Ese urugero rwa ogisijeni mu maraso yawe ni rwo? Reka twige ku ikizamini cya ABG (Arterial Blood Gas) mu buryo bworoshye!

Twese tuzi akamaro ka ogisijeni ku mibiri yacu. Guhumeka neza no kugira ogisijeni ikwiye mu maraso ni ingenzi kugira ngo umuntu agire ubuzima bwiza. Rero, rimwe na rimwe abaganga bagomba kumenya neza ingano ya ogisijeni na dioxyde de carbone biri mu maraso yawe. Icyo gihe ni bwo iki kizamini cyitwa ABG (Arterial Blood Gas) gikorwa.

Iki kizamini cya ABG (Arterial Blood Gas) ni iki?

Mu magambo make, ikizamini cya ABG (Arterial Blood Gas) ni ikizamini gikoresha ikizamini cy'amaraso cyakuwe mu mitsi yawe kugira ngo gipime ingano ya ogisijeni na dioxyde de carbone mu maraso yawe. Tekereza nawe, hari ubwoko bubiri bw'imitsi mu mubiri wacu, bumwe ni imitsi, ubundi ni imitsi. Imitsi itwara amaraso meza kandi akungahaye kuri ogisijeni ava mu mutima ajya mu mubiri wose. Rero, kuri iki kizamini cya ABG, hafatwa ikizamini cy'amaraso ava muri iyo mitsi.

Iki kizamini ntigipima gusa ogisijeni na dioxyde de carbone, ahubwo gipima n'ingano ya aside-base , cyangwa pH, mu maraso yawe. Ubusanzwe imibiri yacu igenzura urugero rwa ogisijeni na dioxyde de carbone mu maraso yacu cyane. Iyo urugero rwa ogisijeni mu maraso yacu rugabanutse (ibyo twita 'hypoxemia' mu buvuzi), bishobora guteza ibibazo bikomeye cyane . Bishobora kwangiza ubwonko bwawe n'umutima wawe by'umwihariko.

Ikizamini cya ABG gifasha abaganga gusobanukirwa indwara zijyanye n'ubuhumekero bwawe, inzira z'amaraso , n'imikorere y'ingufu (uburyo uhindura ibiryo urya mo ingufu). Ibi ni ingenzi cyane cyane mu bihe byihutirwa .

Hari ikindi kizamini cyitwa "isesengura ry'ibyuka mu maraso." Muri iki kizamini, icyitegererezo cy'amaraso gishobora gufatwa ahantu hose mu mubiri (imitsi, imitsi, cyangwa imiyoboro y'amaraso). Ariko, mu isuzuma rya ABG, amaraso agomba gufatwa mu mitsi .

Iki kizamini cya ABG gifite andi mazina menshi:

• Ikizamini cy'imyuka mu maraso
• Imyuka yo mu maraso yo mu mitsi
• ABG
• Isesengura ry'imyuka mu maraso

Ni iki mu by'ukuri gipima ikizamini cya ABG?

Ikizamini cya ABG gisanzwe gipima ibi bikurikira:

• Ingano ya ogisijeni (O2CT) : Ibi bipima ingano ya ogisijeni iri mu maraso yawe.
• Hemoglobini : Hemoglobini ni poroteyine iboneka mu turemangingo dutukura tw'amaraso itwara ogisijeni mu mubiri wose. Ibi bipima ingano ya hemoglobin.
• Kuzura kwa ogisijeni (O2Sat) : Ibi bipima ingano ya ogisijeni itwarwa na hemoglobine mu maraso yawe.
• Igice cy'umuvuduko wa ogisijeni (PaO2) : Ibi bipima umuvuduko wa ogisijeni ishongeshejwe mu maraso yawe. Bigaragaza uburyo ogisijeni yinjira mu maraso yawe ivuye mu bihaha byawe.
• Igice cy'umuvuduko wa dioxyde de carbone (PaCO2): Ibi bipima ingano ya dioxyde de carbone mu maraso yawe n'uburyo dioxyde de carbone iri gukurwa mu mubiri wawe.
• pH (`pH`) : Ibi bipima uburinganire hagati ya aside na base mu maraso yawe. Ubusanzwe, pH y'amaraso igomba kuba hagati ya 7.35 na 7.45. Ikintu cyose kiri munsi y'icyo gifatwa nk'aside nyinshi cyane, kandi ikintu cyose kiri hejuru y'icyo gifatwa nk'ikintu cy'ibanze cyane cyangwa alkaline .
• Bikarubonate (`Bikarubonate - HCO3`) : Ibi bibarwa hakoreshejwe pH na PaCO2. Bigena ingano y'ikintu cy'ibanze cyakozwe muri dioxyde de carbone.

