Ese hari umuganga wigeze akubwira cyangwa inshuti yawe ko afite 'umutima ufunganye'? Wenda wowe ubwawe wumva igituza cyawe gifunganye, ububabare, no guhumeka bigoranye iyo uzamuka ingazi cyangwa ugakora imyitozo ngororamubiri gato? Uyu munsi tugiye kuvuga ku buvuzi abaganga bita 'Angioplasty' cyangwa 'PCI'. Ntugatinye iyo wumvise iri zina, ubu si ukubaga gukomeye cyangwa kwibasira nkuko wabitekereza. Reka tuvuge kuri byose mu buryo bworoshye.
PCI ni iki? Mu magambo make...
Mu magambo make, Percutaneous Coronary Intervention (PCI) ni uburyo bukuraho kuziba mu mitsi ijyana amaraso mu mutima (iyi tuyita imitsi y'umutima) kandi bugatuma amaraso yongera gutembera. Tekereza nk'umuyoboro w'amazi ufite kuziba muri wo kandi udatembera neza. PCI ni nko gukuraho kuziba no kongera gusukura umuyoboro.
Abantu benshi bazi ubu buryo bwo kuvura angioplasty . Ushobora kuba warigeze kubyumva mbere. Bikubiyemo gushyira umuyoboro muto (catheter) mu mutsi uri mu kuboko kwawe cyangwa ku kuguru wawe ugana ku mutsi wafunganye uri mu mutima wawe, hanyuma ugashyiramo agapira gato ku mpera y'umuyoboro kugira ngo wagure agace kafunganye.
Nyuma y'uko umutsi ugabanutse, umuyoboro muto umeze nk'umuyoboro ushyirwa mu mwanya wawo kugira ngo udasubira kugwa. Ibi ni byo twita stent . Ni nk'inkingi iri mu mwobo ugiye gusenyuka.
Inyinshi muri stent nshya zifite umuti ugabanya ibyago byo kongera gufunga imitsi. Tuzita 'stent zikoresha imiti'. Ibi bitanga umusaruro mwiza kurushaho.
Ni nde ukeneye ubu buvuzi?
Uko igihe kigenda gihita, ibintu nk'amavuta na cholesterol byiyongera mu miyoboro y'amaraso yacu, bigahinduka urwego runini. Bimeze nk'ingese ziyongera mu muyoboro w'amazi ushaje. Mu buvuzi, uru rwego turwita 'plaque ' . Ingeso y'uko utwo dukoko twiyongera mu miyoboro y'amaraso, ikagabanya kandi ikagira inkuta, yitwa atherosclerosis .
Ibi bituma imitsi ifungana kandi umutima ntubone amaraso akenewe. Iki ni igihe:
- Iyo wihatiye gato, ukazamuka ingazi, cyangwa ukagenda vuba, wumva ububabare cyangwa gufungana mu gituza cyawe . Ibi byitwa angina .
- Biragoye guhumeka, numva meze nk'aho ngiye gusara.
Ku bantu bafite ibi bimenyetso, ubuvuzi bwa PCI bukorwa kugira ngo haveho icyo kiziba kandi amaraso agaruke.
Nanone, indwara y'umutima itunguranyePCI ni uburyo bukomeye bwo kuvura umuntu ufite indwara y'umutima. Indwara y'umutima ni igihe umuyoboro w'amaraso ufunze burundu, bigatuma amaraso atembera mu gice cy'umutima. Hanyuma, kuziba kw'amaraso bigomba gufungurwa vuba bishoboka maze amaraso agashyirwamo. PCI ishobora kubikora vuba kandi ikagabanya cyane kwangirika k'umutima.
Ese hari aho ubuvuzi bwa PCI budakwiye gukorwa?
Umuganga w’indwara z’umutima azafata icyemezo niba ubikeneye, niba ushobora kubyifatamo ukoresheje imiti gusa, cyangwa niba ukeneye kubagwa bikomeye byitwa "coronary artery bypass graft" (CABG). Ibi biratandukanye kuri buri muntu.
Mu gufata icyo cyemezo, muganga asuzuma by'umwihariko ibi bintu:
- Ingano y'imitsi yawe yazibye, ubukana bw'iyi mitsi, n'aho iherereye.
- Uretse indwara z'umutima, hari izindi ndwara ufite nka diyabete cyangwa indwara z'impyiko?
