So wunim Sickle Cell Crisis ho asɛm? Momma yɛnka tebea a ɛyɛ yaw yi ho asɛm!

Sɛ wowɔ sickle cell yare a, ebia woate ɛyaw a emu yɛ den mpofirim anaa woanya. Eyi ne nea yɛfrɛ no sickle cell ahokyere. Ebetumi ayɛ osuahu a ɛhaw adwene na ɛyɛ yaw ankasa. Nanso mma ɛnhaw wo, yɛbɛka ho asɛm akɔ akyiri nnɛ.

Dɛn ne sickle cell haw yi?

Sɛ yɛbɛka no tiawa a, sickle cell yare ne bere a wo nipadua no ‘sickle cells’, anaa mogya mu nkwammoaa kɔkɔɔ a ɛte sɛ sickle no kɔhyɛ mogya ntini bi mu, na ɛma mogya no kɔ brɛoo anaasɛ egyae. Wunim, yɛn mogya mu nkwammoaa kɔkɔɔ no na ɛde mframa pa kɔ nipadua no mu nyinaa. Enti, sɛ wowɔ sickle cell yare a, wo ntini ne wo akwaa ahorow nnya oxygen a ɛdɔɔso. Eyi betumi de ɛyaw a emu yɛ den ne nsɛnnennen afoforo aba .

Susuw ho sɛ sɛ efĩ kakra bi kɔhyɛ nsu paipu mu a, nsu no brɛ ase. Nanso nea ɛkɔ so wɔ ha ne saa mogya mu nkwammoaa kɔkɔɔ a ɛte sɛ nkankyee no. Eyinom nkɔtow ntɛmntɛm te sɛ mogya mu nkwammoaa kɔkɔɔ kurukuruwa a ɛba daa no, na ɛnkɔfa mmeae nketenkete. Ɛno nti na wɔbɔ mmɔden sɛ wɔbɛkyere wɔn ho.

Ɛtɔ da bi a, wobetumi adi tebea yi ho dwuma wɔ fie, nanso sɛ yare no ho sɛnkyerɛnne no mu yɛ den a, ebia ebehia sɛ wotra ayaresabea hɔ nna kakraa bi kɔsa wo yare.

Dɛn ne sickle cell ahokyere ahorow?

Sickle cell ahokyere ahorow atitiriw anan na ɛwɔ hɔ. Momma yɛnhwɛ nea wɔyɛ:

• Vaso-occlusive crisis: Eyi ne ɔkwan a ɛtaa ba. Nea ɛkɔ so wɔ ha ne sɛ sickle cells no kɔhyɛ wo ntini nketenkete anaa mogya ntini nketenkete afoforo mu, na ɛma mogya a ɛkɔ wo ntini ne wo akwaa ahorow mu no so tew. Eyi na ɛde ɛyaw a emu yɛ den no ba. Ahorow afoforo ka nipadua no mmeae pɔtee bi.

• Aplastic crisis: Eyi ne bere a wo nnompe mu ntini (beae a ɛwɔ wo nnompe mu a ɛyɛ mogya mu nkwammoaa) gyae mogya mu nkwammoaa kɔkɔɔ a ɛba mpofirim no. Mpɛn pii no, ɔyare mmoawa bi na ɛde eyi ba, titiriw parvovirus B19.

• Hyperhemolytic crisis: Eyi ne bere a wo hemoglobin dodow (protein a ɛwɔ mogya mu nkwammoaa kɔkɔɔ mu a ɛde mframa pa kɔ) so tew mpofirim. Nea enti a ɛte saa ne sɛ wo mogya mu nkwammoaa kɔkɔɔ no resɛe ntɛmntɛm dodo. Eyi nso betumi aba bere a wɔde mogya a wɔtaa de sa sickle cell yare no ma akyi.

• Splenic sequestration: Eyi ne bere a sickle cells no kɔhyɛ wo spleen (akwaa bi a ɛwɔ wo yafunu no benkum atifi) mu, na ɛma spleen no yɛ kɛse mpofirim na ɛho ahonhon ma ɛyɛ yaw . Eyi betumi ayɛ nea asiane wom titiriw ama mmofra nkumaa, efisɛ mogya pii betumi aboaboa ano wɔ akisikuru no mu, na ama mogya dodow a ɛwɔ nipadua no mu no so atew.

