Uzizwa sengathi umthambo wakho wezinso wesobunxele uyaqina? Kubizwa ngokuthi i-Nutcracker Syndrome! Ake sixoxe ngakho.

Wake waba nobuhlungu ohlangothini lwakho lwesobunxele lwesisu sakho noma ezimbanjeni zakho? Noma wake waphawula igazi emchameni wakho? Ngezinye izikhathi lezi zinto zinganakwa. Kodwa-ke, zingaba yizimpawu zesimo esidinga ukunakwa okuthile. Esinye isimo esinjalo, okungakhulunywa ngaso kakhulu, kodwa okubalulekile ukwazi ngaso, sibizwa ngokuthi i-Nutcracker Syndrome. Namuhla, sizokhuluma ngaso ngokuningiliziwe nangokulula.

Iyini i-Nutcracker Syndrome? Kwenzekani ngempela?

Kalula nje, i-Nutcracker Syndrome yisimo lapho umthambo wegazi omkhulu osuka ezinso zakho zesobunxele (obizwa nangokuthi "umthambo wezinso wesobunxele"`) uvaleka khona. Lo mthambo wegazi yiwona othwala igazi elihlanziwe lisuka ezinso zakho zesobunxele ulibuyisele enhliziyweni yakho. Ngakho-ke, lapho lo mthambo uvaleka, ukuhamba kwegazi kuyavaleka.

Cabanga nje, lo mthambo wegazi ovela ezinso zakho zesobunxele, kufanele uye enhliziyweni ngemithambo yegazi emibili emikhulu ngaphakathi esiswini sethu. Omunye umthambo omkhulu esiswini sethu, okuyi-"abdominal aorta". Omunye "umthambo we-mesenteric ophakeme kakhulu". Ngokuvamile, umthambo wezinso ungadlula kule mithambo emibili ngaphandle kokuvinjelwa.

Kodwa-ke, kumuntu onesifo se-nutcracker, leyo mithambo emibili emikhulu ihlangana njengemilomo emibili ye-nutcracker, icindezela umthambo wezinso . Njengentonga eqhekeka ngentonga. Yingakho ibizwa ngokuthi "i-nutcracker." Uma iqina, umfutho wegazi uyanda ngaphakathi komthambo wezinso, futhi igazi liqala ukugeleza emuva. Lokhu kungabangela nemithambo yegazi emincane eyizungezile ukuthi ivuvuke.

Kunezinhlobo ezimbili eziyinhloko kuye ngokuthi lokhu kuqina kwenzeka kanjani:

• I-Anterior Nutcracker Syndrome: Lolu uhlobo oluvame kakhulu. Luvela lapho umthambo wezinso ucindezelwa phambi kwe-aorta yesisu, okusho ukuthi ngaphambili kwesisu.
• I-Posterior Nutcracker Syndrome: Lokhu kuyinto engavamile. Lapha, umthambo wezinso ucindezelwa ngemuva kwe-aorta yesisu, lapho udlula khona phakathi komgogodla ne-aorta.

Kunezinye izindlela ezingavamile, kodwa akudingeki sikhulume ngazo kakhulu.

Umehluko phakathi kwe-Nutcracker Phenomenon kanye ne-Nutcracker Syndrome

Ungadideki lokhu kokubili. Isenzakalo se-Nutcracker siwukuthi kukhona ukuncishiswa komthambo wezinso, kodwa kungabikho zimpawu. Ngezinye izikhathi sitholakala ngengozi ngesikhathi sokuhlolwa kwesinye isimo.

Kodwa-ke, i-Nutcracker Syndrome yilapho, ngaphezu kokuqina, uthola nezimpawu. Okusho ukuthi, uzizwa ungakhululekile ngenxa yalokhu kuqina. Yilapho-ke kudingeka ukwelashwa.

Kungani lokhu kubizwa ngokuthi "i-Nutcracker"?

Njengoba ngishilo ngaphambili, ngo-1937, umcwaningi wezokwelapha wachaza lesi simo njengemithambo emibili emikhulu esiswini "njengemihlathi emibili yenkawu" ebamba umthambo wezinso. Wathi futhi "sifana nebhanana elichotshozwa yinkawu." Yingakho sibizwa kanjalo. Igama lezokwelapha elisemthethweni lalokhu yi -'left renal vein entrapment syndrome .'

Ubani othinteka kakhulu yilesi simo? Sivame kangakanani?

