Ke manaʻo nei ʻoe i kekahi manawa he ʻūmiʻi iki a ʻeha paha i kou umauma? A i ʻole he paʻakikī iā ʻoe ke hanu i ka wā e luhi iki ai ʻoe? Hiki i kēia mau mea ke lilo i mau hōʻailona o nā kīʻaha koko i loko o ko kākou puʻuwai (nā aʻa coronary) e ālai mālie ana. Ua like ia me ka lepo e hōʻiliʻili ana i loko o kahi paipu wai i loko o ko kākou hale a e ālai mālie ana. Inā ʻaʻole mālama ʻia kēia, hiki iā ia ke alakaʻi i ka hōʻeha puʻuwai. Akā, mai hopohopo, he mau lāʻau lapaʻau kūpono loa ko ka lāʻau lapaʻau hou no kēia. I kēia lā e kamaʻilio mākou e pili ana i kahi ʻano lapaʻau e hiki ai ke hoʻōla hou i ia ʻano puʻuwai.
He aha kēia Coronary Revascularization?
He huaʻōlelo lōʻihi a ʻano ʻē paha kēia, akā he maʻalahi loa kona manaʻo. ʻO "Coronary" ke ʻano o nā kīʻaha koko e pili ana i ka puʻuwai. ʻO "Revascularization" ke ʻano "e hoʻokumu hou i ke kahe koko." No laila, ma nā huaʻōlelo maʻalahi, ʻo Coronary Revascularization kahi lāʻau lapaʻau e hoʻihoʻi i ke kahe koko i ka puʻuwai ke loaʻa ʻole i ka ʻiʻo puʻuwai ke koko e pono ai (kahi kūlana a mākou e kapa nei he ischemia i ka lāʻau lapaʻau) . Ma ka wehe hou ʻana i ke kīʻaha koko i paʻa ʻia a i ʻole ma ka hana ʻana i kahi ala hou a puni ka mea i paʻa.
Hiki i kēia mau lāʻau lapaʻau ke hōʻemi i ka pōʻino i kou puʻuwai ma hope o ka hāʻule ʻana o ka puʻuwai, a hiki nō hoʻi ke pale aku inā he kiʻekiʻe kou pilikia o ka loaʻa ʻana o ka hāʻule ʻana o ka puʻuwai.
Ma kēia ʻano, ke kamaʻilio nui nei mākou e pili ana i ʻelua mau ʻano lapaʻau:
1. Percutaneous Coronary Intervention (PCI): ʻO kēia ka mea a ka poʻe he nui e kapa nei ʻo "stent placement." Pili kēia i ke komo ʻana i loko o ke kīʻaha koko, ka wehe ʻana i ka mea i ālai ʻia, a me ka hana ʻana i ke ala no ke kahe ʻana o ke koko, me ke ʻoki ʻole ʻana.
2. Coronary Artery Bypass Grafting (CABG): Ua kapa ʻia kēia ʻo "Bypass Surgery." Pili kēia i ka hana ʻana i kahi ala hou (bypass) a puni ke kīʻaha koko i ālai ʻia me ka hoʻohana ʻana i kahi ʻāpana kīʻaha koko i lawe ʻia mai kahi ʻāpana ʻē aʻe o ke kino.
| ʻAno lapaʻau | I ka ʻōlelo maʻalahi... |
|---|---|
| PCI (hoʻokomo stent) | Ua like ia me ke kau ʻana i kahi uea i loko o kahi paipu i paʻa, e hoʻopiha ana iā ia, a e hoʻoponopono ana i ke alanui. ʻAʻohe ʻoki nui. |
| CABG (ʻokiʻoki bypass) | E like me ke kūkulu ʻana i kahi alahele hou e kāpae i kahi alanui paʻahana, ua hoʻoili ʻia kahi kīʻaha koko hou e kāpae i kahi kīʻaha koko i ālai ʻia. He ʻoki kino kēia. |
ʻO wai ka mea e pono ai kēia lāʻau lapaʻau?
