Ese ingingo nyinshi mu mubiri wawe zirananirwa icyarimwe? Reka tuvuge kuri iyi ndwara yitwa Multiple Organ Dysfunction Syndrome (MODS)!

Ushobora kuba warumvise ko iyo umuntu arwaye cyane mu buryo butunguranye kandi ari mu cyumba cy’indembe cy’ibitaro (ICU), bavuga bati: "Abaganga bavuze ko hari ibice bimwe by’umubiri we bidakora neza." Cyangwa bati: "Barimo kubagwa ubuzima n’imashini." Mu by’ukuri, icyo gihe, uwo muntu ashobora kuba afite indwara ikomeye cyane. Mu buvuzi, iyi ndwara tuyita Multiple Organ Dysfunction Syndrome, cyangwa mu Cyongereza, "Multiple Organ Dysfunction Syndrome - MODS." Izina risa n’aho riteye ubwoba gato, ariko reka tuganire ku byo ari byo, impamvu bibaho, n’uburyo bwo kubaho mu buryo bworoshye ushobora kumva.

MODS ni iki mu by'ukuri?

Mu magambo make, MODS ni indwara ikomeye cyane itunguranye (ikomeye) . Ikibaho muri ibi ni uko ingingo ebyiri cyangwa nyinshi z'umubiri wacu zihujwe zihagarara gukora neza mu buryo butunguranye. Tekereza nawe, umubiri wacu ufite izindi ngingo nyinshi nk'iz'ubuhumekero, iz'igogora, n'iz'inkari. Izi ngingo zikorana kugira ngo tugire ubuzima bwiza. Iyo MODS ibayeho, izi ngingo ntizishobora gukora zonyine. Hanyuma ibikoresho byo gufasha ubuzima ('ibyunganira ubuzima') birakenewe kugira ngo ibyo bice by'umubiri bikore akazi kabyo.

MODS ishobora kugira ingaruka ku rugingo urwo arirwo rwose mu mubiri, ariko ikunze kugaragara cyane ni:

• Ibihaha
• Umutima
• Ubwonko
• Impyiko
• Umwijima
• Amaraso (amaraso)

MODS ishobora kugira impamvu nyinshi. Impamvu ikunze kugaragara ni ubwandu bukomeye (sepsis) . Mu kuvura MODS, abaganga babanza kugerageza kugenzura indwara nyamukuru yateye iyo ndwara. Banafata ingamba zo gukumira kwangirika kw'izindi ngingo.

MODS ni indwara iteye akaga cyane . Ishobora kwica iyo idavuwe vuba. Abantu benshi barwaye MODS binjizwa mu cyumba cy’indembe (ICU) kandi bakeneye gukurikiranwa buri gihe no guhabwa ubufasha bwo kubaho.

Iyi ndwara yitwa andi mazina menshi, harimo:

• Kunanirwa kw'ingingo nyinshi
• Kunanirwa kw'ingingo nyinshi

Ni izihe ngingo zishobora kugira ingaruka kuri MODS?

MODS ishobora kugira ingaruka kuri ebyiri cyangwa nyinshi muri izi ngingo zikurikira:

1. Uduce tw'ubuhumekero (ibihaha)

Iyo ibihaha byacu bidashobora guha umubiri ingano ya ogisijeni ukeneye, bivuze ko ingingo z'umubiri zitabona ogisijeni ihagije (hypoxia) cyangwa umubiri ntubona dioxyde de carbone (CO2) ihagije (hypercapnia), tubyita kunanirwa guhumeka. Muri MODS, uhura n'ingorane zo guhumeka ndetse ushobora no gukenera guhumeka mu buryo bwa mechanical kugira ngo bigufashe guhumeka. Indwara ikomeye cyane y'ibihaha muri MODS ni Acute Respiratory Distress Syndrome (ARDS).Muri iyi ndwara ya ARDS, ibihaha birakomera, bigatuma bigorana cyane kugumana ogisijeni isanzwe mu maraso.

