Wali weebuuzizzaako kiki ekituuka ku mutima gwaffe nga tukola dduyiro, nga tudduka, oba nga tulinnya amadaala? Mu kiseera ekyo, omutima gwetaaga omukka gwa oxygen mungi okusinga bwe gwandibadde. Okusobola okutuukiriza obwetaavu buno obweyongedde obw’omukka gwa oxygen, omuwendo gw’omusaayi ogukulukuta mu misuwa gy’omusaayi egigabira omutima gwennyini nagwo gwetaaga okweyongera. Kale, obusobozi bw’omutima gwo okwongera ku kutambula kw’omusaayi ng’obwetaavu bweyongedde buyitibwa buyitibwa Coronary Flow Reserve (CFR). Kino kiringa ‘amaanyi agaterekeddwa’ ag’omutima gwo.
Ekifo ekitereka amazzi g’omusaayi (CFR) kye ki?
Mu ngeri ennyangu, Coronary Flow Reserve (CFR) kipimo omusaayi bwe guyinza okweyongera okuyita mu misuwa gy’omutima gwo mu kiseera ky’okukola ennyo. Kino kiyinza okuwa omusawo wo amawulire ag’omuwendo agakwata ku bulamu bw’omutima gwo naddala embeera y’emisuwa egigaba omusaayi mu mutima gwo (coronary arteries).
Lowooza ku nsonga eno bw’otyo. Bw’oba otudde mu ntebe, omutima gwo gwetaaga omusaayi ogugere. Naye bw’odduka omulundi gumu ng’ogoberera bbaasi, omulimu gw’omutima gwo gweyongera nnyo. Olwo omutima gwo gwetaaga omukka gwa oxygen ogw’emirundi esatu oba ena okusinga ogwa bulijjo. Emisuwa gy’omusaayi gy’omutima omulamu gisobola okugumira obwetaavu buno obweyongedde, ne yongera okutambula kw’omusaayi mu bwangu. Okukebera kwa CFR kupima obusobozi bw’omutima gwo okukola kino.
Okukebera kuno kuyamba okuzuula amangu oba olina obulwadde bw’emisuwa oba oli mu bulabe bw’okufuna embeera ng’okulwala omutima mu biseera eby’omu maaso.
Omuwendo gwa CFR gubalirirwa gutya?
Engeri kino gye kibalirirwamu nnyangu nnyo. Omusawo wo apima omusaayi ogugenda ku mutima gwo mu ngeri bbiri.
1. Okutambula kw’omusaayi ng’owummudde: Kino kipima obungi bw’omusaayi ogukulukuta ku mutima ng’owummudde, nga tofubye .
2. Omusaayi ogusinga obunene: Omutima guwalirizibwa okukuba omusaayi ku maanyi agasinga obungi (eddagala liweebwa ku kino), era omuwendo gw’omusaayi ogusinga obunene ogukulukuta mu kiseera ekyo ne gupimibwa.
Olwo, omusaayi guno ogusinga obunene gugabanyizibwamu omusaayi oguwummudde.
CFR = (Omusaayi ogusinga obunene) / (Omusaayi oguwummudde) .
Okugeza, singa omusaayi gwo ogusinga obunene gukubisaamu emirundi esatu omusaayi gwo ogw’okuwummula, omuwendo gwo ogwa CFR gwandibadde 3.
Omuwendo gwa CFR ogwa wakati kye ki?
CFR y’omuntu omulamu obulungi erina okuba wakati wa 2.0 ne 2.5 . Kino kitegeeza nti omutima gulina okusobola okukuba omusaayi waakiri emirundi ebiri okusinga bwe gusobola nga guwummudde. Mu muntu asinga okuba omulamu obulungi, omuwendo guno guyinza okuba 3, 4 oba n’okusingawo.
- Singa omuwendo gwa CFR guba wansi wa 2.0:Kino kitegeeza nti wayinza okubaawo obuzibu ku misuwa mu mutima. Mpozzi emisuwa gifunda (gizibikira). Abantu nga bano bali mu bulabe bwa maanyi okukwatibwa endwadde z’omutima mu biseera eby’omu maaso.
