Fa no sɛ yɛn nipadua mu mogya ntini nhyehyɛe te sɛ akwan a wɔatwa wɔ kurow a nnipa pii wom mu. Mogya nam saa akwan yi so kɔ so ma yɛn akwaa nyinaa te sɛ yɛn koma, amemene, ne yɛn ahurututu. Enti, sɛ mogya kɛse bi siw ɔkwan kɛse yi, kyerɛ sɛ, mogya ntini bi, mpofirim a, dɛn na ɛba? Te sɛ akwanhyia kɛse bi a esii wɔ kwan so ne kar a ɛkyere so no, mogya a ɛkɔ yɛn akwaa ahorow mu no betumi agyae, na ɛde tebea a ɛyɛ hu paa te sɛ komayare anaa akisikuru aba. Ɛnnɛ, yɛreka ayaresa bi a ɛho hia paa a nnuruyɛfo de di dwuma de tutu mogya a ɛte saa a ɛde nkwa to asiane mu na ɛma mogya san kɔ bio ho asɛm.
Sɛ yɛbɛka no tiawa a, dɛn ne Thrombolytic Therapy?
Eyi kyerɛ ‘mogya a ɛtwetwe mogya mu aduru’ wɔ Sinhala kasa mu. Sɛ yɛbɛka no tiawa a, eyi hwehwɛ sɛ wɔde nnuru a ano yɛ den yiye (thrombolytics) bɛma nipadua no de apete mogya a ɛyɛ hu a akɔhyɛ mogya ntini no mu. Sɛ mogya a ɛtwetwe no tew wie a, mogya ntini a asiw no san bue na mogya no san kɔ akwaa a aka no mu. Eyi yɛ aduru a egye nkwa a wɔde di dwuma wɔ tebea horow a egye ntɛmpɛ kɛse mu . Dodow a wofi ayaresa yi ase ntɛm no, dodow no ara na ɛbɛyɛ yiye.
Henanom na wohia saa ayaresa yi na wɔ tebea horow bɛn mu?
Nnuruyɛfo taa susuw saa ayaresa yi ho wɔ tebea horow a emu yɛ den a egye ntɛmpɛ te sɛ nea edidi so yi mu.
- Myocardial Infarction: Bere a mogya a ɛtwetwe siw ntini a ɛma mogya kɔ koma no mu, titiriw bere a wontumi mfa stent nsi hɔ ntɛm ara anaa oprehyɛn biara.
- Ischemic Stroke: Akisikuru a mogya a ɛtɔ siw ntini bi a ɛde mogya kɔ amemene no mu no na ɛde ba.
- Pulmonary Embolism: Bere a mogya a ɛtɔ a ɛba nipadua no mu mmeae afoforo (mpɛn pii no wɔ nan mu) no bubu na ɛkɔhyɛ ntini bi mu wɔ ahurututu no mu.
- Deep Vein Thrombosis (DVT): Mogya a ɛtwetwe kɛse, titiriw wɔ nan no mu ntini a emu dɔ no mu no de nsɛnnennen te sɛ nan a ɛyɛ bruu, ɛyaw a emu yɛ den, na ɛnyɛ nea wɔtaa de di dwuma wɔ nnuru a ɛma mogya yɛ mmerɛw (anticoagulants) ho.
- Acute Peripheral Arterial Occlusion: Mogya a ɛtɔ siw ntini kɛse bi a ɛwɔ abasa anaa nan bi mu .
So nnipa bi wɔ hɔ a ɛnsɛ sɛ wonya saa ayaresa yi?
Yiw, koraa. Esiane sɛ asiane titiriw a ɛwɔ ayaresa yi mu ne mogya a ɛbɛtɔ nti, wɔmfa mma ayarefo binom. Efisɛ wɔ wɔn fam no, ebia ɔhaw a efi ayaresa no mu bɛboro mfaso a ɛwɔ so no.
