Ese umutsi w'amaraso mu mubiri wawe ushobora kuziba mu buryo butunguranye? Reka tuvuge kuri Embolism!

Ese wigeze wibaza uko byagenda iyo umuyoboro w'amaraso mu mubiri wacu ufunze mu buryo butunguranye? Wenda ibyo ntibyakubayeho. Ariko, iki ni ikintu twese tugomba kumenya. Kuko, umuyoboro w'amaraso ufunze nk'uyu, indwara yitwa (Embolisme), rimwe na rimwe ishobora kuba iteje akaga cyane. None se, twavuga kuri ibi mu buryo burambuye kandi muri iki gihe?

Embolisme ni iki? Mu magambo make...

Mu magambo make, embolisme ni igihe umwe mu mitsi yawe y'amaraso, cyangwa aho amaraso atembera, ufunzwe n'ikintu runaka. Akenshi, uku kuziba kw'amaraso guterwa n'aho amaraso yacitse ahandi. Ariko, si ukuziba kw'amaraso gusa, ahubwo n'ibindi bintu bishobora kuva ahantu hamwe mu mubiri bijya ahandi bigafunga imitsi y'amaraso nk'iyi.

Tekereza nk'igipande cy'umukungugu gifatirwa mu muyoboro w'amazi. Imiyoboro imwe y'amaraso, bitewe n'ingano yayo n'imiterere yayo, ikunze kuziba kurusha indi. Ibi bishobora kubaho cyane cyane aho imiyoboro minini y'amaraso ihinduka mato, cyangwa aho imiyoboro y'amaraso yagabanutse bitewe n'ibinure byinshi (atherosclerosis).

Izi ndwara zishobora kubaho ahantu hose mu mubiri wawe, harimo ubwonko bwawe, ibihaha, impyiko, n'umwobo. Ubwoko bukunze kugaragara bwa "embolism" ni ubwo mu bihaha. Iyo amaraso afashe mu mitsi y'amaguru yawe akagera mu bihaha byawe, byitwa "pulmonary embolism", cyangwa "PE" .

Ni ubuhe buryo butandukanye bwo gutemba kw'amaraso mu mubiri bushobora kubaho?

Embolisme ishobora kugabanywamo ubwoko butandukanye bitewe n'ubwoko bw'ikintu gifatirwa mu mitsi y'amaraso. Reba:

• Kuziba kw'amaraso: Ubu ni bwo bwoko bukunze kugaragara cyane bw'amaraso . Buterwa n'amaraso agwa ahandi mu mubiri, cyane cyane mu mitsi yo mu maguru (Deep Vein Thrombosis - DVT).
• Kuziba kwa kanseri: Ikintu kimeze nk'igice cy'akaremangingo ka kanseri.
• Kuvunika kw'ibinure: Ibinure bishobora kwirundanya mu maraso mu gihe cy'imvune ikomeye y'igufwa.
• Kuziba kw'amaraso mu maraso: Kubumba amaraso bifitanye isano n'ubwandu.
• Kuziba umwuka mu kirere: Urugero, bishobora guterwa n'umwuka wa azote mu gihe cyo kwibira.
• Kuziba kw'amazi yo mu nda: Ibi bifitanye isano no kubyara kandi ni gake cyane.

Muri ibyo, Venous Thromboembolism , ari na yo maraso afunganye mu mitsi akayifunga, ni yo akunze kugaragara cyane kurusha ay’imitsi. Mu by’ukuri, mu gihugu nka Amerika, bivugwa ko abantu bagera ku 900.000 buri mwaka barwara iyi ndwara. Nanone, Pulmonary Embolism ni yo mpamvu ya gatatu itera impfu ziterwa n’umutima n’imitsi y’amaraso ku isi. (Umubare wa mbere n’uwa kabiri ni Stroke n’indwara y’umutima).

Ni ibihe bimenyetso by'indwara yo mu mutwe (embolism)?

