Cudurka sanbabada wadnaha
Pulmonary arteriovenous fistula waa xiriir aan caadi ahayn oo u dhexeeya halbowlaha iyo xididka sanbabada. Sidaa darteed, dhiiggu wuxuu maraa sambabaha isagoon helin oksijiin ku filan.
Fistulas arteriovenous pulmonary badanaa waa natiijada horumarka aan caadiga ahayn ee marinnada dhiigga ee sanbabada. Badankood waxay ku dhacaan dadka qaba telangiectasia (HHT) oo leh hiddo-wadaha dhiigbaxa. Dadkani badanaa waxay leeyihiin xididdada dhiigga ee aan caadiga ahayn qaybo badan oo jirka ka mid ah.
Fistulas sidoo kale waxay dhibaato ku noqon kartaa cudurka beerka ama dhaawaca sambabka, in kastoo sababahan ay aad u yar yihiin.
Dad badan ayaan lahayn wax calaamado ah. Markay astaamuhu dhacaan, waxaa ka mid noqon kara:
- Xaako dhiig leh
- Neefsashada oo ku adkaata
- Jimicsi adag
- Sanka sanka ka baxa
- Neefsasho gaabis ah oo jimicsi leh
- Laab xanuun
- Maqaarka buluuga ah (cyanosis)
- Foobidda faraha
Bixiyaha xanaanada caafimaadka ayaa ku baari doona. Imtixaanku wuxuu muujin karaa:
- Xididdada dhiigga ee aan caadiga ahayn (telangiectasias) maqaarka ama xuubabka xabka
- Sanqad aan caadi ahayn, oo loo yaqaan gunuur markii stethoscope la dul dhigo xididdada dhiigga ee aan caadiga ahayn
- Ogsijiin yar marka lagu cabbiro mitirka mitirka wadnaha
Tijaabooyinka la qaadi karo waxaa ka mid ah:
- Gaaska dhiiga halbowlaha, oo leh ogsijiin iyo la'aanteed (badiyaa daaweynta oksijiinta ma hagaajiso gaaska dhiigga halbowlaha inta lafilayo)
- Tirinta dhiigga oo dhameystiran (CBC)
- Raajo xabadka ah
- Laabta CT iskaanka
- Echocardiogram oo leh daraasad xumbo ah si loo hubiyo shaqada wadnaha loona qiimeeyo jiritaanka shunt
- Imtixaanada shaqada sanbabada
- Baaritaanka sanbabada ee loo yaqaan 'Perfusion radionuclide' si loo cabiro neefsashada iyo wareegga dhiigga (perfusion) dhammaan aagagga sambabaha
- Pulmonary arteriogram si loo daawado halbowlayaasha sanbabada
Tiro yar oo dad ah oo aan lahayn wax calaamado ah uma baahna daaweyn. Dadka badankood ee qaba cudurka 'fistulas', daaweynta dookhu waa in la xakameeyo fistula inta lagu jiro arteriogram (embolization).
Dadka qaarkiis waxay u baahan karaan qalliin si looga saaro maraakiibta aan caadiga ahayn iyo unugyada sambabka ee u dhow.
Marka fistulas arteriovenous waxaa sababa cudurka beerka, daaweynta waa beerka beerka.
Aragtida dadka qaba HHT uma fiicna sida kuwa aan HHT lahayn. Dadka aan HHT lahayn, qalliinka looga saarayo maraakiibta aan caadiga ahayn badanaa wuxuu leeyahay natiijo wanaagsan, xaaladduna uma badna inay soo noqoto.
Dadka qaba cudurka beerka sabab ahaan, saadaashu waxay kuxirantahay cudurka beerka.
Dhibaatooyinka waxaa ka mid noqon kara:
- Dhiiga sanbabada
- Faalig ku yimaad xinjirowga dhiigga ee ka socda sambabaha una tagaya gacmaha, lugaha, ama maskaxda (parabolical venous embolism)
- Infekshinka maskaxda ama waalka wadnaha, gaar ahaan bukaanada qaba HHT
Wac daryeel bixiyahaaga haddii aad marar badan dhiig ka daadato ama neefsashada kugu adkaato, gaar ahaan haddii aad sidoo kale leedahay taariikh shaqsi ama qoys HHT.
Sababta oo ah HHT badiyaa waa hiddo-wadaha, ka-hortagga inta badan suurtagal maahan. La talinta hidaha ayaa laga yaabaa inay caawiso xaaladaha qaarkood.
Cilad-darrada wadnaha - sambabada
Shovlin CL, Jackson JE. Cilladaha xididdada dhiigga ee sanbabada. Gudaha: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray iyo Nadel Buugga Buugga Caafimaadka Neefsashada. 6aad ed. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 61.
Stowell J, Gilman MD, Walker CM. Ciladaha wadnaha ee ku dhasha. Gudaha: Shepard JO, ed. Sawirka Thoracic: Shuruudaha. 3aad ed. Philadelphia, PA: Elsevier; 2019: cutubka 8.
Webb GD, Smallhorn JF, Therrien J, Redington AN. Cudurka wadnaha ee ku dhasha qofka weyn iyo bukaanka carruurta. Gudaha: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Cudurka Wadnaha ee Braunwald: Buugga Buugta Daawada Wadnaha iyo Xididdada. 11aad. Philadelphia, PA: Elsevier; 2019: cutubka 75.