Kia ako atu tātou mō te Venous Thromboembolism (VTE) inaianei tonu.

Kua whakaaro kē koe me pēhea te toto e rere ana i roto i ō tātou uaua ka piri ki te wāhi kotahi, ka hanga he toto totoka? Tērā pea he ahua whakamataku tēnei, engari he mea nui kia mōhio ki tēnei. Nā te mea ko te wā anake ka taea ai e tātou te mahi tere mēnā e tika ana. I tēnei rā kei te kōrero tātou mō te toto totoka i roto i te uaua, he āhuatanga e kiia nei e ngā tākuta ko te `(Venous Thromboembolism - VTE)`.

He aha te Venaous Thromboembolism (VTE)?

Ki te kī māmā noa, ko te `(Venous Thromboembolism)` he toto toto e puta mai ana i roto i te uaua o te tinana, he momo uaua e kawe ana i te toto poke ki te ngākau, e aukati ana i te rere o te toto. I konei, ko te tikanga o te "Thrombo" he toto toto. Ko te tikanga o te "Embolism" ko te haere o taua toto toto i roto i te uaua toto ka piri ki tetahi wāhi. Ko te tikanga o te "Venous" ko roto i ngā uaua.

Ina kōrero ngā tākuta mō te VTE, e rua ngā momo toto totoka e kōrerohia ana e rātou:

1. Te Thrombosis o ngā Uaua Hōhonu (DVT): Koinei te wā e puta ai ngā totoka i roto i ngā uaua hōhonu e rere ana i roto i ngā uaua, i roto rawa i te tinana.

2. Te Pukupuku Pūkahukahu (PE): Ka puta tēnei ina pakaru te toto totoka mai i te DVT, i te toto totoka rānei mai i tētahi atu wāhi, ka mau ki roto i te uaua o ngā pūkahukahu.

Whakaarohia, mā ēnei uaua e whakahoki te toto ki te ngākau mai i ngā wāhi tawhiti o tō tātou tinana, pērā i ō tātou peka. Nō reira, ina āraia te uaua e te toto totoka, ka tīmata te toto ki te kohikohi i muri i te wāhi kua āraia. Kātahi ka pupuhi taua wāhi, ka mumura. Waihoki, kāore ngā pūtau i mua i te wāhi kua āraia e whiwhi i te hāora me ngā matūkai e hiahiatia ana e rātou. Ka taea e tēnei te whakararu nui i ngā uaua, i ngā kiko, tae noa ki ngā whekau. I ētahi wā, hei tauira, ki te āraia te uaua e kawe ana i te toto ki ngā pukahukahu e te "VTE", ka taea te whakararu i te ora .

Me pēhea te hanga o ngā toto totoka i roto i ēnei uaua?

He urupare hauora, he urupare noa te toto totoka o te tinana. Ka taea te whakaaro he rite ki te kōpura e puta mai ana ina maroke he patunga iti i te mata o te kiri, ā, ka puta he toto iti ki waho. Pērā tonu. Ina he whara kei roto i te tinana, ahakoa he mate, ka matotoru te toto kia kore ai e rere te toto ki waho. Ahakoa he mate tēnei, ka rongoatia te arai o te uaua toto me te mea he patunga.

I te nuinga o te wā, ina tīmata te ora o te patunga, te mate rānei, ka memeha te toto totoka. Engari i ētahi wā, kāore e tupu . Tērā pea ka puta he toto totoka me te kore he whara. He maha ngā take ka puta ai tēnei. I roto i ēnei āhuatanga, ki te nui te toto totoka, ka taea e ia te aukati katoa i te uaua.

He aha te pānga o ēnei toto totoka ki tō tinana?

He tokomaha te hunga e whakaaro ana, ina whakaarohia he toto totoka, ko tōna tikanga he toto totoka e puta ai te "Whakaekenga Manawa" me te "Whiu". Heoi, ehara te "VTE" i te momo toto totoka e puta ana i roto i ngā uaua toto (ngā uaua e kawe ana i te toto mai i te manawa ki te toenga o te tinana). Heoi, he rite tonu te mōrearea .

