He aha ka Ankle-Brachial Index? Ke Kumu, nā Pae/Kaʻina Hana & nā Hōʻike

ʻO ka ankle-brachial index (ABI) he hoʻāʻo maʻalahi a ʻaʻohe ʻeha e hoʻohālikelike ana i ke koko i loko o kou kuʻekuʻe wāwae me ke koko i loko o kou lima. Kōkua kēia ana wikiwiki i nā kauka e ʻike i ka maʻi artery peripheral (PAD), kahi maʻi e hōʻemi ai nā aʻa i ka kahe koko i kou mau wāwae a me nā wāwae.

E noʻonoʻo iā ia he loiloi olakino no kou kahe. Ke kahe manuahi ke koko ma nā aʻa olakino, pono e like nā helu kaomi ma waena o kou kuʻekuʻe wāwae a me kou lima. Inā he ʻokoʻa nui, hiki ke hōʻailona ʻaʻole e loaʻa i nā aʻa wāwae ke kahe koko e pono ai.

He aha ka ankle-brachial index?

ʻO ka ankle-brachial index kahi lakio e hoʻohālikelike ana i ke koko i loko o kou kuʻekuʻe wāwae me ke koko i loko o kou lima. Hoʻohālikelike kāu kauka i kēia ma ka puʻunaue ʻana i ke kaomi o kou kuʻekuʻe wāwae me ke kaomi o kou lima, e hāʻawi ana iā ʻoe i kahi helu e hōʻike ana i ka maikaʻi o ke kahe koko i kou mau wāwae haʻahaʻa.

ʻO ka helu ABI maʻamau e hāʻule ma waena o 0.9 a me 1.3. ʻO ia hoʻi, ʻo ke koko i loko o kou kuʻekuʻe wāwae ma kahi o 90% a 130% o ke kaomi i loko o kou lima. Ke hāʻule kēia lakio ma lalo o 0.9, hōʻike ia e hiki ke hōʻemi ʻia a i ʻole ke ālaina ʻia nā aʻa wāwae, hiki ke hōʻike i ka maʻi artery peripheral.

He maʻalahi loa ka hoʻāʻo a he mau minuke wale nō e hoʻopau ai. ʻAʻole pono ʻoe i kahi hoʻomākaukau kūikawā, a ʻaʻohe pilikia e pili ana. ʻO ia kekahi o nā mea hana screening hilinaʻi loa i loaʻa i nā kauka no ka hopu ʻana i nā pilikia kahe i ka wā.

No ke aha e hana ʻia ai ka ankle-brachial index?

Hoʻohana nā kauka i ka ankle-brachial index i ka mea nui e nānā i ka maʻi artery peripheral, kahi maʻi e pili ana i nā miliona o nā kānaka ma ka honua holoʻokoʻa. Loaʻa ka PAD i ka wā e kūkulu ai nā waihona momona i loko o kou mau aʻa wāwae, e hōʻemi ana i ke kahe koko i kou mau wāwae a me nā wāwae.

He mea nui ka ʻike mua no ka mea pinepine ka PAD e ulu mālie me ka ʻole o nā hōʻailona maopopo. ʻAʻole ʻike ka nui o nā kānaka i nā pilikia o ke kahe ʻana o ke koko a hiki i ka wā i holomua nui ai ke kūlana. Hiki i ka hoʻāʻo ABI ke hopu i kēia mau pilikia ma mua o ka lilo ʻana i mau pilikia olakino koʻikoʻi.

Hiki i kāu kauka ke ʻōlelo aku i kēia hoʻāʻo inā he mau mea pilikia kāu no ka maʻi ʻaʻa. Aia kēia mau mea i ka maʻi diabetes, ke koko kiʻekiʻe, ka cholesterol kiʻekiʻe, ka mōʻaukala puhi paka, a i ʻole ma luna o 65 mau makahiki. He mea pono nō hoʻi ka hoʻāʻo inā e ʻeha ana kou wāwae i ka wā e hele ai, nā ʻeha e lohi ana e hoʻōla ma kou mau wāwae, a i ʻole ke anu i kou mau wāwae lalo.

Ma waho aʻe o ka nānā ʻana, kōkua ka ABI i nā kauka e nānā i ka maʻi ʻaʻa peripheral e kū nei a loiloi i ka maikaʻi o ka hana ʻana o nā lāʻau lapaʻau. He mea waiwai nō hoʻi ia no ka loiloi ʻana i kou pilikia cardiovascular holoʻokoʻa, no ka mea, hōʻike pinepine ka PAD i nā pilikia like i nā ʻaʻa ʻē aʻe ma kou kino.

