Ua ʻike anei ʻoe i ke koko kiʻekiʻe o ka puʻuwai? E kamaʻilio kākou e pili ana i ia mea!

Ua lohe paha ʻoe i kahi maʻi e piʻi ai ke kaomi i loko o nā māmā? He ʻokoʻa iki kēia mai ke koko kiʻekiʻe a mākou e kamaʻilio pinepine ai. Kāhea nā kauka i kēia ʻo 'Pulmonary Hypertension' (PH) , a i ʻole ke koko kiʻekiʻe i loko o nā māmā. I ka ʻōlelo maʻalahi, ʻo ia ka wā e piʻi ai ke koko, a i ʻole ke kaomi, i loko o nā aa koko e lawe ana i ke koko nele i ka oxygen mai kou puʻuwai a i kou mau māmā (kāhea mākou i kēia mau 'aʻa pulmonary'), me ke kumu ʻole. He kūlana koʻikoʻi kēia, no ka mea, he hopena nui kona i ko mākou puʻuwai a me nā māmā.

No ke aha he mea weliweli loa ka Pulmonary Hypertension (PH)? He aha ka mea e hana ʻia i ko mākou kino?

E noʻonoʻo i ka mea e hana ʻia ke piʻi aʻe ke kaomi i loko o nā aʻa koko e lawe ana i ke koko i nā māmā. E like me ka wā e ālai ʻia ai kahi paipu wai, e paʻakikī ai ke kahe ʻana o ka wai, e lilo kēia mau aʻa koko i mea haiki, a i kekahi manawa e mānoanoa ana. A laila, pono ka puʻuwai e hana ikaika e pamu i ke koko i nā māmā. ʻO ka ʻaoʻao ʻākau o ka puʻuwai (ka 'ventricle ʻākau') ke ʻano nui o kēia kaumaha. I ka hala ʻana o ka manawa, hoʻomaka ka puʻuwai e nāwaliwali i ka wā e hoʻomau ai i ka hana ikaika. Hiki i kēia kūlana ke hana i nā pilikia like ʻole i loko o ke kino. Eia kekahi laʻana:

• Ua emi ka hemoglobin i loko o ke koko (' Anemia' ).
• Ka puʻuwai kūpono ʻole ('Arrhythmias').
• Nā ʻūpā koko i loko o nā aa koko o nā māmā .
• He hōʻiliʻili wai a puni ka puʻuwai (ʻO ka Pericardial effusion ).

Inā loaʻa i kahi wahine hāpai kēia maʻi, hiki ke lilo i mea weliweli no ka makuahine a me ke pēpē. Inā ʻaʻole mālama ʻia, hiki i kēia maʻi ke alakaʻi i ka hāʻule ʻana o ka puʻuwai ('ʻaoʻao ʻākau o ka puʻuwai') a hiki ke hoʻoweliweli i ke ola. No laila, he mea nui loa ka ʻike ʻana i ka maʻi i ka wā mua a hoʻomaka i ka mālama ʻana .

He aha nā ʻano nui o ke koko kiʻekiʻe o ka puʻuwai (PH)?

Ua hoʻokaʻawale ka World Health Organization (WHO) i kēia maʻi 'Pulmonary Hypertension' (PH) i ʻelima mau ʻano nui e like me nā kumu e hoʻoulu ai. E nānā kākou i ko lākou ʻano. 1. Māhele 1: PH i hoʻokumu ʻia e ka 'Pulmonary Arterial Hypertension (PAH). Ma kēia, lilo nā kīʻaha koko e lawe ana i ke koko i nā māmā ('pulmonary arteries') i ʻokiʻoki ʻia, mānoanoa, a paʻakikī paha. Hiki i kēia ke loaʻa nā kumu like ʻole. Hiki i kekahi mau maʻi, ʻoiai kekahi mau lāʻau lapaʻau, ke hoʻopilikia i kēia. 2. Māhele 2: PH i hoʻokumu ʻia e nā pilikia me ka ʻaoʻao hema o ka puʻuwai. ʻO ka ʻaoʻao hema o ko kākou puʻuwai ka mea e pamu i ke koko i ke kino holoʻokoʻa. No laila, inā he pilikia me ka ʻaoʻao hema o ka puʻuwai, hoʻopilikia ia i ka ʻaoʻao ʻākau a me ka ʻōnaehana e lawe ana i ke koko i nā māmā. ʻAʻole kahe pono ke koko a ua ālai ʻia, a piʻi ke kaomi i loko o nā aa pulmonary. 3. Māhele 3: PH i hoʻokumu ʻia e ka maʻi māmā a i ʻole ka nele o ka oxygen (`hypoxia`).ʻO kekahi mau maʻi māmā ke kumu o ka ololi ʻana o nā kīʻaha koko i loko o nā māmā. ʻO kēia ke kumu o ke ālai ʻia ʻana o ke kahe koko, a me ka piʻi ʻana o ke kaomi. 4. Māhele 4: PH i hana ʻia e nā ālai ʻana i loko o nā māmā. ʻO nā ʻūpā koko i loko o nā māmā a i ʻole ka ʻōpala mai ia mau mea e ālai ana i ke kahe o ke koko. Hoʻokau kēia i ka ʻoi aku o ke kaumaha ma ka ʻaoʻao ʻākau o ka puʻuwai, e hoʻonui ana i ke kaomi koko i loko o nā māmā. 5. Māhele 5: PH i hana ʻia e nā maʻi ʻē aʻe. Hiki ke loaʻa kēia ʻano PH me nā maʻi ʻē aʻe, e like me kekahi mau maʻi koko a me nā maʻi metabolic. Eia naʻe, ʻaʻole maopopo loa pehea e hana ai kēia mau maʻi i ka PH.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi ʻo `Pulmonary Hypertension` (PH)?

