Nea ɛsɛ sɛ wuhu fa Hepatopulmonary Syndrome ho!

Sɛ wo anaa obi a wunim no wɔ mmerɛbo mu yare, anaasɛ w’ankasa wowɔ tebea no a, ɛho hia sɛ wuhu saa tebea yi a ɛtɔ mmere bi a ebetumi ama ayɛ den sɛ wobɛhome. Yɛfrɛ no Hepatopulmonary Syndrome. Ebia edin no bɛyɛ te sɛ nea ɛyɛ den kakra, nanso momma yɛmma ɛnyɛ mmerɛw, ɛnte saa? Efisɛ ɛyɛ ɔhaw a efi mmerɛbo mu kɔ ahurututu mu.

Dɛn ankasa ne Hepatopulmonary Syndrome?

Sɛ yɛbɛka no tiawa a, hepatopulmonary syndrome yɛ mmerɛbo mu yare a ɛntaa nsi nanso ɛyɛ aniberesɛm a ebetumi aka ahurututu no. Asɛmfua "hepato" kyerɛ "ɛfa mmerɛbo ho." "ahurututu mu" kyerɛ sɛ "ɛfa ahurututu ho." So wunim sɛ mogya ntini na ɛka yɛn mmerɛbo ne yɛn ahurututu bom?

Afei susuw ho hwɛ, sɛ obi wɔ mmerɛbo mu yare, titiriw tebea bi te sɛ akisikuru, a mmerɛbo no mu yɛ den na ɛyɛ ketewaa a, mogya ntini a ɛka ahurututu no ho no bi trɛw a ɛho nhia. Te sɛ balloon a ɛrehuruhuruw. Wɔ aduruyɛ mu no, yɛfrɛ eyi ``Vasodilation`` . Sɛ mogya ntini no trɛw wɔ saa kwan yi so a, sɛnea mogya no kɔ ahurututu no mu daa no sesa. Ɛtɔ da bi a, mogya no ne oxygen a ɛwɔ ahurututu mu no nfra yiye, na mmom ɛfa mu tẽẽ. Wɔfrɛ mogya a ɛnkɔ daa saa no ``Shunts`` . Mogya ntini a ɛtrɛw wɔ ahurututu mu no fi ``Vasodilation``, na oxygen dodow a ɛwɔ mogya no mu no so tew esiane saa ``Shunts`` no nti. Yɛfrɛ eyi ``Hypoxemia`` . So wote ase?

Saa tebea yi ka wo dɛn? So ɛyɛ den ma wo sɛ wobɛhome?

Afei ebia woresusuw sɛ, "Okay, eyi ka me dɛn?" Ade titiriw a ɛka eyi ne ahome a ɛyɛ den (Dyspnea) . Eyi mma mpofirim, na mmom ɛkɔ soro nkakrankakra. Ebia nnipa binom renhu no pii mfiase no. Nanso bere kɔ so no, tebea yi betumi ayɛ den araa ma ɛbɛyɛ den sɛ obi bɛhome bere a ogyina hɔ mpo no.

Ɛyɛ den ma nnipa binom sɛ wɔbɛhome bere a wɔte hɔ anaa wogyina hɔ, nanso sɛ wɔda fam a, wɔn ho tɔ wɔn. Wɔ afoforo fam no, ɛyɛ ɔkwan foforo so; sɛ wɔda fam a, ɛyɛ den ma wɔn sɛ wɔbɛhome, na sɛ wɔsɔre a, wɔn ho tɔ wɔn. Nanso, esiane sɛ bere kɔ so no, ahome a ɛyɛ tiaa yi mu yɛ den nti, yɛfrɛ no Ɔhome a Ɛnyɛ Den a Enni Dwuma. Eyi kyerɛ sɛ biribiara nnyae mpofirim, nanso nkakrankakra wo nipadua no akwaa ne ntini ahorow no nnya mframa pa a ɛdɔɔso. Yɛfrɛ eyi hypoxia .

Eyi yɛ tebea a ɛyɛ hu paa. Wunim dɛn? Oxygen ho hia ma yɛn nipadua. Sɛ ɛyera koraa a, ebetumi asɛe akwaa a ɛho hia te sɛ amemene ne koma no daa. Sɛ wɔansa saa tebea yi yiye a, ebetumi de ne nkwa ato asiane mu.

