Ese igifu cyawe kimeze nk'aho kirimo guhinduka ibuye? Reka twige kuri iyi ndwara idasanzwe (Ogilvie Syndrome)

Ese wigeze wumva ikintu cyafashe mu nda yawe, inda yawe irushaho kuba nini, kandi wumvaga kigiye guturika? Byari bimeze nk'aho amara yawe yazibye burundu. Akenshi, ibyo bibaho iyo ikintu cyafashe mu nda yawe. Ariko, hari indwara idasanzwe aho amara yawe ahita ahagarika gukora nta kintu na kimwe cyafashe imbere. Uyu munsi, tugiye kuvuga ku ndwara abantu benshi batigeze bumva. Mu buvuzi, iyi ndwara twita Ogilvie Syndrome cyangwa Acute Colonic Pseudo-obstruction (ACPO) .

Mu magambo make, Ogilvie Syndrome ni iki?

Tekereza, hari imodoka nyinshi, ariko nta mpanuka cyangwa imbogamizi zibaho mu muhanda. Imodoka zihagaze gusa. Ogilvie Syndrome ni ikintu nk'icyo. Ingendo z'ibiryo n'imyanda mu mara yawe zirahagarara mu buryo butunguranye. Ukumva hari ikintu cyafatiwe mu mara yawe, ariko mu by'ukuri nta mbogamizi zifatika zihari. Ikibazo kiri mu buryo bw'imitsi bugenzura imitsi mu mara yawe. Kubera ko idakora neza, ingendo z'amara (twita "peristalsis"`) zirahagarara, kandi ibirimo birahagarara ahantu hamwe. Ibi bituma amara agenda yaguka buhoro buhoro, cyangwa akibyimba.

Ijambo "pseudo-obstruction" mu izina ryaryo risobanura "false mistresses." Ibi bivuze ko bigaragaza ibimenyetso nk'aho hari imbogamizi, nubwo mu by'ukuri nta mbogamizi ihari.

Ibi bitandukanye bite n'ibindi bibazo by'amara?

Hari indwara zitandukanye zibangamira imikorere y'amara. Reka turebe uburyo indwara ya Ogilvie Syndrome itandukanye na zo.

• Ugereranije n'izindi ndwara zo mu mara zifata umuntu ku ngufu: Ogilvie Syndrome ni indwara ifata umuntu ku ngufu. Ni ukuvuga ko ihita ibaho, kandi ikaba iy'igihe gito . Kandi ifata amara manini gusa . Ariko, hari abantu bashobora kugira indwara zo mu mara zifata umuntu ku ngufu zidakira. Akenshi ziterwa n'indi ndwara idakira cyangwa indwara yavutse.
• Itandukaniro riri hagati ya `Paralytic Ileus`: Ushobora kuba warumvise ijambo `Paralytic Ileus`. Rikoreshwa mu gusobanura indwara aho amara ahagarika gukora igihe runaka, cyane cyane nyuma yo kubagwa mu nda. Ni ibisanzwe cyane. Bifata amara mato n'amanini ahagarika gukora by'agateganyo hanyuma agakira ubwayo mu minsi mike. Ariko, Ogilvie Syndrome ni indwara igoye kandi idakunze kugaragara . Ifata cyane cyane amara manini , cyane cyane cecum.

Ni nde uri mu kaga gakomeye ko kurwara iyi ndwara?

Nubwo ishobora kugaragara ku muntu uwo ari we wese, ikunze kugaragara ku bantu bakuze barengeje imyaka 60 bafite izindi ngorane nyinshi z'ubuzima.Iyi ndwara igaragara ku barwayi bagera ku 1.000 bari mu bitaro.

Mu magambo make, ibi bishobora kubaho igihe cyose umubiri uri mu muhangayiko mwinshi. Tekereza kubagwa gukomeye, impanuka ikomeye, indwara y'umutima, cyangwa ubwandu bukomeye. Ibi bintu bigira ingaruka ku mikorere y'imitsi yacu. Iyi mitsi ni yo ibwira imitsi yo mu mara "kwimuka." Rero iyo hari ikibazo cyo kutumvikana, amara arahagarara gukora kandi indwara ya Ogilvie ishobora kubaho.

Ni ibihe bimenyetso bya Ogilvie Syndrome?

Iyo umwuka, ibiryo bidafite amazi n'ibidakoreshejwe bifatiwe mu mara yawe, ushobora kugira ibimenyetso nk'ibi. Ibi bishobora gutangira mu buryo butunguranye kandi bikiyongera buhoro buhoro.

