Ni iki cyo gukora no gusimbuza umuvuduko wa aortique? Intego, uburyo & Ibisubizo

Gukora no gusimbuza umuvuduko wa aortique ni uburyo bwo kubaga umutima bukemura ibibazo bya valve yawe ya aortique, umuryango uri hagati y'umutima wawe n'umubiri wawe wose. Iyo iyi valve idakora neza, umutima wawe ugomba gukora cyane kugira ngo utere amaraso, bishobora gutera ibibazo bikomeye by'ubuzima uko igihe kigenda.

Tekereza valve yawe ya aortique nk'umuryango umwe ufunguka kugira ngo amaraso atemberere ava mu mutima wawe ajya mu mubiri wawe, hanyuma ugafunga kugira ngo wirinde amaraso gusubira inyuma. Iyo uyu muryango uba muto cyane, uvuga cyane, cyangwa ntufunguka kandi ukafunga neza, kubaga birashobora gufasha gusubiza isanzwe itembera ry'amaraso no koroshya umutwaro ku mutima wawe.

Ni iki cyo gukora no gusimbuza valve ya aortique?

Gukora valve ya aortique bisobanura gukosora valve yawe ihari kugira ngo ifashe gukora neza. Mu gihe cyo gukora, umuganga ubaga akosora cyangwa akubaka ibice bya valve yawe karemano akoresha valve y'umwimerere. Ubu buryo bubungabunga imyenda y'umubiri wawe uko bishoboka kose.

Gusimbuza valve ya aortique bikubiyemo gukuraho valve yawe yangiritse no gushyiraho nshya. Valve isimbura irashobora kuba imashini (ikozwe mubikoresho biramba nka icyuma na karubone) cyangwa ibinyabuzima (bikozwe mu nyamaswa cyangwa imyenda yabantu). Umuganga ubaga azaganira niba uburyo bukora neza kubibazo byawe byihariye.

Uburyo bwombi bugamije gusubiza isanzwe itembera ry'amaraso binyuze mu mutima wawe. Gukora akenshi birahinduka iyo bishoboka kuko bigumana valve yawe karemano, ariko gusimbuza biraba ngombwa iyo yangiritse cyane kugirango ikosorwe.

Kuki gukora no gusimbuza valve ya aortique bikorwa?

Ubu buryo buvura ibibazo bibiri byingenzi hamwe na valve yawe ya aortique: stenosis na regurgitation. Aortic stenosis ibaho iyo valve yawe iba nto kandi ikomeye, bigatuma amaraso atava mu mutima wawe. Aortic regurgitation ibaho iyo valve yawe idafunga neza, ikemerera amaraso gusubira mu mutima wawe.

Utavurwa, ibi bibazo bihatira umutima wawe gukora cyane. Mu mezi cyangwa imyaka, uku kunanizwa kwiyongera bishobora kunaniza imitsi y'umutima wawe kandi bigatuma umutima unanirwa. Ushobora kumva ububabare mu gituza, guhumeka bigoranye, isereri, cyangwa umunaniro igihe umutima wawe urwanira gupompa amaraso neza.

Muganga wawe ashobora kugusaba kubagwa niba ibimenyetso byawe bigira ingaruka ku buzima bwawe bwa buri munsi cyangwa niba ibizamini byerekana ko imikorere y'umutima wawe igenda igabanuka. Rimwe na rimwe kubagwa birasabwa mbere yuko ibimenyetso bigaragara, cyane cyane niba ikibazo cya valve gikomeye kandi gishobora kwiyongera.

Intego ni gukemura ikibazo mbere yuko gitera kwangirika ku mutima wawe. Guvura hakiri kare akenshi bituma haboneka ibisubizo byiza kandi bishobora kugufasha gusubira mu bikorwa byawe bisanzwe ufite imbaraga n'umunezero byiyongereye.

Ni iki gikorerwa mu gusana no gusimbuza valve ya aortic?

Intambwe zihariye ziterwa niba uri kubagwa umutima usanzwe cyangwa uburyo butuma umuntu abagwa atabyaye. Uburyo bwinshi bwo kubaga valve ya aortic bikorwa hakoreshejwe anesthesia rusange, bityo uzaba uryamye rwose mugihe cyo kubagwa.

