Ese wigeze utekereza ko imiyoboro y'amaraso iri mu mibiri yacu imeze nk'imiyoboro y'amazi iri mu nzu? Nk'uko uko igihe kigenda gihita, umwanda n'ingese byiyongera mu miyoboro y'amazi bikabuza amazi gutembera, ibintu nk'amavuta n'ibinure na byo bishobora kwiyongera mu miyoboro y'amaraso yacu bikabuza amaraso gutembera. Ibyo ni byo twita 'Endarterectomy', uburyo bwo kubaga kugira ngo hasukurwe imiyoboro y'amaraso nk'iyo yazibye. Uyu munsi, tuzabivugaho mu magambo yoroheje.
Mu magambo make, Endarterectomy ni iki?
Endarterectomy (izwi nka: en-da-te-rek-to-me) ni uburyo bwo kubaga kugira ngo imitsi ifunganye cyangwa ifunganye ifunguke. Muri ubu buryo, abaganga bakuraho plaque , urwego runini rw'ibinure, kalisiyumu, na plaque yishyize mu mitsi yawe.
Nk’uko gusukura umwanda uri mu muyoboro w’amazi no gutuma amazi yongera gutembera neza, nyuma y’uku kubagwa, amaraso atembera neza mu miyoboro y’amaraso aragaruka. Ibi bigabanya cyane ibyago byo kurwara indwara zikomeye nko kubyimba kw’amaraso no gucika intege mu mitsi .
Ubu buryo bwo kubaga busanzwe bukorwa mu rwego rwo kuvura indwara yitwa atherosclerosis. Ibi bibaho iyo plaque yikubira mu miyoboro y'amaraso, bigatuma ikomera buhoro buhoro kandi ikagabanuka. Ubu buryo bwo kubaga bukunze kuba bwiza ku bantu bafite ibimenyetso by'indwara z'imitsi yazibye kandi ikomeye.
Hari indwara ebyiri z'ingenzi zivurwa n'ubu buvuzi:
- Indwara y'imitsi yo mu mpande (PAD): Iyi ni icyirundanya cy'imitsi ijyana amaraso ku maguru cyangwa ku maboko. Ibi bishobora gutuma amaguru yawe ababara iyo ugenda, ibikomere bigakira buhoro buhoro, ndetse rimwe na rimwe bigatera n'urupfu rw'imitsi (gangrene).
- Indwara y'imitsi yo mu muyoboro wa Carotid: Iyi ni indwara ikomeye. Iterwa no kwibumbira mu mitsi ibiri y'ingenzi mu ijosi ijyana amaraso mu bwonko. Iyo itavuwe, ishobora gutera indwara yo gucika imitsi cyangwa indwara y'imitsi iterwa n'amaraso mu buryo bwihuse (TIA).
Ni ubuhe bwoko bw'ibagwa rya endarterectomy?
Ubwoko bw'ikibagwa buratandukanye bitewe n'aho umuyoboro w'amaraso ufunganye mu mubiri wawe. Reba imbonerahamwe iri hepfo kugira ngo bikorohere.
| Ubwoko bw'ukubaga | Gusukura imitsi y'amaraso n'ibisobanuro byayo |
|---|---|
| Kubaga Carotid Endarterectomy | Gusukura imitsi ijyana amaraso mu bwonko iturutse impande zombi z'ijosi. Ubu ni bwo bwoko bukunze kugaragara cyane. |
| Kubaga Endarter y'abagore | Gusukura imitsi mikuru (imitsi yo mu gitsina) iva mu kibuno ikagera ku maguru. |
| Kubagwa kwa Aortic na Iliac Endarterectomy | Gusukura imiyoboro y'amaraso ikomeye mu nda (mu nda) no mu kibuno (mu kibuno). |
| Kubagwa kwa Endaterteri y'imitsi yo mu mutima | Gusukura imitsi y'umutima itanga amaraso mu mutima ubwawo. |
| Kubagwa kw'indwara yo mu mitsi yo mu bihaha | Gukuraho amaraso ashaje mu mitsi ijyana amaraso mu bihaha. Ibi bikunze gukorwa gake cyane. |
Ni gute nakwitegura mbere yo kubagwa?
