Sɔhwɛ a ɛhwɛ koma mu: Momma yensua Transesophageal Echocardiogram (TEE) ho ade!

So wo duruyɛfo ahyɛ sɛ wɔnyɛ nhwehwɛmu titiriw bi mfa nhwɛ sɛ ɔhaw bi wɔ wo koma mu anaa? Ebia ɛbɛyɛ `(Transesophageal Echocardiogram)`, anaa sɛnea yɛfrɛ no `(TEE)` sɔhwɛ. Ɛwom sɛ ebia ɛbɛyɛ te sɛ nea ɛyɛ nwonwa kakra de, nanso ɛyɛ ɔkwan a ɛma wutumi hu wo koma tebea yiye, fi wo mu pɛɛ. Enti ebia wosuro kakra anaasɛ wobɛpɛ sɛ wuhu eyi ho asɛm. Enti momma yɛnka saa `(TEE)` sɔhwɛ yi ho asɛm tiawa, wɔ ɔkwan a wobɛtumi ate aseɛ so.

Dɛn ne eyi (TEE) sɔhwɛ? Wɔyɛ no dɛn?

Sɛ yɛbɛka no tiawa a, Transesophageal Echocardiogram yɛ sɔhwɛ a wɔde nnyigyei asorɔkye twa wo koma mfonini. Eyi nso yɛ echo sɔhwɛ. Nanso ɛyɛ soronko kakra wɔ Transthoracic Echocardiogram (TTE) a wɔtaa yɛ a wɔyɛ wɔ koko so no ho. Eyi te saa efisɛ wotwa mfonini ahorow no fi nipadua no mu.

Oduruyɛfo, adwinnade a ɛyɛ tratraa a ɛte sɛ afiri tenten, yɛfrɛ no ``Endoscope,'' wɔde ahwɛyiye de hyɛ wo menewa ase kɔ wo aduan paipu (esophagus) mu. Wɔ saa tube yi awiei no, ``Transducer'' ketewaa bi wɔ hɔ.Saa ``Transducer'' yi ma nnyigyei asorɔkye ba. Saa nnyigyei asorɔkye yi bɔ koma no afã horow na ɛdannan kɔ akyi, te sɛ nnyigyei a ɛbɔ. ``Transducer'' no fa saa asorɔkye a ɛresan aba no na ɛde kɔ kɔmputa so. Kɔmputa no dan saa data no ma ɛbɛyɛ mfonini. Saa mfonini ahorow yi kyerɛ sɛnea koma no te ne sɛnea ɛyɛ adwuma kɔ akyiri yiye.

Ɛtɔ mmere bi a nnuruyɛfo de akwan titiriw bi a wɔfrɛ no Doppler ultrasound ne Color Doppler di dwuma ka TEE sɔhwɛ yi ho. Eyinom tumi susuw ahoɔhare ne baabi a mogya fa koma no mu no pɛpɛɛpɛ.

Dɛn na nnuruyɛfo hu wɔ saa (TEE) nhwehwɛmu yi mu?

Saa `(TEE)` sɔhwɛ yi betumi ama wɔanya koma no nhyehyɛe ho mfonini a emu da hɔ yiye, kyerɛ sɛ, sɛnea wɔahyehyɛ n'afã horow, ne sɛnea koma no reyɛ adwuma. Eyi betumi aboa ma wɔahu nyarewa ahorow na wɔadi ho dwuma bere a wɔreyɛ ayaresa no. Nhwɛso kakraa bi ni:

• Aortic aneurysm: Eyi ne bere a mogya ntini kɛse a ɛwɔ yɛn nipadua mu (aorta) no fasu yɛ mmerɛw na ɛbɔ te sɛ balloon.
• Mogya a ɛtɔ wɔ koma no mu: Nnipa a wɔwɔ atiridiinini titiriw no taa nya mogya a ɛtɔ wɔ koma no atifi (atria) no mu.
• Koma mu akisikuru: Eyinom betumi ayɛ kokoram anaasɛ ɛnyɛ kokoram.
• Komayare a wɔde awo obi: Eyi kyerɛ komayare ahorow a ɛwɔ hɔ bere a wɔawo no.
• Koma mu ntini mu yare: Sɛ nhwɛso no, mitral valve yare. Saa valve yi betumi ayɛ teateaa (stenosis) anaasɛ mogya akɔ akyi (regurgitation). Afei nso, wobetumi ahwɛ nnipa a wɔwɔ ntini a wɔde yɛ nipadua no mu sɛ ebia ɔhaw ahorow bi wɔ wɔn ntini mu te sɛ ɔyare mmoawa anaa mogya a atɔ.
• Koma mu ntini anaa ntini mu nyarewa: Sɛ nhwɛso no, tebea horow te sɛ `(Infective endocarditis)`.
• Pericardial disease: Eyi kyerɛ nyarewa a ɛba kotoku teateaa (pericardium) a atwa koma no ho ahyia no mu.

Dɛn nti na wɔyɛ saa (TEE) sɔhwɛ yi? Wɔ nsɛm bɛn mu?

Nneɛma pii nti na wobetumi ayɛ TEE sɔhwɛ. Momma yɛnhwɛ nea wɔyɛ:

1. Sɛ echocardiogram (TTE) a wɔyɛ no daa no nnɔɔso a: Sɛ wɔyɛ echocardiogram (TTE) daa wɔ wo moma so wie a, ebia wo duruyɛfo behia sɛ ohu wo koma no pefee na ɛkɔ akyiri. Wɔ tebea horow a ɛtete saa mu no, wobetumi ayɛ TEE nhwehwɛmu de aka TTE no ho de aboa ma wɔahu komayare bi anaasɛ wɔayɛ ayaresa ho nhyehyɛe.

Fa no sɛ worenam abɔnten so na wuhu mprɛte fɛfɛ bi wɔ sotɔɔ bi mu wɔ ahwehwɛ no mu. Wubetumi ahu sɛ mprɛte no wɔ nhwiren nsusuwso, nanso ɛnyɛ nea ɛda adi pefee sɛ nhwiren bɛn na ɛyɛ, nsɛm a ɛkɔ akyiri, efisɛ nnipa atwa ho ahyia na ahwehwɛ nso wɔ hɔ. Enti wokɔ sotɔɔ no mu kɔhwɛ mprɛte no yiye. Ɛno ne bere a wuhu sɛ wɔyɛ roses.

Saa na echocardiogram (TTE) a ɛyɛ daa a wɔyɛ wɔ koko so no te sɛ nea wɔrehwɛ ahwehwɛ mu wɔ sotɔɔ mu. Ebetumi aka nneɛma pii akyerɛ wo. Nanso saa TEE yi te sɛ nea worekɔ sotɔɔ bi mu akɔfa prɛte. Koma no afã horow bi, titiriw nea ɛwɔ akyi no, da adi pefee wɔ TEE yi so. Esiane sɛ wo esophagus no wɔ wo koma akyi nti, ɛyɛ beae pa a transducer no betumi de nnyigyei asorɔkye amena na agye.

Ɛfata sɛ yɛhwɛ afã horow yi titiriw:

* Benkum so atrium: Koma no benkum so dan a ɛwɔ soro.

* Benkum atrial appendage (LAA): Nkotoku ketewaa bi a ɛte sɛ aso a ɛwɔ benkum atrium no mu. Ɛha na ɛtɔ mmere bi a mogya a ɛtɔ.

* Interatrial septum: Ɔfasu a ɛtetew benkum ne nifa atria ntam.

* Thoracic aorta: Aorta no fã a ɛfa koko no mu.

