I kal laiin i ke a na em? Peripheral Artery Disease a ni thei!

I keah pawh na emaw, na emaw i nei em, a bik takin i bawnghnuteah, i kal laiin, a bik takin hla vak loah? Rei vak lo i ṭhut a, i chawlh hnuah a bo mai em, mahse i kal laiin a lo let leh em? Chutiang a nih chuan hei hi i tan thil pawimawh tak a ni mai thei. Hetiang dinhmun hi ‘Peripheral Artery Disease’ , a tawi zawngin PAD kan ti thin. A awlsam zawngin, i hriatthiam theih dan tur angin sawi ila.

‘Peripheral Artery Disease’ tih hi eng nge ni?

A awlsam zawngin sawi ila, Peripheral Artery Disease hi i ke thlenga thisen phurtu thisen kalna kawngah thau (plaque) a lo awm a, zawi zawiin a ti tawi a ni. Tui pipe bawlhhlawhin a khuh a, zawi zawiin tui luang a tihtlem ang maiin han ngaihtuah teh. Kan thisen kalna kawng (arteries) te hi pipe ang mai a ni. An chhungril lamah an nem em em a, chuvangin thisen chu a hmin lova a luang chhuak thei a ni.

Mahse, he ‘plaque’ (thau leh cholesterol layer) hi thisen kalna bang chungah zawi zawiin a lo awm chhoh zel chuan thisen kalna chhunga hmun chu a tlem ta hle a ni. Damdawi lamah chuan hei hi ‘atherosclerosis’ an ti bawk. A châng chuan, he ‘plaque’ chung khauh tak hi a chhe vek a, ‘platelets’ (thisen tichhe theitu thisen cell chi khat) a lo awm thei a, chu chuan thisen kalna kawng chu a tizau lehzual a ni.

Artery pakhat a block chuan thisen a kal thei lo. Chu artery-in a supply thin ke chhunga tissue te chu oxygen leh nutrients te an tlachham a ni. Hei hian chu tissue te chu a tichhia thei a, a tawpah chuan a thi thei (gangrene) . Hetiang dinhmun hian ke ruh leh ke a nghawng tam ber.

Mi thenkhat chuan PAD an nei thuai a, thenkhat erawh chuan an vei zawi zawk thung. Hei hi tichhe thei thil dang tam tak a awm a, chu chu i taksaah khawiah nge plaque hi a awm tih leh i hriselna zawng zawng hi a ni.

He ‘peripheral artery disease’ (PAD) hi engtiang chiahin nge a hluar?

PAD hi a takah chuan i ngaihtuah aia tam zawk a ni. United States-ah hian mi maktaduai 8 leh maktaduai 12 velin he natna hi an vei nia chhut a ni. Mahse, a chang chuan hriat sual leh enkawl loh a ni. Chuvangin number dik tak chu a tam zawk mai thei.

PAD hian engtin nge ka taksa a nghawng? Eng nge a lan chhuah dan?

PAD chhinchhiahna ber leh langsar ber chu claudication a ni . Hei hi kea i kal emaw, exercise i tih lai emawa ke (a bik takin bawnghnute) natna a ni. He natna hi i chawlh hahdam hian a bo thin. Hei hi ke ruhte hian oxygen an hmuh tlem vang a ni.

Mahse PAD hian a nghawng chu kea kal harsatnaah chauh a innghat lo. I ke emaw ke emaw ah nonhealing sores a siam thei bawk.Stroke vei theihna a sang hle. PAD dinhmun a nasat chuan heng hliamte hi tissue thi (gangrene) awmna hmun a lo ni thei a, ke emaw ke emaw (amputation) pawh lakchhuah a ngai thei bawk. Kan u Siripala hi han mitthla teh, dawr lam pan chuan kea kal pawh a kal thei lo, a ke a na tih a sawi fo thin, hetiang thil hi a ni thei.

PAD natna lan chhuah dan tlangpui chu engte nge ni?

PAD vei zawng zawng hian symptom an nei vek dawn lo. 50% vel chuan symptoms an nei lo thei. Hei hi a thleng zauh zauh thin. Artery 60% aia tam a tihtlem chuan symptoms a lang tan thei.

