Isimo esingavamile lapho imithambo yegazi emzimbeni ibanjwa khona: Ake sifunde nje nge-Arteriovenous Fistula!

Wake wezwa ngalesi simo sezokwelapha esibizwa ngokuthi i-Arteriovenous Fistula ? Mhlawumbe uke wezwa leli gama ngoba umngane wakho ehlinzwa i-dialysis yezinso. Noma mhlawumbe uke wabona umthambo endaweni ethile emzimbeni wakho ovuvukele futhi uzwakala ushaya ngendlela exakile uma uwuthinta. Lesi yisimo esiqondile esizokhuluma ngaso namuhla. Ungakhathazeki, sizokhuluma ngalokhu kalula, ngesiSinhala ongasiqonda.

Iyini le fistula yemithambo yegazi?

Kalula nje, i-arteriovenous fistula iwukuxhumana okuqondile phakathi komthambo (umthambo othwala igazi usuka enhliziyweni) nomthambo (umthambo othwala igazi ubuyela enhliziyweni). Kufana nokuxhumanisa amapayipi amabili amanzi ndawonye. Lokhu kungenzeka noma kuphi emzimbeni, ikakhulukazi ngaphakathi kwezitho zethu zomzimba (isib., ubuchopho, izinso) kanye nasezithweni zethu zomzimba.

Cabanga ngalokhu: ukujikeleza kwegazi emzimbeni wethu kufana nohlelo lwemigwaqo.

• Imithambo yegazi: Lezi zifana nemigwaqo emikhulu. Zithwala igazi elihlanzekile (eligcwele umoya-mpilo) lisuka enhliziyweni liye emzimbeni wonke. Umfutho wegazi uphakeme lapha.
• Imithambo: Lena yimithambo yegazi ethwala igazi elingenawo umoya-mpilo (elinomoya-mpilo omningi) libuyele enhliziyweni lisuka ezingxenyeni ezahlukene zomzimba. Umfutho wegazi kule mithambo uphansi kunasemithanjeni yegazi.
• Ama-Capillary: Lawa ayindlela encane kakhulu, emincane, emincane (izindlela zokudlula). Igazi elivela emithanjeni lidlula kula ma-capillary, linikeza ukondla kuwo wonke amaseli emzimbeni, bese libuyela emithanjeni.

Ngokuvamile, igazi elivela emithanjeni aliyi ngqo emithanjeni. Liqala lidlule kunethiwekhi yemithambo yegazi emincane kakhulu ebizwa ngokuthi ama-capillaries. Kodwa-ke, lapho kwakheka i-fistula, igazi liyadlula kulesi simiso se-capillary bese ligxuma ngqo lisuka emithanjeni liye emthanjeni.

Lokhu kungabangela izinkinga eziningana:

• Imithambo ayikwazi ukumelana nomfutho wegazi ophezulu emithanjeni, ngakho-ke iqala ukukhukhumala nokuvuvukala.
• Ukujikeleza kwegazi kuyaphazamiseka. Ezinye izindawo zingase zingatholi igazi elanele.
• Uma le fistula inkulu, inhliziyo kufanele isebenze kanzima ukupompa igazi. Ngokuhamba kwesikhathi, lokhu kungabangela ukuba inhliziyo ibe buthaka, isimo esisibiza ngokuthi "Ukwehluleka Kwenhliziyo."

Ngezinye izikhathi la ma-fistula adalwe ngamabomu odokotela, ikakhulukazi iziguli zezinso ezidinga i-dialysis. Khona-ke kuyasiza. Kodwa-ke, amanye ama-fistula angase angabi yingozi, kodwa amanye angabangela izinkinga ezinkulu zempilo.

Ubani ongaba nalesi simo? Sivame kangakanani?

La ma-fistula angakhula kunoma yimuphi ubudala nakunoma ubani. Avame kakhulu ukukhula ngemva kokulimala. Ezinye izinhlobo zama-fistula zivame kakhulu emaqenjini athile.

