So ɛsɛ sɛ yehu nnuru abien yi a wɔde ma bere a wɔde stent a wɔde sa komayare awie no ho asɛm pɛpɛɛpɛ? (Ayaresa a Ɛko Tia Ntini a Ɛma Nkwammoaa Mu Abien) .

So woanya komayare nnansa yi? Anaasɛ wɔde stent ahyɛ wo koma mu ntini bi mu? Ebia wo duruyɛfo akyerɛw wo nnuru ahorow abien. Ebia biako ne aspirin. Ebia ɔfoforo no bɛyɛ aduru bi a wɔde din foforo ato so. Enti ebia woresusuw ho sɛ, "Dɛn nti na wɔde nnuru ahorow abien rema me wɔ tebea koro no ara ho?" Eyi yɛ asɛmmisa a nnipa pii wɔ. Ɛnnɛ, yɛreka DAPT, anaa Dual Antiplatelet Therapy, a ɛyɛ ayaresa a ɛho hia, a egye nkwa ma mo mu pii ho asɛm.

Dɛn ne DAPT? Momma yɛnte ase tiawa.

Sɛ yɛbɛte eyi ase a, ɛsɛ sɛ yedi kan hu yɛn mogya ho asɛm kakra. Mogya mu nkwammoaa kɔkɔɔ, mogya mu nkwammoaa fitaa, ne nkwammoaa nketenkete afoforo wɔ yɛn mogya mu. Wɔfrɛ eyinom mogya nkwammoaa a ɛma mogya tu . Adwuma titiriw a mogya nkwammoaa yi yɛ ne sɛ ebegyae mogya a ɛretu bere a opira bi wɔ yɛn nipadua mu baabi no, na ɛde ahopere kɔ baabi a ɛwɔ no, bata bom, na ɛyɛ ahama a ɛbɛma mogya no agyae. Ɛte sɛ nea wode plaster bɛhyɛ paipu a abubu so ntɛmntɛm. Eyi ne nea yɛfrɛ no mogya a ɛtwetwe . Eyi yɛ adeyɛ a ɛho hia ankasa na ama yɛagye yɛn nkwa. Nanso, ɔhaw no fi ase wɔ baabi a ɛnsɛ sɛ mogya a ɛtwetwe yi ba, kyerɛ sɛ, sɛ ɛba yɛn mogya ntini no biako mu a. Susuw nea ɛbɛba sɛ mogya a ɛtɔ gu ntini bi mu a ɛde mogya kɔ koma no mu no ho hwɛ? Saa mogya ntini no siw, na ɛma mogya a ɛkɔ koma no mu no gyae na ɛma obi nya komayare (Myocardial Infarction) . Afei nso, sɛ mogya a ɛtɔ yi kɔ amemene no mu a, ebetumi ama obi anya akisikuru . Enti, Dual Antiplatelet Therapy (DAPT) yɛ aduru a ɛma saa mogya a ɛyɛ hu no ntumi nkɔ ntini no mu. Wɔ eyi mu no, wɔde nnuru ahorow abien a wɔfrɛ no "Antiplatelet" bom ma. Antiplatelet yɛ aduru a ɛmma mogya mu nkwammoaa ntumi nkɔ mu, na ɛkyerɛ sɛ ɛmma mogya ntumi nkɔ. "Dual" kyerɛ abien. Enti, wɔfrɛ eyi Dual Antiplatelet Therapy efisɛ wɔde nnuru ahorow abien bom ma.

Henanom na wohia DAPT ayaresa yi?

Nnuruyɛfo mfa saa ayaresa yi mma obiara. Wɔde ma nnipa a asiane kɛse wom sɛ mogya bɛtɔ wɔn ntini mu nkutoo. Wɔtaa kyerɛw saa ayaresa yi wɔ nsɛm a edidi so yi mu:

Nnuru bɛn na wɔde ma DAPT?