Hiki i ka Pulmonary Hypertension (PH) ke hoʻopilikia i nā pākeke o kēlā me kēia makahiki. ʻOi aku ka nui o ka pilikia o ka poʻe me ka maʻi puʻuwai a i ʻole ka maʻi māmā i ka loaʻa ʻana. Hiki ke ʻoi aku ka maʻamau i nā poʻe me nā maʻi ʻē aʻe. Eia kekahi laʻana:

• Kokoke i ka 100% o ka poʻe me ka maʻi valve mitral koʻikoʻi.
• Ma kahi o 65% o ka poʻe me ka maʻi valve aortic (ʻo ia kekahi maʻi valve puʻuwai).
• Ma kahi o 30% o ka poʻe me ka `Scleroderma` (kahi maʻi o ka paʻakikī ʻana o ka ʻili a me nā ʻiʻo pili ).
• Ma kahi o 20% - 40% o nā kānaka me ka maʻi sickle cell .
• Ma kahi o hoʻokahi i loko o 200 mau kānaka i loaʻa i ka maʻi HIV .

Hoʻopilikia pinepine ia i nā pākeke. Eia nō naʻe, he mea kākaʻikahi loa, hiki i nā pēpē hānau hou ke loaʻa i kēia maʻi ('Persistent Pulmonary Hypertension of the Newborn - PPHN`). Inā hana ʻia kēia, pono e mālama ʻia ke pēpē ma ka ʻāpana mālama koʻikoʻi. Ma ka honua holoʻokoʻa, ua manaʻo ʻia he hoʻokahi i loko o 10 mau pākeke ma luna o 65 mau makahiki i loaʻa i kēia maʻi PH. ʻO ke ʻano kēia, ʻoi aku ka maʻamau ma mua o ko mākou manaʻo.

He aha nā hōʻailona mua o ka Pulmonary Hypertension (PH)?

ʻO ka pinepine ka hōʻailona mua he pōkole o ka hanu, a i ʻole ka wheezing . Hiki iā ʻoe ke ʻike i kēia pōkole o ka hanu i ka wā o nā hana maʻamau o kēlā me kēia lā, e like me ke piʻi ʻana i nā alapiʻi, ka lawe ʻana i nā mea kūʻai, a i ʻole ka hoʻoikaika kino. ʻAʻole paha ʻoe e loaʻa i kekahi mau hōʻailona i ka wā mua. Ke ʻike ʻia nā hōʻailona, ​​​​hiki ke akahai loa lākou. Eia nō naʻe, i ka hala ʻana o ka manawa, hiki i kēia mau hōʻailona ke lilo i mea koʻikoʻi a hoʻolilo i mea paʻakikī ke hana i kāu mau hana maʻamau.

He aha nā hōʻailona e ʻike ʻia i ka wā e holomua ai ka maʻi?

I ka piʻi ʻana o ka pae pH, hiki iā ʻoe ke loaʻa ka pōkole o ka hanu ʻoiai ʻoe e kū mālie ana. Hiki ke hele pū ʻia kēia me nā hōʻailona e like me:

• Nā lehelehe polū a ʻili paha.
• ʻEha a ʻūmiʻi paha ka umauma.
• Manaʻo puni a nāwaliwali paha.
• Manaʻo luhi i nā manawa a pauLuhi .
• ʻAʻohe ʻono o ka meaʻai.
• ʻEha ma ka ʻaoʻao ʻākau o luna o ka ʻōpū.
• Manaʻo e kuʻi wikiwiki ana kou puʻuwai.
• Ka pehu ʻana o nā kuʻekuʻe wāwae, nā wāwae, a i ʻole ka ʻōpū (`Edema`).

