Momma yensua Right Heart Catheterization ho ade?

So wo duruyɛfo aka akyerɛ wo sɛ yɛ nhwehwɛmu yi? Anaasɛ ebia wopɛ sɛ wuhu nneɛma pii kɛkɛ. Momma yɛnhwɛ nea ɛyɛ, sɛnea wɔyɛ, ne nea enti a wɔyɛ no tiawa. Mma ɛnhaw wo, mɛkyerɛkyerɛ biribiara mu akyerɛ wo.

Dɛn ne koma nifa a wɔde hyɛ nipadua no mu yi?

Sɛ yɛbɛka no tiawa a, eyi yɛ sɔhwɛ titiriw bi a wɔyɛ de hu sɛnea wo koma reyɛ adwuma yiye. Ne titiriw no, ɛkyerɛ mogya mmoroso ne oxygen dodow a ɛwɔ wo koma nifa ne w’ahurututu mu. Ɛtɔ mmere bi a wɔfrɛ eyi ahurututu mu ntini a wɔde hyɛ nipadua mu . Ebia afoforo nso bɛfrɛ no Swan-Ganz catheter nhwehwɛmu.

Nea ɛbɛyɛ na nnuruyɛfo ayɛ eyi no, wɔde afiri a ɛyɛ tratraa a ɛyɛ mmerɛw a wɔfrɛ no catheter . Wɔde saa afiri yi hyɛ ntini kɛse bi mu wɔ wo kɔn, wo srɛ, anaa wo nsa mu, na wɔde asaawa fa wo koma nifa so nkakrankakra na ɛkɔ mogya ntini titiriw a ɛde mogya kɔ w’ahurututu mu , ahurututu mu ntini no mu. Fa no sɛ wode mfoninitwa afiri ketewaa bi ahyɛ mu, nanso ɛsusuw nhyɛso ne mframa pa.

Dɛn nti na sɔhwɛ yi ho hia saa? Dɛn na ebehu?

Saa ``Right Heart Catheterization'' sɔhwɛ yi boa nnuruyɛfo ma wonya nsɛm fa nyarewa pii ho na wodi ho dwuma. Nhwɛso kakraa bi ni:

• Cardiogenic shock: Tebea a emu yɛ den a ɛba bere a koma no gyae mogya a ɛrebɔ yiye no.
• Cardiomyopathy: Yare a ɛma koma ntini no yɛ mmerɛw anaa ɛyɛ kɛse.
• Komayare a wɔde awo obi: Ebia wɔawo nnipa binom a wɔwɔ komayare bi. Hwɛ sɛ wɔwɔ bi anaa.
• Koma a entumi nyɛ adwuma yiye: Bere a koma no ntumi nkɔ mogya a ɛdɔɔso.
• Koma mu ntini mu yare: Bere a ntini a ɛwɔ koma no mu no ntumi nyɛ adwuma yiye.
• Ahurututu mu mogya mmoroso: Nhyɛso a ɛkɔ soro wɔ mogya ntini a ɛde mogya kɔ ahurututu mu no mu.

Afei nso, ɛtɔ da bi a saa sɔhwɛ yi betumi ayɛ nea ɛho hia ansa na wɔde akwaa foforo akɔma obi foforo anaasɛ bere a wɔde ama akyi, anaasɛ ansa na wɔde afiri titiriw bi a ɛboa koma no ahyɛ mu, te sɛ ``Left Ventricular Assist Device'' . Efisɛ eyi ma nnuruyɛfo hu tebea a ɛwɔ koma no mu no ho mfonini pefee.

Nsonsonoe bɛn na ɛwɔ koma no nifa a wobɛyɛ ne benkum fam a wobɛyɛ no ntam?

Yiw, nsonsonoe a ɛho hia wɔ abien no ntam. Ma yɛnhwɛ nea wɔyɛ.

Wɔ koma nifa mu catheter mu no, oduruyɛfo no de afiri a ɛyɛ tratraa (catheter) hyɛ ntini bi mu.. Ɛne sɛ, efi ntini bi a ɛde mogya fĩ kɔ mu. Eyi ne nea ɛkɔ koma no nifa. Eyi titiriw susuw nhyɛso a ɛwɔ w’ahurututu nifa, ahurututu nifa, ne ahurututu mu ntini a ɛde mogya kɔ w’ahurututu mu no mu.

