Gucika kw'imitsi y'amaraso mu bwonko - Ese uzi iyi ndwara iteje akaga?

Umutima wawe ni wo muyoboro w’amaraso ukomeye utuma umubiri wawe wose uhumeka. Rero umuyoboro w’amaraso munini uva mu mutima ukajyana amaraso meza kandi akungahaye kuri ogisijeni mu mubiri wawe wose witwa aorta. Tekereza nk'umuyoboro w'amazi munini utanga amazi mu nzu yawe. Gucika kw'imitsi ni igihe urukuta rw'uyu muyoboro w'amaraso rucikamo imbere. Iki ni ikibazo gikomeye cyane, gishobora gushyira ubuzima mu kaga, gikunze kubaho mu buryo butunguranye, nta nteguza ibanje.

Gucika kw'imitsi y'amaraso mu bwonko (Aortic Dissection) ni iki? Reka tubisobanukirwe mu buryo bworoshye.

Aorta yacu ni umuyoboro w'amaraso ugizwe n'ibice bitatu. Umeze nk'urukuta rufite ibice bitatu. Iyo ku mpamvu runaka, habaye gucika kw'urukuta rw'imbere, amaraso atemba munsi y'umuvuduko mwinshi yinjira mu gucika maze agatangira kuva hagati y'ibice bibiri by'urukuta. Uko amaraso yuzura muri ubu buryo, ibice byombi biratandukana. Ibyo ni byo twita gucikamo ibice.

Tekereza nk'umuhanda urimo guturikamo kabiri. Iyo ibi bibaye, inzira isanzwe y'amaraso ijya mu bice bitandukanye by'umubiri irahungabana. Kandi rimwe na rimwe, uyu mutsi munini w'amaraso ushobora guturika burundu (gucikagurika).

Ni ubuhe bwoko bw'ingenzi bwo gucika kw'imitsi y'amaraso (aortic dissection)?

Abaganga bagabanya iyi ndwara mo ubwoko bubiri bw'ingenzi, bwitwa Stanford classification, bushingiye ku hantu habera gucika kw'amaraso.

Ni ibihe bimenyetso by'ibi? Wabimenya ute?

Ikintu nyamukuru kiranga gucika kw'imitsi y'amaraso ni uko bibaho mu buryo butunguranye . Nta bimenyetso by'umuburo bihari. Bishobora kubaho igihe icyo ari cyo cyose, nko mu gihe usinziriye, uruhuka, cyangwa ukora akazi gakomeye.

Ibi ni ibimenyetso bishobora kugaragara muri rusange:

• Ububabare butunguranye, budashobora kwihanganira, bukabije mu gituza cyangwa mu mugongo wo hejuru. Abantu benshi babivuga nk'ibyiyumvo byo "gucika" cyangwa "gukomeretswa" . Iki ni cyo kimenyetso nyamukuru kandi gikunze kugaragara.
• Kubabara mu gifu cyane.
• Kugorwa no guhumeka (Dyspnea).
• Kuzungera cyangwa kubabara mu mutwe.
• Kugabanuka gutunguranye k'umuvuduko w'amaraso (umuvuduko muke w'amaraso).
• Gutera kw'umutima mu buryo bugoye kandi bwihuse.
• Kubira ibyuya byinshi.
• Urujijo.
• Gutakaza ubushobozi bwo kureba.
• Ibimenyetso by'indwara yo mu bwonko. Urugero, intege nke ku ruhande rumwe rw'umubiri cyangwa kugorwa no kuvuga.

Kuki ibi bibaho? Ni ibihe bintu bishobora gutera ibyago?

Impamvu nyamukuru itera gucika kw'imitsi y'amaraso ni ugucika intege buhoro buhoro k'urukuta rw'imitsi y'amaraso uko igihe kigenda gihita. Uku gucika intege bibaho mu ibanga mu gihe cy'imyaka myinshi, amaherezo bigacika intege cyane.

Ikintu nyamukuru kandi gikunze gutera ibi ni umuvuduko ukabije w'amaraso (Hypertension) . Umuvuduko ukabije w'amaraso wangiza inkuta z'imitsi y'amaraso, bigatuma idakomera kandi itagira intege nke.

