Fistula yamitsempha yamagazi

Pulmonary arteriovenous fistula ndikulumikizana kwachilendo pakati pa mtsempha wamagazi ndi mtsempha m'mapapu. Zotsatira zake, magazi amadutsa m'mapapu osalandira mpweya wokwanira.

Matenda a m'mapapo mwanga amayamba chifukwa cha kukula kwamitsempha yam'mapapu. Ambiri amapezeka mwa anthu omwe ali ndi cholowa cha hemorrhagic telangiectasia (HHT). Anthu awa nthawi zambiri amakhala ndi mitsempha yachilendo m'magawo ena ambiri amthupi.

Fistula amathanso kukhala vuto la matenda a chiwindi kapena kuvulala kwamapapu, ngakhale izi zimafala kwambiri.

Anthu ambiri alibe zizindikiro. Zizindikiro zikachitika, zimatha kuphatikiza:

• Sputum yamagazi
• Kuvuta kupuma
• Zovuta zolimbitsa thupi
• Kutulutsa magazi m'mphuno
• Kupuma pang'ono ndi kuyesetsa
• Kupweteka pachifuwa
• Khungu labuluu (cyanosis)
• Kalabu yazala

Wothandizira zaumoyo adzakufunsani. Mayeso atha kuwonetsa:

• Mitsempha yamagazi yachilendo (telangiectasias) pakhungu kapena nembanemba
• Phokoso losazolowereka, lotchedwa kung'ung'udza pomwe stethoscope imayikidwa pamitsempha yamagazi yachilendo
• Oxygen wochepa mukamayesa ndi oximeter yamagetsi

Mayeso omwe angachitike ndi awa:

• Mpweya wamagazi wamagazi, wokhala ndi oxygen wopanda (nthawi zambiri chithandizo cha oxygen sichimathandizira mpweya wamagazi wamagazi monga momwe amayembekezera)
• Kuwerengera kwathunthu kwa magazi (CBC)
• X-ray pachifuwa
• Chifuwa cha CT
• Echocardiogram yophunzira ndi kuwira kuti muwone momwe mtima ukugwirira ntchito ndikuyesa kupezeka kwa shunt
• Kuyesa kwa mapapo
• Perfusion radionuclide lung scan kuti muyese kupuma ndi kufalitsa (perfusion) m'malo onse am'mapapu
• Arteriogram ya m'mapapo kuti muwone mitsempha ya m'mapapo

Anthu ochepa omwe alibe zizindikilo sangafunikire chithandizo. Kwa anthu ambiri omwe ali ndi fistula, chithandizo chomwe angasankhe ndikuletsa fistula panthawi ya arteriogram (embolization).

Anthu ena angafunike kuchitidwa opaleshoni kuti achotse ziwiya zachilendo ndi minofu yapafupi yamapapu.

Matenda opatsirana amayamba chifukwa cha matenda a chiwindi, chithandizocho chimakhala choika chiwindi.

Maganizo a anthu omwe ali ndi HHT siabwino kwa omwe alibe HHT. Kwa anthu opanda HHT, kuchitidwa opaleshoni kuti achotse ziwiya zachilendo nthawi zambiri kumakhala ndi zotsatira zabwino, ndipo vutoli silingabwererenso.

Kwa anthu omwe ali ndi matenda a chiwindi chifukwa, kufotokozera kumatengera matenda a chiwindi.

Zovuta zingaphatikizepo:

• Kutuluka magazi m'mapapu
• Stroke chifukwa cha magazi omwe amayenda kuchokera m'mapapu kupita kumikono, miyendo, kapena ubongo (parolical venous embolism)
• Matenda mu ubongo kapena valavu yamtima, makamaka kwa odwala HHT

Itanani omwe akukuthandizani ngati nthawi zambiri mumakhala ndi magazi m'mimba kapena mumavutika kupuma, makamaka ngati muli ndi mbiri ya banja kapena ya HHT.

Chifukwa HHT nthawi zambiri imakhala chibadwa, kupewa nthawi zambiri sikungatheke. Uphungu wa chibadwa ungathandize nthawi zina.

Matenda osokoneza bongo - mapapu

Shovlin CL, Jackson JE. Zovuta zam'mapapo mwanga. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: chap 61.

Stowell J, Gilman MD, Walker CM. Matenda obadwa nawo a thoracic. Mu: Shepard JO, mkonzi. Kujambula Kwamakedzana: Zofunikira. Wachitatu ed. Philadelphia, PA: Elsevier; 2019: mutu 8.

Webb GD, Smallhorn JF, Therrien J, Redington AN. Matenda obadwa nawo mumtima mwa wamkulu komanso wodwala. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: mutu 75.