Ikizamini cya ABG gikorwa ryari?

Ubusanzwe abaganga bategeka ko hakorwa ikizamini cya ABG mu bihe nk'ibi:

• Ubuvuzi bwihutirwa : Ibi bivuga indwara cyangwa impanuka zisaba ubuvuzi bwihuse.
• Anesthesiology : Urwego rw'ubuvuzi rushinzwe kwita ku barwayi mbere, mu gihe cyo kubagwa, na nyuma yaho.
• Ubuvuzi bw'indwara z'imitsi : Ni ishami rishinzwe kurwanya indwara zijyanye n'ubuhumekero bwawe.

Abaganga bakoresha ikizamini cya ABG kugira ngo bamenye indwara zitandukanye, harimo:

• Indwara yo mu bihaha iterwa n’indwara z’ubuhumekero (ARDS) : Iyi ni indwara y’ibihaha ishobora gushyira ubuzima mu kaga itera umwuka muke cyane mu maraso. Ishobora guterwa n’indwara nka sepsis na COVID-19.
• Sepsis ikomeye : Sepsis ni ikibazo cyihutirwa cy’ubuvuzi giterwa n’uko umubiri wawe ubyitwaramo iyo wanduye.
• Ihungabana ry'amaraso : Iyi ni indwara ishobora gushyira ubuzima mu kaga aho umuvuduko w'amaraso ugabanuka cyane nyuma yo kwandura.
• Guhungabana kw'amaraso mu mubiri : Indwara yihutirwa aho umutima udashobora kuvoma amaraso ahagije mu mubiri bitewe no gutakaza amaraso menshi cyangwa gutakaza andi mazi.
• Ketoacidosis ifitanye isano na diyabete (DKA) : Iyi ni ikibazo gikomeye, gishyira ubuzima mu kaga, cyibasira abantu barwaye diyabete (cyane cyane diyabete yo mu bwoko bwa 1) na diyabete yo mu bwoko bwa 1 itaramenyekana. Itera amaraso kugira aside.
• Aside y'umuyoboro w'impyiko (RTA) : Muri iki kibazo, impyiko zawe ntizikura aside mu maraso yawe neza mu nkari zawe, bigatuma amaraso yawe arushaho kuba aside.
• Kunanirwa guhumeka cyane : Ibi bibaho iyo amazi yirundanyije mu dufuka tw’umwuka mu bihaha byawe, bigatuma ibihaha bigorana kurekura ogisijeni mu maraso.
• Umutima unaniwe cyane: Iyi ni indwara umutima ucika intege mu buryo butunguranye kandi imikorere yawo ikaba mike.
• Guhagarara k'umutima : Iki ni cyo gihe umutima wawe uhagarara gukubita mu buryo butunguranye.
• Igitero cya asima : Ukwiyongera gutunguranye kw'ibimenyetso bya asima guterwa no gufungana kw'imitsi ikikije inzira z'ubuhumekero.
• Amakosa yavukanye mu mikorere y'umubiri : Izi ni indwara zidakunze kubaho, zikomoka ku ngirabuzimafatizo (urubyaro) aho umubiri wawe udashobora guhindura neza ibiryo mo ingufu.

Niba ufite kimwe muri ibi bibazo by'ibihaha, muganga wawe ashobora kandi gukora ikizamini cya ABG kugira ngo arebe niba uburyo uvura bukora neza:

• Asima
• Indwara y'ibihaha idakira (COPD)
• Indwara ya cystic fibrosis
• Indwara z'umutima

Ni nde ukora ikizamini cya ABG?

Umuganga w’indwara zo mu myanya y’ubuhumekero asanzwe afata amaraso kugira ngo apimwe ABG. Afata amaraso mu mitsi iri mu kuboko kwawe, mu kuboko, cyangwa mu kibuno. Hanyuma apima amaraso ubwayo, cyangwa akayohereza vuba cyane muri laboratwari, aho abahanga mu bya laboratwari y’ubuvuzi bapimira icyitegererezo.

Ni iki kibaho mbere yo gupimwa ABG?

Mbere y'uko umuvuzi w'ubuhumekero akura amaraso mu kuboko kwawe, ashobora gukora ikizamini cy'amaraso cyitwa Allen test . Ibi bisaba kuzamura ukuboko kwawe ukoresheje ukuboko kwawe. Umuvuzi azakanda ku mitsi yo mu kuboko kwawe mu masegonda make. Iki kizamini cyoroshye kireba niba imitsi yo mu kuboko kwawe ikora neza kandi ko ifunguye.