He aha ke kaʻina hana no ka index ankle-brachial?

He mea maʻalahi loa ke kaʻina hana index ankle-brachial a lawe ma kahi o 10 a 15 mau minuke e hoʻopau ai. E moe ʻoluʻolu ʻoe ma luna o kahi papa hoʻokolokolo i ka wā e ana ai kāu mea mālama ola i ke koko i kou mau lima a me nā kuʻekuʻe wāwae me ka hoʻohana ʻana i kahi cuff koko maʻamau a me kahi mea ultrasound kūikawā i kapa ʻia ʻo Doppler.

Eia ka mea e hana ʻia i ka wā o kāu hoʻāʻo:

1. E wehe ʻoe i kou mau kāmaʻa a me nā kākini a moe pālahalaha ma kou kua
2. Hoʻokomo kāu mea lawelawe i nā cuff koko ma nā lima ʻelua a me nā kuʻekuʻe wāwae ʻelua
3. Hoʻopili lākou i ka gel ultrasound i kou ʻili kahi e nānā ai lākou i nā pulses
4. Me ka hoʻohana ʻana i kahi mea Doppler, ʻike lākou i ka pulse i kou lima a hoʻonui i ka cuff
5. Hoʻokuʻu mālie lākou i ke kaomi i ka wā e hoʻolohe ana i ka wā e hoʻi mai ai ke kahe koko
6. Hoʻopili hou ʻia ke kaʻina hana like no kēlā me kēia kuʻekuʻe wāwae, e nānā ana i nā pulses i kou mau wāwae
7. Hoʻohālikelike kāu mea lawelawe i ka lakio ma ka puʻunaue ʻana i ke kaomi kuʻekuʻe wāwae me ke kaomi lima

Hoʻonui ka mea hana Doppler i ke kani o ke koko e kahe ana ma kou mau ʻaʻa, e maʻalahi ai i kāu mea lawelawe e ʻike i nā pulu nāwaliwali. Hiki paha iā ʻoe ke lohe i nā leo e hū ana i ka wā o ka hoʻāʻo ʻana, he mea maʻamau loa ia a ʻo ke kani wale nō o ke kahe ʻana o kou koko i hoʻonui ʻia.

ʻAʻole ʻeha loa ke kaʻina hana. E ʻike ʻoe i ka manaʻo maʻamau o ka hoʻonui ʻana a me ka hoʻohaʻahaʻa ʻana o ke kaula koko, akā ʻaʻohe mea ʻoluʻolu ʻole ma mua o ka nānā ʻana i ke koko maʻamau. Manaʻo ka hapa nui o nā kānaka he mea hoʻomaha loa ka hoʻāʻo.

Pehea e hoʻomākaukau ai no kāu index ankle-brachial?

ʻO ka mea maikaʻi e pili ana i ka hoʻāʻo index ankle-brachial ʻaʻole ia e koi i ka hoʻomākaukau ʻana ma kāu ʻaoʻao. Hiki iā ʻoe ke ʻai maʻamau, lawe i kāu mau lāʻau maʻamau, a hele e pili ana i kāu mau hana maʻamau ma mua o ka manawa.

Aia kekahi mau mea maʻalahi e hoʻomanaʻo e hana maʻalahi kāu hoʻāʻo:

• E ʻaʻahu i nā lole ʻoluʻolu, ʻoluʻolu e hiki ai ke komo maʻalahi i kou mau lima a me nā wāwae
• E pale i nā socks paʻa a i ʻole nā ​​stockings e waiho ai i nā kaha ma kou mau kuʻekuʻe wāwae
• E hoʻāʻo e hoʻomaha no ka liʻiliʻi o 5 mau minuke ma mua o ka hoʻāʻo ʻana e hōʻoia i nā heluhelu pololei
• E haʻi i kāu mea lawelawe e pili ana i nā lāʻau lapaʻau āu e lawe nei, ʻoi aku hoʻi nā mea lahilahi koko
• E haʻi inā he maʻi ʻili a i ʻole nā ​​ʻeha ma kou mau lima a i ʻole nā ​​wāwae

Inā he mea puhi ʻoe, e hoʻāʻo e pale i ka puhi ʻana no ka liʻiliʻi o 30 mau minuke ma mua o kāu hoʻāʻo ʻana, no ka mea, hiki i ka nicotine ke hoʻopilikia i kāu heluhelu koko no ka manawa. Pēlā nō, inā ua hoʻoikaika ikaika ʻoe, e haʻi i kāu mea lawelawe i hiki iā lākou ke hāʻawi i ka manawa hou no kou kahe ʻana e hoʻi i kona kūlana hoʻomaha.

