Hoʻomaʻo thrombolytic

ʻO ka thrombolytic therapy ka hoʻohana ʻana i nā lāʻau e wāwahi a hoʻopau paha i nā maʻi koko, ʻo ia ke kumu nui o nā puʻuwai ʻelua a me ka hahau.

ʻAe ʻia nā lāʻau thrombolytic no ka mālama ulia pōpilikia o ka hahau a me ka puʻuwai puʻuwai. ʻO ka lāʻau lapaʻau i hoʻohana pinepine ʻia no ka thrombolytic therapy ka mea hoʻoulu kino plasminogen (tPA), akā hiki i nā lāʻau ʻē aʻe ke hana i ka mea like.

ʻO ke kūpono, pono ʻoe e loaʻa nā lāʻau thrombolytic i loko o nā minuke 30 mua ma hope o ka hōʻea ʻana i ka haukapila no ka lāʻau.

HUAKAI PUUWAI

Hiki i ke kīʻaha koko ke ālai i nā aʻa i ka puʻuwai. Hiki i kēia ke kumu i ka hōʻeha puʻuwai, ke make kahi ʻāpana o ka puʻuwai puʻuwai ma muli o ka nele o ka oxygen e hāʻawi ʻia e ke koko.

Hana ka Thrombolytic ma ka hoʻopau ʻana i kahi ʻōpala nui i ka wikiwiki. Kōkua kēia i ke kahe hou ʻana o ke kahe o ke koko i ka puʻuwai a kōkua i ka pale ʻana i ka hōʻino ʻana i ka mākala puʻuwai. Hiki i ka Thrombolytic ke hōʻoki i kahi puʻuwai puʻuwai e ʻoi aku ka nui a make paha. ʻOi aku ka maikaʻi o nā hopena inā loaʻa iā ʻoe kahi lāʻau thrombolytic ma waena o 12 mau hola ma hope o ka hoʻomaka ʻana o ka puʻuwai puʻuwai. Akā ke hoʻomaka koke ka lapaʻau ʻana, ʻoi aku ka maikaʻi o nā hopena.

Hoʻōla ka lāʻau i kekahi kahe o ke koko i ka puʻuwai i ka hapa nui o ka poʻe. Eia nō naʻe, ʻaʻole kūpono ke kahe o ke koko a aia paha he wahi liʻiliʻi o nā mākala i hōʻino ʻia. ʻO ka hoʻōla hou, e like me ka catheterization puʻuwai me ka angioplasty a me ka stenting, pono paha.

E hoʻokumu kāu mea mālama ola i nā hoʻoholo e pili ana i ka hāʻawi ʻana iā ʻoe i kahi lāʻau thrombolytic no ka hōʻeha puʻuwai ma nā kumu he nui. Hoʻopili kēia mau mea i kou mōʻaukala o ka ʻeha o ka umauma a me nā hopena o kahi hoʻokolohua ECG.

Nā kumu ʻē aʻe i hoʻohana ʻia e hoʻoholo inā he moho maikaʻi ʻoe no ka thrombolytic:

• Makahiki (nui ka makaʻu o nā poʻe ʻōpio i nā pilikia)
• Moekolohe
• ʻO ka mōʻaukala olakino (me kāu mōʻaukala no ka hōʻeha puʻuwai ma mua, diabetes, haʻahaʻa koko, a hoʻonui ʻia paha ka helu o ka puʻuwai)

ʻO ka maʻamau, ʻaʻole e hāʻawi ʻia ka thrombolytic inā loaʻa iā ʻoe:

• ʻO kahi ʻeha poʻo poʻo hou
• Nā pilikia koko
• Ulcer hehe
• Hapai keiki
• ʻOki kino hou
• Lawe ʻia i nā lāʻau lahilahi koko e like me Coumadin
• Trauma
• Kāohi koko kiʻekiʻe (ʻole)

HUAKAI

Hana ʻia ka hapa nui o ka hahau ke neʻe ke koko i kahi kīʻaha koko i ka lolo a ālai i ke kahe o ke koko i kēlā wahi. No kēlā ʻano pahū (hahau ischemic), hiki ke hoʻohana i ka thrombolytic e kōkua i ka hoʻopau koke ʻana i ka ʻōpala. ʻO ka hāʻawi ʻana i ka thrombolytic ma waena o 3 mau hola o nā hōʻailona hahau mua hiki ke kōkua i ka hōʻemi ʻana i ka hōʻeha a me ke kīnā ʻole.

