I-pulmonary arteriovenous fistula

I-pulmonary arteriovenous fistula ukuxhumana okungavamile phakathi komthambo nomthambo emaphashini. Ngenxa yalokho, igazi lidlula emaphashini ngaphandle kokuthola umoya-mpilo owenele.

I-pulmonary arteriovenous fistula imvamisa ingumphumela wokukhula okungajwayelekile kwemithambo yegazi yamaphaphu. Eziningi zenzeka kubantu abane-telangiectasia eyophafa (hemorrhagic hemorrhagic telangiectasia (HHT). Laba bantu bavame ukuba nemithambo yegazi engajwayelekile kwezinye izingxenye eziningi zomzimba.

I-Fistula nayo ingaba inkinga yesifo sesibindi noma ukulimala kwamaphaphu, yize lezi zimbangela zivame kakhulu.

Abantu abaningi abanazo izimpawu. Lapho kuvela izimpawu, zingabandakanya:

• Isikhwehlela esinegazi
• Kunzima ukuphefumula
• Kunzima ukuzivocavoca
• Ukopha ngamakhala
• Ukuphefumula kanzima ngokuzikhandla
• Ubuhlungu besifuba
• Isikhumba esiluhlaza (cyanosis)
• Ukushayisana kweminwe

Umhlinzeki wezokunakekelwa kwempilo uzokuhlola. Ukuhlolwa kungakhombisa:

• Imithambo yegazi engajwayelekile (telangiectasias) esikhunjeni noma kulwelwesi lwamafinyila
• Umsindo ongajwayelekile, obizwa ngokukhononda lapho kufakwa i-stethoscope phezu komthambo wegazi ongajwayelekile
• I-oxygen ephansi uma ilinganiswa ne-oximeter ye-pulse

Ukuhlolwa okungenziwa kufaka phakathi:

• Igesi yegazi e-arterial, ene-oxygen nangaphandle kwayo (imvamisa ukwelashwa kwe-oksijeni ayikuthuthukisi igesi yegazi egazini njengoba kulindelwe)
• Qedela ukubalwa kwegazi (CBC)
• I-x-ray yesifuba
• Isikena se-CT esifubeni
• I-Echocardiogram enesifundo se-bubble ukuhlola ukusebenza kwenhliziyo nokuhlola ubukhona be-shunt
• Ukuhlolwa kwemisebenzi yamaphaphu
• I-perfusion radionuclide lung scan ukukala ukuphefumula nokusakazwa kwegazi (perfusion) kuzo zonke izindawo zamaphaphu
• I-pulmonary arteriogram yokubuka imithambo yamaphaphu

Inani elincane labantu abangenazimpawu kungenzeka lingadingi ukwelashwa. Kubantu abaningi abane-fistula, ukwelashwa okuzikhethele ukuvimba i-fistula ngesikhathi se-arteriogram (embolization).

Abanye abantu bangadinga ukuhlinzwa ukuze kususwe imikhumbi engajwayelekile nezicubu zamaphaphu eziseduze.

Lapho ama-fistula we-arteriovenous abangelwa yisifo sesibindi, ukwelashwa ukufakelwa kwesibindi.

Umbono wabantu abane-HHT awufani nakulabo abangenayo i-HHT. Kubantu abangenayo i-HHT, ukuhlinzwa ukuze kususwe imikhumbi engavamile ngokuvamile kuba nomphumela omuhle, futhi isimo kungenzeka singabuyi.

Kubantu abanesifo sesibindi njengesimbangela, ukubikezela kuxhomeke kwisifo sesibindi.

Izinkinga zingafaka:

• Ukopha emaphashini
• Ukushaywa unhlangothi ngenxa yegazi elihamba lisuka emaphashini liye ezingalweni, emilenzeni, noma ebuchosheni (okuyindida embolism)
• Ukutheleleka ebuchosheni noma ku-valve yenhliziyo, ikakhulukazi ezigulini ezine-HHT

Shayela umhlinzeki wakho uma uhlala uphuma igazi noma unenkinga yokuphefumula, ikakhulukazi uma unomlando womuntu siqu noma womndeni we-HHT.

Ngenxa yokuthi i-HHT ivame ukuba nezakhi zofuzo, ukuvimbela akuvamile ukwenzeka. Ukwelulekwa ngofuzo kungasiza kwezinye izimo.

I-arteriovenous malformation - amaphaphu

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