Duktus Arteriosi Idasanzwe: Ibimenyetso, Impamvu, n’Ubuvuzi

Duktus arteriosi idasanzwe (PDA) ni ikibazo cy’umutima aho imiyoboro y’amaraso igomba gufunga nyuma yo kuvuka ikomeza gufunguye. Ubu bufunguzi, bwitwa ductus arteriosus, busanzwe buhuza imiyoboro ibiri y’amaraso hafi y’umutima mu gihe cyo gutwita kugira ngo amaraso atemberere mu mwijima w’umwana. Iyo itafunze neza nyuma yo kuvuka, bishobora kugira ingaruka ku buryo amaraso atembera mu mutima no mu mwijima.

Duktus Arteriosi Idasanzwe Ni Iki?

Duktus arteriosi idasanzwe ibaho iyo ubuhuza bw’imijyana y’amaraso busanzwe budafunga neza nk’uko bikwiye nyuma yo kuvuka. Mu gihe cyo gutwita, abana ntibakenera gukoresha imyanya yabo y’ubuhumekero kugira ngo babone umwuka, bityo ubu buhuza bufasha amaraso kwirinda imyanya y’ubuhumekero.

Iyo umwana avutse akaba atangiye guhumeka, ubu buhuza bugomba gufunga mu minsi mike ya mbere y’ubuzima. Iyo bukomeje gufunguye, amaraso atembera hagati ya aorte (umuyoboro mukuru w’amaraso mu mubiri) n’umuyoboro w’amaraso ujya mu mwijima (ujyana amaraso mu mwijima).

Ubu butembera bw’amaraso bwinshi butera umuvuduko ku mutima no ku mwijima uko iminsi igenda. Iki kibazo gishobora kuba kiremereye cyane ku buryo kidagira ingaruka ku buzima bwa buri munsi kugeza ku bihe bikomeye bisaba ubuvuzi.

Ibimenyetso bya Duktus Arteriosi Idasanzwe Ni Ibihe?

Abantu benshi bafite PDA ntoya ntabwo bagira ibimenyetso na gato, cyane cyane mu bwana. Iyo ibimenyetso bigaragaye, bikunze kuza buhoro buhoro uko umutima ukora cyane kugira ngo upompe amaraso menshi.

Ibimenyetso bisanzwe ushobora kubona birimo:

• Guhumeka nabi, cyane cyane mu gihe cy’imikino cyangwa imyitozo
• Kuruha cyane ugereranije n’ibisanzwe mu bikorwa bya buri munsi
• Gutera kw’umutima cyane cyangwa kudakora neza ushobora kumva
• Kwita umunyu cyane ugereranije n’ibisanzwe, cyane cyane mu gihe cyo konsa mu bana bato
• Kugira ibiro bike cyangwa gukura buhoro mu bana
• Indwara z’ubuhumekero cyangwa pneumonia kenshi

Mu bihe bikomeye, ushobora kumva ububabare mu kifuba cyangwa kumva umutima wawe uhagaze cyane nubwo uri kuruhuka. Bamwe bumva ibara ry’ubururu ku ruhu rwabo, ku minwa, cyangwa ku misumari, ibi bibaho iyo nta mwuka uhagije mu maraso.

Ibi bimenyetso bikunze kugaragara cyane uko umuntu akura, kuko umutima umaze imyaka myinshi ukora cyane. Inkuru nziza ni uko kumenya ibi bimenyetso hakiri kare bishobora kugufasha kubona ubuvuzi bukwiye.

Impamvu za Duktus Arteriosi Idasanzwe Ni Izihe?

Duktus arteriosi idasanzwe ibaho iyo igikorwa gisanzwe cyo gufunga nyuma yo kuvuka kidakora neza, ariko abaganga ntibahora bazi impamvu nyayo yabyo. Duktus arteriosi ikwiye gufunga mu buryo bw’umwimerere mu minsi 2-3 nyuma yo kuvuka uko urwego rw’umwuka rugenda ruzamuka kandi imisemburo imwe na imwe ihinduka.