He mea paʻakikī loa kēia mau hōʻailona e hoʻoikaika kino a hana i nā hana o kēlā me kēia lā.

Aia kekahi mau pae o ka Pulmonary Hypertension (PH)?

ʻAe, ua ʻike ka World Health Organization (WHO) i ʻehā mau pae nui o ka PH. Ua kapa ʻia kēia mau mea he "nā papa hana." Hoʻoholo ʻia kēia e nā hōʻailona āu e ʻike ai a me ka nui o kāu hiki ke hana i kāu mau hana o kēlā me kēia lā. I ka holomua ʻana o ka maʻi, ʻoi aku ka ʻike ʻia o nā hōʻailona a hoʻopilikia i kou ola o kēlā me kēia lā.

• Papa 1: ʻAʻohe hōʻailona.
• Papa 2: ʻAʻohe hōʻailona i ka wā e hoʻomaha ai, akā he ʻeha iki a ʻoluʻolu ʻole paha i ka wā o nā hana maʻamau, e like me ka hana ʻana i nā hana o ka hale a i ʻole ke piʻi ʻana i nā alapiʻi.
• Papa 3: Hiki paha iā ʻoe ke manaʻo maikaʻi i kou noho wale ʻana. Akā, he mea paʻakikī loa ke hana i nā hana maʻamau i kēia manawa. Ua luhi loa ʻoe a ua kaumaha.
• Papa 4: Loaʻa nā hōʻailona ʻoiai ke kū mālie wale. E ʻoi aku ka ʻino o nā hōʻailona ke hoʻāʻo ʻoe e hana i kekahi hana maʻamau.

He aha nā kumu o ke koko kiʻekiʻe o ka puʻuwai (PH)?

Nui nā kumu like ʻole o ka PH. Aia ia i ke ʻano o ka PH āu e loaʻa ai. Hiki ke hana ʻia e nā maʻi like ʻole, nā kūlana olakino ma lalo, a me nā kumu kaiapuni (nā mea ʻawahia, kekahi mau lāʻau lapaʻau).

Māhele 1: Nā kumu o ke `Pulmonary Arterial Hypertension (PAH)`

• Maʻi puʻuwai hānau .
• ʻO kekahi mau lāʻau hoʻemi kaumaha (e like me ka lāʻau "fen-phen," hiki ke hana i ka PAH ma hope o nā makahiki o ka hoʻohana ʻana).
• Nā hoʻololi hoʻoilina .
• ʻO nā maʻi mālama glycogen.
• Ka maʻi HIV.
• Maʻi akepaʻa .
• Ka maʻi Lupus.
• ʻO ke hypertension portal (hoʻonui ʻia ke kaomi i loko o nā veins e alakaʻi ana i ke akepaʻa).
• Nā maʻi ʻaʻa pulmonary kakaikahi e like me ka 'Pulmonary capillary hemangiomatosis' a me ka 'Pulmonary veno-occlusive disease'.
• ʻO Schistosomiasis (kahi maʻi i hoʻokumu ʻia e kahi parasite).
• Ka maʻi Scleroderma.
• Ka hoʻohana ʻana i nā lāʻau lapaʻau e like me ka 'Methamphetamine'.

Hiki i kekahi poʻe ke loaʻa ka PAH me ke kumu ʻole. Ua kapa ʻia kēia he 'idiopathic'.

Māhele 2: Nā kumu o ka PH i hoʻokumu ʻia e nā maʻi o ka ʻaoʻao hema o ka puʻuwai

ʻO ka maʻi puʻuwai kekahi kumu maʻamau o PH. Ma muli o ka hana pū ʻana o nā ʻaoʻao hema a me ka ʻākau o ka puʻuwai, e hoʻopilikia pū ka pilikia ma ka ʻaoʻao hema i ka ʻaoʻao ʻākau.

• Maʻi valve aorticHe pilikia kēia me ka valve ma waena o ke keʻena pamu nui o ka puʻuwai (ka `ventricle hema`) a me ka aorta (ke kīʻaha koko nui loa o ke kino).
• ʻO ka hāʻule ʻana o ka puʻuwai hema : ʻAʻole hiki i ka ʻaoʻao hema o ka puʻuwai ke pamu pono i ke koko.
• ʻO ka hypertrophy ventricular hema (mānoanoa o nā paia o ka ventricle hema) : ʻO kēia ka mea e paʻakikī ai i ka puʻuwai ke pamu koko me ka maikaʻi.
• ʻO ka maʻi valve mitral : He pilikia me ka valve e hiki ai i ke koko ke kahe mai ka atrium hema i ka ventricle hema o ka puʻuwai.

