Ngaba uvakalelwa kukuba ukuhamba kwegazi lakho kuyancipha engalweni yakho? Makhe sithethe ngale (Subclavian Artery Stenosis)!

Ngaba ngamanye amaxesha uziva udiniwe, uqaqanjelwa, okanye ungenamandla xa usebenzisa ingalo yakho okanye uphakamisa into enzima? Okanye ingaba ingalo enye ivakala ibanda kunenye? Ezi zinokuba ziimpawu zokuba umthambo omkhulu wegazi ohambisa igazi engalweni yakho unciphile. Namhlanje siza kuthetha ngenye yeemeko ezinjalo, ebizwa ngokuba yi-`(Subclavian Artery Stenosis)`.

Yintoni i-``(Subclavian Artery Stenosis)``? Masiyiqonde ngokulula!

Ngamafutshane, `(I-Subclavian Artery Stenosis)` kukuncitshiswa, oko kukuthi, imeko efana nokuvaleka komthambo wegazi oyintloko (siwubiza ngokuba yi-`(I-Subclavian Artery)`) onika igazi engalweni yakho. Khawuthelekelele ngokungathi ukungcola kuqokelelene ngaphakathi kombhobho wamanzi kwaye kuncitshiswa kancinci kancinci. Emva koko isantya samanzi siyehla, akunjalo? Yiyo loo nto kunjalo ngale nto. Uninzi lwexesha, oku kuncitshiswa kwenzeka xa izinto ezinamafutha (esizibiza ngokuba yi-`(plaque)`) zifakwa ngaphakathi komthambo wegazi. Kodwa kunokubakho nezinye izizathu. Kufana ne-`(speed bump)` endleleni, ecothisa ukuhamba kwegazi kancinci.

Usenokuba ukhe weva ngemeko ebizwa ngokuba yiPeripheral Artery Disease (PAD), ebangela ukucutheka kwemithambo yegazi emilenzeni. Le meko, eyenzeka kwimithambo yegazi engalweni, ibizwa ngokuba yiSubclavian Artery Stenosis.

Abantu abaninzi banale meko kodwa ababonisi zimpawu. Kungenxa yokuba yonke imithambo yegazi yomzimba wethu isebenza kakuhle kakhulu. Ukuba omnye umthambo wegazi uvalekile, eminye imithambo yegazi izama ukuvala umsantsa. Oko kukuthi, izama ukubonelela ngegazi elifunekayo ngandlel’ ithile.

Ixesha elininzi, le meko ye-`(Subclavian Artery Stenosis)` yenzeka kumthambo ohambisa igazi engalweni yasekhohlo . Kuba, i-`(Subclavian Artery)` engasekhohlo yahlulwe ngokuthe ngqo kwi-`(Aorta)`, umthambo wegazi omkhulu ovela entliziyweni yethu. Ke ngoko, kukho amathuba aphezulu okuba neengxaki ngayo. Lowo ungasekunene uvela komnye umthambo wegazi. Kodwa kunqabile kakhulu, le meko inokubonwa kuzo zombini iingalo zasekhohlo nezasekunene.

Ixhaphake kangakanani le meko?

Ukuba ujonga izibalo kwilizwe elifana neMelika, ngesiqhelo phakathi kwe-2% kunye ne-7% banale meko. Nangona kunjalo, phakathi kwabo sele benayo "i-Peripheral Vascular Disease" (ukuncitshiswa kwemithambo yegazi), eli nani limalunga ne-19%. Kuthiwa le meko ixhaphake kakhulu phakathi kwabasetyhini .

Zithini iimpawu ze-`(Subclavian Artery Stenosis)`?