Mugihe cyo kubagwa umutima usanzwe, umuganga ubaga akora urukanda rumanuka hagati y'igituza cyawe kandi ahagarika by'agateganyo umutima wawe akoresheje imashini y'umutima n'ibihaha. Iyi mashini ifata akazi ko gupompa amaraso no kongeramo umwuka wa oxygen mugihe umuganga ubaga akora kuri valve yawe.

Mugihe cyo gusana valve, umuganga ubaga ashobora gutandukanya ibice bya valve byahujwe, akavana imitsi y'umubiri yarenze urugero, cyangwa akongeramo impeta yo gufasha valve gufunga neza. Uburyo nyabwo buterwa nicyateye valve yawe gukora nabi.

Mugihe cyo gusimbuza valve, umuganga ubaga akuraho valve yangiritse akaboha iyindi nshya mu mwanya wayo. Niba urimo kubona valve ya mekaniki, uzakenera gufata imiti ituma amaraso atiyongera ubuzima bwawe bwose. Valve ya biyolojiya akenshi ntisaba imiti ituma amaraso atiyongera igihe kirekire ariko ishobora gukenera gusimburwa nyuma y'imyaka 10-20.

Uburyo butagira ingaruka nyinshi bukoresha ibikoresho bito byihariye. Ibikorwa bimwe na bimwe bishobora gukorwa binyuze muri kateteri ishyirwa mu kuguru kwawe, bivuze ko nta gice cy'igituza na kimwe gikorwa. Itsinda ry'abaganga bazagena uburyo bwiza bushingiye ku burwayi bwawe bwihariye n'ubuzima bwawe muri rusange.

Ni gute wakitegura igikorwa cyo kubaga umutsi w'umutima?

Gutegura akenshi bitangira mu byumweru byinshi mbere yo kubagwa. Itsinda ryawe ry'abaganga rizakora ibizamini bitandukanye kugirango barebe neza ko witeguye icyo gikorwa kandi bategure uburyo bwiza bwo gukemura ikibazo cyawe.

Birashoboka ko uzakenera ibizamini by'amaraso, imirasire ya X y'igituza, electrocardiogram, n'ubushakashatsi burambuye bw'amashusho y'umutima. Ibi bizamini bifasha umuganga kubaga gusobanukirwa neza icyo kibazo cyawe gifite kandi agategura uburyo bwiza bwo kugikemura. Ushobora kandi gukenera kubona abandi bahanga, nka muganga w'ibihaha cyangwa umuhanga mu by'impyiko, kugirango utunganye ubuzima bwawe muri rusange.

Muganga wawe azasuzuma imiti yawe yose kandi ashobora kukubwira ko uhagarika imiti imwe mbere yo kubagwa. Imiti ituma amaraso atavura, imiti irwanya ibicurane, na bimwe mu byongerera imbaraga birashobora kongera ibyago byo kuva amaraso mugihe cyo kubagwa. Ntukigere uhagarika imiti utabanje kubiganiraho n'itsinda ryawe ry'abaganga.

Mbere yo kubagwa, jya wibanda ku kurya neza, kuruhuka bihagije, no gukomeza gukora nkuko ibimenyetso byawe bibikora. Niba unywa itabi, kureka mbere y'ibyumweru bike mbere yo kubagwa birashobora kunoza cyane gukira kwawe. Itsinda ryawe rishobora kandi kugusaba gukora imyitozo yo guhumeka cyangwa guhura n'umuvuzi w'umubiri kugirango utegure umubiri wawe gukira.

Ni gute usoma ibisubizo byawe byo gupima umutsi w'umutima?

Kumenya ibisubizo byawe byo gupima bifasha gufata ibyemezo bifitiye akamaro kubyerekeye ubuvuzi bwawe. Ikizamini gikunze gukoreshwa ni echocardiogram, ikoresha imiraba y'amajwi kugirango ikore amashusho y'umutima wawe kandi ipime uburyo umutsi wawe ukora neza.

Ku bijyanye na aortic stenosis, abaganga bareba agace ka valve n'itandukaniro ry'umuvuduko. Agace gasanzwe ka valve ya aortic ni santimetero kare 3-4. Stenosis yoroheje yerekana agace ka 1.5-2.0 cm², stenosis yo hagati ni 1.0-1.5 cm², na stenosis ikaze ni munsi ya 1.0 cm². Itandukaniro ry'umuvuduko mwinshi ryerekana ukugabanuka gukabije.

