Ke manaʻo nei ʻoe e paʻa ana kou aa puʻupaʻa hema? ʻO Nutcracker Syndrome kona inoa! E kamaʻilio kākou e pili ana.

Ua loaʻa anei iā ʻoe ka ʻeha ma kou ʻaoʻao hema o kou ʻōpū a i ʻole kou mau iwi ʻaoʻao? A i ʻole ua ʻike ʻoe i ke koko i loko o kou mimi? I kekahi manawa hiki ke hoʻowahāwahā ʻia kēia mau mea. Eia nō naʻe, hiki iā lākou ke lilo i mau hōʻailona o kahi maʻi e pono ai ka nānā ʻana. ʻO kekahi o ia ʻano maʻi, ʻaʻole i kamaʻilio nui ʻia, akā he mea nui e ʻike e pili ana, ua kapa ʻia ʻo Nutcracker Syndrome. I kēia lā, e kamaʻilio mākou e pili ana i ia mea me nā kikoʻī a me ka maʻalahi.

He aha ka Nutcracker Syndrome? He aha ka mea e hana nei?

I ka ʻōlelo maʻalahi, ʻo ka Nutcracker Syndrome kahi kūlana kahi e ālai ʻia ai kahi kīʻaha koko nui mai kou puʻupaʻa hema (i kapa ʻia hoʻi ʻo "left renal vein"). ʻO kēia kīʻaha koko ka mea e lawe i ke koko i hoʻomaʻemaʻe ʻia mai kou puʻupaʻa hema i kou puʻuwai. No laila, ke ālai ʻia kēia kīʻaha koko, ua ālai ʻia ke kahe o ke koko.

E noʻonoʻo, ʻo kēia kīʻaha koko e hele mai ana mai kou puʻupaʻa hema, pono e hele i ka puʻuwai ma o ʻelua mau kīʻaha koko nui i loko o ko kākou ʻōpū. ʻO kekahi ke aʻa nui i loko o ko kākou ʻōpū, ʻo ia ka "aorta ʻōpū". ʻO kekahi ka "superior mesenteric artery". ʻO ka maʻamau, hiki i ka renal vein ke hele ma waena o kēia mau aʻa ʻelua me ke keʻakeʻa ʻole.

Eia nō naʻe, i loko o kekahi kanaka me ka maʻi nutcracker, hui pū kēlā mau aʻa nui ʻelua e like me nā waha ʻelua o ka nutcracker, e ʻūmiʻi ana i ke aʻa renal . E like me ka nati e haki ʻia ana me kahi nati. ʻO ia ke kumu i kapa ʻia ai ʻo "nutcracker." Ke paʻa, piʻi ke koko i loko o ke aʻa renal, a hoʻomaka ke koko e kahe i hope. Hiki i kēia ke hoʻoulu i nā kīʻaha koko liʻiliʻi a puni ia e pehu.

ʻElua mau ʻano nui ma muli o ke ʻano o kēia hoʻopaʻa ʻana:

• ʻO ka Anterior Nutcracker Syndrome: ʻO kēia ke ʻano maʻamau. Hana ʻia ia i ka wā e ʻomi ʻia ai ke aʻa renal i mua o ka aorta abdominal, ʻo ia hoʻi ma ke alo o ka ʻōpū.
• ʻO ka Posterior Nutcracker Syndrome: He mea kākaʻikahi kēia. Maanei, ua ʻomi ʻia ke aʻa renal ma hope o ka aorta abdominal, kahi e hele ai ma waena o ka iwi kuamoʻo a me ka aorta.

Aia kekahi mau ala ʻē aʻe i ʻoi aku ka kakaikahi, akā ʻaʻole pono mākou e kamaʻilio nui e pili ana iā lākou.

ʻO ka ʻokoʻa ma waena o ka Nutcracker Phenomenon a me ka Nutcracker Syndrome

Mai huikau i nā mea ʻelua. ʻO ka Nutcracker Phenomenon ka wā e ʻūlū ai ka aʻa renal, akā ʻaʻohe hōʻailona. I kekahi manawa ʻike ʻia ia ma ke ʻano ulia i ka wā o ka scan no kekahi maʻi ʻē aʻe.

