Ese wigeze wumva ko umutsi w'amaraso w'ingenzi mu mubiri wacu ushobora kubyimba nk'umupira w'inyuma? Iki ni ikibazo giteye ubwoba cyane. Ariko ntugahangayike, bitewe n'iterambere ry'ubumenyi bw'ubuvuzi, ubu ibi bishobora kuvurwa mu buryo bworoshye cyane nta gukata cyane. Uyu munsi tugiye kubiganiraho. Ubu buryo bwitwa EVAR.
Mu magambo make, EVAR ni iki?
Igisobanuro cyuzuye cya EVAR ni Endovascular Aneurysm Repair . Ubu ni uburyo bwo kubaga butagira ingaruka nyinshi. Bukoreshwa mu kuvura aneurysms, cyangwa nk'uko tubyita mu mvugo z'ubuvuzi , aneurysms , muri aorta, umuyoboro w'amaraso munini uri mu nda yacu.
Tekereza ko umutsi munini w'amaraso mu mubiri wacu ari aorta. Aha niho amaraso akwirakwizwa kuva mu mutima kugera ku mubiri wose. Hari igihe, iyo ahantu hari urukuta rw'uyu mutsi w'amaraso hacitse intege, umuvuduko w'amaraso utuma aho hantu hadakomeye habyimba nk'umupira w'amapine. Ibyo ni byo twita aneurysm.
Mu kuvura EVAR, utwobo tubiri duto cyane ni two dukorwa ku mpande zombi z'imitsi, kandi ibikoresho byihariye binyuzwamo kugira ngo bisana umuyoboro w'amaraso wabyimbye uturutse imbere.
Kuki dukeneye ubu buvuzi bwa EVAR?
Intego nyamukuru y'ubu buvuzi ni ukurinda umutsi w'amaraso umeze nk'ibendera (aneurysm) guturika, kuko iyo bigenze bityo, biba ari ikibazo gikomeye ku buzima.
Iyo umutsi w'amaraso uturitse, kuva amaraso menshi bitangira kubaho mu mubiri, bishobora gushyira ubuzima mu kaga mu minota mike.
Mu kuvura EVAR, abaganga bashyiramo umuyoboro wihariye (stent graft) ukozwe mu mwenda n'icyuma mu miyoboro y'amaraso yabyimbye. Nyuma yo gushyiramo uyu muyoboro, amaraso anyura muri uyu muyoboro mushya. Hanyuma umuvuduko w'amaraso ntugera ku rukuta rw'imiyoboro y'amaraso yabyimbye. Kubwibyo, ibyago byo guturika birashira burundu.
Ni nde ubu buvuzi bwa EVAR bukwiriye kurusha ubundi?
Niba ufite aneurysm ya aorta, ubu buryo bushobora kuba bukubereye. Ariko, aneurysm zose si ko zivurirwa icyarimwe. Muganga wawe ashobora gusuzuma EVAR muri ibi bikurikira:
- Niba aneurysm yawe ari nini cyangwa ni nto ariko ikura vuba .
- Niba umubiri wawe udashobora kwihanganira kubagwa mu buryo bugaragara hamwe n'icyuho kinini.
- Niba imitsi y'amaraso iri hejuru no munsi ya aneurysm ari nzima .
Ese hari ubundi buryo nka EVAR? (FEVAR na TEVAR)
Yego, ubu buryo bwo kuvura bukoreshwa mu buryo butandukanye bitewe n'aho aneurysm iherereye.
FEVAR ni iki?
Tekereza kuri aorta yacu nk'igiti. Kuva kuri iki giti, amashami (imitsi mito) ijyana amaraso mu ngingo zo mu nda yacu (nk'impyiko n'amara) yigabanyamo kabiri. Hari igihe habaho aneurysm hafi y'aho rimwe muri aya mashami ryigabanyamo kabiri. Muri icyo gihe, biragoye gukora EVAR isanzwe.
Ku bibazo bigoye cyane, niho hakoreshwa uburyo bwihariye bwitwa FEVAR (Fenestrated Endovascular Aneurysm Repair) . Ishingwa rya stent rikoreshwa hano rifite utwobo duto (fenestrations) twakozwe kugira ngo duhure aho amashami yigabanyamo ibice. Binyuze muri iyo myobo, utwo dutsi duto dushobora gushyirwaho kuri ayo mashami. Kimwe n'umuyoboro wagenewe guhuza igiti n'amashami y'igiti.
Itandukaniro riri hagati ya EVAR na TEVAR
Ibi biroroshye cyane.
- EVAR ikorerwa ku ndwara zo mu nda (aneurysms) .
- TEVAR (Treacic Endovascular Aneurysm Repair) ikorerwa ku ndwara z’imitsi iri mu gituza .
TEVAR ikunze kugira akamaro kanini ku ndwara z’imitsi yo mu gituza inyura mu gatuza, kure gato y’umutima. Ariko, ku ndwara z’imitsi yo mu gituza zegereye cyane umutima, akenshi biba ngombwa kubagwa mu buryo bw’ibanze.
| Ibyiza by'ingenzi byo kuvura EVAR | |
|---|---|
| Akamaro | Ibisobanuro |
| Iminsi yo kumara mu bitaro iragabanuka. | Ushobora gutaha mbere y'igihe ugiye kubagwa. |
| Kuva amaraso make | Kubera ko nta gukomereka gukomeye kugaragara, ingano y'amaraso ava mu mubiri ni nto cyane. |
| Ububabare buke mu gihe cyo gukira | Kubera ko nta gikomere gikomeye kirimo, ububabare n'imibabaro ni bike cyane. |
| Ukire vuba | Ushobora guhita usubira mu bikorwa bisanzwe. |
| Igihe cyo kubagwa ni gito. | Kubagwa bishobora kurangira mu gihe gito kurusha kubagwa ku mugaragaro. |
Ese hari ingaruka zishobora guterwa n'ubu buvuzi?