Ku bijyanye na aortic regurgitation, ubukana bugaragazwa nk'ubworoshye, bwo hagati, cyangwa bukaze bitewe n'ukuntu amaraso asubira inyuma. Muganga wawe azareba kandi uko umutsi w'umutima wawe witwara ku mirimo yiyongereye iterwa na valve ivuza.

Ibipimo bindi by'ingenzi birimo ejection fraction yawe, yerekana uburyo umutima wawe utera amaraso neza buri gitera. Ejection fraction isanzwe ni 55% cyangwa hejuru. Imibare mito ishobora kwerekana ko umutsi w'umutima wawe ugirwaho ingaruka n'ikibazo cya valve.

Muganga wawe azasobanura icyo iyi mibare isobanura ku miterere yawe yihariye. Ifatwa ry'icyemezo cyo kubagwa ntishingiye ku mibare gusa ahubwo rizirikana ibimenyetso byawe, ubuzima muri rusange, n'ibintu by'umubyimba hamwe.

Ni gute wakwitwara nyuma yo kubagwa valve ya aortic?

Kugaruka nyuma yo kubagwa valve ya aortic ni inzira itinda itwara amezi menshi. Abantu benshi bamara iminsi 3-7 mu bitaro, hamwe n'umunsi umwe cyangwa ibiri bya mbere muri intensive care unit kugirango bakurikiranwe neza.

Mugihe uri mu bitaro, uzakora hamwe n'abaforomo na physiotherapists kugirango ugende neza. Kugenda intera ngufi no gukora imyitozo yo guhumeka bifasha kwirinda ingorane no kwihutisha imikurire yawe. Uziga kandi uburyo bwo kwita ku gice cyakomeretse no kumenya ibimenyetso by'ibibazo bishoboka.

Niba uri murugo, buhoro buhoro wiyongere ibikorwa byawe uko imbaraga zawe zigaruka. Abantu benshi bashobora gusubira mu bikorwa byoroheje mu byumweru bike, ariko bitwara ibyumweru 6-8 kugirango igufwa ryo mu gituza rishire neza niba warabazwe umutima ufunguye. Irinde kuzamura ibintu biremereye muri iki gihe.

Ibyo guhura na muganga nyuma y'ubuvuzi ni ngombwa kugira ngo bakurikirane valuve yawe nshya cyangwa yakosowe. Muganga wawe azategura ibizamini bya buri gihe ndetse na echocardiograms ya buri gihe kugira ngo barebe neza ko byose bikora neza. Niba ufite valuve ya mekaniki, uzakenera ibizamini by'amaraso bya buri gihe kugira ngo ukurikirane imiti igabanya amaraso.

Programu zo kuvugurura umutima zirashobora gufasha cyane mugihe cyo gukira. Izi porogaramu zo gukora imyitozo zigenzurwa zigufasha kongera imbaraga zawe n'ubushobozi bwawe mu gihe wigira ku mpinduka z'ubuzima bwiza bw'umutima.

Ni iki gisubizo cyiza cyo gukora ku bijyanye na valuve ya aortic?

Igisubizo cyiza ni valuve ikora neza ikemerera gusubira mu bikorwa byawe bisanzwe nta bimenyetso. Abantu benshi bagira impinduka zigaragara mu rwego rw'imbaraga zabo, guhumeka, n'ubuzima bwabo muri rusange nyuma yo kubagwa valuve neza.

Urwego rwo gutsinda mu bijyanye na valuve ya aortic muri rusange ruri hejuru cyane, aho abantu barenga 95% barokoka kubagwa kandi benshi bagira ibisubizo byiza by'igihe kirekire. Urufunguzo rwo kugira igisubizo cyiza ni ugukora ubuvuzi mbere yuko imitsi y'umutima wawe itangira kunanuka cyane.

Hamwe na valuve yakosowe, urashobora kwitega ko izamara imyaka myinshi, akenshi ubuzima bwawe bwose. Valuve ya mekaniki isimbura irakomeye cyane kandi ntikenera gusimburwa, mugihe valuve ya biyolojiya ikunda kumara imyaka 15-20 cyangwa irenga, cyane cyane kubarwayi bakuze.

Uko uzaba umeze mu gihe kirekire biterwa n'ibintu byinshi, harimo imyaka yawe, ubuzima bwawe muri rusange, n'uburyo imitsi y'umutima wawe yakize neza ikibazo cya valuve. Abantu benshi basubira ku kazi, bagenda, bakora imyitozo, kandi bakishimira ibikorwa byabo byose bakunda nyuma yo gukira.

