Nthawi zina, mungakhale ndi mavuto akuluakulu m'thupi lanu osazindikira. Vuto limodzi lotere ndi aneurysm ya mitsempha ya femoral. Mwachidule, mtsempha waukulu wamagazi (mtsempha) mu ntchafu yanu, pafupi ndi cholumikizira cha m'chiuno, umatupa ngati baluni, yomwe imatchedwa ``Femoral Artery Aneurysm''. Izi ndi zinthu zofunika kuziganizira, chifukwa nthawi zina mungakhale ndi vutoli
popanda zizindikiro zilizonse .
Kodi aneurysm ya mitsempha ya femoral ndi chiyani kwenikweni?
Taganizirani za chitoliro chamadzi. Khoma la chitolirochi limafooka nthawi ina ndipo pang'onopang'ono limatupa. Umu ndi momwe zilili. Mtsempha waukulu wamagazi mu ntchafu yanu (wotchedwa 'femoral artery')
umatupa pafupifupi kawiri kukula kwake kwachibadwa. Izi zimachitika chifukwa zigawo zonse za khoma la mitsempha yamagazi zimatambasulidwa. Khoma la mitsempha yamagazi likafooka motere, limakhala
ndi mwayi wophulika . Ngati litaphulika, uwu ndi mtsempha waukulu wamagazi, kotero magazi ambiri amatha kutayika m'thupi nthawi imodzi. Imeneyo ndi vuto loopsa kwambiri. Komanso, pali mwayi woti magazi amaundana m'chitolirochi ndikumangika m'mitsempha, kapena akhoza kusweka ndikutseka mtsempha kwina.
Kodi pali mitundu ya kutupa kumeneku kutengera komwe kumachitika?
Inde, madokotala amagawa "Femoral Artery Aneurysm" iyi
malinga ndi malo enieni . Mtsempha waukulu wamagazi womwe uli mu ntchafu yanu, tiyeni tiwutche kuti "common femoral artery"`, umagawika m'nthambi zing'onozing'ono m'malo angapo.
- Kutupa kwina kungachitike musanayambe nthambi zazikulu za mitsempha iyi .
- Zina zingachitike pamalo pomwe nthambi zimagawikana , kapena m'nthambi zomwe zimagawikana, ``profunda femoral artery`` kapena ``superficial femoral artery``.
Kugawa kumeneku kumachitika potengera malo chifukwa nthawi zina chithandizocho chimasiyana pang'ono kutengera malo enieni a kutupa.
Ndani amene ali ndi mwayi waukulu wopeza vutoli?
Ngakhale kuti aliyense akhoza kukhala ndi vutoli, lotchedwa ``Femoral Artery Aneurysm,'' anthu ena ali pachiwopsezo chachikulu pang'ono.
- Amuna ndi omwe ali ndi mwayi waukulu wopeza matendawa kuposa akazi.
- Chiwopsezochi ndi chachikulu makamaka kwa anthu azaka zopitilira 70 .
Kuphatikiza apo, mungakhalenso pachiwopsezo ngati muli ndi zinthu izi:
- Kuthamanga kwa magazi : Ngati kuthamanga kwa magazi anu kumakhala kokwera nthawi zonse.
- Cholesterol yambiri : Cholesterol yambiri ndi mafuta omwe amapezeka m'magazi.Ngati muli ndi cholesterol yambiri.
- Matenda a minofu yolumikizana : Pali matenda ena osowa omwe amakhudza minofu ya thupi, mwachitsanzo, Ehlers-Danlos syndrome kapena Marfan syndrome. Anthu omwe ali ndi matendawa nawonso ali pachiwopsezo.
- Kugwiritsa ntchito mankhwala a fodya : Chiwopsezochi chimakhala chachikulu kwa anthu omwe amasuta ndudu, beedis, betel nut, kapena mitundu ina ya fodya.
- Matenda a atherosclerosis : Nthawi zambiri izi ndiye chifukwa chachikulu. Matenda a atherosclerosis ndi kuchuluka kwa mafuta m'makoma a mitsempha yamagazi , zomwe zimapangitsa kuti pang'onopang'ono achepetseke. Ngati mudadwalapo matenda a mtima kale, kapena ngati muli ndi mavuto ndi mitsempha yamagazi m'miyendo yanu, monga matenda a mitsempha yamagazi, mutha kukhala pachiwopsezo cha matenda a atherosclerosis.
