So mogya ntini bi a ɛwɔ wo nipadua mu betumi asiw mpofirim? Momma yɛnka Embolism ho asɛm!

So woasusuw nea ɛbɛba ho pɛn, sɛ biribi siw mogya ntini bi a ɛwɔ yɛn nipadua mu mpofirim a? Ebia ɛno ntoo wo. Nanso, eyi yɛ biribi a ɛsɛ sɛ yɛn nyinaa hu. Efisɛ, ɛtɔ mmere bi a mogya ntini bi a esiw ano saa, tebea bi a wɔfrɛ no (Embolism), betumi ayɛ asiane kɛse. Enti, so yɛbɛka eyi ho asɛm akɔ akyiri kakra na yɛayɛ no tiawa nnɛ?

Dɛn ne embolism? Sɛ yɛbɛka no tiawa a...

Sɛ yɛbɛka no tiawa a, embolism yɛ bere a biribi siw wo mogya ntini biako, anaa baabi a mogya kɔ no. Mpɛn pii no, mogya a asiw wɔ baabi foforo na ɛde saa akwanside yi ba. Nanso, ɛnyɛ mogya a ɛtwetwe nko, na mmom nneɛma afoforo nso tumi fi nipadua no mu baabi kɔ baabi foforo na esiw mogya ntini bi te sɛ eyi.

Fa no sɛ efĩ bi a akɔhyɛ nsu afiri mu. Mogya ntini bi, esiane ne kɛse ne ne nsɛso nti, ɛda adi sɛ ebesiw sen afoforo. Eyi betumi aba titiriw wɔ baabi a mogya ntini kɛse bi ayɛ nkorabata ayɛ nketewa, anaasɛ baabi a mogya ntini no ayɛ ketewaa esiane srade a ɛwɔ hɔ nti (atherosclerosis).

Saa ntini a ɛma mogya tu yi betumi aba wo nipadua mu baabiara, a w’amemene, w’ahurututu, asaabo, ne w’akyi berɛmo ka ho. Embolism a ɛtaa ba ne ahurututu mu. Sɛ mogya a ɛtɔ wo nan mu ntini mu na ɛkɔ w’ahurututu mu a, wɔfrɛ no ahurututu mu ntini a ɛma mogya tu, anaa PE .

Akwan ahorow bɛn na embolism betumi afa so aba?

Wobetumi akyekyɛ embolism mu ahorow pii a egyina ade ko a ɛbɛkyere mogya ntini no mu so. Hwɛ:

• Thromboembolism: Eyi ne mogya a ɛtaa tu . Ɛnam mogya a ɛtwetwe a ɛba nipadua no mmeae afoforo, titiriw wɔ nan no ntini a emu dɔ mu (Deep Vein Thrombosis - DVT) na ɛba.
• Tumor embolism: Biribi a ɛte sɛ kokoram nkwammoaa bi.
• Fat embolism: Srade betumi aboaboa ano wɔ mogya no mu bere a dompe kɛse bi abubu no.
• Septic embolism: Mogya a ɛtɔ a ɛne ɔyare mmoawa bi wɔ abusuabɔ.
• Mframa a ɛma mogya tu: Sɛ nhwɛso no, ebetumi afi nitrogen mframa mu bere a wɔretu nsu no.
• Amniotic fluid embolism: Eyi ne awo wɔ abusuabɔ na ɛntaa nsi koraa.

Eyinom mu no, Venous Thromboembolism , a ɛyɛ mogya a ɛtwetwe a ɛba ntini no mu na esiw ano no abu so sen ntini mu a ɛtwetwe. Nokwarem no, wɔ ɔman te sɛ Amerika mu no, wɔbɔ amanneɛ sɛ nnipa bɛyɛ 900,000 na wonya saa tebea yi afe biara. Afei nso, Pulmonary Embolism ne ade a ɛto so abiɛsa a ɛde owu ba a ɛfa koma ne mogya ntini ho wɔ wiase. (Nnɔmba biako ne abien ne Stroke ne Heart Attack).

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya embolism?

Sɛ embolism bi ba wo ntini mu a, esiw mogya no kwan. Wunim, mogya de mframa pa a yɛn nipadua mu nkwammoaa biara hia no kɔ. Enti, sɛ mogya no ntumi mfa mu a, oxygen no ntumi mfa mu. Oxygen a enni hɔ yi de tebea bi a wɔfrɛ no "infarct" ba, a ɛsɛe akwaa a ehia saa oxygen no. Eyi betumi ama obi ate yaw. Ɛtɔ mmere bi a, mframa pa a enni hɔ yi betumi akum obi mpo.