Iyo embolisme ibaye mu mitsi yawe, ibuza amaraso gutembera. Urabizi, amaraso atwara ogisijeni buri turemangingo two mu mubiri wacu dukeneye. Rero, iyo amaraso adashobora kunyuramo, ogisijeni ntishobora kunyuramo. Uku kubura ogisijeni bitera indwara yitwa "infarct," yangiza urugingo rukeneye ogisijeni. Ibi bishobora gutera ububabare. Hari igihe uku kubura ogisijeni bishobora no kwica.

Tekereza amaraso apfutse mu mitsi miremire mu kuguru kwawe, hanyuma uduce duto twayo tugacika maze amaraso akagendana n'uruhande rw'iburyo rw'umutima wawe. Kuva aho, amaraso ajyanwa mu bihaha. Utu duce duto tw'amaraso (pulmonary emboli) dufata imitsi mito mu bihaha, bigatuma ibihaha bigwa. Ni gake cyane, utunini (pulmonary emboli) dushobora kubuza burundu urujya n'uruza rw'amaraso kuva iburyo bw'umutima kugera mu bihaha.

Ibimenyetso bya embolisme biratandukanye bitewe n'ubwoko n'aho embolisme yabereye. Hari abantu bashobora kuba badafite ibimenyetso na gato. Dore bimwe mu bimenyetso:

• Guhumeka nabi
• Ogisijeni nke mu maraso (Hypoxemia)
• Guhumeka vuba ariko mu buryo buciriritse (Tachypnea)
• Intege nke, umunaniro
• Umutwe
• Uduheri dutukura ku ruhu (Petechiae)
• Kubabara mu gatuza
• Umutima utera vuba (Tachycardia)
• Umuriro
• Kubyimba ukuboko cyangwa ukuguru
• Indwara zo mu mutwe
• Vertigo
• Kuruka no kugira isesemi
• Umuvuduko w'amaraso uri hasi (Hypotension)

Ni iyihe mpamvu nyamukuru itera embolisme?

Akenshi, indwara yo mu bihaha ikunze kugaragara mu bihaha. Impamvu nyamukuru ibitera ni ukuzura kw'amaraso mu mitsi y'amaguru (Deep Vein Thrombosis - DVT) . Hari igihe indwara yo mu bihaha ishobora no guterwa na DVT mu mitsi yo mu maboko.

Hari izindi mpamvu zituma habaho embolism:

• Kwandura igice cy'imbere cy'umutima (infective endocarditis)
• Gutera umutima mu buryo budasanzwe (atrial fibrillation)
• Ifuro ry'umutima w'ibumoso
• Igufwa ryavunitse mu mpanuka ikomeye
• Kanseri
• Indwara zitandukanye
• Pancreatite
• Gukoresha liposuction
• Gutera umwongo w'amagufwa
• Diyabete yo mu gihe cyo gutwita
• Placenta accreta (ifata ryimbitse ry'ingobyi ku rukuta rw'inda ibyara)

Ni nde uri mu kaga gakomeye ko kurwara iyi ndwara (embolism)?

Hari ibintu byinshi bikunze gutera indwara yo kubyimba kw'amaraso (embolism). Reba niba hari kimwe muri ibi kikureba:

• Kudakora imyitozo ngororamubiri: Kuguma ahantu hamwe igihe kirekire cyane, cyane cyane nyuma yo kubagwa.
• Kubagwa n'ubundi buryo bwo kuvura: Nyuma yo kubagwa bikomeye.
• Umutima unanirwa
• Igisebe cy'imitsi
• Kanseri
• Ibikomere by'umubiri (Ihungabana)
• Umuvuduko ukabije w'amaraso (Hypertension)
• Gukoresha ibikomoka ku itabi (kunywa itabi)
• Gukoresha ibinini byo kuboneza urubyaro
• Indwara zituma amaraso yifunga byoroshye
• Ibikoresho bimwe na bimwe byo kwa muganga, nk'ibikoresho bifasha mu mugongo

Ni izihe ngorane zishobora guterwa no gutemba kw'amaraso mu mubiri (embolism)?