Ibintu byinshi bishobora kongera ibyago byo kuvura PDA:

• Kuvuka imburagihe - abana bavutse mbere y’ibyumweru 37 bafite ibyago byinshi byo kugira PDA
• Kuvuka ahantu hari umwuka muke
• Kugira ibibazo bimwe na bimwe by’imiterere nk’indwara ya Down
• Amateka y’umuryango w’ibibazo by’umutima
• Indwara ya rubella ku mubyeyi mu gihe cyo gutwita
• Isuka ry’umubyeyi cyangwa kugenzura nabi isukari mu maraso mu gihe cyo gutwita
• Imiti imwe na imwe ifatwa mu gihe cyo gutwita

Abana bavutse imburagihe bafite ibyago byinshi kuko ductus arteriosus yabo itarabona igihe gihagije cyo gutera imbere kugira ngo ifunge neza. Mu bihe bike bidasanzwe, urukuta rw’umuyoboro ubwarwo rushobora kugira ibibazo by’imiterere birinda gufunga bisanzwe.

Akenshi, PDA ibaho nta mpamvu isobanutse, kandi ni ingenzi kumenya ko nta kintu wowe cyangwa ababyeyi bawe bakoze cyateye iki kibazo.

Ni Ryari Ukwiye Kubonana n’Umutimanama kubera Duktus Arteriosi Idasanzwe?

Ukwiye kuvugana n’umuganga wawe niba ubona ibimenyetso byerekana ko umutima wawe ushobora kuba ukora cyane ugereranije n’ibisanzwe. Ibi ni ingenzi cyane niba ufite guhumeka nabi mu bikorwa byoroshye.

Shaka ubuvuzi vuba niba ufite:

• Ububabare mu kifuba cyangwa umuvuduko, cyane cyane mu gihe cy’imikino
• Guhumeka nabi cyane cyangwa kugira ikibazo cyo guhumeka
• Guta ubwenge cyangwa kumva ushobora guta ubwenge
• Kwiyongera kw’ibiro cyangwa kubyimba mu maguru, mu birenge, cyangwa mu nda
• Ibara ry’ubururu ku minwa, ku misumari, cyangwa ku ruhu

Kubabyeyi, ni ingenzi kwitondera ibimenyetso mu bana nko konsa nabi, gukonja cyane mu gihe cyo kurya, cyangwa kudakura nk’uko bikwiye. Indwara z’ubuhumekero kenshi cyangwa kugaragara nk’abana barushye abandi mu gihe cyo gukina na byo bishobora kuba ibimenyetso by’uburwayi.

Nubwo ibimenyetso bigaragara nk’ibyoroheje, gusuzuma hakiri kare bishobora gufasha kwirinda ingaruka mbi nyuma yaho. Umuganga wawe ashobora kumenya niba ibimenyetso byawe bifitanye isano na PDA cyangwa ikindi kintu.

Ibyago byo Kurwara Duktus Arteriosi Idasanzwe Ni Ibihe?

Ibintu bimwe na bimwe bituma bishoboka ko ductus arteriosus ikomeza gufunguye nyuma yo kuvuka, nubwo kugira ibi byago ntibihamya ko uzavurwa na PDA. Kubyumva bishobora gufasha gusobanura impamvu bamwe bagira ingaruka kurusha abandi.

Ibyago byinshi birimo:

• Kuvuka imburagihe (cyane cyane mbere y’ibyumweru 28 byo gutwita)
• Kuvuka ufite ibiro bike (munsi ya 3.3 ibiro cyangwa 1.5 kilogaramu)
• Kuvuka ahantu hari hejuru y’uburebure bwa metero 2438
• Igitsina gore - abakobwa bafite ibyago bibiri byo kugira PDA kurusha abahungu
• Amateka y’umuryango w’ibibazo by’umutima
• Ibibazo by’imiterere nk’indwara ya Down cyangwa DiGeorge
• Indwara z’umubyeyi mu gihe cyo gutwita, cyane cyane rubella
• Isuka ry’umubyeyi cyangwa isukari mu gihe cyo gutwita

Ibindi byago bike birimo kwibasirwa na chemicals cyangwa imiti mu gihe cyo gutwita, no kugira ibindi bibazo by’umutima bivuka. Ababyeyi bakoresha inzoga cyane mu gihe cyo gutwita nabo bashobora kugira abana bafite ibyago byinshi.

