Ukuthini i-Arteriovenous Fistula? Izimpawu, Izimbangela, & Ukwelashwa

I-arteriovenous fistula iyixhumi eliyingozi phakathi kwe-artery ne-vein elikhuluphula inethiwekhi evamile ye-capillary. Cabanga ngakho njengendlela emfishane evumela igazi ukuthi ligele ngqo kusuka kwi-artery enesondo elikhulu liye kwi-vein enesondo eliphansi ngaphandle kokudlula ezitsheni ezincane ezihlanganisa ngokuvamile.

Le simo singase sibe khona ngokwemvelo ngenxa yokulimaza noma izimo zezokwelapha, noma singase senziwe ngokusebenza kwezokwelapha njengokufinyelela kwe-dialysis. Nakuba igama lingase lizwakale liyinkimbinkimbi, ukuqonda ukuthi kwenzekani emzimbeni wakho kungakusiza uzizwe ukhulu ekuphatheni le simo.

Ziyini izimpawu ze-arteriovenous fistula?

Izimpawu ozibonayo ziyahluka kuye ngokuthi i-fistula ikuphi nobukhulu bayo. Abantu abaningi abane-fistulas ezincane bangase bangabona zimpawu nhlobo, kuyilapho ezinkulu zingabangela ushintsho oluqaphelekayo endleleni ozizwa ngayo.

Nazi izimpawu ezivame kakhulu ongazihlangabezana nazo:

• I-whooshing noma i-buzzing ehlala njalo (ebizwa ngokuthi i-bruit) ongayizwa endaweni ye-fistula
• Ukukhula kwendawo ethintekile, ikakhulukazi ezandleni noma emilenzeni yakho
• Ukuzwa okuphumayo noma ukuphuma okubonakalayo ngaphansi kwesikhumba sakho
• Isikhumba esifudumele ukuthinta phezu kwe-fistula
• Ukukhathala noma ukuzizwa ukhathele kakhulu ngesikhathi semisebenzi yansuku zonke
• Ukuphefumula okufushane, ikakhulukazi ngesikhathi somsebenzi womzimba
• Ukuphefumula okusheshayo noma ukuzizwa sengathi inhliziyo yakho igija

Izimpawu ezingavamile kodwa ezingathi sína zingabandakanya ubuhlungu esifubeni, ukukhungatheka, noma ukulahlekelwa yikwazi. Lezi zimpawu zivame ukuvela kancane kancane, ngakho ungase ungaziboni ngokushesha. Uma uhlangabezana nanoma yiziphi izimpawu ezikukhathazayo, kubalulekile ukuxoxa nazo nodokotela wakho.

Ziyini izinhlobo ze-arteriovenous fistula?

I-Arteriovenous fistulas ngokuvamile ihlukaniswe izigaba ezimbili eziyinhloko kuye ngokuthi zithuthukisa kanjani. Ukuqonda lezi zinhlobo kungakusiza uqonde kangcono isimo sakho esithile.

I-fistulas etholakele ithuthuka ngemva kokuzalwa ngenxa yokulimaza, izinqubo zezokwelapha, noma isifo. Lolu uhlobo oluvamile kakhulu futhi lungabangelwa ukulimala okuthungayo, izinkinga zokusebenza, noma izimo zezokwelapha ezithile ezibuthakathaka izindonga zezitsha zegazi.

I-fistulas ezelwe nayo ikhona kusukela ekuzalweni futhi ivela ngesikhathi sokuthuthukiswa kwesisu. Lezi azivamile futhi zingaba yingxenye yezindlela ezinkulu zokungasebenzi kahle kwe-vascular. Ezinye i-fistulas ezelwe nayo zincane kangangokuba azibangeli lutho, kuyilapho ezinye zingadinga ukwelashwa.

I-fistulas ezenziwe ngokusebenza imelela isigaba esikhethekile lapho odokotela benza ngamabomu uxhumano. Isibonelo esivamile kakhulu yi-arteriovenous fistula ezenziwe engalweni yakho yokufinyelela kwe-dialysis, evumela ukuhlanzwa kwegazi okuphumelelayo ngesikhathi sokwelashwa kwesibindi.

Yini ebangela i-arteriovenous fistula?

