Kei te pēhia tō uaua whatukuhu maui e te kikī? Ko te Nutcracker Syndrome te ingoa! Me kōrero tāua.

Kua pāngia koe e te mamae i tō taha maui o tō puku, i ō rara rānei? Kua kite rānei koe i te toto i roto i tō mimi? I ētahi wā ka taea te wareware i ēnei mea. Heoi anō, he tohu anō hoki ēnei mō tētahi mate e hiahia ana kia arohia. Ko tētahi o aua mate, kāore i te tino kōrerohia, engari he mea nui kia mōhiotia, ko te Nutcracker Syndrome. I tēnei rā, ka kōrerohia e tātou tēnei mate me te taipitopito, me te ngāwari hoki.

He aha te mate Nutcracker? He aha tonu te mea ka tupu?

I te whakarapopototanga, ko te Nutcracker Syndrome he mate e āraihia ai tētahi oko toto nui mai i tō whatukuhu maui (e kiia ana ko te "uaua whatukuhu maui"). Ko tēnei oko toto te mea e kawe ana i te toto kua horoia mai i tō whatukuhu maui ki tō ngākau. Nō reira, ina āraihia tēnei uaua, ka āraihia te rere o te toto.

Whakaarohia, ko tēnei uaua toto e puta mai ana i tō whatukuhu maui, me haere ki te ngākau mā roto i ngā uaua toto nui e rua i roto i tō tātou puku. Ko tētahi ko te uaua matua i roto i tō tātou puku, ko te "aorta puku". Ko tētahi ko te "uaua mesenteric teitei". I te nuinga o te wā, ka taea e te uaua whatukuhu te haere mā roto i ēnei uaua e rua me te kore he ārai.

Heoi, i roto i te tangata e pāngia ana e te mate nati-pakā, ka huihui aua uaua nui e rua, pērā i ngā waha e rua o te nati-pakā, ka pēhi i te uaua whatukuhu . Pērā i te nati e pakaruhia ana ki te nati. Koia i tapaina ai ko "nutcracker." Ina pēhia, ka piki te toto toto i roto i te uaua whatukuhu, ā, ka tīmata te rere whakamuri o te toto. Ka taea hoki e tēnei te pupuhi i ngā uaua toto iti e karapoti ana.

E rua ngā momo matua, i runga i te āhua o te whakawhāititanga:

• Te Mate Puku Nutcracker o Mua: Koinei te momo tino noa. Ka puta ina pēhia te uaua whatukuhu ki mua o te aorta puku, arā, ki mua o te puku.
• Te Mate Puku Nutcracker o Muri: He ahua onge ake tēnei. I konei, ka pēhia te uaua whatukuhu i muri i te aorta puku, te wāhi e haere ana i waenganui i te tuaiwi me te aorta.

Tērā atu anō ētahi tikanga onge, engari kāore e hiahiatia kia nui rawa te kōrero mō ēnei.

Te rerekētanga i waenga i te Mate Nutcracker me te Mate Nutcracker

Kaua e whakapoauau i ngā mea e rua. Ko te āhuatanga Nutcracker he whaiti o te uaua whatukuhu, engari kāore he tohu. I ētahi wā ka kitea noa iho i te wā e tirotirohia ana mō tētahi atu mate.

Heoi, ko te mate Nutcracker Syndrome , hei tāpiri atu ki te kikī o te uaua, ka puta hoki ngā tohu. Arā, kei te pāngia koe e te mamae nā te kikī o te uaua. Koinā te wā e hiahiatia ai te maimoatanga.

He aha i huaina ai tēnei ko "Te Nutcracker"?

E ai ki taku kōrero i mua, i te tau 1937, i whakaahuahia e tētahi kairangahau hauora tēnei āhuatanga hei ngā uaua nui e rua i roto i te puku "pēnei i ngā kauae e rua o te makimaki e pēhi ana i te uaua whatukuhu." I kī anō ia he "pēnei i te panana e kuruhia ana e te makimaki." Koia te take i tapaina ai tēnei. Ko te ingoa hauora mō tēnei ko te 'left renal vein entrapment syndrome '.

Ko wai te hunga e tino pāngia ana e tēnei mate? He pēhea te noa o tōna pānga?

