Ua emi anei nā aʻa e lawe ana i ke koko i kou mau puʻupaʻa? (Renal Artery Stenosis) E kamaʻilio kākou e pili ana i kēia!

ʻO nā puʻupaʻa kekahi o nā ʻōkana koʻikoʻi loa o ko kākou kino. Ua like lākou me kahi kānana e hoʻomaʻemaʻe i nā ʻōpala i loko o ko kākou kino. Akā i kekahi manawa, me ka ʻike ʻole ʻia e kākou, hiki ke ālai ʻia nā kahawai nui e hoʻolako ana i ke koko i nā puʻupaʻa, ʻo ia hoʻi nā aʻa renal. ʻO kēia ka mea a mākou e kapa nei ma ke ʻano lapaʻau ʻo 'Renal Artery Stenosis' (RAS) a i ʻole ka maʻi renal artery. Hiki i kēia ke lilo i maʻi koʻikoʻi, no ka mea hiki ke alakaʻi i nā maʻi e like me ke koko kiʻekiʻe (hypertension) , ka maʻi puʻupaʻa mau (maʻi puʻupaʻa mau), a ma hope ka hāʻule ʻana o ka puʻupaʻa. No laila, he mea nui loa ka makaʻala i kēia.

ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o kēia maʻi?

I ka ʻōlelo maʻalahi, ʻoiai hiki ke ulu kēia ʻano i loko o kekahi, ʻoi aku ka nui o ka pilikia o kekahi poʻe. ʻOi aku ka pilikia o ka poʻe me ka atherosclerosis . ʻO Atherosclerosis kahi ʻano e hōʻiliʻili ai nā mea momona e like me ka cholesterol a me ka plaque i loko o nā paia o ko mākou mau kīʻaha koko, hiki ke alakaʻi i nā blockages. E noʻonoʻo e like me ka paipu wai e paʻa ana i ka lepo i ka hala ʻana o ka manawa.

No laila, inā loaʻa iā ʻoe kekahi o nā kumu pilikia ma lalo nei, he mea maikaʻi ke makaʻala iki aʻe:

• Inā loaʻa iā ʻoe ka maʻi diabetes .
• Inā loaʻa i kekahi o ka ʻohana ka maʻi cardiovascular (ʻo ia hoʻi, kahi loulou hoʻoilina).
• Inā he koko kiʻekiʻe kou.
• Inā he kiʻekiʻe kou mau pae cholesterol koko .
• ʻO ke ʻano momona , ʻo ia hoʻi ke kaumaha o ke kino.
• Hoʻonui ka pilikia me ka makahiki (nā kāne ma luna o 45 mau makahiki, nā wahine ma luna o 55 mau makahiki).
• ʻAi ʻai maikaʻi ʻole , ʻo ia hoʻi ka ʻai pinepine ʻana i nā meaʻai kiʻekiʻe i ka paʻakai, ka ʻaila, a me ke kō.
• Inā ʻoe e puhipaka , he mea pōʻino kēia no nā mea he nui.

He aha ka pilina ma waena o ka stenosis o ke aʻa renal a me ka maʻi aʻa peripheral?

Eia kekahi mea nui. Hoʻopilikia kēia renal artery stenosis (RAS) i nā aʻa e lawe ana i ke koko i nā puʻupaʻa. Akā aia kekahi maʻi i kapa ʻia ʻo 'Peripheral Artery Disease' (PAD) . Ma kēia, ua ālai ʻia nā aʻa e lawe ana i ke koko mai ka puʻuwai a i nā lima a me nā wāwae. E noʻonoʻo, ke hele ʻoe, ʻike ʻoe i ka ʻeha ma kou mau wāwae, a ma hope o kekahi manawa hiki iā ʻoe ke hele hou, hiki iā ʻoe ke ʻike i nā hōʻailona o kēia PAD.

ʻO ke kumu nui o RAS a me PAD ʻo ia ka atherosclerosis i ʻōlelo ʻia ma luna . Ua hōʻike ʻia nā noiʻi ma waena o 14% a me 35% o ka poʻe me PAD hiki ke loaʻa iā RAS. ʻO ke ʻano kēia he pilina ikaika ma waena o nā mea ʻelua.

