Ka taea e te aukati ohorere te oko toto i roto i tō tinana? Me kōrero tātou mō te Embolism!

Kua whakaaro koe he aha te mea ka tupu mēnā ka āraia ohoreretia tētahi oko toto i roto i tō tātou tinana e tētahi mea? Kāore pea i pā ki a koe. Engari, he mea tēnei me mōhio tātou katoa. Nā te mea, ko te ārai i tētahi oko toto pēnei, he āhuatanga e kiia nei ko te (Embolism), he tino morearea i ētahi wā. Nō reira, me kōrero tātou mō tēnei mea me te taipitopito ake, me te ngāwari i tēnei rā?

He aha te embolism? He māmā noa iho...

I te whakarapopototanga, ko te embolism te wā e āraihia ai tētahi o ō uaua toto, te wāhi rānei e rere ai te toto, e tētahi mea. I te nuinga o te wā, ko tēnei ārainga ka puta mai i tētahi toto kua puta mai i tētahi atu wāhi. Heoi, ehara i te mea ko ngā toto kua pakaru anake, engari ko ētahi atu mea anō hoki ka taea te haere mai i tētahi wāhi o te tinana ki tētahi atu, ka ārai i tētahi uaua toto pēnei.

Whakaarohia he rite ki te paru e mau ana i roto i te paipa wai. Ko ētahi oko toto, nā te rahi me te āhua, he nui ake te tūponotanga ka aukatia i ētahi atu. Ka taea tēnei te tupu ina koa ka wehe te oko toto nui ki ngā oko toto iti, ka whaiti rānei te oko toto nā te putunga ngako (atherosclerosis).

Ka taea e ēnei embolism te puta i ngā wāhi katoa o tō tinana, tae atu ki tō roro, ō pukahukahu, ō whatukuhu, me tō whēkau. Ko te momo embolism tino noa kei roto i ngā pukahukahu. Ina puta he toto totoka i roto i ngā uaua o ō waewae ka haere ki ō pukahukahu, ka kiia he pulmonary embolism, PE rānei .

He aha ngā huarahi rerekē ka puta ai te embolism?

Ka taea te wehewehe i te embolism ki ētahi momo, i runga i te momo mea e mau ana i roto i te uaua toto. Tirohia:

• Thromboembolism: Koinei te momo toto totoka e tino kitea ana . Ka puta mai i te totoka e puta mai ana i tētahi atu wāhi o te tinana, inā koa i roto i ngā uaua hohonu o ngā waewae (Deep Vein Thrombosis - DVT).
• Te embolism o te puku: He mea rite ki te wahi o te pūtau matepukupuku.
• Te embolism ngako: Ka taea e te ngako te kohikohi i roto i te toto i te wa e whati nui ana te wheua.
• Te toto totoka: He toto totoka e pā ana ki te mate urutā.
• Te pupuhi hau: Hei tauira, ka puta pea i te hau hauota i te wā e ruku ana.
• Te pupuhi wai amniotic: E pā ana tēnei ki te whānautanga, ā, he tino onge.

O ēnei, ko te Venous Thromboembolism , he toto totoka e puta ana i roto i ngā uaua ka ārai i a rātou, he mea noa ake i ngā toto totoka. Inaa, i roto i tētahi whenua pēnei i a Amerika, e kīia ana e pāngia ana tēnei mate e te 900,000 tāngata i ia tau. Waihoki, ko te Pulmonary Embolism te tuatoru o ngā tino take o te mate e pā ana ki te ngākau me ngā oko toto o te ao. (Ko ngā nama tuatahi me te tuarua ko te Stroke me te Heart Attack).

He aha ngā tohu o te embolism?

