Ngaba uvakalelwa kukuba umthambo wakho wezintso zasekhohlo uyaqina? Ibizwa ngokuba yiNutcracker Syndrome! Makhe sithethe ngayo.

Ngaba wakha waba nentlungu kwicala lakho lasekhohlo lesisu sakho okanye iimbambo zakho? Okanye ngaba wakha waphawula igazi kumchamo wakho? Ngamanye amaxesha ezi zinto zinokungahoywa. Nangona kunjalo, zinokuba ziimpawu zemeko efuna ingqalelo ethile. Enye imeko enjalo, ekungathethwa kakhulu ngayo, kodwa kubalulekile ukuyazi, ibizwa ngokuba yiNutcracker Syndrome. Namhlanje, siza kuthetha ngayo ngokweenkcukacha nangokulula.

Yintoni iNutcracker Syndrome? Kwenzeka ntoni kanye kanye?

Ngamafutshane, iNutcracker Syndrome yimeko apho umthambo wegazi omkhulu osuka kwintso yakho yasekhohlo (okwabizwa ngokuba yi-"left renal vein"`) uvaleka. Lo mthambo wegazi nguwo othwala igazi elicociweyo elisuka kwintso yakho yasekhohlo ulibuyisele entliziyweni yakho. Ngoko ke, xa lo mthambo uvaleka, ukuhamba kwegazi kuyavaleka.

Khawucinge nje, lo mthambo wegazi ovela kwintso yakho yasekhohlo, kufuneka uye entliziyweni ngemithambo yegazi emibini emikhulu ngaphakathi esiswini sethu. Omnye ngumthambo oyintloko esiswini sethu, oyi-"abdominal aorta". Omnye ngumthambo ongaphezulu we-mesenteric. Ngokwesiqhelo, umthambo wezintso unokudlula kule mithambo mibini ngaphandle kokuphazamiseka.

Nangona kunjalo, kumntu one-nutcracker syndrome, loo mithambo mibini mikhulu idibana njengemilomo emibini ye-nutcracker, icinezele umthambo wezintso . Njenge-nut eqhekeka yi-nut. Yiyo loo nto ibizwa ngokuba yi-"nutcracker." Xa iqina, uxinzelelo lwegazi luyanda ngaphakathi komthambo wezintso, kwaye igazi liqala ukubuyela umva. Oku kunokubangela ukuba imithambo yegazi emincinci eyijikelezileyo idumbe.

Kukho iintlobo ezimbini eziphambili ngokuxhomekeke kwindlela oku kuqina ngayo:

• I-Anterior Nutcracker Syndrome: Olu lolona hlobo luxhaphakileyo. Lwenzeka xa umthambo wezintso ucinezelwe phambi kwe-aorta yesisu, oko kuthetha ukuba ngaphambili kwesisu.
• Isifo sePosterior Nutcracker: Esi sisifo esingaqhelekanga. Apha, umthambo wezintso ucinezelwa emva kwe-aorta yesisu, apho udlula khona phakathi komqolo kunye ne-aorta.

Kukho ezinye iindlela ezingaqhelekanga, kodwa akufuneki sithethe kakhulu ngazo.

Umahluko phakathi kweNutcracker Phenomenon kunye neNutcracker Syndrome

Musa ukubhidanisa ezi zinto zimbini. I-Nutcracker Phenomenon iyenzeka xa kukho ukuncitshiswa komthambo wezintso, kodwa kungekho zimpawu. Ngamanye amaxesha ifunyanwa ngengozi ngexesha lokuhlolwa kwesinye isifo.

Nangona kunjalo, iNutcracker Syndrome ithetha ukuba, ukongeza ekuqineni, uphinda ube neempawu. Oko kukuthi, ufumana ukungakhululeki ngenxa yokuxinana. Kulapho ke kufuneka unyango khona.

Kutheni le nto ibizwa ngokuba yi "Nutcracker"?

Njengoko benditshilo ngaphambili, ngo-1937, umphandi wezonyango uchaze le meko njengemithambo emibini emikhulu esiswini "njengemihlathi emibini yenkawu ecinezela umthambo wezintso." Ukwathe "ifana nebhanana etyunyuzwa yinkawu." Yiyo loo nto ibizwa ngolu hlobo. Igama lezonyango elisemthethweni lale nto yi -'left renal vein entrapment syndrome '.

Ngubani ochaphazeleka kakhulu yile meko? Ixhaphake kangakanani?

