Ingaba le yimbangela yentlungu yakho yomlenze? Masifunde ngePopliteal Artery Entrapment Syndrome (PAES)!

Ngaba uziva neentlungu, ukuqina, okanye ubunzima emilenzeni yakho, ingakumbi kwindawo yethole, xa uzilolonga, ubaleka, okanye uhamba ngokukhawuleza? Ngaba iyaphela emva kwexesha elithile, kodwa ingaba iyabuya xa uqala ukuzilolonga kwakhona? Emva koko kubaluleke kakhulu ukuba uqaphele le meko ibizwa ngokuba yi-popliteal artery entrapment syndrome. Ungakhathazeki, masithethe ngayo ngokulula.

Yintoni i-popliteal artery entrapment syndrome (PAES)?

Ngamafutshane, i-Popliteal Artery Entrapment Syndrome (PAES) sisifo esingaqhelekanga semithambo yegazi. Sichaphazela kakhulu abantu abancinci, abakhutheleyo, ingakumbi abo badlala imidlalo. I-popliteal artery yimithambo yegazi ephambili eqala ethangeni iye emqolo ngasemva kwamadolo ethu. Le mithambo yegazi icinezelwa sisihlunu esingasemva kwedolo, nto leyo eyenzekayo kule meko.

Cinga ngayo njengombhobho wamanzi. Ihambisa igazi emlenzeni ongezantsi. Ngoku, lo mthambo ungaxinwa ngenxa yotshintsho kwindlela umsipha wethu we-gastrocnemius onamathela ngayo kwithambo lethanga. Ingakumbi xa sigoba unyawo lwethu (oku kubizwa ngokuba yi-"plantar flexion" ngokwezonyango), lo mthambo we-gastrocnemius uyaxinwa. Emva koko loo mthambo uyaxinwa ngakumbi.

Xa uzilolonga, umthambo uhlala utyhalwa, nto leyo ebangela ukuba uxinezeleke. Kwenzeka ntoni ke ngoko? Ubungakanani begazi eliya emlenzeni buyancipha. Oku kubangela ukuba izinto ezifana ne -lactic acid kunye ne-carbon dioxide ziqokeleleke kwimisipha kunye nemithambo-luvo. Yiyo loo nto uziva ubunzima, iintlungu, ukudinwa, kwaye ngamanye amaxesha uziva ungenamandla emilenzeni nasezinyaweni.

Iindaba ezimnandi zezokuba ezi mpawu zihlala ziphela kwimizuzu emithathu ukuya kwemihlanu emva kokuyeka ukuzilolonga. Nangona kunjalo, ukuba azinyangwa, ngokuhamba kwexesha, ezi mpawu zinokuba nzima ngakumbi kwaye zihlale ixesha elide. Oku kuthetha ukuba uza kuqala ukuziva iintlungu nasemva kokubaleka umgama omfutshane, kwaye kuya kuthatha ixesha elide ukuba uphile.

Ngubani ochaphazeleka kakhulu yile meko ye-PAES?

Le meko, ebizwa ngokuba yi-PAES, idla ngokuchaphazela abadlali abaselula abaphakathi kweminyaka eli-15 nengama-25 ubudala. Lo mngcipheko uphezulu kakhulu kwabo bathatha inxaxheba kwimidlalo ebandakanya ukubaleka. Umzekelo:

• Umdyarho (Ithrekhi)
• Ukubaleka umgama omde
• Ibhola ekhatywayo
• I-Lacrosse
• Ihoki yasentsimini

Cinga ngomntwana othatha inxaxheba kwimidlalo yesikolo yokugijima, okanye umfana odlala ibhola ekhatywayo. Banamathuba amaninzi okuba nale meko kuba basebenzisa imilenze yabo rhoqo.

Ixhaphake kangakanani i-PAES?

I-PAES yimeko engaqhelekanga kakhulu . Kuqikelelwa ukuba ngaphantsi kwe-1% yabantu abanayo. Ngoko ke kunzima ukutsho ukuba bangaphi abantu abanayo.

Ngaba kukho ezinye iimeko ezibonisa iimpawu ezifana neze-PAES?

Ewe, ikho. I-Chronic Exertional Compartment Syndrome (CECS) yimeko eqhelekileyo yemisipha kunye nemithambo-luvo kune-PAES, kwaye ikwabangelwa kukuzilolonga. Inokubangela iintlungu kunye nokudumba kwimisipha yemilenze (kwaye ngamanye amaxesha neengalo). Nangona i-CECS inokuchaphazela nabani na, ixhaphake kakhulu kubagijimi abancinci kunye nabo badlala imidlalo ebandakanya ukudibana rhoqo.

