E aʻo kākou e pili ana i ka Subclavian Steal Syndrome - kahi maʻi e "ʻaihue" i ke koko i ka lolo!

Ke manaʻo nei ʻoe i kekahi manawa ua poniuniu a ua pōʻeleʻele paha kou ʻike? A i ʻole ke manaʻo nei ʻoe e mae a mae paha kou lima, ʻoiai ke hana ʻoe i kahi mea me kou mau lima, hāpai i kahi mea kaumaha, a hoʻohuli koke paha i kou poʻo i kekahi ʻaoʻao? Inā hana ʻia kēia, hiki ke lilo i kūlana a mākou e kamaʻilio nei i kēia lā i kapa ʻia ʻo "Subclavian Steal Syndrome." He ʻano ʻē paha ka inoa, e like me, "He maʻi ʻaihue anei kēia?" Mai hopohopo, e kamaʻilio kākou e pili ana i ia mea me ka maʻalahi a me ka maopopo.

He aha ke ʻano o ka Subclavian Steal Syndrome?

I ka ʻōlelo maʻalahi, ʻo ka subclavian steal syndrome ka wā e "ʻaihue" ai kekahi o ke koko e pono e hele i kou lolo i loko o kou lima. Hana ʻia kēia no ka mea ua ālai ʻia a paʻa paha ke aʻa subclavian, kahi kīʻaha koko nui e hoʻolako ana i ke koko i kou lima (ʻo ka mea ma ka ʻaoʻao hema).

E noʻonoʻo i kēia ʻano. Ke hoʻāʻo nei ʻoe e ʻai i kahi pā meaʻai. Ua like ia me kekahi e kokoke ana iā ʻoe e "ʻai malū" ana i kahi a ʻelua paha o ka meaʻai āu e hoʻāʻo nei e ʻai. ʻO kekahi o ke koko hānai e pono e hele i kou lolo "komo malū" i loko o kou lima. No laila, emi iho ka nui o ke koko e hiki ke hele i kou lolo, e like me ka nui o ka meaʻai āu e hiki ai ke ʻai.

I ka wā e paʻa nui ai kēia aʻa koko, kahe ke koko ma o ke aʻa koko subclavian ma ke kaomi haʻahaʻa. Eia nō naʻe, ʻoi aku ke kiʻekiʻe o ke kaomi koko ma nā aʻa koko ʻē aʻe e kokoke ana. ʻO ka hopena, hoʻohuli ke kahe koko ma ke aʻa koko vertebral, ka mea e lālā ana mai ke aʻa koko subclavian a lawe i ke koko i ka lolo. A laila komo kekahi o kēlā koko i loko o ke aʻa koko subclavian a hele i ka lima. ʻO ia ka mea i kapa ʻia he "ʻaihue."

Aia kekahi maʻi ʻē aʻe i kapa ʻia ʻo "coronary steal syndrome". ʻO kēia ka wā e ālai ʻia ai ke koko e pono ai ke hele i ka ʻiʻo puʻuwai. ʻAʻole kēia e hana i nā kānaka a pau, akā i kekahi poʻe wale nō i loaʻa i kekahi mau ʻano ʻoki puʻuwai (coronary artery bypass surgery). ʻO ke kumu nui o kēia mau syndromes ʻelua, ʻo ia ka hōʻiliʻili ʻana o ka momona i loko o nā paia o ke aʻa, a i ʻole "plaque", kahi maʻi i kapa ʻia ʻo "atherosclerosis" ma nā ʻōlelo lapaʻau. A i ʻole aia paha kekahi mau kumu ʻē aʻe e hoʻoemi ai i ke aʻa subclavian.

Pehea ka maʻamau o kēia ʻano?

ʻAʻole hiki i nā kānaka noiʻi ke ʻōlelo pololei i ka nui o ka poʻe i loaʻa i ka subclavian steal syndrome, akā ua manaʻo lākou ma waena o 0.6% a me 6.4% o ka heluna kanaka e loaʻa paha iā ia. Eia kekahi, ma kahi o 18% o ka poʻe me ka maʻi peripheral artery e loaʻa pū kekahi i ka syndrome.

