So ɛyɛ den ma wo nso sɛ wobɛhome da biara da esiane emphysema a emu yɛ den nti? So wote nka sɛ woatɔ piti bere a woayɛ nnwuma nketenkete mpo awie no? Bere a woanom nnuru na woakɔ nhyehyɛe ahorow a wɔde siesie wo ho akyi mpo no, wo home mu haw no so ntew? Sɛ saa a, ebia wo duruyɛfo betumi ne wo akasa afa oprehyɛn titiriw bi ho. Ɛno na yɛreka ho asɛm nnɛ. Wɔfrɛ eyi Lung Volume Reduction Surgery, anaa LVRS tiawa.
Sɛ yɛbɛka no tiawa a, dɛn ne LVRS oprehyɛn?
Fa w’ahurututu no sɛ sponge abien. Sɛ emphysema mu yɛ den a, mframa a ɛyɛ kurukuruwa ba wɔ saa sponge yi afã horow bi, na ɛma ɛhohoro. Saa mmeae a asɛe yi ntumi nhome bio, na entumi mfa mframa pa nkɔ mogya no mu. Ɛnyɛ ɛno nko, na mmom saa mmeae a ahuru a mfaso nni so yi nso siw ahurututu no afã horow a ɛte apɔw no kwan, na ɛmma entumi nyɛ adwuma yiye.
LVRS oprehyɛn hwehwɛ sɛ wotwitwa saa ahurututu no afã horow a asɛe, ɛho ahonhon, na mfaso nni so no na woyi fi hɔ.
Ɛne sɛ, ahurututu no kɛse so tew. Sɛ woyɛ eyi a, dɛn na ɛba? Wɔma ahurututu no afã horow a aka a ɛte apɔw no trɛw na ɛyɛ adwuma yiye. Afei, mframa pa a ɛwɔ mframa a wohome mu no betumi akɔ mogya no mu yiye na wɔde akɔ nipadua no nyinaa mu.
Nea ɛho hia ne sɛ oprehyɛn yi nsa emphysema koraa. Na ɛnyɛ nea wɔahyɛ bɔ sɛ ɛbɛtrɛw wo nkwa nna mu. Oprehyɛn yi botae titiriw ne sɛ ɛbɛtew wo home mu den na ama w’asetra atu mpɔn.
Henanom na wobetumi ayɛ wɔn oprehyɛn yi? So ɛnyɛ nea ebetumi aba ama obiara?
Dabi, oprehyɛn yi mfata obiara. Nhwehwɛmu ahorow ada no adi sɛ oprehyɛn yi yɛ adwuma yiye ma ayarefo a wodu gyinapɛn ahorow bi ho nkutoo. Wo duruyɛfo bɛhwɛ wo yiye ahwɛ sɛ woyɛ obi a ɔfata sɛ ɔyɛ saa oprehyɛn yi anaa. Wɔtaa susuw saa gyinapɛn ahorow yi ho:
- Sɛ́ onnii mfe 75.
- Ɔhome a ɛyɛ tiaa kɛse (dyspnea) a ɛkɔ so ɛmfa ho nnuru ne ahurututu mu ahoɔden a wɔde siesie no.
- Ɛsɛ sɛ ahurututu no a ɛsɛe no kɛse wɔ atifi fam. Eyi kyerɛ sɛ ɛsɛ sɛ ahurututu a aka no yɛ nea eye kakra.
- Adanse a ɛkyerɛ sɛ ahurututu mu mframa ayɛ kɛse dodo ne mframa a ɛkyere.
- Ɛbɛyɛ sɛ anyɛ yiye koraa no, woagyae sigaretnom koraa asram 4. Wɔrenyɛ saa oprehyɛn yi wɔ obi a ɔkɔ so nom sigaret no so.
- Nya nipadua ne adwene mu tumi de wo ho hyɛ ahurututu mu ahosiesie nhyehyɛe mu adapɛn 6-10 ansa na wɔayɛ oprehyɛn ne adapɛn 10-12 wɔ oprehyɛn no akyi.
