Tekereza uko byagenda iyo amaraso apfutse umuyoboro munini w'amaraso ujya mu mutima wawe, mu bwonko, cyangwa mu bihaha? Ibi byahagarika urujya n'uruza rw'amaraso muri ibyo bice by'umubiri kandi bigatera kwangirika. Iyi ni indwara ishobora gushyira ubuzima mu kaga. Mu gihe cy'impanuka, abaganga bakoresha uburyo bwihariye bwo kuvura kugira ngo barokore ubuzima. Uyu munsi, turimo kuvuga ku buryo bwo kuvura bushongesha kandi bugakuraho ubwo buryo bwo kuvura amaraso, bwitwa 'Thrombolytic Therapy.'
Mu magambo make, ubuvuzi bwa Thrombolytic ni iki?
Nubwo izina rigoye gato, icyo gitekerezo cyoroshye cyane. Muri make, ibi bikubiyemo gukoresha ubwoko bwihariye bw'umuti kugira ngo ushongeshe kandi ukureho uduce tw'amaraso twateje akaga twagiye twirema mu mitsi y'amaraso mu mibiri yacu. Ni nko gushongesha no gukuraho agace kazibye mu muyoboro w'amazi ukoresheje imiti.
Intego nyamukuru y'ubu buvuzi ni ukugarura amaraso yafunzwe n'amaraso yapfubye. Ibi bishobora kugabanya kwangirika kw'ingingo (nk'umutima n'ubwonko) zitangwa n'uwo muyoboro w'amaraso. Ubu buvuzi butangwa mu bihe byihutirwa. Ubu buvuzi bushobora kurokora ubuzima, cyane cyane mu bihe nk'indwara y'umutima (`(Myocardial Infarction)`), indwara yo gucika kw'imitsi iterwa no kuziba kw'imiyoboro y'amaraso mu bwonko (`(Ischemic Stroke)`), cyangwa kuziba kw'amaraso mu bihaha (`(Pulmonary Embolism)`).
Igikuru ni ugutangira ubu buvuzi vuba bishoboka. Uko ubuvuzi butangira vuba ibimenyetso bitangiye, niko umusaruro uba mwiza.
Ni nde ukeneye ubu buvuzi? Kandi ni nde utagomba kubuhabwa?
Ubu si uburyo bwo kuvura bushobora guhabwa buri wese. Abaganga basuzuma ibintu byinshi mbere yo guha umuntu ubu buryo. Kuko bufite ingaruka zimwe na zimwe. Reka turebe igihe ubu buryo bukwiye n'igihe budakwiriye.
| Ibihe bishobora kuba ngombwa ko uvurwa | Igihe ubuvuzi budakwiye gutangwa (kubera ibyago byinshi) |
|---|---|
| Iyo umutsi munini w'amaraso (imitsi cyangwa imitsi) ufunze mu buryo butunguranye kubera kubumba amaraso. | Niba hari amaraso menshi asanzwe ava mu mubiri. |
| Mu bihe nk'iby'imitsi yo mu mitsi yimbitse (DVT) na pulmonary embolism (PE), bidashobora kugenzurwa hakoreshejwe imiti igabanya amaraso isanzwe (anticoagulants). | Niba uherutse kuva amaraso mu bwonko (Intracranial Hemorrhage). |
| Mu masaha make ya mbere nyuma yo kurwara indwara y'umutima cyangwa indwara yo gucika kw'imitsi. | Niba uherutse kubagwa ubwonko cyangwa uruti rw'umugongo. |
| Iyo habayeho ikibazo cyihutirwa bitewe no kuziba kw'imitsi y'amaraso mu ngingo (Indwara y'imitsi yo mu maraso - PAD). | Niba ufite umuvuduko ukabije w'amaraso (hypertension). |
| Iyo catheter yinjijwe mu mubiri ifunzwe n'amaraso apfutse. | Niba ufite indwara ikomeye y'impyiko. |
| Niba uherutse kugira imvune ikomeye mu mutwe. |
Byongeye kandi, abaganga bahangayikishijwe cyane n’ingaruka zishobora guterwa n’ubu buvuzi mu gihe batanga ubu buvuzi ku babyeyi batwite n’abageze mu za bukuru.
Ni ubuhe bwoko bw'ingenzi bw'ubu buryo bwo kuvura?
Hari uburyo bwinshi bwo gutanga uyu muti ugabanya amaraso. Muganga azahitamo uburyo bukwiye cyane bitewe n'uko umurwayi amerewe n'aho amaraso acitse.
