Kahe i ka ʻili

Hiki ke komo i loko o ka ʻili mai nā kīʻaha koko haki i hana ʻia i nā kiko ʻulaʻula liʻiliʻi (i kapa ʻia ʻo petechiae). Hiki i ke koko ke hōʻiliʻili ma lalo o ke kiko i nā wahi pālahalaha nui (i kapa ʻia ʻo purpura), a i ʻole i kahi ʻāpana nui nui (i kapa ʻia he ecchymosis).

Ma waho aʻe o ka ʻeha maʻamau, ke kahe ʻana o ke kahe i ka ʻili a i ʻole nā ​​membrane mucous kahi hōʻailona nui a pono e nānā mau ʻia e kahi mea mālama ola.

ʻAʻole kuhihewa kaʻulaʻula o kaʻili (erythema) no ke kaheʻana o ke kahe. ʻAʻole lilo nā wahi o ke kahe ʻana o ke kahe ma lalo o ka ʻili i ka paler (blanch) ke kaomi ʻoe ma ia wahi, e like me ka ʻula mai erythema.

Hiki i nā mea he nui ke kumu i ke kahe ʻana ma lalo o ka ʻili. ʻO kekahi o lākou:

• Ka hōʻeha a i ʻole trauma
• Ka hopena hoʻowali
• Nā maʻi Autoimmune
• ʻO ka maʻi viral a i ʻole nā ​​maʻi e hoʻopili ana i ke kāpili ʻana o ke koko (coagulation)
• Thrombositopenia
• Lapaʻau lapaʻau, me radiation a me chemotherapy
• Nā lāʻau Antiplatelet e like me clopidogrel (Plavix)
• Bruise (ecchymosis)
• Hānau (petechiae i ka hānau hou)
• ʻElemakule ʻili (ecchymosis)
• Idiopathic thrombositopenic purpura (petechiae a me purpura)
• Henoch-Schonlein purpura (purpura)
• Leukemia (purpura a me ecchymosis)
• Nā Lapaʻau - Anticoagulants e like me warfarin a i ʻole heparin (ecchymosis), aspirin (ecchymosis), steroid (ecchymosis)
• Septicemia (petechiae, purpura, ecchymosis)

Palekana i ka ʻili ʻelemakule. Hōʻalo i ka trauma e like me ke kuʻi a huki paha i nā ʻili. No kahi ʻoki a ʻoki paha, e hoʻohana i ka kaomi pololei e hōʻoki i ke kahe ʻana.

Inā loaʻa iā ʻoe kahi hopena lāʻau, e nīnau i kāu mea hoʻolako e pili ana i ka hoʻokū ʻana i ka lāʻau. Inā ʻole, e hāhai i kāu lāʻau i kau ʻia e mālama ai i ke kumu kumu o ka pilikia.

Kāhea i kāu mea hāʻawi inā:

• Loaʻa koke ʻoe i ke kahe i ka ʻili me ke kumu ʻole
• ʻIke ʻoe i ka palapū ʻaʻole i wehewehe ʻia e hele aku

E nānā ana kāu mea hāʻawi iā ʻoe a nīnau i nā nīnau e pili ana i ke kahe ʻana o ke koko, e like me:

• Ua loaʻa paha ʻoe i kahi ʻeha a ulia paha?
• Ua maʻi paha ʻoe i kēia manawa?
• Ua loaʻa iā ʻoe ka radiation radiation a i ʻole chemotherapy?
• He aha nā lāʻau lapaʻau ʻē aʻe i loaʻa iā ʻoe?
• Lawe ʻoe i ka aspirin ma mua o hoʻokahi manawa i ka pule?
• Lawe anei ʻoe iā Coumadin, heparin, a i ʻole nā ​​"ʻoki koko" (anticoagulants)?
• Ua hana pinepine ʻia ke kahe?
• Ua loaʻa paha iā ʻoe ka maʻa mau e kahe i loko o ka ʻili?
• Ua hoʻomaka ke kahe ʻana i ke kōpiopio (e laʻa me ke ʻoki poepoe ʻana)?
• Ua hoʻomaka paha me ke kahakaha ʻana a i ka wā i huki ʻia ai kahi niho?

E hana ʻia paha nā hoʻokolohua diagnostic penei:

• Nā ho'āʻo Coagulation me INR a me ka manawa prothrombin
• Helu piha ke koko (CBC) me ka helu platelet a me ka hoʻokaʻawale ʻana o ke koko
• Biopsy iwi ʻōiwi

ʻO Ecchymoses; Nā kiko o ka ʻili - ʻulaʻula; Kuhi i nā kiko ʻulaʻula ma ka ʻili; Petechiae; Puʻuloa

• Maka ʻeleʻele

ʻO Hayward CPM. ʻO ka hoʻokokoke ʻana i ka mea maʻi me ka kahe ʻana o ke kō a ʻeha paha. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 128.

ʻO Juliano JJ, Cohen MS, Weber DJ. ʻO ka mea maʻi maʻi ʻeha me ka wela a me ka hū. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 57.

ʻO Schafer AI. E hoʻokokoke aku i ka mea maʻi me ka hoʻokahe ʻana i ka toto a me ka thrombosis. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 162.