Eia nō naʻe, ʻo ka Nutcracker Syndrome ka wā, ma waho aʻe o ka paʻa, loaʻa pū kekahi mau hōʻailona. ʻO ia hoʻi, ke ʻike nei ʻoe i ka ʻoluʻolu ʻole ma muli o kēia paʻa. ʻO ia ka manawa e pono ai ka lāʻau lapaʻau.

No ke aha i kapa ʻia ai kēia ʻo "The Nutcracker"?

E like me kaʻu i ʻōlelo ai ma mua, i ka makahiki 1937, ua wehewehe kekahi mea noiʻi lapaʻau i kēia kūlana e like me nā aʻa nui ʻelua i loko o ka ʻōpū "e like me nā ʻāwae ʻelua o kahi mōneka e ʻomi ana i ke aʻa renal." Ua ʻōlelo pū ʻo ia he "e like me ka maiʻa i kuʻi ʻia e kahi mōneka." ʻO ia ke kumu i kapa ʻia ai kēia. ʻO ka inoa lapaʻau maʻamau no kēia ʻo 'left renal vein entrapment syndrome .'

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi? Pehea ka maʻamau o ia mea?

Hiki i ka maʻi Nutcracker ke hoʻopilikia i nā keiki a me nā pākeke a hiki i ka makahiki 60. Eia nō naʻe, ua hōʻike kekahi mau noiʻi he mea maʻamau ia i nā poʻe i ko lākou mau makahiki iwakālua, iwakālua, a me kanakolu . ʻOi aku ka maʻamau i nā poʻe me ka helu helu kino haʻahaʻa (BMI), ʻo ia hoʻi he wiwi lākou .

Ua manaʻo ʻia kēia he maʻi laha ʻole , akā ʻaʻohe ʻikepili e pili ana i ka nui o ka poʻe i loaʻa iā ia.

He aha ka pōʻino o ka Nutcracker Syndrome? Aia kekahi mau pilikia?

I kekahi manawa hiki ʻole i kēia ke hana i nā hōʻailona nui a hiki ke hoʻopau iā ia iho, ʻoiai i nā keiki. Eia nō naʻe, inā ʻaʻole mālama ʻia, hiki iā ia ke alakaʻi i nā pilikia i ka hala ʻana o ka manawa. ʻO kēia mau mea:

• Hoʻokumu ʻia nā ʻūpā koko i loko o ka aa renal.
• Hiki mai ka hōʻino ʻia ʻana o nā puʻupaʻa ma muli o ka hoʻonui ʻia o ke kaomi i loko o nā aʻa renal i ka hala ʻana o ka manawa.
• Hiki i nā kāne ke ʻike i ka hānau ʻole ʻana o ke kāne a i ʻole hiki i nā wahine ke ʻike i ka hānau ʻole ʻana o ka wahine .
• Hiki ke loaʻa ka ʻeha nui e hiki ke hoʻopilikia i kou ola.

He mea nui: ʻAʻole e ʻike nā kānaka a pau i kēia mau pilikia. Eia nō naʻe, inā loaʻa iā ʻoe nā hōʻailona, ​​ʻoi aku ka maikaʻi o ke ʻike koke ʻana i ke kauka no ka ʻōlelo aʻo.

He aha nā hōʻailona? Nā mea āu e manaʻo ai a me nā mea a kāu kauka e ʻike ai

Aia kekahi mau hōʻailona o ka nutcracker syndrome. ʻO nā mea āu e ʻike ai:

• Koko i loko o ka mimi (hematuria): ʻO kēia ka hōʻailona maʻamau. Hiki ke poni, ʻulaʻula, a ʻeleʻele paha ke kala o ka mimi.
• Manaʻo poniuniu i ke kū ʻana (orthostatic hypotension): ʻO ke ʻano kēia, ke kū koke ʻoe i luna, lilo kou mau maka i polū a manaʻo ʻoe i poniuniu.
• ʻEha hema hema: Hiki ke ʻeha ma ka ʻaoʻao hema, ma hope pono o nā iwi ʻaoʻao.

Hiki ke ʻokoʻa iki kēia mau hōʻailona ma muli o ke kāne.

No nā kāne: ʻO kahi kūlana i kapa ʻia ʻo varicocele , ʻo ia hoʻi ka pehu ʻana o nā kīʻaha koko i loko o nā testicles, e hiki mai paha.

