Koinei te take o tō mamae waewae? Me ako tātou mō te Popliteal Artery Entrapment Syndrome (PAES)!

Kei te mamae, kei te piri, kei te taumaha rānei ō waewae, inā koa i te rohe o te kuao kau, ina whakakorikori tinana koe, ina oma, ina hikoi tere rānei? Ka memeha haere i muri i tētahi wā, engari ka hoki mai anō ina tīmata anō koe ki te whakakorikori tinana? He mea nui kia mōhio koe ki tēnei āhuatanga e kiia nei ko te popliteal artery entrapment syndrome. Kaua e manukanuka, me kōrero noa iho tātou.

He aha te mate hopu o te uaua popliteal (PAES)?

Ki te whakarapopoto, he mate uaua toto onge te Popliteal Artery Entrapment Syndrome (PAES) . Ka pāngia te hunga rangatahi, te hunga hihiko, inā koa te hunga e takaro hākinakina ana. Ko te popliteal artery te uaua toto matua e rere ana mai i te huha ki te hope i muri i ō tātou turi. Ka pēhia tēnei uaua e te uaua i muri i te turi, ā, koinei te mea ka tupu i roto i tēnei mate.

Whakaarohia he rite ki te paipa wai. Ka tukuna te toto ki te waewae o raro. Ināianei, ka taea te whakawhāiti i tēnei uaua nā te huringa o te hononga o te uaua gastrocnemius ki te wheua huha. Ina koa ka piko iho tō tātou waewae (e kiia ana tēnei ko te "plantar flexion" i roto i ngā kupu hauora), ka whakawhāiti tēnei uaua gastrocnemius. Kātahi ka whakawhāiti ake taua uaua.

Ina whakakorikori koe, ka pēhia tonutia te uaua, ka pāngia e te kōpeketanga. Ka ahatia? Ka heke te nui o te toto e rere ana ki te waewae. Ka puta he mea pēnei i te waikawa lactic me te hauhā waro ki roto i ngā uaua me ngā io. Koia te take ka pāngia ai ō waewae me ō waewae e te taumaha, te mamae, te ngenge, ā, i ētahi wā ka ngoikore.

Ko te rongo pai, ka memeha haere ēnei tohu i roto i te toru ki te rima meneti i muri i te whakamutu i te whakakori tinana. Heoi, ki te kore e rongoatia, ka roa ake te wā, ka kaha ake ēnei tohu, ka roa ake hoki te mau. Ko te tikanga ka tīmata koe ki te mamae ahakoa i muri i te oma mō te tawhiti poto, ā, ka roa ake te wā e ora ai.

Ko wai te hunga e tino pāngia ana e tēnei mate PAES?

Ko tēnei āhuatanga, e kiia nei ko te PAES, ka pāngia e ngā kaitākaro taitamariki i waenga i te 15 me te 25 tau te pakeke. He tino teitei tēnei mōrearea mō te hunga e whai wāhi ana ki ngā hākinakina e uru ana ki te oma. Hei tauira:

• Reihi (Ara)
• Oma whenua
• Whutupaoro
• Rekereke
• Hoki papa

Whakaarohia tētahi tamaiti e whai wāhi ana ki ngā whakataetae omaoma me te papa o te kura, tētahi taitama rānei e tākaro whutupaoro ana. He nui ake te tūponotanga ka pāngia rātou e tēnei mate nā te mea ka whakamahia tonutia e rātou ō rātou waewae.

He pēhea te noa o te PAES?

He tino onge te mate PAES. E kiia ana he iti iho i te 1% o te taupori e pāngia ana e tēnei mate. Nō reira, he uaua ki te kī tika e hia ngā tāngata e pāngia ana e tēnei mate.

He aha atu anō ngā āhuatanga e whakaatu ana i ngā tohu rite ki te PAES?

Āe, kei reira. Ko te Chronic Exertional Compartment Syndrome (CECS) he mate uaua me te io e kitea whānuitia ana i te PAES, ā, ka puta mai anō hoki i te whakakori tinana. Ka taea hoki e ia te mamae me te pupuhi i ngā uaua o ngā waewae (me ngā ringa i ētahi wā). Ahakoa ka pā te CECS ki te katoa, he mea tino kitea i roto i ngā kaioma taitamariki me te hunga e takaro ana i ngā hākinakina e pā pinepine ana.

