Imeko engaqhelekanga apho imithambo yegazi emzimbeni ibhijelwa khona: Masifunde nge-Arteriovenous Fistula ngokulula!

Ngaba wakha weva ngale meko yezonyango ebizwa ngokuba yi -Arteriovenous Fistula ? Mhlawumbi ukhe weva eli gama kuba umhlobo wakho efumana i-kidney dialysis. Okanye mhlawumbi ukhe wabona umthambo othile emzimbeni wakho odumbileyo kwaye uvakala ubetha ngendlela engaqhelekanga xa uwuchukumisa. Le yimeko esiza kuthetha ngayo namhlanje. Ungakhathazeki, siza kuthetha ngale nto ngokulula, ngesiSinhala onokuyiqonda.

Yintoni le fistula yemithambo yegazi?

Ngamafutshane, i-arteriovenous fistula lunxibelelwano oluthe ngqo phakathi komthambo (umthambo othwala igazi usuka entliziyweni) kunye nomthambo (umthambo othwala igazi ubuyela entliziyweni). Kufana nokudibanisa imibhobho emibini yamanzi. Oku kunokwenzeka naphi na emzimbeni, ngakumbi ngaphakathi kwamalungu ethu (umz., ingqondo, izintso) nasemalungeni ethu.

Cinga ngale ndlela: ukujikeleza kwegazi emizimbeni yethu kufana nenkqubo yeendlela.

• Imithambo yegazi: Ezi zifana neendlela ezinkulu. Zithwala igazi elicocekileyo (elizele yioksijini) ukusuka entliziyweni ukuya emzimbeni wonke. Uxinzelelo lwegazi luphezulu apha.
• Imithambo: Le yimithambo yegazi ethwala igazi elingenaoksijini (elinekhabhoni diokside eninzi) elibuyela entliziyweni lisuka kwiindawo ezahlukeneyo zomzimba. Uxinzelelo lwegazi kwezi mithambo luphantsi kunakwimithambo yegazi.
• IiCapillaries: Ezi ziindlela ezincinci kakhulu, ezincinci, ezimxinwa (iindlela ezidlulayo). Igazi elivela kwimithambo yegazi lidlula kwezi capillaries, linika ukutya kwiseli nganye emzimbeni, lize libuyele emithanjeni.

Ngokwesiqhelo, igazi elivela kwimithambo yegazi aliyi ngqo kwimithambo yegazi. Liqala lidlule kwinethiwekhi yemithambo yegazi emincinci kakhulu ebizwa ngokuba yi-capillaries. Nangona kunjalo, xa kuvela i-fistula, igazi liyadlula kule nkqubo ye-capillary lize litsibe ngqo lisuka kwimithambo yegazi liye kwimithambo yegazi.

Oku kunokubangela iingxaki ezininzi:

• Imithambo ayikwazi ukumelana noxinzelelo lwegazi oluphezulu kwimithambo yegazi, ngoko ke imithambo iqala ukudumba nokudumba.
• Ukujikeleza kwegazi kuyaphazamiseka. Ezinye iindawo zisenokungafumani gazi laneleyo.
• Ukuba le fistula inkulu, intliziyo kufuneka isebenze nzima ukupompa igazi. Ekuhambeni kwexesha, oku kunokubangela ukuba intliziyo ibe buthathaka, imeko esiyibiza ngokuba yi-"Heart Failure."

Ngamanye amaxesha ezi fistula zenziwa ngabom ngoogqirha, ingakumbi kwizigulana zezintso ezifuna i-dialysis. Emva koko iluncedo. Nangona kunjalo, ezinye i-fistula zisenokuba yingozi, kodwa ezinye zinokubangela iingxaki ezinkulu zempilo.

Ngubani onokufumana le meko? Ixhaphake kangakanani?

Ezi fistula zinokukhula nakweyiphi na iminyaka nakumntu. Zinokwenzeka ngakumbi ukuba zikhule emva kokwenzakala. Ezinye iintlobo ze fistula zixhaphake kakhulu kumaqela athile.

