Ingabe uvame ukuzwa ubuhlungu emhlane wakho wesobunxele noma esiswini esingezansi? Noma uke waphawula igazi elincane emchameni wakho ? Uma unezimpawu ezinjengalezi, imbangela ingaba yisimo esingavamile ongakaze uzwe ngaso. Namuhla sikhuluma ngalesi simo esibizwa ngokuthi i-Nutcracker Syndrome. Ungesabi ukuzwa lokhu. Lokhu ngokuvamile akukubi kangako, futhi uchwepheshe owaziyo ngalokhu angakusiza.
Kalula nje, iyini i-Nutcracker Syndrome?
Cabanga nge-nutcracker. Kufana nokuqhekeza i-nut nge-nutcracker. Kulesi simo, umthambo oyinhloko okhipha igazi ezinso zakho zesobunxele, i-aorta, ucindezelwa phakathi kweminye imithambo yegazi emibili emikhulu esiswini sakho. Yingakho ibizwa ngokuthi i-Nutcracker Syndrome.
Uma umthambo uvalekile ngale ndlela, ukugeleza kwegazi kuyehla, noma umfutho wegazi ukhuphuke bese igazi liqala ukugeleza ngendlela engafanele. Yilokhu okubangela izimpawu ezifana nobuhlungu kanye negazi emchameni .
Ngokuvamile, lo mthambo ubhajwa phakathi komthambo omkhulu ovela enhliziyweni yethu (i-aorta) nomthambo ohlinzeka ngegazi emathunjini ethu (umthambo omkhulu we-mesenteric). Lokhu kubizwa ngokuthi i-anterior nutcracker syndrome . Akuvamile kakhulu, lo mthambo ungabhajwa phakathi komthambo omkhulu nomgogodla . Lokhu kubizwa ngokuthi i-posterior nutcracker syndrome .
“Ungesabi,” kusho uDkt. Caitlin Hicks, udokotela ohlinzayo wemithambo yegazi eJohns Hopkins University. “Kubalulekile ukubona uchwepheshe owaziyo ngalokhu bese ukhuluma ngezinketho zakho. Kodwa isikhathi esiningi, lezi zimpawu ziyaphela ngokwazo ngokuhamba kwesikhathi.”
Ziyini izimpawu ze-Nutcracker Syndrome?
Ekuqaleni, ungase ungaboni lutho olukhulu. Kodwa uma umthambo uvalekile isikhathi eside, kungavela izimpawu ezahlukahlukene. Ake sibheke lezi etafuleni.
| Uhlobo lwesibonakaliso | Incazelo |
|---|---|
| Izimpawu ezivamile |
|
| Izici ezithile eziqondene nabesifazane | |
| Izici ezithile eziqondene namadoda |
Uma igazi lingakwazi ukugeleza kahle ngomthambo wezinso, ukucindezeleka kwalelo gazi kungathinta neminye imithambo e-pelvis. Yingakho izimpawu ziyahlukahluka kuye ngobulili.
Lobuhlungu abuhlali njalo. Ngezinye izikhathi bungaba bubi nakakhulu lapho uhambahamba, usezikhundleni ezithile, noma ngesikhathi sokuya esikhathini kwabesifazane.
Umehluko phakathi kwe-Nutcracker Phenomenon ne-Nutcracker Syndrome
Kudingeka siqonde okunye lapha. Yilowo umehluko phakathi kwalezi ezimbili.
- Isenzakalo se-Nutcracker: Kulesi simo, noma ngabe umthambo wezinso oshiwo ngenhla uvaliwe, awunazo izimpawu .
- I-Nutcracker Syndrome: Kulesi simo, umthambo uvalekile, futhi nawe ubhekene nezimpawu .
Odokotela ngokuvamile abasilaphi lesi simo. Kodwa uma izimpawu zivela kamuva, kufanele nakanjani ubonane nodokotela wakho nixoxe ngaso.
Yiziphi izizathu zalesi simo?
Akukho "phutha" kuwe ukuthi lokhu kwenzeke. Izimbangela ezivame kakhulu yilezi:
- Ukuncipha kwe-engeli lapho imithambo yegazi itholakala khona.
- Ukulahlekelwa amafutha esiswini (ngenxa yokuzaca noma ukwehla kwesisindo ngokuzumayo).
- Ukukhula kobude obungazelelwe (ukukhula okusheshayo, ikakhulukazi ngesikhathi sobusha).
Kalula nje, lezi zinto zinciphisa isikhala somthambo wegazi. Ngokuvamile, kukhona i-fat pad lapho ukuvikela umthambo. Uma lokho kuba mncane, noma lapho indawo yemithambo yegazi ishintsha, umthambo ungavaleka.
Ezinye izimbangela ezingavamile ukubonwa:
- Izimila ezenzeka eduze kwepancreas noma ngaphakathi esiswini.
- Ama-lymph node avuvukele.
- I-aorta ekhulisiwe.
- Ukukhulelwa (ngenxa yokwanda kwesibeletho esicindezela imithambo ezungezile).
- Izinkinga zomgogodla (njengokugoba okukhulu komhlane ongezansi).
Kwenziwa kanjani ukuxilongwa?