EVAR ni uburyo bwiza cyane bwo kuvura, ariko kimwe no kubagwa kose, hari amahirwe make yo kugira ibibazo.
- Uduce tw'amaraso: Hari igihe uduce tw'amaraso dushobora kwirema mu mitsi yo mu birenge. Ibi twita Deep Vein Thrombosis (DVT) .
- Endoleak: Ndetse na nyuma yo gushyirwaho stent, amaraso make ava hagati ya stent n'urukuta rw'imitsi y'amaraso maze agahuza na aneurysm.
- Kwandura: Kwandura aho byakomeretse.
- Kunanirwa kw'impyiko
- Indwara y'umutima
- Kuva amaraso menshi cyane
Izi ngaruka ni nke cyane. Muganga wawe azagusobanurira ibi byose mbere yo kubagwa.
Kubagwa bikorwa gute?
Noneho reka turebe intambwe zikubiye muri ubu buryo bwo kubaga.
1. Ubwa mbere, uzahabwa ikinya kugira ngo usinzire cyangwa usinzire gake. Bityo ntuzumva ububabare ubwo aribwo bwose.
2. Hanyuma, muganga azagera kuri aneurysm yo mu nda yawe anyuze mu mitsi yo mu nda yawe.
3. Hakoreshejwe inshinge ebyiri zoroshye cyane, kathetateri , umuyoboro muto kandi woroshye, yinjizwa muri iyi mitsi yombi. Agashishwa k'umuyoboro twavuze mbere kari kashyizwe muri iyi kathetateri.
4. Mu gihe areba isuzuma rya X-ray ridasanzwe, muganga ayobora iyi catheter ku mitsi y'amaraso kugeza aho aneurysm iri.
5. Iyo igeze ahantu heza, umuyoboro wa stent uri muri catheter uraguka. Hanyuma ugenda ukwirakwira mu mitsi y'amaraso, bigatuma amaraso atembera mu buryo bushya kandi bukomeye.
6. Uyu muyoboro wa stent ufatanye neza n'urukuta rw'imitsi y'amaraso, bikabuza amaraso kwinjira muri aneurysm.
7. Nyuma yo kurangiza igikorwa, catheter ikurwaho witonze. Uduce duto cyane ku buryo nta no kudoda bikenewe. Hashyirwaho plaster nto ku gisebe kugira ngo gikire.
Igihe cyo gukira nyuma yo kubagwa kiba gite?
Ubusanzwe bifata iminsi mike kugeza ku kwezi kugira ngo ukire neza.
- Ugomba kumara iminsi ibiri cyangwa itatu mu bitaro.
- Ushobora gutangira kurya no kunywa ako kanya nyuma yo gusinziriza.
- Ushobora no kuva mu buriri ukagenda ufashijwe n'abaforomo.
- Ushobora kumva unaniwe gato kandi ubabara iminsi mike nyuma yo gutaha. Ugomba gukoresha imiti igabanya ububabare wahawe neza.
- Irinde gutwara imodoka kugeza igihe ufashe imiti igabanya ububabare.
- Abantu benshi bashobora gusubira ku kazi mu gihe cy'ukwezi kumwe.
- Ugomba kwirinda guterura ibintu biremereye mu gihe cy'ibyumweru 4 kugeza kuri 6.
| Niba ufite ibi bimenyetso, hita ubonana na muganga wawe. | |
|---|---|
| Ibiranga | Ibisobanuro |
| Kubyimba amaguru, ububabare | Ibi bishobora kuba ibimenyetso by'indwara yo mu mitsi itemba cyane (DVT) mu maguru. Ibi birimo uruhu rukonje ku maguru. |
| Kuzungera cyangwa gucika intege | Bishobora kuba ikimenyetso cy'ikibazo runaka imbere. |
| Kubabara umugongo, igituza, cyangwa igifu | Ibi bishobora kuba ikibazo kuri stent cyangwa aneurysm. |
| Umutima utera cyane | Umutima utera vuba mu buryo budasanzwe (Umutima utera cyane). |
| Ugutukura cyangwa ububabare mu gice cy'ikibuno | Bishobora kuba ikimenyetso cy'ubwandu aho bakorewe. |
Ubutumwa bwo kujyana mu rugo
- EVAR ni ubundi buryo bwiza cyane kandi butagira ingaruka nyinshi aho kubagwa mu buryo busanzwe.
- Nyuma y'ubu buvuzi, uzakira vuba kandi uzabashe gutaha vuba.
- Ndetse na nyuma yo gukira, ugomba kwita ku mutima wawe n'imitsi y'amaraso. Ibintu nko gukora imyitozo ngororamubiri no kugabanya umunyu mu mirire yawe bishobora kugufasha kwirinda ibibazo bizaza.
- Icy'ingenzi ni ukugaruka kwa muganga ku gihe cyagenwe kugira ngo hakorwe ibizamini byo gukurikirana. Muri ubwo buryo, ushobora kugenzura niba stent washyizemo ikora neza kandi niba hari ibindi bibazo.
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