Wake wezwa igama elithi "fistula"? Kungenzeka ukuthi uke walizwa kudokotela wakho noma ilungu lomndeni. Kungase kwesabe kancane ukulizwa, kodwa ungakhathazeki. Namuhla, sizoxoxa ngokuthi iyini i-fistula, ukuthi kungani yakheka, nokuthi yiziphi izindlela zokwelapha ezitholakalayo zayo ngendlela elula neqondakalayo.

Iyini i-fistula? Masiyiqonde kalula.

Kalula nje, i-fistula iwukuxhumana okusha phakathi kwezingxenye ezimbili zomzimba wethu ezingavami ukuhlangana. Kufana nomhubhe omncane. Cabanga ngakho njengomhubhe omncane phakathi kwezitho ezimbili emzimbeni wakho, noma phakathi kwemithambo yegazi emibili, noma ipayipi elivela ngaphakathi emzimbeni wakho liye ebusweni besikhumba sakho. Ngale mhubhe, izinto ezifana nobomvu, indle, kanye negazi zingaya ezindaweni emzimbeni wakho okungafanele ziye kuzo.

Esikhathini esiningi, le fistula iyinto engavamile, okungukuthi, isifo. Ngakho-ke, idinga ukwelashwa. Kodwa-ke, ngezinye izikhathi odokotela ngokwabo bakha i-fistula njengokwelashwa. Isibonelo, bakha ukuxhumana phakathi komthambo nomthambo ukuze kusizwe ekwelashweni kwe-dialysis kweziguli zezinso.

I-Fistula ingakubangela ubuhlungu futhi yenze kube nzima ukwenza imisebenzi yansuku zonke. Kodwa izindaba ezinhle ukuthi ingelashwa kaningi, ikakhulukazi ngokuhlinzwa. Kwabanye abantu, uma sebethole i-fistula, ayibuyi. Kwabanye, iyaqhubeka nokubuya, futhi ingadinga ukwelashwa izinyanga noma ngisho neminyaka. Kodwa-ke, ithimba lakho lezokunakekelwa kwempilo lizokunikeza ukwelashwa nokusekelwa okudingayo.

Ingakhula kanjani i-fistula? Yiziphi izinhlobo zayo?

Kunezinhlobo eziningana ze-fistula. Zihlukaniswa ngokuya ngokuthi zakheka kuphi. Ake sibheke izinhlobo eziyinhloko ze-fistula ezibonakala:

I-fistula yendunu

Lolu uhlobo oluvame kakhulu lwe-fistula. Lolu uhlobo lwepayipi elincane elakheka ngaphakathi kwe-anus yakho liye esikhumbeni esizungezile. Lokhu kuvame ukubangelwa ukutheleleka (`(Infection)`) noma ukuvuvukala (`(Inflammation)`) kwezindlala ezizungeze i-anus yakho, okungabangela ithumba (`(Parianal abscess)`). Njengoba kungenzeka wazi, abantu abanezimo ezithile zezokwelapha, njenge-`(Crohn's disease)`, basengozini enkulu yokuthola lolu hlobo lokutheleleka kanye ne-fistula. Lokhu kungabangela ubuhlungu lapho uhleli noma uhamba ngamathumbu, futhi ubomvu bungaphuma.

I-fistula ye-Arteriovenous (AV)

Kunezinhlobo ezimbili zemithambo yegazi emzimbeni wethu, ezibizwa ngokuthi imithambo yegazi nemithambo yegazi. Ngokuvamile, lezi ezimbili zihamba ngokwehlukana. Kodwa ku-'(AV) fistula', kwakheka ukuxhumana okuqondile phakathi komthambo nomthambo. Isizathu esiyinhloko salokhu ukulimala. Kodwa akuzona zonke '(AV) fistula' ezimbi. Njengoba kushiwo ngaphambili, odokotela bakha lolu hlobo lokuxhumana ukusiza abantu abanokwehluleka kwezinso futhi abasebenzisa '(Dialysis)'.

Ukuxhumana phakathi kwe-aorta kanye namathumbu amancane (i-Aortoenteric fistula)

Lokhu kuyingozi kakhulu futhi kungaba yingozi empilweni.Uhlobo lwe-fistula. Lokhu kuwukuxhumana phakathi kwe-aorta, umthambo wegazi oyinhloko emzimbeni wethu, kanye namathumbu amancane. Lokhu kungabangela ukuphuma kwegazi ngokweqile ohlelweni lokugaya ukudla (i-GI bleeding), okungaba yingozi ngisho noma ukuhlinzwa okuphuthumayo kungenziwa ngokushesha. Kunezinhlobo ezimbili zalokhu, okuyinhloko kanye nokwesibili. Okuyinhloko kungenzeka ngenxa yobuthakathaka bodonga lwe-aorta (i-Aortic aneurysm), umdlavuza, isifo sofuba, noma izifo ezifana ne-syphilis. Okubili kungenzeka njengomphumela ongavamile kakhulu wokuhlinzwa ohilela i-aorta.

