Ebia nnansa yi ara na woasan aba fie wɔ oprehyɛn kɛse bi akyi. Bere a ɛbɛyɛ sɛ wote nka sɛ wo ho atɔ wo no, ebia woate sɛ wo duruyɛfo reka biribi a wɔfrɛ no ‘Endoleak’ ho asɛm, anaasɛ ebia wɔbɔɔ kɔkɔ sɛ biako betumi apue bere a wobedi w’akyi daakye no. Ntease wom sɛ asɛmfua yi a wobɛte no betumi ama woahaw kakra. Nanso, yɛsrɛ sɛ mommma mo ho nnyɛ mo hu. Ɛnnɛ, wɔ Nirogi Lanka no, yɛbɛka nea eyi yɛ ankasa, nea enti a ɛba, ne sɛnea yɛde ahotoso bɛkɔ ho asɛm.
Sɛ yɛbɛka no tiawa a, dɛn ne Endoleak?
Sɛ yɛbɛte eyi ase a, ma yɛnkae ɔkwan a wofa so yɛ no tiawa. Mogya ntini a ɛsõ sen biara wɔ wo nipadua mu, Aorta, yɛ adwuma te sɛ nsu afiri titiriw a ɛwɔ wo fie no. Ɛtɔ mmere bi a, saa anwenne yi fasu no fã bi yɛ mmerɛw na ɛpue, te sɛ balloon. Yɛfrɛ eyi sɛ Aneurysm .
Esiane sɛ eyi betumi ayɛ asiane nti, nnuruyɛfo de Stent Graft gu baabi a ayɛ kɛse no mu. Fa no sɛ wode paipu foforo a ɛyɛ den bɛhyɛ dedaw bi a ayɛ mmerɛw mu de asan akɔ nsu a ɛsen no kwan. Mprempren, mogya fa stent foforo no nkutoo mu, na ɛma nhyɛso a ɛwɔ ɔfasu dedaw a ayɛ mmerɛw no so no so tew na ɛtew asiane a ɛwɔ hɔ sɛ ɛbɛpaapae no so kɛse.
Nanso, wɔ nsɛm kakraa bi mu no, mogya ketewaa bi betumi atu akɔ stent foforo no ne mfitiase ntini no fasu ntam. Saa nsu a ɛtwetwe pɔtee yi ne nea yɛkyerɛkyerɛ mu wɔ aduruyɛ mu sɛ ‘Endoleak.’
Sɛ endoleak ba wɔ nnafua 30 akyi wɔ wo oprehyɛn no akyi a, wɔbu no sɛ “endoleak a edi kan.” Sɛ epue wɔ nnafua 30 akyi a, wɔka ho asɛm sɛ “endoleak a ɛba akyiri.”
Eyi abu so dɛn, na so ɛde ahodwiriw ba?
Akontaabu kyerɛ no, bɛyɛ nnipa baanan biara mu biako a wɔyɛ wɔn oprehyɛn a wɔde siesie ntini mu ntini (te sɛ EVAR anaa TEVAR) betumi anya endoleak. Ɛnyɛ ade a ɛntaa nsi.
Nea ɛho hia titiriw no, ɛnyɛ endoleak biara na asiane wom.
Endoleaks binom ankasa siesie a biribiara mfa wɔn ho nnye mu. Wo duruyɛfo no bɛhwɛ wo tebea no so ara kwa denam mfoninitwa a wɔyɛ no daa so . Nanso, ahorow afoforo yɛ aniberesɛm kɛse; sɛ wɔma ntini a ɛma mogya tu no trɛw anaasɛ ɛma nhyɛso no yɛ kɛse a, ɛho behia sɛ wɔsa no yare ntɛm ara.
Sɛnea emu yɛ den no gyina ɔkwan a nsu a ɛretu no ko ne beae a ɛwɔ so koraa.
Endoleaks ahorow atitiriw bɛn na ɛwɔ hɔ?
Endoleaks ahorow atitiriw anum na ɛwɔ hɔ, na ɛsono nea ɛde ba. Ɛnam nnɛyi stent mfiridwuma so no, eyinom mu pii reyɛ nea ɛho yɛ na kɛse.