Ka pāngia pea ngā tamariki me ngā pakeke tae atu ki te 60 tau te pakeke e te mate nutcracker. Heoi, e kī ana ētahi rangahau he nui ake te kitea i roto i te hunga kei roto i ō rātou tau rua tekau, rua tekau, me toru tekau . He nui ake hoki te kitea i roto i te hunga he iti te taupū papatipu tinana (BMI), arā, he kikokore rātou .

E kiia ana tēnei he mate onge , engari kāore he raraunga e whakaatu ana i te tokomaha o te hunga kua pāngia e tēnei mate.

He aha te tūponotanga o te mate Nutcracker Syndrome? He raruraru kei reira?

I ētahi wā, kāore e puta he tohu nui, ā, ka taea te memeha noa iho, inā koa i roto i ngā tamariki. Heoi, ki te kore e rongoatia, ka arahi pea ki ngā raruraru i roto i te wā. Ko ētahi o ēnei ko:

• Ka puta he toto totoka i roto i te uaua whatukuhu.
• Ka puta te kino o te whatukuhu nā te pikinga o te pēhanga i roto i ngā uaua whatukuhu i te roanga o te wā.
• Ka pāngia pea ngā tāne e te kore tamariki, e te tāne rānei , ka pāngia rānei ngā wāhine e te kore tamariki .
• Tērā pea ka puta he mamae nui e pā kino ana ki tō oranga.

He mea nui: Ehara i te katoa ka pāngia e ēnei raruraru. Heoi, ki te pāngia koe e ngā tohu, he pai ake te toro atu ki te tākuta tonu mō ētahi tohutohu.

He aha ngā tohu? Ngā mea ka pā ki a koe, me ngā mea ka kitea pea e tō tākuta

He maha ngā tohu o te mate nutcracker. Ko ētahi o ngā mea ka pā ki a koe ko:

• Te toto i roto i te mimi (hematuria): Koinei te tohu tino kitea. Tērā pea he māwhero, he whero, he parauri rānei te tae o te mimi.
• Te pōuriuri i te tūnga (orthostatic hypotension): Ko te tikanga tēnei, ina tū ohorere koe, ka kikorangi ō kanohi, ā, ka pōuriuri koe.
• Mamae o te taha maui: Tērā pea ka mamae te taha maui, i muri tonu i ngā rara.

Tērā pea ka rerekē paku ēnei tohu i runga i te ira tangata.

Mō ngā tāne: Tērā pea ka puta he āhuatanga e kiia nei ko te varicocele , he pupuhi o ngā oko toto i roto i ngā rauropi.

Tērā pea ka pāngia ngā wāhine e ngā tohu o te mate pūngao o te pelvis, e puta mai ana i te putunga toto i roto i te rohe pelvis. Kei roto i ēnei:

• Te mamae i te wā o te moe tāne me te wahine (dyspareunia).
• Te mamae i te wā e mimi ana (dysuria).
• Te mamae i te puku o raro, arā, i te rohe hope (mamae hope).

Haunga ēnei, kei reira anō ngā tohu ka kitea e te tākuta mā roto i ngā whakamātautau. Kāore e kitea.

• He korenga o ngā toto whero i roto i te toto, arā , he anemia .
• Ko te microhematuria te toto iti i roto i te mimi, ā, ko te iti rawa e kitea ana i raro i te karuārai anake.
• Ko te proteinuria te nui rawa o te pūmua i roto i te mimi.

He aha tēnei e tupu nei? He aha ngā take?

Ko te tino take o te mate Nutcracker Syndrome ko ngā panonitanga o te hanganga o ō uaua toto . I ētahi wā ka puta ēnei panonitanga i a koe e noho tonu ana i roto i te kōpū o tō whaea, i te wā e hangaia ana ō uaua toto. I ētahi wā anō, ka puta pea i te wā e piki haere ana te teitei (te tere o te tipu) i te taitamarikitanga, i te hekenga ohorere rānei o te taumaha i te pakeketanga (te hekenga o te taumaha). I ētahi wā, kāore e kitea he take .

Me pēhea te tautuhi tika i tēnei? He aha ngā whakamātautau e mahia ana?