Empeleni, lesi simo esibizwa ngokuthi i-fistula sivame kakhulu. Kodwa akuzona zonke izinhlobo ezinjalo.

• Okuvame kakhulu: Ama-fistula adalwe odokotela ukwelapha iziguli zezinso nge-dialysis.
• Okungavamile kakhulu: ama-fistula akhona lapho ezalwa (siwabiza ngokuthi `(ama-fistula azalwa nawo)`).

Ziyini izimpawu ze-fistula?

Izimpawu zingahluka kuye ngokuthi ikuphi. Abanye abantu bangase bangabi nazo nhlobo izimpawu. Kodwa-ke, izimpawu ezivame kakhulu yilezi:

• Ukuvuvukala: Kungase kube nokuvuvukala okuzungeze i-fistula. Lokhu kubonakala kakhulu kuma-fistula angaphansi kwesikhumba. Isibonelo, indawo eyodwa yengalo noma umlenze ingase ivuvuke kakhulu kunezinye.
• Ukushintsha kombala wesikhumba: Isikhumba kuleyo ndawo singaba nsomi noma sibe bomvu ngokumnyama.
• Imithambo ye-Varicose: Imithambo ingase ibonakale ikhulisiwe futhi igobile.
• Ukuzizwa ufudumele: Uma uthinta indawo lapho kukhona khona i-fistula, ingase izwakale ifudumele kunezinye izindawo.

Izimpawu zokuncipha kokugeleza kwegazi (`(Ischemia)` noma `(Steal Syndrome)`)

Ngezinye izikhathi, uma i-fistula engalweni noma emlenzeni inkulu kakhulu, ukugeleza kwegazi ezingxenyeni zomzimba ezikude ne-fistula (isb., iminwe) kungancipha. Lokhu kubizwa ngokuthi i-ischemia . Kunjengokungathi i-fistula "iba" igazi okufanele liye kulezo zingxenye, yingakho abanye abantu beyibiza ngokuthi "i-Steal Syndrome."

Ngezinye izikhathi ezinje, izimpawu ezinjalo zingavela:

• Ukungazweli kanye nomuzwa wokuthuthumela.
• Ukuqhaqhazela kwemisipha noma ubuhlungu.
• Amanxeba esikhumba (izilonda) ezithatha isikhathi eside ukuphola noma ezingapholi nhlobo.

Izimpawu Zokwehluleka Kwenhliziyo

I-fistula enkulu nayo ingadala izinkinga enhliziyweni. Ngenxa yokuthi igazi alihambi kahle eduze kwe-fistula, inhliziyo kufanele isebenze kanzima ukuze ipompe igazi kahle. Ngokuhamba kwesikhathi, lokhu kungenza inhliziyo ibe buthaka futhi kuholele ekuhlulekeni kwenhliziyo . Izimpawu ezifana nalezi:

• Ubunzima bokuphefumula (i-Dyspnea).
• Ukukhathala, ukukhathala.
• Ukuvuvukala kwemilenze nezinyawo (i-Edema).

Ama-Fistula e-Arteriovenous azalwa nawo (`(Ama-Fistula e-Arteriovenous azalwa nawo)`)

Njengoba lezi zakhiwa ngesikhathi ingane isesesibelethweni, izimpawu zingase zihluke kancane. Lezi zingabangela izinguquko ekukhuleni kwengxenye yomzimba ethintekile.

• Uma ibekwa engalweni noma emlenzeni, leyo ngalo/umlenze ungagcwala imisipha eminingi kunolunye uhlangothi, futhi amathambo angase abe made.
• Abanye abantu bangase babe nokuvuvukala kweminwe, izinzipho ezithambile, ukuvuvukala phakathi nendawo, kanye nokugoba okuphansi esicongweni (lokhu kubizwa ngokuthi i-clubbing ).
• Ngezinye izikhathi, ukugeleza kwegazi engalweni/emlenzeni othintekile kuyancipha, futhi indawo ingase ibe luhlaza okwesibhakabhaka.

