So mogya atɔ wo ntini bi mu wɔ wo basa mu? (Axillo-Subclavian Vein Thrombosis) - Momma yɛnka eyi ho asɛm!

So ɛtɔ mmere bi a, wote ɛyaw a ano yɛ den mpofirim wɔ wo nsa mu, wo hohoro, anaasɛ wo kɔla yɛ bruu? Anaasɛ wo nsa te nka sɛ wo ho ayɛ wo yaw anaasɛ emu yɛ duru? Eyinom nyɛ sɛnkyerɛnne ahorow a ɛsɛ sɛ wobu ani gu so. Ebetumi ayɛ mogya a ɛretu wɔ ntini kɛse bi a ɛwɔ wo nsa anaa wo nsateaa mu. Wɔ aduruyɛ mu no, yɛfrɛ eyi (Axillo-Subclavian Vein Thrombosis) anaa (ASVT) . Mma ɛnhaw wo, yɛbɛka eyi ho asɛm wɔ ɔkwan a ɛnyɛ den so a wubetumi ate ase.

Dɛn ne eyi (Axillo-Subclavian Vein Thrombosis)?

Sɛ yɛbɛka no tiawa a, Axillo-Subclavian Vein Thrombosis (ASVT) yɛ bere a mogya a ɛtɔ gu subclavian vein , ntini kɛse bi a ɛwɔ wo mmati mu, anaa axillary vein, ntini bi a ɛwɔ wo nsateaa mu no mu. Fa wo ntini no sɛ nsu afiri. Sɛ mpampam anaa nam bi a ɛbɛn saa ntini yi mia so a, ebetumi asiw mogya no kwan na ama mogya atɔ.

Mpɛn pii no, tebea yi fi wo nsa atifi a woapira, anaasɛ adwennwen a ɛba wo nsa so esiane sɛ wokankan mpɛn pii nti. Nnipa binom frɛ no Paget-Schroetter syndrome , bere a afoforo frɛ no mmɔdenbɔ a ɛma mogya tu , a ɛkyerɛ “mogya a ɛtwetwe a efi mmɔdenbɔ mu ba.”

So eyi (Deep Vein Thrombosis - DVT) ho yɛ na?

Yiw, wubetumi anya saa ɔhaw no. (ASVT) yɛ tebea bi a wɔfrɛ no (Deep Vein Thrombosis) anaa (DVT) ankasa . (DVT) yɛ bere a mogya a ɛtɔ gu ntini bi a ɛwɔ nipadua no mu tɔnn mu. Nanso mpɛn pii no sɛ yɛka (DVT) ho asɛm a na yɛreka mogya a ɛtɔ a ɛba nan mu ho asɛm. Mpɛn pii no, nneɛma te sɛ kɛseyɛ mmoroso, apɔw-mu-teɛteɛ a wɔnyɛ, onyin, anaa nyarewa afoforo a ɛfa ntini ahorow ho na ɛde ba.

Nanso, mogya a ɛtɔ wɔ nsa mu a wɔfrɛ no ASVT no taa ba esiane akwanhyia anaasɛ nsa a wɔde di dwuma bere tenten nti. Ɛtɔ mmere bi a, tebea abien yi ho sɛnkyerɛnne ne ayaresa betumi ayɛ soronko.

Hena na ɛda adi sɛ obenya eyi (ASVT)?

Ɛwom sɛ obiara betumi anya saa tebea yi de, nanso nnipa binom wɔ asiane kɛse mu. Eyinom bi ne:

• Bere nyinaa ɔyɛ nnam, mpɛn pii no ɔwɔ apɔwmuden .
• Mmabun a wɔadi fi mfe 15 kosi 45 .
• Nnipa a wɔbɔ agumadi (e.g. wɔn a wɔbɔ bɔɔl ntɛmntɛm wɔ kriket mu, asuguarefo, wɔn a wɔma nneɛma a emu yɛ duru so) anaa nnipa a wɔyɛ adwuma a wɔama wɔn nsa so bere nyinaa (e.g. mfoniniyɛfo, anyinam ahoɔden adwumayɛfo, nnipa a wɔyɛ adwuma a wɔde ma nneɛma a emu yɛ duru). Susuw ho hwɛ, sɛ woyɛ adwuma a woama wo nsa so na woakyinkyim wɔ ɔkwan koro no ara so a, wɔde nhyɛso ba saa ntini ahorow no so.
• Nnipa a wɔwɔ awosu mu yare bi a ɛma mogya tu .

So (ASVT) ahorow ahorow wɔ hɔ?