Hena na ɛda adi sɛ obenya hepatopulmonary syndrome?

Nhwehwɛmu ada no adi sɛ nnipa a wɔwɔ mmerɛbo mu yare a enni sabea no mu bɛyɛ nkyem anan mu biako, anaa 25% nya hepatopulmonary syndrome. Ebetumi aba nso wɔ mmerɛbo a ɛyɛ adwuma mpofirim, a wɔfrɛ no acute liver failure, nanso ɛntaa nsi.

Mpɛn pii no, eyi ne nea ɛba: mmerɛbo mu akisikuru ma mogya ntini a ɛne mmerɛbo no wɔ abusuabɔ no mu nhyɛso kɔ soro. Wɔ aduruyɛ mu no, yɛfrɛ no ``Portal Hypertension'' . Saa ``Portal Hypertension'' tebea no ne nea ɛma mogya ntini a ɛwɔ ahurututu mu no trɛw wɔ nnipa binom mu, na ɛde saa hepatopulmonary syndrome yi ba. Nanso, ɛntaa nsi koraa sɛ ``Portal Hypertension'' betumi aba esiane nneɛma afoforo nti, te sɛ mogya a ɛtɔ, na saa yare yi nso betumi aba denam ɛno so.

Dɛn ne nea enti ankasa a ɛte saa?

Nokwarem no, nyansahufo da so ara nnim nea enti a tebea yi a wɔfrɛ no portal hypertension yi ma mogya ntini a ɛwɔ ahurututu mu no trɛw (vasodilation) wɔ nnipa binom mu no ankasa. Nsusuwii ne adwene pii wɔ hɔ a ɛfa ho. Ɛnyɛ nea ɛda adi koraa nso sɛ nea enti a ɛnto obiara, na mmom ɛto nnipa binom nkutoo. Ɛte sɛ nea ɛne sɛnea mmerɛbo mu yare no mu yɛ den no nni abusuabɔ tẽẽ.

Nanso ade biako da adi pefee. Ntini a ɛtrɛw wɔ ahurututu mu no ma oxygen dodow a ɛwɔ mogya no mu no so tew (Hypoxemia). Sɛ yɛbɛka no tiawa a, mframa dodow a ɛhyɛn ahurututu no mu ne mogya dodow a ɛfa ahurututu no mu no nkari pɛ. Eyi nti na nipadua no nnya mframa pa dodow a ehia no.

Dɛn ne sɛnkyerɛnne ahorow no? Yɛyɛ dɛn hu eyi?

Sɛ Hepatopulmonary Syndrome tebea no mu nyɛ den koraa a, ebia worenhu sɛnkyerɛnne biara. Nsɛnkyerɛnne a edi kan a nnipa pii te nka ne sɛnea yɛadi kan aka no, ɛyɛ den sɛ wɔbɛhome (Dyspnea) . Nanso, nneɛma pii nti na ahome betumi ayɛ den. Obi a ɔwɔ mmerɛbo mu yare betumi ayɛ den sɛ ɔbɛhome wɔ akwan horow so. Enti, ɛtɔ mmere bi a ebia ayarefo ne nnuruyɛfo renhu eyi ntɛm ara sɛ Hepatopulmonary Syndrome ho sɛnkyerɛnne.

Bere a tebea no mu yɛ den no, wubetumi nso anya sɛnkyerɛnne afoforo te sɛ:

• Platypnoea: Eyi ne bere a ɛyɛ den ma wo sɛ wobɛhome bere a wote hɔ anaa wugyina hɔ, nanso wote ahotɔ kakra bere a woada fam no.
• Orthopnea: Eyi ne ɔkwan foforo so. Ɛyɛ den sɛ wobɛhome bere a woada fam no, nanso ɛyɛ papa bere a wote ase no.
• Cyanosis: Anofafa, nsateaa nnadewa, ne ɛtɔ mmere bi a honam ani kɔla sesa bruu esiane oxygen a enni nipadua no mu nti. Eyi yɛ sɛnkyerɛnne a wotumi hu.
• Nsateaa a wɔde nhama ayɛ:Ɛte sɛ nea nsateaa anaa nansoaa ano ahonhon na ayɛ kurukuruwa, te sɛ sanku a wɔde bɔ akuturuku ano. Eyi yɛ hypoxemia ho sɛnkyerɛnne foforo.