A lan chhuah dan tlangpui chu:

• Ke emaw, ke emaw, ke emaw, a ke emaw, a na emaw, a na (intermittent claudication) a awm a, chu chu kea kal emaw, stairs-a chhoh emaw a ni. Hei hi chawlh hahdam rualin a tlahniam thin.
• Kang, ke leh ke ruh natna nasa tak (ischemic rest pain) chawlh lai pawhin, a bik takin zan lama khumah mut laiin .
• Kea vun lum.
• Vun a sen emaw, a rawng dang emaw a inthlak danglam hmuh.
• Vun leh soft tissue infection (a bik takin ke emaw ke emaw) a awm fo thin.
• Ke leh ke ruh a ulcer dam thei lo .

Pawimawh: Heng symptoms te hi i neih chuan a rang thei ang bera doctor pan a, thurawn lak a pawimawh hle. A chhan chu PAD hi hriat hmasak a nih chuan harsatna lian tak tak, heart attack emaw stroke emaw a lo thlen hmain enkawl tan theih a ni.

PAD hi stage hrang hrang a awm em?

Ni e, doctor-te chuan PAD classified nan hian method engemaw zat an hmang thin. Fontaine classification hi a awlsam deuh hlek a ni. Heng stage hrang hrangte hi hetiang hi a ni:

• Stage I: Natna lanchhuahna nei lo.
• Stage IIa: Exercise laiin ke na deuh (mild claudication).
• Stage IIb: Ke na lutuk atanga na tak (claudication na lutuk).
• Stage III: Chawlh lai pawhin ke a na (Ischemic rest pain).
• Stage IV: Ulcer emaw gangrene emaw a awm thei.

PAD avanga harsatna awm thei te chu engte nge ni?

Enkawl loh chuan PAD vei te chu ke emaw, ke emaw (leh kut pawh a tlem hle) tansak a ngai mai thei . Hetiang hlauhawmna hi zunthlum vei tan chuan a sang hle.

Kan circulatory system hi a inzawm tlat avangin PAD hian a nghawng chu a natna vei limb-ah chauh a awm lo. Ke ruh (arteries)-a atherosclerosis nei te pawhin taksa hmun dangah pawh he natna hi an nei thei bawk. Chumi awmzia chu PAD vei chuan coronary artery disease, heart attack, stroke, transient ischemic attack (TIA) emaw a nei thei tihna a ni., chu chu PAD nei lo mi aiin stroke tenau ang chi thil hlauhawmna a sang zawk tihna a ni. Lung natna nei mi pakhat chuan an keah PAD vei theihna chance 3 zinga 1 vel an nei a.

PAD awm chhan ber chu eng nge ni?

A chhan ber chu ke ruh (leh a tlem berah kut ruh)-a atherosclerosis lo awm vang a ni. Thinlung arteries-a awm ang bawkin thisen kalna kawng bang-ah thau (plaque) a lo awm a, zawi zawiin thisen kalna kawngte chu a ti tawi a, a tawpah chuan a tikhawlo ta a ni.

PAD vei theihna tur risk factors te chu engte nge ni?

Zuk leh hmuam hman hi PAD leh a harsatna thlentu risk factor pawimawh ber leh chak ber a ni. Dik tak chuan PAD vei zinga 80% chu tuna zu in tawh emaw, zu in tawh emaw an ni. Zuk leh hmuam hman hian PAD vei theihna chu 400% velin a tipung a ni. Tin, symptoms lo awm tanna chu kum 10 thleng a tikhawtlai thei bawk.

Meizial zu lote nena khaikhin chuan meizuk leh PAD nei te hian:

• Heart attack emaw stroke emaw avanga thihna .
• Kea bypass surgery avanga result tha lo.
• Kut emaw ke emaw tan a ngai.

