau lapaʻau a hoʻololi paha iā ʻoe i kahi lāʻau lapaʻau ʻē aʻe. Manaʻo ʻoe he mea maikaʻi ke hoʻōki ʻole i ka lawe ʻana i ka lāʻau lapaʻau?
• Inā ma muli o kahi maʻi, e mālama ʻia kēlā maʻi.
• Inā he maʻi autoimmune, ua mālama ʻia.
• Nā lāʻau lapaʻau no nā platelet koko haʻahaʻa:
• ʻO Corticosteroids : No ka laʻana, nā lāʻau lapaʻau e like me prednisolone. Hāʻawi ʻia kēia mau mea e hoʻōki i ka ʻōnaehana pale mai ka luku ʻana i nā platelets koko (ma nā kūlana e like me ITP).
• Intravenous Immunoglobulin (IVIG): He lāʻau lapaʻau e like me ka saline kēia i hāʻawi ʻia i loko o kahi aa. Hoʻohana ʻia ia e hoʻonui koke i ka helu platelet i nā hihia koʻikoʻi kahi e luku ai ka ʻōnaehana pale i nā platelet koko.
• Nā lāʻau lapaʻau ʻē aʻe e hoʻomalu ana i ka ʻōnaehana pale (immunosuppressants): Hāʻawi ʻia kēia mau mea inā ʻaʻole hana nā steroids a inā ʻoi aku ka koʻikoʻi o nā hopena ʻaoʻao.
• ʻO nā agonists receptor Thrombopoietin (TPO-RAs): Hoʻoulu kēia mau lāʻau i ka iwi iwi e hana i nā platelets hou aʻe.
• Hoʻoili ʻana o ka Platelet: Inā nui kou kahe ʻana o ke koko a inā haʻahaʻa loa kou helu platelet a haʻahaʻa loa (e.g. ma mua o ke ʻoki ʻana), hiki ke hāʻawi ʻia nā platelets iā ʻoe ma waho. Eia nō naʻe, he hopena manawa pōkole wale nō kēia.
• Splenectomy: Inā ʻike ʻia ka spleen ke kuleana no ka luku ʻana i nā platelet, a ʻaʻole pono nā lāʻau ʻē aʻe (ʻoi aku hoʻi i ka ITP lōʻihi), hiki ke hana ʻia ke ʻoki ʻana e wehe i ka spleen. Eia nō naʻe, ʻo ka wehe ʻana i ka spleen e hoʻonui i ka pilikia o ka maʻi.
• Hoʻololi Plasma (a i ʻole Plasmapheresis): Hoʻohana ʻia kēia lāʻau lapaʻau i nā kūlana kūikawā e like me TTP.

He aha kā mākou e hopohopo ai i ka wā e ola nei me kēia maʻi?

Pono ka poʻe me nā platelets koko haʻahaʻa e akahele iki i ko lākou ola o kēlā me kēia lā.

• E pale i nā hana e hiki ai ke hāʻule a me nā ʻeha. Eia kekahi laʻana, ʻaʻole kūpono nā haʻuki pili.
• E akahele loa i ka hoʻohana ʻana i nā mea ʻoi a i ʻole ka ʻoki ʻana i nā mea kanu.
• E hoʻohana i kahi palaki niho palupalu i ka wā e palaki ai i kou mau niho. E makaʻala i ʻole e hōʻeha i kou mau ʻāʻī.
• ʻO ka lawe ʻana i nā lāʻau hoʻokahe koko e like me ka aspirin, NSAID (e like me ka ibuprofen) me ka ʻole o ke aʻo ʻana a ke kaukaMai hoʻohana i kēia mau mea. Hiki i kēia ke hoʻonui i ke kahe ʻana o ke koko. E haʻi i kēlā me kēia kauka a me nā kauka niho āu e ʻike ai he haʻahaʻa kou mau platelets.
• E makaʻala i nā hōʻailona o ke kahe ʻana o ke koko (nā kiko ʻili, ke kahe ʻana o ka ihu, nā ʻāʻī koko). E haʻi i kāu kauka inā ʻike ʻoe i kekahi mau hōʻailona hou.
• E ʻai i ka meaʻai kaulike. Inā ʻaʻole haʻahaʻa kou helu platelet ma muli o ka nele o ka wikamina, ʻaʻole hiki i ka ʻai wale nō ke ho'ōla iā ia. Eia nō naʻe, he mea nui e loaʻa ka meaʻai e pono ai kou kino.
• E hōʻemi a hoʻōki loa paha i ka inu ʻana i ka waiʻona .

Hiki paha kēia ke lilo i mea koʻikoʻi? He aha nā pilikia?

ʻAe, hiki i kēia ke lilo i kūlana koʻikoʻi inā hāʻule nui a koke paha ka helu platelet.

ʻO ke kumu nui o ka pilikia, ʻo ia ke kahe koko nui. Hiki ke ʻike ʻia kēia (mai kahi ʻeha, ihu) a i ʻole mai loko mai (e.g., ma ka lolo, ʻōpū, naʻau). Hiki i ke kahe koko ʻana i loko ke hoʻoweliweli i ke ola.

No laila he mea nui e lawe i ka lāʻau lapaʻau e like me ka ʻōlelo a ke kauka a e makaʻala hoʻi.

Hōʻuluʻulu manaʻo a me nā huaʻōlelo hope loa

ʻAe, no laila ke lana nei koʻu manaʻo ua ʻike maikaʻi ʻoe i ka mea a mākou i kamaʻilio ai i kēia lā (Thrombocytopenia) a i ʻole nā ​​platelets koko haʻahaʻa. E hoʻomanaʻo, ʻo ia hoʻi, ua haʻahaʻa nā platelets i loko o ke koko ma mua o ka maʻamau. Nui nā kumu, a ʻokoʻa nā hōʻailona no kēlā me kēia kanaka.

ʻO ka mea nui loa, inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​ma kahi o ka hoʻoholo ʻana i kāu iho, a i ʻole e ʻimi i nā lāʻau lapaʻau ma ka pūnaewele, e ʻimi i ke kauka maikaʻi, e ʻimi i ke kumu pololei, a loaʻa i ka lāʻau kūpono no ia.

Mai hopohopo, i ka hapa nui o ka manawa, me ka mālama pono ʻana a me ka hoʻokele ʻana, hiki iā ʻoe ke kāohi i kēia kūlana a ola i kahi ola maikaʻi. E wehe a ʻoiaʻiʻo me kāu kauka e pili ana i nā mea āpau, a e nīnau i nā nīnau āu e loaʻa ai. E kōkua kēia iā ʻoe e hoʻomaopopo maikaʻi i kēia a kōkua iā ʻoe e hoʻomanawanui maikaʻi.

ʻO ka thrombocytopenia, ka helu platelet, nā platelets, ka iwi iwi, ke kahe ʻana o ke koko, ka ʻeha, ITP, nā maʻi koko, ʻatikala lapaʻau Sinhala, petechiae