Eia kekahi, ua ʻike ʻia ka poʻe me ka maʻi puʻupaʻa mau loa, hiki ke hana ʻia e RAS, ua ʻoi aku ka nui o ka pilikia o ka loaʻa ʻana o ka PAD. ʻOi aku ka nui o ka pilikia o ke kanaka me nā kūlana ʻelua i ka loaʻa ʻana o nā pilikia olakino koʻikoʻi, e like me ka hōʻeha puʻuwai, ka hahau ʻana, a me ka nalowale ʻana o nā lālā . No laila, he mea nui e makaʻala i kēia mau mea.

He aha nā hōʻailona? Pehea mākou e ʻike ai i kēia?

I ka manawa pinepine, ʻaʻole hōʻike kēia ʻano renal artery stenosis (RAS) i kekahi mau hōʻailona i nā pae mua. Me he mea lā e kolo mālie ana iā ʻoe a e hoʻonui ana i ka maʻi. ʻO nā pilikia, e like me ke koko kiʻekiʻe a me ka hāʻule ʻana o nā puʻupaʻa, hoʻomaka wale e ʻike ʻia ke ʻoi aku ka koʻikoʻi o ka maʻi. Ke hana pono ʻole nā ​​puʻupaʻa, hiki ke loaʻa kēia mau hōʻailona. E nānā inā loaʻa iā ʻoe kekahi o kēia mau mea:

• Ke paʻakikī nei ʻoe i ka noʻonoʻo ʻana a i ʻole ke huikau nei ?
• ʻAʻole hiki ke hiamoe? (Paʻakikī ke hiamoe)
• Aia kekahi mau wahi o kou kino i pehu i ka wai? (Edema), ʻoi aku hoʻi ma nā wāwae a me nā kuʻekuʻe wāwae.
• Ke luhi mau nei ʻoe? Ke luhi nei ʻoe ma hope o ka hana ʻana i kahi hana liʻiliʻi?
• Loaʻa pinepine iā ʻoe ke poʻo ʻeha ?
• Ua nalowale anei kou makemake e ʻai ?
• Ke ʻeha nei ʻoe i nā ʻiʻo a i ʻole nā ​​ʻūmiʻi ?
• Loaʻa iā ʻoe ka nausea a me ka luaʻi ?
• Ke ʻike nei ʻoe i ka pōkole o ka hanu (dyspnea) ? Ke manaʻo nei ʻoe i ka pōkole o ka hanu ʻoiai ma hope o ka hele wāwae ʻana no kekahi manawa pōkole?
• Nā loli o ka ʻili - nā mea e like me ka ʻili maloʻo, ka maneʻo, a i ʻole ka ʻeleʻele ʻana o ka ʻili.
• Ke emi nei kou kaumaha me ke kumu ʻole? (Ka emi ʻana o ke kaumaha i wehewehe ʻole ʻia)
• Ke mimi pinepine nei ʻoe a emi mai paha ma mua o ka maʻamau?

ʻOiai inā loaʻa iā ʻoe kekahi a ʻelua paha o kēia mau hōʻailona, ​​ʻaʻole ia he manaʻo ua loaʻa iā ʻoe ka maʻi. Eia nō naʻe, inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​​​he mea naʻauao ke ʻimi i ka ʻōlelo aʻoaʻo lapaʻau.

No ke aha i ālai ʻia ai kēia mau aʻa renal? He aha nā kumu?

ʻElua kumu nui no kēia.

1. I kahi nui, ma waena o 60% a me 90% o nā hihia o RAS i hoʻokumu ʻia e ke kūlana a mākou i kamaʻilio ai ma mua , ʻo ia hoʻi ka atherosclerosis . ʻO kēia ka hōʻiliʻili ʻana o nā waihona momona (plaque) ma nā paia o nā kīʻaha koko, e hoʻohaiki mālie ana iā lākou. ʻO kēia ke kumu maʻamau.

