Cor pulmonale

ʻO Cor pulmonale kahi kūlana e hoʻonā i ka ʻaoʻao ʻākau o ka puʻuwai e holo pono ʻole. ʻO ke kiʻekiʻe o ke koko kiʻekiʻe ma nā aʻa o ka akemāmā a me ka ventricle ʻākau o ka puʻuwai hiki ke alakaʻi i cor pulmonale.

ʻO ke kahe koko kiʻekiʻe ma nā aʻa o nā akemāmā i kapa ʻia he pulmonary hypertension. ʻO ia ke kumu maʻamau o cor pulmonale.

I ka poʻe i loaʻa i ka pulmonary hypertension, nā loli i loko o nā kīʻaha koko liʻiliʻi i loko o nā māmā e hiki ai ke hoʻonui i ke kahe o ke koko ma ka ʻaoʻao ʻākau o ka puʻuwai. Hoʻonui kēia i ka puʻuwai e pīpī i ke koko i nā ake māmā. Inā hoʻomau kēia kaomi kiʻekiʻe, kau ia i kahi kānana ma ka ʻaoʻao ʻākau o ka puʻuwai. Hiki i kēlā kānana ke kumu i cor pulmonale.

ʻO nā kūlana o ka lolo e hoʻohaʻahaʻa i ke kiʻekiʻe o ka oxygen o ke koko i loko o ke koko ma kahi o ka manawa lōʻihi hiki ke alakaʻi ʻia hoʻi i ka cor pulmonale. ʻO kekahi o kēia mau mea:

• Nā maʻi Autoimmune e hōʻino i nā ake māmā, e like me scleroderma
• ʻO ka maʻi pulmonary obstructive maʻi (COPD)
• Hoʻopili ke koko maʻi i nā māmā
• Cystic fibrosis (CF)
• ʻO Bronchiectasis koʻikoʻi
  
• ʻO ka scarring o kaʻiʻo māmā (interstitial lung disease)
• ʻOloka nui o ka ʻaoʻao kiʻekiʻe o ka iwi kuamoʻo (kyphoscoliosis)
• Pāpale hiamoe ākea, ke kumu e kū ai i ka hanu ʻana ma muli o ka mumū o ke kahawai
• ʻIdiopathic (ʻaʻohe kumu kikoʻī) ke hoʻopaʻa (constrict) o nā kīʻaha koko o nā akemāmā

ʻO ka hanu a me ka lightheadedness i ka wā o ka hana ka pinepine o ka hōʻailona mua o cor pulmonale. Hiki paha iā ʻoe ke kuʻi wikiwiki i ka puʻuwai a manaʻo e like me ke kuʻi ʻana o kou puʻuwai.

I ka hala ʻana o ka manawa, kū nā ʻōuli me ka hana māmā a ʻoiai ʻoe e hoʻomaha ana. ʻO nā ʻōuli āu e loaʻa ai:

• Pāheohehehe maikaʻi ʻia i ka wā o ka hana
• Hōʻoluʻolu o ka umauma, maʻamau i mua o ka umauma
• ʻEha ʻeha
• ʻO ka pehu ʻana o nā wāwae a i ʻole nā ​​kuʻekuʻe wāwae
• Nā ʻōuli o nā maʻi pūkahū, e like me ke kani ʻana a i ʻole ka ʻū ʻana a i ʻole ka hana phlegm
• Nā lehelehe Bluish a me nā manamana lima (cyanosis)

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:

• Kūkulu ka wai i kou ʻōpū
• Kani ka puʻuwai maʻamau
• ʻIli polū
• Huʻi ka ake
• ʻO ka pehu ʻana o nā ʻāʻī o ka ʻāʻī, kahi hōʻailona o ke kaomi kiʻekiʻe ma ka ʻaoʻao ʻākau o ka puʻuwai
• ʻŌiwi wāwae

Hiki ke kōkua i kēia mau hoʻāʻo e hōʻoia i ka pulmonale cor a me ke kumu.