Enyanisweni, le meko ibizwa ngokuba yi-fistula ixhaphake kakhulu. Kodwa ayizizo zonke iintlobo ezinjalo.

• Eyona ixhaphakileyo: IiFistula ezenziwe ngoogqirha ukuze benze i-dialysis kwizigulana zezintso.
• Ezingaqhelekanga: ii-fistula ezikhoyo ekuzalweni (sizibiza ngokuba yi-`(Congenital fistulas)`).

Zithini iimpawu ze-fistula?

Iimpawu zinokwahluka ngokuxhomekeke kwindawo ekuyo. Abanye abantu basenokungabi nazo kwaphela iimpawu. Nangona kunjalo, ezona mpawu zixhaphakileyo zezi:

• Ukudumba: Kusenokuba kukho ukudumba okujikeleze i-fistula. Oku kubonakala ngakumbi kwi-fistula ezingaphantsi kolusu. Umzekelo, indawo enye yengalo okanye umlenze inokuba nokudumba okukhulu kunezinye.
• Ukutshintsha kombala wolusu: Ulusu olukuloo ndawo lunokuba mfusa okanye lube bomvu obumnyama.
• Imithambo yeVaricose: Imithambo isenokubonakala ikhulu kwaye ijijekile.
• Ukuziva ushushu: Xa uchukumisa indawo apho i-fistula ikhona, isenokuvakala ishushu kunezinye iindawo.

Iimpawu zokuncipha kokuhamba kwegazi (`(Ischemia)` okanye `(Steal Syndrome)`)

Ngamanye amaxesha, ukuba i-fistula engalweni okanye emlenzeni inkulu kakhulu, ukuhamba kwegazi kwiindawo zomzimba ezikude ne-fistula (umz., iminwe) kunokuncipha. Oku kubizwa ngokuba yi-ischemia . Kufana nokuba i-fistula "iba" igazi ebelifanele ukuya kwezo ndawo, yiyo loo nto abanye abantu beyibiza ngokuba yi- "Steal Syndrome."

Ngamaxesha anjalo, iimpawu ezinjalo zinokwenzeka:

• Ukungaziva mnandi kunye nokuziva urhawuzelelwa.
• Ukuqhaqhazela kwemisipha okanye intlungu.
• Amanxeba esikhumba (izilonda) ezithatha ixesha elide ukuphola okanye ezingapholiyo kwaphela.

Iimpawu zokusilela kwentliziyo

I-fistula enkulu inokubangela iingxaki entliziyweni. Ngenxa yokuba igazi lingahambi kakuhle lijikeleze i-fistula, intliziyo kufuneka isebenze nzima ukupompa igazi ngokufanelekileyo. Ekuhambeni kwexesha, oku kunokuyenza buthathaka intliziyo kwaye kukhokelele ekusileleni kwentliziyo . Iimpawu ezinje:

• Ubunzima bokuphefumla (i-Dyspnea).
• Ukudinwa, ukudinwa.
• Ukudumba kwemilenze neenyawo (i-Edema).

IiFistula ze-Arteriovenous ezizalwa nazo (`(IiFistula ze-Arteriovenous ezizalwa nazo)`)

Ekubeni ezi zinto zenzeka ngexesha umntwana esesesibelekweni, iimpawu zinokwahluka kancinci. Ezi zinokubangela utshintsho ekuphuhlisweni kwelungu lomzimba elichaphazelekayo.

• Ukuba ibekwe engalweni okanye emlenzeni, loo ngalo/umlenze unokuzaliswa zizihlunu ezingaphezulu kunezinye icala, kwaye amathambo anokuba made.
• Abanye abantu banokuba neminwe evuvukileyo, iinzipho ezithambileyo, ukudumba embindini, kunye nokugoba okusezantsi encamini (oku kubizwa ngokuba yi -clubbing ).
• Ngamanye amaxesha, ukuhamba kwegazi engalweni/emlenzeni ochaphazelekayo kuyancitshiswa, kwaye indawo inokuba luhlaza okwesibhakabhaka.

