Ua ʻike anei ʻoe i kahi ʻeha ʻē a maopopo ʻole i loko o kou ʻōpū a i ʻole ke kua haʻahaʻa? Manaʻo paha mākou he hōʻeha puʻuwai a he ʻeha iki paha i ke kua. Eia naʻe, i kēia lā e kamaʻilio mākou e pili ana i kahi maʻi e hiki ke hele mai me nā hōʻailona like, he mea kakaikahi iki ia, akā he mea nui loa ia no kākou āpau e makaʻala. Ua kapa ʻia kēia ʻo retroperitoneal fibrosis. I kekahi manawa ua kapa ʻia hoʻi ʻo ia ʻo ka maʻi ʻo Ormond.
He aha ka Retroperitoneal Fibrosis? I ka ʻōlelo maʻalahi...
I ka ʻōlelo maʻalahi, ʻo ka fibrosis retroperitoneal
ka hoʻokumu ʻia ʻana o nā ʻiʻo e like me ka ʻōpala (fibrosis) a puni nā ʻōpū i loko o ka hakahaka i kapa ʻia ʻo retroperitoneum, ka hakahaka ma hope o ko kākou ʻōpū. Ua like ia me kahi ʻōpala e hana ana ma ko kākou ʻili, akā hana ia i loko o ko kākou kino. No ka mea, he ʻano holomua ia, hiki i nā hōʻailona e like me ka ʻeha a me ka emi ʻana o ka mimi ke lilo i mea ʻino i ka hala ʻana o ka manawa.
ʻAe, he aha kēia retroperitoneum?
Ua hoʻopuni ʻia nā ʻāpana he nui i loko o ko kākou ʻōpū (e like me ke akepaʻa, ka ʻōpū, nā ʻōpū) e kahi membrane pale i kapa ʻia ʻo ka peritoneum.
ʻO ka hakahaka ma hope o kēia peritoneum, e pili ana i ka iwi kuamoʻo, ua kapa ʻia ʻo ka retroperitoneum. ʻO kēia kahi kahi o kā kākou:
- nā puʻupaʻa
- Nā ʻāpana o ka ʻōnaehana urinary
- Nā kīʻaha koko nui e lawe i ke koko i nā wāwae a mai nā wāwae (e laʻa me ka vena cava haʻahaʻa)
- Aia ma laila nā ʻōpū koʻikoʻi e like me nā kelepa adrenal.
Pehea e pili ai kēia i ko mākou kino?
E like me ka mea i ʻōlelo ʻia, ʻo ka fibrosis, a i ʻole ka ʻiʻo ʻeha, e hōʻiliʻili mālie ana, e hoʻopilikia ana i nā ʻōpū a me nā ʻano ʻē aʻe i loko o ka retroperitoneum.
ʻO ka hapa nui, hoʻopilikia nui kēia i nā ureters, nā ʻōmole e lawe ana i ka mimi mai ko mākou mau puʻupaʻa i ka ʻōpū mimi. E noʻonoʻo i ka mea e hana ʻia ke hana ʻia kēlā ʻiʻo mānoanoa a puni kēia mau ʻōmole a paʻa? Ua like ia me ke kaomi ʻana i kahi paipu wai, e ālai ana i ke kahe o ka mimi. Inā lilo kēia ʻano i mea koʻikoʻi, hiki ke loaʻa
nā pilikia e hoʻoweliweli ana i ke ola e like me ka hāʻule ʻana o ka puʻupaʻa .
ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o ka fibrosis retroperitoneal?
ʻOi aku ka maʻamau o kēia ʻano maʻi i nā kāne ma waena o 40 a me 60 mau makahiki. ʻO ke ʻano kēia, ʻoi aku ka nui o ka pilikia o nā kāne waena. Eia kekahi, aia kekahi mau kumu pilikia ʻē aʻe:
- No ka poʻe e hana me nā mea e like me ka asbestos (ma muli o ka ʻike ʻia ʻana iā lākou).
- No nā mea puhi paka a meNo ka poʻe e hoʻohana ana i nā huahana paka .
He aha ke kumu o kēia? Nā kumu o ka maʻi ʻo Ormond
I ka hapa nui o ka manawa,
he paʻakikī ke loaʻa i kahi kumu kikoʻī no kēia. I ka lāʻau lapaʻau, kapa mākou ia
he idiopathic . ʻO ia hoʻi "no ke kumu i ʻike ʻole ʻia." Eia nō naʻe, aia kekahi mau hihia kahi e kū mai ai ma ke ʻano he pilikia o kekahi maʻi ʻē aʻe. ʻO kekahi o nā kumu:
- Kekahi mau lāʻau lapaʻau (e kamaʻilio mākou e pili ana i kēia ma hope iki).