Dɛn ne akwan a wɔfa so yɛ oprehyɛn?
Akwan titiriw abien na ɛwɔ hɔ a wɔfa so yi ahurututu no afã horow a asɛe. Wo duruyɛfo a ɔyɛ wo oprehyɛn no begyina wo tebea no so asi ɔkwan a eye ma wo ho gyinae.
| Ɔkwan a wɔfa so yɛ oprehyɛn | Wɔakyerɛkyerɛ mu tiawa |
|---|---|
| Thoracoscopy a wɔde hwɛ nipadua no mu | Nea ɛka eyi ho ne sɛ wobetwa mparow no ntam nketenkete paa 3 anaa 5 sen sɛ wɔbɛtwa kɛse wɔ koko no mu. Wɔde mfoninitwa afiri (videoscope) fa ntwitwiridii biako mu de hwɛ ahurututu no, na wɔde nnwinnade a wɔde yɛ oprehyɛn fa ntwitwiridii afoforo mu de yi afã horow a asɛe no. Wɔsan frɛ saa kwan yi VATS (Video-Assisted Thoracic Surgery) . Esiane sɛ ntwitwiridii kɛse biara nni hɔ nti, ebia bere a wɔde bɛsan anya ahoɔden no bɛyɛ ntɛmntɛm kakra. |
| Sternotomy a wɔde yɛ adwuma | Eyi yɛ oprehyɛn a wɔabue ano. Wɔnam nufu no dompe a wotwitwa no tenten wɔ koko no mfinimfini na wobue koko no so na ɛyɛ oprehyɛn no. Mfaso a ɛwɔ saa kwan yi so ne sɛ ɛnyɛ den sɛ wobetumi afa ahurututu abien no nyinaa mu denam ntwitwiridii biako so. |
Bio nso, wɔ tebea horow bi mu no, ɔkwan bi wɔ hɔ a wɔfrɛ no Bronchoscopic Lung Volume Reduction (BLR), a nea ɛka ho ne sɛ wɔde ahurututu mu afiri nketenkete bɛhyɛ ahurututu no mu na ama mframa afi mmeae a asɛe, a wɔnyɛ oprehyɛn. Nanso ɛno yɛ asɛmti a ɛda nsow.
Nhwehwɛmu bɛn na wɔyɛ ansa na wɔayɛ oprehyɛn?
Nea ɛbɛyɛ na wo duruyɛfo ahu sɛ woyɛ obi a ɔfata sɛ wɔyɛ oprehyɛn yi no, ɔbɛka akyerɛ wo sɛ wɔnyɛ nhwehwɛmu mpɛn pii. Mma ɛnhaw wo, wɔyɛ nhwehwɛmu yi nyinaa sɛnea ɛbɛyɛ a wubenya ahobammɔ ne sɛnea ɛbɛyɛ a wubenya nea eye sen biara afi oprehyɛn no mu.
- Mfoninitwa Sɔhwɛ: Chest X-ray ne CT scan a ɛyɛ fɛ betumi akyerɛ mframa dodow a akɔhyɛ ahurututu no mu ne baabi a ɛsɛe ade kɛse.
- Pulmonary Function Tests (PFTs): Wɔde eyinom susuw sɛnea w’ahurututu reyɛ adwuma yiye. Wɔhwɛ nneɛma te sɛ wo FEV1 bo a ɛsom no de kyerɛ mfaso dodow a wubenya afi oprehyɛn mu.
- Apɔw-mu-teɛteɛ Sɔhwɛ: Nneɛma te sɛ simma asia nantew sɔhwɛ no susuw baabi a wubetumi ateɛteɛ w’apɔw mu akodu.
- Lung Diffusion Test (DLCO): Eyi sɔ sɛnea w’ahurututu no twetwe mframa pa kɔ wo mogya mu yiye no hwɛ.
