By’olina okumanya ku bulwadde bwa Hepatopulmonary Syndrome!

Bw’oba ​​ggwe oba omuntu gw’omanyi alina obulwadde bw’ekibumba, oba ggwe kennyini bw’oba ​​olina embeera eno, kikulu okumanya embeera eno oluusi eyinza okukuleetera okukaluubirirwa okussa. Tukiyita obulwadde bwa Hepatopulmonary Syndrome. Erinnya lino liyinza okuwulikika nga lizibu katono, naye ka tulikuume nga lyangu, nedda? Kubanga kizibu ekiva mu kibumba okutuuka mu mawuggwe.

Ddala Hepatopulmonary Syndrome kye ki?

Mu ngeri ennyangu, obulwadde bw’ekibumba (hepatopulmonary syndrome) buzibu obutatera kubaawo naye nga bwa maanyi obuva ku bulwadde bw’ekibumba obuyinza okukosa amawuggwe. Ekigambo "hepato" kitegeeza "ekikwata ku kibumba." "amawuggwe" kitegeeza "ekikwata ku mawuggwe." Obadde okimanyi nti ekibumba n’amawuggwe gaffe biyungibwa emisuwa?

Kati teebereza, omuntu bw’aba n’obulwadde bw’ekibumba naddala embeera ng’obulwadde bwa cirrhosis, ekibumba gye kikaluba ne kikendeera, emisuwa egimu egyekuusa ku mawuggwe gigaziwa nga tekyetaagisa. Nga bbaatule bw’efuuwa. Mu busawo, kino tukiyita ``Vasodilation`` . Emisuwa bwe gigaziwa mu ngeri eno, engeri omusaayi gye gutambulamu mu mawuggwe eya bulijjo ekyuka. Oluusi, omusaayi tegutabula bulungi na mukka gwa oxygen mu mawuggwe, wabula guyita butereevu mu go. Omusaayi ogwo ogutatambula bulungi guyitibwa ``Shunts`` . Okugaziwa kw'emisuwa mu mawuggwe kiva ku ``Vasodilation``, era oxygen level mu musaayi ekendeera olw'ebyo ``Shunts``. Kino tukiyita ``Hypoxemia`` . Otegedde?

Embeera eno ekukwatako etya? Ofuna obuzibu mu kussa?

Kati oyinza okuba ng'olowooza nti, "Okay, kino kinkwata kitya?" Ekisinga okukosa kino kwe kukaluubirirwa okussa (Dyspnea) . Kino tekijja mangu, wabula kyeyongera mpolampola. Abantu abamu bayinza obutakitegeera nnyo mu kusooka. Naye ekiseera bwe kigenda kiyitawo, embeera eno eyinza okukaluba ennyo ne kiba nti kizibu okussa ne bw’oba ​​oyimiridde.

Abantu abamu kibazibuwalira okussa nga batudde oba nga bayimiridde, naye nga bagalamidde bawulira bulungi. Ku balala, kiri mu ngeri endala; bafuna obuzibu mu kussa nga bagalamidde, era bawulira bulungi nga batudde waggulu. Wabula olw’okuba okussa kuno okutono kweyongera okumala ekiseera, tukiyita Chronic Respiratory Failure. Kino kitegeeza nti buli kimu tekikoma mangu, naye mpolampola ebitundu by’omubiri gwo n’ebitundu by’omubiri gwo tebifuna mukka gwa oxygen gumala. Kino tukiyita hypoxia .

Eno embeera ya bulabe nnyo. Omanyi kiki? Oxygen yeetaagibwa nnyo mu mibiri gyaffe. Bwe bubula ddala, busobola okwonooneka enkalakkalira ku bitundu ebikulu ng’obwongo n’omutima. Singa tebajjanjabwa bulungi, embeera eno eyinza okutta omuntu.

Ani asinga okulwala obulwadde bw’ekibumba n’amawuggwe?