I-Nutcracker syndrome inokuchaphazela abantwana kunye nabantu abadala abaneminyaka engama-60 ubudala. Nangona kunjalo, uphando oluthile lubonisa ukuba ixhaphake kakhulu kubantu abakwiminyaka yabo yamashumi amabini, amashumi amabini, namashumi amathathu . Ixhaphake kakhulu nakubantu abane-low body mass index (BMI), oko kuthetha ukuba bancinci .

Oku kuthathwa njengesimo esingaqhelekanga , kodwa akukho datha yokuba bangaphi abantu abanaso.

Iyintoni ingozi yeNutcracker Syndrome? Ngaba kukho iingxaki ezikhoyo?

Ngamanye amaxesha oku akunakubangela zimpawu zinkulu kwaye kunokuzisombulula ngokwako, ingakumbi ebantwaneni. Nangona kunjalo, ukuba akunyangwa, kunokukhokelela kwiingxaki ekuhambeni kwexesha. Ezi ziquka:

• Amahlwili egazi ayenzeka ngaphakathi kumthambo wezintso.
• Ukonakala kwezintso kwenzeka ngenxa yoxinzelelo oluphezulu kwimithambo yezintso ngokuhamba kwexesha.
• Amadoda anokuba nokungabi nabantwana kwamadoda okanye abafazi banokuba nokungabi nabantwana kwabasetyhini .
• Intlungu eqatha enokuchaphazela ubomi bakho inokwenzeka.

Kubalulekile: Ayinguye wonke umntu oza kuba neengxaki. Nangona kunjalo, ukuba uneempawu, kungcono ukubona ugqirha ngokukhawuleza ukuze ufumane ingcebiso.

Zithini iimpawu? Oko unokukuva kunye noko ugqirha wakho anokukufumanisa

Kukho iimpawu ezininzi ze-nutcracker syndrome. Izinto onokuhlangabezana nazo ziquka:

• Igazi kumchamo (hematuria): Olu lolona phawu luqhelekileyo. Umchamo unokuba pinki, bomvu, okanye mdaka ngombala.
• Ukuziva unesizungu xa umile (orthostatic hypotension): Oku kuthetha ukuba xa uphakama ngequbuliso, amehlo akho aba luhlaza okwesibhakabhaka kwaye uzive unesizungu.
• Intlungu ecaleni lasekhohlo: Intlungu ingenzeka kwicala lasekhohlo, ngasemva nje kweembambo.

Ezi mpawu zinokwahluka kancinci ngokuxhomekeke kwisini.

Kumadoda: Imeko ebizwa ngokuba yi-varicocele , ekukudumba kwemithambo yegazi kumasende, inokwenzeka.

Abafazi banokufumana iimpawu zesifo sokuxinana kwe-pelvic, ezibangelwa kukudibana kwegazi kwindawo ye-pelvic. Ezi ziquka:

• Intlungu ngexesha lokwabelana ngesondo (i-dyspareunia).
• Intlungu xa uchama (i-dysuria).
• Intlungu kwisisu esisezantsi, oko kukuthi, kwindawo ye-pelvic (intlungu ye-pelvic).

Ukongeza kwezi, kukwakho neempawu ezinokuthi zibonwe ngugqirha ngovavanyo. Awunakuzibona.

• Ukungabikho kweeseli ezibomvu egazini, oko kukuthi , i-anemia .
• I-Microhematuria kukubakho kwegazi kumchamo elincinci kangangokuba linokubonwa kuphela nge-microscope.
• I-Proteinuria kukubakho kweproteni eninzi kakhulu kumchamo.

Kutheni oku kusenzeka? Zithini izizathu?

Eyona nto ibangela iNutcracker Syndrome kukutshintsha kwendlela emile ngayo imithambo yegazi . Ngamanye amaxesha olu tshintsho lwenzeka usesesibelekweni sikamama wakho, xa imithambo yegazi yakho isenziwa. Ngamanye amaxesha, lunokwenzeka ngexesha lokunyuka kobude ngequbuliso (ukukhula ngokukhawuleza) ebutsheni, okanye ukwehla kobunzima ngequbuliso ebudaleni (ukwehla kobunzima). Kwezinye iimeko, akukho sizathu sifumanekayo .

Uyibona njani kanye kanye le nto? Zeziphi iimvavanyo ezenziwayo?

