Ke ʻeha nei kou mau wāwae i kekahi manawa a i ʻole ke ʻāʻī i kou hele ʻana? A i ʻole ke ʻano uliuli a me ke kui ʻia o kou mau wāwae? Hiki i kēia ke lilo i mau hōʻailona e hōʻike ana he mau pilikia me ka ʻōnaehana hoʻopuni koko, ʻo ia hoʻi, nā kīʻaha koko i loko o ko kākou kino. No laila, i kēia lā, e kamaʻilio kākou e pili ana i kēia mau maʻi e pili ana i nā kīʻaha koko, a i ʻole e like me kā mākou e kapa nei iā lākou ma ke ʻano lapaʻau, 'maʻi vascular'.
I ka ʻōlelo maʻalahi, he aha kēia mau maʻi vascular?
ʻO ka maʻi vascular e pili ana i kekahi kūlana e hoʻopilikia ai i kā mākou ʻōnaehana hoʻopuni koko. E noʻonoʻo e like ko mākou kino me kahi pūnaewele o nā paipu. ʻO kēia pūnaewele o nā paipu ko mākou mau kīʻaha koko. Ma o kēia mau mea e holo ai ke koko ma o ko mākou kino. ʻEkolu mau ʻāpana nui o kēia ʻōnaehana.
- Nā aʻa koko: ʻO kēia nā kīʻaha koko nui e lawe ana i ke koko maʻemaʻe (koko i loaʻa ka oxygen) mai ka puʻuwai a i nā ʻāpana ʻē aʻe o ke kino.
- Nā aʻa koko: ʻO kēia nā aʻa koko e lawe i ke koko haumia (koko nele i ka oxygen) i ka puʻuwai mai nā wahi like ʻole o ke kino.
- Nā Capillaries: ʻO kēia nā kīʻaha koko liʻiliʻi loa a palupalu loa. Hoʻopili lākou i nā aʻa a me nā veins, a hāʻawi lākou i ka oxygen a me nā meaʻai i ko mākou mau ʻiʻo a hōʻiliʻili i nā huahana ʻōpala.
No laila, ʻo kēlā me kēia pilikia e hoʻopilikia ai i kēia mau aʻa, nā veins, nā capillaries, a i ʻole nā kīʻaha lymph, a i ʻole kekahi kūlana e hoʻopilikia ai i ke kahe koko ma muli o nā pilikia pili koko e like me ke kāpili ʻana o ke koko, ʻo ia ka mea a mākou e kapa nei he maʻi vascular.
He aha nā ʻano nui o nā maʻi vascular?
Hiki ke hoʻokaʻawale ʻia kēia mau maʻi i kekahi mau ʻano. Hoʻopilikia kekahi i nā aʻa wale nō, hoʻopilikia kekahi i nā aʻa koko wale nō. Aia kekahi mau maʻi e hoʻopilikia wale i nā wahi kikoʻī o ke kino. E nānā kākou i nā ʻano nui.
1. Maʻi ʻAʻai Peripheral
E like me nā aʻa coronary i loko o ko kākou puʻuwai, ua paʻa pū nā aʻa ma waho o ka puʻuwai i nā mea e like me ka momona a me ka cholesterol, a mākou e kapa nei he 'plaque' , a hoʻomaka nā aʻa e paʻa mai loko mai. Kāhea mākou i kēia ʻano he 'atherosclerosis' . I ka hala ʻana o ka manawa, i ka wā e paʻa ai nā aʻa ma kēia ʻano, emi ke kahe o ke koko. ʻO ka hopena, ʻaʻole paha e loaʻa i nā ʻiʻo o ke kino ka nui o ke koko e pono ai. Kāhea mākou i kēia he 'ischemia' .
Aia ma lalo iho nei kekahi o nā maʻi e hāʻule ana ma lalo o kēia māhele.