Ko te raruraru tino kino ko te wā e pakaru mai ai te VTE, te toto totoka rānei, i tōna wāhi taketake, ka haere mā roto i te toto, ka noho ki roto i ngā uaua o ngā pukahukahu . Ka kiia tēnei ko te Pulmonary Embolism (PE). Ka whakawhāitihia e te PE te rere o te hāora me te toto ki ngā pukahukahu. I taua wā anō, ka piki ake te toto toto i roto i ngā uaua. Ka kiia tēnei āhuatanga ko te Pulmonary Hypertension. Ki te haere tonu tēnei, ka pā te ngoikore o te ngakau, tae atu ki te mate.

Ko te VTE te mea tino kitea i roto i ngā uaua hohonu o te tinana, inā koa i roto i ngā waewae, i ngā ringa rānei, i roto rānei i ngā uaua i roto i ngā uaua. Ina puta he toto totoka i roto i te uaua hohonu, ka kiia ko te Deep Vein Thrombosis (DVT). Ina āraia he uaua e te DVT, ka puta he mumura, he pupuhi, he whero, ka kino pea te uaua i te wā roa. Ka taea e tēnei te arahi ki tētahi āhuatanga e kiia nei ko te Chronic Venous Insufficiency, ko te Post-thrombotic Syndrome rānei. Ehara i te mea ko ngā DVT katoa e ārai ana i te uaua, engari ka taea, nō reira ka whakarōpūtia hei Venous Thromboembolic Disease. He mea nui hoki kia mahara mēnā ka pakaru te toto totoka ka haere ki ngā pukahukahu, ka taea e ia te puta he PE.

He aha te rerekētanga i waenga i te 'Thrombosis' (he toto totoka) me te 'Thromboembolism' (he aukati i te toto totoka i roto i te tohanga toto)?

Ki te whakarapopoto, ko te tikanga o te `(Thrombosis)` he toto totoka. Ko te tikanga o te `(Thromboembolism)` he toto totoka e haere ana i roto i te toto, ka mau ki tētahi wāhi, ka ārai i te rere o te toto. Ko te `(Deep Vein Thrombosis - DVT)` me te `(Pulmonary Embolism - PE)` e rua ngā mea e rua kei raro i te maru o te `(Venous Thromboembolic Disease)`. Nā te mea ka taea e ēnei e rua te ārai i te rere o te toto i roto i ngā uaua.

Ko te toto toto o te uaua o runga (SVT) he toto totoka e puta mai ana i roto i ngā uaua iti, o runga e tata ana ki te mata o te kiri, ā, he iti ake te tūponotanga ka puta he raruraru nui. Ahakoa kāore e puta he raruraru i te haurua o ngā DVT, me whai whakaaro ki ēnei raruraru nā te mea ka taea e rātou te puta he raruraru, ā, he take mōrearea hoki mō te PE.

He pēhea te noa o te ingoa o tēnei mate ko te `VTE`?

Ahakoa i roto i ētahi whenua whakawhanake o te ao, ko te `(VTE)` te tuatoru o ngā mate toto e tino kitea ana i muri i te `(Heart Attack)` me te `(Stroke)`. Ko te tikanga o tēnei, tata ki te kotahi i roto i te 1000 tāngata e pāngia ana e tēnei mate i ia tau. Tata ki te haurua o te hunga e pāngia ana e te `(VTE)` ka pāngia hoki e te `(Pulmonary Embolism - PE)`. Waihoki, tata ki te 25% o te hunga e pāngia ana e te `(PE)` ka mate. E kīia ana hoki ka piki rua te mōrearea o te pāngia e te `(VTE)` i ia tekau tau i muri i te 40 tau .

Ko wai kei te nui ake te mōrearea ki te whakawhanake i te VTE?

