Ðe ʋuka aɖe si le wò ŋutilã me ate ŋu axe kpata? Mina míaƒo nu tso Embolism ŋu!

Èbu nusi adzɔ ne nane xe ʋuka aɖe si le míaƒe ŋutilã me zi ɖeka ŋu kpɔa? Ðewohĩ ema medzɔ ɖe dziwò o. Gake, esia nye nusi wòle be mí katã míanya. Elabena, ʋuka aɖe ƒe xexe alea, nɔnɔme si woyɔna be (Embolism), ate ŋu anye afɔku gã aɖe ɣeaɖewoɣi. Eyata ɖe míaƒo nu tso esia ŋu tsitotsito vie eye wòanɔ bɔbɔe egbea?

Nukae nye ʋumenugbagbeviɣidɔ? Kpuie ko la,...

Kpuie ko la, embolism nye ne nane xe mɔ na wò ʋukawo dometɔ ɖeka, alo teƒe si ʋu sina le. Zi geɖe la, ʋu ƒe sisi si ƒo ƒu ɖe teƒe bubu gbɔe mɔxexe sia tsona. Ke hã, menye ʋu ƒe sisi koe o, ke nu bubuwo hã ate ŋu azɔ mɔ tso teƒe ɖeka le ŋutilãa me ayi bubu eye woaxe ʋuka aɖe abe esia ene.

Bu eŋu abe ɖiƒoƒo aɖe si ge ɖe tsido me ene. Ʋuka aɖewo, le woƒe lolome kple nɔnɔme ta, ate ŋu axe mɔ wu bubuwo. Esia ate ŋu adzɔ vevietɔ le afisi ʋuka gã aɖe alɔ ɖe akpa suewo me le, alo afisi ʋukaa xaxa le le ami siwo le eme ta (ʋukawo me ʋu ƒe sisi).

Embolism siawo ate ŋu adzɔ le wò ŋutilã ƒe akpa sia akpa, siwo dometɔ aɖewoe nye wò ahɔhɔ̃, lãkusi, ayiku, kple dɔgbo. Embolism ƒomevi si bɔ wue nye lãkusiwo me. Ne ʋu si le dodom le wò afɔwo ƒe ʋukawo me eye wòzɔ mɔ yi wò lãkusi me la, woyɔnɛ be aklã me ʋu ƒe sisi, alo PE .

Mɔ vovovo kawo dzie ʋuka me ʋu ƒe sisi ate ŋu ato?

Woate ŋu ama ʋuka me ʋu ƒe sisi ɖe ƒomevi vovovowo me le nusi ƒomevi tsi ʋukaa me nu. Kpɔe ɖa:

• Ʋuka me ʋu ƒe sisi: Esiae nye ʋu ƒe sisi ƒomevi si bɔ wu . Ʋu ƒe sisi si dzɔna le ŋutilã ƒe teƒe bubuwo, vevietɔ le afɔwo ƒe ʋuka goglowo me (Deep Vein Thrombosis - DVT) gbɔe wòtsona.
• Tumor embolism: Nane si le abe kansa lãmenugbagbevi ƒe akpa aɖe ene.
• Ami ƒe ʋuʋu: Ami ate ŋu aƒo ƒu ɖe ʋua me ne ƒu gã aɖe gbã.
• Septic embolism: Ʋu ƒe sisi si do ƒome kple dɔlékui aɖe.
• Ya si me ʋu sina tona: Le kpɔɖeŋu me, ate ŋu atso nitrogen gas gbɔ le tsi me nɔnɔ me.
• Amniotic fluid embolism: Esia do ƒome kple vidzidzi eye ƒã ŋutɔ.

Le esiawo dome la, Venous Thromboembolism , si nye ʋu ƒe sisi si dzɔna le ʋukawo me eye wòxea mɔ na wo la bɔ wu ʋukawo me ʋu ƒe sisi. Le nyateƒe me la, le dukɔ abe Amerika ene me la, woka nya ta be ame siwo ade 900,000 ye xɔa dɔléle sia ƒe sia ƒe. Azɔ hã, Aklã me Ʋukawo ƒe Dɔléle nye nu etɔ̃lia si wua ame si do ƒome kple dzi kple ʋukawo le xexeame. (Xexlẽdzesi ɖeka kple evelia nye Stroke kple Heart Attack).