Hoʻoholo ʻia ka hoʻoholo e hāʻawi i ka lāʻau.

• ʻO kahi scan CT lolo e ʻike pono ʻaʻohe kahe o ke kahe
• ʻO kahi hoʻokolohua kino e hōʻike ana i kahi hahau koʻikoʻi
• ʻO kāu moʻolelo olakino

E like me ka hōʻeha puʻuwai, ʻaʻole hāʻawi pinepine ʻia kahi lāʻau hoʻopau-hoʻopau inā loaʻa iā ʻoe kekahi o nā pilikia olakino ʻē aʻe i helu ʻia ma luna.

Hāʻawi ʻole ʻia ʻo Thrombolytic i kekahi e loaʻa ana i ka maʻi hahau e pili ana i ke kahe ʻana o ka lolo i ka lolo. Hiki iā lākou ke hoʻonui i ka hahau ma o ka hoʻonui ʻana i ke kahe.

HIKI

ʻO ka hoʻokahe ka pilikia maʻamau. Hiki ke hoʻoweliweli i ke ola.

Hiki i ke kahe liʻiliʻi mai nā gum a me ka ihu ke hana ma kahi o 25% o ka poʻe i loaʻa ka lāʻau. Hele ka hele i loko o ka lolo ma kahi o 1% o ka manawa. Ua like kēia makaʻu no nā maʻi ʻelua a me nā puʻuwai puʻuwai puʻuwai.

Inā manaʻo ʻia he weliweli loa ka thrombolytic, hiki i nā mālama ʻē aʻe no nā ʻōpala ke kumu o ka hahau a i ʻole ka puʻuwai puʻuwai.

• Ka hemo ʻana o ka ʻaʻai (thrombectomy)
• ʻO kahi hana e wehe ai i nā kīʻaha koko i hoʻopili ʻia a hāʻawi ʻia i ke koko i ka puʻuwai a i ʻole ka lolo

E kāhea i kahi mea mālama ola a i ʻole kāhea iā 911

ʻO nā hōʻeha puʻuwai a me nā hahau nā hanana olakino. Hoʻomaka ka mālama koke ʻana me ka thrombolytic, ʻoi aku ka maikaʻi o ka manawa kūpono no kahi hopena maikaʻi.

Hoʻoulu i ka plasminogen pūnaewele; TPA; Alteplase; Reteplase; Tenecteplase; Hoʻoponopono i ka mea hana thrombolytic; Nā mea hana hoʻoheheʻe lole; Reperfusion therapy; Pā - thrombolytic; Kaʻi puʻuwai - thrombolytic; Emolism huehue - thrombolytic; Thrombosis - thrombolytic; Lanoteplase; Staphylokinase; Streptokinase (SK); Urokinase; Hahau - thrombolytic therapy; Puʻuwai puʻuwai - thrombolytic therapy; Pā - thrombolysis; Ka hōʻeha puʻuwai - thrombolysis; Infarction Myocardial - thrombolysis

• Hahau
• ʻO Thrombus
• Kau ka myocardial infarction ECG nalu tracings

Bohula EA, ʻApōpō DA. Infarction myocardial ST-kiʻekiʻe: hoʻokele. 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 59.

ʻO Crocco TJ, Meurer WJ. Hahau. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 91.

Jaffer IH, Weitz JI. Nā lāʻau Antithrombotic. I: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Nā Kumumanaʻo a me ka Hoʻomeheu. ʻEpekema 7 Piladelapia, PA: Elsevier; 2018: chap 149.

O'Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka infarction myocardial ST-kiʻekiʻe: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force ma nā Kumu Alakaʻi. Kaapuni. 2013; 127 (4): 529-555. PMID: 23247303 pubmed.ncbi.nlm.nih.gov/23247303/.