He maha ngā wā ka ngoikore koe, ka pāngia koe e te kirika kāore i te mārama, ka heke te taumaha me te mamae o ngā hononga? Ahakoa he āhua noa iho ēnei, i ētahi wā ko te mea e huna ana i muri i ēnei tohu he mate kāore anō kia rangona e tātou, ā, me āwangawanga tātou. I tēnei rā ka kōrero tātou mō tētahi mate onge engari he mea nui me mōhio tātou. Ka kiia tēnei ko te microscopic polyangiitis, ko te MPA rānei te ingoa e kīia ana e ngā tākuta.
He aha te Microscopic Polyangiitis (MPA)?
Ki te whakarapopoto, ko te MPA he āhua e mumura ai ngā oko toto iti me te rahi (ngā oko toto) o roto i tō tātou tinana, arā, ka pupuhi. I roto i te rongoā, e kiia ana tēnei pupuhi o ngā oko toto ko te 'vasculitis'. He mate tino onge tēnei.
Ina mumura ngā uaua toto pēnei, ka tīmata te kino i ngā okana e tukuna ana e rātou te toto ki roto. Ko ngā okana matua ka pāngia e te MPA ko:
- Ngā whatukuhu
- Ngā pūkahukahu
- Ngā io
- Kiri
- Ngā hononga (ngā hononga)
He aha te 'Vasculitis'? He aha ngā hua?
Whakaarohia te pūnaha toto puta noa i tō tātou tinana he pūnaha paipa e kawe ana i te wai. Ina pupuhi, ina mumura rānei ēnei paipa, ka puta he maha ngā raruraru.
1. Te ngoikore o te uaua toto: Nā te pupuhi, ka ngoikore te pakitara o te uaua toto, ā, ka pupuhi pērā i te poihau. Ka kiia tēnei ko te "(Aneurysm)". I ētahi wā ka pakū tēnei wāhi ngoikore, ka toto ki roto i te kiko e karapoti ana.
2. Te whaiti o ngā oko toto: Ko tētahi atu mea, ka whaiti ngā oko toto nā te pupuhi o roto, ā, i ētahi wā ka āraia rawatia. Kātahi ka tīmata te pakaru o ngā whekau e whiwhi ana i te toto me te hāora mai i aua oko toto. Pērā i te rākau e mate ana ina kore he wai.
Koinei te mea e tupu ana i roto i te MPA. Nā te mea ka pāngia ngā uaua toto iti, ka pakaru ngā whekau tairongo e tuku toto ana, pērā i ngā whatukuhu me ngā pukahukahu.
Ko wai ka pāngia e tēnei mate? He aha te take?
He mate tino onge tēnei. E ai ki ngā tatauranga, e pāngia ana te 13 ki te 19 o ia miriona tāngata o te ao e tēnei mate. Ka taea te whanake i ngā tau katoa, ā, te āhua nei ka pāngia ngā tāne me ngā wāhine e te ōrite.
Kāore anō kia kitea te tino pūtake o tēnei mate, engari e mārama ana tēnei:
- Ehara tēnei i te mate pukupuku.
- Ehara i te mate hopuhopu.
- Ehara i te mea he mate tuku iho i te nuinga o te wā.
Kua whakaatuhia e te nuinga o ngā rangahau he mate tēnei i puta mai i te hapa o te pūnaha ārai mate o tō tātou tinana. He māmā noa iho, ko te pūnaha ārai mate, e tika ana kia tiaki i tō tātou tinana, ka tīmata hē ki te whakaeke i ō tātou ake uaua toto. Koinei te take o tēnei mumura.
He aha ngā tohu o te mate MPA?