Mbere y'uko uyu muganga abagwa, azakora ibizamini byinshi kugira ngo amenye neza uburyo imiyoboro y'amaraso yawe yazibye.
- Doppler Ultrasound: Iyi porogaramu ikoresha amajwi kugira ngo irebe aho imiyoboro y'amaraso izibye n'ingano y'amaraso atembera.
- CT Angiography: Muri ibi, haterwa amazi yihariye (irangi ritandukanye) mu mutsi uri mu kuboko kwawe, hanyuma CT scan ikoreshwa mu gufata ifoto y’imitsi yawe y’amaraso mu buryo bwa 3D.
- Angiografiya: Muri ubu buryo, amazi yihariye ashyirwa mu mitsi y'amaraso hanyuma hagafatwa amashusho ya X-ray.
- Isuzuma ry'imitsi ikoresha amashanyarazi (MRA): Ikoresha amashanyarazi n'imiraba ya radiyo kugira ngo ifate amafoto y'imitsi y'amaraso.
Byongeye kandi, muganga wawe azaguha amabwiriza y'uko wakwitegura kubagwa. Ushobora gusabwa guhagarika by'agateganyo gufata imiti imwe n'imwe, nko gufata imiti igabanya amaraso (anticoagulants). Hari igihe ushobora gusabwa gutangira gufata imiti nka aspirine.
Uzakenera kandi kwiyiriza ubusa amasaha make mbere yo kubagwa. Itsinda rishinzwe gutera ikinya rizakubwira icyo gukora neza. Ushobora kandi gukorerwa ibizamini nka 'Echocardiogram' cyangwa 'Stress Test' kugira ngo urebe ubuzima bw'umutima wawe.
Ni nde udashobora kubagwa?
Hari abantu bafite indwara zimwe na zimwe baba bari mu kaga gakomeye ko kubagwa, bityo abaganga ntibabagira inama yo kubagwa. Urugero:
- Niba ufite ikibazo gikomeye cy'umutima kidashoboka (congestive heart failure).
- Niba uherutse kugira indwara y'umutima.
- Niba ufite ibimenyetso by'indwara y'umutima bidashobora kuvurwa.
- Niba ufite indwara ikomeye y'ibihaha nka emphysema cyangwa COPD.
- Niba warigeze kuvurwa hakoreshejwe imirasire mu gace kazakorerwamo ubuvuzi.
- Niba hari ubwandu muri ako gace.
Ariko ntugire ikibazo. Ndetse no ku muntu nk'uyu, hari igihe muganga agerageza gukuraho ikibazo cyo kuziba akoresheje stent mu mitsi y'amaraso, nko kubaga amaraso.
Kubagwa bikorwa gute?
Uzahabwa ikinya kugira ngo utazagira ububabare ubwo aribwo bwose mu gihe cyo kubagwa. Akenshi, uzahabwa ikinya rusange. Ibi bivuze ko uzaba utazi icyo uvuze. Ariko, rimwe na rimwe, cyane cyane iyo usukuye imitsi yo mu ijosi (carotid endarterectomy), ushobora kuba maso kandi ugasigara udafite icyo uvuze muri ako gace (local anesthesia) mu gihe cyo kubagwa kuko ari ngombwa kugenzura imikorere y'ubwonko bwawe.
Mu gihe cyo kubagwa, muganga:
1. Gukata uruhu hejuru y'umuyoboro w'amaraso wafunzwe bikorerwa mu gukata uruhu.
2. Umutsi w'amaraso urafungurwa maze urwego rwa `plaque` ruri imbere rugakurwaho witonze.
3. Umutsi w'amaraso urongerwa hamwe hanyuma ugafungwa. Hari igihe, kugira ngo agace kadakomeza kugabanuka, hakoreshwa "patch" y'ubukorano cyangwa igice cy'umutsi muzima wakuwe mu kindi gice cy'umubiri wawe kugira ngo wongere agace gato.
