Ka turuturu te wai i roto i tō tinana pēnei? Me kōrero tātou mō te Capillary Leak Syndrome!

Kua rongo kē koe i te Capillary Leak Syndrome? Tērā pea he ahua uaua te ingoa. Engari i te kīanga māmā, he āhuatanga tēnei e turuturu ai te wāhanga wai o te toto, e kiia nei ko te plasma, mai i ngā oko toto iti o roto i ō tātou tinana, e kiia nei ko ngā capillaries. Ka turuturu tēnei wai ki roto i ō tātou uaua, kiko, whekau, me ngā kōhao tinana. He āhuatanga kino tēnei, nō reira he mea nui kia mōhio ki tēnei āhuatanga.

He aha tēnei mea e kīia nei ko te mate turuturu o te capillary?

Āe, me whakamārama atu anō. Whakaarohia he pūnaha paipa wai tō tō tinana. Ko ēnei paipa ko ō tātou oko toto. Ko ngā paipa tino angiangi, ririki o roto i tēnei ka kiia he capillaries. Koinei ngā ngongo e haere ai te hāora me ngā matūkai ki ngā wāhanga katoa o tō tātou tinana. Nō reira, i roto i te `(Capillary Leak Syndrome)`, ko te wāhanga wai o te toto, arā , ko te plasma , e turuturu ana i roto i ēnei capillaries iti. He rite ki te wai e turuturu ana i roto i te paipa wai.

Nā te turuturu o te wai nei ka kohia te wai ki ngā wāhanga rerekē o te tinana. Hei tauira, ka turuturu pea tēnei wai ki roto i ngā uaua, ki ngā kiko, ki ngā whekau rerekē, ki ngā wāhi rānei (ngā kōhao tinana) kei reira ngā whekau.

Ka puta pea tēnei `(Capillary Leak Syndrome)` i ētahi wā i te tau, kotahi noa iho rānei i te ao. Heoi, ki te kore e rongoatia wawetia, ka heke ohorere tō toto toto, ka arahi atu ki te ngoikore o ngā okana, ā, i ētahi wā ka mate. Nō reira, ehara tēnei i te mea hei mea ngāwari noa iho.

Kāore anō kia kitea he rongoā tuturu mō tēnei. Heoi, he mea nui kia rapua he awhina hauora tere hei whakahaere i ngā tohu. I ētahi wā, ka taea te ārai i ngā whakaekenga a muri ake nei mā te whakamahi tonu i ngā rongoā, te whiwhi rānei i ngā werohanga tote.

He momo anō ēnei? He aha ngā rerekētanga?

Ae, e rua ngā momo matua o te `(Capillary Leak Syndrome)`. Kia kite tātou he aha ēnei.

• Te Mate Puta o te Ārai Pūnaha: E kiia ana hoki ko te "Mate Puta Tuatahi" ko te "Mate a Clarkson" rānei, he āhuatanga tēnei e puta pinepine ai ngā whakaeke , ahakoa i roto i te tangata hauora noa.
• Te Mate Tūtaki Tuarua o te Āpitihanga: Koinei te wā ka puta te whakaekenga nā tētahi atu mate, āhuatanga, rongoā rānei.

Ki te kī ngāwari, ko tētahi he mea ka tupu tonu, ko tētahi he mea ka tupu mō tētahi wā poto mō tētahi atu take.

Ko wai te mea ka nui ake te tūponotanga ka pāngia e tēnei mate?

He mate tino onge te "Syndrome Leak Capillary Leak".E ai ki ngā pūrongo, he iti iho i te 500 ngā tāngata puta noa i te ao e pāngia ana e tēnei mate. He mea tino noa tēnei i roto i te hunga pakeke. He tino onge i roto i ngā tamariki nohinohi. Heoi, nā te mea ka hē te tautuhi i te hunga whai mate nei he mate kē atu tō rātou, tera pea ka nui ake te tokomaha o te hunga whai mate nei.

Heoi anō, ka pā te "Secondary Capillary Leak Syndrome" ki te tangata o ngā tau katoa. Ka taea e ētahi mate, āhuatanga hauora, me ngā rongoā te take.

