Ukuqondwa kwe-Arteriovenous Malformation: Izimpawu, Izimbangela, Nokwelashwa

I-arteriovenous malformation (AVM) iyinhlanganisela yezinsimbi zegazi ezingajwayelekile lapho i-arteries ne-veins zixhumana ngqo ngaphandle kwenethiwekhi ejwayelekile ye-capillaries encane phakathi kwazo. Cabanga ngayo njengendlela emfishane ohlelweni lwakho lokujikeleza kwegazi okungafanele ibe khona. Lokhu kudala uxhumano oluphezulu lokucindezela okungathinta ukugeleza kwegazi futhi kungenzeka kube nomthelela ezingxeni ezikhathini ezithile.

I-AVMs ingavamile, ithinta cishe umuntu omunye ku-100,000, kodwa kubalulekile ukuyiqonda ngoba ukutholakala kwangaphambi kwesikhathi nokuphathwa okuqondile kungenza umehluko omkhulu emiphumeleni. Abantu abaningi bazalwa be-AVMs, nakuba bengase bangazitholi kuze kube kamuva ekuphileni kwabo.

Ziyini izimpawu ze-arteriovenous malformation?

Abantu abaningi abane-AVMs abanazo izimpawu nhlobo, ikakhulukazi uma i-malformation incane. Noma kunjalo, uma izimpawu zivele, zingase zihluke kakhulu kuye ngokuthi i-AVM itholakala kuphi nokuthi inkulu kangakanani.

Izimpawu ezivamile ongazihlangabezana nazo zihlanganisa:

• Izinhlungu zikhanda ezinzima ezihluke kakhulu ezinhlungwini zakho zikhanda eziqhelile
• Ukuhlupheka, okungase kube yisibonakaliso sokuqala se-AVM yobuchopho
• Ubuthakathaka bemisipha noma ukungabi namandla ezingxenyeni zomzimba wakho
• Izinkinga zobumona noma ubunzima bokukhuluma
• Ukudideka noma ubunzima bokuxhumanisa
• Izinkinga zokuzwa, kuhlanganise nokubhonga ezindlebeni zakho

Ngezinye izikhathi, ungase uqaphele umsindo wokugijima ekhanda lakho ohambisana nesikhathi senhliziyo yakho. Lokhu kwenzeka ngoba igazi ligija ngokushesha ngokuxhumana okungajwayelekile.

Ezimweni ezingavamile, i-AVM ingase ibe nezibonakaliso ezinzima kakhulu njengezinhlungu zikhanda ezinzima ngesikhathi esisodwa ezihambisana nokuhlanza nokugabha. Lokhu kungase kubonise ukuphuza igazi, okudinga ukunakekelwa kwezokwelapha ngokushesha.

Ziyini izinhlobo ze-arteriovenous malformation?

I-AVMs ngokuvamile ihlukaniswa ngokuthi itholakala kuphi emzimbeni wakho. I-AVMs yobuchopho yilona uhlobo olukhulunywa kakhulu, kodwa lezi malformations zingathuthuka kuphi na ohlelweni lwakho lokujikeleza kwegazi.

I-AVMs yobuchopho ithonya izinsimbi zegazi ebuchopho bakho futhi ngokuvamile iyinkathazo kakhulu ngoba ingathinta umsebenzi wezinzwa. I-AVMs yomgogodla ivela emgogodleni wakho futhi ingathinta ukunyakaza nokubona.

Uhlobo ngalunye lubonisa izinselele zalo ezihlukile. I-AVMs yobuchopho ingase ibe nokubamba noma izimpawu ezifana nesifo sokushaya, kuyilapho i-AVMs ezingaphandle ezingaphandle emilenzeni yakho zingase zibangele ubuhlungu, ukukhula, noma ukushintsha kwesikhumba endaweni ethintekile.

Yini ebangela i-arteriovenous malformation?

I-AVMs eningi ithuthuka ngaphambi kokuba uzalwe, ezigabeni zokuqala zokukhula kombungu lapho izinsimbi zakho zegazi zikhahlela. Lokhu kwenza kube yilokho odokotela abakubiza ngokuthi “ukungazalwa,” okusho ukuthi uzalwa nazo ngisho noma zingatholakali kuze kube eminyakeni eminingi kamuva.

