Reka twige ku bijyanye no kubagwa kugira ngo amaraso agabanuke mu bihaha (Pulmonary Thromboendarterectomy - PTE)

Ushobora kuba umaze igihe ugorwa no guhumeka, cyangwa se ukumva uhumeka nabi iyo ugenda. Muganga wawe ashobora kuba yarakubwiye ko ufite umuvuduko ukabije w'amaraso mu bihaha, ari na wo mu mitsi ishaje mu bihaha byawe. Iyo iyi ndwara idashobora kugenzurwa n'imiti, turimo kuvuga kubagwa kwihariye gushobora kurokora ubuzima bwawe.

Mu magambo make, ubu buryo bwo kubaga PTE ni iki?

Ntugatinye izina rirerire rya Pulmonary Thromboendarterectomy. Tuzaryita PTE mu magambo ahinnye. PTE ni uburyo bugoye cyane bukorwa n'abaganga b'inzobere mu kubaga. Bukubiyemo kubaga no gukuraho amaraso ashaje n'inkovu zamaze gufatana ku nkuta z'imitsi minini ijyana amaraso mu bihaha byawe (Pulmonary Arteries).

Tekereza ko umuyoboro w'amazi mu rugo rwawe wafunzwe n'umwanda kandi amazi ntatemba. Kubaga PTE ni nko gusukura imbere mu muyoboro no kongera gutemba neza. Ubu ni bwo buryo bwiza bwo gukuraho ibi bizinga by'amaraso bishaje kandi bikomeye bidashobora gushonga hakoreshejwe imiti. Hari igihe ubu buryo bushobora no gukiza burundu ikibazo.

Ni izihe ndwara zivurwa hakoreshejwe PTE surgery?

Ubu buryo bwo kubaga bukorerwa cyane cyane abantu bafite indwara yitwa Chronic Thromboembolic Pulmonary Hypertension (CTEPH) . Iri zina ni ritoroshye, reka tubisobanukirwe.

• Chronic: bisobanura "kumara igihe kirekire."
• Thromboembolic: bivuze "iterwa n'amaraso apfunditse."
• Umuvuduko ukabije w'amaraso mu bihaha: Ibi bivuze "umuvuduko ukabije w'amaraso mu bihaha."

Mu magambo make, CTEPH ni igihe amaraso yapfundikiye (Pulmonary Embolism - PE) yari yarakozwe mbere mu bihaha idashonga neza, ahubwo igafata ku nkuta z'imitsi y'amaraso mu bihaha, igakora inkovu uko igihe kigenda, ikabuza amaraso gutembera, bigatuma umuvuduko wiyongera mu bihaha.

Ubusanzwe, iyo umuntu afite amaraso apfutse mu bihaha (PE), abaganga bamuha imiti igabanya amaraso. Akenshi, iyi miti ishongesha amaraso apfutse mu bihaha. Ariko ku bantu bake cyane, hafi 2% - 4%, ayo maraso apfutse mu bihaha ntabwo ashonga burundu. Arasaza, agafata ku nkuta z'imitsi y'amaraso, kandi agafunga inzira amaraso atemberamo. Ibi bitera imbaraga nyinshi ku ruhande rw'iburyo rw'umutima, ari na rwo rutuma amaraso ajyanwa mu bihaha. Uko igihe kigenda gihita, ibi bishobora gutera umutima kunanirwa , kwangirika kw'ibihaha, ndetse n'ingorane zishobora gushyira ubuzima mu kaga.

Ni nde ukeneye ubu bubagwa? Ese buri wese ashobora kubugira?

Niba ufite CTEPH, hari ibintu byinshi bizasuzumwa kugira ngo hamenyekane niba ushobora kubagwa.

• Uburemere bw'ibimenyetso byawe.
• Aho amaraso apfundikiye, aho yakwirakwiriye, n'uburyo yazibye imiyoboro y'amaraso.
• Imyaka yawe, ubuzima bwawe muri rusange, n'uko umutima wawe n'ibihaha bikora.

Nk’uko abaganga b’inzobere mu kubaga babivuga, niba ibi bice by’amaraso bishobora gukurwaho mu buryo butekanye, kubaga PTE ni bwo buryo bwiza bwo kuvura CTEPH.

Ariko, si buri wese ufite CTEPH ushobora kubagwa. Hafi 40%, cyangwa bane mu icumi, ntibakwiriye kubagwa. Impamvu nyamukuru ibi ni uko ari ukubagwa gukomeye cyane.

Kuki ubu buryo bwo kubaga bugoye cyane?