Kuki ibi bibaho? Reka turebere hamwe impamvu zibigaragaza.

Nubwo impamvu nyayo y’ibi itaramenyekana neza 100%, abahanga mu bya siyansi bizera ko biterwa n’imikorere mibi mu mikorere y’imitsi yacu . Tekereza nawe, ibintu bibaho mu mubiri wacu mu buryo bwikora, nko gutera umutima, guhumeka, no kugogora, bigenzurwa n’iyi mikorere y’imitsi, ikora nk’imashini ikora ku giti cyayo. Bityo rero, bitewe n’imihangayiko myinshi ku mubiri, iyi gahunda ya "auto-pilot" ishobora kubura ingano, kandi ibimenyetso bigenzura imyakura bishobora guhungabana.

Impamvu z'ingenzi zitera iki kibazo zishobora kugabanywamo ibyiciro byinshi.

Ese ibi bishobora kuba bikomeye? Ni izihe ngorane?

Yego, iyo ibi bitasuzumwe kandi bigavurwa neza, bishobora gutera ingorane zikomeye cyane ndetse zikanashyira ubuzima mu kaga . Tekereza, bigenda bite iyo ukomeje guhumeka umwuka mu ibara ry'umuhondo? Riraturika. Amara ni kimwe.

Ubugari busanzwe bw'amara ni santimetero 8. Ariko, muri Ogilvie Syndrome, iyo irenze santimetero 12, ibyago byo kugira ibibazo biba byinshi cyane.

Ingorane nyamukuru zishobora kubaho ni izi:

• Ischemia: Kwaguka cyane kw'inkuta z'amara bituma imiyoboro y'amaraso yoroshye itanga amaraso ifungana, bigagabanya amaraso atangwa . Ibi bitera kubyimba mu mara (ischemic colitis), iyo itavuwe, ishobora gutuma ingingo zipfa (necrosis).
• Gutobora: Iyo ingingo zipfuye, urukuta rw'amara ruracika intege maze umwobo muto ukaba ushobora kuvuka . Ibi ni bibi cyane kuko mikorobe n'imyanda iva mu mara ishobora kwinjira mu nda, bigatera indwara ikomeye (peritonitis).
• Sepsis: Ubwandu bwakwirakwiriye mu nda ntibugarukira aho. Bushobora kwinjira mu maraso bukagera mu mubiri wose.Iyi ni indwara ishyira ubuzima mu kaga isaba ubuvuzi bwihutirwa. Ishobora no gutuma ingingo z'umubiri zinanirwa gukora kimwe kimwe.

Ni gute wasuzuma neza iyi ndwara?

Abaganga bahangayikishwa cyane n'ibintu bibiri iyo basuzuma iyi ndwara.

1. Ubwa mbere, turareba niba koko hari ikibazo cy’umubiri mu mara.

2. Iyo nta mbogamizi nk'izo zihari, hagaragazwa niba impamvu y'ibi bimenyetso ari Ogilvie Syndrome cyangwa ikindi kintu.

Ibizamini bitandukanye birimo gukorwa kuri ibi.

• Gupima X-ray na CT scan: Gupima X-ray cyangwa CT scan mu nda bishobora kwerekana neza amara manini, yabyimbye kandi yuzuye umwuka. Hari igihe, hatangwa amazi yihariye ('ikinyabutabire cyo kugabanya isura') kugira ngo anyobwe cyangwa ahabwe inshinge kugira ngo haboneke amashusho asobanutse neza.
• Enema ya Gastrografin: Iki ni ikizamini cyihariye cyane. Kuko ari ikizamini ndetse rimwe na rimwe kikaba ari uburyo bwo kuvura. Aha, amazi ashobora gushonga mu mara yitwa `gastrografin` yinjizwa mu mara binyuze mu nzira y'umura, kandi uburyo agenda mu mara bukarebwa na videwo ya X-ray `(fluoroscopy)`. Ibi bishobora kumenya neza niba hari ikibazo mu mara cyangwa nta cyo kirimo. Nanone, iki kiziba cya `gastrografin` gifite ubushobozi bwo kuvura. Kubwibyo, rimwe na rimwe ingaruka zacyo zifasha kongera gutangira gukora kw'amara yahagaze.

Ni ubuhe buryo bwo kuvura ibi?

