Kodi nthawi zonse mumakhala ndi ululu m'khosi, m'mapewa, kapena m'manja? Vutoli likhoza kukhala Thoracic Outlet Syndrome (TOS)!

Kodi nthawi zina mumamva ululu wachilendo kapena dzanzi lomwe limachokera pakhosi ndi mapewa anu mpaka m'manja mwanu? Mwina ululuwu umawonjezeka mukanyamula katundu wolemera kapena kukweza mkono wanu. Ngati muli ndi zizindikiro ngati izi, chifukwa chake chingakhale vuto lomwe lili ndi dzina lovuta pang'ono. Lero tikulankhula za vuto lotere, lomwe ndi Thoracic Outlet Syndrome (TOS) . Ngakhale kuti dzinalo lingamveke loopsa pang'ono mukalimva, ngati mwadziwitsidwa bwino za ilo, mutha kuchepetsa mavuto ambiri.

Kodi Matenda a Thoracic Outlet Syndrome ndi Chiyani?

Mwachidule, Thoracic Outlet Syndrome (TOS) ndi mndandanda wa zizindikiro zomwe zimachitika chifukwa cha kupsinjika kwa mitsempha kapena mitsempha yamagazi m'khosi lanu la pansi ndi pachifuwa chapamwamba. Dzina lina la izi ndi "thoracic outlet."

Tangoganizani kuti pali malo ang'onoang'ono, ngati chitseko, pakati pa khosi lanu ndi chifuwa chanu. Izi ndi zomwe madokotala amatcha "Thracic Outlet." Kudutsa mu malo awa mumadutsa mitsempha yofunika kwambiri yomwe imapita ku dzanja lanu, komanso mitsempha yomwe imanyamula magazi kupita ku dzanja lanu ndi mitsempha yomwe imabweza magazi kuchokera ku dzanja lanu kupita ku mtima wanu. Chofunika kwambiri mwa izi ndi brachial plexus, netiweki ya mitsempha yomwe imapita ku dzanja lanu, ndi mtsempha wa subclavian ndi mtsempha.

Kawirikawiri, malo awa otchedwa "thoracic outlet" amakhala aakulu mokwanira kuti mitsempha ndi mitsempha yamagazi izi zidutse popanda chopinga chilichonse. Komabe, nthawi zina malo awa amatha kukhala ochepa chifukwa cha kusintha kwina kwa thupi lathu kapena chifukwa cha kuvulala kwa khosi kapena pachifuwa. Apa ndi pomwe vutoli limayamba. Malo awa akamachepa, mitsempha kapena mitsempha yamagazi yomwe imadutsamo imayamba kukakamizidwa ndi mafupa kapena minofu yomwe ili pansipa. Kupanikizika kumeneku kumayambitsa zizindikiro monga kupweteka ndi dzanzi m'dzanja lanu, phewa, ndi khosi. Zizindikiro izi zitha kukhala zosiyana komanso zosiyanasiyana, kotero nthawi zina zingatenge nthawi kuzindikira izi ngati vuto la TOS .

Koma musadandaule. Anthu ambiri amatha kupeza mpumulo pogwiritsa ntchito njira zosavuta monga physiotherapy ndi mankhwala ochepetsa ululu. Komabe, ngati zimenezo sizithandiza kapena ngati magazi atsekeka kwambiri, opaleshoni ingafunike.

Kodi pali mitundu ya TOS?

Inde, madokotala amagawa TOS m'magulu atatu akuluakulu, kutengera chomwe chikuyambitsa kupwetekaku:

Matenda a Neurogenic TOS (matenda a mitsempha omwe amayamba chifukwa cha kupsinjika kwa mitsempha)

Uwu ndi mtundu wofala kwambiri wa TOS . Pafupifupi 95% ya odwala onse a TOS ali ndi mtundu uwu. Chomwe chimachitika apa ndi chakuti ``Brachial plexus``, netiweki ya mitsempha yomwe imayenda kuchokera pakhosi panu kudzera m'khwapa mpaka kumanja, imapanikizika. Nthawi zambiri imachitika mwa anthu azaka za m'ma 30. Kuvulala mobwerezabwereza kwa nkhawa - makamaka pamasewera - ndi kuvulala mwadzidzidzi pakhosi, monga ``Whiplash`` chifukwa cha ngozi yagalimoto, ndiye zifukwa zazikulu.

