So wo ho yɛ wo hyew wɔ nnuru a wɔde kum nipadua no ho? Momma yensua (Pseudocholinesterase Deficiency) ho ade?

So woate nka sɛ ehu aka wo kakra wɔ aduru a wɔde kum wo yare a wɔde ma wo oprehyɛn no ho pɛn? Ɛyɛ ade a ɛfata sɛ nnipa binom bɛte nka saa. Nanso susuw nea anka ɛbɛba sɛ nnuru a wɔde kum wo yare a wɔde ma wo no bi mfata wo nipadua no ankasa ho hwɛ. Ɛnnɛ yɛbɛka tebea biako a ɛntaa nsi, nanso ɛho hia yiye a ɛsɛ sɛ yɛma yɛn ani da hɔ ho asɛm. Ɛno yɛ tebea bi a wɔfrɛ no `(Pseudocholinesterase Deficiency)`.

Dɛn ne `(Pseudocholinesterase a Ɛnyɛ Den)`? Momma yɛnte ase tiawa, ɛnte saa?

Okay, saa din yi te sɛ nea ɛware kakra, ɛnte saa? Momma yɛmma ɛnyɛ mmerɛw. `(Pseudocholinesterase)` yɛ enzyme soronko `(Enzyme)` a ɛwɔ yɛn nipadua mu. Dwumadi titiriw biako a saa `(Enzyme)` yi yɛ ne sɛ ɛbɛbubu (kyerɛ sɛ, `(metabolize)`) wɔ nipadua no mu nnuru a wɔde ma ntini ahorow no bi , titiriw bere a wɔama yɛn anesthetized (yɛfrɛ eyinom `(Choline esters)`). Fa no sɛ, bere a wɔreyɛ oprehyɛn no, ɛsɛ sɛ wo ntini ahorow no mmubu kakra. Eyinom ne nnuru a wɔde ma wɔ ɛno ho.

Afei, wɔ tebea bi a wɔfrɛ no `(Pseudocholinesterase Deficiency)` mu no, nea ɛba ne sɛ saa `(Enzyme)` a wɔfrɛ no `(Pseudocholinesterase)` a ɛwɔ wo nipadua mu yi nyɛ nea wɔyɛ no sɛnea ɛsɛ , anaasɛ ɛnyɛ adwuma yiye . Dɛn na ɛba saa bere no? Nnuru a wɔde ma sɛ ɛma ntini no dwo (`(Succinylcholine)` ne `(Mivacurium)` yɛ eyi ho nhwɛso abien) no mfi nipadua no mu ntɛm. Wɔtra nipadua no mu kyɛ.

Ne saa nti, wo ntini betumi ayɛ mmerɛw bere tenten wɔ aduru a wɔde kum wo akyi, na ebetumi ayɛ den ama wo mpo sɛ wobɛhome. Eyi kyerɛ sɛ ebia w’ankasa worentumi nkɔ baabiara anaasɛ wuntumi nhome kosi sɛ aduru no nkɛntɛnso bɛsɛe.

Saa tebea yi abu so dɛn?

Nokwarem no, saa tebea a wɔfrɛ no `(Pseudocholinesterase Deficiency)` yi ntaa mma saa . Sɛ wɔkyekyem pɛpɛɛpɛ a, nnipa 3,200 anaa 5,000 biara mu bɛyɛ biako pɛ na onya saa tebea yi. Ɛne sɛ, dodow kakraa bi pɛ.

Dɛn ne sɛnkyerɛnne ahorow no? Wobɛyɛ dɛn ahu eyi?

Nnipa dodow no ara a wɔwɔ saa tebea yi nnim kosi sɛ wobenya aduru a ɛma obi dwensɔ a madi kan aka ho asɛm no, a wɔfrɛ no ``Choline esters.'' Ɛno ne bere a sɛnkyerɛnne atitiriw no da adi:

• Ntini a ɛyɛ mmerɛw dodo (i.e., nkwa nnim) bere tenten sen sɛnea anka wɔbɛhwɛ kwan.
• Ntini a ɛboa wo ma wohome mpo yɛ nea entumi nyɛ adwuma bere tiaa bi .

Ebia ebegye nnɔnhwerew kakraa bi ansa na saa sɛnkyerɛnne ahorow yi ano abrɛ ase. Saa bere yi gu ahorow wɔ onipa biara mu. Saa berɛ yi mu no, w'aduruyɛ kuo no bɛma woakɔ so ahyɛ aduru a wɔde kum nipadua no mu na wɔaboa wo ama woatumi afa ``ventilator'', afiri a wɔde home a wɔayɛ, akɔsi sɛ w'ankasa wobɛtumi ahome.

Dɛn na ɛde ba? Ɔkwan bɛn so na eyi ba?

Saa tebea yi (Pseudocholinesterase Deficiency) betumi ayɛ nea wonya fi awo mu (i.e. wonya fi awo mu), anaasɛ ebetumi aba akyiri yi wɔ asetra mu..

