Taksa chhunga thisen kalna kawngte a inzawm khawmna dinhmun mak tak: Arteriovenous Fistula chungchang hi thu awlsam takin i zir ang u!

He damdawi lam natna Arteriovenous Fistula tih hi i hre tawh em ? I thianpa pakhatin kidney dialysis a neih avangin he hming hi i hre tawh mai thei. A nih loh leh i taksa hmun khatah vein pakhat i hmu a, chu chu a hring chhuak a, i khawih chuan mak tak maiin a thawk chhuak tih i hre mai thei bawk. Hei hi vawiin a kan sawi tur condition bik chu a ni. Lungngai suh, he thu hi awlsam takin kan sawi dawn a, Sinhala tawngin i hriatthiam theih ang.

He arteriovenous fistula hi eng nge ni?

A awlsam zawngin sawi ila, arteriovenous fistula hi artery (thinlung atanga thisen phur chhuaktu vein) leh vein (thinlung atanga thisen phur kir lehna vein) inkara inzawmna dik tak a ni. Tui pipe pahnih inzawmkhawm ang mai a ni. Hei hi taksa khawi hmunah pawh a thleng thei a, a bik takin kan taksa peng (e.g., thluak, kal) leh kan taksa peng hrang hrangah a thleng thei.

Hetiang hian han ngaihtuah teh: kan taksaa thisen kal dan hi kawngpui kalphung ang mai a ni.

• Arteries: Hengte hi highway lian ang mai a ni. Thinlung atanga thisen thianghlim (oxygen khat) chu taksa peng dang thlengin an phur a. Hetah hian thisen sang a sang hle.
• Veins: Heng thisen kalna kawngte hi taksa peng hrang hrang atanga thisen deoxygenated (carbon dioxide tamna) chu thinlunga phur kir lehtu an ni. Heng vessel-a thisen sang hi arteries aiin a hniam zawk a ni.
• Capillaries: Hengte hi kawng te tak te, te tak te, zim (bypass) te an ni. Arteries atanga thisen lo chhuak chu heng capillaries te hi a kal tlang a, taksa chhunga cell tinte tan chaw tha a pe a, chuta tang chuan veins ah a kir leh thin.

A tlangpuiin arteries atanga thisen hi vein-ah direct-in a kal lo. A hmasa berin thisen kalna kawng te tak te tak tak, capillaries an tih network hmangin a kal a. Mahse, fistula a lo awm chuan thisen hian he capillary system hi a paltlang a, artery atang hian vein chhungah a zuang lut nghal a ni.

Hei hian harsatna engemaw zat a thlen thei a:

• Vein te hian arteries-a thisen sang sang chu an tuar thei lo va, chuvangin veins te chu a bulge tan a, a hring tan thin.
• Thisen kal dan a buai phah thin. Hmun thenkhatah chuan thisen a dawng tlem thei bawk.
• He fistula hi a lian a nih chuan thinlung hian thisen pump turin a thawkrim zawk a ngai a ni. Hun a kal zel a, hei hian thinlung a tichak lo thei a, chu chu ``Heart Failure'' kan tih hi a ni.

A chang chuan heng fistulas te hi doctor ten tumruh takin an siam thin a, a bik takin kidney vei, dialysis mamawh tan chuan an siam thin. Tichuan a hlawkpui a ni. Amaherawhchu, fistula thenkhat chu a pawi lo thei a, a then erawh chuan hriselna lama harsatna lian tak a thlen thei thung.

He natna hi tuin nge nei thei ang? Engtiang chiahin nge a hluar?

Heng fistulas te hi kum eng pawhah leh tu hnenah pawh a lo awm thei. A bik takin inhliam hnuah an lo thanglian thei hle. Fistula chi thenkhat chu group thenkhatah a tam zawk.

Dik tak chuan he fistula an tih hi a awm fo thin. Mahse chi zawng zawng hi chutiang chu an ni vek lo.

• A tlangpui ber: Doctor-te siam fistulas, kidney vei te dialysis tihna atana siam.
• A awm tlem ber: pian tirh atanga fistulas awm (`(Congenital fistulas)` kan ti).

Fistula natna lan chhuah dan chu engte nge ni?