Ni ingenzi kuzirikana ko abana benshi bafite ibi byago batavurwa na PDA, mu gihe abandi badafite ibyago bizwi bavurwa. Uburyo bwo guhuza imiterere n’ibintu by’ibidukikije ni bitoroshye kandi biracyigaho n’abashakashatsi.

Ingaruka zishoboka za Duktus Arteriosi Idasanzwe Ni Izihe?

Iyo PDA ari ntoya, abantu benshi babaho ubuzima busanzwe nta ngaruka. Ariko kandi, gufungura kurenze bishobora gutera ibibazo uko iminsi igenda uko umutima n’imwijima bikora cyane kugira ngo bigenzure amaraso menshi.

Ingaruka zisanzwe ushobora guhura nazo harimo:

• Gucika intege kw’umutima - iyo umutima wawe ucika intege cyane ku buryo udashobora gupompa amaraso neza
• Umuvuduko ukabije w’amaraso mu mwijima (pulmonary hypertension)
• Kudakora neza kw’umutima (arrhythmias)
• Ibyago byiyongereye byo kwandura umutima (endocarditis)
• Stroke iterwa n’amaraso
• Indwara ya Eisenmenger - indwara idasanzwe ariko ikomeye aho amaraso atembera mu bundi buryo

Gucika intege kw’umutima bisanzwe bizamo buhoro buhoro imyaka myinshi. Ushobora kubona umunaniro wiyongereye, kubyimba mu maguru cyangwa mu nda, cyangwa kugira ikibazo cyo guhumeka iyo uri kuryama.

Umuvuduko ukabije w’amaraso mu mwijima ubaho iyo amaraso menshi yangiza imiyoboro mito y’amaraso mu mwijima wawe. Ibi bishobora guhinduka bitagaruka, niyo mpamvu ubuvuzi bwa hakiri kare ari ingenzi cyane kuri PDA nini.

Inkuru nziza ni uko ingaruka nyinshi zishobora kwirindwa hakoreshejwe ubuvuzi bukwiye. Nubwo ingaruka zibaho, nyinshi zishobora gucungwa neza hakoreshejwe imiti n’impinduka mu mibereho.

Duktus Arteriosi Idasanzwe Imenyekanwa Gute?

Kumenya PDA bikunze gutangira iyo umuganga wawe yumvise ijwi ritamenyerewe ry’umutima ryitwa murmur mu isuzuma rya buri munsi. Ubu buryo bwa murmur bufite ubushobozi bwihariye “bw’imashini” abaganga bafite ubunararibonye bashobora kumenya.

Umuganga wawe azakora ibizamini byinshi kugira ngo yemeze uburwayi kandi arebe uko buhambaye. Echocardiogram ni igizamini cya mbere kandi gikomeye - ikoresha amajwi kugira ngo ikore amashusho y’umutima wawe.

Ibindi bizamini bishobora kuba birimo:

• X-ray y’ikifuba kugira ngo urebe ubunini bw’umutima n’ubuzima bw’imwijima
• Electrocardiogram (ECG) kugira ngo upime ibikorwa by’amashanyarazi y’umutima wawe
• Cardiac catheterization kugira ngo upime neza umuvuduko
• CT scan cyangwa MRI kugira ngo ubone amashusho y’umutima arambuye
• Pulse oximetry kugira ngo urebe urwego rw’umwuka mu maraso yawe

Echocardiogram ishobora kwerekana aho ubu bufunguzi buri, ubunini bwayo, n’uburyo amaraso atembera. Aya makuru afasha umuganga wawe gufata umwanzuro w’uko ubuvuzi bukenewe n’ubwo bwakora neza.

