Amaraso apfundika mu mitsi y'umwijima (Portal Vein Thrombosis): Reka tuvuge kuri ibi!

Hari indwara zimwe na zimwe zivuka bucece mu mubiri tutigaragaje ibimenyetso. Imwe muri izo ndwara ni ukuzura kw'amaraso mu mutsi w'umwijima, cyangwa mu buvuzi, indwara yitwa "Portal Vein Thrombosis" . Ibi bishobora kuba bikomeye gato, reka tubiganireho mu buryo burambuye, si byo se?

Iyi ndwara yitwa portal vein thrombosis (`(Portal Vein Thrombosis)` ni iki?

Muri make, umwijima wawe ufite umuyoboro w'amaraso uzana amaraso mu mwijima wawe avuye mu zindi ngingo zo mu nda yawe (nk'igifu cyawe n'amara). Ibi byitwa umuyoboro w'amaraso. Iyo amaraso apfunditse ( thrombus) avutse mu muyoboro w'amaraso, mu mashami agana mu mwijima, cyangwa mu yindi miyoboro iwutangaho amaraso (nk'umuyoboro w'amaraso wa mesenteric uruta iyindi n'umuyoboro w'amaraso wa splenic), umuyoboro w'amaraso uragabanuka cyangwa ugafungwa burundu, ibi byitwa thrombosis y'imiyoboro y'amaraso ya portal, cyangwa PVT.

Mu by’ukuri iyi ni indwara ikomeye. Ariko akenshi ntabwo igaragaza ibimenyetso mu ntangiriro. Rero, ushobora kuba utazi ko ufite ubwoko bw’amaraso afite ubwo bwoko. Bushobora kuboneka mu buryo bw’impanuka mu gihe cyo gupima ikindi kintu, cyangwa bushobora kuboneka nyuma y’ikibazo nko kurwara umuvuduko ukabije w’amaraso mu mitsi y’umwijima (umuvuduko w’amaraso wiyongera mu mitsi y’umwijima). Izi ngorane zishobora gushyira ubuzima mu kaga iyo zitavuwe neza. Cyane cyane niba ufite ibimenyetso nko kuruka amaraso cyangwa gusohora amaraso mu mwanda, ni ikibazo gikomeye kandi ugomba kwihutira gushaka inama kwa muganga.

Abantu bafite umwijima utera indwara ya fibrosis, cyane cyane cirrhose, bafite ibyago byinshi byo kurwara indwara ya portal vein thrombosis. Abantu bafite izindi ndwara, nko kuvura amaraso, nabo bafite ibyago byinshi. Kubwibyo, niba ufite kimwe muri ibi bintu bishobora gutera indwara, ni ngombwa kuvugana na muganga, ugapimwa, ugasuzumwa kandi ugavurwa vuba bishoboka.

Ese hari ubwoko bwa thrombosis y'imitsi yo mu muyoboro wa portal (PVT)?

Yego, abaganga bagabanya iyi "Portal Vein Thrombosis" mo ubwoko bubiri bw'ingenzi, bitewe n'umuntu uyirwaye:

• Indwara ya Cirrhosis yo mu mitsi ifata amaraso (PVT) ni yo ndwara ikunze kugaragara cyane iterwa na cirrhosis . Iyi ni indwara ituma amaraso afungana mu mitsi ifata amaraso mu mitsi ifata amaraso.
• Indwara ya PVT idafata imitsi: Iyi ni amaraso agwa mu mubiri w'umuntu udafite indwara ya cirrhose.

Gusobanukirwa ubu buryo ni ingenzi mu gutegura uburyo bwo kuvura. Urugero, abaganga bafata ibyemezo byo kuvura bashingiye ku kuba ufite cirrhose. Kurwara cirrhose byongera ibyago byo kurwara, bishobora kugira ingaruka ku mibereho yawe. Ariko, abaganga bahora biga byinshi ku bwoko bwombi bwa thrombosis yo mu mitsi yo mu bwoko bwa portal vein n'uburyo bwo kugabanya ingorane. Bityo rero, ni ngombwa kuganira na muganga wawe ku bijyanye n'uburyo bwo kuvura n'icyo ushobora kwitega.

Iyi ndwara ikunze kugaragara gute?