- Nā ʻano maʻi kanesa , ʻoiai ʻo Hodgkin lymphoma a me non-Hodgkin lymphoma.
- Nā kūlana maʻi .
- ʻO ka radiation therapy no nā mea e like me ke kanesa.
- Ka hōʻino ʻana i nā ʻiʻo ma ia wahi, inā paha ma muli o ke ʻoki kino a i ʻole kekahi ulia ʻē aʻe.
He aha nā ʻano lāʻau lapaʻau e hiki ke hana i kēia?
Ua ʻike ʻia hiki ke loaʻa kēia ʻano ke hoʻohana ʻia kekahi mau lāʻau lapaʻau no ka manawa lōʻihi. Eia kekahi mau laʻana:
- ʻO nā Beta- blockers kahi papa o nā lāʻau lapaʻau i hoʻohana ʻia e mālama i nā maʻi puʻuwai . ʻO nā laʻana e like me ka propranolol, metoprolol, a me ka atenolol.
- ʻO nā lāʻau hoʻokūkū Dopamine he mau lāʻau i hoʻohana ʻia e mālama i nā maʻi noʻonoʻo a me ka nausea. Nā laʻana: methyldopa, pergolide.
- Nā papa Hydralazine no ke koko kiʻekiʻe.
- Nā lāʻau lapaʻau e like me ka ergotamine, i hoʻohana ʻia no ka migraines.
- ʻO kekahi mau lāʻau ʻeha, ʻoiai nā analgesics a me nā NSAID .
He mea nui: Inā ʻoe e hoʻohana nei i kēia ʻano lāʻau lapaʻau, mai hopohopo. ʻAʻole e ʻike nā kānaka a pau i kēia maʻi. Akā, he mea nui e makaʻala i kēia a kamaʻilio me kāu kauka e pili ana i ia mea.
He aha nā hōʻailona o kēia?
Hiki ke ʻokoʻa nā hōʻailona mai kēlā kanaka a kēia kanaka. Aia ia i kahi o ka fibrosis a me kona koʻikoʻi.
I nā pae mua, hiki iā ʻoe ke ʻeha ma kou ʻōpū, ke kua haʻahaʻa, a i ʻole nā ʻaoʻao. Hiki ke maopopo ʻole kēia ʻeha, ʻo ia hoʻi he paʻakikī ke kuhikuhi "ma ʻaneʻi a ma laila," a hiki ke lilo i ʻeha maʻamau. ʻO nā hōʻailona ʻē aʻe:
- He paʻakikī ke hoʻoneʻe i kou mau wāwae a neʻe a puni.
- ʻO Hydrocele: He ʻano kēia e pehu ai nā testicles o nā kāne.
- Ka pehu ʻana o nā wāwae, ka ʻeha ma nā wāwae, a i ʻole ka loli ʻana o ke kala o ka ʻili ma nā wāwae.
- Ua emi ka hoʻopuka ʻana o ka mimi.
He aha nā pilikia e hiki mai ana mai ka maʻi ʻo Ormond?
Inā holomua ka fibrosis retroperitoneal, ʻo ia hoʻi, e hoʻonui ʻia ka ʻiʻo ʻeha a hoʻomaka e hoʻopaʻa i nā ʻōpū, hiki ke loaʻa nā pilikia
like ʻole . ʻO kekahi o lākou:
- Anemia: ʻO ke ʻano kēia o ka emi ʻana o ka helu o nā hunaola koko ʻulaʻula i loko o ke kino, a i ʻole "ka hemahema o ke koko".
- Anuria: He kūlana kēia i hoʻokahe ʻole ʻia ai ka mimi. He pilikia kēia.
- Kino ʻānai.
- Jaundice: Melemele o nā maka a me ka ʻili.
- Ka luaʻi a me ka luaʻi.
- Nā pilikia neurological.
- Ka make ʻana o nā ʻiʻo ʻōpū (necrosis).
- Ka emi ʻana o ke kaumaha.
Pehea e ʻike ʻia ai ka fibrosis retroperitoneal?
Inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻike i ke kauka a na lākou e nānā iā ʻoe. Hiki i kēia ke komo pū me:
- Hoʻokolohua kino: E hoʻopā ke kauka i kou ʻōpū e nānā i nā mea ʻē aʻe, e like me nā puʻupuʻu.