Nukawoe nye ʋumenugbagbeviɣidɔ ƒe dzesiwo?

Ne ʋuka si me ʋu sina tona le ʋuka me la, xea mɔ na ʋu ƒe sisi. Ènyaa, ʋu tsɔa ɔksidzin si míaƒe ŋutilã me lãmenugbagbevi ɖesiaɖe hiã. Eyata ne ʋua mete ŋu to eme o la, oxygen mate ŋu ato eme o. Oxygen ƒe anyimanɔmanɔ sia hea nɔnɔme aɖe si woyɔna be "infarct" vɛ, si gblẽa nu le ŋutinu si hiã oxygen ma ŋu. Esia ate ŋu ana ame nase veve. Ɣeaɖewoɣi la, ɔksidzin ƒe anyimanɔmanɔ sia ate ŋu awu ame gɔ̃ hã.

Kpɔe ɖa le susu me be ʋuka aɖe (thrombus) le ƒoƒom ɖe ʋuka goglo aɖe me le wò afɔ me, eye eƒe akpa suesuesuewo gbã hezɔ kple ʋua yi wò dzi ƒe ɖusime. Wokɔa ʋu tso afima yia lãkusiwo me. Ʋu sue siawo (aklã me ʋu ƒe sisi) tsia ʋuka sue siwo le lãkusi me me, si wɔnɛ be ʋuka me ʋu sina tona. Ƒã ŋutɔ hafi gãwo (aklã me ʋu ƒe sisi) ate ŋu axe mɔ na ʋu ƒe sisi nyuie tso dzia ƒe ɖusime yi lãkusi me keŋkeŋ.

Embolism ƒe dzesiwo toa vovo le embolism ƒomevi kple afisi wòle nu. Ðewohĩ dzesi aɖeke manɔ ame aɖewo ŋu kura o. Dzesiawo dometɔ aɖewoe nye esi:

• Yagbɔgbɔ kpuie
• Oxygen ƒe agbɔsɔsɔ si bɔbɔ ɖe ʋu me (Hypoxemia) .
• Gbɔgbɔ kabakaba gake megoglo o (Tachypnea) .
• Gbɔdzɔgbɔdzɔ, ɖeɖiteameŋu
• Taɖuame
• Teƒe dzĩ siwo le ŋutigbalẽa ŋu (Petechiae) .
• Akɔtave
• Dzi ƒe tsotso kabakaba (Tachycardia) .
• Asrã
• Abɔ alo afɔ ƒe vuvu
• Alɔ̃madɔmadɔ
• Vertigo ƒe dɔléle
• Aɖuɖɔtoe kple ʋuʋudedi
• Ʋusɔgbɔdɔ (Hypotension) .

Nuka koŋue hea ʋuka me ʋu ƒe sisi vɛ?

Zi geɖe la, aklã me ʋu ƒe sisi dzɔna le aklã me. Nusi koŋ gbɔ esia tsonae nye ʋu ƒe sisi le afɔwo ƒe ʋukawo me (Deep Vein Thrombosis - DVT) . Ɣeaɖewoɣi la, aklã me ʋu ƒe sisi hã ate ŋu adzɔ le DVT si le abɔta ƒe ʋuka goglowo me ta.

Susu bubuwo hã li siwo tae ʋumenugbagbeviɣidɔ dzɔna ɖo:

• Dɔlékuiwo xɔxɔ le dzia ƒe akpa si le eme (infective endocarditis) .
• Atrial fibrillation (dzi ƒe tsotso si mesɔ o) .
• Miameʋuka ƒe ʋuka me ʋu ƒe sisi
• Ƒu si gbã le afɔku gã aɖe me
• Kansa
• Dɔlékui vovovowo
• Dɔgbo ƒe dɔléle
• Amiɖeɖe ɖe lãme na ame
• Ƒumeŋuɖui dodo na ame
• Suklidɔ le fufɔfɔ me
• Placenta accreta (vidzidɔa ƒe ƒoƒo ɖe vidzidɔa ƒe gli ŋu goglo) .