Kurwara indwara ya Portal Vein Thrombosis ntibikunze kugaragara ku bantu badafite indwara y'umwijima. Ariko, hari amatsinda amwe, cyane cyane arwaye cirrhose, ari mu kaga gakomeye. Hafi umuntu umwe kuri bane barwaye cirrhose azarwara PVT. Ibi biterwa n'uko inkovu mu mwijima zigabanya urujya n'uruza rw'amaraso. Iyo amaraso atembera buhoro, amaraso ashobora kubyimba cyane.

Ni izihe ngorane zishobora guterwa no kuvura imitsi yo mu muyoboro wa portal (PVT)?

Izi ngorane zishobora gutandukana bitewe n'ibintu nko aho amaraso apfundikiye hamwe n'izindi ndwara zisanzwe ufite. Zimwe mu ngorane zishobora kubaho zirimo:

• Kubyimba kw'imitsi mu mwobo (esophageal varices)
• Kuva amaraso mu gifu (GI)
• Kwangirika kw'amara bitewe no kugabanuka kw'amaraso (`(Mesenteric Ischemia)`)
• Ubwiyongere bw'umuvuduko mu mitsi y'umwijima (`(Umuvuduko ukabije w'amaraso mu muyoboro wa Portal)`)
• Splenomegali (agasabo kanini)

Ni ibihe bimenyetso bya thrombosis y'imitsi yo mu muyoboro wa portal (PVT)?

Abantu benshi nta bimenyetso bafite. Abaganga bakunze gusuzuma indwara binyuze mu gupima indwara hakoreshejwe amashusho ku yindi mpamvu.

Ariko, iyo habayeho ingorane, ibimenyetso bishobora kugaragara. Ibimenyetso nk'ibi birimo:

• Kuruka amaraso.
• Amaraso mu gituba (cyangwa umukara cyangwa umutuku).
• Kubyimba inda, kubyimba ibinure.
• Kubyimba amaguru n'uturenge (`(Edema)`).
• Kubabara mu nda, gucumbagira.

Ni iki gitera kubyimba kw'amaraso muri uyu mutsi w'imbere?

Abaganga babyita indwara ya 'multifactorial' . Ibi bivuze ko akenshi iterwa n'ibintu bibiri cyangwa byinshi.

Hari ibintu bitatu by'ingenzi bigira uruhare mu kurema kw'amaraso mu "Portal Vein" yawe:

• Kugira imiterere yo kuvura cyane (`(State Hypercoagulable)`). Ibi bivuze ko amaraso yawe ahita yiyongera kurusha umuntu usanzwe.
• Amaraso atembera buhoro mu mwijima.
• Kwangirika k'urukuta rw'imbere (endothelium) rw'umutsi w'imbere.

Ni ibihe bintu bishobora gutera iyi ndwara?

Indwara zitandukanye zishobora kongera ibyago byo kuvura amaraso no kugabanya amaraso mu mwijima. Zimwe muri izi mpamvu zitera ibyago harimo:

• Ibibyimba byo mu nda.
• Indwara ya Antiphospholipide (`(Indwara ya Antiphospholipide)`).
• Kubura Antithrombin (`(Kubura Antithrombin)`).
• Fibrose y'umwijima (`(Cirrhose)`).
• Factor V Leiden (`(Factor V Leiden)`) - Iyi ni indwara iterwa n'uturemangingo (genetic) igira ingaruka ku kubumba kw'amaraso.
• Indwara zo mu gifu (urugero: pancreatitis).
• Indwara za Myeloproliferative (`(Indwara za Myeloproliferative)`) - Izi ni indwara zifitanye isano n'umusemburo w'amagufwa.
• Indwara ikomeye y'umuvuduko ukabije w'amaraso mu muyoboro w'amaraso.
• Gutwita.
• Kubura Poroteyine C (`(Kubura Poroteyine C)`).
• Kubura poroteyine S (`(Kubura poroteyine S)`).
• Impinduka mu ngirabuzimafatizo ya Prothrombin (`(Impinduka mu ngirabuzimafatizo ya Prothrombin)`).

Byongeye kandi, kubagwa mu nda (urugero, kubaga splenectomy) bishobora no kwangiza urukuta rw'imbere rw'imitsi itwara amaraso, ibyo bikaba byongera ibyago.

Ni gute indwara ya thrombosis yo mu mitsi yo mu muyoboro wa portal (PVT) ipimwa?

Abaganga basuzuma iyi ndwara binyuze mu isuzuma ryuzuye ry’umubiri n’ibizamini bitandukanye. Bazakubaza kandi amateka y’ubuzima bwawe kugira ngo barebe niba hari ibintu bishobora gutuma urwara "Portal Vein Thrombosis".

