Ukuthi yini i-AVM yobuchopho? Izimpawu, Izimbangela, kanye Nokwelashwa

I-arteriovenous malformation (AVM) yobuchopho iyinhlanganisela engaqondakali yezinsimbi zegazi ebuchosheni bakho lapho i-arteries ne-veins zixhuma ngokuqondile ngaphandle kwenethiwekhi evamile yama-capillaries amancane phakathi. Cabanga ngakho njengendlela emfishane endleleni yebhasi lezinsimbi zegazi ebuchosheni bakho ephuma endleleni evamile.

Lesi simo sithinta abantu abangu-1 ku-2,000 kuya ku-5,000 futhi ngokuvamile kuyinto ozalwa nayo, nakuba kungase kubangele izinkinga kamuva ekuphileni. Abantu abaningi abane-AVM yobuchopho baphila impilo evamile, futhi abaningi abazi ngisho ukuthi banayo ngaphandle kokuthi itholakala ngesikhathi sokucubungula kwezokwelapha ngenye isizathu.

Iyini i-AVM yobuchopho?

I-AVM yobuchopho yenzeka lapho i-arteries ne-veins ebuchosheni bakho zixhuma ngokuqondile esikhundleni sokusebenzisa inethiwekhi evamile yama-capillaries. Ebuchosheni obuphilile, igazi ligeleza kusuka kwi-arteries liye kuma-capillaries amancane ahambisa ukugcwala kwegazi ngaphambi kokuba lifike kwi-veins.

Nge-AVM, igazi eliphezulu lokucindezela elivela kwi-arteries ligeleza ngokuqondile kwi-veins ezingaklanywe ukusingatha leyo ndawo. Lokhu kudala iqembu elididekile lezinsimbi zegazi ezingaqondakali elibizwa ngokuthi yi-nidus, okuyi-Latin word for "nest."

Izindaba ezinhle ukuthi i-AVM yobuchopho ivela ekuzalweni futhi ayisabali noma ikhule ngesikhathi esiningi. Ziyincintisana kakhulu, ngakho uma ufunda lokhu ngoba wena noma umuntu omkhulu wakho uqondiwe, awuwedwa ekuzizweni ukukhathazeka ngento engaqondakali.

Ziyini izimpawu ze-AVM yobuchopho?

Abantu abaningi abane-AVM yobuchopho abazange babe nazimpawu nhlobo. Uma izimpawu zivele, zingase zihluke kakhulu kuye ngokuthi i-AVM ikuphi ebuchosheni bakho nokuthi inkulu kangakanani.

Izimpawu ezivamile ongazibona zihlanganisa:

• Izinhlungu zikhanda ezinzima ezihluke kakhulu kunenhlungu yakho yekhanda evamile
• Ukuhlushwa, okungase kube yisibonakaliso sokuqala se-AVM
• Ubuthakathaka noma ukungabi namandla ezandleni noma emilenzeni yakho
• Ubunzima bokukhuluma noma ukuqonda inkulumo
• Izinkinga zobona noma izinguquko
• Izinkinga zokulinganisela noma ukuhlanganiswa
• Ukudideka noma ubunzima bokuhlala ugxile

Abanye abantu baba nezimpawu ezincane ezikhula kancane ngokuhamba kwesikhathi. Lokhu kungase kuhlanganise izinguquko ezingathandeki ezingqondweni, ubunzima bokukhumbula, noma izinkinga ngemisebenzi ethile njengokufunda noma ukubhala.

Ezimeni ezingavamile, i-AVM ingabangela inhlungu yekhanda ehlasimulisayo, ekuvame ukubizwa ngokuthi inhlungu yekhanda embi kunazo zonke ekuphileni kwakho. Lokhu kungase kubonise ukuphuma kwegazi kusuka kwi-AVM, okudinga ukunakekelwa kwezokwelapha ngokushesha.

Ziyini izimbangela ze-AVM yobuchopho?