Hiki i nā wāhine ke ʻike i nā hōʻailona o ka pelvic congestion syndrome, i hoʻokumu ʻia e ke koko e hōʻuluʻulu ana ma ka ʻāpana pelvic. ʻO kēia mau mea:

• ʻEha i ka wā o ka moekolohe (dyspareunia).
• ʻEha i ka wā e mimi ai (dysuria).
• ʻEha ma ka ʻōpū lalo, ʻo ia hoʻi, ma ka ʻāpana pelvic (ʻeha pelvic).

Ma waho aʻe o kēia mau mea, aia kekahi mau hōʻailona e hiki i ke kauka ke ʻike ma o nā hoʻokolohua. ʻAʻole hiki iā ʻoe ke ʻike iā lākou.

• ʻO ka nele o nā hunaola koko ʻulaʻula i loko o ke koko, ʻo ia hoʻi , anemia .
• ʻO Microhematuria ka nui o ke koko i loko o ka mimi, he ʻano liʻiliʻi loa ia a hiki ke ʻike wale ʻia ma lalo o kahi microscope.
• ʻO ka proteinuria ka nui o ka protein i loko o ka mimi.

No ke aha lā kēia e hana nei? He aha nā kumu?

ʻO ke kumu nui o ka Nutcracker Syndrome nā loli i ke ʻano o kou mau kīʻaha koko . I kekahi manawa hana ʻia kēia mau loli i kou wā i loko o ka ʻōpū o kou makuahine, i ka wā e hana ʻia ai kou mau kīʻaha koko. I kekahi manawa, hiki ke hana ʻia i ka wā o ka piʻi koke ʻana o ke kiʻekiʻe (growth spurts) i ka wā ʻōpiopio, a i ʻole ka emi koke ʻana o ke kaumaha i ka wā makua (pohō kaumaha). I kekahi mau hihia, ʻaʻohe kumu i loaʻa .

Pehea ʻoe e ʻike pono ai i kēia? He aha nā hoʻokolohua e hana ʻia?

Hiki ke lōʻihi ka manawa e ʻike ai i ka Nutcracker Syndrome, no ka mea, pono nā kauka e kāpae i nā kūlana ʻē aʻe he nui. Hoʻomaka ka ʻike ʻana me kahi hoʻokolokolo kino . E nīnau kāu kauka iā ʻoe e pili ana i kāu mau hōʻailona a nīnau e pili ana i kāu mau hōʻailona. A laila, hiki iā lākou ke kauoha i hoʻokahi a ʻoi aku paha o nā hoʻokolohua aʻe e ʻike hou aku:

• Nā hoʻāʻo koko
• ʻIke CT (ʻIke CT - ʻIke Tomography i hoʻopili ʻia)
• Hoʻāʻo ultrasound Doppler `(Doppler ultrasound)`
• ʻO ke kani ultrasound intravascular (IVUS)
• MRI scan (MRI - Magnetic Resonance Imaging scan)
• Venogram (lawe ʻana i kahi X-ray o nā veins ma hope o ka hoʻokomo ʻana i kahi dye)
• Ka nānā ʻana i ka mimi

He aha nā lāʻau lapaʻau no ka Nutcracker Syndrome?

Aia ka lāʻau lapaʻau i kou mau makahiki a me ke koʻikoʻi o kou mau hōʻailona. Ma muli o kou kūlana, hiki i kāu kauka ke hoʻomaka me nā lāʻau lapaʻau ʻoi aku ka ikaika . Inā ʻaʻole kōkua kēia mau mea, a inā e ʻoi aʻe ka ʻino o kāu mau hōʻailona, ​​pono paha ʻoe i ke ʻoki kino.

Hoʻokele Kūpaʻa

No nā kānaka he nui, ʻoi aku hoʻi nā keiki ma lalo o 18 makahiki , ʻo kēia ka hana mua i ka mālama ʻana i ke kaumaha o kāu keiki. Inā loaʻa i kāu keiki ka nutcracker syndrome, hiki i kāu kauka ke ʻōlelo aku e hoʻomau lākou i kēia ʻano hana a hiki i ʻelua mau makahiki. Pili kēia i ke kōkua ʻana i kāu keiki e hoʻonui i ke kaumaha me ka nānā ʻana i ke kūlana. Ke piʻi aʻe ke kaumaha i loko o ka ʻōpū, emi iho ke kaomi ma luna o ke aʻa renal. Paipai ʻia nā mākua e hoʻāʻo i kēia ʻano hana no kahi o ʻeono mahina.