ʻOi aku ka maʻamau o kēia ʻano maʻi i nā kāne a me nā poʻe ma luna o 55 mau makahiki .

Eia nō naʻe, mahalo i nā ʻano hana kiʻi holomua i loaʻa i kēia lā, ua ʻoi aku ka maʻalahi o ka ʻike ʻana i kēia ʻano maʻi i nā poʻe me ka ʻole o nā hōʻailona.

He aha nā hōʻailona o ka subclavian steel syndrome?

Hōʻike pinepine ʻia nā hōʻailona o ka subclavian steel syndrome ke hana ʻoe i ka hana lima ikaika a i ʻole e hoʻohuli koke i kou poʻo i kekahi ʻaoʻao.E nānā inā loaʻa iā ʻoe kekahi o kēia mau ʻano:

• ʻIke pōwehiwehi
• Pōʻino
• ʻEha, ʻūlū, ʻūlū, a i ʻole ke kaumaha ma ka lima
• Ka mae ʻana
• Ka nalowale o ka lohe (kākaʻikahi)
• Manaʻo e like me ʻoe e milo ana a puni (Vertigo)
• ʻO ke Ataxia kahi kūlana e nalowale ai ke kaulike o ke kino a hiki ʻole ke hele pono.

Akā, ʻaʻole ʻike ka hapa nui o ka poʻe i kekahi mau hōʻailona. No ka mea, loaʻa i ko lākou lolo ke koko lawa mai nā aʻa olakino ʻē aʻe. ʻAʻole pono lākou i ka lāʻau lapaʻau.

He aha ke kumu o ka subclavian steel syndrome?

Aia kekahi mau kumu nui no kēia:

• Atherosclerosis - ʻO kēia ke kumu maʻamau o ka maʻi.
• Nā malformations arteriovenous (nā pilina maʻamau ʻole ma waena o nā aʻa a me nā veins)
• Ka ʻoki ʻana o ke aorta
• ʻO ka arteritis o Takayasu, kahi maʻi mumū o nā aʻa
• ʻO ka fibromuscular dysplasia kahi ulu ʻano ʻē o nā paia o ke aʻa.

Ua like kēia mau kumu me nā mea e hoʻoulu ai i ka stenosis o ke aʻa subclavian.

ʻO wai ka mea i pilikia nui no kēia?

Eia kekahi mau mea e hoʻonui ai i ka pilikia o ka hoʻomohala ʻana i ka subclavian steel syndrome:

• Inā ua hana ʻia ʻoe i ke ʻoki ʻana e hoʻoponopono i ka ʻūlū ʻana o ka aorta (coarctation o ka aorta).
• Inā he mau pilikia me ke kāʻei aortic a i ʻole kekahi o nā kīʻaha koko mai ka hānau ʻana.
• Ka hoʻopili ʻana o ke aʻa subclavian (he mea maʻamau kēia i kekahi mau mea pāʻani).
• Inā he iwi ʻaoʻao keu (iwi ʻaoʻao cervical) ma ka ʻāpana ʻāʻī.

He aha nā pilikia e hiki ke kū mai mai kēia maʻi?

Inā loaʻa iā ʻoe nā manawa heʻe ma muli o ka subclavian steal syndrome, hiki iā ia ke alakaʻi i ka hāʻule ʻana a me nā ʻeha. Hiki iā ia ke paʻakikī i ka hana ʻana i kekahi hana me ka lima i hoʻopilikia ʻia.

Pehea e ʻike ʻia ai ka subclavian steel syndrome?

ʻO ka mea mua a ke kauka e hana ai e ʻike i kēia, ʻo ia ke hana i kahi hoʻokolokolo kino. E nānā pono ke kauka i ka pulse ma kou mau lima a me nā pulima. E nānā pū ʻo ia i nā aʻa carotid ma nā ʻaoʻao ʻelua o kou ʻāʻī a me ke aʻa subclavian, e ʻimi ana i nā leo "swoosh..." ʻē (bruit). Inā lohe ʻoe i ia leo me ka stethoscope, aia paha he poloka i loko o kēlā aʻa.