I-AVM yobuchopho ithuthukiswa ngesikhathi sokuthuthukiswa kwesikhumba esincane, ngokuvamile emavikini ambalwa okuqala okukhulelwe lapho uhlelo lwezinsimbi zegazi ebuchosheni bakho lukhahlela. Isizathu esiqondile sokuthi lokhu kwenzeke asiqondwa ngokugcwele, kodwa kubonakala sengathi kuyinguquko yokuthuthukiswa okungahleliwe kunokuthile okubangelwe yizenzo zabazali bakho noma i-genetics.

Ngokungafani nezinye izimo, i-AVM yobuchopho ngokuvamile ayidluliselwa kubazali bakho. Zivele ngokungaqondakali, okusho ukuthi zenzeka ngengozi ngesikhathi sokuthuthukiswa kobuchopho. Ososayensi bakholelwa ukuthi kuyindaba nje yokuthi izinsimbi zegazi zenza kanjani futhi zixhuma ngalezo zinsuku ezibalulekile zokuqala zokwakheka kobuchopho.

Akukho lutho wena noma abazali bakho obungalwenza ukwenqaba i-AVM ukuba yenzeke. Ayibangelwa izici zesitayela sempilo, ukulimala, noma ukutheleleka. Lo mkhuba wokuthuthukiswa okungahleliwe usho ukuthi i-AVM yobuchopho ingenzeka kunoma ubani, kungakhathaliseki umlando womndeni noma ezinye izici zezempilo.

Nini okufanele ubona udokotela nge-AVM yobuchopho?

Kufanele ufune ukunakekelwa kwezokwelapha ngokushesha uma uhlushwa inhlungu yekhanda ehlasimulisayo engafani nanoma iyiphi onayo ngaphambili, ikakhulu uma ihambisana nokuphefumula, ukugabha, noma izinguquko ekuqapheleni. Lokhu kungase kubonise ukuphuma kwegazi kusuka kwi-AVM futhi kudinga ukwelashwa okusheshayo.

Hlela i-aphoyintimenti nodokotela wakho uma ubona izimpawu ezintsha noma ezimbi zezinzwa njengokuhlushwa okungachazeki, izinhlungu zikhanda eziqhubekayo ezihluke kakhulu kunesakhiwo sakho esivamile, noma izinguquko eziqhubekayo ekukhulumeni kwakho, ukuboneni, noma ukuhlanganiswa.

Uma usuqondiwe i-AVM yobuchopho, kubalulekile ukuqhubeka ne-aphoyintimenti yokulandelela njalo nodokotela wakho wezinzwa noma i-neurosurgeon. Bazolandelela isimo sakho futhi bakusize ukuqonda noma yiziphi izinguquko ezimpawu zakho noma imiphumela yokucubungula.

Ziyini izici ezingozi ze-AVM yobuchopho?

Njengoba i-AVM yobuchopho ivela ekuzalweni, izici ezingozi ezivamile azisebenzi ngendlela ezenza ngayo kwezinye izimo. Noma kunjalo, izici ezithile zingathinta ukuthi i-AVM ingabangela izinkinga noma izimpawu phakathi nokuphila kwakho.

Ubudala bungase bube nomthelela wokusebenza kwe-AVM. Abantu abaningi abathuthukisa izimpawu benza kanjalo phakathi kweminyaka engu-20 no-40, nakuba izimpawu zingase zivele kunoma yimuphi ubudala. Abantu abasebancane bavame ukuba nomkhuba wokuthola ukuhlushwa njengesimpawu sabo sokuqala.

Ubukhulu nendawo ye-AVM yakho kubaluleke kakhulu kunokuthi izici ezingozi ezivamile. I-AVM enkulu noma lezo ezikumagatsha abalulekile ebuchosheni obulawula inkulumo, ukuhamba, noma ukubona kungase kube nomkhuba wokubangela izimpawu. Noma kunjalo, ngisho ne-AVM encane ngezinye izikhathi ingabangela izinkinga ezinkulu, kuyilapho ezinkulu zingase zingabangeli zimpawu nhlobo.