Yiw, (ASVT) ahorow atitiriw abien na ɛwɔ hɔ:

1. ASVT titiriw: .Eyi ne nea abu so sen biara, a nsa no a wɔde keka ne ho denneennen na ɛtaa ka no.

2. Secondary ASVT: Eyi fi nnuruyɛ mfiri bi a wɔde ahyɛ wo moma so atifi. Nhwɛsoɔ:

• (Central venous catheter) (afiri a wɔde hyɛ ntini titiriw bi mu) .
• (Defibrillator) (afiri a ɛma koma no san yɛ adwuma) .
• (Pacemaker) (afiri a ɛhwɛ sɛnea koma bɔ so) .
• (Medication port) (Afiri ketewaa bi a wɔde si honam ani de ma nnuru) .

Saa mfiri yi nso betumi ama mogya ntini mu ayɛ den na mogya atɔ.

(ASVT) abu so dɛn?

Nokwarem no, ASVT nyɛ tebea a abu so kɛse. Sɛnea akontaabu kyerɛ no, ɛba nnipa biako anaa baanu mu wɔ 100,000 biara mu afe biara. Nanso, DVT a ɛwɔ atifi fam nyinaa mu 10% kosi 20% pɛ na ASVT na ɛde ba. Enti, sɛ yɛhwɛ no a, ɛyɛ dodow a ɛho hia.

Dɛn ne (ASVT) ho sɛnkyerɛnne?

Sɛ wowɔ ASVT a, wubetumi anya saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa:

• Nsa yaw: Efi ase mpofirim, ɛtɔ mmere bi a emu yɛ den.
• Ntini a wotumi hu wɔ nsa no mu: Ntini no betumi ayɛ te sɛ nea ayɛ kɛse esiane mogya a ɛsen no a ɛyɛ den nti.
• Honam ani kɔla bruu (Cyanosis): Nsa no ho were betumi adan bruu. Eyi kyerɛ sɛ mframa pa nni hɔ.
• Nsa mu duru anaa ɔbrɛ a wobɛte nka: Ebia ɛbɛyɛ den ama wo sɛ wobɛma wo nsa so anaa wobɛkanyan wo.
• Nsa no hohoro mpofirim: Nsa no fi ase hohoro mpofirim.

Nea ɛho hia no, wɔ tebea horow bi mu (10% - 20%) saa mogya a ɛtwetwe yi tumi fi ntini no mu, fa mogya no mu, na ɛkɔ ahurututu no mu. Wɔfrɛ eyi sɛ Pulmonary Embolism (PE) . Eyi yɛ tebea a asiane wom yiye . Ebetumi asɛe ahurututu no kɛse, na ebetumi de nkwa mpo ato asiane mu. Enti, sɛ wufi ase nya saa sɛnkyerɛnne ahorow yi mu biara a, akyinnye biara nni ho sɛ ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn a wonsɛe bere biara.

Dɛn nti na eyi (ASVT) ba?

Sɛnea yɛadi kan aka no, nea ɛde ba titiriw ne abasa no a wɔde keka ne ho mpɛn pii. Fa no sɛ, worema nneɛma a emu yɛ duru so anaa woredi agumadi bere nyinaa. Afei ntini a atwa wo mmati ne wo nsateaa ho ahyia no betumi abrɛ na ahonhon. Saa ntini a ahonhon yi betumi amia mogya ntini a ɛwɔ hɔ (titiriw subclavian anaa axillary veins).

Bere kɔ so no, saa nhyɛso yi betumi asɛe ntini no fasu na ama akuru ntini ayɛ. Afei ntini no twetwe fi mu, na ɛma mogya dodow a ebetumi afa mu no so tew. Eyi betumi ama mogya ankɔ yiye na asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no akɔ soro. Ɛtɔ mmere bi a wɔfrɛ saa tebea yi Thoracic Outlet Syndrome (TOS).Wɔsan frɛ no. Ɛkyerɛ sɛ baabi a ɛwɔ koko no atifi (thoracic outlet) no so tew, na ɛde nhyɛso ba ntini ne ntini ahorow no so.

Ɛtɔ da bi a, ASVT betumi afi nea ɛnteɛ wɔ mparow a edi kan no mu, anaasɛ nsakrae a ɛba ntini anaa ntini a atwa ntini a ɛwɔ abasa ne mmati no ho ahyia no mu.

Ɔkwan bɛn so na oduruyɛfo hu eyi (ASVT)?

Sɛ wokɔ oduruyɛfo nkyɛn a wowɔ sɛnkyerɛnne ahorow a yɛadi kan aka ho asɛm no a, obedi kan ahwɛ wo. Oduruyɛfo no betumi ahu nneɛma te sɛ wo nsa a ɛho ahonhon, kɔla a ɛsakra, ne ntini a ɛrehuruhuruw prɛko pɛ.