Yini ebangela ukuthi le fistula yakheke?

Kunezizathu ezintathu eziyinhloko:

1. Ukulimala:Isizathu esiyinhloko sokuthuthukiswa kwe-fistula okungalindelekile ukulimala. Isibonelo, uma kokubili umthambo nomthambo kulimele, kungaba ngenxa yengozi enkulu noma ukunqunywa ngommese, kunganamathelana futhi kwakheke ukuxhumana okufana nalokhu njengoba kuphola. Ngezinye izikhathi lokhu kutholakala kuphela eminyakeni eminingi ngemva kokulimala.

2. Ukuzalwa: Lezi yizimo ezenzeka ngesikhathi umntwana esakhula esibelethweni. Esikhathini esiningi, lezi yi-fistula encane eminingi esikhundleni se-fistula enkulu eyodwa. Kodwa-ke, uma lokhu kwenzeka endaweni ebaluleke kakhulu (njengobuchopho), kungaba yingozi.

3. I-Dialysis: Ukuze kwenziwe i-dialysis ezigulini ezinenkinga yezinso, odokotela benza ukuhlinzwa futhi badale i-fistula ngamabomu. Lokhu kuvumela izinaliti ezixhumene nomshini we-dialysis ukuthi zilingane kahle futhi igazi ligeleze kahle. Eqinisweni, ama-fistula avame ukubonakala ngenxa yalesi sizathu.

Akuvamile kakhulu, i-fistula ingakheka ngenxa yezifo ezifana nomdlavuza, izifo ezithile, noma i-aneurysm, isimo lapho udonga lomthambo luba buthaka futhi luqhume njengebhaluni, okubangela ukucindezeleka emthanjeni oseduze.

Okubalulekile: I-Fistula ayisona isifo esithathelwanayo. Lokhu kusho ukuthi awukwazi ukuyithola komunye umuntu, futhi awukwazi ukuyidlulisela komunye umuntu.

Odokotela bakuthola kanjani lokhu? (Ukuxilongwa)

Udokotela wakho unezindlela eziningana zokuxilonga lesi simo. Ngokuvamile benza ukuhlolwa ngokomzimba kanye nokuhlolwa okukhethekile kwezithombe.

Nazi ezinye izinto okufanele uzenze ngesikhathi sokuhlolwa komzimba:

• Ukuhlolwa: Udokotela uzobheka indawo yomzimba wakho lapho ecabanga ukuthi kunenkinga, noma kwezinye izindawo ezihlobene nayo. Bazobheka ukuvuvukala, ukushintsha kombala, noma ukuvuvuka kwemithambo yegazi.
• Ukulalela: I-stethoscope isetshenziswa ukulalela i-fistula okusolwayo. Lokhu kungenxa yokuthi igazi eligeleza nge-fistula lenza umsindo ongavamile. Lingazwakala njengomshini osebenzayo, ngoba igazi ligeleza kuzo zombili izinhlangothi, hhayi nje indlela eyodwa.
• Ukushaya nge-Palpation: Ungakuzwa ukushaya kwegazi njengoba igazi ligeleza nge-fistula, okungazwakala ngokubeka isandla sakho kuyo. Udokotela angacindezela kancane endaweni. Uma ukushaya kwenhliziyo kwehla kancane lapho enza kanjalo, lokho nakho kuyisibonakaliso se-fistula.

Yiziphi izivivinyo ezenziwayo ukuze kutholakale lesi simo?