- Singa omuwendo gwa CFR gusukka 2.0: Kiraga nti enkola y’emisuwa mu mutima eri ku mutindo mulungi.
Naye ekintu kimu eky’okujjukira nti omuwendo guno ogwa CFR mu butonde gukendeera katono n’emyaka. N’olwekyo, omuwendo ogwa bulijjo eri omuvubuka guyinza okuba ogw’enjawulo ku muwendo ogwa bulijjo eri omuntu omukadde. Omusawo wo yekka y’asobola okutaputa obulungi ebivudde mu kunoonyereza kwo.
Okola otya okukebera kwa CFR?
Waliwo enkola bbiri enkulu ez’okukola okukebera kuno: emu nkola ya kuyingirira, erimu okuyingiza ekyuma mu mubiri, ate endala nkola ya bweru, erimu okukikola mu ngeri etayingirira.
| Enkola y’okugezesa | Ennyinyonnyola ennyangu |
|---|---|
| Invasive - Okuteekebwamu Catheter mu mutima | Mu kino, ttanka ennyimpi ennyo (catheter) eyisibwa mu musuwa mu mukono gwo, ekigere oba mu bulago okutuuka mu misuwa gy’omutima gwo. Olwo waya ey’enjawulo eyisibwamu okupima sipiidi omusaayi gye gutambula. Kino kiyinza okukolebwa mu kiseera kye kimu n’okukebera angiogram. |
| Enkola etali ya kuyingirira - PET Scan | Eno sikaani ya njawulo. Mu kukebera kuno, oweebwa ekirungo ekitono ennyo (radiotracer) okuyita mu IV. Oluvannyuma, sikaani ya PET epima entambula y’omusaayi ng’etunuulira engeri ekintu ekyo gye kitambulamu mu mutima. |
| Enkola endala - Cardiac MRI | Eno nakyo sikaani ya bweru, naye enkola eno tetera kukozesebwa kupima CFR. |
Olina okwetegeka otya nga tonnakeberebwa?
Omusawo wo ajja kukunnyonnyola kino. Okutwalira awamu ebintu bino olina okwegendereza.
- Ebikwata ku ddagala: Buulira omusawo wo ku ddagala lyonna ly’omira (ery’omusawo n’ery’okugula). Eddagala erimu liyinza okukosa okuzimba omusaayi era oyinza okusabibwa okulekera awo okulimira ng’ebula olunaku lumu okukeberebwa.
- Alergy: Kakasa nti otubuulira bw’oba olina alergy yonna ku ddagala lyonna oba langi ya contrast.
- Okusiiba: Bw’oba ogenda okukeberebwa omutima oba PET scan, ojja kuweebwa amagezi okwewala okulya oba okunywa okumala essaawa 6-8 nga tonnakeberebwa.
- Ku MRI: Tosobola kwambala kintu kyonna kya kyuma (amajolobero, essaawa) ku mubiri gwo. Bw’oba olina ekyuma nga pacemaker munda mu mubiri gwo, buuza omusawo wo nga bukyali oba tekirina bulabe ku MRI.
Kiki ky’osuubira mu kiseera ky’okugezesebwa?
Ka kibeere nti olina enkola y’okukebera, IV tube (cannula) ejja kuteekebwa mu mukono gwo. Emitendera gy’okugezesebwa gijja kufaanana bwe giti.
1. Okupima embeera y’okuwummula: Okusooka, omusaayi ogutambula mu mutima gwo gupimibwa ng’oli mukkakkamu era ng’owummudde.
2. Okuwa eddagala: Ekiddako, eddagala (vasodilator) erigaziya emisuwa mu mutima gwo n’okutambuza omusaayi mu ngeri esinga liweebwa nga liyita mu IV. Eddagala erisinga okukozesebwa ye Adenosine . Kino bwe kiweebwa, okutambula kw’omusaayi okutuuka ku mutima kweyongera emirundi 4-5 mu ddakiika 2-3.