Ni ibihe bipimo bikorwa kugira ngo hamenyekane ibi?

Muganga wawe ashobora gutumiza ibipimo nk'ibi kugira ngo apime ``Portal Vein Thrombosis'' kandi arebe ingorane:

• Isuzuma rya CT (`(Isuzuma rya Tomography (CT))`).
• Ikizamini cya Doppler ultrasound (`(Doppler Ultrasound)`). Ibi bishobora gukoreshwa mu kureba uko amaraso atembera mu mitsi y'amaraso ndetse no kureba niba hari amaraso afite ibice.
• Ibizamini by'imikorere y'umwijima (`(Ibipimo by'imikorere y'umwijima)`).
• Isuzuma rya MRI (`(Ishusho ya Magnetic Resonance (MRI))`.)

Gahunda y'ubuvuzi bwawe izagenwa hashingiwe ku bisubizo by'ibi bizamini.

Ni gute abaganga bavura indwara yo kuvura imitsi yo mu muyoboro wa portal (PVT)?

Abaganga bahitamo uburyo bwo kuvura umurwayi ku giti cye. Ni ukuvuga ko bahuza ubuvuzi n'ibyo ukeneye. Hari ibintu byinshi bigira ingaruka kuri ibi:

• Aho amaraso apfundikiye.
• Impamvu yo kubyimba kw'amaraso.
• Izindi ndwara zihishe ufite (urugero: cirrhose).
• Niba hari ingorane.
• Amateka yawe yose y'ubuvuzi.

Uburyo bwo kuvura bushobora kuba burimo:

• Imiti igabanya amaraso: Iyi miti ifasha guhagarika amaraso kuzura no gukumira ko amaraso mashya agabanuka. Ariko, kubera ko abantu barwaye cirrhose baba bafite ibyago byinshi byo kuva amaraso imbere mu mubiri, abaganga bakoresha iyi miti bitonze cyane.
• Uburyo bwo kuvura indwara ya thrombolytic:Niba imiti igabanya amaraso gusa idahagije, ubu buryo bushobora gutangwa nk'amazi ashyirwa mu mitsi (IV) cyangwa binyuze mu muyoboro muto (catheter) kugira ngo amaraso ashonge. Abaganga bashobora kandi gukoresha ubu buryo niba amara yawe adatanga amaraso ahagije.
• Inzira yo kuvura indwara ya Transjugular Intrahepatic Portosystemic Shunt (INAMA): Ubu buryo kandi bukoresha catheter nto. Bukoreshwa mu kugenzura ingorane zo kuvura imitsi yo mu miyoboro ya portal, cyane cyane kuva amaraso mu nda. Bukubiyemo gukora umuyoboro unyura mu mwijima wawe no guhuza imitsi yo mu miyoboro ya portal n'umutsi munini mu mwijima wawe. Ubu buryo bushya butuma amaraso ava mu mara yawe anyura mu mwijima. Ibi bigabanya umuvuduko mu mitsi yo mu mwijima wawe, bigabanya ibyago byo kuva amaraso. Ariko, kubera ko umwijima wawe ubusanzwe uyungurura uburozi buva mu maraso yawe, amaraso atayunguruwe ubu arimo atembera mu mubiri wawe. Rero, kimwe mu byago by'ubu buryo ni uko uburozi bushobora kujya mu bwonko bukagira ingaruka ku mikorere y'ubwonko (`(Hepatic Encephalopathy)`).

Ni ngombwa cyane kuganira ku byiza n'ibibi by'ubu buryo bwo kuvura na muganga wawe kugira ngo wumve ibyiza n'ibibi byabwo bitewe n'uburwayi bwawe.

Ni iki giteganyijwe kuri iki kibazo?

Muganga wawe ni we muntu mwiza wo kubaza ku bijyanye n'uko indwara yawe ihagaze. Azakubwira icyo ukwiye kwitega bitewe n'uko indwara yawe imeze. Amahirwe yo kubaho no kubaho bitewe n'indwara ya portal vein thrombosis ashobora gutandukana bitewe na:

• Impamvu yo kubyimba kw'amaraso.
• Waba ufite `(Cirrhosis)` cyangwa udafite.
• Izindi ndwara zihishe inyuma ufite.
• Ingorane zivuka.
• Imyitwarire y'umwijima wawe.

Muri rusange, gusuzuma indwara hakiri kare no kuyivura bishobora kongera amahirwe yo gukira.

