Patent Ductus Arteriosus (Pda)

Patent ductus arteriosus (PDA) ni ubukingo buhoraho hagati y'imijyana y'amaraso ibiri ikomeye iva mu mutima. Iyo mijyana ni aorte na arteri ya pulumoneri. Iyi ndwara ibaho kuva umwana avutse.

Patent ductus arteriosus (PDA) ni ubukingo buhoraho hagati y'imijyana y'amaraso ibiri ikomeye iva mu mutima. Iki kibazo cy'umutima kibaho kuva umwana avutse. Bisobanura ko ari uburwayi bw'umutima bwavutse umwana afite.

Ubukingo bwitwa ductus arteriosus ni igice cy'imikorere y'amaraso y'uruhinja mu nda. Busanzwe bukinga nyuma gato y'ivuka. Niba bukomeza gufungura, bwitwa patent ductus arteriosus.

Patent ductus arteriosus ntoya akenshi ntabwo itera ibibazo kandi ishobora kutazigera ikenera kuvurwa. Ariko, patent ductus arteriosus nini idavuwe ishobora gutuma amaraso adafite ogisijeni ajya mu buryo butari bwo. Ibi bishobora kugabanya imbaraga z'umutima, bigatera gucika intege kw'umutima n'ibindi bibazo.

Uburyo bwo kuvura patent ductus arteriosus burimo gusuzuma ubuzima buhoraho, imiti, no kubaga cyangwa kubaga kugira ngo dufungure ubukingo.

Ibimenyetso bya patent ductus arteriosus (PDA) biterwa n'ingano y'umwanya ufunguye n'imyaka y'umuntu. PDA nto ishobora kutazigira ibimenyetso. Bamwe ntibabona ibimenyetso kugeza bakuze. PDA nini ishobora gutera ibimenyetso by'ikibazo cy'umutima vuba nyuma yo kuvuka.

PDA nini iboneka mu buto cyangwa mu bwana ishobora gutera:

• Kudafata ifunguro neza, bigatuma adakura neza.
• Kumira ibyuya iyo arira cyangwa afata ifunguro.
• Guhumeka cyane cyangwa guhumeka nabi buri gihe.
• Kunanirwa vuba.
• Gufata umutima vuba.

Hamagara muganga niba umwana wawe, ukiri muto cyangwa mukuru:

• Ananirwa vuba iyo ari kurya cyangwa ari gukina.
• Atari kwiyongera ibiro.
• Apfa guhumeka iyo ari kurya cyangwa ari kurira.
• Ahumeka buri gihe cyangwa apfa guhumeka.

Impamvu nyakuri ziterwa n'ubumuga bw'umutima bwavutse ziracyari zitazwi. Mu gihe cy'ibyumweru bitandatu bya mbere byo gutwita, umutima w'umwana utangira gushinga no gukubita. Udukora tw'amaraso nyamukuru twohereza amaraso ava mu mutima n'ayajyamo bikura. Ni muri icyo gihe ibibazo bimwe na bimwe by'umutima bishobora gutangira gukura.

Mbere y'uko umwana avuka, hari ubwambuzi bw'igihe gito bwitwa ductus arteriosus buri hagati y'imitsi ibiri y'amaraso ikomeye iva mu mutima w'umwana. Iyo mitsi ni aorte na arteri ya pulmona. Ubwambuzi bukenewe kugira ngo amaraso y'umwana atemberere mbere y'uko avuka. Buvana amaraso mu mwijima w'umwana mu gihe arimo gukura. Umwana abona ogisijeni mu maraso ya nyina.

Nyuma yo kuvuka, ductus arteriosus ntiyakibaye ngombwa. Ubusanzwe ifunga mu minsi 2 cyangwa 3. Ariko muri bamwe mu bana, ubwambuzi ntibufunga. Iyo bukomeje gufungura, bita patent ductus arteriosus.