3. Okupima entikko: Omusaayi bwe gutuuka ku ntikko oluvannyuma lw’okuweebwa eddagala, omusaayi guddamu okupimibwa.
4. Okugeraageranya: N’ekisembayo, ebipimo bino ebibiri bigeraageranyizibwa okubala omuwendo gwo ogwa CFR.
Bw’oba olina ekituli mu mutima, oyinza okuweebwa eddagala eriweweeza ku bulwadde okukuyamba okwebaka obulungi. Kino kijja kukuyamba obutawulira bulungi. Bw’oba olina sikaani, kikulu nnyo okusigala ng’osirise okufuna ebifaananyi ebitegeerekeka obulungi.
Kiki ekibaawo oluvannyuma lw’okukeberebwa?
Oluvannyuma lw’okukeberebwa, osobola okubeera mu bulamu obwa bulijjo, naye olina okwegendereza ebintu ebimu.
- Bw’oba obadde ofunye ekituli ky’omutima, ojja kwetaaga okukuuma omukono oba ekigere we baateeka ekituli nga kiyimiridde okumala essaawa nga emu okuziyiza omusaayi okuvaamu.
- Omusawo ajja kukuwa amagezi okunywa amazzi amangi okuyamba langi ya contrast okuva mu mubiri gwo amangu.
- Bw’oba bakuwadde eddagala eriweweeza ku bulwadde, tosobola kuvuga ku lunaku olwo. Kikulu nnyo omuntu okukuwerekera awaka.
Waliwo akabi oba ebizibu ebiyinza okuva mu kukebera kuno?
Okutwalira awamu okukebera CFR kukeberebwa kwa bukuumi nnyo, naye nga bwe kiri ku kukeberebwa kwonna okw’obujjanjabi, waliwo akabi akatono ennyo.
- Obulabe obuva ku catheter:Mu kiseera ky’okuyingiza omutima, omusaayi okuzimba, okwonooneka kw’emisuwa oba okuvaamu omusaayi tebitera nnyo kubaawo.
- Ebizibu ebiva mu adenosine: Abantu abamu bayinza okufuna bino wammanga okumala sekondi ntono oluvannyuma lw’okuweebwa eddagala lino:
- Enkuba y’omutima etali ya bulijjo
- Okukendeera kwa puleesa
- Okukaluubirirwa okussa
- Obutabeera bulungi mu kifuba
Obubonero buno bubula ddala amangu ddala ng’eddagala liweddewo (mu ddakiika emu) . Tewali kyeraliikiriza.
Ekikulu: Adenosine tasaanira bantu abalina asima kubanga asobola okuvaako okusannyalala kw’ennyindo . Bw’oba olina asima, omusawo ajja kukozesa eddagala eddala mu kifo ky’ekyo.
Ebivuddemu bitegeeza ki era tunaamanya ddi?
CFR yo nnamba ekubuulira omusaayi omutima gwo gwe gusobola okukuba nga guli ku situleesi.
Kiyinza okutwala ennaku ntono omusawo okwekenneenya ebyava mu kukeberebwa n’okuwa lipoota. Oluusi, singa ebivaamu biba bya nsalo, bayinza okwebuuzibwako abakugu abalala.
Singa ebyavaamu biraga nti olina obulabe bw’okulwala omutima, omusawo ajja kukuwa enteekateeka y’obujjanjabi okukendeeza ku bulabe obwo.
Obubaka Obutwala Awaka
- Coronary Flow Reserve (CFR) kipimo kya ‘reserve power’ omutima gwo gwe gulina okwongera okutambula kw’omusaayi mu biseera by’okunyigirizibwa.
- Okukebera kuno kuyinza okuwa amawulire amakulu agakwata ku bulamu bw’emisuwa gy’omusaayi. Era kiyinza okuyamba okuzuula obulabe bw’endwadde z’omutima mu biseera eby’omu maaso nga bukyali.
- Okutwalira awamu, omuwendo gwa CFR ogusukkulumye ku 2.0 ngeri ya bulamu.
- Kakasa nti otegeeza omusawo wo ku ddagala lyonna ly’omira ne alergy yonna gy’oyinza okuba nayo nga tonnakeberebwa.
- Kino kigezo kya bulabe nnyo. Bw’oba olina ekibuuzo kyonna ku kukeberebwa, tolwawo kubuuza musawo wo .
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