Māhele 3: Nā kumu o ka PH i hoʻokumu ʻia e ka maʻi māmā a i ʻole ka nele o ka oxygen (`hypoxia`)

• ʻO ka maʻi pulmonary obstructive mau loa (COPD) : Hoʻokomo pū kēia i nā maʻi e like me ka bronchitis mau loa a me ka emphysema. Hoʻolilo kēia i mea paʻakikī ke hanu.
• Maʻi māmā interstitial : Loaʻa ka ʻōpala (fibrosis) i loko o ka ʻiʻo māmā.
• ʻO ka apnea hiamoe obstructive : ʻO kēia ke kumu e ālai ʻia ai ke ala ea i kēlā me kēia manawa i ka wā hiamoe, e hōʻemi ana i ka nui o ka oxygen i loaʻa i ke kino.

Māhele 4: Nā kumu o ka PH ma muli o ke ālai ʻana i loko o nā māmā

ʻO ke kumu nui o kēia ma muli o kahi maʻi i kapa ʻia ʻo 'Chronic Thromboembolic Pulmonary Hypertension (CTEPH) . ʻO ia ka wā e hana ʻia ai nā ʻūpā koko a me nā ʻōpala i loko o nā aa o nā māmā. I kekahi manawa, hiki ke hana ʻia kēia maʻi e ka ʻōpala i hoʻokumu ʻia e ka 'pulmonary embolism' (kahi ʻūpā koko e paʻa ana i loko o nā māmā).

Māhele 5: Nā kumu o ka PH i hoʻokumu ʻia e nā maʻi ʻē aʻe

Hiki ke hoʻoulu ʻia ʻo PH e kekahi mau maʻi ʻē aʻe, a ʻaʻole maopopo loa i nā ʻepekema pehea e hana ai.

• ʻO ka maʻi Gaucher (kahi maʻi metabolic).
• Maʻi puʻupaʻa.
• ʻO ka histiocytosis cell Langerhans (kahi maʻi e hoʻoulu ai i ka ʻeha a me nā puʻupuʻu i loko o nā māmā o nā pākeke).
• ʻO Sarcoidosis (kahi maʻi mumū, e hoʻopilikia pinepine ana i nā māmā a me nā lymph nodes).
• Ka maʻi thyroid.
• Nā Tumors : ʻO nā tumors, inā he maʻi ʻaʻai a maikaʻi ʻole paha, hiki ke hoʻoulu i ke kaomi ma nā aʻa koko i loko o nā māmā.

Pehea e ʻike ʻia ai ka Pulmonary Hypertension (PH)?

E nānā kāu kauka iā ʻoe a, inā pono, e hana i kekahi mau hoʻokolohua e hoʻoholo ai inā loaʻa iā ʻoe ka PH. ʻO ka mea mua, e hana kāu kauka i kahi hoʻokolohua kino . Ma laila,

• Nīnau lākou e pili ana i kou mōʻaukala olakino a me nā hōʻailona.
• E nānā inā he distention venous jugular (hiki i kēia ke hōʻailona o ka hāʻule ʻana o ka puʻuwai ʻākau).
• No ka nānā ʻana i ka nui o ke akepaʻa, e hoʻopā i ka ʻaoʻao ʻākau o luna o ka ʻōpū.
• Hoʻolohe ʻia ka puʻuwai a me nā māmā me ka stethoscope.
• E nānā i ka ʻōpū, nā kuʻekuʻe wāwae, a me nā wāwae no ka pehu (edema).
• Ana ʻia ke kaomi koko.
• Hoʻohana ka pulse oximeter i ke ana o ka oxygen i loko o ke koko.

Hiki ke paʻakikī ke ʻike i nā hōʻailona PH no ka mea ua like lākou me nā kūlana ʻē aʻe. No laila, ma hope o ka hoʻokolokolo kino ʻana, hiki i kāu kauka ke hana i nā hoʻokolohua hou aʻe. Hiki ke kuhikuhi ʻia ʻoe i kahi loea māmā (pulmonologist) a i ʻole kahi loea puʻuwai (cardiologist).

He aha nā hoʻokolohua i hoʻohana ʻia e ʻike ai i ka PH?

