Ua lohe paha ʻoe i kekahi e loaʻa koke ana i kahi wāwae pehu a ʻeha a ua haʻi ʻia e ke kauka he ʻūpā koko ko lākou ma ko lākou wāwae? A i ʻole he kanaka ʻōpio olakino e paʻakikī koke ana i ka hanu ʻana a me ka ʻeha o ka umauma a ua hoʻokomo ʻia i ka haukapila? Ke lohe mākou i nā mea e like me kēia, e noʻonoʻo paha mākou i ka mea e hana nei. ʻO ka hapa nui o ka manawa, ʻike mākou i nā mea e like me ka ʻelemakule a me ka momona ke kumu o kēia. Eia nō naʻe, i kekahi manawa hiki i ke kumu ke lilo i mea e like me ke kala o ko mākou mau maka, ke ʻano o ko mākou lauoho, a i ʻole kahi gene a mākou e hoʻoilina ai mai ko mākou mau mākua. I kēia lā e kamaʻilio mākou e pili ana i kēlā ʻano genetic e hoʻonui ai i ka pilikia o nā ʻūpā koko. Ua kapa ʻia kēia ʻo
Prothrombin Gene Mutation .
I ka ʻōlelo maʻalahi, he aha kēia Prothrombin Gene Mutation?
He inoa ʻepekema paha kēia, akā he maʻalahi loa ka moʻolelo. E nānā mua kākou i ke ʻano o ke kāpili ʻana o ke koko i loko o ko kākou kino. Ke loaʻa iā ʻoe kahi ʻeha liʻiliʻi, kahe iki ke koko a laila pau ma hope o kekahi manawa, ʻeā? No ka mea ua hoʻāla ʻia ka ʻōnaehana kāpili koko i loko o ko kākou kino. He nui nā ʻano protein e kōkua i kēia. Kāhea mākou i kēia mau protein he Clotting Factors. ʻO
Prothrombin kekahi o ia ʻano protein. ʻO kekahi inoa no kēia ʻo
Factor II . ʻO ka maʻamau, hana wale ko mākou kino i ka nui o Prothrombin e pono ai. Eia naʻe, i loko o ke kino o ke kanaka me kahi mutation genetic i kapa ʻia ʻo Prothrombin Gene Mutation, ua hana ʻia kēia protein i kapa ʻia ʻo Prothrombin
ma kahi nui loa ma mua o ka mea e pono ai . E noʻonoʻo, he aha ka mea e hana ai inā hoʻohui kekahi i ʻelima a ʻeono paha punetēpē o ke kō i loko o ke kīʻaha ma kahi o ʻelua punetēpē o ke kō? E like me ka ʻono o ke kī, i ka wā e piʻi ai nā pae prothrombin, lilo ko mākou koko i "sticky" iki, a ʻoi aku
ka maʻalahi o ke kāpili ʻana. Hoʻonui kēia i ka pilikia o ka hana ʻana o nā clots koko i loko o nā aʻa, me ka ʻole o ka ʻeha. Hana ʻia kēia mau clots koko i loko o nā aʻa hohonu o nā wāwae. Kāhea mākou i kēia kūlana
ʻo Deep Vein Thrombosis (DVT) . I kekahi manawa, hiki i kahi ʻāpana o kēia clot koko ke haki a ālai i kahi aa koko i loko o nā māmā. He kūlana weliweli loa kēia, i kapa ʻia ʻo
Pulmonary Embolism (PE) .
Pehea e loaʻa ai kēia gene? He aha nā homozygous a me nā heterozygous?
He mea maʻalahi loa kēia e hoʻomaopopo. Loaʻa iā mākou kekahi gene ma ke ʻano he kope hoʻokahi mai ko mākou makuahine a hoʻokahi kope mai ko mākou makuakāne. E noʻonoʻo e pili ana i kēia gene e hana ai iā Prothrombin. 1.
Heterozygous: Loaʻa iā ʻoe kēia gene kīnā mai kou makuahine
a makuakāne paha, ʻo ia hoʻi, mai kekahi o kou mau mākua. Loaʻa i kekahi kanaka ke gene olakino a maʻamau. He nui ka poʻe ma Sri Lanka a puni ka honua i loaʻa i kēia maʻi. I kēia hihia, ʻoi aku ka kiʻekiʻe o ka pilikia o nā ʻōpū koko ma mua o ke kanaka maʻamau. Ma ke ʻano maʻamau, ʻelua a ʻekolu paha o 1,000 poʻe me kēia maʻi e loaʻa ka pilikia o ka hoʻomohala ʻana i kahi ʻōpū koko. 2.
