Teebereza kiki ekyandibaddewo singa omusaayi guzibikira mu bwangu omusuwa omunene ogugenda mu mutima gwo, ku bwongo, oba mu mawuggwe? Kino kyandisalako omusaayi okutambula mu bitundu ebyo ne kivaako okwonooneka. Eno embeera eyinza okutta omuntu. Mu mbeera ey’amangu bwetyo abasawo mwe bakozesa obujjanjabi obw’enjawulo okutaasa obulamu. Leero, twogera ku bujjanjabi obusaanuusa n’okuggyawo ebizimba ebyo eby’omusaayi, obuyitibwa ‘Thrombolytic Therapy.’
Mu ngeri ennyangu, Thrombolytic Therapy kye ki?
Wadde erinnya lino lizibu katono, endowooza yaayo nnyangu nnyo. Mu ngeri ennyangu, kino kizingiramu okukozesa ekika ky’eddagala eky’enjawulo okusaanuusa n’okuggyawo ebizimba by’omusaayi eby’obulabe ebikoleddwa mu misuwa egy’omunda mu mibiri gyaffe. Kiba ng’okusaanuusa n’okuggyawo ekizibiti mu payipu y’amazzi ng’okozesa eddagala.
Ekigendererwa ekikulu eky’obujjanjabi buno kwe kuzzaawo omusaayi ogubadde guzibiddwa ekizimba. Kino olwo kiyinza okukendeeza ku kwonooneka kw’ebitundu by’omubiri (nga omutima n’obwongo) ebiweebwa omusuwa ogwo. Buno bujjanjabi obuweebwa mu mbeera ez’amangu. Obujjanjabi buno buyinza okutaasa obulamu naddala mu mbeera ng’okulwala omutima (`(Myocardial Infarction)`), okusannyalala okuva ku kuzibikira mu misuwa mu bwongo (`(Ischemic Stroke)`), oba okuzimba omusaayi mu mawuggwe (`(Pulmonary Embolism)`).
Ekisinga obukulu kwe kutandika obujjanjabi buno amangu ddala nga bwe kisoboka. Obujjanjabi gye bukoma okutandika amangu ng’obubonero butandise, ebivaamu gye bikoma okuba ebirungi.
Ani eyeetaaga obujjanjabi buno? Era ani atasaanidde kugifuna?
Buno si bujjanjabi obuyinza okuweebwa buli muntu. Abasawo balowooza ku bintu bingi nga tebannawa muntu bujjanjabi buno. Kubanga kirina akabi akamu. Ka tulabe ddi obujjanjabi buno lwe busaanidde ne ddi lwe butasaana.
| Embeera obujjanjabi mwe buyinza okwetaagisa | Emisango ng’obujjanjabi tebulina kuweebwa (olw’obulabe obw’amaanyi) . |
|---|---|
| Singa omusuwa omunene (omusuwa oba omusuwa) guzibikira mu bwangu olw’omusaayi oguzimba. | Singa wabaawo edda omusaayi ogukola mu mubiri. |
| Mu mbeera nga deep vein thrombosis (DVT) ne pulmonary embolism (PE), ekitasobola kufugibwa na ddagala lya bulijjo erikendeeza omusaayi (anticoagulants). | Bw’oba waakavaamu omusaayi mu bwongo (Intracranial Hemorrhage). |
| Mu ssaawa ezisooka oluvannyuma lw’okulwala omutima oba okusannyalala. | Bw’oba waakalongoosebwa obwongo oba omugongo. |
| Singa wabaawo embeera ey’amangu olw’okuzibikira emisuwa mu bitundu by’omubiri (Peripheral Arterial Disease - PAD). | Bw’oba olina puleesa etafugibwa (hypertension). |
| Singa ekituli ekiyingiziddwa mu mubiri kizibikira omusaayi oguzimba. | Bw’oba olina obulwadde bw’ekibumba obw’amaanyi. |
| Bw’oba waakafuna obuvune obw’amaanyi ku mutwe. |
Okugatta ku ekyo, abasawo beeraliikirivu nnyo ku bulabe bw’ebizibu ebiyinza okuvaamu nga bawa bamaama ab’embuto n’abakadde obujjanjabi buno.
Bika ki ebikulu eby’obujjanjabi buno?
Waliwo engeri eziwerako ez’okugaba eddagala lino eriziyiza omusaayi. Omusawo ajja kulonda enkola esinga okutuukirawo okusinziira ku mbeera y’omulwadde n’ekifo omusaayi we gukutte.
1. Okusengejja omusaayi mu nkola (systemic Thrombolysis).
Eno y’enkola esinga okukozesebwa. Wano, ttanka ya IV eyingizibwa mu musuwa mu mukono, ng’akatonnyeze k’omunnyo, eddagala ne liweebwa nga liyita mu gwo. Eddagala lino litambula mu nkola yonna ey’okutambula kw’omusaayi, gye lisaanuusa omusaayi oguzimba. Enkola eno etera okukozesebwa mu mbeera ez’amangu ng’okulwala omutima, okusannyalala, n’okuzimba omusaayi mu mawuggwe.