Izimo ezithile ze-genetic ezingavamile, njenge-hereditary hemorrhagic telangiectasia, zingandisa amathuba okuba ne-AVM eminingi, kodwa lezi ziyisigamu esincane kakhulu sezimo.

Ziyini izinhlanganisela ezingaba khona ze-AVM yobuchopho?

Inhlanganisela ebucayi kakhulu ye-AVM yobuchopho ukuphuma kwegazi, okuthiwa futhi yi-hemorrhage. Lokhu kwenzeka lapho izinsimbi zegazi ezingaqondakali ziqhekeka, zibangela igazi ukuba ligeleze emathisini ebuchosheni bakho. Nakuba lokhu kuzwakala kukhulu, kubalulekile ukwazi ukuthi i-AVM eningi ayiphumi igazi.

Ingozi yonyaka yokopha igazi kusuka kwi-AVM engaphumanga igazi ngokuvamile iphansi, cishe i-2-3% ngonyaka. Noma kunjalo, le ngozi ingase ihluke kuye ngezici eziningi ezihlanganisa ubukhulu be-AVM, indawo, nezici ezithile zezinsimbi zegazi eziqondwa udokotela wakho.

Ezinye izinhlanganisela ezingaba khona zihlanganisa:

• Ukuhlushwa, okuvela cishe ku-25-30% yabantu abane-AVM
• Izinkinga zezinzwa eziqhubekayo ngenxa ye-AVM ephanga ukugcwala kwegazi kusuka emathisini ebuchosheni obuqondile
• Izingoqoqo ezingqondweni noma ubunzima bokufunda kwezinye izimo
• Izinhlungu zikhanda eziqala ukuba khona noma eziqina ngokuhamba kwesikhathi

Ngokungavamile, i-AVM enkulu kakhulu ingabangela izinkinga ngokuthatha ukugcwala kwegazi kusuka emathisini ebuchosheni obuqondile, okuholela ezingoqoqo zezinzwa eziqhubekayo. Lokhu ngezinye izikhathi kubizwa ngokuthi "ukweba i-phenomenon" ngoba i-AVM ngokuyisisekelo iphanga igazi okufanele liphelise izindawo zebuchosheni ezempilo.

Kubalulekile ukuqaphela ukuthi abantu abaningi abane-AVM yobuchopho baphila impilo yabo yonke ngaphandle kokuba nazinhlanganisela. Iqembu lakho lezempilo lingakusiza ukuqonda ingozi yakho siqu kuye ngezici zakho ze-AVM.

I-AVM yobuchopho ihlonishwa kanjani?

I-AVM yobuchopho ngokuvamile ihlonishwa ngokusebenzisa ukuhlolwa kwezithombe ezizimele okungabonisa uxhumano lwezinsimbi zegazi ezingaqondakali ngokuningiliziwe. Indlela evamile yokuthola i-AVM okokuqala ngokusebenzisa i-CT scan noma i-MRI eyenziwe ngenye isizathu, njengokuhlola izinhlungu zikhanda noma ngemuva kokuhlolwa.

Uma udokotela wakho ekukholelwa ukuthi ungase ube ne-AVM, cishe uzoyala i-MRI ene-contrast, enikeza izithombe ezinemininingwane yezinsimbi zegazi ebuchosheni bakho. Lolu hlolo alulimazi futhi alusebenzisi lutho, nakuba uzodinga ukuhlala uthule ethebula elilingene cishe imizuzu engu-30-60.

Ukuze uthole ukubuka okuningiliziwe kwesakhiwo sezinsimbi zegazi, udokotela wakho angase akukhuthaze i-cerebral angiogram. Lokhu kuhilela ukufaka ithebula elincane esimbeni segazi emadolweni noma engalweni yakho nokufaka i-contrast dye ukudala izithombe ze-X-ray ezinemininingwane yezinsimbi zegazi ebuchosheni bakho. Nakuba lokhu kuzwakala kukhulu, kuyindlela evamile enikeza ulwazi olunembile kakhulu mayelana ne-AVM yakho.

