So woasusuw nea ɛba yɛn koma so bere a yɛteɛteɛ yɛn apɔw mu, tu mmirika, anaa yɛforo antweri no ho pɛn? Saa bere no, koma no hia mframa pa pii sen sɛnea anka ɛbɛyɛ. Sɛnea ɛbɛyɛ na wɔadi oxygen ho ahiade a ɛkɔ soro yi ho dwuma no, ɛsɛ sɛ mogya dodow a ɛsen fa ahrawa mu ntini a ɛde mogya kɔ koma no ankasa mu no nso kɔ soro. Enti, tumi a wo koma tumi ma mogya kɔ soro bere a ahiade no kɔ soro no, wɔfrɛ no Coronary Flow Reserve (CFR) kɛkɛ. Eyi te sɛ wo koma mu ‘tumi a wɔde asie’ no.
Dɛn ne Coronary Flow Reserve (CFR) a wɔde asie?
Sɛ yɛbɛka no tiawa a, Coronary Flow Reserve (CFR) yɛ nea wɔde susuw mogya dodow a fa wo koma ntini mu ntini mu no betumi akɔ soro bere a worebɔ mmɔden kɛse no. Eyi betumi ama wo duruyɛfo anya wo koma akwahosan ho nsɛm a ɛsom bo, titiriw ntini a ɛde mogya kɔ wo koma mu (coronary arteries) no tebea.
Susuw ho saa kwan yi so. Sɛ wote akongua so a, wo koma hia mogya dodow bi. Nanso sɛ wutu mmirika di bɔs akyi mpofirim a, wo koma adwuma kɔ soro kɛse. Afei wo koma hia oxygen a ɛboro nea ɛte daa so mmɔho abiɛsa kosi anan. Koma a ɛte apɔw mogya ntini betumi adi ahwehwɛde a ɛkɔ soro yi ho dwuma, na ama mogya a ɛkɔ soro amonom hɔ ara. CFR sɔhwɛ no susuw sɛnea wo koma tumi yɛ eyi.
Saa nhwehwɛmu yi boa ma wohu ntɛm sɛ ebia wowɔ komayare anaasɛ wowɔ asiane mu sɛ wubenya tebea bi te sɛ komayare daakye.
Ɔkwan bɛn so na wobu CFR bo no ho akontaa?
Ɔkwan a wɔfa so bu eyi ho akontaa no yɛ mmerɛw yiye. Wo duruyɛfo nam akwan abien so susuw mogya a ɛkɔ wo koma mu no.
1. Mogya a ɛsen bere a woregye w’ahome: Eyi kyerɛ mogya dodow a ɛsen kɔ koma no mu bere a woagye w’ahome, a wommɔ mmɔden biara.
2. Mogya a ɛsen sen biara: Wɔhyɛ koma no ma ɛbɔ mogya a ɛsen biara (wɔma aduru bi ma eyi), na wɔsusuw mogya dodow a ɛsen saa bere no.
Afei, wɔkyekyɛ mogya a ɛsen sen biara yi mu denam mogya a ɛkɔ ahomegye mu no so.
CFR = (Mogya a Ɛsen Biara) / (Mogya a Ɛkɔ Ahomegyeɛ mu) .
Sɛ nhwɛso no, sɛ wo mogya a ɛsen sen biara no mmɔho abiɛsa a, wo CFR bo bɛyɛ 3.
Sɛ wɔkyekyem pɛpɛɛpɛ a, dɛn ne CFR bo?
Ɛsɛ sɛ obi a ɔwɔ apɔwmuden CFR yɛ 2.0 kosi 2.5 . Eyi kyerɛ sɛ anyɛ yiye koraa no, ɛsɛ sɛ koma no tumi de mogya a ɛdɔɔso mmɔho abien sen nea ebetumi bere a wagye n’ahome no. Wɔ onipa a ɔwɔ apɔwmuden sen biara mu no, saa bo yi betumi ayɛ 3, 4, anaa nea ɛboro saa mpo.
- Sɛ CFR boɔ no nnu 2.0 a:Eyi kyerɛ sɛ ebia ɔhaw bi wɔ mogya ntini a ɛwɔ koma no mu no ho. Ebia mogya ntini no ayɛ teateaa (asiw). Nnipa a wɔte sɛ eyi wɔ asiane kɛse mu sɛ wobenya komayare daakye.
- Sɛ CFR bo no boro 2.0 a: Ɛkyerɛ sɛ mogya ntini a ɛwɔ koma no mu no dwumadi wɔ ɔkwan pa so.
Nanso ade biako a ɛsɛ sɛ yɛkae ne sɛ saa CFR bo yi so tew kakra fi awosu mu bere a obi nyin no. Enti, ebia mfaso a ɛfata ma aberante ne mmabaa no bɛyɛ soronko wɔ bo a ɛfata ma obi a ne mfe akɔ anim no ho. Wo duruyɛfo nkutoo na obetumi akyerɛ nea efi mu ba no ase pɛpɛɛpɛ.
