Qhov no puas yog qhov ua rau koj mob ceg? Cia peb kawm txog Popliteal Artery Entrapment Syndrome (PAES)!

Koj puas hnov ​​mob, nruj, lossis hnyav hauv koj ob txhais ceg, tshwj xeeb tshaj yog nyob rau thaj tsam ntawm lub duav, thaum koj ua si, khiav, lossis taug kev sai? Puas yog nws ploj mus tom qab ib pliag, tab sis nws puas rov qab los thaum koj pib ua si dua? Yog li ntawd, nws yog ib qho tseem ceeb heev rau koj kom paub txog qhov mob no hu ua popliteal artery entrapment syndrome. Tsis txhob txhawj, cia peb tham txog nws yooj yim.

Mob popliteal artery entrapment syndrome (PAES) yog dab tsi?

Hais yooj yim xwb, Popliteal Artery Entrapment Syndrome (PAES) yog ib qho mob uas tsis tshua muaj rau cov hlab ntsha. Nws feem ntau cuam tshuam rau cov tub ntxhais hluas, cov neeg ua si, tshwj xeeb tshaj yog cov neeg uas ua si kis las. Cov hlab ntsha popliteal yog cov hlab ntsha tseem ceeb uas khiav ntawm lub duav mus rau lub qhov ncauj tom qab peb lub hauv caug. Cov hlab ntsha no raug nias los ntawm cov leeg tom qab lub hauv caug, uas yog qhov tshwm sim hauv qhov mob no.

Xav txog nws zoo li ib lub yeeb nkab dej. Nws muab ntshav rau ceg qis. Tam sim no, cov hlab ntsha no tuaj yeem nqaim vim yog kev hloov pauv hauv txoj kev uas peb cov leeg nqaij gastrocnemius txuas rau pob txha ncej puab. Tshwj xeeb tshaj yog thaum peb khoov peb txhais taw (qhov no hu ua "plantar flexion" hauv cov lus kho mob), cov leeg nqaij gastrocnemius no nqaim. Tom qab ntawd cov hlab ntsha ntawd nqaim dua.

Thaum koj ua si nawv, cov hlab ntsha raug thawb tas li, ua rau nws ntswj. Tom qab ntawd yuav ua li cas? Cov ntshav uas mus rau ceg yuav txo qis. Qhov no ua rau cov khoom xws li lactic acid thiab carbon dioxide sib sau ua ke hauv cov leeg thiab cov hlab ntsha. Yog vim li cas koj thiaj hnov ​​​​​​qhov hnyav, mob, qaug zog, thiab qee zaum loog hauv koj ob txhais ceg thiab ko taw.

Qhov xov xwm zoo yog tias cov tsos mob no feem ntau ploj mus li ntawm peb mus rau tsib feeb tom qab tso tseg kev tawm dag zog. Txawm li cas los xij, yog tias tsis kho, dhau sijhawm, cov tsos mob no tuaj yeem hnyav dua thiab kav ntev dua. Qhov no txhais tau tias koj yuav pib hnov ​​​​​​mob txawm tias tom qab khiav mus deb me ntsis, thiab nws yuav siv sijhawm ntev dua los rov zoo.

Leej twg raug kev cuam tshuam ntau tshaj plaws los ntawm tus mob PAES no?

Tus mob no, hu ua PAES, feem ntau cuam tshuam rau cov tub ntxhais hluas uas muaj hnub nyoog ntawm 15 thiab 25 xyoo. Qhov kev pheej hmoo no yog siab tshwj xeeb rau cov neeg koom nrog kev ua si uas muaj kev khiav. Piv txwv li:

• Kev Sib Tw (Taug Kev)
• Kev khiav hla teb chaws
• Ncaws pob
• Lacrosse
• Kev ua si hockey hauv thaj teb

Xav txog ib tug menyuam yaus uas koom nrog kev sib tw khiav thiab ua si hauv tsev kawm ntawv, lossis ib tug tub hluas uas ncaws pob. Lawv feem ntau yuav muaj tus mob no vim lawv siv lawv ob txhais ceg tas li.

PAES muaj ntau npaum li cas?

