Yintoni i-fistula? Makhe sithethe ngayo ngokweenkcukacha!

Ngaba wakha waliva igama elithi "fistula"? Usenokuba ulivile kugqirha wakho okanye kwilungu losapho. Kunokuba yinto eyoyikisayo ukuliva, kodwa ungakhathazeki. Namhlanje, siza kuthetha ngokuba yintoni i-fistula, isizathu sokuba ivele, kunye nonyango olufumanekayo ngayo ngendlela elula neqondakalayo.

Yintoni i-fistula? Masiyiqonde ngokulula.

Ngamafutshane, i-fistula lunxibelelwano olutsha phakathi kwamalungu amabini omzimba wethu angadibaniyo rhoqo. Ifana nomngxuma omncinci. Cinga ngayo njengomngxuma omncinci phakathi kwamalungu amabini ngaphakathi emzimbeni wakho, okanye phakathi kwemithambo yegazi emibini, okanye umbhobho ovela ngaphakathi emzimbeni wakho uye kumphezulu wolusu lwakho. Ngale mngxuma, izinto ezinje ngobomvu, ilindle, kunye negazi zinokuya kwiindawo emzimbeni wakho ezingafanele ziye kuzo.

Uninzi lwexesha, le fistula yinto engaqhelekanga, oko kukuthi, isifo. Ngoko ke, ifuna unyango. Nangona kunjalo, ngamanye amaxesha oogqirha ngokwabo benza i-fistula njengonyango. Umzekelo, benza unxibelelwano phakathi komthambo kunye nomthambo ukunceda ngonyango lwe-dialysis kwizigulana zezintso.

I-Fistula inokubangela iintlungu kwaye yenze kube nzima ukwenza imisebenzi yemihla ngemihla. Kodwa iindaba ezimnandi zezokuba inokunyangwa rhoqo, ingakumbi ngotyando. Kwabanye abantu, xa befumene i-fistula, ayibuyi. Kwabanye, iyaqhubeka ibuya, kwaye inokufuna unyango kangangeenyanga okanye iminyaka. Nangona kunjalo, iqela lakho lezempilo liya kukunika unyango kunye nenkxaso oyifunayo.

Ingakhula njani i-fistula? Ziziphi iintlobo zayo?

Kukho iintlobo ezahlukeneyo ze-fistula. Zihlulwe ngokwendawo ezidalwe kuyo. Makhe sijonge iintlobo eziphambili ze-fistula ezibonwayo:

I-Anal fistula

Olu lolona hlobo luqhelekileyo lwe-fistula. Olu luthumbu oluncinci oluvela ngaphakathi kwi-anus yakho ukuya kulusu oluyijikelezileyo. Oku kudla ngokubangelwa lusulelo (`(Infection)`) okanye ukudumba (`(Inflammation)`) kwamadlala ajikeleze i-anus yakho, okunokubangela ithumba (`(Parianal abscess)`). Njengoko usenokuba uyazi, abantu abaneengxaki ezithile zempilo, ezifana `(Crohn's disease)`, basengozini enkulu yokufumana olu hlobo losulelo kunye ne-fistula. Oku kunokubangela iintlungu xa uhleli okanye uphuma isisu, kwaye ubomvu bunokuphuma.

I-Fistula ye-Arteriovenous (AV)

Kukho iintlobo ezimbini zemithambo yegazi emzimbeni wethu, ezibizwa ngokuba yimithambo yegazi kunye nemithambo yegazi. Ngokwesiqhelo, ezi zimbini zihamba ngokwahlukeneyo. Kodwa kwi-`(AV) fistula`, unxibelelwano oluthe ngqo lwenziwa phakathi kwemithambo yegazi kunye nomthambo. Isizathu esiphambili soku kukwenzakala. Kodwa ayizizo zonke i-`(AV) fistula` ezimbi. Njengoko bekutshiwo ngaphambili, oogqirha benza olu hlobo lonxibelelwano ukunceda abantu abanengxaki yezintso kwaye abasebenzisa i-`(Dialysis)`.

Unxibelelwano phakathi kwe-aorta kunye namathumbu amancinci (i-Aortoenteric fistula)

Oku kuyingozi kakhulu kwaye kungasongela ubomi.Uhlobo lwe-fistula. Olu lunxibelelwano phakathi kwe-aorta, umthambo wegazi oyintloko emzimbeni wethu, kunye namathumbu amancinci. Oku kunokubangela ukopha okugqithisileyo kwinkqubo yesisu (i-GI bleeding), okunokuba yingozi nokuba utyando olungxamisekileyo alwenziwanga ngokukhawuleza. Kukho iintlobo ezimbini zezi, oluphambili nolwesibini. Oluphambili lunokwenzeka ngenxa yokuba buthathaka kodonga lwe-aorta (i-Aortic aneurysm), umhlaza, isifo sephepha, okanye usulelo olufana ne-syphilis. Olulandelayo lunokwenzeka njengesiphumo esingaqhelekanga kakhulu sotyando olubandakanya i-aorta.

