Ese hari ikintu kibuza amaraso kwinjira no gusohoka mu mutima wawe? Ibi bishobora kuba (Obstructive Shock)!

Iyo amaraso adatembera neza mu mubiri wacu, bivuze ko ingingo zacu zidahabwa ogisijeni ikenewe, akenshi tuyita 'shock'. Ibi bibaho mu buryo butunguranye. Uyu munsi tugiye kuvuga ku bwoko bwihariye bwa 'shock', ariko budasanzwe. Byitwa '(Obstructive Shock)'. Muri make, ikiba muri iki kibazo ni uko hari ikintu kibuza amaraso gutembera mu mutima wacu maze amaraso agasohoka mu mutima, ni ukuvuga ko habaho 'obstruction'. Kubera uku kuziba kw'amaraso, umutima ntushobora gukora neza, umuvuduko w'amaraso ushobora kugabanuka mu buryo butunguranye, umubiri ukabura ogisijeni. Iki ni ikibazo cyihutirwa cyane , bityo ni ngombwa cyane kuvurwa vuba.

None se iyi '(Obstructive Shock)' ni iki? Ese twayisobanuraho gato?

Tekereza, umutima wacu umeze nk'ipompo y'amazi. Iyi pompe ni yo yohereza amaraso mu mubiri wose. None se, bigenda bite iyo amazi yinjira muri iyi pompe azibye mu muyoboro, cyangwa iyo umuyoboro uva muri pompe uzibye? Amazi adatemba neza, sibyo? Ibyo ni byo biba muri `(Obstructive Shock)`.

Hari ikintu kibuza amaraso gutembera mu miyoboro minini y'amaraso (yitwa 'imiyoboro minini') ihuza umutima. Ibi bibuza umutima kubona amaraso ahagije, kandi ntushobora kuyasohora. Ingaruka ni uko ingingo z'ingenzi mu mubiri wacu, ubwonko, impyiko, n'ibihaha, zitabona umwuka uhagije wa ogisijeni. Iki ni ikibazo gihangayikishije ubuzima.

Ni irihe tandukaniro riri hagati ya `(Cardiogenic Shock)` na `(Obstructive Shock)`?

Ibi byombi ni ibyihutirwa by’ubuvuzi, ariko bibaho kubera impamvu ebyiri.

Ihungabana ry’umutima ribaho iyo imitsi y’umutima yangiritse, urugero nk’indwara y’umutima, kandi umutima ntubashe kuvoma amaraso ahagije mu mubiri. Umutima ucika intege.

Ariko muri '(Obstructive Shock)' imitsi y'umutima ikunze kuba myiza. Ikibazo si umutima, ahubwo ni ikindi kintu kibangamira imikorere y'umutima. Tekereza kuri ibi bintu:

• Niba ufite amaraso menshi mu mitsi minini y'amaraso (imitsi y'ibihaha) ijyana mu bihaha byawe.
• Iyo umutima upfunyitse n'agafuka kuzuye amazi gakikije umutima (pericardial tamponade).
• Iyo habayeho gukomereka mu bihaha kandi umuvuduko uri mu gituza wiyongera cyane, urugero, mu ndwara yitwa "Tension pneumothorax".

Guhagarika umutima ni igihe umutima udashobora gukora neza bitewe n'impamvu nk'iyi.

Iyi ndwara yitwa "Obstructive Shock" ikunze kugaragara gute? Igira ingaruka zite ku mubiri?

Indwara yo guhungabana mu buryo butunguranye (Obstructive Shock) mu by’ukuri ni indwara idakunze kugaragara ugereranyije n’izindi ndwara zo guhungabana. Akenshi ifata 1% cyangwa 2% by’abarwayi ba shock. Inkuru nziza ni uko ishobora gukira kurusha izindi ndwara zo guhungabana, ariko gusa iyo ivuwe vuba.

Iyo idavuwe vuba, Obstructive Shock ibuza ingingo z'ingenzi z'umubiri umwuka n'intungamubiri. Ibi bishobora kwangiza ingingo ndetse rimwe na rimwe bigatera urupfu. Niyo mpamvu ari ngombwa gushaka ubuvuzi vuba.

Ni ibihe bimenyetso bya `(Obstructive Shock)`?

Ibimenyetso by'ibi bishobora gusa n'iby'indwara ya ``Cardiogenic Shock.'' Reba niba ibi bisa n'ibisanzwe kuri wewe:

• Umuvuduko wo guhumeka uriyongera mu buryo budasanzwe.
• Umuvuduko w'amaraso ugabanuka cyane (hypotension).
• Igipimo cy'umutima kiriyongera cyane (`Tachycardia`). Nk'aho uherutse kwiruka.
• Amarangamutima ahinduka, wenda agahinda cyangwa guhangayika bishobora kubaho.
• Ingano y'inkari zikorwa iragabanuka cyane, cyangwa ntizibeho na gato.
• Uruhu rumera nk'urukonje kandi rwuzuye ibyuya.
• Hari igihe umwuka ushobora kwirundanya munsi y'uruhu (`Subcutaneous emphysema`). Ibi bivuze ko wumva umeze nk'uduheri duto munsi y'uruhu.
• Ushobora kugira ububabare mu gituza cyangwa mu nda.