ʻO ka mea nui loa, mai hopohopo e pili ana i nā hopena hoʻāʻo ma mua. He mea hana screening ka ABI, a inā ʻike ʻia kekahi pilikia, e hana pū kāu hui mālama ola me ʻoe e hoʻoponopono iā lākou. E hoʻomanaʻo, ʻo ka ʻike mua ʻana i nā pilikia o ke kahe ʻana e hāʻawi iā ʻoe i ka manawa maikaʻi loa no ka mālama pono.

Pehea e heluhelu ai i kāu index ankle-brachial?

He maʻalahi ka hoʻomaopopo ʻana i nā hopena o kāu helu index ankle-brachial ke ʻike ʻoe i ke ʻano o nā helu. E hōʻike ʻia kāu hopena ma ke ʻano he helu decimal, mai 0.4 a 1.4, e hōʻike ana i ka lakio ma waena o ke koko o kou kuʻekuʻe wāwae a me kou lima.

Eia ke ʻano o ka unuhi ʻana i kāu mau hopena ABI:

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• 1.0 a 1.3: Ka holo maʻamau me ke kahe koko olakino i kou mau wāwae
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• 0.9 a 0.99: Borderline, e hōʻike ana i ka ʻuʻuku iki e pono ai ka nānā ʻana
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• 0.8 a 0.89: Maʻi ʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻaʻa\n
  • Hoʻoikaika kino mau: Kōkua nā papahana hele wāwae i ka hoʻomohala ʻana i ke kahe koko e puni ana i nā aʻa i paʻa.
  • Haʻalele i ka puhi paka: ʻO ka haʻalele ʻana i ka puhi paka ka hana nui loa no ka hoʻomaikaʻi ʻana i ke kahe koko.
  • Hoʻoponopono i ka maʻi diabetes: E mālama i nā pae kōpaʻa koko i mea e pale ai i ka pōʻino hou i nā aʻa.
  • Hoʻomalu i ke koko: E mālama i nā helu ma lalo o 130/80 mmHg ma o ka ʻai, ka hoʻoikaika kino, a me ka lāʻau lapaʻau inā pono.
  • Hoʻohaʻahaʻa i ka cholesterol: E hoʻohaʻahaʻa i ka LDL cholesterol e hoʻolohi i ka hana ʻana o ka plaque i loko o nā aʻa.
  • E mālama i ke kaumaha olakino: Hoʻokomo ke kaumaha nui i ke koʻikoʻi hou i kāu ʻōnaehana kahe koko.

  Hiki ke pono nā lāʻau lapaʻau no nā pilikia kahe koko nui. Hiki i kāu kauka ke kuhikuhi i nā lāʻau lapaʻau e hoʻomaikaʻi i ke kahe koko, pale i nā koko koko, a i ʻole e mālama i nā maʻi e like me ka maʻi diabetes a me ke koko kiʻekiʻe. I kekahi mau hihia, hiki ke ʻōlelo ʻia nā kaʻina hana e like me ka angioplasty a i ʻole ke ʻoki bypass e hoʻihoʻi i ke kahe koko.

  ʻO ke kī, ʻo ia ka hana pili pū me kāu hui mālama ola e hoʻomohala i kahi hoʻolālā piha i kūpono i kāu kūlana. Nui ka poʻe e ʻike i nā hoʻomaikaʻi nui i kā lākou ABI i loko o nā mahina o ka hana ʻana i nā loli ola mau, ʻoiai me ka hoʻoikaika kino mau a me ka haʻalele ʻana i ka puhi paka.

  He aha ka helu kuʻekuʻe-brachial maikaʻi loa?

  Aia ka helu kuʻekuʻe-brachial maikaʻi ma waena o 1.0 a me 1.2, e hōʻike ana ua like ke koko i loko o kou kuʻekuʻe wāwae a i ʻole ʻoi aku ka kiʻekiʻe ma mua o ke kaomi i kou lima. Hōʻike kēia pae i ke kahe koko maikaʻi loa me ka ʻole o nā paʻa nui i loko o kou mau aʻa wāwae.

  ʻO ka ABI o 1.0 ke ʻano o ke kaomi o kou kuʻekuʻe wāwae e like me ke kaomi o kou lima, he mea maʻamau a olakino. Manaʻo ʻia nā helu ma waena o 1.0 a me 1.2 he mea maikaʻi loa no ka mea e hōʻike ana lākou i ke kahe koko maikaʻi me ka hōʻike ʻole ʻana i nā aʻa paʻakikī loa.