TOS yoyambitsidwa ndi kutsekeka kwa mitsempha (Venous TOS)

Apa ndi pomwe "mtsempha wanu wa Subclavian" umalowa. Uwu ndiye mtsempha waukulu wamagazi womwe umanyamula magazi odetsedwa kuchokera ku mkono kupita kumtima. Umapezeka kawirikawiri mwa amuna , nthawi zambiri azaka zapakati pa 20 ndi 30. Zizindikiro nthawi zambiri zimawonekera mu mkono womwe umagwiritsidwa ntchito kwambiri ('mkono waukulu').

TOS yoyambitsidwa ndi kupsinjika kwa mitsempha yamagazi (Arterial TOS)

Uwu ndi mtundu wosowa kwambiri wa TOS . Umakhudza pafupifupi 1% ya odwala onse a TOS. Komabe, ndi chifukwa chofala kwambiri cha magazi kuundana mwadzidzidzi m'manja mwa anthu osakwana zaka 40. Mtundu uwu wa TOS umapezeka mumtsempha wanu wamagazi wa subclavian, womwe ndi mtsempha waukulu wamagazi womwe umanyamula magazi okhala ndi mpweya kuchokera pamtima kupita m'manja. Nthawi zambiri umayamba chifukwa cha vuto lobadwa nalo. Chitsanzo ndi nthiti yowonjezera pakhosi (nthiti ya pachibelekero). Pafupifupi 70% ya anthu omwe ali ndi nthiti ya pachibelekero ndi akazi, kotero mtundu uwu wa TOS ndi wofala kwambiri mwa akazi.

Madokotala nthawi zina amaphatikiza mitundu iwiri ya TOS ya mitsempha ndi mitsempha yamagazi ndipo amaitcha "Vascular Thoracic Outlet Syndrome." Mitundu yonseyi nthawi zambiri imafuna opaleshoni kuti ichepetse zizindikiro ndikupewa mavuto. Mtundu wa TOS wokhudzana ndi mitsempha (Neurogenic TOS) umayankha bwino ku chithandizo cha thupi ndi masewera olimbitsa thupi, koma anthu ena angafunike opaleshoni.

Kodi vutoli ndi lofala bwanji?

Malinga ndi ofufuza, chaka chilichonse:

• Matenda a neurogenic TOS amapezeka mwa munthu m'modzi mwa anthu 40,000.
• TOS ya m'mitsempha imapezeka mwa munthu m'modzi mwa anthu 1.25 miliyoni.

Komabe, chifukwa cha kuvutika kupeza matendawa molondola, chiwerengero chenicheni cha anthu omwe akudwala matendawa chikhoza kukhala chokwera kwambiri.

Kodi zizindikiro za TOS ndi ziti?

Zizindikiro za TOS nthawi zambiri zimapezeka mbali imodzi ya thupi lanu lapamwamba (khosi, pachifuwa chapamwamba, phewa, mkono, kapena zala). Mungakumane ndi zinthu monga:

• Ululu: Ululuwu ukhoza kuwonjezeka mukakweza mkono wanu.
• Kusanza kapena kumva "kukwawa".
• Kusamva bwino, kusamva chilichonse m'dzanja .
• Kufooka kwa dzanja.
• Kutupa kapena kulemera m'dzanja.
• Mtundu wa khungu umasintha (khungu limasintha kukhala lofiirira kapena labuluu).
• Kumva kuzizira mukakhudza khungu.
• Mabala a zala amatenga nthawi yayitali kuti achire.

Zizindikirozi zimatha kusiyana malinga ndi mtundu wa TOS yomwe muli nayo. Chifukwa zizindikirozo zimadalira chomwe chikukanikizidwa (mitsempha kapena mtsempha wamagazi). Kunena zoona, ndi izi:

• "Brachial plexus" yanu ndi komwe mkono wanu umapeza kuyenda ndi kumva. Chifukwa chake, pamene mitsempha iyi yakwiya, zinthu monga kupweteka ndi dzanzi zimachitika.
• Mtsempha wanu wa subclavian ndi umene umanyamula magazi kuchokera m'dzanja lanu kubwerera kumtima. Choncho, mtsempha uwu ukatsekedwa, magazi omwe ali m'dzanja lanu sangatuluke bwino, zomwe zimapangitsa kuti dzanja lanu lizitupa ndikumva lolemera.
• Mitsempha yanu ya subclavian imapereka magazi okhala ndi mpweya wambiri m'dzanja lanu. Choncho, pamene mitsempha iyi yatsekedwa, magazi opita ku dzanja lanu ndi zala zanu amachepa. Izi zingayambitse dzanzi, kumva kuwawa, kupweteka, ndi kuzizira m'dzanja lanu.