He aha nā hōʻailona o "Steele Syndrome" i ʻike ʻia i ka wā o ka hoʻokolokolo lapaʻau?

Inā loaʻa iā ʻoe ka subclavian artery syndrome, e ana kāu kauka i kou koko ma nā lima ʻelua a ʻike i kahi ʻokoʻa i nā heluhelu. Hiki i ke koko ma kekahi lima ke piʻi aʻe i 15 millimeters o ka mercury (mmHg) ma mua o kekahi.

Eia kekahi, inā e nānā ʻia nā pulse radial i ka manawa like, ʻike ʻia ka pulse ma ka ʻaoʻao me ka subclavian steel syndrome he nāwaliwali a manaʻo paha e like me ka thud.

He aha nā hoʻokolohua e hana ʻia e hōʻoia i kēia?

E hana mua ke kauka i kahi ultrasound o kou aʻa subclavian. Ma hope o kēlā, hiki ke hana ʻia nā hoʻokolohua aʻe, inā pono:

• Hoʻāʻo MRA (magnetic resonance angiogram).
• Hoʻāʻo CT Angiogram (CT - angiogram tomography i helu ʻia).
• ʻO ka angiogram hoʻokaʻawale kikohoʻe - He ʻano hana kūikawā kēia e wehe ai i nā ʻāpana kino ʻē aʻe mai ke kiʻi a ʻo nā kīʻaha koko wale nō ke ʻike maopopo ʻia.

ʻAe kēia mau hoʻokolohua i nā kauka e hoʻokaʻawale i ke koʻikoʻi o ka subclavian steel syndrome (ʻoluʻolu a koʻikoʻi paha). Hoʻohana lākou i nā papa I, II, a me III, me ka Papa III ka mea koʻikoʻi loa. Kōkua pū lākou i ka hoʻoholo ʻana i ke ʻano o ka lāʻau e pono ai.

He aha nā lāʻau lapaʻau no ka subclavian steel syndrome?

Inā loaʻa iā ʻoe nā hōʻailona, ​​​​pono paha ʻoe e hana i ke ʻoki ʻana e hoʻomaikaʻi i ke kahe koko i loko o ke aʻa subclavian ma ke ʻano he lāʻau lapaʻau no ka stenosis aʻa subclavian. Ma muli o kou kūlana, he ʻoki wehe paha kēia a i ʻole he ʻoki endovascular (kahi hana e pili ana i ka hoʻokomo ʻana i nā mea hana liʻiliʻi ma o kahi kīʻaha koko). Pono ʻoe e pale i ka hoʻohana nui ʻana i ka lima i hoʻopilikia ʻia a hiki i ka pau ʻana o ke ʻoki ʻana.

Inā ʻaʻole ʻoe kūpono no ke ʻoki ʻana, hiki i kāu kauka ke kuhikuhi i nā anticoagulants a i ʻole nā ​​​​antiplatelets.

Inā he mau ʻōuli iki kou, hiki ke hoʻomaikaʻi i ka hala ʻana o ka manawa. I ia mau hihia, hiki i kāu kauka ke kuhikuhi i ka lāʻau lapaʻau e hoʻohaʻahaʻa i kou koko a me nā pae cholesterol.

ʻO ka mea nui , ʻo ka poʻe i ʻike ʻole i nā hōʻailona o ka maʻi, ʻaʻole pono lākou i ka lāʻau lapaʻau. Eia nō naʻe, inā he ʻūlū kou ma kou aʻa subclavian, nui ka manawa e like ai ia ma nā aʻa ʻē aʻe. ʻO kēia no ka mea, ʻo kēia ʻano hōʻiliʻili plaque (atherosclerosis) e hoʻopilikia pinepine i nā aʻa ma ke kino holoʻokoʻa.

