Aneurisme Aorta Abdomen – Penyakit Maut

MASALAH hari esok tidak akan dapat diselesaikan dengan kaedah hari ini. Ia memerlukan kaedah hari esok.” Pepatah ini hasil ilham ahli saintis, Albert Einstein apabila beliau telah menghidap penyakit aneurisme aorta abdomen yang telah gagal dirawat oleh pakar bedah pada ketika itu.

Mungkin anda tidak biasa dengan pepatah ini tetapi bagi pakar penyakit aneurisme aorta abdomen, ia menjadi kata-kata semangat untuk mencari kaedah baru rawatan penyakit ini. Pada tahun 1955, aneurisme Albert telah pecah dan beliau berkata pada detik kematiannya, ” Saya mahu pergi apabila saya mahu. Ia hambar untuk memanjangkan kehidupan dengan cara yang dibuat-buat. Saya sudah lakukan apa yang perlu dikongsi, ini adalah untuk saya pergi. Saya akan lakukannya sebaik mungkin.”

Dua tahun berikutnya, seorang pakar bedah terulung, Dr. Michael DeBakey telah berjaya mencipta graf daripada kain fabrik dacron bagi mengganti salur darah aorta yang rosak. Teknik ini digunakan sehinggalah ke hari ini.

Apakah itu Aorta?

Salur darah utama yang paling besar di badan manusia dinamakan aorta. Salur darah ini membawa darah yang padat kandungan oksigen dari jantung ke seluruh organ tubuh. Aorta abdomen ialah bahagian aorta yang berada di lokasi abdomen, iaitu kawasan di bawah dada dan di atas ruang pelvis. Ia bermula di bawah salur darah ginjal dan berakhir dengan bercabang dua menjadi salur darah utama, iaitu salur darah kaki dan pelvis.

Apakah itu aneurisme?

Disebabkan faktor umur, sebahagian daripada dinding saluran darah akan menjadi lemah. Ini akan menyebabkan sebahagian daripada dinding salur darah bengkak yang dinamakan aneurisme. Perkataan aneurisme ini diambil daripada perkataan Greek yang bermaksud pelebaran. Apabila aneurisme ini membesar, dinding salur darah akan menjadi nipis dan lemah menyebabkan ia boleh pecah dan pesakit akan hilang darah yang banyak. Apabila ini berlaku, pesakit memerlukan rawatan pakar bedah vaskular dengan amat segera. Risiko kematian untuk aneurisme aorta yang pecah menjangkau 90 peratus.

Apakah gejala penyakit aneurisme aorta abdomen?

Kebanyakan pesakit aneurisme abdomen tidak mengalami sebarang gejala. Semasa pemeriksaan kesihatan, doktor mungkin dapat merasakan satu ketulan yang berdenyut di bahagian abdomen. Kadangkala aneurisme ini ditemui tanpa sengaja melalui pemeriksaan ultrabunyi atau ujian imbasan semasa pesakit menjalani siasatan untuk penyakit lain.

Gejala yang paling utama ialah sakit perut dan belakang. Pesakit aneurisme aorta abdomen mengalami sakit yang bersifat dalam yang berlaku pada bahagian abdomen atau di bahagian pinggang. Kadangkala pesakit merasakan denyutan nadi di bahagian kawasan perut. Pembesaran aneurisme aorta abdomen yang cepat juga boleh menyebabkan pemecahan dinding aorta. Ini menyebabkan kesakitan yang teramat sangat di bahagian belakang dan pinggang. Pesakit mungkin pitam atas sebab kesakitan yang amat sangat atau atas sebab tekanan darah yang turun secara mendadak. Pesakit juga akan kelihatan pucat, berpeluh sejuk serta bernafas secara laju. Lima puluh peratus pesakit akan mati secara mendadak disebabkan oleh pendarahan dalaman yang tidak terkawal.

Segelintir pesakit mengalami kesan sampingan aneurisme abdomen seperti jari kaki yang menjadi biru-kebiruan disebabkan oleh darah beku yang terkandung dalam aneurisme telah menghalang perjalanan darah di kaki pesakit.

Apakah punca-punca (faktor risiko) penyakit ini?

Antara risiko utama penyakit aneurisme aorta abdomen ialah faktor umur. Hampir kesemua pesakit berumur 50 tahun ke atas dan kebanyakan penghidap adalah lelaki. Faktor utama yang lain ialah darah tinggi dan merokok. Merokok bukan sahaja menambah risiko seseorang itu menghidap aneurisme aorta abdomen malah kejadian kebocoran penyakit ini boleh membawa maut lebih kerap terjadi pada orang yang menghisap rokok. Faktor keturunan juga dianggap penting. Individu yang mempunyai ahli keluarga yang menghidap penyakit ini lebih kerap mengalami penyakit yang sama. Malah bagi golongan ini, penyakit ini boleh berlaku pada usia yang lebih muda dan mempunyai kadar kebocoran yang lebih tinggi.

Jika pesakit mempunyai penyakit kencing manis dan paras kolesterol yang tinggi, risiko untuk aneurisme aorta abdomen juga akan meningkat. Mereka memerlukan rawatan bukan sahaja untuk menghindari aneurisme aorta abdomen, tetapi juga untuk mengurangkan risiko apabila rawatan pembedahan dijalankan.

Antara punca-punca lain penyakit ini ialah artritis Takayasu, sindrom Marfan dan sindrom Ehlers-Danlos dan juga jangkitan kuman. Jangkitan kuman pada aorta boleh berlaku pada penagih dadah, pesakit injap jantung dan juga pesakit yang mempunyai ketahanan badan yang rendah. Kes-kes seperti ini lebih banyak dilaporkan di rantau Asia berbanding dengan di negara Barat.

Bagaimanakah aneurisme aorta abdomen ini dapat dikesan?

Sekiranya pesakit mempunyai susuk badan yang kurus atau sederhana, doktor yang membuat pemeriksaan fizikal akan dapat mengesan aneurysm aorta abdomen sekiranya saiznya besar. Sekiranya pesakit berbadan gemuk, aneurysm ini sukar dikesan. Pemeriksaan ultrabunyi atau ujian imbasan adalah cara yang berkesan untuk membuat diagnosis yang tepat.

Adakah penyakit ini merbahaya?

Aneurisme aorta abdomen ini boleh membesar dan dindingnya boleh pecah jika dibiarkan.

Sekiranya ini berlaku penghidap penyakit ini akan mengalami pendarahan dalaman yang banyak dan boleh menyebabkan kematian serta-merta.

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