Ngezinye izikhathi odokotela basebenzisa i-CT angiography, ehlanganisa i-CT scanning ne-contrast dye ukudala izithombe ezinemininingwane yezinsimbi zegazi. Lolu hlolo lishesha kune-angiography yendabuko kodwa linikeza imininingwane encane.

Iyini ukwelashwa kwe-AVM yobuchopho?

Ukwelashwa kwe-AVM yobuchopho akuhlale kudingekile, futhi isinqumo siye kuye ngezici eziningi ezihlanganisa izimpawu zakho, ubukhulu nendawo ye-AVM, ubudala bakho, nempilo yakho yonke. Abantu abaningi abane-AVM encane, engabonakali, balandelelwa nje ngokuhlolwa okuvamile kwezithombe.

Uma ukwelashwa kunconywa, kunezindlela ezintathu eziyinhloko ezingase zisetshenziswe zodwa noma ndawonye. Ukususa ngokuhlinzwa kuhilela ukuvula ikhanda nokususa ngokucophelela i-AVM yonke, okungase kunikeze ukwelashwa okuphelele kodwa ngokuvamile kugcinelwe i-AVM encane ezindaweni ezifinyeleleka.

I-Stereotactic radiosurgery isebenzisa imisebe yokushisa egxile ukuvala izinsimbi zegazi ezingaqondakali kancane kancane phakathi kweminyaka engu-1-3. Lokhu ukwelashwa okungenawo ukuhlinzwa kusebenza kahle kwi-AVM encane futhi akudingeki ukuba kube nokuhlinzwa, nakuba kuthatha isikhathi ukubona umphumela ophelele.

I-Endovascular embolization ihilela ukufaka ithebula elincane ngezinsimbi zegazi kuya kwi-AVM nokuyivala nge-glue ekhethekile, ama-coils, noma ama-plugs. Le ndlela ngokuvamile isebenziselwa i-AVM enkulu noma njengokulungiselela ukuhlinzwa noma ukushisa.

Iqembu lakho lokwelapha lizosisebenza nawe ukuze unqume indlela engcono kakhulu kuye ngesimo sakho esithile. Ngezinye izikhathi, indlela ephephile kakhulu ukulandelela ngokucophelela kunokwelashwa okusheshayo, ikakhulukazi kwi-AVM engabangeli zimpawu nhlobo.

Indlela yokuphatha i-AVM yobuchopho ekhaya?

Ukuphila ne-AVM yobuchopho kusho ukuthatha izinyathelo ezifanele ngenkathi ugcina impilo evamile ngangokunokwenzeka. Into ebaluleke kakhulu ukusebenzisa noma yimiphi imithi eyalwe ngokuqondile, ikakhulu uma usebenzisa imithi yokulwa nokuhlushwa.

Abantu abaningi bayazibuza ngokunciphisa umsebenzi, futhi izindaba ezinhle ukuthi imisebenzi eminingi evamile iphephile ngokuphelele. Noma kunjalo, udokotela wakho angase akukhuthaze ukugwema imisebenzi enengozi enkulu yokulimaza ikhanda, njengemidlalo yezemidlalo, kuze kube yilapho i-AVM yakho iwelashwe noma uma usengozini enkulu yokopha igazi.

Gcina ulandelela noma yiziphi izimpawu ezintsha noma eziqhubekayo encwadini elula. Qaphela izinto ezifana nezindlela zenhlungu yekhanda, noma yiluphi umsebenzi wokuhlolwa, noma izinguquko endleleni ozizwa ngayo noma usebenza ngayo. Lolu lwazi lusiza iqembu lakho lezempilo ukulandelela isimo sakho nokwenza izinqumo zokwelashwa.

Ukuphathwa kwengcindezi kungase kube kubalulekile ngoba ukukhathazeka ngesimo sakho kuyinto evamile. Cabanga ngezindlela zokupumula, ukwenza umsebenzi olula njalo njengoba kuvunyelwe udokotela wakho, nokuxhumana namaqembu asekelayo abantu abanezimo ezifanayo.