He aha te mea ka pā ki te tinana ina tupu tēnei? (E toru ngā wāhanga)

E toru ngā wāhanga o te "Capillary Leak Syndrome" e pā mai ana ki te tinana. Kia tirohia tātou he aha ēnei.

Wāhanga Tuatahi: I mua i te putanga mai o ngā tohu (Wāhanga Prodromal)

Koinei te wā i waenganui i te rā kotahi me te rua i mua i te whakaekenga. I tēnei wā, ka tīmata pea koe ki te pāngia e ētahi tohu.

• Te ngenge
• Te nui haere o te matewai mō te wai
• Ka taea pea ngā mea pēnei i te pikinga ohorere o te taumaha .

Wāhanga tuarua: Wāhanga turuturu, wāhanga whakaora rānei

Koinei te wā e tino puta ai te whakaeke. Ko te mea ka tupu ko te turuturu o te wai me te albumin (he momo pūmua i roto i te toto) mai i ō capillaries ki ngā āputa i waenganui i ō kiko. Ka whakaitihia e tēnei te nui o te toto e kawe ana i te hāora. Ka heke tō toto toto, ka huihui ngā pūtau toto whero, ka matotoru ake ō toto. Ka heke te nui o te toto i tēnei turuturu, e kiia nei ko te hypovolemia .

Tuatoru o ngā wāhanga: I muri i te whakaekenga `(Wāhanga i muri i te turuturu, wāhanga kimi rānei)`

Koinei te wā i muri i te mutunga o te whakaeke. Ko te mea ka tupu, ka tīmata anō ō uaua toto ki te mimiti i te wai me te albumin mai i ngā kiko. Heoi, i tēnei wā, ka nui rawa te wai ka kohia e tō tinana (te nui rawa o te wai) . Nō reira, ka nui rawa te mimi ka puta i tō tinana (polyuria) ā, ka kī tonu ō pukahukahu i te wai (te pupuhi pūkahukahu).

Whakaarohia, he rite ki te hautai e mimiti ana i te wai. Tuatahi, ka puta te wai i roto i te tinana, ā, ina mimiti tere rawa, ka mimiti nui atu i te mea e tika ana.

He aha te take o tēnei?

Kia titiro tātou inaianei ki te take o tēnei `(Capillary Leak Syndrome)`.

Ngā Take o te `(Syndrome Leak Capillary Syndrome)`

Ki te pono, kāore anō kia mōhiotia te tino pūtake o te Systemic Capillary Leak Syndrome. E whakapono ana ngā kairangahau tera pea nā te urupare a tō tātou pūnaha ārai mate ki tētahi mate, ki tētahi mate pāwera rānei i puta ai.

Ngā Take o te `(Secondary Capillary Leak Syndrome)`

He maha ngā take mō tēnei. Ko te tino take ko te mate e kiia nei ko te sepsis . Arā, he raruraru morearea e puta mai ana i te mate. Hei tāpiri, tera atu anō ētahi atu take:

• Ngā mate pūnaha ārai mate:Ko te mea ka tupu i tēnei, ka whakaekea e tō tātou ake pūnaha ārai mate ō tātou ake pūtau hauora.
• Te mate rerekētanga: He raruraru ka puta i te wā e rongoatia ana ētahi momo leukemia (te leukemia promyelocytic acute, te leukemia myeloid acute rānei).
• Te mate engraftment: He raruraru ka puta i muri i te whakawhitinga wheua.
• Hemophagocytic lymphohistiocytosis: He mate morearea pea e puta mai ana i te pūnaha ārai mate kaha rawa.
• Te mate whakaohooho ovarian: He raruraru ka puta i te wā e rongoatia ana te momonatanga.
• Te paihana ricin.
• Ngau a te nakahi.
• Te kirika toto huaketo: He rōpū mate pipiri e hua mai ana i ngā huaketo.

Ka taea hoki e ētahi rongoā, pērā i ngā rongoā ārai-matepukupuku gemcitabine (gemcitabine - Gemzar®) me te tagraxofusp (tagraxofusp - Elzonris®) , te whakaputa i tēnei (Secondary Capillary Leak Syndrome).

