Fungidzira uri jaya rine hutano hwakanaka rinotamba cricket, rinoita maekisesaizi nesimba pajimu. Asi kamwe kamwe ruoko rwako runotanga kurwadza, runozvimba, uye rwoita seruvara rwebhuruu. Kazhinji kacho zvinofungidzirwa kuti zvinorema tsandanyama. Asi ichi chinogona kuva chirwere chakakomba, asi chinorapika zvikuru. Nhasi tiri kutaura nezvechimwe chirwere chakadai, 'Axillo-Subclavian Vein Thrombosis' kana muchidimbu ASVT.
Zvichitaurwa zviri nyore, chii chinonzi ASVT ichi?
Zvichitaurwa zviri nyore, ASVT kuumbwa kweropa rakagwamba mutsinga yakadzika muruoko rwako rwepamusoro, senge mutsinga weaxillary kana mutsinga we subclavian. Izvi zvinowanzoitika mushure mekukuvara kweruoko rwako kana kana uchishandisa ruoko rwako zvakanyanya woita chinhu chimwe chete kakawanda. Chirwere ichi chinonziwo Paget-Schroetter syndrome uye effort-induced thrombosis.
Ko iyi imhando yeDVT here? Musiyano uripo ndeupi?
Ehe, ASVT imhando ye deep vein thrombosis (DVT). Asi patinowanzonzwa nezveDVT, tinonzwa nezvemabundu eropa anoumbwa mumakumbo. Izvi zvinokonzerwa nezvinhu zvakaita sekugara panzvimbo imwe chete kwenguva yakareba, kufuta, uye kukwegura. Asi chirwere ichi chinonzi ASVT chakasiyana zvikuru neizvozvo.
Unogona kunzwisisa musiyano uyu zviri nyore kubva patafura iri pazasi.
| Hunhu | DVT yakajairika yatinoziva | ASVT (DVT iri muruoko) |
|---|---|---|
| Chikonzero | Kusaita maekisesaizi, kufuta, kukwegura, mushure mekuvhiyiwa. | Kukuvara paruoko, kumanikidzwa zvakanyanya paruoko (mitambo, basa). |
| Nzvimbo yakabatwa | Kazhinji mitsipa mumakumbo. | Tsinga dziri muruoko rwepamusoro, muhapwa, uye munzvimbo yemafudzi. |
| Vanhu vakabatwa nechirwere ichi | Kazhinji vanhu vakuru, vasinganyanyi kushanda. | Vechidiki vane hutano, vanoshingaira, uye vane mitambo vari pakati pemakore 15-45 . |
Ndiani ane mukana mukuru wekuwana chirwere ichi?
Kunyange zvazvo izvi zvingaita sezvinoshamisa, ASVT inowanzoonekwa nevanhu vane hutano hwakanaka, vane hutano hwakanaka, uye vanoshanda nesimba , kunyanya avo vari pakati pemakore gumi nemashanu nemakumi mana nemashanu.
Funga nezvevanhu vakaita seizvi:
- Vanhu vanoita maekisesaizi anodzokororwa kana mitambo inosanganisira kusimudza maoko avo, zvakaita sekukanda bowling nekukurumidza mucricket, kutamba volleyball, kushambira, kana kusimudza zvinorema.
- Vanhu vanoshanda mabasa emaoko, vakaita sevanopenda nevanogadzira magetsi.
- Vanhu vane matambudziko ekugwamba kweropa vari panjodziwo.
Ndezvipi zviratidzo zvechirwere ichi?
Zviratidzo zveASVT zvinowanzoonekwa kamwe kamwe. Zviratidzo zvikuru ndeizvi:
- Kurwadziwa muruoko.
- Tsinga dziri mumaoko dzinotanga kuzvimba uye dzinoonekwa zvakajeka.
- Kuchinja ruvara rwebhuruu rweganda remaoko (Cyanosis).
- Kunzwa kuremerwa kana kuneta muruoko.
- Kuzvimba kamwe kamwe kweruoko (ichi ndicho chiratidzo chinowanzoitika).
Chimwe chinhu chekuchenjerera! Dzimwe nguva ropa iri rinogona kubuda mutsinga ronamatira mumapapu. Tinoridaidza kuti Pulmonary Embolism (PE) . Ichi chirwere chine njodzi zvikuru, chinotouraya. Saka, kana ukaona kuzvimba muruoko rwako, kuoma kufema, kana kurwadziwa muchipfuva , enda kuchipatara kuEmergency Department (ETU) nekukasika.
Chii chinokonzera ASVT?
Heino mashandiro azvinoita. Fungidzira tsinga yeropa (tsinga) iri pafudzi rako yakaita sepombi yemvura. Kumativi ese epombi iyi, mbabvu netsandanyama zvakasungwa zvakasimba. Paunoita maekisesaizi kana basa rinosanganisira kusimudza ruoko rwako, tsinga inobaiwa pakati petsandanyama iyoyo nembabvu, zvichiita kuti ikuvara.
Nekufamba kwenguva, mavanga anoumbwa panzvimbo yekukuvara uku, zvichiita kuti tsinga itete zvakanyanya. Izvi zvinoderedza kufamba kweropa. Ndipo panotanga kuumbwa mavhinga eropa. Dambudziko riripo rinoita kuti tsinga iyi ivharike rinonzi thoracic outlet syndrome (TOS).