Ɛtɔ mmere bi a nnuruyɛfo yɛ TEE mmom sen sɛ wɔbɛyɛ TTE. Eyi te saa esiane nneɛma a edidi so yi nti:

• Sɛ koko no nhyehyɛe wɔ tebea bi a ɛma ɛyɛ den sɛ wɔbɛyɛ TTE a.
• Sɛ wowɔ ahurututu mu nyarewa (sɛnea ebetumi akata koma no adwene so).

2. Wɔ tebea horow a egye ntɛmpɛ mu, a ɛde nkwa to asiane mu: Wɔ tebea horow bi a egye ntɛmpɛ mu no, ɛsɛ sɛ nnuruyɛfo hu koma no tebea ntɛm. Afei `(TEE)` ho wɔ mfasoɔ kɛseɛ. Nhwɛsoɔ:

• Hemodynamic instability (mogya mmoroso ne mogya a ɛkɔ nipadua no mu ho haw ahorow) .
• Mogya mmoroso a ɛba fam (Hypotension) .
• Oxygen dodow a ɛso tew (Hypoxia) .
• Tebea horow a egye ntɛmpɛ a ɛsɛ sɛ wɔyɛ mu nhwehwɛmu ntɛm ara, te sɛ aortic dissection.
• Bere a wosusuw sɛ obi anya komayare no.
• Ɔhaw ahorow a ɛwɔ prosthetic valves (te sɛ mogya a ɛtɔ, ɔyare mmoawa).
• Trauma a ɛba koko so.

3. Hwɛ sɛ mogya atɔ piti ansa na wɔayɛ aduru biara: Sɛ wɔresa koma no mu ɔhaw ahorow bi (arrhythmias), te sɛ catheter ablation anaa electrical cardioversion a, wɔyɛ TEE de hwɛ sɛ mogya atɔ wɔ koma no mu ansa na wɔayɛ oprehyɛn no. Eyi te saa efisɛ sɛ mogya tu a, ebetumi abubu bere a wɔreyɛ oprehyɛn no na asiw mogya ntini bi (thromboembolism).

4. Sɛ wobɛboa wɔ oprehyɛn ne aduruyɛ mu akwan afoforo so: TEE yɛ adwinnade a ɛsom bo yiye wɔ oprehyɛn ne aduruyɛ mu akwan horow bi mu. Wɔde hwɛ sɛnea koma no te ansa na wɔayɛ oprehyɛn no na wɔde si so dua sɛ oprehyɛn no ayɛ yiye bere a wɔayɛ no awie no. Nhwɛso ahorow:

• Oprehyɛn a wɔyɛ ma komayare a wɔde awo obi.
• Valve a wosiesie.
• Valve a wɔde besi ananmu.

Afei nso, wɔ ayaresa ahorow bi a egyina catheter so, kyerɛ sɛ, ayaresa ahorow a wɔde afiri a ɛyɛ tratraa bi fa mogya ntini bi mu kɔ koma no mu no, wɔde TEE di dwuma de hwɛ nipadua no mu na wɔde mfonini ahorow a ɛwɔ bere ankasa mu ma de kyerɛ ɔkwan a wɔfa so yɛ no kwan. Nhwɛso ahorow:

• `(Transcatheter aortic valve a wɔde besi ananmu - TAVR)`
• `(Transcatheter mitral valve a wosiesie)`
• `(Transcatheter tricuspid valve a wosiesie)`
• `(Transcatheter benkum atrial appendage a wɔto mu)`

So wɔyɛ TEE sɔhwɛ no wɔ nipadua no mu? So wɔde nnuru a wɔde kum nipadua no di dwuma?

Yiw, wobu TEE sɛ sɔhwɛ a wɔde hyɛ nipadua no mu efisɛ ɛhwehwɛ sɛ wɔde afiri bi hyɛ nipadua no mu. Ebia wobɛte nka sɛ wo ho nyɛ wo dɛ kakra, nanso asiane a ɛwɔ hɔ sɛ wubehyia ɔhaw a emu yɛ den no sua.