Ngamanye amaxesha, umntu one-PAES unokuba ne-CECS. Kufunyaniswe ukuba malunga ne-5% yabantu abangazange banyangwe kwi-PAES nabo bane-CECS. Ngoko ke kubalulekile ukukhumbula ukuba zombini ezi meko zinokubakho ngaxeshanye.

Yintoni umahluko phakathi kwe-PAES kunye ne-CECS?

Ugqirha wakho uza kwenza iimvavanyo ezahlukeneyo ukuze ahlukanise phakathi kwezi meko zimbini.

• Kwi-PAES: Uxinzelelo lwegazi lulinganiswa emlenzeni ngelixa uphumle luze luhlolwe ukuba luyancipha na emva kokuzilolonga.
• Kwi-CECS: Uxinzelelo olukwizihlunu ezine emlenzeni lulinganiswa ngaphambi nasemva kokuzilolonga. Kwi-CECS, uxinzelelo olukwizihlunu lunyuka ngendlela engaqhelekanga.

Kuvakala njani ukuba ne-PAES?

Xa uzilolonga, unokufumana iimpawu ezifana nezi kwindawo yakho yamathumbu kunye/okanye emilenzeni:

• Intlungu efana ne-cramp
• Ndidiniwe
• Uvakalelo olunzima
• Ukuqaqamba kwemisipha
• Ukuba ndindisholo
• Ukudumba

Ezi mpawu zihlala ziphela emva kwemizuzu emithathu ukuya kwemihlanu yokuphumla. Nangona kunjalo, njengoko besitshilo ngaphambili, ukuba azinyangwa, ezi mpawu zinokuphinda zibuye ngokuhamba kwexesha kwaye zithathe ixesha elide ukuba ziphinde ziphile.

Zithini izizathu ze-PAES?

Kukho iindlela ezimbini eziphambili apho oku kutyhala kunokwenzeka khona:

1. Ukuxinana kwe-anatomic: Oku kubonakala malunga ne-10% yeemeko. Kubonakala ngathi kwenzeka kancinci kumadoda. Malunga ne-70% yeemeko, kwenzeka kumlenze omnye kuphela.

2. Ukucinezelwa okungenazo izakhi zomzimba, okusebenzayo okanye okungokwasemzimbeni: Oku kwenzeka rhoqo kubasetyhini. Kwiimeko ezingaphezu kwama-90%, kunokwenzeka kwimilenze yomibini.

Uxinzelelo lwe-anatomic

Oku kwenzeka kuba inxalenye yesihlunu sakho se-gastrocnemius iphezulu okanye ingaphantsi kwe-popliteal artery. Mhlawumbi i-tendinous band kwisihlunu inokonakalisa i-artery. Oku kungenxa yokuba:

• Kusenokubakho isilonda okanye isilonda.
• Kusenokubakho ihlwili legazi.
• Ekuhambeni kwexesha, umthambo ungavaleka ngokupheleleyo (uvaleke) okanye imithambo engaphantsi kwawo ingavaleka.

Ngale ndlela, kukho iindlela ezine ezahlukeneyo apho umsipha ubekwe khona ngokumalunga nomthambo.

Uxinzelelo olusebenzayo okanye olusebenzayo

Kule meko, zonke izihlunu zakho zimi ngendlela eqhelekileyo. Nangona kunjalo, izihlunu zihlala zinamathele ngaphezulu kwethambo lethanga, okanye emngxunyeni ongaphakathi kwedolo. Ngoko ke xa ugoba unyawo lwakho (plantar flexion), izihlunu ziyatsala ngaphakathi kwaye zicinezele umthambo.

Ngamanye amaxesha olu xinzelelo lunokubangelwa nasisinye isihlunu (i-popliteus muscle) esiphantsi komthambo. Abaphandi bathi olu xinzelelo olusebenzayo aluzange lufunyanwe lubangela umonakalo kumthambo.

Ifunyaniswa njani i-PAES?

Ingcali yemithambo yegazi ingaxilonga le meko. Iza kukuhlola ize ijonge ukuba akukho kuncipha emlenzeni wakho kunye ne-popliteal pulse. Ingajonga nokuba kukho utshintsho kwi-pulse yakho xa ushukumisa umlenze wakho phezulu nasezantsi kwinto ethile.

Ukuba une-PAES, ugqirha wakho unokuthi:

• Ungaziva ukubetha kwentliziyo yakho xa uphumle.
• Kodwa xa uzilolonga, ukubetha kwentliziyo yakho kunokuncipha xa ugoba okanye ulungisa umlenze wakho.

Zeziphi iimvavanyo ezenziwayo ukujonga i-PAES?

