So woapira kakra pɛn? Ebia wode sekan twaa wo nsa, anaasɛ wohwee baabi. Sɛ ɛba saa a, mogya no gyae bere tiaa bi akyi, ɛnte saa? Nea enti a ɛte saa ne adwinnade bi a ɛyɛ nwonwa wɔ yɛn nipadua mu. Ɛno ne mogya a ɛtwetwe. Nanso ɛtɔ mmere bi a, saa adeyɛ yi ntumi nyɛ adwuma yiye. Mogya no gye bere tenten sen sɛnea ɛsɛ sɛ ɛba, anaasɛ ɛba ntɛmntɛm sen sɛnea ɛsɛ sɛ ɛba. Wɔ tebea horow a ɛtete saa mu no, yɛreka sɔhwɛ bi a ɛyɛ mmerɛw yiye, nanso ɛho hia yiye a wɔyɛ de hu sɛnea wo mogya tu ntɛmntɛm ankasa ho asɛm. Wɔfrɛ no Prothrombin Bere, anaa PT/INR sɔhwɛ.
Sɛ yɛbɛka no tiawa a, dɛn ne PT/INR sɔhwɛ yi?
PT/INR nhwehwɛmu yɛ nhwehwɛmu a wɔfa wo mogya bi na ɛkyerɛ bere tenten a egye ansa na ayɛ mogya. Susuw ho hwɛ, sɛ woapira a, protein ahorow a ɛwɔ yɛn nipadua mu (a wɔfrɛ no clotting factors) bom yɛ mogya a ɛtɔ ma mogya no gyae. Prothrombin yɛ protein foforo a yɛn mmerɛbo na ɛyɛ na ɛho hia ma mogya a ɛtwetwe.
Wobetumi de nea efi sɔhwɛ yi mu aba no ama wɔ sikani mu, anaasɛ wɔtaa de ma wɔ akontabuo soronko bi a wɔfrɛ no ``INR - International Normalized Ratio'' mu. INR yɛ gyinapɛn susudua a ɛnsakra wɔ lab biara mu wɔ wiase nyinaa. Enti, ɛnyɛ den koraa sɛ nnuruyɛfo bɛte nea efi mu ba no ase.
Mpɛn pii no, oduruyɛfo no nso bɛyɛ mogya a ɛtwetwe ho nhwehwɛmu foforo a wɔfrɛ no PTT (Partial Thromboplastin Time) aka PT nhwehwɛmu yi ho. Ɛhwɛ sɛ nneɛma afoforo a ɛboa ma mogya tu no reyɛ adwuma yiye anaa.
Tebea bɛn mu na wɔyɛ saa PT/INR sɔhwɛ yi?
Nnuruyɛfo yɛ nhwehwɛmu yi de hwɛ sɛ wo mogya retu yiye. Susuw ho hwɛ, sɛ wo mogya no ntetew brɛoo a, wubetumi atu mogya mmoroso afi opira ketewaa bi mpo mu. Saa ara nso na sɛ wo mogya tu ntɛmntɛm dodo a, akisikuru no betumi akɔhyɛ wo mogya ntini mu na ɛde tebea horow a ɛyɛ hu aba.
Nneɛma atitiriw nti a ebia wo duruyɛfo bɛyɛ nhwehwɛmu yi ni:
- Hwɛ warfarin dodow a wode di dwuma no so: Warfarin a wɔsan frɛ no Coumadin® yɛ aduru a ɛma mogya yɛ mmerɛw. Wɔde ma na amma mogya a ɛyɛ hu ankɔ nipadua no mu. Sɛ nhwɛso no, wɔde saa aduru yi ma nnipa a wɔwɔ asiane mu sɛ mogya bɛtɔ anan ntini mu (Deep Venous Thrombosis) anaa mogya a ɛbɛtɔ ahurututu mu (Pulmonary Embolism). Enti, wɔtaa yɛ PT/INR nhwehwɛmu yi de hwɛ sɛ ebia warfarin dodow a worenom no teɛ, ɛdɔɔso dodo, anaasɛ ɛnnɔɔso anaa.
- Ansa na Wɔbɛyɛ Oprehyɛn: Wɔyɛ nhwehwɛmu yi ansa na wɔayɛ oprehyɛn de ahwɛ sɛ wo mogya no twetwe sɛnea ɛsɛ anaa. Eyi bɛboa nnuruyɛfo no ma wɔahwɛ ahu sɛ asiane biara nni hɔ sɛ mogya bɛtɔ no dodo bere a wɔreyɛ oprehyɛn no.