  ʻOiai e manaʻo ʻia ana he maʻamau nā heluhelu a hiki i ka 1.3, ʻo nā waiwai kiʻekiʻe ma luna o 1.3 e hōʻike ana ua paʻakikī a i ʻole ua calcified kou mau ʻaʻa. ʻO kēia maʻi, i kapa ʻia ʻo medial sclerosis, ʻoi aku ka maʻamau i ka poʻe me ka maʻi diabetes a i ʻole ka maʻi kīkī maʻi. Hiki i nā ʻaʻa paʻakikī ke hoʻolilo i nā heluhelu ABI i mea hilinaʻi ʻole no ka ʻike ʻana i nā poloka.

  He mea pono e hoʻomaopopo i ka

  • Puhi paka: Hoʻonui nui ka hoʻohana ʻana i ka paka i kou pilikia a hoʻolalelale i ka ʻuʻuku ʻana o nā aʻa
  • Maʻi kō: Hoʻopōʻino ke kō koko kiʻekiʻe i nā kīʻaha koko a hoʻonui i ka pilikia PAD e 2-4 mau manawa
  • Ke koko kiʻekiʻe: Hoʻokau ka maʻi hypertension mau i ke kaomi hou i nā paia aʻa
  • Cholesterol kiʻekiʻe: Hoʻopili ka LDL cholesterol kiʻekiʻe i ka hana ʻana o ka plaque ʻona
  • Makahiki ma luna o 65: Lilo maoli nā aʻa i ka liʻiliʻi o ka maʻalahi a ʻoi aku ka maʻalahi i ka ʻuʻuku me ka makahiki
  • Mōʻaukala ʻohana: Hiki i nā kumu genetic ke hoʻolilo iā ʻoe i ka maʻi cardiovascular
  • Momona: Hoʻonui ke kaumaha nui i ka mumū a me ke kaomi ma kāu ʻōnaehana kaapuni
  • Ola noho mālie: Hoʻopili ka nele o ka hana kino i ke kahe ʻana o ke koko maikaʻi ʻole

  ʻO kekahi mau mea pilikia liʻiliʻi akā nui e pili ana i ka maʻi kīkī mau, nā kūlana mumū e like me ka rheumatoid arthritis, a me ka mōʻaukala o ka maʻi puʻuwai a i ʻole ka hahau. E kū ana nā ʻAmelika ʻApelika a me nā poʻe me ka hoʻoilina Hispanic i nā pilikia kiʻekiʻe no ka hoʻomohala ʻana i ka maʻi aʻa peripheral.

  ʻO ka nui o nā mea pilikia āu e loaʻa ai, ʻo ka nui o kou hiki ke hoʻomohala i nā pilikia kaapuni. Eia naʻe, hiki ke hoʻololi ʻia ka nui o kēia mau mea ma o nā loli ola a me ka mālama olakino kūpono, e hāʻawi ana iā ʻoe i ka mana nui ma luna o kou olakino vascular.

  ʻOi aku ka maikaʻi o ka loaʻa ʻana o ka index kuʻekuʻe-brachial kiʻekiʻe a haʻahaʻa paha?

  ʻAʻole maikaʻi nā helu index kuʻekuʻe-brachial kiʻekiʻe loa a haʻahaʻa paha. ʻO ka pahuhopu ka loaʻa ʻana o kahi ABI i ka pae maʻamau o 0.9 a 1.3, e hōʻike ana i ke kahe ʻana o ke koko olakino me ka ʻole o ka ʻoʻoleʻa aʻa a i ʻole nā ​​poloka.

  Hōʻike ka ABI haʻahaʻa (ma lalo o 0.9) ua ʻāiki a i ʻole ua paʻa nā aʻa o kou wāwae, e hōʻemi ana i ke kahe koko i kou mau wāwae a me nā wāwae. Hiki i kēia maʻi, i ʻike ʻia ʻo ka maʻi aʻa peripheral, ke alakaʻi i nā pilikia koʻikoʻi inā ʻaʻole i mālama ʻia. He mea hopohopo maoli nā heluhelu haʻahaʻa a pono e mālama ʻia e nā kauka.

  Ma kekahi ʻaoʻao, ʻaʻole maikaʻi ka ABI kiʻekiʻe (ma luna o 1.3). Hōʻike pinepine nā heluhelu kiʻekiʻe ua paʻakikī a i ʻole ua calcified kou mau aʻa, hiki ke hana me ka maʻi diabetes, ka maʻi kīkī, a i ʻole ka ʻelemakule. ʻAʻole hiki i nā aʻa paʻakikī ke paʻi pono i ka wā o ka hoʻāʻo ʻana, e alakaʻi ana i nā heluhelu kiʻekiʻe i hana hewa ʻia ʻaʻole e hōʻike pololei i kou kūlana kahe koko maoli.

