Ese uzi ikibazo cy’indwara ya Sickle Cell Crisis? Reka tuvuge kuri iyi ndwara ibabaza!

Niba urwaye indwara ya sickle cell, ushobora kuba warumvise cyangwa warahuye n'ububabare butunguranye kandi bukomeye. Ibi ni byo twita ikibazo cya sickle cell. Bishobora kuba ibintu bibabaza cyane kandi bibabaza. Ariko ntugahangayike, tuzabivugaho birambuye uyu munsi.

Iki kibazo cy’uturemangingo tw’umusemburo ni iki?

Mu magambo make, indwara ya sickle cell ni igihe 'sickle cells' z'umubiri wawe, cyangwa se uturemangingo dutukura dufite ishusho ya sickle, zifata mu mitsi y'amaraso, zigahagarika cyangwa zigahagarika urujya n'uruza rw'amaraso. Urabizi, uturemangingo dutukura tw'amaraso ni two dutwara ogisijeni mu mubiri wose. Rero, iyo urwaye sickle cell, ingingo zawe n'ibice byawe ntibibona ogisijeni ihagije. Ibi bishobora gutera ububabare bukomeye n'izindi ngorane .

Tekereza nk'aho iyo umwanda muto ufatiwe mu muyoboro w'amazi, amazi agenda agabanuka. Ariko ikiba gifatiwe hano ni utwo tunyangingo tw'amaraso dutukura dufite ishusho y'umuhoro. Utwo tunyangingo ntitworohera kugonda nk'utunyangingo dusanzwe dutukura, kandi ntitwinjira mu mwanya muto. Niyo mpamvu tugerageza gufatirwa.

Hari igihe iyi ndwara ishobora gukemurwa uri mu rugo, ariko niba ibimenyetso bikomeye, ushobora gukenera kumara iminsi mike mu bitaro kugira ngo uvurwe.

Ni ubuhe bwoko bw'indwara y'ubumara bw'imitsi?

Hari ubwoko bune bw'ingenzi bw'indwara ya sickle cell. Reka turebere hamwe ibyo ari byo:

• Indwara yo kugabanya imitsi y'amaraso: Iyi ni yo ndwara ikunze kugaragara cyane. Ikibaho hano ni uko uturemangingo tw'imitsi dufata imitsi mito cyangwa indi mitsi mito y'amaraso, bigatuma amaraso atembera mu ngingo no mu bice by'umubiri. Ibi nibyo bitera ububabare bukomeye. Izindi ndwara zigira ingaruka ku bice bimwe na bimwe by'umubiri.

• Ikibazo cya Aplastic: Iki ni igihe umwongo w'amagufwa yawe (ahantu imbere mu magufwa yawe hakora uturemangingo tw'amaraso) uhita uhagarika gukora uturemangingo tw'amaraso dutukura. Ibi akenshi biterwa n'indwara zimwe na zimwe za virusi, cyane cyane parvovirus B19.

• Ikibazo cya Hyperhemolytic: Iki ni igihe urugero rwa hemoglobine yawe (poroteyine iri mu turemangingo dutukura dutwara ogisijeni) igabanuka mu buryo butunguranye. Ibi biterwa nuko uturemangingo dutukura tw'amaraso yawe tuba twangiritse vuba cyane. Ibi bishobora no kubaho nyuma yo guterwa amaraso, ari na bwo buryo busanzwe bwo kuvura indwara ya sickle cell.

• Gufata imitsi yo mu nda: Ibi bibaho igihe uturemangingo tw’imitsi dufata imitsi yo mu nda yawe (urugingo ruri hejuru ibumoso bw’inda yawe), bigatuma imitsi yo mu nda ikura mu buryo butunguranye kandi ikabyimba cyane . Ibi bishobora guteza akaga cyane ku bana bato, kuko amaraso menshi ashobora guteranira mu mitsi yo mu nda, bigatuma amaraso aba make.

Ni ibihe bimenyetso by'ibi?

Ibimenyetso by'indwara ya sickle cell bishobora gutandukana bitewe n'aho umubiri wayo wafashwe. Ibimenyetso bisanzwe birimo:

• Kuzungera.
• Umunaniro ukabije, umunaniro.
• Umutwe.
• Jaundice (umuhondo w'uruhu n'amaso).
• Ububabare (iki ni cyo kimenyetso cy'ingenzi kandi gikomeye cyane).
• Kugorwa no guhumeka.
• Intege nke.