1. Thrombolysis y'umubiri
Ubu ni bwo buryo bukunze gukoreshwa cyane. Aha, umuyoboro wa IV ushyirwa mu mutsi uri mu kuboko, nk'umuti utonyanga, maze umuti ugatangwa binyuze muri wo. Uyu muti unyura mu miyoboro y'amaraso, aho ushongesha amaraso apfunditse. Ubu buryo bukunze gukoreshwa mu bihe byihutirwa nko kurwara indwara z'umutima, gucika imitsi, no kuvura amaraso mu bihaha.
2. Thrombolysis iyobowe na Catheter
Ubu buryo buratandukanye gato. Aha, umuyoboro muremure cyane (iyi yitwa catheter) winjizwa mu mubiri unyuze mu mutsi uri mu gituza, mu ijosi, cyangwa mu kuboko. Hanyuma, hakoreshejwe uburyo nka X-ray, umutwe w'iyi catheter uyoborwa aho amaraso apfundikiye. Hanyuma, aho gutanga umuti ku mubiri wose, ushyirwa mu maraso apfundikiye unyuze muri catheter. Ibi bituma umuti utangwa mu buryo burambuye, ugera ku muntu ugenewe. Ubu buryo bukunze gukoreshwa ku ndwara nka DVT na PAD. Ibi bikunze gukorwa mbere y'igihe.
3. Kubaga Thrombectomy hakoreshejwe ikoranabuhanga
Muri iki gihe, uretse gutanga imiti, amaraso apfutse agakurwaho mu buryo bw'ikoranabuhanga. Hari igikoresho cyihariye (igikoresho kinyeganyega, kizunguruka, cyangwa gikurura amaraso apfutse) kiri ku mpera ya catheter gikoreshwa mu guca amaraso apfutse no kuyakuraho ibice. Hari igihe ubu buryo bukoreshwa hamwe n'uburyo buyobowe na catheter.
Ni iki kibaho mu gihe cyo kuvurwa na nyuma yaho?
Uburyo ubu buvuzi bukorwa buzatandukana bitewe n'ubwoko bw'ubuvuzi uhabwa.
Mu gihe cy'ibiza
Niba ufite ikibazo cyihutirwa, nko kurwara indwara y'umutima cyangwa indwara yo gucika kw'imitsi, abaganga bazagerageza gutangira kuvurwa vuba bishoboka nyuma yo kwinjira mu ishami rishinzwe kuvura indwara zihutirwa (ETU) ry'ibitaro. Kugira ngo ubone ibisubizo byiza, ni ngombwa gutangira kuvurwa mu masaha abiri ibimenyetso bitangiye, cyangwa mu minota 30 ugeze kwa muganga.
Uburyo ubuvuzi bukorwa
Reka turebe uko bigenda muri ubu buryo bubiri bw'ingenzi.
| Kugabanya amaraso mu mubiri (binyuze mu gice cya IV) | Uburyo bwo gufunga amaraso hakoreshejwe catheter (binyuze muri catheter) |
|---|---|
| Ibi bikunze gukorwa mu cyumba cy’indembe (ICU). | Ibi kandi ni ikintu gikorerwa mu cyumba cyihariye kiri mu bitaro. |
| Bazaguha umuti wo kugabanya ububabare kugira ngo utuze. Bazatera ibisebe ahantu hashyizwemo imashini ya IV. | Uzahabwa umuti wo kugabanya ububabare kugira ngo utuze. Aho katheteri izashyirwa (ku muhogo, ku kuboko) hazaba hatameze neza. |
| Umuyoboro w'amaraso ushyirwa mu mutsi uri mu kuboko, maze umuti woherezwa mu mubiri unyuze muri wo. | Hakorwa icyuho gito, hagashyirwamo catheter mu mitsi, hanyuma amaraso agafatana aho agapfundikizo kari gaherereye. |
| Umuti unyura mu mubiri wose hamwe n'amaraso ukagera ku maraso. | Umuti uterwa mu maraso. Hari igihe amaraso acikamo ibice hakoreshejwe icyuma gikoresha ikoranabuhanga. |
| Ubusanzwe iki gikorwa kimara isaha imwe. | Bishobora gufata amasaha 48 (iminsi ibiri) kugira ngo amaraso ashonge burundu. Muri icyo gihe, uzakurikiranwa mu bitaro. |
Mu gihe cyo kuvurwa, itsinda ry’abaganga rizakomeza gukurikirana ibintu nk’uko umutima wawe utera, imikorere y’ibihaha, n’umuvuduko w’amaraso.
Nyuma yo kuvurwa
Muganga azakora ibizamini byinshi kugira ngo arebe niba amaraso yashongeshejwe burundu.
- Angiogramu
- gupima CT (CT scan)
- Echocardiogram
Nyuma yo kuvurwa, uzakenera kumara umunsi umwe mu cyumba cy’indembe (ICU). Nyuma y’ibyo, uzakenera kumara undi munsi umwe cyangwa itatu mu bitaro ukurikiranwa. Ndetse na nyuma yo gutaha, uzakenera gukomeza gufata imiti igabanya amaraso kugira ngo wirinde ko amaraso yongera kubyimba.