Njengoko besitshilo ngaphambili, ayinguye wonke umntu oza kuba neempawu. Kodwa ukuba ziyavela, zingabonakala ngolu hlobo:

• Ukuqaqamba kwemisipha xa usebenzisa ingalo echaphazelekayo. Khawuthelekelele ukuba xa uphakamisa into enzima okanye wenza into ngesandla sakho, izihlunu ezingalweni yakho ziyaqina kwaye zivakale ngathi ziyaqaqamba.
• Intlungu okanye ukuqina kwesandla xa usebenzisa isandla esichaphazelekileyo.
• Ukuba ndindisholo okanye ukuphelelwa yimvakalelo kwisandla esichaphazelekayo (sibiza oku ngokuba yi-"Paresthesia"). Kungathi isandla siyandindisholo.
• Ukudinwa - Oku kuyinto engaqhelekanga.
• Ukuquleka - Oku kunqabile kakhulu.
• I-Vertigo - Le yimvakalelo yokujikeleza ngeenxa zonke kuwe. Oku kunqabile.

Abantu abaninzi ababonisi zimpawu kuba igazi eliya engalweni linikezelwa zezinye imithambo yegazi. Iimpawu ziqala ukubonakala emva kokuba umthambo wegazi unciphile malunga nama-50% . Ngamanye amaxesha, imeko ebizwa ngokuba yi-"Steal Syndrome" inokubangela ezinye iimpawu. Siza kuthetha ngaloo nto kamva.

Zithini izizathu ze-`(Subclavian Artery Stenosis)`?

Eyona nto ibangela le meko yi-"Atherosclerosis". Oko kukuthi, amafutha (afana ne-cholesterol) afakwa ngaphakathi kwemithambo yegazi, anciphise kancinci kancinci imithambo yegazi . Njengokuba i-moss ikhula kumbhobho wamanzi. Le yeyona nto ixhaphakileyo.

Ngaphandle koko, kunokubakho ezinye izizathu ezininzi:

• I-Vasculitis: Yimeko yokudumba eyenzeka kwimithambo yegazi.
• Ukukhanya: Ukuba ukhe wafumana unyango lwemitha olufana nomhlaza esifubeni.
• Isifo seThoracic Outlet: Ukucinezelwa kwemithambo yegazi kunye nemithambo-luvo eqala esifubeni esingaphezulu ukuya entanyeni nasengalo.
• (I-Takayasu's Arteritis): Imeko yokudumba echaphazela imithambo yegazi emikhulu, ingakumbi kubasetyhini abaselula.
• I-Fibromuscular Dysplasia: Ukuncitshiswa kwemithambo yegazi ngenxa yokukhula okungaqhelekanga kwemisipha kunye nezicubu ezidityanisiweyo kwiindonga zemithambo yegazi.
• I-Neurofibromatosis: Imeko yemfuza ebangela ukuba kubekho iithumba kwinkqubo yemithambo-luvo.

Zithini izinto ezibangela oku? Ngubani omele alumke ngakumbi?

Abanye abantu banamathuba amaninzi okufumana i-``(Subclavian Artery Stenosis)``. Jonga ukuba ezi zinto ziyingozi ziyasebenza na kuwe:

• Ukuba phakathi kweminyaka engama-50-60 ubudala.
• Ukuba noxinzelelo lwegazi oluphezulu (iHypertension). Oku sikubiza ngokuba "luxinzelelo lwegazi oluphezulu".
• Ukuba nesifo seswekile (iDiabetes Mellitus / Diabetes). Sikwabizwa ngokuba "sisifo seswekile", akunjalo?
• Amanqanaba aphezulu e-cholesterol egazini.
• Ukutya ukutya okunamafutha agcweleyo kunye namafutha e-trans (afana nebhotolo, i-margarine, ukutya okunamafutha, ukutya okukhawulezayo)
• Ukusetyenziswa kweemveliso zecuba (ezifana nokutshaya, ukuhlafuna i-betel nut).
• Ukuhlala kwindawo enye ixesha elide kakhulu kwaye ungazilolongi.
• I-body mass index (BMI) engaphezulu kwama-25 ithetha ukuba utyebile kakhulu xa kuthelekiswa nobude bakho.
• Ukuba nesifo semithambo yegazi ejikeleze umqolo (i-PAD).
• Ukuba nale meko (iTakayasu's Arteritis).

Ziziphi iingxaki ezinokubakho ze-`(Subclavian Artery Stenosis)`?

