Arteriovenous Fistula

Fistula ye arteriovenous (AV) ndeyekubatanidza kwakashata pakati pe artery nevein. Kazhinji, ropa rinoyerera kubva ku arteries kuenda ku midziyo midiki yeropa (capillaries), uye zvino kuenda ku veins. Zvinovaka muviri uye oxygen iri muropa zvinofamba kubva ku capillaries kuenda kumatishu emuviri.

Ne fistula ye arteriovenous, ropa rinoyerera zvakananga kubva ku artery kuenda ku vein, richisiya mamwe capillaries. Kana izvi zvikaitika, matishu ari pasi pe capillaries akasiiwa anowana ropa shoma.

Arteriovenous fistulas duku mudumbu, maoko, mapapu, itsvo kana uropi kazhinji haina zviratidzo kana zviratidzo. Arteriovenous fistulas duku kazhinji hadidi kurapwa kunze kwekutarisa nevanopa utano. Arteriovenous fistulas huru dzinogona kukonzera zviratidzo nezviratidzo.

Zviratidzo nezviratidzo zveArteriovenous fistula zvinogona kusanganisira:

• Mitsipa ine ruvara rwepepuru, inobuda kunze kwe ganda, yakafanana nevaricose veins
• Kuchema mumaoko kana makumbo
• Kudonha kweropa
• Kuneta
• Kukundikana kwemoyo

Arteriovenous fistula inokosha mumapapu (pulmonary arteriovenous fistula) chirwere chakakomba uye chinogona kukonzera:

• Miromo kana misumari ine ruvara rwegoridhe kana rebhuruu nekuda kwekushomeka kweropa (cyanosis)
• Minwe yekubata inopararira uye inova yakakombama kupfuura kazhinji (clubbing)
• Kukosora ropa

Arteriovenous fistula mudumbu rinogona kukonzera ropa mudumbu (GI bleeding).

Kana uine zviratidzo zve arteriovenous fistula, gara wakaita appointment kuti uone chiremba wako. Kuonekwa kwekukurumidza kwe arteriovenous fistula kunogona kuita kuti chirwere chive nyore kurapwa. Zvinogona kuderedzawo njodzi yekuwana matambudziko, kusanganisira ropa rinogwamba kana kuita kwenhengo dzemwoyo.

Arteriovenous fistulas inogona kuvapo kubva pakuzvarwa (congenital) kana kuti inogona kuitika gare gare muhupenyu (yakawanikwa). Zvinokonzera arteriovenous fistulas zvinosanganisira:

• Kukuvadzwa kunobaya ganda. Arteriovenous fistula inogona kubva pakupfura pfuti kana kuvhunduka kwakaita munzvimbo yemuviri umo tsinga neropa zviri padivi nepadivi.
• Congenital arteriovenous fistulas. Muvana vamwe, arteries nemidziyo yeropa hazvibudiriri zvakanaka mudumbu. Hazvina kujeka kuti nei izvi zvichiitika.
• Zvirwere zvemagwenya. Arteriovenous fistulas mumapapu (pulmonary arteriovenous fistulas) inogona kukonzerwa nechirwere chemagwenya chinoita kuti pave nemidziyo yeropa isina kujairika mumuviri wose, asi kunyanya mumapapu. Imwe yezvirwere izvi ndeye Osler-Weber-Rendu chirwere, chinozivikanwawo se hereditary hemorrhagic telangiectasia.
• Kuongororwa-kwakabatana nekuvhiya. Vanhu vane kutadza kweitsvo kwenguva refu vanogona kuita kuvhiya kuti vagadzire arteriovenous fistula mu forearm kuti zvive nyore kuita dialysis.

Zvimwe zvirwere zvemagwenya kana zvekuzvarwa zvinoita kuti mukana wekuve ne arteriovenous fistulas uwane. Zvimwe zvinhu zvinogona kukonzera arteriovenous fistulas zvinosanganisira:

• Uchuru
• Bonde rechikadzi
• Cardiac catheterization, kunyanya kana nzira yacho ichibatanidza ropa midziyo iri muchiuno
• Mishonga yakati wandei, kusanganisira vamwe vanoderedza ropa (anticoagulants) uye mishonga inoshandiswa kudzora kubuda kweropa (antifibrinolytics)
• Kuderera kweropa
• Kuwedzera kwehuremu hwemuviri (BMI)

Kana isina kurapwa, arteriovenous fistula inogona kukonzera matambudziko. Mamwe matambudziko anogona kuva akakomba. Aya anosanganisira:

• Kukundikana kwemoyo. Iri ndiro dambudziko rakakomba kwazvo re arteriovenous fistulas huru. Ropa rinoyerera nekukurumidza kuburikidza ne arteriovenous fistula kupfuura zvarinoita kuburikidza nemidziyo yeropa yakajairwa. Kuyerera kweropa kwakawedzera kunoita kuti moyo uomese basa. Kufamba kwenguva, kunetseka kwemoyo kunogona kutungamira pakukundikana kwemoyo.
• Zvidzitiro zveropa. Arteriovenous fistula mumitsipa inogona kukonzera kuti zvidzitiro zveropa zviumbwe. Zvidzitiro zveropa mumitsipa zvinogona kutungamira pakuvapo kwechirwere chinonzi deep vein thrombosis (DVT). Deep vein thrombosis (DVT) inogona kutyisidzira hupenyu kana clot ikasvika mapapu (pulmonary embolism). Zvichienderana nekuti fistula iri kupi, inogona kutungamira kurohwa neropa.
• Kurwadziwa kwemitsipa nekuda kwekushayikwa kweropa (claudication). Arteriovenous fistula inogona kudzivirira kuyerera kweropa kune tsandanyama, zvichikonzera kurwadziwa kwemitsipa.
• Kubuda ropa mukati. Arteriovenous fistulas inogona kukonzera kubuda ropa mudumbu nemarunda.

Kuongorora arteriovenous fistula, mushandi wekuchengetedza utano angashandisa stethoscope kuteerera kuyerera kweropa mumaoko nemakumbo. Kuyerera kweropa kuburikidza ne arteriovenous fistula kunoburitsa inzwi rinofananidzwa nehumming.

Kana mushandi wako achifunga kuti une fistula, bvunzo dzakawanda dzinoitwa kazhinji kusimbisa chirwere. Bvunzo dzekuongorora arteriovenous fistula dzinogona kusanganisira:

• Duplex ultrasound. Duplex ultrasound ndiyo nzira inonyanya kushanda uye inowanzo shandiswa yekutarisa arteriovenous fistula mumakumbo kana maoko. Mu duplex ultrasound, mafungu esound anoshandiswa kuongorora kumhanya kweropa.
• Computerized tomography (CT) angiogram. Iyi bvunzo yekufananidzira inogona kuratidza kana kuyerera kweropa kuchipfuura capillaries. Dye (contrast) inopiwa ne IV yeiyi bvunzo. Dye inobatsira ropa kuoneka zviri nani pamifananidzo.
• Magnetic resonance angiography (MRA). Iyi bvunzo inogona kuitwa kana uine zviratidzo zve arteriovenous fistula yakadzika pasi peganda. Kufanana ne MRI, magnetic resonance angiography (MRA) inoshandisa magnetic field nema radio waves kugadzira mifananidzo yematishu emuviri. Dye (contrast) inopiwa ne IV kubatsira ropa kuoneka zviri nani pamifananidzo.

Kana fistula ye arteriovenous iri duku uye haina kukonzera matambudziko mamwe ehutano, kuongororwa kwakanyanya nemunyanzvi wehutano kungave ndiwo chete kurapwa kunodiwa. Mamwe mafistula madiki e arteriovenous anovharwa ega pasina kurapwa.

Kana fistula ye arteriovenous ichida kurapwa, mushandi wako anogona kukurudzira:

• Kuomeswa kunotungamirwa ne ultrasound. Izvi zvinogona kuva sarudzo ye fistula ye arteriovenous iri mumakumbo inoratidzika nyore nyore pa ultrasound. Mukurapwa uku, probe ye ultrasound inomanikidzwa pasi pa fistula kweanenge maminitsi gumi. Kuomeswa kunoparadza kuyerera kweropa ku ropa rakakuvara.
• Catheter embolization. Mukudzidziswa uku, chubhu chakanaka, chinopindika (catheter) chinopinzwa mu artery iri pedyo ne fistula ye arteriovenous. Zvadaro, coil duku kana stent inoiswa panzvimbo ye fistula kuti iite kuti ropa riyerere. Vanhu vazhinji vane catheter embolization vanogaramo muchipatara kwezuva risati rapera uye vanogona kudzokera kumabasa avo zuva nezuva mukati mevhiki.
• Kuvhiya. Mafistula makuru e arteriovenous ausingakwanisi kurapwa ne catheter embolization anogona kuda kuvhiya. Rudzi rwekuvhiya runodiwa runotsamira pakukura nekukosha kwe fistula ye arteriovenous.