Yintoni ebangela ukuba le fistula ivele?

Kukho izizathu ezintathu eziphambili:

1. Ukulimala:Isizathu esiphambili sokuphuhliswa kwe-fistula ngokungalindelekanga kukwenzakala. Umzekelo, ukuba zombini umthambo kunye nomthambo zonakele, nokuba zenzeke ngengozi enkulu okanye ngenxa yokusikwa kwemela, zinokunamathelana kwaye zenze unxibelelwano olunje njengoko ziphila. Ngamanye amaxesha oku kufumaneka kuphela emva kweminyaka emininzi yokwenzakala.

2. Ukuzalwa: Ezi ziimeko ezenzeka ngelixa umntwana esakhula esibelekweni. Uninzi lwexesha, ezi zii-fistula ezincinci ezininzi endaweni ye-fistula enye enkulu. Nangona kunjalo, ukuba oku kwenzeka kwindawo ebaluleke kakhulu (njengengqondo), kunokuba yingozi.

3. I-Dialysis: Ukuze kwenziwe i-dialysis kwizigulana ezinengxaki yezintso, oogqirha benza utyando baze benze i-fistula ngabom. Oku kuvumela iinaliti eziqhagamshela kumatshini we-dialysis ukuba zingene kakuhle kwaye igazi lihambe kakuhle. Enyanisweni, i-fistula ixhaphake kakhulu ngenxa yesi sizathu.

Kunqabile kakhulu ukuba i-fistula ivele ngenxa yezifo ezinje ngomhlaza, usulelo oluthile, okanye i-aneurysm, imeko apho udonga lomthambo lubuthathaka kwaye luvuvukala njengebhaluni, nto leyo ebangela uxinzelelo kumthambo okufutshane.

Kubalulekile: I-Fistula ayisosifo esosulelayo. Oku kuthetha ukuba awunakuyifumana komnye umntu, kwaye awunakuyisasaza komnye umntu.

Oogqirha bayixilonga njani le nto? (Ukuxilongwa)

Ugqirha wakho uneendlela ezininzi zokuxilonga esi sifo. Ngokwesiqhelo benza uvavanyo lomzimba kunye novavanyo oluthile olukhethekileyo lokuthatha imifanekiso.

Nazi ezinye izinto onokuzenza ngexesha lovavanyo lomzimba:

• Uvavanyo: Ugqirha uza kujonga indawo yomzimba wakho apho acinga ukuba kukho ingxaki, okanye kwezinye iindawo ezinxulumene nayo. Baza kujonga ukudumba, ukutshintsha kombala, okanye ukudumba kwemithambo yegazi.
• Ukumamela: I-stethoscope isetyenziselwa ukumamela i-fistula ekrokrelwayo. Oku kungenxa yokuba igazi elihamba nge-fistula lenza isandi esingaqhelekanga. Lingavakala ngathi ngumatshini osebenzayo, kuba igazi lihamba macala omabini, kungekuphela nje kwicala elinye.
• Ukutsalwa ngentloko: Ungaziva ukurhawuzelelwa kwegazi njengoko igazi lihamba nge-fistula, enokuvakala ngokubeka isandla sakho kuyo. Ugqirha angacinezela kancinci kwindawo leyo. Ukuba isantya sentliziyo siyehla kancinci xa esenza njalo, oko kukwaluphawu lwe-fistula.

Zeziphi iimvavanyo ezenziwayo ukuze kufunyaniswe esi sifo?

