Okwongera puleesa munda mu lubuto kya bulabe? (Abdominal Compartment Syndrome) Ka tuyige ku nsonga eno mu ngeri ennyangu!

Ffenna tumanyi ku kulumwa olubuto, okuzimba n’obubonero obulala. Wadde nga bino bitera okubaawo, wali owuliddeko ku mbeera nga puleesa munda mu lubuto yeeyongera nnyo n’eyinza okwonoona ebitundu ebikulu n’okutuuka n’okutta obulamu? Ekyo abasawo kye bayita embeera ey'amaanyi eyitibwa ``Abdominal Compartment Syndrome.'' Erinnya lino liyinza okuwulikika nga lizibu katono, naye katukikuume nga lyangu. Okumanya ebintu bino kiyinza okuba ekikulu ennyo gy’oli n’abaagalwa bo.

Obulwadde bw’okuzimba olubuto kye ki?

Mu ngeri ennyangu, ``Abdominal Compartment Syndrome`` mbeera ya mangu ey'obujjanjabi . Kibaawo nga puleesa eri munda mu lubuto lwaffe, oba mu lubuto, esukkulumye ku kifo ky’esobola okukwata. Teebereza ekibaawo singa tufuuwa empewo ennyingi mu bbaatule? Mu ngeri y’emu, puleesa munda mu lubuto bwe yeeyongera olw’okuzimba, okuvaamu omusaayi oba ensonga endala, ebitundu ebikulu ng’ebyenda byaffe, ekibumba n’ensigo bitandika okusika.

Mu budde obwabulijjo, puleesa munda mu lubuto lw’omuntu omulamu eba wakati wa milimita 0 ne 5 eza mercury (mmHg). Wabula mu balwadde abalwadde ennyo mu bifo eby’abalwadde abayi, omuwendo guno guyinza okuba wakati wa mmHg 5 ne 7. Puleesa eno bwe yeeyongera ebizibu we bitandikira:

• Puleesa mu lubuto (IAH): Mu kino, puleesa eri wakati wa mmHg 12 ne 20.
• Obdominal Compartment Syndrome (ACS): Wano embeera eno w’efuuka ey’akabi. Puleesa yeeyongera okutuuka ku mmHg ezisukka mu 20.

Puleesa eno eremesa ebitundu by’omubiri n’ebinywa ebiri munda mu lubuto okufuna omusaayi ogumala. Mu kiseera kye kimu, omukka gwa oxygen nagwo gukendeera. Kino kivaako okulemererwa kw’ekitundu ekimu oluvannyuma lw’ekirala (okulemererwa kw’ebitundu ebingi). Singa kino tekitegeerwa era ne kijjanjabwa mu budde, omulwadde ayinza okufa. N’olwekyo, eno mbeera eteekwa okumanyibwa n’okujjanjabibwa mu bwangu .

Embeera eno ya bulijjo?

Nedda, `(Abdominal Compartment Syndrome)` mu butuufu mbeera etali ya bulijjo nnyo . Kisinga kukwata bantu abali mu malwaliro naddala mu bifo ebijjanjabirwamu abalwadde abayi `(ICU),` abalina edda embeera z'obujjanjabi ez'amaanyi. Kizibu nnyo omuntu alina obulamu obwa bulijjo, obulungi okubufuna.

Kiki ekivaako obulwadde bw’okuzimba olubuto?

Waliwo ensonga eziwerako lwaki puleesa mu lubuto eyinza okufuuka ey’akabi. Ebikulu kwe kuvaamu omusaayi oba okuzimba ekisusse mu lubuto. Ka tulabe obukwakkulizo buno bwe buli:

• Okulongoosa ennyo mu lubuto lwo: Oluusi okuzimba kuyinza okubaawo munda mu lubuto oluvannyuma lw’okulongoosebwa ennyo.
• Yinfekisoni mu lubuto lwo:Yinfekisoni ez’amaanyi nazo zisobola okuvaako puleesa.
• Okuzibikira ebyenda: Singa ebyenda biba wazibikira, era kiyinza okwongera puleesa.
• Amazzi amangi aga IV (okuzuukusa amazzi): Mu kulongoosa okumu, oba mu mbeera z’obulwadde obw’amaanyi nga sepsis, omubiri gwetaaga okuweebwa amazzi amangi ag’omugaso. Kino oluusi kiyinza okwongera puleesa mu lubuto.
• Okwokya okunene: Embeera eno era esobola okubaawo olw’engeri omubiri gye guddamu ng’ekitundu ekinene eky’omubiri kyokeddwa.
• Okuteekebwamu omusaayi mungi: Obulabe buno bubaawo ne bwe kiba nti omusaayi mungi guteekebwa omulundi gumu.
• Obulwadde bw’olubuto: Kino kye kimu ku bivaako puleesa mu lubuto okweyongera.
• Okukutuka kw’omusuwa gw’omu lubuto: Omusuwa gwe musuwa omukulu ogutambuza omusaayi okuva ku mutima gwaffe okuyita mu kifuba okutuuka mu lubuto. Singa ekibumba (aneurysm) kikula mu kitundu ky’omusuwa guno ogw’olubuto ne kikutuka, kiyinza okuvaako omusaayi omungi n’okweyongera puleesa munda mu lubuto.
• Okulumwa olubuto: Embeera eno esobola okubaawo singa wabaawo okwonooneka okw’amaanyi mu lubuto lwo, gamba ng’akabenje k’emmotoka oba okugwa.