Nā te mea he maha ngā okana e pāngia ana e te MPA, ka whānui haere ngā tohu, ā, ka rerekē hoki i ia tangata, i ia tangata.
| Wāhanga e pāngia ana | Ngā tohu pea |
|---|---|
| Ngā āhuatanga noa | Ngenge, kirika, kore hiahia kai, hekenga taumaha, mamae uaua me ngā hononga. |
| Ngā pūkahukahu | Te uaua ki te manawa, te maremare toto. |
| Ngā io | Ngā kare ā-roto rerekē (pērā i te ru hiko, te omaoma haere a ngā pōpokorua), ā, muri iho ka ngoikore te tinana, ka ngaro te kaha. |
| Kiri | He whero, he papura rānei ngā ira i runga i te kiri (he ponana). |
| Ngā whatukuhu | Koinei te wāhi e takoto ai te mōrearea. Ina pāngia ngā whatukuhu , he maha ngā wā kāore he tohu i ngā wāhanga tōmua. Tērā pea kāore koe e kite i tēnei tae noa ki te tīmatanga o te mutu o te mahi a ō whatukuhu. |
I te mea ka puta te mate tākihi me te kore he tohu, he mea tino nui kia whakamatautauria te mimi o te tangata e whakapaetia ana kua pangia e te vasculitis.
Me pēhea te tautuhi a te tākuta i tēnei mate?
Ehara te tātaritanga o te MPA i te mahi kotahi-taahiraa. Me whakakotahi e te tākuta ētahi āhuatanga kia tae atu ai ki tētahi whakatau.
- Ka pātaihia atu ētahi atu kōrero ki a koe: Ka whakarongo pai te tākuta ki ō tohumate, ki te tīmatanga o aua tohumate, me tō hītori hauora.
- He whakamātautau tinana: Ka tirotirohia tō tinana e tō tākuta kia kitea ai ko ēhea okana e pāngia ana.
- Ngā whakamātautau toto me te mimi: Ka rapua e ngā whakamātautau toto he paturopi e kiia nei ko "(ANCA - Antineutrophil Cytoplasmic Antibodies)". Ka taea tēnei te whakaatu i te pai i roto i ngā mate pēnei i te MPA. Waihoki, he mea nui te tirotiro i te mimi mō te pūmua me ngā toto whero kia mōhio ai ki te āhua o ngā whatukuhu.
- Ngā Matawai: Ka whakamahia ngā hihi-X, ngā matawai CT, ngā matawai MRI rānei hei tirotiro i ngā āhuatanga rerekē o ngā whekau pēnei i ngā pukahukahu.
- Kohikohi pūtau: Mena e whakapaetia ana he mate, ka tangohia he wahi kiko iti mai i te wāhi e pāngia ana (hei tauira, te whatukuhu, te kiri) ka tirohia i raro i te karuārai. Koinei te huarahi pai ki te whakaū mena he vasculitis tōu.
Ahakoa he pai te whakamātautau toto ANCA, ehara i te mea kei a koe te mate. He āwhina noa iho tēnei ki te tautuhi i te mate. Hei whakatau tika, he maha ngā wā ka hiahiatia he koiora.
He aha ngā maimoatanga mō te MPA?
Ko te whāinga matua o te rongoā i te MPA he whakahaere i te kaha rawa o te pūnaha ārai mate, me te aukati i te kino o ngā oko toto. Ka whakamahia ngā rongoā ārai mate mō tēnei.
Ina kino te mate
Mena ka tino pāngia ngā whekau nui pēnei i ngā whatukuhu me ngā pukahukahu, ka hoatuhia ngā corticosteroids me tētahi atu rongoā kaha e pehi ana i te pūnaha ārai mate pēnei i te Cyclophosphamide (Cytoxan®) Rituximab (Rituxan®) rānei.
Mena kāore i te tino kino te mate
Mēnā kāore i te tino kino, ka whakamahia pea ngā corticosteroids me te methotrexate i te tuatahi.
Ko te whāinga o te maimoatanga he whakahaere katoa i te mate, me te whakahoki mai ki te āhua kore mahi. Ka kiia tēnei ko te 'whakakorenga'. Kia whakahaerea te mate, ka āta whakaitihia e te tākuta te horopeta o ngā steroids.