Olu vavanyo lulinganisa ukuhamba kwegazi edolweni, emlenzeni, nasenyaweni. Olu vavanyo lomfanekiso lunokubonisa oku kulandelayo:

• Ingaba umthambo uqhelekile?
• Nokuba kuza kwenzeka ingozi yomthambo.
• Ngaba kukho amahlwili egazi?
• Ingaba umthambo uvuvukile (i-aneurysm - umthambo wegazi omkhulu ngama-50% kunesiqhelo).
• Ngaba izihlunu ziyayicinezela imithambo yegazi?

Ezinye zeemvavanyo ezenziweyo zoku zezi:

• Isalathisi se-Ankle-brachial kunye nomthambo: Oku kulinganisa uxinzelelo lwegazi ezingalweni zakho nasemilenzeni yakho ngaphambi nasemva komthambo. Ngokwesiqhelo, uxinzelelo lwegazi ezingalweni zakho nasemilenzeni yakho luyafana, kwaye zombini ziyanda ngexesha lomthambo. Nangona kunjalo, ukuba imithambo yakho iyaqhekeka ngelixa ubaleka, uxinzelelo lwegazi lwakho emilenzeni yakho emva komthambo lunokwehla ngaphezulu kwe-90% yoxinzelelo lwegazi lwakho ezingalweni zakho.
• I-duplex ultrasound ye-popliteal artery ene-plantar flexion: Oku kusebenzisa amaza esandi ukwenza umfanekiso we-artery kunye nokulinganisa ukuhamba kwegazi. Oku kuvumela ugqirha wakho ukuba abone indlela imithambo esemlenzeni wakho evakalelwa ngayo xa umlenze wakho ugobile kwaye uphumle, kwaye abone ukuba kukho na ukuxinana kwemisipha.
• I-computed tomographic angiography (CTA) ene-plantar flexion: Olu luhlobo lwe-CT scan. Idayi ekhethekileyo isetyenziselwa ukujonga imeko yemithambo-luvo emlenzeni kunye nokujonga ukuba kukho na ukuqaqamba kwemisipha xa umlenze ugobile kwaye uphumle.
• I-Magnetic resonance angiography (MRA) ene-plantar flexion: Olu vavanyo lusebenzisa i-magnetic field kunye namaza erediyo ukujonga imeko yemithambo-luvo emlenzeni kunye nokujonga ukuba kukho na ukuxinana kwemisipha xa umlenze ugobile kwaye uphumle.

Iphathwa njani i-PAES?

Ugqirha wakho unokwenza utyando.Emva koko, susa inxalenye encinci yemisipha ye-gastrocnemius kunye ne-popliteus. Oku kuya kunciphisa uxinzelelo kwi-artery kwaye kuvumele igazi ukuba lihambe ngendlela eqhelekileyo liye emlenzeni.

Olu tyando ludla ngokuthatha malunga neyure. Lwenziwa phantsi kwe-anesthesia eqhelekileyo.

Ngamanye amaxesha, kwiimeko ezinzima apho umthambo wonakalisiwe kwaye uvalekile ngenxa yokuvaleka kwe-anatomical popliteal, ugqirha wotyando unokufuna ukucoca umthambo, awulungise, okanye enze indlela entsha ejikeleze ukuvaleka (bypass).

Utyando lolona nyango lusebenzayo kwi-PAES, njengoko luyinkqubo ephumelele kakhulu kubantu abaninzi. Abantu abangaphezu kwama-90% abenza utyando bafumana uphuculo olukhulu kwiimpawu zabo.

Kwabo bane-PAES esebenzayo, ukhetho lonyango olungelulo utyando yiBotulinum toxin A. Phantsi kwesikhokelo se-CT okanye se-ultrasound, ugqirha ufaka i-'Botox®' okanye i-'Dysport®' kwisihlunu esibangela ukuxhuzula. Oku kuyawukhubaza umsipha okwethutyana. Ithemba kukuba umsipha uya kuwuqhoqhoza ngonaphakade.

Kodwa oku kuhlala iinyanga ezintathu ukuya kwezintandathu kuphela. Ukuba izihlunu azincitshiswanga, iimpawu zingabuya. Olu nyango luye lwaphumelela kubantu abangaphantsi kwama-60% emva konyaka benyangwa.

Kuthatha ixesha elingakanani ukuchacha emva kolu nyango?

Kungathatha iinyanga ezine ukuya kwezintandathu ukuze umntu aphile ngokupheleleyo emva kotyando.

Emva kotyando, kuya kufuneka uhlale esibhedlele ubusuku bonke. Emva koko, kuya kufuneka wenze unyango lomzimba (njengokwenza umthambo wokuzolula) kwiiveki ezimbini zokuqala. Emva kweeveki ezimbini, kuya kufuneka wenze umthambo wokuqinisa nowokulungisa umzimba de uphile ngokupheleleyo.