Muri iki gikorwa cyo kubaga, itsinda ry’abaganga ryimurira by’agateganyo akazi k’umutima n’ibihaha byawe mu mashini ikoresha umutima n’imitsi . Ibi bivuze ko iyi mashini iha umubiri wawe umwuka wa ogisijeni kandi igatuma amaraso asohoka mu gihe cyo kubaga.

Ikirenzeho, mu gihe cyo kubaga, umuganga agomba kureba neza imitsi y'amaraso yoroshye mu bihaha. Kugira ngo ibi bigerweho, hakoreshwa uburyo bwihariye bwo kugabanya ubushyuhe bw'umubiri wawe kugeza kuri dogere selisiyusi 18 (65 Fahrenheit), bugahagarika burundu gutembera kw'amaraso mu gihe runaka (Deep Hypothermic Circulatory Arrest). Umubiri ukonjeshwa muri ubu buryo kugira ngo wirinde kwangirika k'ubwonko. Ubu buryo butuma umuganga ashobora gukuraho amaraso n'inkovu mu buryo bwitondewe mu buryo busobanutse neza, nta maraso arimo kubagwa.

Niba kubagwa bidashoboka, ni izihe nzira zindi zihari?

Niba abaganga bemeje ko udakwiriye kubagwa PTE kubera impamvu iyo ari yo yose, bazagusaba ubundi buryo bwo kuvura.

• Imiti ikoreshwa mu kunywa: Hari imiti yihariye ishobora kugenzura umuvuduko w'amaraso mu bihaha.
• Balloon Pulmonary Angioplasty (BPA): Ibi bikubiyemo gukoresha umuyoboro muto winjizwa mu mutsi uri ku kaguru kugira ngo ugere ku mitsi y'amaraso iri mu bihaha yazibye, hanyuma ukayishyiramo igikoresho kimeze nk'umupira kugira ngo amaraso afunguke.

Witegura ute mbere yo kubagwa?

Muganga wawe azaguha amabwiriza asobanutse neza y'uburyo bwo kwitegura kubagwa kwawe. Ni ingenzi cyane gukurikiza ayo mabwiriza neza.

Ni iki kibaho mu gihe cyo kubagwa?

Ubusanzwe ubu buryo bwo kubaga butangira mu gitondo kandi bugatwara amasaha agera kuri 6. Uzaterwa ikinya cyose kugira ngo ntugire icyo wumva.

1. Gufasha mu guhumeka: Ubwa mbere, umuyoboro muto (Endotracheal Tube - ETT) ushyirwa mu kanwa cyangwa mu mazuru, unyuze mu muhogo, hanyuma ugahuzwa n'imashini ikoresha umwuka wa ogisijeni (airtilator). Iyi mashini izagufasha guhumeka mu gihe cyose cyo kubagwa.

2. Gufungura igituza: Hanyuma, umuganga uzabaga azaca igufwa ryawe ry’ibere (sternum) kugira ngo rigere ku mutima no mu bihaha.

3. Guhuza icyuma gikoresha ikoranabuhanga: Hanyuma uzahuzwa n'icyuma gikoresha ikoranabuhanga rya Cardiopulmonary Bypass Machine. Iyi mashini izakora akazi k'umutima n'ibihaha mu gihe cyo kubagwa.

4. Gukonjesha umubiri: Hanyuma, ubushyuhe bw'umubiri wawe bugabanuka buhoro buhoro bukagera kuri dogere selisiyusi 18.

5. Gukuraho amaraso apfutse: Nyuma yo gukonjesha umubiri no guhagarika urujya n'uruza rw'amaraso by'agateganyo, umuganga ubaga akuraho witonze amaraso apfutse n'inkovu mu mitsi y'amaraso yo mu bihaha akoresheje ibikoresho byihariye.

6. Gutanga ihumure: Nyuma yo gukuraho amaraso apfutse, ubushyuhe bw'umubiri wawe busubira ku busanzwe kandi uvanwa mu mashini ikoresha ikoranabuhanga. Ariko ukomeza guhuzwa n'icyuma gifasha guhumeka umwuka.

7. Gufunga igituza:Amaherezo, umuganga uzagufunga igituza hanyuma ashyiremo imiyoboro mike kugira ngo akuremo amazi arenze ashobora kuba arimo kwegerana mu mubiri wawe.

Ni iki kibaho nyuma yo kubagwa?

Nyuma yo kubagwa, uzajya mu cyumba cy’indembe (ICU) . Uzaguma muri ICU muri iryo joro. Mu gitondo cyakurikiyeho, itsinda ry’abaganga rizasuzuma uburyo uhumeka. Niba ushobora guhumeka wenyine, icyuma gihumeka kizakurwamo.