Niba uri gufata imiti y’umwuka uhumura neza (oxygen therapy), umuvuzi wawe ashobora kuzimya umwuka wawe mu minota 20 mbere yuko ufata amaraso. Ibi byitwa ikizamini cy’umwuka wo mu cyumba . Ariko, niba udashobora guhumeka udafite umwuka uhumura neza (oxygen supported), ntibazakora iki kizamini.

Ni ubuhe bunararibonye ubona iyo ukora ikizamini cya ABG?

Ibipimo byinshi by'amaraso bipima amaraso mu mitsi yawe. Ariko ku isuzuma rya ABG, umuvuzi w'ubuhumekero afata ikizamini cy'amaraso mu mitsi yawe. Ibi biterwa nuko amaraso yo mu mitsi afite ogisijeni nyinshi kurusha amaraso yo mu mitsi.

Umuganga w’indwara z’ubuhumekero asanzwe afata amaraso mu mitsi yo mu kiganza imbere. Hari igihe ashobora no gufata amaraso mu mitsi yo mu kuboko kwawe (brachial artery) cyangwa mu kibuno (femoral artery).

Iyo umwana uvutse akeneye gupimwa ABG, muganga ashobora gufata amaraso mu gatsinsino k'umwana cyangwa mu nda ye.

Icy'ingenzi: Gufata amaraso mu mitsi bishobora kubabaza gato kuruta gufata amaraso mu mitsi. Ibi biterwa nuko imitsi iba iri imbere mu mubiri kurusha imitsi, kandi ifite imitsi iyikikije. Ushobora kumva umeze nk'uzunguruka, ufite isereri, cyangwa ukagira isesemi iyo ufashwe amaraso.

Izi ni intambwe ugomba gukurikiza mu gihe ufata amaraso kugira ngo upime ABG:

1. Uzaba wicaye ku ntebe cyangwa uryamye ku buriri. Umuganga w’ubuhumekero azasangamo umutsi, akenshi uri imbere mu kuboko kwawe. Bashobora kandi gukoresha scan ya ultrasound ('ultrasound imaging') kugira ngo babone umutsi.

2. Iyo umutsi ubonetse, aho hantu hasukurwa kandi hagashyirwa imiti yica udukoko.

3. Hanyuma bazashyira urushinge ruto mu mitsi yawe hanyuma bafate ikizamini cy'amaraso. Ushobora kumva ububabare bukabije iyo urushinge rwinjiye mu mitsi.

4. Nyuma yo gushyira urushinge, amaraso make akusanywa mu nshinge.

5. Nyuma yo gufata amaraso ahagije yo gupimwa, bazakuraho urushinge maze bashyireho igitutu aho hantu bakoresheje ipamba cyangwa gaze kugira ngo amaraso ahagarike. Niba ufata imiti igabanya amaraso, ushobora gukenera gukomeza umuvuduko mu gihe cy'iminota itanu kugeza ku icumi cyangwa irenga.

6. Bashyira igitambaro ku gice cy'umubiri. Hanyuma akazi karangiye.

Ni iki wakwitega nyuma yo gupimwa ABG?

Ushobora kumva hari ibisebe cyangwa ububabare aho urushinge rwashyizwe. Muganga wawe ashobora kukubwira kudaterura ikintu kiremereye mu masaha 24 nyuma yo gukurwamo amaraso.

Ese hari ingaruka zishobora guterwa no gupima ABG?

Iyo umuganga w’indwara zo mu myanya y’ubuhumekero akoze iki kizamini neza, ikizamini cya ABG kiba gito cyane . Imitsi y’amaraso ya buri wese ifite ingano zitandukanye, kandi iratandukanye uvuye ku ruhande rumwe rw’umubiri ujya ku rundi. Bityo rero bishobora kugorana gato gukura amaraso mu bantu bamwe kurusha abandi.

Ingaruka zijyanye no gupimwa amaraso ya ABG ni nke cyane, ariko ibintu nk'ibi bishobora kubaho:

• Kumva umeze nk'uzunguza cyangwa ufite umutwe ukeye.
• Gufata urushinge inshuro nyinshi kugira ngo ubone umutsi.
• Udukoko tw'amaraso (hematoma - uruhurirane rw'amaraso munsi y'uruhu).
• Kuva amaraso menshi cyane.
• Kwandura (hari ibyago bike igihe cyose uruhu rwangiritse).

