Hypertension pulmonary

ʻO ke kiʻekiʻe o ka pulmonary ke koko kiʻekiʻe ma nā aʻa o nā akemāmā. Hana ia i ka ʻaoʻao ʻākau o ka puʻuwai e hana ʻoi aku ka paʻakikī ma mua o ka maʻamau.

ʻO ka ʻaoʻao ʻākau o ka puʻuwai e pīpī i ke koko ma o nā akemāmā, kahi e ʻohi ai i ka oxygen. Hoʻi ke koko i ka ʻaoʻao hema o ka puʻuwai, kahi e pīpī ʻia i ke koena o ke kino.

Ke hele a puni nā aʻa liʻiliʻi (nā kīʻaha koko) o nā ake māmā, ʻaʻole hiki iā lākou ke hāpai i ke koko he nui. Ke hiki mai kēia, ulu aʻe ke kaomi. Kapa ʻia kēia ʻo hypertension pulmonary.

Pono e hana nui ka puʻuwai e hoʻoikaika i ke koko ma o nā moku e kūʻē i kēia kaomi. I ka hala ʻana o ka manawa, lilo kēia i ka ʻaoʻao ʻākau o ka puʻuwai e lilo i nui. Kāhea ʻia kēia ʻano he puʻuwai ʻaoʻao ʻākau, a i ʻole cor pulmonale.

ʻO ke kiʻekiʻe o ka pulmonary hypertension e:

• Nā maʻi Autoimmune e hōʻino i nā akemāmā, e like me scleroderma a me rheumatoid arthritis
• Nā kīnā hānau o ka puʻuwai
• Kahe koko i loko o ka hāhā (pulmonary embolism)
• Hewa puʻuwai
• Maʻi maʻi puʻuwai
• Maʻi HIV
• Nā pae oxygen haʻahaʻa i ke koko no kahi manawa lōʻihi (mau)
• ʻO ka maʻi o ka puʻu, e like me COPD a i ʻole fibrosis pulmonary a i ʻole kekahi ʻano maʻi ʻūhā koʻikoʻi ʻē aʻe
• Nā lāʻau (e laʻa me kekahi mau lāʻau ʻai)
• ʻAha moe hiamoe

I nā hihia maʻamau, ʻike ʻole ʻia ke kumu o ka piʻi kiʻekiʻe o ka pulmonary. I kēia hihia, ua kapa ʻia kēia ʻano he idiopathic pulmonary arterial hypertension (IPAH). ʻO ka manaʻo Idiopathic ʻaʻole ʻike ʻia ke kumu o kahi maʻi. Hoʻopili ka IPAH i nā wahine ʻoi aku ka nui ma mua o nā kāne.

Inā hopena ʻia ka pulmonary hypertension e kahi lāʻau i ʻike ʻia a i ʻole ke olakino, ua kapa ʻia ia he hypertension pulmonary lua.

ʻO ka hanu a me ka lightheadedness i ka wā o ka hana ka pinepine o ka hōʻailona mua. Loaʻa ka helu wikiwiki o ka naʻau (palpitations). I ka hala ʻana o ka manawa, kū nā ʻōuli me ka hana māmā a i ʻole ma ka wā hoʻomaha.

ʻO nā ʻōuli ʻē aʻe e like me:

• ʻO ka kuʻekuʻe wāwae a me ka wāwae
• ʻO kaʻulaʻula polū o nā lehelehe a me kaʻili (cyanosis)
• ʻO ka ʻeha o ka umauma a i ʻole kaomi, ʻo ka mea pinepine i mua o ka umauma
• Puʻupuʻu a poni paha
• Ka luhi
• Hoʻonui ʻia ka nui o ka ʻōpū
• Nawaliwali

ʻO ka poʻe me ka hanu pulmonary e loaʻa pinepine nā ʻōuli e hele a hoʻi. Hōʻike lākou i nā lā maikaʻi a me nā lā maikaʻi ʻole.

E hana i kāu mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i kāu mau hōʻailona. E ʻike paha ka hōʻike:

• Kani ka puʻuwai maʻamau
• ʻIno o kahi lāʻau ikiʻai ma luna o ka umauma
• ʻO ka namunamu o ka naʻau ma ka ʻaoʻao ʻākau o ka puʻuwai
• ʻO nā veins nui ma mua o ka maʻamau i ka ʻāʻī
• Huʻi wāwae
• ʻO ka palahū a me ka ʻōpala
• Kani ka hanu maʻamau inā kiʻekiʻe ka pulmonary hypertension a i ʻole ma muli o ka maʻi puʻuwai congenital
• Kani ka hanu maʻamau inā piʻi ka pulmonary mai kekahi maʻi maʻi maʻi
  

I nā wā mua o ka maʻi, he maʻamau paha ka hoʻokolohua a aneane maʻamau paha. Lawe ʻia ke kūlana i mau mahina e ʻike pono. Hiki i ka Asthma a me nā maʻi ʻē aʻe ke hana i nā hōʻailona like a pono e hōʻole ʻia.