Fa no sɛ mogya a ɛtɔ (thrombus) bi reyɛ wɔ ntini bi a emu dɔ mu wɔ wo nan mu, na emu nketenkete abubu na ɛne mogya no akɔ wo koma nifa. Efi hɔ no, wɔde mogya kɔ ahurututu no mu. Saa mogya nketenkete a ɛtwetwe (pulmonary emboli) yi kɔhyɛ mogya ntini nketenkete a ɛwɔ ahurututu no mu no mu, na ɛma ahurututu mu akisikuru ba. Ɛntaa mma koraa sɛ akɛse (ahurututu mu emboli) betumi asiw mogya a efi koma no fã nifa kɔ ahurututu no mu sɛnea ɛsɛ no kwan koraa.

Embolism ho sɛnkyerɛnne ahorow gu ahorow gyina embolism no su ne beae a ɛwɔ so. Ebia nnipa binom rennya yare no ho sɛnkyerɛnne biara koraa. Nsɛnkyerɛnne no bi ni:

• Ahome a ɛyɛ tiaa
• Oxygen dodow a ɛba fam wɔ mogya mu (Hypoxemia) .
• Ɔhome a ɛkɔ ntɛmntɛm nanso ɛnyɛ den (Tachypnea) .
• Mmerewa, ɔbrɛ
• Ti a ɛyɛ yaw
• Nsonsonoe kɔkɔɔ a ɛwɔ honam ani (Petechiae) .
• Koko mu yaw
• Koma a ɛbɔ ntɛmntɛm (Tachycardia) .
• Huraeɛ
• Abasa anaa nan bi a ɛho ahonhon
• Akisikuru a ɛma obi ho kyere no
• Vertigo a ɛma obi ho kyere no
• Ɔfe ne akisikuru
• Mogya mmoroso a ɛba fam (Hypotension) .

Dɛn ne ade titiriw a ɛde embolism ba?

Mpɛn pii no, ahurututu mu ntini a ɛma mogya tu no ba wɔ ahurututu mu. Nea ɛde eyi ba titiriw ne mogya a ɛtɔ wɔ nan no ntini mu (Deep Vein Thrombosis - DVT) . Ɛtɔ mmere bi a, ahurututu mu ntini a ɛma mogya tu nso betumi aba esiane DVT a ɛwɔ abasa no ntini a emu dɔ no mu nti.

Ntease afoforo nso wɔ hɔ a ɛma embolism ba:

• Ɔyare mmoawa a ɛba koma no mu (infective endocarditis) .
• Atrial fibrillation (koma a ɛbɔ a ɛnteɛ) .
• Benkum so ahurututu mu thrombus
• Dompe a abubu wɔ akwanhyia kɛse bi mu
• Kokoram
• Nyarewa ahorow ahorow
• Pancreatitis a ɛyɛ yare
• Liposuction a wɔde hyɛ nipadua mu
• Nnompe mu ntini a wɔde si ananmu
• Asikreyare a ɛba wɔ nyinsɛn mu
• Placenta accreta (awotwaa no a ɛbata awotwaa no fasu ho kɔ akyiri) .

Hena na ɔwɔ asiane kɛse mu sɛ obenya eyi (embolism)?

Nneɛma pii wɔ hɔ a ɛtaa de asiane ba sɛ mogya tu (embolism). Hwɛ sɛ eyinom mu bi fa wo ho anaa:

• Apɔw-mu-teɛteɛ a wɔnyɛ: Sɛ obi tra baabi biako kyɛ dodo, titiriw bere a wɔayɛ oprehyɛn awie no.
• Oprehyɛn ne ayaresa bi: Bere a wɔayɛ oprehyɛn akɛse akyi.
• Koma a entumi nyɛ adwuma yiye
• Nnwodwoɔ
• Kokoram
• Nipadua mu opira (Trauma) .
• Mogya mmoroso (Hypertension) .
• Tawa a wɔde di dwuma (sigaretnom) .
• Nnuru a wɔde siw awo ano a wɔde di dwuma
• Tebea horow a ɛma mogya tu ntɛmntɛm
• Aduruyɛ mfiri bi te sɛ afiri a ɛma koma no bɔ kɛse

Dɛn ne nsɛnnennen a ebetumi aba esiane embolism nti?

Nsɛnnennen a ɛba wɔ embolism mu no gu ahorow gyina baabi a ɛba so. Ebetumi ayɛ nea asiane wom kɛse. Nsɛnnennen no bi ni:

• Amemene no dwumadi a ɛnteɛ, te sɛ nkae a ɛyera
• Koma a ɛbɔ a ɛnteɛ (Arrhythmia) .
• Koma a ɛyɛ den
• Koma mu yare
• Amemene mu akisikuru
• Ahurututu mu akisikuru
• Ɔhome mu Ahokyere a Ɛyɛ Hu (ARDS) .
• Basa anaa nan bi a wɔhwere
• Splenic akisikuru
• Ntini a ewu wɔ asaabo, akyi berɛmo, anaa akwaa foforo a ɛka ho no mu
• Tricuspid valve regurgitation (mogya a ɛsan fa koma valve bi mu) .
• Asaabo a entumi nyɛ adwuma yiye
• Koma a entumi nyɛ adwuma yiye
• Nnwodwoɔ
• Nkwa a wɔhwere mpo betumi aba.