I-Fistula eyenzeka ngaphakathi endlebeni (i-perilymphatic fistula)

Oku kwenzeka xa kuvela umngxuma okanye ukukrazuka kwi-membrane encinci eyahlula indlebe yethu ephakathi kwindlebe yethu yangaphakathi. Oku kuvumela ulwelo oluvela kwindlebe yangaphakathi ukuba luvuzele kwindlebe ephakathi. Oku kunokubangela utshintsho kuxinzelelo endlebeni, olunokuchaphazela ukuva kunye nokulinganisela. Uninzi lwabantu lufuna utyando ukulungisa oku, kodwa abanye abantu bayaphila ngokulala ebhedini.

I-Tracheoesophageal fistula (TEF)

Olu lunxibelelwano phakathi komphimbo wethu (i-trachea) kunye nomqala wethu (i-oesophagus). Uninzi lwexesha, le yimeko yokuzalwa, oko kuthetha ukuba inokubakho xa umntwana ezalwa. Oogqirha badla ngokuyixilonga baze bayinyange xa ​​abantwana besengabantwana. Nangona kunjalo, abanye abantu abadala banokuba nale meko ngenxa yezinye iimeko zonyango, ezifana nomhlaza.

I-fistula yesini

Oku kwenzeka xa umngxuma uvela eludongeni lwesini somfazi. Lo mngxuma unokudibanisa isini somfazi nesitho esikufutshane, njengesibeleko (`(Isibeleko)`), isinyi (`(Isinyi)`), i-rectum (`(Rectum)`), amathumbu amakhulu (`(Amathumbu amakhulu)`), okanye amathumbu amancinci (`(Amathumbu amancinci)`). Oogqirha bakubiza oku ngokuthi ``I-Vesicovaginal fistula`` ukuba iphakathi kwesini somfazi nesinyi, kwaye ``I-Rectovaginal fistula`` ukuba iphakathi kwesini somfazi nesinyi. I-vaginal fistula eyenzeka njengengxaki ngexesha lokubeleka ikwabizwa ngokuba yi-``Obstetric fistula```.

Kubalulekile: Ngamanye amaxesha oogqirha benza i-fistula njengonyango. Umzekelo yi-`(Mucous fistula)`. Kule nto, amathumbu amancinci okanye amakhulu aqhagamshelwe kumngxuma omncinci (`(Stoma)`) owenziwe eluswini lwesisu. Oku kuluncedo kubantu abaye batyandwa ukuze kususwe inxalenye yamathumbu amakhulu (`(Colostomy)`) okanye kubantu abaye batyandwa ukuze kususwe inxalenye yamathumbu amancinci (`(Ileostomy)`).

Yintoni i-fistula esetyenziselwa i-dialysis?

I-dialysis fistula ngokwenene yi-"Arteriovenous - AV" fistula. Kuba idibanisa umthambo kunye nomthambo. Kodwa ngokungafaniyo nezinye ii-"(AV) fistula", ezi azibangelwa kukwenzakala ngengozi, kodwa zenziwe ngoogqirha botyando ukunceda kunyango lwe-dialysis.

Ugqirha udibanisa umthambo kunye nomthambo ongalweni yakho. Oku kubangela ukuba igazi elingakumbi lihambe ngemithambo yegazi kunesiqhelo. Igazi elivela kumthambo wegazi lihamba ngokukhawuleza kwaye lixinezelekile. Ngoko ke xa elinye lala gazi liphambukiselwa kwimithambo yegazi, umthambo uya ukhula kancinci kancinci, ubanzi, kwaye uqine. Oku kuyinto elungileyo, kuba umthambo onamandla, omkhulu unokuphatha iinaliti ezisetyenziswa kwi-dialysis kwaye unokufaka igazi ngokukhawuleza kwaye ulisuse.

Ukuba ufuna i-dialysis fistula, iqela lakho lezonyango liza kukuchazela izinto ezilungileyo nezingalunganga kwaye liza kukufundisa nendlela yokuyinyamekela ekhaya.

Zithini iimpawu ze-fistula?