Usenokufumana olunye okanye ngaphezulu kwezi vavanyo:

• I-Duplex Ultrasound: Oku kusebenzisa amaza esandi asebenza rhoqo ukujonga ngaphakathi emzimbeni. Oku kufana nendlela ilulwane elisebenzisa ngayo isandi ukufumana izinto ebumnyameni. Oku kunokunceda ekufumaneni indawo ye-fistula kunye nobukhulu bayo.
• I-Angiogram:Kolu vavanyo, kufakwa ulwelo olukhethekileyo (esilubiza ngokuba yi-"Contrast dye"`) kwimithambo yegazi, kwaye kuthathwa i-X-ray okanye i-CT scan. Olu lwelo lwenza imithambo yegazi icace kakhulu, kwaye kulula ukufumana naziphi na iindawo apho kukho ingxaki ngokuhamba kwegazi.
• I-MRI (Magnetic Resonance Imaging): Oku kusebenzisa amandla emagnethi aqinileyo kunye netekhnoloji yekhompyutha ukuthatha imifanekiso ecacileyo yangaphakathi lomzimba. Ingajonga nokuphazamiseka okufana ne-fistula.

Zithini iindlela zokunyanga oku? Ngaba kunokunyangwa?

Uninzi lweefistula lunokunyangeka. Kuxhomekeke kwisizathu sefistula, ubungakanani bayo, kunye nendawo ekuyo. Nangona iifistula zokuzalwa kunzima ukuzinyanga ngokupheleleyo, zihlala zinokunyangeka kwaye iingxaki ezizibangelayo zinokulawulwa.

Abanye abantu basenokungadingi unyango ekuqaleni nokuba bane-fistula. Unyango luyafuneka kwezi meko zilandelayo:

• Ukopha: Ukuba i-fistula iyopha, ingakumbi ukuba inzima kwaye ayinakuyekiswa, kufuneka ilungiswe.
• Ukwanda: Ukuba i-fistula okanye imithambo yegazi edibene nayo iba nkulu okanye itshintsha imo, inokubangela iingxaki kwizicubu ezingqongileyo.
• Ukuvalwa kokuhamba kwegazi: Ukuba i-fistula ithintela ukuhamba kwegazi ukuya kwinxalenye yomzimba okanye ukuba igazi lihlala kwindawo enye, inokubangela iingxaki ezinkulu.
• Utshintsho kwinkangeleko: Abanye abantu banokufumana ukungakhululeki ngokweemvakalelo ngenxa yokudumba kunye nokudumba kwemithambo okubangelwa yi-fistula. Kwiimeko ezininzi, le nkangeleko inokubuyiselwa emva kokuba i-fistula ilungisiwe.

Loluphi uhlobo lonyango okanye unyango olusetyenziswayo?

Iindlela zonyango ezisetyenziswa kakhulu zezi:

• Iindlela ezisebenzisa i-catheter: Kule nto, kufakwa isixhobo eside esifana netyhubhu (i-catheter) kwenye yemithambo yakho emikhulu yegazi (ngesiqhelo emqolo) size siqondiswe kwindawo ye-fistula. Emva koko, i-fistula yenziwa ngaphakathi kuyo. Oku kungenziwa ngokufaka izixhobo ezincinci ezifana nee-coils okanye ii-stents ukuvala i-fistula. Okanye, uhlobo oluthile lweglue olubizwa ngokuba yi-cyanoacrylate glue lungasetyenziswa ukuvala umngxuma.
• Utyando: Ngamanye amaxesha, ukuba i-fistula ayinakufikelelwa ngemithambo yegazi, okanye ukuba i-fistula inkulu kakhulu, ugqirha wotyando angenza ukusika ngqo ukulungisa i-fistula. Oku kunokubandakanya ukwahlula umthambo kunye nomthambo, okanye ukuthatha iqhekeza lomthambo wegazi kwenye inxalenye yomzimba aze alifake kwindawo eyonakeleyo.
• Unyango ngemitha: Kwezinye iimeko, le ndlela isetyenziselwa ukutshabalalisa unxibelelwano phakathi kwe-fistula negazi. Imitha ijoliswe ngqo kwi-fistula, nto leyo ebangela ukuba ibe namanxeba. Oku kuthintela igazi ukuba lingaphumi kuyo.

