Hwehwɛ wo mogya a ɛtwetwe no ho asɛm denam D-Dimer nhwehwɛmu no so!

Ebia woate sɔhwɛ yi a wɔfrɛ no D-Dimer ho asɛm. Anaasɛ ebia wo duruyɛfo aka akyerɛ wo sɛ yɛ. Enti, dɛn ne D-Dimer? Dɛn nti na sɔhwɛ yi ho hia saa? Momma yɛnka eyinom nyinaa ho asɛm nkɔ akyiri, tiawa koraa, nnɛ. Mebɛkyerɛkyerɛ mu wɔ ɔkwan a wobɛtumi ate aseɛ so.

Dɛn ne D-Dimer? Sɛ yɛbɛka no tiawa a...

Susuw ho saa kwan yi so: D-Dimer yɛ protein ketewaa bi a ɛba bere a mogya a ɛtɔ gu wo nipadua mu no tew. Mpɛn pii no, sɛ mogya a ɛtwetwe pii nni wo nipadua mu, anaasɛ mogya a ɛtwetwe no ntumi nsɛe a, ɛkame ayɛ sɛ D-Dimer biara nni wo mogya mu. Anaasɛ ɛwɔ hɔ kakraa bi pɛ.

Afei, sɛ wo D-Dimer nhwehwɛmu no mu aba no yɛ papa anaasɛ wo D-Dimer dodow kɔ soro a , ebetumi akyerɛ sɛ wowɔ mogya a ɛtwetwe. Nanso, ɛnkyerɛ ankasa sɛ wowɔ saa tebea no . Afei nso, D-Dimer nhwehwɛmu nkutoo ntumi nkyerɛ wo mogya a ɛtwetwe tebea ko a wowɔ anaa baabi a mogya a ɛtwetwe no wɔ wo nipadua mu no ankasa. Sɔhwɛ foforo ho hia na ama wɔahu saa.

Ɔkwan bɛn so na mogya a ɛtwetwe no ba ankasa?

Momma yenni kan te nea ɔkwan a ɛfata a ɛma mogya tu no ase. Nokwarem no, mogya a ɛtwetwe no yɛ ade a ɛho hia na ɛho hia paa. Sɛ wupira a, saa adeyɛ yi boa ma mogya pii gyae. Fa no sɛ, sɛ wopira mogya ntini anaa ntini bi mu na wufi ase tu mogya a, wo nipadua no fi ase yɛ adeyɛ bi a wɔfrɛ no ``hemostasis``. Eyi na ɛto mogya a ɛretu no ano hye na awiei koraa no ɛma mogya tu na ama agyae.

Wɔ saa ``hemostasis'' yi mu no, wo nipadua no yɛ protein bi a wɔfrɛ no ``fibrin,`` a ɛyɛ ahama no nhama. Saa ahama yi, ne nkwammoaa bi a wɔfrɛ no ``platelet,`` boa ma mogya a ɛtwetwe no kɔ so tra hɔ kosi sɛ kuru no bɛsa. Ɛtɔ mmere bi a, saa ntini a ɛyɛ mmerɛw yi betumi ada adi sɛ akisikuru wɔ wo honam ani anaasɛ sɛ akuru a ɛwɔ wo honam ani.

Sɛ wo kuru no sa, na wo nipadua no nhia mogya a ɛtɔ no bio a, wo nipadua no yɛ enzyme bi a wɔfrɛ no ``plasmin'' a ɛpaapae akisikuru no mu nketenkete na yi fi hɔ. Wɔfrɛ saa asinasin yi ``fibrin degradation products'' anaa ``fibrin split-products''. Wɔfrɛ saa asinasin no mu biako D-Dimer.

Nanso, sɛ wowɔ yare bi a ɛma mogya tu a, wubetumi anya mogya a ɛtwetwe a wompira mpo. Anaasɛ, ebia ntini a ayɛ no rensɛe bere a ɛsɛ sɛ ɛyɛ no. Sɛ yɛbɛka no tiawa a, wo nipadua no mogya a ɛtwetwe no ntumi nyɛ adwuma yiye. Saa mogya a ɛtwetwe yi betumi ayɛ nea asiane wom na ɛde nkwa mpo ato asiane mu.

