So wo nan ho ahonhon na ɛyɛ yaw? Eyi betumi afi (May-Thurner Syndrome)!

Ɛtɔ mmere bi a, yɛn nan hohoro na ɛyɛ yɛn yaw a ntease biara nnim, ɛnte saa? Titiriw nan benkum no. Nnipa pii mfa wɔn adwene nsi eyi so kɛse. Nanso ebia eyi nyɛ asɛm a ɛyɛ mmerɛw bere nyinaa. Ɛnnɛ yɛrebɛka tebea bi a yɛntee ho asɛm, nanso yɛn nyinaa nim sɛ ɛfata sɛ yɛkɔsra ho asɛm. Ɛno ne `(May-Thurner Syndrome)`. Wɔsan frɛ eyi `(Cockett syndrome)` anaa `(Iliac vein compression syndrome)`.

Dɛn ankasa ne ``May-Thurner Syndrome''?

Sɛ yɛbɛka no tiawa a, `(May-Thurner Syndrome)` yɛ tebea a ɛma wo nifa so ntini (`Right Iliac Artery`) ne wo benkum so ntini (`Left Iliac Vein`) no mia. Seesei ebia woresusuw nea ɛyɛ saa ntini ne ntini ahorow yi ho. Iliac artery nifa no ne mogya ntini titiriw a ɛde mogya kɔ wo nan nifa so. Benkum so ntini no ne mogya ntini titiriw a ɛde mogya fi wo nan benkum mu san kɔ koma no mu. Enti, wɔ saa `(May-Thurner Syndrome)` yi mu no, saa nhyɛso no betumi asiw mogya a ɛbɛfa wo nan mu no kwan.

Dɛn na eyi yɛ nipadua no? Ɛka no dɛn?

Seesei ebia woresusuw nea eyi yɛ nipadua no ne sɛnea ɛka no ho. Ade titiriw ne sɛ esiane saa nhyɛso yi nti, mogya fi ase boaboa ano wɔ nan no mu, titiriw nan benkum , sen sɛ ɛbɛkɔ soro tẽẽ afa benkum akyi ntini no mu, kyerɛ sɛ, akɔ koma no mu. Sɛ eyi ba a, mogya a ɛbɛtɔ wɔ ntini a emu dɔ no mu . Yɛfrɛ eyi wɔ aduruyɛ mu sɛ `(Deep Vein Thrombosis)` anaa `(DVT)`. Eyi yɛ tebea a ɛsɛ sɛ wɔde adwene si so kakra. `(DVT)` ho sɛnkyerɛnne betumi ayɛ sɛ eyi:

• Nsakrae a ɛba honam ani kɔla a ɛwɔ nan no so (ebia kɔkɔɔ, bruu).
• Ɛte sɛ nea ntini a ɛwɔ nan no mu no ayɛ kɛse na ɛho ahonhon.
• Nan mu yaw, ɛyaw a emu yɛ den, anaasɛ ɛyɛ mmerɛw sɛ wode wo nsa bɛka.
• Nan a ɛho ahonhon ne te nka sɛ ne mu yɛ duru.

Mmea binom nso betumi anya pelvic congestion syndrome (PBS) aka May-Thurner syndrome ho. Nnuruyɛfo gye di sɛ ɛyaw a enni sabea yi fi ntini a ɛwɔ akyi berɛmo no mu (i.e., yafunu no ase) ho haw.

Ɔkwan bɛn so na eyi siw mogya kwan?

Mogya nam yɛn nipadua no mogya ntini (ntini ne ntini) mu bere nyinaa. Sɛnea ebia wobɛkae no, ntini ahorow no de mogya a ɛho tew a mframa pa wom fi koma no mu kɔ nipadua no afã afoforo nyinaa. Sɛ saa afã horow no nya mframa pa ne aduannuru wie a, ntini ahorow no de mogya a oxygen nnim a ɛho ntew san kɔ koma ne ahurututu mu.