Hmeichhia emaw mipa emaw pawh ni ila, heng risk factor pakhat emaw a aia tam emaw i neih chuan PAD vei theihna i nei a ni:

• Zuk leh hmuam thil hman (hei hi a chak ber a ni).
• Zunthlum (Diabetes Mellitus) nei.
• Kum 50 aia upa nih.
• African American thlah nei (hei hi Sri Lanka nen hian inzawm vak lo mah se, hriat a tha).
• Mimal emaw chhungkaw emawa thinlung natna emaw thisen kalna kawng natna emaw nei tawh.
• Thisen sang (Hypertension) nei.
• Cholesterol sang (Hyperlipidemia) nei.
• Pum chhunga thau lutuk.
• Thisen zam (blood clotting disorder) nei.
• Kidney natna neih (hei hi risk factor leh PAD result pawh a ni thei).

Engtin nge PAD hi hmuhchhuah a nih? (Diagnosis) tih a ni.

Doctor i hmuh chuan a enfiah ang che a, i medical history leh risk factors te a zawt ang che. Noninvasive test thenkhat pawh PAD i vei em tih hriat nan leh, a neih chuan engtiang chiahin nge a nasat tih hriat nan tih theih a ni bawk. Heng test te hian thisen kalna kawng (blood vessel) ah blockage a awm leh awm loh hriat nan a pui thei a ni:

• Ankle-brachial index (ABI): Hei hian ke ruh leh kut ah thisen sang a teh thin.
• Pulse volume recording (PVR) hmanga tih a ni.
• Vascular ultrasound hmanga tih a ni.

A châng chuan, arterial blockage hriat theih nân invasive test angiogram an tih chu a ngai thei bawk.

PAD hi tihdanglam theih a ni em?

Ni e, zirchianna thenkhatah chuan chu chu a langExercise leh cholesterol leh blood pressure control hian PAD symptoms a tidanglam thei a ni.

Hriat hmasak a nih chuan, nunphung thlak danglam a, enkawl a nih chuan PAD a na zual loh nan tihtawp theih a ni. PAD vei hlauhawma i inhriat chuan, emaw, symptoms i neih tawh chuan, i chhungkaw doctor, vascular medicine specialist emaw, cardiologist emaw pan la, invenna emaw, enkawlna program emaw tan nghal rawh.

PAD enkawl dan tur chu engte nge ni?

PAD hi nunphung thlak danglam, damdawi leh damdawi lam kalphung hmanga enkawl theih a ni.

PAD enkawlnaah hian thil tum lian tak pahnih a awm a, chungte chu:

1. Cardiovascular events , heart attack leh stroke te i neih theihna tur tihtlem.

2. Kal laiin natna tihziaawm la, i nunphung tihchangtlun.

Nunphung a inthlak danglam thin

PAD enkawlna hi i risk factors tihtlem nan nunphung tihdanglam atanga tan a ni. I tih theih ṭhenkhat chu hetiang hi a ni:

• Zuk leh hmuam thil siam chhuah chu bânsan vek. I doctor hnenah meizuk bânsan tura ṭanpui thei program hrang hrangte zawt rawh.
• Fiber tamna leh cholesterol, thau leh sodium tlem zawk ei tur inthlau tak ei rawh. Nitin calorie zawng zawng 30%-ah thau tihtlem. Saturated fat hi calorie zawng zawng atanga 7% aia tam lo tur a ni. Trans fats hmanga siam ei tur, partially hydrogenated leh hydrogenated vegetable oil te hi ei loh tur.
• Insawizawi. Exercise program mumal tak, kea kal ang chi chu tan rawh. Kea kal hi PAD enkawlna tha tak a ni. Kea kal fo thinte chuan an ke a na hmain an kal theihna tur hlat zawng an tipung thei a ni.
• Hriselna dang, thisen sang, zunthlum, leh cholesterol sang te enkawl rawh.
• I stress level chu hniam takin dah la. Exercise, yoga, leh meditation ang chi thilte hian hei hi a pui thei a ni.
• Ke leh vun enkawl dan tha tak hmang la, natna hrik laka invenna leh harsatna awm theihna tur a tihziaawm theih nan.

