So wo ntini yɛ wo yaw te sɛ nea ɛbɛpae bere a woateɛteɛ w’apɔw mu awie no? Ebetumi ayɛ tebea a asiane wom a wɔfrɛ no rhabdomyolysis!

So woyɛ obi a woteɛteɛ w’apɔw mu pii na wotu mmirika pii? Anaasɛ ɛyɛ ade a ɛfata sɛ wobɛma wo ntini ayɛ wo yaw da a edi hɔ bere a woateɛteɛ w’apɔw mu denneennen awie no? Yɛfrɛ no ‘ntini mu yaw’. Nanso ɛtɔ mmere bi a saa ntini mu yaw yi nyɛ nea ɛfata, na ebetumi ayɛ tebea bi a emu yɛ den kɛse ho sɛnkyerɛnne. Ɛnnɛ yɛreka tebea a emu yɛ den saa ho asɛm, nanso ɛsɛ sɛ yɛn nyinaa hu. Ɛno ne Rhabdomyolysis, a yɛfrɛ no ‘Rhabdo’ tiawa.

Sɛ yɛbɛka no tiawa a, dɛn ne Rhabdomyolysis?

Eyi yɛ nyansahu mu din kakra, nanso ɛyɛ mmerɛw yiye sɛ wobɛte ase. Fa no sɛ nhama nketenkete bi na ɛyɛ wo ntini. Wɔ rhabdomyolysis mu no, saa ntini ahorow yi sɛe kɛse na nhama no bubu. Sɛ ɛpaapae a, nneɛma a ɛwɔ saa nhama no mu, titiriw protein a wɔfrɛ no ‘myoglobin’ no pue kɔ mogya no mu tẽẽ. Afei ɔhaw no ni. Nneɛma a ɛba mogya no mu wɔ saa kwan yi so no yɛ awuduru kɛse ma yɛn nipadua. Saa awuduru yi fa mogya no mu kɔ yɛn asaabo mu. Asaabo no adwuma ne sɛ ɛbɛhohoro mogya no ho. Nanso sɛ awuduru pii ba prɛko pɛ a, asaabo no ntumi nni ho dwuma. Ɛte sɛ nea sɛ wode nwura kɛse bi gu adididan mu sink mu a, ɛkyere. Eyi betumi ama asaabo ayɛ adwuma yiye . Ɛno kyerɛ sɛ wontumi nyi nwura mfi hɔ. Eyi yɛ tebea a asiane wom paa. Sɛ wɔansa no ntɛm a, ebetumi de ne nkwa mpo ato asiane mu.

Dɛn ne nneɛma a ɛde rhabdomyolysis ba?

Ɛnyɛ ade biako nti na tebea yi ba, ntease pii betumi aba. Momma yɛnkyekyɛ mu akuw atitiriw abien.

Dɛn ne eyi ho sɛnkyerɛnne? Woyɛ dɛn hu no?

Saa yare yi ho sɛnkyerɛnne nyɛ pɛ wɔ obiara fam. Ɛtɔ mmere bi a, ɛyɛ den sɛ wubehu sɛnkyerɛnne ahorow no. Nanso "classic triad" titiriw a wohu ne sɛ: 1. Ntini mu yaw a emu yɛ den: ɛyaw a wontumi nnyina ano, titiriw wɔ mmati, asen, ne akyi. 2. 2. .Ntini mu mmerɛwyɛ: Ɛbɛyɛ den sɛ wobɛkanyan wo nsa ne wo nan anaa wobɛma so. 3. Nsu a ɛyɛ sum: Eyi ne sɛnkyerɛnne a ɛho hia na asiane wom sen biara . Nsu no yɛ kɔkɔɔ-biribiri, te sɛ cola kɔla . Ebia nsu dodow a wode fa mu nso so bɛtew. Nanso kae sɛ ebia nnipa a wɔwɔ saa tebea yi mu bɛyɛ fã rennya ntini mu yaw anaa mmerɛwyɛ biara. Enti ɛsɛ sɛ wuhu sɛnkyerɛnne afoforo no nso.

Nneɛma afoforo a wɔtaa yɛ:

• Yafunu mu yaw
• Ɔfe ne akisikuru
• Huraeɛ
• Koma a ɛbɔ denneennen
• Kesereneeyɛ
• Nsu a ɛho ntew
• Nhumu a wɔhwere

Wobɛyɛ dɛn ahu eyi, Oduruyɛfo?

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara. Oduruyɛfo no bɛyɛ nhwehwɛmu pii de akyerɛ sɛ wɔahu yare no.

