ʻO ka maʻi peripheral artery - nā wāwae

ʻO ka maʻi maʻi peripheral artery (PAD) kahi ʻano o nā kīʻaha koko e hāʻawi i nā wāwae a me nā wāwae. Kū ʻia ia ma muli o ka hoʻopili ʻana o nā aʻa i nā wāwae. ʻO kēia ke kumu o ka hōʻemi ʻana i ke kahe o ke koko, kahi e hōʻeha ai i nā aʻalolo a me nā mea ʻē aʻe.

Hoʻokumu ʻia ʻo PAD e ka atherosclerosis. Hana ʻia kēia pilikia ke kūkulu ʻia nā mea momona (plaque) ma nā paia o kou aʻa a hoʻoliki iā lākou. Ua ʻoi aku ka paʻakikī o nā paia o nā aʻa a ʻaʻole hiki ke hoʻonui (dilate) e ʻae i ke kahe o ke koko ke pono.

ʻO ka hopena, ʻaʻole hiki i nā io o kou mau wāwae ke lawa i ke koko a me ka oxygen ke hana nui nei lākou (e like me ka wā hoʻoikaika a hele wāwae paha). Inā lilo ka PAD i koʻikoʻi, ʻaʻole lawa paha ke koko a me ka oxygen, ʻoiai ke hoʻomaha nei nā mākala.

ʻO PAD kahi maʻi maʻamau. Hoʻololi pinepine ia i nā kāne ma mua o 50 mau makahiki, akā hiki i nā wahine ke loaʻa pū kekahi. ʻOi aku ka makaʻu o ka poʻe inā he moʻolelo ko lākou o:

• Kolesterol kūpono
• Diabetes
• Maʻi maʻi puʻuwai (coronary artery disease)
• Ke koko kiʻekiʻe (hypertension)
• ʻO ka maʻi kīwī e pili ana i ka hemodialysis
• Puhipaka
• Hahau (cerebrovascular maʻi)

ʻO nā ʻōuli nui o PAD ka ʻeha, achiness, luhi, puhi ʻana a i ʻole hōʻoluʻolu ʻole i nā mākala o kou mau wāwae, nā bipi keiki, a me nā ʻūhā. Hōʻike pinepine ʻia kēia mau ʻōuli i ka hele wāwae ʻana a i ka hoʻoikaika kino paha, a hele aku ma hope o kekahi mau minuke hoʻomaha.

• I ka mua, ʻike ʻia kēia mau ʻōuli ke hele wāwae ʻoe i luna, hele wikiwiki, a hele wāwae paha no kahi mamao loa.
• Lohi, ʻoi aku ka wikiwiki o kēia mau ʻōuli a me ka hoʻoikaika kino.
• Pōpō paha kou mau wāwae a wāwae paha ke hoʻomaha ʻoe. Hiki ke ʻoluʻolu nā wāwae i ka hoʻopā ʻana, a me ka ʻili ke nānā aku.

Ke paʻakikī ke PAD, loaʻa paha iā ʻoe:

• Impotence
• ʻO kaʻeha a me nā kūpikipiki i ka pō
• ʻEha a ʻūlū paha i nā wāwae a me nā manamana wāwae paha, kahi hiki ke koʻikoʻi loa a ʻo ke kaumaha o nā lole a me nā pale moe he ʻeha
• ʻOi ka ʻeha ʻoi aku ka maikaʻi ke hāpai ʻoe i kou mau wāwae, a hoʻomaikaʻi i ke kau ʻana i kou mau wāwae ma ka ʻaoʻao o kahi moe
• ʻIli e nānā ʻeleʻele a polū
• Nā maʻi ʻeha ʻole

I ka wā o kahi hoʻokolohua, ʻike paha ka mea mālama ola:

• Kani kahi kani kani ke paʻa ʻia ka stethoscope ma luna o ke aʻa (hua arterial)
• Hoemi i ke kahe o ke koko i ka lālā i hoʻopili ʻia
• Nā pulses nāwaliwali a i ʻole absent i ka lālā

Ke ʻoi aku ka koʻikoʻi o PAD, hiki i nā hopena ke komo pū:

• ʻO nā mākala bipi e holoholo (mae a atrophy paha)
• ʻO ka lauoho lauoho ma luna o nā wāwae, nā wāwae, a me nā manamana wāwae
• ʻEhaʻeha, ʻeha ʻole ke kahe ʻana ma nā wāwae a me nā manamana wāwae (ʻeleʻele pinepine) i lohi e hoʻōla
• ʻO keʻokeʻo o ka ʻili a i ʻole ʻulaʻula polū i nā manamana wāwae a me nā wāwae (cyanosis)
• ʻĀlohilohi, ʻili paʻa
• Manamana wāwae mānoanoa

Hōʻike paha nā hōʻike koko i ke kiʻekiʻe o ke kōkō a i ʻole ka maʻi kō.