Ka roa pea te wā ki te tautuhi i te Mate Nutcracker, nā te mea me whakakore e ngā tākuta ētahi atu mate. Ko te tikanga ka tīmata te tautuhi mā te whakamātautau tinana . Ka pātai atu tō tākuta ki a koe mō ō tohumate, ā, ka pātai atu anō hoki mō ō tohumate. Kātahi ka tonoa pea e rātou tētahi, ētahi rānei o ngā whakamātautau e whai ake nei hei rapu atu i ētahi atu kōrero:

• Ngā whakamātautau toto
• Matawai CT (matawai CT - Matawai Tomography Rorohiko)
• Whakamātautau orooro Doppler `(orooro Doppler)`
• Te tirotiro oro-ā-roto (IVUS)
• Matawai MRI `(MRI - Matawai Whakaahua Aukume)`
• Venogram (te tango i te hihi-X o ngā uaua i muri i te werohanga i te tae)
• Te tātaritanga mimi

He aha ngā maimoatanga mō te mate Nutcracker Syndrome?

Ka whakawhirinaki te maimoatanga ki tō tau me te kaha o ō tohumate. I runga i tō āhua, ka tīmata pea tō tākuta ki ngā maimoatanga iti ake te kaha . Ki te kore ēnei e āwhina, ki te kino rānei ō tohumate, me pokanga pea koe.

Whakahaere Matatapu

Mō te tini o te tangata, inā koa ngā tamariki kei raro iho i te 18 tau te pakeke , koinei te taahiraa tuatahi ki te whakahaere i te taumaha o tāu tamaiti. Mena he mate nutcracker tō tāu tamaiti, ka tūtohu pea tō tākuta kia haere tonu tēnei huarahi mō te rua tau. Kei roto i tēnei ko te āwhina i tāu tamaiti kia piki ake te taumaha me te aroturuki i te āhua. I te pikinga o te taumaha i roto i te puku, ka heke te pēhanga ki te uaua whatukuhu. E taunakihia ana kia whakamātau ngā pakeke i tēnei huarahi mō te ono marama pea.

Tērā pea ka uru atu hoki ki tēnei whakahaere whānui ngā rongoā hei āwhina i te mahi a ngā whatukuhu. Hei tauira:

• Ngā aukati ACE
• Āpipirini

Te Wawaotanga Pokanga

Mena he nui ngā tohumate e pā mai ana ki a koe, ā, kāore e whai hua ngā maimoatanga noa, me pokanga pea koe, me whakamahi rānei i tētahi tikanga iti rawa te whakaekenga . Ka kōrero tō tākuta ki a koe mō ō kōwhiringa, ngā painga me ngā huakore, me te mea he tika ngā tikanga iti rawa te whakaekenga mōu.

Ko te whāinga matua o te pokanga he waihanga i tētahi ara maeneene, kore ārai mō te rere o te toto mai i te whatukuhu ki te ngākau.

Ko ētahi o ngā pokanga me ngā tikanga e mahia ana mō te Nutcracker Syndrome ko:

• Te whakawhiti uaua whatukuhu: Ko te tango i tō uaua whatukuhu maui ka hono anō ki tētahi uaua nui e kiia nei ko te vena cava o raro. Mā tēnei ka kore e hiahiatia te haere mā te uaua mesenteric o runga me te aorta. Ka taea tēnei mā te laparoscopic , arā, mā roto i ētahi tapahi iti.
• Te whakaurunga o te stent: Ko te whakaurunga o tētahi ngongo iti e kīia nei ko te stent ki roto i te uaua whatukuhu kua āraia mā roto i tētahi kōhao iti i te kiri. Mā tēnei ngongo ka huaki te uaua, ka tukuna te toto kia rere noa.
• Pokanga whakawhitinga whatukuhu whaiaro: I roto i tēnei, ka tangohia tō whatukuhu maui ka whakahokia ki roto i tō tinana, ki roto i te wheua hope.

He morearea ēnei pokanga?

He mōrearea kei roto i ia pokanga mō te Mate Nutcracker. Kōrerohia marietia ki tō tākuta mō ngā mōrearea ka pā ki a koe.

Ko te whakawhitinga whatukuhu whaiaro te mea tino whakaeke i roto i ēnei pokanga. Ko ōna raruraru matua ko te ngoikore o te whatukuhu me te toto. Ka taea te whakaiti i te mōrearea o ngā raruraru mā te whiwhi maimoatanga i tētahi hōhipera nui me ngā taote pokanga mātau e mahi auau ana i aua pokanga .

He huarahi hei whakaiti i tēnei āhuatanga?

Ina hoki, kāore he huarahi e mōhiotia ana hei whakaiti i te mōrearea o te whakawhanaketanga o tēnei mate. Ka puta tonu mai te mate Nutcracker, ā, ehara i te mea tuku iho.