2. Obulwadde bwa Thrombolysis obulung’amibwa catheter
Enkola eno ya njawulo katono. Wano, ttanka ennyimpi ennyo, empanvu (kino kiyitibwa catheter) eyingizibwa mu mubiri ng’eyita mu musuwa mu kisambi, mu bulago oba mu mukono. Olwo, nga bakozesa enkola nga X-ray, ensonga y’ekituli kino elungamizibwa ekifo ekituufu omusaayi we gukutte. Oluvannyuma, mu kifo ky’okuwa eddagala mu mubiri gwonna, lifuyira butereevu mu kizimba ky’omusaayi nga liyita mu kawundo. Kino kisobozesa eddagala okuweebwa mu ngeri esinga okubeera ey’amaanyi, butereevu eri omuntu gw’ayagala. Enkola eno esinga kukozesebwa ku mbeera nga DVT ne PAD. Kino kitera okukolebwa nga bukyali.
3. Okusala Thrombectomy mu ngeri ey’ebyuma
Mu mbeera eno, ng’oggyeeko okugaba eddagala, ekizimba ky’omusaayi kimenyekamenyeka ne kiggyibwamu mu ngeri ey’ebyuma. Ekyuma eky’enjawulo (ekyuma ekikankana, ekikyukakyuka oba ekisonseka ekizimba) ku nkomerero y’ekituli kikozesebwa okumenya omusaayi ne guguggyamu ebitundutundu. Oluusi enkola eno ekozesebwa wamu n’enkola eragiddwa catheter.
Kiki ekibaawo nga bajjanjabwa n’oluvannyuma lw’okujjanjabwa?
Engeri obujjanjabi buno gye bukolebwamu ejja kwawukana okusinziira ku kika ky’ofuna.
Mu mbeera ey’amangu
Bw’oba olina embeera ey’amangu, gamba ng’okulwala omutima oba okusannyalala, abasawo bajja kugezaako okutandika obujjanjabi amangu ddala nga bamaze okuweebwa ekitanda mu kitongole ky’eddwaaliro ekijjanjaba abalwadde ab’amangu (ETU). Okusobola okuvaamu ebirungi, kikulu okutandika obujjanjabi mu ssaawa bbiri ng’obubonero butandise, oba mu ddakiika 30 ng’otuuse mu ddwaaliro.
Engeri obujjanjabi gye bukolebwamu
Ka tulabe ekibaawo mu nkola zino ebbiri enkulu.
| Enkola y’okusengejja omusaayi (systemic thrombolysis) (okuyita mu IV) . | Okusengejja omusaayi (thrombolysis) okulung’amibwa catheter (nga kuyita mu catheter) . |
|---|---|
| Kino kitera okukolebwa mu kifo awajjanjabirwa abalwadde abayi (ICU). | Kino nakyo kintu ekikolebwa mu yuniti ey’enjawulo munda mu ddwaaliro. |
| Bajja kukuwa eddagala eriweweeza ku bulwadde buno okukukkakkanya. Zijja kuziba ekitundu IV w’eyingizibwa. | Ojja kuweebwa eddagala eriweweeza ku bulwadde okukukkakkanya. Ekitundu ekigenda okuteekebwamu ekituli (groin, arm) kijja kuba kizibye. |
| IV tube eyingizibwa mu musuwa mu mukono eddagala ne liyita mu gwo mu mubiri. | Basalako akatundu akatono, ne bateekebwamu ekituli mu musuwa, era ekizimba omusaayi ne kitwalibwa mu kifo ekizimba we kiri. |
| Eddagala lino litambula mu mubiri gwonna n’omusaayi ne lituuka mu kifo we bazimba omusaayi. | Eddagala lino lifukibwa butereevu mu kizimba ky’omusaayi. Oluusi ekizimba kimenyeka n’ekyuma ekikanika. |
| Enkola eno etera okutwala essaawa nga emu. | Kiyinza okutwala essaawa 48 (ennaku bbiri) omusaayi okusaanuuka ddala. Mu kiseera ekyo, ojja kulondoolwa mu ddwaaliro. |
Mu kiseera ky’obujjanjabi, ttiimu y’abasawo ejja kwongera okulondoola ebintu ng’omutima gwo, enkola y’amawuggwe, ne puleesa.
Oluvannyuma lw’okujjanjabwa
Omusawo agenda kukola ebigezo ebiwerako okulaba oba omusaayi gusaanuuse ddala.
- Okukebera emisuwa
- Okukebera CT
- Okukebera omutima (echocardiogram).