Wɔ saa sɛnkyerɛnne ahorow yi akyi no, ebia wubenya sɛnkyerɛnne ahorow a ɛtaa ba mmerɛbo mu yare ne/anaasɛ portal hypertension nso. Nhwɛsoɔ:

• Spider angiomas: Mogya ntini nketenkete a ɛyɛ kɔkɔɔ a ɛte sɛ akɔre a epue wɔ honam ani.
• Varicose veins: Wotumi hu mogya ntini a ayɛ kɛse wɔ yafunu anaa aduan mu.
• Abakɔsɛm a ɛkyerɛ sɛ mogya tu wɔ yafunu mu kan .
• Ascites (yafunu mu a ɛho ahonhon) .

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Nnuruyɛfo hu hepatopulmonary syndrome yi bere a sɛnkyerɛnne atitiriw abiɛsa bom ba no:

1. Portal Hypertension: Eyi taa ba wɔ mmerɛbo mu yare ho.

2. Intrapulmonary vascular dilatations: Eyi kyerɛ sɛ mogya ntini a ɛwɔ ahurututu no mu no atrɛw.

3. Oxygen dodow a ɛso tew wɔ mogya mu (Hypoxemia) .

Mpɛn pii no, sɛ wonya saa `(Hepatopulmonary Syndrome)` yi a, wo nnuruyɛfo ahu dedaw sɛ wowɔ mmerɛbo mu yare `(Mmerɛbo mu Yare)` anaa `(Portal Hypertension).` Sɛ ɛnte saa a, wo nnuruyɛfo kuw no bedi kan ayɛ scan ahorow ne mogya mu nhwehwɛmu ahwɛ sɛ mmerɛbo no asɛe anaa. Afei wɔbɛhwɛ ntini a ɛwɔ w’ahurututu mu no na wɔasusuw oxygen dodow a ɛwɔ wo mogya mu. Saa nhwehwɛmu yi betumi akyerɛ pefee sɛ mogya ntini a ɛwɔ w’ahurututu mu no retrɛw `(Vasodilation)`, a ɛrema oxygen a ɛba wo mogya mu no so atew `(Hypoxemia).`

Sɔhwɛ titiriw bɛn na wɔyɛ ma eyi?

Nnuruyɛfo yɛ nhwehwɛmu ahorow pii de si tebea yi so dua. Ebi ne:

• Pulse oximetry: Ebia woayɛ eyi pɛn. Ɛyɛ sɔhwɛ a ɛyɛ mmerɛw yiye a ɛnyɛ yaw. Wɔde afiri ketewaa bi a ɛte sɛ clip abata wo nsateaa ano. Ɛhyerɛn hann bi fa wo nsateaa mu na ɛsusuw hann dodow a efi ɔfã foforo no, na wɔde susuw oxygen dodow a ɛwɔ wo mogya mu (Oxygen Saturation). Eyi yɛ sɔhwɛ titiriw.
• Arterial Blood Gas (ABG): Sɛ pulse oximetry kyerɛ sɛ wo mogya mu oxygen sua a, nhwehwɛmu a edi hɔ a wobɛyɛ ne ABG. Eyi yɛ nea ɛkɔ akyiri kakra. Wogye mogya ketewaa bi fi ntini bi a ɛwɔ wo nsateaa mu mu . Wɔsɔ mogya no mu nhwehwɛmu de hu oxygen dodow a apete wo mogya mu (PaO2). Eyi yɛ nea ɛkyerɛ sɛnea w’ahurututu retwe mframa pa akɔ wo mogya mu yiye.
• Nsonsonoe a Ɛfa Echocardiography Ho:Eyi ne ɔkwan a eye sen biara a wɔfa so hwehwɛ ahurututu mu ntini a atrɛw. Echocardiogram yɛ ultrasound a wɔde yɛ ade. Ɛde nnyigyei asorɔkye a ano yɛ den di dwuma de twa wo koma ne ntini a ɛwɔ w’ahurututu mu no mfonini. Wɔ ultrasound a ɛma nsonsonoe yɛ kɛse mu no, wɔde ade a ɛma nsonsonoe, nsu titiriw bi, gu ntini bi mu na ama ntini no ada adi yiye. Sɛ woyɛ contrast echocardiogram a, mfiridwumayɛfo bi de nkyene aduru a ayɛ basaa gu wo ntini mu. Eyi yɛ ano aduru a wɔde mframa nketenkete a wɔde gu nkyene nsu mu na ɛyɛ. Afei wɔhwɛ sɛ ebia saa ahurututu nketenkete yi fi wo koma nifa so kɔ benkum so bere a bere kɔ so no (nifa kɔ benkum koma shunt). Wei betumi akyerɛ wɔn sɛ wowɔ `(Hepatopulmonary Syndrome)` anaasɛ wonni bi.