Amayeza asetyenziswa ukunyanga i-fistula. Ukuba i-fistula isengozini yokuqhekeka kwegazi, kunikwa amayeza okunciphisa igazi. La mayeza athintela ukwakheka kwamahlwili egazi kwimithambo yegazi, kwaye athintela ukuba ihlwili lingaphuki lize libambeke kwiindawo ezifana nentliziyo, ingqondo, okanye imiphunga, nto leyo ebangela izifo ezibulalayo ezifana nokuhlaselwa yintliziyo, isifo sohlangothi, okanye i-pulmonary embolism .

I-Fistula ye-dialysis:

Ezi azinyangwa ngaphandle kokuba zibe yingxaki. Ukuba kuvela ingxaki, utyando ludla ngokuba lolona khetho lukhethekileyo.

Iingxaki ezinokubakho okanye iziphumo ebezingalindelekanga zonyango ziyahluka ngokuxhomekeke kunyango, ubungakanani be-fistula, kunye nendawo ekuyo. Ugqirha wakho angakuchazela oku ngokweenkcukacha ezithe vetshe.

Ndingazinyamekela njani/ndizilawula njani iimpawu?

Awunakuyixilonga le meko ye-fistula wedwa. Kuba ezinye zeempawu zayo zinokufana nezezinye izifo ezinzulu, ezifana ne-aneurysms okanye amahlwili egazi. Ngoko ke, ungaze uzixilonge kwaye uzinyange. Ukuba ugqirha wakho ukuxelela ukuba unale meko, uza kukucebisa ngendlela yokuyinyamekela.

Ukuba uza kuphila ngokukhawuleza kangakanani emva konyango, kwaye kuza kuthatha ixesha elingakanani ukuphiliswa, kuya kwahluka ngokuxhomekeke kunyango kunye nohlobo lwe-fistula. Ugqirha wakho uza kukuxelela ngale nto.

Ngaba le meko ingancitshiswa okanye ingathintelwa ngokupheleleyo?

Enyanisweni, kunzima ukuthintela ukwakheka kwezi fistula. Kuba ezona zizathu zixhaphakileyo kukwenzakala (okungengabom) kunye nokuzalwa. Iifistula ezenzelwe ``(Dialysis)`` zenziwe ngabom njengoncedo kunyango lwakho.

Bekuya kwenzeka ntoni ukuba bendinokuba nale meko? (Umbono wexesha elizayo)

Iziphumo zakho ziya kuxhomekeka kubukhulu, indawo, kunye nesizathu se-fistula. Ii-fistula ezincinci, okanye ii-fistula ezifumaneka kwiindawo ezimbalwa, zisenokungafuni unyango. Abantu abaninzi banokuba neempawu ezingephi okanye bangabi nazo kwaphela iimpawu.

Nangona kunjalo, ii-fistula ezinkulu, okanye ii-fistula kwiindawo ezibalulekileyo (ezifana nengqondo okanye intliziyo), zezona zinokubangela iingxaki. Ugqirha wakho ngumntu ongcono ukuthetha nawe ngale nto.

• I-Congenital fistulas: Ukuba ezi azikho kwindawo eyingozi, zihlala zineziphumo ezilungileyo. Nangona kunjalo, ukuba zikwindawo embi kakhulu kwaye ziba nkulu, zinokubangela iingxaki ezinkulu, kwanokufa.
• IiFistula ezenzelwe i-dialysis: Ezi azidli ngokubangela iingxaki. Ukuba kuvela iziphumo ebezingalindelekanga, ugqirha wakho unokuzinyanga.

I-fistula ingahlala ixesha elingakanani?

I-fistula encinci inokubakho ubomi bonke, nokuba kukho naziphi na iingxaki okanye ngaphandle kwazo. Nangona kunjalo, ukuba i-fistula inzima, kubalulekile ukubona ugqirha ngokukhawuleza. Oku kungenxa yokuba i-fistula enkulu inokubangela uxinzelelo entliziyweni kwaye ikhokelele ekusileleni kwentliziyo.Inokwenzeka. Nangona kukho iimeko apho intliziyo ibuyela esiqhelweni emva kokuba i-fistula ilungisiwe, oku akwenzeki rhoqo. Ke ngoko, okukhona unyango lunikwa ngokukhawuleza, kokukhona kungcono.

