Ua pehu a ʻeha kou wāwae? Hiki paha kēia ma muli o ka (May-Thurner Syndrome)!

I kekahi manawa, pehu a ʻeha ko kākou mau wāwae me ke kumu ʻole, ʻeā? ʻOi loa aku ka wāwae hema. ʻAʻole nui ka poʻe e nānā nui i kēia. Akā, ʻaʻole paha he mea maʻalahi kēia i nā manawa a pau. I kēia lā, e kamaʻilio kākou e pili ana i kahi maʻi a kākou i lohe ʻole ai, akā ua ʻike kākou a pau he mea kūpono ke kipa aku. ʻO ia hoʻi ʻo `(May-Thurner Syndrome)`. Ua kapa ʻia hoʻi kēia ʻo `(Cockett syndrome)` a i ʻole `(Iliac vein compression syndrome)`.

He aha ke ʻano o ka "May-Thurner Syndrome"?

I ka ʻōlelo maʻalahi, ʻo `(May-Thurner Syndrome)` kahi kūlana kahi i hoʻopaʻa ʻia ai kou aʻa iliac ʻākau (`Right Iliac Artery`) a me kou aʻa iliac hema (`Left Iliac Vein`). I kēia manawa ke noʻonoʻo nei paha ʻoe i ke ʻano o kēia mau aʻa iliac a me nā aʻa. ʻO ke aʻa iliac ʻākau ke kīʻaha koko nui e lawe ana i ke koko i kou wāwae ʻākau. ʻO ke aʻa iliac hema ke kīʻaha koko nui e lawe ana i ke koko mai kou wāwae hema i ka puʻuwai. No laila, ma kēia `(May-Thurner Syndrome)`, hiki i kēlā hoʻopaʻa ʻana ke hoʻopilikia i ke kahe o ke koko ma o kou mau wāwae.

He aha ka hana a kēia i ke kino? Pehea kona hopena?

I kēia manawa, ke noʻonoʻo nei paha ʻoe i ka mea e hana ai kēia i ke kino a pehea e pili ai. ʻO ka mea nui, ma muli o kēia kaomi, hoʻomaka ke koko e hōʻiliʻili i nā wāwae, ʻoi aku hoʻi ka wāwae hema , ma kahi o ka hele pololei ʻana i luna ma o ka aʻa iliac hema, ʻo ia hoʻi, i ka puʻuwai. Ke hana ʻia kēia, hiki ke hana ʻia nā ʻōpū koko i loko o nā aʻa hohonu . Kāhea mākou i kēia ma ke ʻano lapaʻau he `(Deep Vein Thrombosis)` a i ʻole `(DVT)`. He ʻano kēia e pono ai ka nānā ʻana. Hiki i nā hōʻailona o `(DVT)` ke like me kēia:

• Nā loli i ke kala o ka ʻili ma ka wāwae (hiki ke ʻulaʻula, polū).
• Ke ʻike ʻia nei ka pehu ʻana o nā aʻa koko ma nā wāwae.
• ʻEha ka wāwae, ʻeha nui, a i ʻole ka palupalu i ka hoʻopā ʻana.
• Pehu wāwae a me ke kaumaha.

Hiki i kekahi mau wahine ke loaʻa i ka pelvic congestion syndrome (PBS) me ka May-Thurner syndrome. Manaʻo nā kauka ua hoʻokumu ʻia kēia ʻeha pelvic mau loa e nā pilikia me nā aa koko i loko o ka pelvis (ʻo ia hoʻi, ka ʻōpū lalo).

Pehea e hoʻopilikia ai kēia i ke kahe o ke koko?

Ke neʻe mau nei ke koko ma o nā kīʻaha koko o ko kākou kino (nā aʻa a me nā veins). E like me kāu e hoʻomanaʻo nei, lawe nā aʻa i ke koko maʻemaʻe a piha i ka oxygen mai ka puʻuwai a i nā ʻāpana ʻē aʻe o ke kino. Ma hope o ka loaʻa ʻana o ka oxygen a me nā meaʻai i kēlā mau ʻāpana, lawe nā aʻa i ke koko haumia a nele i ka oxygen i ka puʻuwai a me nā māmā.