Ina hoki, ka taea e te tangata katoa te pāngia e te VTE. Heoi, kei reira ētahi āhuatanga e whakanui ake ana i te mōrearea. Whakaarohia ko te 25% ki te 50% o ngā take VTE ka puta kāore he take mārama. Ko tētahi atu 20% e pā ana ki te mate pukupuku. Ko tētahi atu 20% e pā ana ki te pokanga. Waihoki, ko ētahi tāngata he mate toto totoka, e nui ake ai te tūponotanga ka pāngia rātou e te toto totoka.

He aha ngā pūtake o te VTE?

He maha ngā take e puta ai ngā toto totoka. Heoi, he uaua ki te kī tika mēnā ka nui te toto ka puta hei aukati i te uaua, ka pakaru rānei ka haere ki ngā pukahukahu. Ko te hunga e pāngia ana e te VTE, he maha ngā āhuatanga mōrearea.

He kore taurite te nui o ngā pūmua i roto i te toto o ētahi tāngata e āwhina ana i te toto kia totoka (`(Thrombophilia)`). Mā tēnei ka ngāwari ake te totoka o te toto, ā, ka iti ake te tūponotanga ki te whakarewa i ngā totoka kua puta. He mea tuku iho pea tēnei, he pānga taha rānei nō tētahi atu mate hauora.

I ētahi wā, ina tū tonu te tinana, arā, ina kore e neke , ka puhoi te rere o te toto i roto i ngā uaua, ā, ka puta he toto totoka. Whakaarohia, ina haere roa koe, ina noho koe i te tūranga kotahi mō ngā hāora i runga i te pahi, i te tereina rānei, ina noho noa koe i runga i te tūru i te tari i te rā katoa, ina mate koe, ā, ka takoto noa ki te moenga, kei reira tēnei mōrearea.

Ko te tino take o te toto totoka he whara, he mate pāwera rānei. I ētahi wā, ka puta tēnei whara i te maimoatanga hauora. Hei tauira, ka puta pea i te wā pokanga, i te chemotherapy mō te mate pukupuku, i te wā rānei e whakauruhia ana he aho IV (wai werowero) ki te ringa, e whakauruhia ana rānei he catheter. Ko te hunga e noho roa ana i te hōhipera he nui ake te mōrearea o te toto totoka. Nā te mea kei te ora ake rātou i te whara, i te mate pāwera rānei, kei te whiwhi maimoatanga hauora kaha, ā, he roa te wā e noho ana i te moenga hōhipera.

He aha ngā āhuatanga ka whakanui ake i te mōrearea o te VTE?

Anei ētahi mea ka piki ake ai tō tupono ki te whakawhanake i te VTE:

• Te whara o te uaua nā te whati, te pokanga rānei.
• Ngā āhuatanga pangia.
• Te hekenga o te rere o te toto nā te noho roa i te wāhi kotahi.
• Ngā āhuatanga ira e tukuna iho ana i roto i ngā whakatipuranga me te hītori whānau o te VTE.
• Te pikinga ake o ngā taumata o te homoni `(Estrogen)` nā te haputanga, te whakamahinga o ngā pire ārai whānau, te rongoā whakakapinga homoni rānei (`(Hormone Replacement Therapy)`).
• Ngā mate toto totoka, hei tauira `(Factor V Leiden disease)`, `(Polycythemia Vera)` me `(Sickle Cell Disease)`.
• Ko ētahi mate pūmau, hei tauira te mate pukupuku, te mate ngakau, me te mate puku mumura (IBD).
• Ngā āhuatanga o te noho, arā, te momi hikareti, te momona, me te kore whakakori tinana.
• Tau (he nui ake te kitea o te VTE i waenga i te hunga kaumātua. Tērā pea nā te nui haere o ngā mate tāpiri me ngā āhuatanga kino o te noho i roto i a rātou).

He aha ngā tohu o te 'VTE'?