Cishe uzoba nokuhlolwa okukodwa noma ngaphezulu kwalokhu:

• I-Duplex Ultrasound: Lokhu kusebenzisa amaza omsindo avame kakhulu ukubheka ngaphakathi emzimbeni. Lokhu kufana nendlela ilulwane elisebenzisa ngayo umsindo ukuthola izinto ebumnyameni. Lokhu kungasiza ekunqumeni indawo ye-fistula kanye nobukhulu bayo.
• I-Angiogram:Kulolu vivinyo, kufakwa uketshezi olukhethekile (esilubiza ngokuthi ``udayi wokungafani``) emithanjeni yegazi, bese kuthathwa i-X-ray noma i-CT scan. Lolu ketshezi lwenza imithambo yegazi icace kakhulu, futhi kulula ukuthola noma yiziphi izindawo lapho kunenkinga khona ngokugeleza kwegazi.
• I-MRI (Magnetic Resonance Imaging): Lokhu kusebenzisa insimu enamandla yamagnetic kanye nobuchwepheshe bekhompyutha ukuthatha izithombe ezicacile kakhulu zangaphakathi lomzimba. Kungahlola nokukhubazeka okufana ne-fistula.

Yiziphi izindlela zokwelapha lokhu? Ingabe kungelapheka?

Iningi lama-fistula lingelapheka. Kuye ngokuthi imbangela ye-fistula ibangelwa yini, ubukhulu bayo, nendawo ekuyo. Nakuba ama-fistula azalwa nawo kunzima ukuwaphulukisa ngokuphelele, ngokuvamile angelapheka futhi izinkinga ezibangelwa wona zingalawulwa.

Abanye abantu bangase bangadingi ukwelashwa ekuqaleni noma ngabe bane-fistula. Ukwelashwa kuyadingeka ezimweni ezilandelayo:

• Ukopha: Uma i-fistula iyopha, ikakhulukazi uma inzima futhi ingenakuvinjelwa, kumele ilungiswe.
• Ukukhula: Uma i-fistula noma imithambo yegazi exhunywe kuyo iba mikhulu noma ishintsha isimo, ingabangela izinkinga ezicutshini ezizungezile.
• Ukuvinjelwa kokugeleza kwegazi: Uma i-fistula ivimba ukugeleza kwegazi engxenyeni yomzimba noma uma igazi lihlala endaweni eyodwa, kungabangela izinkinga ezinkulu.
• Izinguquko ekubukekeni: Abanye abantu bangase babe nokungakhululeki ngokomzwelo ngenxa yokuvuvukala nokuvuvuka kwemithambo okubangelwa yi-fistula. Ezimweni eziningi, lokhu kubonakala kungabuyiselwa esimweni uma i-fistula isilungisiwe.

Uhlobo luni lomuthi noma ukwelashwa olusetshenziswayo?

Izindlela zokwelapha ezisetshenziswa kakhulu yilezi:

• Izindlela ezisekelwe ku-catheter: Kulokhu, kufakwa idivayisi ende efana ne-tube (i-catheter) komunye wemithambo yakho emikhulu yegazi (ngokuvamile e-groin) bese iqondiswa endaweni ye-fistula. Ngemuva kwalokho, i-fistula idalwa ngaphakathi kwayo. Lokhu kungenziwa ngokufaka amadivayisi amancane njenge-coil noma ama-stents ukuvala i-fistula. Noma, uhlobo olukhethekile lwe-glue olubizwa ngokuthi i-cyanoacrylate glue lungasetshenziswa ukuvala imbobo.
• Ukuhlinzwa: Ngezinye izikhathi, uma i-fistula ingafinyelelwa ngomthambo wegazi, noma uma i-fistula inkulu kakhulu, udokotela ohlinzayo angenza ukusika okuqondile ukulungisa i-fistula. Lokhu kungabandakanya ukuhlukanisa umthambo nomthambo, noma ukuthatha ucezu lomthambo wegazi kwenye ingxenye yomzimba bese ulufaka endaweni eyonakele.
• Ukwelashwa ngemisebe: Kwezinye izimo, le ndlela isetshenziselwa ukubhubhisa ukuxhumana phakathi kwe-fistula negazi. Ukwelashwa ngemisebe kuqondiswe ngqo kwi-fistula, okubangela ukuthi ibe nesibazi. Lokhu kuvimbela igazi ukuthi ligeleze kuyo.