| Kūlana olakino | He wehewehe maʻalahi |
|---|---|
| ʻO ka maʻi ʻaʻai peripheral (PAD) | I ka manawa pinepine, ua ālai ʻia nā aʻa koko ma nā wāwae. Inā ʻoki loa ʻia ke kahe o ke koko, make ka ʻiʻo a ulu ka gangrene , a pono paha e ʻoki ʻia ka wāwae. |
| ʻO ka maʻi Ischemic ʻōpū | Ka ālai ʻana o nā kīʻaha koko e hoʻolako ana i ke koko i ka ʻōnaehana hoʻoheheʻe. |
| Maʻi ʻAʻa Renal | Ka paʻa ʻana o nā aʻa koko e hoʻolako ana i ke koko i nā puʻupaʻa. Hiki i kēia ke alakaʻi i ka hāʻule ʻana o nā puʻupaʻa. |
| Ka Hanana a Raynaud | Ke hoʻokuʻu ʻia i ke anu nui a i ʻole ke kaumaha, e ʻūmiʻi nā aʻa liʻiliʻi ma nā manamana lima a me nā manamana wāwae, e lilo ai nā manamana lima i keʻokeʻo a polū paha. |
| Ka maʻi o Buerger | He maʻi i pili pono i ka hoʻohana ʻana i ka paka. ʻO ka pani ʻia ʻana o nā aʻa liʻiliʻi a me waena a me nā aʻa koko i loko o nā lima a me nā wāwae e hiki ke alakaʻi i ka nalowale o ke kahe koko i nā manamana lima, ka make ʻana o nā ʻiʻo (gangrene) a me ke ʻoki ʻana o nā manamana lima. |
2. Nā pilikia o ke aʻa Carotid
He mau pilikia kēia e kū mai ana ma nā aʻa carotid nui, aia ma nā ʻaoʻao ʻelua o ko mākou ʻāʻī, kahi e hoʻolako ai i ke koko i ka lolo.
- ʻO ka maʻi Carotid Artery: ʻO ka hāiki ʻana a i ʻole ka paʻa ʻana o kēia aʻa e hoʻolako ana i ke koko i ka lolo e hiki ke hana i kahi transient ischemic attack (TIA) a i ʻole ka hahau ʻana .
- ʻO ka Carotid Artery Dissection: He haehae ʻana i loko o kahi papa o ka paia o ke aʻa, e hoʻokahe ana i ke koko.
- ʻO Carotid Artery Aneurysm: He nāwaliwali o ka paia o ke aʻa e hoʻoulu ai iā ia e puʻupuʻu e like me ka pōpō. Aia kahi pilikia o ka pahū ʻana.
3. Maʻi ʻaʻa koko
Nā kiwikā i loko o ko kākou mau aa kokoAia kekahi mea i kapa ʻia he valve. Ua like ia me ka paipu e ʻae wale i ka wai e kahe i hoʻokahi ʻaoʻao. Ke hoʻopaʻa mākou i ko mākou mau ʻiʻo, wehe kēia mau valve a neʻe ke koko i luna (i ka puʻuwai). Ke hoʻomaha nā ʻiʻo, pani nā valve a oki ke kahe ʻana o ke koko i lalo.
Akā inā ua hōʻino ʻia kēia mau valves, ʻaʻole lākou e pani pono. A laila hoʻomaka ke koko e kahe i nā ʻaoʻao ʻelua. ʻO kēia ke kumu o ka hōʻiliʻili ʻana o ke koko ma nā lālā haʻahaʻa, ʻoi aku hoʻi ma nā wāwae, a hoʻomaka nā aa koko e pehu a nakinaki. ʻO kēia mau kūlana:
- ʻO nā aʻa Varicose: Nā aʻa lahilahi, pehu, a wili e ʻike ʻia ma lalo o ka ʻili.
- Nā aʻa koko: ʻUlaʻula a poni paha, e like me ke koko koko, nā capillaries maikaʻi e ʻike ʻia ma nā kuli a me nā kuʻekuʻe wāwae.
- ʻO ka Thrombosis Vein Deep (DVT): He ʻōpū koko e hana ʻia i loko o kahi vein hohonu i loko o ke kino.
- Ka lawa ʻole o ke kahe koko mau loa (CVI): Paʻakikī i ka hoʻihoʻi ʻana i ke koko i ka puʻuwai ma muli o ka hana pono ʻole ʻana o nā paia a i ʻole nā kiwikā o nā aa koko i nā wāwae.
4. Nā ʻūpā koko
ʻO ke koko ʻūlū (thrombus) he ʻano jelly i loko o ke kīʻaha koko. Hiki i kēia koko ʻūlū ke haki a hele pū me ke koko, e ālai ana i ke kīʻaha koko i loko o nā māmā ( Pulmonary Embolism ), ka puʻuwai ( Heart Attack ), a i ʻole ka lolo ( Stroke ). He mau kūlana weliweli loa kēia.
Inā loaʻa i kekahi kahi DVT (ʻū koko i loko o kahi aʻa hohonu i ka wāwae), hiki i ke ʻū koko ke haki a hele i nā māmā, e hana ana i ka embolism pulmonary. Hiki i kēia ke hoʻoweliweli i ke ola.
5. ʻAneurysm Aortic
ʻO ka aneurysm ka hoʻonāwaliwali ʻana o ka paia o ke kīʻaha koko, e hoʻoulu ai iā ia e puʻupuʻu e like me ka pōpō. ʻOiai hiki ke hana i loko o kekahi kīʻaha koko, ʻike pinepine ʻia ia ma ka aorta, ke aʻa nui e alakaʻi ana mai ka puʻuwai mai.