Amekae le afɔku gã me be wòaxɔ esia (embolism)?

Nu geɖe li siwo bɔ ɖe ʋu ƒe sisi (embolism) me. Kpɔe ɖa be esiawo dometɔ aɖe ku ɖe ŋuwò hã:

• Lãmesẽfefemawɔmawɔ: Teƒe ɖeka nɔnɔ ɣeyiɣi didi akpa, vevietɔ le amekoko vɔ megbe.
• Amekoko kple atikewɔwɔ aɖewo: Le amekoko gãwo megbe.
• Dzi ƒe dɔmawɔmawɔ nyuie
• Gbagbãdᴐ
• Kansa
• Ŋutilã me abixɔxɔ (Trauma) .
• Ʋusɔgbɔdɔ (Hypertension) .
• Atamanuwo zazã (atamanono) .
• Vidzidzinutsitikewo zazã
• Nɔnɔme siwo nana ʋu ƒona bɔbɔe
• Atikewɔnu aɖewo, abe dzitodzito ƒe mɔ̃wo ene

Kuxi kawoe ate ŋu ado mo ɖa le ʋumenugbagbeviɣidɔ ta?

Kuxi siwo dona tso ʋuka me ʋu ƒe sisi me la toa vovo le afisi wòdzɔna le nu. Ate ŋu anye afɔku gã aɖe. Kuxi siwo dona tso eme dometɔ aɖewoe nye esi:

• Ahɔhɔ̃a ƒe dɔwɔwɔ si mesɔ o, abe ŋkuɖoɖonudzi ƒe dɔmawɔmawɔ nyuie ene
• Dzi ƒe tsotso ƒe masɔmasɔ (Arrhythmia) .
• Dzi ƒe dɔmawɔmawɔ nyuie
• Dzidɔ
• Ahɔhɔ̃ me ʋuʋu
• Aklã me ʋuʋu
• Yagbɔgbɔ ƒe Dɔléle Sesẽ (ARDS) .
• Abɔ alo afɔ aɖe ƒe bu
• Aɖuɖɔtoe me ʋuʋudedi
• Lãmetsiwo ƒe kuku le ayiku, dɔgbo, alo ŋutinu bubu si ŋu dɔlélea le me
• Tricuspid valve regurgitation (ʋu ƒe sisi yi megbe to dzitodzito me) .
• Ayiku ƒe dɔmawɔmawɔ nyuie
• Dzi ƒe dɔmawɔmawɔ nyuie
• Gbagbãdᴐ
• Amegbetɔ ƒe agbe gɔ̃ hã ate ŋu adzɔ.

Ema fia be, esia menye nusi woabu nu tsɛe o. Togbɔ be adze nu sue aɖe hã la, ne womewɔ atike nɛ le ɣeyiɣi nyuitɔ dzi o la, ate ŋu ahe kuxi siwo ate ŋu ade ame ƒe agbe afɔku me vɛ.

Aleke ɖɔkta awɔ anya esia (embolism) nyuie?

Ne ʋumenugbagbeviɣidɔ ƒe dzesiwo le ŋuwò la, ɖɔkta aɖe ado wò kpɔ gbã. Ðɔktaa ate ŋu ade dzesi nuwo abe ŋutigbalẽ ƒe tɔtrɔ alo gbɔgbɔ sesẽ ene. Ne wosusu be ʋumenugbagbeviɣidɔ aɖe le eŋu la, ate ŋu awɔ dodokpɔ aɖewo.

Woate ŋu awɔ dodokpɔ siwo gbɔna le ʋuka me ʋu ƒe sisi ƒomevi nu:

• Ʋudodokpɔwo
• Akɔta ƒe X-ray
• Doppler ultrasound - be woalé ŋku ɖe ʋu ƒe sisi le ʋukawo me ŋu.
• ECG (Electrocardiogram - EKG) - Eléa ŋku ɖe dzi ƒe dɔwɔwɔ ŋu.
• CT scan (Kɔmpiutadziɖoɖo - CT scan) .
• MRA dodokpɔ(Magnetic Resonance Angiogram - MRA ƒe Ʋuʋudedi ƒe Nɔnɔmetata - MRA) .
• MRI (Magnetic Resonance Imaging) ƒe nɔnɔmetatawo .
• Angiogram - Ʋukawo ƒe X-ray le amadede dodo vɔ megbe.
• Ultrasound dodokpɔ siwo wowɔna le dzia ŋu: (Transthoracic echocardiogram - TTE) kple (Transesophageal echocardiogram - TEE) .
• Ɣeaɖewoɣi la, woɖea ŋutilã ƒe akpa aɖe tsɔ doa lãkusi aɖe kpɔ.