Yɛka sɛ wɔde nnuru ahorow abien bom ma wɔ DAPT ayaresa mu. Saa nnuru ahorow abien no ne: 1. Aspirin: Eyi yɛ aduru a mo mu pii ate ho asɛm. Ɛwom sɛ wɔtaa de di dwuma wɔ dodow a ɛdɔɔso mu sɛ aduru a ɛma ɛyaw ano brɛ ase de, nanso wɔde ma wɔ dodow a ɛba fam koraa mu na amma mogya antɔ wɔ komayarefo mu. 2. Aduru bi a ɛwɔ P2Y12 Inhibitor kuw no mu: Eyi ne aduru a ɛto so abien. Nnuru ahorow pii wɔ hɔ a ɛka kuw yi ho.

• Clopidogrel a wɔde yɛ aduru
• Prasugrel a wɔfrɛ no Prasugrel
• Ticagrelor na ɔkyerɛwee

Wo duruyɛfo na obesi nnuru abiɛsa yi mu nea ɔde bɛma wo ne dodow a ɔde bɛma wo no ho gyinae .Egyina nneɛma pii so, te sɛ w’ayaresa tebea, mfe a woadi, ne sɛ ebia wowɔ ayaresa tebea afoforo anaa.

Mfaso ne asiane bɛn na ɛwɔ DAPT ayaresa so?

Sɛnea ɛte wɔ ayaresa biara ho no, DAPT ayaresa wɔ mfaso ne asiane ahorow bi. Ɛho hia sɛ wohu abien no nyinaa.

Kakraa bi fa asiane a ɛwɔ mogya a ɛbɛtɔ mu ho...

Nsuro bere a wote "asiane a ɛwɔ mogya a ɛbɛtɔ mu" no. Eyi betumi akyerɛ biribiara fi nneɛma nketenkete so kosi aniberesɛm so.

• Mogya a ɛtɔ nketenkete: Mogya a ɛba anom bere a worehohoro wo sẽ, mogya a ɛba wo hwene mu, ne bruu a wobɛdan ntɛmntɛm bere a woapira ketewaa bi akyi no taa ba.
• Mogya a ɛtɔ kɛse: Ɛwom sɛ ɛntaa nsi koraa de, nanso mogya a ɛba yafunu anaa dwensɔtwaa mu (Gastrointestinal bleeding ) betumi aba. Eyi betumi ama mogya akɔ nsu mu anaasɛ ama nsu no ayɛ tuntum. Ɛntaa mma mpo no, mogya a ɛbɛtɔ amemene no mu betumi aba.

Nsunsuanso bɔne ne nkitahodi a ɛda nnuru afoforo ntam

Ebia nnipa binom a wɔnom DAPT no benya nsunsuanso nketenkete.

• Ɔhome a ɛyɛ den
• Mogya a ɛwɔ nsu mu (Haematuria) .
• Akuru a ɛyɛ akuru
• Ntini mu nkwammoaa a ɛwɔ mogya mu a ɛso tew ( Thrombocytopenia ) .
• Anom ntini a ɛyɛ polyps
• Mogya a ɛba hwene mu (Epistaxis) .

Afei nso, sɛ worenom DAPT a, ɛsɛ sɛ wobɔ wo duruyɛfo amanneɛ wɔ nnuru afoforo a worenom ho. Efisɛ nnuru bi betumi asiw DAPT a etu mpɔn no kwan. Hwɛ yiye titiriw wɔ nnuru yi ho.

• Nnuru afoforo a ɛma mogya yɛ mmerɛw ( Anticoagulants ): Sɛ worenom nnuru te sɛ Warfarin a, asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wo no yɛ kɛse koraa.
• Nnuru a wɔde kum ɛyaw (NSAID): Nnuru te sɛ Ibuprofen ne Diclofenac a wɔtaa de di dwuma no betumi ama asiane a ɛwɔ hɔ sɛ yafunu mu mogya bɛtu no ayɛ kɛse.
• Nnuru bi a wɔde sa adwenemhaw (Antidepressants).
• Nnuru a wɔde sa yafunu mu yare (Proton Pump Inhibitors): Nnuru te sɛ Omeprazole.

