He pupuhi rite ki te poihau tō uma? (Thoracic Aortic Aneurysm) - Me kōrero tātou mō tēnei!

He mamae tō uma, tō kaki, tō kauae rānei i ētahi wā? He uaua rānei ki te manawa, he āhua kōkō rānei i te wā e horomia ana? I te nuinga o te wā, ka wareware tātou ki ēnei mea, me te whakaaro he mea noa iho, he rite pea ki te gastritis. Heoi, i ētahi wā he tohu ēnei mō tētahi mea e hiahia ana kia arohia. Nō reira, i tēnei rā ka kōrero tātou mō te pupuhi rite ki te poihau ka puta i roto i te uaua toto matua o tō tātou uma, te aorta . I roto i te rongoā, ka kiia tēnei he 'Thoracic Aortic Aneurysm' .

He aha tēnei 'Aneurysm o te Thoracic Aortic'? He māmā noa iho...

Whakaarohia he pūnaha wai matua tō tō whare. Koinei te mahi a te aorta i roto i tō tātou tinana. Koinei te uaua nui rawa atu, te uaua nui rawa atu hoki e kawe ana i te toto mai i te ngākau ki te tinana katoa. He rite tōna āhua ki te ngongo.

Nā, ko tēnei 'Aneurysm Aortic Thoracic' ko te wā e ngoikore ai te pakitara o tō aorta e rere ana i roto i tō uma (koia i huaina ai ko 'Thorax', ko te kōhao uma rānei) ka pupuhi haere, pērā i te poihau i te wāhi kotahi. Ka kiia hoki tēnei e ētahi he whānui, he whānui rānei o te uaua. I te nuinga o te wā, ki te whānui ake taua wāhanga o te aorta i te 50% o tōna whānui noa, ka kiia e mātou he 'Aneurysm', he pupuhi/pūpū rānei. Ka rerekē pea tēnei 'whānui noa' i ia wāhi, i ia wāhi o te aorta.

Ka puta ēnei pupuhi i ngā wāhi katoa o te aorta. I te nuinga o te wā, ka puta i te puku (e kiia ana e mātou ko te 'Abdominal Aortic Aneurysm'), engari tata ki te kotahi i roto i te whā tāngata ka pāngia e tēnei mate i roto i te uma.

Kāore pea e hiahiatia he maimoatanga nui mō ngā aneurysm iti. Tērā pea he nui ngā rongoā me ngā whakamātautau whakaahua auau (pēnei i ngā matawai) hei whakahaere i te mate taketake. Heoi, ki te nui tō aneurysm, ki te tere rānei te tipu, me mahi pea he pokanga hei ārai i ngā raruraru e morearea ai te ora . Mā ngā tākuta e whakatau te maimoatanga pai rawa atu māu me te wā e mahia ai, nā te mea e hiahia ana rātou kia whiwhi koe i ngā hua pai rawa atu.

He pēhea te noa o tēnei āhuatanga?

Ko tēnei mate, e kiia nei ko te 'Thoracic Aortic Aneurysm', e pāngia ana i waenga i te 6 me te 10 i roto i te 100,000 tāngata. Heoi, he uaua ki te kī i te tau tika, nā te mea i te nuinga o te wā kāore ēnei aneurysms e whakaatu i ngā tohu, nō reira kāore e kitea. Tata ki te 20% o ngā tūroro e tātaritatia ana i tēnei wā he hītori whānau tō rātou mō te mate, ko te tikanga he hononga ira kei reira.

I te Hononga o Amerika anake, e kiia ana e 30,000 ngā tāngata e mate ana i ia tau i te tapahi, i te pakaru rānei o te aorta, nō reira ehara tēnei i te mea hei whakaaro māmā noa iho.

He aha ngā tohu o te Aneurysm Aortic Thoracic?

I te nuinga o te wā, kāore te hunga whai "aneurysm" nei i te mōhio, nā te mea he maha ngā wā kāore he tohu e kitea ana.Heoi, i ētahi wā ka puta pea ngā tohu penei:

• Te mamae i tō kauae, kaki, uma, tuara rānei o runga .
• Te uaua ki te horomi, te mamae rānei i te wā e horomi ana (mēnā kei te pēhi te aneurysm i tō korokoro).
• Te pāorooro o te reo (mēnā kei te pēhia e tēnei aneurysm ngā io e whakahaere ana i tō reo).
• Te maremare, te uaua rānei ki te manawa (mēnā kei te pēhia tō ara manawa e te aneurysm).

