Loaʻa iā ʻoe ke koko kiʻekiʻe? Ke lawe nei paha ʻoe ma mua o hoʻokahi ʻano lāʻau lapaʻau e kāohi i kou koko. Akā inā pilikia mau ʻoe i ka kāohi ʻana i kou koko, ʻo ke kumu paha he poloka i loko o nā aʻa e hoʻolako ana i ke koko i kou mau puʻupaʻa. No laila i kēia lā, e kamaʻilio kākou e pili ana i ka lāʻau i kapa ʻia ʻo 'Renal Artery Stenting' i hoʻohana ʻia i ia mau hihia. Mai makaʻu i kou lohe ʻana i kēia, e hoʻomaopopo maʻalahi kākou i nā mea āpau e pili ana.
He aha ka Renal Artery Stenting?
I ka ʻōlelo maʻalahi, ʻo nā kīʻaha koko nui e lawe ana i ke koko i nā puʻupaʻa ʻelua i loko o ko kākou kino ua kapa ʻia ʻo 'renal arteries'. E like me nā paipu nui ʻelua e lawe ana i ka wai i kahi māla. I kekahi manawa, hōʻiliʻili nā mea e like me ka momona i loko o kēia mau kīʻaha koko (ua kapa ʻia kēia ʻano he `(Atherosclerosis)`) a lilo ke ala i loko o nā aa koko i haiki. Kāhea mākou i kēia he 'renal artery stenosis'.
E noʻonoʻo i kahi mea e like me ka paipu wai e pani ʻia ana e ka ʻōpala. A laila e haiki ke ala o ka wai, ʻeā? Ma ke ʻano like, e ālai ʻia ke ala i nā puʻupaʻa.
ʻO ka Renal Artery Stenting kahi lāʻau lapaʻau i hoʻohana ʻia e wehe hou, a i ʻole e mālama i kahi kīʻaha koko i paʻa. Ma kēia, ua hoʻokomo ʻia kahi paipu metala liʻiliʻi loa (stent) i loko o ka wahi i paʻa, e wehe ana i ke aʻa. A laila, hoʻomaka hou ke koko e kahe maikaʻi i ka puʻupaʻa.
He aha ka mea e hana maoli ai ke ālai ʻia nā aa koko renal?
E like me kou ʻike, ʻo kekahi o nā hana nui o ko kākou mau puʻupaʻa, ʻo ia ke kānana i ke koko a wehe i nā paʻakai a me nā wai pono ʻole mai ke kino ma ke ʻano he mimi. Ke emi ka nui o ke koko e kahe ana i nā puʻupaʻa, ʻaʻole hiki iā lākou ke hana pono i kēia hana. A laila, hoʻomaka ka wai e hōʻiliʻili i loko o ke kino.
ʻAʻole wale ia, akā he mea nui ʻē aʻe e hana ʻia. Ke ʻike ka puʻupaʻa ua emi ke koko e kahe ana i laila, manaʻo ia ua emi ke koko ma ke kino holoʻokoʻa. No laila, no ka hoʻonui ʻana i ke koko, hoʻokuʻu ka puʻupaʻa i kahi hormone kūikawā i kapa ʻia ʻo `(renin)`. ʻO kēia hormone ke kumu o ka paʻa ʻana o nā kīʻaha koko i loko o ke kino. Akā ʻo ka mea e hana maoli nei, ʻo ke koko i loko o ke kino paha ma kahi kiʻekiʻe loa i kēlā manawa.
ʻO ke koko kiʻekiʻe i hoʻokumu ʻia e ka paʻa ʻana o nā aʻa koko o ka puʻupaʻa ma kēia ʻano ua kapa ʻia ʻo Renal Hypertension . He ʻoi aku ka paʻakikī o kēia ke kāohi ma mua o ke koko kiʻekiʻe maʻamau, a i ka hala ʻana o ka manawa hiki ke hōʻino i nā puʻupaʻa.
ʻO wai ka mea e pono ai ka stent?
