Wali ofunyeeko olubuto oluzimba, engoye ne zinyiga, n’owulira ng’ojjudde amazzi? Oluusi kino kya bulijjo, naye oluusi kiyinza okuba akabonero akalaga nti omuntu alina ekizibu eky’amaanyi mu bulamu. Leero tugenda kwogera ku mbeera emu ng'ezo, "Ascites." Kino amazzi oba amazzi gokka bwe gakuŋŋaanyizibwa mu kifo ekyerere okwetooloola ebitundu by’omubiri mu lubuto lwaffe.
Ddala ascites kye ki?
Mu ngeri ennyangu, ascites kwe kukuŋŋaanyizibwa kw’amazzi mu ngeri etaali ya bulijjo mu kifo ekiri wakati w’ekisenge ky’olubuto (peritoneum) n’ebitundu by’olubuto. Kino mu budde obutuufu tekibaawo mu muntu mulamu bulungi. Olw’okuba mu lubuto mulimu amazzi matono tekitegeeza nti ascites. Abasawo embeera eno bagitegeeza nti ascites nga waliwo amazzi agatakka wansi wa mililita 25 (0.8 ounces).
Embeera eno esinga kubeera mu bantu abalina obulwadde bw’ekibumba obw’amaanyi. Abantu nga 80% abalina ascites balina obulwadde bwa cirrhosis of the liver. Okugatta ku ekyo, ascites era eyinza okuva ku mbeera endala, gamba nga kookolo, endwadde z’omutima, akafuba, n’endwadde z’ekibumba.
Bubonero ki obulaga embeera eno?
Ascites eyinza obutalaga bubonero bwonna bunene mu kusooka. Olw’okuba amazzi agakuŋŋaanyizibwa mu lubuto matono, oyinza obutagategeera. Naye amazzi agakuŋŋaanyizibwa bwe geeyongera mpolampola, ojja kulaba ng’olubuto lwo lweyongera obunene n’okuzimba. Empale yo ejja kutandika okuwulira ng’enywezeddwa.
Wansi waliwo obubonero obuyinza okukuyamba okuzuula obulungi embeera eno. Laba oba olina ekimu oba ebisingawo ku bino.
| Obubonero | Ennyinyonnyola ennyangu |
|---|---|
| Okuzimba n’okugejja | Okuwulira ng’olubuto lwo lweyongera obunene awatali nsonga ate mu bwangu ne weeyongera okugejja. |
| Okukaluubirirwa okussa | Olubuto bwe lujjula amazzi, lussa puleesa ku mawuggwe ne kizibuwalira okussa. |
| Okuzimba amagulu n’enkizi | Amagulu gayinza okuzimba olw’amazzi okukuŋŋaanyizibwa mu mubiri. |
| Okubulwa okwagala okulya n’okuziyira | Oyinza obutawulira nga oyagala kulya kubanga owulira ng’ojjula. Oyinza n’okuwulira ng’oziyira. |
| Obulumi mu lubuto n’obutabeera bulungi | Okuwulira ng’olubuto lunywezeddwa, nga tolina mirembe oba ng’alumizibwa. |
| Obulwadde bwa Hernia | Okufuluma kw’ebitundu by’ekyenda okuva mu kitundu ky’omumwa gwa nnabaana oba eky’omugongo olw’okunyigirizibwa okweyongera mu lubuto. |
Ekisinga obukulu kwe kulaba omusawo mu bwangu bw’oba olina obubonero buno. Ascites etera okuba kabonero akalaga nti ekibumba kyo kiremye. Jaundice, amaaso n’olususu okufuuka ebya kyenvu, kabonero akalala akalaga nti ekibumba kyonooneka.
Biki ebikulu ebivaako ascites?
Nga bwe twagambye emabegako, ekisinga okuvaako ekibumba kibeera kya cirrhosis of the liver. Naye kino kibaawo kitya?