  Ke kiʻekiʻe loa kāu ABI, pono paha i kāu kauka nā hoʻāʻo hou e like me ka index toe-brachial a i ʻole nā ​​palapala leo pulse e kiʻi i kahi kiʻi pololei o kou kahe koko. Hiki i nā heluhelu kiʻekiʻe loa ke hōʻike i ka piʻi ʻana o ka pilikia cardiovascular, ʻoiai inā maikaʻi ke kahe koko o kou wāwae.

ʻO ka wahi maikaʻi ka mālama ʻana i kahi ABI ma waena o 1.0 a me 1.2, e hōʻike ana i ke kahe koko maikaʻi me nā aʻa olakino a maʻalahi. Hōʻike kēia pae i ka hana pono ʻana o kou puʻuwai i ke koko i kou mau wāwae me ka ʻole e hālāwai me ke kūʻē nui mai nā aʻa i ʻāiki a i ʻole i paʻakikī.

He aha nā pilikia hiki ke loaʻa i ka index ankle-brachial haʻahaʻa?

Hōʻike ka index ankle-brachial haʻahaʻa i ka hoʻemi ʻia o ke kahe koko i kou mau wāwae a me nā wāwae, hiki ke alakaʻi i nā pilikia koʻikoʻi inā ʻaʻole i mālama pono ʻia. ʻO ka hoʻomaopopo ʻana i kēia mau pilikia hiki ke kōkua i ka hoʻololi ʻana i ke ʻano o ke ola a me ka mālama ʻana i ka lāʻau lapaʻau e hiki ke pale a hōʻemi paha i kēia mau pilikia.

Hoʻomohala mālie nā pilikia maʻamau o ke kahe koko wāwae maikaʻi ʻole a hiki ke ʻino i ka manawa:

• ʻEha wāwae i ka hele (claudication): ʻAʻole lawa ka oxygen i nā ʻiʻo i ka wā e hana ai, e hoʻoulu ana i ka ʻeha a i ʻole ka ʻeha
• Hoʻōla lohi o ka ʻeha: ʻOki, nā ʻeha, a i ʻole nā ​​ʻeha ma kou mau wāwae a me nā wāwae e lōʻihi loa ka hoʻōla
• Nā loli ʻili: Hiki i kou mau wāwae ke lilo i keʻokeʻo, uliuli, a i ʻole e loaʻa i kahi hiʻohiʻona ʻālohilohi
• Ka nalowale o ka lauoho: Hiki i ka hoʻemi ʻana i ke kahe ke kumu e pau ai ka ulu ʻana o ka lauoho ma kou mau wāwae a me nā wāwae
• Nā pilikia kui: Hiki i nā kui wāwae ke mānoanoa, palupalu, a i ʻole e ulu lohi
• ʻIke wela: Hiki i kou mau wāwae a me nā wāwae ke anu mau

Hiki ke hoʻomohala ʻia nā pilikia koʻikoʻi i nā hihia koʻikoʻi kahi i hoʻopilikia nui ʻia ai ke kahe. ʻO kēia mau mea e pili ana i ka ʻeha mau ʻoiai i ka hoʻomaha ʻana, nā ʻōpū ʻole a i ʻole nā ​​ʻeha, a i nā hihia kakaʻikahi, ka make ʻana o ka ʻiʻo (gangrene) e koi ai i ka amputation.

ʻO ka poʻe me ka ABI haʻahaʻa e kū ana i ka piʻi ʻana o ka pilikia o ka puʻuwai a me ka hahau ʻana no ka mea ʻo ke kaʻina hana maʻi like e pili ana i nā aʻa wāwae e pili pinepine i nā aʻa coronary a me ka lolo. Eia naʻe, me ka mālama olakino kūpono a me nā hoʻololi ʻana i ke ola, hiki i ka hapa nui o ka poʻe me PAD ke pale i kēia mau pilikia koʻikoʻi a mālama i ke ola maikaʻi.

He aha nā pilikia hiki ke loaʻa i ka index ankle-brachial kiʻekiʻe?

ʻOiai ʻo ka index ankle-brachial kiʻekiʻe e ʻike ʻia he mea makemake ʻia ma mua o ka haʻahaʻa, hiki i nā helu ma luna o 1.3 ke hōʻike i ka ʻoʻoleʻa arterial e lawe mai i kāna mau pilikia ponoʻī. Hoʻopili pinepine ʻia kēia mau pilikia i nā kūlana ma lalo e hoʻoulu ai i ka ʻoʻoleʻa o ka ʻaʻa ma mua o ka ABI kiʻekiʻe.

