Kodi ichi ndi chomwe chimayambitsa kupweteka m'khosi, m'mapewa, ndi m'manja? Tiyeni tiphunzire za matenda a Thoracic Outlet Syndrome.

Kodi nthawi zina mumamva ululu wachilendo kapena dzanzi lomwe limatuluka m'khosi mwanu ndi m'mapewa anu? Kodi ululuwu umaoneka kuti ukukulirakulira mukakweza mkono wanu? Anthu ambiri amaganiza kuti izi ndi zachilendo, kapena kuti ndi mtsempha waung'ono m'khosi mwanu womwe ukukanikizidwa, koma chifukwa chake chingakhale chovuta kwambiri kuposa momwe mukuganizira. Lero tikambirana za vuto lomwe lingayambitse zizindikiro zofanana, koma anthu ambiri sanamvepo za ilo. Imeneyo ndi Thoracic Outlet Syndrome (TOS).

Mwachidule, kodi Thoracic Outlet Syndrome (TOS) ndi chiyani?

Dzinali lingamveke ngati lovuta pang'ono. Koma tiyeni tipitirize kulimvetsa mosavuta. Tangoganizani kuti pali malo ang'onoang'ono ofanana ndi ngalande pakati pa khosi ndi chifuwa chathu. Kunena zoona, malo omwe ali pansi pa khosi ndi pamwamba pa nthiti yoyamba. Malo awa ndi omwe timatcha 'malo otulukira chifuwa' mu mankhwala.

Ngalande iyi ndi yofunika kwambiri chifukwa mtolo waukulu wa mitsempha womwe umapereka kumva ndi kuyenda ku dzanja lathu (lotchedwa brachial plexus ), komanso mtsempha waukulu womwe umapereka magazi ku dzanja ( mtsempha wa subclavian ), ndi mtsempha waukulu womwe umanyamula magazi kuchokera ku dzanja kubwerera ku mtima ( mtsempha wa subclavian ) umadutsa m'malo ang'onoang'ono awa.

Kawirikawiri, mitsempha ndi mitsempha yamagazi iyi imatha kuyenda m'malo awa popanda chopinga chilichonse. Koma bwanji ngati ngalande iyi yatsekedwa pazifukwa zina? Ndiko kuti, chimachitika ndi chiyani ngati mitsempha kapena mitsempha yamagazi iyi yakakamizidwa ndi minofu yozungulira, mafupa, ndi zina zotero? Ndicho chimene timachitcha Thoracic Outlet Syndrome (TOS) . Kupsinjika kumeneku ndi komwe kumayambitsa zizindikiro zambiri monga kupweteka, dzanzi, ndi kutupa m'dzanja.

Kodi pali mitundu ikuluikulu ya TOS?

Inde, TOS imagawidwa m'magulu atatu akuluakulu kutengera chomwe chikuyambitsa kupanikizika kumeneku. Kudziwa izi ndikofunikira kwambiri pa chithandizo.

Mitundu yonse ya mitsempha ya m'magazi ndi mitsempha yamagazi imadziwika kuti Vascular Thoracic Outlet Syndrome . Mitundu yonse iwiri nthawi zambiri imafuna opaleshoni. Komabe, mtundu wa Neurogenic womwe umapezeka kwambiri nthawi zambiri umayankha bwino ku chithandizo cha thupi.

Kodi zizindikiro za TOS ndi ziti?

Zizindikiro zimadalira ngati mitsempha kapena mtsempha wamagazi wapanikizika. Zizindikirozi nthawi zambiri zimawoneka mbali imodzi (khosi, pachifuwa chapamwamba, phewa, mkono, kapena dzanja).

Zizindikiro zomwe zimawonedwa kawirikawiri:

• Ululu: Ululu uwu ukhoza kuwonjezeka mukakweza mkono wanu. Anthu ena angamve ngati ululu wochepa .
• Kusanza: Kumva ngati "zikhomo ndi singano", mofanana ndi kumva ngati dzanja lanu lachita dzanzi.
• Kusamva bwino: Kutaya mphamvu m'malo ena a dzanja.
• Kufooka: Kuchepa mphamvu m'dzanja kapena zala, kuvutika kugwira zinthu.
• Kutupa kapena kulemera: Dzanja likhoza kutupa ndikumva kulemera, makamaka pamene mtsempha wachepa.
• Kusintha kwa mtundu wa khungu: Dzanja likhoza kukhala lofiirira kapena labuluu.
• Manja ozizira: Pamene mtsempha wa magazi wachepa ndipo magazi achepa, dzanja likhoza kuzizira kuposa dzanja lina.
• Kuchira mochedwa kwa mabala a zala: Izi zitha kukhala chifukwa cha kusayenda bwino kwa magazi.

Kodi ululu uwu ukhoza kukhala wogwirizana ndi matenda a mtima?

Funso ili ndi lofunika kwambiri. Popeza TOS ingayambitse kupweteka pachifuwa chapamwamba, ena angaope kuti iyi ndi matenda a mtima kapena angina. Komabe, pali kusiyana koonekeratu pakati pa ziwirizi.

• Ululu wa TOS: Nthawi zambiri umakula kwambiri mukakweza mkono wokhudzidwa . Ululuwu sukula kwambiri mukayenda kapena kuchita masewera olimbitsa thupi.
• Ululu wa angina: Uwu ndi ululu womwe umabwera chifukwa chosapereka magazi okwanira mumtima. Nthawi zambiri umakula kwambiri mukamachita masewera olimbitsa thupi, monga kuyenda kapena kukwera masitepe . Umakula bwino mukapuma. Ukhozanso kutsagana ndi zizindikiro monga kupuma movutikira komanso thukuta.