| Korɔ | Adwinnade (Wɔayɛ no Mmerewa) . | Sɛnea emu yɛ den |
|---|---|---|
| Ɔkwan a wɔfa so yɛ 1 | Nsuo a ɛtwetwe wɔ soro anaa ase nsɔano beaeɛ a stent no hyia ntini fasuo no. | Aniberesɛm paa. Asiane kɛse a ɛwɔ hɔ sɛ ɛbɛpaapae. Ɛho hia sɛ wɔyɛ ayaresa ntɛm ara. |
| Ɔkwan a wɔfa so yɛ 2 | Nsen a ɛsan kɔ ntini no mu fi ntini no nkorabata a ɛwɔ nkyɛnkyɛn no mu. | Nea ɛtaa ba. Mpɛn pii no, ɛnyɛ nea asiane wom; 40% siesie fi ne ho wɔ asram 6 mu. Nnuruyɛfo na wɔhwɛ so. |
| Ɔkwan a wɔfa so yɛ 3 | Nsu a ɛtwetwe wɔ stent no afã horow ntam esiane mfiri a asɛe anaasɛ wɔatwa mu nti. | Aniberesɛm paa. Asiane a ɛte saa ara a ɛwɔ Type 1. Ɛho hia sɛ wɔyɛ ayaresa ntɛm ara. |
| Ɔkwan a wɔfa so yɛ 4 | Seepage fa porous nneɛma a ɛwɔ stent graft no ankasa mu. | Ɛho yɛ na koraa. Wɔntaa nhu wɔ nnɛyi stent ahorow mu. |
| Ɔkwan a wɔfa so yɛ 5 | Wɔsan frɛ no “Endotension”; ntini a ɛma mogya tu no kɔ so trɛw a biribiara nni hɔ a wotumi hu a ɛma nsu fi mu. | Nea ɛde ba no mu nna hɔ; hwehwɛ sɛ nnuruyɛfo hwɛ wɔn yiye. |
Dɛn ne Endoleak ho sɛnkyerɛnne ahorow?
Eyi ne asɛm a ɛho hia sen biara: wɔ nsɛm dodow no ara mu no, worente nka koraa sɛ wunni endoleak ho sɛnkyerɛnne biara. Ebia worennya ɛyaw, wo ho nyɛ wo dɛ, anaa wo nipadua mu nsakrae biara.
Wɔnam bere a wodi akyi ne mfoninitwa scan ahorow a wo duruyɛfo yɛ nhyehyɛe so na ehu eyinom. Ɛho hia sɛ wokɔ bere a wɔahyɛ no nyinaa ase na wowie wo scan ahorow no; mesrɛ wo, ntwa wɔn so.
Kɔkɔbɔ a Ɛho Hia Ntɛmntɛm! Hwehwɛ mmoa ntɛm ara sɛ wunya eyinom mu osuahu a:
Sɛ endoleak ma obi paapae a , ɛyɛ aduruyɛ mu ntɛmpɛ a ɛde ne nkwa to asiane mu. Sɛ nea edidi so yi mu biara ba mpofirim a, kɔ baabi a ɛbɛn hɔ a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ (ER) a ɛnntwentwɛn wo nan ase:
- Ɛyaw a ano yɛ den a ɛba mpofirim, a wuntumi nnyina ano, wɔ wo yafunu, w’akyi, anaa wo nan mu.
- Tete a wobɛtetew mpofirim wɔ wo moma so anaa w’akyi.
- Adwene a ɛyɛ basaa anaasɛ obi a ɔtotɔ piti.
- Koma a ɛbɔ ntɛmntɛm mpofirim .
- Fifiri a ɛyɛ nwini ne honam ani a ɛyɛ mmerɛw.
- Akisikuru ne ɔfe .
- Ahome a ɛyɛ tiaa .
Ɔkwan bɛn so na nnuruyɛfo hu eyinom?
Sɛnea yɛadi kan aka no, sɛ wobehu saa nsu a ɛretu yi a, ɛhwehwɛ sɛ wɔyɛ mfoninitwa nhwehwɛmu titiriw. Ɛho behia sɛ woyɛ nhwehwɛmu ahorow yi bere a woreyɛ wo oprehyɛn no, wɔ ɛno akyi pɛɛ, ne asram anaa mfe bi akyi mpo. Eyi te saa efisɛ "late endoleaks" bi betumi ayɛ yiye wɔ wo oprehyɛn a edi kan no akyi.
Sɔhwɛ titiriw a wɔde di dwuma de hwɛ nneɛma so no bi ne:
- CT scan (Computed Tomography): Eyi ma wo nipadua ho mfonini a emu da hɔ, 3D, na ɛma yetumi hu mogya biara a ɛretu a ɛyɛ nnam.
- Doppler Ultrasound: Saa nhwehwɛmu yi hwehwɛ sɛnea mogya fa womogya ntini , a ɛboa yɛn ma yehu ahoɔhare ne ɔkwan a ɛkɔ so na ama yɛahu nneɛma a ebetumi atu.
- Angiogram: Wɔde aduru titiriw bi a ɛma wo mogya ntini mu nsonsonoe gu wo mogya ntini mu, na wɔde X-ray di akyi, na ɛma wonya asase mfonini a ɛyɛ pɛpɛɛpɛ yiye a ɛbɛma woahu baabi pɔtee a nsu biara a ɛretu.
Ɔkwan bɛn so na wɔsa endoleaks?
Wɔayɛ w’ayaresa nhyehyɛe no ama wo titiriw, a egyina endoleak ko, beae pɔtee a ɛwɔ, ne w’akwahosan tebea nyinaa so. Ɛnyɛ obiara na ɔhwehwɛ ɔkwan koro. Nneɛma atitiriw abiɛsa na ɛwɔ hɔ a wubetumi apaw:
1. Nneɛma a wɔhwɛ
Eyi ne ɔkwan a wɔtaa fa so ma nsu nketenkete a asiane nnim te sɛ Type 2 endoleaks. Ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔnyɛ scan daa asram 6 biara de hwɛ beae no. Yɛhwɛ sɛ ebia nsu a ɛretu no ankasa gyae, ɛkɔ so yɛ nea ɛyɛ den, anaasɛ sɛ mogya mu ntini no fi ase nyin anaa. Sɛ ntini a ɛma mogya tu no nnyɛ kɛse a, mpɛn pii no, hwɛ a wɔbɛhwɛ no ne nea ahobammɔ wom na etu mpɔn sen biara.