- Nā hoʻāʻo koko: Hiki i kēia ke ʻike i nā hōʻailona mua o nā maʻi puʻupaʻa a me nā pilikia e like me ka anemia.
- ʻO ke kani ultrasound Renal (kidney): Inā hōʻike nā hōʻailona i kahi pilikia puʻupaʻa, hiki i kēia hoʻāʻo ke loiloi i ka fibrosis a me nā pilikia ʻē aʻe.
- CT scan: Hiki i kēia ke ana i ke koʻikoʻi o ka fibrosis. Hiki iā ia ke kōkua i ka hoʻopau ʻana i nā kūlana ʻē aʻe, e like me nā lymph nodes pehu i loko o ka ʻūhā a i ʻole nā pūpū ʻē aʻe.
He mea pono anei ke hana i kahi biopsy?
I ka hapanui o nā hihia, hiki ke ʻike ʻia ka fibrosis retroperitoneal me nā hoʻāʻo koko a me nā hoʻāʻo kiʻi i ʻōlelo ʻia ma luna (ultrasound, CT scan). Eia nō naʻe, i kekahi mau hihia kūikawā
, pono paha kahi biopsy. ʻO ke ʻano kēia o ka lawe ʻana i kahi ʻāpana ʻiʻo a nānā iā ia ma lalo o kahi microscope. ʻO ia mau hihia:
- Inā he kānalua no ka maʻi ʻaʻai a i ʻole ka maʻi.
- Inā ʻaʻole holomua ka lāʻau lapaʻau mua.
He aha ke ʻano o ka lāʻau lapaʻau e pono ai iaʻu?
ʻO nā koho lapaʻau maikaʻi loa nāu e pili ana i ka wahi a me ke koʻikoʻi o ka fibrosis. I nā pae mua o ka maʻi ʻo Ormond, hiki i kāu lapaʻau ke komo pū me:
- Nā Corticosteroids:Hoʻemi koke kēia mau lāʻau lapaʻau i ka mumū i loko o ke kino a hoʻōki i ka ulu ʻana o ka fibrosis.
- Nā Immunomodulators: Hana kēia mau lāʻau lapaʻau ma ka hoʻololi ʻana i ke ʻano o ka hana ʻana o ka ʻōnaehana pale. Hiki i kēia ke hōʻemi i ka pilikia o ka fibrosis e hoʻi hou ana i ka wā e hiki mai ana. Eia nō naʻe, ʻoiai hiki i nā immunomodulators ke hala i kekahi mau mahina e hana ai, hiki ke hāʻawi ʻia me nā corticosteroids.
- Ka mālama ʻana i ka lāʻau lapaʻau: I kekahi manawa, inā loaʻa ka fibrosis e kahi lāʻau lapaʻau āu e lawe nei, hiki i kāu kauka ke hoʻololi i ka lāʻau lapaʻau a hōʻemi paha i ka dosage.
Inā ua holomua ka fibrosis, pono paha nā lāʻau ʻē aʻe:
- ʻO ke ʻoki kino: Pono paha ke ʻoki kino e wehe i nā ʻiʻo fibrotic a hoʻoponopono i kekahi pōʻino i nā ʻiʻo a puni.
- Nā Stents: E like me ka mea i ʻōlelo ʻia ma mua, inā ua ālai ʻia kahi ureter, hiki ke waiho ʻia kahi mea liʻiliʻi e like me ka paipu (he stent) i loko e wehe mau ai.
Pehea mākou e pale ai i ka hoʻomohala ʻana o ka fibrosis retroperitoneal?
ʻOiai he idiopathic pinepine kēia ʻano,
he paʻakikī ke pale loa. Eia nō naʻe, no ka mea ua ʻike ʻia kekahi mau lāʻau lapaʻau e hoʻoulu ai, e nānā paha kāu kauka iā ʻoe no nā hōʻailona o ka fibrosis, ʻoiai inā ʻoe e lawe ana iā lākou no ka manawa lōʻihi.
Hiki ke hoʻemi ʻia ka manawa e hana hou ai kēia ma hope o ka mālama ʻana?
Inā pono ʻoe e hana i ke ʻoki kino, i kekahi manawa ua ʻōwili ʻia kahi papa o ka ʻiʻo momona a puni ka ureter i ka wā o ke ʻoki kino. Ua ʻōlelo ʻia kēia e paʻakikī ai ka ulu hou ʻana o ka fibrosis.
ʻEhia ka manawa e ʻoi aku ai koʻu maikaʻi?