Bubonero ki obwa `(Abdominal Compartment Syndrome)`?

Wano akabi we kali. Obubonero bwa ``Abdominal Compartment Syndrome'' butera okulabika ekikeerezi , oluvannyuma lw'okwonooneka okumu. Eno y’ensonga lwaki abasawo n’abakozi ba ba nnamusa balondoola nnyo abalwadde abali mu bulabe bw’embeera eno.

Bino bye bimu ku bifaananyi ebiyinza okuzuulibwa:

• Okugaziwa kw’olubuto: Olubuto luyinza okuwulira ng’oluzimba era nga lukalubye .
• Obulumi mu lubuto: Omulwadde ayinza okuwulira obulumi obw’amaanyi mu lubuto.
• Okukaluubirirwa okussa: Puleesa mu lubuto bwe yeeyongera, ekifuba nakyo kiyinza okukosebwa ekizibu okussa.
• Puleesa entono (hypotension): Puleesa eya wansi nayo kabonero ka kino.
• Okukendeera kw’omusulo (oliguria): Olw’okukosebwa kw’ensigo, obungi bw’omusulo ogukolebwa guyinza okukendeera ennyo.

Kino abasawo bakikakasa batya?

Omuntu alina obulwadde bwa ``Abdominal Compartment Syndrome`` ayinza okufuna obubonero nga:

• Puleesa ekka.
• Omusulo ogufuluma mutono.
• Bw’oba ​​oyungiddwa ku kyuma ekissa, emiwendo gyayo egya puleesa giyinza okweyongera.

Wabula obubonero buno bwokka tebusobola kukozesebwa kuzuula bulwadde bwa ACS. Engeri yokka ey’okuzuulamu embeera eno mu ngeri enkakafu kwe kupima puleesa mu lubuto.Omusawo ajja kumaliriza nti olina ACS singa puleesa eno esukka mmHg 20 era nga waliwo obubonero obulaga nti ebitundu by’omubiri biremye.

Enkola enkulu ekozesebwa mu kiseera kino okupima puleesa y’omu lubuto kwe kupima puleesa y’ekibumba . Mu ngeri ennyangu, eno y’engeri gye kikolebwamu:

1. Okusooka, ekyuma ekigonvu ekigonvu (catheter) kiyingizibwa mu kibumba. Kino kikolebwa nga bayita mu misuwa gy’omusulo.

2. Olwo tube eno (catheter) eyisibwa mu kibumba.

3. Kati ensawo erimu amazzi eyungiddwa ku ttanka eno.

4. Ng’okozesa empiso, agamu ku mazzi gafukibwa mu kibumba.

5. N’ekisembayo, puleesa eyo epimibwa.

Okukebera kuno kuddibwamu buli luvannyuma lwa kiseera ttiimu y’abasawo okulaba oba embeera etereera oba yeeyongera okwonooneka.

Okugatta ku ekyo, omusawo wo ayinza n’okukebera ebirala okulaba oba ebitundu byo bikola bulungi. Okugeza nga:

• Okukebera omusaayi: Bino bisobola okupima emiwendo gy’eddagala n’omukka ogw’enjawulo mu mubiri. Okugeza, okukebera creatinine clearance kiyinza okukuwa endowooza ku ngeri enkizi zo gye zikolamu.
• Okukebera ebifaananyi: Bino bisobola okukuba ebifaananyi by’olubuto lwo munda. Ng’ekyokulabirako, bayinza okukolebwa CT scan oba ultrasound mu lubuto.
• Okupima oxygen saturation: Kino kizingiramu okuteeka ekintu nga clip ennyangu ku ngalo yo okukebera oba omubiri gwo gufuna oxygen emala.

Obulwadde bwa Abdominal Compartment Syndrome bujjanjabwa butya?

Obujjanjabi obusinga okukola obulungi ku mbeera eno kwe kulongoosa okukendeeza ku buzito. Omusawo alongoosa akola enkola ey’enjawulo eyitibwa decompressive laparotomy. Kino kizingiramu okusala olususu ne bbugwe w’olubuto, okuggulawo ekituli mu lubuto, n’okumalawo puleesa esukkiridde munda .

Puleesa eri munda mu lubuto ejja kutandika okukendeera mu ssaawa ntono oluvannyuma lw’okulongoosebwa. Kyokka, kiyinza okutwala ennaku eziwerako puleesa okudda mu mbeera eya bulijjo. Okutuusa olwo, ekiwundu ekilongooseddwa kiyinza obutaba kiggaddwa ddala. Abalwadde abamu bayinza okwetaaga okuddamu okulongoosebwa kuno okukendeeza puleesa.