No laila, pono ʻoe e loaʻa ka lāʻau no kēia mau plaques. Inā he mea puhi paka ʻoe, pono ʻoe e hoʻōki i ka puhi paka, a kāohi i kou koko kiʻekiʻe a me ka cholesterol kiʻekiʻe . Hiki i kēia mau mea ke kōkua i ka pale ʻana i ka hōʻeha puʻuwai a i ʻole ka hahau ʻana i ka wā e hiki mai ana.

He aha nā lāʻau lapaʻau/ʻoki kino kikoʻī i hoʻohana ʻia no kēia?

Pono paha ʻoe i hoʻokahi a ʻoi aku paha o kēia mau ʻano hana:

• He ʻoki kino e hana i kahi ala bypass ma ka hoʻopili ʻana i ke aʻa subclavian i kekahi aʻa ʻē aʻe (no ka laʻana, ke aʻa carotid).
• ʻO Angioplasty a me ka stenting - Pili kēia i ka hoʻonui ʻana i ka wahi i paʻa ʻia me kahi mea e like me ka pōpō a laila hoʻokomo i kahi stent e like me ka mesh e pale aku ai i ka paʻa hou ʻana.
• Atherectomy - ʻO ke ʻano kēia o ka wehe ʻana i ka plaque mai loko mai o ke aʻa.
• Endarterectomy - wehe ʻana i kahi ʻāpana o ka uhi o loko o ke aʻa.

Hiki ke loaʻa nā pilikia mai ka mālama ʻana?

ʻAe, ʻokoʻa nā pilikia ma muli o ka lāʻau lapaʻau. Hiki iā lākou ke komo pū me:

• Ke hāiki hou nei kou aʻa subclavian.
• Hiki ke hana ʻia nā ʻūpā koko, a hiki nō hoʻi ke alakaʻi i ka hahau ʻana.
• Ka hōʻino ʻana i ke aʻalolo a i ʻole ke kīʻaha koko.
• Loaʻa kekahi mau pilikia i ka wā e hoʻōla ai.

Pehea ka lōʻihi e hoʻōla ai ma hope o kēia mau lāʻau lapaʻau?

Hiki i ka hoʻōla ʻana mai ka mālama ʻana no ka subclavian steel syndrome ke hala i kekahi mau lā, hoʻokahi pule, a ʻoi aku paha. ʻO ka hoʻōla ʻana mai ke ʻoki ʻana ka mea lōʻihi loa.

He aha kaʻu e manaʻo ai inā loaʻa iaʻu ka subclavian steel syndrome?

ʻOi aku ma mua o 95% o ka poʻe e hana ʻia ana i ka mālama ʻoki no ka subclavian steel syndrome ʻaʻole pono lākou e hana hou i ke ʻoki. Ma ke ʻano laulā, maikaʻi ko lākou prognosis.

He mea hoʻoweliweli anei ke ʻano ʻaihue subclavian i ke ola?

ʻAʻole, ʻaʻole kēia he kūlana hoʻoweliweli i ke ola. Eia nō naʻe, he hōʻailona koʻikoʻi ia! ʻO ia hoʻi, he atherosclerosis kou, kahi maʻi o nā aʻa. Ke hōʻiliʻili ka plaque i loko o kou mau aʻa, ʻaʻole paha e loaʻa i kou puʻuwai a lolo paha ka oxygen lawa i ka wā e hiki mai ana. Hoʻonui kēia i ka pilikia o ka hōʻeha puʻuwai a i ʻole ka hahau.

Hiki ke pale ʻia ka subclavian steel syndrome?

ʻAʻole hiki iā mākou ke kāohi i kekahi o nā kumu o ka subclavian steel syndrome (e like me nā kumu genetic). Eia nō naʻe, hiki ke pale nui ʻia ka ulu ʻana o kēia syndrome ma ka pale ʻana i ka hōʻiliʻili ʻana o ka plaque (atherosclerosis), ʻo ia ke kumu pinepine .

Pehea e hiki ai iaʻu ke hōʻemi i koʻu pilikia?