Wɔ yɛn nipadua mu mmeae bi no, saa ntini ne ntini yi twa wɔn ho wɔn ho. Saa ara nso na yɛn akyi berɛmo mu no, nifa so ntini a ɛwɔ akyi no wɔ benkum akyi ntini no atifi. Mpɛn pii no, eyi nyɛ ɔhaw. Nanso, wɔ obi a ɔwɔ `(May-Thurner Syndrome)` mu no, nifa so ntini a ɛwɔ akyi no de nhyɛso ba benkum akyi ntini no so. Fa no sɛ nsu afiri bi wɔ hɔ, sɛ obi tiatia so a, dɛn na ɛba? Ɛyɛ den sɛ nsu no bɛsen, ɛnte saa? Sɛ yɛbɛka no pɛpɛɛpɛ a, biribi a ɛte saa ara si wɔ ha.Esiane sɛ benkum so ntini a ɛwɔ akyi no mu ayɛ den nti, ɛbɛyɛ den sɛ mogya bɛfa mu kwa.

Hena na ɛda adi sɛ obenya saa tebea yi?

Ɛte sɛ nea saa ``May-Thurner Syndrome'' yi taa ba mmea so kakra . Ɛtaa ba mpanyimfo a wɔadi fi mfe 20 kosi 50 nso so kakra .

Saa tebea yi abu so dɛn?

Nokwarem no, iliac vein thrombosis abu so sen sɛnea ebia wubesusuw. Nhwehwɛmu ahorow bi kyerɛ sɛ ebia nnipa baanum biara mu biako benya thrombosis a ɛte sɛɛ! Nanso nea ɛyɛ nwonwa ne sɛ, ɛwom sɛ nnipa pii wɔ iliac vein thrombosis de, nanso wɔanhu pɔtee sɛ wɔwɔ `(May-Thurner Syndrome)`. Ade biako nti a ɛte saa ne sɛ nnipa pii nnya `(May-Thurner Syndrome)` ho sɛnkyerɛnne kosi sɛ wobenya tebea te sɛ `(DVT)`.

Dɛn ne `(May-Thurner Syndrome)` ho sɛnkyerɛnne?

Nnipa pii a wɔwɔ May-Thurner Syndrome no nhu sɛnkyerɛnne biara , titiriw sɛ wonni DVT a yɛadi kan aka ho asɛm no a. Sɛ sɛnkyerɛnne ahorow ba ampa a, mpɛn pii no ɛka nan benkum no nkutoo . Ebia eyinom bi ne:

• Nkate a ɛte sɛ nea emu yɛ duru wɔ nan no mu. Te sɛ ɔbo a ɛsensɛn so, ɛnyɛ dɛ koraa.
• Ɛtɔ da bi a, akuru a ɛnsa (akuru) tumi ba nan no so.
• Ebia wobɛte ɛyaw wɔ wo nan mu anaasɛ wobɛte akisikuru a efi wo mu.
• Ebia honam ani kɔla bɛsakra. Ebetumi ayɛ bruu anaa bruu.
• Nan a ɛho ahonhon.
• Tebea horow te sɛ ntini a ɛyɛ mmerɛw betumi asɔre.

Dɛn na ɛde `(May-Thurner Syndrome)` ba?

Ade titiriw nti a ɛte saa ne sɛ nifa so ntini a ɛwɔ akyi no piapia benkum akyi ntini no. Nanso nnuruyɛfo ntumi nhu nea enti a eyi ba ankasa . Ɛne sɛ, ebetumi afi nsakrae a ɛba nipadua no nhyehyɛe mu ara kwa.

Ɔkwan bɛn so na nnuruyɛfo hu eyi? (Nyare a Wɔahu) .