He āhuatanga ohorere ēnei o te pakaru o te aneurysm (`Rupture`) te tapahi rānei (`Dissection`)!

He tokomaha te hunga kāore he tohu, kātahi ka pakaru, ka memeha rānei te aneurysm. He āhuatanga hauora ohorere ēnei e rua e hiahia ana kia rongoatia tonutia! Ka tīmata ohorere pea ngā tohu, ā, ka tino kino. Mena kei a koe, kei tētahi atu rānei tētahi o ēnei tohu , me haere tonu koe ki te hōhipera :

• He mamae ohorere, kāore e taea te whakamanawanui i te uma, i te tuara rānei. E kīia ana e ētahi he wero, he haehae, he pahū rānei.
• Pōuriuri, te āhua rānei e takahurihuri ana.
• Te uaua ki te manawa.
• Ka piki ake te tere o te manawa.
• Te werawera nui.
• Pōhēhētanga.
• Te uaua ki te kōrero.
• Te ngaronga o te tirohanga.
• Te ngoikore, te ngoikore rānei i tetahi taha o te tinana.

I roto i tēnei āhuatanga , he mea nui ia hāora, ia meneti. Ki te roa koe e whakaroa ana ki te rapu maimoatanga, ka iti ake te tūponotanga ka ora koe. Nō reira kaua e whakahawea ki ēnei tohu.

He aha ngā take o te 'Thoracic Aortic Aneurysm'?

Ko te tino take o te Aneurysm o te Thoracic Aortic ko te mate e kiia nei ko te Atherosclerosis. He māmā noa iho, koinei te wā e hangai ai ngā putunga ngako (plaque) ki roto i ngā pakitara o ō tātou uaua toto, ka āta whakawhāiti haere i a rātou. I roto i te wā, ka ngoikore ngā pakitara o te aorta i ēnei putunga ngako, ka nui ake te tūponotanga ka puta he aneurysm.

I te nuinga o te wā, he pakari ngā pakitara o tō tātou aorta, ā, me kaha ki te whānui me te whakawhāiti i te wā e tika ana ina rere te toto. Whakaarohia, ko tēnei aorta te wāhi e puta tika mai ai te toto i te ngākau. Nō reira, me kaha ki te tu atu i te pēhanga e puta mai ana i te wā e pupuhi kaha ana te ngākau i te toto.

Ka taea e te aorta hauora te mahi i tēnei me te kore he raruraru. Heoi, ki te ngoikore ngā pakitara o te aorta, ka taea e te pēhanga mai i te ngākau te mea ka pupuhi tetahi wāhanga o te aorta ki waho, ka hanga he aneurysm. He rerekē tēnei pupuhi, ka huri te āhua o te ngongo o te aorta. I te haere tonu o te toto i roto i tēnei pupuhi, ka nui ake te pēhanga ka pā ki ngā pakitara kua ngoikore kē, ka ngoikore ake. Nō reira, ka pupuhi ake ngā pakitara. Ka nui haere te aneurysm, ka nui ake te mōrearea.

He aha ngā āhuatanga mōrearea?

Ko ngā mea katoa e ngoikore ai ngā pakitara o te aorta ka whakanui ake i te tūponotanga o te whakawhanake i te aneurysm. Haunga te atherosclerosis, he maha atu anō ngā āhuatanga tūpono:

• `Aortitis`He mate mumura e puta ana i roto i te aorta.
• 'Matenga takirere aorta bicuspid ': E rua ngā rau o te takirere aorta o te ngākau (ko te tikanga kia toru).
• Mate pūkahukahu o te ngākau (CAD) : Ngā mate e pā ana ki ngā pūkahukahu o te ngākau e tuku toto ana ki te uaua o te ngākau.
• He hītori whānau tō te aneurysm (hītori whānau).
• Te toto toto tiketike .
• Te mate Loeys-Dietz : He mate ira onge e pā ana ki te kiko honohono.
• Te mate Marfan : Ko tētahi atu mate ira e pā ana ki te kiko honohono.
• Neke atu i te 65 tau te pakeke.
• Te momi hikareti, te whakamahi rānei i tētahi hua tupeka.
• 'Te mate Turner' : He mate ira ka pā ki ngā wāhine anake.
• Te mate ā-toto Ehlers-Danlos : He mate hononga onge e pā ana ki ngā oko toto.

