Amakuru

Ikibazo cy’imisemburo yo mu mitsi ku isi (VTE)

Indwara yo mu mitsi (VTE), ihurizo ry’indwara yo mu mitsi itemba cyane (DVT) na pulmonary embolism (PE), ihitana abantu barenga 840.000 ku isi buri mwaka—bingana n’urupfu rumwe buri masegonda 37. Igiteye ubwoba kurushaho, 60% by’indwara zo mu mitsi ziba mu bitaro, bigatuma ziba impamvu ikomeye y’impfu zitateganijwe mu bitaro. Mu Bushinwa, umubare w’abantu barwaye VTE ukomeje kwiyongera, ukagera kuri 14.2 kuri 100.000 mu baturage muri 2021, aho abantu barenga 200.000 banduye burundu. Kuva ku barwayi bageze mu zabukuru nyuma yo kubagwa kugeza ku bagenzi b’ubucuruzi mu ngendo ndende, ibyago byo kurwara thrombosis bishobora kwihisha bucece—ibi bikaba ari ikimenyetso cy’uko VTE iteye nabi kandi ko ikwirakwira hose.

I. Ni bande bari mu kaga? Gutanga imiterere y'amatsinda afite ibyago byinshi

Abaturage bakurikira bakeneye kwitonda cyane:

1. "Abasinzikajwe n'abantu batagaragara" bamara igihe gito
   Kwicara igihe kirekire (amasaha arenze 4) bigabanya cyane urujya n'uruza rw'amaraso. Urugero, umuhanga mu by'imyitozo witwa Zhang yagize ikibazo cyo kubyimba amaguru mu buryo butunguranye nyuma yo gukora amasaha menshi yikurikiranya, maze basanga afite DVT—ingaruka isanzwe yo guhagarara kw'imitsi.

2. Amatsinda y'ibyago bya Iatrogenic

   • Abarwayi babazwe: Abarwayi basimbura ingingo nyuma yo kubagwa bahura n'ibyago byo kugabanuka k'amaraso ku kigero cya 40% badakoresheje imiti igabanya ubukana bw'amaraso.
   • Abarwayi ba Kanseri: Impfu ziterwa na VTE zigize 9% by'impfu zose ziterwa na kanseri. Umurwayi wa kanseri y'ibihaha witwa Li, utarigeze ahabwa imiti igabanya amaraso mu gihe cy'imiti ya kanseri, yahitanywe na PE—inkuru y'ubwitonzi.
   • Abagore batwite: Impinduka mu misemburo no gukanda imiyoboro y'amaraso mu nda byatumye umugore utwite witwa Liu agira ikibazo cyo kubura umwuka mu gihembwe cya gatatu cy'amavuko, nyuma byemezwa ko ari PE.

3. Abarwayi b'indwara zidakira bafite ibyago byinshi
   Kugabanuka k'amaraso mu bantu bafite umubyibuho ukabije n'abarwaye diyabete, hamwe no kugabanuka k'umuvuduko w'umutima mu barwayi bafite ikibazo cy'umutima, bituma habaho ubwiyongere bw'imitsi mu maraso.

Icyitonderwa: Shaka abaganga vuba niba ukuguru kwawe kwabyimbye mu buryo butunguranye, ububabare mu gituza buterwa no kubura umwuka, cyangwa gucika intege mu mubiri—iki ni irushanwa rihanganye n'igihe.

II. Uburyo bwo Kwirinda mu Ntambwe: Kuva ku Ishingiro kugeza ku Gukumira Ubuziranenge

1. Kwirinda kw'ibanze: "Mantra y'amagambo atatu" yo kwirinda thrombosis
   • Kwimuka: Gutembera cyangwa koga buri munsi iminota 30. Ku bakozi bo mu biro, kora imyitozo yo gukaraba ku kaguru (amasegonda 10 yo gukaraba + amasegonda 10 yo gukaraba ku kaguru, bisubirwamo mu minota 5) buri masaha 2. Ishami ry’abaforomo ry’ibitaro bya Peking Union Medical College ryasanze ibi byongera amaraso yo mu gice cyo hasi ku kigero cya 37%.
   • Gutanga amazi: Nywa igikombe kimwe cy'amazi ashyushye ubyutse, mbere yo kuryama, no mu gihe cyo kubyuka nijoro (ni ukuvuga 1.500–2.500 mL ku munsi). Inzobere mu ndwara z'umutima Dr. Wang akunze kugira inama abarwayi agira ati: "Igikombe kimwe cy'amazi gishobora kugabanya kimwe cya cumi cy'ibyago byo kuvura indwara ya thrombosis."
   • Kurya: Kurya salmon (ikungahaye kuri Ω-3 irwanya ububyimbirwe), ibitunguru (quercetin ibuza platelets kwibumbira), na fungus y'umukara (polysaccharides igabanya ubukana bw'amaraso).
2. Kwirinda kwa Mekanike: Gutuma amaraso atembera hakoreshejwe ibikoresho byo hanze
   • Amasogisi yo mu nda yarangije kwiga (GCS): Umugore utwite witwa Chen yambaraga GCS kuva mu cyumweru cya 20 atwite kugeza nyuma yo kubyara, ibi bikaba byararindaga imitsi yo mu nda no kwangirika kw'imitsi.
   • Gukanda mu mitsi mu gihe gito (IPC): Abarwayi b'amagufwa nyuma yo kubagwa bakoresheje IPC bagabanutseho 40% ibyago byo kwandura DVT.
3. Kwirinda imiti: Uburyo bwo kurwanya amaraso mu buryo bwa Stratified Anticoagulation
   Hashingiwe ku manota ya Caprini:

   Icyiciro cy'ibyago	Abaturage basanzwe	Porogaramu yo Gukumira
   Hasi (0–2)	Abarwayi bakiri bato babagwa mu buryo buciriritse	Gukangura abantu hakiri kare + IPC
   Iringaniye (3–4)	Abarwayi ba Laparoscopic bakorewe kubagwa cyane	Enoxaparin 40 mg/umunsi + IPC
   Hejuru (≥5)	Abarwayi ba kanseri yo mu kibuno/barwaye kanseri ikomeye	Rivaroxaban 10 mg/umunsi + IPC (inyongera y'ibyumweru 4 ku barwayi ba kanseri)

Icyitonderwa ku birebana no kwirinda: Imiti igabanya amaraso ntikoreshwa mu gihe cyo kuva amaraso cyangwa umubare wa platelet uri munsi ya 50×10⁹/L. Gukingira hakoreshejwe uburyo bwo kwirinda ni byiza muri bene ibyo bihe.

III. Imibare yihariye: Ingamba zo gukumira zihariye

1. Abarwayi ba kanseri
   Suzuma ibyago ukoresheje icyitegererezo cya Khomana: Umurwayi wa kanseri y'ibihaha witwa Wang afite amanota ≥4 asabwa buri munsi na heparini ifite uburemere buke bwa molekile. Isuzuma rishya rya PEVB barcode (96.8% by'ubuhanga) rituma hamenyekana hakiri kare abarwayi bafite ibyago byinshi.

2. Abagore batwite
   Warfarin ntiyemerewe (ingaruka zo gutera amaraso)! Hindura ukoreshe enoxaparin, nk'uko byagaragajwe n'umugore utwite witwa Liu wabyaye neza nyuma yo kugabanya amaraso kugeza ku byumweru 6 nyuma yo kubyara. Kubyara kwa ba serivise cyangwa umubyibuho ukabije ukomoka ku gitsina/imyaka yo kubyara isaba ko amaraso ahita agabanuka.

3. Abarwayi b'amagufwa
   Umuti ugabanya amaraso mu kibuno ugomba gukomeza iminsi ≥14 nyuma yo gusimburwa kw'ikibuno n'iminsi 35 ku mvune y'ikibuno. Umurwayi witwa Zhang yagize PE nyuma yo guhagarika imburagihe—isomo ryo gukurikiza amabwiriza.

IV. Amavugurura y'amabwiriza y'Ubushinwa yo mu 2025: Iterambere ry'iterambere

1. Ikoranabuhanga ryo Gusuzuma byihuse
   Kaminuza ya Westlake yitwa Fast-DetectGPT igera ku buziranenge bwa 90% mu kumenya inyandiko zakozwe na AI, ikora vuba inshuro 340—ifasha ibinyamakuru mu gusesengura inyandiko za AI zifite ubuziranenge buciriritse.

2. Amabwiriza yo kuvura arushijeho kunozwa

   • Intangiriro ya "catastrophic PTE" (umuvuduko w'amaraso wa sistolike <90 mmHg + SpO₂ <90%), bituma itsinda rya PERT rigira uruhare mu mikorere yaryo.
   • Kugabanya igipimo cya apixaban gisabwa ku ndwara y'impyiko (eGFR 15–29 mL/umunota).

V. Igikorwa cya rusange: Gukuraho indwara ya Thrombose binyuze mu bufatanye rusange

1. Ibigo by'ubuvuzi
   Kuzuza amanota ya Caprini mu masaha 24 nyuma yo kwinjira mu bitaro ku barwayi bose bari mu bitaro. Ibitaro bya Peking Union Medical College byagabanyije umubare w’abarwaye VTE ho 52% nyuma yo gushyira mu bikorwa iyi gahunda.

2. Kwicunga ku giti cya rubanda
   Kugabanya ibiro 5% ku bantu bafite BMI >30 bigabanya ibyago byo kugabanuka kwa thrombosis ku kigero cya 20%! Kureka kunywa itabi no kugenzura glycemic (HbA1c <7%) ni ingenzi cyane.

3. Uburyo bwo kubona ikoranabuhanga
   Gusoma kode kugira ngo ubone inyigisho zo gukora imyitozo ngororamubiri ku kaguru. Serivisi zo gukodesha ibikoresho bya IPC ubu zikorera mu mijyi 200.

Ubutumwa bw'ingenzi: VTE ni "uburyo bwo kwica bucece" bushobora kwirindwa kandi bugenzurwa. Tangira n'imyitozo ikurikira yo gupampa ku kaguru. Tangira n'ikirahure cy'amazi gikurikiraho. Komeza amaraso atembera neza.

Amareferensi

1. Guverinoma y'Umujyi wa Yantai. (2024).Uburezi ku buzima ku bijyanye no kuvura imitsi yo mu mitsi.
2. Amabwiriza y'Abashinwa yo kwirinda no kuvura indwara ya Thrombotic. (2025).
3. Ikigo cy’Ubushinwa cy’Ubumenyi bw’Ikoranabuhanga n’Ubutabire. (2025).Iterambere rishya mu guteganya ibyago bya VTE ku barwayi ba kanseri.
4. Uburezi bw'Ubuzima Rusange. (2024).Gukumira by'ibanze abaturage bafite ibyago byinshi byo kwandura VTE.
5. Kaminuza ya Westlake. (2025).Raporo ya tekiniki ya GPT yihuse.