Dɛn ne eyi ho sɛnkyerɛnne?

Sickle cell yare ho sɛnkyerɛnne betumi ayɛ soronko a egyina baabi a ɛka no wɔ nipadua no mu so. Nsɛnkyerɛnne a ɛtaa ba no bi ne:

• Adwene a ɛyɛ basaa.
• Ɔbrɛ a ɛtra so, ɔbrɛ.
• Tipaeɛ.
• Jaundice (honam ani ne aniwa a ɛyɛ kɔkɔɔ).
• Ɛyaw (eyi ne sɛnkyerɛnne titiriw ne nea emu yɛ den sen biara).
• Ɔhome a ɛyɛ den.
• Mrɛyɛ.

Ɛyaw a sickle cell yare de ba no betumi ayɛ nea ɛyɛ kusuu, ɛyɛ nnam, ɛyɛ sekan, anaa sekan . Ebetumi atra hɔ nnɔnhwerew pii, nna pii, anaa adapɛn pii mpo. Ɛyaw no betumi aba nipadua no mu baabiara, baabiara anaa mmeae pii. Nhwɛsoɔ:

• Wɔ nsa anaa nsateaa mu.
• Wɔ koko mu.
• Wɔ nan anaa anan mu.
• Wɔ akyi berɛmo no ase.
• Wɔ yafunu mu.

Dɛn nti na sickle cell haw yi ba?

Sickle cell yare ba bere a mogya mu nkwammoaa kɔkɔɔ a ɛte sɛ sickle boaboa ano na esiw mogya ntini bi ano no. Nanso, ɛnyɛ bere nyinaa na abenfo nim nea ɛma eyi fi ase ankasa.

Nanso, nneɛma bi wɔ hɔ a ɛkanyan obi a ebetumi ama tebea yi aba:

• Nsu a ɛho nhia : Sɛ nipadua no nni nsu a, mogya no mu yɛ den na ɛda adi sɛ nkwammoaa no siw.
• Sɛ wɔkɔ mmeae a ɛkorɔn (efisɛ oxygen kakraa bi na ɛwɔ mmeae a ɛkorɔn).
• Nyarewa : Nyarewa biara, te sɛ atiridii anaa atiridiinini.
• Nyinsɛn a wɔde di dwuma.
• Sigaretnom anaa Vaping a wɔnom.
• Apɔw-mu-teɛteɛ a emu yɛ den dodo.
• Adwennwen : Nneɛma te sɛ dadwen ne ehu a ɛtra so.
• Ɔhyew a ɛboro so sesa mpofirim (sɛ nhwɛso no, aguare a ɛyɛ nwini bere a woakɔ baabi a ɛhɔ yɛ hyew kɛse akyi).
• Vitamin ahorow bi a enni nipadua mu, sɛ nhwɛso no, folate.

Nsɛnnennen bɛn na eyi betumi de aba?

Sɛnea sickle cell haw no mu yɛ den no gyina baabi a mogya ntini a asiw no wɔ so. Sɛ mogya ntini siw wo ntini anaa wo akwaa ahorow mu a, nsɛnnennen te sɛ:

• Acute chest syndrome : Eyi yɛ tebea a emu yɛ den a ɛde nkwa to asiane mu a ɛba wɔ koko mu. Nsɛnkyerɛnne no bi ne atiridiinini, koko mu yaw, ne ahome a ɛyɛ den.
• Mogya a ɛtwetwe.
• Ɛyaw a enni sabea (ɛyaw a ɛkɔ so).
• Akisikuru a ɛtrɛw ne nyarewa afoforo a ɛfa akyi berɛmo ho.
• Akuru a ɛnyɛ nea ɛsa wɔ nan so.
• Mmɛn mu yare.
• Sɛ nhwɛso no, ahurututu mu nyarewa, ahurututu mu mogya mmoroso.
• Necrosis : Dompe anaa ntini a ewu esiane mogya a ɛyera nti (titiriw wɔ mmeae te sɛ asen).
• Ɛyaw a ɛba ɔbarima no akyi (a wɔsan frɛ no `priapism` wɔ mmarima mu).
• Stroke : Ɛyɛ mogya ntini bi a ɛde mogya kɔ amemene no mu a esiw anaa ɛpaapae.