Mena ka āraia te uaua nā te toto totoka hohonu (DVT), ka puta pea ngā tohu i te wāhi i totohu ai te toto. Ko ētahi o ēnei:

• Te pupuhi (ina koa i te waewae kotahi, i te ringa rānei)
• Whero
• Ka mahana te tinana ina pā atu koe ki taua wāhi
• Te mamae (ina koa i te tū, i te hikoi rānei)

Ka puta ohorere pea ngā tohu o te ``(PE)``, arā, he toto totoka i roto i ngā pukahukahu, i ētahi wā kāore he tohu o mua o te ``(DVT)``. Ko ēnei tohu ko:

• Te mamae o te uma (ina koa i te wa e manawa hohonu ana)
• Te uaua ki te manawa (te tīmatanga ohorere)
• Te pikinga o te tere o te ngakau
• Te tere o te manawa
• Vertigo (te āhua e hurihuri ana koe)
• Ngaronga o te māramatanga
• Te werawera, te mātao rānei
• Te maremare toto

He mea nui: Ki te pā mai tētahi o ēnei tohu, he mea nui kia rapu tohutohu hauora tonu atu , nā te mea he tohu pea ēnei o tētahi mate kino.

Me pēhea te tātaritanga o te `VTE`?

Tērā atu anō ngā āhuatanga he rite ngā tohu ki te DVT me te PE. Hei whakarite kei a koe te Mate Thromboembolic Venous, ka pātai tō tākuta mō tō hītori hauora, ka tautuhi i ngā āhuatanga mōrearea mō te VTE, ā, ka whakakore i ētahi atu āhuatanga. Tērā pea ka whakahaerehia e rātou he whakamātautau toto taketake hei rapu i ngā tohu o te toto totoka. Kātahi ka whakamahia e rātou ngā whakamātautau whakaahua, pērā i te matawai, hei kimi i te wāhi o te toto totoka.

He aha ngā whakamātautau e whakamahia ana hei tautuhi i te `VTE`?

He maha ngā whakamātautau e mahia ana hei tautuhi i te `(DVT)` me te `(PE)`.

Ngā whakamātautau e kitea ai te `DVT`

• Ngā whakamātautau toto: He whakamātautau toto kei reira e kiia nei ko te whakamātautau D-dimer. Mā tēnei ka ine i te taumata o tētahi matū e tukuna ana ina pakaru ngā toto toto. Mena he teitei te taumata o tēnei matū, he tohu pea tēnei o tētahi toto toto kua pakaru. Ka taea hoki te whakahaere i ngā whakamātautau toto hei ine i te taumata hāora i roto i te toto, hei tirotiro hoki mō ngā mate toto toto tuku iho.
• Te whakamātautau whakaahua ā-ira toto: He whakamātautau whakaahua kore mamae tēnei. Koinei te kōwhiringa tuatahi hei tirotiro i ngā uaua me te rere o te toto i roto i a rātou. I ētahi wā ka kiia he whakamātautau whakaahua takirua nā te mea e rua ngā wāhanga. I te wāhanga tuatahi, ka whakamahia e te tākuta he taputapu rite ki te tokotoko hei tuku i ngā ngaru oro ki ngā uaua me te tiki whakaahua i runga i te mata. Kātahi ka taea te pēhi i te uaua kia kite mēnā kei te pēhi noa, mēnā rānei kua āraia e te toto totoka. I te wāhanga tuarua, ka tukuna ngā ngaru oro kia kite ai mēnā kei te rere te toto i roto i te uaua. Ina rere noa te toto, ka huri ngā ngaru oro mā te āhuatanga e kiia nei ko te pānga Doppler.
• Te tātaritanga MR venography:He pono ake te tikanga e kiia nei ko te Magnetic Resonance Imaging (MRI) i te ultrasound mō te tirotiro i ngā uaua i ngā wāhi pēnei i te puku, te uma, me te hope. I roto i te MR venography, ka whakamahia ngā ngaru auau irirangi hei kite i ngā toto totoka. Me takoto koe ki roto i tētahi mīhini MRI paerewa mō tēnei whakamātautau. Tērā pea ka hoatu he tae motuhake ki a koe hei āwhina i te whakaatu mārama ake i ngā uaua.
• Te whakamātautau hihi-X tuku iho: He whakamātautau hihi-X tuku iho tēnei. Anō, ka werohia he tae hihi-X ki roto i te uaua kia kitea ake ai ngā uaua i runga i ngā whakaahua. Ahakoa he ahua whakaeke ake i ētahi atu whakamātautau whakaahua, e kiia ana he tika ake. Tērā pea ka mahia tēnei mēnā kāore i te tino kitea ngā hua o ētahi atu whakamātautau. Ka whakauruhia e te tohunga hihi-X he ngongo iti ki roto i tētahi o ō uaua nui, ka ārahi i te huarahi tika, ka werohia te tae hihi-X, kātahi ka tangohia he hihi-X.