Rimwe na rimwe PDA iboneka mu gihe cyo gutwita binyuze muri fetal echocardiography, cyane cyane niba hari ibindi bibazo by’umutima bikekwa. Mu bindi bihe, ishobora kudamenyekana kugeza mu bukure iyo ibimenyetso bigaragaye cyangwa mu gihe cyo gusuzuma ibindi bibazo by’ubuzima.

Ubuvuzi bwa Duktus Arteriosi Idasanzwe Ni Buhe?

Ubuvuzi bwa PDA biterwa n’ibintu byinshi, birimo ubunini bw’ubufunguzi, imyaka yawe, niba ufite ibimenyetso. PDA ntoya zidatera ibibazo zishobora gukenera gukurikiranwa gusa nta kundi.

Kuri PDAs zikenera ubuvuzi, ufite amahitamo atandukanye:

• Imiti ifasha gufunga ductus, cyane cyane mu bana bavutse imburagihe
• Gusiba binyuze mu muyoboro w’amaraso hakoreshejwe igikoresho gito cyinjizwa mu muyoboro w’amaraso
• Gusiba hakoreshejwe ubuvuzi bwo kubaga
• Imiti yo gucunga ibimenyetso nk’gucika intege kw’umutima cyangwa umuvuduko ukabije w’amaraso

Indomethacin ni imiti ishobora gufasha ductus gufunga mu buryo bw’umwimerere mu bana bato cyane. Ibi bikora neza mu minsi mike ya mbere y’ubuzima kandi bikora cyane ku bana bavutse imburagihe.

Gusiba binyuze mu muyoboro w’amaraso byabaye ubuvuzi bukunzwe cyane kuri PDAs nyinshi zikenera ubuvuzi. Muri ubu buryo, umuganga w’umutima ayobora igikoresho gito cyo gufunga binyuze mu muyoboro w’amaraso kugira ngo afunge ubu bufunguzi. Ibi bikorwa mu gihe uri mu biro by’abaganga, ariko ntibisaba kubaga.

Kubaga bishobora kugerwaho niba PDA ari nini cyangwa ifite ishusho ituma gusiba binyuze mu muyoboro w’amaraso bigorana. Ubuvuzi burimo gukora umunwa muto hagati y’amagufwa yawe kugira ngo ugere ku mutima kandi ufunge ubu bufunguzi burundu.

Uko Wakwitaho Mu Rugo ufite Duktus Arteriosi Idasanzwe

Niba ufite PDA ntoya idasaba ubuvuzi bw’ihutirwa, hari ibintu byinshi ushobora gukora mu rugo kugira ngo ugumane ubuzima bwiza kandi ukurebe uko ubuzima bwawe buhagaze. Ikintu nyamukuru ni ugutera imbere ubuzima bwiza bw’umutima mu gihe ureba impinduka zose mu bimenyetso byawe.

Dore bimwe mu bintu by’ingenzi byo kwita ku buzima bwawe:

• Kora imyitozo ngororamubiri ya buri munsi, ukoresheje umuvuduko uboneye nk’uko umuganga wawe yabyemeje
• Kurya indyo nzima y’umutima yuzuyemo imbuto, imboga, n’ibinyampeke byuzuye
• Kugira ibiro byiza kugira ngo ugabanye umuvuduko ku mutima wawe
• Kwirinda itabi no kugabanya kunywa inzoga
• Fata imiti yose yagenewe neza nk’uko byategetswe
• Kwita ku buzima bw’amenyo kugira ngo wirinda kwandura
• Kugira inkingo zigenewe, cyane cyane kuri pneumonia na grippe

Ni ingenzi kumenya imipaka yawe mu bijyanye n’imyitozo ngororamubiri. Nubwo imyitozo ngororamubiri ari nziza muri rusange, ugomba guhagarara no kuruhuka niba wumva uhumeka nabi, ucika intege, cyangwa ugira ububabare mu kifuba.