Ibintu byongera ibyago byo kugira patent ductus arteriosus (PDA) birimo:

• Kuvuka imburagihe. Patent ductus arteriosus ibaho cyane mu bana bavutse imburagihe kurusha abana bavutse ku gihe.
• Amateka y'umuryango n'izindi ndwara zikomoka ku mbaraga. Amateka y'umuryango afite ibibazo by'umutima bivuka ashobora kongera ibyago bya PDA. Abana bavutse bafite chromosome ya 21 yiyongereyeho, uburwayi bwitwa Down syndrome, nabo bashobora kugira iki kibazo.
• Kugira rubella mu gihe cyo gutwita. Kugira rubella mu gihe cyo gutwita bishobora gutera ibibazo mu iterambere ry'umutima w'umwana. Ibizamini by'amaraso bikorwa mbere yo gutwita bishobora kumenya niba ufite ubudahangarwa kuri rubella. Hari urukingo ruhari ku badafite ubudahangarwa.
• Kuvuka ahantu hari hejuru. Abana bavutse hejuru ya metero 2499 bafite ibyago byinshi byo kugira PDA kurusha abana bavutse ahantu hasi.
• Kuba umukobwa. Patent ductus arteriosus ibaho inshuro ebyiri kurusha abakobwa.

Umuhogo muto utari ukingiye neza ushobora kutazana ibibazo. Ibibazo binini bitavuwe bishobora gutera:

• Gucika intege kw'umutima. Ibimenyetso by'iki kibazo gikomeye birimo guhumeka cyane, akenshi ugafata umwuka mu gihe kirekire, no kudakura neza.
• Amazi mu mutima, yitwa endocarditis. Umuhogo utari ukingiye neza ushobora kongera ibyago byo kwandura mu mitsi y'umutima. Iyi ndwara yitwa endocarditis. Ishobora kuba ikomeye cyane.

Bishoboka kuba ufite imbyaro nziza ufite umuhogo muto utari ukingiye neza. Ariko, kugira umuhogo munini cyangwa ibibazo nk'igicika intege cy'umutima, gutera kw'umutima nabi cyangwa kwangirika kw'ibihaha byongera ibyago by'ibibazo bikomeye mu gihe utwite.

Mbere yo gutwita, banza uvugane n'abaganga bawe ku bibazo bishoboka byo gutwita n'ingaruka mbi. Imiti imwe y'umutima ishobora gutera ibibazo bikomeye ku mwana uri mu nda. Umuganga wawe ashobora guhagarika cyangwa guhindura imiti yawe mbere yo gutwita.

Hamwe mushobora kuganira no gutegura ubufasha bwihariye bukenewe mu gihe utwite. Niba uri mu kaga gakomeye ko kubyara umwana ufite ikibazo cy'umutima kuva avutse, ibizamini bya genetique no gusuzuma bishobora gukorwa mu gihe utwite.

Nta gukumira kwa patent ductus arteriosus bizwi. Ariko rero, ni ingenzi gukora ibishoboka byose kugira ngo ugire imbyaro nzima. Dore bimwe mu bintu by'ibanze:

• Shaka ubuvuzi bwo kwitaho imbyaro hakiri kare, mbere y'uko utwite. Kureka kunywa itabi, kugabanya umunaniro, guhagarika imiti yo kuboneza urubyaro — ibi byose ni ibintu ugomba kuvugana n'abaganga bawe mbere y'uko utwite. Bwira umuganga wawe imiti yose ufashe, harimo n'iyaguze utabifitiye amabwiriza.
• Funga indyo yuzuye. Fata inyongeramusaruro irimo acide folique. Kufata imicrogramu 400 ya acide folique buri munsi mbere y'uko utwite no mu gihe utwite byagaragaye ko bigabanya ibibazo by'ubwonko n'umugongo ku mwana. Bishobora kandi kugabanya ibyago by'indwara z'umutima.
• Kora siporo buri gihe. Korana n'abaganga bawe kugira ngo mugire gahunda y'imyitozo ikubereye.
• Ntunywe cyangwa utanywe itabi. Izi migenzo yo kubaho zishobora kwangiza ubuzima bw'umwana. Irinde kandi itabi rya kabiri.
• Fata inkingo zisabwa. Uburizwemo inkingo zawe mbere yo gutwita. Ubwoko bumwe na bumwe bw'indwara bushobora kwangiza umwana uri gutera imbere.
• Genzura isukari y'amaraso. Niba ufite diyabete, kugenzura neza isukari y'amaraso bishobora kugabanya ibyago by'ibibazo bimwe na bimwe by'umutima mbere y'uko umwana avuka.