Qiniseka ukuthi umndeni wakho nabangane bakho abaseduze bayazi ngesimo sakho futhi baqonde ukuthi yiziphi izimpawu ezingase zidinga ukunakekelwa kwezokwelapha ngokushesha. Ukuba neqembu lokusekela eliqonda isimo sakho kungakunikeza usizo olusebenzayo kanye nenduduzo yothando.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ngaphambi kwe-aphoyintimenti yakho, bhala zonke izimpawu zakho, ngisho noma zibonakala zingahlobene ne-AVM yakho. Faka lapho zaqala khona, zingaki zivele, nokuthi yini ezenza zibe ngcono noma zimbi. Lolu lwazi olunemininingwane lusiza udokotela wakho ukuqonda ukuthi i-AVM yakho ingase ikuthinte kanjani.

Letha uhlu oluphelele lwemithi yonke, izithasiselo, namavithamini owasebenzisayo, kuhlanganise nezinani. Futhi, buthana nanoma yiziphi izifundo zangaphambili zezithombe noma amarekhodi ezempilo ahlobene ne-AVM yakho, njengoba ukuqhathanisa lokhu ngokuhamba kwesikhathi kunikeza ulwazi oluyigugu mayelana nanoma yiziphi izinguquko.

Lungiselela uhlu lwemibuzo ofuna ukuyibuza. Ungase ufune ukwazi ngokunciphisa umsebenzi, izinketho zokwelashwa, ukubuka kwesikhathi eside, noma yiziphi izimpawu ezifanele zikhuthaze ukunakekelwa kwezokwelapha ngokushesha. Ukubhala lokhu phansi kuqinisekisa ukuthi ngeke ukhohlwe imibuzo ebalulekile ngesikhathi se-aphoyintimenti.

Cabanga ukuletha ilungu lomndeni othembekile noma umngane ongakusiza ukukhumbula ulwazi oluxoxwe futhi anikeze ukwesekwa kothando. I-aphoyintimenti yezokwelapha mayelana nezimo zobuchopho ingase izwakale ikhulu, futhi ukuba nomuntu lapho kungakusiza ukucubungula ulwazi kamuva.

Uma kungenzeka, hlola uhlobo lwakho oluthile lwe-AVM ngaphambi kwesikhathi ukuze ube nezingxoxo ezilwazi kakhulu nodokotela wakho. Noma kunjalo, khumbula ukuthi i-AVM ngayinye iyona, ngakho-ke ulwazi olutholakala ku-inthanethi lungase lungasebenzi ngokuqondile esimweni sakho.

Iyini into ebaluleke kakhulu mayelana ne-AVM yobuchopho?

Into ebaluleke kakhulu okumele uyiqonde mayelana ne-AVM yobuchopho ukuthi zizimo ezilawuleka, futhi abantu abaningi baphila impilo egcwele, evamile nazo. Nakuba ukuxilongwa kungase kuzwakale kukhulu ekuqaleni, khumbula ukuthi ukwelashwa kuye kwaqina kakhulu, futhi i-AVM eminingi ayibangeli izinkinga ezinkulu.

Iqembu lakho lezempilo lizosisebenza nawe ukwakha uhlelo oluqondene oluqondene nezingozi nezinzuzo zezindlela ezahlukene. Lokhu kungase kuhilele ukwelashwa, noma kungase kuhilele ukulandelela ngokucophelela ngokuhlola okuvamile kanye nezifundo zezithombe.

Hlala uxhumene neqembu lakho lezempilo, landela izincomo zabo, futhi ungangabazi ukubuza imibuzo uma unayo. Ukuqonda isimo sakho kukwenza ube namandla okuthatha izinqumo ezilwazi futhi kusize ukunciphisa ukukhathazeka ngokungaziwa.