ʻO nā helu ABI kiʻekiʻe e hana pinepine ʻia i ka poʻe me ka maʻi diabetes, ka maʻi kīkī maʻi, a i ʻole ka makahiki kiʻekiʻe, a ʻo nā pilikia e hōʻike pinepine i kēia mau kūlana ma lalo:

• Nā pilikia o ke kahe koko i hūnā ʻia: Hiki i nā aʻa paʻakikī ke hūnā i nā poloka maoli, e paʻakikī ai ka ʻike ʻana i ka PAD
• Hoʻonui ʻia ka pilikia o ka maʻi cardiovascular: Hōʻike pinepine ka paʻakikī o nā aʻa i ka maʻi vascular ākea
• Hoʻōla ʻeha maikaʻi ʻole: ʻOiai ke kahe koko maʻamau, hiki nō ke hoʻopōʻino ʻia ka hoʻōla ʻana o ka ʻiʻo
• Nā pilikia o ka maʻi diabetes: Hōʻike pinepine ka ABI kiʻekiʻe i ka maʻi diabetes i ka maʻi microvascular holomua
• Nā pilikia e pili ana i ka puʻupaʻa: Hiki i ka paʻakikī o nā aʻa ke hoʻonui i ka hana o ka puʻupaʻa i ka wā

ʻO ka hopohopo nui me ka ABI kiʻekiʻe, hiki iā ia ke hāʻawi i ka hōʻoia wahaheʻe e pili ana i ke kūlana o kou kahe koko. Pono paha kāu kauka i nā hoʻokolohua hou e kiʻi i kahi kiʻi pololei o ke kahe koko i kou mau wāwae a me nā wāwae. Hiki i kēia ke komo i nā ana index toe-brachial a i ʻole nā ​​haʻawina kiʻi kiʻi hou.

Pono ka poʻe me nā helu ABI kiʻekiʻe mau i ka nānā pono ʻana no ka maʻi cardiovascular a pono paha i ka mālama ʻana i nā kūlana maʻi e like me ka maʻi diabetes a i ʻole ka maʻi puʻupaʻa. ʻO ka pahuhopu ka pale ʻana i ka holomua ʻana o ka paʻakikī o nā aʻa i ka hōʻoia ʻana i ke kahe koko kūpono i kou mau wēlau.

I ka manawa hea wau e ʻike ai i ke kauka no ka index ankle-brachial?

Pono ʻoe e noʻonoʻo e kiʻi i kahi hoʻokolohua index ankle-brachial inā he mau mea pilikia kāu no ka maʻi artery peripheral a i ʻole e ʻike nei i nā hōʻailona e hōʻike ana i nā pilikia o ke kahe koko. Hiki i ka ʻike mua a me ka mālama ʻana ke pale i nā pilikia koʻikoʻi a hoʻomaikaʻi i kou maikaʻi o ke ola.

Nui nā kūlana e pono ai ke kūkākūkā me kāu kauka e pili ana i ka hoʻāʻo ABI:

• Ua ʻoi aku ma luna o 65 makahiki: Manaʻo ʻia ka nānā maʻamau me ka nānā ʻole i nā hōʻailona
• ʻEha wāwae i ka hele ʻana: Ka ʻūlū, ka ʻeha, a i ʻole ka luhi i kou mau wāwae i ka wā e hana ana
• Nā ʻeha e lohi ana i ka hoʻōla: Nā ʻoki a i ʻole nā ʻeha ma kou mau wāwae a i ʻole nā wāwae ʻaʻole e hoʻōla i loko o nā manawa maʻamau
• Ke kū ʻana o nā mea pilikia: Maʻi diabetes, puhi paka, ke koko kiʻekiʻe, a i ʻole ka cholesterol kiʻekiʻe
• Mōʻaukala ʻohana: Nā ʻohana pili me ka maʻi artery peripheral a i ʻole ka maʻi cardiovascular
• Nā pilikia wāwae: Nā wāwae anuanu, nā loli kala, a i ʻole ka emi ʻana o ka pulupulu i kou mau wāwae

Pono ʻoe e ʻimi koke i ka lāʻau lapaʻau inā loaʻa iā ʻoe ka ʻeha wāwae nui i ka wā hoʻomaha, nā ʻeha hāmama ʻaʻole e hoʻōla, a i ʻole nā hōʻailona o ka maʻi i nā ʻeha ma kou mau wāwae a i ʻole nā wāwae. Hōʻike paha kēia mau hōʻailona i nā pilikia o ka holo ʻana o ke koko e pono ai ka lāʻau lapaʻau wikiwiki.

