Ese ni iki? Ibimenyetso, Impamvu, n’Uko Bivurwa

Ese ni ububabare bukomeye bw’igitsina cy’umugabo buramara amasaha arenga ane, bitabayeho kubera ubushake cyangwa gukorakora. Iki kibazo gisaba ubufasha bwa muganga vuba cyane kuko gishobora kwangiza igitsina cy’umugabo kikagira ingaruka ku bushobozi bwo kubona ubushake bw’imibonano mpuzabitsina mu gihe kitavuwe.

Tekereza ko ari nk’aho imitsi y’amaraso mu mubiri wawe ihagaze ku buryo bwo gukora, mu gihe byagombye kugaruka mu buryo busanzwe. Nubwo ibi bishobora kuba bigoye kuvuga, ni ikibazo gikomeye cy’ubuvuzi abaganga bavura buri gihe kandi mu buryo bw’umwuga.

Ibimenyetso bya Ese ni ibihe?

Ikimenyetso nyamukuru ni ubushake bw’igitsina cy’umugabo budashira ubwa kabiri, busanzwe buramara amasaha ane cyangwa arenga. Uzabona ko ubushake bw’igitsina cy’umugabo buhoraho nubwo utifuza imibonano mpuzabitsina, ntukorakore, cyangwa ntugire ubushake.

Dore ibimenyetso by’ingenzi byerekana ko ushobora kuba ufite Ese:

• Ubushake bw’igitsina cy’umugabo buramara amasaha arenga 4
• Ubushake bw’igitsina cy’umugabo budashingiye ku bushake cyangwa gukorakora
• Igitsina cy’umugabo gikomeye ariko impera yacyo ikaba yoroshye (ubwoko bwinshi)
• Ububabare buhoraho buhora bwiyongera
• Kugira ikibazo cyo kwinjira mu gikari mu bihe bimwe bimwe
• Igitsina cy’umugabo kibabaza cyangwa kikaba kiremereye

Ububabare busanzwe butangira nk’ububabare buke ariko bushobora kuba bukomeye uko igihe gihita. Ibi bibaho kuko amaraso aba afunze kandi urugero rw’umwuka mu mubiri rugabanuka.

Ese ni ubwoko bangahe?

Hari ubwoko bubiri nyamukuru bwa Ese, kandi gusobanukirwa itandukaniro bifasha abaganga guhitamo uburyo bwiza bwo kuvura. Ubwoko ufite bugira ingaruka ku buryo bwihuse bwo kuvura n’uburyo bwihariye bwa muganga bukenewe.

Ese ya Ischemic (izwi kandi nka Ese ya low-flow) ni ubwoko bwinshi kandi bukomeye. Amaraso afungirwa mu gitsina cy’umugabo kandi ntashobora kuva neza, bituma umubiri ubura umwuka. Ubwo bwoko butera ububabare bukomeye kandi busaba kuvurwa vuba kugira ngo hirindwe kwangirika burundu.

Ese ya Non-ischemic (izwi kandi nka Ese ya high-flow) ibaho iyo amaraso menshi ajya mu gitsina cy’umugabo, akenshi biterwa n’imvune. Ubwo bwoko busanzwe budatera ububabare bukomeye kandi budasaba kuvurwa vuba, nubwo bukenewe kuvurwa na muganga. Igitsina cy’umugabo gishobora kumera nk’ikomeye ariko kitagira imbaraga zose.

Ese iterwa n’iki?

Ese ishobora guterwa n’ibibazo bitandukanye n’ibintu byongera ibyago bigira ingaruka ku mimerere y’amaraso mu gitsina cy’umugabo. Rimwe na rimwe impamvu nyamukuru iba itaramenyekana, ariko abaganga bashobora kumenya ibintu byagize uruhare mu gihe cyo gusuzuma.

Impamvu zikunze kugaragara zirimo:

• Indwara ya sickle cell (igira uruhare mu bipimo bigera kuri 40%)
• Imiti yo kuvura ubushake bw’igitsina cy’umugabo ikoreshwa nabi
• Imiti yoroha amaraso nka warfarin cyangwa heparin
• Imiti yo kuvura ihungabana, cyane cyane trazodone
• Imiti yo kuvura umuvuduko w’amaraso
• Ibiyobyabwenge, cyane cyane cocaine
• Kunywa inzoga nyinshi
• Imvune cyangwa kwangirika ku gitsina cy’umugabo cyangwa mu kibuno

Impamvu zidakunze kugaragara ariko zishoboka zirimo leukemia, izindi ndwara z’amaraso, imvune y’umugongo, n’ubwandu bumwe na bumwe. Mu bihe bimwe na bimwe, Ese ibaho nta mpamvu imenyekanye, abaganga babyita Ese ya idiopathic.

