Momma yensua ntini mu nhwehwɛmu ho ade. So wo nso wubehia eyi?

So woate ‘Muscle Biopsy’ ho asɛm pɛn? Ebia oduruyɛfo bi aka akyerɛ wo anaa obi a wunim no sɛ ɔnyɛ eyi. Dɛn ankasa ne no? Dɛn nti na wɔyɛ? Momma yɛmfa nsɛm a ɛnyɛ den nka ho asɛm, sɛnea ɛbɛyɛ a wubetumi ate ase. Ɛho nhia sɛ wusuro, wɔtaa yɛ de boa ma wuhu nea wo haw no yɛ ankasa.

Dɛn ne ntini mu nhwehwɛmu?

Sɛ yɛbɛka no tiawa a, ntini mu nhwehwɛmu yɛ adeyɛ a wɔfa so yi ntini ketewaa bi fi wo ntini mu, kyerɛ sɛ, fi ntini bi a ɛwɔ wo nipadua mu mu, na wɔhwehwɛ mu. Wɔyɛ eyi de hwehwɛ sɛ wowɔ nyarewa pɔtee bi (`myopathies`) a ɛka wo ntini anaa. Oduruyɛfo bi de nnompe mu ntini a wɔde yɛ nhwehwɛmu no kɔ baabi a wɔyɛ nhwehwɛmu. Ɛhɔ no, wɔde afiri a wɔde hwɛ nneɛma nketenkete hwɛ mu hwɛ sɛ ebia nneɛma bi a ɛnteɛ anaa ɔhaw bi wɔ hɔ anaa. Ɛte sɛ nea woretwitwa ntama bi na woahwɛ sɛ nhama no ye anaasɛ ɛnte saa.

Bere bɛn na ɛsɛ sɛ wɔyɛ me ntini mu nhwehwɛmu?

Fa no sɛ woate nka sɛ wo ntini mu yɛ mmerɛw bere tiaa bi, anaasɛ wo ntini reyɛ yaw, ɛreyɛ wo yaw, anaasɛ wowɔ sɛnkyerɛnne afoforo bi a ɛyɛ soronko (`myopathy` ho sɛnkyerɛnne). Afei ebia oduruyɛfo bi bɛka akyerɛ wo sɛ ɛsɛ sɛ woyɛ saa biopsy yi. Nanso wɔrenyɛ no ntɛm ara.

Nnuruyɛfo taa di kan yɛ nhwehwɛmu afoforo kakraa bi:

• Nipadua ne ntini mu nhwehwɛmu : Wɔbɛhwehwɛ wo mu yiye ahwɛ sɛnea wo ntini ahorow no reyɛ adwuma.
• Mogya mu nhwehwɛmu : Sɛ nhwɛso no, wobetumi ayɛ nhwehwɛmu a ɛhwɛ enzyme bi a wɔfrɛ no creatine kinase, anaa awosu mu nhwehwɛmu.
• Mfoniniyɛ mu nhwehwɛmu : Nneɛma te sɛ MRI scan ne CT scan.
• Ntini mu ntini ho nhwehwɛmu ne electromyography (EMG) : Eyinom hwɛ sɛnea nkrasɛm kɔ wo ntini ne wo ntini ntam, ne sɛnea ɛreyɛ adwuma.

Sɛ wɔyɛ nhwehwɛmu yi mpo a, ɛtɔ mmere bi a wontumi nhu nea ɛde yare no ba ankasa. Ɛno ne bere a nnuruyɛfo hyɛ sɛ wɔnyɛ ntini mu nhwehwɛmu na ama wɔahu nsɛm pii na wɔahu yare no koraa .

Ebia ɛho behia sɛ wɔyɛ ntini mu nhwehwɛmu sɛ wo duruyɛfo susuw sɛ wowɔ tebea horow a edidi so yi mu biara a:

• Ntini mu yare : Nhwɛso ahorow bi ne Duchenne ntini mu yare, Becker ntini mu yare, ne myotonic dystrophy.
• Parasitic infections : Nyarewa te sɛ trichinosis ne toxoplasmosis a ɛka wo ntini.
• Ntini a ɛyɛ hyew: te sɛ polymyositis ne dermatomyositis.
• Metabolic myopathies : Sɛ nhwɛso no, Pompe yare ne nyarewa afoforo a ɛkora glycogen so.
• Congenital myopathies : Tebea horow a ɛwɔ hɔ wɔ awo mu, te sɛ nemaline myopathy.
• Toxic myopathies : Tebea horow a ebetumi aba bere a wɔde nnuru bi adi dwuma bere tenten, sɛ nhwɛso no, steroid anaa statin.