ʻO nā hoʻāʻo no PAD me:

• Angiography o nā wāwae
• Hoʻopili ʻia ke kaomi koko i nā lima a me nā wāwae no ka hoʻohālikelike (ankle / brachial index, a i ʻole ABI)
• ʻO ka hōʻike ultrasound Doppler o kahi hopena
• Mākōkō resonance angiography a i ʻole CT angiography

Nā mea hiki iā ʻoe ke hana e kaohi i ka PAD:

• E kaulike i ka hoʻoikaika kino me ka hoʻomaha. Hele wāwae a hana i kahi hana ʻē aʻe a i ke kiko o ka ʻeha a hoʻololi iā ia me nā wā hoʻomaha. I ka hala ʻana o ka manawa, hoʻomaikaʻi paha kāu kahe ʻana ma ke ʻano he mau kīʻaha koko liʻiliʻi hou. E kamaʻilio mau i ka mea hoʻolako ma mua o ka hoʻomaka ʻana i kahi papahana hoʻoikaika kino.
• Uoki ka puhipaka. Hoʻopili ka puhipaka i nā aʻa, hoʻemi i ka hiki i ke koko ke hāpai i ka oxygen, a hoʻonui i ka makaʻu o ka hoʻokumu ʻana i nā clots (thrombi a me emboli).
• E mālama i kou mau wāwae, keu hoʻi inā he diabetes ʻoe. E komo i nā kāmaʻa e kūpono pono. E nānā i kēlā me kēia ʻoki, ʻoki, a ʻeha paha, a ʻike koke i kāu mea lawelawe. Hoola mālie nā kolo a ʻoi aku paha ka maʻi ʻana ke hōʻemi ʻia ka holo.
• E mālama pono i kou kahe koko
• Inā kaumaha nui ʻoe, hoʻēmi i kou kaupaona.
• Inā kiʻekiʻe kou kolesterol, ʻai i ka papa haʻahaʻa kolesterol a me ka papaʻai momona momona.
• E nānā i kāu pae kō kō inā loaʻa kou maʻi diabetes, a mālama ia i ka mālama.

Pono paha nā lāʻau e kāohi i ka maʻi, e like me:

• ʻO Aspirin a i ʻole kahi lāʻau i kapa ʻia ʻo clopidogrel (Plavix), ka mea e mālama i kou koko mai ka hana ʻana i nā clots i loko o kou aʻa. Mai hōʻoki i ka lawe ʻana i kēia mau lāʻau me ke kamaʻilio mua ʻole ʻana me kāu mea hāʻawi.
• ʻO Cilostazol, kahi lāʻau e hana e hoʻonui (hoʻonui) i nā aʻa i hoʻopili ʻia a i ʻole nā ​​aʻa no nā hihia kaulike a paʻakikī ʻaʻole nā ​​moho no ke ʻoki.
• ʻO ka lāʻau e kōkua i ka hoʻohaʻahaʻa i kāu kolesterol.
• Nā mea hōʻeha ʻeha.

Inā ʻoe e lawe i nā lāʻau no ke koko kiʻekiʻe a diabetes paha, e lawe iā lākou e like me ka mea a kāu mea hāʻawi.

Hiki ke hana ʻia ke ʻoki kino inā koʻikoʻi ke ʻano a hoʻopilikia i kou hiki ke hana a hana i nā hana nui, ke ʻeha nei ʻoe i ka hoʻomaha, a i ʻole he ʻeha a ʻeha paha kou wāwae e hoʻōla ʻole ai. Nā koho he:

• ʻO ke kaʻina hana e wehe i nā kīʻaha koko ākea a i ʻole nā ​​poloka e hāʻawi i ke koko i kou mau wāwae
• Ke ʻoki kino e reroute i ka lako o ke koko a puni kahi aʻa i ālai ʻia

Pono paha kekahi poʻe me PAD e hemo ka lālā (ʻoki ʻia).

ʻO ka hapa nui o nā hihia o PAD o nā wāwae hiki ke kāohi ʻia me ka ʻole o ke kahakaha. ʻOiai ke ʻoki e hāʻawi i ke kōkua maikaʻi i nā hōʻailona koʻikoʻi, hoʻohana ʻia ka angioplasty a me nā kaʻina stenting ma kahi o ke ʻoki pinepine a pinepine.