Ma kekahi mau wahi o ko kākou kino, keʻa nei kēia mau aʻa a me nā veins kekahi i kekahi. Pēlā nō, i loko o ko kākou pelvis, aia ke aʻa iliac ʻākau ma luna o ke aʻa iliac hema. ʻO ka maʻamau, ʻaʻole kēia he pilikia. Eia nō naʻe, i loko o kekahi me ka `(May-Thurner Syndrome)`, kau ke aʻa iliac ʻākau i ke kaomi ma luna o ke aʻa iliac hema. E noʻonoʻo he paipu wai, he aha ka mea e hana ai inā hehi kekahi ma luna? He paʻakikī ke kahe ʻana o ka wai, ʻeā? I ka pololei, hana ʻia kekahi mea like ma ʻaneʻi.Ma muli o ke kaomi ʻia o ka aʻa iliac hema, ua paʻakikī ke kahe ʻana o ke koko ma o ia mea.

ʻO wai ka mea i ʻoi aku ka paʻakikī o ka loaʻa ʻana o kēia maʻi?

ʻIke pinepine ʻia kēia "May-Thurner Syndrome" i nā wahine . He mea maʻamau nō hoʻi ia i nā pākeke ma waena o 20 a me 50 mau makahiki .

Pehea ka maʻamau o kēia ʻano?

ʻO ka ʻoiaʻiʻo, ʻoi aku ka maʻamau o ka iliac vein thrombosis ma mua o kou manaʻo. Hōʻike kekahi mau noiʻi e hiki i hoʻokahi o ka ʻelima mau kānaka ke loaʻa i kēia ʻano thrombosis! Akā ʻo ka mea kupanaha, ʻoiai he nui ka poʻe i loaʻa i ka iliac vein thrombosis, ʻaʻole lākou i ʻike pono ʻia me ka `(May-Thurner Syndrome)`. ʻO kekahi kumu no kēia, ʻo ia paha ka nui o ka poʻe i ʻike ʻole i nā hōʻailona o `(May-Thurner Syndrome)` a hiki i ka wā e loaʻa ai iā lākou kahi maʻi e like me `(DVT)`.

He aha nā hōʻailona o ka `(May-Thurner Syndrome)`?

ʻAʻole ʻike ka nui o ka poʻe me ka May-Thurner Syndrome i kekahi mau hōʻailona , ​​ʻoiai inā ʻaʻohe o lākou DVT a mākou i kūkākūkā ai ma mua. Inā loaʻa nā hōʻailona, ​​​​​​hoʻopilikia wale lākou i ka wāwae hema . Hiki i kēia mau mea ke komo pū me:

• Ke kaumaha o nā wāwae. E like me ka pōhaku e kau ana mai koʻu wāwae, he mea ʻoluʻolu ʻole loa ia.
• I kekahi manawa, hiki ke loaʻa nā ʻeha ho'ōla ʻole (nā ʻeha ʻeha) ma nā wāwae.
• Hiki iā ʻoe ke ʻeha ma kou wāwae a i ʻole kahi ʻūlū e puka mai ana mai loko mai.
• Hiki ke loli ke kala o ka ʻili. Hiki ke lilo i polū a ʻeleʻele paha.
• Pehu wāwae.
• Hiki ke loaʻa nā maʻi e like me nā veins varicose.

He aha ke kumu o ka `(May-Thurner Syndrome)`?

ʻO ke kumu nui o kēia, ʻo ia ka paʻi ʻana o ke aʻa iliac ʻākau i ke aʻa iliac hema. Akā, ʻaʻole i hiki i nā kauka ke loaʻa kahi kumu kūpono no ke aha e hana ai kēia. ʻO ia hoʻi, hiki ke lilo ia ma muli o kahi loli i ke ʻano o ke kino.