Unoona sei izvi, Chiremba?
Zvichienderana nezviratidzo zvako, kana chiremba wako achifungidzira izvi, acharaira bvunzo dzinoverengeka kuti asimbise chirwere chacho mushure mekuongororwa kwemuviri.
- Duplex ultrasound: Iyi ndiyo bvunzo inonyanya kushandiswa. Inoshandisa mafungu eruzha kuona kuti ropa rinoyerera sei mukati metsinga uye kuona kana paine mabundu eropa.
- Kuongororwa kweropa neCatheter: Kachubhu kadiki (catheter) kanopinzwa mutsinga, dhayi chaiyo inobayiwa, uye X-ray inotorwa kuti ionekwe kuti ropa rakagwamba papi uye kuti tsinga yacho yakavharika sei.
- CTA (computerized tomography angiography): Kuongororwa kweCT kunotora mifananidzo yakadzama yetsinga.
- MRA (magnetic resonance angiography): Kuongorora tsinga uchishandisa MRI scan.
Ndezvipi zvinorapwa izvi?
ASVT chirwere chinofanira kurapwa. Kunonoka kurapwa hakuna kunaka. Nzira huru yekurapa ndeye `Thrombolysis`.
Nzira dzekurapa
- Kunyungudika kweropa (thrombolysis): Izvi zvinosanganisira kupa mushonga unonyungudika weropa zvakananga mutsinga umo ropa rinowanikwa kuburikidza nechubhu yakaita secannula (catheter).
- Kubviswa kweThrombectomy (kubvisa ropa rakagwamba): Dzimwe nguva vanachiremba vanobvisa ropa rakagwamba mumuviri kuburikidza nekuvhiyiwa kudiki.
- Zvinoderedza ropa: Mushure mekunge ropa ragwamba, muchapihwa mishonga inoderedza ropa kwemwedzi yakati wandei kudzivirira kuti ropa risagwamba zvakare.
Pamwe chete nekurapwa uku, chiremba achakupa mamwe mazano.
- Kuzorora ruoko kusvika zviratidzo zvapera.
- Kusimudza ruoko mudenga kunonzi "kukwidziridza ruoko" (arm elevations).
- Kutumirwa kuchipatara.
- Kupfeka chifukidziro chakaita sebhandeji (compression sleeve) paruoko.
Mune zvimwe zviitiko, kachidimbu kadiki kemhasuru kana chidimbu chembabvu yekutanga chiri kuvhara tsinga chinobviswa nekuvhiyiwa kuti tsinga ifambe zvakanaka.
Mamiriro ezvinhu akaita sei mushure mekurapwa?
Ichi ndicho chinhu chakakosha. Kana ASVT ikaonekwa nekukurumidza uye kurapwa kukatanga nekukurumidza, mhedzisiro yacho inobudirira zvikuru. Zvidzidzo zvakaratidza kuti pane mwero wekubudirira uri pakati pe90% ne95%.
Zvisinei, vamwe vanhu vanogona kuva nedambudziko rinonzi `post-thrombotic syndrome (PTS).` Izvi zvinoreva kuti zviratidzo zvakaita sekurwadziwa, kurema, uye kuzvimba paruoko zvinoramba zviripo kunyangwe mushure mekurapwa. Saka, zvakakosha kutevedzera mirairo yachiremba nemazvo.
Mamiriro ezvinhu aya anogona kudzivirirwa here?
Kunyange zvazvo zvisingagone kudzivirirwa zvachose, pane zvinhu zvakati wandei zvaunogona kuita kuti uderedze njodzi yacho.
- Usaite maekisesaizi anorema kana kushanda kwenguva yakareba, uye tora nguva yekuzorora pakati pawo.
- Tambanudza muviri usati waita maekisesaizi uye wapedza kuita maekisesaizi kuti utambanudze tsandanyama dzemaoko ako.
- Usasimudza zvinorema zvisingagone kubatwa netsandanyama dzako.
- Edza kushandisa ruoko rwako rusingakudzvinyiriri pese pazvinogoneka.
Ndinofanira kuona chiremba rini?
Enda kuna chiremba nekukasika kana zviratidzo zvekutanga zveASVT (kuzvimba kamwe kamwe, kurwadziwa, kusviba kweruoko). Uyewo, kana zviratidzo zvinotevera zvikaitika, funga kuti idambudziko uye enda kuEmergency Treatment Unit (ETU) yechipatara nekukasika.
- Kurwadziwa kwechipfuva
- Kuoma kufema (dyspnea)
- Kushaya simba
Mharidzo Yekuenda Nayo Kumba
- ASVT igwamba reropa riri mutsinga yeruoko rinogona kuitika kunyange kune vechidiki vane hutano uye vanoshanda.
- Kuzvimba kamwe kamwe, kurwadziwa, uye ganda rebhuruu ndizvo zviratidzo zvikuru. Kana ukaona izvi, usazviregeredza.
- Kana zviratidzo zveruoko rwako zvichiperekedzwa nekurwadziwa pachipfuva kana kuoma kwekufema, zvinogona kunge zviri chiratidzo che pulmonary embolism (PE) inotyisidzira hupenyu. Enda kuchipatara nekukurumidza.
- Dambudziko iri rinogona kurapwa zvinobudirira kana rikaongororwa uye rikarapwa nekukurumidza. Saka, kana usina chokwadi, ona chiremba wako.
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