• ʻO ke catheterization puʻuwai ʻākau: Ua kapa ʻia hoʻi ʻo pulmonary artery catheterization, ke ana kēia i ke kaomi i loko o nā aa pulmonary a me ka nui o ke koko e hiki i ka puʻuwai ke pamu i kēlā me kēia minuke. ʻO kēia ka hoʻāʻo nui e hōʻoia i ka PH.
• ʻO Doppler echocardiogram: He scan kēia e hoʻohana ana i nā nalu kani. Hiki iā ia ke hōʻike i ke ʻano o ka hana ʻana o ka ventricle ʻākau o ka puʻuwai a pehea ke kahe ʻana o ke koko ma o nā valves. Hiki i kēia i ke kauka ke helu i ke kaomi systolic pulmonary artery.
• Nā hoʻāʻo koko: Nānā kēia i nā mea e like me ka hana o nā ʻōkana, nā pae hormone, a me nā maʻi. Hoʻokomo pū kēia me nā hoʻāʻo e like me ka "Complete metabolic panel" a me ka "complete blood count."
• ʻO ke kiʻi CT umauma: Nānā i nā ʻūpē koko a me nā pilikia ʻē aʻe o ka māmā.
• X-ray o ka umauma: Hiki ke hoʻohana ʻia kēia e ʻike ai inā ʻoi aku ka nui o ka ʻaoʻao ʻākau o ka puʻuwai a i ʻole nā ​​​​aʻa koko pulmonary ma mua o ka maʻamau.
• Hoʻāʻo hiamoe (`Polysomnogram - PSG`): He hoʻāʻo i ka pō e ʻike ai inā loaʻa iā ʻoe ka `sleep apnea`.
• ʻO ke nānā ʻana i ka ea/perfusion pulmonary (VQ): Nānā i nā ʻūpē koko i loko o nā māmā.

Hiki i kāu kauka ke hana i kahi hoʻāʻo hele wāwae ʻeono minuke . E ana kēia i ka nui o ka hoʻoikaika kino hiki iā ʻoe ke ʻae a me ka nui o ka oxygen i loko o kou koko i ka wā o ka hoʻoikaika kino. Hiki i kēia ke hāʻawi iā ʻoe i kahi manaʻo inā he akahai a koʻikoʻi paha kou PH.

He aha nā lāʻau lapaʻau no ke koko kiʻekiʻe o ka puʻuwai (PH)?

ʻO ke ʻano o ka mālama ʻana no ka PH e pili ana i ke ʻano o ka PH āu e loaʻa ai a me kou mau kūlana olakino ʻē aʻe. E hoʻomohala kāu hui lapaʻau i kahi hoʻolālā lapaʻau kūpono loa iā ʻoe. I kēia manawa, ʻelua wale nō ʻano o ka PH e hiki ke mālama pololei ʻia:

• ʻO ke koko kiʻekiʻe o ke aʻa puʻuwai (PAH)
• ʻO ke koko kiʻekiʻe o ka puʻuwai thromboembolic mau loa (CTEPH)

Hoʻōla ʻia nā ʻano PH ʻē aʻe ma o ka kaohi ʻana i nā kūlana olakino kumu e hoʻokumu ai iā lākou. Lapaʻau no ka `Pulmonary Arterial Hypertension (PAH):

• Nā mea pale o ke kahawai calcium: Kōkua kēia mau lāʻau lapaʻau e hoʻemi i ke koko i loko o nā veins pulmonary a ma ke kino holoʻokoʻa.
• Nā lāʻau diuretic ("nā lāʻau wai"): Kōkua i ka wehe ʻana i ka wai keu mai ke kino.
• ʻO ka lāʻau lapaʻau oxygen: Pono paha kēia inā ʻaʻole lawa ka oxygen i loko o ke koko.
• Nā mea hoʻōla vasodilator pulmonary:Hoʻomaha kēia mau lāʻau lapaʻau i nā aʻa koko pulmonary a wehe maikaʻi iā lākou. Hoʻomaikaʻi kēia i ke kahe koko a hoʻemi i ka ukana ma ka puʻuwai.

Lapaʻau no ka `CTEPH`:

• Nā Anticoagulants (nā lāʻau lapaʻau e pale ai i ke kāpili ʻana o ke koko).
• ʻO ka Balloon atrial septostomy (BAS): ʻOiai hana pinepine ʻia kēia no nā pēpē me nā kīnā puʻuwai koʻikoʻi, hoʻohana ʻia nō hoʻi ia e hoʻopaʻa i nā pākeke me PH a hiki i ka loaʻa ʻana o kahi hoʻoili māmā.
• ʻO ka Balloon pulmonary angioplasty (BPA): He kaʻina hana kēia e hoʻohana ana i kahi catheter e hoʻonui i nā aʻa pulmonary. Hana ʻia ia no ka poʻe hiki ʻole ke hana i ke ʻoki kino nui.
• Lāʻau lapaʻau: Hiki i kahi lāʻau lapaʻau i kapa ʻia ʻo 'Soluble guanylate cyclase stimulator (SGCS)' ke kōkua i ka kaohi ʻana i ka holomua o ka maʻi.
• ʻO ka endarterectomy pulmonary (PEA): He ʻoki kino kēia. Wehe ia i nā ʻōpū koko mai nā māmā. ʻO kēia wale nō ke ala e ho'ōla loa ai iā PH. Eia naʻe, hiki ke hana ʻia i nā poʻe me CTEPH wale nō.