Kodi ululu wa TOS umamveka bwanji? Kodi umasokonezedwa ndi angina?

Kupweteka kwa minofu ya TOS kungayambitse ululu pakhosi, pachifuwa, paphewa, ndi pa mkono. Izi zitha kukhala ululu wosasangalatsa, monga ululu wopitirira muyeso, ndipo zitha kukulirakulira mukasuntha mkono wanu.

Anthu ena amasokoneza ululu wa TOS ndi angina , matenda a mtima. Angina ndi ululu pachifuwa womwe umayamba chifukwa chakuti minofu ya mtima silandira mpweya wokwanira. Koma pali kusiyana kwakukulu pakati pa ziwirizi:

• Ululu wa TOS subwera kapena kukulirakulira poyenda. Komabe, ululu wa angina nthawi zambiri umakula. Angina imatha kutsagana ndi zizindikiro zina monga kupuma movutikira, kugunda kwa mtima mofulumira, komanso chizungulire.
• Ululu wa TOS nthawi zambiri umawonjezeka mkono wokhudzidwa ukakwezedwa. Izi sizimachitika ndi angina.

Chofunika: Musasokoneze TOS ndi matenda a mtima kapena sitiroko!

Ichi ndi chinthu chomwe muyenera kukumbukira . Zizindikiro zina za TOS zitha kufanana ndi za matenda akuluakulu monga matenda a mtima ndi sitiroko, zomwe zimafuna chithandizo chadzidzidzi. Mwachitsanzo:

• Kupweteka pachifuwa , makamaka ngati kwachitika mwadzidzidzi komanso mosayembekezereka, kungakhale chizindikiro cha matenda a mtima. Komabe, pa matenda a mtima, pakhoza kukhala zizindikiro zina, monga kupuma movutikira, kupweteka m'mimba, thukuta, komanso kuopa kufa.
• Kufooka mbali imodzi ya thupi kungakhale chizindikiro cha kufooka. Komabe, kufooka kumathanso kukhala ndi zizindikiro zina, monga kulankhula movutikira, kugwada kwa mbali imodzi kapena zonse ziwiri za nkhope, komanso kutaya masomphenya mwadzidzidzi.

Ngati muli ndi zizindikiro za matenda a mtima kapena sitiroko, pitani kuchipatala nthawi yomweyo. Izi ndi zoopsa zomwe zingawononge moyo wanu. Kuchedwetsa chithandizo kungakhale koopsa.

Kodi zifukwa za TOS ndi ziti?

Madokotala amagawa zomwe zimayambitsa TOS m'magulu atatu akuluakulu:

Zoyambitsa kubadwa nazo

Izi ndi zina mwa zosintha zomwe zimapezeka m'thupi lanu mukabadwa. Mwachitsanzo, mungabadwa ndi nthiti yowonjezera ('nthiti ya chiberekero') m'khosi mwanu. Izi zili pafupi, ndipo mwina zimalumikizidwanso ndi nthiti yoyamba. Kapena mungakhale ndi zolakwika m'nthiti mwanu, minofu ya khosi, kapena mitsempha. Kusintha kumeneku kungayambitse kupanikizika pa mitsempha kapena mitsempha yamagazi mu 'chotulutsa cha pachifuwa'.

Chifukwa cha ngozi (Zoopsa)

Izi ndi kuvulala mwadzidzidzi pakhosi ndi pachifuwa. Kuvulala chifukwa cha ngozi zamagalimoto, makamaka whiplash, ndi chitsanzo chabwino cha izi. Tangoganizirani, ngati mukukwera galimoto yamawilo atatu ndipo mwachita ngozi ndipo khosi lanu lathyoka mwadzidzidzi, izi zitha kuchitika.