Afei, ebia ebehia sɛ woyɛ sɔhwɛ kakraa bi na ama woahu sɛ:

• (Duplex ultrasound): Mpɛn pii no, eyi ne sɔhwɛ a edi kan a wɔyɛ. Ɛde nnyigyei asorɔkye di dwuma de hwɛ mogya a ɛkɔ ntini no mu na ɛhwɛ sɛ mogya atɔw bi anaa. Eyi yɛ sɔhwɛ a ɛnyɛ yaw na ɛnyɛ den.
• Catheter-guided venography: Ɛtɔ mmere bi a wɔyɛ nhwehwɛmu yi. Wɔ sɔhwɛ yi mu no, wɔde afiri ketewaa bi a ɛyɛ tratraa (catheter) fa ntini bi mu kɔ baabi a wosusuw sɛ mogya a ɛretu no wɔ, na wɔde aduru soronko bi fa catheter no mu gu ntini no mu. Afei wɔyɛ X-ray de hwɛ baabi a ntini no asiw ne sɛnea ntini no kɛse te.
• (CTA - computerized tomography angiography): Eyi te sɛ CT scan, nanso ɛhwɛ mogya ntini no pɔtee. Wɔnam aduru a wɔde hyɛ nipadua mu nso so na ɛyɛ.
• (MRA - magnetic resonance angiography): Nhwehwɛmu a wɔde MRI scan hwɛ mogya ntini mu.

Saa sɔhwɛ ahorow yi betumi ahu sɛ ebia tebea no (ASVT) wɔ hɔ, baabi a ɛwɔ, ne sɛnea emu yɛ den no ankasa.

Dɛn ne ayaresa ahorow a wɔde sa (ASVT)?

Nea eye sen biara ne sɛ, ayaresa ahorow a etu mpɔn wɔ hɔ a wɔde sa ASVT. Wɔfrɛ ayaresa titiriw no thrombolysis anaa thrombolytic therapy .

Nea ɛka eyi ho ne sɛ wɔde aduru bi a ɛma mogya a ɛretu no tew na eyi fi mu, sɛnea yɛadi kan aka no, akɔ ntini a mogya a ɛretu no wɔ no mu tẽẽ denam afiri ketewaa bi (catheter) mu . Eyi ma mogya a ɛretu no tew na ɛma mogya san kɔ ntini no mu.

Ɛtɔ mmere bi a, wɔde biribi a wɔfrɛ no (thrombectomy) ka saa (thrombolysis) ayaresa yi ho . Ɛne sɛ, wɔde mfiri anaa oprehyɛn ketewaa bi na yi mogya a ɛretu no fi hɔ.

Sɛ wɔyɛ saa ayaresa ahorow yi wie a, wɔbɛma wo nnuru a ɛma mogya yɛ mmerɛw , te sɛ Warfarin anaa nnɛyi nnuru afoforo asram pii na amma mogya a ɛbɛtɔ bio. Ɛho hia yiye sɛ wobɛnom saa aduru yi bere tenten pɔtee a wo duruyɛfo bɛka akyerɛ wo no.

Nea ɛka ho no, oduruyɛfo no nso bɛma wo afotu a edidi so yi:

• Tew nsa a ɛka no a wode bedi dwuma no so kosi sɛ yare no ho sɛnkyerɛnne no bɛbrɛ ase koraa.
• Ma wo nsa so kakra bere a ɛbɛyɛ yiye (abasa a wobɛma so).
• Nipadua mu ayaresaHwɛ. Eyi bɛboa wo ma woasan akanyan wo ho na woanya ahoɔden wɔ wo nsam.
• Hyɛ compression sleeve (te sɛ sɔks a ɛyɛ den) wɔ abasa a ayɛ basaa no so. Eyi bɛboa ma akisikuru no so atew na ama mogya a ɛkɔ nipadua no mu no atu mpɔn.

So ɛho behia sɛ wɔyɛ oprehyɛn?

Wɔ tebea horow bi mu no, yiw. Ebia wɔbɛkamfo akyerɛ sɛ wɔnyɛ oprehyɛn na wɔayi nea asiw no afi hɔ koraa na wɔatew asiane a ɛwɔ hɔ sɛ mogya a ɛbɛtɔ bio no so. Nea ɛka oprehyɛn yi ho ne sɛ woyi nea asiw kwan no fi hɔ. Sɛ nhwɛso no, wobetumi ayi mparow a edi kan no asinasin anaa nam bi a ɛrema asiw no afi hɔ. Eyi ma mogya fa ntini no mu kwa.

Dɛn na yebetumi ayɛ de asiw (ASVT) nkɔso ano?

