Ingaba unengxaki engaqhelekanga yemithambo yegazi entlokweni yakho? (I-Dural Arteriovenous Fistula - dAVF) Masithethe ngale nto!

Ngaba ngamanye amaxesha uyayiva ingxolo ngaphakathi entlokweni yakho? Okanye usoloko unentloko ebuhlungu? Usenokucinga ukuba ezi zinto ziqhelekile, kodwa ngamanye amaxesha kukho into engasemva koku efuna ingqalelo ethile. Yiloo nto ibizwa ngokuba yi-dural arteriovenous fistula (dAVF) . Makhe sithethe ngale nto ngokulula.

Yintoni i-dural arteriovenous fistula (dAVF)?

Ngamafutshane, kukho inwebu encinci ekhuselayo ejikeleze ingqondo yethu kunye nomqolo. Oku sikubiza ngokuba yi-dura mater . Kufana nekhava engasemva yencwadi.

Ngoku khangela, sinothungelwano lwemithambo yegazi yokuthwala igazi ukuya kuwo onke amalungu omzimba wethu. Imithambo yegazi ithwala igazi elicocekileyo, elinomoya-mpilo omninzi ukusuka entliziyweni ukuya kuzo zonke ezinye izitho zomzimba, kuquka nengqondo. Imithambo yegazi ithwala igazi elisetyenzisiweyo, elingenawo umoya-mpilo omninzi ukubuyela entliziyweni. Phakathi kwezi mithambo yegazi kunye nemithambo yegazi, kukho uthungelwano oluhle kakhulu lwemithambo yegazi, esilubiza ngokuba zii-capillaries . Ezi capillaries zilawula ukuhamba kwegazi kwaye zisasaze igazi ngokufanelekileyo kwizitho zomzimba.

Ngoku, kule meko ibizwa ngokuba yi-fistula , umthambo uqhagamshela ngqo kumthambo, ngaphandle kwenkqubo ephakathi yee-capillaries. Khawuthelekelele ngokungathi umbhobho omkhulu wamanzi uqhagamshelwe ngequbuliso kumbhobho omncinci. Emva koko, igazi lingena kuloo mthambo ngesantya esiphezulu naphantsi koxinzelelo oluphezulu. Umthambo awuqhelanga igazi elininzi noxinzelelo olunjalo.

Ngoko ke, le fistula ibizwa ngokuba yi- dural arteriovenous fistula (dAVF) lunxibelelwano olungaqhelekanga phakathi komthambo kunye nomthambo ongaphakathi kwi-dura mater, i-membrane ejikeleze ubuchopho. Ngamanye amaxesha ugqirha wakho unokubiza oku ngokuba yi-dural arteriovenous malformation .

Olu qhagamshelo lungaqhelekanga lunokubangela ukuba uxinzelelo lwegazi ngaphakathi kwimithambo yegazi lungazinzi, imilo yemithambo yegazi inokutshintsha, kwaye igazi lisenokungahambi ngendlela elifanele lihambe ngayo. Ngamanye amaxesha, umthambo wegazi unokuqhuma kuba awukwazi ukumelana noxinzelelo oluphezulu. Ukuba oko kuyenzeka, kunokubangela ukopha okusongela ubomi.

Ixhaphake kangakanani le meko?

Enyanisweni, le meko (dAVF) ayiqhelekanga kangako. Umzekelo, eMelika, kuthiwa yenzeka ngesantya esiphakathi kwe-0.15 kunye ne-0.19 kubantu abayi-100,000 ngonyaka. Oko kuthetha ukuba ayiqhelekanga kakhulu.

Ingaba le (dAVF) yimeko enzulu?

Nantsi indlela esebenza ngayo. Ezinye (i-dAVF) zithambile kakhulu kwaye azibangeli naziphi na iingxaki zempilo ezinkulu. Nangona kunjalo, ezinye zinzima kakhulu kwaye zinokuba yingozi ebomini. Ingakumbi ukuba umthambo wegazi uyaqhuma kwaye wophe, njengoko kukhankanyiwe ngasentla, unokonakalisa izicubu zobuchopho kwaye ubangele isifo sohlangothi .

Eyona nto ibalulekileyo kukubona ugqirha ngokukhawuleza ukuba uneempawu. Ukuba wena okanye umntu osondeleyo kuwe ufumana iimpawu zestroke (umz., ubuthathaka kwelinye icala, ukuthetha okungacacanga, ukulahlekelwa zingqondo), kufuneka ufowunele u-911 ngokukhawuleza okanye kwigumbi likaxakeka elikufutshane.

Zithini iimpawu ze (dAVF)?