Mpɛn pii no, TEE nhwehwɛmu hwehwɛ sɛ wɔde aduru a ɛma obi dwensɔ wɔ baabiara ne aduru a ɛma obi dwo kakra nkutoo . Eyi kyerɛ sɛ oduruyɛfo no bɛpete aduru bi a ɛma wo ho yɛ wo yaw wɔ wo menewa akyi. Ɔbɛma wo aduru bi a wɔde fa ntini mu (IV) nso na aboa wo ma woagye w’ahome.

Nnipa dodow no ara nhia nnuru a wɔde kum nipadua no nyinaa, nanso ɛyɛ papa sɛ wo ne wo duruyɛfo bɛkasa afa nea eye ma wo ho.

Enti, so wɔde yɛn reda saa bere yi? So yɛwɔ n’adwene?

Nnuru a wɔde dwudwo wo a ɛkɔ fam no bɛma woate nka sɛ woada na ɛbɛma woatumi ayɛ sɔhwɛ no a worenhaw wo kɛse. Aduruyɛ adwumayɛfo bɛkɔ so ahwɛ wo so ahwɛ sɛ ebia worehyia ɔhaw bi anaa. Ebia wɔbɛma wo nnuru a ɛma wo ho dwo pii sɛ ɛho hia a.

Sɛ wɔma wo `(General anesthesia)` mpo a, wobɛda koraa na worenkae sɔhwɛ no ho hwee. Nanso, sɛ wɔma wo `(General anesthesia)` a, anka ɛsɛ sɛ wɔde wo bata `(Afiri a wɔde home) ho.` Afei nso, esiane sɛ wɔde wo da kɛse nti, egye bere tenten kakra ansa na wo ho atɔ wo sen sɛ wode aduru a ɛma wo ho dwo no brɛoo.

Bere tenten ahe na sɔhwɛ yi gye?

TEE sɔhwɛ no betumi agye simma 90 ansa na wɔawie. Mmom,Mpɛn pii no, mfoninitwa no gye bɛyɛ simma 15.

Ɔkwan bɛn so na ɛsɛ sɛ yɛsiesie yɛn ho ansa na yɛayɛ (TEE) sɔhwɛ no?

Hwɛ hu sɛ wo ne wo duruyɛfo bɛbɔ w’aduruyɛ ho abakɔsɛm ho nkɔmmɔ. Ayaresa mu tebea horow bi betumi ama TEE nhwehwɛmu ayɛ nea asiane wom. Hwɛ hu sɛ wobɛka akyerɛ wo duruyɛfo sɛ wowɔ tebea horow a edidi so yi mu biara a:

• Kokoram a ɛwɔ aduan mu
• Yafunu mu yare
• GERD (Asidi a ɛkɔ nipadua no mu a enni sabea) .
• Hiatal hernia a ɛyɛ mmerɛw
• Abakɔsɛm a ɛfa nnubɔne a wɔde fa ntini mu (IV nnubɔne a wɔde di dwuma) ho .
• Ɔhaw ahorow a ɛma obi mene ade
• Dae mu ahomegye a ɛyɛ den
• Yafunu mu kokoram

Afei nso, ka kyerɛ yɛn sɛ worenom nnuru ama saa nneɛma yi anaa:

• Dae ho nsɛm
• Brɛ
• Yeaw

Wo duruyɛfo bɛma wo akwankyerɛ a ɛkɔ akyiri wɔ sɛnea wubesiesie wo ho ama TEE sɔhwɛ no ho. Hwɛ hu sɛ wubedi saa akwankyerɛ ahorow no akyi pɛpɛɛpɛ. Nsuro sɛ wobɛbisa sɛ biribi wɔ hɔ a wonte aseɛ anaa. Akwankyerɛ no bɛka nea edidi so yi ho:

• Bere a ɛsɛ sɛ wogyae adidi ne anom (mpɛn pii no anyɛ yiye koraa no nnɔnhwerew asia ansa na wɔayɛ sɔhwɛ no).
• Bere bɛn na ɛsɛ sɛ wonom nnuru a wotaa de di dwuma no?
• Kwati sɛ wobɛnom nsa bere bi (ebia nna kakraa bi ansa na wɔayɛ sɔhwɛ no).
• Nneɛma foforo a ɛsɛ sɛ woyɛ anaasɛ ɛnsɛ sɛ woyɛ ansa na `(TEE)` aba.