2. ʻO nā hihia i koe i hoʻokumu pinepine ʻia e kahi kūlana i kapa ʻia ʻo 'Fibromuscular dysplasia' . He ʻokoʻa iki kēia. ʻO kēia kahi e ulu ai nā cell i loko o nā paia o ke aʻa a hoʻolilo i nā aʻa e haiki. ʻAʻole kēia he waihona momona. ʻOi aku ka maʻamau o kēia kūlana i nā wahine. Manaʻo ʻia ua hoʻokumu ʻia e ka genetics a i ʻole nā ​​​​hormones.

He aha nā hopena ʻaoʻao (nā pilikia) e hiki mai ana o kēia?

ʻAʻole he maʻi maʻalahi ka stenosis o ke aʻa Renal. Inā ʻaʻole mālama pono ʻia, hiki iā ia ke alakaʻi i kekahi mau pilikia ʻē aʻe. Eia kekahi laʻana:

• Maʻi puʻupaʻa mau loa: Ka emi mālie ʻana o ka hana a nā puʻupaʻa.
• ʻO ka maʻi o ke aʻa coronary: Hiki ke pale ʻia nā mea like i loko o nā aʻa e hoʻolako ana i ke koko i ka puʻuwai.
• Ka atrophy o ka puʻupaʻa: Hiki ke emi iho ka nui o nā puʻupaʻa.
• Ka hāʻule ʻana o ka puʻupaʻa: I ka hopena, hiki i nā puʻupaʻa ke ho'ōki loa i ka hana ʻana, e koi ana i ka dialysis a i ʻole kahi hoʻoili puʻupaʻa.
• ʻO ka maʻi aʻa peripheral: Ka pale ʻana o nā aʻa e lawe ana i ke koko i nā lālā.
• Ke koko kiʻekiʻe o ka renal: Ke koko kiʻekiʻe i loko o nā aʻa renal.

ʻO ia ke kumu he mea nui loa e ʻike koke i ke kauka inā kānalua ʻoe i kahi ʻano e like me kēia a i ʻole he mau hōʻailona.

Pehea e ʻike pono ʻia ai kēia maʻi?

I kekahi manawa, ʻike nā kauka i ka stenosis o ke aʻa renal ma ke ʻano ulia. ʻO ia hoʻi, ke hoʻāʻo nei lākou iā ʻoe no kekahi maʻi ʻē aʻe. Eia nō naʻe, inā kānalua kāu kauka he RAS kou, hiki iā lākou ke hana i kekahi mau hoʻokolohua, e like me:

• Hoʻokolokolo kino: ʻO ka mea mua, e nānā pono ʻia ʻoe. E nānā ʻia kou koko . I kekahi poʻe, hiki i kēia kūlana ke hoʻoulu i ke koko kiʻekiʻe hiki ʻole ke kāohi ʻia. E nānā lākou i ka pehu ʻana i kou mau lālā a hoʻolohe i kou hanu ʻana. Hiki i ke kauka ke kau i kahi stethoscope ma luna o kou mau puʻupaʻa e hoʻolohe i ke koko e gurgling. Hiki iā ʻoe ke lohe i kahi kani 'whooshing' i ke kahe ʻana o ke koko ma o kahi aʻa i paʻa. ʻO ka hōʻailona nui o RAS ʻo ia ke koko kiʻekiʻe i wehewehe ʻole ʻia .
• Nā hoʻāʻo hana puʻupaʻa: ʻO ka mea aʻe, hana ʻia nā hoʻāʻo koko a me ka mimi e ʻike i ka maikaʻi o ka hana ʻana o kou mau puʻupaʻa. Ke nānā nei kēia mau hoʻāʻo i nā pae kiʻekiʻe o nā huahana ʻōpala e like me ka protein, creatinine , a me ka naikokene i loko o kou kino. ʻO kēia nā mea e pono ai kou mau puʻupaʻa e kānana i waho o kou kino. Inā kiʻekiʻe lākou, ʻo ia hoʻi ʻaʻole kāu mau puʻupaʻa e kānana pono i nā huahana ʻōpala.
• Nā scan kiʻi: Eia kekahi, aia nā ʻano scan kiʻi like ʻole e hiki ke hoʻohana ʻia e ʻike pono i ka nui o kou mau puʻupaʻa a me ke kahe maikaʻi ʻana o ke koko iā lākou. Hiki i kēia mau mea ke hōʻike i ke ʻano o ka haiki o kou mau aʻa. Hiki i kāu kauka ke ʻōlelo aku i kahiHiki ke noi ʻia ʻoe e hana i kahi scan renal, duplex ultrasound, computerized tomographic angiography (CTA), a i ʻole magnetic resonance angiogram (MRA) . Hiki i kēia mau scan ke hāʻawi i kahi kiʻi maopopo o nā aʻa renal.