Ukuba le meko ayinyangwa kakuhle okanye ayilawulwa, ezinye iingxaki zinokubakho.

• (Isifo Sokubamba iSubclavian):Le yimeko ekhethekileyo kancinci. Okwenzekayo apha kukuba ngenxa yokuba ukuhamba kwegazi ezandleni kuyancipha, elinye igazi eliya engqondweni litsalwa "ngokufihlakeleyo" ezandleni xa lisetyenziswa ngazo. Emva koko inani legazi eliya engqondweni liyancipha, nto leyo enokubangela ukuba kubekho isiyezi namehlo aluhlaza okwesibhakabhaka.
• Isifo Sokuba Negazi Esibizwa Nge-Coronary Steal Syndrome: Esi sifana nesokuqala, kodwa apha igazi elithile eliya entliziyweni lidluliselwa engalweni. Oku kunqabile kakhulu, ingakumbi kubantu abaye benza utyando lwe-bypass.
• Iqhekeza le-fatty plaque elifakwe kwimithambo yegazi liyaqhekeka lize linamathele kwimithambo yegazi emincinci kufutshane neminwe. Oku kunokuthintela ukuhamba kwegazi ukuya kwiminwe, okubangela ukuba ibe buhlungu kwaye ibe nezilonda.
• Ukuncipha kokuhamba kwegazi ukuya entliziyweni, engqondweni, okanye ezandleni.
• (TIA - Uhlaselo lwe-Ischemic oluThutyana): Oku kufana ne-mini `(stroke)`. Iimpawu ezinje ngokuncipha kokuhamba kwegazi ukuya ebuchotsheni okwethutyana elifutshane, ukungakwazi ukuthetha, kunye nokulahlekelwa ngamalungu omzimba kuyafika kudlule. Nangona kunjalo, oku kunokuba sisandulela se-`(stroke)` enkulu.

Oogqirha bayixilonga njani le meko (i-Subclavian Artery Stenosis)?

Ukuba uneempawu ezichazwe apha ngasentla, xa ubona ugqirha, uza kuqala akuhlole. Oku kubizwa ngokuba "luvavanyo lomzimba".

• Apho, baza kujonga ukubetha kwentliziyo yakho kunye noxinzelelo lwegazi .
• Mhlawumbi ujonge ukuba isandla esinye sibanda kunesinye.
• Jonga ukuba kukho na amanxeba ezandleni zombini, kwaye ukuba akapholi na (amanxeba athatha ixesha elide ukuphola ngenxa yokungahambi kakuhle kwegazi).
• Ungajonga kwakhona ukuba i-pulse engalweni enye ibuthathaka na.

Okukhethekileyo kukuba, ngokungafaniyo nokuhlolwa rhoqo, ugqirha uza kulinganisa uxinzelelo lwakho lwegazi kwiingalo zombini . Oku kwenzelwa ukuthelekisa `(uxinzelelo)` kwiingalo zombini. Ukuba uxinzelelo lwe `(systolic)` (inani eliphezulu) kwingalo enye luphezulu malunga ne-10-15 millimeters `(mmHg)` kunenye ingalo, inokuba luphawu lwemeko ebizwa ngokuba yi `(Subclavian Artery Stenosis)`. `(uxinzelelo)` luphezulu kwingalo efumana igazi kwimithambo yegazi ephilileyo.

Ukongeza, ukuba ugqirha wakho uva isandi esithi "swoosh" (esibizwa ngokuba yi "bruit") xa emamele imithambo yegazi yakho entanyeni yakho nge-stethoscope, oku kungaba luphawu lokuncitshiswa kwemithambo yegazi.

Amaxesha amaninzi, abantu abafumana le meko ngenxa yezinye izizathu banokubonakalisa iimpawu ezinxulumene nezo zifo zinxulumene nayo.

Zeziphi ezinye iimvavanyo ezenziwayo ukuqinisekisa?

Ukuba ugqirha wakho ukrokrela ukuba une-Subclavian Artery Stenosis, angaqala ngokuyalela i-ultrasound. Oku kunokujonga isantya sokuhamba kwegazi kunye nemeko yemithambo yegazi.