- Mbiri ya Banja : Ngati wina m'banja mwanu, monga amayi anu, abambo anu, kapena abale anu, adakhalapo ndi aneurysm ngati iyi kale, inunso mungakhale pachiwopsezo chochepa.
Kodi vutoli ndi lofala bwanji?
Kwenikweni, `(Femoral Artery Aneurysm)` iyi ndi
matenda osowa kwambiri . Izi zikutanthauza kuti, si matenda wamba. Komabe, ngakhale kuti ndi osowa, anthu ena amatha kutupa miyendo yonse iwiri. Ena amatha kutupa (aneurysms) osati m'mitsempha iyi ya femoral yokha, komanso m'mitsempha ina yamagazi m'thupi (monga aorta m'mimba) nthawi imodzi. Malinga ndi ziwerengero, vutoli limakhudza amuna 0.007% okha. Pakati pa akazi, chiwerengerochi ndi chotsika kwambiri. Chifukwa chake, musaope kuganiza kuti izi ndizosowa kwambiri, koma ndikofunikira kwambiri kudziwa izi.
Kodi chimachitika ndi chiyani m'thupi pamene mitsempha yamagazi iyi ikukulirakulira?
Ngati muli ndi `(Femoral Artery Aneurysm)`, pali zoopsa ziwiri zazikulu. 1.
Kuundana kwa magazi : Kuundana kwa magazi kumatha kuchitika pamalo omwe pali aneurysm ndikukakamira mumtsempha umenewo. Kapena, kuuma kwa magazi kumatha kusweka ndikuyenda m'magazi kuti kutseke mtsempha wamagazi waung'ono kwinakwake (mwachitsanzo, m'munsi mwa mwendo kapena phazi). Izi zitha kuletsa kuyenda kwa magazi kupita kumalo amenewo ndikuyambitsa mavuto. 2.
Kuphulika : Uku ndiye koopsa kwambiri. Khoma lofooka la mtsempha limatha kuphulika mwadzidzidzi. Ngati zimenezo zitachitika, monga tafotokozera kale, zingayambitse kutuluka magazi kwambiri komanso imfa.
Kodi zizindikiro za izi ndi ziti?
Nthawi zambiri,
Pafupifupi 40% ya anthu omwe ali ndi vutoli alibe zizindikiro zilizonse! Gawo loopsa ndi limenelo. Komabe, ngati zizindikirozo zikuwonekera, zitha kuphatikizapo:- Chotupa m'mimba mwanu : Mungamve chotupa m'mimba mwanu. Nthawi zina, chotupachi chingamveke ngati chikugunda.
- Kutupa kwa mwendo wapansi : Mwendo wapansi ukhoza kutupa.
- Ululu kapena kupanikizika m'chifuwa kapena mwendo : Mutha kumva kupweteka m'chifuwa, m'chiuno, kapena mwendo, kapena kumva kupsinjika.
- Magazi amaundana : Monga tanenera kale, zizindikiro za magazi amaundana (monga kuzizira mwadzidzidzi, kufiira, kupweteka kwambiri) zingachitike.
- Kutupa : Izi zimachitika kawirikawiri, koma ngati zitachitika, zingayambitse vuto lalikulu la ululu wadzidzidzi komanso woopsa.
Kumbukirani kuti ikhoza kukhalapo popanda zizindikiro zilizonse, choncho ndi bwino kulankhula ndi dokotala ngati muli ndi zinthu zomwe zingakuike pachiwopsezo.
Kodi n’chiyani chimayambitsa izi?
Pali zifukwa zingapo zomwe khoma la mtsempha wa femoral lingathe kufooka ndikuyambitsa mtundu uwu wa kutupa (aneurysm).- Matenda a atherosclerosis : Ichi ndiye chifukwa chachikulu komanso chofala kwambiri . Mafuta akamaunjikana m'mitsempha yamagazi, makoma a mitsempha amakhuthala pang'onopang'ono ndikutaya kulimba kwawo, sangathenso kupirira kupanikizika kwa magazi ndipo amatha kufooka ndikutupa m'malo ena.
- Kuthamanga kwa magazi : Kuthamanga kwa magazi kukakwera kwa nthawi yayitali, mitsempha yamagazi imakhala ndi kupanikizika kwakukulu nthawi zonse. Izi zitha kufooketsanso makoma a mitsempha.
- Kuvulala : Ngati mtsempha wamagazi m'dera la ntchafu wawonongeka chifukwa cha ngozi kapena kuvulala mwadzidzidzi, derali likhoza kutupa pambuyo pake. Mwachitsanzo, kuvulala pang'ono chifukwa cha njira zina zachipatala (monga kuyika catheter) nthawi zina kungakhale chifukwa.
