“Mu buvuzi bw’ibanze, indwara yo kubura amaraso mu buryo butangaje ikomeza kuba ikibazo cy’ubuvuzi kidakunze kumenyekana, kikaba n’ingaruka zikomeye. Iki kimenyetso cy’indwara yo kubura umwuka mu buryo butangaje kirangwa no kwangirika k’umwuka mu buryo butangaje nta guhumeka neza (cyitwa ‘hypoxia iteruye’), kikaba ari ikimenyetso cy’ingenzi cy’uko umwuka ugiye gucika intege mu buryo butunguranye. Ibimenyetso byinshi byemeza uruhare rwacyo nk’uburyo buhishe bwo kuvura indwara, aho gutinda gusuzuma indwara bigira uruhare mu gutuma impfu zishobora kwirindwa mu gihe cy’umusonga, COVID-19, n’indwara z’ibihaha zidakira. Ikinyamakuru New England Journal of Medicine giherutse kugaragaza iki ‘kimenyetso cy’indwara zo mu bwoko bwa paradox’ – aho imbaraga zisanzwe zo guhumeka zipfukirana ibura ry’umwuka mu buryo bukabije, bigasaba ko habaho kongera kwitonda mu buvuzi no gukurikirana ivugurura ry’amabwiriza.”
Hypoxemia ni iki??
“Hypoxemia, isobanurwa nk’ibura ry’umwuka wa ogisijeni mu maraso y’imitsi (PaO2 < 80 mmHg ku rwego rw’inyanja ku bantu bakuru), ivuka iyo igitutu cy’igice cy’umubiri kigabanutse munsi y’umurongo ngenderwaho ugenwa n’imyaka (AARC Clinical Practice Guideline 2021). Amatsinda y’abantu bafite ibyago byinshi agaragaza imiterere itandukanye y’indwara:
- Kutajyana kw'umwuka/imyotsi: Abarwayi ba pneumonia ikomeye bafite alveolar binjira mu mubiri bigatuma ubushobozi bwo gukwirakwiza amazi mu mubiri bugabanuka.
- Imiterere y'umutima: Itsinda ry'abafite ikibazo cy'umutima kidakora neza ibumoso/iburyo rigaragaza kubyimba kw'ibihaha biterwa n'umuvuduko (PCWP >18 mmHg)
- Imitsi yo mu bwonko: Abana bafite imitsi yo mu nda idakora neza ndetse n'abantu bakuru bafite ikibazo cyo kudakora neza kw'imitsi yo mu bwonko
- Kurwara indwara idakira: Abanywa itabi bagaragaza impinduka mu miterere y'ibihaha (emphysema, COPD-GOLD stage ≥2)
- Itera indwara ya Iatrogenic: Abarwayi nyuma yo kubagwa bagira ikibazo cyo guhumeka giterwa na opioid (RR <12/min) na atelectasis
Ikigaragara ni uko 38% by'abarwayi babazwe igituza bagira ikibazo cyo kubura amaraso mu masaha 24 nyuma yo gukurwamo amaraso (ASA Closed Claims Data 2022), ibi bikaba bishimangira ko ari ngombwa gukurikirana imikorere y'umutima muri abo bantu.
Ni izihe ngaruka mbi zo kubura amaraso menshi mu mubiri (hypoxemia)?
Dukurikije imibare y’abaganga, igipimo cy’impfu ku barwayi bafite ikibazo cyo kubura amaraso menshi gishobora kugera kuri 27%, kandi mu bihe bikomeye kurushaho, igipimo cy’impfu gishobora kugera no ku kigero kirenga 50%. Iyo hatabayeho ubufasha ku gihe mu ntangiriro z’indwara, ingaruka zikomeye zishobora kubaho.
- Ingaruka ku bwonko: Iyo urugero rwa ogisijeni mu maraso rugabanutse (hypoxemia), ubwonko bubura ogisijeni. Ibi bishobora gutera ibimenyetso byihuse nko kuribwa umutwe, isereri, no kwibagirwa. Iyo bitavuwe, inzara ya ogisijeni igihe kirekire ishobora kwangiza uturemangingo tw'ubwonko, bishobora gutera indwara zo mu bwonko ziterwa no kuziba kw'amaraso (cerebral infarction) cyangwa imiyoboro y'amaraso yacitse (cerebral hemorrhage). Kumenya hakiri kare ibi bimenyetso ni ingenzi kugira ngo hirindwe kwangirika burundu k'ubwonko.