Hiki iā ʻoe ke hōʻemi i kou pilikia o ka hoʻomohala ʻana i kēia ʻano - a no laila kou pilikia o ka subclavian steel syndrome - ma ka hana ʻana i kēia mau hoʻololi i kou ola o kēlā me kēia lā:

• E mālama i kahi kaumaha olakino e kūpono iā ʻoe.
• E hana i ka hana kino (hoʻoikaika kino) no ka liʻiliʻi he 30 mau minuke i ka lā i ka hapa nui o nā lā.
• E pale loa i ka hoʻohana ʻana i nā huahana paka (e like me nā cigarettes a me nā beedis).
• E ʻai i nā meaʻai olakino no ka puʻuwai (haʻahaʻa i ka momona saturated a me ka momona trans).
• Inā loaʻa iā ʻoe nā maʻi e like me ke cholesterol kiʻekiʻe, ke koko kiʻekiʻe, a me ka maʻi diabetes, e kaohi pono iā lākou.

Pehea wau e mālama ai iaʻu iho?

Inā loaʻa iā ʻoe ka subclavian steel syndrome, he mea nui e lawe i kāu mau lāʻau lapaʻau e like me ke kuhikuhi a kāu kauka, e hana i kekahi hana ʻoki kino e pono ai, a kaohi i ke koko kiʻekiʻe, ka cholesterol kiʻekiʻe, a me ka maʻi diabetes (inā loaʻa iā ʻoe) a pale i nā huahana paka.

Āhea wau e ʻike ai i kaʻu kauka?

Ma hope o ka lāʻau lapaʻau, pono ʻoe e hana i nā nānā maʻamau, ʻoiai inā hoʻi hou kāu mau hōʻailona. Inā manaʻo kāu kauka ua emi hou kou aʻa subclavian, hiki iā ia ke kauoha i nā hoʻokolohua kiʻi hou aku. Pono ʻoe e hana i nā nānā ma hoʻokahi mahina, ʻeono mahina, a i ʻole hoʻokahi makahiki ma hope o ka lāʻau lapaʻau. Ma hope o kēlā, hiki iā ʻoe ke ʻike i kāu kauka ma kahi o hoʻokahi manawa i ka makahiki.

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

He mea maikaʻi ke nīnau i kāu kauka i nā nīnau e like me kēia:

• ʻEhia ka manawa e pono ai iaʻu ka lāʻau lapaʻau?
• He aha ke ʻano lapaʻau kūpono loa iaʻu?
• He aha kou pae kūleʻa i ka mālama ʻana i nā poʻe me kēia maʻi?

No laila, he aha ka mea nui loa e pono ai kākou e hoʻomanaʻo mai kēia mau mea a pau?

ʻOiai ka huaʻōlelo "Steal" ma kona inoa, he maʻi hiki ke mālama ʻia ka subclavian steal syndrome. ʻAʻole pono ka hapa nui o ka poʻe i ka lāʻau lapaʻau. Akā ʻo ka leka nui loa a mākou e loaʻa ai mai kēia, ʻo ia ka hōʻiliʻili ʻana o ka plaque (atherosclerosis) i loko o kou mau aʻa. Ke haʻi aku nei kou kino iā ʻoe, "E hoʻomaka i nā hana olakino puʻuwai i kēia manawa, a i ʻole e hoʻomaikaʻi i nā mea āu i loaʻa mua." E nīnau i kāu kauka e pili ana i nā hoʻololi hiki iā ʻoe ke hana e hoʻomaikaʻi i kou olakino. ʻOiai nā hoʻololi liʻiliʻi hiki iā ʻoe ke hana i kēia lā hiki ke loaʻa nā hopena nui. No laila, mai makaʻu kākou, e ʻike, a e kau i ke kahua no ke ola olakino, ʻeā?

ʻO ka maʻi ʻaihue subclavian, subclavian steal syndrome, emi ʻana o ke kahe koko i ka lolo, ka mae ʻana o ka lima, ka poniuniu, ka atherosclerosis