Nanso wɔ benkum fam catheter mu no, wɔde catheter no hyɛ ntini bi mu . Ɛne sɛ, ntini a ɛde mogya a ɛho tew kɔ. Sɛ nhwɛso no, asen mu ntini a ɛwɔ nan no mu, brachial artery a ɛwɔ abasa no mu, anaa axillary artery a ɛwɔ abasa no mu. Eyi ne baabi a koma no benkum kɔ. Eyi susuw nhyɛso a ɛwɔ benkum so ahurututu no mu, hwɛ aorta ne ne valve , na ɛhwehwɛ biribiara a asiw wɔ ahrawa mu ntini a ɛde mogya kɔ koma no mu no mu. Wɔtaa frɛ nhwehwɛmu a wɔyɛ wɔ benkum so yi nso koma mu catheterization anaa coronary angiography . So wote nsonsonoe a ɛwɔ mu no ase?

Hena na ɔreyɛ sɔhwɛ yi? Ɛhe na wɔyɛ no?

Wɔyɛ saa `(Right Heart Catheterization)` sɔhwɛ yi wɔ dan titiriw bi mu wɔ ayaresabea hɔ. Wɔfrɛ no `Cardiac Catheterization Laboratory` anaa `cath lab` tiawa. Animdefo kuw bi a wɔatete wɔn na wɔyɛ. Mpɛn pii no, `Advanced Heart Failure Cardiologist` anaa `Interventional Cardiologist` na odi anim. Enti, wubetumi anya awerɛhyem sɛ wowɔ nsa pa mu.

Ɔkwan bɛn so na ɛsɛ sɛ wusiesie wo ho ma eyi?

Wo duruyɛfo bɛma wo akwankyerɛ pɔtee a ɛfa sɛnea wusiesie wo ho, nanso mpɛn pii no ɛyɛ biribi te sɛ eyi:

• Ɛsɛ sɛ woka nnuru a worenom nyinaa kyerɛ wo duruyɛfo. Nea ɛka eyi ho ne nnuru a wɔkyerɛw ma obi, nnuru a wɔde ka aduan ho, ne nnuru a wɔtɔn a wɔmfa nnuru nhyɛ mu. Ebia ɛho behia sɛ wogyae nnuru bi, titiriw nnuru a ekum mogya a ɛtwetwe/mogya a ɛma mogya tu , nna kakraa bi. Ɛsɛ sɛ wɔyɛ eyi sɛnea wo duruyɛfo ka kyerɛ wo no pɛpɛɛpɛ.
• Fa obi bra ma ɔde wo bɛkɔ fie wɔ sɔhwɛ no akyi, efisɛ ɛtɔ mmere bi a ebetumi ayɛ wo yaw kakra, anaasɛ sɛ wɔma wo nnuru a ɛma woda a, ɛnyɛ adwene pa sɛ wobɛka kar.
• Yɛsrɛ sɛ yi agude anaa nnadewa biara a ebia mohyɛ no fi hɔ.
• Nnidi anaa nnom biribiara nnɔnhwerew 6 kosi 12 ansa na woayɛ sɔhwɛ no. Eyi ho hia yiye, efisɛ yafunu a ɛda mpan ma sɔhwɛ no yɛ mmerɛw, na sɛ biribi si ntɛm a, wubetumi asiesie wo ho.

Ɛho hia paa sɛ wudi saa nneɛma yi akyi yiye na ama woatumi atwa sɔhwɛ no yiye.

Dɛn na ɛba ansa na sɔhwɛ no aba?

Bere a sɔhwɛ no reyɛ afi ase no, oduruyɛfo anaa ɔyarehwɛfo no bɛyɛ nea edidi so yi:

• Wɔbɛka akyerɛ wo sɛ hyɛ ayaresabea atade na totow (yi wo akisikuru).
• Wɔka kyerɛ wo sɛ da mpa soronko bi so.
• Wɔde nneɛma nketenkete bata wo moma so. Wɔfrɛ wɔn electrode ahorow . Eyinom ne nea ɛkɔ so hwɛ wo koma dwumadi te sɛ ECG.

Mpɛn pii no, eyi yɛ sɔhwɛ a wɔyɛ no ntɛm a wɔfrɛ no ``Right Heart Catheterization'', enti wɔmfa aduru nhyɛ wo koraa. Eyi kyerɛ sɛ wowɔ n’adwene. Nanso ɛtɔ da bi a, wobetumi de afiri ketewa bi a wɔfrɛ no ``IV line'' ahyɛ ntini bi mu wɔ wo basa mu, a wobetumi afa so ama wo nsu anaa nnuru a ɛma wo ho dwo a ɛbɛma wo ho adwo wo kakra anaasɛ woada. Wɔyɛ eyi na ama wo ho akyere wo no so atew.