Damdawi chi hrang hrang

Damdawi antihypertensive medications , statin damdawi, leh zunthlum damdawi te hian PAD vei theihna tur risk factors control nan a pui thei a, stroke leh heart attack hlauhawmna a ti tlem thei bawk.

I doctor chuan thisen zam ven nan antiplatelet damdawi, aspirin emaw clopidogrel emaw a pe thei ang. I kal theihna tur hlat zawkna tur damdawi cilostazol an pe thei bawk. He damdawi hian intermittent claudication exercise nei te chu an ke a na hmain hun rei zawk a pui thin.

Exercise programme enkawltu a ni

Damdawi lam enkawlna hnuaia exercise program hian ke natna a tihziaawm thei a, kea kal belh zel turin a pui thei bawk. Hei hian kar khatah ni thum tal treadmill-a kal a ngai tlangpui.

PAD vei te chu ni khatah minute 30 atanga 60 vel kea kal tur a ni a, in lamah pawh. Thurawn hman tlanglawn ber chu "Start/Stop" exercise hi hman tur a ni:

• Natna a tlem thlengin kal la, chutah chuan chawlhsan rawh.
• A natna chu a bo vek hma chu nghak rawh.
• Kal tan leh rawh.

Minimally invasive emaw surgical emaw hmanga enkawlna

Mi thenkhat tan chuan thla tam tak chhung exercise leh damdawi an ei hnuah pawh ke na hi a nasat em avangin nitin hnathawh a tibuai thei a ni. A nasat zawkah chuan chawlh lai pawha natna tihziaawmna tur emaw, hliam tihdamna tura pui turin thisen kal dan tihchangtlun a ngai mai thei.

PAD natna zual zawk, natna nasa tak leh kea kal theih lohna thlentu tan chuan endovascular (minimally invasive) emaw surgical treatment emaw a ngai thei. Lung natna enkawlna atana hman thin thenkhat chu PAD tan pawh hman a ni:

• Angioplasty: Balloon ang chi hmanga thisen kalna kawng (artery block) tihzauh.
• Stent dah dan: Artery inhawng reng turin mesh tube te tak te dah a ni.
• Peripheral artery bypass surgery: Thisen kalna tur kawng dang siam (taksa chhunga vein dang hman fo thin) a blocked artery bypass.
• Atherectomy: Artery chhunga plaque awm chu instrument bik hmanga lakchhuah.

Enkawlna hnua harsatna awm thei

Heng enkawlna hnua a hnuaia harsatna te hi i tawk a nih chuan doctor hnenah hriattir nghal tur a ni. Hengte hi natna hrik emaw, harsatna dang emaw chhinchhiahna a ni thei:

• Catheter dahna hmuna hliam, thisen chhuah emaw, natna emaw.
• A rilru a na.
• Thâwk harsa.
• Khawsik emaw, khawsik emaw.
• Luak chhuak thei.
• Ke ruh a hring chhuak.
• Pum natna.
• Surgical incision chu a inhawng a.

Enkawlna atanga dam leh hun chhung hi i enkawlna a zirin a inang lo. Damdawi inah zan khat emaw a aia tam emaw i awm a ngai mai thei. Atherectomy tih hian a dam leh theih nan ni engemaw zat a la ngai thei a, angioplasty erawh chuan kar khat vel a la ngai thei thung. Peripheral artery bypass graft hi a dam kim theih nan kar 6 atanga kar 8 vel a ngai thei.

PAD vei theihna hi engtin nge kan tihziaawm theih ang? (Invenna) 1.1.

PAD vei theihna tur risk factors i nei tih i hriat veleh chuan venhimna kawngah i infuih mai thei. I thinlung hriselna atana thurawn ang chiah hi i thisen kal dan enkawlnaah pawh hman a ni:

• I rihna control rawh.
• Thau tlem, sugar tlem, nitin thei leh thlai thar vawi nga tal ei tur ei tur a ni.
• Zuk leh hmuam hman loh tur.
• I doctor phalna la hmasain ni khatah minute 30 tal exercise la la, kar khat chhunga ni tam zawk chu.