Hoʻōla ʻia ka PH i hoʻokumu ʻia e ka maʻi puʻuwai a i ʻole ka maʻi māmā ma o ka kaohi ʻana i ka maʻi kumu, no laila hiki ke ʻokoʻa loa nā hoʻolālā lapaʻau mai kēlā kanaka a kēia kanaka.

E hoʻomanaʻo, pono ʻoe e kamaʻilio me kāu kauka a hoʻoholo i ka lāʻau lapaʻau kūpono loa iā ʻoe.

Pono paha kekahi poʻe me ka PH koʻikoʻi e hana i kahi hoʻoili māmā ma ke ʻano he koho hope loa.

Pehea e mālama ai i nā lāʻau lapaʻau no ka Pulmonary Hypertension (PH)?

Ke lawe nei paha ʻoe i nā lāʻau lapaʻau he nui no PH a me nā kūlana ʻē aʻe. Hiki ke paʻakikī ke hoʻomanaʻo i kēia mau mea a pau a hana pono. Eia kekahi mau ʻōlelo aʻoaʻo:

• E ʻike i nā inoa o nā lāʻau lapaʻau āpau āu e lawe ai a pehea lākou e hana ai. E hana i kahi papa inoa a mālama mau me ʻoe.
• E lawe i kāu lāʻau lapaʻau i ka manawa like i kēlā me kēia lā. Inā poina iā ʻoe kahi mahele lāʻau, mai lawe i ʻelua mau mahele lāʻau e hoʻopiha ai. E kāhea i kāu kauka a nīnau i ka mea e hana ai.
• Mai lawe i nā lāʻau lapaʻau ma waho o ke kauka me ka ʻole o ke kūkākūkā ʻana me kāu kauka. ʻO kekahi mau lāʻau lapaʻau anu, kuni, a me ke kuni, a me nā mea hōʻoluʻolu ʻeha, hiki ke hoʻopilikia i ka poʻe me ka maʻi puʻuwai.
• Mai lawe i kekahi lāʻau lapaʻau i kapa ʻia he kūpono ʻole no ka poʻe me ke koko kiʻekiʻe.
• Mai ho'ōki i ka lawe ʻana i kekahi lāʻau lapaʻau a hoʻololi paha i ka dosage me ka ʻole o ke kamaʻilio ʻana me kāu kauka.
• E hōʻalo i ka hoʻohana ʻana i nā mea hoʻohui lāʻau a me nā kī lāʻau. Hiki iā lākou ke launa pū me kekahi mau lāʻau lapaʻau āu e lawe nei.

He aha ka manaʻo no kekahi me ke koko kiʻekiʻe o ka puʻuwai (PH)?

ʻOkoʻa kēia mai kēlā kanaka a kēia kanaka. Aia ia i:

• Ke kumu o PH.
• Pehea ka wikiwiki o ka ʻike ʻia ʻana o ka maʻi.
• Ka nui o nā hōʻailona.
• Nā maʻi ʻē aʻe e hele pū ana.

ʻAʻole hiki ke ho'ōla loa ʻia nā ʻano PH he nui. Kuhikuhi nā kauka i nā lāʻau lapaʻau e hōʻemi i nā hōʻailona, ​​hoʻomaikaʻi i ke ʻano o ke ola, a kāohi i ka holomua o ka maʻi. Eia nō naʻe, hiki ke ho'ōla ʻia kekahi poʻe me CTEPH me ke ʻoki kino. Inā ʻaʻole mālama ʻia, hiki i ka Pulmonary Hypertension (PH) ke alakaʻi i ka hāʻule ʻana o ka puʻuwai ʻākau a me ka make. No laila, ʻo ka loaʻa ʻana o ka lāʻau kūpono e hiki ke kōkua iā ʻoe e ola lōʻihi a mālama i kahi ola maikaʻi.

He aha nā mea e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ka Pulmonary Hypertension (PH)?

• Ka hōʻike ʻia ʻana i ka asbestos.
• Loaʻa kahi moʻolelo ʻohana o nā ʻōpū koko.
• He lālā o ka ʻohana me ka Pulmonary Hypertension (PH).
• Noho ma nā wahi kiʻekiʻe ma luna o ka ʻilikai.
• Ka puhipaka a me ka hoʻohana ʻana i nā huahana paka.
• ʻO kekahi mau lāʻau lapaʻau i hoʻohana ʻia no ka hoʻemi kaumaha (e like me "fen-phen" - 'dexfenfluramine' a me 'phentermine').
• ʻO kekahi mau lāʻau lapaʻau no ke kanesa a me ke kaumaha.
• Ka hoʻohana ʻana i nā lāʻau lapaʻau.