Hiki i kekahi mea me ke kahe koko i emi iho i ka puʻuwai ke pōmaikaʻi mai kēia mau lāʻau lapaʻau. ʻO ke kumu nui o kēia, ʻo ia ka maʻi ʻaʻa coronary . Hoʻonui ka pilikia o kēia ʻano me ka makahiki. No laila, ʻo ka poʻe ma luna o 65 mau makahiki ka poʻe e pono nui ai kēia mau lāʻau lapaʻau.
E noʻonoʻo, he mea mānoanoa i hana ʻia me ka ʻaila a me ka cholesterol (kapa mākou he plaque) e hōʻiliʻili mālie ana i loko o ko mākou mau kīʻaha koko. Ua kapa ʻia kēia kaʻina hana he atherosclerosis . Ua like ia me ka ʻaila e paʻa ana i loko o ka paipu poho kīhini a paʻa. I ka hala ʻana o ka manawa, hoʻohaiki kēia waihona i ke kīʻaha koko. Inā pahū kēia waihona i kekahi lā, hiki ke hana ʻia kahi ʻūpā koko ma ia wahi a ālai loa i ke kīʻaha koko. ʻO ia ka manawa e pau ai ke koko i kahi hapa o ka puʻuwai, e hana ana i ka hōʻeha puʻuwai.
No laila, no ka poʻe me kēia ʻano ālai ʻana, hoʻohana ʻia kēia lāʻau lapaʻau e hoʻihoʻi koke i ke kahe koko ma mua o ka make ʻana o nā hunaola puʻuwai.
He aha nā kūlana i mālama ʻia me kēia mau lāʻau lapaʻau?
Hoʻohana nui ʻia kēia mau lāʻau lapaʻau no nā kūlana e hāʻule ana ma lalo o ka māhele o ka maʻi coronary acute. ʻO ia hoʻi:
- Hoʻouka puʻuwai: Ka hōʻino ʻia ʻana o nā ʻiʻo puʻuwai ma muli o ke ālai koke ʻia ʻana o ke kīʻaha koko.
- ʻAngina Paʻa: He ʻano e loaʻa ai ka ʻeha o ka umauma i ka wā o ka hoʻoikaika kino, e like me ke piʻi ʻana i nā alapiʻi, a emi iho ke hoʻomaha ʻoe.
- ʻO ka Angina Paʻa ʻole: He kūlana weliweli i hōʻailona ʻia e ka ʻeha o ka umauma e ʻoi aku ka ʻino ʻoiai i ka wā e hoʻomaha ai.
He aha ka mea e hana ʻia ma mua o ka lāʻau lapaʻau?
Ke hoʻoholo ʻoe e hana i kekahi o kēia mau lāʻau lapaʻau, e hana nā kauka i kekahi mau hoʻokolohua e loiloi pololei i kou kūlana a hoʻolālā i ke ʻano lapaʻau maikaʻi loa.
| Hoʻāʻo | He aha kāu e hana wale ai? |
|---|---|
| Electrocardiogram (ECG a i ʻole EKG) | Nānā ʻia ka hana uila o ka puʻuwai. |
| ʻEchocardiogram | Ua like ia me kahi scan, e nānā ana i ka hana a me ka nui o ka puʻuwai. |
| Ka hoʻokomo ʻana o ka catheter o ka puʻuwai / Angiogram | Hoʻokomo ʻia kahi wai kūikawā i loko o nā kīʻaha koko a lawe ʻia kahi X-ray e ʻike i kahi a me ka nui o ko lākou ālai ʻia. |
| ʻO ka angiography scan CT | Nānā kahi scan CT i nā mea e ālai ʻia ai nā kīʻaha koko. |
| Nā hoʻāʻo koko | Nānā ʻia nā mea e like me nā enzymes a me nā pae cholesterol e ʻike ai inā ua hōʻino ʻia ka puʻuwai. |
Inā ʻaʻole he pilikia, pono ʻoe e hoʻokē ʻai no kahi o 8 mau hola ma mua o ke kaʻina hana. Ma mua o ka hoʻomaka ʻana o ke kaʻina hana, e kau ʻia kahi laina IV (kahi paipu e hāʻawi iā ʻoe i ka saline) i loko o kahi aa koko ma kou lima. Maanei e hāʻawi ʻia ai nā lāʻau lapaʻau a me nā wai e pono ai i kou kino. No ka PCI, e hāʻawi ʻia ʻoe i ka sedation. No ke ʻoki bypass CABG, e kau ʻia ʻoe ma lalo o ka anesthesia laulā.