Enti, D-Dimer dodow a ɛkɔ soro wɔ wo mogya mu no betumi ayɛ sɛnkyerɛnne a ɛkyerɛ sɛ wo nipadua no reyɛ mogya a ɛtɔ na ɛrepaapae kɛse. Ɛno nti na ɛyɛ mogya a ɛtwetwe no ho sɛnkyerɛnne.

Dɛn ne D-Dimer sɔhwɛ a wɔde hu?

Nnuruyɛfo taa de D-Dimer nhwehwɛmu di dwuma de boa ma wohu mogya a ɛtwetwe mogya. Tebea atitiriw no bi ne:

• Deep Vein Thrombosis (DVT) anaa Venous Thrombosis: Eyi ne bere a mogya a ɛtɔ gu ntini bi a ɛwɔ wo nipadua mu tɔnn mu. Saa mogya a ɛtwetwe yi betumi asiw mogya a ɛsen fa ntini no mu no ano koraa anaa ne fã bi. DVT taa ba wɔ nan ase, asen, anaa asen mu. Nanso, ebetumi aba nipadua no afã afoforo te sɛ abasa, amemene, dwensɔtwaa, mmerɛbo, anaa asaabo nso.
• Pulmonary Embolism (PE): Eyi ne bere a mogya a ɛtwetwe a ayɛ nipadua no fã foforo (mpɛn pii no wɔ nan anaa abasa mu) fa mogya no mu na ɛkɔhyɛ mogya ntini bi mu wɔ ahurututu no mu. Eyi yɛ tebea a ɛyɛ hu paa.
• Disseminated Intravascular Coagulation (DIC): Wɔ tebea yi mu no, mogya a ɛtɔ gu wo nipadua mu pii dodo . Eyi betumi asɛe akwaa ahorow na ɛde ɔhaw afoforo a emu yɛ den aba. Ɛnyɛ sɛ wɔde D-Dimer sɔhwɛ no di dwuma de hu DIC nko, na mmom wɔde hwɛ sɛnea DIC ayaresa reyɛ adwuma yiye nso.
• Akisikuru: Wɔ tebea yi a yɛsan frɛ no "mogya a ɛtwetwe wɔ amemene no mu" mu no, mogya ntini bi a ɛwɔ amemene no mu no siw anaasɛ ɛpae.

Dɛn nti na mihia D-Dimer sɔhwɛ?

Sɛ wowɔ mogya a ɛretu ho sɛnkyerɛnne a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ D-Dimer nhwehwɛmu. Eyinom yɛ tebea horow te sɛ `(DVT)`, `(PE)`, `(DIC)`, `(Stroke)` a yɛaka ho asɛm wɔ atifi hɔ no ho sɛnkyerɛnne.

Mpɛn pii no, wɔyɛ D-Dimer nhwehwɛmu wɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ anaa ayaresabea.

Dɛn ne ntini a emu dɔ a ɛma mogya tu (DVT) ho sɛnkyerɛnne?

DVT taa ba wo nan anaa wo nsa so. Ɛnyɛ obiara na ɔwɔ yare no ho sɛnkyerɛnne. Nanso, ebia wubenya yare no ho sɛnkyerɛnne te sɛ:

• Nan anaa nsa a ɛho ahonhon (ɛtɔ mmere bi a mpofirim).
• Nan mu yaw anaasɛ ɛyɛ mmerɛw (betumi ate bere a wogyina hɔ anaa wonam nkutoo).
• Nkate a ɛho ahonhon na ɛyɛ yaw wɔ nan anaa abasa mu.
• Wora a ɛyɛ kɔkɔɔ anaasɛ ne kɔla bɛsakra.
• Mogya ntini a ɛwɔ honam ani no te sɛ nea ɛsõ sen sɛnea ɛte daa.