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

Lokhu kwenzeka lapho kuvela imbobo noma ukudabuka olwelwesini oluncane oluhlukanisa indlebe yethu ephakathi nendlebe yethu yangaphakathi. Lokhu kuvumela uketshezi oluvela endlebeni yangaphakathi ukuthi luvuzele endlebeni ephakathi. Lokhu kungabangela ushintsho ekucindezelweni endlebeni, okungathinta ukuzwa kanye nokulinganisela. Iningi labantu lidinga ukuhlinzwa ukuze kulungiswe lokhu, kodwa abanye abantu bayalulama ngokuphumula embhedeni.

I-Tracheoesophageal fistula (TEF)

Lokhu kuhlobene phakathi komphimbo wethu (i-trachea) kanye nomphimbo wethu (umphimbo). Esikhathini esiningi, lesi yisimo sokuzalwa, okusho ukuthi singaba khona lapho kuzalwa. Odokotela bavame ukusixilonga futhi basiphathe lapho izingane zisesezinsana. Kodwa-ke, abanye abantu abadala nabo bangahlakulela lesi simo ngenxa yezinye izimo zezokwelapha, njengomdlavuza.

I-fistula yesitho sangasese sowesifazane

Lokhu kwenzeka lapho kwakheka imbobo odongeni lwesitho sowesifazane sangasese sowesifazane. Lo mbobo ungaxhuma isitho sangasese sowesifazane nesitho esiseduze, njengesibeletho (`(Isibeletho)`), isinyi (`(Isinyi)`), i-rectum (`(Rectum)`), ithumbu elikhulu (`(Ithumbu elikhulu)`), noma ithumbu elincane (`(Ithumbu elincane)`). Odokotela bakubiza lokhu ngokuthi ``i-Vesicovaginal fistula`` uma iphakathi kwesitho sowesifazane nesinye, kanye ``i-Rectovaginal fistula`` uma iphakathi kwesitho sowesifazane ne-rectum. I-vaginal fistula eyakheka njengenkinga ngesikhathi sokubeletha ibizwa nangokuthi ``i-Obstetric fistula``.

Okubalulekile: Ngezinye izikhathi odokotela benza i-fistula njengokwelashwa. Isibonelo yi-`(Mucous fistula)`. Kulokhu, amathumbu amancane noma amakhulu axhunywe embotsheni encane (`(Stoma)`) eyenziwe esikhumbeni sesisu. Lokhu kuyasiza kubantu abaye bahlinzwa ukuze kususwe ingxenye yamathumbu amakhulu (`(Colostomy)`) noma kubantu abaye bahlinzwa ukuze kususwe ingxenye yamathumbu amancane (`(Ileostomy)`).

Iyini i-fistula esetshenziselwa i-dialysis?

I-dialysis fistula empeleni iyi-"Arteriovenous - AV" fistula. Ngoba ixhumanisa umthambo nomthambo. Kodwa ngokungafani nezinye i-"(AV) fistula", lezi azibangelwa ukulimala ngengozi, kodwa zenziwa odokotela abahlinzayo ukuze basize ekwelashweni kwe-dialysis.

Udokotela ohlinzayo uxhuma umthambo kanye nomthambo ongalweni yakho. Lokhu kubangela ukuthi igazi eliningi ligeleze emthanjeni kunokujwayelekile. Igazi elivela emthanjeni ligeleza ngokushesha futhi licindezeleke kakhulu. Ngakho-ke uma elinye lala gazi liphambukiselwa emthanjeni, umthambo uba mkhulu kancane kancane, ubanzi, futhi uqine. Lokhu kuyinto enhle, ngoba umthambo onamandla, omkhulu ungaphatha izinaliti ezisetshenziswa ku-dialysis futhi ungawufaka futhi uwususe ngokushesha.

Uma udinga i-dialysis fistula, ithimba lakho lezokwelapha lizokuchazela izinzuzo nezinkinga futhi lizokufundisa nendlela yokunakekela i-fistula ekhaya.

Ziyini izimpawu ze-fistula?