He aha nā lāʻau lapaʻau no kēia?

ʻO nā lāʻau lapaʻau nui no kēia maʻi (RAS) he mau hoʻololi ʻana i ke ʻano o ka nohona a me nā lāʻau lapaʻau . Pono e hoʻohana pū ʻia nā mea ʻelua. Eia nō naʻe, inā ua ʻūmiʻi loa nā aʻa renal, aia kahi pilikia o ka pani ʻana o ke aʻa, inā ʻaʻole hiki i ka lāʻau lapaʻau ke kāohi i ke kaomi, a inā hoʻomau ka hana o nā puʻupaʻa i ka emi ʻana, pono paha ke ʻoki kino .

Pehea e hiki ai ke kaohi ʻia kēia kūlana ma o nā hoʻololi ʻana i ke ʻano o ka nohona?

He mea nui loa kēia. ʻAʻole lawa ka lawe ʻana i ka lāʻau lapaʻau wale nō. E paipai maoli kāu kauka i kekahi mau hoʻololi i ke ʻano o ka nohona e kōkua i ka hoʻomalu ʻana i kēia maʻi (RAS) a hoʻohaʻahaʻa i kou koko kiʻekiʻe. Eia nā mea āu e hana ai:

• ʻAi ʻana i ka ʻai olakino: E ʻai i nā meaʻai haʻahaʻa i ka momona, cholesterol, paʻakai (sodium), a me ke kō. ʻO ke ʻano kēia e hōʻemi i ka laiki palai, nā meaʻai palai, nā mea inu kō, a me nā meaʻai māmā momona. E hoʻokomo i nā mea kanu home, nā huaʻai, a me nā nati i kāu papaʻai. ʻOiai nā hoʻololi liʻiliʻi e like me kēia hiki ke hana i kahi ʻokoʻa nui.
• Ka hoʻoikaika kino mau: E hana i kekahi mea e like me ka hele wāwae a i ʻole ke kaʻa paikikala no 30 mau minuke i ka lā. ʻAʻole pono ka hoʻoikaika kino e hele i ka hale hoʻoikaika kino.
• Ka hoʻemi kaumaha: E ho'āʻo e mālama i kahi kaumaha kūpono no kou kiʻekiʻe.
• Ke hoʻōki ʻana i ka puhipaka: Inā ʻoe e puhipaka, e hoʻōki koke. Hiki ke paʻakikī kēia, akā aia nā ala e loaʻa ai ke kōkua.

He aha ke kōkua e hāʻawi ai nā lāʻau lapaʻau?

Me nā hoʻololi ʻana i ke ʻano o ka nohona, hiki i kāu kauka ke kuhikuhi i kekahi mau lāʻau lapaʻau e kōkua i ka kaohi ʻana i ke koko kiʻekiʻe a hoʻōki a kāohi paha i ka holomua o ka maʻi puʻupaʻa. Pono e hoʻohana ʻia kēia mau mea e like me ka ʻōlelo a kāu kauka iā ʻoe.

