Ebia woate oprehyɛn a wɔde twa koma no ho asɛm, ɛnte saa? Ebia ɛsɛ sɛ wɔyɛ obi a ɔwɔ w’abusua mu anaa w’adamfo bi oprehyɛn a ɛte sɛɛ. Mpɛn pii no, sɛ yɛka oprehyɛn a wɔde twa kwan ho asɛm a, yesusuw oprehyɛn kɛse bi a ɛfa koma no a wobesiw na wɔde abɔ afiri ho no ho. Nanso so wunim sɛ oprehyɛn bi nso wɔ hɔ a wobetumi ayɛ a wontumi nsiw koma no kwan, kyerɛ sɛ, bere a koma no da so ara bɔ? Ɛno ne nea yɛfrɛ no "Off-pump" bypass oprehyɛn, anaa "Beating Heart Surgery." Momma yɛmfa nsɛm a ɛnyɛ den nka eyi ho asɛm nnɛ.
Okay, dɛn ne saa bypass oprehyɛn a wɔyɛ a wontumi nsiw koma no kwan yi?
Sɛ yɛbɛka no tiawa a, eyi yɛ coronary artery bypass graft (CABG) bi. Wɔ oprehyɛn a wɔde twa ho hyia mu no, wɔyɛ ntini foforo bi a ɛbɛfa ntini bi a asiw (coronary artery) a ɛde mogya kɔ koma no mu no ho. Wɔde mogya ntini a ɛte apɔw (graft) a wogye fi nipadua no fã foforo, sɛ nhwɛso no, nan anaa koko mu na ɛyɛ eyi.
Fa no sɛ, kar pii wɔ ɔkwan bi so, enti kar ntumi nkɔ. Afei yɛyɛ ɔkwan a wɔfa so twa ho na yɛakwati saa kar no. Eyi ma mogya san kɔ koma no mu yiye.
Wɔ oprehyɛn a wɔde twa ɔyarefo no ho (On-pump CABG) , mu no , nnuruyɛfo a wɔyɛ oprehyɛn no gyae ɔyarefo no koma koraa. Afei, wɔde afiri soronko bi na ɛyɛ koma ne ahurututu no adwuma kosi sɛ wobewie oprehyɛn no. Wɔfrɛ eyi afiri a wɔde twa koma ne ahurututu mu. Saa afiri yi gye mogya fi nipadua no mu, de mframa pa ka ho, yi mframa bɔne fi mu, na ɛde mogya a ɛho tew san kɔ nipadua no mu.
Nanso wɔ off-pump CABG mu no, wɔmfa koma-ahurututu afiri no nni dwuma. Oduruyɛfo a ɔyɛ oprehyɛn no yɛ oprehyɛn no bere a wo koma rebɔ no . Ɛno nti na wɔfrɛ no "Beating Heart" oprehyɛn.
Henanom na wohia oprehyɛn yi?
Wɔyɛ saa oprehyɛn yi wɔ ayarefo a wɔwɔ ahrawa mu ntini mu yare (CAD) so titiriw. Wɔ CAD mu no, srade (plaque) boaboa ano wɔ koma no mogya ntini mu, na ɛma mogya no mu yɛ ketewaa. Eyi betumi de sɛnkyerɛnne ahorow te sɛ koko mu yaw ne ahome a ɛyɛ tiaa aba. Sɛ saa ntini ahorow yi siw koraa a, asiane a ɛwɔ hɔ sɛ obi benya komayare no yɛ kɛse paa.
Sɛ yare no mu yɛ den dodo sɛ wobetumi de asetra mu nsakrae, nnuru, ne ayaresa afoforo adi ho dwuma a, nnuruyɛfo kamfo kyerɛ sɛ wɔnyɛ oprehyɛn a wɔde twa ho hyia. Oprehyɛn yi betumi atew yare no ho sɛnkyerɛnne so, atew asiane a ɛwɔ hɔ sɛ obi benya komayare no so, na ama nkwa a wonya no ayɛ kɛse. Enti, wɔ ayarefo binom a wosi gyinae sɛ wɔbɛyɛ wɔn oprehyɛn a wɔde twa kwan no fam no, ebia saa oprehyɛn a wɔmfa pɔmpɛ nni dwuma yi bɛyɛ ɔkwan pa.
Ɔkwan bɛn so na wusiesie wo ho ansa na wɔayɛ wo oprehyɛn?
Sɛ wɔayɛ nhyehyɛe sɛ wɔbɛyɛ wo oprehyɛn yi a, w’aduruyɛfo kuw no bɛma wo akwankyerɛ wɔ sɛnea wubesiesie wo ho. Ebia akwankyerɛ ahorow yi bi ne:
- Sɛ wonom sigaret a, gyae ntɛm ara.
- Wo duruyɛfo betu wo fo sɛ gyae nnuru bi a wobɛnom, titiriw nnuru a ekum mogya a ɛtwetwe mogya no bere tiaa bi.