Niba ufite kimwe cyangwa byinshi muri ibi bimenyetso, ni ngombwa cyane gushaka inama kwa muganga byihutirwa.

Ni izihe mpamvu za `(Obstructive Shock)`?

Hari impamvu nyinshi zitera `(Obstructive Shock)`. Reka turebe izikuru:

• `(Tension pneumothorax)` (gucika kw'ibihaha): Ibi bibaho iyo umwuka winjiye mu bihaha ntushobore gusohoka, bigatuma ufatwa n'ibihaha. Hanyuma ibihaha biracika, bigatera umuvuduko mwinshi mu gituza bigatuma umutima utangira gutera.
• Vena cava compression syndrome: Gukanda imitsi minini mu mubiri wacu (vena cava). Ibi bishobora kubaho mu mpera z'inda, iyo uburemere bw'umwana bukanda uyu mutsi w'amaraso.
• Indwara yo gukanda imitsi y'ibihaha: Indwara yo gukanda imitsi y'ibihaha.
• `(Guhumeka cyane)`: Indwara aho umuvuduko mu bihaha uba uri hejuru cyane ku muntu uhujwe n'icyuma gihumeka.
• Ibibyimba: Hari ubwoko bumwe na bumwe bw'ibibyimba bikura mu gituza nabyo bishobora kuziba umutima cyangwa imiyoboro minini y'amaraso.
• Kuvura amaraso mu mitsi yo mu bihaha: Ibi ni bibi cyane. Iyo amaraso apfutse ahantu nk'ukuguru agacika agafata imitsi yo mu bihaha, bihagarika amaraso kuva mu mutima akajya mu bihaha.
• Tamponade yo mu mutima: Agafuka gato gakikije umutima (pericardium) kuzuyemo amazi, gakamya umutima. Ibi bibuza umutima kwifata no kwaguka neza.
• Gucika kw'imitsi y'amaraso: Gucika kw'imitsi y'amaraso, umutsi munini w'amaraso usohoka mu mutima.
• Stenosis y'imitsi y'amaraso: Kugabanuka k'umuyoboro w'amaraso y'umutima. Ibi bituma amaraso asohoka mu mutima bigorana.
• Hypertrophic cardiomyopathy: Kuziba kw'amaraso bitewe no kubyimba gukabije kw'imitsi y'umutima.
• Indwara ya Constrictive Pericarditis: Agafuka gakikije umutima karabyimba, bigatuma umutima udakora neza.

Icy'ingenzi: Izi mpamvu zose ni izihutirwa, bityo jya kwa muganga vuba niba ufite ibimenyetso.

Ni gute wamenya `(Obstructive Shock)`?

Muganga wawe azabanza kugusuzuma. Azatega amatwi umutima wawe n'ibihaha akoresheje stethoscope. Indwara yo guhungabana mu gihe cy'impanuka ni indwara ishobora kwiyongera vuba, bityo ni ngombwa kuyisuzuma vuba.

Kugira ngo umuntu amenye neza indwara, hashobora gukorwa ibizamini bikurikira:

• Ultrasound: Ibi bishobora kureba ibintu nk'umutima, imiyoboro minini y'amaraso, ndetse no kureba niba hari amazi akikije ibihaha.
• Echocardiogram (Echo): Ibi ni nk'isuzuma ry'umutima rya ultrasound. Rishobora kwerekana neza imikorere y'umutima, imiterere y'imitsi, ndetse niba hari amazi akikije umutima.
• Gupima hakoreshejwe ikoranabuhanga rya 'computer tomography': Ibi bishobora gufata amashusho arambuye y'umwobo wo mu gituza. Bishobora gufasha kumenya ibintu nk'amaraso apfunditse, ibibyimba, no gucika kw'imitsi.
• Electrocardiogram (ECG cyangwa EKG): Ibi bipima imikorere y'amashanyarazi y'umutima. Bishobora gufasha kumenya niba hari ikibazo mu mutima wawe.

Indwara yo gucika intege (Obstructive Shock) ivurwa ite?

Ubwa mbere, uzahabwa amazi yo mu maraso (nk'amazi ya saline - IV crystalloid) kandi umuvuduko w'amaraso yawe n'urugero rwa ogisijeni bizagenzurwa buri gihe. Hanyuma, icy'ingenzi ni ukumenya icyateye Obstructive Shock no kuvura iyo mpamvu.