He aha ngā tohu e puta mai ana i mua i te tīmatanga o tēnei mate?

I te nuinga o te wā, kotahi, e rua rānei ngā rā i mua i te whakaekenga o te "Capillary Leak Syndrome", arā, i te wā o te "wāhanga prodromal", ka pāngia pea koe e ngā tohu pēnei i:

• Te mamae o te puku, te mamae rānei o te uaua (myalgia).
• Te ngenge nui, te ngoikore rānei.
• Te mamae o te upoko .
• Te nui haere o te matewai mō te wai.
• Te riri tere, te tere o te riri.
• Whakapairuaki.
• Te pikinga ohorere o te taumaha.
• Ngā tohu o te mate huaketo, te mate rānei o te ara manawa o runga.

Ki te pāngia koe e ēnei tohu, kaua e whakahawea, e mea, "Āe, he makariri noa iho pea," ina koa kua pāngia koe e ēnei momo wheako i mua.

He aha ngā tohu ka puta mai ina pāngia koe e te mate?

I te wā o te whakaekenga o te `(Capillary Leak Syndrome)`, arā, i te wā `(leak, restoration rānei)`, ka rerekē pea ngā tohu i ia tangata, i ia tangata. Heoi, ko ēnei ngā tohu noa ka kitea:

• Te pupuhi, inā koa ki ngā peka me ngā waewae (peripheral edema).
• Te korere.
• Te toto toto iti (te toto toto iti).
• Te toto totoka (hypercoagulability) - Ka puta pea tēnei i te pikinga o te maha o ngā toto whero (hematocrit) i te pikinga rānei o te maha o ngā toto ma (leukocytosis).

Me pēhea te mōhio o ngā tākuta ki tēnei?

Mā te tākuta e tātaritanga te mate o te Capillary Leak Syndrome mā te pātai mō tō hītori hauora me te tirotiro tinana. Ka tirohia e rātou mēnā he iti tō toto toto.

I mua hoki i te whakaū he mate turuturu tēnei, me whakakore atu ētahi atu āhuatanga. Tērā pea ka whakahaerehia ētahi whakamātautau toto hei mahi i tēnei:

• Tirohia mēnā he nui te hematocrit (te maha o ngā toto whero i roto i te toto).
• Tirohia mēnā he tiketike te taumata o te hemoglobin (he pūmua kei roto i ngā toto whero).
• Tirohia mēnā he iti te pūmua i roto i te toto (hypoalbuminemia).

Hei tāpiritanga, ka taea te whakamātautau toto hei tirotiro i tētahi pūmua ārai mate rerekē e kiia nei ko te "monoclonal gammopathy, te pūmua M rānei" i roto i te toto. Tērā pea kei roto i te toto o te hunga whai "Capillary Leak Syndrome".

Me pēhea te rongoā? Ka taea te whakaora?

Engari, kāore he rongoā tuturu mō te Capillary Leak Syndrome. Ka ngana ngā tākuta ki te whakahaere i ngā tohu me te ārai i ngā raruraru.

I te wā e pāngia ana e te "Capillary Leak Syndrome", ka ngana ngā tākuta ki te whakahaere i te toto toto me te pupuri i te rere tika o te toto ki ngā whekau. Ka ngana hoki rātou ki te ārai i te pupuhi nui me te kohikohinga wai. Ka whakamahia pea e rātou:

• Glucocorticoids: He momo steroid ēnei e āwhina ana ki te whakaiti i te turuturu wai mai i ngā capillaries.
• Wai i roto i ngā uaua: Ka hoatu ngā mea pēnei i te tote hei whakanui ake i te rere o te toto ki ngā whekau pēnei i ngā whatukuhu.

I te nuinga o te wā me kawe koe ki te hōhipera i muri i te whakaekenga. I te wā e rongoatia ana, ka aroturuki tonu tō tākuta i tō toto me tō toto kia kore ai e nui rawa te wai i roto i tō tinana, ka ara ake pea tēnei i ētahi atu raruraru, pērā i te pupuhi pūkahukahu me te hopukanga ohorere o te ngakau.