Ko ngā rongoā kaha ake pēnei i te `Cyclophosphamide` ka hoatu kia tae rā anō ki te wā e whakahaerea ai te mate (mō te 3-6 marama pea). Whai muri i tēnā, ka whakawhitia koe ki te `Rongoā Tiaki`, pēnei i te `Azathioprine (Imuran®)` me te `Mycophenolate Mofetil (Cellcept®)` rānei, hei pupuri i te mate kia noho haumaru, hei ārai hoki i tōna hokinga mai. Me tango pea tēnei maimoatanga tiaki mō te tau, e rua rānei, neke atu rānei.
Kei a koe anō te wehi kei kī koe, "He rongoā mate pukupuku ēnei, tika?"
He pātai tā te tini o te tangata i konei. Ka hoatu hoki ngā rongoā e kīia nei ko te 'Cyclophosphamide' me te 'Methotrexate' mō te mate pukupuku, nō reira e kīia ana ko ēnei he rongoā 'Chemotherapy'. Ae, ka hoatu hoki ēnei mō te mate pukupuku. Engari ko te horopeta i hoatu mō te 'Vasculitis' he 10-100 ngā wā iti iho i te horopeta i hoatu mō te mate pukupuku. I konei, ehara te mahi a ēnei rongoā i te patu i ngā pūtau mate pukupuku, engari ko te whakahaere i te mahi a te pūnaha ārai mate.
Nā te mea ka pehia e ēnei rongoā te pūnaha ārai mate, ka tūpono te pāngia e ngā mate kino. Waihoki, ka pāngia pea ia rongoā e ētahi pānga taha. Nō reira, he mea tino nui kia whakamātauria i te wā tika, kia noho tonu hoki i raro i te tirotiro hauora, e ai ki te whakahau a te tākuta.
Ka pēhea rā te āhua o te oranga me tēnei mate?
Ahakoa he mate kino te MPA, mā te maimoatanga tika, ka taea e te nuinga o te tangata te whakahaere angitu i te āhua. Ka rerekē ngā putanga i runga i te kaha o te mate. Heoi, i te nuinga o te wā, neke atu i te 80% o te tangata e ora pai ana i muri i te 5 tau o te tautuhi i te mate.
Mā te kitenga wawe me te maimoatanga wawe ka āwhina i te whakaiti i te kino o ngā okana. He mea nui anō hoki kia mau tonu te whakapā atu ki tō tākuta.
Kia oti te mate te whakahaere, arā, i muri i te taenga ki te "Whakamāmātanga", ka hoki mai anō i ētahi wā. Ka kiia tēnei he "Hoki anō". Tata ki te 50% o ngā tūroro ka pāngia e tēnei momo hokinga anō o te mate. Nō reira, me whakamōhio tonu koe ki tō tākuta mō ngā tohu hou ka puta mai i a koe.
Karere Tangohia ki te Kāinga
- He mate onge te MPA e whakaekea ai e tō tātou ake pūnaha ārai mate ngā oko toto.
- Ka taea e tēnei te kino i ngā whekau nui pērā i ngā whatukuhu, ngā pukahukahu, me ngā io. Ina koa ka pāngia ngā whatukuhu, kāore pea he tohu i ngā wāhanga tōmua.
- Mā te tautuhi me te maimoatanga wawe ka ārai i ngā kino mō te wā roa.
- Nā te mea e whakamahia ana ngā rongoā ārai mate hei rongoā, he mea tino nui kia noho tonu koe i raro i te tirotiro a te tākuta, me te tiaki i a koe anō mai i ngā mate urutā.
- Ahakoa kua whakahaeretia te mate, tera pea ka hoki anō te mate. Nō reira, ki te pāngia koe e ētahi tohu hou, ahakoa he iti noa iho, me kōrero tonu ki tō tākuta.
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