| Tebea atitiriw a wɔmfa Thrombolytic Therapy mma | |
|---|---|
| Gyinabea | Nkyerɛmu |
| Mogya a ɛtɔ denneennen | Sɛ mogya retu wo dedaw afi nipadua no mu baabi (e.g. efi dwensɔtwaa mu). |
| Mogya a ɛtɔe wɔ amemene mu nnansa yi | Sɛ nnansa yi ara na mogya ntini bi apae wɔ amemene no mu (mogya a ɛtɔ gu wo mu). |
| Oprehyɛn bi a wɔyɛe nnansa yi | Titiriw sɛ ɛnkyɛe fi bere a wɔyɛɛ amemene anaa akyi berɛmo oprehyɛn a. |
| Mogya mmoroso a wontumi nni so | Mogya mmoroso a wontumi nni so wɔ nnuru mpo mu. |
| Asaabo mu yare a emu yɛ den | Asaabo ntumi nyɛ adwuma yiye koraa. |
| Nnansa yi ti a opirae | Sɛ ɛnkyɛe bere a obi ti apirae kɛse a. |
Bio nso, nnuruyɛfo susuw eyi ho mprenu efisɛ ɛnanom a wɔyem ne wɔn a wɔn mfe akɔ anim wɔ asiane kɛse mu sɛ wobenya ɔhaw ahorow.
Ɔkwan bɛn so na wɔyɛ saa ayaresa yi?
Akwan titiriw abien na ɛwɔ hɔ a wɔfa so sa yare, a egyina wo tebea ne ntɛmpɛ so.
1. Nkwammoaa mu Ntini a Ɛma Nkwa Wom
Eyi ne ɔkwan a wɔtaa fa so wɔ tebea horow a egye ntɛmpɛ mu (komayare, ɔyare a ɛma obi hwe ase).
- Nea ɛka eyi ho ne sɛ wɔde nnuru a ɛma mogya tu kɔ mogya no mu tẽẽ denam IV kankyee a wɔde ahyɛ ntini bi a ɛwɔ abasa no mu so.
- Saa aduru yi ne mogya no tu kwan, kɔ baabi a mogya no tu no, na efi ase sɛe.
- Wɔtaa yɛ saa adeyɛ yi wɔ baabi a wɔhwɛ wɔn a wɔyare denneennen (ICU) . Adeyɛ no nyinaa betumi agye bɛyɛ dɔnhwerew biako.
2. Thrombolysis a wɔde catheter kyerɛ kwan
Wɔtaa de saa kwan yi di dwuma ma ayaresa a wɔadi kan ayɛ ho nhyehyɛe te sɛ DVT anaa PAD.
- Wɔ saa adeyɛ yi mu no, wɔyɛ tokuru ketewaa bi fa asen, kɔn, anaa abasa honam ani, na wɔde afiri atenten a ɛyɛ tratraa paa a wɔfrɛ no catheter fa mu fa mogya ntini no ho.
- Sɛ wɔde mfiridwuma a ɛte sɛ X-ray di dwuma a, wɔde saa afiri yi ano kyerɛ baabi a mogya no atɔ no pɛpɛɛpɛ.
- Afei, wɔde aduru no fa catheter no mu gu mogya a ɛretu no mu tẽẽ . Ɛtɔ mmere bi a, wobetumi de afiri titiriw bi a ɛwɔ catheter no awiei adi dwuma de abubu mogya a ɛretu no (mfiri a wɔde twa thrombectomy).
- Saa kwan yi betumi agye nnɔnhwerew 48 (nnafua 2) ansa na mogya a ɛretu no ayow koraa. Saa bere yi mu no, wɔde wo bɛto ayaresabea na nnuruyɛfo kuw no ahwɛ wo so.
Asiane ne nsɛnnennen bɛn na ɛwɔ ayaresa mu?
Sɛnea ɛte wɔ aduruyɛ biara ho no, asiane ahorow bi wɔ hɔ.
Asiane titiriw a emu yɛ den sen biara a ɛwɔ saa ayaresa yi mu ne mogya a ɛbɛtɔ obi wɔ nipadua no mu , titiriw sɛ ɛba amemene no mu a, ebetumi ama obi anya akisikuru a.
Wɔ asiane titiriw yi akyi no, hokwan ketewaa bi nso wɔ hɔ sɛ nneɛma a edidi so yi bɛba:
- Nneɛma a ɛma obi ho yɛ no hyew wɔ aduru no ho.
- Mogya a ɛretu anaasɛ akisikuru wɔ baabi a wɔde kankyee anaa catheter no hyɛɛ mu no.
- Mogya mmoroso a ɛba fam (hypotension).