Nukawoe nye atike siwo wozãna na ʋumenugbagbeviɣidɔ?

Taɖodzinu vevitɔ si le ʋuka me ʋu ƒe sisi dada ŋue nye be woaɖe ʋuka si xe mɔ na ʋukaa ɖa eye wòana ʋu nagazɔ ayi teƒe bubu. Zi geɖe la, tiatia gbãtɔe nye be woatsɔ atikewo adae.

Atikewɔwɔ aɖewo na ʋumenugbagbeviɣidɔe nye esi:

• Anticoagulants : Míegblɔna be esiawo "thrombify" ʋua.
• Thrombolytics : Esiawo tsɔa ʋu si le ʋuʋum la ƒua gbe tẽ eye woɖenɛ ɖa.
• Dɔlékuiwutikewo na Embolism
• Atike siwo nana dzi ƒe dɔwɔwɔ dzina ɖe edzi (Inotropes) .
• Oxygen-dɔdamɔnu alo oxygen -dɔdamɔnu si me oxygen sɔ gbɔ ɖo
• Embolectomy (amekoko be woaɖe ʋumenugbagbeviɣidɔ aɖe ɖa) .

Le nɔnɔme sesẽ ŋutɔwo me la, amesiwo ŋu ʋuka me ʋu ƒe sisi le ate ŋu ahiã atike bubu siwo akpe ɖe wo ŋu woanɔ agbe, abe CPR , ECMO (mɔ̃ si wɔa dɔ ɖe dzi kple lãkusi teƒe), kple mɔ̃ siwo akpe ɖe wo ŋu woagbɔ ya gɔ̃ hã.

Ðe atikewɔwɔa ƒe nugbegblẽ aɖewo lia?

Ẽ, nublanuitɔe la, nugbegblẽ aɖewo ate ŋu ado tso eme. Afɔku le ʋudodo me, vevietɔ ne wozã atike siwo woyɔna be ʋumenugbagbeviɣitikewo kple ʋumenugbagbeviɣitikewo. Ne woɖe ʋu ƒe sisi le amekoko me (embolectomy) la, afɔkuwo ate ŋu anɔ eme abe:

• Nusiwo gblẽ le ʋuka aɖe ŋu
• Ʋu si le dodom
• Dzi ƒe tsotso blewu (Bradycardia) .
• Ʋusɔgbɔdɔ (Hypotension) .
• Dzi ƒe dɔmawɔmawɔ nyuie

Nukae dzɔna ne ʋumenugbagbeviɣidɔ aɖe dzɔ?

Ðewohĩ dzesi aɖeke manɔ ame aɖewo siwo ŋu ʋumenugbagbeviɣidɔ le ŋu kura o, evɔ dzesiwo ate ŋu asẽ ŋutɔ le ame bubuwo ŋu. Alesi woawɔ atike na wòe anɔ te ɖe nu geɖe dzi, siwo dometɔ aɖewoe nye ʋumenugbagbeviɣidɔa ƒe lolome kple eƒe sesẽme, kple afisi wòdzɔ tso.

Embolism nye dɔléle si ate ŋu ade ame ƒe agbe afɔku me, eyata ne èkpɔ dɔlélea kaba eye nèdae kaba la, ate ŋu ana mɔnukpɔkpɔ si li be nàhaya nadzi ɖe edzi.

Nukae míate ŋu awɔ atsɔ axe mɔ ɖe ʋumenugbagbeviɣidɔ nu?