- Hwɛ sɛ mogya tu ne mogya a ɛtwetwe: Sɛ wowɔ akisikuru a wontumi nkyerɛkyerɛ mu, wo hwene mu mogya taa tu, anaasɛ ɛyɛ den sɛ wubegyae mogya a efi kuru ketewaa bi mpo mu a, nhwehwɛmu yi betumi aboa ma woahu nea ɛde ba.
- Sɛ wususuw sɛ mmerɛbo mu yare a: Yɛadi kan aka sɛ mmerɛbo na ɛyɛ prothrombin. Enti, sɛ ɔhaw bi wɔ protein yi ho a, ebetumi akyerɛ sɛ mmerɛbo mu yare bi wɔ hɔ. PT/INR sɔhwɛ no yɛ nhwehwɛmu pii a wɔde hwɛ mmerɛbo dwumadi no mu biako.
So ahosiesie titiriw bi wɔ hɔ a ɛho hia ansa na wɔayɛ sɔhwɛ no?
Yiw, ɛtɔ mmere bi a, ebia ɛho behia sɛ wosiesie wo ho kakra. Wo duruyɛfo bɛkyerɛkyerɛ eyi mu akyerɛ wo. Mpɛn pii no, ebia ɛbɛyɛ biribi te sɛ eyi:
- Gyae nnuru bi bere tiaa bi: Nnuru bi te sɛ nnuru a ekum ɔyare mmoawa betumi ama wo PT/INR akɔ soro. Nnuru a ɛma nipadua no nya ahoɔden te sɛ nnuru a wɔde siw awo ano nso betumi atew saa bo yi so. Enti, ɛsɛ sɛ woka nnuru a worenom nyinaa kyerɛ wo duruyɛfo. Nanso kae sɛ, nnyae wo nnuru no da gye sɛ wo duruyɛfo ka kyerɛ wo.
- Tew Vitamin K a wudi so: Vitamin K yɛ ade a ɛboa ma mogya tu. Enti sɛ wonom nnuru a wɔfrɛ no vitamin K, anaasɛ wudi nnuan a vitamin K wom pii te sɛ kabege, akutu, ne broccoli a, ebia wɔbɛka akyerɛ wo sɛ tew so kakra. Efisɛ ɛno nso betumi aka nea ebefi mu aba no. Nanso ansa na wobɛyɛ eyinom mu biara no, akyinnye biara nni ho sɛ ɛsɛ sɛ wubisa wo duruyɛfo.
Dɛn na ɛba bere a wɔreyɛ sɔhwɛ no?
Eyi yɛ mmerɛw yiye, te sɛ mogya a wɔde ma sɛnea ɛsɛ no.
1. Ɔyarehwɛfo anaa lab technician de nsa bɛprapra wo nsa mu na ɔde elastic band atwa wo nsa no atifi ho ahyia.
2. Afei wɔbɛka akyerɛ wo sɛ fa wo nsa twitwiw. Afei wubehu ntini no yiye.
3. Wɔde ade twetwe mogya bi fi ntini no mu kɔ toa ketewa bi mu. Wobɛte nka sɛ wo ho ayɛ wo yaw kakra bere a wode ade no ahyɛ mu no.
4. Sɛ wɔtwe mogya no a, wɔbɛka akyerɛ wo sɛ fa plaster anaa kotoku ketewaa bi ngu ade no so na fa kura mu.
Ɛtɔ mmere bi a, titiriw wɔ nnipa a wɔnom warfarin fam no, ɛsɛ sɛ wɔyɛ nhwehwɛmu no daa, enti ɛsɛ sɛ wogye mogya a ɛtɔ fi wɔn nsateaa ano. Nneɛma a wɔde sɔ hwɛ wɔ fie nso wɔ hɔ. Sɛ wopɛ bi a, wo duruyɛfo bɛkyerɛ wo sɛnea wode bedi dwuma ne sɛnea wobɛbɔ nea efi mu ba no amanneɛ akyerɛ wo duruyɛfo.
Nea efi mu ba anaasɛ ɔkwan bɛn so na yɛbɛte nea efi mu ba no ase?