Ingorane zo guterwa na embolisme ziratandukanye bitewe n'aho ibera. Ishobora kuba mbi cyane. Dore zimwe mu ngorane:

• Utumenyero duto mu mikorere y'ubwonko, nko gutakaza kwibuka
• Ugutera kw'umutima nabi (Arrhythmia)
• Guhagarara k'umutima
• Indwara y'umutima
• Kubyimba k'ubwonko
• Kubyimba kw'ibihaha
• Indwara yo mu myanya y'ubuhumekero ikabije (ARDS)
• Gutakaza ukuboko cyangwa ukuguru
• Igisebe cy'umusemburo
• Gupfa kw'ingingo mu mpyiko, mu mugongo, cyangwa mu rundi rugingo rwanduye
• Gusubira inyuma kw'amaraso binyuze mu mugozi w'umutima (tricuspid valve regurgitation)
• Kunanirwa kw'impyiko
• Umutima unanirwa
• Igisebe cy'imitsi
• Ndetse no gutakaza ubuzima bishobora kubaho.

Ibyo bivuze ko iki atari ikintu cyo gufata nk'ikintu cyoroshye. Nubwo gishobora gusa n'aho ari ikintu gito, iyo kidakemuwe ku gihe, gishobora gutera ibibazo bishobora gushyira ubuzima mu kaga.

Ni gute umuganga asuzuma neza ibi (embolism)?

Niba ufite ibimenyetso bya embolisme, muganga azabanza kugusuzuma. Muganga ashobora kubona ibintu nk'impinduka z'uruhu cyangwa kugorwa no guhumeka. Niba bikekwa ko embolisme ihari, ashobora gukora ibizamini bimwe na bimwe.

Bitewe n'ubwoko bwa embolisme, ibizamini bikurikira bishobora gukorwa:

• Gupima amaraso
• X-ray yo mu gituza
• Doppler ultrasound - Reba uburyo amaraso atembera mu mitsi y'amaraso.
• ECG (Electrocardiogram - EKG) - Igenzura imikorere y'umutima.
• Gupima CT (Isuzuma rya mudasobwa - Gupima CT)
• Ikizamini cya MRA(Angiogramu ya Magnetic Resonance - MRA)
• MRI (Ishusho ya Magnetic Resonance)
• Angiogramu - Isuzuma rya X-ray ry'imitsi y'amaraso nyuma yo gutera irangi.
• Ibipimo bya Ultrasound by'umutima: (Transthoracic echocardiogram - TTE) na (Transesophageal echocardiogram - TEE)
• Hari igihe hakorwa biopsy kugira ngo hasuzumwe igice cy'urugingo.

Ni ubuhe buryo bwo kuvura indwara yo kubura amaraso?

Intego nyamukuru yo kuvura indwara yo kubura amaraso ni ukuvanaho imitsi ifunganye no kugarura amaraso atembera neza. Akenshi, amahitamo ya mbere ni ukuvura hakoreshejwe imiti.

Dore uburyo bumwe na bumwe bwo kuvura indwara yo kubura amaraso:

• Imiti igabanya amaraso : Tuvuga ko iyi "itera amaraso kugabanuka".
• Imiti igabanya amaraso : Iyi ishongesha amaraso mu buryo butaziguye ikayakuraho.
• Antibiyotike zo Gutera Embolisme
• Imiti yongera imikorere y'umutima (Inotropes)
• Kuvura ogisijeni cyangwa kuvura ogisijeni ikabije
• Embolectomy (gukuramo embolisme kubagwa)

Mu bihe bikomeye cyane, abantu bafite ikibazo cyo kubura umwuka bashobora gukenera ubundi buryo bwo kubafasha mu buzima, nka CPR , ECMO (imashini ikora aho gukora ku mutima n'ibihaha), ndetse n'imashini zibafasha guhumeka.

Ese hari ingaruka mbi zikomoka ku buvuzi?

Yego, ikibabaje ni uko hari ingaruka zimwe na zimwe zishobora kubaho. Hari ibyago byo kuva amaraso, cyane cyane iyo ukoresheje imiti yitwa anticoagulants na thrombolytics. Iyo amaraso agabanutse hakoreshejwe uburyo bwo kubaga (embolectomy), hashobora kubaho ingaruka nka:

• Kwangirika k'umuyoboro w'amaraso
• Kuva amaraso
• Umutima utera buhoro buhoro (Bradycardia)
• Umuvuduko w'amaraso uri hasi (Hypotension)
• Guhagarara k'umutima

Bigenda bite iyo habayeho embolisme?