2. Umutima n'imitsi (umutima)

Imitsi yacu y'umutima n'imitsi ni byo bipompa amaraso mu mubiri wose. Kunanirwa k'umutima no guhagarara kw'amaraso ni indwara aho imitsi y'umutima iba igoranye cyangwa igakomera, bigatuma idakomeza gusohora amaraso ahagije mu mubiri wose. Kubyimba gukabije bibaho kuri MODS bishobora gutuma imitsi y'amaraso yaguka, bigagabanya ingano y'amaraso agera ku ngingo n'ibice by'umubiri. Ibi bishobora gutuma umuvuduko w'amaraso ugabanuka (umuvuduko w'amaraso uri hasi cyangwa guhagarara) muri MODS. Amazi ashobora kandi kuva muri iyo mitsi y'amaraso, bigatuma habaho kubyimba (edema).

3. Uturemangingo tw'amaraso (amaraso)

MODS ishobora gutera ubusumbane muri poroteyine zimwe na zimwe mu maraso. Ibi bishobora gutera kuva amaraso no kuvura indwara zo kuvura . Ushobora kubona udusebe ku ruhu cyangwa kuva amaraso mu nda. Ikibazo gikomeye cyane gishobora kugira ingaruka ku maraso yawe ni Disseminated Intravascular Coagulation (DIC) . Muri iki kibazo, amaraso ashobora gutangira kuva mu miyoboro cyangwa mu miyoboro y'uruhu rwawe.

4. Udutsinga tw'imitsi (ubwonko)

Ubwonko bwacu ni urugingo rw'ingenzi rugenzura buri rwego rw'umubiri. Iyo igice cyangwa ubwonko bwose buhagaze gukora bitewe no kwangirika k'ubwonko cyangwa ibindi bice by'ubwonko bwo hagati (harimo n'umugongo n'imitsi ijyana nabwo), tubyita "kunanirwa k'ubwonko". Muri MODS, kubyimba, kuvura amaraso bitewe n'ibibazo by'urusobe rw'amaraso, n'umuvuduko muke w'amaraso bishobora kugabanya ingano y'amaraso atembera mu bwonko. Ibi bishobora kwangiza ubwonko no gutera urujijo (`delirium`) .

5. Uduce tw'impyiko (impyiko)

Kunanirwa kw'impyiko ni igihe impyiko zidashobora gukora bimwe mu bikorwa byazo cyangwa byose, harimo no kuyungurura imyanda mu maraso. Sisitemu y'impyiko iyungurura amaraso yacu, igakora inkari, kandi ikavana amazi atari ngombwa mu mubiri. Muri MODS, iyi gahunda ishobora kwangirika.

6. Umubiri w'umwijima (umwijima)

Kunanirwa k'umwijima ni igihe umwijima udashobora gukora bimwe mu bikorwa byawo byinshi cyangwa byose, nko gukura uburozi mu maraso, kuyungurura uturemangingo dutukura twa kera, no gukora inyo (aside y'umuhondo/icyatsi ifasha mu gusya ibiryo). Kubyimba no kugabanuka kw'amaraso ajya mu mwijima bishobora gutuma umwijima unanirwa. Ibi bishobora gutuma uruhu n'amaso bihinduka umuhondo (jaundice). Kunanirwa k'umwijima bishobora no gutuma izindi ngingo zinanirwa gukora.

MODS ikunze kugaragara gute?

MODS ni indwara ikunze kugaragara mu ndwara zikomeye kandi zikomeye. Ubushakashatsi bwerekana ko hagati ya 28% na 88% by'abarwayi bari mu byumba byita ku barwayi bashobora kurwara MODS. Ni nayo mpamvu ikomeye itera urupfu mu byumba byita ku barwayi barembye cyane (ICUs).

Ni ibihe bimenyetso bya mbere bya MODS?

Kubera ko MODS ishobora kugira ingaruka ku rugingo urwo arirwo rwose mu mubiri, ibimenyetso biterwa n'urugingo rwafashwe. Ibi bimenyetso bishobora kuba byoroheje mu ntangiriro z'indwara itera MODS, cyangwa bikaba bikomeye . Uko MODS igenda ikura mu burwayi bukomeye, ushobora guhura n'ibi bikurikira:

• Isesemi no kuruka
• Gukunda kurya
• Kumva ufite intege nke cyane cyangwa unaniwe cyane
• Umuriro
• Gukonjesha
• Guhuzagurika cyangwa kugorwa no kwibanda ku bintu
• Guhumeka vuba kandi mu buryo buciriritse
• Umutima utera vuba cyangwa utari umeze neza
• Kubabara igituza cyangwa igifu igihe kirekire
• Kubyimba inda
• Kubyimba kw'ingingo
• Ibara ry'umuhondo ku ruhu cyangwa amaso (jaundice)
• Ibara ry'ubururu cyangwa imvi/umweru ry'uruhu, iminwa, ururimi, ishinya, inzara, cyangwa amaso (cyanosis)
• Gutakaza ubwenge

Ni iki gitera MODS?