Sɛ wunya nea efi mu ba no a, ma yɛnhwɛ nea akontaabu no kyerɛ. Eyi ho hia yiye sɛ wobɛte ase, titiriw sɛ worenom warfarin a.
| Nea efi mu ba no su | Normal Range a Ɛyɛ Fɛ |
|---|---|
| Prothrombin Bere (wɔ sikɔne mu) . | Wɔ sikɔne 11 kosi 13.5 ntam. |
| INR (obi a ɔwɔ apɔwmuden de) . | Wɔ 0.8 ne 1.1 ntam. |
| INR (Warfarin - botaeɛ ma obi a ɔnom Warfarin) . | Wɔ 2.0 ne 3.0 ntam. (Wɔ aduruyɛ tebea horow bi mu no, ebia botae a wɔde asi wɔn ani so yi bɛyɛ nea ɛba fam anaasɛ ɛboro saa. Wo duruyɛfo na ɔbɛkyerɛ eyi.) |
Dɛn na nea efi mu ba a ɛnteɛ kyerɛ?
Sɛ PT botae anaa INR bo no yɛ kɛse a:
Eyi kyerɛ sɛ wo mogya gye bere tenten sen sɛnea ɛte daa ansa na atumi atɔ.
- Sɛ wo nnom warfarin a, ebia eyi fi mogya a ɛretu, mmerɛbo mu haw, anaa vitamin K a wunni.
- Sɛ worenom warfarin na wo INR boro nea wɔde asi wɔn ani so (e.g., ɛboro 3.0) a, asiane wom sɛ mogya bɛtɔ wo. Ebia eyi fi:
- Wo warfarin dodow no dɔɔso dodo kakra.
- Esiane aduru foforo a wonom a woankyerɛ oduruyɛfo no nti (nnuru bi a wɔde kum ɛyaw, aduru a wɔde kum atiridii).
- Warfarin ne nneɛma te sɛ akutu, kale, kranberɛ nsu, anaa nsa di nkitaho.
Sɛ PT botae anaa INR bo no sua a:
Eyi kyerɛ sɛ wo mogya tu ntɛmntɛm sen sɛnea ɛte daa. Sɛ obi a ɔnom warfarin no INR bo a ɛba fam sen nea wɔde asi n’ani so (e.g., ennu 2.0) a, asiane da so ara wɔ hɔ sɛ mogya a ɛbɛtɔ no bɛba.
Nea ɛho hia sen biara ne sɛ, ɛmfa ho nea ebefi mu aba biara no, mma wo ho nnpopo na wo ne wo duruyɛfo nkasa. Ɔno na obehu nea ɛde ba no na wayɛ nea ɛho hia.
Sɛ nea efi mu ba no nyɛ nea ɛfata a, dɛn na woyɛ akyi?
Wo duruyɛfo no begyina nea ebefi mu aba no so asi nea ɔbɛyɛ akyi.
- Sɛ worenom warfarin a: Wo duruyɛfo no bɛsakra wo dodow no kakra na ama wo INR asan akɔ baabi a wopɛ sɛ wonom no. Eyi kyerɛ sɛ ebia ɛho behia sɛ woma wo dodow no kɔ soro anaasɛ wotew so kakra.
- Sɛ wosusuw sɛ yare foforo bi a: Oduruyɛfo no bɛbom asusuw nea ebefi PT ne PTT nhwehwɛmu no nyinaa mu aba no ho. Ebia ɔde wo nso bɛkɔ akɔyɛ nhwehwɛmu foforo de ahu yare no.
Mpɛn pii no, wonya nea efi mu ba no wɔ nnɔnhwerew kakraa bi anaa da koro mu. Nsateaa a wɔde sɔ hwɛ gye simma kakraa bi pɛ.
Nkrasɛm a Wɔde Kɔ Fie
- PT/INR yɛ mogya mu nhwehwɛmu a ɛnyɛ den a ɛkyerɛ bere a egye ansa na wo mogya atɔ.
- Ɛsɛ sɛ nnipa a wɔnom nnuru a ɛma mogya yɛ mmerɛw te sɛ Warfarin yɛ nhwehwɛmu yi daa. Ɛboa ma wɔhwɛ aduru no dodow so pɛpɛɛpɛ.
- Saa sɔhwɛ yi nso boa ma wohu nneɛma te sɛ mogyatɔw ne mmerɛbo mu nyarewa.
- Sɛ nea efi mu ba no boro nea ɛfata so a, mma ɛnhaw wo. Wo ne wo duruyɛfo nkasa mfa nea ɛkyerɛ ne nea ɛsɛ sɛ woyɛ akyi.
- Ɛho hia paa sɛ wobɔ wo duruyɛfo amanneɛ wɔ nnuru, vitamin, ne w’aduan nyinaa ho.
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