Ɛwom sɛ wontumi nsiw ano koraa de, nanso nneɛma pii wɔ hɔ a yebetumi ayɛ de atew asiane no so:

• Bere nyinaa fa ntini a ɛwɔ wo nsa so no brɛoo na fa wo ho hyɛ apɔw-mu-teɛteɛ te sɛ nea wobɛtrɛw mu mu .
• Mma wo nsa nyɛ adwuma ntra so .
• Sɛ worema nneɛma a emu yɛ duru so anaasɛ woreyɛ apɔw-mu-teɛteɛ denneennen a, gye w’ahome kakra wɔ ntam .
• Bere biara a ɛbɛyɛ yiye no, bɔ mmɔden sɛ wode wo nsa a ɛnyɛ nea ɛwɔ tumi no bɛyɛ adwuma . (e.g. sɛ wowɔ nsa nifa a, fa wo nsa benkum di dwuma bere a ɛbɛyɛ yiye a).

Tebea no bɛyɛ dɛn wɔ ayaresa akyi?

Nnipa dodow no ara a wɔwɔ ASVT no yɛ yiye paa wɔ ayaresa akyi. Nhwehwɛmu ahorow ada no adi sɛ sɛ wohu yare no na wɔsa no ntɛm a, sɛ yare no ho sɛnkyerɛnne fi ase ara pɛ a, nkonimdi 90% kosi 95% na ɛwɔ hɔ .

Nanso, nnipa binom betumi anya ɔhaw bi a wɔfrɛ no Post-thrombotic Syndrome (PTS) . Wɔ eyi mu no, sɛnkyerɛnne ahorow te sɛ ɛyaw a ɛtra hɔ kyɛ, emu duru, ne abasa a ɛho ayɛ kurukuruwa no betumi akɔ so. Enti, ɛho hia sɛ wudi wo duruyɛfo akwankyerɛ akyi bere a wɔasa wo yare mpo akyi.

Bere bɛn na ɛsɛ sɛ yɛkɔ oduruyɛfo nkyɛn ntɛm ara sɛnea yebetumi?

Sɛ wuhu ASVT ho sɛnkyerɛnne a edi kan no bi a, hwehwɛ aduruyɛfo afotu ntɛm ara . Mma nntwentwɛn wo nan ase, titiriw sɛ wuhyia nneɛma a edidi so yi mu biara a:

• Koko mu yaw
• Nsa anaa anan abien no nyinaa a ɛyɛ mmerɛw
• Ɔhome a ɛyɛ den (dyspnea) .

Eyinom betumi ayɛ tebea bi a asiane wom te sɛ Pulmonary Embolism (PE) ho sɛnkyerɛnne.

(ASVT) Sɛ saa a, nsɛm bɛn na ɛsɛ sɛ wubisa oduruyɛfo no?

Sɛ wo duruyɛfoɔ ka kyerɛ wo sɛ wowɔ ASVT a, ɛyɛ papa sɛ wobɛbisa nsɛm bi te sɛ yeinom:

• Nsakrae bɛn na metumi ayɛ wɔ m’asetra mu na ama asiane a ɛwɔ hɔ sɛ mogya bɛtɔ me no so atew?
• So metumi akɔ so ateɛteɛ m’apɔw mu na mayɛ nsaanodwuma?
• Dɛn na metumi ayɛ na amma mogya a ɛretu bio?
• Bere tenten ahe na ehia sɛ wonom nnuru a ɛma mogya yɛ mmerɛw?

Ade a ɛho hia sen biara a ɛsɛ sɛ wokae (Take-Home Message) .

Mewɔ anidaso sɛ seesei woanya ntease pa wɔ nea yɛkaa ho asɛm nnɛ (Axillo-Subclavian Vein Thrombosis - ASVT) no ho. Sɛ yɛbɛbɔ no mua a:

• (ASVT) yɛ mogya a ɛtɔ gu ntini kɛse bi mu wɔ wo nsa anaa wo nsateaa mu.
• Eyi taa ba efisɛ wɔde nsa no di dwuma wɔ ɔkwan a ɛkɔ so na ɛyɛ ɔbrɛ so.
• Ebia wubesusuw sɛ ɛyɛ saa sɛ wuhu sɛnkyerɛnne ahorow te sɛ ɛyaw a ɛba mpofirim, ɛho wosow, ne wo nsa ho were bruu a.
• Thrombolysis (aduru a wɔde ma mogya a ɛtɔ) ne thrombectomy (mogya a ɛtwetwe a woyi fi hɔ) ne ayaresa atitiriw.
• Nea ɛho hia sen biara ne sɛ wubehu yare no ntɛm na woafi ase sa yare. Sɛ woyɛ saa a, wowɔ hokwan a eye sen biara sɛ wobɛsan anya ahoɔden koraa.

Sɛ wowɔ saa nsɛnkyerɛnne yi a, nsuro na kɔ oduruyɛfo nkyɛn ntɛm. Kɔ so nya apɔwmuden!

` axillo-subclavian vein thrombosis, ASVT, mogya a ɛtɔ, nsa ntini, mmati mu yaw, nsa a ɛho ahonhon, DVT, Pulmonary Embolism, Paget-Schroetter syndrome