Pehea e ʻike ai nā kauka i kēia? (Diagnosis)

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​ʻo ka mea mua āu e hana ai, ʻo ia ke ʻike i ke kauka a kamaʻilio maopopo e pili ana i kāu mau hōʻailona a me kou mōʻaukala olakino. E nānā ke kauka iā ʻoe. A laila, hana paha lākou i kekahi mau hoʻokolohua kūikawā e hiki ke nānā i kēia mau kīʻaha koko.

• ʻO ke scan `CT (Computed Tomography)` : Hoʻohana kēia i nā kukuna X a me nā kamepiula kūikawā e lawe i nā kiʻi ʻokiʻoki o nā kīʻaha koko. A laila hiki ke hoʻohana ʻia kēia e ʻike inā he mea paʻa.
• ʻMRI (Magnetic Resonance Imaging) : Hoʻohana kēia i nā magnet, nā nalu lekiō, a me nā kamepiula e hana i nā kiʻi kikoʻī o nā kīʻaha koko.
• Ultrasound: Hoʻohana kēia hoʻāʻo i nā nalu kani e nānā i ke kahe o ke koko i loko o ke kino, ʻoi aku hoʻi i loko o nā kīʻaha koko (Doppler Ultrasound).
• Venogram : Ma kēia, ua hoʻokomo ʻia kahi dye kūikawā (contrast dye) i loko o kahi aa koko a nānā ʻia ka dye ma lalo o nā kukuna X e ʻike inā he ālai ʻia ke kahe koko.
• Hiki ke hana ʻia kahi "venogram e pili ana i ka catheter" . ʻO ke ʻano kēia, ua hoʻokomo ʻia kahi ʻōmole liʻiliʻi (catheter) i loko o kahi aa koko a hoʻokomo ʻia ka dye ma o ia mea.
• ʻO Intravascular Ultrasound (IVUS) : He hoʻāʻo holomua iki kēia. Maanei, hoʻokomo ʻia kahi catheter i loko o kahi kīʻaha koko, a hoʻokomo ʻia kahi mea ultrasound liʻiliʻi (probe) ma o ka catheter e lawe i nā kiʻi maopopo loa a kikoʻī o loko o ke kīʻaha koko. Hiki i kēia ke ana pololei i ka nui o ke kaomi.

He aha nā lāʻau lapaʻau no kēia?

ʻElua mau pahuhopu nui i ka mālama ʻana i ka `(May-Thurner Syndrome)`. ʻO kekahi, ʻo ia ka hoʻomaikaʻi ʻana i ke kahe koko . ʻO kekahi, ʻo ia ka hoʻēmi ʻana i ka pilikia o ka loaʻa ʻana o ka `(DVT)`. Ma muli o kou kūlana, hiki i kāu kauka ke ʻōlelo i kēia mau lāʻau lapaʻau:

• ʻO Angioplasty a me Stenting : ʻO kēia ka lāʻau lapaʻau maʻamau. Ma kēia kaʻina hana, hoʻokomo ʻia kahi catheter me kahi pōpō liʻiliʻi i loko o ke aʻa iliac hema i paʻa. Ke hiki i kahi kikoʻī o ka paʻa, hoʻopiha ʻia ka pōpō. Wehe kēia i ke aʻa i paʻa. A laila, hoʻokomo ʻia kahi ʻōmole mesh liʻiliʻi, i kapa ʻia he stent , i loko o ka puka e pale aku ai i ka pani hou ʻana, a wehe ʻia ka pōpō. Ua like kēia me ka wehe ʻana i kahi paʻa ma ke alanui a me ke kūkulu ʻana i kahi alahaka e maʻalahi ai ke hele.
• ʻO ke ʻoki ʻoki ʻana : I kekahi manawa, hana ʻia kahi ala hou ma ka hoʻohana ʻana i kahi ʻāpana ʻiʻo i lawe ʻia mai kahi ʻē aʻe a i ʻole kahi paipu hana e kāpae i ke aʻa koko i ālai ʻia. Hoʻihoʻi kēia i ke kahe koko. He ʻoki nui kēia.
• ʻO ka shunting artery iliac ʻākau : I kekahi manawa, hiki ke hana ʻia ke ʻoki kino e hoʻoneʻe iki i ke artery iliac ʻākau e hōʻoluʻolu i ke kaomi ma ka aʻa iliac hema. I kekahi manawa, hiki ke kau ʻia kahi ʻāpana ʻiʻo ma waena o ke aʻa a me ke aʻa e hōʻoluʻolu i ke kaomi.