Dɛn na ɛba bere a wɔreyɛ sɔhwɛ no? Dɛn na ɛsɛ sɛ yɛhwɛ kwan?

Sɔhwɛ no ankasa taa gye bɛyɛ dɔnhwerew biako. Nanso, bere a wɔde siesie ne ho ne bere a wɔde bɛsan anya ahoɔden wɔ sɔhwɛ no akyi no betumi agye nnɔnhwerew pii. Mma ɛnhaw wo, eyi yɛ ade a ɛfata.

Wobɛda wo ho so wɔ sɔhwɛ no nyinaa mu. Oduruyɛfo no bɛyɛ nea edidi so yi:

• Wɔbɛhohoro baabi a wɔde catheter no bɛhyɛ (asen, abasa, anaa kɔn) na sɛ ɛho hia a, wɔbɛyiyi nhwi a ɛwɔ hɔ no bi.
• Wɔde nnuru a ɛma obi dwensɔ kakra gu nipadua no mu de ma beae no yɛ mmerɛw. Afei worente ɛyaw biara nka. Ɛbɛyɛ te sɛ nea ntɛtea ketewaa bi rewe wo bere a wode aduru no ahyɛ wo mu no.
• Afei, wɔde ade titiriw anaa adwinnade ketewaa bi yɛ tokuru ketewaa bi wɔ ntini no mu. Eyi betumi ayɛ asen mu ntini a ɛwɔ wo nan mu, jugular ntini a ɛwɔ wo kɔn mu, anaa ntini bi a ɛwɔ wo nsa mu.
• Afei, wɔde saa afiri teateaa, catheter , no hyɛ mu nkakrankakra na wɔkyerɛ no kwan kɔ koma no ne mogya ntini no afã horow. Worente nka bere a wɔreyɛ no.
• Wɔsusuw nneɛma fi mmeae a ɛho hia, na ɛtɔ mmere bi a wobetumi afa koma no mu ntini ketewaa bi (tissue sample / biopsy) , a wɔnam saa catheter yi so nso yɛ.
• Ɛtɔ mmere bi a wobetumi aka akyerɛ wo sɛ tra hɔ dinn, sesa wo nipadua gyinabea, anaa home wɔ ɔkwan pɔtee bi so.
• Wɔ tebea horow bi mu no, ebia wo duruyɛfo nso bɛka akyerɛ wo sɛ teɛteɛ w’apɔw mu kakra (ebia denam wo nan a wode bɛbɔ pedal ketewaa bi so). Eyi bɛhwɛ sɛnea wo koma bɔ sesa bere a woreyɛ apɔw-mu-teɛteɛ no.
• Wubetumi nso afa IV a ɛwɔ wo nsa mu no so ama nnuru bi na woahu sɛnea wo koma yɛ ho biribi.
• Awiei koraa no, woyi catheter no na wɔto kuru ketewa no mu.

Biribiara nni hɔ a ɛsɛ sɛ wusuro, nnuruyɛfo ne ayarehwɛfo no nyinaa ka wo ho, sɛ wote nka sɛ biribi yɛ wo yaw a, ka kyerɛ wɔn.

Dɛn na ɛba wɔ sɔhwɛ no akyi?

Bere a wɔyɛɛ nhwehwɛmu no wiei no, nnuruyɛfo kuw no yii anyinam ahoɔden a wɔde abɔ ne moma so no.Wɔbɛyi IV no na wɔde ahyɛ mu Afei wɔde wo bɛkɔ dan a ɛyɛ soronko mu (dan a wɔsan nya ahoɔden) . Ɛhɔ na wɔbɛhwɛ nea edidi so yi mu yiye:

• So mogya bi fi baabi a wɔde catheter no hyɛɛ mu no reba?
• Mogya mmoroso.
• Koma a ɛbɔ.
• Nipadua mu hyew.

Wɔbɛhwɛ wo so kosi sɛ eyi nyinaa bɛsan aba sɛnea na ɛte kan no.

Bere tenten ahe na egye na obi ho atɔ no?