Ɛno kyerɛ sɛ, eyi nyɛ biribi a ɛsɛ sɛ wobu no adewa. Ɛwom sɛ ebia ɛbɛyɛ te sɛ ade ketewaa bi de, nanso sɛ wɔansa wɔ bere ano a, ebetumi de ɔhaw ahorow a ɛde nkwa to asiane mu aba.

Ɔkwan bɛn so na oduruyɛfo hu eyi (embolism) pɛpɛɛpɛ?

Sɛ wowɔ embolism ho sɛnkyerɛnne a, oduruyɛfo bi bedi kan ahwɛ wo. Ebia oduruyɛfo no behu nneɛma te sɛ honam ani nsakrae anaasɛ ɛyɛ den sɛ ɔbɛhome. Sɛ wosusuw sɛ embolism bi wɔ hɔ a, ebia ɔbɛyɛ nhwehwɛmu ahorow bi.

Wobetumi ayɛ nhwehwɛmu ahorow a edidi so yi a egyina embolism ko a obi wɔ so:

• Mogya mu nhwehwɛmu
• Koko so X-ray a wɔyɛ
• Doppler ultrasound - Hwɛ mogya a ɛkɔ mogya ntini mu.
• ECG (Electrocardiogram - EKG) - Ɛhwɛ sɛnea koma no yɛ adwuma.
• CT scan (Kɔmputa so Tomography - CT mfonini) .
• MRA sɔhwɛ(Magnetic Resonance Angiogram - MRA) Nsɛm a Wɔka Kyerɛ (Magnetic Resonance Angiogram) .
• MRI (Magnetic Resonance Imaging) .
• Angiogram - X-ray a wɔyɛ wɔ mogya ntini mu bere a wɔde aduru bi ahyɛ mu akyi.
• Ultrasound nhwehwɛmu a wɔyɛ wɔ koma no ho: (Transthoracic echocardiogram - TTE) ne (Transesophageal echocardiogram - TEE) .
• Ɛtɔ mmere bi a wɔyɛ nipadua mu nhwehwɛmu de hwehwɛ ntini bi mu.

Dɛn ne ayaresa ahorow a wɔde sa embolism?

Botae titiriw a ɛwɔ embolism ayaresa mu ne sɛ wobeyi nea asiw mogya ntini no mu no afi hɔ na ama mogya no asan akɔ. Mpɛn pii no, nea edi kan a wobetumi apaw ne sɛ wɔde nnuru bɛsa yare.

Ayaresa ahorow bi a wɔde sa embolism ni:

• Anticoagulants : Yɛka sɛ eyinom "thrombify" mogya no.
• Thrombolytics : Eyinom ma mogya a ɛtɔ no tẽẽ na yi fi hɔ.
• Nnuru a ekum ɔyare mmoawa a wɔde sa Embolism
• Nnuru a ɛma koma no yɛ adwuma kɛse (Inotropes) .
• Oxygen a wɔde sa yare anaasɛ hyperbaric oxygen a wɔde sa yare
• Embolectomy (oprehyɛn a wɔde yi embolism bi fi hɔ) .

Wɔ nsɛm a emu yɛ den yiye mu no, ebia nnipa a wɔwɔ embolism no behia ayaresa foforo a ɛboa wɔn nkwa, te sɛ CPR , ECMO (afiri a ɛyɛ adwuma mmom sen koma ne ahurututu), ne mfiri mpo a ɛbɛboa wɔn ma wɔahome.

So ayaresa no mu nsunsuanso bɔne bi wɔ hɔ?

Yiw, awerɛhosɛm ne sɛ, nsunsuanso bɔne bi betumi aba. Asiane wɔ hɔ sɛ mogya bɛtɔ, titiriw wɔ nnuru a wɔfrɛ no nnuru a ekum mogya a ɛtwetwe ne thrombolytics ho. Sɛ wɔyɛ oprehyɛn yi mogya a ɛtɔ gu nipadua no mu (embolectomy) a, asiane ahorow te sɛ:

• Mogya ntini bi a ɛsɛe
• Mogya a ɛretu
• Koma a ɛbɔ brɛoo (Bradycardia) .
• Mogya mmoroso a ɛba fam (Hypotension) .
• Koma a ɛyɛ den

Sɛ embolism ba a, dɛn na ɛba?