Gukurikiza inama za muganga wawe zo kwitabwaho nyuma y'ubuvuzi, gufata imiti yategetswe, no gukomeza ubuzima bwiza bw'umutima byose bitanga umusanzu mu gisubizo cyiza gishoboka cyane mu gihe kirekire.

Ni ibihe bintu byongera ibyago byo gukenera kubagwa valuve ya aortic?

Ibintu bitandukanye bishobora kongera amahirwe yo kurwara indwara y'umutima ya aortic, bishobora kuzasaba kubagwa. Imyaka ni kimwe mu bintu byongera ibyago cyane, kuko ibibazo bya valve bikunda gutera buhoro buhoro mu myaka myinshi yo gukoreshwa.

Abantu bamwe bavukana ibitagenda neza kuri valve bituma ibibazo bishoboka cyane nyuma mu buzima. Valve ya aortic ya bicuspid, aho valve ifite ibice bibiri aho kuba bitatu, ifata abantu bagera kuri 1-2% kandi akenshi bitera ibibazo bya valve mu myaka yo hagati.

Dore ibintu by'ingenzi byongera ibyago bishobora gutuma indwara ya valve ya aortic:

• Ubukure (bukunda kuboneka cyane ku bantu bafite imyaka irenga 65)
• Ubumuga bwo mu mutima bwo kuvuka, cyane cyane valve ya aortic ya bicuspid
• Amateka y'umuriro wa rheumatic cyangwa indwara y'umutima ya rheumatic
• Umubyigano w'amaraso mwinshi utera umutwaro mwinshi kuri valve
• Cholesterol nyinshi itera calcium kwiyongera ku bice bya valve
• Diabetes, ishobora kwihutisha imikorere ya valve
• Indwara y'impyiko, cyane cyane abasaba dialysis
• Ubuvuzi bwa radiation bwo mu gituza bwakozwe mbere
• Ibintu bimwe na bimwe byo kwivumbura kw'umubiri
• Amateka y'umuryango y'indwara ya valve

Kugira ibi bintu byongera ibyago ntibisobanura ko uzakeneye kubagwa valve, ariko byongera amahirwe yo kurwara ibibazo bya valve. Kugenzura buri gihe bishobora gufasha kumenya ibibazo hakiri kare igihe uburyo bwo kuvura bufite akamaro cyane.

Mbese ni byiza gukora gusana valve cyangwa kuyisimbuza?

Gusana valve muri rusange birahabwa agaciro iyo bishoboka mu buryo bwa tekiniki kandi bishobora gutanga umusaruro urambye. Gusana bituma ugumana igice cyawe cy'umubiri wa valve, akenshi kimara igihe kirekire kandi gifite ibyago bike byo kugira ingaruka ugereranije na valve zisimbura.

Hamwe no gusana, mubisanzwe ntukeneye imiti igabanya amaraso igihe kirekire, ibyo bikuraho ibyago byo kuva amaraso bifitanye isano n'iyo miti. Igice cyawe cy'umubiri wa valve kandi gikunda kurwanya indwara neza kurusha ibikoresho by'ubukorano.

Ariko, gusana ntibishoboka buri gihe cyangwa ngo bigirwe inama. Niba valuve yawe yangiritse cyane cyangwa gusana bitazamarana igihe kirekire, kuyisimbuza biba ari uburyo bwiza. Ibibazo bimwe na bimwe bya valuve, cyane cyane gukara cyane cyangwa ubwoko runaka bwo kwangirika kw'imiterere, bivurwa neza no kuyisimbuza.

Umuvuzi wawe uzasuzuma neza uko umeze ukoresheje isesengura ry'amashusho rimwe na rimwe no kugenzura mu gihe cyo kubaga. Icyemezo gishingira ku bintu nk'imyaka yawe, ubwoko n'urugero rwo kwangirika kwa valuve, ubuzima bwawe muri rusange, n'ibyo ukunda ku bijyanye no gukoresha imiti igihe kirekire.

Gusana no gusimbuza byombi bishobora gutanga ibisubizo byiza iyo bikozwe n'abaganga babishoboye. Ikintu cy'ingenzi ni uguhitamo uburyo bushobora kuguha umusaruro mwiza igihe kirekire hashingiwe ku miterere yawe bwite.

Ni izihe ngaruka zishobora guterwa no kubagwa kwa valuve ya aortique?