Yintoni endifanele ndiyixhalabele? Ndifanele ndidibane nini nogqirha?

Ukuba une-fistula eneempawu ezimbalwa okanye ezingenazo kwaphela, eyona nto ingcono onokuyenza kukulinda naluphi na utshintsho.

Ukuba une-fistula eneempawu, ugqirha wakho uza kukunika iingcebiso malunga nendlela yokuyinyamekela kunye noko kufuneka ukuqaphele. Abanye abantu banokuxelelwa ukuba banxibe iimpahla zokucinezela ezikhethekileyo. Ezi zinceda ekunciphiseni ukwakheka kolwelo kuloo ndawo.

Bona ugqirha ukuba ufumana ezi mpawu:

• Intlungu entsha okanye ukuqina kwentlungu ekhoyo.
• Ukwanda kokudumba kwindawo ye-fistula, ukubonakala okutsha okufana neqhuma (ukuba awazi ukuba une-fistula, ukudumba/iqhuma elitsha elivela ngaphandle kwesizathu).
• Utshintsho lombala kwinxalenye yomzimba ekude kakhulu ne-fistula (umzekelo, ukuba i-fistula isesandleni, kwiminwe).

Ukuba une-fistula eyenzelwe `(i-Dialysis)`:

Ukuba umntu onolu hlobo lwe-fistula ubona naluphi na utshintsho olulandelayo kule ndawo, kufuneka axelele ugqirha wakhe ngoko nangoko:

• Iimpawu zosulelo: ukudumba, ukuba bomvu, kunye nokufudumala xa uchukumisa.
• Utshintsho kwisantya sokuhamba kwegazi nge-fistula ngexesha le-dialysis.
• Ukudumba okanye utshintsho olungaqhelekanga kwimilo.

Ufanele uye nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba ufumana iimpawu ezibonisa ukopha ngaphakathi, okanye ukuba uqaphela ukuba igazi alihambi kakuhle kwinxalenye yomzimba wakho (ingakumbi ingalo okanye umlenze), yiya esibhedlele ngokukhawuleza.

Ezo mpawu zezi:

• Ukutshintsha kombala wolusu (kufutshane ne-fistula okanye umzimba wonke).
• Isiyezi, ukuba nentloko ekhaphukhaphu.
• Ukubetha kwentliziyo ngokukhawuleza okanye ukuphefumla.
• Ubunzima bokuphefumla.
• Ukuqala ngequbuliso kwentlungu enzima kufutshane ne-fistula.

Ugqirha wakho angakuxelela ngezinye iimpawu ezinokufuna unyango olungxamisekileyo, kuxhomekeke kwimeko yakho.

Ekugqibeleni (Umyalezo Wokuya Ekhaya)

I-Arteriovenous fistula yimeko enokuthi ngamanye amaxesha ingabi nafuthe ebomini bakho, kodwa ngamanye amaxesha inokubangela iingxaki ezinkulu. Kuqhelekile ukuba abantu abanesifo sezintso batyandwe nge-fistula ukuze baxiliswe, kwaye iluncedo kubo. Nangona kunjalo, kunqabile ukuba kubekho iingxaki ezinkulu ngenxa yoku. Iindaba ezimnandi zezokuba ngesayensi yezonyango yanamhlanje ephucukileyo, le meko inokunyangwa, kwaye ngamanye amaxesha ide inyangeke. Ke ngoko, ukuba unamathandabuzo okanye imibuzo malunga noku, ungathandabuzi ukubona ugqirha kwaye uthethe naye.

I- Fistula ye-Arteriovenous, i-Arteriovenous Knot, i-Venous Tangle, i-Dialysis Fistula, isifo sentliziyo, imithambo yegazi, utyando