- Mogya a ɛretu no fã ketewaa bi mu paapae na ɛkyere mogya ntini foforo mu.
- Asaabo a ɛsɛe (titiriw wɔ nnipa a wɔwɔ asikreyare mu).
- Mogya nketenkete a efi hwene mu, ne nsu a ɛwɔ nsu mu, anaa nsu a wɔde gu mu.
Wo duruyɛfo bɛkyerɛkyerɛ asiane ahorow yi mu akyerɛ wo anaa wɔn a wɔhwɛ wo no ansa na wɔayɛ ayaresa.
Bere a wɔasa no yare na ne ho atɔ no akyi
Sɛ oduruyɛfo no sa yare no wie a, ɔbɛyɛ nhwehwɛmu ahorow pii, te sɛ angiogram ne CT scan, de ahwɛ sɛ mogya a ɛretu no ayow koraa anaa.
Anyɛ yiye koraa no, ɛho behia sɛ wotra baabi a wɔhwɛ wɔn a wɔyare denneennen (ICU) da koro, na ɛno akyi no, wɔde da koro kosi abiɛsa foforo bɛhwɛ wo wɔ ayaresabea a wɔhwɛ ayarefo nyinaa.
Sɛ wokɔ fie wie a, ɛda adi sɛ wo duruyɛfo bɛkyerɛw wo nnuru a ɛma mogya yɛ mmerɛw na amma mogya a ɛbɛtɔ bio . Ɛho hia paa sɛ wudi akwankyerɛ ahorow yi akyi pɛpɛɛpɛ.
Kɔkɔbɔ nsɛnkyerɛnne a ɛkyerɛ sɛ ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn bere a woakɔ fie awie no
Sɛ wuhu sɛnkyerɛnne ahorow a edidi so yi mu biara a, .Bɔ wo duruyɛfo amanneɛ ntɛm ara anaa kɔ ayaresabea Emergency Department (ETU) a ɛbɛn wo no.
| Nsɛnkyerɛnne a ɛkyerɛ | Nkyerɛmu |
|---|---|
| Koko mu yaw | Koko mu yaw a ɛba mpofirim anaasɛ ɛkɔ soro. |
| Mogya a ɛba bere nyinaa | Mogya a ɛkɔ so tu anaasɛ nsu a ɛretu fi baabi a wɔde cannula/catheter no gu no. |
| Huraeɛ | Atiridiinini a ntease biara nnim. |
| Tiyɛ anaa akisikuru a emu yɛ den | Tiyɛ, ɔfe, anaa akisikuru a ɛkɔ soro nkakrankakra. |
| Nkwammoaa a ɛyɛ mmerɛw | Nsa anaa anan a ɛyɛ mmerɛw anaasɛ ɛyɛ mmerɛw. |
| Kuru no a ɛho ahonhon/ɛyɛ kɔkɔɔ | Ɛyaw, ɔfe (edema), kɔkɔɔ, anaa ɔhyew a wɔte nka wɔ baabi a wɔde aduru no guu no. |
Nkrasɛm a Wɔde Kɔ Fie
- Thrombolytic therapy yɛ ayaresa a ɛho hia yiye, egye nkwa a ɛma mogya a ɛtwetwe mogya ntini mu no tew wɔ tebea horow a egye ntɛmpɛ te sɛ komayare ne akisikuru mu.
- Dodow a wofi ayaresa yi ase ntɛm no, dodow no ara na nea ebefi mu aba no bɛyɛ yiye. Ɛno nti na ɛho hia sɛ wɔde no kɔ ayaresabea bere a yare no ho sɛnkyerɛnne afi ase ara pɛ no.
- Asiane titiriw a ɛwɔ saa ayaresa yi mu ne mogya a ɛbɛtɔ nipadua no mu.Eyi te saa. Enti, saa ayaresa yi mfata obiara.
- Sɛ wɔsa yare wie a, ɛho hia sɛ wɔnom nnuru a oduruyɛfo no akyerɛw ama no no pɛpɛɛpɛ na wɔnom bere ano na amma mogya a ɛbɛtɔ bio.
- Sɛ wunya kɔkɔbɔ sɛnkyerɛnne biara bere a woasan aba fie akyi a, hwehwɛ aduruyɛfo afotu ntɛm ara.
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