Ngaba ngamanye amaxesha uziva intlungu engaqhelekanga okanye ukungakhululeki okuphuma entanyeni yakho nasegxeni ukuya engalweni yakho? Ngaba le ntlungu ibonakala iba mandundu xa uphakamisa ingalo yakho? Abantu abaninzi bacinga ukuba oku kuqhelekile, okanye ukuba ngumthambo omncinci entanyeni yakho ocinezelwayo, kodwa unobangela unokuba nzima ngakumbi kunokuba ucinga. Namhlanje siza kuthetha ngemeko enokubangela iimpawu ezifanayo, kodwa abantu abaninzi abakayiva loo nto. Yiyo leyo i-Thoracic Outlet Syndrome (TOS).
Ngamafutshane, yintoni iThoracic Outlet Syndrome (TOS)?
Eli gama lisenokuvakala liyinkimbinkimbi kancinci. Kodwa masiligcine lilula. Khawuthelekelele ukuba kukho indawo encinci efana nomngxuma phakathi kwentamo nesifuba sethu. Ngokuchanekileyo, indawo engaphantsi kwethambo lentamo nangaphezulu kombambo wokuqala. Le ndawo yileyo siyibiza ngokuba 'yi-thoracic outlet' kwezonyango.
Le tunnel ibaluleke kakhulu kuba inqwaba enkulu yemithambo-luvo enika imvakalelo kunye nentshukumo engalweni yethu (ebizwa ngokuba yi -brachial plexus ), kunye nomthambo ophambili onika igazi engalweni ( umthambo we-subclavian ), kunye nomthambo omkhulu othwala igazi ukusuka engalweni ukuya entliziyweni ( umthambo we-subclavian ) zidlula kule ndawo incinci.
Ngokwesiqhelo, ezi mithambo-luvo kunye nemithambo yegazi zinokuhamba kule ndawo ngaphandle kokuphazanyiswa. Kodwa kuthekani ukuba le tunnel ivalekile ngesizathu esithile? Oko kukuthi, kwenzeka ntoni ukuba ezi mithambo-luvo okanye imithambo yegazi icinezelwe zimisipha ezingqongileyo, amathambo, njl.njl.? Yiloo nto siyibiza ngokuba yiThoracic Outlet Syndrome (TOS) . Olu xinzelelo lubangela iimpawu ezininzi ezifana nentlungu, ukungaziva, kunye nokudumba engalweni.
Ngaba kukho iintlobo eziphambili ze-TOS?
Ewe, i-TOS yahlulwe yaba ziintlobo ezintathu eziphambili kuxhomekeke kwinto ebangela olu xinzelelo. Ukwazi oku kanye kubaluleke kakhulu kunyango.
| Uhlobo lwe-TOS | Yintoni ebaluleke kakhulu kunye nenkcazo |
|---|---|
| I-Neurogenic Thoracic Outlet Syndrome (ukucinezelwa kwemithambo-luvo) | Olu lolona hlobo luxhaphakileyo (malunga nama-95% ezigulane ze-TOS). Lubandakanya ukucinezelwa kwe-nerve bundle eqala engalweni ukuya egxalabeni (brachial plexus). Idla ngokuvela kubadlali abenza iintshukumo eziphindaphindayo okanye kubantu abaye benzakala ngequbuliso entanyeni (njengokubethelwa nge-whiplash ngenxa yengozi yemoto). |
| Isifo seThroat Outlet Syndrome (i-Venous Throat Syndrome) | Kulapho umthambo oyintloko obuyisa igazi engalweni (umthambo we-subclavian) uvaleka khona. Oku kunokubangela ukuba igazi lihlangane engalweni, nto leyo ebangela ukuba idumbe ngequbuliso ize ibe luhlaza okwesibhakabhaka . Oku kuxhaphake kakhulu kumadoda aselula, ingakumbi engalweni ayisebenzisa kakhulu (ingalo elawulayo). |
| I-Arterial Thoracic Outlet Syndrome (Umphimbo Womqala We-Arterial) | Olu lolona hlobo lungaqhelekanga (malunga ne-1% yezigulana ze-TOS). Apha, umthambo ophambili othwala igazi engalweni (umthambo we-subclavian) uyancipha. Oku kunokunciphisa ukuhamba kwegazi engalweni, okubangela ukuba kubande, kube mdaka, kwaye kube buhlungu. Ngamanye amaxesha, amahlwili egazi anokwenziwa ngaphakathi kulo mthambo. Oku kudla ngokubangelwa yinto efana nombambo owongezelelweyo ozalwa unombambo wesibeleko. |
Zombini iintlobo zemithambo yegazi kunye nezemithambo yegazi zaziwa ngokuba yiVascular Thoracic Outlet Syndrome . Zombini ezi ntlobo zihlala zifuna utyando. Nangona kunjalo, uhlobo lweNeurogenic oluqhelekileyo ludla ngokuphendula kakuhle kunyango lomzimba.