I-Nutcracker Syndrome ingaba nzima ukuyixilonga ngoba izimpawu (ubuhlungu besisu, igazi emchameni) zifana kakhulu nezinye izimo ezivamile, njengezinso, izifo zomgudu womchamo, kanye ne-endometriosis. Ngakho udokotela wakho uzoqala ahlole ezinye izimbangela.
Uma lezo zimbangela sezisusiwe, uma kusolwa ukuthi i-Nutcracker Syndrome, kungenziwa izivivinyo ezilandelayo ukuze kuhlolwe ukuvaleka kwemithambo yezinso:
- Ukuhlolwa komchamo: Lokhu kungabona ngisho namaconsi amancane egazi amancane kakhulu ukuthi angabonwa ngamehlo enyama.
- I-Doppler ultrasound: Lokhu ukuhlolwa okungenabuhlungu okusebenzisa amaza omsindo ukukala ukuthi igazi lihamba ngokushesha kangakanani emithanjeni yezinso. Nakuba lokhu kukodwa kungenakukuqinisekisa ukuxilongwa, kunganikeza izinkomba ezibalulekile.
- I-CT angiography (CTA) noma i-MR angiography (MRA): Lezi zinhlobo zokuskena zingaveza isithombe esicacile kakhulu semithambo yegazi esiswini. Zingabona kahle ukuthi umthambo uvaliwe, ukuthi igazi ligeleza emuva, noma ukuthi lithatha enye indlela.
- I-Venogram: Lokhu kuhilela ukufaka ipayipi elincane emthanjeni bese ulinganisa ingcindezi ngaphambi nangemva kokuvaleka. Uma kukhona umehluko omkhulu ekucindezelweni, lokhu kuwubufakazi obuqinile bokuthi lesi simo sikhona. Indlela ebizwa ngokuthi i-IVUS (intravascular ultrasound) ingasetshenziswa futhi ngalesi sikhathi ukubheka ngaphakathi emthanjeni.
Yiziphi izindlela zokwelapha?
Ukwelashwa kuncike ekutheni izimpawu zakho zithinta kangakanani impilo yakho yansuku zonke. Abanye abantu bayalulama ngokwelashwa okulula nangokuhamba kwesikhathi. Abanye bangadinga ukuhlinzwa.
Ukuqapha nokulawula izimpawu
Uma izimpawu zakho zingezimbi kakhulu, udokotela wakho angase akuncome ukuthi ulinde uqaphile. Ikakhulukazi ezinganeni ezincane, lesi simo cishe sizothuthuka ngokwaso njengoba umzimba ukhula. Phakathi nalesi sikhathi:
- Ama-painkiller (isib. i-paracetamol) angasetshenziswa.
- Eminye imithi esiza izinso (isib. i-ACE inhibitors) inganikezwa.
- Uma ukwehla kwesisindo kuyimbangela, ungase welulekwe ukuthi ukhuluphale.
- Lesi simo siqashwa njalo ngokuskena noma ukuhlolwa komchamo.
Ukuhlinzwa nezinye izindlela
Uma izimpawu zingathuthuki noma ziphazamisa kakhulu impilo yakho yansuku zonke, kungadingeka ucabangele ukuhlinzwa. Inketho engcono kakhulu kuwe izoncika eminyakeni yakho, impilo, kanye nohlobo lwezimpawu zakho.
- Ukuguqulwa kwemithambo yezinso: Lokhu kuhilela ukususa umthambo ovalekile bese uwuxhumanisa kabusha endaweni enesikhala esikhulu. Lokhu ukuhlinzwa okuvamile nokuphumelelayo kakhulu.
- Ukubopha: Ipayipi elincane eline-mesh (i-stent) lifakwa ngaphakathi komthambo ovalekile ukuze lihlale livulekile. Kodwa-ke, lokhu akuyona inketho engcono kakhulu kubantu abasha, njengoba la ma-stent engapheli.
- Ukufakwa kwemithambo ye-gonadal: Lokhu kusetshenziselwa ukwelapha imithambo evuvukele ethanjeni. Kuvimba ukugeleza kwegazi kuleyo mithambo. Lokhu kungaba usizo uma ubuhlungu be-pelvic buyinkinga eyinhloko.
- Ukufakelwa kwezinso ngokuzenzakalelayo: Inso yonke iyasuswa bese itshalwa kwenye indawo efanele emzimbeni. Lokhu kwenziwa kuphela uma konke okunye kwehluleka.
Umlayezo Wokuya Nawe Ekhaya
- I-Nutcracker Syndrome yisimo esingavamile esibangelwa ukucindezelwa komthambo osezinso zesobunxele.
- Izimpawu eziyinhloko ubuhlungu bomhlane/besisu obuvela ohlangothini lwesobunxele kanye negazi emchameni.
- Lokhu kuvame ukubonakala kubantu abasebasha, abancane futhi kungase kuphulukise ngokwako njengoba umzimba ukhula.
- Ungazinaki izimpawu. Uma ziqhubeka noma ziba zimbi kakhulu, qiniseka ukuthi ufuna iseluleko sezokwelapha.
- Izinketho zokwelapha zisukela ekubhekweni kuya ekuhlinzweni, futhi zinqunywa udokotela wakho ngokusekelwe esimweni sakho.
I-Nutcracker Syndrome, Ubuhlungu bezinso, Igazi emchameni, Ubuhlungu be-flank, i-Hematuria, Ubuhlungu be-left side
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