- Matenda a minofu yolumikizana : Monga tanenera kale, anthu omwe ali ndi matenda osowa omwe amakhudza minofu yolumikizana ya thupi, monga Ehlers-Danlos syndrome, Marfan syndrome, kapena matenda a adventitial cystic, akhoza kukhala ndi kufooka kwa makoma a mitsempha yamagazi.
- Matenda a Behçet : Matenda a Behçet angayambitsenso kutupa kwa mitsempha yamagazi ndipo angayambitse kutupa motere.
Ichi ndichifukwa chake khoma la mtsempha wanu wamagazi limafooka ndipo pang'onopang'ono limatambasuka chifukwa cha kupanikizika kwa magazi, zomwe zimapangitsa aneurysm ngati iyi. Kodi madokotala amazindikira bwanji izi?
Mukapita kukaonana ndi dokotala, angamve chotupa m'chifuwa chanu mukayesedwa thupi. Koma si chotupa chilichonse m'chifuwa chanu chomwe chimakhala ndi aneurysm. Nthawi zina chingakhale hernia. Chifukwa chake, kuti mudziwe bwino lomwe, komanso kuti mudziwe kukula kwake, komwe kuli, komanso komwe kuli, dokotala wanu adzakufunsani kuti muchite mayeso monga:- Kujambula kwa Ultrasound : Iyi ndi njira yosavuta komanso yopanda ululu yomwe ingayang'ane mkati mwa mtsempha wamagazi, komwe kutupa kuli, komanso kukula kwake.
- CT angiogram : Iyi ndi mtundu wapadera wa CT scan. Mu mayeso awa, utoto wapadera (utoto wosiyana) umalowetsedwa m'mitsempha yanu yamagazi, ndipo CT scanner imatenga zithunzi zatsatanetsatane za mitsempha yamagazi yamitundu itatu (3D). Izi zingapereke zambiri zokhudza kutsekeka kwa mitsempha.
- M.R. Angiogram (Magnetic Resonance Angiogram - MRA) : Iyi ndi MRI scan yapadera yomwe imayang'ana mitsempha yamagazi, yofanana ndi CT angiogram.
Dokotala adzasankha chithandizo chomwe chili chabwino kwa inu kutengera zomwe zapezeka kuchokera ku mayesowa. Kodi mumachiza bwanji mitsempha yamagazi yotupa iyi m'miyendo yanu?
Chiwopsezo cha kuphulika kwa "Femoral Artery Aneurysm" ndi chochepa (pafupifupi 1% mpaka 14%). Chifukwa chake, si aliyense amene angafunike opaleshoni nthawi yomweyo . Komabe, dokotala wanu angakulangizeni opaleshoni kuti akonze aneurysm pazochitika zotsatirazi:- Ngati muli ndi zizindikiro (monga kupweteka, kutupa, magazi kuundana).
- Ngati kutupa kwaphulika (izi ndi zadzidzidzi ndipo zimafuna opaleshoni yachangu).
- Ngati kutupa kukukulirakulira (dokotala adzakuyang'anani nthawi zonse).
- Ngati kukula kwa chipolopolocho kuli kokulirapo kuposa masentimita 2.5 (pafupifupi inchi imodzi) .
Kuti akonze chotupachi, madokotala nthawi zambiri amachita opaleshoni yotseguka . Izi zikutanthauza kuti, amadula khungu ndikuyang'ana mwachindunji mtsempha wamagazi. Iyi si opaleshoni ya `laparoscopic` yomwe nthawi zambiri imachitika kudzera m'mabala ang'onoang'ono pogwiritsa ntchito kamera. Dokotalayo amachotsa gawo lotupa, lofooka la mtsempha wamagazi ndikulisintha ndi chubu chopangira, chotchedwa `fabric graft` (chubu chopangidwa ndi nsalu yapadera). Izi zili ngati kudula malo ofooka mu payipi yozimitsira moto ndikuyikapo chidutswa chatsopano, cholimba. Kenako magazi amatha kuyambiranso kuyenda bwino komanso popanda kusokonezedwa.
Kodi ndi mavuto otani omwe angachitike pambuyo pa opaleshoni iyi?