Iimpawu ze-fistula ziyahluka ngokuxhomekeke kuhlobo lwayo. Nazi ezinye zeempawu onokuzifumana kwiintlobo ezithile ze-fistula:

• I-fistula yempundu:
• Intlungu engapheliyo kunye nokudumba okujikeleze i-anus.
• Intlungu xa ukhupha indle.
• Ukuphuma kobofu okanye ulwelo olufana negazi oluphuma eluswini olujikeleze i-anus, ngamanye amaxesha olunevumba elibi.
• Ukurhawuzelelwa kunye nokubomvu kolusu olujikeleze i-anus.
• Ifiva.
• I-fistula yesini:
• Ukuvuza komchamo okanye ilindle eliphuma kwilungu lobufazi.
• Ukuphuma kolwelo olungcolileyo oluphuma kwilungu lobufazi.
• Usulelo oluqhelekileyo lwesini okanye lwendlela yomchamo.
• Intlungu ngexesha lokwabelana ngesondo.
• Intlungu kunye nokurhawuzelelwa lusu olujikeleze i-vagina.
• I-Tracheoesophageal fistula (TEF):
• Ukukhohlela kunye nokuphelelwa ngumoya xa usitya okanye usela.
• Usulelo oluqhelekileyo esifubeni (njenge-pneumonia).
• Kumntwana, iba luhlaza okwesibhakabhaka xa encancisa.
• I-Fistula ngaphakathi kwendlebe (`i-Perilymphatic fistula`):
• Ukudinwa, ukuziva ngathi ujikeleza.
• Ukulahlekelwa yibhalansi ngelixa uhamba.
• Ukulahlekelwa kukuva.
• Ukuva isandi ezindlebeni.
• I-fistula ye-aortoenteric:
• Intlungu ebuhlungu yesisu ngequbuliso.
• Ukuhlanza igazi.
• Indle emnyama okanye enegazi.
• Ukudinwa, ukuquleka (ngenxa yokopha igazi).
• Ifiva.

Ukuba unenye okanye ngaphezulu kwezi mpawu, qiniseka ukuba ubonana nogqirha.

Zithini izizathu zokwakheka kwe-fistula?

Izizathu zokwakheka kwe-fistula ziyahluka ngokuxhomekeke kuhlobo lwayo. Ngokubanzi, ukwakheka kwe-fistula kunokubangelwa zezi zinto zilandelayo:

• Ukudumba kunye/okanye usulelo: Le yimbangela eyintloko.
• Ukulimala okanye ukwenzakala kwilungu lomzimba: Ezinye iingozi zinokwenzeka ngexesha lotyando.
• Njengesiphumo esingesiso sotyando ('Ingxaki yotyando'): I-Fistula ayifumaneki rhoqo emva kotyando oluthile.
• Njengesiphumo esingesihle sonyango: Umzekelo, unyango lwemitha yomhlaza.
• Utshintsho olwenzekayo ngexesha lokukhula komntwana ongekazalwa: Oku kuthetha ukuba iingxaki zenzeka ngelixa umntwana esesesibelekweni.

Ugqirha uyixilonga njani i-fistula?

Nantsi indlela oogqirha abaxilonga ngayo i-fistula:

1. Thetha nawe ngeempawu zakho: buza ukuba uziva njani kwaye unexesha elingakanani unale ngxaki.

2. Uvavanyo lomzimba: Kuya kwenziwa uvavanyo lomzimba ukuze kubonwe ukuba i-fistula iyabonakala na, okanye iindawo ezithile zomzimba ziya kuhlolwa (ngemvume yakho).

3. Uvavanyo olongezelelweyo: Uvavanyo lwenziwa ukuze kufunyaniswe ukuba kwenzeka ntoni ngaphakathi emzimbeni.

Zeziphi iimvavanyo ezenziwayo?

Olu vavanyo lunokunceda oogqirha ukuba baqonde ngcono okwenzekayo emzimbeni wakho. Nokuba ukrokrela ukuba une-fistula ngokusekelwe kwiimpawu ozichazayo, ezinye ii-fistula azibonakali. Ngoko ke uvavanyo olunokuthabatha imifanekiso yamalungu akho angaphakathi lunokunceda ekufumaneni ezi zinto:

• Loluphi uhlobo lwe-fistula onalo?
• Iphi kanye kanye?
• Yaba naliphi ifuthe kwizicwili ezingqongileyo?

