Tekereza, byagenda bite niba uburyo umubiri wawe usanzwe ukoresha bwo guhagarika kuva amaraso butunguranye bugahagarara burundu? Uduce duto tw'amaraso twibasiwe ku mubiri wawe wose, ibintu byose bikenewe kuri yo bikaba byarashize, hanyuma ntushobora guhagarika kuva amaraso nubwo waba wakomeretse gato. Iyo ni imwe mu ndwara zikomeye cyane kandi zigoye tuvuga uyu munsi , DIC (Disseminated Intravascular Coagulation) . Nubwo iri zina risa n'iriteye ubwoba, reka turisobanukirwe mu buryo bworoshye.
DIC ni iki mu by'ukuri?
Muri make, DIC ni indwara ikomeye igira ingaruka ku bushobozi bw'amaraso yawe bwo kuvura. Icyaba ari uko uburyo bwo kuvura amaraso mu mubiri wawe bugenda bushira burundu. Iyi ndwara ishobora kubaho mu byiciro bibiri by'ingenzi.
1. Icyiciro cya 1 (Icyiciro cyo Gutera Amaraso): Muri iki cyiciro, udukoko duto tw'amaraso ibihumbi dutangira kwirema mu mubiri wawe wose, mu mitsi yawe . Kugira ngo dukore utu dukoko, dukoresha platelets nyinshi n'ibintu bituma amaraso agwa. Ni nko gukoresha sima nyinshi kugira ngo twubake inkuta nto zitari ngombwa mu mujyi wose. Muri ubu buryo, ibi bintu bikoreshwa vuba.
2. Icyiciro cya 2 (Icyiciro cyo kuva amaraso): Ubu, umubiri uba wabuze plaquettes na poroteyine zikenewe kugira ngo amaraso apfunde. Kuri iyi ngingo, ndetse n'igikomere gito ntigishobora guhagarika kuva amaraso . Ibi biterwa nuko umubiri uba utakigira "simenti" ikenewe kugira ngo amaraso apfunde. Ibi bitera kuva amaraso menshi mu buryo budashobora kugenzurwa. Iki ni cyo cyiciro giteje akaga cyane cy'indwara kandi gisaba kuvurwa vuba.
Icy'ingenzi ni uko DIC itigera iba ubwayo. Ihora iba bitewe n'indi ndwara ikomeye cyangwa ingorane. Bivugwa ko ibaho ku barwayi bagera kuri 1% bari mu bitaro.
Ni iki gitera DIC?
Nkuko twabivuze mbere, DIC iterwa n'indwara runaka. Impamvu iratandukanye bitewe n'indwara. Akenshi itangirana n'ikintu kidasanzwe (urugero: uburozi bwa bagiteri , ibice byangiritse by'imitsi) byinjira mu maraso. Reka turebe impamvu nyamukuru.
| Ubwoko bw'impamvu | Ingero n'ibisobanuro |
|---|---|
| Impamvu zitera DIC itunguranye (itunguranye) |
|
| Impamvu za DIC idakira |
|
Ni ibihe bimenyetso bishobora kugaragara ku ndwara ya DIC?
Ibimenyetso ubona biterwa nuko indwara ya DIC ihita igaragara (itunguranye) cyangwa buhoro buhoro (idakira).
Ibimenyetso bya DIC ikabije
Ikimenyetso nyamukuru kandi giteje akaga cyane cy’ibi ni ukuva amaraso mu buryo budasubirwaho.
- Kuva amaraso menshi cyane mu gice cy’abazwe, mu gice cy’imitsi, mu mazuru, cyangwa mu ishinya.
- Ibikomere bigaragara ku mubiri wose nta mpamvu.
- Kuruka amaraso.
- Gutera amaraso hamwe n'imyenge.
- Kuva amaraso mu bwonko, mu nzira y'igogora, mu mitsi, cyangwa mu mwobo w'umubiri.
Ibimenyetso bya DIC idakira
Akaga gakomeye muri ubu bwoko si ukuva amaraso, ahubwo ni ukuva amaraso afunganye mu ntangiriro. Ayo maraso ashobora kugenda no kuziba imiyoboro y'amaraso mu ngingo z'ingenzi.
- Kunanirwa kw'ingingo: Iyo amaraso apfunditse abuza amaraso gutembera mu ngingo nk'impyiko, umwijima, cyangwa ibihaha.