- Da a edi oprehyɛn no anim no, wɔbɛka akyerɛ wo sɛ nnnidi anaa nnom biribiara fi anadwo fã.
Nea ɛka ho no, ebia wobɛyɛ nhwehwɛmu pii nso de ahwɛ sɛ wowɔ tebea pa mu sɛ wɔbɛyɛ wo oprehyɛn anaa:
- Mogya mu nhwehwɛmu
- Chest X-ray nhwehwɛmu a wɔyɛ
- Echocardiogram (Echo) .
- ECG nhwehwɛmu (Electrocardiogram) .
- Sɔhwɛ titiriw te sɛ Nuclear Cardiac Stress Test
Dɛn na ɛba bere a wɔreyɛ oprehyɛn no?
Oduruyɛfo a ɔyɛ wo oprehyɛn no bɛkyerɛkyerɛ nea ɛbɛba bere a wɔreyɛ oprehyɛn no mu akyerɛ wo. Nneɛma bi a ɛbɛtaa asi ni:
1. Anesthesia: Wɔde wo da koraa na wɔma wo anesthetic sɛnea ɛbɛyɛ a worente ɛyaw biara.
2. Graft Harvesting: Wogye mogya ntini a ɛte apɔw a ehia ma bypass no fi wo nan, wo nsa, anaa wo moma so mu.
3. Ntwitwiridii: Wɔtwa koko no mfinimfini, na wɔde ahwɛyiye de nufu no dompe no kɔ afã abien no nyinaa. Ɛtɔ mmere bi a, egyina baabi a ntini a asiw no wɔ so no, wobetumi atwitwa kakra wɔ mparow a ɛwɔ koko no benkum so no ntam.
4. Koma no a wɔbɛma ayɛ den: Esiane sɛ wɔyɛ oprehyɛn no bere a koma no rebɔ nti, wɔde afiri titiriw bi a wɔfrɛ no ``Stabilizer`` di dwuma de kura koma no fã ketewaa a wɔreyɛ no oprehyɛn no sɛnea ɛbɛyɛ a ɛrenhinhim. Eyi ma oduruyɛfo a ɔyɛ oprehyɛn no tra hɔ dinn na ɔyɛ oprehyɛn no pefee.
5. Bypass: Wɔma mogya a ɛsen fa ntini a asiw no mu no gyae bere tiaa bi, na wɔde mogya ntini a ɛwɔ apɔwmuden a wɔadi kan agye no ano biako bata aorta no ho na wɔde ano foforo no bata ahrawa mu ntini a ɛwɔ asiw no ase no ho. Eyi na ɛma bypass foforo no ba.
6. Wɔto mu: Sɛ wɔyɛ adwuma no wie a, mogya no gyae bere tiaa bi, wɔde nhama soronko san bata koko dompe no ho, na wɔpam honam ani na wɔto mu.
So oprehyɛn a wɔyɛ wɔ amanne kwan so (On-pump) anaa ɔkwan foforo yi (Off-pump) ye?
Nhwehwɛmu da so ara kɔ so de hu akwan abien yi mu nea eye sen biara wɔ bere tenten mu. Wo duruyɛfo a ɔyɛ oprehyɛn no ne wo besusuw ɔkwan a eye ma wo ho. Momma yɛnhwɛ nsonsonoe titiriw ne mfaso ne ɔhaw ahorow a ɛwɔ akwan abien yi mu.
| Nneɛma titiriw | Amanne kwan so Ɔkwan (On-Pump) . | "Koma a Ɛbɔ" Ɔkwan (Off-Pump) . |
|---|---|---|
| Koma mu tebea | Koma no gyae bere a wɔreyɛ oprehyɛn no. | Wɔyɛ oprehyɛn no bere a koma no rebɔ no. |
| Koma-ahurututu afiri | De di dwuma. | Wɔmfa nni dwuma. |
| Mfaso a ɛwɔ so ma oduruyɛfo a ɔyɛ oprehyɛn no | Wobetumi ayɛ oprehyɛn no pefee efisɛ enni kankyee anaa mogya biara. | Mfiridwuma mu no, ɛyɛ den kɛse. Ɛhwehwɛ ntetee titiriw. |
| Mfaso a ebetumi aba ama ɔyarefo no | Standard, ɔkwan a wɔtaa de di dwuma. | Ntwitwiridii nketenkete, ayaresabea a wɔtra bere tiaa mu, ne ho tɔ ntɛmntɛm. Ebetumi atew asiane a ɛwɔ hɔ sɛ ɔhaw ahorow te sɛ nkae a ɛyera, ɔyare a ɛma obi hwe ase, ne ɔyare mmoawa a obenya no so atew. |
Nea ɛho hia sen biara ne sɛ ɛnyɛ obiara na obetumi ayɛ oprehyɛn a ɛnyɛ nea ɛma koma no gyae yi. Afei nso, sɛ wobɛyɛ oprehyɛn yi a, wuhia oprehyɛn ho oduruyɛfo a ɔwɔ osuahu soronko wɔ mu.