Ka taea te tuku iho i te mate Thoracic Aortic Aneurysm?

Ae, ka taea e te Thoracic Aortic Aneurysm te horapa i roto i ngā whānau. Arā, ka taea te tuku iho i roto i ngā whakatipuranga. Kua kitea e ngā kairangahau ētahi whakarerekētanga ira e whakanui ana i te mōrearea. O ēnei, ko ngā whakarerekētanga ira o te ira ACTA2 te mea tino noa.

Ka tohutohu te ira ACTA2 i tō tātou tinana kia hanga ētahi pūmua i roto i ngā pakitara o ō tātou uaua. Ka āwhina ēnei pūmua i ngā pakitara o ō tātou uaua kia mau tonu tō rātou āhua mā te tautoko i te pēhanga o te toto e rere ana i roto i a rātou. Mena he whakarerekētanga ira kei roto i te ira ACTA2, ka totoro rawa ngā pakitara o ō tātou uaua ina rere te toto i roto i a rātou.

Heoi, kāore e taea e koe te kī kua riro mai i a koe tētahi whakarerekētanga ira nā te mea he aneurysm tōu. Heoi, he nui ake te mōrearea. Mena kua pāngia tētahi o tō whānau tata (he whanaunga koiora) e te Thoracic Aortic Aneurysm, he mea pai kia kōrero koe ki tō tākuta. Tērā pea ka tūtohu ia i tētahi whakamātautau ira .

Kei hea te putanga mai o tēnei 'Aneurysm o te Thoracic Aortic'?

Ka puta ēnei i ngā wāhi e ngoikore ai ngā pakitara o te aorta. Ko ngā mea pēnei i te 'Atherosclerosis' (ngā putunga ngako) i kōrerohia e tātou i mua ake nei, ngā mate kiko honohono rānei, ka ngoikore ai ngā pakitara o te aorta, ka māmā ake te hanganga o te 'Aneurysm'.

I mōhio koe ko te aorta te oko toto nui rawa atu o tō tātou tinana? He rite ki te tokotoko tawhito. Ka tīmata i te ngākau, ka piko ki runga, kātahi ka heke ki raro i te uma me te puku. Ka mutu i runga ake i te pito.

I te nuinga o te wā, ka puta te Aneurysm Aortic Thoracic i roto i te aorta ascending , i te aorta descending rānei. I ētahi wā, ka puta anō hoki i te wāhanga piko o te aorta – te wāhanga e rite ana ki te kakau o te rākau.

He pēhea te kino o te 'Thoracic Aortic Aneurysm'?

He mate hauora kino te Aneurysm o te Thoracic Aortic. He maha ngā raruraru ka pā mai:

• Te pakaru o te aneurysm.
• Te tapahi i te aorta .
• Ka puta ngā toto totoka ki te wāhi o te aneurysm ka haere ki ētahi atu wāhanga o te tinana (thromboembolism). Ka taea e ēnei toto totoka te whakararu i ngā āhuatanga kino pērā i te whiu , te mesenteric ischemia rānei.
• Te ruakitanga o te takirere aorta .

He tino kino ēnei āhuatanga. Koia tātou me tūpato ki tēnei 'Aneurysm'.

Me pēhea te tautuhi i tēnei 'Aneurysm o te Aorta o te Thoracic'?

I te nuinga o te wā, ka kitea he aneurysm o te uma o te uma mā te tūpono . Ko te tikanga ka kitea i te wā e whakahaerehia ana e ngā tākuta he whakamātautau mō tētahi atu take. Hei tauira, ka whakaatu pea he hihi-X o te uma he whānui ake te wāhanga waenga o tō uma (te mediastinum) i te mea noa. He tohu pea tēnei nō te aneurysm.

