Huʻi ʻia ke aʻa koʻikoʻi - hakuʻala

ʻO ka huehue ākea ākea o ka puʻupaʻa he lohi nui ia, paʻa paʻa o ke aʻa e hāʻawi i ke koko i ka puʻupaʻa.

Pono nā puʻupaʻa i kahi lako koko maikaʻi. ʻO ke aʻa nui i ka puʻupaʻa i kapa ʻia ʻo ke aʻa ākea. Hiki i ke kahe o ke kahe ke hōʻemi i ka hana o ka puʻupaʻa. ʻO kahi paʻa loa o ke kahe o ke koko i ka puʻupaʻa hiki ke hopena pinepine i ka hopena kīnā ʻole paʻa mau.

Hiki ke hana i ke aʻa aʻa ākea o ke aʻa ākea ma hope o ka hōʻeha a i ʻole trauma i ka ʻōpū, ʻaoʻao, a i ʻole kua. Hiki ke moe i nā kahe koko e hele ma waena o ke kahe o ke kahawai (emboli) i loko o ke aʻa koko.Hiki i nā ʻāpana o nā pā mai nā paia o nā aʻa ke hemo (iā lākou iho a i ʻole i kahi kaʻina hana). Hiki i kēia ʻōpala ke ālai i ke aʻa nui o ke kīʻaha a i ʻole o kekahi o nā moku liʻiliʻi.

Hoʻonui ka makaʻu o ka ʻaʻa puʻuwai i nā poʻe i loaʻa i kekahi mau maʻi puʻuwai, kahi e hana ai i nā huʻa koko. Hoʻopili kēia i ka stenosis mitral a me ka fibrillation atrial.

Kapa ʻia kahi ʻākoʻako o ke aʻa ākea i ka stenosis arenal renal. Hoʻonui kēia ʻano i ka makaʻu o ka ālai koke ʻana.

ʻAʻole paha ʻoe e loaʻa nā ʻōuli ke hana ʻole kekahi puʻupaʻa no ka mea hiki i ka ʻokena ʻelua ke kānana i ke koko. Eia nō naʻe, hiki koke mai ke kiʻekiʻe o ke koko (hypertension) a paʻakikī e kaohi.

Inā ʻaʻole holo pono kāu kīʻaha ʻē aʻe, blockage of the renal artery may cause sintomas of acute acute kidney failed. ʻO nā ʻōuli ʻē aʻe o ka hoʻoliʻiliʻi arterial ākea o ke aʻa ākea e komo pū me:

• Abdominal eha
• Hōʻemi hōʻemi o ka puka mimi
• ʻEha kua
• Koko i ka mimi
• Paʻi ʻeha a ʻeha paha ma ka ʻaoʻao
• Nā ʻōuli o ke koko kiʻekiʻe e like me ka headache, hoʻololi i ka hihiʻo, a me ka ʻōhū

Kaha: ʻAʻohe paha ʻeha. ʻO ka ʻeha, inā aia ia, ulu pinepine ka ulu ʻana.

ʻAʻole hiki i ka mea mālama olakino ke hoʻomaopopo i ka pilikia me kahi hōʻike wale nō ke ʻole ʻoe i hoʻomohala i ka maikaʻi ʻole o ka hakuʻala.

Nā hoʻokolohua āu e pono ai e hoʻopili:

• ʻO ka hoʻāʻo ʻana Duplex Doppler ultrasound o nā aʻa lāki e hoʻāʻo i ke kahe o ke koko
• MRI o nā aʻa puʻupaʻa, i hiki ke hōʻike i ka nele o ke kahe o ke koko i ka puʻupaʻa e hoʻopili ʻia
• Hōʻike ka arteriography Renal i kahi kikoʻī o ka paʻa
• Ultrasound o ka hakuʻala e nānā i ka nui o ka hakuʻala

ʻO ka manawa pinepine, ʻaʻole pono ka poʻe i ka lāʻau. ʻOi aku ka maikaʻi o ke kahe koko ma o kā lākou iho i ka hala o ka manawa.