He aha ka mea e hana ʻia i ka wā o ka mālama ʻana?
ʻOiai like ka pahuhopu o nā kaʻina hana PCI a me CABG, ʻokoʻa loa ke ʻano o kā lākou hana.
Ke kaʻina hana PCI (hoʻokomo stent)
Maanei, hoʻokomo ke kauka i kahi ʻōmole lahilahi a palupalu (catheter) i loko o kahi kīʻaha koko nui, ma o kou pulima a i ʻole ka ʻūhā. A laila alakaʻi ʻia ka ʻōmole i ke kīʻaha koko i paʻa i loko o kou puʻuwai ma lalo o ke alakaʻi X-ray.
A laila, hoʻopiha ʻia kahi pōpō liʻiliʻi ma ka hopena o ka ʻōmole ma kahi o ka paʻa. ʻO kēia ke kumu o ka hoʻonui ʻana o ke kīʻaha koko i haiki mai loko mai. Ua kapa ʻia kēia he balloon angioplasty .
E noʻonoʻo, ʻo ka mea e hana ʻia ma ʻaneʻi ua like ia me ke kau ʻana i kahi pōpō i loko o kahi paipu i paʻa a hoʻopiha iā ia, e pahu ana i ka lepo i loko o ka paipu i nā ʻaoʻao ʻelua, e hana ana i alanui.
A laila, i mea e pale ai i ke kīʻaha koko i hoʻonui ʻia mai ka haʻihaʻi hou ʻana, ua kau ʻia kahi kiʻi hao liʻiliʻi i hana ʻia e like me ka ʻupena ma kahi. ʻO kēia ka mea a mākou e kapa nei he stent . Aia kekahi mau stent i loko o lākou kahi lāʻau lapaʻau e pale ai i ke kīʻaha koko mai ka haʻihaʻi hou ʻana. Ua kapa ʻia kēia he stent drug-eluting . Ma hope o ka pau ʻana o ka hana, ua lawe ʻia ka ʻōmole, ua kau ʻia kahi humuhumu liʻiliʻi ma kahi i hoʻokomo ʻia ai, a ua hoʻopau ʻia ka mālama ʻana.
Ke ʻAno Hana CABG (ʻokiʻoki Bypass)
He hana ʻoki kino kēia. Lawe mua ke kauka ʻoki i kahi ʻāpana o ke kīʻaha koko olakino mai kahi ʻē aʻe o kou kino (mai kou wāwae, lima, a i ʻole i loko o kou umauma).
Ma hope o kēlā, hiki ke hōʻea i ka puʻuwai ma nā ʻano ʻelua:
- ʻO ke ʻoki hāmama: Hana ʻia kahi ʻoki i kekahi mau ʻīniha i lalo o waenakonu o ka umauma, e wehe ana i ka iwi umauma (sternum) e komo i ka puʻuwai.
- ʻO ke ʻoki kino liʻiliʻi loa: Pili kēia i ka hana ʻana i hoʻokahi a ʻoi aku paha mau ʻoki liʻiliʻi ma ka umauma a me ka hoʻohana ʻana i kahi kāmela a me nā mea hana kūikawā e hiki ai i ka puʻuwai ma o nā iwi ʻaoʻao. I kekahi manawa hana ʻia kēia me ka hoʻohana ʻana i ke ʻoki robotic.