PAES yog ib yam mob uas tsis tshua muaj . Kwv yees li ntawm 1% ntawm cov pej xeem muaj nws. Yog li ntawd, nws nyuaj rau hais tias muaj pes tsawg tus neeg muaj nws.

Puas muaj lwm yam mob uas qhia cov tsos mob zoo ib yam li PAES?

Yog, muaj. Mob Chronic Exertional Compartment Syndrome (CECS) yog ib qho mob ntawm cov leeg thiab cov hlab ntsha uas pom ntau dua li PAES, thiab kuj yog los ntawm kev tawm dag zog. Nws kuj tseem tuaj yeem ua rau mob thiab o ntawm cov leeg ntawm ob txhais ceg (thiab qee zaum caj npab). Txawm hais tias CECS tuaj yeem cuam tshuam rau leej twg los xij, nws feem ntau tshwm sim rau cov tub ntxhais hluas khiav thiab cov neeg uas ua si kis las uas muaj kev sib cuag ntau zaus.

Qee zaum, ib tug neeg uas muaj PAES kuj tuaj yeem muaj CECS. Nws tau pom tias kwv yees li 5% ntawm cov neeg uas tsis tau kho PAES kuj muaj CECS. Yog li nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias ob qho mob no tuaj yeem muaj tib lub sijhawm.

Qhov txawv ntawm PAES thiab CECS yog dab tsi?

Koj tus kws kho mob yuav ua ntau yam kev kuaj mob kom paub qhov txawv ntawm ob yam mob no.

• Rau PAES: Ntshav siab raug ntsuas hauv ceg thaum so thiab tom qab ntawd kuaj xyuas seb nws puas txo qis tom qab ua si.
• Rau CECS: Lub siab nyob rau hauv plaub qhov chaw leeg ntawm ceg raug ntsuas ua ntej thiab tom qab kev tawm dag zog. Hauv CECS, lub siab nyob rau hauv cov chaw no nce ntxiv tsis zoo li qub.

Koj xav li cas txog qhov muaj PAES?

Thaum koj ua si nawv, koj yuav muaj cov tsos mob zoo li no hauv koj thaj chaw koj lub qhov quav thiab/lossis ob txhais ceg:

• Ib qho mob zoo li mob plab
• Nkees lawm
• Ib qho kev xav hnyav
• Mob nqaij ntshiv
• Kev tsis muaj zog
• Kev o

Cov tsos mob no feem ntau ploj mus tom qab peb mus rau tsib feeb so. Txawm li cas los xij, zoo li peb tau hais ua ntej lawm, yog tias tsis kho, cov tsos mob no tuaj yeem rov tshwm sim dua thiab siv sijhawm ntev dua los kho.

Cov ua rau muaj PAES yog dab tsi?

Feem ntau muaj ob txoj hauv kev uas qhov kev thawb no tuaj yeem tshwm sim:

1. Kev nias ntawm lub cev: Qhov no pom muaj li ntawm 10% ntawm cov neeg mob. Zoo li nws tshwm sim ntau dua me ntsis rau cov txiv neej. Kwv yees li ntawm 70% ntawm cov neeg mob, nws tshwm sim rau ib ceg xwb.

2. Kev nias uas tsis yog raws li lub cev, kev nias ua haujlwm lossis kev nias lub cev: Qhov no tshwm sim ntau dua rau cov poj niam. Hauv ntau dua 90% ntawm cov rooj plaub, nws tuaj yeem tshwm sim rau ob txhais ceg.

Kev sib zog ntawm lub cev

Qhov no tshwm sim vim tias ib feem ntawm koj cov leeg nqaij gastrocnemius nyob saum lossis hauv qab ntawm cov hlab ntsha popliteal. Tej zaum ib txoj hlua khi hauv cov leeg nqaij tuaj yeem ua rau cov hlab ntsha puas tsuaj. Qhov no yog vim:

• Tej zaum yuav muaj mob qog los yog mob nqaij.
• Tej zaum yuav muaj ntshav txhaws.
• Dhau sij hawm mus, cov hlab ntsha yuav raug thaiv tag (occluded) lossis cov hlab ntsha hauv qab nws yuav raug thaiv.

