He aha ke ʻano o ke kau ʻana o kahi stent i loko o nā kīʻaha koko e hiki aku ana i ka puʻupaʻa? (Renal Artery Stenting)

Loaʻa iā ʻoe ke koko kiʻekiʻe? Malia paha ke hoʻohana nei ʻoe i kekahi mau lāʻau lapaʻau, akā ke pilikia nei ʻoe i ka kaohi ʻana i kou koko? I ia mau hihia, ʻo ke kumu paha he paʻa ʻana i loko o ke kīʻaha koko nui e lawe ana i ke koko i kou mau puʻupaʻa. I kēia lā, e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau kūikawā no ia mau hihia.

I ka ʻōlelo maʻalahi, he aha ka Renal Artery Stenting?

He mea maʻalahi loa ia. Hiki i nā kīʻaha koko nui e hoʻolako i ke koko i kou mau puʻupaʻa (kapa mākou i kēia mau mea he mau aʻa renal) ke ālai ʻia i kekahi manawa e nā waihona momona. Ua kapa ʻia kēia ʻano he `(Renal Artery Stenosis)`. No laila, ʻo `Renal Artery Stenting` kahi hana e pili ana i ka hoʻokomo ʻana i kahi ʻōmole liʻiliʻi e like me ka mesh (ua kapa ʻia kēia he `stent`) i loko o ke kīʻaha koko i ālai ʻia, e wehe hou ana i kahi i ālai ʻia a hoʻihoʻi i ke kahe o ke koko.

E noʻonoʻo e pili ana i ia mea, ʻo nā puʻupaʻa ke ʻano nui e kāohi ana i ka nui o ka paʻakai a me ka wai i loko o ko kākou kino. Hana lākou i kēia ma ke kānana ʻana i ke koko a me ka hana ʻana i ka mimi. No laila, inā ʻaʻole loaʻa i nā puʻupaʻa ka nui o ke koko e pono ai, ʻaʻole hiki iā lākou ke hana pono i kēia hana. A laila hoʻomaka ka wai a me ka paʻakai e hōʻiliʻili i loko o ke kino.

Hoʻopuka pū nā puʻupaʻa i kahi hormone i kapa ʻia ʻo `(Renin).` Kōkua kēia hormone i ke kino e paʻa i ka paʻakai a me ka wai a hoʻopaʻa i nā kīʻaha koko. Ke ʻike ka puʻupaʻa ua haʻahaʻa ke koko e hele mai ana i laila, manaʻo ka puʻupaʻa ua haʻahaʻa maoli ke koko i loko o ke kino. A laila hoʻopuka hou aku ia i ka `(Renin).` Akā ʻo ka mea e hana maoli nei, ua ālai ʻia ke kīʻaha koko a ua emi ke kahe o ke koko i ka puʻupaʻa, a hiki i ke koko i loko o ke kino ke kiʻekiʻe i kēlā manawa. Ke hui pū ʻia kēia mau mea a pau, hana mākou i kahi kūlana i kapa ʻia ʻo `(Renal Hypertension)` e hoʻoulu ai i ke koko kiʻekiʻe. Hiki i kēia ke kau i ka nui o ke kaomi ma ka puʻuwai a me nā ʻōpū ʻē aʻe, a i ka hala ʻana o ka manawa, hiki iā ia ke alakaʻi i ka hāʻule ʻana o ka puʻupaʻa .

No ke aha he mea pono e kau i kahi stent i loko o kahi kīʻaha koko i loko o ka puʻupaʻa?

Inā hoʻoholo kāu kauka he paʻa nui kou i loko o ke kīʻaha koko e alakaʻi ana i kou puʻupaʻa a pono e mālama ʻia, paipai paha lākou e kau i kahi stent. Kōkua kēia i ka pale ʻana i ka hōʻino hou ʻana i kou mau puʻupaʻa. Akā e hoʻomanaʻo, ʻaʻole pono nā paʻa āpau i loko o nā aʻa renal i kahi stent.