MODS ishobora guterwa n'indwara iyo ari yo yose ikomeye, imvune, cyangwa ubwandu. Abaganga n'abashakashatsi ntibaramenya impamvu nyayo ya MODS. Ariko, ubushakashatsi buriho bugaragaza ko kubyimba no kugabanuka kw'amaraso akenshi ari byo bitera MODS. MODS ntabwo iterwa n'indwara imwe y'ingenzi. Iterwa n'ibintu byinshi bigira ingaruka ku ngingo nyinshi z'umubiri cyangwa zose. Kugabanuka kw'amaraso na ogisijeni bishobora kwangiza.

Tekereza, mu ndwara ikomeye, hashobora kubaho ibintu byinshi biganisha kuri MODS.

1. Impamvu y'ibanze: Iyi ni yo mpamvu y'ibanze. Urugero, kwandura indwara ikomeye (sepsis), impanuka ikomeye (nk'impanuka y'imodoka), cyangwa indwara ikomeye y'umutima.

2. Icya kabiri: Iki ni igihe ubudahangarwa bw'umubiri bwawe bukabije, bigatera ububyimbirwe bukomeye mu mubiri wose.

3. Ikiza cya gatatu: Niba ugize ubwandu bushya, cyangwa ukaba ugomba kubagwa kugira ngo uvurwe indwara ya mbere, icyo gishobora kuba ikiza gatatu.

Zimwe mu mpamvu zikunze gutera MODS ni izi:

• Sepsis cyangwa septic shock: Ibi bishobora kuba ububyimbirwe bukomeye buterwa n'ubwandu bukomeye bwa bagiteri cyangwa virusi.
• Gukomereka mu buryo butunguranye: Ibintu nk'impanuka y'imodoka, gushya cyane, gukomeretswa, cyangwa kurasa.
• Pancreatite: Kubyimba kwa pancreas. Ibi bishobora guterwa n'amabuye y'agahinda, kunywa inzoga nyinshi, imiti imwe n'imwe, n'ibindi bintu.
• Indwara ikomeye y'umutima: Iterwa no kuziba kw'imitsi y'amaraso itanga amaraso mu mutima.
• Kunanirwa k'umwijima: Ibi bishobora guterwa n'umwijima wa B, umwijima wa C, indwara y'umwijima w'ibinure, kunywa inzoga nyinshi, na cirrhose.
• Gukomeretsa no guhumanya:Biterwa no guhura n'uburozi. Urugero, gukoresha ibiyobyabwenge cyangwa inzoga mu buryo bukabije cyangwa buhoraho, imiti ihumanya nk'imiti yica udukoko n'ibikoresho bishaje byo gukingira (asbestos), hamwe n'indwara zandurira mu mikorobe.

Izi ndwara zitera impinduka zikomeye mu budahangarwa bw'umubiri wawe no mu maraso, ibyo bikaba bigira ingaruka no ku zindi ngingo.

Ni uruhe rugingo rwa mbere runaniwe muri MODS?

Hafi ya buri wese ufite MODS abanza kugira ibibazo by'ibihaha , ariko abaganga n'abashakashatsi ntibarasobanukirwa neza impamvu ibihaha bikunze kunanirwa mbere ya MODS.

Ni nde ugerwaho cyane na MODS?

Umuntu wese ashobora kurwara MODS, ariko ushobora kurwara MODS iyo ufite ikibazo kidasobanutse, nk'indwara idakira cyangwa indwara idakira y'ubudahangarwa bw'umubiri.

Ni gute wamenya MODS?

Abaganga bakoresha ibizamini bitandukanye kugira ngo barebe niba ingingo zawe zose zananiwe gukora neza. Ibi bishobora kuba birimo:

• Gupima amaraso
• Ikizamini cy'imyuka mu maraso yo mu mitsi
• Ibizamini by'imikorere y'umwijima
• Ibipimo by'imikorere y'impyiko
• Imiterere y'amaraso n'imitsi
• Echocardiogram (ultrasound y'umutima)
• Ibizamini byo gufata amashusho nka ultrasound cyangwa CT scan

MODS ivurwa ite?