Ki te puta he embolism i roto i tō uaua, ka aukati i te rere o te toto. Kei te kawe te toto i te hāora e hiahiatia ana e ngā pūtau katoa o tō tātou tinana. Nō reira, ki te kore e taea e te toto te haere, e kore e taea e te hāora te haere. Nā tēnei korenga o te hāora ka puta he āhuatanga e kiia nei ko te "infarct," e kino ai te okana e hiahia ana ki taua hāora. Ka taea e tēnei te mamae. I ētahi wā, ka mate pea tēnei korenga o te hāora.

Whakaarohia he toto totoka (thrombus) e hanga ana i roto i tētahi uaua hohonu i roto i tō waewae, ā, ka pakaru ngā wahi iti o taua totoka ka haere tahi me te toto ki te taha matau o tō ngākau. Mai i reira, ka pupuhihia te toto ki ngā pūkahukahu. Ka mau ēnei totoka iti (pulmonary emboli) ki roto i ngā oko toto iti i roto i ngā pūkahukahu, ka puta te infarction o te pūkahukahu. He tino onge, ka taea e ngā totoka nunui (pulmonary emboli) te aukati katoa i te rere noa o te toto mai i te taha matau o te ngākau ki ngā pūkahukahu.

Ka rerekē ngā tohu o te embolism i runga i te momo me te wāhi o te embolism. Tērā pea kāore he tohu o ētahi tāngata. Anei ētahi o ngā tohu:

• Te poto o te manawa
• Te iti o te hāora i roto i te toto (Hypoxemia)
• Te manawa tere engari pāpaku (Tachypnea)
• Ngoikore, ngenge
• Te upoko o te upoko
• Ngā ira whero i runga i te kiri (Petechiae)
• Mamae o te uma
• Te tere o te manawa (Tachycardia)
• Kirika
• Te pupuhi i te ringa, i te waewae rānei
• Ngā mate hopuhopu
• Pōuriuri
• Te ruaki me te whakapairuaki
• Te toto toto iti (hypotension)

He aha te tino take o te embolism?

I te nuinga o te wā, ka puta te pulmonary embolism i roto i ngā pukahukahu. Ko te tino take o tēnei ko ngā toto totoka i roto i ngā uaua o ngā waewae (Deep Vein Thrombosis - DVT) . I ētahi wā, ka puta anō hoki te pulmonary embolism nā te DVT i roto i ngā uaua hohonu o ngā ringa.

Tērā atu anō ngā take e puta ai te embolism:

• Te mate o te arai o roto o te ngākau (infective endocarditis)
• Te fibrillation atrial (te ngakau koretake)
• Te totohu o te ventricle maui
• He wheua whati i roto i tētahi aituā nui
• Matepukupuku
• Ngā momo mate urutā
• Te mate pāwera
• Te tango momona
• Te whakawhitinga wheua
• Mate huka hāputanga
• Te hononga hohonu o te whenua ki te pakitara o te kōpū (te hononga hohonu o te whenua ki te pakitara o te kōpū)

Ko wai kei te nui ake te mōrearea ki te pāngia e tēnei (embolism)?

He maha ngā āhuatanga mōrearea e pā ana ki te toto totoka (embolism). Tirohia mēnā e pā ana tētahi o ēnei ki a koe:

• Kore mahi tinana: Te noho roa ki te wāhi kotahi, inā koa i muri i te pokanga.
• Ngā pokanga me ētahi maimoatanga hauora: Whai muri i ngā pokanga nui.
• Te ngoikore o te ngākau
• Whiu
• Matepukupuku
• Ngā whara tinana (Whara)
• Te toto toto tiketike (hypertension)
• Te whakamahi i ngā hua tupeka (te momi hikareti)
• Te whakamahinga o ngā pire ārai whānau
• Ngā āhuatanga e ngāwari ai te toto te toto
• Ko ētahi taputapu hauora, pērā i ngā taputapu whakatere

He aha ngā raruraru ka puta mai i te embolism?