Chifukwa cha ntchito zomwe zikuchitika (Zogwira ntchito)

Izi zikutanthauza kuti mukachita chinthu chomwecho mobwerezabwereza, zinthu zomwe zili mu "thoracic outlet" zimawonongeka. Ichi ndi chifukwa chofala cha izi pakati pa othamanga (makamaka osewera cricket - oponya mipira, omenya, ndi osambira) chifukwa cha mayendedwe achangu a manja. Chitsanzo china ndi kukweza zinthu pamwamba pa mutu nthawi zonse pantchito zina. Ngakhale munthu amene amagwira ntchito patsogolo pa kompyuta tsiku lonse ndi kaimidwe koipa akhoza kukhala pachiwopsezo.

Ngakhale kuti anthu ena amabadwa ndi zinthu zomwe zimayambitsa matenda a TOS, sangakhale ndi zizindikiro zilizonse mpaka atachita ngozi yadzidzidzi pakhosi kapena akuchita ntchito yomweyo nthawi zonse ndipo khosilo limawonongeka.

Ndani ali pachiwopsezo chachikulu chotenga matenda a TOS?

Mungakhale pachiwopsezo chachikulu chotenga matenda a TOS ngati:

• Ngati mumasewera masewera omwe nthawi zambiri amafuna mobwerezabwereza manja kapena mapewa. Zitsanzo: cricket, kusambira, gofu, volleyball.
• Ngati mukuchita zolemera.
• Ngati nthawi zambiri mumanyamula matumba olemera pamapewa anu kapena kunyamula zinthu pamwamba pa mutu wanu. (monga anthu ogwira ntchito zomangamanga, anthu okweza katundu)
• Ngati mwavulala khosi kapena msana, mwachitsanzo `(Whiplash)`.
• Ngati muli ndi zotupa kapena ma lymph nodes akuluakulu pachifuwa chapamwamba kapena kwapa.
• Ngati kaimidwe kanu kokhala kapena kuyimirira sikoyenera. (Mwachitsanzo: anthu omwe amagwira ntchito pa kompyuta ndi msana wawo wopindika tsiku lonse)

Kodi TOS ndi matenda oopsa? Kodi mavuto omwe angakhalepo ndi ati?

Ngati sichichiritsidwa, matenda a Thoracic Outlet Syndrome angayambitse mavuto aakulu. Ena mwa mavutowa ndi awa:

• Kuundana kwa magazi m'khwapa ndi m'mitsempha yokhudzana nayo (`Axillo-subclavian vein thrombosis`).
• Kutupa kosalekeza ndi kupweteka m'dzanja, makamaka kwa iwo omwe ali ndi venous TOS (`Venous TOS`).
• Kufa kwa minofu (`Gangrene`).
• Zilonda za ischemic zimachitika pa zala chifukwa cha kuchepa kwa magazi.
• Kuwonongeka kwa mitsempha kosatha.
• Kutsekeka kwa mapapo - Ichi ndi vuto loopsa kwambiri.

Kotero, mukuona, si bwino kungoganiza kuti vutoli ndi laling'ono chabe. Ndikofunikira kwambiri kuzindikira ndi kuchiza msanga.

Kodi mungadziwe bwanji ngati muli ndi TOS? (Kuzindikira)

Dokotala adzakuyang'anirani ndikukufunsani za mbiri yanu yachipatala kuti adziwe ngati muli ndi TOS. Pa nthawi yoyezetsa thupi, dokotala wanu adzakufunsani kuti muchite mayeso ena oyenda. Mwachitsanzo:

• `Mayeso okakamiza miyendo ya mmwamba` (mayeso oti awone ngati mwendo wa mmwamba wakhudzidwa)
• `Mayeso okwera a mkono`

Pa nthawi ya mayeso amenewa, dokotala wanu adzakufunsani kuti muchite zinthu zosavuta monga kukweza mkono wanu, kutembenuza mutu wanu, ndikugwedeza dzanja lanu. Kenako adzayang'ana mayendedwe omwe amayambitsa ululu kapena zizindikiro zina. Zotsatira zake zingathandize kuzindikira vutoli.

Kuphatikiza apo, dokotala wanu angafune mayeso a labu ndi mayeso ojambula zithunzi kuti atsimikizire kupezeka kwa matenda a TOS ndikuchotsa zina zomwe zimayambitsa zizindikiro zanu.

Ndi mayeso ena ati omwe mumachita?