A awmna hmun azirin symptoms a inang lo thei. Mi thenkhat chuan symptom engmah an nei lo mai thei. Mahse, a lan chhuah dan tlangpui chu:

• Swelling: Fistula chhehvelah hian swelling a awm thei. Hei hi vun hnuaia awm fistula-ah chuan a langsar hle. Entirnan, kut emaw, ke emaw hmun khat chu a dangte aiin a hring zawk thei.
• Vun rawng danglam: Chu hmuna vun chu a sen emaw, a sen dum emaw a lo ni thei.
• Varicose veins: Veins hi a lianin a inher chhuak thei.
• Khaw lum tih hriat: Fistula awmna hmun i khawih chuan hmun dang aiin a lum zawk tih i hre thei.

Thisen kal tlem (`(Ischemia)` emaw `(Steal Syndrome)`) emaw a lan chhuah dan.

A châng chuan kut emaw ke emawa fistula hi a lian hle a nih chuan fistula aṭanga hla zawka taksa peng hrang hrang (e.g., kut zungtang)-a thisen kal chu a tlahniam thei a ni. Hei hi ischemia an ti a . Fistula hian chutiang hmuna kal tur thisen chu a "ru" ang mai a ni a, chuvang chuan mi thenkhat chuan "Steal Syndrome" an ti thin.

Hetiang hunah hian hetiang symptom hi a awm thei a:

• Numbness leh tingling sensation a awm bawk.
• Muscle twitching emaw, natna emaw.
• Vun hliam (ulcer) dam rei tak emaw, a dam lo emaw.

Heart Failure natna lan chhuah dan

Fistula lian tak hian thinlung tan harsatna a thlen thei bawk. Fistula vel ah thisen a kal tha tawk lo a, thisen pump tha tur chuan thinlung hian nasa zawkin hna a thawh a ngai a ni. Hun a kal zel a, hei hian thinlung a tichak lo thei a, thinlung chak lohna a thlen thei bawk . Symptoms te chu:

• Thâwk harsa (Dyspnea).
• Chauhna, hahna.
• Ke leh ke a hring (Edema).

Congenital Arteriovenous Fistulas (`(Nau piang atanga thisen kalna kawng fistulas)`)

Hengte hi nausen pum chhunga a la awm laia siam a nih avangin a natna lan chhuah dan hi a inang lo deuh thei a ni. Chungte chuan taksa peng a nghawng danah inthlak danglamna a thlen thei a ni.

• Kut emaw ke emaw chunga dah a nih chuan chu kut/ke chu a sir lehlamah aiin thau tam zawkin a khat thei a, ruhte pawh a sei thei bawk.
• Mi thenkhat chuan kut zungtang hrual, nail nêm, a laiah bulge, leh tip-ah hnuai lam hawia curve (hei hi clubbing an ti) an nei thei.
• A châng chuan, a natna kut/ke-a thisen kal chu a tlahniam a, a hmun chu a sen (blue) thei bawk.

Eng thilin nge he fistula hi a lo awm chhan?

A chhan lian ber pathum a awm a, chungte chu:

1. Hliam tuar: 1.1.Beisei loh taka fistula lo awm chhan ber chu hliam vang a ni. Entirnan, artery leh vein pahnih a chhiat chuan, accident na tak emaw, chemte hliam emaw a nih pawhin, an inzawm khawm thei a, an dam chhoh zel chuan hetiang hian inzawmna an siam thei a ni. A châng chuan hei hi hliam aṭanga kum tam tak hnuah chauh hmuhchhuah a ni.

2. Congenital: Hengte hi nausen pum chhunga a la thanlen laia lo awm thin a ni. A tam zawkah chuan hengte hi fistula lian tak pakhat ni lovin fistula te tak te tam tak an ni. Mahse, hei hi hmun pawimawh tak (thluak ang chi)-ah a thleng a nih chuan thihna a thlen thei a ni.

3. Dialysis: Kidney failure nei damlote dialysis tih theih nan doctor ten surgery an ti a, tumruh takin fistula an siam thin. Hei hian dialysis machine nena inzawm needle te chu a fit tha thei a, thisen pawh a luang tha thei bawk. Dik tak chuan fistulas hi hei vang hian hmuh tur a tam ber.