Nubwo kubagwa kwa valuve ya aortique muri rusange bifite umutekano kandi bigatanga umusaruro mwiza, kimwe n'izindi nkubito zikomeye, bifite ibyago bimwe na bimwe. Kumva izi ngaruka zishobora kuvuka bifasha gufata ibyemezo bifitiye akamaro no kumenya icyo ugomba kwitaho mu gihe cyo gukira.

Ingaruka zisanzwe zikunda kuba iz'igihe gito kandi zishobora gucungwa neza n'ubuvuzi bukwiriye. Izi zishobora kuba zirimo imirimo y'umutima idasanzwe, imikorere y'impyiko y'igihe gito, cyangwa kuva amaraso gake bisaba gukurikiranwa ariko bikunda gukira byonyine.

Dore ingaruka zishobora kuvuka, kuva ku zisanzwe kugeza ku zitabaho cyane:

• Umutima utagenda neza (arrhythmias) bishobora gusaba imiti cyangwa gukurikiranwa
• Ukuva amaraso bishobora gusaba ko wongererwa amaraso
• Udukoko two ku gice cyabagirijwe cyangwa twibasira valve nshya
• Uduce tw'amaraso dushobora kujya mu bindi bice by'umubiri
• Ibibazo by'agateganyo byo mu mpyiko, cyane cyane ku bantu bafite indwara z'impyiko
• Ibibazo byo guhumeka bisaba ubufasha bw'agateganyo bwo guhumeka
• Umutsi w'ubwonko, bikaba bidakunze kubaho ariko bikaba bishoboka cyane ku bantu bafite ibyago
• Umutima ufata, cyane cyane ku bantu bafite indwara z'imitsi y'umutima
• Ibibazo bya valve bisaba kubagwa bundi bushya
• Guhinduka kw'urwibutso cyangwa gutekereza, akenshi by'agateganyo

Ibyago byo guhura n'ibibazo bikomeye ni bike, cyane cyane iyo kubagwa bikorerwa mu bitaro bifite ubunararibonye. Itsinda ry'abaganga bazakubwira ibyago byawe byihariye kandi bafate ingamba zo kugabanya ibibazo bitewe n'ubuzima bwawe bwihariye.

Ni ryari nkwiriye kubona umuganga kubera ibibazo bya valve ya aortic?

Ugomba kuvugana n'umuganga wawe niba ugaragaza ibimenyetso bishobora kugaragaza ibibazo bya valve, cyane cyane niba ari bishya cyangwa bigenda birushaho. Kumenya no kuvura ibibazo bya valve hakiri kare akenshi bituma haboneka ibisubizo byiza.

Uburibwe mu gituza, guhumeka bigoranye, isereri, cyangwa kuruka byose bishobora kuba ibimenyetso by'ibibazo bya valve, nubwo bishobora no kugaragaza izindi ndwara z'umutima. Ntukirengagize ibi bimenyetso, cyane cyane niba bibaho mu gihe ukora imyitozo ngororamubiri cyangwa bisa nkaho bigenda byiyongera.

Nyuma yo kubagwa valve, ibimenyetso bimwe na bimwe bisaba ubufasha bwihuse bw'abaganga. Hamagara umuganga wawe ako kanya niba urwaye umuriro, ubona umutuku wiyongera cyangwa amazi ava mu gice cyabagirijwe, cyangwa ubona uburibwe butunguranye mu gituza cyangwa guhumeka bigoranye cyane.

Niba ufite valve ya mekaniki, kuvira amaraso cyangwa gukomeretsa bidasanzwe bigomba kumenyeshwa muganga wawe, kuko bishobora kugaragaza ikibazo cy’imiti igabanya amaraso ukoresha. Kimwe n'ibyo, niba ufite ubundi bwoko bwo gusimbuza valve, menyesha muganga wawe mbere yo gukorerwa imiti y'amenyo cyangwa izindi nshinga, kuko ushobora gukenera imiti yica mikorobe kugirango wirinde indwara.

Gusuzumwa buri gihe ni ngombwa kabone niyo wumva umeze neza. Muganga wawe ashobora kumenya impinduka mu mikorere ya valve yawe mbere yuko ibimenyetso bigaragara, bigatuma hakorwa ubufasha ku gihe igihe kuvura ari byiza cyane.