Isizathu esiqondile sokuthi kungani abanye abantu bathuthukisa i-AVMs asiqondwa ngokugcwele. Kubonakala sengathi kuyindlela yokukhula engavamile kunokuthile okubangelwa yizenzo zabazali bakho noma ama-genes, nakuba izimo ze-genetic ezingavamile ngezinye izikhathi zingase zidlale indima.

Ngokungafani nezinye izinkinga zezinsimbi zegazi, i-AVMs ngokuvamile ayibangelwa izinto zokuphila njengokudla, ukuzivocavoca, noma ukucindezeleka. Ziyindlela nje yokwahluka endleleni izinsimbi zakho zegazi ezakhiwe ngayo ngesikhathi sokuthuthuka.

Ezimweni ezingavamile kakhulu, i-AVMs ingathuthuka ngemva kokuzalwa ngenxa yokulimala noma ukutheleleka, kodwa lokhu akukuvamile. Ngezinye izikhathi, uma une-AVM, ibe khona kusukela ngaphambi kokuba uzalwe.

Nini okumele ubheke udokotela nge-arteriovenous malformation?

Kufanele ufuna ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nezinhlungu zikhanda ezinzima ngesikhathi esisodwa ezingafani nanoma yiziphi eziqhelile, ikakhulukazi uma zihambisana nokuhlanza, ukugabha, noma ukushintsha kobumona bakho noma inkulumo. Lokhu kungase kube izibonakaliso zokopha igazi kusuka ku-AVM.

Xhumana nodokotela wakho ngokushesha uma uthuthukisa ukubamba okusha, ubuthakathaka obuzuma noma ukungabi namandla ohlangothini olulodwa lomzimba wakho, noma izinkinga zokuzwa eziqhubekayo njengokubhonga ezindlebeni zakho. Lezi zimpawu zidinga ukuhlolwa ngisho noma zibonakala zingenamandla.

Uma unezimpawu ezilula njengezinhlungu zikhanda eziqhubekayo ezihluke esimweni sakho esiqhelile, ukushintsha kancane kancane kobumona bakho, noma iziqephu zokudideka, cisha i-aphoyintimenti nodokotela wakho. Nakuba lokhu kungase kungabi yizimo eziphuthumayo, kufanele kunakekelwe.

Themba izinzwa zakho ngomzimba wakho. Uma kukhona okubonakala kuhlukile kakhulu noma okukukhathazayo, kuhlale kungcono ukuthi kuhlolwe kunokulinda ukubona uma izimpawu ziyanda.

Ziyini izinto ezingase zikubeke engozini ye-arteriovenous malformation?

Njengoba i-AVMs eningi ivela ekuzalweni, izinto ezingase zikubeke engozini eziqhelile azisebenzi ngendlela ezenza ngayo kwezinye izimo. Noma kunjalo, izinto ezithile zingathinta ukuthi i-AVM iba yinkinga noma itholakala.

Ubudala budlala indima ekuthuthukiseni izimpawu. Abantu abaningi abanawo izimpawu kuze kube yilapho beseminyakeni yabo yobusha, amashumi amabili, noma amashumi amathathu, ngisho noma i-AVM ibe khona kusukela ekuzalweni. Lokhu kungase kube ngoba i-malformation ikhula noma ishintsha ngokuhamba kwesikhathi.

Ubulili kubonakala sengathi bunomthelela othile, nge-AVMs yobuchopho ethinta amadoda nabesifazane ngokulinganayo, nakuba ezinye izifundo zikhomba ukwahluka kancane engozini yokopha igazi phakathi kwawo womabili ubulili. Ukukhulelwa ngezinye izikhathi kungathinta izimpawu ze-AVM ngenxa yokwanda kwegazi nokucindezela.

Ukuba nezimo ze-genetic ezingavamile, njenge-hereditary hemorrhagic telangiectasia, kungase kukhulise amathuba akho okuthuthukisa i-AVMs eminingi. Noma kunjalo, lokhu kuthinta izingxenye ezincane kakhulu zabantu abane-AVMs.