Mungafunike kuchita chimodzi kapena zingapo mwa izi:

• Kuyezetsa magazi .
• X-ray ya pachifuwa .
• Kujambula pachifuwa ndi/kapena msana pogwiritsa ntchito CT scan .
• Kuyesa kwa EMG (`Electromyography (EMG)`) – Izi zimayesa momwe minofu ndi mitsempha zimagwirira ntchito.
• Magnetic resonance angiography (MRA) ya mitsempha yanu yamagazi .
• Kujambula kwa maginito (MRI) pachifuwa ndi/kapena msana .
• Kuphunzira za kayendedwe ka mitsempha - Izi zimayesa liwiro lomwe mauthenga amadutsa m'mitsempha.

Mayeso awa angathandize dokotala kudziwa:

• Yang'anani ngati pali zolakwika zobadwa nazo (monga nthiti ya pakhosi).
• Yang'anani momwe magazi amayendera kudzera m'mitsempha yanu ndi m'mitsempha.
• Dziwani matenda ena omwe angayambitse zizindikiro izi.
• Yang'anani momwe minofu ndi mitsempha yanu imagwirira ntchito.
• Dziwani komwe kuli kupanikizika.

Kodi mankhwala a TOS ndi otani?

Chithandizo cha TOS chimasiyana malinga ndi mtundu wa TOS yomwe muli nayo komanso zizindikiro zanu. Cholinga chachikulu cha chithandizo ndikuchepetsa zizindikiro ndikupewa mavuto omwe angakhalepo. Dokotala wanu adzasankha chithandizo chomwe chili chabwino kwa inu.

Nazi njira zina zochiritsira:

• Kuchiza ndi thupi: Uwu ndiye njira yoyamba yothandizira matenda a mitsempha. Katswiri wa zamaganizo angakuthandizeni kukulitsa mayendedwe anu m'khosi ndi m'mapewa, kulimbitsa minofu yanu, komanso kukhalabe ndi kaimidwe koyenera. Izi ndi mpumulo waukulu kwa anthu ambiri omwe ali ndi matenda a mitsempha.
• Mankhwala ochepetsa ululu: Dokotala wanu angakulembereni mankhwala ochepetsa ululu, monga NSAIDs (mankhwala oletsa kutupa omwe si a steroidal), omwe mungagule ku pharmacy.
• Mankhwala omwe amaletsa kapena kusungunula magazi kuundana:Anthu omwe ali ndi vuto la magazi kapena mitsempha yamagazi (TOS) angathandizidwe ndi `thrombolytic therapy` (chithandizo chothetsa magazi). Izi zimaphatikizapo kupereka mankhwala kudzera mu IV line kapena catheter kuti asungunule magazi omwe alipo ndikuletsa atsopano kuti asapangidwe. Dokotala wanu angakupatseninso `mankhwala oletsa magazi kuundana`.
• Opaleshoni: Anthu ambiri omwe ali ndi TOS yomwe imakanikiza mitsempha kapena mitsempha amafunika opaleshoni. Anthu ena omwe ali ndi TOS yomwe imakanikiza mitsempha angafunikenso opaleshoni ngati njira zina sizikuthandiza. Madokotala amagwiritsa ntchito njira zosiyanasiyana zochitira opaleshoni kutengera mtundu wa TOS ndi mtundu wa thupi lanu. Mwachitsanzo, opaleshoni yochotsa kupsinjika imachotsa fupa kapena minofu yolakwika yomwe imayambitsa kupsinjika. Ma opaleshoni ena amatha kukonza kuyenda kwa magazi mwa kukonza mavuto a m'mitsempha yamagazi. Dokotala wanu adzakufotokozerani ngati mukufunikira opaleshoni, momwe imachitikira, komanso zoopsa zake.

Kodi TOS idzakhala bwino yokha ?

Ayi, musayembekezere kuti zizindikirozo zichepe zokha. Ngati muli ndi zizindikiro za TOS , funani thandizo lachipatala nthawi yomweyo. Ngakhale zinthu zosavuta monga chithandizo chamankhwala nthawi zambiri zingathandize kuchepetsa zizindikiro, anthu ena angafunike opaleshoni kapena chithandizo china kuti apewe mavuto aakulu. Dokotala wanu adzakuuzani njira yothandizira yomwe ili yabwino kwa inu.

Kodi TOS ingapewedwe?