Ngā whakamātautau e kitea ai te `PE`

• Te oximetry pāhekoheko: Mena kei te tohu ō tohu he PE, ka ine tuatahi pea tō tākuta i te taumata hāora i roto i tō toto mā te whakatakoto i tētahi pūoko oximetry pāhekoheko ki tō matimati. Mena he iti te taumata hāora, tera pea nā te PE, nā tētahi atu mate pūkahukahu, mate ngākau rānei.
• X-ray o te uma: Ahakoa kāore e taea e te X-ray o te uma te tautuhi i te PE, ka taea e ia te tautuhi i ētahi atu mate pūkahukahu, mate ngākau rānei e puta ai ō tohu.
• Ko te angiography pūkahukahu CT (CTPA): Koinei te whakamātautau paerewa mō te tautuhi i te PE. Ka puta he whakaahua toru-ahu (3-D) o ngā uaua me ngā uaua i roto i ō pūkahukahu i roto i te matawai CT. Ko te tikanga o te "pūkahukahu" he hononga ki ngā pūkahukahu, ā, ko te "angiography" he hihi-X o ngā uaua toto. Kāore he whakaekenga toto i te CTPA, engari me werohanga pea he tae rerekē ki roto i te uaua.
• Angiogram pūkahukahu: Mena kāore i te tino kitea ngā hua o ētahi atu whakamātautau, ka taea e te angiogram pūkahukahu tuku iho te whakarato i ngā hua tino tika. Heoi, he ahua pokanoa. Mō tēnei angiogram, ka whakauruhia e te tohunga hihi-X he ngongo ki roto i tētahi o ō uaua nui, ka mirohia mā roto i tō uma, ka werohia he tae rerekē, kātahi ka tangohia he hihi-X.

He aha ngā maimoatanga mō te VTE?

Ko ngā kōwhiringa maimoatanga mō te `(Venous Thromboembolism)` e whakawhirinaki ana ki te mōrearea o te toto totoka. Ka taea te whakahaere i ētahi take `(DVT)` mā te rongoā ā-waha. Heoi, me tango wawe ētahi take `(PE)`. Ka tangohia pea e tō tākuta tētahi `(PE)` e morearea ana ki te ora mā te whakamahi i tētahi catheter e whakaurua ana mā roto i tētahi uaua, ka werohia rānei he rongoā `(thrombolytic)` e tere ai te whakarewa i te toto totoka. Heoi, nā te mea he maha ngā raruraru ka puta, ka mahia noa ēnei wawaotanga i roto i ngā āhuatanga ohorere.

Mena kāore te VTE e tino mōrearea ki te ora, ka arotahi te maimoatanga ki te aukati i te nui haere o ngā toto totoka o mua, me te ārai i te hanganga o ngā toto totoka hou. Ko ēnei maimoatanga ārai ko ngā rongoā ārai toto, arā, ngā rongoā e whakangawari ana i te toto, me ngā tōkena kōpeketanga, e āwhina ana ki te pupuri i te rere pai o te toto. I ngā take uaua ake, ka tūtohu pea tō tākuta i tētahi wawaotanga tinana, pērā i te whakauru i tētahi tātari ki roto i tētahi uaua hei ārai i te haere o ngā toto totoka ki ō pukahukahu.