A tlem hle a, fistula hi cancer, infection thenkhat, emaw aneurysm ang chi natna avang pawh hian a lo awm thei a, chu chu thisen kalna kawng bang a chak lo va, balloon ang maia a bulh a, a bula vein-ah pressure a siam thei a ni.

Pawimawh: Fistula hi natna hrik kai theih a ni lo. Chumi awmzia chu midang hnen atangin i man thei lo tihna a ni a, midang hnenah pawh i thehdarh thei lo tihna a ni.

Engtin nge doctor-te hian hei hi an hriat chian? (Diagnosis) tih a ni.

I doctor hian he natna hi a hriat theih dan kawng engemaw zat a nei a. An taksa enfiahna leh special imaging test thenkhat an ti tlangpui.

Taksa enfiahna neih chhunga tih tur thenkhat chu hetiang hi a ni:

• Examination: Doctor chuan i taksa chhunga harsatna awm nia an hriatna hmun emaw, a kaihhnawih hmun dang emaw chu a en ang. Anni chuan swelling, discoloration, bulging veins an zawng ang.
• Ngaithla: Stethoscope hmangin fistula nia rinhlelh chu ngaihthlak a ni. Hei hi a chhan chu fistula atanga thisen luang chhuak hian thawm danglam tak a siam vang a ni. Machine hnathawk ang maiin a ri thei a, a chhan chu thisen chu kawng khat chauh ni lovin a sir lehlamah a luang a ni.
• Palpation: Fistula chhunga thisen a luang chhuah rualin pulsation chu i hre thei a, chu chu i kut dahin i hre thei. Doctor pawhin zawi zawiin a hmun chu a press thei bawk. Chutianga tih laiin heart rate a tlahniam deuh a nih chuan chu pawh chu fistula chhinchhiahna a ni.

He natna hi hriat theih nan eng test nge tih thin?

Heng test zinga pakhat emaw a aia tam emaw i nei ngei ang:

• Duplex Ultrasound: Hei hian high-frequency sound wave hmangin taksa chhung lam a en thin. Hei hi bat-in ri hmanga thim zinga thil a zawn dan nen a inang hle. Hei hian fistula awmna hmun leh a lian leh te hriat theih nan a pui thei a ni.
• Angiogram tih hi: 1.1.He test-ah hian thisen kalna kawngah hian tui bik (``Contrast dye`` kan ti) an inject a, X-ray emaw CT scan emaw an la a ni. He tui hian thisen kalna kawng a ti fiah hle a, thisen kal dan tur harsatna awmna hmun eng pawh hmuh a awlsam hle.
• MRI (Magnetic Resonance Imaging): Hei hian magnetic field chak tak leh computer technology hmangin taksa chhung lam thlalak chiang tak tak a la thei a ni. Fistulas ang chi thil dik lo awm leh awm loh a enfiah thei bawk.

Hei hi eng enkawlna nge ni? Tihdam theih a ni em?

Fistula tam zawk hi chu tihdam theih a ni. Fistula awm chhan, a lian leh te, leh a awmna hmunah a innghat a ni. Congenital fistulas hi tihdam kim a harsa viau nachungin, a tlangpuiin enkawl theih a ni a, harsatna a thlen thin te chu thunun theih a ni.

Mi thenkhat chuan fistula nei mahse a tir lamah enkawl an ngai lo mai thei. A hnuaia mite hi enkawl a ngai a ni:

• Hemorrhage: Fistula hi thisen a chhuak a nih chuan, a bik takin a nasat a, tihtawp theih loh a nih chuan siamthat a ngai a ni.
• Enlargement: Fistula emaw, a kaihhnawih thisen kalna kawng emaw a lian emaw, a pianzia a inthlak emaw chuan a chhehvel tissue te tan harsatna a thlen thei a ni.
• Thisen kal dan tikhawlo: Fistula hian taksa peng pakhata thisen kal a tikhawlo emaw, hmun khata thisen a ding reng emaw chuan harsatna lian tak a thlen thei a ni.
• Hmêl danglam: Mi ṭhenkhat chuan fistula vanga thisen kalna (veins) hring leh bulging vangin rilru lama harsatna an nei thei. A tam zawkah chuan fistula siamthat a nih veleh he hmel hi a lo awm leh thei a ni.

Eng ang damdawi emaw, enkawl dan emaw hi hman a nih?

