So wo ba kumaa no wɔ ɔhaw ketewaa yi wɔ ne koma ho? (Patent Ductus Arteriosus - PDA) Momma yensua ho ade!

So woate nka pɛn sɛ na ɛyɛ den ma wo ba ketewa no sɛ ɔbɛhome bere a wɔawo no akyi? Anaasɛ woahyɛ no nsow sɛ wɔn ho fifiri na wɔreyɛ akisikuru bere a wɔrema nufu no? Ɛtɔ mmere bi a, ɔhaw ketewaa bi a ɛwɔ mmofra nkumaa koma mu no betumi de eyinom aba. Tebea a ɛte saa no mu biako a yɛrebɛka ho asɛm nnɛ no, wɔfrɛ no `Patent Ductus Arteriosus` anaa `(PDA)`. Mma ɛnhaw wo, momma yɛnka eyi ho asɛm tiawa.

Dɛn ne `Patent Ductus Arteriosus (PDA)`?

Sɛ yɛbɛka no tiawa a, `PDA` yɛ komayare a ebetumi aba wɔ nkokoaa a wɔawo wɔn foforo mu. Ɛba bere a mogya ntini bi a wɔfrɛ no `ductus arteriosus` a wɔkyerɛ sɛ ɛto mu bere a wɔawo akokoaa no akyi no ntumi nto mu yiye. Fa no sɛ tokuru ketewaa bi a wɔagyaw wɔ nsu afiri mu.

Dɛn na ɛba wɔ `Ductus Arteriosus` no ho?

Sɛ yɛbɛte eyi ase a, ɛsɛ sɛ yɛsan kɔ bere a akokoaa no wɔ ɛna no awotwaa mu no so kakra. Sɛ akokoaa no wɔ awotwaa mu a, n’ahurututu no nyɛ adwuma pii. Nea enti a ɛte saa ne sɛ akokoaa no nam awotwaa mu hama no so nya mframa pa a ohia fi ɛna no hɔ. Enti, saa bere yi mu no, mogya a ehia sɛ efi akokoaa no koma mu kɔ ahurututu mu no mu dodow no ara twa ahurututu no ho hyia. Mogya ntini soronko bi a ɛboa wɔ eyi mu no, wɔfrɛ no `ductus arteriosus`. Eyi te sɛ, sɛ yɛbɛka no pɛpɛɛpɛ a, ɛte sɛ bridge ketewaa bi a ɛda koma no ntini titiriw (`aorta`) ne ntini titiriw a ɛkɔ ahurututu mu (`ahurututu mu ntini`) ntam. Sɛ wɔwo akokoaa no na n’ankasa fi ase home wie a, saa `ductus arteriosus` yi ho nhia bio, enti ɛtaa to n’ankasa mu wɔ nna kakraa bi mu.

Dɛn na ɛto nkokoaa a wɔwɔ `PDA`?

Afei, nea ɛkɔ so wɔ akokoaa a ɔwɔ `PDA` mu ne sɛ `ductus arteriosus` no ntoto koraa, na ɛma tokuru ketewaa bi. Esiane eyi nti, mogya foforo fi koma no ntini titiriw (`aorta`) mu kɔ ntini a ɛkɔ ahurututu mu (`ahurututu mu ntini`) no mu. Ɛdenam sɛnea tokuru yi kɛse te so no, ɛsɛ sɛ akokoaa no koma ne n’ahurututu yɛ adwumaden na ama wɔatumi abɔ mogya. Sɛ yɛbɛka no pɛpɛɛpɛ a, ɛsɛ sɛ wɔyɛ adwuma pii.

Hena na saa `PDA` tebea yi aka no kɛse?

Saa `PDA` tebea yi taa ba nkokoaa a wɔawo wɔn ntɛm mu, a ɛkyerɛ sɛ wɔwo wɔn ɔsram biako ntɛm. Wɔahu nso sɛ ɛtaa ba mmeawa so kakra sen mmarimaa.

`PDA` abu so dɛn?

Nokwarem no, PDA yɛ komayare a wɔtaa hu wɔ mmofra a wɔawo wɔn foforo mu no mu biako. Ɛtaa ba nkokoaa a wɔawo wɔn ntɛm mu titiriw. Asiane no gu ahorow gyina dapɛn a wɔwo akokoaa no so.