Ukongeza, ezi mvavanyo zilandelayo zingenziwa ukujonga imithambo yegazi:

• (CT Angiogram - I-Computed Tomography Angiogram): Olu luhlobo olukhethekileyo lwe-CT scan. Uhlobo lwedayi lufakwa ukuze lubone ngokucacileyo imithambo yegazi.
• (MRA - Magnetic Resonance Angiogram): Oku kufana ne-MRI scan, kodwa yenzelwe ukujonga imithambo yegazi.
• I-Angiogram Yendabuko (Engena Ngomdla):Kule nto, kudluliselwa ityhubhu encinci ngemithambo yegazi, kufakwe idayi, kuthathwe i-``(X-ray)''. Ngamanye amaxesha kusetyenziswa indlela ebizwa ngokuba yi-``(Digital Subtraction)''. Oku kususa izinto ezifana nethambo kwaye kuvumela kuphela imithambo yegazi ukuba ibonakale ngokucacileyo.

Ziziphi iindlela zonyango ze-`(Subclavian Artery Stenosis)`?

Unyango luxhomekeke ekubeni unazo na iimpawu okanye awunazo kunye nobunzima bemeko.

Abantu abaneempawu banokufuna unyango olufana nolu:

• (I-Aspirin): Inciphisa ukujiya kwegazi kwaye inceda ekunciphiseni igazi.
• Amayeza okwehlisa i-cholesterol: Nciphisa ubuninzi bamafutha aqokelelana kwimithambo yegazi.
• Amayeza oxinzelelo lwegazi oluphezulu .
• Ukuba unobangela yi-`(Vasculitis)`, ngoko ke ifuna amayeza.
• I-Angioplasty: Kule meko, kufakwa isixhobo esincinci esifana nebhaluni kumthambo wegazi ovalekileyo size sivuthelwe umoya ukuze sandise umthambo. Rhoqo, kufakwa i-stent (isixhobo esincinci esifana ne-mesh) ukuze singaphinde sinciphe.
• Utyando lwe-Bypass: Le yinkqubo engaqhelekanga kakhulu. Ibandakanya ukudlula umthambo wegazi ovalekileyo kunye nokudala indlela entsha kusetyenziswa omnye umthambo wegazi (mhlawumbi othathwe emlenzeni) okanye owenziweyo.

Nokuba awunazo iimpawu, ugqirha wakho usenokukhangela ukuba kukho amafutha amaninzi kangakanani kwimithambo yakho yegazi (atherosclerosis). Le meko inokuchaphazela imithambo yegazi naphi na emzimbeni kwaye inokukhokelela "kwistroke" okanye "kwisifo sentliziyo." Ke ngoko, ugqirha wakho usenokukuxelela ukuba:

• Zilolonge umzimba ubuncinane imizuzu engama-30 ngosuku, uninzi lweentsuku zeveki. (Njengokuhamba, ukubaleka, ukuzilolonga)
• Gcina ubunzima bakho busempilweni.
• Ziphephe ngokupheleleyo iimveliso zecuba.
• Yitya ukutya okunamafutha agcweleyo aphantsi kunye namafutha e-trans (yitya imifuno, iziqhamo, iimbotyi kunye nefayibha engaphezulu).

Ngaba kukho naziphi na iingxaki okanye iziphumo ebezingalindelekanga zonyango?

Naliphi na iyeza linokubangela iziphumo ebezingalindelekanga ezincinci. Ukuba ufumana naziphi na iziphumo ebezingalindelekanga eziphazamisayo nezihlala zihleli ngelixa usela amayeza akho, thetha nogqirha wakho.

Ngamanye amaxesha, utyando okanye iinkqubo ezifana ne-"Angioplasty" zinokubangela iingxaki ezifana nezi:

• Ukopha.
• Ukonakala komthambo wegazi.
• Amahlwili egazi.
• I-stent efakiweyo ayizange ikhule kakuhle okanye yayingekho kwindawo eyiyo.
• I-stent efakiweyo iyaqhekeka.
• Umthambo wegazi uvalekile kwakhona.
• Akuqhelekanga ukuba kubekho isifo sohlangothi emva kwe-angioplasty okanye utyando.