Ububabare buterwa n'indwara ya sickle cell bushobora kuba budakomeye, bukabije, buteye icyuma, cyangwa buteye icyuma . Bushobora kumara amasaha menshi, iminsi, cyangwa ibyumweru. Ububabare bushobora kugaragara ahantu hose mu mubiri, ahantu hamwe cyangwa ahantu henshi. Urugero:

• Mu biganza cyangwa mu kiganza.
• Mu gituza.
• Mu maguru cyangwa ibirenge.
• Mu gice cyo hasi cy'umugongo.
• Mu nda.

Kuki iki kibazo cy’uturemangingo tw’umusemburo kibaho?

Indwara ya sickle cell ibaho iyo uturemangingo dutukura tw’amaraso dufite ishusho ya sickle twishyize hamwe tugafunga imitsi y’amaraso. Nyamara, abahanga ntibazi neza impamvu ibi bitangira.

Ariko, hari ibintu bimwe na bimwe bishobora gutera iyi ndwara:

• Kubura amazi mu mubiri : Iyo umubiri ubuze amazi, amaraso arakomera kandi uturemangingo tuba dufite amahirwe menshi yo kuziba.
• Kujya mu misozi miremire (kuko umwuka wa ogisijeni uba muke mu misozi miremire).
• Indwara : Indwara iyo ari yo yose, nk'ibicurane cyangwa ibicurane.
• Gutwita.
• Kunywa itabi cyangwa kunywa itabi ry'ubumara.
• Gukora imyitozo ngororamubiri ikabije cyane.
• Stress : Ibintu nko guhangayika cyane no gutinya.
• Impinduka zitunguranye z'ubushyuhe bukabije (urugero, kwiyuhagira mu bwogero bukonje nyuma yo kuba mu kirere gishyushye cyane).
• Kubura vitamine zimwe na zimwe, urugero nka folate.

Ni izihe ngorane ibi bishobora gutera?

Uburemere bw'ikibazo cy'uturemangingo tw'amaraso biterwa n'aho umuyoboro w'amaraso wafunzwe uri. Iyo imiyoboro y'amaraso ifunzwe mu ngingo zawe cyangwa mu ngingo zawe, ingorane nka:

• Indwara yo mu gituza ikabije : Iyi ni indwara ikomeye kandi ishobora gushyira ubuzima mu kaga igaragara mu gituza. Ibimenyetso birimo umuriro, ububabare mu gituza, no guhumeka bigoranye.
• Amaraso apfutse.
• Ububabare budakira (ububabare buhoraho).
• Ubwiyongere bw'uduheri n'izindi ndwara zifitanye isano n'uduheri.
• Ibikomere bidakira ku maguru.
• Indwara y'umwijima.
• Indwara z'ibihaha, urugero, umuvuduko ukabije w'amaraso mu bihaha.
• Necrosis : Gupfa kw'amagufwa cyangwa ingingo (cyane cyane ahantu nko mu kibuno) bitewe no kubura amaraso atembera neza.
• Kubabara mu gitsina cy'umugabo (byitwa kandi 'priapism').
• Indwara yo gucika kw'amaraso : Iterwa no kuziba cyangwa gucika k'umuyoboro w'amaraso utanga amaraso mu bwonko.

Ubimenya ute?

Niba urwaye indwara ya sickle cell, ushobora kuba usanzwe ubonana na muganga buri mezi 6 cyangwa rimwe mu mwaka kugira ngo agupime amaraso. Ariko niba ufite ikibazo cya sickle cell, uzakenera gukora ibizamini byose byo muri laboratwari. Ibi bishobora kuba birimo:

• Gupima ubwoko bw'amaraso (niba ukeneye guterwa amaraso).
• CBC (Umubare wuzuye w'amaraso) : Ibi bipima urugero rwa hemoglobine n'umubare w'uturemangingo tw'amaraso dutukura n'umweru.
• CMP (Akanama gapima imikorere y'umubiri) : Urutonde rwuzuye rw'ibizamini bya metabolike bireba imikorere y'ingingo nk'impyiko n'umwijima.
• Ibizamini by'imikorere y'umwijima .
• Umubare wa reticulocytes : Ibi bipima umubare w'uturemangingo dutukura tw'amaraso dushya. Ibi bishobora gutanga igitekerezo cy'uburyo umwongo w'amagufwa ukora neza.