Asiane bɛn na ɛwɔ oprehyɛn yi mu?
Sɛnea ɛte wɔ oprehyɛn kɛse biara ho no, asiane ahorow bi wɔ mu. Nanso, nnipa dodow no ara nya nea efi mu ba no yiye. Asiane ahorow a ebetumi aba no bi ne:
- Mogya a ɛretu
- Mogya a ɛtɔ (a ebetumi ama obi anya akisikuru anaa komayare) .
- Nsɛnnennen a efi nnuru a wɔde kum nipadua no mu ba
- Nyarewa a wɔde nyarewa ba
- Koma a ɛbɔ daa (Arrhythmia) .
- Asaabo a Ɛnyɛ Den
Bere tenten ahe na egye na obi ho atɔ no?
Bere a wo ho bɛtɔ wo wɔ oprehyɛn akyi no gyina nneɛma pii so, te sɛ mfe a woadi, w’akwahosan nyinaa, ne sɛnea woatwitwa no kɛse. Ɛtaa kɔ saa:
- Wubetumi afi ase anom nsu ne nnuan nketenkete da koro no ara anaa da a edi hɔ wɔ oprehyɛn no akyi.
- Wɔ da anaa nnanu a edi kan no mu no, wubetumi atra akongua bi so a mmoa wom na wonantew kakra.
- Ɛsɛ sɛ wotra ayaresabea hɔ nna kakraa bi.
- Akyinnye biara nni ho sɛ ɛho hia sɛ wunya obi a ɔbɛboa wo wɔ nna kakraa a edi kan wɔ wo fie akyi.
- Wobeyi nhama no afi hɔ wɔ bɛyɛ adapɛn du mu.
- Ɛyɛ papa sɛ woremma nneɛma a emu duru biara so adapɛn kakraa bi.
- Ebia ebegye adapɛn pii anaa nea ɛboro saa ansa na ne ho atɔ no koraa.
- Nnuruyɛfo betu wo fo sɛ fa wo ho hyɛ nhyehyɛe bi a wɔde siesie koma no mu na ama woasan anya ahoɔden.
Nsɛm bɛn mu na ɛsɛ sɛ wohwehwɛ aduruyɛ mu afotu ntɛm ara?
Bere a wo ho retɔ wo no, ɛho behia sɛ wokɔ ayaresabea hɔ wɔ nna a wɔahyɛ ato hɔ mu kɔhwɛ wo duruyɛfo. Nanso, sɛ wunya sɛnkyerɛnne ahorow a edidi so yi mu biara a, frɛ wo duruyɛfo ntɛm ara anaa kɔ ayaresabea a ɛbɛn wo no Dwumadibea a Ɛhwɛ Ntɛmntɛm (ETU) so.
| Nsɛnkyerɛnne a ɛsɛ sɛ yɛhwɛ yiye wɔ ho |
|---|
| Koko mu yaw anaa yafunu mu yaw a ɛnkɔ. |
| Awɔw a wɔte nka anaasɛ fifiri a ɛboro so. |
| Nkate a ɛkyerɛ sɛ nufu dompe no retu anaasɛ ɛreyɛ "clicking" nnyigyei. |
| Koma a ɛbɔ ntɛmntɛm anaasɛ ɛnteɛ daa. |
| Akisikuru anaa ɔfe. |
| Ɔhome a ɛyɛ den. |
| Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya ɔyare mmoawa (atiridiinini, kɔkɔɔ a ɛbɛn baabi a wɔatwa no, ɛho ahonhon, akisikuru a ɛtwetwe). |
| Mu duru a ɛkɔ soro mpofirim (bɛboro kilogram 2 dapɛn biara). |
Nkrasɛm a Wɔde Kɔ Fie
- Off-pump bypass surgery yɛ bypass oprehyɛn titiriw bi a wɔyɛ wɔ koma a ɛrebɔ so a wonnyae koma no.
- Ayarefo binom betumi anya saa kwan yi so mfaso, te sɛ ayaresabea a wɔbɛtew so, wɔn ho atɔ wɔn ntɛmntɛm, ne asiane a ɛwɔ hɔ sɛ wobenya ɔhaw ahorow bi no so tew.
- Saa oprehyɛn yi mfata mma ɔyarefo biara. Ɛho hia sɛ wohu sɛ ɔyarefo no fata no ne sɛ ebia oduruyɛfo a ɔyɛ oprehyɛn no wɔ ntetee titiriw ma no anaa.
- Sɛ wuhia oprehyɛn a wɔde twa wo ho hyia a, wo ne wo koma ne ahurututu ho oprehyɛn susuw ho sɛ ebia ɔkwan a wɔfa so yɛ no (on-pump) anaa saa kwan yi (off-pump) ye ma wo anaa.
- Aduruyɛ ho akwankyerɛ a wobedi akyi yiye wɔ oprehyɛn akyi no ho hia na ama obi ho atɔ no ntɛmntɛm na ayɛ yiye.











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