Lung natna i neih chuan PAD vei theihna tur risk factors te chu i doctor nen sawiho rawh. I natna lan chhuahna eng pawh, ke na, chak lohna, emaw, rilru hahna te chu i doctor hnenah hrilh rawh.

PAD i neih chuan eng nge i beisei theih ang?

Hriselna lama harsatna tam tak ang bawkin PAD hi a hmaa hmuhchhuah a nih chuan enkawl a awlsam zawk. PAD a kal zel dan hi mi hrang hrangah a inang lo. Thil tam takah a innghat a, chutah chuan plaque awmna hmun leh i hriselna zawng zawng pawh a tel.

PAD hi i dam chhunga i neih theih tur condition a ni. PAD damdawi awm lo mah se, i enkawl thei a ni. Heng thilte hi tih hian PAD a na zual loh nan i veng thei ang:

• Zuk leh hmuam thil hman loh.
• Exercise neih fo thin.
• Thau tihtlem la, ei leh in hrisel ei rawh.
• I risk factors, zunthlum, cholesterol sang, leh thisen sang te enkawl dan.

Engtin nge ka in enkawl ang? (Mahni invenna) .

Hliam dam lo a awm loh nan i ke enkawl that a pawimawh. PAD vei te ke enkawlnaah hian:

• Kekawr nuam tak, in fit tha tak ha rawh.
• Nitin i ke leh keah hian blister, cut, crack, abrasion, emaw sores emaw a awm leh awm loh enfiah thin ang che. Tin, ke ruh sen, lum, ingrown toenail, corn, leh callus te pawh zawng bawk ang che. Zunthlum vei ang bawkin i ke i enkawl a ngai a ni.
• Ke leh vun lama harsatna tenau tak pawh enkawl chu tihkhawtlai suh.
• I ke chu fai leh hnim tha takin vawng la (hliam inhawngah moisturizer hnawih suh).
• Inbual zawhah i nail te chu a la nem laiin trim la. Cut straight across la, nail file hmangin file flat rawh.

Thil engemaw takah chuan i doctor chuan podiatrist -ah a refer thei che a, a bik takin zunthlum i neih chuan. Bunions, bunions, a nih loh leh ke lama harsatna dang a neih chuan a pui thei a ni.

Engtikah nge Doctor i hmuh ang?

A hnuaia thil awmte hi doctor pan rawh:

• I ke hliamah natna tha lo i neih chuan i taksa ruh, tissue, thisen leh ruh thlengin natna hi a darh thei a ni. Infection a nasat chuan damdawi inah dah a ngai mai thei.
• Hna pangngai pawh tih theih loh khawpa kal a harsat chuan.
• Chawlh lai pawhin i ke a na a nih chuan , hei hi thisen supply tha lo tihna a ni.

Rikrum:I ke i hriat theih loh emaw, i che thei lo emaw, a chunga vun chu i ke dang aiin a rawng danglam a nih chuan emergency room-ah kal nghal rawh. Chumi awmzia chu i kea thisen pek chu vaukhânna awm lovin a tawp tawh tihna a ni.

Doctor hnenah eng zawhna nge ka zawh ang?

• PAD ka vei theihna tur tihtlem nan damdawi ka mamawh em?
• Kea kal program ka tan hian eng chen nge ka kal ang?
• PAD hi surgical treatment ka mamawh em?

A tawp berah chuan hei hi hre reng ang che (Take-Home Message) .

Peripheral Artery Disease, a nih loh leh PAD hi nunphung thlak danglamin a lo zual zel tur venna emaw, tihkhawtlai emaw nan thil tam tak i ti thei a ni. I follow-up appointment zawng zawng chu i doctor leh vascular specialist hnenah vawng reng la, i damdawi zawng zawng chu a tih angin ei vek rawh. PAD complications vaukhânna chhinchhiahna hriat hian ṭanpuina i zawn hun tûr hriat theih nân a ṭanpui ang che. I ke kha enkawl tha la, a chhan chu hla takah a phur dawn che a ni!

` Peripheral artery natna, PAD, ke na, thisen kalna kawngkhar, thisen kal dan, zuk leh hmuam, zunthlum, cholesterol, atherosclerosis, claudication