4. Amaherezo, aho uruhu rucagagurwa harafungwa kandi hagashyirwamo imisumari.
Ibyiza, ingaruka, n'igihe cyo gukira
Akamaro nyamukuru k'ubu buvuzi ni uko bufungura imiyoboro y'amaraso yazibye kandi bugasubiza amaraso mu muyoboro wayo. Ibi bigabanya cyane ububabare bw'amaguru, ibikomere bidakira, cyane cyane ibyago byo gucika intege. Ibisubizo by'ubu buvuzi bikunze kumara imyaka myinshi.
Nkuko bigenda mu kubagwa kose, hari ingaruka zimwe na zimwe, ariko amahirwe yo kuba ibi bibaho ni make.
- Kuva amaraso
- Indwara z'umutima, nk'indwara z'umutima
- Indwara zandurira mu mubiri
- Kwangirika kw'imitsi (akenshi by'igihe gito)
- Kugabanuka k'umutsi umwe wakoreweho ububabare
- 'Stroke'
Igikuru ni ukumenya ko muganga wawe agusaba kubagwa kuko inyungu zo kubagwa ziruta kure ingaruka mbi.
Bifata igihe kingana iki kugira ngo umuntu akire?
Igihe uzamara mu bitaro giterwa n'ubwoko bw'ubuvuzi bwakorewe.
- Kubagwa imitsi yo mu ijosi (carotid): hafi umunsi umwe.
- Ku kubagwa imitsi yo mu kibuno (imitsi yo ku maguru): Hafi iminsi ibiri cyangwa ine.
- Kubagwa kw'imitsi yo mu nda (aortic artery): hafi icyumweru.
Uzasabwa kuza gukurikiranwa nyuma y'ibyumweru bine nyuma yo kubagwa. Abantu benshi bashobora gusubira ku kazi nyuma yo gukurikiranwa. Ariko, niba ufite akazi gasaba guterura ibintu biremereye, bishobora gufata ukwezi cyangwa abiri kugira ngo ukire neza.
Ni ryari nkwiye guhamagara muganga?
Niba ubonye kimwe mu bimenyetso bikurikira nyuma yo kubagwa, ugomba guhita uhamagara muganga wawe cyangwa ukajya mu bitaro bikuru by’ubutabazi bw’ibanze (ETU) biri hafi yawe.
- Kubabara mu gatuza
- Guhumeka bigoranye
- Niba wumva ufite umuriro cyangwa ufite ibicurane
- Niba wumva ufite intege nke cyangwa ufite ikibazo aho wakomerekejwe
- Iyo hari kubyimba, gutukura, cyangwa amazi asa n'ibibyimba hafi y'aho habereye icyuho
- Impinduka mu kureba, kuvuga nabi, cyangwa kunama k'uruhande rumwe rw'isura
- Iyo habayeho isesemi cyangwa kuruka
Ubutumwa bwo kujyana mu rugo
- Endarterectomy ni uburyo bwo kubaga bukuraho ibinure (imyanda) imbere mu mitsi y'amaraso kandi bugasukura imitsi.
- Uku kubagwa bishobora kugabanya cyane ibyago byo kurwara indwara zikomeye nka stroke.
- Mbere yo kubagwa, hakorwa ibizamini byinshi kugira ngo hamenyekane ingano y'aho umutima wawe uzibye n'ubuzima bw'umutima wawe.
- Nubwo ubu ari uburyo bukomeye bwo kubaga, ni uburyo bwo kuvura bufite umusaruro mwiza kandi bumara imyaka myinshi.
- Bifata igihe kugira ngo umuntu akire nyuma yo kubagwa. Muri icyo gihe, ni ngombwa cyane gukurikiza amabwiriza ya muganga neza.
- Niba hari ibimenyetso biteje akaga bigaragara nyuma yo kubagwa, shaka ubufasha bwa muganga vuba.
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