Sɛ wowɔ saa `(DVT)` ho sɛnkyerɛnne yi a, sɛ mpo wo nni ayaresabea mprempren a, kɔ wo duruyɛfo nkyɛn ntɛm ara sɛnea wubetumi.

Dɛn ne ahurututu mu ntini a ɛma mogya tu (PE) ho sɛnkyerɛnne?

Eyi yɛ asɛm a egye ntɛmpɛ. `(PE)` bi su ne:

• Ɔhome a ɛyɛ den mpofirim (dyspnea) anaasɛ ɔhome ntɛmntɛm.
• Koko mu yaw a ano yɛ den (ɛtaa yɛ kɛse bere a ɔrefefe anaasɛ ɔretu).
• Akyi yaw.
• Ɔfe (ɛtɔ mmere bi a mogya ayɛ no fĩ).
• Fifiri a ɛba nipadua no mu sen sɛnea ɛtaa ba.
• Koma a ɛbɔ ntɛmntɛm (tachycardia).
• Adwene a ɛyɛ basaa anaasɛ obi a ɔtotɔ piti.

Nea ɛho hia: Sɛ wowɔ saa `(PE)` sɛnkyerɛnne yi a, ɛsɛ sɛ wofrɛ 911 anaa wokɔ dan a ɛbɛn wo a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu ntɛm ara. Ɛnsɛ sɛ wɔtwentwɛn eyi ase.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ ntini mu mogya a ɛtrɛw (DIC)?

DIC ho sɛnkyerɛnne betumi ayɛ:

• Mogya a ɛretu wɔ anom.
• Akisikuru ne/anaasɛ ɔfe.
• Ntini mu yaw a emu yɛ den ne yafunu mu yaw.
• Nneɛma a ɛma obi ho popo.
• Nsu a ɛba kakraa bi sen sɛnea ɛte daa.

Sɛ wɔahu sɛ wowɔ DIC dedaw na worenya ayaresa a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ D-Dimer nhwehwɛmu daa de hwɛ sɛ w’ayaresa no reyɛ adwuma yiye anaa.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya ɔyare a ɛma obi hwe ase?

obubuafo nso yɛ ade a egye ntɛmpɛ. Nsɛnkyerɛnne no ne:

• Anim, nsa, anaa nan (titiriw wɔ nipadua no fã biako) a ɛyɛ mmerɛw anaa ɛyɛ mmerɛw mpofirim.
• Adwene a ɛyɛ basaa mpofirim, ɛyɛ den sɛ wobɛkasa, anaa ɛyɛ den sɛ wobɛte nea obi reka ase.
• Ɛyɛ den mpofirim sɛ wubehu ade wɔ aniwa biako anaa abien no nyinaa mu.
• Nantew a ɛyɛ den mpofirim.
• Adwene a ɛyɛ basaa mpofirim, sɛ obi ntumi nkari pɛ, anaasɛ ontumi nyɛ adwuma yiye.
• Tiyɛ a emu yɛ den a ɛba mpofirim a ntease biara nnim.

Nea ɛho hia kɛse: Sɛ wo anaa obi foforo nya saa sɛnkyerɛnne ahorow yi a ɛkyerɛ sɛ obi anya ɔyare a ɛma obi hwe ase , ɛsɛ sɛ wofrɛ 911 anaa wokɔ ayaresabea a ɛbɛn wo ntɛm ara. Bere yɛ ade titiriw.

Hena na ɔyɛ D-Dimer sɔhwɛ no? Wɔyɛ no dɛn?

Mpɛn pii no, oduruyɛfo a ɔhwɛ mogya a ɛma mogya tu no na ɔtwe mogya no, a D-Dimer nhwehwɛmu no ka ho. Nanso, akwahosan ho ɔbenfo biara a wɔatete no sɛ ɔntwe mogya betumi ayɛ. Afei wɔde wo mogya no kɔ aduruyɛdan mu. Ɛhɔ no, nyansahufo bi a ɔwɔ aduruyɛdan mu siesie nhwɛsode no na ɔsɔ hwɛ wɔ mfiri a wɔfrɛ no analyzers so.