Ntini bɛn na wɔtaa paw ma wɔyɛ biopsy?

Wɔtaa gye saa biopsy yi fi wo nipadua mu ntini pɔtee pii no biako mu. Nea ɛtaa ba ne:

• Quadriceps : Ntini kuw kɛse a ɛwɔ w’asen anim.
• Deltoid : Ntini a ɛka wo mmati anim, ɔfã, ne akyi bom.
• Bicep : Ntini a ɛwɔ wo nsa a ɛwɔ soro no anim, a ɛda wo mmati ne wo nsateaa ntam.

Oduruyɛfo no bɛpɛ sɛ ɔhwɛ hu sɛ ntini a wɔapaw sɛ wɔmfa nyɛ biopsy no nyɛ mmerɛw dodo anaasɛ ɛwɔ sɛnkyerɛnne afoforo. Nanso, oduruyɛfo no bɛpɛ nso sɛ ɔhwɛ hu sɛ ntini no nyɛ mmerɛw dodo, wɔamfa aduru anhyɛ mu nnansa yi, anaasɛ wɔapira. Eyi betumi aka nea ebefi biopsy no mu aba na ebia ɛremma nsɛm a edi mu.

Ɔkwan bɛn so na ɛsɛ sɛ misiesie me ho ma ntini mu nhwehwɛmu?

Wo duruyɛfo bɛkyerɛkyerɛ biopsy no mu akyerɛ wo kɔ akyiri na wama wo akwankyerɛ wɔ sɛnea wubesiesie wo ho. Ɛho hia paa sɛ wudi akwankyerɛ ahorow yi akyi pɛpɛɛpɛ. Sɛ woante biribi ase anaa wowɔ nsɛmmisa bi a, nsuro sɛ wubebisa wo duruyɛfo.

Mpɛn pii no, ɛsɛ sɛ wohwɛ yiye wɔ nneɛma yi ho:

• Sɛ wɔde ntini bi a wɔde twitwiw wo mu, wɔayɛ wo ntini mu nhwehwɛmu te sɛ EMG, anaasɛ woapira wo ntini biara wɔ asram asia a atwam no mu a, akyinnye biara nni ho sɛ ɛsɛ sɛ woka kyerɛ wo duruyɛfo.
• Ebia wo duruyɛfo bɛka akyerɛ wo sɛ gyae nnuru a ekum mogya a ɛtwetwe te sɛ aspirin nom nna kakraa bi ansa na wɔayɛ biopsy no na amma mogya a ɛbɛtɔ no ho haw ahorow asiw. Nanso, ɛyɛ papa sɛ worennyae nnuru biara a wobɛnom kosi sɛ wo duruyɛfo bɛka akyerɛ wo.
• Ebia wɔbɛka akyerɛ wo sɛ mmuada nnɔnhwerew kakraa bi ansa na wɔayɛ biopsy, a wunnni anaa wonnom biribiara (gye nsu).
• Sɛ wɔma wo nnuru a ɛma wo ho dwo anaasɛ wɔma wo aduru a wɔde kum nipadua no nyinaa wɔ saa adeyɛ yi mu a, wubehia obi a ɔde wo bɛkɔ fie bere a wɔayɛ wo nipadua mu nhwehwɛmu no awie no.

Dɛn ne ɔkwan a wɔfa so yɛ ntini mu nhwehwɛmu?

Anamɔn a wɔfa so yɛ ntini mu nhwehwɛmu no gu ahorow kakra a egyina ɔkwan a wɔfa so yɛ no so. Akwan titiriw abien na ɛwɔ hɔ: ``open`` biopsy ne ``needle`` biopsy. Ɔkwan biara so no, wobetumi ama wo (anaa wo ba) ``sedation`` anaa ``general anesthesia`` ansa na wɔayɛ.

