I-fistula yemithambo yegazi

I-pulmonary arteriovenous fistula liqhagamshelo elingaqhelekanga phakathi komthambo kunye nomthambo emiphungeni. Ngenxa yoko, igazi lidlula emiphungeni ngaphandle kokufumana ioksijini eyaneleyo.

I-pulmonary arteriovenous fistula idla ngokuba sisiphumo sokukhula ngokungaqhelekanga kwemithambo yegazi yemiphunga. Uninzi lwenzeka kubantu abane-telangiectasia eyophafa yegazi (HHT). Aba bantu bahlala benemithambo yegazi engaqhelekanga kwamanye amalungu omzimba.

I-Fistula nayo isenokuba sisifo sesibindi okanye ukonzakala kwemiphunga, nangona ezi zizathu zingaqhelekanga kakhulu.

Abantu abaninzi abanazimpawu. Xa iimpawu zenzeka, zinokubandakanya:

• Isikhohlela esinegazi
• Kunzima ukuphefumla
• Kunzima ukuzilolonga
• Iimpumlo
• Ukuphefumla kancinci ngokuzimisela
• Iintlungu zesifuba
• Ulusu oluhlaza okwesibhakabhaka (cyanosis)
• Iiklabhu zeminwe

Umboneleli wezempilo uyakukuvavanya. Uviwo lunokubonisa:

• Imithambo yegazi engaqhelekanga (telangiectasias) kulusu okanye inwebu yangaphakathi
• Isandi esingaqhelekanga, esibizwa ngokuba kukumbombozela xa kubekwa i-stethoscope ngaphezulu kwesitya segazi esingaqhelekanga
• I-oksijini ephantsi xa kulinganiswa nge-oximeter yokubetha

Uvavanyo olunokwenziwa lunokubandakanya:

• Irhasi yegazi eyi-arterial, kunye nangaphandle kweoksijini (ihlala inyango yeoksijini ingayiphuculi iarterial yegazi yegazi njengoko kulindelwe)
• Gcwalisa ubalo lwegazi (CBC)
• I-x-ray yesifuba
• Isifuba se-CT scan
• I-Echocardiogram ngofundo lwebhola ukujonga ukusebenza kwentliziyo kunye nokuvavanya ubukho be-shunt
• Uvavanyo lomsebenzi wemiphunga
• I-perfusion radionuclide lung scan ukulinganisa ukuphefumla nokujikeleza (perfusion) kuzo zonke iindawo zemiphunga
• I-arteriogram yePulmonary ukujonga imithambo yemiphunga

Inani elincinci labantu abangenazo iimpawu abanokufuna unyango. Kubantu abaninzi abane-fistula, unyango olukhethiweyo kukuthintela i-fistula ngexesha le-arteriogram (embolization).

Abanye abantu banokufuna utyando ukususa iinqanawa ezingaqhelekanga kunye nezicubu zemiphunga ezikufuphi.

Xa i-fterula ye-arteriovenous ibangelwa sisifo sesibindi, unyango kukufakelwa kwesibindi.

Imbonakalo yabantu abane-HHT ayilunganga njengaleyo ingenayo i-HHT. Kubantu abangenayo i-HHT, utyando lokususa iinqanawa ezingaqhelekanga zihlala zinesiphumo esihle, kwaye imeko ayinakulindeleka ukuba ibuye.

Kubantu abanesifo sesibindi njengesizathu, ukuxela kwangaphambili kuxhomekeke kwisifo sesibindi.

Iingxaki zinokubandakanya:

• Ukopha kumphunga
• Ukubetha ngenxa yegazi elihamba liphuma kwimiphunga lisiya ezingalweni, emilenzeni, okanye kwingqondo (paradoxical venous embolism)
• Usulelo kwingqondo okanye kwi-valve yentliziyo, ngakumbi kwizigulana ezine-HHT

Biza umboneleli wakho ukuba uhlala unomphunga okanye uphefumla nzima, ngakumbi ukuba unembali yobuqu okanye yosapho ye-HHT.

Ngenxa yokuba i-HHT ihlala ifana nemfuza, ukuthintela akusoloko kunokwenzeka. Iingcebiso ngemfuzo zinokunceda kwezinye iimeko.

I-Arteriovenous malformation - pulmonary

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UStellell J, uGilman MD, i-Walker CM. Ukukhubazeka kwento ozalwa nayo. Ku: Shepard JO, ed. Ukulinganisa kweToracic: Izinto ezifunwayo. Ngomhla wesi-3. IPhiladelphia, PA: Elsevier; I-2019: isahluko 8.

IWebb GD, i-Smallhorn JF, iTherrien J, iRedington AN. Isifo sentliziyo esibelekwe kumntu omkhulu nakwisigulana sabantwana. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 75.