Ma keʻano laulā, aia kekahi mau kūlana e pono ai ʻoe i kēia lāʻau lapaʻau:

• Inā ʻoi aku ma mua o 60% o nā kīʻaha koko i ālai ʻia ma muli o nā waihona momona i loko o nā kīʻaha koko (atherosclerosis), a ʻaʻole hiki ke kāohi ʻia me ka lāʻau lapaʻau.
• Inā ʻoe e lawe ana i ʻekolu a ʻoi aku paha nā lāʻau lapaʻau koko kiʻekiʻe i nā nui loa a ʻaʻole hiki ke hoʻomalu i kou koko.
• Inā ua ālai ʻia nā kīʻaha koko ʻelua e alakaʻi ana i nā puʻupaʻa ʻelua ma mua o 60%.
• Inā hoʻokahi wale nō kou puʻupaʻa, a ua ālai ʻia ke kīʻaha koko e hele ana i laila ma mua o 60%.
• Inā ʻike ʻoe i nā kūlana e like me ka "flash pulmonary edema" kahi e piha koke ai nā māmā i ka wai.

He aha ka mea e hana ʻia ma mua o ka lāʻau lapaʻau?

Ma mua o ka hana ʻana i kēia lāʻau lapaʻau, e nānā kāu kauka i kou olakino holoʻokoʻa a hana i kekahi mau hoʻokolohua e hoʻoholo ai inā pono ʻoe i kahi stent.

Pono ʻoe e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei (me nā huaora a me nā lāʻau lapaʻau lāʻau) . Hiki i kekahi mau lāʻau lapaʻau, e like me ka aspirin, nā mea hoʻokahe koko, a me nā mea hoʻomaha ʻeha, ke hoʻonui i kou pilikia o ke kahe ʻana o ke koko. No laila,Mai ho'ōki i ka lawe ʻana i kekahi lāʻau lapaʻau me ka ʻole o ke nīnau ʻana i kāu kauka.

Eia kekahi, e haʻi mai iā mākou e pili ana i nā maʻi ʻaleka āu e loaʻa nei. Hoʻokomo pū kēia i nā maʻi ʻaleka i nā lāʻau lapaʻau, kekahi mau huahana hoʻomaʻemaʻe (e like me ka iodine), a me nā meaʻai.

He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?

ʻAʻole kēia e hoʻolilo iā ʻoe i mea hoʻomaopopo ʻole loa. E hāʻawi ʻia ʻoe i kahi wai saline ma o kahi aʻa koko ma kou lima e kōkua iā ʻoe e noho mālie a hiamoe. No laila, ʻaʻole ʻoe e hoʻomanaʻo nui i ka lāʻau lapaʻau.

E hana ke kauka i kahi ʻoki liʻiliʻi loa ma kou ʻūhā a lima paha. Ma o kēlā ʻoki ʻana, e hoʻokomo ʻia kahi ʻōmole hakahaka (ʻūpā) i loko o ke kīʻaha koko. A laila, e hoʻokomo ʻia kekahi ʻōmole lahilahi (catheter) ma o kēlā ʻōmole i ke kīʻaha koko i paʻa e alakaʻi ana i ka puʻupaʻa.

Ke hiki i ka mea e paʻa ai, ua hoʻopiha ʻia kahi pōpō liʻiliʻi ma ka hopena o ka ʻōmole e hoʻonui i ka mea e paʻa ai. A laila, ua kau ʻia ka stent mesh metala a mākou i ʻōlelo ai ma mua ma ia wahi a wehe ʻia. A laila kaomi ia i ka paia o ke kīʻaha koko, e wehe ana i ka mea e paʻa ai a wehe i ke ala no ke kahe ʻana o ke koko. He mea paʻa loa kēia stent i loko o ke kino.