Kuthatha ixesha elingakanani ukuchacha kwezi ndlela zonyango?

Emva kwe-Angioplasty, kuya kufuneka uphumle malunga nosuku. Uya kukwazi ukuqhuba imoto uye emsebenzini kwisithuba seveki. Nangona kunjalo, utyando lwe-Bypass luya kuthatha ixesha elide ukuba luphile. Ugqirha wakho uya kukuxelela okungakumbi ngale nto kuxhomekeke kwimeko yakho.

Kuza kwenzeka ntoni ukuba ndine-`(Subclavian Artery Stenosis)`? Liyintoni ikamva?

Ukuba uneempawu, unyango lunokunceda kakhulu ekuvuleni imithambo yegazi yakho nasekuthomalaliseni iimpawu zakho. Ukuba awunazo iimpawu, unyango lusenokungabi yimfuneko.

Kodwa nokuba uneempawu okanye awunazo, i-Subclavian Artery Stenosis luphawu olusisilumkiso oluvela emzimbeni wakho . Ngokuqhelekileyo, ibangelwa yi-Atherosclerosis (ukugcinwa kwamafutha kwimithambo yegazi). Ukuba umthambo omnye wegazi uvalekile, unokuchaphazela neminye imithambo yegazi. Yiyo loo nto ugqirha wakho eya kukuxelela ukuba ulawule izinto ezinokubangela isifo sentliziyo .

Oku kuquka:

• Ukuba usebenzisa icuba, yeka ngokupheleleyo.
• Ukulawula uxinzelelo lwegazi oluphezulu.
• Ukulawula i-cholesterol ephezulu.
• Ukulawula okanye ukuthintela isifo seswekile.

I-Angioplasty isebenza ngaphezu kwama-95% ekunciphiseni iimpawu. Kwiminyaka emihlanu emva kwe-angioplasty, malunga nama-90% emithambo yegazi eyayivaliwe ngaphambili ihlala ivulekile. Utyando oluvulekileyo lunokubonelela ngeziphumo ezihlala ixesha elide ngakumbi.

Ukuba umthambo wakho wegazi uvalekile ngokupheleleyo, iziphumo zisenokungasebenzi kakuhle.

Ngaba i-Subclavian Artery Stenosis ingathintelwa?

Ewe, kwiimeko ezininzi, ukugcwala kwamafutha kwimithambo yegazi (i-atherosclerosis) okubangela oku kunokuthintelwa. Konke okufuneka ukwenze kukwenza utshintsho oluthile kwindlela ophila ngayo.

• Ukuba nomdla womzimba.
• Ukulandela ukutya okunempilo (ioyile encinci, iswekile, ityuwa encinci, imifuno neziqhamo ezingaphezulu)
• Kuphephe ukutshaya.
• Ukugcina ubunzima obusempilweni.

Kubalulekile kwakhona ukulawula ngokufanelekileyo naziphi na iimeko zempilo osenokuba unazo, ezinje ngezi:

• I-cholesterol ephezulu.
• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu).
• Isifo seswekile.

Ndingazinyamekela njani?

Utshintsho oluncinci kwindlela yokuphila onokulwenza ukuthintela i-Subclavian Artery Stenosis luya kukunceda nasemva konyango. Imikhwa esempilweni inokunceda ukuthintela ukuba le meko ingaphindi ivele. Ukuba ugqirha ufaka i-stent kumthambo wakho, kuya kufuneka uqhubeke nokusela amayeza afana ne -aspirin kunye ne-clopidogrel ukuze ungavaleki kwakhona.

Ndifanele ndimbone nini ugqirha?

Emva konyango, uza kucelwa ukuba ubonane nogqirha wakho malunga neenyanga ezintandathu kwiminyaka emibini yokuqala. Emva koko malunga kanye ngonyaka. Oku kunokwahluka ngokuxhomekeke kwimeko yakho kunye nendawo onyangwa kuyo. Ngoko ke, landela imiyalelo kagqirha wakho ngokuchanekileyo.