Me pēhea te ārai i te VTE?

He maha ngā āhuatanga mōrearea mō te whakawhanaketanga o te venous thromboembolism, kāore e taea e tātou te whakahaere katoa i ēnei. Heoi, i te nuinga o te wā, ko te noho kaha te huarahi māmā ki te ārai i tēnei . Nā te mea ka puta te nuinga o ngā DVT i ngā waewae, mā te pupuri i te tohanga toto pai i roto i ngā waewae ka tino whakaiti i te mōrearea.

Ki te noho roa koe, ahakoa kei te mahi koe, kei te haereere rānei, kia tū ake koe, kia hikoi haere i ngā wā katoa, kia whakakorikori hoki i ngā uaua o ō waewae. Mā tēnei ka āwhina i te whakaiti i te toto e pupū ana. Ahakoa kei te mate koe, kei te ora rānei i te pokanga, mā te tū ake me te neke haere i te wā e taea ai ka āwhina i te whakaiti i tō tupono ki te toto totoka. Ka taea hoki e te whakakorikori tinana te āwhina i te whakaiti i te ahotea me te pupuri i te taumaha hauora . Ko ēnei ētahi atu āhuatanga ka whai wāhi ki te VTE.

Me pēhea te tiaki i a koe anō i muri i te VTE?

Ki te pāngia koe e te VTE, kia mōhio ki ēnei mea:

• Me haere tonu ki te tirotiro i tō āhua. Ka aroturukihia tō āhua e tō tākuta, ā, ka whakatau ia kia pēhea te roa me tango e koe tō rongoā.
• Tangohia tō rongoā kia rite ki te mea i tohua. Heoi, ki te nui rawa te toto e pāngia ana e koe (he pānga kino o ngā rongoā whakaiti toto), kati tonu te tango i te rongoā ka whakapā atu ki tō tākuta.
• Kia tūpato ki ngā tohu o te toto totoka, inā koa te pupuhi o ngā waewae me te mamae ina pāngia.
• Kia ora te tinana. Kia kaha te tinana, kia nui te wai e inumia ana, kia pai te whakahaere i te ahotea, ā, kati te kai paipa mēnā he kai paipa koe.

Kia maumahara, he maha ngā take rerekē o te Veous Thromboembolism. Tērā pea ētahi āhuatanga mōrearea kāore koe i te mōhio, ā, kāore e taea e koe te whakarerekē.

I muri i tēnei kōrero katoa, koinei ngā mea hei maumahara māu!

He maha ngā āhuatanga ka whai wāhi ki tētahi mate e kiia nei ko te `(Venous Thromboembolism - VTE)`. Tērā pea he āhuatanga mōrearea kei a koe kāore koe i te mōhio, ā, ko ētahi o aua āhuatanga kāore e taea e mātou te whakahaere. Heoi, he maha ngā mea ka taea e koe te mahi hei ārai i te `(VTE)` . Ā, ki te puta, ka taea te whakahaere angitu.

Mena he āwangawanga āu mō tēnei, kōrero ki tō tākuta mō ō āhuatanga mōrearea me pēhea e taea ai e koe te whakaiti i tō mōrearea. Ko te mea nui ko te rapu tohutohu hauora tonu mēnā ka puta he tohu o te "VTE". Ka tino aro nui mātou ki ngā toto toto katoa, arā, ko ngā mea kei a koe i nāianei me ērā pea ka puta ake i te heke mai. Nō reira kaua e wehi ki te toro atu ki te tākuta i te wā tonu ka puta he āwangawanga. Ko tō hauora te mea nui ki a mātou!

` Totoka toto, uaua, DVT, PE, pukahukahu, Thromboembolism uaua, VTE