Momma yensua oprehyɛn a wɔyɛ de yi mogya a ɛwɔ ahurututu mu (Pulmonary Thromboendarterectomy - PTE) no ho ade .

Ebia na ɛyɛ den ma wo sɛ wobɛhome bere bi, anaasɛ mpo wote nka sɛ wo home yɛ den bere a wonam no. Ebia wo duruyɛfo aka akyerɛ wo sɛ wowɔ ahurututu mu mogya mmoroso, a ɛyɛ mogya dedaw a aboaboa ano wɔ w’ahurututu mu. Bere a wontumi mfa nnuru nni saa tebea yi so no, yɛreka oprehyɛn titiriw bi a ebetumi agye wo nkwa ho asɛm.

Sɛ yɛbɛka no tiawa a, dɛn ne PTE oprehyɛn yi?

Mma edin tenten a wɔde frɛ wo Pulmonary Thromboendarterectomy no nnyɛ wo hu. Yɛbɛfrɛ no PTE tiawa. PTE yɛ adeyɛ a ɛyɛ den yiye a nnuruyɛfo a wɔyɛ oprehyɛn ho abenfo yɛ. Nea ɛka ho ne oprehyɛn a wode beyi mogya a ɛtɔ dedaw ne akuru ntini a abata mogya ntini atitiriw a ɛde mogya kɔ w’ahurututu mu (Ahurututu mu Ntini) no afasu ho no.

Fa no sɛ efĩ ayɛ nsu paipu bi a ɛwɔ wo fie ma na nsu nsen. PTE oprehyɛn te sɛ nea wɔhohoro paipu no mu na wɔma nsu no san sen yiye bio. Eyi ne ɔkwan a eye sen biara a wobɛfa so ayi mogya a ayɛ dedaw na ayɛ den a wontumi mfa nnuru ntutu yi. Ɛtɔ mmere bi mpo a, oprehyɛn yi betumi asa tebea no koraa.

Tebea horow bɛn na wɔde PTE oprehyɛn sa?

Wɔyɛ oprehyɛn yi titiriw ma nnipa a wɔwɔ tebea bi a wɔfrɛ no Chronic Thromboembolic Pulmonary Hypertension (CTEPH) . Eyi yɛ din a ɛyɛ den kakra, enti momma yɛnte ase.

• Chronic: kyerɛ sɛ "ɛtena hɔ bere tenten."
• Thromboembolic: kyerɛ sɛ "mogya a ɛtwetwe na ɛde ba."
• Pulmonary Hypertension: Eyi kyerɛ sɛ "mogya mmoroso a ɛkɔ soro wɔ ahurututu mu."

Sɛ yɛbɛka no tiawa a, CTEPH yɛ bere a mogya a ɛtɔ (Pulmonary Embolism - PE) a adi kan ayɛ wɔ ahurututu mu no ntumi ntutu yiye, na mmom ɛbata mogya ntini a ɛwɔ ahurututu no mu no afasu ho, na ɛyɛ akuru ntini bere tenten, na esiw mogya a ɛkɔ mu no kwan, na ɛma nhyɛso kɔ soro wɔ ahurututu no mu.

Mpɛn pii no, sɛ obi mogya tu (PE) wɔ n’ahurututu mu a, nnuruyɛfo ma no nnuru a ɛma mogya tu. Mpɛn pii no, saa nnuru yi ma mogya a atu no. Nanso wɔ nnipa kakraa bi pɛ mu, bɛyɛ 2% - 4%, saa mogya a ɛtwetwe yi ntumi ntutu koraa. Wɔbɔ akwakoraa, bata mogya ntini no afasu ho, na esiw kwan ma mogya nkɔ. Eyi de nhyɛso pii ba koma no nifa a ɛde mogya kɔ ahurututu no mu no so. Bere kɔ so no, eyi betumi ama obi anya komayare , ahurututu mu asɛe, ne ɔhaw ahorow a ɛde ne nkwa to asiane mu mpo.

Henanom na wohia oprehyɛn yi? So obiara betumi anya bi?

Sɛ wowɔ CTEPH a, wobesusuw nneɛma pii ho de ahu sɛ ebia wubetumi ayɛ wo oprehyɛn yi anaa.