Ngamanye amaxesha usenokungabi nazo naziphi na iimpawu nokuba unayo (dAVF) . Kodwa ukuba unayo, zinokuqala kwezincinci ukuya kwezinzima. Iimpawu ziyahluka ngokuxhomekeke ekubeni iphi ingqondo apho i-fistula ikhoyo khona. Khangela ezi:

• Intloko ebuhlungu: Isenokungabi yintloko eqhelekileyo nje, kodwa luhlobo olutsha lwentloko ebuhlungu oluthi ngamanye amaxesha lube qatha kancinci.
• Isicaphucaphu nokuhlanza: Oku kunokwenzeka, ingakumbi xa kukho intloko ebuhlungu.
• I-pulsatile tinnitus: Olu luphawu oluthile. Lufana nesandi "sokukhala" okanye "sokubhonga" endlebeni yakho, esifana nesandi sokubetha kwentliziyo yakho. Abanye abantu basichaza njengesandi "sokukhala endlebeni yakho."
• Utshintsho lombono: Ukufiphala ngequbuliso kombono, ukubona kabini, okanye ukuziva ngathi umbono awucacanga.
• Ubunzima bokuthetha okanye bolwimi: Ukungakwazi ukuthetha kakuhle, ngokungathi awukwazi ukuthetha.
• Ukulahlekelwa yibhalansi xa uhamba, kuba nzima ukulawula amalungu omzimba xa usebenza.
• Ubuthathaka okanye ukungaqini kwemisipha: Ukuziva ungaqini okanye ubuthathaka kwelinye icala lengalo, umlenze, okanye ubuso.
• Intlungu ebusweni, ezingalweni, okanye emilenzeni.
• Ukulahlekelwa yinkumbulo.
• Iimvakalelo okanye iimvakalelo ezingaqhelekanga.

Ezi mpawu zihlala zibangelwa kukopha ngaphakathi kwengqondo yakho . Ngoko ke ukuba unazo ezi mpawu, bonana nogqirha ngokukhawuleza.

Zithini izizathu zoku (dAVF)?

Oogqirha abakayazi kakuhle into ebangela i-dAVF . Nangona kunjalo, izazinzulu ezininzi zikholelwa ukuba inokubangelwa kukwenzakala entloko . Ingabonakala emva kweminyaka emininzi yenzakele. Ezinye izifundo zibonisa ukuba inxulumene nokuvaleka kwemithambo yegazi ethwala igazi liye engqondweni. Oku kuvaleka kunokubangelwa sisifo, ingozi, okanye esinye isiganeko. Umzekelo:

• Ukuqhekeka kwegazi (iThrombosis).
• Ukulimala kwengqondo okubuhlungu.
• Utyando lobuchopho, olufana notyando lwe-craniotomy.

Amaxesha amaninzi, umntu unokuzalwa enale ngxaki (dAVF) , kodwa ayizuzisi. Le meko isaphandwa.

Ngubani osengozini enkulu yokuhlaselwa yile (dAVF)?

Le meko (dAVF) inokukhula nakweyiphi na iminyaka, kodwa ixhaphake kakhulu kubantu abadala abaphakathi kweminyaka engama-40 nama-60 .

Ziziphi iingxaki ezinokubakho ze (dAVF)?

Iingxaki ezibangelwa yile (dAVF) ngamanye amaxesha zinokuba yingozi ebomini. Ezona ziphambili zezi:

• Ukopha ngaphakathi kwithishu yobuchopho (ukuvuza kwegazi).
• Ukopha ngaphakathi kwekhakayi, kodwa ngaphandle kwengqondo (i-subdural hematoma).
• Ukopha phakathi kwengqondo kunye ne-membrane ekhuselayo eyijikelezileyo (i-Subarachnoid hemorrhage).
• Uxinzelelo oluphezulu ngaphakathi kwekhakayi (uxinzelelo lwangaphakathi kwentloko).
• Ukuxhuzula.
• Istroke.

Khawucinge nje, bekuya kwenzeka ntoni ukuba impompo encinci eqhagamshelwe kumbhobho omkhulu ozisa amanzi kwitanki yamanzi yendlu yethu ibingaphuma ngequbuliso? Bekuya kubakho amanzi kuyo yonke indlu. Yiloo nto ebekuya kwenzeka ukuba umthambo wegazi uqhume ngaphakathi kwengqondo. Yiyo loo nto oku kuyingozi kangaka.

Ifunyaniswa njani le meko (dAVF)?

Ugqirha uxilonga le meko (dAVF) emva kwala manyathelo alandelayo:

• Uvavanyo lomzimba.
• Uvavanyo olunxulumene nenkqubo yemithambo-luvo.
• Uvavanyo olukhethekileyo lokufota.

