Lung chhunga thisen kalna kawng te tak tea pressure a sang nghal mai thin dinhmun hi i hre tawh em? Tui pipe-a thil a tlakbuak a, pressure a sang chho ang mai a ni. Chu chu CTEPH chu a ni. A hming hi a sei deuhin a lang thei a, mahse hriatthiam a awlsam hle. Condition hmuh tur awm lo tak a ni a, mahse kan hriat vek tur pawimawh tak a ni.
A awlsam zawngin CTEPH chu eng nge ni?
CTEPH hi lungah thisen sang a ni. Damdawi lamah chuan hei hi `(Pulmonary Hypertension)` kan ti a. Mahse hei hi thisen sang pangngai nen a danglam a ni. CTEPH a lo awm chhan bik a awm. Chu chu, a hmaa lung thisen kalna kawng `(Pulmonary Embolism)`-a thisen zam (blood clots) lo awm tawh chu a hmin tha lo tihna a ni .
Mi pakhat chu a lungah thisen zam a awm tih han mitthla teh. A tlangpuiin kan taksa mechanism ngei hian heng thisen zamte hi hun kal zelah a tithianghlim thin. Mahse mi thenkhatah chuan heng thisen zamte hi a bo vek lo. Chu ai chuan thisen kalna kawnga awm, hliam ang chi tissue upa tak an lo ni ta zawk a ni. Hun a kal zel a, he scar tissue hian thisen kalna kawng a tizau a.
Thisen kalna kawng a zim chuan, chu thisen kalna kawng a zim tak tak kal tlanga thisen pump turin thinlung chuan nasa zawkin hna a thawk a ngai a ni. Hei hian lung chhunga thisen kalna kawng chhunga pressure a ti sang lutuk thin. Chu chu CTEPH (Chronic Thromboembolic Pulmonary Hypertension) kan tih chu a ni.
A pawimawh ber chu he natna hi pulmonary embolism history nei tawhte chauhah a awm thin. Chutiang history nei lo chuan lung chhunga pressure a sang a nih chuan damdawi lam natna dang a ni thei bawk.
CTEPH hian engtin nge i taksa a nghawng?
Kan thinlung dinglam chuan oxygen tlachham, thisen thianghlim lo chu lungah a pump chhuak a, chu chu tihthianghlim nan a ni. Tunah chuan CTEPH avanga lung chhunga thisen kalna kawngte a zim a, pressure a san chuan he thisen hi lung lama nawr luh kawngah hian thinlung dinglam hian daltu lian tak a hmachhawn a ngai ta a ni.
Hei hian harsatna lian tak pahnih a siam a:
1. Thinlung phur lutuk: Hetianga i thawhrim reng hian thinlung dinglam chu a chak lo tan thin. Hei hi tui pump-in hmun blocked luah khat tura nasa taka a thawh ang mai a ni. Hun a kal zel a, pump chu a chak lo hle.
2. Taksaa oxygen level tlahniam: Thisen hian lung chhungah mumal takin a kal thei lo va, oxygen a la thei lo. Hei hian taksaa oxygen level a tihhniam phah a ni. Hei hi hahna leh thawk hah ang chi symptoms anga kan tawn thin chu a ni.
Eng thil nge CTEPH vei theihna tipung?
A hmaa kan sawi tawh ang khan a chhan ber chu lung chhunga thisen zamte chu a hmin vek loh vang a ni. Mahse, mi thenkhat chuan he natna hi an nei tam zawk. Heng risk factors te hi eng nge ni tih hi han thlir ila.
| Risk factor a ni | Hrilhfiahna |
|---|---|
| Thisen chi hrang hrang | ‘O’ tih loh thisen chi dang nei. |
| Thisen zam natna | Nangmah emaw, i chhungte emaw hian thisen zam natna (e.g. Antiphospholipid Syndrome ) i neih chuan. |
| Spleen lakchhuah a ni | Splenectomy (surgery hmanga spleen lakchhuah) . |
| Hun rei tak chhunga hri kai theihna | Hun rei tak chhunga natna hrik, ruh natna (osteomyelitis) . |
| Damdawi lam thil dang | Cancer chi hrang hrang leh natna chi hrang hrang Inflammatory Bowel Disease te . |
| Thil dangte pawh | Hmeichhia nih te, thinlunga pacemaker neih te, thyroid hormone hmanga enkawlna te hi natna kai theihna tur risk factor a ni. |
He natna lan chhuah dan hi eng nge ni thei ang?
CTEPH symptoms hi a tir lamah chuan a lang lo mai thei. Zawi zawiin an lo thang chho zel a. Hei hi hahna pangngai mai niin i ngai mai thei. Mahse heng symptoms te hi ngaihven a pawimawh hle.
| Symptom a ni | Thu belhchian dawl zawk |
|---|---|
| Thâwk harsa | A bik takin i thawhrimnaah a thleng thin a, chu chu kea kal emaw, stairs i chhoh lai emaw a ni. Natna a zual zel chuan he natna hi i ding reng lai pawhin a awm thei a ni. |
| Chauhna leh hah lutuk | Hna engmah thawk lo pawhin chau reng reng. |
| Chest na emaw tightness emaw a awm | He natna hi thinlungin a thawhrim a ngaih avangin a lo awm thei a ni. |
| Ke leh ke ruh a hring (Edema) . | Lung hnathawh that loh avangin taksaah tui a pungkhawm a, keah a hring chhuak thin. |
| Luak chhuak leh muhil (Syncope) . | Hei hi thluak hian oxygen a dawn tlem chuan a thleng thei a ni. |
| Lung na tak tak | Mahni thinlung thawk pawh hre thei ang maia inhriatna. |
| Blue rawng danglam (Cyanosis) . | Thisenah oxygen a tlem avangin hmui leh kut zungtang te chu a sen a ni. |
Heng symptoms te hi i neih chuan, a bik takin lungah thisen zam a awm tawh a nih chuan doctor rawn nghal tur a ni.
