Ke manaʻo nei hoʻi ʻoe i ka hanu pōkole a i ʻole ka wheezing ke hoʻoikaika ʻoe iā ʻoe iho, piʻi i nā alapiʻi, a hana paha i nā hana maʻamau? I kekahi manawa ʻo ke kumu o kēia he ʻūpā koko kahiko i loko o kou mau māmā no ka manawa lōʻihi. ʻO ka maʻamau, ʻoiai inā ʻoe e hoʻāʻo e kāohi i kēia kūlana me ka lāʻau lapaʻau, inā ʻaʻole ia e holo pono, kuhikuhi nā kauka iā ʻoe i kahi ʻoki kino kūikawā e hiki ke hoʻopakele i kou ola. I kēia lā ke kamaʻilio nei mākou e pili ana i kēlā ʻoki kino paʻakikī, akā koʻikoʻi loa, ʻo PTE.
He aha kēia ʻoki kino PTE?
I ka ʻōlelo maʻalahi, ʻo PTE kahi pōkole no Pulmonary Thromboendarterectomy . He hana ʻoki kēia e wehe ai i nā ʻōpū koko kahiko a me nā ʻiʻo ʻeha i paʻa i loko o nā kīʻaha koko nui (nā aʻa pulmonary) i loko o kou mau māmā. He hana paʻakikī iki kēia e pono ai ka ʻike kūikawā. Akā hiki iā ia ke ho'ōla loa i kekahi mau maʻi.
He aha nā kūlana i mālama ʻia me ke ʻoki PTE?
Hana nui ʻia kēia ʻoki kino no ka mālama ʻana i kahi maʻi i kapa ʻia ʻo CTEPH (Chronic Thromboembolic Pulmonary Hypertension) . Manaʻo paha ʻoe, 'He inoa lōʻihi loa kēlā,' ʻeā? E maʻalahi kākou.
E noʻonoʻo, he ʻūpā koko ko kekahi i loko o ko lākou mau māmā. Kāhea mākou iā ia he "Pulmonary Embolism (PE)". ʻO ka hapa nui o ka manawa, e heheʻe kēia mau ʻūpā koko ke hāʻawi ʻia iā lākou i nā lāʻau hoʻokahe koko. Akā, he mea kākaʻikahi loa, i kekahi poʻe, ʻaʻole e heheʻe loa kēia mau ʻūpā koko, akā e pili ana i nā paia o nā kīʻaha koko i loko o nā māmā, a i ka hala ʻana o ka manawa, e lilo i ʻiʻo ʻeha.
Ke ālai ʻia nā kīʻaha koko kahiko a me nā ʻiʻo ʻeha i nā kīʻaha koko i loko o nā māmā, lilo ke koko i loko o kēlā mau kīʻaha koko i kiʻekiʻe loa. ʻO ia ka mea a mākou e kapa nei ʻo CTEPH.
ʻO kēia ke kumu e hana nui ai ka ʻaoʻao ʻākau o ka puʻuwai e pamu i ke koko i nā māmā. I ka hala ʻana o ka manawa, hiki i kēia ke alakaʻi i nā kūlana koʻikoʻi e like me ka hāʻule ʻana o ka puʻuwai a me ka hōʻino ʻana o ka māmā. ʻO ke ʻoki kino PTE wale nō ka lāʻau e hiki ai ke ho'ōla iā CTEPH.
ʻO wai ka mea e pono ai kēia ʻoki kino? Hiki i nā kānaka a pau ke hana?
Inā loaʻa iā ʻoe ka CTEPH, e hoʻoholo kekahi mau kumu inā hiki iā ʻoe ke hana i ke ʻoki PTE.
| Manaʻo | Wehewehena |
|---|---|
| Ka nui o nā hōʻailona | Pehea ka koʻikoʻi o kāu mau hōʻailona, e like me ka hanu pōkole a me ka wheezing. |
| Kahi o ke koko koko | ʻO ka ʻoiaʻiʻo aia nā ʻūpā koko a me nā ʻiʻo ʻeha ma nā wahi e hiki ai ke wehe palekana ʻia ma ke ʻoki ʻana. |
| Kou olakino holoʻokoʻa | He mea nui nō hoʻi kou mau makahiki, ka hana o ka puʻuwai a me ka māmā, a inā he mau maʻi ʻē aʻe kou. |
ʻAʻole kūpono nā poʻe maʻi CTEPH āpau no kēia ʻoki kino. Ma kahi o 40% o nā poʻe maʻi ʻaʻole kūpono no kēia ʻoki kino. ʻO ke kumu o kēia, he ʻoki kino paʻakikī loa ia.
No ke aha i paʻakikī ai ke ʻoki kino?
E noʻonoʻo i ka wā o ke ʻoki ʻana, ua kau ʻia kou puʻuwai a me kou mau māmā ma luna o kahi mīkini bypass cardiopulmonary e kōkua i kekahi o nā hana. A laila, i hiki i ke kauka ʻoki ke ʻike i loko o kou mau māmā, ua hoʻohaʻahaʻa ʻia ka mahana o kou kino i 18 degere Celsius (65°F), a ua hoʻōki ʻia ke kahe koko no kekahi manawa. Ua kapa ʻia kēia he 'deep hypothermic circulatory arrest.' Mai hopohopo, hiki i kēia kaʻina hana i ke kauka ʻoki ke wehe i nā clots koko a me nā ʻiʻo ʻeha me ka maʻemaʻe loa me ka pale ʻana i kou lolo mai kekahi pōʻino.
Pehea e hoʻomākaukau ai no ke ʻoki kino?