Okunoonyereza kuzudde nti abantu nga kimu kyakuna oba 25%, abalina obulwadde bw’ekibumba obutawona bafuna obulwadde bw’ekibumba n’amawuggwe. Era kiyinza okubaawo mu mbeera z’okulemererwa kw’ekibumba okw’amangu, okw’amaanyi, okuyitibwa okulemererwa kw’ekibumba okw’amaanyi, naye nga tekitera kubaawo.

Ebiseera ebisinga kino kye kibaawo: Obulwadde bw’ekibumba obuyitibwa Cirrhosis buleeta puleesa okweyongera mu misuwa egyegatta ku kibumba. Mu busawo, tugiyita ``Portal Hypertension'' . Embeera eyo eya ``Portal Hypertension'' y'ereetera emisuwa mu mawuggwe okugaziwa mu bantu abamu, ekivaako obulwadde buno obw'ekibumba. Naye, si bulijjo nnyo, ``Portal Hypertension'' esobola okubaawo olw'ensonga endala, gamba ng'okuzimba omusaayi, era obulwadde buno nabwo busobola okubaawo nga buyita mu ekyo.

Ensonga entuufu lwaki kino kikoleddwa?

Mu butuufu, bannassaayansi n’okutuusa kati tebamanyi bulungi lwaki embeera eno eyitibwa portal hypertension ereetera emisuwa mu mawuggwe okugaziwa (vasodilation) mu bantu abamu. Waliwo endowooza n’endowooza nnyingi ku nsonga eyo. Era tekitegeerekeka bulungi lwaki tekituuka ku buli muntu, wabula ku bantu abamu bokka. Kirabika tekikwatagana butereevu na buzibu bw’obulwadde bw’ekibumba.

Naye ekintu kimu kyeyoleka bulungi. Okugaziwa kw’emisuwa mu mawuggwe kireetera oxygen okukendeera mu musaayi (Hypoxemia). Mu ngeri ennyangu, waliwo obutakwatagana wakati w’empewo eyingira mu mawuggwe n’omusaayi oguyita mu mawuggwe. Eno y’ensonga lwaki omubiri tegufuna mukka gwa oxygen gwe gwetaaga.

Obubonero bwe buliwa? Kino tukitegeera tutya?

Singa embeera ya Hepatopulmonary Syndrome si ya maanyi nnyo, oyinza obutalaba bubonero bwonna. Akabonero akasooka abantu bangi ke bawulira, nga bwe kyayogeddwako emabegako , obuzibu mu kussa (Dyspnea) . Kyokka waliwo ensonga nnyingi eziviirako okussa okukaluba. Omuntu alina obulwadde bw’ekibumba asobola okufuna obuzibu mu kussa mu ngeri ez’enjawulo. N’olwekyo, oluusi abalwadde n’abasawo bayinza obutamanya mangu kino ng’akabonero k’obulwadde bwa Hepatopulmonary Syndrome.

Embeera eno bw’egenda yeeyongera okwonooneka, oyinza n’okufuna obubonero obulala nga:

• Platypnoea: Kino w’ofuna obuzibu mu kussa ng’otudde oba ng’oyimiridde, naye ng’owulira obuweerero ng’ogalamidde.
• Orthopnea: Kino kiri bwe kityo. Kizibu okussa ng’ogalamidde, naye kisingako ng’otudde.
• Cyanosis: Okukyusa langi y’emimwa, enjala, n’oluusi olususu olw’obutaba na mukka gwa oxygen mu mubiri. Kano kabonero akalabika.
• Engalo eziriko ebikonde:Ensonga z’engalo oba engalo zirabika nga zizimba era nga zibuguma, ng’ensonga z’omuggo gw’engooma. Kano kabonero kalala akalaga nti obulwadde bwa hypoxemia.

