Pulistary arteriovenous fistula

ʻO ka pulistary arteriovenous fistula kahi pilina maʻamau ma waena o ke aʻa a me ke aa i nā māmā. ʻO ka hopena, hele ke koko ma waena o nā māmā me ka loaʻa ʻole o ka oxygen.

ʻO ka pulmonary arteriovenous fistulas ka hopena o ka ulu maʻamau o nā kīʻaha koko o ka akemāmā. Loaʻa ka hapanui i nā poʻe me nā telangiectasia hemorrhagic hoʻoilina (HHT). Loaʻa pinepine kēia poʻe i nā kīʻaha koko i nā ʻāpana ʻē aʻe o ke kino.

Hiki i nā fistula ke lilo i mea pilikia o ka maʻi akepaʻa a i ʻole ka ʻeha māmā, ʻoiai ʻoi aku ka liʻiliʻi o kēia mau kumu.

Nui nā kānaka ʻaʻohe ʻōuli. Ke kū nā hōʻailona, ​​hiki iā lākou ke hoʻopili:

• Kaha koko
• Hanu paʻakikī
• Paʻahana hoʻoikaika kino
• Nā Nosebleeds
• Ka hanu ʻana o ka hanu me ka hoʻoikaika
• ʻEha ʻeha
• ʻO kaʻili polū (cyanosis)
• ʻO ka ʻōniu ʻana o nā manamana lima

E nānā ka mea mālama ola iā ʻoe. Hōʻike paha ka hōʻike:

• ʻO nā kīʻaha koko maʻamau (telangiectasias) ma ka ʻili a me nā membrane mucous
• ʻO ke kani maʻamau, i kapa ʻia kahi ʻōhumu ke kau ʻia kahi stethoscope ma luna o ke kīʻaha koko ʻokoʻa
• ʻO oxygen haʻahaʻa ke ana ʻia me ka oximeter pulse

ʻO nā hoʻāʻo e hana ʻia ana paha:

• Ke kinoea koko Arterial, me a me ka ʻole o oxygen (ʻo ka maʻamau maʻamau ʻaʻole hoʻomaikaʻi ka hoʻomaʻamaʻa oxygen i ka gas koko arterial e like me ka mea i manaʻo ʻia)
• Helu piha koko (CBC)
• Pākuʻi x-ray
• Scanner CT pahu
• ʻO Echocardiogram me ka hoʻopaʻa ʻana i ka huʻa e nānā i ka hana o ka puʻuwai a nānā no ke kū ʻana o kahi shunt
• Nā hoʻāʻo hana lung
• Perfusion radionuclide lung scan e ana ai i ka hanu ʻana a me ka holo ʻana (perfusion) ma nā wahi āpau o nā akemāmā
• Pulmonary arteriogram e nānā i nā aʻa māmā

ʻAʻole pono ka hapa liʻiliʻi o ka poʻe i loaʻa ʻole nā ​​ʻōuli i ka lāʻau. No ka hapanui o ka poʻe me nā fistula, ʻo ka mālama ʻana i ke koho e pale i ka fistula i ka wā o kahi arteriogram (embolization).

Pono paha kekahi poʻe i ke ʻoki e wehe i nā moku kūpono ʻole a me nā kiko o nā māmā kokoke.

Ke hoʻokumu ʻia nā fistulas arteriovenous e ka maʻi akepaʻa, ʻo ka mālama ʻana he hoʻoliʻiliʻi ate.

ʻAʻole maikaʻi ka nānā aku no ka poʻe me HHT e like me ka poʻe me ka ʻole o HHT. No ka poʻe me ka ʻole o HHT, he hopena maikaʻi ka hana ʻoki ʻana e hoʻoneʻe i nā moku ʻokoʻa a ʻaʻole hoʻi e hoʻi hou ke ʻano.

No nā poʻe me nā maʻi hepa he kumu, pili ka wānana i ka maʻi ate.

Komo pū nā pilikia:

• Kahe i ka hake
• ʻO ka hahau ma muli o ke kīpē o ke koko e hele mai nā māmā i nā lima, nā wāwae, a me ka lolo (paradoxical venous embolism)
• ʻO ka maʻi i ka lolo a i ʻole ka puʻuwai puʻuwai, keu hoʻi i nā mea maʻi me HHT

Kāhea i kāu mea hāʻawi inā loaʻa pinepine ka nosebleeds a paʻakikī i ka hanu ʻana, keu hoʻi inā he moʻolelo pilikino a ʻohana paha kāu o HHT.

Ma muli o ke ʻano pinepine o ka HHT, ʻaʻole hiki ke kāohi. Kōkua paha ka ʻōlelo aʻoaʻo genetic i kekahi mau hihia.

Malformation o Arteriovenous - pulmonary

ʻO Shovlin CL, Jackson JE. Pulmonary vascular abnormalities. I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. ʻO Murray a me Nadel's Textbook of Respiratory Medicine. ʻElua huaʻōlelo Piladelapia, PA: Elsevier Saunders; 2016: chap 61.

ʻO Stowell J, ʻo Gilman MD, ʻo Walker CM. Nā hanaʻino kūpona congenital. I: Shepard JO, ed. Kaha Thoracic: Nā Koi. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2019: chap 8.

Webb GD, Smallhorn JF, Therrien J, Redington AN. ʻO ka maʻi puʻuwai Congenital i ke kanaka makua a me ka mea maʻi pediatric. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 75.