Mena kei te whakapae tō tākuta kei te pāngia koe e te Thoracic Aortic Aneurysm, mā te hihi-X, mā ētahi atu take rānei, ka whakahaua e ia ngā whakamātautau e whai ake nei:

• 'Angiogram tomography rorohiko (CT)' : He matawai CT motuhake tēnei.
• `Echocardiogram (echo)` : He matawai ultrasound o te ngākau.
• Angiogram aukume aukume (MRA) : He matawai e tirotiro ana i ngā oko toto mā te whakamahi i te hangarau MRI.
• Whakamātautau oro-ā-ringa puku : He whakamātautau oro-ā-ringa hei tirotiro mō te aneurysm i roto i te aorta puku.

He aha ngā maimoatanga mō te Thoracic Aortic Aneurysm?

Ko te pokanga aorta te maimoatanga matua me te tino pumau mō te Thoracic Aortic Aneurysm. He maha ngā tikanga pokanga e whakamahia ana e ngā tākuta. Ko ētahi o ēnei ko:

• Pokanga tuwhera tuku iho : Ko te tikanga he tapahi roa i waenganui o te uma, ka tangohia te wāhanga pakaru o te aorta, ka whakakapia ki tētahi ngongo horihori (tāpiri). Ka whakamahia tēnei tikanga hei rongoā i ngā aneurysms i roto i te aorta piki, me ngā aneurysms uaua i roto i te uma me te puku.
• Te whakatikatika i te aorta endovascular o te uma (TEVAR) : He tikanga pokanga iti rawa te whakaekenga . Ko te tikanga ka mahia, kāore he tapahi nui. Ka whakamahia hei rongoā i ngā aneurysms i roto i te aorta heke. I roto i tēnei tikanga, ka tapahia e te taote pokanga he tapahi iti i roto i tō hope, ka whakamahia he uaua (uaua femoral) e tika ana mā roto, ā, ka whakamahia he catheter (ngongo angiangi) hei whakauru i tētahi tākai ki roto i te aneurysm.
• Te whakakapinga o te pakiaka aortaKa mahia tēnei pokanga mō te `Aneurysm` i te wāhi e hono ai te aorta ki te ngākau (`Aortic root`). Tērā pea ka uru atu ki tēnei te whakakapi i tō takirere aorta. Tērā atu rānei, ka taea te whakamahi i ngā `tikanga tiaki takirere` hei pupuri i tō takirere tūturu.

I ētahi wā, ka whakakotahi ngā taote pokanga i ngā tikanga neke atu i te kotahi (hei tauira, te pokanga tuwhera me te maimoatanga endovascular) i runga i te āhua o te aneurysm. Mā te whiwhi maimoatanga i te pokapū aorta ka nui ake ō kōwhiringa me ō tūponotanga ki te hua pai.

Āhea ahau e hiahia ai ki te pokanga?

Mā te tākuta e whakatau mēnā me pokanga koe, ā, mēnā me pērā, āhea, mā te whai whakaaro ki ēnei āhuatanga:

• Te rahi me te tauwāhi o te aneurysm.
• Te tere o te tipu o te aneurysm .
• Mēnā ka puta mai ngā tohu i te aneurysm, me te kaha o aua tohu .
• Ētahi atu mate hauora kei a koe.

Mena he nui te aneurysm, he tohu rānei e puta ai, me pokanga pea kia kore ai e pahū. He mea nui te rahi o te aneurysm nā te mea ka nui ake, ka nui ake te tūponotanga ka pahū. I te nuinga o te wā, ka whakatau ngā tākuta ki te mahi pokanga mena kei waenga i te 2 me te 2.2 inihi (tata ki te 5 ki te 5.5 henimita) te whānui o te aneurysm, mena rānei kei te tipu haere i te tere o te haurua henimita ia tau.

Engari, ehara i te rahi anake te mea nui. Mena he mate hononga tōu, he takirere aorta bicuspid, he āhuatanga rānei e whakanui ake ana i te tūponotanga o te pakaru, te pakaru rānei, ka whakatau pea tō tākuta ki te mahi pokanga wawe atu. Kōrero ki tō tākuta mō te rahi o tō aneurysm me te wā e hiahiatia ai te pokanga.