• Sɛnea wo sɛnkyerɛnne ahorow no mu yɛ den.
• Baabi a mogya a ɛtwetwe no wɔ, baabi a atrɛw, ne baabi a asiw mogya ntini no.
• Mfe a woadi, w’akwahosan nyinaa, ne sɛnea wo koma ne w’ahurututu reyɛ adwuma.

Sɛnea nnuruyɛfo a wɔyɛ oprehyɛn kyerɛ no, sɛ wotumi yi mogya a ɛtwetwe yi fi hɔ dwoodwoo a, ayaresa a wɔpaw ma CTEPH ne PTE oprehyɛn.

Nanso, ɛnyɛ obiara a ɔwɔ CTEPH na obetumi ayɛ saa oprehyɛn yi. Bɛyɛ 40%, anaa nnipa du biara mu baanan, mfata mma oprehyɛn yi. Nea enti titiriw a ɛte saa ne sɛ ɛyɛ oprehyɛn a ɛyɛ den yiye.

Dɛn nti na oprehyɛn yi yɛ den saa?

Wɔ oprehyɛn yi mu no, nnuruyɛfo kuw no de wo koma ne w’ahurututu adwuma no kɔ afiri bi a wɔde twa koma ne ahurututu mu bere tiaa bi mu . Eyi kyerɛ sɛ saa afiri yi ma wo nipadua nya mframa pa na ɛbɔ mogya bere a wɔreyɛ oprehyɛn no.

Nea ɛho hia sen saa mpo no, bere a wɔreyɛ oprehyɛn no, ɛsɛ sɛ oduruyɛfo a ɔyɛ oprehyɛn no hu mogya ntini a ɛyɛ mmerɛw a ɛwɔ ahurututu no mu no pefee. Nea ɛbɛyɛ na wɔayɛ eyi no, wɔde ɔkwan titiriw bi di dwuma de ma wo nipadua mu hyew so tew kodu digrii Celsius 18 (65 Fahrenheit), na ɛma mogya a ɛkɔ nipadua no mu no gyae koraa bere tiaa bi (Deep Hypothermic Circulatory Arrest). Wɔma nipadua no dwo wɔ saa kwan yi so na amma amemene no ansɛe. Saa kwan yi ma oduruyɛfo a ɔyɛ oprehyɛn no tumi de ahwɛyiye kɛse yi mogya a ɛtɔ ne akuru ntini wɔ oprehyɛn a emu da hɔ a mogya nnim mu.

Sɛ oprehyɛn ntumi nyɛ yiye a, akwan foforo bɛn na ɛwɔ hɔ?

Sɛ nnuruyɛfo si gyinae sɛ womfata sɛ wɔyɛ PTE oprehyɛn esiane biribi nti a, wɔbɛkamfo ayaresa afoforo akyerɛ wo.

• Nnuru a Wɔnom: Nnuru titiriw bi wɔ hɔ a etumi siw mogya mmoroso ano wɔ ahurututu mu.
• Balloon Pulmonary Angioplasty (BPA): Nea ɛka eyi ho ne sɛ wɔde afiri teateaa bi a wɔde fa ntini bi a ɛwɔ nan no mu mu bedi dwuma de adu mogya ntini a asiw wɔ ahurututu no mu no ho, na wɔde afiri a ɛte sɛ balloon abɔ mu ma abue mogya no mu.

Ɔkwan bɛn so na wusiesie wo ho ansa na wɔayɛ wo oprehyɛn?

Wo duruyɛfo bɛma wo akwankyerɛ a emu da hɔ wɔ sɛnea wubesiesie wo ho ama oprehyɛn no ho. Ɛho hia paa sɛ wubedi saa akwankyerɛ ahorow no akyi pɛpɛɛpɛ.

Dɛn na ɛba bere a wɔreyɛ oprehyɛn no?

Mpɛn pii no, oprehyɛn yi fi ase anɔpa na egye bɛyɛ nnɔnhwerew 6. Wɔbɛma wo anesthetized koraa sɛnea ɛbɛyɛ a worente biribiara nka.