Uburyo bwo kuvura buratandukanye bitewe n'impamvu. Reka turebe ingero nke:

• Iyo amaraso agize akabyimba (embolism), karakurwaho haba mu kubagwa cyangwa mu gushyiramo kannula (catheter).
• Niba ari valve ya aorta yagabanutse cyane, izasimburwa.
• Mu gihe imitsi y'umutima ifite ubukana (hypertrophic cardiomyopathy), ubunini bushobora kugabanuka haba mu kubagwa cyangwa uburyo bwihariye bukoresha inzoga (catheter-based alcohol ablation).
• Baguha umuti wo gushonga amaraso apfutse.
• Iyo hari amazi akikije umutima (pericardial tamponade) cyangwa pneumothorax yo guhangayika, amazi cyangwa umwuka bizakurwaho (wenda hakoreshejwe umuyoboro muto).
• Niba uri kuri ventilator, ushobora guhindura imiterere yayo.
• Mu gihe umuntu arwaye indwara nka "Vena cava compression syndrome", imiterere y'umubiri irahinduka.
• Iyo umuvuduko mu bihaha uri hejuru, umuvuduko ugabanuka hakoreshejwe urushinge cyangwa umuyoboro.

Ni iyihe miti ikoreshwa?

Mu gihe icyateye kiri kuvurwa, ushobora guhabwa imiti nk'iyi kugira ngo ugire ubuzima bwiza:

• Amatembabuzi nka `IV` saline (`IV crystalloid fluids`).
• Imiti yo kongera umuvuduko w'amaraso: `(Norepinephrine (Levophed®))`, `(Vasopressin (Vasostrict®))`, `(Phenylephrine (Vazculep® cyangwa Biorphen®))`.
• Niba ufite amaraso make, uzahabwa amaraso cyangwa ibikomoka ku maraso (nk'uturemangingo dutukura tw'amaraso na plasma).

Nzakira vuba gute nyuma yo kuvurwa?

Impamvu nyinshi zitera Obstructive Shock zigomba kuvurwa vuba , kuko icyo gihe amahirwe yo kurokoka aba menshi. Ku bw'amahirwe, ubu buryo bwo kuvura bukora vuba. Ariko, nubwo nyuma yo kuvura icyayiteye, bifata igihe kugira ngo umubiri ukire ingaruka za Obstructive Shock. Ntushobora kwirukanka gusa ngo ukore akazi kawe.

Ni iki giteganijwe kuri `(Obstructive Shock)`?

Iyo itavuwe, "Obstructive Shock" ni indwara ishobora kwica abantu benshi. Gukira nyuma yo kuvurwa biterwa n'ibintu byinshi, birimo:

• Ni iyihe mpamvu ya `(Obstructive Shock)`?
• Byatwaye igihe kingana iki kugira ngo umuntu avurwe?
• Ni izihe ndwara zindi ufite?
• Ubuvuzi bwagufashije bute?

Ariko, nk'uko byavuzwe mbere, amahirwe yo gukira indwara ya "Obstructive Shock" ari menshi kurusha ubwoko busanzwe bwa "Shock" nka "Septic Shock". Kubwibyo, hari icyizere.

Nitwara nte?

Nyuma yuko muganga akuvanye mu bitaro, ugomba gukurikiza amabwiriza ye neza.

• Uzakenera kuruhuka mu rugo igihe gito mbere yo gusubira ku kazi.
• Ugomba gufata umuti wanditswe na muganga wawe ku gihe . Ntugahagarike gufata umuti uwo ari wo wose uko ubyifuza.
• Jya mu nama zo gukurikirana buri gihe .

Ni ryari nkwiye kongera kubonana na muganga? Ni iki nkwiye gukora mu gihe cyihutirwa?

Noneho uzi icyaguteye '(Obstructive Shock)'. Witondere niba ibimenyetso bijyanye n'icyo kibazo byongeye kugaragara. Niba wongeye kugira ibimenyetso nk'ibyo, cyangwa niba hari umuntu wo mu muryango wawe ubonye iyi mpinduka muri wowe, hamagara Ishami ry'Indwara z'Abatabazi ryo mu 1990 (Wind) (Ambulance Service), cyangwa ujye mu cyumba cy'ubutabazi bw'ibanze cy'ibitaro biri hafi yawe. Igihe ni ingenzi cyane.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Ushobora kubaza ibibazo nk'ibi:

• Nkeneye gufata umuti wanditswe igihe kingana iki?
• Ni amahirwe angahe yo kongera kugira iyi ndwara?
• Ese ibi bizagira ingaruka ku mibereho yanjye mu gihe kirekire?
• Ni izihe mpinduka nkwiye gukora ku mirire yanjye no ku myitozo ngororamubiri?

Amaherezo, icyo ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Indwara yo mu bwoko bwa Obstructive Shock ni indwara idasanzwe ariko ikomeye cyane isaba ubuvuzi bwihutirwa. Kubwibyo, ni ngombwa kumenya ibimenyetso no gushaka ubuvuzi vuba. Abaganga bamaze kubona icyateye indwara yo mu bwoko bwa Obstructive Shock, bazatangira ubuvuzi bukwiye.

Wibuke ko abantu benshi bashobora gukira indwara yo gucika intege, ariko bifata igihe. Ihangane, kurikiza amabwiriza ya muganga wawe, kandi wite ku buzima bwawe. Ntabwo uri wenyine, kandi hari abaganga, abaforomo, n'abakunzi bawe bashobora kugufasha.

` Ihungabana rishobora guterwa no guhungabana, ihungabana, indwara z'umutima, umuvuduko w'amaraso, ogisijeni, kuziba, ubuvuzi bwihutirwa, ibihaha, umutima