So wo nsa ahonhon na ɛyɛ bruu? So eyi betumi ayɛ Venous Thoracic Outlet Syndrome (VTOS)? Momma yenhu!

So woahyɛ no nsow pɛn sɛ mpofirim ara wo nsa te yaw anaa emu yɛ duru a ɛyɛ nwonwa? Ebia ɛho ahonhon na ɛyɛ bruu? Yɛtaa susuw sɛ eyi yɛ akisikuru anaa biribi a ɛba esiane ɔbrɛ nti ara kwa. Nanso ɛtɔ mmere bi a, wɔ sɛnkyerɛnne ahorow a ɛte sɛ nea ɛyɛ mmerɛw yi akyi no, ɛsɛ sɛ yɛhwɛ yiye kakra, efisɛ ebia aduruyɛ mu tebea bi a wonnim no yiye ahintaw wɔ n’akyi. Tebea a ɛte saa no biako ne `Venous Thoracic Outlet Syndrome`. Ɛwom sɛ ebia edin no bɛyɛ te sɛ nea ɛware kakra de, nanso momma yɛnte ase kɛkɛ.

Dɛn ne Venous Thoracic Outlet Syndrome (VTOS) a ɛma obi nya akisikuru?

Sɛ yɛbɛka no tiawa a, Venous Thoracic Outlet Syndrome (anaasɛ VTOS tiawa) yɛ tebea a ɛma ntini bi a ɛwɔ yɛn nipadua mu a wɔfrɛ no ntini no mia. Saa ntini yi de mogya a wɔde adi dwuma, anaa mogya a mframa pa nni mu no san kɔ koma ne ahurututu mu fi yɛn nipadua mu ntini ahorow mu. Wɔ VTOS mu no, ntini titiriw a ɛka no ne subclavian vein a ɛwɔ yɛn kɔn mu dompe (clavicle) akyi. Saa ntini yi wɔ mmati no mu.

Beae a saa ntini yi fa no, wɔfrɛ no `(Thoracic outlet)`. Fa no sɛ ɛte sɛ nsu paipu. Ɛtɔ da bi a, sɛ wɔsiw saa nkyekyɛmu yi ano a, ɛno na ɔhaw no fi ase. Ɛno na ɛba obi a ɔwɔ `VTOS` so. `(Subclavian vein)` no nya nhyɛso wɔ saa `(Thoracic outlet)` yi mu. Ɛno na wuhu nneɛma te sɛ ɛyaw wɔ abasa mu, ɛho ahonhon, na ɛtɔ mmere bi a ne kɔla sesa wɔ abasa mu. Edin foforo a wɔde frɛ saa tebea yi ne `Paget-Schroetter syndrome (PSS).`

Hena na ɛda adi sɛ obenya saa tebea yi?

Ɛwom sɛ saa tebea a wɔfrɛ no `VTOS` yi betumi aba obiara mu de, nanso nnipa binom taa nya bi.

• Mmea a wɔadi fi mfe 20 kosi 50 taa nya `Thoracic Outlet Syndrome` (a ɛyɛ kuw kɛse a `VTOS` ka ho).
• Afei nso, wɔn a wodi agumadi a ɛhwehwɛ sɛ wɔde wɔn nsa ne wɔn mmati di dwuma mpɛn pii (sɛ nhwɛso no, volleyball, tennis, asuguare, baseball) anaa wɔn a wɔyɛ adwuma wɔ nnwuma a ɛtaa ka wɔn ho (susuw ho, obi a ɔma wɔn nsa so da mũ nyinaa de boaboa nneɛma ano, anaa obi a ɔde ne nsa di dwuma saa ara wɔ adeyɛ bi mu) wɔ asiane kɛse mu sɛ wobenya saa tebea yi.

So VTOS betumi ayɛ nea asiane wom? Dɛn ne nsɛnnennen no?

Yiw, `VTOS` yɛ tebea a sɛ yebu yɛn ani gu so a, ebetumi ayɛ asiane. Efisɛ, sɛ wɔmia saa ntini no a, mogya a ɛkɔ mu no siw kwan. Afei mogya a ɛbɛtɔ no betumi ayɛ saa ``Subclavian vein`` no mu. Esiane mogya a ɛtwetwe yi nti, mogya a ɛkɔ abasa ne nsa no mu no tumi siw koraa.