- ʻO ka Thoracic Aortic Aneurysm: He puʻupuʻu i loko o ka aorta ma ka ʻāpana umauma.
- ʻO ka Aneurysm Aortic Abdominal: He puʻupuʻu i loko o ka aorta i loko o ka ʻōpū.
6. Lymphedema
He pūnaewele o nā kīʻaha koko palupalu ko kākou ʻōnaehana lymphatic e kōkua ana i kā kākou ʻōnaehana pale. Inā hōʻino ʻia a ālai ʻia paha kēia mau kīʻaha koko, hōʻiliʻili ka wai lymph a hoʻoulu i ka pehu ʻana i ko kākou mau lālā. Ua kapa ʻia kēia ʻo Lymphedema .
He aha nā kumu a me nā kumu pilikia no kēia mau maʻi?
Hiki ke hoʻoilina ʻia kekahi mau maʻi vascular (genetic), akā i ka hapanui o ka manawa, hoʻokumu ʻia kēia mau maʻi e nā ʻano nohona maikaʻi ʻole a me nā kūlana olakino ʻē aʻe.
- Kolesterol kiʻekiʻe
- Ke koko kiʻekiʻe
- Ka puhipaka a me ka hoʻohana ʻana i ka paka
- Maʻi diabetes
- Ka momona a me ka piʻi ʻana o ke kaumaha
- ʻAʻole hoʻoikaika kino
- Ka moʻolelo ʻohana o kēia mau maʻi
- Ka ʻelemakule ʻana
Loaʻa iā ʻoe kēia mau hōʻailona?
ʻOkoʻa nā hōʻailona ma muli o ke kūlana. E nānā kākou i nā hōʻailona o kekahi mau kūlana nui.
| Māhele maʻi | Nā hōʻailona maʻamau |
|---|---|
| ʻO ka maʻi ʻaʻai peripheral (PAD) | ʻEha a ʻūmiʻi paha ma nā wāwae, ʻoiai hoʻi nā keiki bipi, i ka wā e hele ai a laila nalo ma hope o kekahi manawa, nā loli o ke kala o ka ʻili ma nā wāwae, nā ʻeha e ho'ōla ʻole ai, a me ka luhi ma nā wāwae. |
| Maʻi ʻaʻa Carotid | ʻAʻohe pinepine nā hōʻailona i nā pae mua. Hiki ke ʻike ʻole ʻia a hiki i ka loaʻa ʻana o ka hahau a i ʻole TIA, hiki ke hana i nā pilikia ʻike a ʻōlelo paha, huikau, a me nā pilikia hoʻomanaʻo. |
| Nā ʻaʻa Varicose (CVI) | Pehu wāwae, ʻeha, manaʻo kaumaha ma nā wāwae, ʻike ʻia nā aʻa koko polū/poni, ʻili maneʻo. |
| Nā ʻūpā koko (DVT, PE) | DVT: Pehu, ʻeha, ʻulaʻula, a me ka mehana ma kekahi wāwae. ʻO ka Pulmonary Embolism: ʻEha koke ka umauma, paʻakikī ka hanu ʻana, ʻū ʻana i ke koko. (He pilikia kēia!) |
| ʻO ka aneurysm o ke aʻa nui | ʻAʻohe pinepine nā hōʻailona. Inā haki kahi aneurysm, hiki iā ʻoe ke ʻike koke i ka ʻeha nui o ka umauma a i ʻole ka ʻōpū, ka poniuniu, a me ka puʻuwai wikiwiki. (He pilikia nō hoʻi kēia!) |
Pehea e ʻike ai ke kauka i kēia mau maʻi?
Ke kipa aku ʻoe i kāu kauka, e nānā pono ʻo ia iā ʻoe, e nīnau e pili ana i kāu mau hōʻailona, kou mōʻaukala olakino ʻohana, a e kauoha paha i kekahi mau hoʻokolohua e hōʻoia i ka hōʻailona.
- ʻO Vascular Ultrasound: He scan kēia e hoʻohana ana i nā nalu kani e nānā i ke ʻano o ke kahe ʻana o ke koko i loko o nā kīʻaha koko a e ʻike inā he mea paʻa.
- CT Angiography: Hana ʻia kahi scan CT e kiʻi i nā kiʻi kikoʻī ʻekolu-dimensional o nā kīʻaha koko ma ke komo ʻana i kahi mea kūikawā i loko o ke kino.
- MR Angiography: Ke kiʻi ʻana i nā kiʻi o nā kīʻaha koko me kahi mīkini MRI e hoʻohana ana i kahi kahua magnetic.