Wobɛyɛ dɛn ahu eyi?

Sɛ wowɔ sickle cell yare a, ebia woakɔ wo duruyɛfo nkyɛn dedaw asram 6 biara anaa pɛnkoro afe biara akɔyɛ mogya mu nhwehwɛmu. Nanso sɛ wowɔ sickle cell haw a, ɛho behia sɛ woyɛ lab nhwehwɛmu ahorow a edi mũ. Ebia eyinom bi ne:

• Mogya mu nhwehwɛmu (sɛ wuhia mogya a wɔde ma a).
• CBC (Complete Blood Count) : Eyi kyerɛ hemoglobin dodow ne mogya mu nkwammoaa kɔkɔɔ ne fitaa dodow.
• CMP (Comprehensive Metabolic Panel) : Nkwammoaa mu nhwehwɛmu a ɛkɔ akyiri a ɛhwɛ sɛnea akwaa te sɛ asaabo ne mmerɛbo yɛ adwuma.
• Mmɛn dwumadi ho nhwehwɛmu .
• Reticulocyte count : Eyi kyerɛ mogya mu nkwammoaa kɔkɔɔ dodow a wɔayɛ no foforo. Eyi betumi ama woanya sɛnea nnompe mu ntini no reyɛ adwuma yiye ho adwene.

Bio nso, wo duruyɛfo betumi ayɛ nipadua mu nhwehwɛmu a edi mũ ne mfoniniyɛ ho nhwehwɛmu te sɛ:

• Doppler ultrasound : Hwɛ sɛnea mogya fa mogya ntini mu.
• MRI : Titiriw sɛ adwenem naayɛ bi wɔ hɔ sɛ tebea bi te sɛ ɔyare a ɛma obi hwe ase a.
• Ultrasound : Sɛ wobɛhwɛ nneɛma te sɛ yafunu mu akwaa ne akyi berɛmo.
• Chest X-ray : Sɛnea ɛbɛyɛ a wobɛhwɛ sɛ tebea bi te sɛ acute chest syndrome.

Ɔkwan bɛn so na wɔsa?

Sɛ wowɔ sickle cell haw a, ebia wubehia nnuru a wɔde kum ɛyaw na aboa ma woadi sɛnkyerɛnne ahorow a ɛnyɛ dɛ no so. Wɔ tebea horow a emu nyɛ den mu no, wubetumi de nnuru a wɔtɔn te sɛ acetaminophen (e.g. Panadol®, Tylenol®) anaa ibuprofen (e.g. Advil®, Brufen®) adi eyi ho dwuma wɔ fie.

Nanso, sɛ ɛyaw a emu yɛ den ba a, ebia ebehia sɛ wotra ayaresabea hɔ nna kakraa bi. Afei nnuruyɛfo no betumi ama wo nnuru a ano yɛ den a wɔde kum ɛyaw (te sɛ morphine), nsu a wɔde fa IV mu (na ama wo mogya akɔ so asen yiye), ne oxygen sɛ ɛho hia a.

Bio nso, ɛsono sɛnea wɔsa sickle cell yare no, na egyina nipadua no akwaa a ɛka no ne sɛnea yare no ho sɛnkyerɛnne no mu yɛ den so. Nnuruyɛfo betumi de nnuru, mogya a wɔde ma, nnompe mu ntini a wɔde ma obi foforo, anaa ayaresa ahorow yi a wɔaka abom adi dwuma.

Nnuru a wɔde di dwuma bere tenten

Nnuru ahorow pii wɔ hɔ a nnuruyɛfo de di sickle cell haw ahorow ho dwuma bere tenten na ɛtew mpɛn dodow a ɛba no so:

• Hydroxyurea: Saa aduru yi ma wo mogya mu nkwammoaa kɔkɔɔ no yɛ kɛse, ɛma tumi a ɛbobɔw no yɛ kɛse, na ɛma hemoglobin bi a wɔfrɛ no awotwaa mu hemoglobin yɛ kɛse. Eyi ma nkwammoaa no mu ntini a ɛtwetwe no so tew.
• Crizanlizumab `(Krizanlizumab)`: 1. Nnipa a wɔde wɔn ho hyɛ mu.Eyi yɛ nipadua mu nkwammoaa a ɛko tia nyarewa a wɔfrɛ no monoclonal antibody bi. Ebetumi asiw wo mogya mu nkwammoaa kɔkɔɔ no kwan sɛ ɛbɛbata wo mogya ntini no afasu ho.
• L-glutamine: Eyi yɛ amino acid a ɛboa ma mogya mu nkwammoaa kɔkɔɔ a ɛsɛe ade no so tew.
• Voxelotor: Saa aduru yi mma wo mogya mu nkwammoaa kɔkɔɔ no ntumi nkɔ sickled na ɛnbata ho.

Mogya a wɔde ma

Nnuruyɛfo betumi de mogya a wɔde ma adi dwuma de asa aplastic anaa hyperhemolytic sickle cell haw ahorow. Saa ayaresa yi betumi ama wo mogya mu nkwammoaa kɔkɔɔ a ɛte apɔw no ayɛ ma na ama asiane a ɛwɔ hɔ sɛ wubenya sickle cell nsɛnnennen no so atew. Ebia ɛho behia sɛ wɔma nnipa binom mogya mpɛn pii.

Nneɛma a wɔde si nipadua foforo mu

Ebia nnompe mu ntini a wɔde bɛma obi foforo anaa ntini mu nkwammoaa a wɔde bɛma obi foforo nkutoo ne ɔkwan a wɔbɛfa so asa sickle cell yare wɔ tebea horow bi mu. Nanso, sɛ wubenya obi a ɔne no bɛma no (te sɛ onua bi) a, ebetumi agye bere kakra. Afei nso, nnompe mu ntini a wɔde si ananmu betumi de nsɛnnennen afoforo a emu yɛ den aba, te sɛ graft vs. host disease (GvHD). Esiane eyi nti, nnuruyɛfo ntaa nyɛ nnompe mu ntini foforo bere a wɔresa sickle cell haw ahorow no. Mmom no, botae titiriw ne sɛ wobɛsa wo yare no ho sɛnkyerɛnne na woayi wo yaw no afi hɔ.

So wobetumi asiw eyi ano?

Wontumi nsiw sickle cell haw ano bere nyinaa. Nanso, nneɛma bi wɔ hɔ a ebetumi aboa ma asiane no so atew:

• Kwati sigaretnom koraa.
• Sɛ wowɔ baabi a awɔw wom a, siesie wo ho fɛfɛɛfɛ. Atiridii betumi asiw mogya ntini mu na ɛde ɔhaw aba.
• To nsa no ano hye anaasɛ gyae koraa . Nsã betumi ama nsu atra mu.
• Anyɛ yiye koraa no, nom nsu nkotoku 8-10 da biara (tra nsu mu).
• Fa folic acid aduru da biara da na ama mogya mu nkwammoaa kɔkɔɔ a ɛba no akɔ soro (ɛsɛ sɛ wɔyɛ eyi sɛnea oduruyɛfo no afotu kyerɛ no).
• Fa samina hohoro wo nsa daa na ama asiane a ɛwɔ hɔ sɛ wubenya ɔyare mmoawa no so atew.
• Nya nnuru a wɔde bɔ wo ho ban a ɛho hia nyinaa wɔ bere ano (e.g. atiridiinini aduru, ahurututu mu yare mmoawa).
• Kwati apɔw-mu-teɛteɛ a emu yɛ den dodo, nanso apɔw-mu-teɛteɛ a ɛfata ye.
• Hwehwɛ akwan a wobɛfa so atew adwennwen so (e.g. yoga, nsusuwii).

Mɛyɛ dɛn ahwɛ me ho (bere a ɔhaw bi asi)?