Ibikunze kubazwa ku bijyanye n'imikorere ya valve ya aortic

Q1: Mbese kubagwa valve ya aortic ni byiza ku mutima wananiwe?

Yego, kubagwa valve ya aortic birashobora kunoza cyane ibimenyetso byo kunanirwa k'umutima iyo kunanirwa k'umutima guterwa n'ibibazo bya valve. Iyo valve yawe ya aortic idakora neza, itegeka umutima wawe gukora cyane, bishobora gutuma umutima unanirwa.

Gukemura ikibazo cya valve akenshi bituma imitsi y'umutima wawe ikira kandi igakora neza. Abantu benshi bagira impinduka zikomeye mu rwego rw'imbaraga zabo, guhumeka, n'ubushobozi bwo gukora nyuma yo kubagwa valve neza. Ariko, urugero rw'impinduka rushingiye ku buryo imitsi y'umutima wawe yagizweho ingaruka mbere yo kubagwa.

Q2: Mbese gusimbuza valve ya aortic bikemura ikibazo burundu?

Gusimbuza valve ya aortic mubisanzwe bitanga igisubizo kirambye, ariko ntibisobanura ko bihoraho. Valve ya mekaniki ntikunze gukenera gusimburwa kandi irashobora kumara imyaka myinshi, mugihe valve ya biyolojiya akenshi imara imyaka 15-20 cyangwa irenga, cyane cyane ku barwayi bakuze.

Mugihe valve nshya ubwayo ikora neza mumyaka myinshi, uzakenera kwitabwaho buri gihe kugirango ukurikirane imikorere yayo. Abantu bamwe bashobora gukenera ibindi bikorwa, ariko benshi bishimira imyaka myinshi y'ubuzima bwiza n'imibereho myiza nyuma yo gusimbuza valve.

Q3: Mbese nshobora gukora imyitozo nkibisanzwe nyuma yo kubagwa valve ya aortic?

Abantu benshi bashobora gusubira mu myitozo ngororamubiri isanzwe n'ibikorwa bya buri munsi nyuma yo gukira kubagwa umutima, akenshi bafite ubushobozi bwo gukora imyitozo kurusha mbere yo kubagwa. Ariko, bifata igihe kugira ngo wongere urwego rwawe rw'ibikorwa.

Mu mezi make ya mbere yo gukira, buhoro buhoro uzongera urwego rwawe rw'ibikorwa ukurikiranwa n'abaganga. Iyo ukize neza, abantu benshi bashobora kwitabira imikino myinshi n'ibikorwa, nubwo muganga wawe ashobora kugusaba kwirinda ibikorwa bimwe na bimwe bikomeye cyangwa by'amarushanwa bitewe n'uko ubuzima bwawe bumeze.

Q4: Nzamara igihe kingana iki mfata imiti igabanya amaraso nyuma yo kubagwa umutima?

Icyo ukeneye imiti igabanya amaraso biterwa n'ubwoko bwa valve wakiriye. Niba wakiriye valve ya mekaniki, uzakenera gufata imiti igabanya amaraso (nka warfarin) ubuzima bwawe bwose kugira ngo wirinde amaraso gukora ibibumbe kuri valve.

Hamwe na valve ya biyoloji, mubisanzwe ukeneye imiti igabanya amaraso mu mezi 3-6 nyuma yo kubagwa, rimwe na rimwe ntunabikore. Muganga wawe azagena gahunda nziza y'imiti ishingiye ku bwoko bwa valve yawe n'ibintu byihariye byo kwirinda amaraso.

Q5: Biba bite niba ntabazwe valve ya aortic igihe byasabwe?

Utazabazwe, ibibazo bikomeye bya valve ya aortic mubisanzwe birushaho gukomera uko igihe kigenda gihita kandi bishobora gutera ibibazo bikomeye birimo kunanirwa k'umutima, imirimo y'umutima iteye akaga, cyangwa urupfu rutunguranye. Igihe cy'ibi bibazo ntigishobora kumenyekana, niyo mpamvu abaganga bakunze gusaba kubagwa mbere yuko ibimenyetso bikomera.

Ariko, icyemezo cyo kubagwa kigomba buri gihe kuzirikana ubuzima bwawe muri rusange, icyizere cyo kubaho, n'ibyifuzo byawe bwite. Muganga wawe ashobora kugufasha gusobanukirwa ibyago n'inyungu zo kubagwa ugereranije no gutegereza ukurikiza uko ubuzima bwawe bumeze.