Izimpawu ze-fistula ziyahlukahluka kuye ngohlobo. Nazi ezinye zezimpawu ongase uzizwe ngezinhlobo ezithile ze-fistula:

• I-fistula yendunu:
• Ubuhlungu obungapheli kanye nokuvuvukala okuzungeze indunu.
• Ubuhlungu lapho ukhipha indle.
• Ukuphuma kobomvu noma uketshezi olufana negazi esikhumbeni esizungeze indunu, ngezinye izikhathi okunephunga elibi.
• Ukuluma kanye nokubomvu kwesikhumba esizungeze indunu.
• Imfiva.
• I-fistula yesitho sangasese sowesifazane:
• Ukuvuza komchamo noma indle esithweni sangasese sowesifazane.
• Ukuphuma koketshezi olunuka kabi esithweni sangasese sowesifazane.
• Ukutheleleka okuvamile kwesitho sangasese sowesifazane noma kwendlela yomchamo.
• Ubuhlungu ngesikhathi socansi.
• Ubuhlungu nokulunywa kwesikhumba esizungeze isitho sangasese sowesifazane.
• I-Tracheoesophageal fistula (TEF):
• Ukukhwehlela kanye nokuphelelwa umoya lapho udla noma uphuza.
• Ukutheleleka kwesifuba okuvamile (njenge-pneumonia).
• Kumntwana, kuba luhlaza okwesibhakabhaka uma encelisa.
• I-Fistula ngaphakathi kwendlebe (`i-Perilymphatic fistula`):
• Isiyezi, umuzwa wokuzungeza.
• Ukulahlekelwa ibhalansi ngenkathi uhamba.
• Ukulahlekelwa ukuzwa.
• Ukuzwa ukukhala ezindlebeni.
• I-fistula ye-aortoenteric:
• Ubuhlungu obukhulu besisu obungazelelwe.
• Ukuhlanza igazi.
• Indle emnyama noma enegazi.
• Ukuzizwa unesizungu, ukuquleka (ngenxa yokopha).
• Imfiva.

Uma unesinye noma ngaphezulu salezi zimpawu, qiniseka ukuthi ubona udokotela.

Yiziphi izimbangela zokwakheka kwe-fistula?

Izimbangela zokwakheka kwe-fistula ziyahlukahluka kuye ngohlobo. Ngokuvamile, ukwakheka kwe-fistula kungabangelwa okulandelayo:

• Ukuvuvukala kanye/noma Ukutheleleka: Lokhu ngokuvamile kuyimbangela eyinhloko.
• Ukulimala noma ukulimala kwengxenye yomzimba: Ezinye izingozi zingavela ngesikhathi sokuhlinzwa.
• Njengomphumela ongemuhle wokuhlinzwa ('Inkinga yokuhlinzwa'): Ama-fistula awavamile ukuvela ngemva kokuhlinzwa okuthile.
• Njengomphumela ongemuhle wokwelashwa: Isibonelo, ukwelashwa ngemisebe yomdlavuza.
• Izinguquko ezenzeka ngesikhathi sokukhula kombungu: Lokhu kusho ukuthi izinkinga zenzeka ngesikhathi umntwana esesesibelethweni.

Udokotela uyixilonga kanjani i-fistula?

Nansi indlela odokotela abaxilonga ngayo i-fistula:

1. Khuluma nawe ngezimpawu zakho: buza ukuthi uzizwa kanjani nokuthi usunesikhathi esingakanani unalezi zinkinga.

2. Ukuhlolwa ngokomzimba: Kuzohlolwa ngokomzimba ukuze kubonakale ukuthi i-fistula iyabonakala yini, noma izindawo ezithile zomzimba zizohlolwa (ngemvume yakho).

3. Ukuhlolwa okwengeziwe: Ukuhlolwa kwenziwa ukuze kutholakale ukuthi kwenzekani ngaphakathi emzimbeni.

Yiziphi izivivinyo ezenziwayo?

Lezi zivivinyo zingasiza odokotela ukuthi baqonde kangcono okwenzekayo emzimbeni wakho. Ngisho noma usola ukuthi une-fistula ngokusekelwe ezimpawini ozichazayo, amanye ama-fistula awabonakali. Ngakho-ke izivivinyo ezingathatha izithombe zezitho zakho zangaphakathi zingasiza ekutholeni ngalezi zinto:

• Uhlobo luni lwe-fistula onalo?
• Kukuphi ngempela?
• Yaba namuphi umphumela ezicutshini ezizungezile?