"Te tatari mataara"

Mena he iti te aneurysm, ā, kāore he tohu, kāore pea koe e hiahia ki te pokanga tonu. Engari, ka aroturukihia tō āhua e tō tākuta (e kiia ana tēnei ko te tatari mataara). Tērā pea ka tohua e ia he rongoā hei whakaiti i te tūponotanga o ngā raruraru.

Hei tauira, ka tonoa pea he matawai whakaahua i ia 6 ki te 12 marama hei tirotiro i ngā huringa o te aneurysm. Tērā pea ka hoatu he rongoā ki a koe hei whakaheke i tō toto toto me te whakaiti i te pēhanga ki te wāhanga ngoikore o tō aorta. Ka tūtohu pea tō tākuta i te pokanga ina nui ake ngā painga o te pokanga i ngā mōrearea .

Ka taea te ārai i te Aneurysm Aortic Thoracic?

Kāore he huarahi motuhake hei ārai i tēnei mate. Heoi, ka taea e koe te whakaiti i tō tupono ki te whakawhanake i te atherosclerosis (he tino take o ngā aneurysms). Anei ētahi mea ka taea e koe te mahi:

• Whakahaerehia tō toto toto me ngā taumata cholesterol.
• Whāia he kai hauora mō te ngākau (hei tauira, te Kai Mediterranean ).
• Āta karohia ngā hua tupeka katoa.
• Me mahi kia 150 meneti pea te iti rawa o te whakakori tinana kaha-waenga ia wiki (engari kōrero ki tō tākuta i mua i te tīmatanga o tētahi mahere whakakori tinana hou).
• Me whai tirotiro hauora ā-tau, ā, me haere ki ngā wā tirotiro hauora katoa kua whakaritea.

Kia pēhea te roa ka taea e koe te ora me te Thoracic Aortic Aneurysm?

Ko te roa o te oranga e whakawhirinaki ana ki ngā āhuatanga maha, tae atu ki te rahi o te aneurysm me te mea ka puta he raruraru. He mea morearea pea ngā aneurysm nui. Tata ki te 65% o te hunga he aneurysm nui, kāore i rongoatia, ka ora i te tau kotahi i muri i te tātaritanga. E 20% anake ka ora i roto i ngā tau e rima.

Heoi, mā te maimoatanga tika, ka taea te whakanui ake i tō roanga o te ora, ā, ka taea e koe te ora roa, te ora hauora hoki. Koia te mea nui kia mōhio koe mēnā kei te tūpono koe ki te whakawhanake i te Thoracic Aortic Aneurysm, me te mahi tahi me tō tākuta ki te whakahaere i te mate.

Me pēhea taku tiaki i ahau anō?

Mena he aneurysm tōu, ka hoatu e tō tākuta he tohutohu mō te tiaki i a koe anō. Tērā pea ka kī atu ia i ēnei mea:

• Kaua e whakakorikori tinana kaha. Ka taea e ngā mahi pēnei i te hiki taumaha, te whakangungu wā roa rānei (HIIT) te whakararu i ō uaua toto. Pātai atu ki tō tākuta he aha ngā momo whakakorikori tinana e haumaru ana māu.
• Āta karohia te kai tupeka. Ka whakanui ake te tupeka i te mōrearea o ngā mate pūnaha toto maha. Ki te kai paipa koe, ki te whakamahi rānei i ētahi atu hua tupeka, rapua he āwhina hei whakamutu.
• Hurihia tō kai. Me whakaiti pea tō kai tote, me mahi rānei i ētahi atu huringa pai mō te hauora o ō uaua.
• Tangohia ō rongoā kia rite ki te whakahaunga. Tērā pea ka hiahia koe ki ngā rongoā hei whakahaere i ngā mate o raro. Pātai atu ki tō tākuta mēnā he pātai āu mō te tango i ēnei rongoā.
• Āta karohia ngā matū e whakanui ake ana i te tere o te manawa. Hei tauira, ko te kōkaini, te amphetamines, me ētahi tāpiringa otaota.

Āhea ahau me toro atu ki taku tākuta?