Sɛ wowɔ saa nsɛnkyerɛnne yi a, ade a edi kan a ɛsɛ sɛ woyɛ ne sɛ wobɛkɔ oduruyɛfo nkyɛn na woaka wo sɛnkyerɛnne ne w’akwahosan ho abakɔsɛm pefee. Oduruyɛfo no bɛhwɛ wo. Afei, ebia wɔbɛyɛ nhwehwɛmu titiriw bi a ebetumi ahwɛ mogya ntini yi.

• `CT (Computed Tomography) scan` : Eyi de X-ray ne kɔmputa soronko di dwuma de twa mogya ntini ho mfonini a wɔatwa no akuturuku. Afei wobetumi de eyi adi dwuma de ahwɛ sɛ ebia biribi asiw kwan anaa.
• `MRI (Magnetic Resonance Imaging)` : Eyi de magnet, radio asorɔkye, ne kɔmputa di dwuma de yɛ mogya ntini ho mfonini a ɛkɔ akyiri.
• Ultrasound: Saa sɔhwɛ yi de nnyigyei asorɔkye di dwuma de hwɛ mogya a ɛkɔ nipadua no mu, titiriw wɔ mogya ntini mu (Doppler Ultrasound).
• Venogram : Wɔ eyi mu no, wɔde aduru soronko bi (contrast dye) gu ntini bi mu na wɔhwɛ aduru no wɔ X-ray ase hwɛ sɛ ebia mogya no mu kwan asiw anaa.
• Wobetumi nso ayɛ ``catheter-based venogram'' . Eyi kyerɛ sɛ wɔde afiri ketewaa bi (catheter) hyɛ ntini bi mu na wɔde aduru a wɔde yɛ nneɛma gu mu.
• Intravascular Ultrasound (IVUS) : Eyi yɛ sɔhwɛ a ɛkɔ akyiri kakra. Ɛha yi, wɔde catheter bi hyɛ mogya ntini bi mu, na wɔde ultrasound afiri ketewaa bi (probe) fa catheter no mu de twa mogya ntini no mu mfonini a emu da hɔ yiye na ɛkɔ akyiri. Eyi betumi asusuw nhyɛso dodow a ɛwɔ mu no pɛpɛɛpɛ.

Dɛn ne ayaresa ahorow a wɔde sa eyi?

Botae atitiriw abien na ɛwɔ hɔ bere a wɔresa `(May-Thurner Syndrome)`. Biako ne sɛ wɔbɛma mogya a ɛkɔ nipadua no mu atu mpɔn . Ɔfoforo no ne sɛ wɔbɛtew asiane a ɛwɔ hɔ sɛ wobenya `(DVT)` no so. Ɛdenam wo tebea so no, wo duruyɛfo betumi akamfo ayaresa ahorow a edidi so yi akyerɛ wo:

• Angioplasty ne Stenting : Eyi ne ayaresa a wɔtaa yɛ. Wɔ saa adeyɛ yi mu no, wɔde catheter a balloon ketewaa bi wom hyɛ benkum akyi ntini a asiw no mu. Sɛ edu baabi pɔtee a asiw no a, wɔma balloon no mu mframa gu mu. Eyi ma ntini a asiw no bue. Afei, wɔde afiri ketewaa bi a wɔde ahama ayɛ a wɔfrɛ no stent , gu baabi a wɔabue no mu na amma antoto bio, na woyi balloon no. Eyi te sɛ nea woyi siw kwan bi fi hɔ na wosi abɔnten so kwan na ama ayɛ mmerɛw sɛ wobetwa.
• Oprehyɛn a wɔde twa kwan : Ɛtɔ mmere bi a, wɔde ntini bi a wɔafa afi beae foforo anaa afiri a wɔde ayɛ ade a wɔde twa ntini a asiw no ho hyia no so na ɛyɛ ɔkwan foforo. Eyi ma mogya san kɔ. Eyi yɛ oprehyɛn kɛse.
• Right iliac artery shunting : Ɛntaa mma sɛ wɔbɛyɛ oprehyɛn de atutu nifa so ntini no kakra na ama nhyɛso a ɛwɔ benkum iliac ntini no so no afi hɔ. Ɛtɔ mmere bi a, wobetumi de ntini bi ahyɛ ntini no ne ntini no ntam na ama nhyɛso no afi hɔ.