Homozygous: He mea kākaʻikahi kēia. ʻO ka mea e hana ʻia ma ʻaneʻi, loaʻa iā ʻoe ka gene kīnā mai kou makuahine a me kou makuakāne. ʻO ke ʻano kēia, loaʻa iā ʻoe nā kope ʻelua o ka gene kīnā
mai nā mākua ʻelua . I kēia hihia,
ʻoi aku ka nui o ka pilikia o nā ʻōpū koko ma mua o ka poʻe 'Heterozygous'. E hoʻoilina anei kēia na kaʻu mau keiki mai oʻu aku?
He pilikia kēia i nā mākua he nui.
- Inā loaʻa iā ʻoe ke kūlana homozygous (ʻo ia hoʻi, ua hemahema nā kope ʻelua o ka gene), e hoʻoili maoli ʻoe i hoʻokahi gene hemahema i kēlā me kēia o kāu mau keiki .
- Inā he heterozygous ʻoe (ʻo ia hoʻi, hoʻokahi wale nō gene kīnā āu), aia he 50% ka manawa e hoʻoilina ai kekahi o kāu mau keiki i kēlā gene. Ua like ia me ka hoʻolei ʻana i kahi ʻāpana kālā; loaʻa paha iā ʻoe a ʻaʻole paha.
He aha nā hōʻailona o kēia maʻi?
Eia ka mea nui loa.
ʻAʻohe hōʻailona e pili pono ana i ka hoʻololi ʻana o ka genetic i kapa ʻia ʻo Prothrombin Gene Mutation. ʻO ia hoʻi, inā loaʻa iā ʻoe kēia gene i loko o kou kino, ʻaʻole ʻoe e ʻike i kekahi ʻokoʻa a paʻakikī paha. ʻAʻole ʻike ka nui o ka poʻe he loaʻa iā lākou kēia gene, a ola lākou i ko lākou ola holoʻokoʻa me ka ʻole o nā ʻōpū koko e hana ana. No laila, aia ma hea ka pilikia? Hiki mai ka pilikia inā hana ʻia kahi ʻōpū koko ma muli o kēia gene. A laila ʻike mākou i nā hōʻailona e pili ana i kēlā ʻōpū koko.
| Kahi o ke koko koko | Nā hōʻailona e manaʻo ʻia |
|---|
| ʻO ka thrombosis vein hohonu (DVT) ma ka wāwae a i ʻole ka lima | - ʻEha koke, ʻoiai i ka wā e kū ana a hele wāwae paha.
- Ka pehu ʻana o ka wāwae a i ʻole ka lima.
- ʻIli ʻulaʻula a poni paha.
- Ke hoʻopā ʻoe iā ia, ʻoi aku ka mehana o ia wahi ma mua o nā wahi ʻē aʻe.
|
| I loko o nā māmā (Pulmonary Embolism - PE) | |
He mea nui: He pilikia olakino ka pulmonary embolism . No laila, he mea nui loa e hele koke i ka haukapila inā loaʻa nā hōʻailona i luna.
Aia kekahi mau mea ʻē aʻe ma waho aʻe o nā genes e hoʻonui ai i ka pilikia o nā ʻūpā koko?
ʻAe, ʻoiaʻiʻo nō. Ua ʻōlelo mākou ʻaʻole nā kānaka a pau i loaʻa kēia gene e loaʻa nā ʻūpā koko. Eia nō naʻe, ke loaʻa kekahi a ʻoi aku paha o nā mea aʻe, hiki ke hoʻonui ʻia ka pilikia. Ua like ia me ka ninini ʻana i ka ʻaila ma luna o ke ahi.
- Puhipaka: Hoʻopōʻino ka puhipaka i nā kīʻaha koko a hoʻonui i ka pilikia o ke kāpili ʻana o ke koko .
- Ke hana ʻoki kino nei: Ma hope o ke ʻoki kino nui, hiki ke hoʻopaʻa ʻia ʻoe i ka moena no kekahi mau lā, kahi e hiki ai ke emi i ke kahe koko a me nā clots.
- Momona : I ka piʻi ʻana o ke kaumaha o ke kino, piʻi aʻe kēia pilikia i ka wā e kau ʻia ai ke kaomi ma luna o nā aa koko.
- Hāpai keiki: I ka wā hāpai keiki, piʻi maoli ka pilikia o ke koko ma muli o nā loli hormonal i ke kino a me ke kaomi ma luna o nā aa koko i hoʻokumu ʻia e ka pēpē e ulu ana.
