Wali owuliddeko ku mbeera nga puleesa mu misuwa emitonotono munda mu mawuggwe yeeyongera mu bwangu? Kiba ng’ekintu ekisibira mu payipu y’amazzi ne yeeyongera puleesa. Ekyo CTEPH ky’eri. Wadde erinnya lino liyinza okuwulikika ng’ewanvu katono, kyangu okutegeera. Embeera eno etali ya bulijjo, naye nsonga nkulu ffenna gye tusaanidde okumanya.
Mu ngeri ennyangu, CTEPH kye ki?
CTEPH ye puleesa mu mawuggwe. Mu by’obusawo, kino tukiyita `(Pulmonary Hypertension)`. Naye kino kyawukana ku puleesa eya bulijjo. Waliwo ensonga entongole lwaki CTEPH ebaawo. Kwe kugamba, ebizimba by’omusaayi ebyabadde bikwatiddwa emabegako mu misuwa gy’amawuggwe `(Pulmonary Embolism)` tebisaanuuka bulungi .
Teebereza omuntu ng’alina omusaayi mu mawuggwe. Mu budde obwabulijjo, enkola z’omubiri gwaffe zennyini zisaanuusa ebizimba bino eby’omusaayi oluvannyuma lw’ekiseera. Naye mu bantu abamu, ebizimba bino omusaayi tebisaanuuka ddala. Mu kifo ky’ekyo, zifuuka ebitundu ebikaddiye ebiringa enkovu ebisula mu misuwa. Ekiseera bwe kigenda kiyitawo, ekitundu kino eky’enkovu kireetera emisuwa okufunda.
Emisuwa bwe gifunda, omutima gulina okukola ennyo okusobola okuyisa omusaayi mu misuwa egyo egyafunda. Kino kireetera puleesa munda mu misuwa mu mawuggwe okulinnya ennyo. Ekyo kye tuyita CTEPH (Chronic Thromboembolic Pulmonary Hypertension) .
Ekikulu obulwadde buno bubeera mu bantu bokka abalina ebyafaayo by’okuzimba amawuggwe. Singa puleesa mu mawuggwe eba waggulu nga tewali byafaayo ng’ebyo, eyinza okuba embeera endala ey’obujjanjabi.
CTEPH ekosa etya omubiri gwo?
Oludda olwa ddyo olw’omutima gwaffe lupampagira omusaayi ogutaliimu mukka gwa oxygen era ogutali mulongoofu mu mawuggwe okusobola okugulongoosa. Kati emisuwa mu mawuggwe bwe gifunda olw’obulwadde bwa CTEPH era puleesa n’eyongera, oludda olwa ddyo olw’omutima lulina okwolekagana n’ekizibu ekinene mu kusika omusaayi guno mu mawuggwe.
Kino kireeta ebizibu bibiri ebikulu:
1. Okutikka omutima ekisukkiridde: Bw’okola ennyo bw’otyo buli kiseera, oludda olwa ddyo olw’omutima lutandika okunafuwa. Kino kiringa ppampu y’amazzi ekola ennyo okujjuza ekifo ekizibiddwa. Ekiseera bwe kigenda kiyitawo, ppampu enafuwa.
2. Okukendeera kw’omukka gwa oxygen mu mubiri: Omusaayi tegusobola kuyita bulungi mu mawuggwe ne gukwata oxygen. Kino kireetera omukka gwa oxygen mu mubiri okukka. Kino kye tulaba ng’obubonero ng’okukoowa n’okussa obubi.
Biki ebiyongera ku bulabe bw’okulwala CTEPH?
Nga bwe kyayogeddwako emabegako, ekisinga okuvaako omusaayi ebizimba mu mawuggwe tebisaanuuka ddala. Kyokka abantu abamu batera okufuna embeera eno. Ka tulabe ensonga zino ez’akabi kye ziri.