Xa usenza olu vavanyo, ugqirha wakho uza kukubuza ngeempawu zakho kunye neenkcukacha malunga nezifo zakho zangaphambili.

Ngamanye amaxesha, usenokungabi nazimpawu kwaye zinokufunyanwa ngengozi xa uvavanywa ingqondo okanye umqolo wakho ngesinye isizathu.

Uvavanyo olukhethekileyo olunceda ekufumaneni (i-dAVF)

Ugqirha angathabatha umfanekiso ofanelekileyo wemithambo yegazi yakho aze asebenzise iimvavanyo ezifana nezi ukuze abone ukuba unayo na le nto (dAVF) :

• Iskeni ye-MRI (Magnetic Resonance Imaging) okanye i-MRA (Magnetic Resonance Angiography).
• Uvavanyo lwe-CT Angiography (CTA - Computed Tomography Angiography).

Zombini ezi mvavanyo azibuhlungu kwaye azibangeli ntlungu ingako. Zivumela ugqirha wakho ukuba afumane umfanekiso ocacileyo wemithambo yegazi kwinkqubo yakho yemithambo-luvo, enokuba yimbangela yeempawu zakho.

Ukuba uvavanyo lomfanekiso olufana nolu (dAVF) lubangela inkxalabo, oogqirha bakho baya kuthetha nawe ngolunye uvavanyo olukhethekileyo olubizwa ngokuba yi-cerebral angiogram .

I-cerebral angiogram luvavanyo olungangenisi gazi olunokuvelisa imifanekiso emihle necacileyo yemithambo yegazi engqondweni yakho. Kolu vavanyo, oogqirha bafaka ityhubhu encinci kakhulu - esiyibiza ngokuba yi-catheter - kwimithambo yegazi esihlahleni sakho okanye emlenzeni ongasentla, baze bayifake ngemithambo entanyeni yakho baye kwimithambo yegazi engqondweni yakho. Emva koko, ngaloo catheter , kufakwa ulwelo olukhethekileyo.I-arhente yokwahlulahlula ifakwa emzimbeni. Xa ixubana negazi lakho, inokubonwa kwiividiyo ze-X-ray njengoko igazi lihamba ngemithambo yegazi ebuchotsheni kwaye libuya kwimithambo yegazi. Oku kuvumela oogqirha ukuba bamisele ukuba i-dAVF ijongeka njani kwaye loluphi unyango olufanelekileyo kuyo.

Ngaba ikho indlela yokunyanga le meko (i-dAVF)?

Ewe, unyango lungayisusa le fistula kwaye lubuyisele ukuhamba kwegazi okuqhelekileyo emithanjeni. Oku kunokunciphisa okanye kuthintele iimpawu ezintsha kunye neengxaki.

Iphathwa njani (i-dAVF)?

Injongo ephambili yolu nyango (dAVF) kukususa unxibelelwano olungaqhelekanga (i-fistula) phakathi komthambo kunye nomthambo. Kunokubakho iindlela zonyango ezifana nezi:

• Utyando: Utyando oluvulekileyo lunokwenziwa ukuze kususwe unxibelelwano olungaqhelekanga (i-fistula) kumthambo wegazi ochaphazelekayo.
• Ukufakwa kwemithambo yegazi: Kule nto, njengoko bekutshiwo ngaphambili, ityhubhu encinci kakhulu (i-catheter) idluliselwa kwenye yemithambo yakho, ukuya apho i-fistula ikhona, ize ivalwe. Kufana nokuvala indawo evuzayo.
• Utyando lwe-Stereotactic radiosurgery: Olu luhlobo lonyango lwe-radiation. Kule meko, imisebe ye-radiation ejoliswe kakhulu ijoliswe kumthambo wegazi ochaphazelekayo apho i-fistula idibene khona, iwuvale.

Ugqirha wakho uza kumisela isicwangciso sonyango esifanelekileyo kuwe. Oku kuya kuxhomekeka kwizinto ezininzi, kuquka uhlobo lwe- (dAVF) , impilo yakho ngokubanzi, iimpawu, kunye nomngcipheko wakho wokopha okanye iingxaki.

Ukuba awunazo iimpawu, ugqirha wakho usenokungakunyangi ngoko nangoko, kodwa unokukujonga rhoqo ukuze athintele iingxaki.

Ithini i-prognosis ye-(dAVF)?