Izici eziningi zingadala ukuthuthukiswa kwe-arteriovenous fistula. Ukuqonda lezi zimbangela kungakusiza uqaphele izimo ezingaba yingozi futhi wenze izinqumo ezilwemi mayelana nempilo yakho.

Izimbangela ezivamile zihlanganisa:

• Ukulimala okuthungayo okuvela ezingozi, ekuwa, noma udlame olulimaza kokubili i-artery ne-vein eseduze
• Izinqubo zezokwelapha njenge-cardiac catheterization, i-biopsy, noma ukufakwa kwe-central line
• Izinkinga zokusebenza ngesikhathi sokusebenza eduze kwezitsha zegazi ezinkulu
• Isifo sesibindi esingapheli esidinga ukuqhuma okuphindaphindayo kwe-needle ye-dialysis
• Ukutheleleka okuthile okubuthakathaka izindonga zezitsha zegazi ngokuhamba kwesikhathi
• Izifo ze-connective tissue ezithinta amandla ezitsha zegazi

Izimbangela ezingavamile zingabandakanya izimo ezithile ze-genetic, i-tumors ezihlasela izitsha zegazi, noma izinkinga ezivela ekwelapheni kwe-radiation. Kwezinye izimo, imbangela eqondile ihlala ingaziwa, okungase kuzwakale kuyadumaza kodwa akusishintshi isendlela yokwelapha.

Kubalulekile ukuqaphela ukuthi izinqubo eziningi zezokwelapha zinezingozi ezincane kakhulu zokwakheka kwe-fistula. Iqembu lakho lokunakekelwa kwezempilo lithatha izinyathelo eziningi ngesikhathi sezinqubo ukuze linciphise lezi zingozi ngenkathi liqinisekisa ukuthi uthola ukunakekelwa okudingekayo.

Nini okufanele ubona udokotela nge-arteriovenous fistula?

Kufanele uxhumane nodokotela wakho uma uqaphela noma yiziphi izimpawu ezingavamile, ikakhulukazi ngemva kokulimaza noma inqubo yezokwelapha. Ukubheka kwangaphambi kwesikhathi kungasiza ukuvimbela izinkinga futhi kuqinisekise ukwelashwa okufanele.

Funani ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nobuhlungu esifubeni, ukuphefumula okufushane kakhulu, ukulahlekelwa yikwazi, noma izimpawu zokwehluleka kwenhliziyo njengokwanda kwesisindo ngokushesha noma ukukhula okukhulu. Lezi zimpawu zingase zibonise ukuthi i-fistula ithonya ikhono lenhliziyo yakho lokupompa igazi ngokuphumelelayo.

Hlela i-aphoyintimenti yokuhlinzwa uma uqaphela ukukhula okuqhubekayo, ukuzwa okusha okuphumayo, imisindo engavamile evela emzimbeni wakho, noma ukukhathala okulokhu kuya kubi. Ngisho noma izimpawu zibonakala zingenamandla, kungcono ukuthi zihlolwe kunokulinda ubona uma ziya kubi.

Uma une-fistula ezenziwe ngokusebenza ye-dialysis, landela imiyalo ethile yeqembu lakho lokukhathalela impilo yokubeka amehlo nokuthumela izinguquko. Bazokufundisa ukuthi yini okufanele uyibheke nokuthi nini kufanele ucele usizo.

Ziyini izici ezingaba yingozi ze-arteriovenous fistula?

Izici ezithile zingandisa amathuba akho okukhula kwe-arteriovenous fistula. Ukuqaphela lezi zici ezingaba yingozi kungakusiza uhlale uqaphile izimpawu futhi uthathe izinyathelo ezifanele.

Izici ezingaba yingozi zezokwelapha zihlanganisa:

• Isifo sesibindi esingapheli esidinga i-dialysis noma izinqubo ezivamile zezokwelapha
• Isifo senhliziyo noma izimo ezidinga i-cardiac catheterization
• Izifo ze-connective tissue njenge-Ehlers-Danlos syndrome
• Umbhalo wokuhlinzwa kwezitsha zegazi noma ukungenelela
• Izimo ezithile ze-genetic ezithinta ukuthuthukiswa kwezitsha zegazi
• Ukwelashwa komdlavuza okuhlanganisa ukwelashwa kwe-radiation eduze kwezitsha zegazi ezinkulu

Izici zesitayela sokuphila nezimo ezingase zikhulise ingozi zihlanganisa ukuhlanganyela emisebenzini engozi enenkinga yokulimaza okuthungayo, imisebenzi ethile enokubekwa kwe-trauma, kanye nezinqubo ezivamile zezokwelapha noma ukungena esibhedlela.