| Ensonga y’akabi | Okunnyonnyola |
|---|---|
| Ekika ky’omusaayi | Okubeera n’ekika ky’omusaayi ekitali ‘O’. |
| Endwadde z’omusaayi okuzimba | Singa ggwe kennyini oba omuntu mu maka go alina obuzibu mu kuzimba omusaayi (e.g. Antiphospholipid Syndrome ). |
| Okuggyamu enseke | Okuggyamu enseke (okulongoosa okuggyamu enseke) . |
| Yinfekisoni ezimala ebbanga eddene | Yinfekisoni eziwangaala nga yinfekisoni z’amagumba (osteomyelitis) . |
| Embeera endala ez’obujjanjabi | Ebika bya kookolo ebimu n'endwadde nga Inflammatory Bowel Disease . |
| Ensonga endala | Okubeera omukyala, okubeera n’ekyuma ekikuba omukka mu mutima, n’okumira obujjanjabi bw’obusimu bwa thyroid biyinza okuvaako yinfekisoni. |
Bubonero ki obuyinza okuba nga bulaga obulwadde buno?
Obubonero bwa CTEPH buyinza obutalabika mu kusooka. Zikula mpolampola. Oyinza okulowooza nti buno bukoowu bwa bulijjo. Naye kikulu nnyo okufaayo ku bubonero buno.
| Obubonero | Ebisingawo |
|---|---|
| Okukaluubirirwa okussa | Kibaawo naddala ng’ofuba nnyo, gamba ng’otambula oba ng’olinnya amadaala. Obulwadde bwe bugenda bweyongera, obutabeera bulungi buno buyinza okubaawo ne bw’oba oyimiridde buyimiridde. |
| Obukoowu obuyitiridde n’okukoowa | Okuwulira ng’okooye buli kiseera ne bw’oba tokola mulimu gwonna. |
| Obulumi mu kifuba oba okunyiga | Obulumi buno buyinza okubaawo kubanga omutima gulina okukola ennyo. |
| Okuzimba amagulu n’enkizi (Edema) . | Olw’omutima obutakola bulungi, amazzi gakuŋŋaanyizibwa mu mubiri, ekivaako okuzimba mu magulu. |
| Okuziyira n’okuzirika (Syncope) . | Kino kiyinza okubaawo ng’obwongo tebufunye mukka gwa oxygen gumala. |
| Okukuba kw’omutima | Okuwulira ng’osobola okuwulira okukuba kw’omutima gwo. |
| Okukyusa langi ya bbululu (Cyanosis) . | Emimwa n’engalo bifuuka bbululu olw’omukka gwa oxygen omutono mu musaayi. |
Bw’oba olina obubonero buno naddala ng’olina ebyafaayo by’omusaayi okuziyira mu mawuggwe, nsaba olabe omusawo mu bwangu.
CTEPH ezuulibwa etya?
Bw’olaba omusawo ajja kukubuuza ku bubonero bwo era akukebere. Singa wabaawo okuteebereza kwonna nti olina CTEPH, bajja kukuteesa okukeberebwa okuwerako okukakasa nti olina obulwadde buno.
- V/Q scan: Eno etunuulira engeri omusaayi gye gukulukuta okutuuka mu mawuggwe n’engeri empewo gy’eyitamu. Sikaani eno esobola okuzuula ebitundu ebizimba omusaayi, kubanga omusaayi gukendeera.
- Transthoracic Echocardiogram (TTE): Kino kiyinza okukebera puleesa eri ku ludda olwa ddyo olw’omutima n’engeri omutima gye gunafuye.
- CT Pulmonary Angiogram: Eno CT scan ey’enjawulo esobola okulaba obulungi omusaayi omukadde n’okufunda kw’emisuwa mu mawuggwe.
Ebigezo ebirala okukakasa
Obulwadde bwe bumala okukakasibwa, okukeberebwa okulala okuwerako kuyinza okukolebwa okuzuula obuzibu bwabwo n’okuteekateeka obujjanjabi.
- Right Heart Catheterization: Eno y’engeri esinga obutuufu ey’okupima puleesa y’amawuggwe. Akatundu akatono (catheter) kayingizibwa okuyita mu musuwa gw’omusaayi mu mubiri ne kayingira ku ludda olwa ddyo olw’omutima n’omusuwa omukulu ogugenda mu mawuggwe, era puleesa n’epimibwa.
- Okukebera situleesi mu kukola dduyiro: Okukebera kuno kukolebwa okulaba engeri omutima n’amawuggwe gye bikolamu ng’okola dduyiro.
Bujjanjabi ki obukolebwa ku kino?