• Nā hoʻāʻo antibody koko
• E hoʻāʻo i ke koko e nānā no kahi lāʻau i kapa ʻia ʻo ka lolo natriuretic peptide (BNP)
• Pākuʻi x-ray
• CT scan o ka umauma, me ka loaʻa ʻole o ka injection o ka wai ʻokoʻa (kala)
• ʻEchocardiogram
• ECG
• ʻO Biopsy Lung (hana pinepine ʻole ʻia)
• Ka ana o ka oxygen o ke koko ma o ka nānā ʻana i ke kinoea koko arterial (ABG)
• Nā hoʻāʻo o ka pulmonary (lung)
• Catheterization naʻau ʻākau
• Ventilation a me ka perfusion scan o nā māmā (V / Q scan NineManga.com)
• Nā hoʻāʻo no ka maʻi maʻi autoimmune

ʻO ka pahuhopu o ka mālama ʻana e kaohi i nā ʻōuli. He mea nui e mālama i nā pilikia olakino e hiki ai i ka pulmonary hypertension, no ka mea hiki iā lākou ke alakaʻi i ka cor pulmonale.

Loaʻa nā koho lapaʻau he nui. Ma ka laulaha, ʻo ke kumu o kāu cor pulmonale e hoʻoholo ai i kahi lapaʻau e loaʻa iā ʻoe.

Inā kuhikuhi kāu mea hāʻawi i nā lāʻau, hiki iā ʻoe ke lawe iā lākou ma ka waha (waha), loaʻa iā lākou ma o ke aa (intravenous a i ʻole IV), a hanu paha iā lākou i (inhaled). E kiaʻi pono ʻia ʻoe i ka wā o ka mālama ʻana e kiaʻi ai i nā hopena a ʻike i ke ʻano o ka hana a ka lāʻau iā ʻoe. Mai hōʻoki i ka lawe ʻana i kāu lāʻau i ke kamaʻilio mua ʻole ʻana i kāu mea hāʻawi.

Hiki i nā mālama ʻē aʻe ke:

• ʻO nā mea lahilahi o ke koko e hōʻemi i ka makaʻi o ke koko koko
• Nā lāʻau lapaʻau e hoʻokele i nā ʻōuli puʻuwai puʻuwai
• Oxygen therapy ma ka home
• ʻO kahi transplant lung a puʻuwai paha, inā ʻaʻole holo ka lāʻau

Nā ʻōlelo aʻoaʻo nui e ukali ai:

• Hōʻalo i nā hana ikaika a me ka hāpai hāpai kaumaha.
• 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 ākea pneumonia.
• Inā puhi ʻoe, kū.
• Palena i ka nui o ka paʻakai āu e ʻai ai. E noi paha kāu mea hāʻawi iā ʻoe e kaohi i ka nui o ka wai āu e inu ai i ka lā.
• E hoʻohana i ka oxygen inā kauoha kāu mea hāʻawi iā ia.
• ʻAʻole hāpai nā wahine.

Ma muli o ke kumu o kāu pulmonale cor.

Ke hele a paʻakikī kou maʻi, pono ʻoe e hoʻololi i kou home i hiki iā ʻoe ke hoʻokele me ka hiki. Pono ʻoe e kōkua ma kahi o kou hale.

Hiki i Cor pulmonale ke alakaʻi iā:

• Ka hanu hoʻoweliweli o ke ola
• Kūkulu ka wai paʻa i kou kino
• Pāhaʻi
• Make

Kāhea i kāu mea hāʻawi inā loaʻa ka pōkole o ka hanu a me ka ʻeha o ka umauma.

Mai puhi. ʻO ke puhipaka ka mea e maʻi ai ka maʻi māmā, a hiki i ka cor pulmonale.

Hoka puʻuwai ʻaoʻao ʻākau; Maʻi maʻi pulmonary

• ʻO ka maʻi pulmonary obstructive maʻi - nā mākua - hoʻokuʻu

• Sarcoid, kahua IV - umauma x-ray
• Kūpono vs. nā kūlana hoʻomau
• Cor pulmonale
• ʻŌnaehana hanu

ʻO Barnett CF, De Marco T. Pulmonary hypertension ma muli o ka maʻi maʻi. 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 59.

ʻO Bhatt SP, Dransfield MT. Nā maʻi maʻi maʻi maha a me nā maʻi maʻi ʻōpū. 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 86.