I ka wā o ke ʻoki ʻana, hiki ke hoʻōki ʻia ka puʻuwai no kekahi manawa a hoʻopili ʻia i kahi mīkini bypass puʻuwai- maha e hana i ka hana. Eia nō naʻe, hana ʻia kekahi mau ʻoki ʻana i ka wā e kuʻi mau ana ka puʻuwai (bypass off-pump).
A laila hoʻohana ke kauka lapaʻau i ke kīʻaha koko i wehe mua ʻia e hana i ala hou ma ka hoʻohui ʻana i ke kīʻaha koko i paʻa ma luna a ma lalo. Ua like ia me ka hana ʻana i kahi alahele hou e alahele ai i kahi alanui paʻahana. Hoʻopau kēia i ke alahele a hiki i ke koko ke kahe i ka ʻiʻo puʻuwai ma ke ala hou. Ke pau ke alahele, pani ʻia ka umauma, hoʻopili ʻia nā humuhumu, a hoʻopau ʻia ke ʻoki ʻana.
He aha ka mea e hana ʻia ma hope o ka lāʻau lapaʻau?
Pono ʻoe i kekahi manawa e hoʻōla ai ma hope o ke kaʻina hana. Pili kēia manawa i ke ʻano o ke kaʻina hana āu i loaʻa ai (PCI a i ʻole CABG) a me kou olakino holoʻokoʻa. ʻO ka maʻamau, e hoʻi hou ʻoe i ka maʻamau i loko o kekahi mau lā ma hope o ka PCI. Eia nō naʻe, hiki ke hala i kekahi mau pule a i ʻole nā mahina ma hope o ke ʻoki ʻana o CABG.
I kou wā e ho'ōla ai, hiki i kāu kauka ke kuhikuhi iā ʻoe i kahi papahana hoʻoponopono puʻuwai . Ma kēia mau papahana, hana pū nā kauka, nā kahu maʻi, nā kumu aʻo hoʻoikaika kino, a me nā meaʻai meaʻai e kōkua iā ʻoe.
- He aha ka hoʻoikaika kino kūpono iā ʻoe?
- He aha nā meaʻai āu e ʻai ai?
- Pehea e lawe pono ai i ka lāʻau lapaʻau?
- Pehea e hoʻi hou ai i ke ola olakino?
E haʻi aku wau iā ʻoe i nā mea a pau i ʻōlelo ʻia.
Eia kekahi, he mea nui e hele i nā manawa hoʻopaʻa i hāʻawi ʻia e ke kauka. ʻO ka lawe ʻana i kāu lāʻau lapaʻau i ka manawa kūpono, ka kaohi ʻana i kāu ʻai, a me ka hahai ʻana i nā ʻōlelo a kāu kauka he mea nui loa ia e wikiwiki ai kou hoʻōla ʻana a pale i ka hoʻi hou ʻana o kēia maʻi.
He aha nā pōmaikaʻi a me nā pilikia o kēia mau lāʻau lapaʻau?
E like me nā lāʻau lapaʻau āpau, loaʻa i kēia mau ʻano nā pono a me nā pilikia.
He aha nā pono?
- Ka hiki ke hoʻōla ola: He mea ola kēia mau lāʻau i nā hihia e like me ka hāʻule puʻuwai.
- Kāohi ʻana i ka hōʻeha puʻuwai: Inā ʻike ʻoe i kahi kīʻaha koko i ālai ʻia i ka wā mua, hiki iā ʻoe ke pale aku i ka hōʻeha puʻuwai ma ka mālama ʻana iā ia ma mua o ka hiki ʻana mai.
- Ke pale ʻana i ka hana o ka puʻuwai: Inā mālama koke ʻia, hiki ke pale loa ʻia a hoʻēmi ʻia paha ka hōʻino ʻana i ka ʻiʻo o ka puʻuwai.
He aha nā pilikia a me nā pilikia?