Sɛ wonya `(DVT)` a, dɛn na ɛsɛ sɛ woyɛ?

Afei fa no sɛ wowɔ `(May-Thurner Syndrome)` na wo nso wowɔ `(DVT)`. Sɛ ɛba saa a, wɔ ayaresa ahorow a yɛaka ho asɛm wɔ atifi hɔ no akyi no, wo duruyɛfo no de ayaresa afoforo bi bɛka ho:

• Nnuru a ɛko tia mogya a ɛtwetwe : Eyinom mma mogya ntumi nkɔ, ɛmma mogya a ɛwɔ hɔ dedaw no ntumi nyɛ kɛse, na ebetumi mpo aboa ma mogya a ɛtɔ dedaw no apete nkakrankakra.
• Clot-busting medications / Thrombolytics : Eyinom yɛ nnuru a tumi wom a wɔde ma tẽẽ de ma mogya a ɛtɔ gu nipadua no mu no tew. Wɔtaa fa catheter so de nnuru yi ma, kɔ mogya a ɛretu no mu tẽẽ.
• `Vena Cava Filter` : Eyi yɛ afiri ketewa bi a ɛte sɛ mesh. `Inferior Vena Cava` ne ntini a ɛso sen biara wɔ yɛn nipadua mu. Ɛha na mogya a efi nan ne yafunu mu kɔ koma no mu. Sɛ wɔde saa afiri a wɔde yiyi mu yi si saa ntini no mu a, ɛmma mogya a ɛtɔ wɔ nan no mu no mfi kwan no so na ɛnkɔ ahurututu no mu.

So ɔkwan bi wɔ hɔ a wɔbɛfa so asiw eyi ano?

Sɛ yɛbɛka nokware a, ɔkwan biara nni hɔ a ɛyɛ nokware a wɔbɛfa so asiw saa ``May-Thurner Syndrome'' yi ano., efisɛ wonnim nea ɛde ba ankasa. Nanso wubetumi ama wo mogya a ɛkɔ nipadua no nyinaa akɔ so ayɛ papa na woatew asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so denam nea edidi so yi a wobɛyɛ so:

• Mma ntra baabi nkyɛ dodo. Sɛ woyɛ adwuma wɔ adwumayɛbea bi a, sɔre na nantew kakra, teɛ wo nan mu, anyɛ yiye koraa no pɛnkoro dɔnhwerew biara.
• Nom nsu pii. Ɛyɛ papa sɛ anyɛ yiye koraa no wobɛnom nsu lita 2-3 da biara.
• Apɔw-mu-teɛteɛ daa , titiriw apɔw-mu-teɛteɛ a ɛma mframa bɔ (te sɛ nantew, mmirikatu, ne sakre so).
• Sɛ wowɔ ayaresa mu tebea afoforo te sɛ asikreyare, mogya mmoroso, anaa ntini a ɛwɔ akyi (PAD) a, wo ne wo duruyɛfo nkasa na ma wodi so yiye.
• Sɛ wonom sigaret a, akyinnye biara nni ho sɛ gyae . Sigaretnom nye mma wo mogya ntini paa.
• Sɛ wo duruyɛfo kamfo kyerɛ a, hyɛ compression stockings soronko. Eyinom boa ma mogya a ɛboaboa ano wɔ wo nan mu no so tew na ɛboa ma wokɔ soro.

Nsɛnnennen bɛn na eyi betumi de aba?