Monga momwe zimakhalira ndi opaleshoni ina iliyonse, pali mwayi wochepa woti pakhale mavuto ena pambuyo pa opaleshoni ya femoral artery bypass grafting. Koma madokotala amasamala kwambiri za izi.- Matenda : Chilonda cha opaleshoni chikhoza kuipiraipira ndi kutenga matenda.
- Kutuluka magazi : Kutuluka magazi kungachitike pambuyo pa opaleshoni.
- Magazi amaundana: Magazi amaundana m'miyendo.
Izi nthawi zambiri zimakhala zinthu zomwe zingathe kulamuliridwa. Ngati mukumva china chake chachilendo, muyenera kuuza dokotala wanu nthawi yomweyo. Kodi zimatenga nthawi yayitali bwanji kuti munthu achire pambuyo pa chithandizochi?
Pambuyo pa opaleshoni, muyenera kukhala m'chipatala kwa masiku atatu kapena khumi. Zingatenge mwezi umodzi kapena kuposerapo kuti muchiritse bwino ndikubwerera ku zochita zanu zachizolowezi. Chifukwa chake, ndikofunikira kwambiri kutsatira malangizo a dokotala molondola komanso kukhala oleza mtima panthawiyi. Kodi ndingatani kuti ndichepetse chiopsezochi?
Monga tafotokozera kale, chifukwa chachikulu cha `(Femoral Artery Aneurysm)` ichi ndi `(Atherosclerosis)`, mafuta omwe amasonkhana m'mitsempha yamagazi. Chifukwa chake, kuwongolera izi kungachepetse chiopsezo cha aneurysms izi.- Yesetsani kuchepetsa kuchuluka kwa mafuta m'thupi ndi kuthamanga kwa magazi . Imwani mankhwala omwe dokotala wanu wakupatsani.
- Kuchita masewera olimbitsa thupi nthawi zonse . Ngakhale kuyenda kwa mphindi 30 patsiku n'kwabwino.
- Idyani zakudya zabwino komanso zopanda mafuta ambiri . Idyani zipatso, ndiwo zamasamba, ndi zakudya zokhala ndi ulusi wambiri.
- Ngati mukusuta fodya, siyani kusuta konse . Siyaninso kugwiritsa ntchito zinthu zopangidwa ndi fodya. Izi ndizofunikira kwambiri.
- Kwa anthu ena, kuwonjezera pa kusintha kwa moyo wawo, dokotala angalimbikitsenso kupitiriza kumwa mankhwala ochepetsa cholesterol.
Ngati ndili ndi kutupa m'mimba chonchi, ndiyenera kuyembekezera chiyani?
`(Femoral Artery Aneurysm)` iyi sidzatha yokha popanda chithandizo. Ngati dokotala wanu akukuuzani kuti muli nayo, adzaiyang'ana nthawi zonse (adzakuuzani kuti mubwere kudzayang'ananso). Izi zikutanthauza kuti, adzachita mayeso monga `(Ultrasound scan)` nthawi zina kuti aone ngati kutupa kukukulirakulira kapena ngati pali mavuto ena. Kutengera ndi zimenezo, adzasankha ngati opaleshoni ikufunika kapena ngati adikira pang'ono. Zotsatira za opaleshoni imeneyi nthawi zambiri zimakhala zabwino kwambiri. Chiwopsezo cha imfa panthawi ya opaleshoni ndi chochepa kwambiri, pakati pa 1% ndi 5%. Ngakhale patatha zaka zisanu kuchokera pamene opaleshoniyo inachitidwa, pafupifupi 85% ya mitsempha yamagazi yokonzedwayo ikugwirabe ntchito bwino, popanda vuto lililonse la kuyenda kwa magazi. Iyi ndi nkhani yabwino kwambiri. Kodi ndingadzisamalire bwanji?
Ngati muli ndi `(Femoral Artery Aneurysm)` ndipo mwachitidwa opaleshoni, kapena mukuyang'aniridwa ndi dokotala popanda opaleshoni, muyenera kuyang'aniridwa ndi dokotala nthawi zonse kwa moyo wanu wonse. Kuwunika kumeneku kungathandize kuzindikira aneurysms yatsopano isanayambe kukula ndi kuphulika. Ngati mukusuta, kungapangitse aneurysms izi kukhala zazikulu. Chifukwa chake, dokotala wanu adzakulangizani kuti musiye kusuta. Komanso, tsatirani malangizo omwe aperekedwa kuti muchepetse cholesterol yanu ndi kuthamanga kwa magazi. Kodi ndiyenera kupita ku chisamaliro chadzidzidzi liti?