I-Nutcracker syndrome ingathinta izingane kanye nabantu abadala abaneminyaka engu-60. Kodwa-ke, ucwaningo oluthile lubonisa ukuthi ivame kakhulu kubantu abaseminyakeni yabo yamashumi amabili, amashumi amabili, namashumi amathathu . Ivame kakhulu nakubantu abane-body mass index (BMI) ephansi, okusho ukuthi bancane .

Lokhu kubhekwa njengesimo esingavamile , kodwa akukho datha yokuthi bangaki abantu abanaso.

Iyini ingozi ye-Nutcracker Syndrome? Ingabe zikhona izinkinga?

Ngezinye izikhathi lokhu akubanga zimpawu ezinkulu futhi kungaxazululeka ngokwakho, ikakhulukazi ezinganeni. Kodwa-ke, uma kungelashwa, kungaholela ezinkingeni ngokuhamba kwesikhathi. Lokhu kufaka phakathi:

• Amahlule egazi akheka ngaphakathi komthambo wezinso.
• Ukulimala kwezinso kwenzeka ngenxa yokucindezela okukhulu emithanjeni yezinso ngokuhamba kwesikhathi.
• Amadoda angaba nokungabi nabantwana kwabesilisa noma abesifazane bangaba nokungabi nabantwana kwabesifazane .
• Ubuhlungu obukhulu obungathinta impilo yakho bungenzeka.

Okubalulekile: Akuwona wonke umuntu ozobhekana nalezi zinkinga. Kodwa-ke, uma unezimpawu, kungcono ukubona udokotela ngokushesha ukuze uthole iseluleko.

Ziyini izimpawu? Lokho ongase ukuzwe kanye nalokho udokotela wakho angase akuthole

Kunezimpawu eziningana ze-nutcracker syndrome. Izinto ongase uzibone zifaka:

• Igazi emchameni (hematuria): Lolu uphawu oluvame kakhulu. Umchamo ungaba nombala opinki, obomvu, noma onsundu.
• Ukuzizwa unesizungu lapho umi (i-orthostatic hypotension): Lokhu kusho ukuthi uma usukuma ngokuzumayo, amehlo akho aba luhlaza okwesibhakabhaka futhi uzizwa unesiyezi.
• Ubuhlungu ohlangothini lwesobunxele: Ubuhlungu bungase buvele ohlangothini lwesobunxele, ngemuva nje kwezimbambo.

Lezi zimpawu zingase zihluke kancane kuye ngobulili.

Kwabesilisa: Kungase kube nesimo esibizwa ngokuthi i-varicocele , okuwukuvuvukala kwemithambo yegazi emasendeni.

Abesifazane bangase babe nezimpawu ze-pelvic congestion syndrome, ezibangelwa ukugeleza kwegazi endaweni ye-pelvic. Lokhu kufaka phakathi:

• Ubuhlungu ngesikhathi socansi (i-dyspareunia).
• Ubuhlungu lapho uchama (i-dysuria).
• Ubuhlungu esiswini esingezansi, okungukuthi, endaweni ye-pelvic (ubuhlungu be-pelvic).

Ngaphezu kwalokhu, kukhona nezimpawu udokotela angazibona ngokuhlolwa. Awukwazi ukuzibona.

• Ukuntuleka kwamaseli abomvu egazini, okungukuthi , i-anemia .
• I-Microhematuria ukuba khona kwegazi emchameni elincane kangangokuthi lingabonakala kuphela ngaphansi kwe-microscope.
• I-Proteinuria ukuba khona kwamaprotheni amaningi kakhulu emchameni.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Imbangela eyinhloko ye-Nutcracker Syndrome izinguquko esakhiweni semithambo yegazi yakho . Ngezinye izikhathi lezi zinguquko zenzeka usesesibelethweni sikamama wakho, lapho imithambo yegazi yakho yakheka. Ngezinye izikhathi, kungenzeka ngesikhathi sokwanda kokuphakama okungazelelwe (ukukhula okusheshayo) ebusheni, noma ukwehla kwesisindo ngokuzumayo ebudaleni (ukwehla kwesisindo). Kwezinye izimo, akukho sizathu esingatholakala .

Ukubona kanjani lokhu ngqo? Yiziphi izivivinyo ezenziwayo?