Komeza ukurebe ibimenyetso bishya cyangwa impinduka mu buryo wumva mu bikorwa bya buri munsi. Bamwe basanga ari byiza kwandika ibyiyumvo byabo, guhumeka, n’ibintu bitamenyerewe.

Komeza witabire ibizamini byose byateganijwe n’umutimanama wawe, nubwo wumva umeze neza. Gukurikirana buri gihe bifasha gufata impinduka hakiri kare kandi bihamya ko gahunda yawe y’ubuvuzi ikomeza kuba ikwiye.

Uko Wakwitegura Kugira Inama n’Umuganga Wawe

Kwitoza neza kugira inama n’umutimanama wawe bishobora kugufasha kubona byinshi mu ruzinduko rwawe kandi bihamya ko umuganga wawe afite amakuru yose akenewe kugira ngo aguhe ubuvuzi bwiza. Tangira ukusanya ibisubizo by’ibizamini byabanje cyangwa imyirondoro y’ubuvuzi ifitanye isano n’uburwayi bwawe bw’umutima.

Mbere y’inama yawe, andika:

• Ibimenyetso byose wahuye na byo, nubwo bigaragara nk’ibyoroheje
• Iyo ibimenyetso bibaho n’icyo biba byiza cyangwa biba bibi
• Imiti yose n’ibindi byongewemo ubu ukoresha
• Ibibazo ushaka kubabaza umuganga wawe
• Amateka y’umuryango wawe w’ibibazo by’umutima
• Impinduka zose mu mikorere yawe cyangwa mu buzima bwawe bwa buri munsi

Tekereza ku ngero zihariye z’uburyo ibimenyetso bigira ingaruka ku buzima bwawe bwa buri munsi. Urugero, ushobora kuzamuka mu ndunduro udatakaza umwuka? Ukeneye kuruhuka mu bikorwa wakoraga utabikora?

Zana urutonde rw’imiti yawe yose ukoresha, harimo amazina nyayo, umunaniro, n’uko unywa kenshi. Ntucikwe no kuvuga imiti yo mu maduka, amavitamini, n’ibindi byongewemo by’ibimera.

Teganya kuzana umuntu wo mu muryango wawe cyangwa inshuti yizewe izagufasha kwibuka amakuru y’ingenzi yavuzwe mu nama. Bashobora no gutekereza ku bibazo utatekerejeho.

Icyo Ugomba Kumenya Ku bijyanye na Duktus Arteriosi Idasanzwe

Duktus arteriosi idasanzwe ni ikibazo cy’umutima gishobora kuvurwa gifite ingaruka zitandukanye ku bantu bitewe n’ubunini bw’ubufunguzi n’ibintu byihariye. Abantu benshi bafite PDA ntoya babaho ubuzima busanzwe rwose, mu gihe abandi bagira inyungu nyinshi mu buvuzi bushobora gukorwa nta kubaga bikomeye.

Ikintu cy’ingenzi cyo kwibuka ni uko kubona hakiri kare no kwitaho neza bishobora kwirinda ingaruka nyinshi. Niba ufite ibimenyetso nko guhumeka nabi bitasobanuwe cyangwa umunaniro, ntutinye kubivugana n’umuganga wawe.

Ubuvuzi bwa PDA bugezweho bufite akamaro kanini kandi budakora cyane ugereranije n’uko byahoze. Abantu benshi bakenera ubuvuzi bakomeza kubaho ubuzima bukomeye kandi bwiza nta mipaka myinshi.

Komeza ube hafi y’itsinda ryawe ry’ubuvuzi, kurikiza ibyo bagutegeka, kandi ntureka impungenge z’uburwayi bwawe zigukura mu kwishimira ubuzima. Ufite ubuvuzi bukwiye no gukurikirana, PDA ntigomba kugabanya intego zawe cyangwa ibikorwa byawe cyane.