- Ingaruka ku mutima: Iyo umutima utabonye ogisijeni ihagije, ugorwa no guhumeka neza. Uku gucika intege gushobora gutera ibimenyetso by'uburibwe nko gutera kw'umutima vuba cyangwa kutari ku murongo, gufungana mu gituza (angina), n'umunaniro udasanzwe. Uko igihe kigenda gihita, kubura ogisijeni bitavuwe bishobora gutuma imitsi y'umutima icika intege, bigatera ingorane zishobora guterwa n'ubuzima nko kunanirwa k'umutima, aho umutima udashobora guhaza ibyo umubiri ukeneye.
- Ingaruka ku bihaha: Ogisijeni nke itera ibihaha gukora cyane kugira ngo bikomeze kugenda neza. Uko igihe kigenda gihita, iyi mikorobe ishobora kwangiza inzira z'ubuhumekero n'imitsi y'ibihaha, byongera ibyago byo kurwara indwara zo guhumeka nka COPD (indwara idakira y'ibihaha). Mu bihe bikomeye, kubura ogisijeni igihe kirekire bishobora no gutuma uruhande rw'iburyo rw'umutima rucika intege mu gihe urwana no gukurura amaraso mu bihaha bikomeye, indwara izwi nka cor pulmonale.
- Ingaruka ku mubiri wose: Kubura umwuka wa ogisijeni mu buryo buhoraho bibangamira buri rugingo nk'imodoka ikoresha lisansi nkeya. Impyiko n'umwijima bigenda bigabanuka buhoro buhoro mu kuyungurura uburozi, mu gihe ubudahangarwa bw'umubiri bugenda bucika intege, bigatuma indwara zisanzwe zigorana kurwanya. Uko igihe kigenda gihita, uyu mwenda wa ogisijeni mu buryo bucecetse wongera ibyago byo kwangirika kw'urugingo kandi ugasiga umubiri ubangamiwe n'ibibazo by'ubuzima - kuva ku ndwara zikunze kugaragara kugeza ku nkovu zirambye z'urugingo. Ibi bituma kugenzura urugero rwa ogisijeni hakiri kare ari ingenzi mu gukumira ibibazo by'urugingo rwinshi.
Ni gute wamenya niba ufite ikibazo cyo kubura amaraso?
Igipimo cya ogisijeni mu maraso ni ingenzi mu kumenya ibura rya ogisijeni. Ku bantu bazima, ibipimo bisanzwe biri hagati ya 95% na 100%. Ibipimo biri hagati ya 90-94% bigaragaza ibura rya ogisijeni riciriritse, rishobora kutagaragaza ibimenyetso bigaragara. Kugabanuka kuri 80-89% bigaragaza ibura rya ogisijeni riri hagati, akenshi bigatera guhumeka nabi cyangwa urujijo. Ibipimo biri munsi ya 80% bigaragaza ubutabazi bukomeye, aho ingingo z'ingenzi zishobora kwangirika bitewe no kwiyima ogisijeni cyane kandi bigasaba ubuvuzi bwihuse.
Ni gute wakomeza kuzura umwuka wa ogisijeni mu maraso bisanzwe?
- Fungura amadirishya kugira ngo habeho umwuka mwiza
Shyira umwuka mwiza mu nzu yawe ufungura amadirishya buri munsi kugira ngo umwuka mwiza unyure mu kirere. Kugira ngo ubone umusaruro mwiza, jya usura pariki cyangwa ahantu hakungahaye ku bidukikije hanze y'imijyi kugira ngo uhumeke umwuka mwiza kandi usukuye ufasha kongera umwuka mwiza mu mubiri wawe.
- Aerobics
Gukora imyitozo ngororamubiri isanzwe nko kugenda n'amaguru, koga, cyangwa kugendera ku igare bishobora kongera amaraso atembera neza no gutembera kwa ogisijeni. Hitamo uburyo bwo gukora imyitozo ngororamubiri mu buryo budakomeye nko gukora imyitozo ngororamubiri yo mu mazi cyangwa kwiruka buhoro buhoro niba uri mushya mu gukora imyitozo ngororamubiri - iyi myitozo yoroshye irushaho kunoza gutanga ogisijeni mu buryo bwizewe mu gihe ikomeza kwiyongera.
- Uburyo bwo kuvura umwuka wa ogisijeni mu rugo
Ku bantu bafite ibibazo byo guhumeka bidakira kandi bafite ikibazo cyo kubura umwuka wa ogisijeni, gukoresha igikoresho gitanga umwuka wa ogisijeni mu rugo bishobora gufasha mu kubungabunga umwuka wa ogisijeni uhagije. Abaganga bakunze gutanga inama yo gutangira gukoresha ibikoresho bitwara umwuka wa ogisijeni mu gihe cyo gusinzira cyangwa mu mirimo ya buri munsi - iyo bikoreshejwe nk'uko byategetswe, ubu buryo bwo kuvura bushobora kongera ingufu, kugabanya guhumeka nabi, no gutuma abantu baryama neza.
Igihe cyo kohereza: 25 Mata 2025