Matenda a TOS sangapewedwe nthawi zonse. Chifukwa zinthu zambiri zomwe zimayambitsa matendawa sitingathe kuzilamulira (monga majini), pali zinthu zina zomwe mungachite kuti muchepetse chiopsezo chanu:

• Ngati mumachita masewera omwe amafuna kuti manja aziyenda pafupipafupi, lankhulani ndi mphunzitsi wanu kapena mphunzitsi wanu za masewera olimbitsa thupi omwe angalimbikitse minofu yozungulira mapewa anu.
• Ngati ntchito yanu ikufuna kuti munyamule zolemera kapena kugwira ntchito zina zowonjezera, lankhulani ndi dokotala za masewera olimbitsa thupi omwe angachepetse chiopsezo chanu chovulala.
• Khalani ndi kaimidwe koyenera. Khalani wowongoka msana wanu mutakhala pansi, mutaimirira, komanso mukugwira ntchito.
• Musakhale pamalo omwewo nthawi zonse. Imirirani ndikuyenda mozungulira osachepera kamodzi pa ola limodzi, mukutambasula thupi lanu pang'ono.

Ngati muli ndi matenda a TOS, muyenera kuyembekezera chiyani? / Kodi mungadzisamalire bwanji?

Chiyembekezo cha munthu amene ali ndi TOS chimasiyana malinga ndi mtundu wa TOS yomwe ali nayo. Dokotala wanu angakuuzeni bwino momwe mukuonera.

Ngati muli ndi matenda a TOS, tsatirani malangizo a dokotala wanu a momwe mungadzisamalire. Dokotala wanu angakuuzeni zinthu monga:

• Chepetsani kapena siyani kunyamula matumba olemera pamapewa anu ndikunyamula zinthu pamutu panu momwe mungathere.
• Gwirani ntchito ndi katswiri wa zamaganizo. Chitani masewero olimbitsa thupi omwe amakupatsani.
• Chitani masewera olimbitsa thupi omwe mungachite kunyumba kuti mulimbikitse minofu yanu ndikukweza kaimidwe kanu.
• Chepetsani kapena pewani mayendedwe ena omwe amawonjezera zizindikiro.Sinthani zochita zanu za tsiku ndi tsiku.

Kodi muyenera kupita kwa dokotala liti? / Mafunso oti mufunse dokotala

Ngati muyamba zizindikiro zatsopano kapena ngati zizindikiro zanu zasintha, lankhulani ndi dokotala wanu. Iye adzakuuzani kangati komwe muyenera kupita kwa dokotala wanu komanso ngati muyenera kuyezetsa.

Ngati mwapezeka ndi matenda a Thoracic Outlet Syndrome posachedwapa, nayi mafunso ena omwe mungafunse dokotala wanu:

• Kodi ndili ndi mtundu wanji wa Thoracic Outlet Syndrome?
• Kodi chifukwa chake ndi chiyani?
• Kodi ndi mankhwala ati omwe mumalimbikitsa? Kodi ayenera kuchitidwa liti?
• Kodi tingadziwe bwanji ngati chithandizocho chayenda bwino?
• Kodi zoopsa za chithandizo ndi ziti?
• Ndi kusintha kotani komwe ndiyenera kusintha pa zochita zanga za tsiku ndi tsiku kapena zizolowezi zanga?
• Kodi ndingachite chiyani kunyumba kuti ndichepetse zizindikiro?
• Kodi maganizo anga ndi otani?

Zinthu zoti muzikumbukire kuchokera munkhaniyi (Uthenga Wopita Nawo Kunyumba)

Matenda a Thoracic Outlet Syndrome (TOS) angasokoneze moyo wanu watsiku ndi tsiku. Zingakhale zokhumudwitsa kupuma pa masewera kapena ntchito yanu. Koma khalani oleza mtima. Mwa kudzisamalira nokha ndi chithandizo cha thupi kapena mankhwala ena, mutha kupezanso mphamvu zanu ndikukhala bwino pamapeto pake.

Chofunika kwambiri ndikufunsa upangiri kwa dokotala ngati muli ndi zizindikiro, m'malo mozinyalanyaza. Kuzindikira msanga kumathandiza kuti chithandizo chikhale chosavuta komanso kumachepetsa chiopsezo cha zovuta.

Ngati muli ndi mafunso okhudza matenda anu, dongosolo la chithandizo, kapena momwe zinthu zilili, lankhulani ndi dokotala wanu.

Matenda a Thoracic Outlet, TOS, kupweteka kwa khosi, kupweteka kwa mkono, kupweteka kwa phewa, dzanzi, kupsinjika kwa mitsempha