Ɔkwan bɛn so na wɔyɛ CFR sɔhwɛ no?
Akwan titiriw abien na wɔfa so yɛ sɔhwɛ yi: biako yɛ ɔkwan a wɔfa so kɔ nipadua no mu, a ɛhwehwɛ sɛ wɔde afiri bi hyɛ nipadua no mu, na biako nso yɛ ɔkwan a wɔfa so fi akyi, a ɛhwehwɛ sɛ wɔyɛ no a wɔmfa nhyɛ nipadua no mu.
| Ɔkwan a wɔfa so sɔ hwɛ | Nkyerɛkyerɛmu a ɛnyɛ den |
|---|---|
| Invasive - Koma mu Catheterization a wɔde hyɛ nipadua mu | Wɔ eyi mu no, wɔde afiri (catheter) a ɛyɛ tratraa paa fa ntini bi a ɛwɔ wo nsa, wo nan, anaa wo kɔn mu kɔ wo koma mu ntini a ɛma mogya tu no mu. Afei wɔde hama titiriw bi fa mu de susuw sɛnea mogya no tu ntɛmntɛm. Wobetumi ayɛ eyi bere koro no ara a wɔyɛ angiogram. |
| Ɔkwan a ɛnyɛ nea wɔde hyɛ nipadua mu - PET Scan | Eyi yɛ scan titiriw bi. Wɔ sɔhwɛ yi mu no, wɔma wo ade ketewaa bi a ɛyɛ radioactive (radiotracer) denam IV so. Afei, PET scanner susuw mogya a ɛkɔ denam sɛnea ade no fa koma no mu hwɛ so. |
| Akwan foforo - Koma MRI | Eyi nso yɛ abɔnten so scan, nanso wɔntaa mfa saa kwan yi nni dwuma mfa nsusuw CFR. |
Ɔkwan bɛn so na ɛsɛ sɛ wusiesie wo ho ansa na woayɛ sɔhwɛ?
Wo duruyɛfo bɛkyerɛkyerɛ eyi mu akyerɛ wo. Mpɛn pii no, ɛsɛ sɛ wohwɛ yiye wɔ saa nneɛma yi ho.
- Nnuru Ho Nsɛm: Ka nnuru a worenom nyinaa (a wɔkyerɛw ma wo ne nea wɔtɔn wɔ aduruyɛdan mu nyinaa) kyerɛ wo duruyɛfo. Nnuru bi betumi aka mogya a ɛtwetwe no na ebia wɔbɛka akyerɛ wo sɛ gyae nom da koro ansa na wɔayɛ nhwehwɛmu no.
- Allergies: Hwɛ hu sɛ wobɛka akyerɛ yɛn sɛ wowɔ allergy bi wɔ nnuru anaa contrast dye biara ho a.
- Mmuadadi: Sɛ wɔreyɛ wo koma mu catheterization anaa PET scan a, wɔbɛtu wo fo sɛ kwati adidi anaa anonne nnɔnhwerew 6-8 ansa na wɔayɛ nhwehwɛmu no.
- Sɛ wopɛ MRI a: Worentumi mfa dade nneɛma biara (agude, dɔn) nhyɛ wo nipadua so. Sɛ wowɔ afiri bi te sɛ nea ɛma wo koma yɛ den wɔ wo nipadua mu a, di kan bisa wo duruyɛfo sɛ ɛyɛ nea asiane biara nni ho sɛ wɔbɛyɛ MRI anaa.
Dɛn na ɛsɛ sɛ yɛhwɛ kwan wɔ sɔhwɛ no mu?
Ɛmfa ho ɔkwan a wobɛfa so ayɛ nhwehwɛmu no, wɔde IV tube (cannula) bɛhyɛ wo nsa mu. Sɔhwɛ no anammɔn bɛyɛ te sɛ eyi.
1. Ahomegye tebea susuw: Nea edi kan no, wɔsusuw mogya a ɛkɔ wo koma mu bere a wo ho adwo wo na woagye w’ahome no.
2. Aduru a wode bɛma: Afei, wɔde aduru (vasodilator) a ɛtrɛw mogya ntini a ɛwɔ wo koma mu na ɛma mogya no kɔ soro kɛse no ma denam IV so. Aduru a wɔtaa de di dwuma ne Adenosine . Sɛ wɔde eyi ma a, mogya a ɛkɔ koma no mu no kɔ soro mpɛn 4-5 wɔ simma 2-3 mu.