E hāʻawi aku kāu kauka iā ʻoe i nā kuhikuhi a pau āu e pono ai ma mua o ke ʻoki kino. E haʻi pinepine lākou iā ʻoe e hoʻolohe i kēia mau mea:
- Nā lāʻau lapaʻau: E noi ʻia ʻoe e hoʻōki i ka lawe ʻana i nā lāʻau hoʻokahe koko (e like me ka aspirin a me ka warfarin) a me kekahi mau lāʻau hoʻomaha ʻeha (NSAID) i kekahi mau lā ma mua o ke ʻoki ʻana, no ka mea hiki i kēia ke hoʻonui i ka pilikia o ke kahe ʻana o ke koko i ka wā o ke ʻoki ʻana.
- ʻAi a me ka mea inu: E noi ʻia ʻoe e hoʻokē ʻai (ʻaʻole e ʻai a inu paha) no kekahi mau hola ma mua o ke ʻoki ʻana. ʻOi aku ka palekana o ka ʻōpū hakahaka i ka wā e hāʻawi ʻia ai ka anesthesia.
- Ka puhipaka a me ka waiʻona: Inā hoʻohana ʻoe i nā mea ʻelua, he mea nui loa e hoʻōki loa ma mua o ke ʻoki ʻana, no ka mea, e hoʻopaneʻe ana lākou i ke kaʻina hana ho'ōla a hoʻonui i ka pilikia o nā pilikia.
He aha ka mea e hana ʻia ma hope o ke ʻoki kino?
Ma hope o ke ʻoki kino, e hoʻokomo ʻia ʻoe i ka ʻāpana mālama koʻikoʻi (ICU). E noho ʻoe ma laila i kēlā pō. I ke kakahiaka aʻe, e nānā lākou inā hiki iā ʻoe ke hanu iā ʻoe iho a laila e wehe i ka ventilator.
E noho mau ʻoe ma ka haukapila no 7 a 10 mau lā. I loko o kēia manawa, e hoʻomaka mālie ʻoe e hele. E loaʻa nō hoʻi iā ʻoe kekahi mau hoʻokolohua e ʻike ai inā pono ʻoe i ka oxygen ma mua o kou hoʻi ʻana i ka home. He ʻike like kēia me ka hoʻōla ʻana mai ke ʻoki puʻuwai hāmama.
He aha nā pono a me nā pilikia?
E like me nā hana ʻoki kino a pau, loaʻa iā PTE nā pono a me nā pilikia.
| Nā Pōmaikaʻi | Nā Pōʻino |
|---|---|
| ʻO ka hiki ke ho'ōla piha ʻia mai CTEPH. | ʻO ka pilikia o ka make i ka wā o ke ʻoki ʻana (i kēia manawa he haʻahaʻa kēia e like me 1%). |
| Hoʻomaikaʻi nui i ka hanu ʻana a me ka hiki ke hoʻoikaika kino. | Ka pilikia o ka hahau ʻana (1%-2%). |
| Hoʻōla hou ʻia ka pohō ma ka ʻaoʻao ʻākau o ka puʻuwai. | Noho nō ke koko kiʻekiʻe pulmonary (PH) i kekahi pae ma hope o ke ʻoki kino. |
| ʻO ka hiki ke ola i kahi ola lōʻihi a olakino hoʻi ma hope o ke ʻoki ʻana. | Ka hōʻiliʻili ʻana o ka wai a puni ka puʻuwai (pericardial effusion). |
Pōpilikia!
Inā loaʻa iā ʻoe ka ʻeha umauma koke a koʻikoʻi, ka pōkole o ka hanu, a i ʻole ka hiolo ʻana ma hope o ke ʻoki ʻana, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila kokoke loa. Eia kekahi, inā loaʻa iā ʻoe nā hōʻailona e like me ka pehu, ka ʻulaʻula, ka pus, a i ʻole ke kuni ma kahi i ʻoki ʻia ai, e ʻike koke i kāu kauka.
Pehea ka manawa ho'ōla?
Ma kahi o 3 mahina e ho'ōla piha ai.
- Nā pule 6 mua: ʻAʻohe kalaiwa, hele i ka hana, a i ʻole ka hāpai ʻana ma mua o 4.5 kg (10 lbs).
- Pule 7 a 12: Hiki ke hāpai a hiki i 11 kg (25 lbs).
- Ma hope o 12 mau pule: ʻAʻohe kapu.
Hiki ke hoʻomaikaʻi mālie ʻia kou hiki ke hanu a me ka hoʻoikaika kino a hiki i 4 mau makahiki ma hope o ke ʻoki ʻana.
Leka Lawe-Home
- ʻOiai he ʻoki kino paʻakikī ka PTE e wehe ai i nā ʻōpū koko kahiko i loko o nā māmā, hiki iā ia ke ho'ōla loa i ke kūlana i kapa ʻia ʻo CTEPH.
- ʻAʻole no nā kānaka āpau kēia ʻoki kino. Na kāu kauka a me ka hui o nā loea e hoʻoholo inā kūpono ia iā ʻoe.
- ʻOiai ua lōʻihi iki ka manawa hoʻōla, e hoʻomaikaʻi nui ʻia kou ʻano ola, kou hiki ke hanu, a me kou neʻe ʻana ma hope o ke ʻoki ʻana.
- Ma hope o ke ʻoki ʻana, pono ʻoe e lawe i nā anticoagulants no ke koena o kou ola e pale ai i ke kūkulu hou ʻana o nā clots koko.
- He mea nui e ʻike i kāu kauka i ka manawa kūpono a hoʻāʻo ʻia. Mai makaʻu e kamaʻilio me kāu kauka e pili ana i kekahi ʻano pilikia āu e ʻike nei.
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