So ɛsɛ sɛ meyɛ biribi ansa na wɔayɛ sɔhwɛ no?

Dabi, enhia sɛ woyɛ biribi titiriw biara ansa na woayɛ D-Dimer sɔhwɛ. Wubetumi atra ase sɛnea ɛsɛ.

Dɛn na ɛba bere a wɔreyɛ sɔhwɛ no?

D-Dimer yɛ mogya mu nhwehwɛmu. Enti sɛ wofa mogya a, eyinom ne nneɛma a ɛba:

• Wobɛtena nkongua so anaasɛ wobɛda mpa so. Afei akwahosan ho ɔbenfo no bɛhwɛ wo nsa na wanya ntini bi a ɛnyɛ den sɛ obetumi atwe mogya afi mu. Mpɛn pii no, ɛwɔ wo nsa no mu, wɔ wo nsateaa akyi pɛɛ.
• Sɛ wohu ntini bi a, wɔhohoro mu na wɔde nnuru a ekum mmoawa gu mu.
• Afei wɔde ade ketewaa bi hyɛ wo ntini mu na wogye mogya. Eyi bɛyɛ te sɛ ntɛtea ketewaa bi a wɔaka no.
• Sɛ wɔde ade no hyɛ mu wie a, mogya kakra bɛboaboa ano wɔ afiri bi a wɔde yɛ nhwehwɛmu mu.
• Sɛ wɔgye mogya a ɛdɔɔso ma nhwehwɛmu no wie a, woyi ade no na wɔde kotoku anaa gauze bi gu beae no so na ama mogya no agyae.
• Afei wɔde plaster gu beae no na wowie adwuma no.

Mpɛn pii no, saa adeyɛ yi nyinaa gye nea ennu simma anum. Ntɛmntɛm paa.

Dɛn na ɛba wɔ sɔhwɛ no akyi?

Sɛ wɔfa wo mogya wie a, wɔde kɔ aduruyɛdan mu. Sɛ sɔhwɛ no aba wie a, wo duruyɛfo bɛka nea efii mu bae no akyerɛ wo.

So asiane ahorow bi wɔ D-Dimer sɔhwɛ no mu?

Mogya mu nhwehwɛmu yɛ aduruyɛ mu nhwehwɛmu a abu so yiye na ɛho hia. Asiane a ɛwɔ mogya mu nhwehwɛmu a wɔbɛyɛ mu no sua koraa. Ebia wobɛte yaw kakra anaasɛ woapirapira baabi a wɔtwee mogya no. Nanso ɛno befi hɔ ntɛm. Enti biribiara nni hɔ a ɛsɛ sɛ wohaw wo ho wɔ ho.

Dɛn na nea efii D-Dimer sɔhwɛ no mu bae no kyerɛ?

Mogya mu nhwehwɛmu amanneɛbɔ, D-Dimer nhwehwɛmu amanneɛbɔ mpo, taa kura nsɛm te sɛ eyi:

• Mogya mu nhwehwɛmu no din, anaa nea wɔsusuu wɔ wo mogya mu.
• Wo mogya mu nhwehwɛmu aba no dodow anaa susuw.
• Range a ɛfata ma saa sɔhwɛ no.
• Nsɛm a ɛkyerɛ sɛ ebia nea efi mu ba no yɛ nea ɛfata, ɛnyɛ ne kwan so, ɛkorɔn, ɛba fam, ɛyɛ papa, anaasɛ enye.

Dɛn ne D-Dimer a ɛyɛ daa a efi mu ba?

Akwan ahorow wɔ hɔ a wobɛfa so asɔ wo D-Dimer dodow a ɛwɔ wo mogya mu ahwɛ. Enti, amansan range biara nni hɔ a ɛka sɛ "eyi ne normal level." Wo lab amanneɛbɔ no bɛka nsɛm a ɛkyerɛ sɛ ebia wo D-Dimer dodow no yɛ nea ɛfata, ɛba fam, ɛkorɔn, ɛyɛ papa, anaasɛ ɛnyɛ papa.