Ɛnyɛ ɛno nko, ɛtɔ mmere bi a mogya a ɛtwetwe yi betumi abubu na afa mogya ntini no mu akɔ ahurututu no mu. Ɛno yɛ tebea a asiane wom paa. Yɛfrɛ no ``Ahurututu mu ntini a ɛma mogya tu''. Sɛ ɛba saa a, sɛnkyerɛnne ahorow te sɛ koko mu yaw a emu yɛ den mpofirim, ɔfe, ne ɔhome a ɛyɛ den betumi aba.Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ eyinom a, ɛho hia sɛ wokɔ ayaresabea ntɛm ara.

Enti, sɛ wususuw sɛ wowɔ Thoracic Outlet Syndrome ho sɛnkyerɛnne ahorow a, ɛho hia sɛ wokɔ oduruyɛfo nkyɛn kɔhu nea ɛyɛ ɔhaw no ankasa.

Dɛn nti na saa VTOS yi ba? Dɛn na ɛde ba?

Subclavian vein no wɔ yɛn kɔn mu dompe (clavicle) ne yɛn mpampam a edi kan no ntam, na ɛde mogya fi yɛn abasa mu kɔ yɛn koma mu. Nnipa dodow no ara wɔ baabi a ɛdɔɔso a ntini yi betumi afa mu a biribiara nsiw wɔn kwan. Nanso, wɔwo nnipa binom a baabi a ɛyɛ teateaa.

Wɔ saa nkurɔfo no fam no, sɛ wɔde wɔn nsa ne wɔn mmati di dwuma bere nyinaa na wɔde di dwuma mpɛn pii a, ɛda adi sɛ ntini a ɛwɔ saa beae teateaa no mu no bɛmia anaasɛ ɛbɛhyɛ. Saa nhyɛso yi betumi asɛe mogya no na ama mogya atɔ.

Wɔ saa ade titiriw yi akyi no, nneɛma afoforo pii wɔ hɔ a ebetumi aboa ma `VTOS` aba:

• Kɛse mmoroso : Sɛ yɛn mu duru yɛ kɛse a, ɛde nhyɛso kɛse ba yɛn nkwaa so. Ɛno nso betumi aka eyi.
• Nipadua mu opira : Apirakuru a ɛba mmati anaa kɔn mu esiane kar akwanhyia anaa asehwe nti.
• Posture : Ɔkwan a yɛfa so tra ase na yegyina. Gyinabea a enye nso betumi de nhyɛso a ɛho nhia aba saa beae yi so.
• Nyinsɛn : Ɛtɔ mmere bi a saa tebea yi betumi aba bere a nsakrae ba nipadua no mu bere a wɔyem no.
• Nneɛma a wɔde keka wo ho mpɛn pii : Sɛnea yɛaka wɔ atifi hɔ no, bere a woyɛ nneɛma te sɛ bɔɔl a wobɛtow, nneɛma a wobɛma so wɔ wo ti so, anaa biribi te sɛ baseball a wobɛwosow ntɛmntɛm mpɛn pii no.

Dɛn ankasa ne VTOS ho sɛnkyerɛnne?

Mpɛn pii no, nnipa a wɔwɔ `VTOS` no nya sɛnkyerɛnne wɔ wɔn nsa biako ne wɔn nsateaa mu. Eyinom ne sɛnkyerɛnne atitiriw no:

• Sɛ wote ɛyaw anaa ɛyaw nka wɔ nsa mu .
• Nsa no ho were no dan kɔla bruu-akuturuku .
• Nsa a wɔte nka sɛ emu yɛ duru wɔ nsa no mu.
• Rehono .
• Ɛtɔ mmere bi a , ntini a ɛwɔ mmati, abasa, anaa moma so no fã biako fi ase da adi pefee .

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, ɛyɛ papa sɛ wobɛhaw wo ho wɔ ho.

Wobɛyɛ dɛn ahu sɛ wowɔ VTOS? Dɛn ne sɔhwɛ ahorow no?

Sɛ wowɔ `VTOS` ho sɛnkyerɛnne a, oduruyɛfo bedi kan ahwɛ wo mmati, wo kɔn, ne wo nsa. Wɔbɛma wo nsa akɔ anim ne akyi na wɔakɔ mmeae ahorow de ahwɛ sɛnea wotumi keka wo ho.