Uvavanyo ekufuneka ulwenze luya kuxhomekeka kuhlobo lwe-fistula onayo. Ugqirha wakho uza kukuxelela ngalo. Nangona kunjalo, ungacelwa ukuba wenze olu vavanyo lulandelayo:

• Uvavanyo lwegazi okanye lomchamo: Jonga ukudumba okanye usulelo.
• Ii-X-reyi, ii-CT scans (ii-computed tomography scans) okanye i-MRI (i-magnetic resonance imaging): Jonga iindawo ezahlukeneyo zomzimba.
• I-ultrasound ye-Endoscopic: Jonga ngaphakathi kwenkqubo yokugaya ukutya.
• I-sigmoidoscopy eguquguqukayo okanye i-colonoscopy: Jonga ngaphakathi kwamathumbu amakhulu.
• I-Cystoscopy: Jonga ngaphakathi kwesinyi kunye ne-urethra.
• I-Bronchoscopy okanye i-Endoscopy: Jonga ngaphakathi kwimigudu yomoya (i-endoscopy apha ithetha imigudu yomoya).
• I-Angiogram: Ukujonga ukuba akukho zithintelo kwimithambo yegazi.

Ziziphi iindlela zonyango lwe-fistula?

Unyango oluqhelekileyo lwe-fistula ngamayeza kunye/okanye utyando. Ugqirha wakho uza kukuxelela ukuba loluphi unyango olufanelekileyo kwimeko yakho.

Umzekelo, ugqirha wakho angakunika amayeza okunciphisa ukudumba okanye ukutshintsha indlela esebenza ngayo inkqubo yomzimba wakho yokuzikhusela. La mayeza anokunyanga unobangela we-fistula. Ukuba unentsholongwane esebenzayo, unganikwa amayeza okubulala iintsholongwane. Ukuba amayeza awasebenzi, okanye ukuba amayeza odwa awanele, ungadinga utyando.

Masifunde ngotyando lwe-fistula.

Utyando lweFistula luyinkqubo elungisa unxibelelwano olungaqhelekanga phakathi kwamalungu amabini omzimba. Oku kunokunceda ukunciphisa iimpawu zakho nokuthintela iingxaki zexesha elizayo. Iinkcukacha zotyando ziya kwahluka kakhulu ngokuxhomekeke kuhlobo lwefistula onayo, ubungakanani bayo, kunye nendawo ekuyo. Ezinye iindlela zotyando lwefistula zilula kakhulu, kodwa ezinye ziyinkimbinkimbi. Ukuba unefistula eyinkimbinkimbi, unokufuna utyando oluninzi.

Khumbula, utyando lwe-rectal fistula lwahlukile kakhulu kutyando lwe-ear fistula. Ngoko ke iqela lakho lezonyango liza kukuchazela ngotyando, iingozi ezibandakanyekileyo, kunye nexesha lokuchacha.

Kwenzeka ntoni ukuba une-fistula? Yintoni onokuyilindela

I-Fistula inganyangeka lula, kodwa kufuneka ubone ugqirha ukuze uqale unyango. Amayeza asekhaya okanye ukulinda ukuba iimpawu ziphele ngokwazo aziyi kunceda. Ukuba uziva okanye ubona nantoni na engaqhelekanga, bona ugqirha ngoko nangoko.

Ugqirha wakho uza kukuxelela into omawuyilindele ngokwemeko yakho. Ngamanye amaxesha, emva konyango, ingxaki iya kuphela ngokupheleleyo kwaye ungalibala ngayo. Kodwa ngamanye amaxesha i-fistula okanye usulelo lunokubuya. Emva koko ungadinga unyango olongezelelweyo okanye olunye utyando. Oku kunokuba yingxaki enkulu. Kodwa ugqirha wakho uza kukunceda kuyo yonke inyathelo aze achaze isizathu sokuba ezi zinto zenziwe.

Ngaba ukwakheka kwe-fistula kungathintelwa?

Akukho nto sinokuyenza ukuthintela ukwakheka kwe-fistula ezininzi. Zibangelwa kukwenzakala okanye zizifo esingenakuzilawula.

Nangona kunjalo, oogqirha ngamanye amaxesha banokuyithintela i-obstetric fistula, ingxaki yokubeleka. Olu hlobo lwe-fistula lunokukhula xa umntwana ezelwe kade okanye ukuba unyango olungxamisekileyo (njengotyando lwe-C-section) alubonelelwa ngexesha. Kumazwe afana neSri Lanka, iingxaki ezinjalo azifumaneki kuba oogqirha banyamekela kakuhle umama nomntwana ngexesha lokubeleka. Nangona kunjalo, ezi ndawo azifani kuyo yonke indawo kwihlabathi. Imibutho efana neWorld Health Organisation (WHO) izama ukuthintela i-obstetric fistula ngokuphucula iindawo zonyango.