He rerekē ngā raruraru o te embolism i runga i te wāhi e puta ai. He tino morearea pea. Anei ētahi o ngā raruraru:

• Ngā āhuatanga rerekē o te mahi roro, pērā i te ngaronga o te mahara
• Ngā rerekētanga o te pā o te ngakau (Arrhythmia)
• Te hopukanga o te ngākau
• Te whakaekenga o te ngakau
• Pupuhi roro
• Te pupuhi o te pūkahukahu
• Te Mate Pōuri Manawa Whakapeka (ARDS)
• Te ngaronga o te ringa, o te waewae rānei
• Te whēkau
• Te mate o ngā kiko i roto i te whatukuhu, te ate, tetahi atu okana rānei e pāngia ana
• Te regurgitation o te takirere tricuspid (te rere o te toto i roto i te takirere ngākau)
• Te ngoikore o te whatukuhu
• Te ngoikore o te ngākau
• Whiu
• Ka taea anō te ngaronga o te ora.

Arā, ehara tēnei i te mea hei whakaaro māmā noa iho. Ahakoa he mea iti noa iho te āhua, ki te kore e rongoatia i te wā tika, ka arahi pea ki ngā raruraru e morearea ai te ora.

Me pēhea te tātaritanga tika a te tākuta i tēnei (embolism)?

Mena kei a koe ngā tohu o te embolism, ka tirohia tuatahitia koe e te tākuta. Tērā pea ka kite te tākuta i ngā āhuatanga pēnei i te panoni o te kiri, te uaua rānei o te manawa. Mena kei te whakapaetia he embolism, tērā pea ka whakahaerehia e ia ētahi whakamātautau.

I runga i te momo embolism, ka taea te whakahaere i ngā whakamātautau e whai ake nei:

• Ngā whakamātautau toto
• X-ray o te uma
• Doppler ultrasound - hei tirotiro i te rere o te toto i roto i ngā oko toto.
• ECG (Electrocardiogram - EKG) - Ka tirohia te mahi a te ngākau.
• Matawai CT (Tomography Rorohiko - matawai CT)
• Whakamātautau MRA(Angiogram Āhuatanga Aukume - MRA)
• MRI (Whakaahua Āhua Aukume)
• Angiogram - He hihi-X o ngā oko toto i muri i te werohanga o te tae.
• Ngā whakamātautau ultrasound o te ngākau: (Transthoracic echocardiogram - TTE) me te (Transesophageal echocardiogram - TEE)
• I ētahi wā ka mahia he koiora hei tirotiro i tētahi wahi kiko.

He aha ngā maimoatanga mō te embolism?

Ko te whāinga matua o te maimoatanga mō te embolism he tango i te aukati i roto i te uaua toto me te whakahoki mai i te rere o te toto. I te nuinga o te wā, ko te kōwhiringa tuatahi ko te rongoā.

Anei ētahi maimoatanga mō te embolism:

• Ngā rongoā ārai toto : Ka kīia e mātou ka "whakapūpū" i te toto.
• Ngā rongoā thrombolytic : Ka whakarewa tika ēnei i te toto totoka ka tango atu.
• Ngā rongoā paturopi mō te Embolism
• Ngā rongoā hei whakanui ake i te mahi a te ngākau (Inotropes)
• Whakaora hāora, whakaora hāora hyperbaric rānei
• Te tango pokanga i te embolism (embolectomy)

I ngā take tino kino, ka hiahia pea te hunga whai embolism ki ētahi atu maimoatanga tautoko ora, pērā i te CPR , te ECMO (he mīhini e mahi ana hei whakakapi mō te ngākau me ngā pukahukahu), tae atu ki ngā mīhini hei āwhina i a rātou ki te manawa.

He pānga taha kei te rongoā?

Āe, heoi anō, tera pea ētahi pānga taha. He tūponotanga kei te toto, inā koa ngā rongoā e kiia nei ko ngā anticoagulants me ngā thrombolytics. Ina tangohia te toto totoka mā te pokanga (embolectomy), tera pea ētahi tūponotanga pēnei i:

• Te pakaru o te oko toto
• Te toto
• Te puhoi o te manawa (Bradycardia)
• Te toto toto iti (hypotension)
• Te hopukanga o te ngākau

Ka aha mēnā ka puta he embolism?