Umuforomokazi akora isuzuma ngororamubiri kandi abaza ibibazo ku mateka yawe y'ubuzima. Umuforomokazi ashobora kumva ijwi ry'umutima ryitwa guhindahira igihe yumva umutima akoresheje stetoskope.

Ibizamini bishobora gukorwa kugira ngo hamenyekane indwara ya patent ductus arteriosus birimo:

• X-Ray y'Ikibero. Iki kizamini kigaragaza uko umutima n'ibihaha bimeze.
• Electrocardiogramme. Iki kizamini cyihuse kandi cyoroshye cyandika ibimenyetso by'amashanyarazi bigize umutima. Kigaragaza uburyo umutima ukubita cyangwa gahoro.
• Cardiac catheterization. Iki kizamini ntigikenewe cyane kugira ngo hamenyekane PDA. Ariko gishobora gukorwa niba PDA ibaye hamwe n'ibindi bibazo by'umutima. Umuyoboro muremure, mwiza kandi woroshye (catheter) ushyirwa mu mubiri w'amaraso, akenshi mu kibuno cyangwa mu kuboko, hanyuma ukajyanwa ku mutima. Muri iki kizamini, umuforomokazi ashobora gukora ibikorwa byo gufunga patent ductus arteriosus.

Ubuvuzi bwa patent ductus arteriosus biterwa n'imyaka y'umuntu uvurwa. Bamwe mu bantu bafite PDA nto zidatera ibibazo bakeneye gusa gusuzuma ubuzima buhoraho kugira ngo barebe ko nta bibazo byavutse. Niba umwana wavutse imburagihe afite PDA, umuvuzi arasuzuma buri gihe kugira ngo arebe ko ifunze.

Imiti yitwa imiti idafite steroide (NSAIDs) ishobora guhabwa abana bavutse imburagihe kugira ngo bavurwe PDA. Iyi miti ibuza imiti runaka y'umubiri ikomeza PDA ifunze. Ariko, iyi miti ntabwo ifunga PDA mu bana bavutse ku gihe, abana cyangwa abakuze.

Mu gihe cyahise, abaganga babwiraga abantu bavutse bafite PDA gufata antibiotike mbere y'akazi ko mu menyo na bimwe mu bikorwa byo kubaga kugira ngo birinde indwara zimwe na zimwe z'umutima. Ibi ntibikigenda bisabwa ku bantu benshi bafite patent ductus arteriosus. Baza umuvuzi wawe niba antibiotike zo kwirinda ari ngombwa. Bishobora gusabwa nyuma y'ibikorwa bimwe na bimwe by'umutima.

Ubuvuzi buzamuka bwo gufunga patent ductus arteriosus burimo:

• Gukoresha umuyoboro mwinshi witwa catheter na plug cyangwa coil kugira ngo ufungure. Ubu buvuzi bwitwa catheter procedure. Buretse ko ubugororangingo bukorwa hatakozwe igikorwa cyo kubaga umutima.

  Mu gihe cyo gukoresha catheter, umuvuzi ashyiramo umuyoboro mwinshi mu mubiri w'amaraso mu kibuno maze awujyana ku mutima. Plug cyangwa coil ica mu muyoboro. Plug cyangwa coil ifunga ductus arteriosus. Ubu buvuzi busanzwe ntibukenera ijoro ryose mu bitaro.

  Abana bavutse imburagihe baba bato cyane ku buryo batabasha kuvurwa na catheter. Niba PDA idatera ibibazo, kuvurwa kwa catheter kugira ngo ifungurwe bishobora gukorwa iyo umwana akuze.