Engtin nge CTEPH hi hmuhchhuah a nih?
Doctor i hmuh hunah i natna lan chhuah dan a zawt ang a, a enfiah ang che. CTEPH i vei nia rinhlelhna a awm chuan i natna hriat chian nan test eng emaw zat neih an rawt ang.
- V/Q scan: Hei hian lung chhunga thisen a kal dan leh boruak a kal dan a en thin. He scan hian thisen zam awmna hmun a hmu thei a, thisen kal a tihtlem avangin.
- Transthoracic Echocardiogram (TTE): Hei hian thinlung dinglam a pressure leh thinlung chak loh zia a enfiah thei a ni.
- CT Pulmonary Angiogram: Hei hi CT scan bik a ni a, chu chuan thisen zam hlui leh lung chhunga thisen kalna kawng a zim tih chiang takin a hmu thei a ni.
Test dang neih belh leh tur a ni
Natna hi finfiah a nih veleh a nasat dan leh enkawl dan tur ruahmanna siam turin test eng emaw zat tih belh leh theih a ni.
- Right Heart Catheterization: Hei hi pulmonary pressure tehna dik ber a ni. Tube te tak te (catheter) chu taksa chhunga thisen kalna kaltlangin thinlung dinglam leh lung lam panna thisen kalna bulpuiah dahin, pressure chu an teh thin.
- Exercise Stress Test: He test hi exercise i tih laiin i thinlung leh lung hnathawh dan hriat nan tih a ni.
Hei hi eng enkawlna nge ni?
CTEPH chungchanga thu lawmawm tak chu natna tihdam theih a ni tih hi a ni. Damlo tam zawk chu operation emaw, enkawlna dang emaw hmangin an hahdam thei. Enkawlna kawng hrang hrang pahnih a awm.
1. Pulmonary Endarterectomy (PTE) hmanga tih a ni a:
Hei hi open-heart surgery a ni. Hetiang tihnaah hian surgeon-te chuan lung chhunga thisen kalna kawng lian ber berte chu an hawng a, a chhunga thisen zam hlui leh scar tissue lo awm tawh zawng zawng chu an scrape chhuak vek a ni. Hei hi surgery buaithlak tak ni mahse, a hlawhtlin chuan natna hi a tidam vek theihna chance a sang hle.
2. Pulmonary Balloon Angioplasty (BPA) hmanga tih theih a ni:
He enkawlna hi thisen zam (vein)-a thisen zam, operation tih loh lutuk te tan hman a ni. Hetianga enkawlnaah hian ke chhunga vein pakhatah tube te tak te (catheter) dahin a tawp berah balloon te tak te hmangin vein narrowed chu inflate leh widen a ni. Hei hi surgery angin a lian lo.
Heng enkawlna pahnih zinga pakhat hian CTEPH hi a tidam vek mai thei. Inenkawl zawhah mi tam zawk chuan nun pangngaiin an khawsa thei a ni.
A châng chuan, operation tih theih loh emaw, operation hnua an lungah pressure sang deuh emaw la awmte tan chuan chu pressure control nan damdawi bik (e.g., Riociguat) an pe ṭhin.
CTEPH nena kan khawsak huna hriat tur thil
Inenkawl hnuah i nun a lo tha chho hle ang a, mahse i hriat chian ngai tlemte a awm.
- Lifelong blood thinners: Thisen zam belh zel tur ven nan i dam chhung zawng thisen tithianghlimtu i ei a ngai dawn a ni. Doctor thupek dik taka zawm a pawimawh.
- Diet: `Warfarin` ang damdawi i ei a nih chuan vitamin K tamna ei tur (cabbage, spinach, broccoli ang chi) lakah fimkhur tur a ni. Hemi chungchang hi i doctor nen sawiho rawh.
- Meizial zuk loh tur: Meizial zuk hian i lung a tichhe nasa hle. Meizial zu mi i nih chuan bânsan vek a pawimawh hle.
- Exercise light: Exercise light, kea kal ang chi hian i chakna a tipung thei a ni. Mahse, exercise program eng pawh i tan hmain doctor rawn hmasa phawt ang che. Damdawi lam enkawlna hnuaia rehabilitation program ``Pulmonary Rehabilitation'' tih-ah hruai i ni thei bawk.
- Rilru hrisêlna: Hetiang natna hun rei tak neia nun hian rilru hahna, lungkhamna, a nih loh leh lungngaihna a thlen thei a ni. Hetiang hian i awm a nih chuan i doctor emaw, i hnaih ber emaw biak pawh zak suh.
Take-Home Thuchah a ni
- CTEPH hi thisen sang tak a ni a, thisen zam hlui chu lung chhunga thisen kalna kawngah a tlakbuak vang a ni.
- Hei hi thisen sang pangngai nen inzawm tir suh.
- Thâwk harsa, hah lutuk, i ke a hring ang chi symptom i neih chuan, a bik takin thisen zam i neih tawh chuan doctor pan nghal rawh.
- He natna hi surgery emaw, kawng dang emaw hmangin a dam kim thei fo.
- Enkawlna hnuah pawh i doctor thupek dik takin zawm la, a bik takin thisen tihthianghlimna damdawi ei chungchangah.
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