Ua li no, muaj plaub txoj kev sib txawv uas cov leeg nqaij nyob rau hauv qhov chaw piv rau cov hlab ntsha.

Kev ua haujlwm lossis kev sib zog ntawm lub cev

Hauv qhov no, tag nrho koj cov leeg nqaij nyob rau hauv qhov chaw ib txwm. Txawm li cas los xij, cov leeg nqaij feem ntau txuas rau saum pob txha ncej puab, lossis hauv qhov zawj ntawm sab hauv ntawm lub hauv caug. Yog li thaum koj khoov koj txhais taw (plantar flexion), cov leeg nqaij rub mus rau hauv thiab nias rau ntawm cov hlab ntsha.

Qee zaum qhov kev nyem no kuj tseem tuaj yeem tshwm sim los ntawm lwm cov leeg nqaij (cov leeg nqaij popliteus) nyob hauv qab cov hlab ntsha. Cov kws tshawb fawb hais tias qhov kev nyem no tsis tau pom tias ua rau cov hlab ntsha puas tsuaj.

Yuav kuaj mob PAES li cas?

Ib tug kws kho mob tshwj xeeb txog cov hlab ntsha tuaj yeem kuaj xyuas qhov mob no. Nws yuav kuaj koj thiab xyuas seb koj txhais ceg thiab lub plawv dhia puas poob qis. Lawv kuj tseem yuav xyuas seb koj lub plawv dhia puas hloov pauv thaum koj txav koj txhais ceg mus rau saum thiab nqis rau ib yam dab tsi.

Yog koj muaj PAES, koj tus kws kho mob yuav:

• Koj tuaj yeem hnov ​​koj lub plawv dhia thaum koj so.
• Tiamsis thaum koj tawm dag zog, koj lub plawv dhia yuav txo qis thaum koj khoov lossis ncaj koj ceg.

Yuav ua li cas thiaj kuaj tau PAES?

Cov kev kuaj no ntsuas cov ntshav ntws los ntawm lub hauv caug, ceg, thiab ko taw. Cov kev kuaj duab no tuaj yeem qhia cov hauv qab no:

• Cov hlab ntsha puas zoo li qub?
• Seb puas yuav muaj kev raug mob ntawm cov hlab ntsha.
• Puas muaj cov ntshav txhaws?
• Cov hlab ntsha puas o (aneurysm - ib txoj hlab ntsha uas loj dua li qub 50%).
• Ib cov leeg nqaij puas nias ib txoj hlab ntsha?

Qee qhov kev ntsuam xyuas uas tau ua rau qhov no yog:

• Qhov ntsuas ntawm pob luj taws thiab ceg nrog kev tawm dag zog: Qhov no ntsuas cov ntshav siab hauv koj txhais tes thiab ob txhais ceg ua ntej thiab tom qab kev tawm dag zog. Feem ntau, cov ntshav siab hauv koj txhais tes thiab ob txhais ceg yog tib yam, thiab ob qho tib si nce ntxiv thaum lub sijhawm tawm dag zog. Txawm li cas los xij, yog tias koj cov hlab ntsha ntswj thaum khiav, koj cov ntshav siab hauv koj ob txhais ceg tom qab kev tawm dag zog tuaj yeem poob ntau dua 90% ntawm koj cov ntshav siab hauv koj txhais tes.
• Kev kuaj mob Duplex ultrasound ntawm cov hlab ntsha popliteal nrog rau kev khoov plantar: Qhov no siv cov suab nthwv dej los tsim ib daim duab ntawm cov hlab ntsha thiab ntsuas kev ntws ntshav. Qhov no tso cai rau koj tus kws kho mob pom tias cov hlab ntsha hauv koj ceg xav li cas thaum koj ceg khoov thiab so, thiab saib seb puas muaj cov leeg nqaij ntswj.
• Kev siv tshuab computer tomographic angiography (CTA) nrog kev khoov ntawm ko taw: Qhov no kuj yog ib hom kev luam theej duab CT. Ib qho xim tshwj xeeb yog siv los saib xyuas qhov xwm txheej ntawm cov hlab ntsha hauv ceg thiab saib seb puas muaj cov leeg nqaij ntswj thaum koj khoov ceg thiab so.
• Kev kuaj mob magnetic resonance angiography (MRA) nrog plantar flexion: Qhov kev kuaj no siv lub zog magnetic thiab cov xov tooj cua los saib qhov xwm txheej ntawm cov hlab ntsha hauv ceg thiab saib seb puas muaj cov leeg nqaij spasm thaum ceg khoov thiab so.