• ʻO nā lāʻau lapaʻau e like me nā ACE inhibitors a me Angiotensin Receptor Blockers (ARBs) e ālai i kekahi mau hormones e hiki ke hoʻopaʻa i kou mau kīʻaha koko.
• ʻO nā anticoagulants, e like me ka aspirin , kōkua i ke kahe koko ma o nā aa koko me ka maʻalahi.
• ʻO nā mea pale Beta a me nā mea pale calcium, e hoʻemi ana i ke koko kiʻekiʻe.
• ʻO nā diuretics , i ʻike ʻia hoʻi he 'nā pila wai', hana ma ke kōkua ʻana i kou mau puʻupaʻa e wehe i ka wai keu a me ka paʻakai mai kou kino, e hoʻohaʻahaʻa ana i kou koko koko.
• Hoʻohaʻahaʻa i nā pae cholesterol kokoNā Statins.

He aha nā ʻano hana ʻoki kino e loaʻa ana no kēia?

Inā koʻikoʻi ke kūlana (RAS) e hiki ai ke kāohi ʻia e ka lāʻau lapaʻau a me nā hoʻololi ʻana i ke ʻano o ka nohona, e like me ka wā i ālai ʻia ai ke aʻa ma mua o 70%, pono paha ke ʻoki kino. ʻEkolu mau ʻano nui o ke ʻoki kino:

1. Angioplasty a me ka stenting: ʻO kēia ke kaʻina hana maʻamau. Ma kēia kaʻina hana, hoʻokomo ke kauka lapaʻau i kahi paipu lahilahi a palupalu (catheter) i loko o kou aʻa renal i paʻa, ma o kou ʻūhā a lima paha. A laila hoʻopiha ʻia ka catheter me kahi pōpō liʻiliʻi ma ka hopena e hoʻonui i ke aʻa. A laila kau ʻia kahi stent (kahi paipu liʻiliʻi e like me ka mesh) i loko o ke aʻa e pale aku ai i ka pani hou ʻana a e ʻae i ke koko e kahe i ka puʻupaʻa. He kaʻina hana minimally invasive kēia.

2. ʻO ke kāpae ʻana i ke aʻa renal: He hana nui kēia. Ua like ia me ke kāpae ʻana i ka puʻuwai. Ma kēia kaʻina hana, hana ke kauka lapaʻau i kahi ala hou no ke kahe ʻana o ke koko i ka puʻupaʻa, e kāpae ana i ke aʻa renal i paʻa a i ʻole i ālai ʻia. ʻO ka maʻamau, pili kēia i ka hoʻohana ʻana i kahi graft mai kou wāwae ponoʻī a i ʻole kahi paipu hana. Hoʻopili ʻia kēia graft a i ʻole ka paipu i kahi aʻa olakino e kū nei, a ua hoʻopili ʻia kekahi ʻaoʻao i ke aʻa i ālai ʻia, ma waena o ke aʻa i ālai ʻia a me ke puʻupaʻa.

3. Renal endarterectomy: Ma kēia kaʻina hana, wehe ke kauka lapaʻau i ke aʻa renal i ālai ʻia a wehe i ka plaque a me nā mea ʻē aʻe e ālai ana i ke kahe koko.

Na kāu kauka e hoʻoholo i kahi o kēia mau ʻoki kino e kūpono iā ʻoe.

Pehea mākou e pale ai iā mākou iho mai kēia maʻi? (Ka pale ʻana)

"ʻOi aku ka maikaʻi o ka pale ʻana ma mua o ka hoʻōla ʻana," wahi a lākou. No laila, eia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia o ka loaʻa ʻana o kēia maʻi (RAS):

• E ʻai i ka meaʻai kaulike .
• E hoʻoikaika kino i nā manawa a pau .
• Ke mālama ʻana i kou koko . E nānā mau i kou koko.
• Ka mālama ʻana i ke kaumaha o ke kino olakino .
• Mai puhi paka .

ʻO ka hana ʻana i kēia mau mea ʻaʻole wale nō e pale aku i ke ālai ʻana o nā aʻa puʻupaʻa, akā hiki nō hoʻi iā ia ke pale aku iā ʻoe mai nā maʻi ʻē aʻe he nui.

He aha ka manaʻo no kekahi me kēia maʻi?