Inā ua loaʻa iā ʻoe kahi hoʻāʻo ABI a he mea maʻamau ʻole kāu mau hopena, e hahai i nā ʻōlelo a kāu kauka no ka nānā ʻana a me nā hoʻāʻo hou. Kōkua nā nānā maʻamau i ka nānā ʻana i nā loli i kou holo ʻana o ke koko a hoʻoponopono i ka lāʻau lapaʻau e like me ka mea e pono ai.

Mai kali a hiki i ka wā e koʻikoʻi ai nā hōʻailona ma mua o ka ʻimi ʻana i ka loiloi. Nui ka poʻe me ka maʻi artery peripheral mua ʻaʻole loaʻa nā hōʻailona, e hana ana i nā hoʻāʻo screening e like me ka ABI i mea waiwai loa no ka ʻike mua a me ka pale ʻana.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka index ankle-brachial

Q.1 He mea maikaʻi anei ka hoʻāʻo index ankle-brachial no ka ʻike ʻana i ka maʻi puʻuwai?

He mea maikaʻi loa ka hoʻāʻo index ankle-brachial no ka ʻike ʻana i ka maʻi artery peripheral i kou mau wāwae, a hiki iā ia ke hāʻawi i ka ʻike waiwai e pili ana i kou olakino cardiovascular holoʻokoʻa. ʻOiai ʻaʻole ia e hōʻoia pololei i ka maʻi puʻuwai, hōʻike pinepine ka ABI haʻahaʻa iā ʻoe he atherosclerosis (ka hoʻopili ʻana o ka artery) e pili pū ana i kou mau aʻa puʻuwai.

He nui ka pilikia o ka poʻe me ka maʻi ʻaʻaʻa peripheral i ka loaʻa ʻana o ka puʻuwai a me ka hahau ʻana no ka mea, ʻo ke kaʻina maʻi like e ālai ana i nā ʻaʻaʻa wāwae e pili pinepine ana i nā ʻaʻaʻa coronary a me ka lolo. Hōʻike nā haʻawina i ka poʻe me ka ABI haʻahaʻa he 2-3 mau manawa ʻoi aku ka pilikia o nā hanana cardiovascular i hoʻohālikelike ʻia me ka poʻe me nā helu maʻamau.

E hoʻohana kāu kauka i nā hopena ABI ma ke ʻano he ʻāpana o ka loiloi pilikia cardiovascular piha. Inā he abnormal kāu ABI, hiki iā lākou ke ʻōlelo i nā hoʻokolohua hou no kou puʻuwai, e like me ka EKG, ka hoʻāʻo koʻikoʻi, a i ʻole echocardiogram e kiʻi i kahi kiʻi piha o kou olakino cardiovascular.

Q.2 Ua hoʻokumu anei ka index ankle-brachial haʻahaʻa i ka ʻeha wāwae?

ʻAʻole i hoʻokumu pololei ka index ankle-brachial haʻahaʻa i ka ʻeha wāwae, akā hōʻike ia i ka emi ʻana o ke kahe koko e hiki ke alakaʻi i ka ʻeha i ka wā o ka hana kino. ʻO kēia ʻano ʻeha, i kapa ʻia ʻo claudication, e hana ʻia i ka wā ʻaʻole e loaʻa i kou mau ʻiʻo wāwae ke koko i waiwai i ka oxygen i ka wā e hoʻoikaika ai a hele wāwae paha.

ʻO ka maʻamau, ʻo ka claudication e like me ka ʻeha, ka ʻeha, a i ʻole ka luhi i loko o kou bipi, ʻūhā, a i ʻole nā ʻiʻo ʻūhā. Hoʻomaka ka ʻeha ma hope o ka hele ʻana i kahi mamao a hele aku i ka wā e hoʻomaha ai ʻoe. Ke ʻino ka holo ʻana, hiki ke emi mālie ka mamao e hiki ai iā ʻoe ke hele ma mua o ka ʻike ʻana i ka ʻeha.

ʻAʻole nā ​​mea a pau me ka ABI haʻahaʻa e ʻike i ka ʻeha wāwae. Hoʻomohala kekahi poʻe i nā ala koko ʻē aʻe (collateral circulation) e kōkua i ka mālama ʻana i ke kahe koko kūpono me ka ʻole o nā ʻaʻaʻa i hoʻopaʻa ʻia. Eia naʻe, inā he ABI haʻahaʻa a me ka ʻeha wāwae, he mea nui e hana pū me kāu kauka e hoʻomaikaʻi i ke kahe a mālama i nā hōʻailona.

Q.3 Hiki i nā hopena index ankle-brachial ke loli i ka manawa?