Ɔkwan bɛn so na wɔsa eyi?

Mprempren ayaresa biako pɛ a wɔde sa hepatopulmonary syndrome ne oxygen a wɔde ka ho . Oxygen ayaresa hwehwɛ sɛ wobɛhome oxygen 100% de aboa wo nipadua. Ebia ɛho behia sɛ wunya mframa pa fi ɔdan bi a wɔde nhyɛso ahyɛ mu wɔ ayaresabea, a wɔfrɛ no hyperbaric oxygen therapy mu. Anaasɛ, ebia wɔbɛma wo afiri bi a wubetumi de akɔ fie, te sɛ oxygen akataso. Oxygen betumi aboa ma yare no ho sɛnkyerɛnne ahorow so atew, titiriw ahome a ɛyɛ tiaa, na ama wo nipadua no ntini ahorow no ayɛ adwuma yiye denam oxygen a wohia a ɛbɛma wɔn no so.

So hepatopulmonary syndrome san ba bio? So wobetumi asa no koraa?

Ayaresa biako pɛ a wɔde sa mmerɛbo ne ahurututu mu yare yi ne mmerɛbo a wɔde bɛma obi foforo . Yiw, wotee me asɛm no yiye. Bere a wɔde mmerɛbo si ananmu yiye akyi no, mogya ntini a ɛtrɛw wɔ ahurututu no mu (vasodilation) ne oxygen a enni mogya no mu (hypoxemia) no dan nkakrankakra. Ɛno kyerɛ sɛ ɛyɛ yiye. Egye bɛyɛ asram asia kosi dumien ansa na w’ahurututu mu dwumadi asan ayɛ sɛnea na ɛte kan no.

Nanso, ɛnyɛ obiara na ɔfata sɛ wɔde mmerɛbo foforo ma. Nneɛma ahorow nti na ɛte saa. Sɛ wɔfata mpo a, mmere bi wɔ hɔ a ɛsɛ sɛ wɔtwɛn bere tenten ansa na wɔanya mmerɛbo. Enti saa ahotɔ yi te sɛ mmirikatu a ɛne bere di asi.

So eyi di awu? Na bere a wɔde tra ase no nso ɛ?

Sɛ wowɔ Hepatopulmonary Syndrome a, ebia wowɔ Chronic Liver Disease dedaw. mmerɛbo mu yare a ɛba awiei yɛ tebea a ebetumi akum obi a wɔmfa mmerɛbo foforo nsi ananmu. Hepatopulmonary Syndrome yɛ nsunsuanso bɔne ne nsɛnnennen a ɛde ba no mu biako pɛ. Nnipa pii nwuwu wɔ Hepatopulmonary Syndrome a ɛyɛ oxygen a wonnya (hypoxemia) mu, nanso ɛboa ma wɔn akwahosan nyinaa nya nkɔso nso na ɛma wɔn nkwa nna yɛ tiaa.

Bere tenten a wubetumi atra ase wɔ Hepatopulmonary Syndrome ho no gyina nneɛma pii so. Nea ɛka eyi ho ne sɛnea wo mmerɛbo mu yare no mu yɛ den, w’akwahosan nyinaa, ne sɛ ebia wowɔ ayaresa mu tebea afoforo anaa. Sɛ wɔkyekyem pɛpɛɛpɛ a, obi a ɔwɔ mmerɛbo mu yare nanso onni Hepatopulmonary Syndrome betumi atra ase bɛyɛ mfe ason a wɔmfa mmerɛbo foforo nsi ananmu. Nanso, wɔ obi a ɔwɔ mmerɛbo mu yare ne Hepatopulmonary Syndrome fam no, sɛ wɔkyekyem pɛpɛɛpɛ a, wobetumi atew nkwa nna a wɔamfa mmerɛbo foforo biara mma no so akodu bɛyɛ mfe abien.