ʻAʻole pono nā kānaka a pau me kahi aʻa renal i ālai ʻia i kahi stent. E paipai wale kāu kauka i kēia lāʻau lapaʻau i kekahi mau hihia kūikawā.
| Kūlana | Wehewehena |
|---|---|
| Ke koko kiʻekiʻe i kāohi ʻole ʻia | Inā ʻaʻole i kāohi ʻia kou koko koko ʻoiai ke lawe nei i ʻekolu a ʻoi aku paha mau lāʻau antihypertensive kiʻekiʻe. |
| Ka paʻa ʻana o nā aa koko koʻikoʻi | Inā ʻoi aku ma mua o 60% o nā aʻa koko renal i ālai ʻia a ʻaʻole hiki ke kāohi ʻia me ka lāʻau lapaʻau. |
| Ka wai e hoʻopiha ana i nā māmā | Inā loaʻa koke iā ʻoe kahi maʻi i kapa ʻia ʻo "flash pulmonary edema". |
| He pilikia me nā puʻupaʻa ʻelua | Inā ua ālai ʻia nā aa koko ʻelua e alakaʻi ana i nā puʻupaʻa ʻelua ma mua o 60%. |
He aha nā hoʻokolohua e hana ʻia ma mua o ka stenting?
Ma mua o ka hoʻoholo ʻana e kau i kahi stent, e hana kāu kauka i kekahi mau hoʻokolohua e hoʻoholo ai i ke ʻano o ka paʻa ʻana o kou aʻa.
- Duplex Doppler Ultrasonography: Ua like kēia me kahi scan maʻamau. Hoʻohana ia i nā nalu kani e ana i ke ʻano o ka haiki o ke aʻa a me ka wikiwiki o ke kahe ʻana o ke koko.
- ʻO ka Computed Tomography Angiogram (CT Angiogram): ʻO kēia ke komo ʻana i kahi kala kūikawā i loko o kou mau aa a me ka hoʻohana ʻana i kahi scanner CT e lawe i kahi kiʻi ʻekolu-dimensional (3D) o nā aa. Hiki iā ʻoe ke ʻike maopopo i kahi i ālai ʻia ai nā aa.
- ʻO Magnetic Resonance Angiogram (MRA): Ua like kēia me kahi scan MRI. Hoʻokomo ʻia kahi dye a hoʻohana ʻia kahi kahua magnetic e hana i nā kiʻi maopopo o nā kīʻaha koko.
- Angiogram: ʻO kēia ke ʻano pololei loa. Ma kēia, ua hoʻokomo ʻia kahi paipu lahilahi loa (catheter) ma o kahi aʻa koko ma ka ʻūhā a i ʻole ka lima a alakaʻi ʻia i ka aʻa koko renal. A laila, ua hoʻokomo ʻia kahi dye ma o ia mea a ua lawe ʻia kahi X-ray e ʻike i ke kahe ʻana o ke koko. Hana pinepine ʻia ka stenting i ka wā o kēia hoʻāʻo.
Mea nui: Ma mua o kēia mau hoʻokolohua, pono ʻoe e haʻi i kāu kauka e pili ana i nā lāʻau lapaʻau āpau āu e lawe nei (ʻoi aku hoʻi nā lāʻau hoʻokahe koko e like me ka aspirin) a me nā maʻi allergies āu e loaʻa ai.
Pehea e hana ʻia ai ke ʻoki stenting?
ʻAʻole kēia he ʻoki kino nui hāmama. ʻAʻole ʻoe e hoʻohiamoe ʻia. Hāʻawi ʻia ʻoe i kahi lāʻau lapaʻau i kapa ʻia ʻo `sedation` e hoʻomaha a hiamoe ai ʻoe. No laila, ʻaʻole ʻoe e ʻeha a ʻaʻohe ou hoʻomanaʻo ma hope.
Penei wale nō ka lāʻau lapaʻau:
1. Hana ʻia kahi ʻoki liʻiliʻi loa (he mau milimita) ma ka ʻili o kou ʻūhā a lima paha.
2. Ma o ia mea, ua hoʻokomo ʻia kahi ʻōmole palupalu (ʻūpā) i loko o ke aʻa.
3. Ma o kēlā ʻōmole, ua hoʻouna ʻia kekahi ʻōmole lahilahi loa (catheter) i ke aʻa koko i paʻa i loko o ka puʻupaʻa.
4. A laila, ua hoʻopiha ʻia kahi pōpō liʻiliʻi ma ka hopena o ka ʻōmole e hoʻonui i ka wahi i ālai ʻia.
5. ʻO ka mea hope loa, ua kau ʻia ka stent e like me ka ʻupena a mākou i kamaʻilio ai ma mua ma kahi i hoʻonui ʻia. Hoʻopili ka stent i ka paia o ke aʻa, e mālama ana i ke aʻa e hāmama.