Ke kau ʻia ka stent, e hoʻohaʻahaʻa ʻia ka pōpō a wehe ʻia ke catheter. A laila e pani ʻia ka ʻoki ma ke kaomi ʻana a i ʻole ka hoʻohana ʻana i kahi mea hana kūikawā, a laila e kau ʻia kahi bandage.

He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?

Ma hope o ka mālama ʻana, pono ʻoe e noho i ka haukapila no kekahi mau hola, malia paha i ka pō. E nānā nā limahana lapaʻau i kou koko, ka ʻeha, a me ke olakino holoʻokoʻa. Pono paha e hoʻololi i kāu lāʻau lapaʻau ma mua o kou hoʻi ʻana i ka home. E wehewehe ʻia kēia iā ʻoe.

Ke hoʻoholo ʻia ua kūpono ʻoe e hoʻi i ka home, e hoʻokuʻu ʻia ʻoe mai ka haukapila. Eia nō naʻe , pono ʻoe e kiʻi i kahi lālā o ka ʻohana a i ʻole hoaaloha e hele mai e lawe iā ʻoe i ka home.

He aha nā pōmaikaʻi a me nā pilikia o kēia lāʻau lapaʻau?

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

ʻEhia ka lōʻihi e ho'ōla ai?

Ua ʻoi aku ka maikaʻi o ka hapa nui o ka poʻe i loko o kekahi mau lā. E aʻo aku kāu kauka iā ʻoe i ke ʻano o kou hana no nā lā mua.

Pono ʻoe e lawe i nā lāʻau hoʻokahe koko e pale aku i nā ʻūpā koko a hiki i ka hoʻōla ʻia ʻana o ka stent. Eia kekahi laʻana, nā lāʻau lapaʻau e like me 'Aspirin' a i ʻole 'Clopidogrel'. Ma muli o kou kūlana, pono paha ʻoe e lawe i kēia mau mea a hiki i hoʻokahi mahina a i ʻole hoʻokahi makahiki. He mea nui loa ka lawe ʻana i kēia mau lāʻau lapaʻau e like me ke kauoha a ʻaʻole e hoʻōki iā lākou me ka ʻole o ke kūkākūkā ʻana me kāu kauka.

Hiki i ka hapa nui o ka poʻe ke hoʻi i ka hana a i ʻole kā lākou mau hana maʻamau i loko o hoʻokahi pule. Eia nō naʻe, inā ʻoe e hana i nā hana ikaika kino, e like me ka hāpai ʻana i nā mea kaumaha, hiki ke lōʻihi iki ka manawa e hoʻōla ai.

Āhea wau e ʻike hou ai i ke kauka?

I kekahi manawa hiki ke loaʻa nā ālai hou ma kahi ʻē aʻe o ke kīʻaha koko. No laila e hōʻoia e hele i ke keʻena lapaʻau i nā lā i hoʻonohonoho ʻia a ʻike i ke kauka.

Eia kekahi, inā ʻike ʻoe i kekahi o nā hōʻailona ma lalo nei , e kāhea koke aku i kāu kauka:

• Inā loaʻa iā ʻoe ke kuni.
• Inā pilikia ʻoe i ka hanu ʻana.
• Inā loaʻa kahi ʻulaʻula o ka ʻili.
• Inā ʻulaʻula, poni, ʻeleʻele, pehu, ʻeha, a i ʻole ke kahe koko kahi i hoʻokomo ʻia ai ka ʻōmole.
• Inā ʻeha, anu, keʻokeʻo, a nāwaliwali paha ka wāwae kahi i hoʻokomo ʻia ai ka ʻōmole.
• Inā loaʻa iā ʻoe ka ʻeha hou i loko o kou ʻōpū a i ʻole ma ka ʻaoʻao i mālama ʻia.
• Inā manaʻo ʻoe ua poniuniu a ua haʻahaʻa loa kou koko (hypotension).