Lowooza ku kibumba kyaffe ng’ekisengejja. Kye kisinga okulongoosa omusaayi mu mubiri. Omusuwa omukulu oguleeta omusaayi mu kibumba guyitibwa Portal Vein. Ekibumba bwe kyonoonese olw’obulwadde bwa cirrhosis, omusaayi oguyita mu musuwa guno guziyizibwa. Nga payipu y’amazzi bw’esibira wakati, omusaayi tegusobola kuyita mu kibumba era puleesa yeeyongera.
Puleesa eno eyeyongera nayo esobola okukosa ensigo okumala ekiseera. Ensigo bwe zitasobola kuggya bulungi munnyo ogwongezeddwa mu mubiri, amazzi gatandika okukuŋŋaanyizibwa mu mubiri. Amazzi ago ag’enjawulo gakulukuta okuva mu misuwa ne gakuŋŋaanyizibwa mu lubuto.
Ensonga endala:
- Kookolo: Kookolo ezimu ezibeera mu lubuto nazo zisobola okuvaako amazzi okukuŋŋaanyizibwa mu lubuto. Obutoffaali bwa kookolo bwennyini bufulumya amazzi mu kisenge ky’olubuto.
- Omutima okulemererwa: Mu mbeera ezimu ez’omutima okulemererwa ennyo, omutima tegusobola kussa musaayi gumala. Olwo omubiri ne gukola obusimu okugezaako okukuuma amazzi. Amazzi gano era gasobola okukuŋŋaanyizibwa mu lubuto.
Ozuula otya embeera eno?
Bw’ogenda ew’omusawo ajja kukukebera n’akubuuza ku bubonero bwo. Oluvannyuma, ayinza okukola ebigezo ebimu okukakasa embeera eyo.
- Paracentesis: Kino kizingiramu omusawo okuyingiza empiso ennungi ennyo mu lubuto n’amira amazzi amatono agakung’aanyiziddwayo okukeberebwa. Amazzi gano gasobola okukeberebwa okulaba oba waliwo yinfekisoni oba obutoffaali bwa kookolo.
- Okukebera omusaayi: Bino bisobola okuyamba okuzuula oba olina obulwadde obulala, gamba nga sukaali, oba olina yinfekisoni.
- Okukebera ebifaananyi: Ekifaananyi kya X-ray, ultrasound scan, oba CT scan kisobola okulaba obulungi embeera y’ebitundu by’omubiri ebiri munda mu lubuto.
- SAAG test: Kino kigezo kya njawulo. Kigeraageranya emiwendo gya puloteyina eyitibwa albumin mu musaayi gwo n’amazzi agali mu lubuto lwo. Albumin kika kya puloteyina ekolebwa ekibumba. Omuwendo guno bwe guba munene, kitegeeza nti puleesa mu misuwa egireeta omusaayi mu kibumba yeeyongera.
Bujjanjabi ki obuweebwa obulwadde bwa ascites?
Obujjanjabi businziira ku kivaako ascites. Wabula ekigendererwa eky’awamu kwe kukendeeza ku mazzi agakuŋŋaanyizibwa mu lubuto.
1. Okukendeeza sodium: Omunnyo gwe gusinga okuvaako amazzi okusigala mu mubiri. Omusawo wo oba omukugu mu by’endya ajja kukubuulirira ku mmere erimu omunnyo omutono.
- Kendeeza ku mmere epakibwa, emmere eguliddwa mu maduuka, ne ssoosi nga bwe kisoboka.
- Lya nnyo enva endiirwa n’ebibala ebibisi.
- Kozesa eby’akaloosa (entungo, entungo, kumini) mu kifo ky’omunnyo okuwooma emmere.
2. Eddagala erifulumya omusulo: Omusawo ajja kukuwa eddagala erikuyamba okugoba amazzi n’omunnyo ebisukkiridde mu mubiri ng’oyita mu musulo. Ebibiri ku bisinga okukozesebwa ye Furosemide (Lasix) ne Spironolactone (Aldactone). Bino birina okutwalibwa nga balabirirwa abasawo bokka.