Mofananamo, kufooka mbali imodzi ya thupi kungakhale chizindikiro cha sitiroko. Komabe, sitiroko ingayambitsenso zizindikiro monga kugwada pakamwa mbali imodzi, kuvutika kulankhula, komanso kusintha kwa masomphenya.

Kodi chimayambitsa TOS ndi chiyani?

Madokotala amagawa zomwe zimayambitsa matenda a TOS m'magulu atatu akuluakulu.

Nthawi zina, ngakhale patakhala chiopsezo chobadwa nacho (monga nthiti yowonjezera), zizindikiro sizingawonekere mpaka ngozi kapena kuchita zinthu molakwika kwa nthawi yayitali.

Kodi vuto ili ndi lalikulu? Nanga chingachitike n’chiyani ngati silikuchiritsidwa?

Inde, TOS ingayambitse mavuto aakulu ngati sichitha kuchiritsidwa, makamaka ngati mitsempha yamagazi yachepa.

• Kutsekeka kwa magazi m'thupi: Magazi amaundana m'manja chifukwa cha kuchepa kwa mitsempha. Ngati magazi amaundanawa atuluka m'mapapo, angayambitse matenda oopsa omwe amaika moyo pachiswe otchedwa pulmonary embolism .
• Kutupa kosatha ndi ululu: Kutupa kosatha ndi ululu m'dzanja.
• Kufa kwa minofu (Gangrene): Ngati mtsempha wamagazi watsekeka ndipo magazi akupita m'dzanja adulidwa kwathunthu, minofu ya zala imatha kufa.
• Mabala osachiritsa: Mabala a zala sangachiritsidwe chifukwa cha kusayenda bwino kwa magazi.
• Kuwonongeka kwa mitsempha kosatha: Kupsinjika kwa mitsempha kwa nthawi yayitali kungayambitse kuwonongeka kosatha.

Kodi dokotala amazindikira bwanji matenda a TOS?

Kuzindikira matenda a TOS nthawi zina kumakhala kovuta chifukwa zizindikiro zake zimatha kufanana ndi za matenda ena ambiri. Dokotala wanu adzakufunsani kaye za zizindikiro zanu ndikukuyesani.

Pa nthawi yoyezetsa thupi, dokotala adzakufunsani kuti muchite zinthu zina. Mwachitsanzo:

• Kwezani manja anu mmwamba ndipo muwapemphe kuti atembenuze ndi kutambasula manja awo (Mayeso Okweza a Kupsinjika kwa Manja).
• Amakupemphani kuti mutembenuze khosi lanu mbali zosiyanasiyana.

Dokotala wanu akhoza kudziwa izi poona ngati mukukumana ndi zizindikiro monga kupweteka kapena dzanzi mukamayendetsa zinthuzi, komanso momwe zimachitikira.

Kuphatikiza apo, mayeso otsatirawa akhoza kuyitanidwa kuti atsimikizire matendawa ndikuchotsa matenda ena:

• X-ray ya pachifuwa: Yang'anani nthiti yowonjezera (nthiti ya pachifuwa).
• Kujambula kwa CT kapena MRI: Kuona komwe kapangidwe ka khosi ndi chifuwa kakanikizidwa, komanso mitsempha ndi mitsempha yamagazi.
• Electromyography (EMG) / Kafukufuku Woyendetsa Mitsempha: Amafufuza momwe mitsempha imagwirira ntchito komanso kuwonongeka kwake.
• Angiography (MRA kapena CT Angiography): Kuyang'ana momwe magazi amayendera m'mitsempha yamagazi komanso ngati pali kutsekeka kulikonse kapena magazi kuundana.

Kodi mankhwala a TOS ndi otani?

Chithandizo chimadalira mtundu wa TOS yomwe muli nayo, kuopsa kwa zizindikiro zanu, ndi chifukwa chake.

1. Chithandizo cha Thupi: Ichi ndi chithandizo choyamba komanso chofunikira kwambiri cha matenda a neurogenic TOS. Katswiri wa physiotherapy adzakuphunzitsani masewera olimbitsa thupi kuti alimbitse minofu m'khosi ndi mapewa anu, kuwonjezera kusinthasintha, komanso kukuthandizani kukhala ndi kaimidwe koyenera. Kwa anthu ambiri, chithandizochi chingachepetse kwambiri zizindikiro.

2. Mankhwala:

• Mankhwala Ochepetsa Ululu: Dokotala wanu angakulembereni mankhwala ochepetsa ululu monga NSAIDs kuti muchepetse ululu.
• Mankhwala Oletsa Kuundana kwa Magazi: Ngati magazi aundana m'mitsempha yamagazi kapena ali pachiwopsezo chopanga magazi, mankhwala ochepetsa magazi amaperekedwa. Nthawi zina, jakisoni wapadera (thrombolytic therapy) angapatsidwe kuti asungunule magazi oundanawo.

3. Opaleshoni:

• Mitundu ya TOS ya mitsempha yamagazi ndi mitsempha (mitundu ya kutsekeka kwa mitsempha yamagazi) nthawi zambiri imafuna opaleshoni chifukwa cha chiopsezo chachikulu cha mavuto aakulu.
• Opaleshoni imaganiziridwanso kwa odwala omwe ali ndi matenda a Neurogenic TOS omwe sayankha chithandizo chamankhwala.
• Opaleshoni imaphatikizapo kuchotsa chomwe chimayambitsa kupsinjika kwa mitsempha kapena mitsempha yamagazi. Mwachitsanzo, kuchotsa nthiti yowonjezera kapena kudula minofu yolimba (opaleshoni yochepetsa kupsinjika).

Dokotala wanu adzakufotokozerani mwatsatanetsatane ngati mukufunikira opaleshoni, zomwe zimachitika, komanso zoopsa zake.