Ese ibihaha byawe bifite ikibazo cyo guhumeka? Reka twige kuri iyi ndwara iteje akaga ya ARDS (Acute Respiratory Distress Syndrome)!

Ese wigeze ubona bigoye cyane guhumeka, ukumva igituza cyawe cyarafunze? Cyangwa wibuka igihe umuntu uzi yarwaye cyane, adashobora guhumeka neza maze yinjira mu cyumba cy’indembe (ICU) cy’ibitaro? Birashoboka ko icyabiteye ari indwara yitwa ARDS (Acute Respiratory Distress Syndrome) . Ibi ni ibintu bikomeye gato, ariko iyo ubibwiwe neza, biroroha gusobanukirwa ibintu byinshi. Reka tubiganireho birambuye, si byo se?

ARDS ni iki? Reka tubisobanukirwe mu buryo bworoshye.

Mu magambo make, ARDS ni indwara ikomeye igira ingaruka ku bihaha byacu. Tekereza kuri ubu buryo: Ibihaha byacu bifite udusaho duto tw’umwuka (twitwa alveoli). Tumeze nk’inzabibu nto ku muzabibu. Iyo duhumeka, utu dusaho tw’umwuka bifata ogisijeni mu mwuka tukayirekura mu maraso. Ariko iyo ARDS ibayeho, utu dusaho tw’umwuka twuzura amazi. Biba bimeze nk’umupira w’amazi. Hanyuma ibihaha ntibishobora kuzuza umwuka neza, kandi ingano ya ogisijeni ijya mu maraso igabanuka cyane. Ibi tubyita hypoxia. Abaganga bakunze gushyira ARDS mu byiciro byoroheje, biri hagati, cyangwa bikomeye . Bigaragazwa no kugereranya urwego rwa ogisijeni mu maraso n’ingano ya ogisijeni igomba gutangwa kuri urwo rwego. ARDS ishobora kandi gutuma izindi ngingo z’ingenzi nk’ubwonko bwacu, umutima, impyiko, n’amara zitabona ogisijeni bakeneye. Kubwibyo, ARDS ni indwara iteje akaga ishobora no gushyira ubuzima mu kaga. ARDS ikunze kubaho iyo umuntu arimo kuvurwa mu bitaro kubera ubundi bwandu, indwara, cyangwa impanuka. Ariko, niba ugaragaje ibi bimenyetso mu rugo, ni ngombwa kwihutira gushaka ubuvuzi.

Ese hari ibyiciro bitatu bya ARDS?

Abaganga rimwe na rimwe bagabanya ARDS mu byiciro bitatu: Exudative, Proliferative, na Fibrotic. Ibi ahanini bivuga ku rugero rwo kubyimba no kwibumbira kw'amazi mu bihaha, hanyuma uburyo ibihaha bitangira gukira. Si buri wese ugera ku cyiciro cya 3. Iki cyiciro gikubiyemo inkovu mu bihaha (`(Lung fibrosis)`) no gukenera guhumeka umwuka mu buryo buhoraho.

ARDS ikunze kugaragara gute?

Iyi ni indwara ikomeye. Yibasira abantu bagera ku 200.000 buri mwaka muri Leta Zunze Ubumwe za Amerika gusa. Ku isi yose, yibasira abantu bagera kuri miliyoni 3 buri mwaka. ARDS niyo itwara hafi 10% by'abantu bose binjira mu cyumba cyita ku barwayi barembye cyane (ICU). Niyo itwara kandi hafi 25% by'abantu bose binjira mu bitaro kugira ngo bahumeke hakoreshejwe imashini.

Ni ibihe bimenyetso bya ARDS? Ubimenya ute?

Ibimenyetso bya ARDS bishobora gutandukana bitewe n'icyabiteye, ubukana bw'iyi ndwara, ndetse n'indwara iyo ari yo yose y'ibihaha cyangwa umutima ufite. Ibimenyetso by'ingenzi ni ibi bikurikira:

• Guhumeka bigoranye cyane:Bisa nkaho udashobora guhumeka, nk'aho uri guhumeka.
• Guhumeka vuba kandi bigoye: Guhumeka n'imbaraga nyinshi, nk'aho uhumeka umwuka ufunze.
• Igipimo cy'umutima kiriyongera.
• Guhinduka kw'ibara ry'ubururu ku nzara n'iminwa: Ibi biterwa n'urugero ruto rw'umwuka wa ogisijeni mu maraso.