Sɛnea wɔyɛ ntini a wɔabue mu biopsy

Mpɛn pii no, anammɔn a wɔfa so yɛ ntini a wɔabue mu biopsy no te sɛ nea edidi so yi:

• Oduruyɛfo no di kan de aduru a ekum ɔyare mmoawa hohoro baabi a wɔatwa no yiye.
• Afei, wɔde aduru bi a ɛma obi dwensɔ gu baabi a ɛwɔ hɔ no, enti worente ɛyaw biara bere a wɔatwa no.
• Afei, wɔbɛtwa wo honam ani fã bi a ne tenten bɛyɛ sɛntimita 4 kosi 6.
• Oduruyɛfo no bɛtetew wo honam ani, srade a ɛwɔ honam ani (srade a ɛwɔ honam ani), ne ntini a ɛkata ntini no so (ntini mu ntini - ntini a ɛka bom), na afei wakɔ ntini a ɛwɔ ase no so.
• Wotwa ntini mu ntini ketewaa bi fi hɔ.
• Afei oduruyɛfo no de nhama to ntini no mu ntini ne honam ani bio.
• Wɔde nnuru ne aduru a wɔde kyekyere kuru no ne gauze kata kuru no so.

Sɛnea wɔyɛ needle muscle biopsy

Mpɛn pii no, anammɔn a wɔfa so yɛ ade a wɔde yi ntini mu ntini mu no te sɛ nea edidi so yi:

• Oduruyɛfo no di kan de aduru a ekum ɔyare mmoawa hohoro baabi a wɔyɛɛ nipadua no mu nhwehwɛmu no.
• Afei wɔde aduru bi a ɛma obi dwensɔ gu nipadua no mu, enti worente ɛyaw biara bere a wɔreyɛ biopsy no.
• Oduruyɛfo no bɛtwa wo honam ani fã ketewaa bi pɛ.
• Afei, wɔde adwinnade titiriw bi a wɔde yi nipadua mu nneɛma a wɔde nnade yɛ no fa baabi ketewaa a wɔatwa no mu. Mpɛn pii no, eyi kɛse bɛyɛ sɛ pɛnsere.
• Wɔde afiri a wɔde yɛ ultrasound (ultrasound imaging) di dwuma de kyerɛ saa afiri yi kwan kɔ ntini no mu pɛpɛɛpɛ.
• Afei oduruyɛfo no de adwinnade no twa ntini nketenkete pii. Mpɛn pii no, wɔfa nhwɛsode bɛyɛ 3 anaa 4.
• Sɛ woyi ntini dodow a wɔhwehwɛ no fi hɔ wie a, woyi adwinnade no, wɔde nhyɛso gu beae no so kakra ma mogya no gyae, wɔde nnuru gu kuru no so, na wɔde gauze ne ntama kata so.

Eyi yɛ yaw dɛn?

Sɛ wɔma wɔyɛ saa biopsy yi wɔ general anesthesia ase a, worente ɛyaw biara. Sɛ woma wɔyɛ no wɔ aduru a wɔde kum nipadua no mu a, ɛyaw no bɛyɛ ketewaa bi, anaasɛ ɛrenni hɔ mpo. Nanso, ebia wobɛte nka sɛ woabɔ wo kakra anaasɛ woatwe wo ho.

Sɛ wɔyɛ nipadua no mu nhwehwɛmu wie a, ebia wobɛte ɛyaw kakra nka wɔ baabi a wɔayɛ nipadua no mu nhwehwɛmu no bɛyɛ nnansa kosi nnansa. Titiriw sɛ woyɛɛ wo nipadua mu nhwehwɛmu a wɔabue mu a, ebia beae no bɛyɛ yaw bɛyɛ dapɛn biako. Ebia akuru bi nso wɔ beae no ho.

Ɛyɛ papa sɛ wubebisa wo duruyɛfo no nea wobetumi ayɛ ama ɛyaw no ne nnuru ko a ɛsɛ sɛ wonom.

Dɛn na ɛba bere a wɔayɛ biopsy no akyi?

Sɛ wɔmaa wo nnuru a ɛma wo ho dwo anaasɛ wɔmaa wo aduru a wɔde kum nipadua no a, wɔde wo bɛkɔ dan a wɔhwɛ wɔn a wɔn ho tɔ wɔn mu bere tiaa bi wɔ nipadua no mu nhwehwɛmu no akyi. Wobɛtena hɔ akosi sɛ aduru no nkɛntɛnso bɛbrɛ ase. Afei wubetumi akɔ fie, nanso ɛsɛ sɛ woma obi foforo de wo kar kɔ fie. Wo duruyɛfo bɛma wo akwankyerɛ wɔ sɛnea wobɛhwɛ biopsy kuru no ho.