Ko ētahi tāngata he embolism, kāore pea he tohu o te mate, ko ētahi he tino kino ngā tohu. Ka whakawhirinaki te āhua o te maimoatanga ki ētahi āhuatanga, tae atu ki te rahi me te kaha o te embolism, me te wāhi i ahu mai ai.

He mate morearea te embolism, nō reira mā te tautuhi wawe me te maimoatanga tere ka nui ake te tūponotanga o te ora.

He aha tā tātou e taea ai te aukati i te embolism?

Āe, ka taea e tātou te ārai i ētahi momo embolism. Mena kei te mōrearea koe ki te embolism, ka tūtohu pea tō tākuta i ēnei e whai ake nei:

• Ina haere tawhiti koe (pērā i runga waka rererangi, pahi rānei), whakatika i ia torutoru hāora ka hiki ake, ka whakaheke mārire i ō pona waewae (ka pupuhi te waewae).Ka āwhina tēnei ki te pupuri i te rere pai o te toto i roto i ngā waewae.
• Ngā rongoā whakaiti toto (Ngā rongoā ārai toto) .
• Te whakamahi i ngā tōkena kōpeketanga motuhake.
• He taputapu e pēhi ana i ngā waewae (Intermittent Pneumatic Compression Device - IPC device) .
• Mō ētahi tāngata, ka whakanohoia pea he tātari ki roto i te uaua matua e kawe ana i te toto mai i te tinana o raro ki te ngākau (te tātari vena cava o raro) . Mā tēnei ka ārai i te rere o ngā toto toto ki te ngākau me ngā pukahukahu.

Me pēhea taku tiaki i ahau anō mēnā ka pāngia ahau e te embolism?

I muri i te embolism, me whai whakaora pea koe kia ora ai. Nā te mea kua pakaru pea ngā wāhi o te embolism pērā i tō roro, i tō pukahukahu rānei. Ka puta tēnei kino nā te mea kua tapahia e te embolism te hāora ki taua okana, ki taua wāhi rānei.

Āhea ahau me toro atu ki te tākuta?

Ki te puta mai ngā tohu o te embolism, me rapu tonu koe i te awhina hauora. Kaua e whakaroa.

I muri i te embolism, me haere tonu koe ki te kite i tō tākuta, me te whai i ana tohutohu. Ina koa mēnā kei te tango koe i ngā rongoā pēnei i ngā anticoagulants, ka tirohia e tō tākuta mēnā kei te tika tāu tango, ā, mēnā kua rerekē tō mōrearea o te toto.

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

Ka taea e koe te pātai atu ki tō tākuta i ēnei pātai:

• He aha i pā mai ai tēnei ki ahau (embolism)?
• He aha ngā tūponotanga ka ora ake ahau i runga i tōku āhua?
• He aha te maimoatanga pai rawa atu mōku?
• Me aha ahau kia kore ai e puta anō tētahi atu embolism pēnei?

Hei whakarāpopototanga (Karere hei tango ki te kāinga)

He mea noa te āwangawanga mō tētahi āhuatanga e kiia nei ko te embolism, nā te mea ka taea e ia te whakararu i te ora. Koia te mea nui kia whiwhi maimoatanga tonu. Mena ka puta he tohu o te embolism, rapua tonutia he awhina hauora. I muri i te maimoatanga, rapua he tautoko mai i tō whānau me ō hoa. Mena kei te āwangawanga koe, kei te awangawanga rānei mō tētahi atu embolism, kōrero ki tētahi kaitohutohu. Kāore koe i te mokemoke, ā, kaua e wehi ki te tono awhina.

` Te toto totoka, te aukati i ngā oko toto, te toto totoka pūkahukahu, Te toto totoka pūkahukahu, DVT, ngā tohu, te maimoatanga, te ārai