Kwenzeka ntoni kumntu one-PAES?

Ukuba une-functional popliteal entrapment kwaye intlungu yakho yomlenze ayinzima kakhulu ngexesha lokuzilolonga, ungafuna ukunciphisa umthambo wakho. Ugqirha wakho unokujonga imeko yakho.

Nangona kunjalo, njengoko besitshilo ngaphambili, utyando luphumelele ngaphezu kwe-90%, kwaye umngcipheko wokuphinda ubuye uphantsi. Uninzi lwabadlali lubuyela kwimisebenzi yabo yesiqhelo emva kotyando.

Ukuba kukho ukuvalelwa kwezicubu zomzimba, oogqirha bacebisa ukuba kususwe izihlunu ezingaqhelekanga ngotyando. Oku kungenxa yokuba, ukuba akwenziwanga, umthambo ungonakala ngokuhamba kwexesha. Ukuba uyalibazisa unyango kwaye une-PAES yesakhiwo eyonakalise umthambo we-popliteal, unokuba nentlungu engapheliyo emlenzeni xa uhamba. Kwiimeko ezingaqhelekanga, umlenze unokufuneka unqunyulwe. Kodwa oko kunqabile kakhulu .

Ndifanele ndiphinde ndimbone ugqirha kwakhona?

Emva kotyando, kuya kufuneka ubone ugqirha:

• Kwinyanga.
• Kwiinyanga ezintandathu.
• Kwiinyanga ezilishumi elinesibini.

Kwezi ntlanganiso:

• Kuya kwenziwa uvavanyo lwe-ultrasound lwe-artery yakho elungisiweyo.
• Bajonga uxinzelelo lwegazi emilenzeni yakho.

Ukuba umthambo wakho ubuyele esiqhelweni, akuyi kufuneka amanye amadinga ngaphandle kokuba iimpawu zibuya okanye kufuneka uvalwe umthambo.

Ndingayibuza yiphi imibuzo ugqirha wam?

• Ngaba ndine-anatomic PAES okanye i-functional PAES?
• Ngaba ucebisa utyando ngenxa yemeko yam?

Ukuba uselula kwaye unentlungu emilenzeni, qiniseka ukuba ubona ugqirha. Zininzi izizathu ezibangela le ntlungu. Okukhona ufumana ukuxilongwa ngokuchanekileyo, kokukhona unokuqala unyango ngokukhawuleza. Ukuba une-popliteal artery entrapment syndrome, thetha nogqirha wakho malunga nokuba utyando luyindlela elungileyo na kuwe. Olu lube lonyango oluphumeleleyo kwiimeko ezininzi.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, masishwankathele ezinye zezinto ekufuneka uzikhumbule koko sithethe ngako:

• I-PAES yimeko apho umthambo oyintloko ongasemva kwedolo, umsipha, uxinanise kwaye unciphise ukuhamba kwegazi emlenzeni.
• Oku kuchaphazela kakhulu abadlali abaselula , ingakumbi abo babalekayo.
• Ukuba ufumana iimpawu ezifana nentlungu, ubunzima, okanye ukurhawuzelela kwindawo yempumlo ngexesha lokuzilolonga, kodwa ziyaphela xa uphumle, usenokuba ne-PAES.
• Kukwakho nemeko ebizwa ngokuba yi-CECS eneempawu ezifanayo, ngoko ke ukuxilongwa ngokuchanekileyo kubalulekile.
• Esi sifo singaqinisekiswa ngokuba ingcali ikuxilonge (njenge-`Ankle-brachial index`, `Duplex ultrasound`, `CTA`, `MRA`).
• Utyando ludla ngokuba lolona nyango lusebenzayo . Abanye abantu banikwa inaliti ye-`(i-Botulinum toxin A)`.
• Ukuba ayinyangwa, ngokuhamba kwexesha, umthambo ungonakala kwaye imeko inokuba mandundu.
• Ngoko ke, ukuba unezi mpawu, kubaluleke kakhulu ukufuna ingcebiso kagqirha ngokukhawuleza.

Ungakhathazeki, ukuba uyayibona le meko, kukho unyango olufanelekileyo. Eyona nto iphambili kukubona ugqirha ngokukhawuleza, ngaphandle kokuzityeshela iimpawu. Emva koko ungaba sempilweni kwaye usebenze kwakhona!

isifo sokuvaleka kwemithambo yegazi ye - popliteal, i-PAES, iintlungu zomlenze, iintlungu zesinqe, umthambo, abadlali abaselula, imithambo yegazi, umthambo wegazi we-popliteal