Aduruyɛ kuw no bɛtwɛn wo nnɔnhwerew kakraa bi. Nnipa dodow no ara tumi kɔ fie wɔ ɛno akyi. Nanso kae sɛ wobɛma obi aka wo kar efisɛ ebia wobɛte nka sɛ woada kakra anaasɛ woabrɛ.

Nanso, sɛ sɔhwɛ no hu biribi a anibere wom a, ebia ebehia sɛ woyɛ nhwehwɛmu foforo, wo nsa kɔ wo yare, anaa wotra ayaresabea. Oduruyɛfo no bɛka eyi ho asɛm akyerɛ wo.

So sɔhwɛ yi yɛ yaw?

Eyi yɛ asɛm a nnipa pii bisa. Ka nea wote nka wɔ nhwehwɛmu no nyinaa mu kyerɛ oduruyɛfo no.

Mpɛn pii no, wobɛte ɛyaw kakra bere a wɔde aduru a ɛma wo ho yɛ wo hyew no ama wo no. Ebia wobɛte nhyɛso kakra nso nka bere a wɔde catheter no ahyɛ mu no. Nea ɛka ho no, ebia nnipa binom behyia nea edidi so yi:

• Bere a catheter no bɔ wo koma afasu no, ebia wobɛte nka sɛ wo moma so rehuruhuruw anaasɛ wobɛhuruw abɔ wo. Eyi yɛ ade a ɛfata, enti mma ɛnhaw wo.
• Ebia nnipa binom ti bɛyɛ wɔn yaw .
• Ebia wobɛte nka sɛ wo ho ayɛ wo yaw (tiyɛ a ɛyɛ hare) .
• Ebia akisikuru betumi aba.
• Ebia wobɛte nhyɛso kakra nka bere a catheter no fa mogya ntini no mu no.
• Ebia wobɛte nka sɛ wopɛ sɛ wofefe .
• Nnuru bi betumi ama wo ho ayɛ hyew kakra anaasɛ wo ho ayɛ wo hyew .

Nea wote nka biara no, ka kyerɛ oduruyɛfo anaa ɔyarehwɛfo no. Wɔbɛboa wo.

So asiane ahorow bi wɔ sɔhwɛ yi mu?

`(Right Heart Catheterization)` taa yɛ sɔhwɛ a ahobammɔ wom . Nanso, te sɛ aduruyɛ mu nhwehwɛmu biara no, ebetumi de asiane ahorow bi aba. Esiane sɛ ɛyɛ adeyɛ a wɔde hyɛ nipadua mu nti , ɛho hia sɛ wuhu nea saa asiane ahorow no yɛ:

• Nnuru anaa nneɛma a wɔde di dwuma no ho akisikuru .
• Koma a ɛbɔ a ɛnteɛ `(Arrhythmia)` .
• Mogya ntini nketenkete a ɛsɛe (Artery damage) (eyi ntaa nsi).
• Mogya anaa akuru betumi aba wɔ baabi a wɔde catheter no hyɛɛ mu no.
• Mogya a ɛbɛtɔ no betumi aba (eyi nso ho yɛ na yiye).
• Ɛntaa mma koraa, koma mu akisikuru , .Ebetumi ayɛ biribi te sɛ komayare anaasɛ akisikuru . Eyinom ho yɛ na koraa, nanso ɛho hia sɛ wohu.
• Ebia ɔyare mmoawa bɛba.
• Ahurututu a abubu (eyi nso ho yɛ na yiye).

Nea ɛho hia ne sɛ asiane ahorow yi mu dodow no ara sua koraa. Sɛ nnuruyɛfo susuw sɛ mfaso a ɛwɔ so no sõ koraa sen asiane nketenkete a ɛwɔ mu no nkutoo a, na wɔyɛ nhwehwɛmu yi. Sɛ wowɔ nsɛmmisa bi fa eyi ho a, nsuro sɛ wubebisa wo duruyɛfo.

Bere bɛn na mɛhu nea efi sɔhwɛ no mu aba?

Mpɛn pii no, oduruyɛfo no bɛka nea ebefi mu aba no ho asɛm akyerɛ wo ansa na woakɔ fie. Anaasɛ, wɔbɛka akyerɛ wo sɛ san bra da foforo abɛka nea ebefi mu aba no ho nkɔmmɔ (`akyi nhyehyɛe`) . Nanso, wɔbɛma wo nea ebefi mu aba no ho nkyerɛkyerɛmu a emu da hɔ.

Ɔkwan bɛn so na ɛsɛ sɛ mehwɛ me ho wɔ sɔhwɛ no akyi?