- Koma mu Nhwehwɛmu: Wɔyɛ nneɛma te sɛ EKG, echocardiogram, ne adwennwen ho nhwehwɛmu de hwɛ hu sɛ wo koma reyɛ adwuma yiye.
- Nhwehwɛmu afoforo: Nneɛma te sɛ V/Q scan ne mogya mu mframa a wɔde yɛ ntini mu nhwehwɛmu ma wonya ɔhome nhyehyɛe no ho nsɛm pii.
Mfaso ne asiane a ɛwɔ oprehyɛn so
Te sɛ oprehyɛn biara no, eyi wɔ mfaso ne asiane nyinaa. Ɛho hia sɛ wo ne wo duruyɛfo bɛbɔ eyi ho nkɔmmɔ pefee na woanya ntease pa.
Mfaso bɛn na ɛwɔ so?
- Asetra mu nneɛma atu mpɔn kɛse.
- Ahome a ɛyɛ tiaa a ɛso tew.
- Ahurututu mu dwumadi a ɛkɔ anim.
- Tumi a ɛma obi teɛteɛ n’apɔw mu a ɛkɔ soro.
- Ɔhome a ɛyɛ mmerɛw.
Asiane bɛn na ɛwɔ mu?
Oprehyɛn biara wɔ asiane ahorow, na nnuruyɛfo yɛ nea wobetumi biara sɛ wɔbɛtew so.
- Nneɛma bɔne a ɛba bere a wɔde nnuru a wɔde kum nipadua no mu yɛ den.
- Ahurututu a abubu (pneumothorax).
- Mframa a ɛretu fi nhama a wɔde ntama no mu.
- Tebea horow a ɛde ɔyare mmoawa ba te sɛ ahurututu mu yare.
- Koma mu yare (myocardial infarction) a ɛma obi nya komayare.
Eyi yɛ oprehyɛn a anibere wom. Sɛnea akontaabu kyerɛ no, asiane a ɛwɔ hɔ sɛ obi bewu wɔ oprehyɛn yi mu no yɛ 3% kosi 5%. Ɛno nti na ɔyarefo a ɔfata a yɛbɛpaw no ho hia paa no.
Bere tenten ahe na egye na obi ho atɔ no?
Sɛ wɔyɛ oprehyɛn no wie a, ɛho behia sɛ wotra ayaresabea hɔ nnafua 3 kosi 7. Sɛ wokɔ fie wie a, wɔbɛka akyerɛ wo sɛ san fi ase yɛ ahurututu mu ahosiesie nhyehyɛe bio wɔ adapɛn kakraa a edi kan no mu. Eyi ho hia yiye efisɛ saa apɔw-mu-teɛteɛ ne ntetee yi ho hia na ama woanya wo oprehyɛn no so mfaso kɛse.
Ɔhome mu ahotɔ a ɛba bere a wɔyɛ oprehyɛn no taa di mfe abien kosi anum. Enti, ɛho hia paa sɛ wobɛtwe wo ho afi sigaretnom ho koraa na woadi oduruyɛfo no akwankyerɛ akyi wɔ saa bere yi mu.
Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?
Sɛ sɛnkyerɛnne ahorow a edidi so yi mu biara ba wɔ oprehyɛn akyi a, ɛsɛ sɛ wokɔ ayaresabea hɔ Emergency Treatment Unit (ETU) ntɛm ara .
- Huraeɛ.
- Koko mu yaw a emu yɛ den.
- Ɔhome a ɛyɛ den kɛse.
- Honam ani, anofafa, anaa nsateaa nnadewa a ɛsakra bruu (cyanosis).
Nkrasɛm a Wɔde Kɔ Fie
- LVRS yɛ oprehyɛn a wɔyɛ wɔ ayarefo kuw bi a wɔapaw wɔn a wɔwɔ ahurututu mu yare a emu yɛ den nkutoo so.
- Sɛ woreyɛ nhyehyɛe ayɛ wo oprehyɛn yi a, ɛho hia sɛ wugyae sigaretnom koraa.