Tirohia tō tākuta mō tētahi tirotiro ā-tau, ā, kia mau tonu ō whakaritenga tirotiro katoa. Waea atu ki tō tākuta tonu mēnā:

• Mena ka kite koe i ngā tohu hou, i ngā huringa rānei o ngā tohu o nāianei .
• Mena ka puta mai ngā pānga taha kāore i te tumanakohia i te rongoā.
• Mena he pātai, he āwangawanga rānei āu mō tō mahere maimoatanga.

Āhea ahau me haere ki te rūma ohorere (ER)?

Ngā tohu o te aneurysm pakaru, pakaru rāneiMena koinā, waea atu ki te 911 (1990 i Sri Lanka) me haere rānei ki te rūma whawhati tata tonu. He whawhati hauora ēnei e hiahia ana kia rongoatia tonutia hei whakaora i ngā oranga.

He aha ngā pātai me pātai atu e au ki taku tākuta?

Ki te kī atu tō tākuta he mate puku uaua tōu, kāore pea koe e mōhio he aha te mea hei pātai tuatahi. Anei ētahi pātai hei tīmatanga māu:

• Kia pēhea te rahi o taku aneurysm?
• He mea hei āwangawanga mō tēnei nui?
• He aha pea te take o tēnei 'aneurysm'?
• He aha te momo maimoatanga e taunaki ana koe māku?
• He aha ngā huringa me mahi e au i roto i tōku āhua noho?
• Kia pēhea te auau o taku haerenga mai mō ngā whakamātautau whai muri?

He aha tēnei 'Aneurysm Thoracoabdominal'?

He momo 'Aneurysm' anō hoki tēnei. He 'Aneurysm' tēnei e toro atu ana puta noa i tō uma ('Thorax') me tō puku ('Abdomen'). E 15% pea o ngā 'Aneurysm' katoa e puta ana i roto i te aorta e pā ana ki tēnei momo.

He mea whakamataku te kitenga he aneurysm kei roto i tō uma. Tērā pea kāore koe i whakaaro ki te hauora o ō uaua, ki te āhua rānei o tā rātou mahi. Tērā pea i whānau mai koe me te mate hononga kiko, nō reira e tino mōhio ana koe ki ngā mahi o roto o tō tinana. Ahakoa he aha tāu e mōhio ana, koinei te wā ki te ako atu mō tō āhua me te mahi hei whakaiti i te tūponotanga o ngā raruraru.

Kōrero ki tō tākuta mō ngā mea ka taea e koe te tumanako i runga i tō āhua. Ka taea e ia te whakarite i tētahi mahere maimoatanga kia rite ki ō hiahia, te whakautu i ō pātai, me te whakarato i ngā mōhiotanga e hiahiatia ana e koe hei anga whakamua.

Hei whakamutunga, ngā mea hei maumahara (Karere hei tango ki te kāinga)

He mate kino te Aneurysm o te Uma. Heoi, mā te mōhio wawe, te tohutohu hauora tika, me te maimoatanga tika, he nui te tūponotanga ka ora hauora koe, ka roa hoki te ora.

• Kia tūpato ki ngā tohu: Kaua e warewarehia ngā mea pēnei i te mamae ohorere, te mamae nui o te uma, o te tuara rānei.
• Me whakamātau koe mēnā he āhuatanga mōrearea tōu: Mēnā kua pāngia tētahi o tō whānau e tēnei mate, he toto toto tiketike rānei tōu, he kaipaipa rānei, me rapu tohutohu hauora.
• Kia tino whai i ngā tohutohu a tō tākuta: tangohia ō rongoā kua tohua, whai i ngā tohutohu mō te whakakori tinana me te kai, me te haere ki ngā whakamātautau me ngā wā whakarite.
• Āta karohia te momi hikareti: Koinei tētahi o ngā mea tino nui ka taea e koe te mahi.

Kaua e manukanuka, kāore koe i te mokemoke. Kei te rite tō tīma hauora ki te āwhina i a koe. Ko te mea nui ko te mōhio ki tēnei āhuatanga, me te tiaki i tō hauora.

` Te Aneurysm o te Uma, te aorta, te mamae o te uma, te mate manawa, ngā uaua toto, te aneurysm, te pokanga