• Kubaga umutima kugira ngo ufungure PDA. Ubu buvuzi bwitwa surgical closure. Kubaga umutima bishobora kuba ngombwa niba imiti idakora cyangwa PDA ari nini cyangwa itera ibibazo.

  Umuganga akora umunwa muto hagati y'amaguru kugira ngo agere ku mutima w'umwana. Ufunguzi ufungwa hakoreshejwe imishumi cyangwa ama clips. Bisanzwe bimamara ibyumweru bike kugira ngo umwana akire neza nyuma y'ubu buvuzi.

Gukoresha umuyoboro mwinshi witwa catheter na plug cyangwa coil kugira ngo ufungure. Ubu buvuzi bwitwa catheter procedure. Buretse ko ubugororangingo bukorwa hatakozwe igikorwa cyo kubaga umutima.

Mu gihe cyo gukoresha catheter, umuvuzi ashyiramo umuyoboro mwinshi mu mubiri w'amaraso mu kibuno maze awujyana ku mutima. Plug cyangwa coil ica mu muyoboro. Plug cyangwa coil ifunga ductus arteriosus. Ubu buvuzi busanzwe ntibukenera ijoro ryose mu bitaro.

Abana bavutse imburagihe baba bato cyane ku buryo batabasha kuvurwa na catheter. Niba PDA idatera ibibazo, kuvurwa kwa catheter kugira ngo ifungurwe bishobora gukorwa iyo umwana akuze.

Kubaga umutima kugira ngo ufungure PDA. Ubu buvuzi bwitwa surgical closure. Kubaga umutima bishobora kuba ngombwa niba imiti idakora cyangwa PDA ari nini cyangwa itera ibibazo.

Umuganga akora umunwa muto hagati y'amaguru kugira ngo agere ku mutima w'umwana. Ufunguzi ufungwa hakoreshejwe imishumi cyangwa ama clips. Bisanzwe bimamara ibyumweru bike kugira ngo umwana akire neza nyuma y'ubu buvuzi.

Bamwe mu bantu bavutse bafite PDA bakeneye gusuzuma ubuzima buhoraho ubuzima bwabo bwose, na nyuma yo kuvurwa kugira ngo ufunguzi ufungwe. Muri ibyo bisuzumwa, umuvuzi ashobora gukora ibizamini kugira ngo arebe ko nta bibazo byavutse. Ganira n'umuvuzi wawe ku gishushanyo cy'ubuvuzi bwawe. Ni byiza gushaka ubufasha bw'umuvuzi wahuguwe mu kuvura abantu bakuru bafite ibibazo by'umutima mbere y'ivuka. Uyu muvuzi yitwa congenital cardiologist.

Umuntu wese wavutse afite patent ductus arteriosus agomba gufata ingamba zo kubungabunga ubuzima bw'umutima no gukumira ingaruka. Izi nama zishobora gufasha:

• Kureka kunywa itabi. Kunywa itabi ni ikintu gikomeye cyane gishobora gutera indwara z'umutima n'ibindi bibazo by'umutima. Kureka kunywa itabi ni bwo buryo bwiza bwo kugabanya ibyago. Niba ukeneye ubufasha bwo kureka kunywa itabi, vugana n'abaganga bawe.
• Kurya indyo iboneye. Funga imbuto, imboga n'ibinyampeke byuzuye. Gabanuka isukari, umunyu n'amavuta yuzuye.
• Kwita ku isuku. Koga intoki buri gihe no gukaraba amenyo no kuyakosoresha kugira ngo ugire ubuzima bwiza.
• Kubaza ibyerekeye ibikorwa bya siporo. Bamwe mu bantu bavutse bafite ikibazo cy'umutima bashobora kuba bakeneye kugabanya imyitozo ngororamubiri cyangwa imikino. Baza umuvuzi wawe imikino n'uburyo bw'imyitozo ngororamubiri bikubereye wowe cyangwa umwana wawe.