Imithi isetshenziselwa nokwelapha i-fistula. Uma i-fistula isengozini yokuqhekeka kwegazi, kunikezwa imithi yokunciphisa igazi. Le mithi ivimbela ukwakheka kwamahlule egazi emithanjeni yegazi, futhi ivimbela ihlule ukuthi liqhekeke futhi libhajwe ezindaweni ezifana nenhliziyo, ubuchopho, noma amaphaphu, okubangela izimo ezibulalayo njengokuhlaselwa yinhliziyo, isifo sohlangothi, noma i-pulmonary embolism .

I-Fistula ye-dialysis:

Lezi ngokuvamile azelashwa ngaphandle kokuba zibe yinkinga. Uma kuvela inkinga, ukuhlinzwa kuvame ukuba yindlela kuphela.

Izinkinga ezingaba khona noma imiphumela emibi yokwelashwa iyahlukahluka kuye ngokwelashwa, ubukhulu be-fistula, kanye nendawo ekuyo. Udokotela wakho angakuchazela lokhu ngokuningiliziwe.

Ngingazinakekela kanjani/ngiphatha kanjani izimpawu?

Awukwazi ukuxilonga lesi simo se-fistula wedwa. Ngoba ezinye zezimpawu zaso zingafana nezezinye izimo ezingathi sína, njenge-aneurysms noma amahlule egazi. Ngakho-ke, ungalokothi uzihlole futhi uzelapha. Uma udokotela wakho ekutshela ukuthi unalesi simo, uzokweluleka ukuthi ungasinakekela kanjani.

Ukuthi uzolulama ngokushesha kangakanani ngemva kokwelashwa, nokuthi kuzothatha isikhathi esingakanani ukuphulukiswa, kuzohluka kuye ngokwelashwa kanye nohlobo lwe-fistula. Udokotela wakho uzokutshela ngalokhu.

Ingabe lesi simo singancishiswa noma singavinjelwa ngokuphelele?

Eqinisweni, kunzima ukuvimbela ukwakheka kwalezi zinhlayiya. Ngoba izimbangela ezivame kakhulu ukulimala (okungewona amabomu) kanye nokuzalwa nakho. Ama-fistula adalelwe "(i-Dialysis)" adalwe ngamabomu njengosizo ekwelashweni kwakho.

Bekungenzekani uma ngiba nalesi simo? (Umbono wesikhathi esizayo)

Umphumela wakho uzoncika ngobukhulu, indawo, kanye nembangela ye-fistula. Ama-fistula amancane, noma ama-fistula atholakala ezindaweni ezimbalwa kuphela, angase angadingi ukwelashwa. Abantu abaningi bangase babe nezimpawu ezincane kuphela noma bangabi nazo nhlobo izimpawu.

Kodwa-ke, ama-fistula amakhulu, noma ama-fistula ezindaweni ezibalulekile (njengobuchopho noma inhliziyo), yiwona angabangela izinkinga kakhulu. Udokotela wakho ungumuntu ongcono kakhulu ongakhuluma nawe ngalokhu.

• Ama-fistula azalwa nawo: Uma lawa engekho endaweni eyingozi, ngokuvamile anesimo esihle sokubikezela. Kodwa-ke, uma esendaweni embi kakhulu futhi eba makhulu, angabangela izinkinga ezinkulu, ngisho nokufa.
• Ama-Fistula enzelwe i-dialysis: Lawa ngokuvamile awabangeli izinkinga. Uma kuvela imiphumela emibi, udokotela wakho angayilapha.

I-fistula ingahlala isikhathi esingakanani?

I-fistula encane ingaba khona impilo yonke, noma ngabe kunezinkinga noma cha. Kodwa-ke, uma i-fistula inzima, kubalulekile ukubona udokotela ngokushesha okukhulu. Lokhu kungenxa yokuthi i-fistula enkulu ingacindezela inhliziyo futhi iholele ekuhlulekeni kwenhliziyo.Kungenzeka. Nakuba kunezimo lapho inhliziyo ibuyela esimweni sayo esijwayelekile ngemva kokulungiswa kwe-fistula, lokhu akwenzeki njalo. Ngakho-ke, uma ukwelashwa kusheshe, kungcono.