Ukuhlolwa okudingeka ukwenze kuzoncika ohlotsheni lwe-fistula onayo. Udokotela wakho uzokutshela ngakho. Kodwa-ke, ungase ucelwe ukuthi wenze ukuhlolwa okulandelayo:

• Ukuhlolwa kwegazi noma komchamo: Hlola ukuvuvukala noma ukutheleleka.
• Ama-X-ray, ama-CT scan (ama-computed tomography scan) noma i-MRI (magnetic resonance imaging): Bheka izingxenye ezahlukene zomzimba.
• I-ultrasound ye-Endoscopic: Bheka ngaphakathi kwesistimu yokugaya ukudla.
• I-sigmoidoscopy eguquguqukayo noma i-colonoscopy: Bheka ngaphakathi kwamathumbu amakhulu.
• I-Cystoscopy: Bheka ngaphakathi kwesinye kanye ne-urethra.
• I-Bronchoscopy noma i-Endoscopy: Bheka ngaphakathi kwemigudu yomoya (i-endoscopy lapha isho imigudu yomoya).
• I-Angiogram: Ukuhlola ukuvaleka kwemithambo yegazi.

Yiziphi izindlela zokwelapha i-fistula?

Izindlela zokwelapha ezivame kakhulu ze-fistula imithi kanye/noma ukuhlinzwa. Udokotela wakho uzokutshela ukuthi yikuphi ukwelashwa okulungele isimo sakho.

Isibonelo, udokotela wakho angase akunike imithi yokunciphisa ukuvuvukala noma ukushintsha indlela amasosha omzimba wakho asebenza ngayo. Le mithi ingelapha imbangela eyinhloko ye-fistula. Uma unegciwane elisebenzayo, unganikezwa ama-antibiotic. Uma imithi ingasebenzi, noma uma imithi yodwa inganele, ungadinga ukuhlinzwa.

Ake sifunde ngokuhlinzwa kwe-fistula.

Ukuhlinzwa kwe-Fistula kuyinqubo elungisa ukuxhumana okungavamile phakathi kwezingxenye ezimbili zomzimba. Lokhu kungasiza ekunciphiseni izimpawu zakho futhi kuvimbele izinkinga zesikhathi esizayo. Imininingwane yokuhlinzwa izohluka kakhulu kuye ngohlobo lwe-fistula onayo, usayizi wayo, kanye nendawo ekuyo. Okunye ukuhlinzwa kwe-fistula kulula kakhulu, kodwa okunye kuyinkimbinkimbi. Uma une-fistula eyinkimbinkimbi, kungadingeka ukuthi uhlinzwe kaningana.

Khumbula, ukuhlinzwa kwe-rectal fistula kuhluke kakhulu ekuhlinzeni i-ear fistula. Ngakho-ke ithimba lakho lezokwelapha lizokuchazela ngokuhlinzwa, izingozi ezihilelekile, kanye nesikhathi sokululama.

Kwenzekani uma une-fistula? Yini ongayilindela

I-Fistula ivame ukwelashwa kalula, kodwa kufanele ubonane nodokotela ukuze uqale ukwelashwa. Amakhambi asekhaya noma ukulinda izimpawu ziphele zodwa ngeke kusize. Uma uzizwa noma ubona into engavamile, bonana nodokotela ngokushesha.

Udokotela wakho uzokutshela ukuthi yini ongayilindela ngokusekelwe esimweni sakho. Ngezinye izikhathi, ngemva kokwelashwa, inkinga izophela ngokuphelele futhi ungakhohlwa ngayo. Kodwa ngezinye izikhathi i-fistula noma ukutheleleka kungabuya. Khona-ke ungase udinge ukwelashwa okwengeziwe noma olunye ukuhlinzwa. Lokhu kungaba ukucindezeleka okukhulu. Kodwa udokotela wakho uzokusiza kuzo zonke izinyathelo futhi achaze ukuthi kungani lezi zinto zenziwa.

Ingabe ukwakheka kwe-fistula kungavinjelwa?

Akukho esingakwenza ukuvimbela ukwakheka kwe-fistula eminingi. Ibangelwa ukulimala noma izifo esingenakuzilawula.

Kodwa-ke, odokotela ngezinye izikhathi bangavimbela i-obstetric fistula, okuyinkinga yokubeletha. Lolu hlobo lwe-fistula lungavela lapho umntwana ezalwa sekwephuzile noma uma ukunakekelwa kwezokwelapha okuphuthumayo (njengokuhlinzwa ngokuhlinzwa) kunganikezwa ngesikhathi. Emazweni afana neSri Lanka, izinkinga ezinjalo azivamile ngoba odokotela banakekela kahle umama nomntwana ngesikhathi sokubeletha. Kodwa-ke, lezi zikhungo azifani yonke indawo emhlabeni. Izinhlangano ezifana ne-World Health Organization (WHO) zizama ukuvimbela i-obstetric fistula ngokuthuthukisa izikhungo zezokwelapha.