Sɛ wo anaa obi a ɔbɛn wo wɔ sickle cell haw a, saa nneɛma yi a wobɛyɛ no betumi aboa ma yare no ho sɛnkyerɛnne ahorow no afi hɔ:

• Ma wo ho nyɛ hyew. Sɛ woguare a ɛyɛ hyew anaasɛ wode afiri a ɛma ɔhyew si baabi a ɛyɛ yaw no a, ɛbɛma wo mogya ntini no atrɛw na ama mogya no akɔ yiye. Ɔhyew no nso bɛboa ma ntini a ɛyɛ yaw no adwo.(Mfa nsukyenee nhyɛ wo ho. Awɔw betumi akanyan ɛyaw ho haw. Enti eye sɛ wobɛma wo ho ayɛ hyew sɛnea wubetumi biara.)
• Nom nsu pii. Sɛ wonom nsu pii a, wo mogya mu nkwammoaa kɔkɔɔ no ntumi nkɔ mu pii, na ɛma wotumi fa akwan no mu ntɛmntɛm.
• Nya aduru a wɔde twitwiw nipadua no. Sɛ obi de ne nsa twitwiw obi brɛoo a, ebetumi ama mogya no akɔ soro, ama ntini ahorow no adwo, na ɛyaw no so atew.
• Fa adwene mu nhumu di dwuma. Nhwehwɛmu ada no adi sɛ sɛ wode w’adwene si botae biako so bere tiaa bi a, ebetumi aboa ma w’adwene atwetwe w’adwene na atew ɛyaw a ɛbata sickle cell yare ho no so. Biribi a ɛyɛ mmerɛw te sɛ nea wode w’adwene besi wo home so mpo betumi aboa.
• Fa nnuru a wɔde kum ɛyaw a wɔtɔn a wɔmfa nnuru nhyɛ mu. Eyinom bi ne paracetamol, ibuprofen, anaa naproxen (e.g. Aleve®). Nanso nnom pii nsen nea wo duruyɛfo akyerɛ wo no.

Bere bɛn na ɛsɛ sɛ wokɔ Emergency Treatment Unit (ETU) ?

Sɛ wowɔ saa sɛnkyerɛnne yi bi a, kɔ Emergency Department (ETU) a ɛbɛn wo ntɛm ara :

* Sɛ wote ɛyaw a emu yɛ den mpofirim a wuntumi mfa nnuru a wɔde sa fie nni ano a.

* Ɔhome a ɛyɛ den anaa koko mu yaw.

* Atiridiinini a ano yɛ den (ɛboro 101°F anaa 38.3°C).

* Mmerewa a ɛba mpofirim, ɛyɛ den sɛ ɔbɛkasa, n’anim fã biako a ɛtɔ fam (akisikuru ho sɛnkyerɛnne).

* Yafunu mu yaw a emu yɛ den anaasɛ ne ho popo.

* Sɛ jaundice kɔ soro a.

* Wɔ mmarima fam no, ɔbarima ne ɔbea nna a ɛyɛ yaw a ɛtra hɔ bɛboro nnɔnhwerew 4.

Ntwentwɛn wo nan ase. Sɛ wofi ayaresa ase ntɛm a, ebetumi atew asiane a ɛwɔ hɔ sɛ wobenya ɔhaw ahorow a ɛtra hɔ kyɛ no so.

Nneɛma a ɛho hia paa a ɛsɛ sɛ wokae

Sɛ wowɔ sickle cell yare a, ɔhaw bi ho adwene betumi ayɛ wo yaw kakra. Saa tebea horow yi betumi de sɛnkyerɛnne ahorow a ɛnyɛ dɛ ne nkwa nna nyinaa mu nsɛnnennen aba. Sɛ woanya sickle cell haw pɛn a, wunim sɛnea bere som bo.

Sɛ wo yare no ho sɛnkyerɛnne no ankɔ yiye denam nnuru a wɔde sa ɛyaw a wɔtɔn a wontɔn anaasɛ wo fie nnuru a wotaa de di dwuma so a, ɛyɛ bere a ɛsɛ sɛ wokɔ wo duruyɛfo nkyɛn. Wɔwɔ ha sɛ wɔrebɛboa. Nsuro sɛ wo ne wo duruyɛfo bɛkasa afa wo tebea no ho. Ayaresa a wodi ntɛm ye sen biara. Wo ne wo duruyɛfo nyɛ adwuma na yɛ nhyehyɛe a ɛbɛma woatumi asiw ɛyaw ano a ɛbɛyɛ adwuma ama wo.

` Sickle Cell Crisis, Sickle Cell Yare, Mogya Nkwammoaa Kɔkɔɔ, Ɛyaw, Mogya Ntini, Oxygen