Ubuvuzi buterwa n'uburyo amara yawe yabyimbye ndetse niba uri mu kaga ko kugira ingorane. Igihe cyose bishoboka, abaganga bagerageza kuvura bakoresheje uburyo bworoshye bwo kuvura (`ubuvuzi busanzwe`) aho gukoresha ibintu nko kubaga.

Ubuvuzi bw'abadakoresha uburyo bwa kera

Mu ntangiriro, ubu buvuzi bukorwa hakurikiranwa neza uko umurwayi ameze.

• Kuvura indwara zisanzwe: Iyo hari indwara isanzwe, nk'indwara yandurira mu maraso cyangwa indwara y'umutima, ibanza kuvurwa.
• Guhagarika imiti: Imiti ikekwaho gutera indwara ya Ogilvie irahagarikwa by'agateganyo.
• Kuruhuka amara: Guhagarika burundu ibiryo n'amazi yo kunywa.
• Umunyu wa IV: Ingano y'amazi n'umunyu umubiri ukeneye itangwa binyuze mu mitsi (amazi ya IV).
• Kugenda no guhindura imiterere: Niba bishoboka, shishikariza umurwayi kugendagenda gato no guhindura imiterere mu buriri. Ibi bishobora gutuma amara atangira kugenda.
• Gushyiramo umuyoboro: Umuyoboro (`Umuyoboro wa Nasogastric`) unyuzwa mu mazuru ujya mu gifu kugira ngo ukuremo umwuka n'amazi menshi. Umuyoboro (`Umuyoboro wa Rectal`) nawo unyuzwa mu kibuno kugira ngo umwuka usohoke.

Muri ubu buryo bwo kuvura, abaganga bakora isuzuma rya X-ray n'amaraso buri gihe kugira ngo barebe uko amara ameze n'ingorane zose afite.

Bite ho niba ubuvuzi bushyigikira budafashe neza?

Iyo indwara idakira nyuma y'amasaha agera kuri 72, cyangwa amara akaba yagutse cyane, abaganga bazakomeza intambwe ikurikira.

• Gukuraho igitutu cy’amara: Muri ibi, umuyoboro ufite kamera ifatanye (`colonoscope`) ushyirwa mu kibuno hanyuma umwuka wakusanyije mu mara ukazamurwa unyuze muri uwo muyoboro. Ibi bihita bigabanya umuvuduko mu mara. Ariko, kubera ko iki gikorwa kidashimishije kandi rimwe na rimwe hakabaho ibyago bike byo gutobora amara, bikorwa witonze cyane.
• Inshinge za Neostigmine: Iyi ni inshinge ikomeye cyane itera imitsi imbaraga. Ubusanzwe ikoreshwa mu gufasha imitsi gukira nyuma yo gusinziriza. Iyo uyu muti utanzwe nk'urushinge rwa IV ku bantu bafite Ogilvie Syndrome, imitsi yo mu mara yongera gukora, kandi ibisubizo byiza byabonetse. Ariko, kubera ko uyu muti ushobora gutera umutima gutera gahoro cyane, utangwa gusa munsi y'ubugenzuzi bwa hafi bwa muganga uri mu cyumba cy'indembe (ICU) .
• Kubagwa (Colectomy / Colostomy): Nubwo hari ubwo buvuzi bwose, amara agakomeza kubyimba, cyangwa habayeho ikibazo gikomeye nko gutobora, kubagwa bishobora kuba ari bwo buryo bwa nyuma. Muri iki gihe, igice cyangiritse cy'amara kiracibwamo (Colectomy). Hari igihe hagomba gukorwa umwenge w'agateganyo cyangwa uhoraho mu nda kugira ngo umwanda unyuremo. Ibi tubyita Colostomy.

Ese iyi ndwara ishobora gushyira ubuzima mu kaga?

Nta ngorane, ibyago byo gupfa ku muntu urwaye Ogilvie Syndrome gusa ni hafi 15%. Ariko, iri janisha rinakubiyemo ingaruka z'izindi ndwara umurwayi afite.

Ariko, iyo habayeho ikibazo gikomeye nko gutobora amara, igipimo cy'impfu kiba kiri hejuru cyane kugeza kuri 40%. Ibi bigaragaza uburyo iki kibazo gishobora kuba gikomeye.

Igikuru ni ukwitondera ibimenyetso ako kanya bikigaragara, gusuzuma indwara vuba, no gutangira kuyivura. Iyo ubikoze, ushobora kwirinda ingorane zikomeye no gukira vuba hakoreshejwe uburyo bworoshye bwo kuvura.