3. Peak susudua: Sɛ mogya no du ne sorokɔ bere a wɔde aduru no ama akyi a, wɔsan susuw mogya no.
4. Ntotoho: Awiei koraa no, wɔde saa metrics mmienu yi toto ho de bu wo CFR boɔ.
Sɛ wɔreyɛ wo koma mu catheterization a, ebia wɔbɛma wo aduru a ɛma wo ho dwo wo na aboa wo ma woada mmerɛw. Eyi bɛboa wo ho anyɛ wo dɛ. Sɛ woreyɛ scan a, ɛho hia yiye sɛ wobɛtra hɔ dinn na ama woanya mfonini ahorow a emu da hɔ.
Dɛn na ɛba wɔ sɔhwɛ no akyi?
Sɔhwɛ no akyi no, wubetumi atra ase sɛnea ɛsɛ, nanso ɛsɛ sɛ wohwɛ yiye wɔ nneɛma bi ho.
- Sɛ wɔde koma mu afiri ahyɛ wo mu a, ɛho behia sɛ woma wo nsa anaa wo nan a wɔde afiri no guu mu no gyina hɔ bɛyɛ dɔnhwerew biako na amma mogya antɔ.
- Oduruyɛfo no betu wo fo sɛ nom nsu pii na aboa ma contrast dye no afi wo nipadua mu ntɛmntɛm.
- Sɛ wɔama wo aduru a ɛma obi dwo a, wuntumi nka kar saa da no. Ɛho hia sɛ obi ka wo ho kɔ fie.
So asiane anaa nsunsuanso bɔne bi wɔ sɔhwɛ yi mu?
Mpɛn pii no, CFR nhwehwɛmu yɛ sɔhwɛ a ahobammɔ wom yiye, nanso sɛnea ɛte wɔ aduruyɛ mu nhwehwɛmu biara ho no, asiane nketenkete bi wɔ hɔ.
- Asiane ahorow a ɛfa catheter ho:Bere a wɔde koma mu catheter rema no, mogya a ɛbɛtɔ, mogya ntini a ɛsɛe, anaa mogya a ɛbɛtɔ no ntaa mma.
- Adenosine ho nsunsuanso bɔne: Nnipa binom betumi anya nea edidi so yi wɔ sikani kakraa bi mu bere a wɔama wɔn aduru yi akyi:
- Koma mu nnyigyei a ɛnyɛ ne kwan so
- Mogya mmoroso a ɛba fam
- Ɔhome a ɛyɛ den
- Koko mu a ɛyɛ mmerɛw
Saa sɛnkyerɛnne ahorow yi yera koraa bere a aduru no sa ara pɛ (wɔ simma biako mu) . Biribiara nni hɔ a ɛsɛ sɛ yɛhaw yɛn ho.
Nea ɛho hia: Adenosine mfata mma nnipa a wɔwɔ ayamtu efisɛ ebetumi ama ahurututu mu akisikuru . Sɛ wowɔ ayamtu a, wo duruyɛfo de aduru foforo bedi dwuma mmom.
Dɛn na nea efi mu ba no kyerɛ na bere bɛn na yebehu?
Wo CFR yɛ nɔma a ɛkyerɛ wo mogya dodow a wo koma betumi abɔ bere a ayɛ basaa no.
Ebetumi agye nna kakraa bi ansa na oduruyɛfo no ahwehwɛ nea efii nhwehwɛmu no mu bae na ɔde amanneɛbɔ ama. Ɛtɔ mmere bi a, sɛ nea efi mu ba no yɛ ɔhye so a, wobetumi akɔ animdefo afoforo nkyɛn.
Sɛ nea efi mu ba no kyerɛ sɛ asiane a ɛwɔ hɔ sɛ wubenya komayare a, wo duruyɛfo bɛma wo ayaresa nhyehyɛe bi a ɛbɛma saa asiane no so atew.
Nkrasɛm a Wɔde Kɔ Fie
- Coronary Flow Reserve (CFR) yɛ ade a wɔde susuw ‘tumi a wɔde asie’ a wo koma wɔ na ama mogya akɔ soro wɔ bere a wowɔ adwennwen mu.
- Saa nhwehwɛmu yi betumi ama yɛanya nsɛm a ɛho hia a ɛfa koma no mogya ntini no akwahosan ho. Ebetumi aboa nso ma wɔahu asiane ahorow a ebetumi aba daakye a ɛbɛma wɔanya komayare ntɛm.
- Mpɛn pii no, CFR bo a ɛboro 2.0 yɛ su a ɛma apɔwmuden.
- Hwɛ hu sɛ wobɛka nnuru biara a worenom ne nea ebia wo ho yɛ wo hyew ho asɛm akyerɛ wo duruyɛfo ansa na woayɛ nhwehwɛmu no.
- Eyi yɛ sɔhwɛ a ahobammɔ wom yiye. Sɛ wowɔ nsɛmmisa bi fa nhwehwɛmu no ho a, ntwentwɛn wo nan ase sɛ wubebisa wo duruyɛfo .
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