- Uburyo imitsi y'umutima wawe ikora, ibintu nk'imyaka yawe, ni gute?
Kubwibyo, muganga azagusobanurira uburyo bwo kuvura bukubereye.
Ni iki wakora mbere yo kuvurwa?
Keretse niba ari indwara y'umutima itunguranye, muganga wawe azaguha inama z'uko wakwitegura.
- Kurya no kunywa: Ubusanzwe uzasabwa guhagarika kurya no kunywa amasaha 6-8 mbere y'uko uvurwa.
- Imiti: Icy'ingenzi ni uko niba ufata imiti igabanya amaraso cyangwa indi miti iyo ari yo yose, ugomba kubimenyesha muganga wawe. Bashobora kugusaba guhagarika kuyifata iminsi mike mbere y'uko uvurwa. Bitabaye ibyo, ushobora kugira amaraso menshi mu gihe cyo kuvurwa. Ugomba kubikora neza neza nk'uko muganga wawe abikubwira. Ntukigere uhagarika cyangwa ngo uhindure imiti yawe wenyine.
Ni iki kibaho mu gihe cyo kuvurwa?
Ntugatinye iyo ubyumvise, ntabwo ari ikintu gikomeye nkuko ubyibwira. Ibi bikorwa n'umuganga wahawe amahugurwa yihariye mu kuvura indwara z'umutima (Interventional Cardiologist). Uzahabwa umuti woroshye wo kugabanya ububabare kugira ngo ukomeze gutuza no gutuza. Bityo ntuzumva ububabare ubwo aribwo bwose, ariko uzaba uri maso. Uzumva icyo muganga avuga.
Dore intambwe zoroshye zo kuvurwa:
| Intambwe | Ni iki kiri kuba? |
|---|---|
| 1. Kubona uburenganzira bwo kwinjira | Umuyoboro muto (agahu) winjizwa mu mutsi munini uri mu kuboko kwawe, hafi y'ukuboko kwawe (imitsi yo mu bwoko bwa radial artery) cyangwa mu nda yawe (imitsi yo mu gitsina). Ibi ni nk'uruziga runyuramo ibindi bikoresho. |
| 2. Kohereza catheter | Umuyoboro muto cyane kandi woroshye (catheter) unyuzwa mu muyoboro washyizwemo mbere ukajya mu mitsi y'umutima iri mu mutima. Ntabwo uzabyumva. |
| 3. Kwita ku gice | Irangi ryihariye (irangi ritandukanye) rigaragara neza kuri X-ray rishyirwa mu mitsi binyuze muri catheter. Hanyuma muganga ashobora kureba neza aho imitsi iri n'uburyo ifunze kuri X-ray monitor. |
| 4. Gufungura umutsi | Hanyuma, undi mugozi muto ufite agapira unyuzwa muri ako gace, maze agapira kakazura umwuka kugira ngo gakandagire urwego rw'amaraso rwafashwe ku rukuta rw'umutsi, bigatuma amaraso atembera neza. |
| 5. Gushyira stent | Kugira ngo imitsi idakomeza kuziba, stent ishyirwamo hanyuma igashyirwa mu mwobo. |
| 6. Kurangiza | Iyo akazi karangiye, catheter n'ibindi bikoresho birakurwaho, igitutu gishyirwa aho umuyoboro washyizwe, hanyuma hagashyirwa igitambaro. |
Igikorwa cyose gishobora gufata iminota 30 kugeza ku masaha abiri, bitewe n'imiterere y'aho imitsi yawe yazibye.
Bigenda bite nyuma yo kuvurwa?
Nyuma ya PCI, uzaguma mu cyumba cyo gukira amasaha make kugira ngo ukurikirane umuvuduko w'umutima wawe n'umuvuduko w'amaraso. Hashobora kubaho ibisebe cyangwa ububabare aho catheter yashyizwe. Ibi ni ibisanzwe kandi bizashira mu minsi mike. Kenshi na kenshi, uzabasha gutaha muri iryo joro cyangwa mu gitondo gikurikiyeho.
Ni izihe nyungu n'ingaruka z'ubu buvuzi?
Nk’uko bigenda ku buvuzi ubwo aribwo bwose, ubu bugira akamaro n’ingaruka nto.
Ibyiza by'ingenzi
- Gukira vuba: Kubera ko ubu atari ukubagwa gukomeye, ushobora gukira ugasubira mu buzima busanzwe vuba kurusha kubagwa bypass.