Nneɛma a ɛde ba a wonya fi awo mu

Nnipa a wɔwo wɔn a wɔwɔ saa tebea yi no wɔ nsakrae, anaa mutation, wɔ gene bi a wɔfrɛ no `(BCHE)` mu. Saa `(BCHE)` gene yi ne nea ɛka kyerɛ yɛn nipadua sɛ ɛnyɛ enzyme `(Pseudocholinesterase)`. Enti, sɛ nsakrae ba saa awosu mu abɔde yi mu a, wo nipadua no ntumi nyɛ saa enzyme yi kakraa bi pɛ, anaasɛ ebia ɛrenyɛ koraa.

Nneɛma a ɛde ba a ɛba wɔ nkwa mu (Acquired) .

Ɛtɔ da bi a, saa tebea yi (Pseudocholinesterase Deficiency) betumi aba wɔ nkwa nna nyinaa mu. Ebetumi afi nyarewa ahorow ne nnuru bi mu aba.

Nyarewa bi a ebetumi de saa tebea yi aba:

• Aduan pa a wonnya nni
• Ɔhyew a emu yɛ den a opira
• Asaabo mu yare
• Mmɛn mu yare
• Hypothyroidism (thyroid a ɛnyɛ adwuma) .
• Kokoram
• Nyinsɛn a wɔde di dwuma

Nnuru bi a ebetumi ama asiane a ɛwɔ hɔ sɛ obi benya tebea yi ayɛ kɛse no bi ne:

• Nnuru a esiw MAO ano (sɛ nhwɛso no, Phenelzine (Nardil®)) .
• Nnuru a wɔde siw awo ano (Nnuru a wɔde siw nyinsɛn ano) .
• Echothiophate aniwa mu nsu a wɔde gu aniwa so
• Metoclopramide a wɔde di dwuma
• Cyclophosphamide a wɔde yɛ aduru
• Pyridostigmine a wɔde yɛ aduru

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Sɛ ɛyɛ den ma wo sɛ wubedi wo ntini so anaasɛ wobɛhome wɔ aduru a wɔde kum wo nyinaa akyi a, ebia wo duruyɛfo besusuw sɛ pseudocholinesterase nnim. Nea ɛbɛyɛ na wɔasi eyi so dua no, wobetumi ayɛ mogya mu nhwehwɛmu de ahwɛ sɛnea enzyme pseudocholinesterase no dɔɔso wɔ wo mu.

Sɛ obi wɔ w’abusua mu wɔ saa yare yi a, oduruyɛfo betumi ayɛ awosu mu nhwehwɛmu de ahu sɛ wo nso wowɔ bi anaa. Nea ɛka eyi ho ne sɛ wobɛfa mogya na woahwɛ sɛ wowɔ (BCHE) awosu mu nkwaadɔm mu nsakrae no anaa.

Sɛ wo duruyɛfo susuw sɛ wowɔ saa tebea yi a, wɔde nnuru afoforo a ɛma ntini mu dwo a enni enzyme ``Pseudocholinesterase'' so bedi dwuma.

Dɛn ne ayaresa no?

Sɛ wunya `(Pseudocholinesterase Deficiency)` ho sɛnkyerɛnne bere a wɔama wo aduru a wɔde kum nipadua no nyinaa akyi a, ebia wubehia ayaresa ntɛm ara. Aduruyɛ kuw no bɛhwɛ wo yiye kosi sɛ wo ho bɛtɔ wo. Sɛ ɛho hia a, wɔde wo bɛto aduru a wɔde kum nipadua no ase na wɔde `` mfiri a wɔde ma mframa`` afiri adi dwuma de aboa wo ma woahome kosi sɛ w’ankasa wubetumi ahome.

Sɛ wowɔ saa tebea yi a, dɛn na ɛsɛ sɛ wohwɛ kwan?

Sɛ wohu sɛ wowɔ `(Pseudocholinesterase Deficiency)` a, ade a eye sen biara a wubetumi ayɛ ne sɛ wobɛbɔ wo nnuruyɛfo amanneɛ wɔ ho – titiriw nnuruyɛfo a wɔbɛhwɛ wo ama wɔayɛ wo oprehyɛn no .

Afei nso, ɛsɛ sɛ woka eyi ho asɛm kyerɛ w’abusua nso., afei wobetumi nso asɔ wɔn ahwɛ sɛ ebia wɔwɔ `(BCHE)` awosu mu nkwaadɔm mu nsakrae no anaa. Sɛ saa a, ɛsɛ sɛ wɔbɔ wɔn nnuruyɛfo nso amanneɛ ansa na wɔayɛ wɔn oprehyɛn biara.

Ɛyɛ papa nso sɛ wobɛhyɛ aduruyɛ ho ID abɔso sɛnea ɛbɛyɛ a nnuruyɛfo betumi ahu sɛ ɛsɛ sɛ woyɛ wo oprehyɛn ntɛm anaa.