Zithini iimpawu ze-TOS?
Iimpawu zixhomekeke ekubeni umthambo wegazi okanye imithambo yegazi icinezelwe na. Ezi mpawu zihlala zibonakala kwelinye icala (intamo, isifuba esingaphezulu, igxalaba, ingalo, okanye isandla).
Iimpawu eziqhelekileyo:
- Intlungu: Le ntlungu inokwanda xa uphakamisa ingalo yakho. Abanye abantu banokuvakalelwa kukuba oku yintlungu engephi .
- Ukungaziva ngqindilili: Imvakalelo "yokuxinwa kweenaliti", efana nemvakalelo yokuba isandla sakho singathi ngqindilili.
- Ubungqindilili: Ukulahlekelwa yimvakalelo kwezinye iindawo zesandla.
- Ubuthathaka: Ukuncipha kwamandla esandleni okanye kwiminwe, ubunzima bokubamba izinto.
- Ukudumba okanye ubunzima: Ingalo ingadumba ize ivakale ngathi inzima, ingakumbi xa umthambo uxinzelelekile.
- Umbala wolusu uyatshintsha: Isandla sinokuba mhlophe okanye sibe luhlaza okwesibhakabhaka.
- Izandla ezibandayo: Xa umthambo uncipha kwaye ukuhamba kwegazi kuncipha, isandla sinokubanda kunesinye isandla.
- Ukuphola okulibazisekileyo kwamanxeba eminwe: Oku kusenokuba kubangelwa kukungahambi kakuhle kwegazi.
Cinga ngale ndlela: imithambo-luvo ifana neentambo zombane emizimbeni yethu. Xa icinezelwe, kuvela iimpawu ezifana neentlungu kunye nokungaziva. Imithambo yegazi ifana nemibhobho yamanzi. Ukuba umbhobho othwala igazi (umthambo) uvalekile, isandla siyabanda kwaye siswele igazi. Ukuba umbhobho obuyisela igazi (umthambo) uvalekile, isandla siyadumba size sizaliswe ligazi. Xa ucinga ngale ndlela, kulula ukuqonda iimpawu.
Ngaba le ntlungu inxulumene nokuhlaselwa yintliziyo?
Lo ngumbuzo obaluleke kakhulu. Ngenxa yokuba i-TOS inokubangela iintlungu esifubeni esingaphezulu, abanye basenokoyika ukuba oku kukuhlaselwa yintliziyo okanye i-angina. Nangona kunjalo, kukho umahluko ocacileyo phakathi kwezi zimbini.
- Intlungu ye-TOS: Ihlala iba mandundu xa uphakamisa ingalo echaphazelekayo . Le ntlungu ayibi mandundu xa uhamba okanye uzilolonga.
- Intlungu ye-Angina: Le yintlungu ebangelwa kukungafumani igazi elaneleyo entliziyweni. Ihlala iba mandundu xa uzilolonga, njengokuhamba okanye ukunyuka izinyuko . Iba ngcono xa uphumle. Ingakhatshwa ziimpawu ezifana nokuphefumla nzima nokubila.
Ngokufanayo, ubuthathaka kwelinye icala lomzimba bunokuba luphawu lwestroke. Nangona kunjalo, istroke inokubangela iimpawu ezifana nokugoba komlomo kwelinye icala, ubunzima bokuthetha, kunye notshintsho ekuboneni.