Ndingazinyamekela njani? Impilo yengqondo nayo ibalulekile!

Ukuphila ne-fistula kunokuba nzima, ingakumbi ukuba une-fistula eyinkimbinkimbi, utyando oluninzi, okanye unezifo ezingapheliyo. Kuyaqondakala ukuba ugxile emzimbeni wakho okwangoku. Kodwa ungalibali ukucinga nangempilo yakho yengqondo.

Zininzi izizathu zokuba uzive uxinezelekile okanye uxhalabile. Usenokuba ucinga oku:

• Ngaba unyango luza kuphumelela?
• Ngaba i-fistula iya kuphinda ivele?
• Ndivakalelwa ngendlela eyahlukileyo ngomzimba wam.
• Oku kuyichaphazela njani ubudlelwane bam bobuqu?

Kuqhelekile ukuziva ezi zinto, kwaye iimvakalelo zakho zibalulekile. Kodwa musa ukuthwala lo mthwalo wedwa. Thetha nogqirha wakho malunga nendlela oziva ngayo. Usenokukwazi ukukuthumela kwinkonzo efana nengcebiso, okanye kumaqela enkxaso apho abanye abantu abane-fistula banokudibana khona. Abanye abantu abadlula kwinto efanayo nawe baya kuqonda kwaye banokukunceda uqhubeke phambili.

Ngawaphi amaxesha afanelekileyo okubonana nogqirha?

Ukuba uneempawu ze-fistula, okanye uqaphela nantoni na engaqhelekanga, bonana nogqirha ngokukhawuleza.

Ukuba sele ufumana unyango lwe-fistula, fowunela ugqirha wakho nangaliphi na ixesha:

• Ukuba kuvela uphawu olutsha, okanye ukuba iimpawu ezikhoyo ziyatshintsha.
• Ukuba unemibuzo malunga nesicwangciso sakho sonyango.
• Ukuba kuvela iimpawu ezintsha emva kotyando, okanye ukuba iimpawu zangaphambili ziyabuya.

Imibuzo ebalulekileyo yokubuza ugqirha wakho

Xa usiya kugqirha wakho, kunokuba luncedo ukubuza imibuzo efana nale:

• Loluphi uhlobo lwe-fistula endinalo?
• Ndingenza ntoni ukulawula iimpawu ekhaya?
• Ziziphi iindlela zonyango endinazo?
• Zithini iingozi zotyando?
• Kuza kuthatha ixesha elingakanani ukuphiliswa?
• Yintoni endifanele ndiyenze kwaye yintoni endingafanele ndiyenze ngexesha lokuchacha?
• Lithini ithuba lokuba i-fistula iphinde ivele?
• Ndingenza ntoni ukuthintela ukwakheka kwe-fistula kwixesha elizayo?

Usenokuba awuzange uve nge-fistula ngaphambili, kodwa mhlawumbi ubusoloko ucinga ngayo ukusukela oko wafumanisa ukuba unayo. I-fistula inokuphazamisa imisebenzi yakho yemihla ngemihla kwaye ichaphazele indlela oziva ngayo. Ngethamsanqa, unyango lunokukunceda ufumane ulawulo kwiindawo zomzimba wakho oziva ngathi uphulukene nazo. Nangona kunjalo, ukuchacha kungathatha ixesha. Ugqirha wakho unokukuxelela okungakumbi ngale nto aze akunike naluphi na uncedo olongezelelweyo onokulufuna.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

• I-Fistula ayisiyonto yokoyika, kodwa yimeko efuna unyango olukhawulezileyo.
• Ukuba uneempawu ze-fistula, bonana nogqirha ngokukhawuleza.
• Iintlobo ezininzi ze-fistula zinokunyangwa ngempumelelo, ingakumbi ngotyando.
• Inkqubo yonyango ingathatha ixesha, kodwa ngomonde nangokulandela imiyalelo kagqirha wakho, ungaphila.
• Impilo yakho yengqondo ibaluleke njengempilo yakho yomzimba. Musa ukuthandabuza ukucela uncedo ukuba uyalufuna.

Ndiyathemba ukuba olu lwazi uza kulufumana luluncedo. Hlala usempilweni!

i - fistula, i-anal fistula, i-AV fistula, i-vaginal fistula, iimpawu ze-fistula, unyango lwe-fistula, utyando lwe-fistula