Embeera eno teyinza kuziyizibwa?

Nga tekinnagenda mu butuufu ku mutendera gwa `(Abdominal Compartment Syndrome - ACS)`, kwe kugamba, bwe wabaawo puleesa mu lubuto (IAH), osobola okugezaako okuddukanya embeera eno nga tolongooseddwa. Obujjanjabi buno obutali bwa kulongoosa busobola okuyamba okukomya `(IAH)` okugenda mu maaso okutuuka ku `(ACS)`. Enzijanjaba ng’ezo mulimu:

• Okukyusa embeera y’omubiri: Okuteeka omulwadde mu mbeera ekendeeza ku puleesa n’okumusanyusa.
• Eddagala erifulumya amazzi: Eddagala lino liyamba okuggya amazzi agasukkiridde mu mubiri.
• Okuggya amazzi mu lubuto nga oyita mu ttanka.
• Okufulumya ebyenda: Kino kiyinza okukendeeza ku puleesa munda mu lubuto n’okuleetawo ekifo ekiwera.
• Okuwa eddagala eriweweeza ku bulumi.
• Okukendeeza ku mazzi agaweebwa omubiri.

Omutindo gw'okuwona kw'abalwadde abalina ``Abdominal Compartment Syndrome'' guli gutya?

Eno nsonga nkulu nnyo. Singa ``Abdominal Compartment Syndrome'' tejjanjabibwa bulungi, kiyinza okutta. Kubanga, puleesa munda mu lubuto bwe yeeyongera okweyongera, kimu ku kimu ebitundu by’omubiri bitandika okulemererwa. Ate era singa okuzuula n’okujjanjaba bilwawo, emikisa gy’okuwona nagyo gikendeera.

Wabula singa obulwadde buno buzuulibwa nga bukyali era obujjanjabi ne butandika mangu, kisoboka okuwona ddala okuva mu bulwadde bwa Abdominal Compartment Syndrome.

Kyokka, kiyinza okutwala wiiki, wadde emyezi, embeera y’obujjanjabi eyaliwo eyaviirako ACS okugonjoola. Mu kiseera ekyo, omulwadde ayinza okwetaaga:

• Obujjanjabi bwa dialysis okukola emirimu gy’ensigo.
• Obujjanjabi bw’abalwadde abajjanjabirwa mu ddwaaliro okumala ebbanga eddene.
• Okuziyiza amazzi oba eddagala erifulumya amazzi.
• Okulondoola buli kiseera enkola y’omutima.
• Ekyuma ekifuuwa empewo (mechanical ventilation) okuyamba mu kussa.

Obdominal Compartment Syndrome mbeera ya mangu ey’obujjanjabi eyinza okubaawo mu bantu abalwadde ennyo. Embeera okuzimba n’okunyigirizibwa munda mu lubuto mwe bituuka ku ddaala ery’akabi. Okuzuula amangu n’okujjanjaba kyetaagisa nnyo okuziyiza ebizibu eby’amaanyi n’okufa.

Ebintu ebikulu by'olina okukuuma mu birowoozo (Take-Home Message)

Okay, kale kati olina endowooza ennungi ku kye tubadde twogera, Abdominal Compartment Syndrome. Wadde nga eno embeera ya maanyi, kikulu okugimanya.

• Acute intra-abdominal pressure (ACS) mbeera ya mangu ereetebwa puleesa esukkiridde mu lubuto. Kino kiyinza okwonoona ebitundu by’omubiri.
• Wadde nga kino tekitera kubaawo , kiyinza okubaawo mu balwadde abali mu bifo eby’abalwadde abayi.
• Okutegeera amangu obubonero, okupima puleesa, okukakasa obulwadde, n’okutandika amangu obujjanjabi bitaasa obulamu. Obujjanjabi obukulu kwe kulongoosa okukendeeza ku buzito.
• (IAH) , ekitegeeza nti puleesa eri waggulu katono naye nga si ya maanyi nga ``(ACS)``, esobola okuddukanyizibwa awatali kulongoosebwa.
• Okuwona kisinziira ku ngeri obujjanjabi gye butandikibwamu amangu.

Tusuubira nti amawulire gano gakuyamba. Omuntu gw’omanyi bw’aba ali mu kifo awajjanjabirwa abalwadde abayi, okumanya kuno kujja kukuyamba okutegeera ng’abasawo boogera ku mbeera zino. Bulijjo goberera ebiragiro by’omusawo era buuza omusawo wo bw’oba ​​olina ekibuuzo kyonna.

`Obulwadde bw’ekisenge ky’olubuto, puleesa y’olubuto, puleesa mu lubuto, okulongoosebwa, ekisenge ky’abalwadde abayi, okulemererwa kw’ebitundu by’omubiri, embeera ey’amangu ey’obujjanjabi