- Kugabanya ibimenyetso: Ibintu nko kubabara mu gatuza (angina) no kubura umwuka igihe umuntu yihuta (dyspnea) biragabanuka cyane.
- Kurokora ubuzima: Ibi bishobora kurokora ubuzima mu kugabanya kwangirika k'umutima mu gihe cy'indwara y'umutima.
Ingaruka zishobora kubaho
Nubwo PCI ari uburyo bwizewe cyane , hari ingorane nke zishobora kubaho gake cyane.
- Kuva amaraso cyangwa kwandura aho umuyoboro w'amaraso washyizwe.
- Amaraso afungana imbere muri stent (imiti itangwa kugira ngo ibi bitagenda neza).
- Umutsi wavuwe wongera kuziba uko igihe kigenda gihita.
- Kwangirika kw'impyiko (cyane cyane ku bantu barwaye impyiko mbere).
- Ni gake cyane, indwara yo gucika kw'imitsi itera stroke.
Ariko ibuka ko iyo abaganga bakoresheje stent igabanya ubukana bw'imiti, amahirwe yo kongera gufunga imitsi ni munsi ya 5%. Ibyo bivuze ko mu barwayi 95 kuri 100, ikibazo ntikizabaho.
Bifata igihe kingana iki kugira ngo ngire gukira kandi ni iki ngomba guhangayikishwa nacyo?
Ubusanzwe ushobora gusubira mu mirimo yawe isanzwe mu cyumweru kimwe. Ariko, niba ufite akazi gasaba guterura ibintu biremereye cyangwa gukora imyitozo ngororamubiri, bishobora gufata igihe mbere yuko usubira ku kazi. Vugana na muganga wawe kuri ibi.
Iki ni cyo kintu cy'ingenzi kurusha ibindi:
Nyuma yo kuvurwa, muganga wawe azaguha imiti igabanya ububabare bw'amaraso (nka Clopidogrel, Prasugrel, Ticagrelor). Ni ngombwa gufata iyi miti neza uko byategetswe, nta munsi n'umwe ubura. Iyi miti ibuza amaraso kuzura mu gice cy'amaraso. Kubwibyo, kurikiza amabwiriza ya muganga wawe neza.
Nkwiye kongera kubonana na muganga saa ngahe?
Niba ubonye kimwe muri ibi bimenyetso bikurikira nyuma yo gusubira mu rugo nyuma yo kuvurwa, menyesha muganga wawe ako kanya cyangwa ujye mu ishami rishinzwe ubutabazi bw’ibanze (ETU) ry’ibitaro biri hafi yawe.
| Ibimenyetso byo kwitondera |
|---|
| Hariho kuva amaraso bidashira, amazi asa n'ibibyimba ava aho umuyoboro washyizwe, cyangwa kubyimba gukabije aho washyizwe. |
| Kugaruka k'ububabare bwo mu gatuza (angina) cyangwa kubura umwuka nkuko byari bimeze mbere yo kuvurwa. |
| Kumva mfite ibicurane kandi nkagira umuriro. |
| Ubushye cyangwa ubukonje mu kuboko cyangwa ku kuguru aho umuyoboro washyizwe. |
| Kuzungera cyangwa gucika intege (syncope). |
| Gutangira gushya kw'ingorane zo guhumeka (dyspnea). |
Ubutumwa bwo kujyana mu rugo
- PCI ni uburyo bwo kuvura budasaba kubagwa, bufite akamaro kanini kandi bwizewe bwo gufungura imitsi y'umutima.
- Ibi bigabanya cyane ibimenyetso nko kubabara mu gatuza no kubura umwuka. Ni ingenzi kandi mu kurokora ubuzima mu gihe habayeho indwara y'umutima.
- Nyuma yo kuvurwa, ni ngombwa gufata imiti yoroshya amaraso yandikiwe na muganga neza uko yabitegetswe, nta munsi n'umwe ubura. Ni ingenzi cyane ku buzima bwawe.
- Ndetse na nyuma yo kuvurwa, kugira imibereho myiza (indyo yuzuye, gukora imyitozo ngororamubiri, kwirinda kunywa itabi n'inzoga, no kugabanya stress) bishobora gufasha cyane mu gukumira ko imitsi yo mu mitsi yongera kuziba.
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