Kua whakamahia e koe tētahi rongoā ko Heparin te ingoa? Tērā pea i muri i tētahi pokanga, hei ārai rānei i ngā toto totoka, kua hoatu pea tēnei rongoā e te tākuta ki a koe. Heoi, ahakoa he tino onge, ka taea e tēnei heparin te hanga i ngā toto totoka maha atu i roto i tō tātou tinana, ā, ka whakaiti i te maha o ngā pereti toto. Koinei te mea e kiia nei e tātou ko te 'Heparin-Induced Thrombocytopenia', ko te '(HIT)' rānei. Kaua e manukanuka, he ahua uaua pea tēnei, engari me kōrero noa iho.
He aha te heparin? He aha te take e puta ai te HIT?
He whakarāpopototanga noa iho, he
rongoā whakaheke toto te heparin (he rongoā whakangawari toto). Ka whakamahia hei ārai i te hanganga o ngā toto toto i roto i ō tātou oko toto. Ka tohua e ngā tākuta i muri i te pokanga nui, hei whakarewa rānei i te toto toto kua hanga kē. Heoi, he tino onge, ina hoatu he heparin ki ētahi tāngata, ka puta he urupare kino. Koinei te wā
ka honoa hē ai tō tātou pūnaha ārai mate ki te heparin, ka whakahohe i ō tātou ake pereti toto. He momo pūtau ngā pereti toto e āwhina ana ki te aukati i tō tātou toto. Nō reira, ina whakahohehia ngā pereti toto pēnei, hei utu mō te aukati i te hanganga o ngā toto toto,
ka tīmata te hanga toto toto koretake (thrombosis). I taua wā anō, ka tere te heke o te maha o ngā pereti toto (thrombocytopenia). Koia te take e kiia ai tēnei āhuatanga i ētahi wā ko 'Heparin-Induced Thrombocytopenia and Thrombosis (HITT)'.
Whakaarohia, he mea rerekē te whakaaro ko te rongoā e hoatu ana hei ārai i te toto totoka ka whakanui ake i te hanganga toto totoka me te whakaiti i ngā pereti toto, tika? Engari tera pea ka tupu.
E rua ngā momo matua o ngā HIT.
E wehea ana tēnei āhuatanga `(HIT)` e ngā tākuta kia rua ngā momo matua: 1.
HIT I (Momo 1): I tēnei take, ka paku heke te taumata o ō pereti toto i ngā rā tuatahi i muri i te tīmatanga o te heparin, engari ka hoki anō ki te āhua noa i roto i ētahi rā.
Ehara tēnei i te āhuatanga morearea , ā, kāore he mōrearea o te toto totoka, nō reira kāore he maimoatanga motuhake e hiahiatia ana. 2.
HIT II (Momo 2): Koinei te momo me āwangawanga tātou. I tēnei take, ka whakahohehia e tō tātou pūnaha ārai mate ngā pereti totoka hei whakautu ki te heparin. Ka heke te taumata o ngā pereti totoka, ā, he
mōrearea kei te toto totoka kino . I te nuinga o te wā, ina kōrero tātou mō te `(HIT)`, he maha ngā wā ka kōrero tātou mō tēnei momo morearea e kiia nei ko te `(HIT II)`.
Ko wai te mea ka nui ake te tūponotanga ka pāngia e tēnei HIT?
Ahakoa te horopeta, te roa rānei o te whakamahinga, ka pāngia pea tēnei mate e te hunga e whakamahi ana i te heparin. Heoi, kua kitea he nui ake te tūponotanga o te pāngia o
ngā wāhine neke atu i te 40 tau te pakeke . Kāore anō kia mōhiotia e ngā tākuta he aha i pāngia ai ētahi tāngata e tēnei tauhohenga ki te heparin, ko ētahi kāore.
Ehara i te mea tino noa. Ka puta tēnei āhuatanga "(HIT)" i roto i tētahi rōpū iti o te tangata, tata ki te 5%, e tango ana i te heparin mō ngā rā neke atu i te whā. He aha ngā tohu o te HIT? Me pēhea tātou e mōhio ai?