2. Endovascular Ayaresa a Wɔde Ma
Eyinom yɛ oprehyɛn a ɛnyɛ den pii a wɔde tow ketewaa bi so yɛ, a wɔde afiri a wɔde fa wo mogya ntini mu di dwuma sen sɛ ebehia sɛ wɔyɛ oprehyɛn kɛse.
- Embolization: Yɛde coil soronko anaa aduruyɛ gluu di dwuma de siw nsukorade nketewa a ɛma nsu a ɛretu no ma no kwan.
- Stent Graft Extension: Yɛde stent graft no fã foforo si hɔ de trɛw nea ɛkata so no mu na yɛkata nsu a ɛretu no ano yiye.
- Glue Embolization: Yebetumi akɔ aneurysm kotoku no mu tẽẽ akɔfa aduru a wɔde siw ano a ɛyɛ aduruyɛ mu de ato baabi a nsu no retu no mu.
3. Oprehyɛn a Wɔbue Mu
Eyi ho yɛ na koraa. Sɛ wontumi mfa akwan a ɛnyɛ den pii so nsiesie endoleak bi nkutoo a, na yebu eyi sɛ ɔkwan a etwa to nkutoo, na ɛho hia sɛ wɔyɛ oprehyɛn a wɔtaa yɛ a wɔabue ano.
Nsɛmmisa a wode bɛma wo duruyɛfo
Ɛyɛ ade a ɛfata koraa sɛ wubenya w’akwahosan ho dadwen. Sɛ wosan kɔ wo duruyɛfo nkyɛn a, ntwentwɛn wo nan ase sɛ wubebisa nsɛm a edidi so yi:
- Nsɛnnennen afoforo bɛn na ebetumi aba a ɛsɛ sɛ mihu sɛ midi saa adeyɛ yi akyi?
- Dɛn ne m’ankasa asiane dodow a ɛbɛma manya endoleak?
- Mpɛn ahe na ebehia sɛ mesan kɔ hɔ kɔyɛ nhyehyɛe a wɔde bedi akyi?
- Mfoninitwa sɔhwɛ pɔtee bɛn na mihia daakye?
- Anamɔn bɛn na metumi ayɛ na ama me koma ne me ntini akwahosan ayɛ papa?
Ntini a ɛma mogya tu a wobesiesie no yɛ ade a egye nkwa, na ɛboa sɛ wubebu oprehyɛn akyi nsɛnnennen nketenkete sɛ anammɔn a wubetumi adi ho dwuma wɔ w’akwantu a wode bɛsan agye wo ho no mu. Mpɛn pii no, nsɛm yi nhia sɛ wɔde wɔn ho gye mu, na sɛ ɛba saa a, nnɛyi nnuruyɛ de ano aduru a etu mpɔn kɛse na ɛnyɛ den ma. Sɛ wote nka da bi sɛ wo ho yeraw wo anaasɛ woayɛ basaa a, yɛsrɛ wo kɔ wo duruyɛfo nkyɛn anaa wo ne w’adɔfo nsusuw saa nkate horow yi ho.
Nkrasɛm a Wɔde Kɔ Fie
- Endoleak yɛ ade a wɔtaa hu wɔ ntini a ɛma mogya tu akyi, nanso ɛnyɛ bere nyinaa na ɛyɛ tebea a asiane wom.
- Endoleaks dodow no ara nni sɛnkyerɛnne biara, na ɛno nti na ɛho hia sɛ wokɔ bere a woayɛ nhyehyɛe sɛ wobɛkɔ akɔhwɛ wo no.
- Type 1 ne 3 endoleaks yɛ aniberesɛm na ɛhwehwɛ sɛ wɔsa no ntɛm, bere a Type 2 a ɛtaa ba no taa siesie wɔn ho.
- Sɛ wote yafunu anaa wo koko mu yaw a emu yɛ den mpofirim, anaasɛ wotɔ piti a, eyi betumi akyerɛ sɛ ebia ntini a ɛma mogya tu no mu paapae . Hwehwɛ ayaresa a egye ntɛmpɛ ntɛm ara denam 911 a wobɛfrɛ anaasɛ wobɛkɔ dwumadibea a ɛbɛn wo a wɔhwɛ ntɛmpɛ so no so.
- Sɛ w’adwene mu yɛ wo naa anaa nsɛmmisa bi fa wo tebea no ho a, yɛsrɛ wo ntwentwɛn wo nan ase da sɛ wo ne wo duruyɛfo bɛkasa.
Endoleak, Aneurysm, Oprehyɛn, Stent Graft, Mogya a ɛtwetwe, Aorta, EVAR, TEVAR, Komayare