Sɛ wokɔ fie pɛ a, wo duruyɛfo anaa ɔyarehwɛfo bɛma wo akwankyerɛ a ɛfa sɛnea wobɛtra hɔ, nea ɛsɛ sɛ woyɛ, ne nea ɛnsɛ sɛ woyɛ ho. Wɔtaa ka nsɛm te sɛ eyi:

• Kwati sɛ wobɛkotow, wobɛma so, wobɛpia wo ho, anaa wobɛtwe nnɔnhwerew pii, anaa nna pii mpo. Eyi betumi aka baabi a wɔde catheter no gu no.
• Sɛ wɔama wo aduru a ɛma woda a ɛma woda a, nka kar anaa mfa mfiri a emu yɛ duru nni dwuma bere tiaa bi.
• Nom nsu pii. Ɛboa ma mmoawa fi nipadua no mu na ɛboa nso ma aduru no fi nipadua no mu.
• Fa aduru a wɔde kyekyere aduru no si baabi a wɔde catheter no hyɛɛ mu no so da koro anaa nnanu. Sesa no sɛnea wo duruyɛfo kyerɛ no.
• Wubetumi de nsukyenee ahyɛ beae hɔ na ama ɛyaw anaa ɔfe biara a ɛbɛtew so .
• Nguare nnɔnhwerew 24 kosi 48 wɔ sɔhwɛ no akyi. Kwati sɛ wobɛguare kosi sɛ kuru no bɛsa koraa.
• Sɛ kuru no yɛ nsu a, bɔ no brɛoo ma ɛnwo, a womfa ahoɔden ntwiw so.

Akwankyerɛ ahorow yi a wubedi akyi yiye no ho hia yiye na ama obi ho atɔ no ntɛmntɛm.

Bere bɛn na wopɛ sɛ wo ne oduruyɛfo no kasa bere a wɔayɛ nhwehwɛmu no awie no?

Sɛ wohu saa sɛnkyerɛnne yi bi wɔ nhwehwɛmu no akyi a, ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn anaa wokɔ ayaresabea ntɛm ara:

• Sɛ mogya fi baabi a wɔde catheter no retu, anaasɛ akuru kɛse bi ayɛ wɔ hɔ a.
• Sɛ koma no bɔ ntɛmntɛm anaasɛ ɛnte saa a.
• Sɛ nan anaa basa a wɔde catheter no ahyɛ mu no yɛ yaw, dan bruu, ɛyɛ nwini, anaasɛ ɛyɛ mmerɛw a.
• Nhumu a wɔhwere.
• Komayare ho sɛnkyerɛnne:Koko mu yaw anaa nhyɛso, fifiri a ɛboro so, ahome a ɛyɛ tiaa.
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya ɔyare no: Atiridiinini, kɔkɔɔ, nsu a ɛte sɛ akisikuru, ɔfe, ne ɔhyew wɔ baabi a wɔde catheter no gu no.

Sɛ biribi te sɛ eyi si a, hwehwɛ aduruyɛ mu afotu a ɛnkyɛ.

Enti, nkrasɛm a etwa to a wɔde kɔ fie:

Okay, enti mewɔ anidaso sɛ seesei woanya ntease pa wɔ sɔhwɛ a yɛkaa ho asɛm a wɔfrɛ no ``Right Heart Catheterization'' no ho.

Sɛ yɛbɛka no tiawa a, eyi yɛ sɔhwɛ a wɔde susuw nhyɛso a ɛwɔ ahurututu nifa, ahurututu, ne ahurututu mu ntini mu. Eyi boa nnuruyɛfo ma wohu koma ne ahurututu mu nyarewa na wɔsa.

Sɛ oduruyɛfo bi ka kyerɛ wo sɛ yɛ nhwehwɛmu yi a, oduruyɛfo no bɛkyerɛkyerɛ biribiara mu akyerɛ wo, a nea enti a wɔayɛ, sɛnea wobesiesie wo ho ama no, ne nea nea ebefi mu aba no bɛkyerɛ ka ho. Nsuro, bisa sɛ wowɔ nsɛmmisa bi a. Ade a ɛho hia sen biara ne sɛ wobɛhwɛ w’akwahosan yiye.

` Koma mu catheterization, koma mu nhwehwɛmu, ahurututu mu mogya mmoroso, komayare, cath lab, koma akwahosan, aduruyɛ mu nhwehwɛmu