Sɛ wo lab amanneɛbɔ ka sɛ wo D-Dimer dodow sua, ɛnyɛ papa, anaasɛ ɛyɛ nea ɛfata , ɛda adi kɛse sɛ ɛkyerɛ sɛ wunni mogya a ɛtwetwe mogya.

Sɛ wɔahu sɛ wowɔ Disseminated Intravascular Coagulation (DIC) na worenya ayaresa a, D-Dimer dodow a ɛfata anaasɛ ɛba fam wɔ wo mogya mu no kyerɛ sɛ ɛda adi sɛ w’ayaresa no reyɛ adwuma yiye.

Dɛn na D-Dimer a ɛkɔ soro a efi mu ba no kyerɛ?

Sɛ nea efi mu ba no kyerɛ sɛ D-Dimer dodow a ɛwɔ wo mogya mu no dɔɔso sen sɛnea ɛte daa a , ebetumi akyerɛ sɛ wowɔ mogya a ɛtwetwe. Nanso, sɛnea madi kan aka no, D-Dimer nhwehwɛmu nkutoo ntumi nkyerɛ wo mogya a ɛtwetwe tebea pɔtee a ebia wowɔ anaa baabi a mogya a ɛtwetwe no wɔ wo nipadua mu.

Sɛ wɔahu sɛ wowɔ Disseminated Intravascular Coagulation (DIC) na worenya ayaresa a, D-Dimer a ɛdɔɔso wɔ wo mogya mu no betumi akyerɛ sɛ w’ayaresa no ntumi nyɛ adwuma yiye.

Nanso, nsɛm bi wɔ hɔ a wobetumi ama D-Dimer dodow akɔ soro a mogya a ɛtwetwe no ho haw biara nni hɔ mpo. Nneɛma afoforo nti a D-Dimer dodow betumi akɔ soro sen sɛnea ɛte daa no bi ne:

• Nyinsɛn a wɔde di dwuma.
• Koma mu yare.
• Oprehyɛn bi a wɔyɛe nnansa yi.
• Akwanhyia anaa opira a ɛba nipadua no so (trauma).
• Ɔyare mmoawa bi.

Afei nso, D-Dimer dodow taa kɔ soro bere a obi nyin no. Sɛ wowɔ tebea bi te sɛ ntini mu yare a, ebia wubenya nea efi mu ba a ɛnyɛ nokware.

Enti, sɛ nea efi mu ba no kyerɛ sɛ wo D-Dimer dodow no nyɛ nea ɛfata a, ɛda adi sɛ wo duruyɛfo no bɛhyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu foforo ne/anaasɛ mfoniniyɛ mu nhwehwɛmu foforo na ama woahu sɛ wowɔ wo.

Bere bɛn na mehu nea efii D-Dimer sɔhwɛ no mu bae?

Nnuruyɛfo taa hyɛ sɛ wɔnyɛ D-Dimer nhwehwɛmu wɔ tebea horow a egye ntɛmpɛ mu, efisɛ mogya a ɛtɔ no betumi de nkwa ato asiane mu. Sɛ woma wɔyɛ nhwehwɛmu yi wɔ tebea a egye ntɛmpɛ mu a, ɛda adi sɛ wo duruyɛfo no benya nea efi mu ba no wɔ nnɔnhwerew kakraa bi mu.

Sɛ woyɛ D-Dimer nhwehwɛmu de hwɛ sɛnea w’ayaresa no reyɛ adwuma yiye bere a wɔresa wo yare wɔ mogya a ɛretu ho a, ɛda adi sɛ wubenya nea efi mu ba no wɔ adwuma da biako anaa abien ntam.

Dɛn na ɛba akyi? Sɛ nea efi mu ba no yɛ nea ɛnteɛ a...