Ubudala bungase futhi bube nomthelela, njengoba izitsha zegazi zingase zibe buthakathaka ngokuhamba kwesikhathi. Noma kunjalo, i-arteriovenous fistulas ingase ivela kunoma yiliphi izinga, futhi ukuba nezici ezingaba yingozi akusho ukuthi uzokuthuthukisa ngokuqinisekile.

Ziyini izinkinga ezingase zenzeke nge-arteriovenous fistula?

Nakuba i-arteriovenous fistulas eminingi ibangela izinkinga ezincane, ezinye zingadala izinkinga ezithinta impilo yakho yonke. Ukuqonda lezi zinkinga ezingase zenzeke kungakusiza uqaphele ukuthi nini kufanele ucele ukunakekelwa kwezokwelapha.

Izinkinga ezivamile zihlanganisa:

• Ukuhlupheka kwenhliziyo ngenxa yokwanda kokugelela kwegazi, okungase kuholele ekukhuleni kwenhliziyo ngokuhamba kwesikhathi
• Ukwehluleka kwenhliziyo okuphezulu uma i-fistula inkulu futhi ihlukanisa ukugelela kwegazi okukhulu
• I-blood clots eyenziwe ngokuxhumana okungalungile
• Ukutheleleka endaweni ye-fistula, ikakhulukazi nge-fistulas ezenziwe ngokusebenza
• Ukukhula kwelungu lomzimba nezinkinga zokugelela
• Izinkinga zokopha ngesikhathi sezinqubo zezokwelapha

Izinkinga ezingavamile kodwa ezingathi sína zingabandakanya i-stroke uma i-blood clots ihamba ebuchosheni, ukungasebenzi kahle kwenhliziyo okukhulu, noma izinkinga zokugelela ezisongela ilungu lomzimba. Lezi zinkinga zivame kakhulu nge-fistulas ezinkulu noma lezo eziye zasale zingalashwa isikhathi eside.

Izindaba ezinhle ukuthi ngokubeka amehlo okufanele nokwelashwa, izinkinga eziningi zingavikeleka noma ziphathwe kahle. Iqembu lakho lokukhathalela impilo lizokusebenza nawe ukuze linciphise lezi zingozi ngenkathi ligcina impilo yakho yonke.

I-arteriovenous fistula ingavikeleka kanjani?

Nakuba ungakwazi ukuvimbela zonke i-arteriovenous fistulas, ikakhulukazi ezelwe nayo, kunezinyathelo ongazithatha ukuze unciphise ingozi yakho ye-fistulas etholakele. Ukuvimbela kugxile ekunciphiseni i-trauma nokulandela izincomo zezokwelapha ngokucophelela.

Amasu okuvimbela avamile ahlanganisa ukugqoka imishini yokhuseleko efanele ngesikhathi semisebenzi engozi, ukulandela izinqubo zokuphepha emsebenzini, nokufuna ukunakekelwa kwezokwelapha ngokushesha kunoma yiliphi ukulimala okuthungayo eduze kwezitsha zegazi.

Uma uthola izinqubo zezokwelapha, khetha abahlinzeki bezempilo abanolwazi kanye nezindawo uma kungenzeka. Landela yonke imiyalo yangaphambi kwenqubo nangemuva kwenqubo ngokucophelela, kuhlanganise nokunciphisa imisebenzi kanye nemiyalo yokunakekelwa kwezilingo.

Kubantu abanezimo ezingapheli ezidinga izinqubo ezivamile, sebenzani eduze neqembu lakho lokukhathalela impilo ukuze linciphise izingozi ezihlanganisiwe. Lokhu kungase kuhlanganise ukujikeleza izindawo zezinqubo, ukusebenzisa imishini emincane efanele, noma ukucabangela izindlela ezihlukile zokwelapha uma zitholakala.