Ng’oggyeeko obubonero buno, oyinza n’okuba n’obubonero obutera okulabika ku bulwadde bw’ekibumba ne/oba puleesa ey’omu mulyango. Okugeza nga:

• Spider angiomas: Emisuwa emitono, emmyufu, eringa enkonge era nga girabika wansi w’olususu.
• Varicose veins: Emisuwa egyagazi girabika mu lubuto oba mu nnywanto.
• Ebyafaayo by'okuvaamu omusaayi mu lubuto emabegako .
• Ascites (okuzimba olubuto) .

Abasawo kino bakizuula batya?

Abasawo bategeera obulwadde buno obw’ekibumba n’amawuggwe ng’obubonero busatu obukulu bulabika wamu:

1. Portal Hypertension: Kino kitera okubaawo n’obulwadde bw’ekibumba.

2. Okugaziwa kw’emisuwa mu mawuggwe: Kino kitegeeza nti emisuwa egiri munda mu mawuggwe gigaziwa.

3. Okukendeera kw’omukka gwa oxygen mu musaayi (Hypoxemia) .

Ebiseera ebisinga, bw’ofuna obulwadde buno obwa `(Hepatopulmonary Syndrome)`, abasawo bo bamaze okukizuula nti olina obulwadde bw’ekibumba `(Obulwadde bw’ekibumba)` oba `(Portal Hypertension).` Bwe kitaba ekyo, abasawo bo bajja kusooka kukola sikaani ez’enjawulo n’okukebera omusaayi okulaba oba waliwo ekibumba ekyonoonese. Olwo bajja kutunuulira emisuwa mu mawuggwe go ne bapima omukka gwa oxygen mu musaayi gwo. Ebigezo bino bisobola okulaga bulungi nti emisuwa mu mawuggwe go gigaziwa `(Vasodilation)`, ekivaako omukka gwa oxygen omutono mu musaayi gwo `(Hypoxemia).`

Bikebe ki eby’enjawulo ebikolebwa ku kino?

Abasawo bakola ebigezo ebiwerako okukakasa embeera eno. Ebimu ku byo bye bino:

• Pulse oximetry: Oboolyawo kino okikozeeko emabegako. Kye kigezo kyangu nnyo, ekitaliimu bulumi. Akasimu akatono akalinga aka clip kakwatibwa ku nsonga y’olugalo lwo. Kitangaaza ekitangaala nga kiyita mu ngalo yo ne kipima obungi bw’ekitangaala ekifuluma oludda olulala, nga kino kikozesebwa okupima omukka gwa oxygen mu musaayi gwo (Oxygen Saturation). Kino kigezo kya musingi.
• Omukka gw’omusaayi ogw’emisuwa (ABG): Singa ekyuma ekipima omukka (pulse oximetry) kiraga nti omukka gwa oxygen mu musaayi gwo mutono, ekiddako ky’ogenda okukola kwe kukebera ABG. Kino kisingako katono. Omusaayi omutono guggyibwa mu musuwa oguli mu mukono gwo . Sampuli y’omusaayi ekeberebwa okuzuula obungi bwa oxygen asaanuuse mu musaayi gwo (PaO2). Kino kipimo ku ngeri amawuggwe go gye gayingizaamu omukka gwa oxygen mu musaayi gwo.
• Okukebera omutima mu ngeri ey’enjawulo:Eno y’enkola esinga obulungi ey’okukuba ebifaananyi okuzuula emisuwa gy’amawuggwe egyagaziye. Echocardiogram ye nkola ya ultrasound. Ekozesa amaloboozi aga frequency enkulu okukuba ebifaananyi by’omutima gwo n’emisuwa mu mawuggwe go. Mu ultrasound eyamba enjawulo, ekirungo ekiraga enjawulo, amazzi ag’enjawulo, kifukibwa mu musuwa okusobola okulabika obulungi emisuwa. Bw’oba ​​olina ‘contrast echocardiogram’, omukugu akukuba empiso y’omunnyo ogutabuddwatabuddwa mu musuwa gwo. Kino kizimbulukusa ekikolebwa nga oteeka obuwundo obutono obw’empewo mu mazzi ag’omunnyo. Olwo ne batunuulira okulaba oba obuwujjo buno obutono buva ku ludda olwa ddyo olw’omutima gwo okudda ku ludda olwa kkono okumala ekiseera (right to left cardiac shunt). Kino kiyinza okubategeeza oba olina `(Hepatopulmonary Syndrome)` oba nedda.