Kubaluleke kakhulu: Ukuba ufumana iimpawu ezifana nentlungu yesifuba ngequbuliso, ubunzima bokuphefumla, ukubila, ubuthathaka kwelinye icala lomzimba, okanye ubunzima bokuthetha, musa ukucinga ukuba yi-TOS kwaye uye kwigumbi likaxakeka esibhedlele (ETU) ngoko nangoko. Ezi zinokuba ziimpawu zokuhlaselwa yintliziyo okanye istroke, ezifuna unyango olukhawulezileyo.
Yintoni ebangela i-TOS?
Oogqirha bahlula izizathu ze-TOS zibe ziindidi ezintathu eziphambili.
| Udidi lwesizathu | Inkcazo kunye nemizekelo |
|---|---|
| Ukuzalwa | Olu lutshintsho lolwakhiwo oluzalwa unalo. Umzekelo, abanye abantu banokuba nembambo eyongezelelweyo entanyeni yabo (imbambo yomlomo wesibeleko). Olu mbambo lungaphezulu lunokunciphisa indawo kwindawo yokukhupha isifuba kwaye lubangele uxinzelelo kwimithambo-luvo okanye kwimithambo yegazi. |
| Ingozi (Eyenzeke Kakhulu) | Le meko inokubangelwa kukwenzakala entanyeni okanye esifubeni esingaphezulu. Umzekelo oqhelekileyo yi -whiplash , ebangelwa kukuxhuzula ngequbuliso kwentamo kwingozi yemoto. Ingabangelwa nayinto efana ne-collarbone eyaphukileyo. |
| Isebenza kakuhle | Oku kwenzeka ngenxa yokuphindaphindwa rhoqo kweentshukumo ezifanayo, ingakumbi imisebenzi ebandakanya ukuphakamisa iingalo zakho.
|
Ngamanye amaxesha, nokuba kukho umngcipheko wokuzalwa (umz., ubambo olongezelelweyo), iimpawu zisenokungabonakali de kube yingozi okanye umsebenzi ongafanelekanga wexesha elide.
Ingaba le yimeko embi kakhulu? Kuza kwenzeka ntoni ukuba ayinyangwa?
Ewe, i-TOS inokubangela iingxaki ezinkulu ukuba ayinyangwa, ingakumbi ngohlobo lokuxinana kwemithambo yegazi.
- I-Thrombosis: Amahlwili egazi anokwenziwa engalweni ngenxa yokuncitshiswa kwemithambo. Ukuba eli hlwili legazi liyaqhekeka lize lihlale emiphungeni, linokubangela imeko enzima, esongela ubomi ebizwa ngokuba yi-pulmonary embolism .
- Ukudumba okungapheliyo kunye nentlungu: Ukudumba okungapheliyo kunye nentlungu esandleni.
- Ukufa kwezicubu (Gangrene): Ukuba umthambo uvalekile kwaye ukuhamba kwegazi esandleni kunqunyulwe ngokupheleleyo, izicubu eziseminweni zinokufa.
- Amanxeba angapholiyo: Amanxeba aseminweni asenokungaphili ngenxa yokungahambi kakuhle kwegazi.
- Ukonakala kwemithambo-luvo okungapheliyo: Ukucinezelwa kwemithambo-luvo ixesha elide kunokubangela umonakalo ongapheliyo.
Ngoko ke, ukuba unezi mpawu, kubaluleke kakhulu ukubona ugqirha wakho kwaye ucele ingcebiso, endaweni yokucinga nje ukuba "oku kuza kuphela."
Ugqirha uyixilonga njani i-TOS?
Ukuchonga i-TOS ngamanye amaxesha kunokuba nzima kancinci kuba iimpawu zinokufana nezezinye iimeko ezininzi. Ugqirha wakho uza kuqala akubuze ngeempawu zakho aze akuhlole.
Ngexesha lovavanyo lomzimba, ugqirha uza kukucela ukuba wenze iintshukumo ezithile. Umzekelo:
- Phakamisa iingalo zakho phezulu uze ubacele ukuba bagobe baze bolule izandla zabo (Uvavanyo Loxinzelelo Lwengalo Ephakamileyo).
- Bakucela ukuba ujike intamo yakho kwiindlela ezahlukeneyo.
Ugqirha wakho angafumana umbono woku ngokujonga ukuba ngaba ufumana iimpawu ezinje ngeentlungu okanye ukungaziva xa usenza ezi ntshukumo, kunye nendlela ezenzeka ngayo.