Susuw ho saa kwan yi so:

• Nkokoaa bɛyɛ 10% a wɔwo wɔn wɔ adapɛn 30 kosi 37 ntam.
• Nkokoaa bɛyɛ 80% a wɔwo wɔn wɔ adapɛn 25 kosi 28 ntam.
• Nkokoaa a wɔwo wɔn ansa na wɔadi adapɛn 24 no mu bɛyɛ 90% betumi anya saa tebea yi, a wɔfrɛ no `PDA'.

Mma akontaabu ahorow yi nnyɛ wo hu. Eyi kyerɛ asiane a ɛwɔ mu no nkutoo. Eyi renyɛ aniberesɛm mma obiara.

Ɔkwan bɛn so na PDA ka wo ba no?

Sɛ wowɔ PDA a ɛyɛ mfinimfini anaa kɛse a, ebia wo ba no bɛhome ntɛmntɛm na ayɛ den sen sɛnea ɔtaa yɛ. Nea enti a ɛte saa ne sɛ nipadua no rebɔ mmɔden sɛ ebegyina mogya a ɛboro so a ɛkɔ ahurututu mu no ano. Sɛ wɔannya saa tebea yi bere tenten a, ebetumi ama mogya mmoroso aba ahurututu mu (Pulmonary Hypertension) na asɛe mogya ntini no. Eyi nti na ɛho hia sɛ wohu eyi no.

Dɛn ne nneɛma a ɛde `PDA` ba?

Nhwehwɛmufoɔ da so ara ntumi nka nea enti a tebea a wɔfrɛ no `PDA` yi ba ankasa. Nanso, wɔahu nneɛma bi.

• Awosu mu nkɛntɛnso: Awosu mu tebea horow bi anaa abusua abakɔsɛm a ɛfa komayare ho nso betumi anya nkɛntɛnso.
• Rubella bere a nyinsɛn: Sɛ ɛna no nya rubella bere a onyinsɛn a, asiane kɛse wom sɛ akokoaa no benya PDA.
• Neonatal Respiratory Distress Syndrome: Saa ɔhome ho haw yi betumi aba nkokoaa a wonnya surfactant a ɛdɔɔso ansa na wɔawo wɔn no so. Nkokoaa a wɔte saa nso taa nya PDA.

Dɛn ne PDA ho sɛnkyerɛnne ahorow?

PDA ho sɛnkyerɛnne gu ahorow gyina PDA no kɛse so. Ebia PDA ketewaa bi remma yare no ho sɛnkyerɛnne biara mma, gye koma mu nwiinwii, a ebia oduruyɛfo de afiri a wɔde tie asɛm bɛte.

Nanso, PDA a ɛsõ kakra betumi ada sɛnkyerɛnne ahorow te sɛ:

• Ahome a wɔhome ntɛmntɛm.
• Ɔhome a ɛyɛ den (dyspnea).
• Fifiri a ɛba bere a ɔrema nufu anaa ɔrema aduan no.
• Ɔbrɛ a ɛba ntɛmntɛm, ɔbrɛ.
• Ɔhaw ahorow a ɛba wɔ adidi ne anom, nufusu a wɔnom so tew.
• Mu duru a ɛkɔ soro anaa onyin a enni hɔ.
• koma a ɛbɔ ntɛmntɛm anaa koma a ɛbɔ ntɛmntɛm.

Sɛ wo ba no wɔ saa sɛnkyerɛnne ahorow yi a, ɛbɛyɛ papa sɛ wobɛkɔ mmofra oduruyɛfo nkyɛn ntɛm ara sɛnea wubetumi.

Ɔkwan bɛn so na nnuruyɛfo hu PDA?

Sɛ wode wo ba kɔhwɛ no daa anaasɛ wode no kɔ yareɛ bi nti a, oduruyɛfoɔ no bɛtumi ate koma nwiinwii a yɛadi kan aka ho asɛm (`PDA koma nwiinwii`) no berɛ a ɔrehwɛ wo ba no. Sɛ oduruyɛfo no susuw sɛ eyi yɛ a, ɔde wo bɛkɔ mmofra komayare ho oduruyɛfo nkyɛn.

Sɔhwɛ bɛn na wɔyɛ de hu `PDA`?