Ndingaya nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Abantu abane-Subclavian Artery Stenosis banokuba namafutha amaninzi kwezinye imithambo yegazi emzimbeni. Oku kuquka imithambo yegazi ehambisa igazi entliziyweni yakho (imithambo yegazi yentliziyo). Ukuba le mithambo yegazi iyavaleka, unokuba nesifo sentliziyo. Ukuba uneempawu zokuhlaselwa sisifo sentliziyo , funa uncedo lwezonyango ngokukhawuleza.

Iimpawu zokuhlaselwa yintliziyo zingabandakanya:

• Intlungu yesifuba okanye ukuxinana (le ntlungu ingasasazeka ingalweni, entanyeni, okanye emhlathini).
• Ubunzima bokuphefumla.
• Ukuba nesiyezi, ukuziva ukhaphukhaphu.
• Ukuziva ngathi intliziyo yakho ibetha ngokukhawuleza.
• Ukuphazamiseka kwesisu, isicaphucaphu, ukuhlanza.

Ndingayibuza yiphi imibuzo ugqirha wam?

Xa ubona ugqirha wakho, ungambuza imibuzo efana nale:

• Ngaba ndifuna unyango?
• Yeyiphi indlela engcono yonyango lwengxaki yam?
• Zingaphi kwezi ntlobo zonyango ozenzayo esibhedlele/kwikliniki yakho ngonyaka?
• Ungandithumela kumntu onokundinceda ndiphuhlise imikhwa enempilo yentliziyo? (umz., ingcali yesondlo)

Ingaba i-`(Subclavian Artery Stenosis)` iyingozi?

Ewe, oku kunokuba yingozi, ingakumbi ukuba kubangela imeko ebizwa ngokuba yi-"Steal Syndrome", nto leyo ethetha ukuba igazi elincinci lithunyelwa engqondweni okanye entliziyweni, endaweni yoko lithunyelwa ezingalweni. Eyona nto ingcono onokuyenza ukuthintela ezi ngxaki kukulandela icebiso likagqirha wakho malunga nokutya okunempilo kunye nokuzilolonga rhoqo.

Xa ufumanisa ukuba une-Subclavian Artery Stenosis, kusenokwenzeka ukuba lixesha lokuqala uve ngaloo mthambo wegazi. Kodwa, cinga oku njengomyalezo ovela emzimbeni wakho: Une-Atherosclerosis. Ukuba ikwimithambo yegazi enye, inokuba nako komnye. Ngoko ke, thabatha amanyathelo ngoku ukugcina intliziyo yakho kunye nemithambo yegazi isempilweni.

Okokugqibela, umyalezo oya ekhaya

Kulungile, ngoku uyaqonda ngcono into ebesithetha ngayo, ``(Subclavian Artery Stenosis)``. Ungakhathazeki , ukuba ifunyenwe kwangethuba kwaye ilawulwa ngokufanelekileyo, ungaphila.

Into ebalulekileyo kukuba oku kudla ngokunxulumene nendlela esiphila ngayo. Oko kuthetha ukutya ukutya okunempilo, ukuzilolonga rhoqo , ukuphepha ukutshaya, nokulawula iimeko ezifana nesifo seswekile, uxinzelelo lwegazi oluphezulu, kunye ne-cholesterol .

• Ukuba uhlala uva iintlungu, ukungaziva, okanye ukudinwa ezandleni zakho, musa ukuzityeshela kwaye ufune ingcebiso kugqirha.
• Landela unyango kunye nemiyalelo kagqirha ngokuchanekileyo.
• Oku akusiyongxaki yesandla nje kuphela, kodwa luphawu lokuba kufuneka unikele ingqalelo kwimpilo yentliziyo yakho iyonke.

Mamela umzimba wakho uze uzame ukuhlala uphilile!

I- Subclavian Artery Stenosis, Intlungu Yengalo, Ukungaziva Kakuhle Kwengalo, Ukuncitshiswa Kwemithambo Yegazi, I-Angioplasty, I-Stent, I-Atherosclerosis