Hari abantu bafite ikibazo cyo kubura amaraso bashobora kutagira ibimenyetso na gato, mu gihe abandi bashobora kugira ibimenyetso bikomeye cyane. Uburyo uvurwa buzaterwa n'ibintu byinshi, harimo ingano n'uburemere bwacyo, n'aho cyatangiriye.

Embolisme ni indwara ishobora gushyira ubuzima mu kaga, bityo gusuzuma indwara hakiri kare no kuyivura vuba bishobora kongera amahirwe yo gukira.

Ni iki twakora kugira ngo wirinde indwara yo kubura amaraso?

Yego, dushobora gukumira ubwoko bumwe na bumwe bwa embolism. Niba uri mu kaga ko kurwara embolism, muganga wawe ashobora kukugira inama ikurikira:

• Mu gihe ugiye mu rugendo rurerure (nk'iyo mu ndege cyangwa muri bisi), haguruka buri masaha make uzamuke kandi umanure gato utubuto tw'amaguru (calf pumps).Ibi bishobora gufasha mu gukomeza gutembera neza kw'amaraso mu maguru.
• Imiti igabanya amaraso (Anticoagulants) .
• Gukoresha amasogisi yihariye yo gukanda.
• Igikoresho gishyira igitutu ku maguru (Intermittent Pneumatic Compression Device - IPC device) .
• Ku bantu bamwe, akayunguruzo gashobora gushyirwa mu mutsi mukuru utwara amaraso ava mu mubiri wo hasi akayajyana mu mutima (akayunguruzo ka vena cava kari munsi y’utuyira) . Ibi bibuza amaraso kuzura mu mutima no mu bihaha.

Nitwara nte iyo mbonye ikibazo cyo kubura amaraso?

Nyuma yo guterwa imyobo, ushobora gukenera kuvurwa kugira ngo ukire. Ibi biterwa nuko imyobo ishobora kuba yangiritse nk'ubwonko bwawe cyangwa ibihaha. Ibi byangiritse bitewe nuko imyobo yahagaritse ogisijeni kuri urwo rugingo cyangwa agace.

Ni ryari ngomba kujya kwa muganga?

Niba ufite ibimenyetso bya embolisme, ugomba guhita ugana kwa muganga. Ntugatinde.

Nyuma yo guterwa imyobo, uzakenera gukomeza kubonana na muganga wawe no gukurikiza amabwiriza ye. Cyane cyane niba ufata imiti nka anticoagulants, muganga wawe azasuzuma niba uyifata neza kandi niba ibyago byawe byo kuva amaraso byarahindutse.

Ni ibihe bibazo ngomba kubaza muganga?

Ushobora kubaza muganga wawe ibibazo nk'ibi:

• Kuki nabonye ibi (embolism)?
• Ni amahirwe angahe yo gukira bitewe n'uburwayi bwanjye?
• Ni ubuhe buryo bwiza bwo kuvura kuri njye?
• Ni iki nakora kugira ngo ngire ko nta kindi kintu nk'iki cyakongera kubaho?

Muri make (Ubutumwa bwo kujyana mu rugo)

Ni ibisanzwe kumva uhangayikishijwe n'indwara yitwa embolism, kuko ishobora gushyira ubuzima mu kaga. Niyo mpamvu ari ngombwa cyane kwivuza ako kanya. Niba ufite ibimenyetso bya embolism, shaka ubufasha bwa muganga ako kanya. Nyuma yo kuvurwa, shaka ubufasha bw'umuryango wawe n'inshuti zawe. Niba uhangayikishijwe cyangwa uhangayikishijwe no kugira indi embolism, vugana n'umujyanama. Ntabwo uri wenyine, kandi ntutinye gusaba ubufasha.

` Embolisme, amaraso afunganye, kuziba kw'imitsi y'amaraso, embolisme y'ibihaha, Embolisme y'ibihaha, DVT, ibimenyetso, uburyo bwo kuvura, kwirinda