Oduruyɛfo no de nnuru titiriw di dwuma de ma ntini nhwɛsode a wɔfaa fii biopsy no mu no yɛ nwini ntɛmntɛm (`flash freeze`). Wɔyɛ eyi na ama ntini no akɔ so ayɛ nea enni dɛm na ɛfata sɛ wɔyɛ mu nhwehwɛmu. Afei wɔde kɔ lab bi mu. `Pathologist bi a ne ho akokwaw wɔ neuromuscular nyarewa mu` wɔ hɔ. Ɔde afiri a wɔde hwɛ nneɛma nketenkete bɛhwehwɛ nhwɛsode no mu yiye. Ɛtɔ da bi a, oduruyɛfo titiriw no bɛyɛ sɔhwɛ afoforo wɔ nhwɛsode no so. Sɛ nhwɛso no, wɔde nnuru soronko (`stains`) bedi dwuma anaasɛ wɔbɛhwɛ sɛ `antibodies` bi wɔ hɔ.

So asiane bi wɔ ntini mu nhwehwɛmu mu?

Nsɛnnennen a efi ntini mu nhwehwɛmu mu ba no ho yɛ na koraa. Nanso, nneɛma kakraa bi wɔ hɔ a ebetumi asi wɔ nsɛm a ɛntaa nsi mu:

• Nyarewa a ɛwɔ kuru no mu.
• Ntini a ɛpuepue fa kuru no mu (`ntini a ɛyɛ mmerɛw`).
• Kuru no a wɔsan bue bere a nhama no ayɛ mmerɛw akyi.
• Akwanhyia mu opira yɛ wo ntini, wo ntini, anaa wo mogya ntini a wɔanhyɛ da sɛe.

Ebia akuru bi bɛkɔ so atra baabi a wɔyɛɛ biopsy no. Nnipa binom honam ani akuru a ɛyɛ mmerɛw sen afoforo.

Bere bɛn na menya amanneɛbɔ no?

Sɛ wɔyɛ nipadua mu nhwehwɛmu wie a, ebia nea ebefi mu aba a wɔbɛtwɛn no ne ade a ɛyɛ den sen biara. Wo duruyɛfo bɛkyerɛkyerɛ ɔkwan a wobɛfa so ne bere a wubenya amanneɛbɔ no mu. Ebia ebegye nna kakraa bi, anaasɛ ebegye bɛboro dapɛn biako. Sɛ amanneɛbɔ no ansan amma da a wo duruyɛfo no kae no a, frɛ wo duruyɛfo no bio na bisa ho asɛm.

Dɛn na amanneɛbɔ no ka fa ho?

Ntini mu nhwehwɛmu amanneɛbɔ no kura ntini mu nhwɛsode a wɔfaa no su ho nsɛm kɔ akyiri. Ebia nneɛma te sɛ:

• Nneɛma te sɛ ntini nhama (i.e. ntini nkwammoaa) nhyehyɛe), sɛnea wɔwɔ apɔwmuden, ne wɔn "mfe".
• Nkwammoaa afoforo a ɛwɔ saa ntini no mu ho nsɛm a ɛkɔ akyiri, sɛ nhwɛso no, ntini mu nkwammoaa (neurons).
• Nneɛma te sɛ ɔfe, mitochondrial a ɛnyɛ ne kwan so, glycogen ne lipid akorae a ɛnteɛ.

Wo duruyɛfo bɛkyerɛkyerɛ nea ɛwɔ amanneɛbɔ yi mu ne nea ɛkyerɛ mu akyerɛ wo.

Ɛtɔ da bi a, ebia biopsy no bɛyɛ te sɛ nea ɛteɛ, anaasɛ ebia yare no ho sɛnkyerɛnne nketenkete paa na ɛwɔ hɔ. Wɔ eyi mu no, ɛtɔ mmere bi a wɔfrɛ no "unspecified myopathy." Nea enti a ɛte saa ne sɛ ebia na biopsy no anhu baabi pɔtee a yare no wɔ, anaasɛ ebia yare no da so ara wɔ ne mfiase. Sɛ eyi ba a, ebia ɛsɛ sɛ wosan yɛ ntini mu nhwehwɛmu foforo.