Ɔhaw titiriw a ɛwɔ `(May-Thurner Syndrome)` mu ne `(DVT)` a yɛkaa ho asɛm no. Nanso, biribi wɔ hɔ a ebetumi ayɛ nea asiane wom kɛse mpo . Ɛne sɛ, sɛ mogya a atu wɔ nan no mu no mu tetew fi hɔ, fa mogya no mu na ɛkyere ntini bi a ɛwɔ ahurututu no mu a. Yɛfrɛ saa `(Pulmonary Embolism)` (mogya a ɛtɔ gu ahurututu mu) .

Pulmonary Embolism yɛ aduruyɛ mu tebea a egye ntɛmpɛ a ɛde nkwa to asiane mu. Sɛ wowɔ saa sɛnkyerɛnne foforo anaa nea ɛreyɛ kɛse yi bi a , kɔ ayaresabea dwumadibea a ɛhwɛ ntɛmpɛ a ɛbɛn wo no ntɛm ara anaa frɛ ambulance:

* Mogya a wɔde ɔfe a ɛyɛ nwini.

* Koma a ɛbɔ (koma a ɛbɔ ntɛmntɛm anaasɛ ɛnteɛ mpofirim).

* Ɔhome a ɛyɛ den kɛse, te nka sɛ wo ho atɔ wo (Dyspnea).

* Sɛ mpofirim ara wote wo koko mu yaw a emu yɛ den a ɛyɛ kɛse bere a wohome no.

Dɛn ne daakye ma obi a ɔwɔ `(May-Thurner Syndrome)`?

Nnipa pii tra ase kyɛ na wonya apɔwmuden a May-Thurner Syndrome nni ɔhaw biara. Sɛ wunni sɛnkyerɛnne biara a, ebia wunnim mpo sɛ wowɔ tebea no.

Nanso, sɛ wuhu `(Deep Vein Thrombosis - DVT)` ho sɛnkyerɛnne ahorow a yɛkaa ho asɛm no bi (te sɛ ɛho hohoro, kɔkɔɔ, ɛyaw, nan a ɛyɛ hyew) a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn . Mpɛn pii no, wobetumi de nnuru ne sɛ ɛho hia a, wɔde ayaresa afoforo adi `(DVT)` so yiye.

Nsɛmmisa a ɛsɛ sɛ wobisa oduruyɛfo no

Sɛ wowɔ May-Thurner Syndrome, anaasɛ wususuw sɛ ebia wowɔ, a, ebetumi aboa sɛ wubebisa wo duruyɛfo nsɛm yi:

• Dɛn ne ``May-Thurner Syndrome'' ho sɛnkyerɛnne a ɛka me?
• Dɛn na ɛda adi sɛ ɛde me yare no ho sɛnkyerɛnne ahorow ba?
• Sɔhwɛ bɛn na ɛsɛ sɛ meyɛ na ama mahu eyi pɛpɛɛpɛ?
• Dɛn ne `(DVT)` ho sɛnkyerɛnne? Sɛ minya wɔn a, dɛn na ɛsɛ sɛ meyɛ?
• Dɛn ne `(Pulmonary Embolism)` ho sɛnkyerɛnne? Sɛ minya wɔn a, dɛn na ɛsɛ sɛ meyɛ?
• Ayaresa bɛn na wokamfo kyerɛ ma ``May-Thurner Syndrome''? Dɛn ne mfaso ne ɔhaw ahorow a ɛwom?
• Hokwan ahorow bɛn na ɛwɔ hɔ sɛ sɛnkyerɛnne ahorow no bɛsan ada adi bere a wɔasa no yare awie no?

So `(May-Thurner Syndrome)` de nkwa to asiane mu?

`(May-Thurner Syndrome)` nyɛ nea ɛde nkwa to asiane mu tẽẽ. Nanso, ebetumi de ɔhaw bi a ɛyɛ hu a wɔfrɛ no `(Pulmonary Embolism)` aba. Ɛno ne nea ɛde nkwa to asiane mu. Enti, ɛho hia paa sɛ wobɛhunu `(Pulmonary Embolism)` ho sɛnkyerɛnne na sɛ wote biribi a ɛte saa nka a, hwehwɛ aduruyɛfoɔ afotuo ntɛm ara .