Inā ʻoe e lawe ana i nā lāʻau lapaʻau e like me corticosteroids, a i ʻole ma hope o ka mālama ʻana i ka lāʻau lapaʻau
, e hoʻomaka paha ʻoe e ʻoluʻolu i loko o kekahi mau pule. Eia nō naʻe, inā pono ʻoe i nā immunomodulators, stents, a i ʻole ke ʻoki ʻana, e lōʻihi iki ka manawa e hoʻōla ai.
He aha ka manaʻolana no ka poʻe me ka fibrosis retroperitoneal?
Hoʻōla piha ka hapa nui o nā kānaka. ʻO ka manawa kūpono loa no ka mālama pono ʻana, ʻo ia
ka wā e ʻike mua ʻia ai ka maʻi. Eia nō naʻe, he mea nui e hoʻomanaʻo e hiki i ka fibrosis ke hoʻi hou mai i nā mahina a i ʻole nā makahiki ma hope o ka mālama ʻana.
He aha ke ʻano o ka noho ʻana me ka maʻi ʻo Ormond?
No ka poʻe me nā hihia ʻoluʻolu,
pono ʻoe e hoʻomau ma lalo o ka nānā ʻana o ke kauka. ʻO ke ʻano kēia, pono ʻoe e ʻike pinepine i kāu kauka e nānā i nā hōʻailona o ka hoʻi hou ʻana mai o ka maʻi.
He aha ka mea e hana ʻia ma hope o ke ʻoki ʻana e hoʻoponopono ai i ka ālai ʻana o ke ala urinary?
Hiki ke hana ʻia ka Hydronephrosis i ka wā, i loko o kekahi mau lā ma hope o ke ʻoki ʻana, hoʻokuʻu koke nā kauka i ka mimi i hōʻiliʻili ʻia i loko o kou mau puʻupaʻa.E makaʻala i ka pilikia i kapa ʻia ʻo "paʻa ʻana o ka mimi." Ke puka koke mai ka mimi i hoʻopaʻa ʻia i loko o ke kino, hiki ke hana ʻia kēia mau mea:
- Nā hoʻololi ʻole o ke kaulike electrolyte i loko o ke kino.
- Ka maloʻo ʻana o ka wai.
- Hypovolemic shock (kahi kūlana i hoʻokumu ʻia e ka emi ʻana o ka nui o ke koko).
ʻO ka fibrosis retroperitoneal, a i ʻole ka maʻi ʻo Ormond, he ʻano ia e hana ʻia ai nā ʻiʻo e like me ka ʻōpala ma ke kua o ka ʻōpū. ʻOi aku ka nui o ka pilikia o ka poʻe e lawe ana i kekahi mau lāʻau lapaʻau i ka loaʻa ʻana o kēia ʻano. Inā ua ʻike ʻia ʻoe me kēia ʻano, e kamaʻilio me kāu kauka e pili ana i nā nīnau a hopohopo paha āu e loaʻa ai. Aia lākou ma laila e kōkua iā ʻoe.
Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)
ʻAe, i kēia manawa ua ʻoi aku ka maikaʻi o ko kākou ʻike i ke ʻano o ka Retroperitoneal Fibrosis.
ʻOiai he maʻi kakaikahi ia, he mea nui loa ia e ʻike i ia mea.- E hoʻomanaʻo, he ʻiʻo mānoanoa kēia e hana ʻia a puni nā ʻōpū i manaʻo ʻia aia i loko o ka ʻōpū, e pili ana i ka iwi kuamoʻo.
- Hoʻopilikia pinepine ia i nā ureters a hiki ke hōʻino i nā puʻupaʻa.
- ʻAʻole maopopo mau ke kumu, akā hiki i nā mea e like me kekahi mau lāʻau lapaʻau, ka maʻi ʻaʻai, a me nā maʻi ke lilo i kumu.
- He mea nui e ʻimi i ke kōkua lapaʻau inā loaʻa iā ʻoe nā hōʻailona e like me ka ʻeha ʻōpū/kua i ʻike ʻole ʻia a me ka emi ʻana o ka mimi ʻana.
- Aia nā lāʻau lapaʻau maikaʻi inā ʻike mua ʻia. No laila, mai hoʻowahāwahā i nā hōʻailona.
- Inā he mau nīnau kāu e pili ana i kēia, mai makaʻu e nīnau i kāu kauka.
Manaʻolana mākou he kōkua kēia ʻike iā ʻoe. E noho olakino!
Retroperitoneal Fibrosis, ka maʻi ʻo Ormond, ka maʻi puʻupaʻa, ka ʻeha o ka ʻōpū, nā pilikia mimi, fibrosis, ke ʻoki kino
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