I ētahi wā, ka pāngia hoki te tangata whai PAES e te CECS. Kua kitea e tata ana ki te 5% o te hunga kāore anō kia ora i te PAES ka pāngia anō hoki e te CECS. Nō reira, he mea nui kia mahara ka taea e ngā āhuatanga e rua te noho i te wā kotahi.

He aha te rerekētanga i waenga i te PAES me te CECS?

Ka whakahaerehia e tō tākuta ngā whakamātautau maha hei wehewehe i waenga i ēnei āhuatanga e rua.

• Mō ngā PAES: Ka inehia te toto toto i te waewae i a koe e okioki ana, kātahi ka tirohia mēnā ka heke iho i muri i te whakakori tinana.
• Mō te CECS: Ka inehia te pēhanga i roto i ngā wāhanga uaua e whā o te waewae i mua atu, ā, i muri mai hoki i te whakakori tinana. I roto i te CECS, ka piki haere te pēhanga i roto i ēnei wāhanga i te āhua rerekē.

He aha te āhua o te whai PAES?

I a koe e whakakorikori tinana ana, ka pāngia pea koe e ēnei tohu i roto i tō hope me/ranei i ō waewae:

• He mamae pērā i te kōpeketanga
• Ngenge
• He kare taumaha
• Te māuiui o te uaua
• te ngoikore
• mumura

I te nuinga o te wā ka memeha haere ēnei tohu i muri i te toru ki te rima meneti o te okiokinga. Heoi, e ai ki tā mātou i kōrero ai i mua ake nei, ki te kore e rongoatia, ka hoki mai anō ēnei tohu i roto i te wā, ā, ka roa ake te wā e ora ai.

He aha ngā pūtake o te PAES?

E rua ngā huarahi matua ka puta ai tēnei pana:

1. Te pēhanga ā-tinana: Ka kitea tēnei i roto i te 10% pea o ngā take. Te āhua nei he nui ake te kitea i roto i ngā tāne. I roto i te 70% pea, ka kitea i roto i te waewae kotahi anake.

2. Te pēhanga kore-hanganga, te pēhanga mahi, te pēhanga ā-tinana rānei: He maha ake ngā wā ka pā tēnei ki ngā wāhine. Neke atu i te 90% o ngā take, ka pā pea ki ngā waewae e rua.

Te pēhanga ā-tinana

Ka puta tēnei nā te mea kei runga ake, kei raro iho rānei i te uaua popliteal tētahi wāhanga o tō uaua gastrocnemius. Tērā pea ka pakaru te uaua i tētahi whitiki uaua i roto i te uaua. Nā te mea:

• Tērā pea ka puta he mate pukupuku, he kiri mākū rānei.
• Tērā pea ka puta he toto totoka.
• I roto i te wā, ka āraia rawatia pea te uaua toto (āraitia), ka āraia rānei ngā uaua toto i raro iho.

Nō reira, e whā ngā huarahi rerekē e tū ai te uaua e pā ana ki te uaua.

Te pēhanga mahi, te pēhanga ā-tinana rānei

I tēnei wā, kei te tū tika ō uaua katoa. Heoi, ko te tikanga ka piri te uaua ki runga ake i te wheua huha, ki roto rānei i te awaawa i te taha o roto o te turi. Nō reira, ina piko tō waewae ki raro (plantar flexion), ka kumea te uaua ki roto, ka pēhi i te uaua.

I ētahi wā ka puta mai tēnei pēhanga i tētahi atu uaua (uaua popliteus) kei raro i te uaua toto. E ai ki ngā kairangahau kāore anō kia kitea he kino tēnei pēhanga kaha ki te uaua toto.

Me pēhea te tātaritanga o te PAES?

Ka taea e te tohunga toto te tātaritanga i tēnei mate. Ka tirotirohia koe e ia, ka tirohia mēnā kua heke te pā o tō waewae me te pā o te manawa o te waewae. Tērā pea ka tirohia anō hoki e ia mēnā he rerekētanga o tō pā o te manawa ina nekehia tō waewae ki runga, ki raro ki tētahi mea.

Mena kei a koe te PAES, ka taea e tō tākuta te:

• Ka taea e koe te rongo i tō pā o te manawa i a koe e okioki ana.
• Engari i a koe e whakakorikori tinana ana, ka heke pea tō pā o te manawa ina piko, ina whakatika rānei koe i tō waewae.

He aha ngā whakamātautau e mahia ana hei tirotiro i te PAES?