Ni ryari ukwiye kujya kwa muganga kubera Ese?

Ugomba gushaka ubufasha bwa muganga vuba cyane niba ufite ubushake bw’igitsina cy’umugabo buramara amasaha arenga ane. Iki si ikibazo ushobora kuvura mu rugo cyangwa gutegereza, kuko gutinda kuvurwa byongera cyane ibyago byo kwangirika burundu.

Jya kwa muganga vuba niba ufite ubushake bw’igitsina cy’umugabo buhoraho bufite ububabare, nubwo butarageze ku masaha ane. Kuvurwa hakiri kare biguha amahirwe meza yo kubungabunga imikorere isanzwe no kwirinda ingaruka.

Nturetse isoni zikubuza gushaka ubufasha. Abakozi bo mu bitaro n’abaganga b’inzobere mu kuvura indwara z’igitsina cy’umugabo bafite uburambe muri ibi bibazo kandi bazakwitaho mu buryo bw’umwuga kandi mu ibanga. Ibi ni ikibazo cy’ubuvuzi, si ikibazo cy’ubuzima bw’imibonano mpuzabitsina ukwiye gutinya.

Ibintu byongera ibyago bya Ese ni ibihe?

Ibintu bimwe na bimwe n’imimerere bituma Ese ibaho cyane. Gusobanukirwa ibintu byongera ibyago bishobora kugufasha kumenya iki kibazo hakiri kare no gushaka ubufasha bukwiye igihe bikenewe.

Dore ibintu by’ingenzi byongera ibyago ukwiye kumenya:

• Indwara ya sickle cell cyangwa sickle cell trait
• Izindi ndwara z’amaraso nka leukemia cyangwa thalassemia
• Kunywa imiti yo kuvura ubushake bw’igitsina cy’umugabo
• Kunywa ibiyobyabwenge, cyane cyane cocaine cyangwa marijuana
• Kugira imvune y’umugongo
• Kwibasirwa mu gice cy’ibitsina vuba aha
• Kunywa imiti imwe na imwe
• Kuba waragize Ese mbere

Imyaka igira uruhare, Ese ibaho cyane mu matsinda abiri y’imyaka: abana bafite imyaka 5-10 (akenshi bifitanye isano n’indwara ya sickle cell) n’abagabo bafite imyaka 20-50. Niba ufite ibyo bintu byongera ibyago, gabagana na muganga wawe uburyo bwo kubikumira.

Ingaruka zishoboka za Ese ni izihe?

Ingaruka ikomeye y’Ese idavuwe ni ubushake bw’igitsina cy’umugabo budashira, buva mu kubura umwuka mu mubiri w’igitsina cy’umugabo. Iyo kwangirika bishobora kuba bidakira niba kuvurwa byatinze iminsi 24-48.

Ingaruka zishoboka zirimo:

• Kudakomeza kubona ubushake bw’igitsina cy’umugabo
• Kwibasirwa mu mubiri w’igitsina cy’umugabo
• Igitsina cy’umugabo kigahindura ishusho
• Ububabare buhoraho
• Umujinya n’ihungabana
• Ibibazo mu rukundo
• Gangrene mu bihe bitoroshye cyane

Inkuru nziza ni uko kuvurwa hakiri kare bigabanya cyane ibyo byago. Abagabo benshi bavuwe mu masaha 24 ya mbere bakomeza kugira ubushake bw’igitsina cy’umugabo busanzwe. Niyo mpamvu ubufasha bwa muganga bwihuse ari ingenzi cyane.

Ese imenyekanwa gute?

Abaganga bashobora kumenya Ese hakurikijwe ibimenyetso byawe n’isuzuma ry’umubiri. Kumenya Ese bisanzwe biroroshye, ariko kumenya impamvu nyamukuru n’ubwoko byasaba ibizamini by’inyongera.

Muganga wawe azakubaza amateka yawe y’ubuzima, imiti urimo kunywa, n’ibindi biyobyabwenge uheruka gukoresha. Azakora isuzuma ry’umubiri kugira ngo asuzume imbaraga z’ubushake bw’igitsina cy’umugabo kandi arebe ibimenyetso by’imvune cyangwa ubwandu.

Ibizamini by’inyongera bishobora kuba harimo ibizamini by’amaraso kugira ngo harebwe indwara ya sickle cell, ubwandu, cyangwa ibibazo byo gukomera kw’amaraso. Mu bihe bimwe na bimwe, abaganga bakoresha ultrasound kugira ngo bapime imiterere y’amaraso mu gitsina cy’umugabo, ibyo bifasha gutandukanya ubwoko bubiri bwa Ese kandi bigatuma bafata ibyemezo byo kuvura.