Hiki i kēia hoʻokele laulā ke komo pū me nā lāʻau lapaʻau e kōkua ai i ka hana ʻana o nā puʻupaʻa. Eia kekahi laʻana:

• Nā mea hoʻopaʻa ACE
• ʻAspirina

Hana ʻoki kino

Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi a ʻaʻole holo pono nā lāʻau lapaʻau maʻamau, pono paha ʻoe i ke ʻoki kino a i ʻole ke kaʻina hana minimally invasive . E kamaʻilio kāu kauka me ʻoe e pili ana i kāu mau koho, nā pono a me nā pōʻino, a inā kūpono nā kaʻina hana minimally invasive iā ʻoe.

ʻO ka pahuhopu nui o ke ʻoki kino, ʻo ia ka hana ʻana i kahi ala laumania a me ke keʻakeʻa ʻole no ke kahe ʻana o ke koko mai ka puʻupaʻa a i ka puʻuwai.

ʻO kekahi o nā hana a me nā kaʻina hana i hana ʻia no ka Nutcracker Syndrome:

• ʻO ka hoʻololi ʻana o nā aʻa renal: Pili kēia i ka wehe ʻana i kou aʻa renal hema a hoʻopili hou iā ia i kahi aʻa nui i kapa ʻia ʻo ka vena cava haʻahaʻa. Hoʻopau kēia i ka pono e hele ma o ke aʻa mesenteric kiʻekiʻe a me ka aorta. Hiki ke hana ʻia kēia ma ke ʻano laparoscopically , ʻo ia hoʻi ma o kekahi mau ʻoki liʻiliʻi.
• Hoʻokomo ʻana i ka stent: ʻO kēia ke komo ʻana i kahi ʻōmole liʻiliʻi i kapa ʻia he stent i loko o ke aʻa renal i ālai ʻia ma o kahi lua liʻiliʻi i loko o ka ʻili. Wehe kēia ʻōmole i ke aʻa a ʻae i ke koko e kahe manuahi.
• ʻO ke ʻoki ʻana o Renal autotransplantation: Ma kēia, ua wehe ʻia kou puʻupaʻa hema a hoʻihoʻi ʻia i loko o kou kino, ma ka iwi ʻūhā.

He mea weliweli anei kēia mau ʻoki kino?

Loaʻa i kēlā me kēia ʻoki kino no ka Nutcracker Syndrome kekahi mau pilikia. E kamaʻilio pono me kāu kauka e pili ana i nā pilikia o ke ʻoki kino āu e hana ai.

ʻO ka Renal autotransplantation ka mea komo nui loa o kēia mau ʻoki kino. ʻO kāna mau pilikia nui ka hāʻule ʻana o nā puʻupaʻa a me ke kahe ʻana o ke koko. Hiki ke hoʻemi ʻia ka pilikia o nā pilikia ma ka mālama ʻia ʻana ma kahi haukapila nui me nā kauka ʻokiʻoki akamai e hana mau ana i ia mau ʻoki kino .

Aia kekahi ala e hōʻemi ai i kēia hanana?

ʻO ka ʻoiaʻiʻo, ʻaʻohe ala i ʻike ʻia e hōʻemi ai i ka pilikia o ka hoʻomohala ʻana i kēia maʻi. Hoʻomaka koke ka maʻi Nutcracker, ʻaʻole ia he hoʻoilina.

Eia nō naʻe, ʻike pinepine nā kauka i ka hanana nutcracker (asymptomatic renal vein stenosis) ma ka ulia i ka wā o nā hoʻokolohua i hana ʻia no nā kumu ʻē aʻe. No laila, he mea nui loa ia e hoʻomau i kāu mau hoʻokolohua lapaʻau a me nā manawa hoʻonohonoho keʻena lapaʻau. A laila, hiki iā ʻoe ke ʻike inā loaʻa iā ʻoe ka renal vein stenosis ma mua o kou loaʻa ʻana o nā hōʻailona. A laila, e ʻike ʻoe e pono ʻoe e ʻimi koke i ka lāʻau lapaʻau inā loaʻa nā hōʻailona.

He aha ka mea e hiki mai ana no ka poʻe me ka Nutcracker Syndrome?