Ingqikelelo yakho ixhomekeke kwizinto ezininzi, njengendawo ekuyo i-fistula kunye nokuba iyopha na. Ukuba ifunyenwe kwaye inyangwa kwangethuba, ingqikelelo idla ngokuba ntle. Ngelishwa, ezinye (i-dAVF) zinokubangela iingxaki ezingapheliyo okanye ezisongela ubomi. Ukuba iingxaki ezinjalo zenzeka, kukho iinkonzo zokhathalelo emva kwesifo kunye nenkxaso yokunceda, njengonyango lomzimba , unyango lomsebenzi , kunye nonyango lokuthetha .

Ugqirha wakho ngumntu onokukunika umbono ochanekileyo ngokusekelwe kwimeko yakho.

Izinga lokusinda ukusuka kwi (dAVF)

Ngenxa yokuba le meko (dAVF) ayixhaphakanga kangako, uphando malunga namazinga okusinda lusaqhubeka. Izifundo zangoku zibonisa ukuba izinga lokufa ngonyaka ngenxa yesi simo liphezulu kakhulu.Kuqikelelwa ukuba phakathi kwe-11% kunye ne-19%. Oku kuthetha ukuba kwezinye iimeko, izinga lokusinda lonyaka lingaqikelelwa ukuba lingaphezulu kwe-80%.

Ngaba le meko (i-dAVF) ingathintelwa?

Akukho ndlela eyaziwayo yokuthintela le meko (dAVF) . Nangona kunjalo, unganciphisa umngcipheko wakho ngokulawula iimeko zempilo ezisisiseko (ezifana neengxaki zokujiya kwegazi) ezinokukhokelela kule meko. Ungazikhusela nakwiingozi zentloko ngokunxiba izixhobo zokuzikhusela ezifanelekileyo xa udlala imidlalo neminye imisebenzi.

Ndifanele ndibonane nogqirha nini?

Bona ugqirha ukuba ufumana naziphi na kwezi mpawu:

• Intloko ebuhlungu ngequbuliso.
• Ubuthathaka okanye ukuba ndindisholo kwemisipha.
• Utshintsho kwindlela othetha ngayo, ukuhamba, ukulinganisela, okanye ukubona.
• Ukuqala okutsha, ukukhala ezindlebeni (i-Pulsatile tinnitus).

Ukuba wena okanye umntu osondeleyo kuwe ufumana iimpawu zestroke (umz., ubuthathaka kwelinye icala, ukuthetha okungacacanga, ukulahlekelwa zingqondo), kufuneka utsalele umnxeba ku-911 okanye kwigumbi likaxakeka elikufutshane nawe ngoko nangoko. Ixesha libaluleke kakhulu!

Ndingayibuza yiphi imibuzo ugqirha wam?

Xa ubona ugqirha, kungcono ukubuza imibuzo efana nale:

• Iphi le fistula?
• Loluphi unyango olucebisayo?
• Ngaba ndiyaludinga ngokwenene utyando?
• Zithini iziphumo ebezingalindelekanga zolu nyango?
• Ingaba le fistula ingaphinda ivele emva konyango?
• Kuza kuthatha ixesha elingakanani ngaphambi kokuba ndibuye ukuze ndifumane iimvavanyo?

Okokugqibela, umyalezo oya ekhaya

Le meko, ebizwa ngokuba yi -dural arteriovenous fistula (dAVF), inokuba nefuthe elikhulu okanye elincinci ebomini bakho. Kwezinye iimeko, inokuba yingxaki encinci enokulawulwa lula phantsi kweliso likagqirha. Nangona kunjalo, ukuba ayifunyaniswanga kwaye inyangwa ngokukhawuleza, inokukhokelela kwiingxaki ezihlala zihleli okanye ezisongela ubomi.

Ukuba uneempawu okanye ukhathazekile ngento ethile, fowunela ugqirha okanye igumbi longxamiseko ngokukhawuleza. Kukho unyango olunokunceda ukususa i-fistula nokubuyisela ukuhamba kwegazi kuzo zonke iindawo zomzimba wakho. Kukho iindlela ezahlukeneyo zonyango, kungekhona zonke ezifuna utyando oluvulekileyo. Iqela lakho lezonyango liza kuvavanya iimpawu zakho kwaye ligqibe isicwangciso sonyango esifanelekileyo kuwe ukuthintela iingxaki.

Uyazi kakuhle impilo yakho. Ngoko ke ukuba ubona naluphi na utshintsho emzimbeni wakho, musa ukulutyeshela. Ukuthatha amanyathelo ngokukhawuleza kunokuthintela izifo ezininzi ezinzulu.

I - fistula yemithambo yegazi emithanjeni esecaleni, i-dAVF, imithambo yegazi yobuchopho, intloko ebuhlungu, i-pulsatile tinnitus, ukopha kwegazi lobuchopho, istroke