Ngati mwendo kapena phazi lanu mwadzidzidzi likuwonetsa chimodzi mwa zizindikiro izi, muyenera kupita kuchipatala mwamsanga, mwamsanga :- Ngati mwendo wafooka kapena ukumva ngati wopanda moyo.
- Ngati mwendo wayamba kutupa mwadzidzidzi.
- Ngati mukumva ululu wosapiririka.
- Ngati mwendo wanu wachita dzanzi .
- Ngati mwendo wanu ukumva wozizira kuposa mwendo winawo mukamaukhudza.
- Ngati mwendo wasanduka wotumbululuka kapena wasintha mtundu.
Zizindikiro zimenezi zimasonyeza vuto lalikulu la kuyenda kwa magazi kupita ku mwendo, zomwe zingatanthauze kuti kutupako kungayambitse magazi kuundana kapena kutupako kungayambitse kuphulika. Chifukwa chake, kupeza chithandizo mwachangu popanda kuwononga nthawi kungapulumutse moyo. Ndi mafunso ati omwe ndiyenera kufunsa dokotala?
Ngati muli ndi mafunso kapena nkhawa zokhudzana ndi vutoli, musazengereze kufunsa dokotala wanu. Mwachitsanzo, mutha kufunsa mafunso ngati awa:- "Dokotala, n’chiyani kwenikweni chikuchititsa kutupa kumeneku m’mitsempha yanga?"
- "Kodi ndikufunikadi opaleshoni pa izi? Kodi palibe mankhwala ena?"
- "Kodi ndingakhale ndi kutupa kotereku m'thupi langa?"
- "Kodi mungandipatse upangiri pa zakudya zomwe zingathandize kuchepetsa cholesterol yanga?"
Ndikofunikira kwambiri kufunsa mafunso ngati awa kuti mumvetse bwino za vuto lanu. Kodi kusiyana pakati pa `Femoral Artery Aneurysm` ndi `Pseudoaneurysm` ndi kotani?
Nthawi zina mumamvanso mawu akuti `(Pseudoaneurysm)`. Izi zikutanthauza "bodza lotupa". `(Pseudoaneurysm)` iyi ndi yofala kwambiri kuposa `(Femoral Artery Aneurysm)` yeniyeni yomwe takhala tikulankhula. Nthawi zambiri, `(Pseudoaneurysm)` imapangidwa pambuyo pa opaleshoni yachipatala pamitsempha yanu yamagazi (mwachitsanzo, pamene `(angiogram)` yapangidwa kapena `(catheter)` yayikidwa), ndipo khoma la mtsempha wamagaziwo limawonongeka pang'ono, ndipo magazi ena amatuluka ndikusonkhana mozungulira mtsempha, ndikupanga chotupa. Kusiyana kwakukulu ndikuti mu `(aneurysm)` yeniyeni, zigawo zonse za khoma lamitsempha yamagazi zimatambasuka ndikutupa. Koma mu `(pseudoaneurysm)`, sizichitika, ndi kusonkhanitsa kwa magazi komwe kumatuluka kudzera mu dzenje lomwe lili pakhoma lamitsempha yamagazi. Kodi uthenga umene tikufuna kutenga kuchokera mu nkhaniyi ndi wotani?
Ngakhale kuti aneurysm ya mitsempha ya m'mimba yomwe takambiranayi ndi yosowa kwambiri, ndikofunikira kwambiri kuti inu ndi banja lanu mudziwe za izi.- Izi nthawi zambiri zimakhala zopanda zizindikiro .
- Ngati muli ndi zinthu zomwe zingakuike pachiwopsezo (kuthamanga kwa magazi, cholesterol, kusuta fodya, mbiri ya banja), funsani upangiri wa dokotala .
- Ngati dokotala wanu akupeza kuti muli ndi vuto, musachite mantha. Pali mankhwala othandiza omwe angagwiritsidwe ntchito kuchotsa, ngakhale opaleshoni, lisanaphulike .
- Kukumana ndi dokotala yemwe ali ndi luso lochiza matenda amtunduwu kudzakuthandizani kwambiri.
- Nthawi zonse muzisamalira thanzi lanu, khalani ndi moyo wathanzi, ndipo tsatirani malangizo a dokotala wanu molondola.Mukatero mungathe kupewa mavuto ambiri azaumoyo ngati awa ndikukhalabe ndi thanzi labwino.
Ngati muli ndi mafunso ena, onetsetsani kuti mwalankhula ndi dokotala wa banja lanu kapena katswiri.
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