ʻO nā hoʻokolohua i kauoha ʻia e komo pū:

• Nā hoʻāʻo koko
• ʻO ka catheterization Cardiac
• Pākuʻi x-ray
• CT scan o ka umauma
• ʻEchocardiogram
• ECG
• Nā hoʻāʻo hana lung
• Nānā māmā nuklear
• Pulmonary arteriogram
• Hōʻoia hele hele wāwae he 6 mau minuke
• Haʻawina hiamoe
• Nā hoʻāʻo e nānā no nā pilikia autoimmune

ʻAʻohe lāʻau no ka pulmonary hypertension. ʻO ka pahuhopu o ka mālama ʻana ka kaohi ʻana i nā ʻōuli a pale i ka nui o ka pohō. He mea nui e mālama i nā maʻi olakino e hiki ai i ke kiʻekiʻe o ka pulmonary, e like me ka hiamoe hiamoe ākea, nā kūlana māmā, a me nā pilikia puʻuwai puʻuwai.

Loaʻa nā koho lapaʻau he nui no ka hypertension arterial pulmonary. Inā kuhikuhi ʻia ʻoe i nā lāʻau, lawe ʻia lākou e ka waha (waha), i loaʻa ma o ke aa (intravenous, a i ʻole IV), a i ʻole hanu ʻia i (hanu ʻia).

E hoʻoholo kāu mea nāna e hāʻawi i ka lāʻau pono iā ʻoe. E kiaʻi pono ʻia ʻoe i ka wā o ka mālama ʻana e kiaʻi ai i nā hopena a ʻike i kou ʻano ke pane i ka lāʻau. Mai hōʻoki i ka lawe ʻana i kāu lāʻau i ke kamaʻilio ʻole ʻana me kāu mea hāʻawi.

Hiki i nā mālama ʻē aʻe ke:

• ʻO nā mea lahilahi o ke koko e hōʻemi i ka makaʻu o ke kahe o ke koko, keu hoʻi inā he IPAH kāu
• Oxygen therapy ma ka home
• Lū, aiʻole i kekahi mau hihia, hoʻoneʻe i ka puʻuwai puʻuwai, inā ʻaʻole holo pono nā lāʻau

Nā ʻōlelo aʻoaʻo nui ʻē aʻe e hāhai:

• Hōʻalo i ka hāpai ʻana
• Hōʻalo i nā hana kino kaumaha a me ka hāpai ʻana
• Hōʻalo i ka hele ʻana i kahi kiʻekiʻe
• E kiʻi i ka lāʻau lapaʻau flu makahiki, a me nā lāʻau āpau ʻē aʻe e like me ka lāʻau lapaʻau pneumonia
• Uoki ka puhipaka

Maikaʻi kāu hana ma muli o ke kumu o ke ʻano. Hiki i nā lāʻau no IPAH ke kōkua i ka lohi o ka maʻi.

Ke hele a māhuahua ka maʻi, pono ʻoe e hoʻololi i kou home e kōkua iā ʻoe e hele a puni ka hale.

Kāhea i kāu mea hāʻawi inā:

• Hoʻomaka ʻoe e hoʻomohala i ka hanu ke hana ʻoe
• ʻOi aku ka maikaʻi o ka hanu
• Hoʻokumu ʻoe i ka ʻeha o ka umauma
• Hoʻokumu ʻoe i nā ʻōuli ʻē aʻe

Pulmonary arterial hypertension; ʻO ka hypertension pulmonary mua nui Sporadic; Famtial primer pulmonary hypertension; Idiopathic pulmonary arterial hypertension; ʻO ke kiʻekiʻe o ka pulmonary hypertension; PPH; Kiʻekiʻe kiʻekiʻe pulmonary hypertension; Cor pulmonale - pulmonary hypertension

• ʻŌnaehana hanu
• ʻO ke kiʻekiʻe o ka pulmonary hypertension
• Ke kuʻi puʻuwai puʻuwai - series

ʻO Chin K, Channick RN. Hypertension pulmonary. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 58.

Mclaughlin VV, Humbert M. Pulmonary hypertension. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 85.