Tekereza, Bwana Nalin yagize umuriro mwinshi n'inkorora mu gihe cy'iminsi ibiri. Ako kanya, yagize ikibazo cyo guhumeka, igituza cye kiramufunga. Umugore we yabonye ko inzara ze zahindutse ubururu. Ubwo bihutiraga kugana kwa muganga, abaganga bavuze ko bishobora kuba ari indwara ya ARDS .

ARDS ishobora kugaragara mu masaha make cyangwa iminsi mike nyuma y’uko ikibazo gitangiye, kandi ishobora no kwiyongera vuba cyane.

Ni izihe mpamvu zitera ARDS?

Hari impamvu nyinshi zishobora gutera ARDS. Reka turebe izikuru:

• Sepsis : Impamvu nyamukuru itera ARDS ni indwara yitwa sepsis. Iyi ndwara ishobora kubaho iyo indwara ikomeye mu bihaha byawe ( nk'umusonga ) cyangwa indwara mu rundi rugingo ikwirakwira mu mubiri wawe, bigatera kubyimba gukabije.
• Umusonga wo mu gifu : Iyo ibiri mu gifu (ibiryo, amazi) bigiye mu bihaha, bishobora kwangiza ibihaha cyane ndetse no kwangiza ARDS. Ibi bibaho iyo ikintu turya cyangwa tunywa kigiye mu nzira z'ubuhumekero. Ibi bishobora cyane cyane kuba ku muntu utazi icyo atekereza cyangwa ugeze mu za bukuru.
• Guterwa amaraso: Hari ibyago byo kurwara ARDS iyo uhawe amaraso arenga 15 mu gihe gito.
• Covid-19 `( COVID-19 )`: Virusi ya Covid-19 ishobora gutera ARDS zikomeye.
• Pancreatite : Kubyimba gukabije kwa pancreas.
• Impanuka zikomeye cyangwa ubushye: Impanuka no kugwa bishobora kwangiza ibihaha mu buryo butaziguye, cyangwa bishobora kwangiza izindi ngingo z'umubiri bigatuma ibihaha bibyimba cyane.
• Guhumeka: Guhumeka umwuka w’ibinyabutabire cyangwa umwotsi mwinshi cyane.
• Kunywa ibiyobyabwenge birenze urugero : Gufata ibiyobyabwenge byinshi, nka kokayine cyangwa opiyopiya.
• Kurohama cyangwa hafi yo kurohama: Iyo urohama, amazi yinjira mu bihaha byawe akabyangiza.

Ni nde uri mu kaga gakomeye ko kurwara ARDS?

ARDS ikunze kugaragara ku bantu basanzwe bari mu bitaro kubera impanuka cyangwa indwara. Ariko, ntibivuze ko uzayirwara gusa kuko uri mu bitaro. Hari ibintu byinshi byongera ibyago byo kwandura:

• Kuba afite imyaka irenga 65.
• Kunywa itabi (kunywa itabi).
• Gukoresha ibiyobyabwenge.
• Kuba ufite indwara y'ibihaha yari isanzweho.

Ni izihe ngorane zishobora guterwa na ARDS?

ARDS ishobora gutera ingorane zitandukanye, haba mu bitaro ndetse no mu gihe wamaze gutaha. Zimwe muri zo ni izi:

• Kuziba kw'amaraso cyangwa kugabanya imitsi yo mu mitsi (DVT).
• Pneumothorax: Ibi bishobora guterwa n'umuvuduko w'umwuka ukoreshwa n'icyuma gihumeka ku bihaha byangiritse kandi bikomeye.
• Kudatekereza: Guhungabanywa n'ubwenge.
• Kunanirwa kw'ingingo nyinshi .
• Intege nke z'imitsi.
• Inkovu zo mu bihaha cyangwa fibrosis.
• Indwara yo guhangayika nyuma yo guhungabana (PTSD)
• Ingorane z'ubuzima bwo mu mutwe nko guhangayika no kwiheba .