Yuav kho PAES li cas?

Koj tus kws kho mob yuav ua phais.Tom qab ntawd, tshem ib feem me me ntawm cov leeg nqaij gastrocnemius thiab popliteus. Qhov no yuav txo qhov kev nyem ntawm cov hlab ntsha thiab cia cov ntshav ntws mus rau ceg li qub.

Feem ntau qhov kev phais no yuav siv sijhawm li ib teev. Nws ua tiav los ntawm kev siv tshuaj loog dav dav.

Qee zaum, thaum muaj mob hnyav uas cov hlab ntsha raug puas tsuaj thiab raug thaiv vim yog qhov kev cuam tshuam ntawm lub cev, tus kws phais yuav tsum tau ntxuav cov hlab ntsha, kho nws, lossis tsim txoj hauv kev tshiab ncig qhov kev thaiv (bypass).

Kev phais yog kev kho mob zoo tshaj plaws rau PAES, vim nws yog ib qho kev kho mob zoo heev rau cov neeg feem coob. Ntau tshaj 90% ntawm cov neeg uas tau phais pom tias lawv cov tsos mob zoo dua qub.

Rau cov neeg uas muaj PAES ua haujlwm tau, kev kho mob uas tsis tas phais yog Botulinum toxin A. Nyob rau hauv CT lossis ultrasound kev taw qhia, tus kws kho mob txhaj tshuaj 'Botox®' lossis 'Dysport®' rau hauv cov leeg uas ua rau mob co. Qhov no ua rau cov leeg tsis muaj zog ib ntus. Kev cia siab yog tias cov leeg yuav qaug zog mus tas li.

Tiamsis qhov no tsuas kav ntev li peb mus rau rau lub hlis xwb. Yog tias cov leeg tsis txo qis, cov tsos mob tuaj yeem rov qab los. Kev kho mob no tau ua tiav hauv tsawg dua 60% ntawm cov neeg tom qab ib xyoos ntawm kev kho mob.

Tom qab cov kev kho mob no tas, yuav siv sijhawm ntev npaum li cas mam li rov zoo?

Nws yuav siv sijhawm plaub mus rau rau lub hlis kom rov zoo tag nrho tom qab phais.

Tom qab phais lawm, koj yuav tsum tau nyob hauv tsev kho mob ib hmos. Tom qab ntawd, koj yuav tsum tau ua kev kho lub cev (xws li kev tawm dag zog ncab) rau ob lub lis piam thawj zaug. Tom qab ob lub lis piam, koj yuav tsum tau ua kev tawm dag zog kom muaj zog thiab ua kom lub cev khov kho kom txog thaum koj zoo tag nrho.

Yuav ua li cas rau ib tus neeg uas muaj PAES?

Yog tias koj muaj mob pob qij txha caj qaum thiab koj qhov mob ceg thaum lub sijhawm tawm dag zog tsis hnyav, tej zaum koj yuav xav txwv koj txoj kev tawm dag zog. Koj tus kws kho mob tuaj yeem saib xyuas koj tus mob.

Txawm li cas los xij, raws li peb tau hais ua ntej lawm, kev phais mob muaj ntau dua 90% kev vam meej, thiab qhov kev pheej hmoo ntawm kev rov qab mob dua yog tsawg. Feem ntau cov neeg ncaws pob rov qab mus ua lawv cov dej num ib txwm tom qab phais mob.