- ʻO ka lawe ʻana i nā pila hoʻomalu hānau a i ʻole ka lāʻau lapaʻau hormone: Hiki ke hoʻonui ʻia ka pilikia e ka hormone estrogen i loko o kekahi mau pila hoʻomalu hānau a me ka lāʻau lapaʻau hormone.
- Ka ʻelemakule: Hoʻonui maoli ka pilikia o ke koko i ka wā ʻelemakule.
- Noho lōʻihi loa ma ke kūlana hoʻokahi:
- E moe ana ma kahi moe ma ka haukapila no nā lā he nui.
- Ke kau nei i kahi ʻaʻahu hoʻolei i ka wā e haki ai kou wāwae.
- Ke holo nei ma luna o ka mokulele, kaʻa ʻōhua, a i ʻole ke kaʻa no nā hola he nui i ka manawa hoʻokahi.
Pehea e ʻike ai inā loaʻa iaʻu kēia maʻi?
ʻAʻole hiki ke ʻike ʻia kēia me kahi hoʻāʻo koko maʻamau (e like me ka helu koko piha). Pono kahi
hoʻāʻo genetic kikoʻī no kēia. Hana ʻia kēia ma ka lawe ʻana i kahi hāpana koko. Eia naʻe, ʻaʻole haʻi ke kauka i nā mea āpau e hana i kēia hoʻāʻo. ʻO ka maʻamau, kānalua ke kauka i kēia a kauoha i kahi hoʻāʻo ma nā hihia aʻe:
- Inā ua loaʻa iā ʻoe ma mua o hoʻokahi ʻūpā koko ma mua.
- Inā loaʻa iā ʻoe kahi ʻūpā koko i kou wā ʻōpiopio, olakino, a ʻaʻohe ou maʻi ʻē aʻe.
- Inā loaʻa i kahi hoahānau pili loa o kou ʻohana (makuahine, makuakāne, kaikaina) kēia ʻano pilikia koko.
Pehea e mālama ʻia ai?
Maanei pono mākou e hana i ʻelua mau kiko maopopo. 1.
Ka mālama ʻana no nā hoʻololi genetic: Wahi a ka ʻepekema lapaʻau o kēia manawa,
ʻaʻohe ala e mālama ai a hoʻololi paha i kā mākou mau genes. ʻO ke ʻano kēia e noho pū ka Prothrombin Gene Mutation me ʻoe no ke koena o kou ola. 2.
Ka mālama ʻana no nā clots koko: Eia nō naʻe, hiki iā mākou
ke kāohi i ka pilikia o nā clots koko i hoʻokumu ʻia e kēia gene a mālama i kahi clot koko i hana ʻia . Inā loaʻa iā ʻoe kahi DVT a i ʻole PE paha, e hoʻomaka pinepine kāu kauka i ka mālama ʻana ma ka hāʻawi ʻana iā ʻoe i kahi ʻano lāʻau lapaʻau e pale ai i nā clots koko (ka mea a mākou e kapa pinepine ai he mau mea hoʻokahe koko). Ma nā ʻōlelo lapaʻau, ua kapa ʻia kēia mau mea
he anticoagulants . I kekahi mau kūlana pilikia, hāʻawi ʻia nā lāʻau lapaʻau i kapa ʻia
he thrombolytics ma o ka injection e hoʻoheheʻe a wehe i ke clot koko. He mea kākaʻikahi loa, hiki ke hoʻohana ʻia kahi catheter a i ʻole ke ʻoki ʻana e wehe i ke clot koko. ʻOkoʻa ka lōʻihi o ka mālama ʻana mai kēlā kanaka a i kēia kanaka. No kekahi poʻe, ʻo ka lawe ʻana i ka lāʻau no kahi o ʻekolu mahina ua lawa. Pono paha kekahi e lawe i nā lāʻau hoʻokahe koko no ke koena o ko lākou ola. E hoʻoholo kāu kauka i kēlā hoʻoholo ma muli o kou kūlana a me kāu mau mea pilikia.
Pehea ka hopena o kēia maʻi i ka hāpai ʻana?
He mea nui kēia pilikia no nā wāhine he nui.
- Inā loaʻa iā ʻoe kēia Prothrombin Gene Mutation a ua loaʻa iā ʻoe kahi ʻūpā koko ma mua , hiki i kāu kauka ke ʻōlelo aku iā ʻoe e lawe i kahi lāʻau hoʻokahe koko haʻahaʻa (pale) i kēlā me kēia lā (e like me ka heparin) i kou wā hāpai a no kekahi mau pule ma hope o ka hānau ʻana o kāu pēpē. ʻAʻole hōʻino kēia mau ʻano inikini i kāu pēpē.