ʻO ka maʻi ʻaʻa Renal (RAS) kahi maʻi e holomua ana e ʻoi aku ka ʻino i ka hala ʻana o ka manawa. ʻO ka nānā ʻana no kekahi me kēia maʻi e pili ana i ke koʻikoʻi o ka maʻi, pehea ka wikiwiki o ka ʻike ʻia ʻana, a pehea ka maikaʻi o kā lākou pane ʻana i ka lāʻau.

Ua hōʻike ʻia e ka noiʻi he 48% wale nō o ka poʻe me 95% a ʻoi aku paha i ālai ʻia nā aʻa renal he ʻehā makahiki ka nui o ke ola. ʻO ia hoʻi, ʻo ka hapalua wale nō o ka poʻe me nā ālai piha e ola ana i ʻehā mau makahiki ma hope o ka hōʻoia ʻana.No laila, he mea nui loa ka ʻike ʻana i kēia maʻi i ka wā mua a ʻimi i ka lāʻau lapaʻau. Inā ʻike koke ʻia, hiki ke hoʻemi ʻia ka hōʻino ʻana i nā puʻupaʻa a hiki ke hoʻolōʻihi ʻia ke ola.

Āhea wau e ʻike ai i ke kauka e pili ana i kēia?

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o nā hōʻailona ma lalo nei, e ʻike koke i ke kauka . He mau hōʻailona paha kēia o ka hana haʻahaʻa loa o nā puʻupaʻa:

• Inā ʻike ʻoe i kahi ʻono metala i loko o kou waha.
• Inā loaʻa iā ʻoe ka ʻeha o ka ʻōpū .
• Inā pilikia ʻoe i ka noʻonoʻo ʻana, ka huikau a i ʻole nā ​​pilikia e noʻonoʻo ai .
• Inā haʻahaʻa loa ka nui o ka mimi e hoʻopuka ʻia (Low urine output) .
• Inā hoʻomau ka nausea a me ka luaʻi .
• Inā loaʻa iā ʻoe nā ʻōʻili .
• Ka pehu ʻana ma kou mau wāwae, lima a i ʻole ke alo .

Mai hoʻowahāwahā i kēia mau mea. Inā loaʻa koke iā ʻoe ka lāʻau lapaʻau, hiki iā ʻoe ke pale i ka pōʻino nui.

ʻO ka mea hope loa, nā mea e pono ai ʻoe e hoʻomanaʻo (Leka Lawe-Home)

ʻO ka Renal Artery Stenosis (RAS) kahi ʻokiʻoki o nā aʻa e hoʻolako koko i nā puʻupaʻa. ʻO ke kumu nui o kēia, ʻo ia nā waihona momona i loko o nā aʻa (atherosclerosis) . Hiki i kēia ke alakaʻi i nā pilikia olakino koʻikoʻi e like me ke koko kiʻekiʻe, ka maʻi puʻupaʻa mau, a me ka hāʻule ʻana o ka puʻupaʻa.

E hoʻomanaʻo, ʻaʻole hōʻike pinepine kēia i nā hōʻailona i ka wā mua, akā hiki ke lilo i mea weliweli inā ʻaʻole mālama pono ʻia.

ʻO nā hoʻololi ʻana i ke ʻano o ka nohona (ʻai maikaʻi, hoʻoikaika kino, a me ka haʻalele ʻana i ka puhipaka) a me nā lāʻau lapaʻau i kuhikuhi ʻia e kāu kauka nā lāʻau lapaʻau nui. I kekahi mau hihia, pono paha ke ʻoki kino. No laila, ʻo ka nānā ʻana i nā hōʻailona, ​​​​ka kaohi ʻana i nā kumu pilikia inā loaʻa iā ʻoe, a me ka ʻimi ʻana i ke aʻo lapaʻau i ka manawa kūpono he mea nui loa ia e mālama i ke olakino o kou mau puʻupaʻa. E mālama i kou kino, no ka mea, ʻo ke olakino ka waiwai nui loa!

ʻO ka Stenosis o ke aʻa Renal, ke koko kiʻekiʻe, ka maʻi puʻupaʻa, Atherosclerosis, Arterial Stenosis, Ola Kino