3. Paracentesis: Kino kikebera era kijjanjaba. Singa mu lubuto mubaamu amazzi mangi, bateekamu empiso okuggyamu amazzi ago okukendeeza ku kuzimba. Kyokka kino kiyinza okuvaako amazzi okuddamu okuzimba.
4. Shunts n’okulongoosa: Singa obujjanjabi obulala bulemererwa okufuga embeera eno, omusawo ayinza okukozesa enkola zino.
- AMAGEZI (Transjugular intrahepatic portosystemic shunt): Kino kizingiramu okuteeka akatundu akatono aka mesh tube (stent) munda mu musuwa mu kibumba okusobola okwanguyiza omusaayi okutambula.
- Okukyusa ekibumba: Singa ekibumba kiba kifuuse kumpi nga tekikola bulungi olw’obulwadde bwa cirrhosis, ekisembayo kwe kukyusa ekibumba ekiramu.
Embeera eno eyinza etya okukuumibwa n’okufugibwa?
Waliwo ebintu ebiwerako by’osobola okukola okuziyiza obulwadde bwa ascites n’okufuga okweyongera kwayo singa embeera eno ebaawo.
- Lekera ddala okunywa omwenge:Omwenge gwe gusinga okwonoona ekibumba.
- Ekkomo ku munnyo: Abasawo bawa amagezi obutanywa munnyo gusukka miligiraamu 2,000-4,000 buli lunaku.
- Kuuma omugejjo omulungi: Omugejjo guyinza okuvaako obulwadde bwa ascites. Bw’oba olina ascites, weepime buli ku makya era owandiike obuzito bwo. Bw’ofuna kkiro ezisukka mu 1 (pawundi 2.2) buli lunaku okumala ennaku ssatu ez’omuddiring’anwa oba singa weeyongera mu bwangu kkiro ezisukka mu 4.5 (pawundi 10), tegeeza omusawo amangu ago.
- Obulamu obulungi: Lya emmere ennungi, dduyiro era weewale okunywa sigala.
- Okwegatta okutali kwa bulabe: Obulwadde bw’akawuka nga Hepatitis B ne C busobola okubaawo. Bino bisobola okwonoona ekibumba ne bivaako obulwadde bwa cirrhosis.
Ddi lw’osaanidde okulaba omusawo?
Bw’oba olina obubonero buno, genda mangu omusawo amagezi:
- Singa weeyongera omugejjo mu bwangu
- Singa olubuto lweyongera obunene
- Bw’oba olina obulumi mu lubuto obupya oba obweyongera
- Bw’oba olina omusujja
Mu mbeera zino wammanga ez’amaanyi, genda mu kitongole ky’eddwaaliro eky’amangu (ETU) mu bwangu:
- Bw’oba olina obuzibu obw’amaanyi mu kussa
- Singa osesema omusaayi oba ekintu ekiringa ebikuta bya kaawa
Ascites mbeera ya maanyi nnyo. Kitegeeza nti ekibumba kyo tekikola bulungi. Kale tobuusa maaso bubonero. Bw’ofuna obujjanjabi obutuufu n’okukyusa mu bulamu bw’omuntu, osobola okufuga embeera eno, okuziyiza ebizibu ebiyinza okuvaamu n’okusigala ng’oli mulamu bulungi.
Obubaka Obutwala Awaka
- Ascites kwe kukuŋŋaanyizibwa kw’amazzi mu lubuto. Kino kitera okuba akabonero k’obulwadde obw’amaanyi obw’ekibumba.
- Bw’oba olina obubonero ng’okuzimba mu ngeri etategeerekeka, okugejja oba okukaluubirirwa okussa, tobuusa maaso. Laba omusawo mu bwangu.
- Ebikulu mu bujjanjabi kwe kuyimiriza omwenge n’okufuga omunnyo mu mmere.
- Kikulu nnyo okukozesa eddagala omusawo lye yakulagidde ddala n’ogoberera ebiragiro.
- Bw’oba osesema omusaayi oba ng’olina obuzibu obw’amaanyi mu kussa, genda mu ddwaaliro mu kitongole ky’abalwadde ab’amangu (ETU) mu bwangu.
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