Kino kikwatibwa kitya?

Obujjanjabi bwokka obuliwo kati eri obulwadde bw'ekibumba n'amawuggwe ye oxygen ey'okugatta . Obujjanjabi bwa oxygen buzingiramu okussa oxygen 100% okuyamba omubiri gwo. Oyinza okwetaaga okufuna omukka gwa oxygen okuva mu kisenge ekirimu puleesa mu ddwaaliro, ekiyitibwa hyperbaric oxygen therapy. Oba, oyinza okuweebwa ekyuma ky’osobola okutwala awaka, gamba nga masiki ya oxygen. Oxygen asobola okuyamba okukendeeza ku bubonero naddala okussa obubi n’okukuuma ebitundu by’omubiri gwo nga bikola bulungi ng’abiwa omukka gwa oxygen gwe byetaaga.

Obulwadde bw’ekibumba n’amawuggwe buddamu? Kisobola okuwona ddala?

Obujjanjabi bwokka obuwonya obulwadde buno obw'ekibumba n'amawuggwe kwe kusimbuliza ekibumba . Yee, wampulidde bulungi. Oluvannyuma lw’okusimbuliza ekibumba obulungi, okugaziwa kw’emisuwa mu mawuggwe (okugaziwa kw’emisuwa) n’obutaba na mukka gwa oxygen mu musaayi (hypoxemia) bigenda bidda emabega. Ekyo kitegeeza nti kitereera. Kitwala emyezi nga mukaaga ku kkumi n’ebiri enkola y’amawuggwe go okudda mu mbeera eya bulijjo.

Kyokka si buli muntu nti alina ebisaanyizo by’okusimbuliza ekibumba. Waliwo ensonga ez’enjawulo eziviiriddeko kino. Ne bwe baba bayitamu, waliwo ebiseera lwe balina okulinda ebbanga eddene ekibumba kifune. Kale okudda engulu kuno kulinga emisinde n’ebiseera.

Kino kitta abantu? Ate ekiseera ky’okuwonawo?

Bw’oba ​​olina obulwadde bwa Hepatopulmonary Syndrome, osanga olina dda obulwadde bw’ekibumba obutawona. Obulwadde bw’ekibumba obw’omutendera ogw’enkomerero mbeera eyinza okutta omuntu nga tokyusiddwa kibumba. Obulwadde bw’ekibumba (Hepatopulmonary Syndrome) kye kimu ku bizibu n’ebizibu ebivaamu. Abantu bangi tebafa bulwadde bwa Hepatopulmonary Syndrome, nga buno bwe butabeera na mukka gwa oxygen (hypoxemia), naye era buyamba ku bulamu bwabwe okutwalira awamu era bukendeeza ku bulamu bwabwe.

Ebbanga ly’osobola okuwangaala n’obulwadde bwa Hepatopulmonary Syndrome kisinziira ku bintu bingi. Kuno kw’ogatta engeri obulwadde bw’ekibumba gy’obuzibu, obulamu bwo okutwalira awamu, n’okumanya oba olina embeera endala ez’obujjanjabi. Ku kigero, omuntu alina obulwadde bwa cirrhosis of the liver naye nga talina Hepatopulmonary Syndrome asobola okuwangaala emyaka nga musanvu nga takyusiddwa kibumba. Wabula ku muntu alina obulwadde bwa cirrhosis ne Hepatopulmonary Syndrome, obulamu bwe obwa wakati nga takyusiddwa kibumba busobola okukendeezebwa okutuuka ku myaka nga ebiri.