Komo pū nā pilikia:

• Hoʻopili ke koko a i ʻole emboli e ālai i nā aʻa liʻiliʻi
• Maʻi maʻi ʻaʻai Coronary
• Impotence
• Wehe i nā ʻeha (nā ischemic ulcer ma nā wāwae lalo)
• ʻO ka make ʻana o ka ʻupena (gangrene)
• Pono e ʻoki ʻia ka wāwae i pili a i ʻole ka wāwae

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• ʻO ka wāwae a wāwae paha e lilo i mea hōʻoluʻolu i ka hoʻopā, pale, polū, a i ʻole numb
• ʻEha o ka umauma a i ʻole ka liʻiliʻi o ka hanu me ka ʻeha o ka wāwae
• ʻO ka ʻeha o ka wāwae e hele ʻole, ʻoiai ke hele ʻole ʻoe a neʻe paha (kapa ʻia ka ʻeha hoʻomaha)
• ʻO nā wāwae ʻulaʻula, wela, a pehu paha
• Nā maʻi hou / ulcer
• Nā hōʻailona o ka maʻi (fiva, ʻulaʻula, manaʻo maʻi maʻamau)
• Nā ʻōuli o arteriosclerosis o nā ʻāʻī

ʻAʻohe hōʻike loiloi e kuhikuhi ʻia e ʻike i ka PAD i nā maʻi me ka ʻole o nā hōʻailona.

ʻO kekahi o nā pilikia no ka maʻi aʻa i hiki iā ʻoe ke loli:

• ʻAʻole puhipaka. Inā puhi ʻoe, haʻalele.
• Ke kaohi nei i kāu kolamu ma o ka papaʻai, hoʻoikaika kino, a me nā lāʻau.
• Ke kaohi ʻana i ke koko kiʻekiʻe ma o ka papaʻai, hoʻoikaika kino, a me nā lāʻau, inā pono.
• Ka mālama ʻana i ka maʻi diabetes ma o ka papaʻai, hoʻoikaika kino, a me nā lāʻau, inā pono.
• Hoʻomaʻamaʻa ma ka liʻiliʻi 30 mau minuke i ka lā.
• Ke mālama nei i kahi kaupaona olakino e ka ʻai ʻana i nā meaʻai olakino, ka ʻai ʻana i ka mea liʻiliʻi, a me ke komo ʻana i kahi papahana hoʻemi kino, inā pono ʻoe e lilo i ka kaumaha.
• Ke aʻo ʻana i nā ala olakino e pale ai i ke koʻikoʻi ma o nā papa kūikawā a i ʻole nā ​​papahana, a i ʻole nā ​​mea e like me ka noʻonoʻo a yoga paha.
• Ka palena ʻana i ka nui o ka waiʻona āu e inu ai i 1 inu i ka lā no nā wahine a me 2 i kēlā me kēia lā no nā kāne.

Maʻi maʻi vas peripheral; PVD; PAD; Nā mea holoʻokoʻa Arteriosclerosis; Ka paʻa ʻana o nā aʻa wāwae; Hoʻopau; Pākuʻi wā waena; Maʻi Vaso-occlusive o nā wāwae; ʻO ka lawa ʻole o ka arterial o nā wāwae; ʻO ka ʻeha o ka wāwae hou a me ka cramping; ʻEha bipi keiki me ka hoʻoikaika kino

• Hoʻokomo ʻia ka Angioplasty a me stent - nā aʻa ākea - hoʻokuʻu
• Nā lāʻau Antiplatelet - nā mea kūpaka P2Y12
• ʻO Cholesterol a me ka nohona
• Ua wehewehe ʻia nā momona momona
• ʻLelo aʻoaʻo ʻai wikiwiki
• Hoʻokiʻoki wāwae - hoʻokuʻu
• Pehea e heluhelu ai i nā lepili ʻai
• Hoʻokiʻoki wāwae - hoʻokuʻu
• ʻO ka ʻoki wāwae a me ka wāwae paha - hoʻololi i ka lole
• Papaʻai Mediterranean
• Holo ke ākea peripheral - wāwae - hoʻokuʻu

• ʻO Atherosclerosis o nā wēlau
• ʻO ka wāwae bypass Arterial - series

Bonaca MP, Creager MA. Maʻi maʻi peripheral artery. 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 64.

ʻO Ridker PM, Libby P, Buring JE. ʻO nā māka hōʻailona a me ka pale mua ʻana i ka maʻi maʻi maʻi maʻi. 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 45.

ʻO Simons JP, Robinson WP, Schanzer A. ʻO ka maʻi ʻoihana kiʻekiʻe loa: ka mālama olakino a me ka hoʻoholo ʻana. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 105.

ʻO ka Pūʻali Hana Hana Hana US, Curry SJ, Krist AH, Owens DK, et al. ʻO ka loiloi no ka maʻi ākea ākea a me ka loiloi ʻana i ka maʻi maʻi maʻi maʻi me ka helu kuʻekuʻe wāwae - brachial index: US Preventive Services Task Force Recommended Statement. JAMA. 2018; 320 (2): 177-183. PMID: 29998344 pubmed.ncbi.nlm.nih.gov/29998344/.

Keʻokeʻo CJ. ʻO Atherosclerotic peripheral arterial maʻi. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 71.