Ziyini izingozi ezingase zenzeke nge-arteriovenous malformation?

Inkinga enzima kakhulu evela ku-AVM ukopha igazi, okubizwa ngodokotela ngokuthi i-hemorrhage. Lokhu kwenzeka lapho ukugeleza kwegazi oluphezulu ngokuxhumana okungajwayelekile kubangela enye yezinsimbi zegazi ukuba iphuze.

Ukopha igazi kwe-AVM yobuchopho kungase kubangele izimpawu ezifana nesifo sokushaya futhi kudinga ukunakekelwa kwezokwelapha ngokushesha. Ingozi yokopha igazi ihluka kuye ngobukhulu nendawo ye-AVM yakho, kodwa ngokujwayelekile, ingozi yonyaka incane kakhulu kubantu abaningi.

Ezinye izingozi zihlanganisa:

• Ukubamba okungase kuqhubeke ngokuhamba kwesikhathi
• Izinkinga zezinzwa eziqhubekayo njengobuthakathaka noma ubunzima bokukhuluma
• Izinhlungu zikhanda eziqhubekayo eziphazamisa imisebenzi yansuku zonke
• Ukuhlupheka kwenhliziyo ngenxa yokwanda kokugeleza kwegazi nge-AVM
• Ukuncipha kokugeleza kwegazi kwindawo yobuchopho evamile

Ezimweni ezingavamile, i-AVMs enkulu ingathinta ikhono lenhliziyo yakho lokupompa igazi ngokuphumelelayo ngoba igazi eliningi ligija ngokuxhumana okungajwayelekile. Lokhu kuvame kakhulu nge-AVMs enkulu kakhulu noma i-malformations eminingi.

Izindaba ezinhle ukuthi abantu abaningi abane-AVMs abanawo ubunzima obukhulu, ikakhulukazi ngokubeka iliso okuqondile nokwelashwa uma kudingeka.

I-arteriovenous malformation ihlonishwa kanjani?

Ukuhlola i-AVM ngokuvamile kuqala ngodokotela wakho ebuza ngezimpawu zakho nomlando wakho wezokwelapha. Bazokwenza ukuhlolwa komzimba, belalele imisindo engavamile engase ibonise ukugeleza kwegazi okungajwayelekile.

Izivivinyo ezivamile zokuthola izithombe ezisetshenziswa ukuhlola i-AVMs zihlanganisa i-MRI scans, enikeza izithombe ezinemininingwane yobuchopho bakho nezinsimbi zegazi. I-CT scans ingase futhi isetshenziswe, ikakhulukazi uma kukhona ukukhathazeka ngokopha igazi.

Ukuze uthole umbono oqondile wezinsimbi zegazi, udokotela wakho angase akukhuthaze i-cerebral angiogram. Lokhu kuhilela ukufaka umbala wokuphambana ezinsimbini zakho zegazi nokudubula izithombe ze-X-ray ukuze ubone ukuthi igazi ligeleza kanjani nge-AVM.

Ngezinye izikhathi i-AVMs itholakala ngengozi ngesikhathi sezivivinyo zokuthola izithombe zezinye izimo. Lokhu empeleni kuyinto evamile futhi kungase kududuze ngoba kusho ukuthi i-AVM itholakele ngaphambi kokuba ibe nezinkinga ezinkulu.

Luyini ukwelashwa kwe-arteriovenous malformation?

Ukwelashwa kwe-AVMs kuncike ezintweni eziningi, kuhlanganise ubukhulu nendawo ye-malformation, izimpawu zakho, nokuqina kwakho kwempilo. Akuzona zonke i-AVMs ezidinga ukwelashwa ngokushesha, futhi ezinye zingase zibekwe iliso ngokuhamba kwesikhathi.

Amakhetho ayinhloko okwelashwa ahlanganisa ukususwa ngokusebenza, lapho udokotela esusa khona i-AVM ngokuqondile ngokusebenza. Lokhu ngokuvamile kuyilona ukwelashwa oluqinisekile kakhulu kodwa kuncike endaweni ye-AVM nokuqina kwakho kwempilo.