Ni izihe nyungu n'ingaruka z'ubu buvuzi?
Nk’uko bigenda ku buvuzi ubwo aribwo bwose, ubu buvuzi bufite ibyiza n’ibyago.
Ibyiza by'ingenzi:
- Ubushobozi bwo kurokora ubuzima: Iyi ni yo nyungu ikomeye. Ubu buryo bwo kuvura bushobora gufasha mu gukumira impfu mu gihe cy'indwara z'umutima n'imitsi yo mu bwonko.
- Gukumira ubumuga buhoraho: Mu kugabanya kwangirika k'ubwonko, birashoboka kwirinda ingorane zo kuvuga no gutakaza amaguru n'amaboko nyuma yo gucika intege mu bwonko.
- Kurinda gucibwamo ibice: Iyo umutsi munini wo ku kuboko cyangwa ukuguru ufunze, icyo gice cy'umubiri gishobora gupfa amaraso adatembera. Ubu buryo bugabanya ibyo byago.
Ingaruka nyamukuru:
Ingaruka zikomeye kandi zikomeye z'ubu buvuzi ni uko umuntu ashobora kuva amaraso imbere mu mubiri.
- Kuva amaraso mu bwonko: Iki ni cyo kibazo giteje akaga cyane. Abantu bagera kuri 1% bahabwa ubu buvuzi bashobora kurwara indwara yo mu bwonko iterwa no kuva amaraso mu bwonko.
- Andi maraso: Ushobora kuva amaraso mu mazuru, mu mwanda wawe, cyangwa mu nkari zawe. Ushobora kugira ibisebe cyangwa amaraso aho katheteri cyangwa imashini ya IV byashyizwe.
- Izindi ngaruka mbi:
- Ubushobozi bwo kugira ubwivumbure
- Kwangirika kw'impyiko (cyane cyane ku bantu barwaye diyabete)
- Umuvuduko w'amaraso uri hasi (`(Hypotension)`)
- Amaraso acika maze ajya ahandi hantu maze agafatwa.
- Indwara z'umutima (`(Ventricular arrhythmia)`)
Kubera izo ngaruka, abaganga basuzuma ibintu byinshi mbere yo guha umuntu ubu buryo bwo kuvura.
Ni ryari nkwiye kujya kwa muganga nyuma yo kuvurwa?
Umaze gutaha, ni ngombwa gukomeza gukurikirana ibimenyetso bimwe na bimwe. Niba ubonye kimwe mu bimenyetso biri hepfo, ugomba guhita ubimenyesha muganga wawe.
| Ibimenyetso byo kwitondera | Ibisobanuro |
|---|---|
| Kubabara mu gatuza | Ububabare butunguranye cyangwa bukomeza kwiyongera mu gituza. |
| Impinduka mu gushyira IV/catheter | Iyo agace gakomeje kuva amaraso cyangwa gusohoka, kagahinduka umutuku, kakumva gashyushye, cyangwa kakagira kubyimba/ububabare bwinshi. |
| Umuriro | Niba urwaye umuriro nta mpamvu. |
| Kuribwa umutwe cyangwa isesemi | Niba urwaye umutwe ukabije cyangwa ufite isesemi. |
| Gucika intege mu maguru | Niba wumva urimo gucika intege cyangwa ukagira ibinya mu biganza cyangwa amaguru. |
Ibi bimenyetso bishobora kugaragaza ko hari ikibazo, bityo ntukabirengagize.
Ubutumwa bwo kujyana mu rugo
- Ubuvuzi bwa Thrombolytic ni ubuvuzi bw'ingenzi cyane bushobora kurokora ubuzima binyuze mu gushonga kw'amaraso mu bihe byihutirwa nko mu ndwara z'umutima no mu bwonko.
- Igihe ni ingenzi cyane kugira ngo ubu buvuzi bugire icyo bugeraho. Kujya kwa muganga ibimenyetso bikimara kugaragara bishobora gutuma umusaruro urushaho kuba mwiza.
- Kubera ko ibyago nyamukuru byo kurwara ibi ari ukuva amaraso, abaganga bazahitamo kuguha ubu buvuzi nyuma yo gusuzuma neza uko umeze.
- Nyuma yo kuvurwa, ni ngombwa cyane gukurikiza amabwiriza ya muganga wawe neza, cyane cyane gufata imiti igabanya amaraso, kugira ngo wirinde ko amaraso ashobora kugabanuka mu gihe kizaza.
- Umaze kuvurwa, banza umenyeshe muganga wawe ibimenyetso bidasanzwe ubonye.
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