Ni gute wasuzuma indwara ya ARDS? (Isuzuma)

Abaganga bapima ARDS hashingiwe ku isuzuma ry’umubiri n’ibisubizo by’ibizamini byinshi. Kubera ko ibimenyetso bya ARDS bisa n’iby’indwara zidakira z’ibihaha cyangwa iz’umutima, muganga agomba kandi gukuraho izindi mpamvu. Umuganga ashobora gutegeka ko habaho ibizamini bitandukanye, nka:

• X-ray yo mu gituza: Kureba ingano y'amazi ari mu bihaha.
• Isuzuma ry'amaraso: Ripima urugero rwa ogisijeni mu maraso kandi rigapima ubukana bwa ARDS.
• Echocardiogram (ikizamini cy'umutima cya ultrasound): Reba uko umutima ukora.
• Electrocardiogram (EKG): Ipima imikorere y'amashanyarazi y'umutima.
• Sensor y'urutoki `(Pulse oximetry)`: Gukurikirana buri gihe urugero rwa ogisijeni.
• Gupima CT (Computed Tomography - CT scan): Shaka amakuru arambuye ku bihaha.
• Gufata icyitegererezo cy'ibisigazwa by'amaraso mu nzira y'ubuhumekero: Shaka icyateye ubwandu.

Ni ubuhe buryo bwo kuvura ARDS?

Intego nyamukuru yo kuvura ARDS ni ukongera urugero rwa ogisijeni mu maraso no gukumira kunanirwa kw'ingingo. Abantu barwaye ARDS bashobora gukenera icyuma gihumeka cyangwa ogisijeni kugira ngo bongere urugero rwa ogisijeni mu maraso. Bashobora kandi gukenera ubufasha bwo gufungura inzira z'ubuhumekero zafunzwe n'ibyangiritse. Muganga wawe ashobora gufata ingamba zo kugabanya ingorane za ARDS, nko:

• Gutanga ibinini byo gusinzira (gutuza) kugira ngo bifashe mu kugabanya ububabare no gutuza.
• Aho kuguhindura imiterere, ishyire mu mwanya wawe. Ibi byongera umuvuduko wa ogisijeni.
• Kora ibizamini byo guhumeka kandi umenye igihe gikwiye cyo gukuramo umuyoboro n'umwuka uhumeka.
• Gutanga imiti igabanya amaraso kugira ngo hirindwe kubyimba kw'amaraso.
• Gutanga imiti igabanya ubukana bw'amaraso kugira ngo ikure amazi arenze urugero mu mubiri.
• Gutanga imiti igabanya amazi yiyongera mu bihaha.
• Antibiyotike zitangwa kugira ngo zikumire indwara cyangwa zivure indwara zisanzwe.
• Gutanga uburyo bwo gukora imyitozo ngororamubiri no kuvura imitsi kugira ngo wirinde intege nke z'imitsi.
• Kohereza gahunda zo kuvura ibihaha kugira ngo bikomeze ibihaha kandi byongere ubushobozi bw'ibihaha.

Bifata igihe kingana iki kugira ngo umuntu akire indwara ya ARDS? Igipimo cyo gukira ni ikihe?

Biterwa n'uburemere bw'indwara n'igihe bifata kugira ngo ibihaha by'umuntu bikire. Ubushakashatsi bwinshi bwerekana ko akenshi bifata amezi atandatu kugeza ku mwaka kugira ngo imikorere isanzwe y'ibihaha igaruke nyuma ya ARDS. Ariko, hari abantu batigera bakira neza. Igipimo cyo kubaho kwa ARDS kiri hagati ya 55% na 70% , iyo kivuwe vuba. Igipimo cyo kubaho kiragabanuka iyo ubuvuzi butinze cyangwa izindi ngingo zitangiye kunanirwa. Isuzuma ry'uko indwara yawe ihagaze riterwa n'ibintu nk'uburwayi bwawe, amateka y'ubuzima bwawe, n'uburemere bw'ingorane zo guhumeka. Muganga wawe azabiganiraho nawe.

Ese ARDS ishobora kwirindwa?

Nta buryo bwihariye bwo kwirinda indwara ya ARDS. Ariko, niba ufite ibimenyetso byo guhumeka nabi, cyangwa niba ufite ikibazo cy'ibihaha cyangwa indi ndwara, gushaka abaganga byihuse bishobora gufasha gukumira ko iyi ndwara irushaho gukomera. Kwirinda kunywa itabi no kugabanya inzoga bishobora kugabanya ibyago byo kurwara indwara ya ARDS ikomeye.

Ubuzima bumeze bute nyuma ya ARDS? Ni iki twagombye kumenya?