Mmofra komayare ho oduruyɛfo no betumi ayɛ nhwehwɛmu ahorow pii de akyerɛ sɛ wɔahu sɛ ɔwɔ PDA:

• Koko so X-ray a wɔyɛ.
• Koma no mu nnyigyei a wɔde yɛ ultrasound (echocardiogram). Eyi betumi ahwɛ nneɛma te sɛ koma no dwumadi ne sɛnea ductus arteriosus no kɛse te.
• Electrocardiogram (EKG) a wɔde hwɛ koma no. Eyi sɔ anyinam ahoɔden a ɛwɔ koma no mu hwɛ.

So mpanyimfo betumi anya PDA?

Yiw, ɛtɔ mmere bi a wohu PDA wɔ mpanyimfo nso mu. Sɛ wɔannya PDA ketewaa bi aduru wɔ mmofraase a, ebia wɔrenhu kosi sɛ ɛbɛyɛ kɛse. Nsɛnkyerɛnne a ɛwɔ mpanyimfo mu no bi ne:

• Koma mu nwiinwii.
• Koma a ɛbɔ denneennen.
• Ahurututu mu mogya mmoroso.

Nneɛma a ɛte saa betumi asi.

Ɔkwan bɛn so na wɔsa PDA?

Oduruyɛfo no begyina nneɛma te sɛ wo ba no mfe, ne mu duru, ne n’akwahosan so akyerɛ ayaresa nhyehyɛe.

• Twɛn a wɔwɛn: Ɛtɔ mmere bi a oduruyɛfo no betumi ahwɛ akokoaa no yiye, ahwɛ na wayɛ nhwehwɛmu ahwɛ sɛ ebia PDA no ankasa bɛto mu anaa. Ebia PDA ketewaa bi renhia ayaresa koraa.
• Nnuru a wɔde sa yare: Wobetumi de nnuru a ɛnyɛ steroid a ɛko tia ɔyare mmoawa (NSAID) ama de aboa ma wɔatoto PDA no mu, titiriw ma nkokoaa a wɔawo wɔn ntɛm. Eyinom boa ma duct no twetwe na ɛto mu. Nanso, wɔmfa saa nnuru yi mma mmofra a wɔn mfe akɔ anim anaa mpanyimfo.
• Ayaresa afoforo:
• Koma mu Catheterization: Eyi hwehwɛ sɛ wɔde afiri a ɛyɛ tratraa a ɛyɛ mmerɛw (catheter) bɛhyɛ asen no mu na wɔde asaawa afa mogya ntini bi mu akɔ koma no mu. Afei, wɔde afiri ketewaa bi (plug anaa coil) fa tube no mu kɔ PDA no mu na wɔto mu. Eyi ma mogya a ɛboro so no gyae. Wɔntaa nyɛ saa adeyɛ yi mma nkokoaa a wɔawo wɔn ntɛm, nanso wobetumi ayɛ ama nkokoaa a wɔn mfe akɔ anim ne mmofra.
• PDA oprehyɛn (Patent Ductus Arteriosus oprehyɛn): Wɔ eyi mu no, nnuruyɛfo a wɔyɛ oprehyɛn no twa koko no fã ketewaa bi na wɔde nhama anaa dade ketewaa bi to PDA no mu.

Fa saa ayaresa ahorow yi sɛ nea wosiesie tokuru bi a ɛwɔ nsu paipu mu. Wode plɔg ketewaa bi hyɛ mu, anaasɛ wutwa tokuru no na woyɛ foforo.

Bere a wɔasa yare no awie no, ɛrenkyɛ na mogya a ɛkɔ nipadua no mu no asan ayɛ nea ɛfata?

Sɛ wɔto PDA no mu wie a, sɛ́ ɛyɛ koma mu catheter anaa oprehyɛn so no, ɛkame ayɛ sɛ mogya no san kɔ sɛnea na ɛte kan no mu ntɛm ara, sɛ koma no mu dɛmdi foforo biara nni hɔ a.

So PDA betumi de nsɛnnennen afoforo aba?

Sɛ wɔto PDA no mu wie a, mogya a ɛkɔ nipadua no mu no yɛ nea ɛfata, enti ɔhaw akɛse kakraa bi na ɛwɔ hɔ. Nanso, ɛho behia sɛ nkokoaa a wɔde koma mu catheter ato wɔn PDA mu no nom nnuru a ekum ɔyare mmoawa bɛyɛ asram asia na wɔasiw komayare (endocarditis) ano. Wo duruyɛfo bɛkyerɛkyerɛ eyi mu akyerɛ wo kɔ akyiri. Ɛsɛ sɛ mpanyimfo nso nom nnuru a ekum ɔyare mmoawa wɔ ɔkwan koro no ara so bere a wɔato PDA mu akyi na wɔkɔ so kɔ koma ho oduruyɛfo nkyɛn daa.