So wobetumi asiw eyi ano?

Pseudocholinesterase a enni nipadua no mu yɛ tebea a wɔde awo obi a wontumi nsiw ano. Nanso, sɛ obi a ɔwɔ w’abusua mu wɔ bi a, wobetumi asɔ wo ahwɛ sɛ ebia BCHE awosu mu nkwaadɔm mu nsakrae no wɔ ansa na wɔayɛ wo aduru a wɔde kum nipadua no nyinaa. Eyi betumi aboa ma wɔasiw nsɛnnennen ano bere a wɔreyɛ oprehyɛn no.

Sɛ wowɔ awosu mu nsakrae no a, ɛda adi sɛ wo duruyɛfo no behuruw Choline esters no na wapaw aduru foforo a wɔde kum nipadua no. Rocuronium ne aduru a wɔtaa de kum nnipa a wɔwɔ Pseudocholinesterase Deficiency.

Ebia wubetumi atew asiane a ɛwɔ hɔ sɛ wubenya Acquired Pseudocholinesterase Deficiency akyiri yi wɔ w’asetra mu no so denam tebea horow a ɛhyɛ ase te sɛ aduan pa a wonnya nni anaa asaabo mu yare a enni sabea (CKD) a wobɛsa so. Afei nso, sɛ worenom nnuru biara a ɛtew enzyme Pseudocholinesterase a ɛba no so a, ebia wobɛpɛ sɛ wo ne wo duruyɛfo kasa fa sɛnea wobɛsesa w’aduru no ho.

Dɛn ne nnuru a ɛko tia, kyerɛ sɛ, nnuru bɛn na ɛnyɛ papa sɛ wɔde bedi dwuma ama nnipa a wɔwɔ saa tebea yi?

Sɛ wɔahu sɛ wowɔ `(Pseudocholinesterase Deficiency)` a, ɛsɛ sɛ wokwati nnuru ahorow a edidi so yi a wɔde kum nipadua no :

• Succinylcholine `(Suksinilkoline)`
• Mivacurium a ɛma nipadua no yɛ adwuma
• Procaine a wɔde di dwuma
• Chloroprocaine a wɔde ma
• Benzocaine a wɔde di dwuma
• Tetracaine a wɔde di dwuma

Nsɛmmisa a ɛsɛ sɛ wubisa wo duruyɛfo

Sɛ wowɔ tebea bi a wɔfrɛ no ``Pseudocholinesterase Deficiency'', sɛ́ wɔwoo wo a na wowɔ bi anaasɛ wunya bi akyiri yi a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm bi te sɛ:

• Dɛn ne nnuru pɔtee a ɛtia me, kyerɛ sɛ, nnuru bɛn na ɛsɛ sɛ mekwati?
• So tebea yi yɛ biribi a wɔde woo me anaasɛ yare foforo na ɛde ba?
• So ɛyɛ adwene pa sɛ mɛma wɔayɛ awosu mu nhwehwɛmu wɔ m’abusua ho?

Oprehyɛn a wobɛkɔ no betumi ayɛ adwennwen kakra. Yɛn mu pii de yɛn adwene asi oprehyɛn no so araa ma yensusuw ho mpo sɛ ebia aduru a wɔde kum nipadua no bɛyɛ yɛn ade wɔ ɔkwan a enye so. Aduru biara nni hɔ a wɔde sa Pseudocholinesterase Deficiency. Nanso, sɛ wunim sɛ ebia wowɔ bi a, ebetumi aboa wo ma woakwati bere tiaa mu ntini a ɛyɛ mmerɛw ne ɔhome mu haw a ebetumi aba wɔ oprehyɛn akyi no. Sɛ wowɔ Pseudocholinesterase Deficiency a, ka ho asɛm kyerɛ w’abusua mufo. Wobetumi nso ayɛ awosu mu abɔde no mu nhwehwɛmu na wɔakwati nsɛnnennen biara a ɛho nhia a ebetumi aba wɔ wɔn akwahosan akwantu no mu.

Nea etwa to no, nneɛma a ɛsɛ sɛ yɛkae

Enti, `(Pseudocholinesterase Deficiency)` yɛ din a ɛyɛ hu kakra, nanso ɛho hia yiye sɛ wobɛhu. Titiriw sɛ worekɔyɛ oprehyɛn, anaasɛ sɛ obi a ɔwɔ w’abusua mu ahyia biribi a ɛte sɛɛ a , ɛbɛyɛ papa sɛ wo ne wo nnuruyɛfo bɛkasa afa eyi ho. Kae sɛ mpɛn pii no, nhumu yɛ kyɛm a eye sen biara a ebetumi agye yɛn afi ɔhaw ahorow a ɛho nhia mu!

` Anesthesia, pseudocholinesterase, enzyme a enni nipadua mu, oprehyɛn mu nsɛnnennen, awosu mu tebea, ntini a entumi nyɛ adwuma yiye, nnuru a wɔde kum nipadua no