Uburyo bwo kuvura MODS buterwa n'impamvu nyamukuru ndetse n'ingingo z'umubiri zagize ingaruka. Hari uburyo bumwe bwo kuvura burimo:

• Vura amaraso make utanga ibinyobwa mu mitsi (IV) .
• Gutanga imiti igabanya umuvuduko w'amaraso mu mitsi no mu ngingo (imitsi isohoka).
• Tanga imiti yica udukoko kugira ngo uvure indwara zandurira mu maraso cyangwa sepsis.
• Gutera amaraso ni inzira yo gusimbuza amaraso yatakaye bitewe n'imvune cyangwa kubagwa.
• Uburyo bwo kuvura umwuka wa ogisijeni kugira ngo umubiri uhabwe umwuka mwinshi wa ogisijeni.
• Niba udashobora guhumeka wenyine, ushobora gukenera guhumeka hakoreshejwe ikoranabuhanga kugira ngo bigufashe guhumeka.
• Dialysis ifasha gukura imyanda n'amazi arenze urugero mu mubiri wawe.
• Gutanga ogisijeni hanze y'umubiri (ECMO) kugira ngo hongerwe ogisijeni mu maraso kandi bikuremo dioxyde de carbone.
• Sisitemu yo kuzenguruka umwijima ikoresha molekile (MARS) kugira ngo ishyigikire umwijima.
• Kubagwa abarwayi bafite ibikomere bikomeye.
• Kubaga ingingo ni ugusimbuza ingingo irwaye cyangwa idakora neza n'ingingo nzima ivuye ku muntu wayitanze.
• Niba ufite amaraso mu gifu (GI) cyangwa ikibazo cy’igifu kikubuza kurya, cyangwa niba udashobora kurya, ushobora gukenera guhabwa intungamubiri binyuze mu mirire ya IV (ishyirwa mu mitsi) cyangwa iy’imbere (indyo yuzuye).

Nzumva meze neza vuba gute nyuma yo kuvurwa?

Gukira kwawe bizaterwa n'impamvu nyamukuru n'uburyo bwo kuvura. Muganga ashobora kuguha igitekerezo cyiza cy'igihe ushobora kwitega kubona iterambere nyuma yo kuvurwa.

Ejo hazaza ha MODS ni he?

Ahazaza ha MODS haterwa n'impamvu nyamukuru. Hari igihe zimwe mu bwenge bwawe cyangwa zose zishobora gusubira mu buzima busanzwe, ariko ushobora gukenera ubufasha bw'igihe gito kugeza igihe uzakira.

Kumenya no kuvura hakiri kare MODS n'impamvu yayo ni ingenzi cyane kugira ngo iki kibazo gikemuke neza.

Uburyo MODS ikwirakwira mu byumba byita ku barwayi barembye cyane (ICUs). Abaganga babona ko iyi ndwara ari yo mpamvu ikunze gutera urupfu ku barwayi bakirwa mu byumba byita ku barwayi barembye cyane.

Iyo indwara igeze ku ntera ikomeye, ingingo zishobora kwangirika burundu. Ushobora gukenera ubufasha bw'igihe kirekire cyangwa guterwa urugingo. Bishobora no kwica.

Hakenewe ubushakashatsi bwinshi kugira ngo hamenyekane ibintu bishobora kugira ingaruka kuri MODS, bishobora gutuma abarwayi bagira ahazaza heza.

Ni iki gipimo cyo kurokoka gituruka kuri MODS?

Abaganga n'abashakashatsi bavuga ko igipimo cyo kubaho kwa MODS kiri hagati ya 50% na 60% .

Ese MODS ishobora kwirindwa?

Zimwe mu mpamvu zitera MODS ntizishobora kwirindwa. Kandi nta muti wihariye ushobora gufasha gukumira MODS. Abashakashatsi bagiye bashakisha uburyo bwo kuvura MODS mu ntangiriro zayo kugira ngo hirindwe ko iyi ndwara ikomeza kwiyongera. Ubushakashatsi butandukanye burimo gukorwa muri uru rwego.