1. Boa ma wohome: Nea edi kan no, wɔde afiri a ɛyɛ tratraa (Endotracheal Tube - ETT) fa w’anom anaa wo hwene mu, sian wo mframa afiri mu, na wɔde bata oxygen afiri (ventilator) ho. Saa afiri yi bɛboa wo ma woahome wɔ oprehyɛn no nyinaa mu.

2. Wo koko a wobɛbue: Afei, oduruyɛfo a ɔyɛ oprehyɛn no betwa wo nufu dompe (sternum) mu ma adu koma ne w’ahurututu mu.

3. Nkitahodi a ɛkɔ bypass afiri no so: Afei wɔde wo bɛka Cardiopulmonary Bypass Machine no ho. Saa afiri yi bɛyɛ koma ne ahurututu adwuma bere a wɔreyɛ oprehyɛn no.

4. Nipadua mu nwini: Afei, wo nipadua mu hyew so tew nkakrankakra kodu digrii Celsius 18.

5. Mogya a ɛtwetwe no a wobeyi afi hɔ: Bere a oduruyɛfo a ɔyɛ oprehyɛn no ama nipadua no ayɛ nwini na wagyae mogya no bere tiaa bi akyi no, ɔde ahwɛyiye yi mogya a ɛtɔ ne akuru ntini no fi ahurututu no mogya ntini mu denam nnwinnade soronko so.

6. Ɔhyew a Wɔsan Yɛ: Sɛ woyi mogya a ɛtɔ no fi hɔ wie a, wo nipadua mu hyew san ba sɛnea na ɛte kan no na wotwa afiri a wɔde twa kwan no ho. Nanso wokɔ so yɛ nea ɛne mframa a wɔde ma no di nkitaho.

7. Koko a wɔde to mu:Awiei koraa no, oduruyɛfo a ɔyɛ oprehyɛn no bɛto wo moma so na ɔde nsu a ɛyɛ tratraa pii ahyɛ mu na ama nsu a ɛboro so biara a ebia ɛreboaboa ano wɔ wo nipadua mu no akɔ.

Dɛn na ɛba wɔ oprehyɛn no akyi?

Sɛ wɔyɛ oprehyɛn wie a, wɔde wo bɛkɔ ayaresabea a wɔhwɛ wɔn a wɔyare denneennen (ICU) . Wobɛtena ICU hɔ saa anadwo no. Ade kyee anɔpa no, nnuruyɛfo kuw no bɛhwɛ sɛnea wohome. Sɛ w’ankasa wutumi home a, wobeyi mframa a wɔde ma no afi hɔ.

Mpɛn pii no, ɛsɛ sɛ wotra ayaresabea hɔ nnafua 7 kosi 10. Wobedi kan akɔ ICU, na afei wɔde wo akɔ ayaresabea a wɔhwɛ wo daa bere a wo tebea no retu mpɔn no.

Adeyɛ a ɛma obi ho tɔ no no te sɛ nea obi ho tɔ no wɔ koma a wɔabue mu oprehyɛn mu no ara pɛ. Wobɛtumi anantew nna kakraa bi mu na nkakrankakra woatumi ayɛ adwuma bi. Ansa na wobɛkɔ fie no, wɔbɛyɛ wo nhwehwɛmu bi nso de ahwɛ sɛ wuhia oxygen anaa.

Mfaso ne asiane bɛn na ɛwɔ PTE oprehyɛn so?

Mfaso a ɛwɔ so

• Eyi nkutoo ne ɔkwan a wɔfa so sa CTEPH koraa .
• Wɔ nnipa pii fam no, oprehyɛn no di yiye, na ɔhome ne ahurututu mu dwumadi tu mpɔn kɛse.
• Nnipa pii a na wɔde wɔn ho to oxygen so ansa na wɔreyɛ oprehyɛn no renhia oxygen bio wɔ oprehyɛn akyi.
• Mpɛn pii no, wɔdan ɔsɛe a yare no de ba koma no nifa so no.
• Hokwan a ɛwɔ hɔ sɛ obenya nkwa bere tenten wɔ oprehyɛn akyi no dɔɔso yiye.