Abantu abamu bayinza okuba n’obulwadde bw’ekibumba obutono (mild hepatopulmonary syndrome), obutaba bwa maanyi ng’obulwadde bw’ekibumba. Bayinza okusobola okuwangaala nga bakozesa obujjanjabi obuyamba. Ate era abantu abamu bayinza obutawona kusimbibwa kibumba singa obulwadde bwabwe buba bwa maanyi. Omuwendo gw’abantu abalina obulwadde bw’ekibumba (hepatopulmonary syndrome) abawangaala emyaka etaano nga balongooseddwa bulungi guli ebitundu nga 70%. Kino kiri wansi katono okusinga omuwendo gw’obulamu okutwalira awamu oluvannyuma lw’okusimbuliza ekibumba (75%).

Obulwadde bw’ekibumba bukwata buli muntu mu ngeri ya njawulo. Hepatopulmonary Syndrome mbeera etali ya bulijjo era eyinza okutta omuntu eyinza okubaawo. Oyinza okuba nga tokiwulirako okutuusa nga kikutuukako oba ku muntu akuli ku lusegere.

Abantu bangi tebalina bubonero butono oba tebalina. Naye eri abamu naddala abo abaafuna edda obulamu obubi, kino kiyinza okuwulira ng’ekisu “ekisembayo.” Okufaananako n’obulwadde bw’ekibumba, obulwadde bw’ekibumba (HPS) bweyongera okusajjuka oluvannyuma lw’ekiseera. Bw’oba ​​oli dda ku lukalala lw’abalindiridde okusimbibwa ekibumba, ojja kutwalibwa waggulu ku lukalala ng’ozuuliddwa nti olina HPS. Kino kiri bwe kityo kubanga abasawo bakimanyi nti embeera eno esobola okukendeeza ku bulamu bwo n’okukendeeza ku mutindo gw’obulamu bwo – era bakimanyi nti okukyusa ekibumba kisobola okukiwonya. Mu kiseera kino, okugenda mu maaso n’obujjanjabi bwa oxygen kiyinza okukuyamba okufuna obuweerero n’okukuyamba okuwangaala.

N’ekisembayo, ebintu ebimu ebikulu by’olina okujjukira

Kale, nsuubira nti ofunye okutegeera okuva mu bye twogeddeko ku Hepatopulmonary Syndrome. Ensonga zino zikuume mu birowoozo:

• Kino kizibu ekitatera kubaawo naye nga kiyinza okuvaako obulwadde bw'ekibumba obw'amaanyi .
• Akabonero akakulu kwe kukaluubirirwa okussa (dyspnea) , naddala mu muntu alina obulwadde bw’ekibumba.
• Singa omuntu alina obulwadde bw’ekibumba afuna obuzibu mu kussa, embeera eno (Hepatopulmonary Syndrome) nayo erina okuteeberezebwa era omusawo alina okugibuulira.
• Okusimbuliza ekibumba bwe bujjanjabi bwokka obuwonya mu kiseera kino.
• Okutuusa ng’obujjanjabi obwo buweddewo, obujjanjabi bwa oxygen busobola okuyamba okufuga obubonero n’okukuuma obulamu.
• Bw’oba ​​ggwe oba omuntu gw’omanyi alina obubonero buno, kikulu nnyo okugenda ew’omusawo mu bwangu okufuna amagezi. Kubanga, singa amanyibwa nga bukyali, kyangu okuddukanya n’okuteekateeka okwongera obujjanjabi. Tosattira naye kirungi n’omanya.

` Hepatopulmonary syndrome, obulwadde bw’ekibumba, obulwadde bw’amawuggwe, okukaluubirirwa okussa, obutaba na mukka gwa oxygen, cirrhosis, okusimbuliza ekibumba