Dɛn na ɛba bere a wɔreyɛ (TEE) sɔhwɛ no?

Eyinom ne anammɔn a ɛtaa ba wɔ `(TEE)` sɔhwɛ mu:

1. Wɔbɛma wo ayaresabea atade a wobɛhyɛ.

2. Oduruyɛfo no de sticker nketewa a wɔfrɛ no ``Electrodes'' bɛhyɛ wo moma so. Wobetumi de eyinom ahwɛ anyinam ahoɔden dwumadi a ɛwɔ wo koma mu wɔ ``TEE'' no mu.

3. Wɔde mogya mmoroso afiri bɛhyɛ wo basa so, na wɔde pulse oximeter abɔ wo nsateaa ho de ahwɛ oxygen dodow a ɛwɔ wo nsateaa mu.

4. Wɔbɛma wo gargle de ayɛ wo menewa. Oduruyɛfo no bɛpete aduru bi agu wo menewam. Eyi yɛ aduru a wɔde kum nipadua no wɔ mpɔtam hɔ. Eyi nti na worente ɛyaw biara nka bere a woreyɛ TEE no.

5. Wɔbɛma wo aduru a wɔde fa ntini mu (IV) a ɛma wo ho dwo wo na aboa wo ma woagye w’ahome.

6. Ebia wubehia sɛ wode afiri ketewaa bi (nasal cannula) bɛhyɛ wo hwene mu na ama woanya oxygen.

7. Wɔbɛdan wo akɔ sɔhwɛ pon no benkum so na wɔama woada.

8. Oduruyɛfo no de ``Endoscope`` (afiri a ɛyɛ tratraa, tenten, ɛyɛ mmerɛw) bɛhyɛ w'anom nkakrankakra. Wɔ tube no ano no, ``Transducer`` bi wɔ hɔ. Saa afiri yi sian kɔ wo menewam na ɛkɔ w’aduan paipu mu. Wɔde srade ahyɛ mu sɛnea ɛbɛyɛ a ɛbɛyɛ mmerɛw sɛ wobɛkɔ fam. Ɛtɔ da bi a wɔbɛka akyerɛ wo sɛ mene na aboa ``Transducer`` no ma wakɔ beaeɛ a ɛfata. Ebia eyi bɛyɛ te sɛ nea ɛnyɛ dɛ kakra, nanso oduruyɛfo no de ahwɛyiye kɛse bɛyɛ eyi. Wɔbɛma wo nnuru a ɛbɛma wo menewa ayɛ mmerɛw, enti worente ɛyaw pii.

9. Oduruyɛfo no retwa mfonini. Ebia wobɛte ɛyaw nka. Nanso `(Transducer)` no yɛ soronko.Ebia wobɛte nhyɛso kakra nka wɔ wo moma so bere a woretu no. Saa ɔfã yi gye bɛyɛ simma 10-15.

10. Oduruyɛfo no beyi afiri no afi wo menewam na wakɔ so ahwɛ wo mogya mmoroso, wo koma bɔ, ne oxygen dodow so.

11. Twɛn kosi sɛ oduruyɛfo no bɛka sɛ wubetumi akɔ fie.

Dɛn na metumi ahwɛ kwan wɔ (TEE) sɔhwɛ no akyi?

