E aʻo wale kākou e pili ana i ka mālama ʻana iā PCI e wehe ai i ka poloka puʻuwai! (Percutaneous Coronary Intervention - PCI)

Ke manaʻo nei ʻoe i kekahi manawa i kahi ʻeha iki ma kou umauma, ka luaʻi ? A i ʻole he paʻakikī kou hanu ʻana i ka piʻi ʻana i nā alapiʻi? Hiki i kēia ke lilo i mau hōʻailona liʻiliʻi e hōʻike ana ua ālai iki ʻia nā kīʻaha koko (nā aʻa) i loko o ko kākou puʻuwai. ʻOiai he nui ka poʻe e makaʻu nei i ka "hōʻeha puʻuwai", ma muli o ka holomua o ka lāʻau lapaʻau i kēia lā, aia nā ala e wehe ai i kēlā mau ālai me ka ʻole o ke ʻoki kino nui. ʻO ia ke kumu e kamaʻilio nei mākou e pili ana i kahi ʻano lapaʻau koʻikoʻi loa i kēia lā.

He aha ka PCI? I ka ʻōlelo maʻalahi...

ʻO PCI, ʻo ia hoʻi ka Percutaneous Coronary Intervention , he hana lapaʻau maʻalahi ia i hoʻohana ʻia e wehe i nā mea i ālai ʻia i loko o nā aʻa coronary e hoʻolako ana i ke koko i ka puʻuwai. Ua lohe paha ʻoe iā ia he "angioplasty." He inoa kahiko kēlā no ia.

E noʻonoʻo inā paʻa kahi paipu wai i loko o ko mākou hale i ka lepo, a kahe mālie loa ka wai, ʻeā? Pēlā e waiho ʻia ai nā mea e like me ka momona a me ka cholesterol i loko o nā aa o ko mākou puʻuwai, e ālai ana i ke kahe koko. I ka mālama ʻana iā PCI, hoʻokomo ʻia kahi mea liʻiliʻi e like me ka pōpō i loko o ke aa i paʻa, hoʻopiha ʻia, a wehe hou ʻia ke aa.

I ka manawa pinepine, ua kau mau ʻia kahi ʻōmole mesh liʻiliʻi, i kapa ʻia he stent, i loko o ke aʻa e pale aku ai i ka paʻa hou ʻana. ʻO ka nui o nā stent i hoʻohana ʻia i kēia lā he ʻano kūikawā ia e hoʻokuʻu mālie i kahi lāʻau lapaʻau e hōʻemi i ka pilikia o ka paʻa hou ʻana o ke aʻa. Ua kapa ʻia kēia mau mea he drug-eluting stents .

ʻO wai ka mea e pono maoli ai kēia lāʻau lapaʻau?

Inā hōʻiliʻili kahi papa mānoanoa o ka momona a me ka ʻaila i loko o nā kīʻaha koko o kou puʻuwai, kapa mākou ia he atherosclerosis ma ke ʻano lapaʻau. Kapa mākou i kēia papa momona he plaque . Hoʻopaʻa kēia kūlana i ke kahe koko i kou puʻuwai. ʻO ia ka manawa e ʻike ai ʻoe i nā hōʻailona e like me:

• ʻEha a ʻeha paha ka umauma (angina)
• Paʻakikī ka hanu ʻana

Pehea e hana ʻia ai ka mālama ʻana iā PCI? E nānā kākou i kēlā me kēia ʻanuʻu

Hana ʻia kēia lāʻau lapaʻau e kahi kauka cardiologist interventional. E hāʻawi ʻia ʻoe i ka lāʻau lapaʻau e hoʻohiamoe a mālie iā ʻoe i kēia manawa. No laila, ʻaʻole ʻoe e ʻeha, akā e ʻike ʻoe. E wehewehe mākou pehea e hana ai kēia kaʻina hana.

Hiki i kēia kaʻina hana holoʻokoʻa ke hala ma waena o 30 mau minuke a me ʻelua hola, ma muli o ka nui o ke ālai ʻana i kou mau aa koko.

Hiki i nā kānaka a pau ke loaʻa kēia lāʻau lapaʻau?

ʻAʻole. Pono ʻoe a me kāu kauka e hoʻoholo pū i ka lāʻau lapaʻau kūpono loa iā ʻoe. Inā pono ʻoe i ka PCI, ka lāʻau lapaʻau wale nō, a i ʻole ke ʻoki kino nui (Coronary Artery Bypass Graft - CABG) e hilinaʻi ʻia i kekahi mau kumu. No ka laʻana, ka helu o nā aʻa i ālai ʻia, pehea ka maikaʻi o ka hana ʻana o kou puʻuwai, a inā he mau maʻi ʻē aʻe kāu.

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

E like me nā lāʻau lapaʻau āpau, loaʻa i kēia kekahi nā pōmaikaʻi a me nā pōʻino liʻiliʻi.

ʻO nā pono nui:

• Hoʻihoʻi ʻia ke kahe koko i ka puʻuwai.
• Nalo aku nā hōʻailona e like me ka ʻeha o ka umauma a me ka pōkole o ka hanu.
• ʻOi aku ka maʻalahi ma mua o ke ʻoki bypass a me ka manawa hoʻōla pōkole.

Nā pilikia hiki ke loaʻa:

• Ke kahe koko a i ʻole ka maʻi ma kahi i hoʻokomo ʻia ai ka catheter.
• Hoʻokumu ʻia kahi ʻūpā koko i loko o ka stent (hāʻawi ʻia nā lāʻau hoʻokahe koko e pale aku i kēia).
• Ke ālai hou ʻia nei ke aʻa koko like (akā ʻoi aku ka liʻiliʻi o kēia pilikia ma mua o 5% ma muli o ka stent drug-eluting).
• He mea kākaʻikahi loa ka loaʻa ʻana o ka hahau ʻana.

Hiki iā ʻoe ke hoʻi hou i nā hana maʻamau i loko o hoʻokahi pule ma hope o ka PCI. Eia nō naʻe, pono paha ʻoe e hoʻōki i ka hana ʻana i nā mea e like me ka hāpai kaumaha no kekahi manawa. ʻO ka mea nui loa, ʻo ia ka lawe ʻana i nā lāʻau hoʻokahe koko (e.g., clopidogrel, ticagrelor) a kāu kauka i kuhikuhi ai no ka lōʻihi o ka lāʻau, me ka ʻole o ka hala ʻana o hoʻokahi lā.

E makaʻala i kēia mau hōʻailona! E ʻike koke i ke kauka!

Inā ʻike ʻoe i kekahi o nā hōʻailona ma hope o ka mālama ʻana iā PCI, e kāhea koke aku i kāu kauka a i ʻole e hele i ka Emergency Department (ETU) kokoke loa.

• Ke kahe koko, ka wai e like me ka pus, a i ʻole ka pehu ʻana mai kahi i hoʻokomo ʻia ai ke catheter.
• Hoʻi hou mai ka ʻeha o ka umauma (angina) .
• Kuni a i ʻole ke anu.
• Ka maneʻo a i ʻole ke anu loa ma ka lima a i ʻole ka wāwae kahi i hoʻokomo ʻia ai ke catheter.
• Ka poniuniu a i ʻole ka nāwaliwali (syncope) .
• Paʻakikī nui ka hanu ʻana.