- Angiography Catheter: Hoʻokomo ʻia kahi ʻōmole lahilahi (catheter) ma o kahi kīʻaha koko a hoʻokomo ʻia kahi wai kūikawā i loko e ʻike ai i nā ālai ʻana i nā aa koko ma lalo o ka X-ray.
He aha nā lāʻau lapaʻau?
ʻOkoʻa nā ʻano lapaʻau ma muli o ke kūlana a me kona koʻikoʻi. ʻO ka ʻōlelo aʻoaʻo maʻamau i hāʻawi ʻia i nā maʻi āpau, ʻo ia ka hoʻololi ʻana i ke ʻano o ka nohona . ʻO ia hoʻi ka ʻai ʻana i kahi meaʻai olakino, ka hoʻoikaika kino, a me ka pale ʻana i ka puhipaka. Eia kekahi, aia nā lāʻau lapaʻau e like me:
- Nā lāʻau lapaʻau: Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e like me nā lāʻau hoʻokahe koko, nā lāʻau hoʻohaʻahaʻa cholesterol (statins), nā lāʻau koko kiʻekiʻe, a me nā vasodilators.
- ʻO Angioplasty a me Stenting: He kaʻina hana e hoʻokomo ʻia ai kahi mea like me ka pōpō i loko o kahi kīʻaha koko i paʻa, e hoʻopiha ʻia e hoʻonui i ke kīʻaha koko (angioplasty), a hoʻokomo ʻia kahi mea like me ka mesh (stent) e pale ai i ka pani hou ʻana.
- ʻOki kino: I kekahi mau hihia, pono e wehe i ke aʻa koko i paʻa a hoʻololi iā ia me kahi aʻa koko ʻē aʻe (ʻoki kino bypass) a i ʻole e wehe i ke koko i loko o ke koko (thrombectomy). I nā kūlana e like me nā aʻa koko varicose, hoʻohana ʻia ka mālama ʻana i ka laser a i ʻole ke ʻoki kino e wehe i ke aʻa.
ʻO ka mea nui loa, ʻo ia ka hoʻoholo ʻana o kāu kauka i ka lāʻau lapaʻau maikaʻi loa nāu. No laila, mai hele e kiʻi i ka lāʻau lapaʻau no ka mea ua ʻike ʻoe ma ka pūnaewele a lohe paha e pili ana iā ia mai kekahi.
He aha nā manawa e pono koke ai ʻoe e hele i ETU?
Inā ʻike ʻoe a i ʻole kekahi āu i ʻike ai i kekahi o kēia mau hōʻailona, e hele koke i ka ʻOihana Pilikia (ETU) o ka haukapila. He mau hōʻailona paha kēia o kahi maʻi hoʻoweliweli ola e like me ka hahau ʻana, ka hōʻeha puʻuwai, a i ʻole ka haki ʻana o ka aortic aneurysm.
- ʻEha koke a koʻikoʻi ka umauma
- ʻEha koke ka ʻōpū nui
- Ka paʻakikī o ka ʻōlelo ʻana, ka slurring o nā huaʻōlelo
- Ke kūlou ʻana o kekahi ʻaoʻao o ka maka
- Ka maneʻo a nāwaliwali paha o kekahi lima a wāwae paha
- Ka huikau nui koke a i ʻole ka poniuniu
- Ka nalowale a i ʻole ka pohihihi o ka ʻike
Leka Lawe-Home
- He maʻi maʻamau ka maʻi vascular e hoʻopilikia ana i ka ʻōnaehana hoʻopuni koko i loko o ko mākou kino.
- ʻO ke koko kiʻekiʻe, ka maʻi diabetes, ka cholesterol kiʻekiʻe, a me ka puhipaka nā kumu nui o ka pilikia.
- Mai hoʻowahāwahā i nā hōʻailona e like me ka ʻeha o ka wāwae, nā ʻūmiʻi wāwae, a i ʻole ka paʻakikī o ka hanu ʻana. E ʻike koke i kāu kauka.
- Hiki ke pale ʻia a kāohi ʻia ka nui o kēia mau maʻi e kahi nohona olakino (ʻai maikaʻi, hoʻoikaika kino, a me ka pale ʻana i ka puhipaka).
- He mea nui loa ka hoʻohana pono ʻana i ka lāʻau lapaʻau i kuhikuhi ʻia e ke kauka a no ka manawa i kuhikuhi ʻia.
- Inā loaʻa iā ʻoe nā hōʻailona ulia pōpilikia (ʻeha nui o ka umauma, ʻulaʻula o ka maka, paʻakikī ke ʻōlelo), e hele koke i ka haukapila.
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