Nā holoi Thromboangiitis

ʻO Thromboangiitis obliterans kahi maʻi laha ʻole kahi e paʻa ai nā kīʻaha koko o nā lima a me nā wāwae.

Hoʻokumu ʻia nā Thromboangiitis obliterans (maʻi Buerger) e nā kīʻaha koko liʻiliʻi e lilo i mumū a pehu. Hoʻopili nā kīʻaha koko a i ʻole ke ālai ʻia e nā clots koko (thrombosis). Hoʻopili nui ʻia nā kīʻaha koko o nā lima a me nā wāwae. ʻOi aku ka hopena o nā aʻa ma mua o nā veins. ʻO ka makahiki maʻamau ke hoʻomaka nā ʻōuli ma kahi o 35. Hoʻohālikelike ka liʻiliʻi o nā wahine a me nā mākua.

Hoʻololi kēia ʻano i nā kāne ʻōpio 20 a 45 paha ka makahiki he poʻe puhipuhi kaumaha a nau i ka paka. Pilikia paha ka wahine puhipaka. Hoʻopili kēia ʻano i nā poʻe he nui ma ka Hikina Waena, ʻAsia, ke Kaiwaenahonua, a me ʻEulopa Hikina. Nui nā poʻe me kēia pilikia i loaʻa ʻole ke olakino niho, ʻo ka mea paha ma muli o ka hoʻohana paka ʻana.

Hoʻopili pinepine nā ʻōuli i ka 2 a ʻoi paha nā lālā a hoʻopili ʻia paha:

• ʻO nā manamana lima a me nā manamana wāwae paha e hākea, ʻulaʻula, a bluish a anuanu hoʻi i ka paʻi.
• ʻEhaʻeha loa i nā lima a me nā wāwae. ʻIke paha kaʻeha e like me ke ahi a kani paha.
• ʻO kaʻeha ma nā lima a me nā wāwae e hana pinepine ʻia i ka wā e hoʻomaha ai. Eʻoi aku paha ka ʻeha o ka ʻohana ke anuanu nā lima a me nā wāwae a i ʻole i ke kaumaha o ka naʻau.
• ʻEha ma nā wāwae, nā kuʻekuʻe wāwae, a i ʻole nā ​​wāwae ke hele wāwae (intermittent claudication). Hoʻokomo pinepine kaʻeha i ka paʻa o ka wāwae.
• Hoʻololi ka ʻili a i ʻole nā ​​maʻi ʻeha ʻeha ma nā manamana lima a me nā manamana wāwae.
• ʻO ka maʻamau, hoʻomohala ka arthritis i nā pulima a i ʻole nā ​​kuli ma mua o ka paʻa ʻana o nā kīʻaha koko.

Hōʻike paha nā hōʻike aʻe i ka paʻa ʻana o nā kīʻaha koko i nā lima a i ʻole nā ​​wāwae i hoʻopili ʻia.

• ʻO Ultrasound o nā kīʻaha koko i ka hope loa, i kapa ʻia plethysmography
• ʻO Doppler ultrasound o ka hopena
• Arteriogram x-ray i hoʻokumu ʻia me Catheter

Nā hoʻokolohua koko no nā kumu ʻē aʻe o nā kīʻaha koko i hoʻāla ʻia (vasculitis) a ālai ʻia (hiki i nā moku koko) ke hana ʻia. Hoʻopili kēia mau kumu i ka maʻi diabetes, scleroderma, vasculitis, hypercoagulability, a me atherosclerosis. ʻAʻohe hoʻokolohua koko e hōʻike i nā obliterans thromboangiitis.

Hana ʻia paha kahi echocardiogram puʻuwai e ʻimi ai i nā kumu o ke kahe o ke koko. I nā hanana kakaʻikahi ke maopopo ʻole ke kuhi, hana ʻia kahi biopsy o ke kīʻaha koko.

ʻAʻohe mea ola no nā mea holoʻokoʻa thromboangiitis. ʻO ka pahuhopu o ka mālama ʻana ka kaohi ʻana i nā ʻōuli a pale i ka maʻi mai ka ʻino.

ʻO ke kū ʻana i ka paka o kēlā me kēia ʻano ke kī i ka kaohi ʻana i ka maʻi. Paipai ikaika ʻia nā hōʻoki paka ʻana. He mea nui nō hoʻi e hōʻalo i nā mahana anuanu a me nā kūlana ʻē aʻe e hōʻemi i ke kahe o ke koko i nā lima a me nā wāwae.

Ke noi ʻana i ka mehana a me ka hana ʻana i nā hana maʻalahi hiki ke kōkua i ka hoʻonui ʻana i ka holo.

Hiki ke kōkua iā aspirin a me nā lāʻau e wehe i nā kīʻaha koko (vasodilators). I nā hihia maikaʻi ʻole, hiki i ke ʻoki ʻana e ʻokiʻoki i nā aʻalolo i ka wahi (sympathectomy surgical) hiki ke kōkua i ke kaohi i ka ʻeha. Kākaʻikahi wale nō, noʻonoʻo ʻia ke kāʻalo bypass i kekahi poʻe.

Pono paha e ʻokiʻoki i nā manamana lima a me nā manamana wāwae inā maʻi nui ka wahi a make ka mea.

Hiki ke hele aku nā ʻōuli o nā thromboangiitis obliterans inā kū ke kanaka i ka hana paka. Pono paha ka poʻe e hoʻomau i ka hoʻohana paka ʻana i nā ʻoki ʻana.

Komo pū nā pilikia:

• ʻO ka make ʻana o ka ʻupena (gangrene)
• Hoʻololi o nā manamana a me nā manamana wāwae
• Kahe o ke kahe o ke koko i ka lālā o nā manamana lima a i ʻole nā ​​manamana wāwae

Kāhea i kāu kahu mālama ola inā:

• Loaʻa iā ʻoe nā ʻōuli o nā thromboangiitis obliterans.
• Loaʻa iā ʻoe he thromboangiitis obliterans a ʻoi aku ka maikaʻi o nā ʻōuli, ʻoiai me ka lāʻau.
• Hoʻokumu ʻoe i nā ʻōuli hou.

ʻO nā kānaka me ka mōʻaukala o Raynaud hanana a polū paha, nā manamana lima ʻeha a me nā manamana wāwae paha, ʻo ia hoʻi me nā puʻupuʻu, ʻaʻole pono e hoʻohana i kekahi ʻano paka.

Maʻi maʻi Buerger

• ʻO nā mea holoi Thromboangiites
• ʻŌnaehana puni

Akar AR, Inan B. Thromboangiitis obliterans (maʻi Buerger). I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 138.

Gupta N, Wahlgren CM, Azizzadeh A, Gewertz BL. ʻO ka maʻi o Buerger (Thromboangiitis obliterans). I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 13th ed. Piladelapia, PA: Elsevier; 2020: 1054-1057.

ʻO Jaff MR, ʻo Bartheolomew JR. Nā maʻi arterial peripheral ʻē aʻe. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 72.