Asiane ne Nsɛnnennen a Ɛba

Esiane sɛ eyi yɛ oprehyɛn kɛse nti, asiane ahorow bi wɔ mu. Nanso, esiane sɛ mfiridwuma anya nkɔso wɔ mfe kakraa a atwam no mu nti, asiane ahorow yi so atew kɛse.

• Mprempren asiane a ɛwɔ hɔ sɛ obi bewu bere a wɔreyɛ oprehyɛn no sua te sɛ 1%.
• Asiane a ɛwɔ hɔ sɛ obi benya ɔyare a ɛma obi hwe ase no bɛyɛ 1% - 2%.
• Ebia nnipa binom da so ara wɔ ahurututu mu mogya mmoroso bi wɔ oprehyɛn akyi. Ɛho behia sɛ wɔkɔ so nom nnuru.
• Ɛtɔ mmere bi a, nsu a ɛboaboa ano wɔ koma no ho (pericardial effusion) betumi aba.

Sɛ wuhu sɛnkyerɛnne ahorow a edidi so yi a, frɛ 1990 ntɛm ara anaa kɔ ayaresabea Emergency Department (ETU) a ɛbɛn wo:

• Koko mu yaw a emu yɛ den
• Nnipa a wɔtotɔ piti
• Ahome a ɛyɛ tiaa a emu yɛ den mpofirim

Bere tenten ahe na egye ansa na asa?

Bere kɔ so no, wubetumi asan akɔ asetra a ɛfata mu. Nanso, ɛsɛ sɛ wunya abotare kakra.

• Adapɛn 6 a edi kan: Worentumi nka kar, nkɔ adwuma, anaasɛ womma wo mu duru bɛboro nkaribo 10 (bɛyɛ kilogram 4.5).
• Adapɛn 7 kosi 12: Otumi ma ne mu duru so bɛyɛ nkaribo 25 (bɛyɛ kilogram 11).
• Adapɛn 12 akyi: Wɔtaa yi anohyeto ahorow a ɛfa nneɛma a wɔde ma so no fi hɔ.

Nnipa dodow no ara tumi san kɔ wɔn dwumadi ahorow a wɔtaa yɛ no mu wɔ asram 3 ntam. Wo home ne sɛnea wubetumi ateɛteɛ w’apɔw mu no bɛkɔ anim nkakrankakra, na ebia wubehu nkɔso a ɛbɛkɔ akodu mfe 4.

Ɔkwan bɛn so na nnuruyɛfo a wɔhwɛ wɔn so wɔ oprehyɛn no akyi?

Sɛ wɔyɛ oprehyɛn no wie a, ɛsɛ sɛ wokɔ so kɔ oduruyɛfo nkyɛn.

• Wobɛyɛ nhwehwɛmu titiriw pii de ahwɛ w’ahurututu mu wɔ oprehyɛn no akyi adapɛn 6 ne bio wɔ asram 3-6 akyi.
• Ade a ɛho hia sen biara ne sɛ ɛsɛ sɛ wofa nnuru a ekum mogya a ɛtwetwe/mogya a ɛma mogya tu wo nkwa nna nyinaa na amma mogya a ɛbɛtɔ foforo ankɔ.

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, wo ne wo duruyɛfo nkasa.

• Sɛ ɛyaw no yɛ nea wontumi nnyina ano, anaasɛ ɛyaw no so tew na afei ɛsan kɔ soro bio a.
• Sɛ koma no bɔ ntɛmntɛm anaasɛ ɛnte saa a.
• Sɛ kuru a wɔayɛ no oprehyɛn no yɛ kɔkɔɔ, ɛho ahonhon, akisikuru a ɛretu, anaasɛ atiridiinini (eyinom yɛ ɔyare mmoawa ho sɛnkyerɛnne).

PTE yɛ oprehyɛn a ɛsom bo yiye a ebetumi ama obi a ɔwɔ CTEPH anya nkwa a ɛto so abien. Ɛwom sɛ ɛyɛ oprehyɛn a emu yɛ den na egye bere tenten ansa na ne ho atɔ no de, nanso nea efi mu ba, a ɛne hokwan a obi nya sɛ ɔbɛtra ase ahofadi mu a ɔmfa ne mene mu bio no som bo.