Byongeye kandi, muganga wawe ashobora gukora isuzuma ryuzuye ry’umubiri no gupima amashusho nka:

• Doppler ultrasound : Reba uburyo amaraso atembera mu mitsi y'amaraso.
• MRI : Cyane cyane iyo hari amakenga ku ndwara nk'indwara yo mu bwonko.
• Ultrasound : Kureba ibintu nk'ingingo zo mu nda n'umwobo.
• X-ray yo mu gituza : Gusuzuma indwara nk'indwara y'igituza ifata umuntu.

Ivurwa ite?

Niba ufite ikibazo cy’indwara ya sickle cell, ushobora gukenera imiti igabanya ububabare kugira ngo igufashe kugenzura ibimenyetso bikubabaza. Mu bihe byoroheje, ushobora kubikemura mu rugo ukoresheje imiti igurishwa na muganga nka acetaminophen (urugero: Panadol®, Tylenol®) cyangwa ibuprofen (urugero: Advil®, Brufen®).

Ariko, mu gihe ufite ububabare bukabije, ushobora kumara iminsi mike mu bitaro. Abaganga bashobora kuguha imiti ikomeye igabanya ububabare (nk'umuti wa morphine), imiti iva mu maraso (IV fluids) kugira ngo amaraso yawe akomeze gutembera neza), na ogisijeni nibiba ngombwa.

Byongeye kandi, uburyo bwo kuvura indwara ya sickle cell buratandukanye bitewe n'ibice by'umubiri byafashwe n'uburemere bw'ibimenyetso. Abaganga bashobora gukoresha imiti, guterwa amaraso, gutera umworera mu magufwa, cyangwa uburyo bwo kuvura buvanze.

Imiti yo kuvura igihe kirekire

Hari ubwoko butandukanye bw'imiti abaganga bakoresha kugira ngo barwanye ibibazo bya sickle cell mu gihe kirekire kandi bagabanye inshuro zikunze kugaragara:

• Hydroxyurea: Uyu muti utuma uturemangingo dutukura tw’amaraso turushaho kuba tunini, wongera ubushobozi bwo kwivanga, kandi wongera ubwoko bwa hemoglobine yitwa hemoglobine y’umwana. Ibi bigabanya kuzura kw’uturemangingo.
• Crizanlizumab `(Crizanlizumab)`:Ubu ni ubwoko bwa antibody ya monoclonal. Bushobora kubuza uturemangingo tw'amaraso dutukura gufata ku nkuta z'imitsi yawe.
• L-glutamine: Iyi ni aside amine ifasha kugabanya kwangirika kw'uturemangingo dutukura tw'amaraso.
• Voxelotor: Uyu muti urinda uturemangingo tw'amaraso dutukura gufatwa n'umusemburo no gufatana.

Guterwa amaraso

Abaganga bashobora gukoresha amaraso mu kuvura ibibazo bya sickle cells zidafite plastic cyangwa hyperhemolytic. Ubu buryo bushobora kongera uturemangingo tw’amaraso dutukura kandi bukagabanya ibyago byo kurwara sickle cells. Hari abantu bashobora gukenera guterwa amaraso kenshi.

Gutera ibimera

Gutera umwongo cyangwa gutera uturemangingo tw’umugongo bishobora kuba bwo buryo bwonyine bwo kuvura indwara ya sickle cell mu bihe bimwe na bimwe. Ariko, kubona umuterankunga uhuye (nk'umuvandimwe wawe) bishobora gufata igihe. Nanone, gutera umwongo bishobora gutera izindi ngorane zikomeye, nka graft vs. host disease (GvHD). Kubera iyo mpamvu, abaganga ntibakunze gukora gutera umwongo mu gihe bavura ibibazo bya sickle cell. Ahubwo, intego nyamukuru ni ukuvura ibimenyetso byawe no kugabanya ububabare bwawe.

Ese ibi bishobora kwirindwa?

Ibibazo by’uturemangingo tw’umutsi ntibishobora kwirindwa buri gihe. Ariko hari ibintu bimwe na bimwe bishobora kugabanya ibyago:

• Irinde kunywa itabi burundu.
• Niba uri ahantu hakonje, ambara neza. Ubukonje bushobora kugabanya imiyoboro y'amaraso bigatera ikibazo.
• Kugabanya cyangwa guhagarika burundu kunywa inzoga . Inzoga zishobora gutuma amazi aguma mu mubiri.
• Nywa nibura ibirahuri 8-10 by'amazi ku munsi (komeza kunywa amazi).
• Fata ibinini bya aside folike buri munsi kugira ngo wongere umusaruro w'uturemangingo dutukura mu maraso (ibi bigomba gukorwa nk'uko muganga yabigusabye).
• Karaba intoki zawe n'isabune buri gihe kugira ngo ugabanye ibyago byo kwandura.
• Guhabwa inkingo zose zisabwa ku gihe (urugero: urukingo rw'ibicurane, urukingo rw'umusonga).
• Irinde gukora imyitozo ngororamubiri isaba imbaraga nyinshi, ariko imyitozo ngororamubiri iringaniye ni nziza.
• Shaka uburyo bwo kugabanya imihangayiko (urugero: yoga, gutekereza cyane).

