Thrombositopenia

ʻO Thrombocytopenia kekahi maʻi i loko kahi kahi haʻahaʻa haʻahaʻa o nā pālaha. ʻO nā pāpale he mau ʻāpana o ke koko e kōkua i ke kōkuʻu ʻana i ke koko. Pili kēia ʻano i kekahi manawa me ke kahe koko ʻole.

Māhele pinepine ʻia ʻo Thrombocytopenia i 3 kumu nui o nā pā haʻahaʻa.

1. ʻAʻole lawa nā platelet i hana ʻia i ka iwi iwi
2. Hoʻonui i ka haki ʻana o nā platelet i ke kahe o ke koko
3. Hoʻonui i ka haki ʻana o nā platelet i loko o ka māpala a i ʻole ke ake

ʻAʻole hiki i kāu momona o ka iwi ke hana i nā pālule lawa inā loaʻa iā ʻoe kekahi o kēia mau kūlana:

• Aplastic anemia (maʻi a ʻaʻole hiki i ka iwi o ka iwi ke lawa ke koko.)
• Ka maʻi ʻaʻai i loko o ka iwi iwi, e like me leukemia
• ʻO Cirrhosis (scarring ate)
• Ka hemahema folate
• Nā maʻi i ka iwi iwi (ʻano laha ʻole)
• Myelodysplastic Syndrome (ʻaʻole e lawa ka momona o ka iwi o ka iwi a i ʻole e hana i nā huna kīnā)
• Ka nele o ka Vitamin B12

Hoʻohana ʻia kekahi mau lāʻau i hiki ke alakaʻi i kahi hana haʻahaʻa o nā platelet i ka iwi iwi. ʻO ka laʻana maʻamau ka mālama ʻana i ka chemotherapy.

ʻO nā kūlana olakino aʻe e hoʻonui ai i ka haki ʻana o nā platelet:

• ʻO ka maʻi kahi e mālama ai nā proteins e kaohi i ka hoʻopili ʻana o ke koko ma mua o ka hana, pinepine i ka manawa o kahi maʻi koʻikoʻi (DIC)
• Helu pālāki haʻahaʻa i hoʻoulu ʻia e ka lāʻau
• ʻLepala hoʻonui
• ʻO ka maʻi kahi e hoʻopau ai ka ʻōnaehana pale i nā platelet (ITP)
• ʻO ka maʻi e hana i nā kīʻaha koko e hana i loko o nā kīʻaha koko liʻiliʻi, e hoʻoulu ana i ka helu platelet haʻahaʻa (TTP)

ʻAʻohe ou mau ʻōuli. A i ʻole loaʻa paha iā ʻoe nā hōʻailona laulā, e like me:

• Kahe i ka waha a me ka gum
• ʻUpala
• Nā Nosebleeds
• Rash (pinpoint ʻulaʻula kiko i kapa ʻia petechiae)

Pili nā ʻōuli ʻē i ke kumu.

E hana i kāu mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i kāu mōʻaukala a me nā hōʻailona. E hana ʻia paha kēia mau hoʻāʻo:

• Helu piha koko (CBC)
• Nā hoʻāʻo ʻana o ke kāpili koko (PTT a me PT)

ʻO nā hoʻokolohua ʻē aʻe i hiki ke kōkua i ke kuhi ʻana i kēia ʻano me ka makemake o ka iwi o ka iwi a me ka biopsy.

Pili ka mālama ʻana i ke kumu o ke ʻano. I kekahi mau hihia, koi ʻia kahi transfusion o nā platelet e hōʻoki a pale aku paha i ke kahe ʻana o ke kahe.

Pili ka hopena i ka maʻi e hōʻemi ana i nā helu platelet haʻahaʻa.

ʻO ke kahe nui (hemorrhage) ka pilikia nui. Hiki ke holo i ka lolo i ka lolo a i ʻole ka gastrointestinal tract.

Kāhea i kāu mea hāʻawi inā ʻike ʻoe i ke kahe koko ʻole a i ʻole ʻeha.

Kū ka pale i ke kumu kikoʻī.

Helu pālāki haʻahaʻa - thrombocytopenia

ʻO Abrams CS. Thrombositopenia. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 163.

ʻO Arnold DM, Zeller MP, Smith JW, Nazy I. Nā maʻi o ka helu platelet: immune thrombositopenia, neonatal alloimmune thrombositopenia, a me posturaansfusion purpura. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 131.

ʻO Warkentin TE. Hoʻokumu ʻia ʻo Thrombocytopenia e ka luku ʻana i ka platelet, hypersplenism, a i ʻole hemodilution. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 132.