Ushobora gufasha mu kurinda ingingo zawe ukora ibintu nk'ibi bikurikira:

• Rinda ingingo zawe kugira ngo zidahungabana umbara imikandara yo mu modoka n'ibikoresho byo kuzirinda mu gihe ukina siporo ikomeye.
• Jyana urukingo kugira ngo wirinde indwara zikomeye iyo abaganga babigusabye.
• Gabanya cyangwa uhagarike gufata imiti idategetswe na muganga, nk'imiti igabanya ubushyuhe idakoresha steroide (NSAIDs), ishobora kwangiza impyiko.
• Gabanya cyangwa uhagarike gufata imiti cyangwa ibindi bintu bishobora gutera ibisebe byo mu gifu, nka NSAIDs, kunywa itabi, n'inzoga .
• Shaka ubuvuzi bw'umuvuduko ukabije w'amaraso (hypertension) .

Niba uri mu bitaro ufite indwara ikomeye, abaganga bawe bashobora gukora ibintu nk'ibi kugira ngo wirinde ko MODS irushaho kuba mbi:

• Kugabanya kwangirika kw'ibihaha byawe bitewe n'umwuka uhumeka mu buryo bwa mashini.
• Kugabanya guterwa amaraso kugeza igihe bibaye ngombwa rwose.
• Gukoresha imiti igabanya amaraso mu gihe bibaye ngombwa kugira ngo hirindwe kubyimba kw'amaraso.

Ni ryari ngomba kujya kwa muganga?

Niba ufite indwara idakira kandi ukaba ufite ibimenyetso bya MODS, bishobora gutera indwara ikomeye no kunanirwa kw'ingingo, ni byiza kujya kwa muganga. Bashobora kukubwira ibimenyetso cyangwa ibimenyetso byihariye ugomba kwitaho n'uburyo bwo guhangana n'indwara iyo ari yo yose.

Ni ryari nkwiye kujya mu ishami rishinzwe ubutabazi bwihutirwa (ETU) ?

Niba ufite ibimenyetso bya MODS, jya mu cyumba cy’ubutabazi kiri hafi yawe cyangwa uhamagare 911. Ibi bishobora kwica iyo bidavuwe vuba.

Ni ibihe bibazo ngomba kubaza muganga?

Dore ibibazo bimwe na bimwe ushobora kubaza muganga wawe:

• Ni iki gitera MODS?
• Ni ubuhe buryo bwo kuvura mfite?
• Ni iyihe miti usaba?
• Intego z'ubuvuzi bwanjye ni izihe?
• Ni kangahe nkeneye kuvurwa?

Incamake n'ubutumwa bwa nyuma

Noneho rero, ubu uzi ko indwara yo kudakora neza kw'ingingo nyinshi (MODS) ari indwara ikomeye ifata ingingo ebyiri cyangwa nyinshi mu mubiri wawe. Nubwo MODS ishobora kugira ingaruka ku ngingo iyo ari yo yose, ikunze kugira ingaruka ku bihaha, umutima, impyiko, umwijima, ubwonko, n'amaraso. Hari impamvu nyinshi zishobora gutera ibi. Ikunze kugaragara ni ihungabana rikomeye, indwara zikomeye, n'indwara zandura. Ubuvuzi bwibanda ku kuvura indwara iri inyuma y'iyi ndwara mu gihe hirindwa kwangirika kw'izindi ngingo.

Ni ibisanzwe kugira ubwoba iyo wumvise ko ingingo zawe cyangwa iz'umuntu ukunda zidakora. Ariko abaganga n'abakozi bo mu Ishami rishinzwe Ubuvuzi bw'Ibanze (ETU) n'Ishami rishinzwe Abarwayi Bakomeye (ICU) bahuguwe kugira ngo bafashe ingingo zose z'ingingo zawe, birinde kwangirika gukabije, kandi bafashe umubiri wawe gukira. Bityo rero ntucike intege. Uramutse uvuwe vuba kandi ukagirwa inama n'abaganga, ushobora kugerageza kuva muri iki kibazo.

Kunanirwa kw'ingingo nyinshi , MODS, kunanirwa kw'ingingo, sepsis, ubuvuzi bw'inyongera, kunanirwa kw'ingingo, ubufasha bwo gufasha ubuzima