Ese wigeze ubona umuntu uri mu cyumba cy’indembe (ICU) cyangwa umuntu wazanywe mu cyumba cy’indembe (ETU) ufite ikibazo gikomeye cyo guhumeka, maze abaganga bakihutira kumubwira ngo "bakore ABG"? Iki ni ikizamini cy’amaraso cy’ingenzi cyane kandi cyihariye. Uyu munsi, turakivugaho mu buryo bworoshye, mu buryo ushobora gusobanukirwa.
Mu magambo make, iki kizamini cya ABG ni iki?
ABG (Arterial Blood Gas) ni ikizamini gifata amaraso make mu mitsi yo mu mubiri wacu. Noneho ushobora kuba urimo kwibaza uti "Ibindi bipimo by'amaraso bipima amaraso mu mitsi, itandukaniro ni irihe?"
Tekereza muri ubu buryo. Umubiri wacu umeze nk'umujyi.
- Imitsi ni nk'imihanda minini izana ibintu by'ingenzi nk'umwuka wa ogisijeni n'imirire mu mujyi.
- Imiyoboro y'amazi ni nk'imihanda ishaje yo mu mujyi itwara imyanda nka dioxyde de carbone igaruka mu mujyi.
Niba rero dushaka kumenya neza ingano ya ogisijeni igera mu ngingo z'umubiri wacu, cyane cyane ubwonko n'umutima, tugomba gupima amaraso ari kuri uwo "muhanda munini," sibyo? Niyo mpamvu amaraso akurwa mu mitsi kugira ngo apimwe ABG.
Iki kizamini ahanini gipima urugero rwa ogisijeni na dioxyde de carbone mu maraso yawe. Kinapima ingano ya aside-base, cyangwa pH, mu maraso yawe. Iki kizamini ni ingenzi ku mikorere yose mu mibiri yacu.
Ni iki mu by'ukuri gipima ikizamini cya ABG?
Iyo urebye raporo ya ABG, uzabona inyuguti zimwe na zimwe zigoye kumva. Ariko ibisobanuro biroroshye cyane. Reka turebe icyo buri imwe muri izo ndangagaciro isobanura.
| Igipimo | Ubusobanuro bworoshye |
|---|---|
| pH | Ibi bikwereka uburyo amaraso yawe afite aside. Aka gaciro kagomba kuba hagati ya 7.35 na 7.45. Ikintu cyose kiri munsi y’icyo gisobanura ko amaraso yawe afite aside, naho ikindi cyose kiri hejuru gisobanura ko afite aside. |
| PaO2 (Umuvuduko w'umwuka wa ogisijeni) | Ingano ya ogisijeni ishongeshejwe mu maraso. Ibi bigaragaza uburyo ogisijeni yinjira mu maraso ivuye mu bihaha byawe. |
| PaCO2 (Igitutu cy'igice cya dioxyde de carbone) | Ingano ya dioxyde de carbone mu maraso yawe. Ibi bigaragaza uburyo umubiri wawe urimo gukuramo dioxyde de carbone. |
| HCO3 (Bikarubonate) | Iki ni ishingiro mu maraso yacu. Kigenzurwa n'impyiko. Ni ingenzi cyane mu kuringaniza pH y'amaraso. |
| O2Sat (Oxygen saturation) | Igaragaza ingano ya poroteyine ya hemoglobin iri mu maraso itwara ogisijeni, nk'ijanisha. Igipimo cy'imitsi ushyira ku rutoki rwawe gipima agaciro kamwe. |
Ni ryari ikizamini cya ABG gikenewe?
Iki si ikizamini gikorerwa isuzuma risanzwe. Akenshi gikorerwa mu bihe byihutirwa no gukurikirana imiterere y'abarwayi basanzwe mu bitaro . Dore zimwe mu mpamvu z'ingenzi zishobora gutuma muganga ategeka iki kizamini:
- Kugorwa cyane no guhumeka: Mu bihe nk'ubukana bwa asima no kwirundanya amazi mu bihaha (kunanirwa guhumeka cyane).
- Indwara zikomeye zandura: Mu ndwara zishobora gushyira ubuzima mu kaga nka sepsis cyangwa septic shock.
- Ingorane ziterwa na diyabete: Mu gihe amaraso ahinduka aside, nka diyabete ketoacidosis (DKA).
- Indwara y'umutima cyangwa indwara y'umutima: Iyo umutima uhagaze gukora mu buryo butunguranye (guhagarara k'umutima) cyangwa iyo umutima uhagaze (guhagarara k'umutima).
- Kunanirwa kw'impyiko: Iyo impyiko zidashobora gukura aside mu maraso neza, amaraso ahinduka aside. Menya kuri iyi ndwara.
- Uburozi: Iyo hari uburozi bunyoye, pH y'amaraso irahinduka.