Kungathatha isikhathi ukuxilonga i-Nutcracker Syndrome, ngoba odokotela kudingeka basuse ezinye izimo eziningi. Ukuxilonga kuvame ukuqala ngokuhlolwa ngokomzimba . Udokotela wakho uzokubuza ngezimpawu zakho futhi akubuze ngezimpawu zakho. Ngemuva kwalokho, bangase bakucele ukuhlolwa okukodwa noma ngaphezulu kwalokhu okulandelayo ukuze bathole okwengeziwe:

• Ukuhlolwa kwegazi
• Iskeni se-CT (i-CT scan - Iskeni se-Computed Tomography)
• Ukuhlolwa kwe-Doppler ultrasound `(i-Doppler ultrasound)`
• I-ultrasound yemithambo yegazi (IVUS)
• Ukuskena kwe-MRI (i-MRI - Ukuskena kwe-Magnetic Resonance Imaging)
• I-Venogram (ukuthatha i-X-ray yemithambo yegazi ngemva kokujova idayi)
• Ukuhlolwa komchamo

Yiziphi izindlela zokwelapha i-Nutcracker Syndrome?

Ukwelashwa kuncike eminyakeni yakho kanye nobunzima bezimpawu zakho. Kuye ngesimo sakho, udokotela wakho angase aqale ngemithi yokwelapha enganamandla kakhulu . Uma lokhu kungasizi, noma uma izimpawu zakho ziba zimbi kakhulu, ungase udinge ukuhlinzwa.

Ukuphathwa Kokugcina

Kubantu abaningi, ikakhulukazi izingane ezingaphansi kweminyaka engu-18 , lesi yisinyathelo sokuqala sokulawula isisindo sengane yakho. Uma ingane yakho ine-nutcracker syndrome, udokotela wakho angase ancome ukuthi iqhubeke nale ndlela kuze kube yiminyaka emibili. Lokhu kuhilela ukusiza ingane yakho ukuthi ithole isisindo ngenkathi iqapha isimo. Njengoba isisindo sikhula esiswini, ingcindezi emthanjeni wezinso iyancipha. Abantu abadala bayelulekwa ukuba bazame le ndlela cishe izinyanga eziyisithupha.

Lokhu kuphathwa okuvamile kungafaka nemithi esiza izinso ukuthi zisebenze. Isibonelo:

• Izithibi ze-ACE
• I-aspirini

Ukungenelela Kokuhlinzwa

Uma unezimpawu ezinzima futhi ukwelashwa okuvamile kungasebenzi, ungadinga ukuhlinzwa noma inqubo engadingi ukungenelela okukhulu . Udokotela wakho uzokhuluma nawe ngezinketho zakho, izinzuzo nezingozi, nokuthi ngabe izinqubo ezingadingi ukungenelela okukhulu zikulungele yini.

Umgomo oyinhloko wokuhlinzwa ukudala indlela ebushelelezi nengavimbelwe yokuthi igazi ligeleze lisuka ezinso liye enhliziyweni.

Ezinye zezinqubo zokuhlinzwa kanye nezinqubo ezenziwayo ze-Nutcracker Syndrome yilezi:

• Ukuguqulwa kwemithambo yezinso: Lokhu kuhilela ukususa umthambo wakho wezinso wesobunxele bese uwunamathisela kabusha emthanjeni omkhulu obizwa ngokuthi i-inferior vena cava. Lokhu kuqeda isidingo sokudlula emthanjeni we-mesenteric ophakeme kanye ne-aorta. Lokhu kungenziwa nge-laparoscopically , okusho ukuthi ngokusika okuncane okumbalwa.
• Ukufakwa kwe-stent: Lokhu kuhilela ukufaka ithubhu elincane elibizwa ngokuthi i-stent emthanjeni wezinso ovinjiwe ngembobo encane esikhumbeni. Leli thubhu livula umthambo futhi livumele igazi ukuthi ligeleze ngokukhululeka.
• Ukuhlinzwa kokufakelwa kwezinso ngokuzenzakalelayo: Kulokhu, izinso zakho zesobunxele ziyasuswa bese ziphinde zifakwe emzimbeni wakho, ethanjeni lesinqe.

Ingabe lokhu kuhlinzwa kuyingozi?

Ukuhlinzwa ngakunye kwe-Nutcracker Syndrome kunengozi ethile. Khuluma nodokotela wakho ngokucophelela ngezingozi zokuhlinzwa ozokwenza.

Ukufakelwa kwezinso ngokuzenzakalelayo yikona okuhlasela kakhulu kulokhu kuhlinzwa. Izinkinga zako eziyinhloko ukwehluleka kwezinso nokopha. Ingozi yezinkinga ingancishiswa ngokuthola ukwelashwa esibhedlela esikhulu esinodokotela abanolwazi abenza njalo ukuhlinzwa okunjalo .

Ingabe ikhona indlela yokunciphisa lokhu kwenzeka?

Eqinisweni, ayikho indlela eyaziwayo yokunciphisa ingozi yokuthola lesi simo. I-Nutcracker syndrome ikhula cishe ngokushesha, futhi ayizuzisi njengefa.