I-Endovascular embolization ihilela ukufaka i-tube encane ezinsimbini zakho zegazi kuye ku-AVM nokuyivala ngama-coils, unamathisela, noma ezinye izinto. Le ndlela engathinti kakhulu isebenza kahle kwezinye izinhlobo ze-AVMs.

I-Stereotactic radiosurgery isebenzisa imisebe yokukhanya egxile ukuvala izinsimbi zegazi ezingajwayelekile kancane kancane ngokuhamba kwesikhathi. Lokhu ukwelashwa kuthatha izinyanga kuze kube yiminyaka ukuze kube nomphumela ophelele kodwa kungaba kuhle kwe-AVMs ezindaweni ezinzima ukufinyelela kuzo.

Iqembu lakho lezokwelapha lizosisebenza nawe ukuze unqume indlela engcono kakhulu ngokuya ngesimo sakho esithile. Ngezinye izikhathi ukusetshenziswa kokwelashwa okuningi kusebenza kangcono.

Indlela yokuphatha i-arteriovenous malformation ekhaya?

Nakuba ungakwazi ukuwelapha i-AVM ngokwakho, kunezindlela ezibalulekile zokuphatha isimo sakho nokunciphisa izingozi ekhaya. Ukuthatha imithi yakho ngokuqondile njengoba kulotshwe kubalulekile, ikakhulukazi uma usebenzisa imithi yokubamba noma imithi yokucindezela kwegazi.

Ukuqeda imisebenzi ekhuphula kakhulu ukucindezela kwegazi kungasiza ekuqedeni ingozi yokopha igazi. Lokhu kungase kusho ukulinganisela ukuzivocavoca okunzima kakhulu, ukugwema ukuphakamisa izinto ezinzima, noma ukuphatha ukucindezeleka ngezindlela zokuphumula.

Gcina idayari yezimpawu ukuze uqaphele noma yikuphi ukushintsha ezinhlungwini zikhanda, ukubamba, noma ezinye izimpawu. Lolu lwazi lusisiza iqembu lakho lezokwelapha ukwenza izinqumo ezingcono kakhulu zokwelashwa ngawe.

Gcina i-aphoyintimenti yokulandelela njalo neqembu lakho lezokwelapha, ngisho noma uzizwa kahle. Ukuqapha okuqhubekayo kungabamba ukushintsha ngaphambi kokuba kube yinkinga.

Funda ukuqaphela izibonakaliso zezexwayiso ezidinga ukunakekelwa kwezokwelapha ngokushesha, njengezinhlungu zikhanda ezinzima ngesikhathi esisodwa, izimpawu zezinzwa ezintsha, noma ukushintsha esimweni sakho esiqhelile sezimpawu.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho nodokotela?

Ngaphambi kwe-aphoyintimenti yakho, bhala zonke izimpawu zakho, kuhlanganise nokuthi zaqala nini nokuthi yini ezenza zibe ngcono noma zibe zimbi. Yiba uchwepheshe ngezindlela zezinhlungu zikhanda, noma yikuphi ukusebenza kokubamba, noma ukushintsha kwezinzwa okuqaphile.

Letha uhlu oluphelele lwazo zonke imithi oyithathayo, kuhlanganise nemithi yokuthengwa ngaphandle komthetho kanye nezinhlanganisela. Futhi, lungiselela uhlu lwemibuzo ofuna ukuyibuza udokotela wakho ngesimo sakho kanye namakhetho okwelashwa.

Uma kungenzeka, letha ilungu lomndeni noma umngani ongasiza ekukhumbula ulwazi olubalulekile oluxoxwe ngesikhathi se-aphoyintimenti. I-aphoyintimenti yezokwelapha ingase ibe nzima, futhi ukuba nokusekelwa kukusiza ukucubungula ulwazi kangcono.