6. Hoʻokomo mau ʻia ka stent ma laila, wehe ʻia ka pōpō a me ka paipu, pani ʻia ka ʻoki ʻana, a kau ʻia kahi kāʻei.
He aha nā pōmaikaʻi a me nā pilikia ma hope o ka mālama ʻana?
E like me nā lāʻau lapaʻau āpau, aia nā pono a me nā pōʻino liʻiliʻi.
| Nā Pōmaikaʻi | Nā Pōʻino |
|---|---|
| ʻO ke ʻano hana maʻalahi me ka ʻole o ka ʻoki nui. | ʻEha a kahe paha ke koko ma kahi i hoʻokomo ʻia ai ka ʻōmole. |
| Hoʻihoʻi hou ʻana o ke kahe koko i ka puʻupaʻa. | Ka hōʻino ʻana o ke kīʻaha koko a i ʻole nā puʻupaʻa (kākaʻikahi loa). |
| Kōkua i ka hoʻokele ʻana i ke koko. | Nā ʻūpā koko. |
| Ke pale nei i ka hana o nā puʻupaʻa. | Ka maʻi ʻaleka i ka waihoʻoluʻu. |
Ma hope o ka mālama ʻana, pono ʻoe e noho i ka haukapila no kekahi mau hola a i ʻole e hoʻomoe i ka pō. E hiki iā ʻoe ke hoʻi i nā hana maʻamau i loko o kekahi mau lā ma hope o ka hoʻi ʻana i ka home. E hiki iā ʻoe ke hoʻi hou i kāu mau hana maʻamau i loko o hoʻokahi pule.ʻO ka mea nui loa, ʻo ia ka lawe ʻana i ka lāʻau hoʻokahe koko (e like me ka ʻAspirin, Clopidogrel) i kuhikuhi ʻia e kāu kauka no ka manawa i kuhikuhi ʻia. Mai hoʻōki i ka lawe ʻana i ka lāʻau me ka ʻole o ke nīnau ʻana i kāu kauka.
Āhea wau e ʻike hou ai i ke kauka?
ʻOiai ma hope o ke kau ʻia ʻana o ka stent, pono ʻoe e hele no nā kipa hoʻi e like me ka ʻōlelo a ke kauka, no ka mea, i kekahi manawa hiki ke ālai hou ʻia ka stent a i ʻole kahi ʻē aʻe.
Inā loaʻa kekahi o kēia mau hōʻailona, 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 ka wahi i hoʻokomo ʻia ai ka ʻōmole, pehu, ʻeha, a inā he koko a he pehu paha e kahe ana mai laila mai.
- Inā ʻeha, anu, a maeʻele paha ka wāwae ma ka ʻaoʻao i mālama ʻia.
- 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 hāʻule nui kou koko.
He ʻāpana mau loa ke stent o ke kino. ʻAʻohe ʻeha maʻamau. ʻOiai hiki iā ia ke kōkua i nā poʻe he nui e kāohi i ko lākou koko kiʻekiʻe, pono paha ʻoe e lawe i ka lāʻau lapaʻau e kāohi i kou koko. Na kāu kauka e hoʻoholo i kēia ma muli o kou kūlana.
Leka Lawe-Home
- ʻO ka Renal Artery Stenting kahi lāʻau maʻalahi a ʻaʻohe invasive e hoʻoponopono ai i nā ālai koʻikoʻi i loko o nā kīʻaha koko e hiki aku ana i nā puʻupaʻa.
- Kōkua kēia i ka kaohi ʻana i ke koko kiʻekiʻe, kahi mea paʻakikī ke kaohi, a pale i nā puʻupaʻa.
- Ma hope o ka lāʻau lapaʻau, he mea nui loa e lawe i nā lāʻau hoʻokahe koko i kauoha ʻia e kāu kauka no ka manawa i kuhikuhi ʻia.
- E hōʻoia e hele i nā hālāwai hoʻomau ma nā lā i hoʻonohonoho ʻia.
- Inā ʻike ʻoe i nā hōʻailona e like me ke kuni, ka ʻeha nui, a i ʻole ke kahe ʻana o ke koko, e hoʻomaopopo koke i kāu kauka.
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