Hiki iā ʻoe ke mālama e wehe i ke aʻa inā loaʻa koke ka blockage a i ʻole e hoʻopili ana i ka hakuʻala e hana wale ana. Hiki i ka mālama ʻana e wehe i ke aʻa ke komo pū:

• ʻO nā lāʻau lapaʻau e hoʻopau ana i ka lole (thrombolytic)
• Nā lāʻau lapaʻau e pale ai i ke koko mai ka hoʻopili ʻana (anticoagulants), e like me warfarin (Coumadin)
• Hoʻoponopono ʻoki ʻana o ke aʻa kōkā
• Hoʻokomo o kahi paipu (catheter) i loko o ke aʻa ākea e wehe i ka paʻa

Hiki paha iā ʻoe ke dialysis manawa pokole e mālama pono ʻole i ke kōkō nui. Pono paha nā lāʻau e hoʻohaʻahaʻa i ka cholesterol inā kū ka poloka ma muli o nā ʻōpala mai ke kūkulu ʻia ʻana o ka pā i nā aʻa.

ʻO nā pohō e kumu ʻia e ka ʻaʻa arterial e hele aku paha. Eia nō naʻe, i ka nui o nā hihia, paʻa mau ia.

Inā hoʻokahi kīʻaha e loli, hiki i ke kīkī olakino ke lawe i ka kānana ʻana i ke koko a me ka hana ʻana i ka mimi. Inā loaʻa iā ʻoe kahi hakuʻala e hana wale ana, hiki i ka occ arterial ke alakaʻi i ka holo pono ʻole o ka hakuʻala. Hiki i kēia ke ulu i loko o ke kīkino ʻole ʻole.

Komo pū nā pilikia:

• Hewa kōwi koʻikoʻi
• Maʻi maʻi ʻōniʻoniʻo
• Piʻi koko kiʻekiʻe
• Hypertension māinoʻino

Kāhea i kāu mea hāʻawi inā:

• Kū ʻoe i ka hana mimi
• ʻIke ʻoe i ka ʻeha a me ka ʻeha nui ma ke kua, kaʻe, a me ka ʻōpū.

E kiʻi koke i ke kōkua olakino pilikia inā loaʻa iā ʻoe nā ʻōuli o ka hoʻoliʻiliʻi arterial a hoʻokahi wale nō hakuʻala e hana ana.

I nā manawa he nui, ʻaʻole hiki ke pale ʻia ka maʻi. ʻO ke ala nui e hōʻemi ai i kou makaʻu ka hoʻopau ʻana i ka puhipaka.

Pono paha ka poʻe hopohopo no ka hoʻomohala ʻana i nā clots koko e lawe i nā lāʻau anti-clotting. ʻO ka lawe ʻana i nā kaohi e mālama i nā maʻi e pili ana i ka atherosclerosis (paʻakikī o nā aʻa) e hoʻoliʻiliʻi paha i kou makaʻi.

Trombosis arenal ākea ākea; Embolism o ka ʻaʻa puʻuwai; Huehue; Embolism - ʻaʻaʻaʻa

• Anatomia hakuʻala
• ʻO Kidney - ke kahe o ke koko a me ka mimi
• Hāʻawi ke koko

DuBose TD, Santos RM. Nā maʻi kīnā ʻole o ka hakuʻala. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 125.

ʻO Myers DJ, Myers SI. Nā ʻōnaehana ʻōnaehana: renal. I: Sidawy AN, Perler BA, hua. ʻO Rutherford's Vascular Surgery a me Endotherapy Therapy. 9th ed. Piladelapia, PA: Elsevier; 2019: chap 44.

Ruggenenti P, Cravedi P, Remuzzi G. Microvascular a me nā maʻi macrovascular o ka puʻupaʻa. I: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. ʻO Brenner a me Rector's The Kidney. 10 o ka lā. Piladelapia, PA: Elsevier; 2016: chap 35.

ʻO Watson RS, ʻo Cogbill TH. ʻO stenosis ʻaʻaʻa ʻaʻa Atherosclerotic. I: Cameron JL, Cameron AM, eds. ʻO ke kaʻoki lāʻau lapaʻau o kēia manawa. 12th ed. Piladelapia, PA: Elsevier; 2017: 1041-1047.