Yini okufanele ngikhathazeke ngayo? Kufanele ngibone nini udokotela?

Uma une-fistula enezimpawu ezimbalwa noma ezingenazo nhlobo, into engcono kakhulu ongayenza ukuqaphela noma yiziphi izinguquko.

Uma une-fistula enezimpawu, udokotela wakho uzokunikeza iseluleko sokuthi ungayinakekela kanjani nokuthi yini okufanele uyiqaphele. Abanye abantu bangase batshelwe ukuthi bagqoke izingubo ezikhethekile zokucindezela. Lokhu kusiza ekunciphiseni ukwakheka koketshezi endaweni.

Bona udokotela uma uhlangabezana nalezi zimpawu:

• Ubuhlungu obusha noma ukwanda kobuhlungu obukhona.
• Ukuvuvukala okwandayo endaweni ye-fistula, ukubukeka okusha okufana neqhubu (uma ungazi ukuthi une-fistula, ukuvuvukala/iqhubu elisha elivela ngaphandle kwesizathu).
• Ukushintsha kombala engxenyeni yomzimba ekude kakhulu ne-fistula (isibonelo, uma i-fistula isesandleni, eminweni).

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

Uma umuntu onalolu hlobo lwe-fistula ebona noma yiluphi ushintsho olulandelayo endaweni, kufanele atshele udokotela wakhe ngokushesha:

• Izimpawu zokutheleleka: ukuvuvukala, ukubomvu, nokufudumala uma kuthintwa.
• Ushintsho ekusheshiseni kwegazi nge-fistula ngesikhathi sokuhlanza igazi.
• Ukuvuvukala noma ushintsho olungavamile esimweni.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Uma ubona izimpawu ezibonisa ukopha kwangaphakathi, noma uma ubona ukuthi igazi aligelezi kahle engxenyeni yomzimba wakho (ikakhulukazi engalweni noma emlenzeni), hamba esibhedlela ngokushesha.

Izici ezinjalo ziyi:

• Ukushintsha kombala wesikhumba (eduze kwe-fistula noma umzimba wonke).
• Isiyezi, ikhanda elikhanyayo.
• Ukushaya kwenhliziyo okusheshayo noma ukuphefumula.
• Ubunzima bokuphefumula.
• Ukuqala ngokuzumayo kobuhlungu obukhulu eduze kwe-fistula.

Udokotela wakho angakutshela ngezinye izimpawu ezingadinga ukwelashwa okuphuthumayo, kuye ngesimo sakho.

Ekugcineni (Umyalezo Wokuya Ekhaya)

I-arteriovenous fistula yisimo esingaba nomthelela empilweni yakho ngezinye izikhathi, kodwa ngezinye izikhathi singadala izinkinga ezinkulu. Kuvamile kakhulu kubantu abanesifo sezinso ukuba ne-fistula ehlinzwe ukuze kuhlinzwe i-dialysis, futhi kuyabazuzisa. Kodwa-ke, akuvamile ukuba kube nezinkinga ezinkulu ngenxa yalokhu. Izindaba ezinhle ukuthi ngesayensi yezokwelapha ethuthukisiwe yanamuhla, lesi simo singelashwa, futhi ngezinye izikhathi singelapheka. Ngakho-ke, uma unokungabaza noma imibuzo ngalokhu, ungangabazi ukubona udokotela futhi ukhulume naye.

I- Fistula Enemithambo Emikhulu, Ifindo Lemithambo Emikhulu, I-Tangle Yemithambo Emikhulu, I-Fistula Yokuhlanza Imithambo Emikhulu, Isifo Senhliziyo, Imithambo Yegazi, Ukuhlinzwa