Kodwa-ke, odokotela ngezinye izikhathi bathola ukuthi lesi simo se-nutcracker (i-renal vein stenosis engabonakali) ngengozi ngesikhathi sokuhlolwa okwenziwe ngezinye izizathu. Ngakho-ke, kubaluleke kakhulu ukuhambisana nokuhlolwa kwakho kwezokwelapha kanye nokuqokwa emtholampilo. Ngemuva kwalokho, ungathola ukuthi une-renal vein stenosis ngaphambi kokuba ube nezimpawu. Ngemuva kwalokho, uzokwazi ukuthi udinga ukufuna ukwelashwa ngokushesha uma kuvela izimpawu.

Lizobaphatheleni ikusasa abantu abane-Nutcracker Syndrome?

Ezinganeni, umphumela uvame ukuba muhle kakhulu. Izingane eziningi ziyalulama ngaphandle kokwelashwa okukhulu, njengokuhlinzwa. Kubantu abadala, umphumela uyahlukahluka kuye ngokuthi izimpawu zibucayi kangakanani kanye nesikhathi esithathayo ukuqala ukwelashwa. Khuluma nodokotela wakho ngesimo sakho.

Kufanele ngimbone nini udokotela? Yimiphi imibuzo okufanele ngiyibuze?

Uma unezimpawu ze-nutcracker syndrome, noma uma izimpawu zakho ziba zimbi kakhulu , qiniseka ukuthi ubona udokotela.

Uma uhlinzwa, landela imiyalelo kadokotela wakho ngokucophelela mayelana nendlela yokuzinakekela ekhaya. Futhi, qiniseka ukuthi uya kuma-aphoyintimenti okulandelela .

Uma udokotela wakho ekutshela ukuthi une-Nutcracker Syndrome, ungase ube nemibuzo eminingi. Kubalulekile ukufunda okuningi ngangokunokwenzeka mayelana nezinketho zakho zokwelashwa kanye nesikhathi esingcono kakhulu sokufuna ukwelashwa. Nansi eminye imibuzo ongayibuza:

• Lesi simo sithinta kanjani umzimba wami?
• Isimo sami sibi kangakanani?
• Ingabe ngidinga ukwelashwa? Uma kunjalo, nini?
• Iyiphi indlela yokwelapha engcono kakhulu kimi?
• Lingakanani izinga lempumelelo yalokhu kwelashwa?
• Ziyini izingozi zokwelashwa?
• Kuzothatha isikhathi esingakanani ukuphulukiswa?

Abanye abantu abane-nutcracker syndrome bangase babe nezinye izinkinga zemithambo yegazi. Khuluma nodokotela wakho nganoma yiziphi ezinye izimo onazo nokuthi ungazisingatha kanjani.

Uma usunezimpawu isikhathi eside kodwa ungayazi imbangela, kungaba impumuzo ekugcineni ukuthola ukuxilongwa. Kodwa kungaba yinto eyesabekayo ukucabanga ngezindlela zokwelapha nokuthi uzodinga ukuhlinzwa yini. Izindaba ezinhle ukuthi abacwaningi bahlala befunda kabanzi ngalesi simo nokuthi bangasiphatha kanjani ngezindlela ezingangenisi kakhulu. Khuluma nodokotela wakho mayelana nohlelo lokwelashwa olungcono kakhulu kuwe nokuthi yini ongayilindela esikhathini esizayo.

Okokugcina, amaphuzu abalulekile (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho-ke sesikhulume kakhulu nge-Nutcracker Syndrome. Nazi ezinye zezinto ezibaluleke kakhulu okufanele uzikhumbule:

• Lesi yisimo esibangelwa ukuvaleka komthambo wegazi ezinso zesobunxele .
• Uma ubona izimpawu ezifana negazi emchameni wakho noma ubuhlungu ohlangothini lwakho lwesobunxele, bona udokotela.
• Izingane zivame ukululama zodwa .
• Kunezindlela ezahlukene zokwelapha abantu abadala, ngisho nokuhlinzwa, kuye ngezimpawu.
• Ungesabi, kodwa kubalulekile ukwaziswa. Khuluma nodokotela wakho ngokukhululekile bese ukhetha ukwelashwa okufanele wena.

Ngithemba ukuthi lolu lwazi luwusizo. Hlala uphilile!

I- Nutcracker syndrome, isifo sezinso, umthambo wezinso wesobunxele, i-stenosis yemithambo yegazi, igazi emchameni, ubuhlungu besisu, ukuhlinzwa