He aha kāu e hana ai inā loaʻa iā ʻoe kahi `(DVT)`?

I kēia manawa, e noʻonoʻo ʻoe he `(May-Thurner Syndrome)` kou a he `(DVT)` nō hoʻi kou. I kēlā hihia, ma waho aʻe o nā lāʻau lapaʻau i ʻōlelo ʻia ma luna, e hoʻohui kāu kauka i kekahi mau lāʻau lapaʻau hou aʻe:

• Nā Anticoagulants : Pale kēia i ke koko mai ke kāpili ʻana, pale i nā ʻōpū koko e ulu nui ana, a hiki ke kōkua i ka hoʻoheheʻe mālie ʻana i nā ʻōpū koko.
• Nā lāʻau lapaʻau e wāwahi ana i ke koko / Thrombolytics : He mau lāʻau lapaʻau ikaika kēia i hāʻawi pololei ʻia e hoʻoheheʻe i nā ʻōpū koko. Hāʻawi pinepine ʻia kēia mau lāʻau lapaʻau ma o kahi catheter, pololei i loko o ke ʻōpū koko.
• ʻO ka `Vena Cava Filter` : He mea hana liʻiliʻi kēia e like me ka ʻupena. ʻO ka `Inferior Vena Cava` ka aa koko nui loa i loko o ko kākou kino. Maanei ke koko mai nā wāwae a me ka ʻōpū e hele ai i ka puʻuwai. Ke kau ʻia kēia kānana i loko o kēlā aa koko, pale ia i nā ʻūpā koko i hana ʻia ma nā wāwae mai ka puka ʻana i waho a hele i nā māmā.

Aia kekahi ala e pale aku ai i kēia mai ka hana ʻana?

ʻO kaʻoiaʻiʻo, ʻaʻohe ala maopopo e pale aku ai i kēia "May-Thurner Syndrome"., no ka mea, ʻaʻole ʻike ʻia ke kumu pololei. Akā hiki iā ʻoe ke mālama i kou kahe koko holoʻokoʻa i ke kūlana maikaʻi a hōʻemi i kou pilikia o nā ʻōpū koko ma ka hana ʻana i kēia mau mea:

• Mai noho ma kahi hoʻokahi no ka lōʻihi loa. Inā ʻoe e hana ana ma ke keʻena, e ala a hele wāwae no kekahi manawa, e kīkoʻo ana i kou mau wāwae, ma ka liʻiliʻi hoʻokahi manawa i ka hola.
• E inu i ka nui o ka wai. He mea maikaʻi ke inu ma ka liʻiliʻi he 2-3 lita o ka wai i ka lā.
• E hoʻoikaika kino mau , ʻoiai hoʻi ka hoʻoikaika kino aerobic (e like me ka hele wāwae, ka holo ʻana, a me ke kaʻa paikikala).
• Inā loaʻa iā ʻoe nā maʻi ʻē aʻe e like me ka maʻi diabetes mellitus, ke koko kiʻekiʻe, a i ʻole ka maʻi peripheral artery (PAD), e kamaʻilio me kāu kauka a e hoʻomalu pono iā lākou.
• Inā ʻoe e puhipaka, e hoʻōki loa . He mea ʻino loa ka puhipaka no kou mau kīʻaha koko.
• Inā ʻōlelo kāu kauka, e ʻaʻahu i nā kāmaʻa hoʻopaʻa kūikawā. Kōkua kēia i ka hōʻemi ʻana i ke koko i loko o kou mau wāwae a kōkua iā ʻoe e neʻe i luna.