Okubaluleke kakhulu, ukuxilongwa kwe-AVM yobuchopho akuchazi wena noma akunqamuki lokho ongakukwazi ukukufinyelela ekuphileni. Ngokunakekelwa kwezokwelapha okufanele nokulandelela, ungaqhubeka uphishekela imigomo yakho nokuphila impilo ofuna ukuyiphila.

Imibuzo evamile ebuzwa mayelana ne-AVM yobuchopho

Ingabe i-AVM yobuchopho ingakhula ngokuhamba kwesikhathi?

I-AVM yobuchopho eningi ayikhule ngokukhulu ngemuva kokuzalwa, nakuba ingase ibonakale ngokwengeziwe njengoba ukhula ngenxa yezinguquko ezindleleni zokugcwala kwegazi. Ngokungafani nezinhlungu, i-AVM iyizinto ezingaqondakali ezihlala zihlala zingakhula noma ziningi. Noma kunjalo, udokotela wakho uzolandelela i-AVM yakho ngezithombe eziqondile ukuze alandele noma yiziphi izinguquko ngokuhamba kwesikhathi.

Kuphephile yini ukuba nabantwana uma ngine-AVM yobuchopho?

Abesifazane abaningi abane-AVM yobuchopho baba nokukhulelwa okuphephile nokubeletha, nakuba lokhu kudinga ukuhlela ngokucophelela neqembu lakho lezempilo. Ukukhulelwa kungase kukhulise ingozi yokopha igazi kusuka kwezinye i-AVM ngenxa yokwanda kwegazi kanye nezingoqoqo ze-hormonal. Odokotela bakho bazohlola isimo sakho esithile futhi bangase bancome ukwelashwa ngaphambi kokukhulelwa noma ukulandelela okukhethekile ngesikhathi sokukhulelwa nokubeletha.

Ingabe ngizodinga ukugwema ukuhamba ngendiza noma emazingeni aphezulu?

Abantu abaningi abane-AVM yobuchopho bangakwazi ukuhamba nokuhamba ngendiza ngokuvamile ngaphandle kokunciphisa. Izingoqoqo zokucindezela ngesikhathi sokuhamba ngendiza ngokuvamile azibalulekile ngokwanele ukuba zithinte i-AVM yakho. Noma kunjalo, uma usanda kuthola ukwelashwa noma uhlushwa izimpawu ezisebenzayo, kufanele uxoxe ngezinhlelo zokuhamba nodokotela wakho ukuqinisekisa ukuthi kuphephile esimweni sakho esithile.

Ingabe ukucindezeleka noma umsebenzi womzimba kungabangela ukuphuma kwegazi kusuka kwi-AVM?

Nakuba ukwenza umsebenzi womzimba onamandla kakhulu noma ukucindezeleka okukhulu komzwelo kungase kukhulise ukucindezela kwegazi ngokwanele ukuba kube yingozi, imisebenzi yansuku zonke evamile kanye nomsebenzi olula ngokuvamile iphephile kubantu abaningi abane-AVM. Udokotela wakho angakunikeza isiqondiso esithile mayelana namazinga omsebenzi kuye ngezici ze-AVM yakho nengozi yokopha igazi. Ikhona ukufumana ibhalansi efanele phakathi kokuba semsebenzini nokugwema izingozi ezingadingekile.

Ngazi kanjani ukulandelela izifundo zezithombe?

Ukuqina kokulandelela izithombe kuye kuye ngezici ze-AVM yakho, noma ngabe usuthole ukwelashwa, kanye nezimpawu zakho. I-AVM engaphathwe ingase ilandelwe unyaka ngamunye noma eminyakeni emi-3, kuyilapho lezo ezilashwe zingase zidinga ukulandelela okuvamile okuqala ukuqinisekisa ukuthi ukwelashwa kusebenza. Iqembu lakho lezempilo lizokwakha uhlelo lokulandelela oluqondene oluqondene nesidingo solwazi ngokunciphisa ukuhlolwa okungadingekile nokukhishwa komshini.