Amawulire amalungi ku CTEPH gali nti bulwadde buwonyezebwa. Abalwadde abasinga basobola okuwummuzibwa nga balongooseddwa oba obujjanjabi obulala. Waliwo engeri bbiri enkulu ez’obujjanjabi.
1. Okusala amawuggwe (PTE): .
Kuno kulongoosa mutima nga guggule. Mu nkola eno, abalongoosa baggulawo emisuwa emikulu mu mawuggwe ne basekula omusaayi gwonna omukadde n’enkovu eziyinza okuba nga zazimba munda. Wadde nga kuno kulongoosa kuzibu nnyo, singa kutuuka ku buwanguzi, kulina emikisa mingi okuwonya ddala obulwadde buno.
2. Okulongoosa emisuwa mu bbaatule y’amawuggwe (BPA):
Obujjanjabi buno bukozesebwa ku bantu abalina ebizimba omusaayi mu misuwa emitono ennyo nga tebasobola kulongoosebwa. Mu bujjanjabi buno, akatundu akatono (catheter) kayingizibwa mu musuwa mu kigere ate akapiira akatono ku nkomerero ne kakozesebwa okufuuwa n’okugaziya omusuwa ogufunda. Kino si kinene ng’okulongoosa.
Bumu ku bujjanjabi buno kumpi busobola okuwonya ddala CTEPH. Oluvannyuma lw’okujjanjabibwa, abantu abasinga basobola okubeera mu bulamu obwa bulijjo.
Oluusi, eri abo abatasobola kulongoosebwa oba abakyalina puleesa ey’amaanyi mu mawuggwe gaabwe oluvannyuma lw’okulongoosebwa, eddagala ery’enjawulo (e.g., Riociguat) liweebwa okufuga puleesa eyo.
Ebintu by’olina okumanya ng’obeera ne CTEPH
Obulamu bwo bujja kutereera nnyo ng’omaze okujjanjabwa, naye waliwo ebintu ebitonotono by’olina okumanya.
- Eddagala eriweweeza ku musaayi obulamu bwo bwonna: Ojja kwetaaga okumira eddagala eriweweeza ku musaayi obulamu bwo bwonna okutangira omusaayi okwongera okuzimba. Kikulu okugoberera ddala ebiragiro by’omusawo wo.
- Endya: Bwoba omira eddagala nga `Warfarin`, olina okwegendereza emmere erimu ekirungo kya Vitamiini K (nga kkabichi, sipinaki, broccoli). Yogerako n’omusawo wo ku nsonga eno.
- Weewale okunywa sigala: Okunywa sigala kya bulabe nnyo eri amawuggwe go. Bw’oba onywa ssigala, kikulu nnyo okumulekera ddala.
- Dduyiro omutono: Dduyiro omutono, gamba ng’okutambula, asobola okukuyamba okwongera amaanyi go. Wabula kakasa nti weebuuzizza ku musawo wo nga tonnatandika nteekateeka yonna ya dduyiro. Oyinza okusindikibwa mu nteekateeka y'okuddaabiriza etunuulirwa abasawo eyitibwa ``Okuddaabiriza amawuggwe.''
- Obulamu bw’obwongo: Okubeera n’obulwadde obw’ekiseera ekiwanvu nga buno kiyinza okukuleetera okuwulira ng’olina situleesi, okweraliikirira oba okwennyamira. Bw’oba owulira bw’otyo, tokwatibwa nsonyi kwogera na musawo wo oba omuntu akuli ku lusegere.
Obubaka Obutwala Awaka
- CTEPH mbeera ya puleesa ereetebwa omusaayi omukadde okusibira mu misuwa gy’amawuggwe.
- Kino tokitabula na puleesa eya bulijjo.
- Bw’oba olina obubonero ng’okussa obubi, okukoowa ennyo, oba okuzimba mu magulu naddala ng’olina ebyafaayo by’omusaayi okuziyira, laba omusawo mu bwangu.
- Obulwadde buno emirundi mingi busobola okuwona ddala nga bulongooseddwa oba mu ngeri endala.
- Ne bw’omala okujjanjabwa, goberera ddala ebiragiro by’omusawo naddala ku by’okumira eddagala erigonza omusaayi.
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