Nea ɛka ho no, wobebisa wo wo yare no ho sɛnkyerɛnne na wɔahwɛ wo mogya mmoroso. Sɛ oduruyɛfo no susuw sɛ VTOS a, ɔbɛkamfo akyerɛ sɛ wɔnyɛ nhwehwɛmu titiriw kakraa bi bio mfa nhwɛ ɔkwan a wɔfa so fi ahurututu no mu no.

Sɔhwɛ ahorow a wɔde hu sɛ VTOS wɔ hɔ anaa:

Wɔtaa de mfoninitwa sɔhwɛ ahorow di dwuma ma eyi. Ɛne sɛ, sɔhwɛ ahorow a ebetumi ahwɛ ntini ahorow, nneɛma afoforo a ɛwɔ nipadua no mu, ne mogya a ɛkɔ nipadua no mu.

• (CT scan) .: Nea ɛka eyi ho ne sɛ wɔbɛkyerɛ X-ray ahorow kwan afi mmeae ahorow na wɔde kɔmputa ayɛ nipadua no fã a ɛfa ho no ho mfonini a ɛkɔ akyiri te sɛ nea wɔatwa no.
• (MRI) : Eyi de magnet a ano yɛ den ne radio asorɔkye di dwuma de yɛ nipadua no mu mfonini a emu da hɔ yiye na ɛkɔ akyiri.
• Ultrasound : Eyi de nnyigyei asorɔkye di dwuma de hwɛ nipadua no mu. Etumi hwɛ mogya a ɛkɔ ntini no mu mpo.
• (Venogram) : Eyi yɛ sɔhwɛ soronko kakra. Ɛha yi, wɔde afiri ketewa bi a ɛyɛ tratraa (`(catheter)`) ne nsuo soronko bi (`(contrast dye)`) kɔ ntini no mu, na afei wɔtwa ``X-ray`` mfonini. Nsu no ma ntini no da adi pefee.
• (X-ray) : Wobetumi de X-ray a wɔyɛ no daa nso ahwɛ sɛ nnompe no mu nneɛma bi anyɛ yiye anaa.

Oduruyɛfo betumi ahu sɛ wowɔ VTOS anaasɛ wunni bi denam nhwehwɛmu ahorow yi biako anaa nea ɛboro saa a ɔbɛyɛ so.

Dɛn ne ayaresa ahorow a wɔde sa VTOS?

VTOS ayaresa ahorow abien na ɛwɔ hɔ: nea ɛnyɛ oprehyɛn ne oprehyɛn. Mpɛn pii no, oduruyɛfo bedi kan abɔ mmɔden sɛ ɔbɛpete mogya a atɔ mu no sɛ ɛwɔ hɔ a. Wɔnam nnuru a ɛmma mogya nkɔ nipadua no mu (nnuru a ɛko tia mogya a ɛtwetwe) a wɔde ma so na ɛyɛ eyi . Sɛ nhwɛso no, wobetumi akyerɛw Warfarin (Coumadin®) anaa nnuru a wɔde ko tia mogya a ɛtwetwe mogya a wɔnom tẽẽ (Xarelto®) anaa Eliquis®.

Sɛ mogya a ɛtɔ gu nipadua no mu no ayow wie a, ebia ɛho behia sɛ wɔyɛ oprehyɛn na ama mogya a ɛtɔ no ansan ankɔ bio na ama nhyɛso a ɛwɔ ntini no so no so atew . Bere a oduruyɛfo bi reyɛ oprehyɛn no, obetumi:

• Yi ntini anaa ntini a ɛboro so biara a atwa subclavian vein no ho ahyia a ebia ɛde nhyɛso reba ntini no so no fi hɔ.
• Ɛtɔ mmere bi a, wobetumi asan akɔ mogya a ɛkɔ mu no kwan ma wɔatwa ntini a asɛe no ho na ama mogya asan akɔ sɛnea ɛsɛ.

Oduruyɛfo na obegyina wo tebea no so asi ayaresa a ɛfata wo ho gyinae.

Wobɛyɛ dɛn atumi atew asiane a ɛwɔ hɔ sɛ wubenya VTOS no so?