Ese ivurwa gute?

Kuvura biterwa n’ubwoko bwa Ese ufite n’igihe ubushake bw’igitsina cy’umugabo bumaze. Intego ni ugushyira amaraso mu buryo busanzwe no kwirinda kwangirika burundu kw’igitsina cy’umugabo.

Kubera Ese ya ischemic, abaganga batangira bakoresha igishushanyo cyo gukurura amaraso, aho bakoresha umwenge muto gukurura amaraso afunze mu gitsina cy’umugabo. Iyo nzira ikunze gutanga ihumure ryihuse kandi ishobora gukorwa mu bitaro hakoreshejwe imiti ibitera uburibwe.

Niba gukurura amaraso bitakora, muganga wawe ashobora gushyira imiti mu gitsina cy’umugabo kugira ngo afashe gukomera imitsi y’amaraso no kugabanya amaraso. Imiti ikunze gukoreshwa irimo phenylephrine cyangwa epinephrine, isanzwe ikora neza kandi ikaba itekanye.

Mu bihe bikomeye bitavurwa n’iyo miti, kubaga bishobora kuba ngombwa. Uburyo bwo kubaga burimo gukora umuyoboro w’agateganyo (bypass) kugira ngo amaraso ahindurire inzira cyangwa, mu bihe bitoroshye, uburyo bugoye bwo gusubiza amaraso mu buryo busanzwe.

Ese ya Non-ischemic ikunze gukira ubwayo uko igihe gihita, bityo abaganga bashobora kugutegereza bakakurinda, ariko niba ikomeje, uburyo bwo kuvura burimo imiti cyangwa uburyo bwo kugabanya amaraso muri ako gace.

Uko wakwitwara mu rugo mu gihe ufite Ese

Nubwo Ese isaba kuvurwa na muganga, hari ibintu bike ushobora gukora mu gihe ugiye kwa muganga bishobora kugufasha by’agateganyo. Ariko, ibi ntibisimbura ubufasha bwa muganga.

Urashobora kugerageza koga mu mazi ashyushye, ibyo bishobora gufasha imitsi y’amaraso kuruhuka no kunoza imiterere y’amaraso. Abagabo bamwe basanga imyitozo ngororamubiri yoroheje, nko kugenda cyangwa kuzamuka, ifasha guhindura imiterere y’amaraso ikava mu gice cy’ibitsina.

Shyira ubukonje ku mavi cyangwa perineum (igice kiri hagati y’ibitsina n’inyuma) iminota 10-15. Ntuzigere ushyira ubukonje ku gitsina cy’umugabo, kuko bishobora kwangiza umubiri.

Irinde imibonano mpuzabitsina cyangwa gukorakora, kuko bishobora kuba bibi kurushaho. Irinde kandi imiti cyangwa uburyo bwo kuvura ushobora kubona kuri internet, kuko bishobora kuba bibi kandi bikabuza kuvurwa neza.

Uko wakwitegura kujya kwa muganga

Kubera Ese, ushobora kujya mu bitaro aho gutegura gahunda isanzwe. Ariko, kwitegura amakuru bishobora gufasha abaganga kukwitaho neza.

Andika cyangwa wibuke imiti yose urimo kunywa, harimo imiti y’abaganga, imiti yo mu maduka, n’ibindi. Harimo ibiyobyabwenge niba bikenewe, kuko ayo makuru ari ingenzi mu kumenya Ese no kuvura.

Tegura amateka yawe y’ubuzima harimo indwara z’amaraso, Ese wari waragize mbere, imvune uheruka kugira mu gice cy’ibitsina, n’ibindi bibazo by’ubuzima ufite. Bandika igihe ubushake bw’igitsina cy’umugabo bwatangiye n’ibikorwa cyangwa ibyabaye mbere yabyo.

Zana urutonde rw’abaganga bawe n’amakuru yabo, cyane cyane niba uvuza indwara ya sickle cell, indwara z’amaraso, cyangwa unywa imiti yo kuvura ubushake bw’igitsina cy’umugabo. Ibyo bifasha abaganga mu bitaro guhuza ubufasha ukeneye.

Ese ishobora kwirindwa?

Nubwo udashobora kwirinda Ese yose, ushobora gufata ingamba zo kugabanya ibyago, cyane cyane niba ufite ibintu byongera ibyago. Uburyo bwo kwirinda bugamije gucunga ibibazo by’ubuzima no kwirinda ibintu byongera ibyago.