He aha nā pilikia e hiki ai i kēia ke hana?

ʻO ka pilikia nui o ka `(May-Thurner Syndrome)` ʻo ia ka `(DVT)` a mākou i kamaʻilio ai. Eia nō naʻe, aia kekahi mea e ʻoi aku ka weliweli . ʻO ia hoʻi, inā e haki kahi ʻūpā koko i hana ʻia ma ka wāwae mai laila mai, e hele ma ke kahe koko a paʻa i loko o kahi aʻa koko i loko o nā māmā. Kāhea mākou i kēlā `(Pulmonary Embolism)` (he ʻūpā koko i paʻa i loko o nā māmā) .

He pilikia olakino hoʻoweliweli ola ka Pulmonary Embolism. Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona hou a i ʻole e ʻoi aku ka ʻino , e hele koke i ka keʻena pilikia o ka haukapila kokoke loa a kāhea aku i kahi ambulance:

* Ke ʻū ʻana i ke koko me ka huʻa.

* Nā palpitations o ka puʻuwai (ka wikiwiki koke a i ʻole ka puʻuwai kūpono ʻole).

* Paʻakikī nui ka hanu ʻana, me he mea lā e hanu ana ʻoe (Dyspnea).

* Inā loaʻa koke iā ʻoe ka ʻeha nui o ka umauma e ʻoi aʻe ka ʻino ke hanu ʻoe.

He aha ka wā e hiki mai ana no kekahi me ka `(May-Thurner Syndrome)`?

He nui ka poʻe e ola lōʻihi a olakino me ka May-Thurner Syndrome me ka ʻole o nā pilikia. Inā ʻaʻohe ou hōʻailona, ​​ʻaʻole paha ʻoe e ʻike he maʻi kou.

Eia nō naʻe, inā ʻike ʻoe i kekahi o nā hōʻailona o ka `(Deep Vein Thrombosis - DVT)` a mākou i kamaʻilio ai (e like me ka pehu ʻana, ka ʻulaʻula, ka ʻeha, ka mehana ma ka wāwae), e ʻike pono i ke kauka . Hiki ke hoʻomalu pono ʻia ka `(DVT)` me ka lāʻau lapaʻau a, inā pono, nā lāʻau ʻē aʻe.

Nā nīnau e nīnau aku ai i ke kauka

Inā loaʻa iā ʻoe, a i ʻole manaʻo paha ʻoe he May-Thurner Syndrome paha, he mea kōkua paha ke nīnau aku i kāu kauka i kēia mau nīnau:

• He aha nā hōʻailona o ka "May-Thurner Syndrome" e hoʻopilikia iaʻu?
• He aha ke kumu kūpono loa o koʻu mau hōʻailona?
• He aha ke ʻano o nā hoʻokolohua e pono iaʻu e hana e ʻike pono ai i kēia?
• He aha nā hōʻailona o ka `(DVT)`? He aha kaʻu e hana ai inā loaʻa iaʻu?
• He aha nā hōʻailona o ka `(Pulmonary Embolism)`? He aha kaʻu e hana ai inā loaʻa iaʻu?
• He aha nā lāʻau lapaʻau āu e ʻōlelo ai no ka "May-Thurner Syndrome"? He aha nā pōmaikaʻi a me nā pōʻino?
• He aha nā mea e hiki ai ke hoʻi hou mai nā hōʻailona ma hope o ka mālama ʻana?

He mea hoʻoweliweli anei ke ola o ka `(May-Thurner Syndrome)`?