Kungathatha ixesha ukufumanisa iNutcracker Syndrome, kuba oogqirha kufuneka basuse ezinye iimeko ezininzi. Ukuxilongwa kudla ngokuqala ngovavanyo lomzimba . Ugqirha wakho uya kukubuza ngeempawu zakho aze akubuze ngeempawu zakho. Emva koko, banokuyalela olunye okanye ngaphezulu kwezi vavanyo zilandelayo ukuze bafumane okungakumbi:

• Uvavanyo lwegazi
• Iskeni ye-CT (iskeni ye-CT - iskeni ye-Computed Tomography)
• Uvavanyo lwe-Doppler ultrasound `(i-Doppler ultrasound)`
• I-ultrasound yemithambo yegazi (IVUS)
• Iskeni se-MRI `(Iskeni se-MRI - Iskeni se-Magnetic Resonance Imaging)`
• I-Venogram (ukuthatha i-X-ray yemithambo emva kokufaka idayi)
• Uhlalutyo lomchamo

Ziziphi iindlela zonyango lweNutcracker Syndrome?

Unyango luxhomekeke kwiminyaka yakho kunye nobunzima beempawu zakho. Ngokuxhomekeke kwimeko yakho, ugqirha wakho unokuqala ngonyango olungenabundlongondlongo kangako . Ukuba ezi azincedi, okanye ukuba iimpawu zakho ziya zisiba mandundu, unokufuna utyando.

Ulawulo lweConservative

Kwabaninzi abantu, ingakumbi abantwana abangaphantsi kweminyaka eli-18 ubudala , eli linyathelo lokuqala lokulawula ubunzima bomntwana wakho. Ukuba umntwana wakho une-nutcracker syndrome, ugqirha wakho unokucebisa ukuba aqhubeke nale ndlela ukuya kuthi ga kwiminyaka emibini. Oku kubandakanya ukunceda umntwana wakho atyebe ngelixa ejonga imeko. Njengoko ubunzima busanda esiswini, uxinzelelo kumthambo wezintso luyehla. Abantu abadala bayacetyiswa ukuba bazame le ndlela kangangeenyanga ezintandathu.

Olu lawulo ngokubanzi lungabandakanya amayeza anceda ukusebenza kwezintso. Umzekelo:

• Izithinteli ze-ACE
• I-aspirin

Utyando

Ukuba uneempawu eziqatha kwaye unyango oluqhelekileyo alusebenzi, unokufuna utyando okanye inkqubo engangeni kakhulu . Ugqirha wakho uza kuthetha nawe malunga neendlela onokukhetha kuzo, izinto ezilungileyo nezingalunganga, kunye nokuba iinkqubo ezingangeni kakhulu zikulungele na.

Injongo ephambili yolu tyando kukudala indlela egudileyo nengaphazanyiswayo yokuba igazi liphume ezintsoni liye entliziyweni.

Ezinye zeenkqubo zotyando nezenziwayo zeNutcracker Syndrome zezi:

• Ukutshintshwa kwemithambo yezintso: Oku kuquka ukususa umthambo wakho wezintso wasekhohlo uze uwudibanise kwakhona nomthambo omkhulu obizwa ngokuba yi-inferior vena cava. Oku kususa isidingo sokudlula kwi-superior mesenteric artery kunye ne-aorta. Oku kungenziwa nge-laparoscopically , oko kuthetha ukuba ngokusika okuncinci okumbalwa.
• Ukufakwa kwe-stent: Oku kuquka ukufaka ityhubhu encinci ebizwa ngokuba yi-stent kumthambo wezintso ovalekileyo ngomngxuma omncinci eluswini. Le tyhubhu ivula umthambo kwaye ivumela igazi ukuba lihambe ngokukhululekileyo.
• Utyando lokuzifakela izintso ngokuzenzekelayo: Kule nto, izintso zakho zasekhohlo ziyasuswa zize zifakwe kwakhona emzimbeni wakho, kwithambo lesinqe.

Ngaba ezi tyando ziyingozi?

Lonke utyando lweNutcracker Syndrome lunengozi ethile. Thetha nogqirha wakho ngononophelo malunga neengozi zotyando oza kulwenza.

Ukufakelwa kwezintso ngomatshini wokufakelwa izintso ngoomatshini bokufakelwa izintso ngoomatshini bokufakelwa izintso ngoomatshini bokufakelwa izintso ngoomatshini bokufakelwa izintso ngoomatshini bokufakelwa igazi. Iingxaki eziphambili zezintso kukungasebenzi kakuhle nokopha. Umngcipheko weengxaki ungancitshiswa ngokufumana unyango kwisibhedlele esikhulu esinoogqirha abanamava abenza olu hlobo lotyando rhoqo .

Ngaba ikho indlela yokunciphisa oku kwenzekayo?