Ukugcina impilo enhle yenhliziyo ngokuzivocavoca okuvamile, ukudla okulinganiselayo, nokuphatha izimo ezifana nesifo sikashukela kanye nokuphakama kwegazi kungasiza ukugcina izitsha zakho zegazi ziphilile futhi zikhuthazele ukukhathala.

I-arteriovenous fistula ihlonishwa kanjani?

Ukuhlonishwa kwe-arteriovenous fistula ngokuvamile kuqala ngodokotela wakho olalela izimpawu zakho futhi ahlole indawo ethintekile. Bazosebenzisa i-stethoscope ukulalela umsindo we-whooshing ovamile futhi bazizwe bephuma noma ukuzamazama okungavamile.

Ivivinyo lokuhlola elivamile kakhulu yi-duplex ultrasound, esebenzisa amaza omsindo ukwenza izithombe zokugelela kwegazi ngezitsha zakho. Le nqubo engahluphiyo ingabonisa indawo nobukhulu be-fistula futhi isize udokotela wakho ahlele ukwelashwa.

Ivivinyo elengeziwe lingase lihlanganise i-CT angiography noma i-MR angiography, enikeza izithombe eziningiliziwe zezitsha zakho zegazi usebenzisa i-contrast dye. Lezi zilingo zisiza ukuqamba ngokuqondile i-anatomy futhi zithole indlela engcono kakhulu yokwelapha.

Kwezinye izimo, udokotela wakho angase acele ukuhlolwa kwenhliziyo njenge-echocardiogram ukuhlola ukuthi i-fistula ithonya kanjani umsebenzi wenhliziyo yakho. Izivivinyo zegazi zingasiza ukuhlola impilo yakho yonke futhi zithole noma yiziphi izinkinga.

Inqubo yokuhlola ngokuvamile ilula futhi ayihluphi. Iqembu lakho lokukhathalela impilo lizokuchaza yonke imilingo nokuthi yini abayifuna, likusize uzizwe ulungile futhi ulwemi kulo lonke ukuhlola.

Ukuphathwa kwe-arteriovenous fistula kuyini?

Ukuphathwa kwe-arteriovenous fistula kuncike ezintweni eziningi ezihlanganisa ubukhulu, indawo, imbangela, kanye nezimpawu ozibonayo. Akuzona zonke i-fistulas ezidinga ukwelashwa, futhi udokotela wakho uzo sebenza nawe ukuze unqume indlela engcono kakhulu yesimo sakho esithile.

I-fistulas encane, engabonakaliyo ingase ibekwe amehlo nje ngokuhlola okuvamile kanye nezivivinyo zezithombe. Udokotela wakho uzobheka noma yiziphi izinguquko ebukhoneni noma izimpawu ezingase zibonise isidingo sokungenelela.

Ngokuphathelene ne-fistulas edinga ukwelashwa, izinketho zihlanganisa:

• Izinqubo ezincane ezingekho emzimbeni njenge-balloon occlusion noma ukufakwa kwe-stent
• Ukulungiswa kokusebenza ukuvala uxhumano olungalungile
• Ukusebenza kwe-bypass ukuqondisa ukugelela kwegazi eduze kwe-fistula
• Imithi yokuphatha izinkinga ezihlobene nenhliziyo
• Ukucindezela ukwelashwa ngokukhula nokukhathazeka kokugelela

Ukukhethwa kokwelashwa kuncike empilweni yakho yonke, izici ze-fistula, kanye nezifiso zakho siqu. Iqembu lakho lokukhathalela impilo lizoqala izinzuzo nezingozi zeminye izinketho, likusize wenze isinqumo esilwemi mayelana nokukhathalelwa kwakho.

Ukuphulukisa kuyahluka kuye ngokwelashwa okukhethiwe, kodwa abantu abaningi bangabuyela emisebenzini evamile phakathi kwamasonto ambalwa kuya ezinyangeni. Udokotela wakho uzonikeza imiyalo ethile yesimo sakho.

Indlela yokuphatha i-arteriovenous fistula ekhaya?

Ukuphatha i-arteriovenous fistula yakho ekhaya kuhlanganisa ukulandela imiyalo ethile yomhlinzeki wakho wezempilo ngenkathi ubeka amehlo kunoma yiziphi izinguquko esimweni sakho. Ikhona ukuba uqaphele izimpawu ngenkathi ugcina isitayela sokuphila esivamile, esinempilo.