I muri i te whakaekenga o te Capillary Leak Syndrome, e mōhiotia ana ko te wāhanga post-leak, ko te wāhanga recruitment rānei, ka tohua pea e te tākuta he diuretic (he rongoā e meinga ai koe kia nui ake te mimi) hei whakaiti i te nui o te wai tāpiri i roto i tō tinana.

Ka taea te ārai i te hokinga mai o te Systemic Capillary Leak Syndrome (SCLS)?

Kāore e taea te ārai i te Systemic Capillary Leak Syndrome i te tīmatanga. Engari, ina pāngia koe e te mate, ka mōhio koe kei a koe taua mate.

Heoi, mā te tango rongoā i ngā wā katoa, mā te werohanga tote rānei ka āwhina i te ārai i ngā whakaekenga a muri ake nei me te whakaiti i tōna kaha. Kei roto i ēnei maimoatanga:

• Te whiwhi i te immunoglobulin ārai mate (IVIG) ā-uaua i ia marama.
• Ngā rongoā ā-waha mō te mate huango, pērā i te theophylline (theophylline - Elixophyllin®), te terbutaline (terbutaline - Brethine®), me te montelukast (montelukast - Singulair®) .
• Whakaitihia te mumuraNgā steroids.

He aha te heke mai mō te hunga e noho tahi ana me tēnei mate?

Ko te tikanga, ka taea te whakahaere i te Systemic Capillary Leak Syndrome mā te whakamahi i ngā maimoatanga ārai. He nui ake te tūponotanga ka angitu te maimoatanga ina kitea wawe te mate, ā, he iti noa ngā raruraru. Ko ētahi o ngā raruraru nui ka puta mai i te Capillary Leak Syndrome ko:

• Te mate wāhanga: Te pikinga o te pēhanga i roto i te uaua me te hekenga o te rere o te toto.
• Te kohikohinga wai huri noa i te ngākau me ngā pukahukahu (te tamponade o te ngākau, te rerenga wai o te pericardial, me te rerenga wai o te pleural).
• Te ngoikore o te ngākau.
• Te ngoikore o te whatukuhu.
• Te mate pukupuku roro.
• Te pupuhi o te pūkahukahu.
• Rhabdomyolysis: Te ngoikore o te whatukuhu nā te kino o te uaua.
• Te whiu.

Ahakoa te āhua whakamataku o ēnei, engā, e ai ki te kōrero i mua ake nei, he mea tino nui te tere o te maimoatanga me te whakahaere tika.

Āhea ahau me toro atu ki te tākuta?

Ki te whakaaro koe kei te pāngia koe e te mate urutā o te Capillary Leak Syndrome, me toro atu ki te tākuta tonu. Ka taea e rātou te āwhina i a koe ki te whakahaere i ō tohu me te whakaora i a koe.

Kia maumahara, ahakoa he mate onge tēnei, he mea nui kia mōhio ki ngā tohu, ā, me rapu tohutohu hauora tonu mēnā he ruarua koe.

Karere Tangohia ki te Kāinga

Āe, me whakarāpopoto tātou i ngā kōrero nui mō te `(Capillary Leak Syndrome)` i kōrerohia e tātou:

• Koinei te wā e turuturu ai te wāhanga wai o te toto (plasma) i roto i ngā oko toto iti (capillaries) o tō tātou tinana.
• Ka taea tēnei te tupu kotahi, ka tupu anō rānei.
• Ki te kore e rongoatia, ka puta pea ngā raruraru nui, nō reira me tere te aro atu ki te taote.
• Ahakoa kāore he rongoā tuturu, kei reira ngā maimoatanga hei whakahaere i ngā tohu me te ārai i ngā whakaekenga a meake nei.
• Ki te whakapae koe i tētahi o ēnei tohu, me toro atu ki te tākuta tonu. Ko te wawe o tō tautuhi i te mate me te tīmata i te maimoatanga, ka nui ake te tūponotanga o tō ora.

Nō reira, ko tāku tumanako he whai hua ēnei kōrero ki a koe. Kia ora tonu!

Te Mate Puta o te Āpiti, Te Puta o te Plasma, Te Pēhanga Toto Iti, Te Mate a Clarkson, Te Pupuhi, Te Puta Wai i roto i te Tinana