- Gucika kw'amaraso mu bwonko: Iyo amaraso apfutse umuyoboro w'amaraso mu bwonko.
- Indwara y'umutima: Iyo umuyoboro w'amaraso utanga amaraso mu mutima ufunze.
- Kuziba kw'imitsi yo mu bwonko (DVT): Amaraso afungana mu mitsi y'amaguru cyangwa amaboko, bigatera kubyimba no kubabara muri utwo duce.
- Guhumeka bigoranye: Iyo amaraso yagabanutse ajya mu bihaha.
Hari igihe DIC itangira buhoro buhoro ishobora kutagira ibimenyetso. Nanone, kuva amaraso ahantu hatatu hadafite aho bihuriye icyarimwe (urugero: kuva amaraso mu mazuru, ishinya, n'inkari) bishobora kuba ikimenyetso cya DIC.
Ni ubuhe buryo bwo kuvura DIC?
Ikintu cya mbere kandi cy'ingenzi abaganga bakora mu gihe umuntu arwaye DIC ni ukuvura indwara yateye DIC. Urugero, niba DIC iterwa n'ubwandu (sepsis), imiti igabanya ubukana bw'indwara izatangwa kuri iyo ndwara.
Byongeye kandi, hanatangwa ubuvuzi kugira ngo hagenzurwe ibimenyetso biterwa na DIC.
- Guterwa amaraso mu maraso: Iyo habayeho gutakaza amaraso menshi, amaraso atangwa kugira ngo asimbuze poroteyine (ibintu bituma amaraso agwa) zikenewe kugira ngo amaraso agwane.
- Guterwa plaquettes: Ibi bitangwa kugira ngo bigarure umubare wa plaquettes zagabanutse bitewe no kuva amaraso.
- Uburyo bwo kuvura umwuka wa ogisijeni: Iyo amaraso agana ku rugingo runaka ahungabanye bitewe n’amaraso apfunditse, umwuka wa ogisijeni utangwa kugira ngo hirindwe kwangirika kw’urwo rugingo.
- Imiti igabanya amaraso: Imiti igabanya amaraso nka heparin irashobora gukoreshwa. Ushobora kuba wibaza uti “Wow, kuki umuntu usanzwe ava amaraso akeneye imiti myinshi igabanya amaraso?” Iyi ikoreshwa witonze cyane. Itangwa kugira ngo hirindwe ko amaraso ashobora kugabanuka cyane, cyane cyane mu gihe cy’indwara ya DIC idakira cyangwa mu ntangiriro z’indwara. Iki ni icyemezo muganga wawe wenyine ashobora gufata.
Indwara ya DIC ikabije ni ikibazo cyihutirwa cy’ubuvuzi. Isaba kuvurirwa mu cyumba cy’indembe cy’ibitaro (ICU) cyangwa mu cyumba cy’indembe cy’ibitaro (ETU). Ariko ntugahangayike, akenshi ibi bibaho mu gihe cyo kubagwa cyangwa kubyara, kandi itsinda ry’abaganga riba riri aho ngaho.
Nyuma yo kuva mu bitaro, umuganga wawe azakomeza kugukurikirana no gukurikirana niba hari indwara n'ingorane byatewe na DIC.
Ubutumwa bwo kujyana mu rugo
- DIC si indwara yibasira ubwayo. Buri gihe iba ari ikibazo cy’indi ndwara ikomeye (urugero: sepsis, kanseri, ihungabana rikomeye).
- Icyo bibaho muri iki gihe ni uko mbere na mbere, amaraso acikamo ibice bitari ngombwa mu mubiri wose, hanyuma ibintu bikenewe kugira ngo amaraso apfuke bigasohoka, bigatuma amaraso ava mu buryo butagenzurwa.
- Ubuvuzi bwibanda ku kuvura indwara yateye DIC, ndetse no kuvura ibimenyetso.
- Niba ugize kuva amaraso mu buryo butunguranye cyangwa gukomereka gukomeye mu bice byinshi by'umubiri wawe nta mpamvu igaragara, cyane cyane niba ufite indi ndwara ikomeye, hita ubonana na muganga wawe cyangwa ujye mu bitaro bikuru byita ku buzima bw'abantu (ETU).
DIC, Gufungana kw'imitsi mu maraso, Gufungana kw'amaraso, Kuva amaraso, Kuva amaraso menshi, Sepsis, Ibimenyetso
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