Wobɛyɛ dɛn ahu sɛ wowɔ `(May-Thurner Syndrome)`?

Nokwarem no, ebia worentumi nhu no yiye sɛ wowɔ `(May-Thurner Syndrome)` efisɛ nnipa pii nnim mpo sɛ wɔwɔ bi kosi sɛ wobenya `(DVT)` ho sɛnkyerɛnne.

Ɔkwan biako pɛ a wobɛfa so ahu no yiye ne sɛ wobɛma oduruyɛfo ayɛ mfoninitwa nhwehwɛmu ahorow a yɛadi kan aka ho asɛm (te sɛ CT, MRI, Venogram, IVUS) na asi so dua sɛ benkum so ntini no retu afi nifa so ntini no mu.

Nneɛma a ɛho hia a ɛsɛ sɛ wokae (Take-Home Message) .

Okay, enti, nneɛma a ɛho hia paa a ɛsɛ sɛ wokae fa ``May-Thurner Syndrome'' a yɛaka ho asɛm tenten no ni:

• May-Thurner Syndrome yɛ tebea a ɛma wo nifa ntini no mia wo benkum so ntini no, na esiw mogya a efi wo nan benkum mu san kɔ wo koma mu no kwan.
• Eyi ma asiane a ɛwɔ hɔ sɛ obi benya tebea bi a wɔfrɛ no ``Deep Vein Thrombosis - DVT'' (mogya a ɛtɔ wɔ ntini a emu dɔ no mu) no yɛ kɛse.
• Nnipa dodow no ara nhu sɛnkyerɛnne biara . Sɛ sɛnkyerɛnne ahorow no ba ampa a, ɛtaa yɛ nneɛma te sɛ ɛyaw wɔ nan benkum mu, ɛho ahonhon, emu duru, ne honam ani kɔla a ɛsakra.
• Ayaresa no botae ne sɛ ɛbɛtew nhyɛso no so, ama mogya asan akɔ, na ɛbɛtew asiane a ɛwɔ hɔ sɛ obi benya DVT no so. Angioplasty ne stenting ne ayaresa a wɔtaa de di dwuma.
• Sɛ wuhu DVT ho sɛnkyerɛnne (ɛhohoro mpofirim, ɛyaw, ɛyɛ kɔkɔɔ, ɔhyew a ɛba bere a woka wo nan ho) a, kɔ oduruyɛfo nkyɛn ntɛm ara.
• ``Pulmonary Embolism'' (ɔhome a ɛyɛ tiaa mpofirim, koko mu yaw, mogya a ɔfe, ɔte nka sɛ watɔ piti) ho sɛnkyerɛnne yɛ aduruyɛ mu asɛm a egye ntɛmpɛ. Sɛ ɛba saa a, kɔ ayaresabea ntɛm ara a ntwentwɛn wo nan ase.

Ɛho hia paa sɛ wuhu saa tebea yi. Efisɛ, sɛ wohu ntɛm a, ɛbɛboa kɛse ma wɔasiw nsɛnnennen a emu yɛ den ano. Mma wo ho nnpopo, nanso hu sɛnkyerɛnne ahorow a yɛaka ho asɛm wɔ atifi hɔ no na sɛ ɛho hia a, ntwentwɛn wo nan ase sɛ wobɛhwehwɛ aduruyɛfo afotu.

`May-Thurner Syndrome, Iliac Vein Thrombosis, DVT, Deep Vein Thrombosis, Nan a Ɛhonhon, Nan mu Ɛyaw, Ahurututu mu Ntini a Ɛyɛ Fɛ, Mogya a Ɛtwetwe, Ntini mu Yare