Ebia nnipa binom wɔ hepatopulmonary syndrome a emu nyɛ den, a ɛnyɛ den te sɛ mmerɛbo mu yare. Ebia wobetumi atra ase akyɛ denam ayaresa a ɛboa so. Afei nso, ebia nnipa binom rennya nkwa wɔ mmerɛbo a wɔde ma wɔn no mu sɛ wɔn yare no mu yɛ den a. Sɛ wɔkyekyem pɛpɛɛpɛ a, mfe anum nkwa nna a nnipa a wɔwɔ hepatopulmonary syndrome a wɔde mmerɛbo foforo ma wɔn yiye no nya bɛyɛ 70%. Eyi sua kakra sen nkwa a wonya nyinaa wɔ mmerɛbo a wɔde ma akyi (75%).

Ɛsono sɛnea mmerɛbo mu yare ka obiara. Hepatopulmonary Syndrome yɛ tebea a ɛntaa nsi na ebetumi akum obi a ebetumi aba. Ebia woante ho asɛm kosi sɛ ɛbɛto wo anaa obi a ɔbɛn wo.

Nnipa pii nnya yare no ho sɛnkyerɛnne kakraa bi anaasɛ wonni bi koraa. Nanso wɔ ebinom fam, titiriw wɔn a wɔn akwahosan nyɛ papa dedaw no, eyi betumi ate nka sɛ “sare a etwa to.” Te sɛ mmerɛbo mu yare no, bere kɔ so no, hepatopulmonary syndrome (HPS) no mu yɛ den. Sɛ wowɔ mmerɛbo a wɔde bɛma obi foforo a wɔretwɛn no mu dedaw a, wɔbɛma wo akɔ soro wɔ din no mu bere a wɔahu sɛ wowɔ HPS no. Eyi te saa efisɛ nnuruyɛfo nim sɛ saa tebea yi betumi ama wo nkwa nna ayɛ tiaa na ama w’asetra so atew – na wonim sɛ mmerɛbo a wɔde ma obi foforo betumi asa. Saa bere yi de, oxygen ayaresa a wobɛkɔ so ayɛ no betumi aboa wo ma woanya ahotɔ kakra na aboa wo ma woatra ase akyɛ.

Nea etwa to no, nneɛma bi a ɛho hia a ɛsɛ sɛ wokae

Enti, mewɔ anidaso sɛ woanya pefeeyɛ bi afi nea yɛaka ho asɛm afa Hepatopulmonary Syndrome ho no mu. Ma nsɛntitiriw yi ntra w’adwenem:

• Eyi yɛ mmerɛbo mu yare ho haw a ɛntaa nsi nanso ebetumi ayɛ kɛse .
• Nsɛnkyerɛnne titiriw ne sɛ ɛyɛ den sɛ ɔbɛhome (dyspnea) , titiriw wɔ obi a ɔwɔ mmerɛbo mu yare mu.
• Sɛ obi a ɔwɔ mmerɛbo mu yare no nya ahoɔden a ɛyɛ den sɛ ɔbɛhome a, ɛsɛ sɛ wosusuw saa tebea yi (Hepatopulmonary Syndrome) nso ho na wɔka ho asɛm kyerɛ oduruyɛfo no.
• Mmɛn a wɔde ma obi foforo nkutoo ne ayaresa a wɔde sa yare a ɛwɔ hɔ mprempren.
• Enkosi sɛ wobenya saa ayaresa no, oxygen a wɔde sa yare no betumi aboa ma wɔadi yare no ho sɛnkyerɛnne ahorow so na wɔakura nkwa mu.
• Sɛ wo anaa obi a wunim no wɔ saa sɛnkyerɛnne yi a, ɛho hia paa sɛ wobɛkɔ oduruyɛfo nkyɛn ntɛm ara akɔhwehwɛ afotu. Efisɛ, sɛ wohu ntɛm a, ɛnyɛ den sɛ wobedi ho dwuma na wɔayɛ nhyehyɛe ama ayaresa foforo. Mma wo ho nnpopo, nanso eye sɛ wobɛma wo ho ada hɔ.

` Hepatopulmonary syndrome, mmerɛbo mu yare, ahurututu mu yare, ahome a ɛyɛ den, oxygen a wonnya, mmerɛbo mu yare, mmerɛbo a wɔde si ananmu