Oluvannyuma lw’okujjanjabibwa, ojja kwetaaga okubeera mu kifo awajjanjabirwa abalwadde abayi (ICU) okumala olunaku nga lumu. Oluvannyuma lw’ekyo, ojja kwetaaga okubeera mu ddwaaliro okumala ennaku endala emu oba ssatu ng’otunuuliddwa. Ne bw’omala okudda eka, ojja kwetaaga okugenda mu maaso n’okumira eddagala erigonza omusaayi okuziyiza okuzimba omusaayi okuddamu okukola.
Migaso ki n’akabi akali mu bujjanjabi buno?
Okufaananako n’obujjanjabi bwonna, buno bulina emigaso n’akabi.
Ebirungi ebikulu:
- Obusobozi bw’okutaasa obulamu: Eno y’enkizo esinga obunene. Obujjanjabi buno busobola okuyamba okutangira okufa mu mbeera ng’okulwala omutima n’okusannyalala.
- Okuziyiza obulemu obw’olubeerera: Nga tukendeeza ku kwonooneka kw’obwongo, kisoboka okutangira obuzibu mu kwogera n’okufiirwa ebitundu by’omubiri oluvannyuma lw’okusannyalala.
- Okuziyiza okutemebwako: Singa omusuwa omunene mu mukono oba okugulu guzibikira, ekitundu ekyo eky’omubiri kisobola okufa nga tekikulukuta musaayi. Obujjanjabi buno bukendeeza ku bulabe obwo.
Obulabe obukulu:
Obulabe obusinga obunene era obw’amaanyi obuli mu bujjanjabi buno kwe kusobola okuvaamu omusaayi munda.
- Okuvaamu omusaayi mu bwongo: Kino kye kizibu ekisinga okuba eky’obulabe. Abantu nga 1% abafuna obujjanjabi buno bayinza okulwala stroke olw’okuvaamu omusaayi mu bwongo.
- Okuvaamu omusaayi omulala: Oyinza okuva mu nnyindo, n’omusulo oba omusulo. Oyinza okuba ng’olina ebiwundu oba okuvaamu omusaayi we baateeka IV oba catheter.
- Obulabe obulala:
- Obulwadde bwa alergy
- Okwonooneka kw’ekibumba (naddala mu bantu abalina ssukaali) .
- Puleesa eya wansi (`(Hypotension)`) .
- Omusaayi gukutuka ne gugenda mu kifo ekirala ne gusibira.
- Obuzibu bw’okukuba kw’omutima (`(Ventricular arrhythmia)`)
Olw’akabi kano, abasawo balowooza ku bintu bingi nga tebannawa muntu bujjanjabi buno.
Ddi lwe nnina okulaba omusawo nga mmaze okujjanjabibwa?
Bw’omala okudda eka, kikulu okukuuma eriiso ku bubonero obumu. Bw’olaba obubonero bwonna ku buno wammanga, olina okutegeeza omusawo mu bwangu.
| Obubonero bw’olina okwegendereza | Okunnyonnyola |
|---|---|
| Obulumi mu kifuba | Obulumi mu kifuba obw’amangu oba obweyongera. |
| Enkyukakyuka mu kuteeka IV/catheter | Singa ekitundu kigenda mu maaso n’okuvaamu omusaayi oba okukulukuta, ne kimyufu, ne kiwulira ebbugumu, oba nga kyeyongedde okuzimba/obulumi. |
| Omusujja | Bw’ofuna omusujja awatali nsonga. |
| Okulumwa omutwe oba okuziyira | Bw’oba olina omutwe ogweyongera, okulumwa ennyo oba okuziyira. |
| Okuzirika mu bitundu by’omubiri | Bw’owulira ng’onyiganyiga oba ng’ozirika mu ngalo oba mu magulu. |
Obubonero buno buyinza okulaga nti waliwo ekizibu, n’olwekyo tobubuusa maaso.
Obubaka Obutwala Awaka
- Obujjanjabi bwa thrombolytic bujjanjabi bukulu nnyo obuyinza okutaasa obulamu nga busaanuusa ebizimba mu musaayi mu mbeera ez’amangu ng’okulwala omutima n’okusannyalala.
- Ebiseera bye bikulu mu buwanguzi bw’obujjanjabi buno. Okugenda mu ddwaaliro amangu ddala ng’obubonero bulabika kiyinza okulongoosa ennyo ebivaamu.
- Olw’okuba akabi akasinga okuva mu kino kwe kuvaamu omusaayi, abasawo bajja kusalawo okukuwa obujjanjabi buno nga bamaze okwekenneenya embeera yo n’obwegendereza.
- Oluvannyuma lw’okujjanjabwa, kikulu nnyo okugoberera ddala ebiragiro by’omusawo naddala ng’omira eddagala erigonza omusaayi, okuziyiza omusaayi okuzimba mu biseera eby’omu maaso.
- Bw’odda eka ng’omaze obujjanjabi, tegeeza mangu omusawo wo ku bubonero bwonna obutali bwa bulijjo bw’olaba.
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