Enkawlna hman tlanglawn ber berte chu:

• Catheter hmanga tih dan: Hetah hian i thisen kalna kawng lian tak pakhatah (a tlangpuiin groin-ah) tube ang maia hmanraw sei tak (catheter) dahin fistula awmna hmunah hruai a ni. Tichuan, a chhungah fistula chu a lo piang ta a ni. Hei hi fistula khar nan hmanraw te te, coil emaw stent emaw dahin tih theih a ni. A nih loh leh, glue chi khat bik cyanoacrylate glue an tih hmangin a khur chu khar theih a ni.
• Surgery: A chang chuan fistula hi thisen kaltlangin a thleng thei lo a nih chuan, a nih loh leh fistula hi a lian hle a nih chuan, surgeon chuan fistula siamthat nan direct cut a siam thei a ni. Hei hian thisen kalna kawng leh thisen kalna (vein) thliar hran emaw, taksa peng dang atanga thisen kalna kawng khat lak a, a chhe lai hmuna graft emaw a huam thei a ni.
• Radiation therapy: A then phei chuan he method hi fistula leh thisen inzawmna tihchhiat nan hman a ni. Radiation hi fistula lam hawiin direct a ni a, chu chuan scar a siam thin. Hei hian a chhungah thisen a luang chhuak thei lo.

Damdawi hi fistulas enkawl nan pawh hman a ni. Fistula a awm chuan thisen zam a hlauhawm a nih chuan thisen tithianghlimtu damdawi pek thin a ni. Heng damdawi te hian thisen kalna kawngah thisen zam a awm loh nan a veng a, thisen zam chu a chhuak lo va, thinlung, thluak, emaw lung ang hmunah te a tang lo va, chu chuan heart attack, stroke, emaw pulmonary embolism ang chi natna hlauhawm tak a thlen thei a ni.

Dialysis hman tur fistula:

Chungte chu harsatna a nih loh chuan enkawl loh a ni tlangpui. Harsatna a lo awm tak tak chuan operation chauh hi tih theih a ni fo.

Enkawlna avanga harsatna emaw, nghawng tha lo emaw awm thei chu enkawlna, fistula lian leh te, leh a awmna hmun a zirin a inang lo. I doctor chuan hei hi chipchiar zawkin a hrilhfiah thei che a ni.

Engtin nge ka in enkawl/symptoms ka enkawl?

He fistula natna hi nangmah chauhin i diagnose thei lo. A chhan chu a lan chhuah dan ṭhenkhat chu natna khirh tak dang, thisen zam emaw, thisen zam emaw ang chite nen a inang thei a ni. Chuvangin mahni inhriatthiamna nei ngai suh la, mahni inenkawl suh. I doctor-in he natna hi i nei tih a hrilh che chuan enkawl dan tur a hrilh ang che.

Enkawlna hnua i dam thuai dan tur te, a dam leh hun tur te chu enkawl dan leh fistula awm dan azirin a inang lo ang. I doctor pawhin he thu hi a hrilh ang che.

Hetiang dinhmun hi tihziaawm theih a ni em, tihtawp vek theih a ni em?

Dik tak chuan heng fistulas lo piang tur hi ven a harsa hle. A chhan chu a chhan tam ber chu hliam (tum tum ni lo) leh pianpui a nih vang a ni. ``(Dialysis)`` atana siam fistulas hi i enkawlna atana puitu atan tumruh taka siam a ni.

Hetiang dinhmun hi nei ila eng nge thleng ang? (Hmalam hun thlirna)

I result chu fistula lian leh te, a awmna hmun leh a chhan a zirin a innghat ang. Fistula te te, hmun tlemte chauha awm fistula te hian enkawl a ngai lo mai thei. Mi tam tak chuan symptoms na lo tak tak chauh an nei thei a, symptoms engmah an nei lo thei bawk.

Mahse, fistula lian zawk, a nih loh leh hmun pawimawh (thluak emaw thinlung emaw ang chi)-a fistula awmte hian harsatna a thlen tam ber. Hemi chungchang hi sawipui tur chein i doctor hi a tha ber a ni.