Ubusanzwe ugomba kumara iminsi 7 kugeza ku 10 mu bitaro. Uzabanza uri mu cyumba cy’indembe, hanyuma uzajya wimurirwa mu cyumba gisanzwe uko ubuzima bwawe bugenda burushaho kuba bwiza.

Uburyo bwo gukira bumeze nk'ubukize nyuma yo kubagwa umutima. Uzaba ushobora kugenda mu minsi mike kandi buhoro buhoro ugakora akazi runaka. Mbere yo gutaha, uzakorerwa ibizamini kugira ngo urebe niba ukeneye ogisijeni.

Ni izihe nyungu n'ingaruka mbi zo kubagwa PTE?

Ibyiza

• Ubu ni bwo buryo bwonyine bwo gukiza burundu CTEPH.
• Ku bantu benshi, kubagwa byagenze neza, kandi imikorere y'ubuhumekero n'ibihaha irushaho kuba myiza cyane.
• Abantu benshi bari basanzwe bahumekewe na ogisijeni mbere yo kubagwa ntibazongera gukenera ogisijeni nyuma yo kubagwa.
• Indwara yangiza uruhande rw'iburyo rw'umutima akenshi ihinduka.
• Amahirwe yo kubaho igihe kirekire nyuma yo kubagwa ni menshi cyane.

Ingaruka n'ingorane

Kubera ko ubu ari ukubaga gukomeye, hari ingaruka zimwe na zimwe. Ariko, bitewe n'iterambere ry'ikoranabuhanga mu myaka mike ishize, izo ngaruka zaragabanutse cyane.

• Ingaruka zo gupfa mu gihe cyo kubagwa ubu ziri hasi cyane kugeza kuri 1%.
• Ingaruka zo kurwara indwara yo gucika kw'imitsi (stroke) ni hagati ya 1% na 2%.
• Hari abantu bashobora kuba bagifite urugero runaka rw'umuvuduko ukabije w'amaraso mu bihaha nyuma yo kubagwa. Bazakenera gukomeza gufata imiti.
• Hari igihe amazi yirundanya hafi y'umutima (pericardial effusion).

Niba ubonye ibimenyetso bikurikira, hamagara 1990 ako kanya cyangwa ujye ku bitaro bikuru byita ku bibazo byihutirwa (ETU) biri hafi yawe:

• Ububabare bukomeye mu gituza
• Kuzinduka
• Guhumeka nabi cyane mu buryo butunguranye

Bifata igihe kingana iki kugira ngo umuntu akire?

Uko igihe kigenda gihita, ushobora gusubira mu buzima busanzwe. Ariko, ugomba kwihangana gato.

• Ibyumweru 6 bya mbere: Ntushobora gutwara imodoka, kujya ku kazi, cyangwa guterura ibiro birenga 10 (hafi ibiro 4.5).
• Icyumweru cya 7 kugeza kuri 12: Ishobora guterura ibiro bigera kuri 25 (hafi ibiro 11).
• Nyuma y'ibyumweru 12: Imipaka yo guterura ibiremereye ikunze gukurwaho.

Abantu benshi bashobora gusubira mu mirimo yabo isanzwe mu mezi 3. Guhumeka kwawe n'ubushobozi bwawe bwo gukora imyitozo ngororamubiri bizagenda birushaho kuba byiza, kandi ushobora kubona impinduka mu gihe cy'imyaka 4.

Ubugenzuzi bw'abaganga bumeze bute nyuma yo kubagwa?

Nyuma yo kubagwa, ugomba gukomeza kubonana na muganga.

• Uzakora ibizamini byinshi byihariye byo gusuzuma ibihaha byawe nyuma y'ibyumweru 6 nyuma yo kubagwa, hanyuma uzongera upime hagati y'amezi 3-6 nyuma yaho.
• Igikuru ni uko uzakenera gufata imiti igabanya amaraso mu gihe cyose cy'ubuzima bwawe kugira ngo wirinde ko amaraso mashya yangirika.

Niba ufite ibi bimenyetso, vugana na muganga wawe.

• Iyo ububabare budashobora kwihanganira, cyangwa niba ububabare bugabanuka hanyuma bukongera kwiyongera.
• Niba umutima utera vuba cyangwa utari mu buryo busanzwe.
• Niba igikomere cyo kubagwa gitukura, cyabyimbye, gisohora amabyi, cyangwa gifite umuriro (ibi ni ibimenyetso by'ubwandu).

PTE ni ubuvuzi bw'agaciro gakomeye bushobora guha ubuzima bwa kabiri umuntu urwaye CTEPH. Nubwo ari ubuvuzi bugoye kandi bufata igihe kirekire kugira ngo umuntu akire, umusaruro wabwo, ari na wo amahirwe yo kubaho mu bwisanzure nta kongera kubura umwuka, ni ntagereranywa.