Ngizinakekela kanjani? Impilo yengqondo nayo ibalulekile!

Ukuphila ne-fistula kungaba yinselele, ikakhulukazi uma une-fistula eyinkimbinkimbi, uke wahlinzwa kaningi, noma unezifo ezingapheli. Kuyaqondakala ukuthi ugxile emzimbeni wakho njengamanje. Kodwa ungakhohlwa ukucabanga nangempilo yakho yengqondo.

Kunezizathu eziningi zokuthi kungani ungase uzizwe ucindezelekile noma ukhathazekile. Ungase ucabange:

• Ingabe ukwelashwa kuzophumelela?
• Ingabe i-fistula izophinde ivele?
• Ngizizwa ngendlela ehlukile ngomzimba wami.
• Lokhu kuthinta kanjani ubudlelwano bami bomuntu siqu?

Kuvamile ukuzizwa lezi zinto, futhi imizwa yakho ibalulekile. Kodwa ungathwali lo mthwalo wedwa. Khuluma nodokotela wakho ngendlela ozizwa ngayo. Angase akwazi ukukudlulisela enkonzweni efana nokwelulekwa, noma emaqenjini okusekela lapho abanye abantu abane-fistula bengahlangana khona. Abanye abantu abadlula entweni efanayo nawe bazoyiqonda futhi bangakusiza ukuthi uqhubekele phambili.

Yiziphi izikhathi ezinhle kakhulu zokubona udokotela?

Uma unezimpawu ze-fistula, noma ubona noma yini engavamile, xhumana nodokotela ngokushesha.

Uma usuvele uthola ukwelashwa kwe-fistula, shayela udokotela wakho noma nini:

• Uma kuvela uphawu olusha, noma uma izimpawu ezikhona zishintsha.
• Uma unemibuzo mayelana nohlelo lwakho lokwelashwa.
• Uma kuvela izimpawu ezintsha ngemva kokuhlinzwa, noma uma izimpawu zangaphambilini zibuya.

Imibuzo ebalulekile okufanele uyibuze udokotela wakho

Uma uya kudokotela wakho, kungaba usizo ukubuza imibuzo efana nale:

• Uhlobo luni lwe-fistula enginalo?
• Yini engingayenza ukuze ngiphathe izimpawu ekhaya?
• Yiziphi izindlela zokwelapha enginazo?
• Ziyini izingozi zokuhlinzwa?
• Kuzothatha isikhathi esingakanani ukuphulukiswa?
• Yini okufanele ngiyenze futhi yini okungafanele ngiyenze ngesikhathi sokululama?
• Iyini amathuba okuthi i-fistula iphinde ivele?
• Yini engingayenza ukuze ngivimbele ukwakheka kwe-fistula esikhathini esizayo?

Kungenzeka ukuthi awukaze uzwe nge-fistula ngaphambili, kodwa kungenzeka ukuthi ubulokhu ucabanga ngayo selokhu wathola ukuthi unayo. I-fistula ingaphazamisa imisebenzi yakho yansuku zonke futhi ithinte umuzwa wakho wokuzibona. Ngenhlanhla, ukwelashwa kungakusiza ukuthi uphinde ulawule izingxenye zomzimba wakho ozizwa sengathi ulahlekelwe ukuzilawula. Kodwa-ke, ukululama kungathatha isikhathi. Udokotela wakho angakutshela okwengeziwe ngalokhu futhi akunikeze noma yiluphi usizo ongase uludinge.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

• I-Fistula akuyona into okufanele uyesabe, kodwa yisimo esidinga usizo lwezokwelapha ngokushesha.
• Uma unezimpawu ze-fistula, xhumana nodokotela ngokushesha.
• Izinhlobo eziningi ze-fistula zingelashwa ngempumelelo, ikakhulukazi ngokuhlinzwa.
• Inqubo yokwelashwa ingathatha isikhathi, kodwa ngokubekezela nangokulandela imiyalelo kadokotela wakho, ungalulama.
• Impilo yakho yengqondo ibaluleke njengempilo yakho engokomzimba. Unganqikazi ukucela usizo uma uludinga.

Ngithemba ukuthi lolu lwazi luwusizo. Hlala uphilile!

i- fistula, i-anal fistula, i-AV fistula, i-vaginal fistula, izimpawu ze-fistula, ukwelashwa kwe-fistula, ukuhlinzwa kwe-fistula