Eia kekahi, ʻoi aku ka nui o ka pilikia o ka poʻe me kēia mau kūlana:

• Nā ʻūpā koko i loko o nā aa koko o nā māmā.
• Ka maʻi pili o nā ʻiʻo.
• ʻO ka maʻi Down syndrome.
• ka maʻi Gaucher.
• Maʻi puʻuwai.
• ʻO ka maʻi HIV.
• Maʻi akepaʻa.
• Nā maʻi o ka māmā.

Hiki ke pale ʻia ke koko kiʻekiʻe o ka puʻuwai (PH)?

ʻAʻole hiki ke pale ʻia ka PH i nā manawa a pau. ʻAʻole hiki ke kāohi ʻia kekahi mau mea pilikia. Inā he mau mea pilikia kou, hiki i kāu kauka ke paipai i kekahi mau hoʻokolohua e nānā i kou puʻuwai a me ka hana o kou māmā. Hiki iā ʻoe ke hōʻemi i kou pilikia o ka PH ma ka hana ʻana i nā mea āpau e hiki ai iā ʻoe ke pale a kāohi paha i nā kūlana olakino ʻē aʻe.

• E hana i kahi hoʻolālā hoʻoikaika kino. E nīnau i kāu kauka i nā hoʻoikaika kino palekana nou.
• E hahai i kahi papaʻai olakino no ka puʻuwai. E hōʻalo i nā meaʻai kiʻekiʻe i ka paʻakai, ka ʻaila, ke kō, a me nā meaʻai hana.
• E ho'ōki i ka puhipaka a me ka hoʻohana ʻana i ka paka. ʻO kēia nā kumu nui o ka pilikia no ka maʻi puʻuwai a me ka māmā.
• E lawe i nā lāʻau lapaʻau no ke koko a me nā maʻi ʻē aʻe e like me ke kauoha a kāu kauka.

He aha ke ʻano o ka mālama ma hope e pono iaʻu e loaʻa?

E kamaʻilio me kāu kauka e pili ana i ke ʻano o ka mālama ʻana a me ka nānā ʻana i kou kūlana. E haʻi aku kāu kauka iā ʻoe i ka wā e pono ai ʻoe e hele mai no nā hoʻokolohua a me nā nānā ʻana. E haʻi koke aku i kāu kauka inā loaʻa iā ʻoe kekahi mau hōʻailona hou a inā paha e loli kāu mau hōʻailona. Eia kekahi, e kamaʻilio me kāu kauka e pili ana i:

• Nā ʻano hoʻolālā ʻohana a inā paha he palekana ka hāpai ʻana. He mea pilikia ka hāpai ʻana no ka poʻe me PH.
• E hana i kahi pahu hana pilikia. Pono ka poʻe me PH e mālama i kekahi mau mea a me nā ʻike kokoke i ka lima i nā manawa a pau.
• Hoʻoikaika kino.E nīnau i nā mea palekana iā ʻoe, pehea e hoʻokomo ai i ka hoʻoikaika kino i kou ola o kēlā me kēia lā, a me nā hoʻomaʻamaʻa e pale aku ai.
• Nā lāʻau pale kau (e like me ka maʻi flū, ka maʻi pneumonia).
• Nā hui kākoʻo a i ʻole ke aʻo ʻana. Hiki iā ʻoe ke ʻike i nā ʻano manaʻo like ʻole i kou hoʻomaʻamaʻa ʻana i ka noho ʻana me PH.
• Nā hoʻolālā huakaʻi. Pono paha ʻoe e hana i nā hana palekana kūikawā inā ʻoe e holo ana ma ka mokulele. Pono ʻoe e makaʻala i ka wā e hele ai i nā wahi kiʻekiʻe.

He aha nā hoʻololi i ka meaʻai e pono iaʻu e hana?

E hāʻawi aku kāu kauka iā ʻoe i nā ʻōlelo aʻoaʻo kikoʻī. ʻO kahi mea nui e hōʻemi i kāu lawe ʻana i ka paʻakai (sodium). ʻO ke ʻano kēia:

• E ho'ōki i ka ho'ohui 'ana i ka pa'akai ma ka papa'aina a me ka ho'ohana 'ana i ka "pa'akai mea ho'onanea."
• E hōʻalo i nā ʻiʻo a me nā iʻa i puhi ʻia, i paʻakai ʻia, a me nā mea i hoʻopaʻa ʻ
• E koho i nā meaʻai i kapa ʻia ʻo "low sodium" (ka paʻakai haʻahaʻa).
• E hoʻēmi i ka ʻai ʻana i nā meaʻai wikiwiki a me nā meaʻai lawe ʻia.