Ese thrombosis y'imitsi yo mu muyoboro wa portal (PVT) ishobora kwirindwa?

Kuziba kw'amaraso, harimo n'ibiri mu mutsi wo mu muyoboro w'amaraso, ntibishobora kwirindwa buri gihe. Ariko hari ibintu bimwe na bimwe ushobora gukora kugira ngo ugabanye ibyago byo kurwara:

• Jya kwisuzumisha kwa muganga buri mwaka, kandi witabire ibizamini byose bikurikiranwa na muganga wawe. Urugero, niba ufite indwara ya cirrhose mu ntangiriro, kuyimenya hakiri kare bishobora gufasha kwirinda PVT.
• Korana na muganga wawe kugira ngo umenye indwara iyo ari yo yose ishobora kukubaho. Urugero, niba ufite indwara nka diyabete (`(Diabete Mellitus)`), komeza kuyigenzura neza.
• Fata imiti yawe yose uko wabitegetswe, mu gihe gikwiye.
• Niba ugaragaje ibimenyetso bishya, cyangwa niba ibimenyetso byawe bihindutse, bwira muganga wawe ako kanya.

Ni ryari ngomba kujya kwa muganga?

Menya neza ko ugiye kwisuzumisha kwa muganga buri mwaka. Niba ugaragaje ibimenyetso bishya kandi bitazwi, banza uganire na muganga wawe.

Niba ufite ikintu kimwe cyangwa byinshi bishobora gutuma ugira `(Portal Vein Thrombosis)`, ni byiza kubivuganaho na muganga wawe. Azakubaza urwego rw'ibyago byawe bwite n'icyo wakora kugira ngo ubigabanuke.

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

Ingorane yo kuva amaraso mu mitsi yo mu bwoko bwa portal vein thrombosis ni ukuva amaraso mu gifu (GI). Ibimenyetso bikunze kugaragara mu buryo butunguranye kandi bishobora kuba bikomeye. Niba ufite kimwe muri ibi bimenyetso, jya kwa muganga cyangwa uhamagare 911 ako kanya:

• Niba wumva umeze nk'uzu ...
• Niba ufite imyakura y'umukara cyangwa itukura, cyangwa niba uruka amaraso.
• Niba umutima utera vuba.

Ni ibihe bibazo ngomba kubaza muganga wanjye?

Dore ibibazo bimwe na bimwe bizagufasha kumenya byinshi ku bijyanye n'imimerere yawe:

• Kuki nagize iki kibazo cy'amaraso?
• Ni iyihe gahunda nziza yo kuvura kuri njye?
• Ese ngomba gufata umuti uwo ari wo wose? Niba ari byo, ni igihe kingana iki?
• Ni izihe nyungu n'ibibi by'ubuvuzi?
• Ni iki nkwiye kwitega mu gihe nzaba nduhutse?
• Ni iki gipimo cy'igihe kirekire (`(Guhanura)`)?

Kumenya ko ufite amaraso apfutse bishobora gutera ubwoba. Mu gihe nk'iki ``Portal Vein Thrombosis'', ushobora kwibaza ingorane zizavuka n'uburemere bwazo. Andika ibibazo byawe hanyuma ubisangize muganga wawe. Menya byose ukeneye kumenya ku ndwara yawe n'uburyo bwo kuyivura. Hamwe na muganga wawe, mushobora kubona inzira yo gukira.

Ibintu by'ingenzi cyane ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Nibyo, muri make, muri make ibyo twavuzeho, Portal Vein Thrombosis ni amaraso afunga umutsi munini ujyana amaraso mu mwijima.

Nubwo akenshi idatanga ibimenyetso mu ntangiriro, iyi ishobora kuba indwara ikomeye cyane cyane ku bantu bafite cirrhose.

Niba ugize ikibazo cyo kuruka amaraso cyangwa amaraso mu mwanda wawe, shaka ubufasha bwa muganga ako kanya.

Niba ufite ibintu bishobora gutera ibyago, ni ngombwa kuganira na muganga wawe ku byerekeye ibyo bintu no gukora ibizamini bikenewe. Gusuzuma hakiri kare no kuvura ni byo byiza. Kurikiza amabwiriza ya muganga witonze, kandi ntutinye kubaza ibibazo niba ufite. Komeza ubuzima bwiza!

` Kuziba kw'imitsi yo mu muyoboro wa portal, kuziba kw'amaraso mu mwijima, cirrhosis, hematemesis, indwara y'umwijima, kuziba kw'imitsi y'amaraso, PVT