Nitwara nte (iyo habaye ikibazo gikomeye)?

Niba wowe cyangwa umuntu wawe wa hafi ufite ikibazo cya sickle cell, gukora ibi bintu bishobora kugabanya ibimenyetso:

• Komeza ushyushye. Kwiyuhagira ushyushye cyangwa gushyira agakoresho gashyushya ahantu hababara bizagabanya imiyoboro y'amaraso kandi bitume amaraso atembera neza. Ubushyuhe buzafasha kandi kugabanya ububabare bw'imitsi.(Ntugashyireho udupaki tw'urubura. Ubukonje bushobora gutera ikibazo cy'ububabare. Rero ni byiza kuguma ushyushye uko bishoboka kose.)
• Nywa amazi menshi. Iyo unyoye amazi ahagije, uturemangingo tw’amaraso dutukura turafatana gake, bigatuma tunyura mu miyoboro byoroshye.
• Fata massage. Massage yoroheje ishobora kongera amaraso atembera, ikaruhura imitsi, kandi ikagabanya ububabare.
• Itoze kwitonda. Ubushakashatsi bwagaragaje ko gushyira ubwenge bwawe ku ntego imwe mu gihe gito bishobora gufasha kurangaza ubwonko bwawe no kugabanya ububabare buterwa n'indwara ya sickle cell. Ndetse n'ikintu cyoroshye nko kwibanda ku guhumeka kwawe gishobora gufasha.
• Fata imiti igabanya ububabare igurishwa na muganga. Iyi miti irimo parasetamol, ibuprofen, cyangwa naproxen (urugero: Aleve®). Ariko ntugafate imiti irenze iyo muganga yagutegetse.

Ni ryari ugomba kujya mu Kigo cyita ku Buvuzi bw’Ingoboka (ETU) ?

Niba ufite kimwe muri ibi bimenyetso, jya ku ishami rishinzwe ubutabazi bwihutirwa (ETU) riri hafi yawe vuba :

* Niba ufite ububabare butunguranye kandi bukomeye budashobora gukemurwa n'imiti yo mu rugo.

* Kugorwa no guhumeka cyangwa kubabara mu gatuza.

* Umuriro mwinshi (uri hejuru ya 101°F cyangwa 38.3°C).

* Gucika intege bitunguranye, kugorwa no kuvuga, kunama k'uruhande rumwe rw'isura (ibimenyetso by'indwara yo mu bwonko).

* Kubabara cyane mu gifu cyangwa kubyimba inda.

* Iyo indwara y'umuhondo ikomeje kwiyongera.

* Ku bagabo, gushyukwa kubabaza kumara amasaha arenga 4.

Ntutinde. Gutangira kuvurwa hakiri kare bishobora kugabanya ibyago byo kugira ibibazo by'igihe kirekire.

Ibintu by'ingenzi ugomba kwibuka

Niba urwaye indwara ya sickle cell, gutekereza ku kibazo gishobora kugutera ikibazo. Ibi bishobora gutera ibimenyetso bibi n'ingorane z'ubuzima bwawe bwose. Niba warigeze kugira ikibazo cya sickle cell, uzi ukuntu igihe ari ingenzi.

Niba ibimenyetso byawe bitaragabanuka ukoresheje imiti igabanya ububabare igurishwa ku iduka cyangwa imiti isanzwe yo mu rugo, ni cyo gihe cyo kubonana na muganga wawe. Bari hano kugufasha. Ntutinye kuvugana na muganga wawe ku kibazo cyawe. Kuvurwa hakiri kare ni byo byiza. Korana na muganga wawe kugira ngo utegure gahunda yo kuvura ububabare ikubereye.

Ikibazo cy'uturemangingo tw'umutsi, Indwara y'uturemangingo tw'umutsi, Uturemangingo dutukura tw'amaraso, Ububabare, Imitsi y'amaraso, Ogisijeni