Enti, mma wo werɛ mmfi sɛ wobɛka biribiara a wonom, a nnuru, vitamin, ne nnuru a wɔde di dwuma wɔ amanne kwan so ka ho akyerɛ wo duruyɛfo .

Bere tenten ahe na ɛsɛ sɛ menom saa aduru yi?

Eyi nso yɛ ɔhaw ma nnipa pii. Bere tenten a wɔde fa DAPT no nyɛ pɛ mma obiara. Ɛsono nnipa biara.

• Nnipa binom tumi de ma bere tiaa bi, te sɛ ɔsram biako anaa abien.
• Ɛsɛ sɛ nnipa pii nom nsa afe biako anaa nea ɛboro saa.
• Sɛ wogyae DAPT ayaresa mpo a, ebia wo duruyɛfo bɛka akyerɛ wo sɛ nom aspirin nkutoo wo nkwa nna nyinaa.

Wo duruyɛfo na ɔkyerɛ bere yi. Nneɛma pii wɔ hɔ a ɛka no:

• Dɛn ne nea enti a wofii ase yɛɛ wo DAPT (komayare? Efisɛ wɔde stent sii hɔ?).
• Wo mfe a woadi ne w’akwahosan nyinaa.
• Asiane ahe na wowɔ sɛ mogya bɛtɔ wo?
• Asiane a ɛwɔ hɔ sɛ obi benya komayare anaa akisikuru bio daakye.

Dɛn na ɛsɛ sɛ woyɛ de bɔ wo ho ban bere a worenom DAPT no?

Ɛsɛ sɛ wususuw w’ahobammɔ ho nso bere a woreyɛ saa ayaresa yi no. Nneɛma a ɛnyɛ den bi a wubetumi ayɛ de aboa ni.

• Nom w’aduru no bere ano: Nom w’aduru no sɛnea wo duruyɛfo ka kyerɛ wo no pɛpɛɛpɛ , a wuntwa nna biara so . Sɛ wopa dodow bi a, ebetumi ama mogya atɔw. Nnyae w’aduru nom da a wommisa wo duruyɛfo.
• Hyɛ aduruyɛ ho ID krataa:Sɛ ɛbɛyɛ yiye a, fa abɔso anaa kaad a ɛkyerɛ sɛ worenom DAPT bere nyinaa. Sɛ biribi si ntɛm a, eyi bɛboa wɔn a wɔresa wo yare no ma wɔahu sɛ worenom nnuru a ɛma mogya tu.
• Ka kyerɛ wo nnuruyɛfo nyinaa: Sɛ worekɔ akɔhwɛ sẽ ho oduruyɛfo anaasɛ wobɛyɛ wo oprehyɛn foforo biara mpo a, ɛsɛ sɛ woka kyerɛ wɔn sɛ worenom DAPT, efisɛ oprehyɛn ahorow bi hwehwɛ sɛ wugyae aduru yi nom bere tiaa bi.

Dɛn ne sɛnkyerɛnne ahorow a ehia sɛ wokɔ ayaresabea ntɛm ara?

Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a, ebetumi ayɛ mogya a ɛretu kɛse ho sɛnkyerɛnne. Enti, ntwentwɛn wo nan ase na frɛ wo duruyɛfo ntɛm ara anaa kɔ ayaresabea a ɛbɛn wo no Emergency Department (ETU). Afei nso, sɛ wususuw sɛ woanom nnuru pii a, frɛ wo duruyɛfo ntɛm ara. Anyɛ saa a,Wubetumi nso afrɛ Ɔman Awuduru Ho Amanneɛbɔbea a ɛwɔ Colombo Ɔman Ayaresabea hɔ akɔhwehwɛ afotu. DAPT, Dual Antiplatelet Therapy, mogya a ɛtwetwe, komayare, ɔyare a ɛma obi hwe ase, stent, aspirin, clopidogrel, Clopidogrel, komayare, nnuru a ɛma mogya yɛ mmerɛw