Ka inehia e ēnei whakamātautau te rere o te toto i roto i te turi, te waewae, me te waewae. Ka taea e ēnei whakamātautau whakaahua te whakaatu i ngā mea e whai ake nei:

• He noa te uaua?
• Mehemea ka pā mai he whara uaua.
• He toto toto kei reira?
• Kua pupuhi te uaua toto (aneurysm - he uaua toto e 50% te rahi ake i te rahi noa).
• Ka pēhia e te uaua te uaua?

Ko ētahi o ngā whakamātautau i mahia mō tēnei ko:

• Te taupū pona-puku me te whakakori tinana: Ka ine tēnei i te toto i roto i ō ringaringa me ō waewae i mua atu, ā, i muri mai hoki i te whakakori tinana. I te nuinga o te wā, he rite tonu te toto i roto i ō ringaringa me ō waewae, ā, ka piki ake i te wā e whakakori tinana ana. Heoi, ki te pupuhi ō uaua i a koe e oma ana, ka taea e tō toto i roto i ō waewae te heke iho i te neke atu i te 90% o tō toto i roto i ō ringaringa.
• Te tirotiro oro-rua o te uaua popliteal me te piko o te tipu: Ka whakamahia ngā ngaru oro hei hanga i tētahi whakaahua o te uaua me te ine i te rere o te toto. Mā tēnei ka taea e tō tākuta te kite i te āhua o ngā uaua i roto i tō waewae ina piko tō waewae, ā, ina okioki, me te kite mēnā he uaua e māuiui ana.
• Te angiography tomographic rorohiko (CTA) me te piko o te waewae: He momo matawai CT anō hoki tēnei. Ka whakamahia he tae motuhake hei tirotiro i te āhua o ngā uaua o te waewae, hei tirotiro hoki mēnā he uaua e pupuhi ana ina piko te waewae, ina okioki.
• Te angiography aukume (MRA) me te piko o te waewae: Ka whakamahia e tēnei whakamātautau he papa aukume me ngā ngaru reo irirangi hei tirotiro i te āhua o ngā uaua o te waewae, hei tirotiro hoki mēnā he uaua e pupuhi ana ina piko te waewae, ina okioki.

Me pēhea te rongoā mō te PAES?

Tērā pea ka whakahaerehia e tō tākuta te pokanga.Kātahi ka tangohia he wāhanga iti o ngā uaua gastrocnemius me te popliteus. Mā tēnei ka whakamama i te pēhanga ki runga i te uaua toto, ā, ka taea te rere o te toto ki te waewae.

E tata ana ki te haora te roa o tēnei pokanga. Ka mahia i raro i te mate whakamoe whānui.

I ētahi wā, i ngā wā tino kino ka pakaru, ka āraia hoki te uaua nā te mau o te popliteal anatomical, me horoi pea e te taote te uaua, me whakapiripiri, me waihanga rānei he ara hou huri noa i te mea ārai (bypass).

Ko te pokanga te maimoatanga tino whai hua mō te PAES, nā te mea he tikanga tino angitu mō te nuinga o te tangata. Neke atu i te 90% o te hunga e pokangahia ana ka kite i te whakapainga nui o ō rātou tohu.

Mō te hunga he PAES mahi, ko te kōwhiringa maimoatanga kore-pokanga ko te Botulinum toxin A. I raro i te aratohu CT, ultrasound rānei, ka werohia e te tākuta te 'Botox®', te 'Dysport®' rānei ki roto i te uaua e meinga ana te wiri. Ka pararutiki te uaua mō te wā poto. Ko te tumanako ka whakapoto te uaua mō ake tonu atu.

Engari e toru ki te ono marama anake te roa o tēnei. Ki te kore te uaua e whakaitihia, ka hoki mai anō pea ngā tohu. Kua angitu tēnei maimoatanga i roto i te iti iho i te 60% o te hunga i muri i te tau kotahi o te maimoatanga.

Kia pēhea te roa o te wā e ora ai i muri i ēnei maimoatanga?

E whā ki te ono marama pea te roa hei whakaora katoa i muri i te pokanga.

I muri i te pokanga, me noho koe ki te hōhipera mō te pō. Kātahi ka mahi koe i te whakaora tinana (pēnei i ngā mahi totoro) mō ngā wiki tuatahi e rua. I muri i ngā wiki e rua, me mahi koe i ngā mahi whakapakari tinana me te whakapakari tinana kia ora rawa koe.