Sɛ wo D-Dimer nhwehwɛmu no mu aba no nyɛ nea ɛfata a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ mfoninitwa nhwehwɛmu biako anaa nea ɛboro saa na ama woahu sɛ wowɔ mogya a ɛtwetwe mogya mu yare bi, na sɛ ɛte saa a, baabi a mogya a ɛtwetwe no wɔ. Saa sɔhwɛ ahorow yi bi ne:

• Doppler ultrasound: Eyi de nnyigyei asorɔkye di dwuma de yɛ wo ntini (mogya ntini) ho mfonini.
• Computed tomography (CT) angiography: Wɔ sɔhwɛ yi mu no, oduruyɛfo bi de aduru soronko bi gu wo ntini biako mu. Eyi ma wotumi hu wo mogya ntini wɔ X-ray afiri titiriw bi so.
• Lung ventilation-perfusion (V/Q) scan: Eyi hwehwɛ sɛ wɔyɛ mframa (V) scan, a ɛkyerɛ sɛnea mframa rekɔ w’ahurututu mu, ne perfusion (Q) scan, a ɛhwɛ baabi a mogya sen wɔ w’ahurututu mu. Wɔ scan abien no nyinaa mu no, wɔde radioactive ade ketewaa bi a ahobammɔ wom di dwuma de boa scanner no ma ohu sɛnea mframa ne mogya fa w’ahurututu mu yiye.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ sɛnkyerɛnne ahorow a ɛkyerɛ sɛ woayɛ akisikuru anaa ahurututu mu ntini a ɛma mogya tu (PE) a, frɛ 911 ntɛm ara anaa kɔ baabi a ɛbɛn wo a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ mu. Ntwentwɛn wo nan ase.

Sɛ wowɔ mogya a ɛtɔ wɔ ntini a emu dɔ mu ho sɛnkyerɛnne (Deep Vein Thrombosis - DVT) a, kɔ wo duruyɛfo nkyɛn ntɛm ara sɛnea wubetumi.

Dɛn ne asiane ahorow a ɛma mogya tu?

Asiane ahorow a ebetumi ama mogya a ɛtwetwe mogya a ɛmfata anaasɛ ɛnyɛ ne kwan so no bi ne:

• Oprehyɛn kɛse a wɔbɛyɛ anaasɛ nipadua mu opira kɛse (trauma).
• Beae biako a wobɛtra bere tenten (sɛ nhwɛso no, akwantu atenten a wobɛtra, anaasɛ mpa so a wobɛtra bere tenten).
• Nnuru a wɔde siw awo ano anaa aduru a wɔde si hormone ananmu a wɔnom.
• Nyinsɛn anaa awo a wɔawo nnansa yi.
• Sɛ wowɔ abusua abakɔsɛm a ɛkyerɛ sɛ mogya atɔ, anaasɛ wowɔ aduruyɛ tebea pɔtee bi te sɛ Factor V Leiden yare, Antiphospholipid syndrome, anaa Polycythemia vera.
• Kokoram pɔtee bi a wobenya.
• Coronavirus Disease 2019 (COVID-19) a ɛpae gui no.
• Sɛ́ obi bɛyɛ kɛse mmoroso.
• Sigaretnom.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Ɛyɛ ade a ɛfata sɛ wobɛte ehu ne dadwen nka bere a woanya sɔhwɛ mu aba a ɛnyɛ ne kwan so no. Nanso kae sɛ, D-Dimer nhwehwɛmu a ɛkɔ soro no nkyerɛ ankasa sɛ wowɔ mogya a ɛtwetwe mogya. Sɛ nea efi mu ba no kyerɛ sɛ wo D-Dimer dodow dɔɔso a, ɛda adi sɛ wo duruyɛfo bɛhyɛ sɛ wɔnyɛ nhwehwɛmu foforo na ama woahu sɛ wowɔ wo.

Sɛ wowɔ nsɛmmisa bi a, nsuro sɛ wubebisa wo duruyɛfo. Nnuruyɛfo wɔ hɔ sɛ wɔbɛboa wo. Wɔbɛkyerɛkyerɛ biribiara mu akyerɛ wo.

Mewɔ anidaso sɛ saa nsɛm yi ho bɛba wo mfaso. Kɔ so nya apɔwmuden!

` D-Dimer, mogya a ɛtwetwe, mogya mu nhwehwɛmu, DVT, PE, Stroke, DIC, mogya a ɛtwetwe