• Congenital fistulas: Hengte hi hmun hlauhawma awm loh chuan prognosis tha tak an nei tlangpui. Mahse, hmun na takah an awm a, an lian a nih chuan harsatna lian tak an thlen thei a, thihna thlengin an thlen thei a ni.
• Dialysis atana siam fistulas: Hengte hian harsatna a thlen lo tlangpui. Side effect a awm chuan i doctor chuan a enkawl thei ang.

Fistula hi eng chen nge a awm theih?

Fistula tenau tak hi dam chhung zawngin a awm thei a, harsatna nei emaw nei lo emaw pawh a awm thei. Amaherawhchu, fistula a nasat chuan a rang thei ang bera Doctor pan a pawimawh. Hei hi a chhan chu fistula lian tak hian thinlungah pressure a siam thei a, heart failure a thlen thei a ni.A lo thleng thei a ni. Fistula siamthat a nih hnua thinlung chu a pangngaia a lo awm lehna tur awm mahse, chutiang chu a thleng ngai lo. Chuvang chuan, a enkawlna pek hma poh leh a tha zawk.

Eng thil nge ka ngaihtuah tur? Engtikah nge Doctor ka hmuh ang?

Fistula i vei a, a lan chhuah dan tlemte emaw, a lan chhuah loh emaw a nih chuan i tih theih tha ber chu a danglamna awm leh awm loh enfiah reng hi a ni.

Symptomatic fistula i neih chuan i doctor chuan a enkawl dan tur leh fimkhur tur thurawn a pe ang che. Mi thenkhat chu special compression garment ha turin an hrilh mai thei. Hengte hian chu hmuna tui awm zat tihtlem nan a pui thin.

Heng symptoms te hi i neih chuan doctor pan rawh:

• Natna thar emaw, natna awm tawha zual zel emaw.
• Fistula awmna hmunah a hring tam, lump ang maia lang thar (fistula i nei tih i hriat loh chuan, chhan awm lova lo lang chhuak thar/lump).
• Fistula atanga hla zawk taksa peng pakhata rawng inthlak danglamna (entir nan, fistula chu kut ah a awm a nih chuan, kut zungtang ah).

`(Dialysis)` atana fistula siam i neih chuan:

Hetiang fistula vei mi pakhatin a hmuna a hnuaia thil thlengte hi a hriat chuan a doctor hnenah a hrilh nghal tur a ni:

• Infection chhinchhiahna: a hring, a sen, leh khawih pawhin a lum.
• Dialysis neih laiin fistula kaltlanga thisen kal chak dan inthlak danglamna.
• Bulge danglam tak emaw, a pianzia inthlak danglam emaw.

Engtikah nge Emergency Treatment Unit (ETU) ah i kal ang ?

Internal bleeding tilang thei symptoms i neih chuan emaw, i taksa peng pakhatah (a bik takin kut emaw ke emaw ah thisen a luang tha lo tih i hriat chuan damdawi in pan nghal rawh.

Chutiang mizia chu:

• Vun rawng danglam (fistula bulah emaw taksa pum puiah emaw).
• Luak chhuak, lu hah.
• Thinlung thawk chak tak emaw thawk hah.
• Thâwk harsa.
• Fistula bulah natna nasa tak a lo awm nghal.

I doctor chuan i dinhmun a zirin emergency treatment ngai thei symptom dang a hrilh thei che a ni.

A tawp berah chuan (Take-Home Message) .

Arteriovenous fistula hi a chang chuan i nunah nghawng a nei lo thei a, mahse a chang chuan harsatna lian tham a thlen thei a ni. Kidney natna nei tan chuan dialysis atana surgery hmanga siam fistula neih hi thil awmze nei tak a ni a, an tan a hlawkthlak hle. Mahse, a tlem berah chuan hei vang hian harsatna lian tak tak a thleng thei a ni. Thu lawmawm tak chu tunlai damdawi lam thiamna sang tak nen hian he natna hi enkawl theih a ni fo a, a chang chuan tihdam theih a ni bawk. Chuvangin, hemi chungchangah hian rinhlelhna emaw, zawhna emaw i neih chuan Doctor rawn pan hreh suh la, an biak pawh hreh suh ang che.

` Arteriovenous Fistula, Arteriovenous Knot, Venous Tangle, Dialysis Fistula, Lung natna, Thisen kalna kawng, Surgery tih te