ʻAe, hiki i nā hopena index ankle-brachial ke loli i ka manawa, a ʻo ka nānā ʻana i kēia mau loli e kōkua i kāu kauka e nānā i ka holomua o ka maʻi ʻaʻaʻa peripheral a loiloi i ka pono o ka mālama ʻana. Hiki ke hana nā loli ma nā ʻaoʻao ʻelua, ma muli o nā mea like ʻole e pili ana i kāu kahe.

Hiki ke maikaʻi aʻe kāu ABI me nā loli ola e like me ka hoʻoikaika kino mau, ka haʻalele ʻana i ka puhi paka, a me ka mālama maikaʻi ʻana i ka maʻi diabetes, ke koko kiʻekiʻe, a me ka cholesterol. Nui ka poʻe e ʻike i nā hoʻomaikaʻi nui ʻana i kā lākou ABI i loko o 6-12 mau mahina o ka hana ʻana i nā loli olakino mau, ʻoiai me nā papahana hoʻoikaika kino i mālama ʻia.

Ma ka ʻaoʻao ʻē aʻe, hiki ke ʻino aʻe kāu ABI inā e holomua ka maʻi artery peripheral, ʻoiai inā ʻaʻole i mālama pono ʻia nā mea pilikia. ʻO ia ke kumu e ʻōlelo ai kāu kauka i ka hoʻāʻo ABI i kēlā me kēia manawa e nānā i kou kahe koko i ka manawa a hoʻoponopono i ka lāʻau lapaʻau e like me ka mea e pono ai.

Q.4 He ʻeha anei ka hoʻāʻo index ankle-brachial?

ʻAʻole ʻeha loa ka hoʻāʻo index ankle-brachial a manaʻo e like me ka nānā ʻana i kou koko i kahi kipa lapaʻau maʻamau. E ʻike ʻoe i ka manaʻo maʻamau o ka cuff koko e hoʻonui ana a puni kou lima a me kou kuʻekuʻe wāwae, akā ʻaʻohe mea ʻoluʻolu ʻole ma mua o kēlā.

I ka wā o ka hoʻāʻo ʻana, e moe ʻoluʻolu ʻoe ma luna o kahi papa hoʻokolokolo aʻoiai e hoʻopili ana kāu mea mālama ola i ka gel ultrasound i kou ʻili a hoʻohana i kahi mea Doppler e ʻimi i kāu mau pulsa. Hiki i ka gel ke ʻoluʻolu iki, akā ʻaʻole ia he ʻoluʻolu ʻole. Hoʻomaha wale ka mea Doppler ma kou ʻili a ʻaʻole ia e hana i kekahi manaʻo.

He 10-15 mau minuke ka hana holoʻokoʻa, a ʻike ka hapa nui o ka poʻe he mea hoʻomaha loa ia. Hiki iā ʻoe ke lohe i nā leo i hoʻonui ʻia o ke kahe koko ma o ka mea Doppler, he mea maʻamau loa ia a hōʻike wale nō e hana pono ana ka hoʻāʻo.

Q.5 Pehea ka pinepine e loaʻa ai iaʻu kahi hoʻāʻo index ankle-brachial?

Aia ka pinepine o ka hoʻāʻo index ankle-brachial i kāu mau mea pilikia pilikino, nā hōʻailona, ​​a me nā hopena hoʻāʻo mua. No ka hapa nui o ka poʻe, hoʻohana ʻia ka ABI ma ke ʻano he mea nānā hoʻokahi manawa, akā pono kekahi mau kūlana i ka nānā mau.

Inā maʻamau kāu ABI mua a ʻaʻohe ou hōʻailona a i ʻole nā mea pilikia, ʻaʻole pono ʻoe e hana hou i ka hoʻāʻo ʻana ke ʻole e loli kou kūlana olakino. Eia naʻe, inā e loaʻa iā ʻoe nā hōʻailona hou a i ʻole nā mea pilikia e like me ka maʻi diabetes, hiki i kāu kauka ke ʻōlelo aku i ka nānā ʻana i kēlā me kēia manawa.

Pono ka poʻe me nā hopena ABI maʻamau ʻole e hana hou i ka hoʻāʻo ʻana i kēlā me kēia 6-12 mahina e nānā i ka holomua o ka maʻi a me ka pane ʻana i ka lāʻau lapaʻau. E hoʻoholo kāu kauka i ka papa hana hoʻāʻo kūpono e pili ana i kou kūlana kikoʻī, nā hōʻailona, a me ka hoʻolālā lapaʻau. ʻO ka pahuhopu ka hopu ʻana i nā loli i ka wā mua me ka pale ʻana i nā hoʻāʻo pono ʻole.