Bifata igihe kingana iki kugira ngo ubone ibisubizo by'ikizamini cya ABG?

Ibipimo bya ABG bikunze gutanga ibisubizo byihuse cyane . Abavuzi b'indwara z'ubuhumekero n'abahanga mu bya laboratwari bakoresha ibikoresho byikora bipima imyuka y'amaraso, bishobora gutanga ibisubizo mu minota 10-15.

Ibisubizo by'ikizamini cya ABG bivuga iki?

Raporo z'ibipimo by'amaraso, harimo na raporo z'ibipimo bya ABG, ubusanzwe ziba zikubiyemo amakuru akurikira:

• Izina ry'ikizamini cy'amaraso cyangwa icyapimwe mu maraso yawe.
• Umubare cyangwa igipimo cy'ibyavuye mu isuzuma ry'amaraso yawe.
• Ubwo ni bwo buryo busanzwe bwo gupima ikizamini.
• Amakuru agaragaza niba ibisubizo byawe ari ibisanzwe, bidasanzwe, cyangwa biri hejuru cyangwa hasi.

Niba ibisubizo byawe bya ABG bitameze neza, bishobora gusobanura ibintu nk'ibi:

• Ntabwo ubona ogisijeni ihagije.
• Ntabwo usohora umwuka uhagije wa dioxyde de carbone.
• Amaraso yawe afite ihindagurika rya pH (yaba aside nyinshi cyangwa alkaline nyinshi).

Ikizamini cya ABG gishobora gufasha mu gusuzuma indwara zimwe na zimwe. Niba ibisubizo byawe bitameze neza, muganga wawe ashobora gutegeka ko hakorwa ibindi bipimo (nk'ibindi bipimo by'amaraso cyangwa ibizamini byo gupima) kugira ngo byemezwe cyangwa byemezwe ko nta ndwara ufite.

Ni ibihe bipimo bisanzwe by'ikizamini cya ABG?

Ingano zisanzwe zishobora gutandukana gato bitewe na laboratwari. Iyo ubonye ibisubizo by'ibipimo by'amaraso yawe, bizaba birimo amakuru agaragaza ingano zisanzwe kuri buri gipimo cyavuye muri iyo laboratwari. Niba ufite ikibazo ku bisubizo byawe, menya neza ko wabaza muganga wawe .

Muri rusange, impuzandengo y'agaciro k'inyanja ni iyi ikurikira:

• pH : 7.35-7.45
• Igice cy'umuvuduko wa ogisijeni (`PaO2`) : milimetero 75 kugeza 100 za mercure (mmHg)
• Igice cy'umuvuduko wa dioxyde de carbone (`PaCO2`) : 35 kugeza 45 mmHg
• Bikarubonati (`HCO3`) : mililitiro 22 kugeza kuri 26 kuri litiro (mEq/L)
• Kuzura kwa ogisijeni (`O2Sat` cyangwa `SaO2`) : 95% kugeza 100%

Ku butumburuke bwa metero 900 no hejuru, urugero rwa ogisijeni rusanzwe ruri hasi cyane.

Ni ryari ngomba kubonana na muganga wanjye?

Niba ufite indwara y’ibihaha idakira nka COPD cyangwa asima, ushobora gukenera kujya kwa muganga wawe buri gihe no gupimwa ABG kugira ngo umenye neza ko ubuvuzi bwawe bukora neza. Niba ugaragaje ibimenyetso biguhangayikishije bijyanye n’indwara y’ibihaha, vugana na muganga wawe vuba bishoboka.

Amaherezo, ibintu byo kwibuka

Ikizamini cya ABG ni igikoresho cy'ingirakamaro cyo gusuzuma indwara , cyane cyane mu bihe bimwe na bimwe byihutirwa. Abaganga bakoresha iki kizamini kugira ngo bakurikirane indwara zimwe na zimwe. Niba urimo gupimwa ABG, ibuka ko ari igikorwa gitandukanye gato n'ikizamini gisanzwe cy'amaraso, kandi gishobora kubabaza gato. Niba ufite ikibazo ku bijyanye n'icyo gikorwa cyangwa icyo wakwitega, ntutindiganye kubaza muganga wawe . Barahari kugira ngo bagufashe.

Ikizamini cy'umwuka mu maraso , umwuka mu maraso, ogisijeni, dioxyde de carbone, pH, uburyo bwo guhumeka, ibizamini by'ubuvuzi