Ebia nnipa binom a wɔwɔ embolism no nni sɛnkyerɛnne biara koraa, bere a afoforo nso betumi anya yare no ho sɛnkyerɛnne a emu yɛ den yiye. Sɛnea wɔbɛsa wo yare no begyina nneɛma pii so, a nea ɛka ho ne sɛnea embolism no kɛse ne sɛnea emu yɛ den, ne baabi a efii ase.

Embolism yɛ tebea a ɛde wo nkwa to asiane mu, enti sɛ wuhu ntɛm na wosa yare ntɛm a, ebetumi ama hokwan a wowɔ sɛ wo ho bɛtɔ wo no ayɛ kɛse.

Dɛn na yebetumi ayɛ de asiw embolism ano?

Yiw, yebetumi asiw embolism ahorow bi ano. Sɛ wowɔ asiane mu sɛ wubenya embolism a, ebia wo duruyɛfo bɛkamfo nea edidi so yi akyerɛ wo:

• Sɛ woretu kwan tenten (te sɛ wimhyɛn anaa bɔs mu) a, sɔre nnɔnhwerew kakraa biara na ma wo nansoaa so kakra (nantwi ba pɔmpɛ).Eyi betumi aboa ma mogya no akɔ so yiye wɔ nan no mu.
• Nnuru a ɛma mogya yɛ mmerɛw (Anticoagulants) .
• Sɛ wode compression stockings soronko di dwuma.
• Afiri a ɛde nhyɛso ba nan no so (Intermittent Pneumatic Compression Device - IPC mfiri) .
• Wɔ nnipa binom fam no, wobetumi de afiri bi a wɔde yiyi mu ahyɛ ntini titiriw a ɛde mogya fi nipadua no ase kɔ koma no mu (vena cava a ɛwɔ fam a wɔde yiyi mogya) no mu . Eyi mma mogya a ɛtwetwe no ntumi nkɔ koma ne ahurututu mu.

Sɛ minya embolism a, mɛyɛ dɛn ahwɛ me ho?

Sɛ wonya embolism wie a, ebia ebehia sɛ wɔsan siesie wo na ama wo ho atɔ wo. Eyi te saa efisɛ ebia embolism no asɛe mmeae te sɛ w’amemene anaa w’ahurututu. Saa ɔsɛe yi ba efisɛ embolism no atwa oxygen a ɛkɔ saa akwaa anaa beae no mu.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ embolism ho sɛnkyerɛnne a, ɛsɛ sɛ wokɔ ayaresabea ntɛm ara. Ntwentwɛn wo nan ase.

Sɛ wonya embolism wie a, ɛho behia sɛ wokɔ so kɔ wo duruyɛfo nkyɛn na wudi n’akwankyerɛ akyi. Titiriw sɛ worenom nnuru te sɛ nnuru a ekum mogya a ɛtwetwe mogya a, wo duruyɛfo bɛhwɛ sɛ worenom no yiye ne sɛ ebia asiane a ɛwɔ hɔ sɛ mogya bɛtɔ wo no asesa anaa.

Nsɛm bɛn na ɛsɛ sɛ mibisa oduruyɛfo no?

Wubetumi abisa wo duruyɛfo nsɛm te sɛ eyinom:

• Dɛn nti na minyaa eyi (embolism)?
• Hokwan ahorow bɛn na ɛwɔ hɔ sɛ me ho bɛtɔ me a egyina me tebea no so?
• Dɛn ne ayaresa a eye sen biara ma me?
• Dɛn na ɛsɛ sɛ meyɛ na amma embolism foforo te sɛ eyi ansi bio?

Sɛ yɛbɛbɔ no mua a (Take-Home Message) .

Ɛyɛ ade a ɛfata sɛ wobɛte nka sɛ wohaw wo ho wɔ tebea bi a wɔfrɛ no embolism ho, efisɛ ebetumi de wo nkwa ato asiane mu. Ɛno nti na ɛho hia paa sɛ wonya ayaresa ntɛm ara no. Sɛ wowɔ embolism ho sɛnkyerɛnne a, kɔ oduruyɛfo ntɛm ara. Sɛ wosa yare wie a, nya mmoa fi w’abusua ne wo nnamfo hɔ. Sɛ ɛhaw wo anaasɛ ɛhaw wo sɛ wubenya embolism foforo a, wo ne ɔfotufo bi nkasa. Ɛnyɛ wo nko ara, na nsuro sɛ wobɛsrɛ mmoa.

` Embolism, mogya a ɛtɔ, mogya ntini a ɛsiw, ahurututu mu embolism, Pulmonary Embolism, DVT, sɛnkyerɛnne, ayaresa, siw ano