Nā hoʻololi ʻē aʻe i ka meaʻai:

• E ʻai i nā meaʻai waiwai i ka fiber (nā palaoa piha, nā bran, nā huaʻai, nā mea kanu).
• E ʻai i nā meaʻai waiwai i ka potassium (nā hua waina, nā maiʻa, nā ʻalani).
• E ʻai i nā meaʻai waiwai i ka magnesium (pīni, tofu, broccoli).
• E hoʻēmi i nā meaʻai i loaʻa ke kō i hoʻomaʻemaʻe ʻia, ka momona saturated, a me ka cholesterol.

Āhea wau e ʻike ai i ke kauka?

E kamaʻilio me kāu kauka inā loaʻa iā ʻoe kekahi o kēia mau nīnau:

• Ka wikiwiki o ka puʻuwai (ʻoi aku ma mua o 120 mau kuʻi i kēlā me kēia minuke).
• Inā loaʻa iā ʻoe kahi maʻi hanu a i ʻole ka ʻūlū e ʻoi aʻe ana.
• Inā pinepine ʻoe e manaʻo poniuniu a nāwaliwali paha.
• ʻEha ka umauma a i ʻole ka ʻoluʻolu ʻole me ka hana kino.
• Luhi nui a i ʻole hiki ʻole ke hana i nā hana maʻamau.
• Ka luaʻi a i ʻole ka nalowale o ka makemake.
• Ka hoʻomaha ʻole a i ʻole ka huikau.
• Inā ua hoʻonui ʻia kou hanu pōkole, ʻoiai ke ala ʻoe i ke kakahiaka.
• Inā piʻi aʻe ka pehu ʻana ma nā kuʻekuʻe wāwae, nā wāwae, a i ʻole ka ʻōpū.
• Inā pilikia ʻoe i ka hanu ʻana i ka wā o nā hana maʻamau a i ʻole ke kū mālie wale ʻana.
• Ka piʻi ʻana o ke kaumaha (ma kahi o 1 kilokani i ka lā, a i ʻole ma kahi o 2.5 kilokani i ka pule).

Āhea wau e hele ai i ka lumi pilikia (ER)?

Inā loaʻa kekahi mea e like me kēia, e hele koke i ka lumi pilikia, a i ʻole e kelepona iā 1990:

• Inā wikiwiki loa ka helu o ka puʻuwai (120-150 mau kuʻi i kēlā me kēia minuke) a ʻaʻole e lohi.
• Inā nalowale kou ʻike a maule.
• Inā ʻoe e lawe ana i nā lāʻau lapaʻau intravenous e like me prostacyclins ma o kahi catheter Hickman, aia nā pilikia e like me ka maʻi, ka neʻe ʻana o ka catheter, ka liki ʻana o ka lāʻau lapaʻau, ke kahe ʻana o ke koko, a i ʻole ka hāʻule ʻana o ka pamu IV.
• Inā ʻaʻole e emi ka pōkole o ka hanu ʻoiai ke kū mālie ʻoe.
• Inā loaʻa koke iā ʻoe ka ʻeha nui o ka umauma.
• Inā loaʻa koke iā ʻoe kahi ʻeha poʻo nui.
• Inā loaʻa koke iā ʻoe ka nāwaliwali a i ʻole ka mae ʻana o kou mau lālā.

ʻO ka mea hope loa, ʻo ka leka koʻikoʻi loa

ʻO ka ʻike ʻia ʻana me ka Pulmonary Hypertension (PH) hiki ke lilo i mea huikau. He manawa ka lōʻihi e hoʻomaopopo ai i ke ʻano o ia mea, nā mea e hana nei i loko o kou kino, a pehea ʻoe e noho ai me ia i ka wā e hiki mai ana. E kamaʻilio me kāu kauka e loaʻa ke kākoʻo āu e pono ai. E hoʻokomo i kou ʻohana a me nā hoaaloha i kāu mau hoʻololi nohona. E haʻi iā lākou e pili ana i kou kūlana. Eia kekahi, i kou hoʻomaʻamaʻa ʻana i kēia maʻamau hou, mai kānalua e noi i ke kōkua a hilinaʻi i nā poʻe ʻē aʻe. ʻAʻole ʻoe hoʻokahi. Hiki iā ʻoe ke hoʻokele maikaʻi i kēia kūlana me ka ʻōlelo aʻoaʻo lapaʻau kūpono a me kahi ʻano maikaʻi. Pulmonary Hypertension, PH, Pulmonary Hypertension, Maʻi puʻuwai, Maʻi puʻuwai, Paʻakikī hanu, Maʻi hanu