Izindi mpamvu zishobora gutera ibyago ni izi:

• Ateriosclerosis cyangwa cholesterol nyinshi.
• Gukoresha ibikomoka ku itabi (kunywa itabi).
• Aneurysm y'imitsi yo mu bwonko.
• Indwara z'umuyoboro w'amaraso w'umutima.
• Ubusembwa bw'umutima bw'imyororokere, urugero, valve ya bicuspid aortic (valve ebyiri aho kuba eshatu zisanzwe).
• Indwara z'imitsi ihuza ibice, nka Marfan syndrome na Ehlers-Danlos syndrome . Izi ni indwara zishobora kuragwa.
• Niba hari umuntu wo mu muryango wigeze kugira ikibazo cyo gucika kw'imitsi.
• Gukomereka bikomeye mu gituza (urugero: impanuka ikomeye y'imodoka).
• Kuba afite imyaka iri hagati ya 40 na 70.
• Umuvuduko w'amaraso ukabije mu gihe utwite.
• Gukoresha ibiyobyabwenge nka kokayine.

Ni gute umuganga asuzuma ibi?

Iyo ugiye kwa muganga, muganga ashobora gukeka iyi ndwara bitewe n'ibimenyetso byawe. Ariko, kubera ko ibi bimenyetso bisa n'indwara y'umutima cyangwa indwara yo gucika kw'imitsi, hagomba gukorwa ibizamini byinshi vuba kugira ngo byemezwe neza.

• Gupima CT (Computed Tomography): Ubu ni bwo buryo bwiza kandi bwihuse bwo kubona neza umuyoboro w'amaraso mu gihe cy'impanuka.
• Echocardiogram: Iki ni ikizamini cya ultrasound. Echocardiogram ya transesophageal (TEE) ishobora kwerekana neza umuyoboro w'amaraso kurusha echocardiogram ya transthoracic.
• X-ray yo mu gituza: Ishobora gutanga igitekerezo gifatika cy'uko umuyoboro w'amaraso (aorta) wagutse.
• MRI (Magnetic Resonance Imaging): Nubwo ibi bishobora no gutanga amashusho asobanutse neza, ntibikunze gukoreshwa mu bihe byihutirwa kuko bifata igihe kirekire kurusha CT scan.

Ivurwa ite?

Uburyo bwo kuvura buterwa n'aho icyuho cyacitse (Ubwoko bwa A cyangwa Ubwoko bwa B) n'uko umurwayi amerewe.

Kubagwa n'ubundi buryo bwo kuvura

1. Gusimbuza Ishinge: Ubu ni ukubaga umutima ufunguye. Muri ubu kubaga, umuganga akura igice cyangiritse cy'umuyoboro w'amaraso (aorta) akagisimbuza ishinge rya sintetike. Ubu buvuzi bukorwa mu buryo bwihutirwa ku gucibwamo kw'ubwoko bwa A.

2. Gusana amenyo y'imitsi yo mu nda: Ibi bikubiyemo gukata gato umuyoboro w'amaraso mu gituza no gukoresha insinga na catheter kugira ngo ushyiremo umuyoboro w'icyuma (stent graft) mu gice cy'imitsi cyacitse intege. Ibi bikomeza urukuta rwacitse intege imbere. Ubu buryo bukunze gukoreshwa mu gukata amaraso mu buryo bugoye.

3. Uburyo bwo guhuza: Mu bihe bimwe na bimwe bigoye, uburyo bwo kubaga bwakozwe ku mugaragaro ndetse n'uburyo bwo gutera stent-graft bushobora gukoreshwa hamwe.

Imiti (imiti)

Imiti ikoreshwa cyane cyane mbere yo kubagwa, nyuma yo kubagwa, no mu bihe byo mu bwoko bwa B aho kubagwa bidakenewe.

• Imiti nka beta-blockers ishobora gutangwa kugira ngo igabanye umuvuduko w'umutima n'umuvuduko w'amaraso. Ibi bigabanya umuvuduko ku muyoboro w'amaraso kandi bikarinda ko amarira arushaho gukwirakwira.
• Ugomba gufata imiti ubuzima bwawe bwose kugira ngo ugabanye umuvuduko w'amaraso.

Ese ibi bishobora kwirindwa?

Ntidushobora guhindura ibintu bimwe na bimwe bishobora gutera ibyago (urugero: indwara z’uruhererekane). Ariko, hari ibintu bimwe na bimwe dushobora kugenzura.

• Komeza ugenzure neza umuvuduko w'amaraso yawe.Niba ufite umuvuduko ukabije w'amaraso, fata imiti muganga wawe yakwandikiye neza kandi ugabanye umunyu urya.
• Niba unywa itabi, hagarika ako kanya.
• Komeza kugira ibiro byiza by'umubiri.
• Niba hari umuntu wo mu muryango wawe (ababyeyi, abavandimwe) wagize iyi ndwara, vugana na muganga wawe hanyuma ukore ibizamini bikenewe.
• Kwambara umukandara w'imodoka bishobora gukumira imvune zo mu gituza mu mpanuka y'imodoka.