He aha te mea ka pā ki te tangata whai PAES?

Mena kei te mau te popliteal trap i a koe, ā, kāore tō waewae i te mamae nui i te wā e whakakorikori ana, me whakawhāiti pea koe i tō whakakorikori tinana. Ka taea e tō tākuta te aroturuki i tō āhua.

Heoi, e ai ki tā mātou i kōrero ai i mua, neke atu i te 90% te angitu o te pokanga, ā, he iti te mōrearea o te hokinga mai anō. Ka hoki te nuinga o ngā kaitākaro ki ā rātou mahi o ia rā i muri i te pokanga.

Mena he mauheretanga ā-tinana, ka tūtohu ngā tākuta kia tangohia te kiko uaua rerekē mā te pokanga. Nā te mea, ki te kore e mahia, ka pakaru pea te uaua i roto i te wā. Mena ka whakaroa koe i te maimoatanga, ā, ka pāngia koe e te PAES hanganga kua pakaru te uaua popliteal, tera pea ka mamae tonu tō waewae i a koe e hikoi ana. I ētahi wā onge, me tapahi pea te waewae. Engari he tino onge tēnā.

Āhea ahau me kite anō i te tākuta?

I muri i te pokanga, me toro atu koe ki te tākuta:

• I roto i te marama.
• I roto i ngā marama e ono.
• I roto i ngā marama tekau mā rua.

I ēnei hui:

• Ka whakahaerehia he whakamātautau ultrasound o tō uaua kua whakatikatikaina.
• Kei te tirotirohia e rātou te toto i roto i ō waewae.

Mena kua hoki tō uaua ki te āhua noa, kāore he hiahia mō ētahi atu wā tirotiro mēnā kāore e hoki mai ngā tohu, mēnā rānei me pokanga toto.

He aha ngā pātai me pātai atu e au ki taku tākuta?

• He PAES ā-tinana, he PAES mahi rānei taku?
• E taunaki ana koe i te pokanga mō tōku mate?

Mena he taitamariki koe, ā, kei te mamae ō waewae, me toro atu ki te tākuta. He maha ngā take mō tēnei mamae. Ko te tere o te tautuhi tika i te mate, ko te tere hoki o te tīmatanga o te maimoatanga. Mena kei a koe te mate hopunga uaua popliteal, kōrero ki tō tākuta mēnā he kōwhiringa pai te pokanga māu. He maimoatanga angitu tēnei i roto i te maha o ngā wā.

Ngā mea tino nui hei maumahara (Karere hei kawe ki te kāinga)

Āe, me whakarāpopoto e tātou ētahi o ngā mea hei maumahara māu mai i ngā mea kua kōrerohia e tātou:

• Ko te PAES he āhuatanga e whakawhāiti ana te uaua matua i muri i te turi, arā, he uaua, ā, ka whakaiti i te rere o te toto ki te waewae.
• Ko te nuinga o tēnei ka pā ki ngā kaitākaro rangatahi , inā koa ko te hunga e oma ana.
• Mena ka pāngia koe e ngā tohu pēnei i te mamae, te taumaha, te ngau rānei i te rohe o te hope i te wā e korikori ana, engari ka memeha haere i te wā e okioki ana koe, tera pea he PAES tōu.
• Tērā anō tētahi āhuatanga e kīia nei ko te CECS , he rite tonu ngā tohu, nō reira he mea nui te tautuhi tika i te mate.
• Ka taea te whakaū i te mate mā te tirotiro i a koe e te tohunga (pēnei i te `Ankle-brachial index`, `Duplex ultrasound`, `CTA`, `MRA`).
• Ko te pokanga te maimoatanga tino whai hua i te nuinga o te wā . Ka werohia ētahi tāngata ki te `(Botulinum toxin A)`.
• Ki te kore e rongoatia, ka pakaru pea te uaua toto i roto i te wā, ā, ka kino haere te āhua.
• Nō reira, ki te pā mai ēnei tohu, he mea nui kia rapu tohutohu hauora tonu koe.

Kaua e manukanuka, ki te kite koe i tēnei mate, he pai ngā maimoatanga kei reira. Ko te mea nui ko te toro atu ki te tākuta i te wā poto, me te kore e aro ki ngā tohu. Kātahi ka taea e koe te ora me te kaha anō!

` te mate mau o te uaua popliteal, PAES, mamae waewae, mamae hope, whakakori tinana, kaitākaro taitamariki, uaua toto, uaua popliteal