So metumi asiw me ba no kwan sɛ ɔrennya PDA?

Nokwarem no, biribiara nni hɔ a wubetumi ayɛ de asiw PDA ano. Ɛtaa ne akokoaa no nyin wɔ abusuabɔ.

So tebea horow bi wɔ hɔ a ɛma asiane a ɛwɔ hɔ sɛ me ba no benya PDA no yɛ kɛse?

Yiw, sɛnea yɛadi kan aka no, sɛ wunya German akisikuru (`Rubella`) wɔ nyinsɛn mu a, akokoaa no wɔ asiane kɛse mu sɛ obenya `PDA`. Enti, sɛ woanyinsɛn na wo ne obi a ɔwɔ German akisikuru adi nkitaho a, ɛho hia yiye sɛ woka kyerɛ oduruyɛfo ntɛm ara.

Sɛ me ba no wɔ PDA a, dɛn na ɛsɛ sɛ mehwɛ kwan?

Asɛmpa no ne sɛ, wɔ ayaresa akyi no, nkokoaa dodow no ara a wɔwɔ PDA no kɔ so tra ase a ahoɔden wom na wɔyɛ nnam. Enti biribiara nni hɔ a ɛsɛ sɛ wohaw wo ho wɔ ho.

So wobetumi asa PDA yare koraa?

Aane. Sɛ PDA no ankasa anto mu a, sɛ ɛho hia a, nnuruyɛfo betumi asiesie. Nanso, nkokoaa ne mmofra a wɔwɔ PDA a ɛyɛ mfinimfini anaa kɛse no wɔ asiane kɛse mu sɛ wobenya komayare bere a wɔanyinyin sɛ wɔansa wɔn yare ntɛm ara a. Enti, ɛho hia yiye sɛ wo ne wo duruyɛfo kasa sɛ ebia wo ba no hia ayaresa a ɛkɔ so daa anaa.

Mɛyɛ dɛn ahwɛ me ba a mewɔ PDA no?

Nea ɛho hia sen biara ne sɛ wubedi akwankyerɛ a wo duruyɛfo de ama wo no nyinaa akyi. Fa wo ba no kɔhwɛ no wɔ nna a wɔahyɛ da ayɛ no mu. Sɛ wo ba no nya sɛnkyerɛnne foforo biara, te sɛ ɛyɛ den sɛ ɔbɛhome, nufusu a ɔnom so tew, anaasɛ ɛte sɛ nea wabrɛ sen sɛnea ɔtaa yɛ a, ma wo duruyɛfo nhu ntɛm ara.

Bere bɛn na ɛsɛ sɛ mefrɛ oduruyɛfo no?

Sɛ wo ba no nya sɛnkyerɛnne foforo biara a, frɛ wo duruyɛfo ntɛm ara. Titiriw sɛ ɛyɛ den ma wo ba no sɛ ɔbɛhome a, eyi yɛ nea egye ntɛmpɛ, enti fa no kɔ ayaresabea ntɛm ara.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Ɛwom sɛ `Patent Ductus Arteriosus` anaa `(PDA)` yɛ komayare a wɔde awo obi de, nanso biribiara nni hɔ a ɛsɛ sɛ ɛhaw adwene. Ayaresa pa wɔ hɔ a wɔde sa no.

Nea ɛho hia sen biara ne sɛ wobehu yare no wɔ bere a ɛfata mu na wɔde ayaresa a ɛho hia ama.

Wo ne wo duruyɛfo nkasa na si ayaresa a eye ma wo ba no ho gyinae. Sɛ wosa wo ba kumaa no yare yiye a, obetumi atra ase anigye ne apɔwmuden te sɛ abofra foforo biara. Ɔhwɛ a woda no adi ma wo ba no ne n’ahoɔden a ɛsen biara!

` Patent Ductus Arteriosus, PDA, Nkokoaa Koma Yare, Nkokoaa a Wɔawo no Ntɛmntɛm, Koma mu Nwiinwii, Ɔhome mu Ahokyere, Mmofra Akwahosan