Ẽ, míate ŋu axe mɔ ɖe ʋumenugbagbeviɣidɔ ƒomevi aɖewo nu. Ne ʋuka me ʋu ƒe sisi le afɔku me la, wò ɖɔkta ate ŋu aɖo aɖaŋu na wò:

• Ne èle mɔ didiwo zɔm (abe le yameʋu alo bɔs me ene) la, fɔ gaƒoƒo ʋɛ ɖesiaɖe eye nàkɔ wò afɔkpodziwo ɖe dzi vie ahaɖiɖi wo (nyitsu ƒe pɔmpiwo).Esia ate ŋu akpe ɖe ame ŋu be ʋu nayi edzi nyuie le afɔawo me.
• Atike siwo nana ʋu mekɔna o (Anticoagulants) .
• Wozãa compression stockings tɔxɛwo.
• Mɔ̃ si tsɔa nyaƒoɖeamenu dea afɔwo dzi (Intermittent Pneumatic Compression Device - IPC device) .
• Le ame aɖewo gome la, woate ŋu ade ʋuka gã si tsɔa ʋu tso ametia ƒe akpa si le ete yia dzia me (vena cava ƒe ʋuka si le ete) . Esia wɔnɛ be ʋukawo mete ŋu zɔa mɔ yia dzi kple lãkusi me o.

Aleke mawɔ akpɔ ɖokuinye dzi ne ʋumenugbagbeviɣidɔ dze dzinye?

Le ʋuka me ʋu ƒe sisi vɔ megbe la, ahiã be nàgbugbɔ aɖɔ wò ɖo hafi nàhaya. Esia le alea elabena ate ŋu anye be embolism la gblẽ nu le teƒewo abe wò ahɔhɔ̃ alo wò lãkusi ene ŋu. Nusiwo gblẽa nu sia dzɔna elabena ʋuka si me ʋu sina tona la tso oxygen si yia ŋutinu alo nuto ma me.

Ɣekaɣie wòle be makpɔ ɖɔkta?

Ne ʋumenugbagbeviɣidɔ ƒe dzesiwo le ŋuwò la, ele be nàyi atikewɔƒe enumake. Mègahe ɖe megbe o.

Le ʋumenugbagbeviɣidɔ megbe la, ahiã be nàyi edzi ayi wò ɖɔkta gbɔ eye nàwɔ ɖe eƒe mɔfiamewo dzi. Vevietɔ ne èle atikewo abe ʋumenugbagbeviɣitikewo ene zãm la, wò ɖɔkta akpɔe ɖa be èle wo nom nyuie hã eye ne ʋudodo ƒe afɔkua trɔ hã.

Nya kawoe wòle be mabia ɖɔktaa?

Àte ŋu abia wò ɖɔkta nya siawo abe esiawo ene:

• Nukatae dɔléle sia (embolism) dze dzinye?
• Mɔnukpɔkpɔ kawoe li be mahaya le nye nɔnɔmea nu?
• Nukae nye atikewɔwɔ nyuitɔ kekeake nam?
• Nukae wòle be mawɔ be ʋuka me ʋu ƒe sisi bubu abe esia ene nagadzɔ o?

Kpuie ko la (Take-Home Message) .

Enye nusi sɔ be nàtsi dzi ɖe nɔnɔme aɖe si woyɔna be embolism ŋu, elabena ate ŋu ade ame ƒe agbe afɔku me. Esia tae wòle vevie ŋutɔ be woawɔ atike na ame enumake. Ne ʋuka me ʋu ƒe sisi ƒe dzesiwo le ŋuwò la, yi atikewɔƒe enumake. Le atikewɔwɔ vɔ megbe la, xɔ kpekpeɖeŋu tso wò ƒometɔwo kple xɔlɔ̃wo gbɔ. Ne ètsi dzi alo nètsi dzi be yeagaxɔ ʋuka me ʋu ƒe sisi bubu la, ƒo nu kple aɖaŋuɖola aɖe. Menye wò ɖeka koe o, eye mègavɔ̃ be yeabia kpekpeɖeŋu o.

` Embolism, ʋu ƒe sisi, ʋukawo ƒe xexe, aklã me embolism, Pulmonary Embolism, DVT, dzesiwo, atikewɔwɔ, mɔxexe ɖe enu