Ukongeza, iimvavanyo ezilandelayo zinokuyalelwa ukuqinisekisa ukuxilongwa kunye nokuthintela ezinye iimeko:
- I-X-reyi yesifuba: Jonga ukuba akukho mbambo yongezelelweyo (imbambo yomlomo wesibeleko).
- I-CT scan okanye i-MRI scan: Ukubona ngqo apho izakhiwo zentamo nesifuba zicinezelwe khona, kunye nemithambo-luvo kunye nemithambo yegazi.
- I-Electromyography (EMG) / Uphononongo lwe-Neurve Conduction: Ijonga ukusebenza kwemithambo-luvo kunye nomonakalo.
- I-Angiography (i-MRA okanye i-CT Angiography): Ukujonga ukuhamba kwegazi kwimithambo yegazi kunye nokuba kukho na ukuvaleka okanye ukuqhekeka kwegazi.
Ziziphi iindlela zonyango ze-TOS?
Unyango luxhomekeke kuhlobo lwe-TOS onayo, ubukhali beempawu zakho, kunye nesizathu.
1. Unyango Lomzimba: Olu lolona nyango lokuqala nolubaluleke kakhulu kwi-Neurogenic TOS. Ingcali yonyango lomzimba iya kukufundisa imithambo ethile yokuqinisa izihlunu entanyeni nasemagxeni akho, yonyuse ukuguquguquka, kwaye ikuncede uhlale umile kakuhle. Kwabaninzi, olu nyango lunokunciphisa kakhulu iimpawu.
2. Amayeza:
- Iipilisi zokunciphisa iintlungu: Ugqirha wakho unokukunika amayeza okunciphisa iintlungu anjengee-NSAID ukulawula iintlungu.
- Ii-Anticoagulants: Ukuba amahlwili egazi akheke kwimithambo yegazi okanye asemngciphekweni wokwakheka, kunikwa amayeza okunciphisa igazi. Ngamanye amaxesha, kunokunikwa iinaliti ezikhethekileyo (unyango lwe-thrombolytic) ukuze kunyibilikiswe ihlwili legazi.
3. Utyando:
- Ii-TOS zemithambo yegazi kunye nemithambo yegazi (iintlobo zokuxinana kwemithambo yegazi) zihlala zifuna utyando ngenxa yomngcipheko omkhulu weengxaki ezinkulu.
- Utyando lukwaqwalaselwa nakwizigulane ezine- Neurogenic TOS ezingaphenduliyo kunyango lomzimba.
- Utyando lubandakanya ukususa unobangela wokucinezelwa kwemithambo-luvo okanye imithambo yegazi. Umzekelo, ukususa ubambo olongezelelweyo okanye ukunqumla umsipha oqinileyo (utyando lokunciphisa uxinzelelo).
Ugqirha wakho uza kukuchazela ngokweenkcukacha ukuba udinga utyando, ukuba lubandakanya ntoni, kunye neengozi zalo.
Umyalezo Wokuya Ekhaya
- Ukuba unentlungu engapheliyo, ukungaziva, okanye ubuthathaka entanyeni, emagxeni, okanye engalweni yakho, musa ukuyityeshela loo nto.
- Ezi mpawu zisenokubangelwa yiThoracic Outlet Syndrome (TOS), ebangelwa kukucinezelwa kwemithambo-luvo okanye imithambo yegazi kwindawo ephakathi kwentamo nesifuba.
- Ukungazinaki iimpawu, ingakumbi kwiimeko ze-TOS ezibandakanya imithambo yegazi, kunokukhokelela kwiingxaki ezinkulu ezifana nokuqhekeka kwegazi.
- Qiniseka ukuba ubona ugqirha ukuze ufumane uxilongo olufanelekileyo kunye nonyango.
- Abantu abaninzi banokuzilawula iimpawu zabo ngonyango lomzimba, kwaye kwezinye iimeko, utyando lunokufuneka.
- Ukuba uneempawu ezifana nentlungu yesifuba ngequbuliso okanye ubuthathaka kwelinye icala lomzimba, yiya kwigumbi longxamiseko (ETU) ngokukhawuleza.
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