- Eyi nyɛ oprehyɛn a wɔde sa yare, ne botae titiriw ne sɛ ɛbɛtew ɔhome a ɛyɛ den so na ama asetra atu mpɔn.
- Nea efi oprehyɛn no mu ba no di mfe pii, na ahurututu mu a wɔbɛsan asiesie no ho hia yiye na ama wɔatumi ayɛ kɛse.
- Ansa na wubesi gyinae biara no, wo ne wo duruyɛfo nsusuw mfaso, ɔhaw, ne asiane ahorow a ɛwɔ oprehyɛn yi mu ho na ama woanya ntease a emu da hɔ.
👩🏽 ⚕️ Nsɛmmisa foforo (FAQs)
💬 Dɛn ne Nan a Ɛhohoro / Peripheral Edema?
Eyi nyɛ wo nan a ɛreyɛ den bere a wo mu duru reyɛ kɛse/worenyin no ara kwa! ‘Leg Swelling’ yɛ tebea a wo nan biako (nanso mpɛn pii no wo nan abien no nyinaa), wo nansoaa ne wo nan ase yɛ kɛse soronko esiane nsu a ɛboaboa ano (Edema) wɔ honam ani, na ɛma ɛyɛ den sɛ wobɛhyɛ mpaboa/nantew. Sɛ wode wo nsateaa mia beae a ahonhon yi a, ɛbɛkɔ fam te sɛ amoa kakra (Pitting edema). Eyi yɛ nipadua no ‘koma anaa asaabo’ a ɛsɛe ade kɛse a edi awu!
💬 Dɛn ne nneɛma atitiriw a ekum nnipa a ɛma anan ne anan hohoro (Leg Swelling)?
Nneɛma titire 4 na ɛde eyi ba: 1) ‘Koma no Di Dwuma’ - Sɛ koma no ntumi nkɔ mogya/yɛ mmerɛw (te sɛ bere a woakɔhyɛ wimhyɛn mu), saa mogya no boaboa ano wɔ nan no mu esiane tumi a ɛtwe ade ba fam nti na ɛho ahonhon. 2) 'Kidney Failure/Nephrotic Syndrome' - Sɛ asaabo no ntumi nnyɛ nsuo/asaabo no hwere protein na nsuo hyɛ mu ma. 3) Nneɛma bɔne a efi mogya mmoroso nnuru bi ne nufu mu kokoram nnuru mu ba. 4) Liver Cirrhosis - Wɔ saa tebea yi mu no, yafunu no nyinaa hyɛ nsu ma na ɛyɛ kɛse te sɛ balloon.
💬 Sɛ nan bi hohoro a, dɛn ne 'nkwa-to asiane mu/emergency situations' a ɛsɛ sɛ wokɔ ayaresabea/emergency department ntɛm ara, a womfa ngo/balm kɛkɛ nhyɛ wo so?
Ɛyɛ ade a ɛfata sɛ wo nan ho ahonhon bere a wonyinsɛn no na wo hohoro bere a woagyina hɔ akyɛ akyi (Mild leg edema - ma wo nan nkɔ soro). Nanso eyi ne asiane kɛse! Ka ho ne nan a ahonhon, 1) 'Sɛ nan biako pɛ (ɔfã biako pɛ) ahonhon, ayɛ kɔkɔɔ na ɛrehyew (Ɔhyew/Kɔkɔbɔ/Ɛyaw a emu yɛ den - DVT/mogya a ɛtwetwe)', 2) Sɛ mpofirim ara ɛyɛ den ma wo sɛ wobɛhome na wo moma so ayɛ wo den na wofe/fefe (Pulmonary Embolism / Heart Failure) a, wubetumi awu wɔ simma kakraa bi mu, ɛsɛ sɛ wokɔ ayaresabea dwumadibea a wɔhwɛ ntɛmpɛ so (Ambulance) ntɛm ara!
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