Ibibazo Bikunze Kubazwa Ku bijyanye na Duktus Arteriosi Idasanzwe

Q1: Duktus arteriosi idasanzwe ishobora kwifunga yonyine mu bakuru?

Ikibabaje ni uko PDAs zidasanzwe zifunga gake mu bakuru. Nubwo ductus arteriosus ishobora rimwe na rimwe kwifunga mu buryo bw’umwimerere mu mezi ya mbere y’ubuzima, cyane cyane hakoreshejwe imiti mu bana bavutse imburagihe, ibi biba bidashoboka nyuma y’umwaka wa mbere. Niba uri umuntu mukuru ufite PDA, ubu bufunguzi buzakomeza gufunguye keretse ufashwe n’ubuvuzi. Ariko kandi, abantu bakuru benshi bafite PDA ntoya babaho ubuzima busanzwe nta buvuzi bakenera.

Q2: Ni byiza gukora imyitozo ngororamubiri niba mfite Duktus Arteriosi idasanzwe?

Abantu benshi bafite PDA bashobora gukora imyitozo ngororamubiri mu mutekano, ariko uburyo n’umuvuduko biterwa n’imiterere yawe. Niba ufite PDA ntoya idafite ibimenyetso, ushobora gukora ibikorwa byose bisanzwe harimo imikino. Ariko kandi, niba ufite PDA nini cyangwa ibimenyetso nko guhumeka nabi, umuganga wawe ashobora kugutegeka kwirinda ibikorwa bikomeye cyane. Itegura gahunda yawe y’imyitozo ngororamubiri n’umutimanama wawe kugira ngo ubone inama zikwiye zishingiye ku buzima bwawe.

Q3: Abagore bafite Duktus Arteriosi idasanzwe bashobora gutwita mu mutekano?

Abagore benshi bafite PDA bashobora gutwita neza kandi mu mutekano, ariko ibi biterwa n’ubunini bwa PDA yawe niba ufite ingaruka. PDA ntoya ntiziterwa ibibazo mu gihe cyo gutwita. Ariko kandi, PDA nini cyangwa izatera pulmonary hypertension bishobora gutera ibyago byo gutwita. Niba uteganya gutwita, biganiro n’umutimanama wawe n’umuganga w’abagore mbere y’igihe kugira ngo mugire gahunda y’ubuvuzi itekanye.

Q4: Umwana wanjye azakomereza Duktus Arteriosi idasanzwe niba mfite?

Nubwo PDA ishobora rimwe na rimwe kuba mu muryango, abana benshi b’ababyeyi bafite PDA ntibabona uburwayi. Ibyago biri hejuru gato ugereranije n’abantu basanzwe, ariko biracyari bike. Niba ufite PDA kandi uteganya kubyara, umuganga wawe ashobora kugutegeka gukora fetal echocardiography mu gihe cyo gutwita kugira ngo arebe uko umutima w’umwana wawe uhagaze. Inama ku miterere ishobora kugufasha gusobanukirwa ibyago byihariye by’umuryango wawe.

Q5: Igihe kingana iki cyo gukira nyuma yo gufunga PDA?

Igihe cyo gukira gitandukanye bitewe n’uburyo wakoresheje. Nyuma yo gufunga binyuze mu muyoboro w’amaraso (uburyo bwo gukoresha catheter), abantu benshi bashobora gusubira mu bikorwa bisanzwe mu minsi mike cyangwa icyumweru kimwe. Ushobora kugira ibikomere aho catheter yinjijwe, ariko ibi bikira vuba. Kubaga bisanzwe bisaba igihe kirekire cyo gukira - akenshi ibyumweru 2-4 mbere yo gusubira mu bikorwa bisanzwe n’ibyumweru 6-8 mbere yo gutwara ibiremereye cyangwa gukora imyitozo ikomeye. Umuganga wawe azakugira inama zihariye zishingiye ku buryo wakoresheje n’uburyo bwawe bwo gukira.