- Mbere na nyuma yo kubagwa bikomeye: Genzura uko umurwayi ahagaze mu gihe cyo gusinziriza no nyuma yo kubagwa.
- Indwara z'ibihaha zidakira: Reba niba ubuvuzi bwagenze neza ku bantu bafite indwara nka COPD (indwara y'ibihaha idakira).
Iki kizamini gikorwa gite? Ese kirababaza?
Gupimisha amaraso mu buryo bwa ABG bitandukanye gato no gupimisha amaraso mu buryo busanzwe.
Mbere y'ikizamini
Hari igihe, niba uhabwa ogisijeni y'inyongera, ishobora guhagarara iminota 20 mbere y'ikizamini. Ibi ni ukureba uko umubiri wawe ukora udafite ogisijeni. Ariko niba udashobora kubikora udafite ogisijeni, ushobora kutabikora. Niba amaraso arimo gukurwa mu kuboko kwawe, muganga cyangwa umukozi wabihuguriwe ashobora gukora ikizamini cyoroshye cyitwa 'Allen test' kugira ngo arebe niba amaraso atembera neza mu kuboko kwawe.
Mu gihe cyo gukora ikizamini
1. Umuganga cyangwa inzobere mu by’ubuvuzi azasangamo umutsi w’amaraso imbere mu kuboko kwawe (radial artery), hafi y’inkokora yawe (brachial artery), cyangwa mu nda yawe (femoral artery).
2. Sukura neza aho hantu hanyuma ushyireho umuti wica udukoko.
3. Hanyuma, urushinge ruto cyane rushyirwa mu mitsi maze amaraso make agakururwa mu nshinge.
4. Mu by'ukuri , ibi bishobora kubabaza cyane kuruta gukura amaraso mu mitsi. Ibi biterwa nuko imitsi iherereye munsi y'uruhu rwacu kandi ifite imitsi myinshi iyikikije. Ariko ububabare bubaho gusa igihe urushinge rushyizwemo.
5. Nyuma yo gukusanya amaraso akenewe, kura urushinge hanyuma ushyireho igitutu aho hantu ukoresheje ipamba cyangwa gaze kugira ngo amaraso ahagarike kuva mu minota 5 kugeza ku 10. Niba ufata imiti igabanya amaraso, ushobora gukenera gukoresha igitutu igihe kirekire.
Nyuma y'ikizamini
Aho urushinge rwashyizwe hashobora kuba hari udusebe duto cyangwa ubururu. Ibi ni ibisanzwe. Muganga wawe azakubwira kwirinda guterura ibintu biremereye ukoresheje uwo kuboko mu gihe cy'amasaha 24 nyuma yo gukurwamo amaraso.
Ibisubizo by'ikizamini cya ABG biboneka vuba cyane, akenshi mu minota 10-15. Ibi bisubizo ni ingenzi cyane mu gufata ibyemezo byihuse mu bihe byihutirwa.
Impuzandengo y'agaciro kari muri raporo imeze ite?
Izi ndangagaciro zishobora gutandukana gato bitewe na laboratwari, ariko izi ni zo ndangagaciro mpuzandengo ku muntu mukuru muzima uri ku rwego rw'inyanja. Ni byiza kubaza muganga wawe ibisobanuro byuzuye ku ndangagaciro ziri muri raporo yawe.
| Igipimo | Intera Isanzwe |
|---|---|
| pH | 7.35 - 7.45 |
| PaO2 | 75 - 100 mmHg |
| PaCO2 | 35 - 45 mmHg |
| HCO3 | 22 - 26 mEq/L |
| O2Sat | 95% - 100% |
Niba izi ngengo z’umubiri zirenze urugero rusanzwe, bishobora gusobanura ko umubiri wawe utari kubona ogisijeni ihagije , cyangwa ko dioxyde de carbone idasohoka neza mu mubiri wawe , cyangwa ko aside/base iri mu maraso yawe idakora neza . Muganga wawe azakoresha iyi raporo, ibimenyetso byawe, n'ibindi bipimo kugira ngo amenye neza ikibazo cyawe.
Ubutumwa bwo kujyana mu rugo
- ABG si isuzuma ry’amaraso risanzwe rikorerwa mu mitsi, ahubwo ni isuzuma ryihariye rikorerwa mu mitsi, umutsi munini w’amaraso utanga umwuka wa ogisijeni mu mubiri.
- Ibi ahanini bipima ogisijeni, dioxyde de carbone, na aside (pH) mu maraso.
- Ibi ni ingenzi kugira ngo hamenyekane hakiri kare indwara mu bihe byihutirwa n'ibihe bikomeye nko kugorwa no guhumeka, indwara zikomeye, n'indwara z'umutima.
- Nubwo bishobora kubabaza gato kurusha gupimwa amaraso buri gihe, amakuru atanga ashobora kurokora ubuzima.
- Buri gihe vugana na muganga ukuvura ibyavuye mu isuzuma rya ABG n'icyo bivuze.
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