Mena kei te tango koe i te heparin, ka tirohia e tō tākuta te maha o ngā pūtau i roto i tō toto, inā koa te maha o ngā pereti toto. Ko te iti o te maha o ngā pereti toto he tohu wawe pea o te HIT. Tata ki te haurua o te hunga whai HIT ka puta he toto toto hou. He thrombosis uaua hohonu (DVT) pea tēnei i te waewae, he embolism pūkahukahu rānei (PE). Kia mataara ki ēnei tohu: Hei tāpiritanga, ka kite pea koe i te mamae, i te hakihaki, i te ponana kiri rānei i te wāhi i werohia ai te heparin. Ko te mea nui: Mena kei te tango koe i te heparin , ā, ka pāngia koe e tētahi o ēnei tohu, rapua tonutia he awhina hauora ohorere . Kaua tēnei e whakaroa.
Āhea ka puta te HIT?
I te nuinga o te wā, ka tīmata ngā tohu i roto i ngā rā e rima ki ngā wiki e rua o te tīmatanga o te rongoā heparin. Heoi, ka puta anō hoki i ētahi atu wā:- PĀNGA TŪMATA: Ka puta pea tēnei i roto i te kotahi ki te toru rā o te tīmatanga o te heparin. He nui ake te tūponotanga ka puta tēnei mēnā kua whakamahia e koe te heparin i mua (i roto i ngā marama e toru). Kātahi ka "maumahara" tō tinana ki te heparin, ka hanga paturopi hei ārai i a ia, ā, kua rite ki te tere tauhohe.
- PĀNGA Ātete: Ka roa pea tēnei āhuatanga mō ngā wiki i muri i te whakamutua o te tango heparin.
- Te HIT tīmatanga whakaroa: Ka puta tēnei i muri i te whakamutua o te maimoatanga heparin. I te nuinga o te wā ka puta i ngā rā e rima, neke atu rānei, i muri i te whakamutua o te rongoā.
He aha te tino take o tēnei PATUA?
Ka puta te 'HIT' ina herea te rongoā heparin ki tētahi pūmua e kiia nei ko te 'PF4' (Platelet Factor 4) i roto i ō tātou pereti toto. Ka honoa tēnei heparin me te 'PF4' hei hanga i tētahi 'Heparin-PF4 complex'. Ina kite tātou i taua 'Heparin-PF4 complex' i roto i tō tātou tinana, ka manukanuka tō tātou pūnaha ārai mate, ka tīmata ki te hanga paturopi hei ārai i a ia. Ka haere ēnei paturopi ka herea ki taua 'Heparin-PF4 complex'. Koinei te tīmatanga. Ina herea ēnei paturopi, ka whakahohehia tonutia ngā pereti toto, ka tīmata ki te hanga toto totoka. Mā tēnei ara, ka tukuna he 'PF4' nui ake mai i ngā pereti totoka e hanga totoka ana. Kātahi ka herea anō taua 'PF4' hou ki te heparin, ka hanga he 'Heparin-PF4 complex' nui ake. Ka hoki mai ngā paturopi ka herea anō ki a ia, ka puta he toto totoka nui ake... Ka haere tonu tēnei, pērā i te mekameka tauhohenga. Nā te hanga totoka katoa nei, ka tere te pau o ngā pereti totoka i roto i te tinana. Nō reira, ka heke te taumata o ngā pereti totoka. Nā te nui rawa o te toto e totoka ana, ka puta pea ngā totoka nunui e morearea ana ki te ora, ka ārai i ō tātou uaua me ngā uaua toto. He aha ngā āhuatanga mōrearea mō te HIT?
He maha ngā āhuatanga e whakanui ake ai i te mōrearea o te whakawhanake i te HIT:- Tō ira tangata: He nui ake te tūponotanga ka pāngia ngā wāhine e te PATUA.
- Te momo heparin e whakamahia ana: E kī ana ētahi rangahau he rerekē pea te mōrearea o te HIT i runga i te momo heparin e tangohia ana e koe. Hei tauira, kei reira ētahi taunakitanga e whakaatu ana ko te whakamahi i te heparin kore-wāhanga hei utu mō te heparin taumaha-iti ka whakaiti i te mōrearea. Heoi, me nui ake ngā rangahau mō tēnei.