Heoi, i ētahi wā ka kitea e ngā tākuta te āhuatanga nati-pakaru (asymptomatic renal vein stenosis) mā te tūpono i roto i ngā whakamātautau e mahia ana mō ētahi atu take. Nō reira, he mea tino nui kia mau tonu ō whakamātautau hauora me ngā wā whakarite ki te whare hauora. Kātahi ka taea e koe te kimi mēnā he renal vein stenosis tōu i mua i te puta o ngā tohu. Kātahi ka mōhio koe me rapu wawe koe i te maimoatanga mēnā ka puta ngā tohu.

He aha te āhua o te heke mai mō te hunga e pāngia ana e te mate Nutcracker?

Mō ngā tamariki, he tino pai te hua. He maha ngā tamariki ka ora ake me te kore he maimoatanga nui, pērā i te pokanga. Mō ngā pakeke, ka rerekē te hua i runga i te kaha o ngā tohu me te roa o te wā e pau ana ki te tīmata i te maimoatanga. Kōrero ki tō tākuta mō te tirohanga mō tō āhua.

Āhea ahau me toro atu ki te tākuta? He aha ngā pātai me pātai atu e au?

Mena kei a koe ngā tohu o te mate nutcracker, ki te kino haere rānei ō tohu , me toro atu koe ki te tākuta.

Ki te pokanga koe, me ata whai i ngā tohutohu a tō tākuta mō te tiaki i a koe anō i te kāinga. Me whakarite hoki kia haere koe ki ngā wā tirotiro whai muri .

Ki te kī atu tō tākuta kei a koe te mate Nutcracker Syndrome, tera pea he maha āu pātai. He mea nui kia ako koe i ngā mea katoa e taea ana e koe mō ō whiringa maimoatanga me te wā pai ki te rapu maimoatanga. Anei ētahi pātai ka taea e koe te pātai:

• He aha te pānga o tēnei āhuatanga ki tōku tinana?
• He pēhea te kino o tōku āhua?
• Me rongoā ahau? Mēnā koinā, āhea?
• Ko tēhea kōwhiringa maimoatanga te mea pai mōku?
• He aha te ōrau angitu o tēnei maimoatanga?
• He aha ngā mōrearea o te maimoatanga?
• Kia pēhea te roa e ora ai?

Tērā pea ētahi atu raruraru uaua kei ētahi tāngata e pāngia ana e te mate nati. Kōrero ki tō tākuta mō ētahi atu mate kei a koe me pēhea te whakahaere i aua mate.

Mena kua roa koe e pāngia ana e ngā tohu engari kāore koe i te mōhio ki te pūtake, he mea whakamarie pea te whiwhi i tētahi tātaritanga. Engari he mea whakamataku hoki te whakaaro ki ngā kōwhiringa maimoatanga me te hiahia ki te pokanga. Ko te rongo pai ko te ako tonu a ngā kairangahau i ngā mea e pā ana ki tēnei mate me pēhea te whakahaere i a ia mā roto i ngā tikanga iti rawa te whakaekenga. Kōrero ki tō tākuta mō te mahere maimoatanga pai rawa atu māu me ngā mea hei tumanakohia i roto i ngā rā kei mua.

Hei whakamutunga, ētahi kōrero nui (Karere hei tango ki te kāinga)

Āe, kua maha ā tātou kōrero mō te Nutcracker Syndrome. Anei ētahi o ngā mea tino nui hei maumahara:

• He āhuatanga tēnei e puta mai ana i te aukati i roto i te uaua toto i te whatukuhu maui .
• Ki te pāngia koe e ngā tohu pēnei i te toto i roto i tō mimi, te mamae rānei i tō taha maui, me toro atu ki te tākuta.
• He maha ngā wā ka taea e ngā tamariki te ora ake i a rātou anō.
• He maha ngā kōwhiringa maimoatanga mō ngā pakeke, tae atu ki te pokanga, i runga i ngā tohumate.
• Kaua e wehi, engari he mea nui kia mōhio koe. Kōrero mārire ki tō tākuta, ā, whiriwhiria te maimoatanga e tika ana māu.

Ko tāku tumanako ka whai hua ēnei kōrero ki a koe. Kia ora tonu!

` Te mate nutcracker, mate tākihi, uaua tākihi maui, te toto totoka, te toto i roto i te mimi, te mamae o te puku, te pokanga