Uma une-fistula ezenziwe ngokusebenza ye-dialysis, gcina indawo ihlanzekile futhi yomile, gwema izingubo eziqinile noma ubucwebe phezu kwendawo, futhi hlola nsuku zonke izimpawu zokutheleleka njengokubomvu, ukufudumeka, noma ukopha. Ungalokothi uvumele ukulinganiswa kwegazi ezingalweni nge-fistula yakho.

Kuzo zonke izinhlobo ze-fistulas, beka amehlo ezimpawu zakho futhi ugcine i-log elula yanoma yiziphi izinguquko ozibonayo. Lolu lwazi lusiza iqembu lakho lokukhathalela impilo ukuthi libeke amehlo esimweni sakho futhi lilungise ukwelashwa uma kudingeka.

Gcina impilo enhle yonke ngokuzivocavoca okuvamile njengoba kunconywe udokotela wakho, ukudla okunempilo yenhliziyo, ukulala okwanele, nokuphatha ukucindezeleka. Lezi zici zesitayela sokuphila zisekela uhlelo lwakho lwe-cardiovascular kanye nempilo yonke.

Thatha imithi ngokuqondile njengoba kunqunyiwe futhi ube khona kuzo zonke i-aphoyintimenti zokulandelela. Uma unemibuzo noma ukukhathazeka phakathi kwezivakashi, ungangabazi ukuxhumana nodokotela wakho kunokulinda i-aphoyintimenti yakho elandelayo.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ukulungiselela i-aphoyintimenti yakho kungasiza ukuqinisekisa ukuthi uthola okuningi kakhulu ekuhambeni kwakho futhi unike udokotela wakho ulwazi abaludingayo ukuze akusize ngokuphumelelayo. Ukuzilungiselela kancane kuyasiza kakhulu ekutheni i-aphoyintimenti yakho ibe nomphumela.

Bhala zonke izimpawu zakho, kuhlanganise nokuthi zaqala nini, yini ezenzayo zibe ngcono noma zibe zimbi, nokuthi zithinta kanjani imisebenzi yakho yansuku zonke. Yiba uchwepheshe ngezinto ezifana nokuphefumula okufushane ngesikhathi semisebenzi ethile noma izinguquko emazingeni amandla.

Letha uhlu oluphelele lwemithi yakho, kuhlanganise nemithi yokuthengwa ngaphandle komthetho kanye nezinhlanganisela. Futhi, buthana nanoma yimaphi amarekhodi ezempilo afanele, ikakhulukazi kusuka ezinqubweni zakamuva noma izifundo zezithombe ezihlobene ne-fistula yakho.

Lungiselela uhlu lwemibuzo ofuna ukuyibuza, njengezinketho zokwelapha, ukuguqulwa kwesitayela sokuphila, izimpawu zokuqaphela, kanye nombono wesikhathi eside. Ukubhala lokhu phansi kuqinisekisa ukuthi awukhohlwa izihloko ezibalulekile ngesikhathi sokuvakasha kwakho.

Cabanga ukuletha ilungu lomndeni noma umngani ongakusiza ukukhumbula ulwazi oluxoxwe ngesikhathi se-aphoyintimenti. Bangase futhi banikeze ukwesekwa ngokomzwelo futhi basize ukukhuthaza izidingo zakho uma kudingeka.

Yini eyinhloko mayelana ne-arteriovenous fistula?

Into ebaluleke kakhulu okumele uyikhumbule ukuthi i-arteriovenous fistulas izimo ezilawuleka ngezinketho eziningi zokwelapha ezisebenzayo ezitholakalayo. Kungakhathaliseki ukuthi i-fistula yakho itholakele ngenxa yokulimaza noma izinqubo zezokwelapha, noma yenziwe ngokusebenza kwezokwelapha, ukusebenza eduze neqembu lakho lokukhathalela impilo kuholela kwimiphumela emihle kakhulu.