I nā keiki, maikaʻi loa ka hopena. Hoʻōla ka nui o nā keiki me ka ʻole o ka lāʻau nui, e like me ke ʻoki ʻana. I nā pākeke, ʻokoʻa nā hopena ma muli o ke koʻikoʻi o nā hōʻailona a me ka manawa e hoʻomaka ai ka lāʻau. E kamaʻilio me kāu kauka e pili ana i ka nānā ʻana no kou kūlana.

Āhea wau e ʻike ai i ke kauka? He aha nā nīnau e pono ai iaʻu e nīnau?

Inā loaʻa iā ʻoe nā hōʻailona o ka nutcracker syndrome, a inā e ʻoi aʻe ka ʻino o kāu mau hōʻailona , ​​​​e ʻike pono i ke kauka.

Inā hana ʻoe i ke ʻoki kino, e hahai pono i nā ʻōlelo a kāu kauka e pili ana i ke ʻano o ka mālama ʻana iā ʻoe iho ma ka home. Eia kekahi, e hōʻoia e hele i nā hālāwai hoʻopaʻa .

Inā haʻi aku kāu kauka iā ʻoe he Nutcracker Syndrome kou, nui paha kāu mau nīnau. He mea nui e aʻo i ka nui o kāu hiki e pili ana i kāu mau koho lapaʻau a me ka manawa kūpono e ʻimi ai i ka lāʻau lapaʻau. Eia kekahi mau nīnau hiki iā ʻoe ke nīnau:

• Pehea ka hopena o kēia maʻi i koʻu kino?
• Pehea ke koʻikoʻi o koʻu kūlana?
• Pono anei au i ka lāʻau lapaʻau? Inā pēlā, i ka manawa hea?
• He aha ke koho lapaʻau kūpono loa iaʻu?
• He aha ka holomua o kēia lāʻau lapaʻau?
• He aha nā pilikia o ka mālama ʻana?
• ʻEhia ka lōʻihi e ho'ōla ai?

Hiki i kekahi poʻe me ka nutcracker syndrome ke loaʻa nā pilikia aa koko ʻē aʻe. E kamaʻilio me kāu kauka e pili ana i nā kūlana ʻē aʻe āu i loaʻa ai a pehea e mālama ai iā lākou.

Inā ua loaʻa iā ʻoe nā hōʻailona no kekahi manawa akā ʻaʻole ʻoe i ʻike i ke kumu, hiki ke lilo i mea hōʻoluʻolu ke loaʻa kahi hōʻailona. Akā hiki nō hoʻi ke hopohopo iki ke noʻonoʻo e pili ana i nā koho lapaʻau a inā pono ʻoe i ke ʻoki kino. ʻO ka nūhou maikaʻi, ke aʻo mau nei nā mea noiʻi e pili ana i kēia kūlana a pehea e hoʻokele ai me nā ʻano invasive minimally. E kamaʻilio me kāu kauka e pili ana i ka hoʻolālā lapaʻau maikaʻi loa nāu a me nā mea e manaʻo ai i ka wā e hiki mai ana.

ʻO ka mea hope loa, kekahi mau mea nui (Leka Lawe-Home)

ʻAe, ua kamaʻilio nui mākou e pili ana i ka Nutcracker Syndrome. Eia kekahi o nā mea nui e hoʻomanaʻo:

• He kūlana kēia i hoʻokumu ʻia e kahi paʻa ʻana o kahi kīʻaha koko ma ka puʻupaʻa hema .
• Inā ʻike ʻoe i nā hōʻailona e like me ke koko i loko o kou mimi a i ʻole ka ʻeha ma kou ʻaoʻao hema, e ʻike i ke kauka.
• Hiki i nā keiki ke ho'ōla pinepine iā lākou iho.
• Aia nā koho lapaʻau like ʻole no nā pākeke, ʻoiai ke ʻoki kino, ma muli o nā hōʻailona.
• Mai makaʻu, akā he mea nui e ʻike ʻia. E kamaʻilio ākea me kāu kauka a koho i ka lāʻau lapaʻau kūpono iā ʻoe.

Manaʻolana wau he mea pono kēia ʻike nou. E ola kino!

ʻO ka maʻi Nutcracker, maʻi puʻupaʻa, aʻa puʻupaʻa hema, stenosis o ke kīʻaha koko, koko i loko o ka mimi, ʻeha ʻōpū, ʻoki kino