ʻAʻole hoʻoweliweli pololei ke ʻano o ka maʻi ʻo May-Thurner Syndrome i ke ola. Eia nō naʻe, hiki iā ia ke alakaʻi i kahi pilikia weliweli i kapa ʻia ʻo Pulmonary Embolism. ʻO ia ka mea e hoʻoweliweli ai i ke ola. No laila, he mea nui loa ka makaʻala i nā hōʻailona o Pulmonary Embolism a e ʻimi koke i ke kōkua lapaʻau inā manaʻo ʻoe i kekahi mea e like me ia.

Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe ka `(May-Thurner Syndrome)`?

ʻO ka ʻoiaʻiʻo, ʻaʻole paha ʻoe e hiki ke ʻike maopopo inā loaʻa iā ʻoe ka `(May-Thurner Syndrome)` no ka mea, ʻaʻole ʻike ka poʻe he nui ua loaʻa iā lākou a hiki i ka loaʻa ʻana o nā hōʻailona o `(DVT)`.

ʻO ke ala wale nō e ʻike maopopo ai, ʻo ia ke hana i nā hoʻokolohua kiʻi a mākou i kamaʻilio ai ma mua (e like me CT, MRI, Venogram, IVUS) a hōʻoia i ka kahe ʻana o ke aʻa iliac hema mai ke aʻa iliac ʻākau.

Nā mea nui e hoʻomanaʻo (Leka Lawe-Home)

ʻAe, eia nā mea nui e pono ai ʻoe e hoʻomanaʻo e pili ana i ka "May-Thurner Syndrome" a mākou i kamaʻilio nui ai:

• ʻO ka May-Thurner Syndrome kahi kūlana kahi e ʻomi ai kou aʻa iliac ʻākau i kou aʻa iliac hema, e ālai ana i ke kahe o ke koko mai kou wāwae hema i kou puʻuwai.
• Hoʻonui kēia i ka pilikia o ka hoʻomohala ʻana i kahi maʻi i kapa ʻia ʻo "Deep Vein Thrombosis - DVT" (nā ʻōpū koko i loko o nā aʻa hohonu) .
• ʻAʻole ʻike ka hapa nui o ka poʻe i kekahi mau hōʻailona . Inā loaʻa nā hōʻailona, ​​​​​​ʻo ia pinepine nā mea e like me ka ʻeha ma ka wāwae hema, ka pehu ʻana, ke kaumaha, a me nā loli o ke kala o ka ʻili.
• ʻO ka pahuhopu o ka mālama ʻana e hōʻemi i ke kaomi, hoʻihoʻi i ke kahe koko, a hoʻemi i ka pilikia o DVT. ʻO ka angioplasty a me ka stenting nā lāʻau lapaʻau maʻamau.
• Inā ʻike ʻoe i nā hōʻailona o kahi DVT (pehu koke, ʻeha, ʻulaʻula, mehana i ka pā ʻana i kou wāwae), e ʻike koke i ke kauka.
• ʻO nā hōʻailona o ka "Pulmonary Embolism" (ka pōkole koke o ka hanu, ka ʻeha o ka umauma, ke kuʻi ʻana i ke koko, ka manaʻo palupalu) he pilikia olakino ia. I kēlā hihia, e hele koke i ka haukapila me ka hoʻokaʻulua ʻole.

He mea nui loa ka makaʻala i kēia maʻi. No ka mea, inā ʻike mua ʻia, e kōkua nui ia i ka pale ʻana i nā pilikia koʻikoʻi. Mai hopohopo, akā e makaʻala i nā hōʻailona i ʻōlelo ʻia ma luna a mai kānalua e ʻimi i ke aʻo lapaʻau inā pono.

`ʻO ka maʻi May-Thurner, Iliac Vein Thrombosis, DVT, Deep Vein Thrombosis, Pehu ʻana o ka wāwae, ʻeha wāwae, Pulmonary Embolism, Blood Clots, Maʻi aʻa