Ukuqaphela kwangaphambi kwesikhathi nokuphathwa okufanele kungavimbela izinkinga eziningi futhi kukusize ugcine ikhwalithi enhle yokuphila. Abantu abaningi abane-arteriovenous fistulas baphila impilo evamile, esebenzayo ngokuphathwa okufanele nokulandelwa okuvamile kwezokwelapha.

Hlala ulwemi mayelana nesimo sakho, landela uhlelo lwakho lokwelapha, futhi ungangabazi ukubuza imibuzo noma ucele usizo uma ulikhona. Iqembu lakho lokukhathalela impilo likhona ukukusekela kuzo zonke izinyathelo, futhi ukuxhumana okuvulekile kuyisihluthulelo sokuphathwa okuphumelelayo.

Khumbula ukuthi ukuba ne-arteriovenous fistula akuchazi wena noma akulinganiselisi kakhulu impilo yakho. Ngokunakekelwa okufanele nokukhathalela, ungaqhubeka uphishekela imigomo yakho futhi ujabulele imisebenzi ebalulekile kuwe.

Imibuzo evamile ebuzwayo mayelana ne-arteriovenous fistula

Ingase iphulukiswe yodwa i-arteriovenous fistula?

I-arteriovenous fistulas encane ngezinye izikhathi ingase ivale ngokwayo, ikakhulukazi lezo ezingelwe ukukhathazeka okuncane noma izinqubo zezokwelapha. Noma kunjalo, i-fistulas ezinkulu ngokuvamile idinga ukungenelela kwezokwelapha ukuze ivale kahle. Udokotela wakho uzobheka i-fistulas encane ngezithombe ezivamile ukubona uma ziyaphuka ngokwemvelo noma uma ukwelashwa kuya kudingeka.

Kuphephile yini ukuzivocavoca nge-arteriovenous fistula?

Abantu abaningi abane-arteriovenous fistulas bangazivocavoca ngokuphepha, kodwa kufanele ulandele izincomo ezithile zedokotela wakho kuye ngesimo sakho siqu. Ngokuvamile, imisebenzi ephansi kuya ephakathi iyanakekelwa kahle, kuyilapho ukuzivocavoca okukhulu kungase kudingeke kunciphise. Uma une-fistula ye-dialysis, gwema imisebenzi engalimaza indawo yokufinyelela.

I-arteriovenous fistulas ezenziwe ngokusebenza ihlala isikhathi esingakanani?

I-fistulas ezenziwe ngokusebenza yokufinyelela kwe-dialysis ngokuvamile ihlala iminyaka eminingi ngokunakekelwa okufanele, nakuba lokhu kuyahlukahluka kumuntu ngamunye. Ezinye zingase zisebenze kahle iminyaka emihlanu kuya kwelishumi noma ngaphezulu, kuyilapho ezinye zingase zidinga ukulungiswa noma ukushintshwa ngokushesha. Ukubekwa amehlo okuvamile nokunakekela okuhle kuyasiza ukwandisa impilo ye-fistula yakho.

Ingabe ngizodinga ukusebenza nge-arteriovenous fistula yami?

Akuzona zonke i-arteriovenous fistulas ezidinga ukusebenza. Isidingo sokungenelela kokusebenza kuncike ezintweni ezifana nobukhulu nendawo ye-fistula yakho, izimpawu ozibonayo, kanye nanoma yiziphi izinkinga ezithuthukayo. I-fistulas eminingi encane, engabonakaliyo ibekwa amehlo nje ngokuhamba kwesikhathi. Udokotela wakho uzokuncoma ukusebenza kuphela uma kudingeka ngempilo yakho nokuthuthuka kwakho.

Ingabe i-arteriovenous fistulas ingabangela izinkinga zenhliziyo?

I-arteriovenous fistulas enkulu ingase ihluphe inhliziyo yakho ngokwandisa inani legazi eludingayo inhliziyo yakho ukupompa. Ngemuva kwesikhathi, lo msebenzi owengeziwe ungase uholele ekukhuleni kwenhliziyo noma ukwehluleka kwenhliziyo okuphezulu. Noma kunjalo, ngokubeka amehlo okufanele nokwelashwa, lezi zinkinga ngokuvamile zingavikeleka noma ziphathwe kahle. Ukuhlinzwa okuvamile kuyasiza ukubamba noma yiziphi izinkinga ezihlobene nenhliziyo ngokushesha.