Aia ka pilikia i ka lāʻau lapaʻau, kou makahiki, a me nā kūlana olakino ʻē aʻe āu e loaʻa ai (e like me ka maʻi diabetes a me ke koko kiʻekiʻe).
| ʻAno lapaʻau | Nā pilikia maʻamau |
|---|---|
| PCI (hoʻokomo stent) | Ka hōʻino ʻana i ka puʻuwai a i ʻole nā kīʻaha koko, nā puʻuwai puʻuwai kūpono ʻole (arrhythmias) , nā ʻōpū koko, ka hahau ʻana, a i ʻole ke kahe ʻana o ke koko. |
| CABG (ʻokiʻoki bypass) | Nā pilikia i loko o ke ʻoki kino. Eia kekahi laʻana, ʻeha, kahe nui ʻana o ke koko, ka maʻi ʻeha. |
Akā, mai makaʻu i kēia mau mea. E wehewehe pono kāu kauka i nā mea āpau iā ʻoe a hana i nā mea āpau e hiki ai iā ia ke hōʻemi i kou mau pilikia. Inā he mau nīnau a hopohopo paha kāu, e nīnau koke i kāu kauka.
ʻEhia ka lōʻihi e ho'ōla ai? Āhea wau e pono ai e ʻike hou i ke kauka?
ʻOiai hiki iā ʻoe ke hoʻi i ke ola maʻamau i loko o kekahi mau lā ma hope o ka PCI, hiki ke hala kekahi mau mahina e hoʻōla piha ai mai ke ʻoki CABG. E haʻi pololei kāu kauka iā ʻoe i ka lōʻihi o kou pono e hoʻomaha, nā mea hiki iā ʻoe ke hana a me nā mea hiki ʻole iā ʻoe ke hana.
Ma hope o ka mālama ʻana, inā loaʻa nā hōʻailona aʻe, pono ʻoe e ʻike koke i ke kauka .
- ʻEha umauma (Angina)
- Ka paʻakikī o ka hanu ʻana (Dyspnea)
- Pōʻino a i ʻole ke poʻo māmā
- Nalowale o ka ʻike
He mea maʻamau ka makaʻu a me ka hopohopo ke lohe ʻoe e pili ana i kahi pilikia puʻuwai. Eia nō naʻe, hiki i kēia lāʻau i kapa ʻia ʻo Coronary Revascularization ke hoʻomaikaʻi nui i nā pilikia puʻuwai a pale iā lākou mai ka ʻino ʻana. ʻO ka mea nui loa, ʻo ia ka hoʻomaopopo pono ʻana i kēia lāʻau, e kiʻi i ke kōkua lapaʻau e pono ai me ka makaʻu ʻole, a e hoʻāʻo e ola hou i kahi ola olakino a hauʻoli.
Leka Lawe-Home
- ʻO ka revascularization coronary e pili ana i nā lāʻau lapaʻau e hoʻihoʻi i ke kahe koko i nā kīʻaha koko i ālai ʻia i loko o ka puʻuwai.
- ʻO PCI (ke kau ʻana o ka stent) a me CABG (ʻoki bypass) nā ʻano hana nui ʻelua.
- Hiki i kēia mau lāʻau lapaʻau ke pale i nā hōʻeha puʻuwai a hoʻopakele i nā ola.
- Ma hope o ka lāʻau lapaʻau, he mea nui loa ia e hahai pololei i nā ʻōlelo lapaʻau, lawe i ka lāʻau lapaʻau, kaohi i kāu ʻai, a me ka hoʻoikaika kino.
- E kamaʻilio ākea me kāu kauka e pili ana i ka lāʻau lapaʻau kūpono loa no kou kūlana a me nā pōmaikaʻi a me nā pōʻino.
💬 Comments (0)
ʻAʻohe manaʻo i kau ʻia. Hoʻohui i kāu manaʻo ma ʻaneʻi no ka manawa mua.
Hoʻohui i kāu manaʻo