• Creatine Kinase (CK) mogya mu nhwehwɛmu: CK ne nnuru titiriw a ɛkɔ mogya no mu bere a ntini mu ntini asɛe no. Wɔ rhabdomyolysis mu no, CK dodow kɔ soro yiye. Wɔyɛ saa sɔhwɛ yi nso mpɛn pii de hwɛ sɛ ebia dodow no so tew bere a wɔreyɛ ayaresa no anaa.
• Myoglobin urine test : Eyi hwehwɛ protein a madi kan aka ho asɛm, a efi ntini ahorow mu, wɔ nsu mu no mu. Nanso, eyi nyɛ pɛpɛɛpɛ te sɛ CK nhwehwɛmu no, efisɛ woyi myoglobin fi nipadua no mu ntɛmntɛm.
• Nhwehwɛmu afoforo: Wobetumi ayɛ nhwehwɛmu afoforo te sɛ mmerɛbo dwumadi ho nhwehwɛmu ne EKG.

Bere bɛn na ɛsɛ sɛ wokɔ ayaresabea ntɛm ara?

Eyi ne ɔfã a ɛho hia sen biara. Mpɛn pii no, sɛnkyerɛnne ahorow no fi ase wɔ nnɔnhwerew 24 kosi 72 akyi wɔ ntini a asɛe akyi. Ɛnyɛ den sɛ wobɛfrafra ntini a ɛyɛ yaw a ɛba bere a woayɛ apɔw-mu-teɛteɛ sɛnea ɛsɛ akyi no ne ntini a ɛyɛ yaw a efi rhabdomyolysis mu ba.

Sɛ wote ntini mu yaw a emu yɛ den a wuntumi nnyina ano, woyɛ mmerɛw, na wuhu sɛ wo nsu no adan bruu tuntum anaa cola kɔla a, nsusuw ho mprenu. Kɔ ayaresabea a ɛbɛn wo no Emergency Department (ETU) ntɛm ara.

Sɛ wufi ase sa yare ntɛm a, ɛno ne ɔkwan a eye sen biara a wobɛfa so abɔ wo ho ban afi nsɛnnennen a emu yɛ den ho.

Ɔkwan bɛn so na wɔsa?

Sɛ wosi rhabdomyolysis so dua a, akyinnye biara nni ho sɛ wɔde wo bɛkɔ ayaresabea na wɔasa wo yare.

• IV Fluids (Saline ): Ayaresa titiriw ne sɛ wɔde nkyene bɛfa ntini bi mu. Eyi boa ma nipadua no nya nsu pa, ɛma nsu a ɛkɔ nipadua no mu no yɛ kɛse, na ‘ɛhohoro’ saa awuduru no fi asaabo no mu.
• Dialysis: Sɛ asaabo no sɛe kɛse na entumi nhohoro mogya no mu a, ebia ebehia sɛ wɔyɛ dialysis, ɔkwan a wɔfa so tew mogya ho a wɔde afiri di dwuma.
• Oprehyɛn: Ɛtɔ mmere bi a, ntini a apira no betumi ahonhon na apia mogya ntini ne ntini a atwa ho ahyia no. Wɔfrɛ eyi sɛ ‘compartment syndrome’. Wɔ tebea horow a ɛtete saa mu no, wobetumi ayɛ oprehyɛn ketewaa bi (fasciotomy) de ayi nhyɛso no afi hɔ.
• Nea ɛde ba no a wɔbɛsa: Sɛ asikreyare, ɔyare mmoawa, anaa nnuru bi na ɛde tebea no ba a, wɔbɛma saa ade no ho ayaresa a ɛfata nso.

Nkrasɛm a Wɔde Kɔ Fie

• Rhabdomyolysis yɛ tebea a emu yɛ den a ntini a ɛpaapae na ɛde ba. Eyi betumi asɛe asaabo no.
• Nsɛnkyerɛnne titiriw ne ntini mu yaw a emu yɛ den, mmerɛwyɛ, ne titiriw no nsu a ɛyɛ bruu tuntum/cola.
• Sɛ wuhu saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, nsɛe bere na kɔ ayaresabea Dwumadibea a Ɛhwɛ Ntɛmntɛm (ETU) ntɛm ara.
• Sɛ woreyɛ apɔw-mu-teɛteɛ, titiriw nna a ɛhɔ yɛ hyew a, nom nsu a ɛdɔɔso a ɛbɛma wo nipadua no anya nsu. Mma nteɛteɛ w’apɔw mu nsen sɛnea wo nipadua betumi adi ho dwuma.
• Sɛ wohu yare no ntɛm na wɔsa no a, ebetumi ama ne ho atɔ no koraa. Enti mmu w’ani ngu sɛnkyerɛnne ahorow no so da.

Rhabdomyolysis, ntini a ɛpaapae, asaabo a entumi nyɛ adwuma yiye, nsu a ɛyɛ tumm, apɔw-mu-teɛteɛ, creatine kinase