- Eia nō naʻe, ʻoiai inā loaʻa iā ʻoe kēia gene, inā ʻaʻole ʻoe i loaʻa i kahi ʻūpā koko i kou ola , ʻaʻole pono ʻoe i kekahi lāʻau lapaʻau i ka wā hāpai.
Eia nō naʻe, he mea kēia e hoʻoholo ʻia e ke kauka ma muli o kou kūlana pilikino. Inā ʻoe e hoʻolālā ana e hāpai a ʻike paha ua hāpai ʻoe, he mea nui e hoʻomaopopo i kāu gynecologist a me nā kauka ʻē aʻe ua loaʻa iā ʻoe kēia maʻi genetic.
Āhea ʻoe e ʻike ai i ke kauka?
He mea nui loa kēia. ʻO ka ʻike ʻana i nā hōʻailona a me ka hana ʻana i ka wā mua e hiki ke pale i nā kūlana koʻikoʻi.
| Nā hōʻailona āu e ʻike nei | Hana e hana ʻia |
|---|
| ʻO nā hōʻailona o ka DVT me ka ʻeha, ka pehu ʻana, ka ʻulaʻula, a me ka mehana i ka wāwae a i ʻole ka lima. | E kāhea koke aku i kāu kauka ʻohana, a i ʻole e hele i ka haukapila kokoke loa i ka Emergency Department (ETU) . |
| ʻO nā hōʻailona o ka PE e komo pū me ka ʻeha o ka umauma, ka paʻakikī o ka hanu ʻana, a me ka wikiwiki o ka puʻuwai. | E hele koke i ka ʻOihana Pilikia kokoke loa (ETU) me ka hoʻokaʻulua ʻole. He pilikia hoʻoweliweli kēia i ke ola. |
| Inā ʻoe e hoʻohana nei i nā lāʻau hoʻokahe koko (anticoagulants). | E hōʻoia e hele i nā hoʻokolohua koko a me nā keʻena lapaʻau e like me ka mea i hoʻonohonoho ʻia e kāu kauka. |
ʻO ka mea hope loa, mai hopohopo inā ʻike ʻoe he Prothrombin Gene Mutation kou. E hoʻomanaʻo, hiki i ka hapa nui o ka poʻe me kēia gene ke ola i kahi ola olakino me ka ʻole o nā pilikia. ʻO ka mea nui loa, ʻo ia ka makaʻala i kēia, e noho mamao mai nā mea pilikia (e like me ka puhipaka, ka momona), e ola i kahi nohona olakino, a e ʻimi koke i ke aʻo lapaʻau inā loaʻa iā ʻoe kekahi mau hōʻailona o ke koko koko.
Leka Lawe-Home
- ʻO ka Prothrombin Gene Mutation kahi maʻi genetic i hoʻoili ʻia i nā hanauna. ʻAʻole na ʻoe ia hewa.
- ʻAʻole pale ka loaʻa ʻana o kēia gene i nā ʻūpā koko. ʻAʻole pilikia ka hapa nui o ka poʻe.
- ʻAʻohe hōʻailona e pili ana i kēia gene. Loaʻa wale nā hōʻailona inā ulu kahi ʻūlū koko, e like me DVT a i ʻole PE.
- E makaʻala mau i nā hōʻailona o ka pehu ʻana o ka wāwae, ka ʻeha (DVT), a me ka ʻeha koke o ka umauma a me ka pōkole o ka hanu (PE).
- ʻO ka Pulmonary Embolism (PE) kahi pilikia olakino e pono ai ka mālama koke ʻana.
- ʻO ka pale ʻana i ka puhipaka, ka kaohi ʻana i ke kaumaha o ke kino, a me ke alakaʻi ʻana i kahi nohona hana hiki ke hōʻemi i ka pilikia o ke kāpili ʻana o ke koko.
- Inā ʻike ʻoe he maʻi kou, he mea nui loa ia e hoʻomaopopo i kekahi kauka ke ʻike ʻoe iā lākou, ma mua o ke ʻoki ʻana, a i ʻole i ka wā hāpai.
- ʻO ka noho mau ʻana me kāu kauka a me ka hahai ʻana i kāna ʻōlelo aʻo he mea maikaʻi loa ia no kou olakino.
ʻO ka hoʻololi ʻana o ka Prothrombin Gene, ka hoʻololi ʻana o ka Factor II, ke kāpili ʻana o ke koko, ka Deep Vein Thrombosis, ka Pulmonary Embolism, DVT, PE, nā maʻi genetic, nā mea hoʻomāmā koko, nā Anticoagulants
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