Enyanisweni, akukho ndlela eyaziwayo yokunciphisa umngcipheko wokufumana le meko. I-Nutcracker syndrome ikhula ngokukhawuleza, kwaye ayizuzisi.

Nangona kunjalo, oogqirha ngamanye amaxesha bafumana i-nutcracker phenomenon (i-renal vein stenosis engabonakali) ngengozi ngexesha lovavanyo olwenziwe ngezinye izizathu. Ke ngoko, kubaluleke kakhulu ukuqhubeka novavanyo lwakho lwezonyango kunye ne-aphoyintimenti yeklinikhi. Emva koko, ungafumanisa ukuba unayo na i-renal vein stenosis ngaphambi kokuba ube neempawu. Emva koko, uya kwazi ukuba kufuneka ufune unyango ngokukhawuleza ukuba kuvela iimpawu.

Ikamva libaphathele ntoni abantu abaneNutcracker Syndrome?

Kubantwana, isiphumo sidla ngokuba sihle kakhulu. Abantwana abaninzi bayaphola ngaphandle konyango olukhulu, njengotyando. Kubantu abadala, isiphumo siyahluka ngokuxhomekeke kubukhali beempawu kunye nexesha elithathayo ukuqala unyango. Thetha nogqirha wakho malunga nemeko yemeko yakho.

Ndifanele ndimbone nini ugqirha? Zeziphi imibuzo endifanele ndizibuze zona?

Ukuba uneempawu ze-nutcracker syndrome, okanye ukuba iimpawu zakho ziya zisiba mandundu , qiniseka ukuba ubona ugqirha.

Ukuba utyando, landela imiyalelo kagqirha wakho ngononophelo malunga nendlela yokuzinyamekela ekhaya. Kwakhona, qiniseka ukuba uya kwiindawo zokulandelela .

Ukuba ugqirha wakho ukuxelela ukuba uneNutcracker Syndrome, unokuba nemibuzo emininzi. Kubalulekile ukufunda okuninzi kangangoko unako malunga neendlela zakho zonyango kunye nexesha elifanelekileyo lokufuna unyango. Nazi ezinye zemibuzo onokuyibuza:

• Le meko ichaphazela njani umzimba wam?
• Ingxaki yam inzulu kangakanani?
• Ngaba ndifuna unyango? Ukuba kunjalo, nini?
• Loluphi unyango olungcono kum?
• Ingakanani izinga lempumelelo yolu nyango?
• Zithini iingozi zonyango?
• Kuza kuthatha ixesha elingakanani ukuphiliswa?

Abanye abantu abane-nutcracker syndrome banokuba nezinye iingxaki zemithambo yegazi. Thetha nogqirha wakho ngazo naziphi na ezinye iimeko onazo kunye nendlela yokuzilawula.

Ukuba ubuneempawu okwethutyana kodwa ungayazi imbangela, kunokuba luncedo ekugqibeleni ukufumana uxilongo. Kodwa kunokuba yinto eyoyikisayo ukucinga ngeendlela zonyango kunye nokuba uza kufuna utyando na. Iindaba ezimnandi zezokuba abaphandi bahlala befunda ngakumbi ngale meko kunye nendlela yokuyilawula ngeendlela ezingaphantsi kakhulu. Thetha nogqirha wakho malunga nesicwangciso sonyango esifanelekileyo kuwe kunye nento onokuyilindela kwixesha elizayo.

Okokugqibela, amanqaku abalulekileyo (Umyalezo Wokuya Ekhaya)

Kulungile, ngoko ke sithethe kakhulu ngeNutcracker Syndrome. Nazi ezinye zezinto ezibalulekileyo ekufuneka uzikhumbule:

• Le yimeko ebangelwa kukuvaleka komthambo wegazi kwizintso zasekhohlo .
• Ukuba ufumana iimpawu ezifana negazi kumchamo wakho okanye intlungu kwicala lakho lasekhohlo, bona ugqirha.
• Abantwana badla ngokuziphilisa ngokwabo .
• Kukho iindlela ezahlukeneyo zonyango kubantu abadala, kwanotyando, kuxhomekeke kwiimpawu.
• Musa ukoyika, kodwa kubalulekile ukuba nolwazi. Thetha ngokukhululekileyo nogqirha wakho uze ukhethe unyango olukufaneleyo.

Ndiyathemba ukuba olu lwazi uza kulufumana luluncedo. Hlala usempilweni!

Isifo seNutcracker, isifo sezintso, umthambo wezintso wasekhohlo, i-stenosis yemithambo yegazi, igazi kumchamo, iintlungu zesisu, utyando