Sɛ ɔhaw bi wɔ amanneɛbɔ no mu a, dɛn na woyɛ akyi?

Nea efi ntini mu nhwehwɛmu mu ba no taa tumi hu ntini mu yare pɔtee bi (`myopathy`).

Sɛ wohu sɛ wowɔ yare pɔtee bi a, wo duruyɛfo bɛkyerɛkyerɛ mu akyerɛ wo na wasusuw nea ɛsɛ sɛ woyɛ akyi. Mobɛbom ayɛ ayaresa nhyehyɛe a ɛbɛyɛ adwuma yiye ama mo. Mma ɛnhaw wo, wo duruyɛfo bɛboa wo.

Bere bɛn na ɛsɛ sɛ wo ne oduruyɛfo no kasa?

Sɛ wuhu nsɛnkyerɛnne a edidi so yi mu biako anaa nea ɛboro saa a ɛkyerɛ sɛ baabi a woreyɛ wo nipadua mu nhwehwɛmu no anya ɔyare no a, ɛsɛ sɛ wofrɛ wo duruyɛfo ntɛm ara:

• Kuru no ho a ɛho ahonhon, honam ani kɔkɔɔ, anaa kɔla a ɛsakra no yɛ ade a ɛfata.
• Wora a atwa kuru no ho ahyia no te nka sɛ ɛyɛ hyew sen mmeae afoforo.
• Pus anaa nsuo foforɔ a ɛfiri kuru no mu ba (`Pus anaa drainage`).
• Atiridiinini a wobenya.
• Ɔbrɛ a ɛboro so a wɔte nka (`Ɔbrɛ`).

So ntini mu nhwehwɛmu betumi ahu MS (Multiple Sclerosis)?

Wɔntaa mfa ntini mu nhwehwɛmu nni dwuma mfa nsi MS (Multiple Sclerosis) a wɔahu no so dua. Nanso, ebia oduruyɛfo bi bɛkamfo biopsy yi akyerɛ de ayi tebea afoforo a ɛwɔ sɛnkyerɛnne a ɛte sɛ MS no afi hɔ.

Ɛyɛ ade a ɛfata sɛ wobɛte ehu ne dadwen nka bere a wuhu sɛ wuhia ntini mu nhwehwɛmu no. Na ɛyɛ ade a ɛfata nso sɛ wobɛte dadwen nka bere a woretwɛn nea ebefi mu aba no. Wo duruyɛfo behu nneɛma bɔne a ebetumi afi biopsy yi mu aba nyinaa, enti nsuro sɛ wubebisa nsɛm biara a ebia wowɔ. Sɛ wo biopsy amanneɛbɔ kyerɛ sɛ biribi anyɛ yiye a, bɔ mmɔden sɛ wubesusuw ho sɛ ɛyɛ anammɔn a edi kan wɔ w’akwantu a ɛkɔ wo ho a wobɛtɔ mu no mu. Wo duruyɛfo ne wo bɛyɛ adwuma de asi w’akwahosan ho gyinae a ɛho hia.

Dɛn ne ade a ɛho hia sen biara a ɛsɛ sɛ yɛde fi saa asɛm yi mu kɔ fie?

Okay, enti ade a ɛho hia sen biara a ɛsɛ sɛ yɛma ɛtra yɛn adwenem fi nea yɛaka ho asɛm no mu ne sɛ ntini mu nhwehwɛmu yɛ sɔhwɛ a ɛho hia yiye a ɛboa ma wohu ɔhaw anaa yare bi a ɛwɔ wo ntini mu no pɛpɛɛpɛ.

Ebia eyi bɛyɛ te sɛ nea ɛyɛ hu kakra ama wo. Nanso ebetumi aboa wo ma woahu yare no pɛpɛɛpɛ na woafi ayaresa a ɛfata ase ama wo. Sɛ wowɔ nsɛmmisa anaa nsɛm bi a ɛhaw wo a, hwɛ hu sɛ wo ne wo duruyɛfo bɛbɔ ho nkɔmmɔ. Kae sɛ eyi yɛ anammɔn a ɛho hia a ɛbɛma woate wo tebea no ase na woadi ho dwuma sɛnea ɛfata.

` Muscle Biopsy, Muscle Biopsy, myopathy, ntini mu mmerɛwyɛ, ntini mu yare, nhwehwɛmu, aduruyɛ mu nhwehwɛmu, oprehyɛn