Wobɛhia obi a ɔbɛka wo akɔ fie wɔ TEE sɔhwɛ no akyi. Worentumi nka kar nnɔnhwerew 24 esiane nnuru a ɛma obi dwo no nkɛntɛnso nti. Wubetumi ahwɛ nea edidi so yi kwan:

• Wo menewa bɛyɛ dɔnhwerew biako. Ɛbɛbrɛ ase bere tiaa bi akyi. Nni anaa nnom biribiara kosi sɛ akisikuru no befi hɔ. Sɛ wodidi anaa wonom ntɛm dodo a, ebetumi ama obi amene.
• Ebia wo menewam bɛyɛ wo yaw bɛyɛ nna abien. Eyi yɛ ade a ɛfata na ɛbɛbrɛ ase wɔ nna kakraa bi mu. Nanso, sɛ ɛyaw no kɔ so anaasɛ emu yɛ den a, wo ne wo duruyɛfo nkasa.

So asiane bi wɔ (TEE) nhyehyɛe no mu?

Nnipa binom menewam yɛ wɔn yaw bere a wɔayɛ TEE akyi. Ebetumi atra hɔ nnɔnhwerew kakraa bi anaasɛ akosi nnansa kosi anum.

Nsɛnnennen afoforo ntaa mma, nanso ebetumi aba:

• Nnuru a ɛma obi ho yɛ no hyew.
• Aspiration pneumonia fi aduan anaa nsu a ɛkɔ ɔhome kwan no mu.
• Ɔhaw ahorow a ɛfa mogya mmoroso anaa koma a ɛbɔ ho.
• Mogya nketenkete a efi aduan mu.

Ansa na wobɛyɛ nhwehwɛmu yi no, ɛho hia sɛ wo ne wo duruyɛfo kasa fa asiane ahorow a ɛwɔ TEE mu ho.

Mɛyɛ dɛn anya (TEE) sɔhwɛ no mu aba?

Wo duruyɛfo no ne wo bɛkasa afa wo nhwehwɛmu no mu aba ho. Wubetumi nso anya bi sɛ wo kɔmputa so aduruyɛ ho kyerɛwtohɔ (intanɛt nhyehyɛe a wubetumi ahu w’ayaresa ho nsɛm) no fã. Wo ne wo duruyɛfo nkasa mfa bere a wubenya nea ebefi mu aba ne sɛnea wobɛhwɛ no ho.

Ɛyɛ ade a ɛfata sɛ nnipa binom bɛte ehu anaa ehu nka kakra bere a ɛfa aduruyɛ mu nhwehwɛmu ho no. Nanso, nhwehwɛmu te sɛ Transesophageal Echocardiogram (TEE) betumi adi dwuma kɛse wɔ wo akwahosan a wobɛkɔ so ayɛ anaasɛ ɔhaw ahorow a ɛsɔre no mu. TEE yɛ sɔhwɛ a wɔtaa yɛ a asiane a ɛwɔ hɔ sɛ ɛbɛma nsɛnnennen aba no sua. Sɛ woreyɛ TEE a, wo ne wo duruyɛfo nkasa mfa sɛnea wubesiesie wo ho ama no ne nea wobɛhwɛ kwan.

Nea etwa to no, kae eyi.

TEE sɔhwɛ no yɛ ɔkwan titiriw bi a ɛma wutumi hu wo koma mu yiye. Ɛwom sɛ ebia ɛbɛyɛ te sɛ nea ɛnyɛ dɛ kakra de, nanso ɛboa kɛse ma wohu komayare na wɔsa no yiye. Nea ɛho hia paa ne sɛ, sɛ wowɔ nsɛmmisa anaa adwenem naayɛ bi a, wo ne wo duruyɛfo nka ho asɛm. Afei wubetumi agyina sɔhwɛ yi ano a wunsuro na wowɔ ahotoso.

` Transesophageal echocardiogram, TEE, koma mu nhwehwɛmu, koma, endoscope, echo sɔhwɛ, aduan mu nhwehwɛmu