Butha noma yimaphi amarekhodi ezokwelapha adlule noma izifundo zokuthola izithombe ezihlobene ne-AVM yakho. Lokhu kusiza udokotela wakho ukuqonda umlando wakho wezokwelapha nokulandelela noma yikuphi ukushintsha ngokuhamba kwesikhathi.

Yini okufanele uyikhumbule nge-arteriovenous malformation?

Ukuphila ne-AVM kungase kuzwakale kunzima ekuqaleni, kodwa khumbula ukuthi abantu abaningi abanezi zimo baphila impilo egcwele, esebenzayo ngokunakekelwa okuqondile kwezokwelapha. Ikhona ukusebenzisana eduze neqembu lakho lezokwelapha ukuze uqaphe isimo sakho futhi wenze izinqumo eziqondile ngokwelashwa.

Ukutholakala kwangaphambi kwesikhathi nokuphathwa okuqondile kwenza umehluko omkhulu emiphumeleni. Kungakhathaliseki ukuthi i-AVM yakho idinga ukwelashwa ngokushesha noma ukuqapha okucophelelayo, ukuhlala uhileleke ekunakekelweni kwakho kwezokwelapha kukunika ithuba elihle kakhulu lokuba nomphumela omuhle.

Unganqikazi ukubuza imibuzo nokufuna imibono yesibili uma ungaqiniseki ngezincomo zokwelashwa. Ukuqonda isimo sakho kukwenza ukwazi ukwenza izinqumo ezingcono kakhulu ngempilo yakho nokuzola kwakho.

Imibuzo evamile ebuzwa nge-arteriovenous malformation

Ingabe i-arteriovenous malformations ingaphela yodwa?

I-AVMs ngokuvamile ayipheli ngaphandle kokwelashwa. Noma kunjalo, ezinye i-AVMs ezincane zingase zibe buthakathaka ngokuhamba kwesikhathi noma zithuthukise ama-blood clots azivala. Noma kunjalo, lokhu akuyona into okufanele uyithembele kuyo, futhi ukuqapha okuqhubekayo kubalulekile ngisho noma izimpawu zibe ngcono.

Ingabe i-arteriovenous malformation iyefa?

I-AVMs eningi ayitholwa kubazali bakho. Ithuthuka ngokungahleliwe ngesikhathi sokuthuthuka kombungu. Noma kunjalo, izimo ze-genetic ezingavamile njenge-hereditary hemorrhagic telangiectasia zingase zikhulise amathuba okuthuthukisa i-AVMs eminingi, kodwa lokhu kuthinta abantu abambalwa kakhulu ngokujwayelekile.

Ngingazivocavoca yini uma ngine-arteriovenous malformation?

Abantu abaningi abane-AVMs bangazivocavoca, kodwa kufanele uxoxe ngokulinganiselwa kwemisebenzi nodokotela wakho. Ngokuvamile, ukuzivocavoca okuqondile kulungile, kodwa imisebenzi ebangela ukwanda okukhulu kokucindezela kwegazi kungase kudingeke ukulinganiselwe. Udokotela wakho angakunikeza imiyalo ehambisana nesimo sakho esithile.

Kwenzekani uma i-arteriovenous malformation iopha igazi?

Ukopha igazi kwe-AVM kuyisimo esiphuthumayo sezempilo esidinga ukunakekelwa kwesibhedlela ngokushesha. Ukwelashwa ngokuvamile kuhilela ukukunika uzinti ngokwelapha bese ulungisa ukopha igazi ngokusebenza, i-embolization, noma ezinye izindlela zokwelapha. Abantu abaningi bayaphila kahle ngokopha igazi kwe-AVM, ikakhulukazi ngokwelashwa okusheshayo.

Zingaki i-arteriovenous malformations ebangela ukubamba?

Cishe amaphesenti angu-40-60 abantu abane-AVMs yobuchopho bahlangabezana nokubamba ngesikhathi esithile. Lokhu kubamba ngokuvamile kuphendula kahle emithini yokulwa nokubamba. Ukwelashwa okuphumelelayo kwe-AVM ngezinye izikhathi kunganciphisa noma kuphelise ukubamba, nakuba lokhu kuhluka kumuntu ngamunye kuye ngezinto eziningi.