- Te tango i te heparin i muri i te pokanga: Ko te hunga e tango ana i te heparin hei ārai i te toto totoka i muri i te pokanga he nui ake te tūponotanga ki te pāngia e te HIT i te hunga e tango ana hei rongoā i te toto totoka kua oti kē te totoka. He tino teitei tēnei mōrearea i muri i te pokanga wheua, te pokanga ngākau, me te cardiopulmonary bypass .
Me pēhea te tātaritanga o te HIT? (Tauātanga)
He maha ngā whakamātautau toto ka āwhina i a koe ki te whakatau mēnā kei a koe te HIT:- Ngā taumata pereti toto: Mā tēnei ka taea te tirotiro mēnā he iti te maha o ō pereti toto (thrombocytopenia).
- Te hanganga toto totoka: Ka whakaatuhia e ngā whakamātautau toto mēnā kua totoka ō toto.
- Ngā taumata paturopi PF4: Mā te nui o ngā paturopi PF4 i roto i tō toto ka taea te whakatau mēnā kei te whakahohehia e tō pūnaha ārai mate ngā pereti toto. Mā tēnei whakamātautau paturopi e whakaū te tautuhi i te HIT.
Tērā pea ka tonoa e tō tākuta he ultrasound hei tirotiro i ngā toto totoka i roto i ō waewae (DVT). I runga i tō āhua, ka tonoa pea e rātou he whakamātautau hei tirotiro i ngā toto totoka i ētahi atu wāhi, pērā i ō ringaringa. Heoi, nā te mea he roa te wā e puta mai ai ngā hua o tēnei whakamātautau paturopi, kāore ngā tākuta e tatari kia puta mai i mua i te tīmatanga o te maimoatanga. Nā te mea he āhua mate pea te HIT mēnā kāore e rongoatia, ka whakatauhia te maimoatanga i runga i te tūponotanga ka pāngia koe e te HIT. He aha tēnei "whakamātautau 4T"?
Ko te whakamātautau `4Ts` he pūnaha whakatauranga e whakatau ana i te tūponotanga ka pāngia koe e te `HIT`. Ka whakaratohia ngā mōhiohio e hiahiatia ana e koe hei tīmata i te maimoatanga me te kore e tatari mō ngā hua o te whakamātautau paturopi. Ka hoatu e te tākuta he whakatauranga (mai i te 0 ki te 2) mō ēnei āhuatanga e whā:- Thrombocytopenia (te iti o te maha o ngā pereti toto): Kia pehea te iti o te maha o ō pereti toto?
- Te wā (te wā o te tauhohenga ki te heparin): Nōnahea i heke ai ō taumata pereti toto?
- Te toto totoka (toto totoka): He tohu kei te totoka?
- Ētahi atu take: Tērā pea he take anō ehara i te heparin mō te iti o te maha o ngā pereti toto?
Ka teitei ake te kaute, ka nui ake te tūponotanga ka pāngia koe e te 'PAUNGA'. He aha ngā maimoatanga mō te HIT?
Ko te taahiraa tuatahi i roto i te maimoatanga ko te whakamutu tonu i te tango i te heparin. Kātahi ka whakawhitia koe ki tētahi atu rongoā whakaiti toto. Me tīmata anō te piki o tō tau pereti toto i roto i ētahi rā i muri i te whakamutu i te heparin. Kia tae rā anō ki taua wā, tera pea ka tohua e tō tākuta tētahi atu rongoā hei āwhina i te aukati i te hanganga o ngā toto totoka. He maha ngā rongoā ka taea te whakamahi hei whakakapi i te heparin:- ``Ngā aukati thrombin tika'' (hei tauira `argatroban', `bivalirudin')
- `Fondaparinux`
- 'Ngā rongoā ārai toto ā-waha tika' (ngā rongoā hei ārai i te toto totoka ka taea te tango tika mā te waha)
Kia hoki anō ngā taumata o ō pereti toto ki te āhua noa, ā, kua kore te mōrearea o te toto totoka nā te HIT, ka taea e tō tākuta te whakawhiti i a koe ki tētahi atu rongoā whakaiti toto, pērā i te warfarin. Ka taea e tātou te ārai i te HIT?
Kāore rawa he mea e taea e koe te mahi hei ārai i te HIT. Heoi, mā te aroturuki tonu i ō taumata pereti toto e tō tākuta ka āwhina i te whakaiti i te tūponotanga o ngā raruraru mai i te heparin. He aha ngā mea hei tumanakohia mēnā kei a koe te HIT?