Bere a ɔkwan biara nni hɔ a yɛbɛfa so asiw `VTOS` a ɛbɛba no ano koraa no, nneɛma pii wɔ hɔ a yebetumi ayɛ de atew ɔsɛe a saa asorɔkye yi de ba no so:

• Kura mu duru a ɛfata a ɛfata wo mfe, bɔbeasu, ne nipadua ko.
• Kwati sɛ wode bag a emu yɛ duru bɛsoa wo mmati biako pɛ. Ɛyɛ papa sɛ wode bag ahorow a ɛkyekyɛ mu duru no bedi dwuma.
• To wo soro a wobɛkanyan no mpɛn pii no ano hye. Sɛ ɛsɛ sɛ woyɛ eyi a, gye w’ahome wɔ ntam.
• Yɛ apɔw-mu-teɛteɛ a ɛhyɛ wo mmati den. Ntetee a wɔde gyina ano anaasɛ nneɛma a emu duru so a wɔma so betumi aboa wɔ eyi mu.
• Yɛ apɔw-mu-teɛteɛ a wode trɛw wo kɔn, mmati, ne wo moma so da biara da.

Sɛ wudi anammɔn yi akyi a, wubetumi atew asiane yi so akodu baabi.

Nneɛma a ɛho hia sen biara a ɛsɛ sɛ wuhu fa VTOS (Take-Home Message) ho .

Enti, `Venous Thoracic Outlet Syndrome` yɛ tebea a ɛka yɛn `(Subclavian vein)`. Saa ntini yi betumi amia, na ama abasa no ahonhon, ne kɔla asakra, na ayɛ yaw. Sɛ ɔkwan a ɛkɔ saa ntini a ɛwɔ wo nipadua mu no yɛ teateaa fi awosu mu, anaasɛ wowɔ adwuma a ɛtaa de wo mmati ne wo nsa di dwuma a, ɛda adi sɛ wubenya `VTOS`.

Nea ɛho hia ne sɛ, sɛ wɔannya saa tebea yi a, ebetumi de ɔhaw ahorow a ɛyɛ hu te sɛ mogya a ɛtɔ. Nanso, sɛ wuhu sɛnkyerɛnne ahorow no ntɛm na wufi ase sa yare no ntɛm a, wubetumi anya nea eye sen biara. Nhwehwɛmu ada no adi mpo sɛ sɛ wofi ase sa yare wɔ nnafua 14 a edi kan bere a yare no ho sɛnkyerɛnne no afi ase no mu a ɛma hokwan a ɛwɔ hɔ sɛ ebefi mu aba no yɛ kɛse kɛse .

Enti, sɛ wowɔ saa sɛnkyerɛnne yi bi a, yɛsrɛ sɛ mmu w’ani ngu so na kɔ oduruyɛfo nkyɛn ntɛm ara. Ɔbɛhwehwɛ wo mu na waka ayaresa a eye ma wo akyerɛ wo. Asɛm biara nni hɔ a ɛsɛ sɛ yɛhaw yɛn ho, nanso ɛho hia sɛ yɛyɛ ho biribi ntɛm!

Sɛ wowɔ nsɛmmisa foforo bi fa eyi ho a, wubetumi abisa wo duruyɛfo no sɛ:

• Dɛn na ebetumi ayɛ ade titiriw nti a merenya saa sɛnkyerɛnne ahorow yi?
• Sɔhwɛ ahorow bɛn na ɛsɛ sɛ meyɛ?
• Ayaresa ahorow bɛn na mewɔ?
• So ayaresa a ɛnyɛ oprehyɛn bɛma me yare no ho sɛnkyerɛnne atu mpɔn?
• Nsakrae bɛn na metumi ayɛ wɔ m’asetra kwan mu na ama saa sɛnkyerɛnne ahorow yi so atew?

Ɛyɛ wo yiyedi sɛ wubebisa nsɛm te sɛ eyinom na woanya wo tebea no ho ntease pa.

` Venous Thoracic Outlet Syndrome, VTOS, Paget-Schroetter syndrome, subclavian vein, mogya a ɛtwetwe, ahurututu mu embolism, nsa a ɛho ahonhon, abasa mu yaw, nsa a ɛho ahonhon, abasa mu yaw, mogya a ɛtwetwe, thoracic outlet syndrome, venous thromboembolism