Niba ufite indwara ya sickle cell, korana n’umuganga wawe kugira ngo ubone ubufasha bukwiye. Iba uhagaze neza, irinda ubushyuhe bukabije, kandi ukore uko bagutegetse kugira ngo ugabanye ibyago by’indwara ya sickle cell zishobora gutera Ese.

Koresha imiti yo kuvura ubushake bw’igitsina cy’umugabo uko muganga yabiguhaye. Ntuzigere urenza umuganga yagutegetse cyangwa ukavanga imiti itandukanye yo kuvura ubushake bw’igitsina cy’umugabo. Niba ukoresha imiti yo guterwa mu gitsina cy’umugabo, komeza uburyo bwiza bwo guterwa n’umuganga yagutegetse.

Irinde ibiyobyabwenge, cyane cyane cocaine n’inzoga nyinshi, bishobora kongera ibyago. Niba unywa imiti izwiho gutera Ese nk’ingaruka, gabagana na muganga wawe niba ufite ikibazo.

Icyo ukwiye kumenya kuri Ese

Ese ni ikibazo cy’ubuvuzi gisaba ubufasha bwihuse, ariko kuvurwa hakiri kare, abagabo benshi barakira neza nta kibazo cy’igihe kirekire. Ikintu nyamukuru ni ukumenya ibimenyetso hakiri kare no gushaka ubufasha vuba.

Wibuke ko ubushake bw’igitsina cy’umugabo buramara amasaha arenga ane bukenera ubufasha bwa muganga, bitaba ububabare cyangwa oya. Nturetse isoni zikubuza kubona ubufasha ukeneye – abaganga bafite uburambe muri ibi bibazo kandi bazakwitaho mu buryo bw’umwuga kandi mu ibanga.

Niba ufite ibintu byongera ibyago nka sickle cell cyangwa unywa imiti imwe na imwe, gabagana na muganga wawe uburyo bwo kubikumira. Kumenya no kwitegura bishobora kugufasha gusubiza vuba niba Ese ibaho kandi bishobora kugufasha kuyirinda.

Ibibazo bikunze kubaho kuri Ese

Q: Ese ibabaza buri gihe?

Oya buri gihe, ariko Ese ya Ischemic (ubwoko bwinshi) ikunze kubabaza cyane uko igihe gihita. Ese ya Non-ischemic ishobora gutera ububabare buke, ariko ubushake bw’igitsina cy’umugabo buhoraho buramara amasaha arenga ane bukenera ubufasha bwa muganga hatitawe ku bubabare.

Q: Ese ishobora kubaho inshuro nyinshi?

Yego, abagabo bamwe bagira Ese kenshi, cyane cyane abafite indwara ya sickle cell cyangwa izindi ndwara z’amaraso. Niba wari waragize Ese mbere, uri mu kaga cyane cyo kugira izindi, bityo ni ingenzi gukorana na muganga wawe ku buryo bwo kubikumira no kugira gahunda yo gutabara.

Q: Nzagira ubushake bw’igitsina cy’umugabo busanzwe nyuma ya Ese?

Abagabo benshi bavuwe mu masaha 24 ya mbere bakomeza kugira ubushake bw’igitsina cy’umugabo busanzwe. Ariko, gutinda kuvurwa byongera ibyago byo kudakomeza kubona ubushake bw’igitsina cy’umugabo. Uko uvuwe vuba, niko amahirwe yawe yo kubungabunga imikorere isanzwe y’igitsina cy’umugabo ari menshi.

Q: Ese ishobora kugira ingaruka ku kubyara?

Ese ubwayo ntishobora kugira ingaruka ku kubyara cyangwa ubushobozi bwawe bwo kubyara abana. Iki kibazo kigira ingaruka ku mimerere y’amaraso mu gitsina cy’umugabo aho kuba ku gutera intanga, ibyo bikorwa mu gituza. Ariko, ingaruka zikomeye ziterwa na Ese idavuwe zishobora kugira ingaruka ku mibonano mpuzabitsina n’imibanire.

Q: Ndakwiye gutinya gushaka ubufasha kubera Ese?

Oya rwose. Ese ni ikibazo gikomeye cy’ubuvuzi, kandi abaganga bahuguwe mu kuvura ibi bibazo mu buryo bw’umwuga kandi mu bwumvikane. Abakozi bo mu bitaro n’abaganga b’inzobere mu kuvura indwara z’igitsina cy’umugabo babona ibi bibazo buri gihe, kandi ubuzima bwawe ni byo baharanira, si ukugucira urubanza.