He mate kino te Thrombocytopenia i puta mai i te Heparin (HIT) ka mate pea mēnā kāore e tere te rongoā. Ka taea e ngā toto toto nui i roto i ngā ringa me ngā waewae te whakararu i aua whekau mō te wā roa. Ka mate pea ngā toto toto e pā ana ki ngā whekau nui. Waimarie, nā te nui haere o te mōhiotanga ki te HIT me ngā kōwhiringa maimoatanga pai ake, kua tino pai ake ngā reiti oranga. Ko te kitenga wawe, i mua i te whanaketanga o ngā toto toto kino, te mea nui ki te hua pai.Kia kite tō tākuta i ngā tohu o te HIT, pērā i te iti o te maha o ngā pereti toto, ka taea e ia te tohu maimoatanga hei whakaiti i te mōrearea o ngā toto totoka kino. Me pēhea taku tiaki i ahau anō?
Me toro atu koe ki tō tākuta i ia wā, i ia wā, hei aroturuki i ngā taumata o ō pereti toto, hei whakarite hoki kāore koe e puta he toto totoka. Hei tāpiri, ka mōhio tō tākuta ki ngā pānga taha pea (pēnei i te toto i roto i ētahi tāngata) ina huri mai i te heparin ki tētahi rongoā ārai toto hou. I taua wā tonu, he mea tino nui kia tangohia e koe tō rongoā kia rite ki te whakahaunga. Ahakoa kāore anō kia puta he toto totoka ki a koe, me tango e koe tētahi rongoā ārai totoka kore-heparin mō te iti rawa i te kotahi marama. Mena kua puta he toto totoka ki a koe, me roa ake pea te tango. Ko te huarahi pai ki te tiaki i a koe anō ko te kōrero ki tētahi tākuta e rongoā ana i a koe ā muri ake nei kua pāngia koe e tēnei raruraru. Mēnā kua pāngia koe e te 'HIT', kaua rawa koe e tango anō i te heparin.
Ki te kite koe i ētahi panonitanga o tō tinana i a koe e tango ana i te heparin, rapua tonutia he awhina hauora ohorere. He mate onge te Thrombocytopenia i puta mai i te Heparin (HIT), engari he tino kino rawa te tohu o te toto totoka hei wareware. Ki te kore he maimoatanga, ka mate pea te HIT. Mā te maimoatanga, me hoki anō ō taumata pereti toto ki te āhua noa, ā, me heke iho tō tupono ki te toto totoka. Kōrero ki tō tākuta mō te rongoā pai hei whakamahi hei utu mō te heparin i roto i ngā rā kei mua. Karere Whakamutunga mō te Tango ki te Kāinga
- Ahakoa he rongoā nui te heparin hei ārai i te toto totoka, he onge noa iho te pānga o tētahi mate kino e kiia nei ko te 'Heparin-Induced Thrombocytopenia (HIT).'
- Ko te mea ka tupu i tēnei take, i te kore e ārai i ngā totoka, ka nui ake te hanganga o ngā totoka, ā, ka heke te maha o ngā pereti toto.
- Kia tūpato ki ngā tohu pēnei i te pupuhi o ō waewae/ringa, te mamae, te mamae o te uma, me te uaua ki te manawa. Ki te kite koe i ēnei, me toro atu ki te tākuta tonu.
- Ki te kitea te mate `HIT`, ko te mea tuatahi me mahi ko te whakamutu i te heparin. Kātahi ka hiahia koe ki te whakamahi i ētahi atu rongoā whakaiti toto.
- Mena kua pāngia koe e te `HIT`, tuhia ki roto i ō pūkete hauora katoa, ā, kōrero atu ki tētahi tākuta ka toro atu koe ā muri ake nei. Kaua rawa koe e hoatu he heparin anō ki a ia.
Ko tāku tumanako he whai hua ēnei kōrero ki a koe. Kia ora tonu koe! Heparin, Thrombocytopenia, Ngā toto totoka, Ngā pereti toto, Anticoagulant, HIT, Ngā pānga taha, Ngā toto totoka, Ngā pereti toto, Heparin, Ngā pānga taha
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