ARDS ishobora gushyira ubuzima mu kaga kandi ikagira ubwoba. Ariko hamwe n’uburyo bwiza bwo kuvura no gutanga ubufasha mu guhumeka (cyane cyane kuvura abarwayi basinziriye kugira ngo bongere ubushobozi bwo gutanga umwuka mwiza), abantu benshi ubu barimo kurokoka, kandi ibibazo bya ARDS birimo kugabanuka. Abantu bari munsi y’imyaka 65 n’abarwaye ARDS nyuma y’impanuka cyangwa guterwa amaraso muri rusange bafite icyerekezo cyiza. Gukira muri ARDS bishobora gufata igihe kirekire. Abantu benshi bakuwe mu cyuma gihumeka babasha guhumeka neza. Bamwe bakira burundu, ariko abandi bashobora kugira ibibazo by’ibihaha bidakira. Bakeneye kwitabwaho n’inzobere mu bihaha (inzobere mu by’imitsi).

"Mama yarwaye indwara ya ARDS kandi yamaze amezi menshi mu bitaro. Ndetse na nyuma yo gutaha, yari ananiwe cyane. Nta n'imirimo mito yashoboraga gukora. Ariko nyuma yo gukurikiza amabwiriza y'abaganga no gukora physiotherapy, agenda arushaho koroherwa. Muri iki gihe, inkunga n'urukundo by'umuryango we ni ingenzi cyane."

Ubuzima nyuma ya ARDS bushobora kugorana. Gira kwihangana kandi usabe inkunga umuryango n'inshuti mu gihe ukize. Ushobora kandi gukenera ubufasha mu mirimo ya buri munsi kugeza igihe ibihaha byawe bizakira. Vugana na muganga wawe ku byerekeye amatsinda y'abaterankunga cyangwa izindi nzego zishobora kugufasha kongera kugira imbaraga.

Ni iyihe sano iri hagati ya COVID-19 na ARDS?

Ibi si ibintu bimwe. Umuntu urwaye COVID-19 ashobora kurwara ARDS iyo virusi igeze mu bihaha. Abashakashatsi bavuga ko igipimo cyo kurokoka ku muntu urwaye COVID-19 na ARDS kiri hagati ya 50% na 60%. Ariko ibi biterwa n'ibintu byinshi, nk'amateka y'ubuzima n'izindi ndwara. Kumara igihe mu cyumba cyita ku barwayi barembye (ICU) bishobora kuba ibintu bibabaza kandi bigoye. Abantu bakize ARDS bashobora kutabasha gusubira mu buzima bwabo busanzwe vuba, bityo rero ukeneye ubufasha. Ni ngombwa gushaka ubufasha bw'inzobere n'inama mu gihe cyo gukira kwa ARDS. Baza itsinda ry'abaganga bawe gahunda zo gukira nyuma yo gukira kwa muganga barembye n'amatsinda y'ubufasha kuri interineti mu gace utuyemo.

Icy'ingenzi: Ibintu byo kwibuka (Ubutumwa bwo kujyana mu rugo)

Sawa, dore ibintu bike ugomba kwibuka mu byo twavuze:

• ARDS ni indwara ikomeye itera kwangirika kw'ibihaha. Udupfunyika tw'umwuka mu bihaha twuzuyemo amazi, bigatuma umwuka wa ogisijeni ushobora kugera mu maraso ugabanuka.
• Niba ugize ibimenyetso nko guhumeka nabi cyane, guhumeka vuba, cyangwa inzara z'ubururu/iminwa, shaka ubufasha bwa muganga byihutirwa.
• ARDS ishobora gutera impamvu nyinshi. Sepsis, pneumonia, COVID-19, n'impanuka zikomeye ni bike muri byo.
• Ubuvuzi bukubiyemo ahanini ogisijeni, ubufasha mu guhumeka, no gucunga ingorane .
• Bifata igihe kugira ngo umuntu akire, kandi bamwe bashobora kugira ibibazo by'ibihaha by'igihe kirekire.
• Kuvurwa vuba no kuvurwa neza ni ingenzi cyane kugira ngo ubuzima burokorwe kandi bigabanye ingorane.
• Inkunga ituruka mu muryango no muri sosiyete ni ingenzi ku muntu ukize indwara ya ARDS.

Wibuke ko ari ngombwa kumenya iyi ndwara. Niba wowe cyangwa undi muntu uzi agize kimwe muri ibi bimenyetso, ntugatinye cyangwa ngo ugire ubwoba, ahubwo jya kwa muganga ako kanya. Muri ubwo buryo, ushobora gutangira kuvurwa vuba bishoboka.