Yog tias muaj kev cuam tshuam ntawm lub cev, cov kws kho mob pom zoo kom phais tshem cov nqaij ntshiv uas tsis zoo. Qhov no yog vim tias, yog tias tsis ua, cov hlab ntsha tuaj yeem puas tsuaj raws sijhawm. Yog tias koj ncua kev kho mob thiab muaj cov qauv PAES uas tau ua rau cov hlab ntsha popliteal puas tsuaj, koj yuav mob ceg tas li thaum koj taug kev. Hauv qee kis tsis tshua muaj, ib ceg yuav tsum tau txiav tawm. Tab sis qhov ntawd tsis tshua muaj .

Kuv yuav tsum mus ntsib kws kho mob dua thaum twg?

Tom qab phais lawm, koj yuav tsum mus ntsib kws kho mob:

• Hauv ib hlis.
• Hauv rau lub hlis.
• Hauv kaum ob lub hlis.

Hauv cov rooj sib tham no:

• Yuav muaj kev kuaj mob ultrasound ntawm koj cov hlab ntsha uas tau kho lawm.
• Lawv tab tom kuaj xyuas cov ntshav siab hauv koj ob txhais ceg.

Yog tias koj cov hlab ntsha rov qab mus rau qhov qub, tsis tas yuav teem caij ntxiv tshwj tsis yog tias cov tsos mob rov qab los lossis koj xav tau kev phais hla cov hlab ntsha.

Kuv yuav tsum nug kuv tus kws kho mob li cas?

• Kuv puas muaj anatomic PAES los yog functional PAES?
• Koj puas pom zoo kom phais mob rau kuv tus mob?

Yog tias koj tseem hluas thiab mob ceg, nco ntsoov mus ntsib kws kho mob. Muaj ntau yam ua rau mob no. Thaum koj kuaj mob tau zoo, koj yuav pib kho tau sai dua. Yog tias koj muaj mob popliteal artery entrapment syndrome, nrog koj tus kws kho mob tham txog seb puas yog kev phais mob zoo rau koj. Qhov no tau ua tiav kev kho mob ntau zaus.

Tej yam tseem ceeb tshaj plaws uas yuav tsum nco ntsoov (Cov Lus Coj Mus Tsev)

Zoo, yog li cia peb sau qee yam uas koj yuav tsum nco ntsoov los ntawm qhov peb tau tham txog:

• PAES yog ib qho mob uas cov hlab ntsha tseem ceeb tom qab lub hauv caug, uas yog ib qho leeg, nqaim, ua rau cov ntshav ntws mus rau ceg tsawg dua.
• Qhov no feem ntau cuam tshuam rau cov tub ntxhais hluas ncaws pob , tshwj xeeb tshaj yog cov neeg khiav.
• Yog tias koj muaj cov tsos mob xws li mob, hnyav, lossis tingling hauv thaj chaw ntawm lub pob tw thaum lub sijhawm ua si, tab sis lawv ploj mus thaum koj so, koj yuav muaj PAES.
• Kuj tseem muaj ib yam mob hu ua CECS uas muaj cov tsos mob zoo sib xws, yog li kev kuaj mob kom raug yog qhov tseem ceeb.
• Tus kab mob no yuav paub tseeb los ntawm kev kom ib tug kws tshwj xeeb kuaj koj (xws li `Ankle-brachial index`, `Duplex ultrasound`, `CTA`, `MRA`).
• Feem ntau kev phais yog txoj kev kho mob zoo tshaj plaws . Muaj ib txhia neeg tau txhaj tshuaj "(Botulinum toxin A)" rau hauv lawv lub cev.
• Yog tias tsis kho, dhau sijhawm, cov hlab ntsha tuaj yeem puas tsuaj thiab qhov mob tuaj yeem hnyav zuj zus.
• Yog li ntawd, yog tias koj muaj cov tsos mob no, nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev pab kho mob yam tsis muaj kev ncua.

Tsis txhob txhawj, yog tias koj paub qhov mob no, muaj kev kho mob zoo. Qhov tseem ceeb tshaj plaws yog mus ntsib kws kho mob sai sai, tsis txhob tsis quav ntsej cov tsos mob. Ces koj tuaj yeem noj qab nyob zoo thiab ua ub ua no dua!

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