Ingabe lokhu kuyimbangela yobuhlungu emilenzeni yakho? Ake sifunde nge-Popliteal Artery Entrapment Syndrome (PAES)!

Ingabe uzizwa ubuhlungu, ukuqina, noma isisindo emilenzeni yakho, ikakhulukazi endaweni yethole, lapho uzivocavoca, ugijima, noma uhamba ngokushesha? Ingabe kuyaphela ngemva kwesikhashana, kodwa ingabe kuyabuya uma uqala ukuzivocavoca futhi? Khona-ke kubaluleke kakhulu ukuthi uqaphele lesi simo esibizwa ngokuthi i-popliteal artery entrapment syndrome. Ungakhathazeki, ake sixoxe ngakho kalula.

Iyini i-popliteal artery entrapment syndrome (PAES)?

Kalula nje, i-Popliteal Artery Entrapment Syndrome (PAES) iyisifo esingavamile semithambo yegazi. Sithinta kakhulu abantu abasebasha, abakhuthele, ikakhulukazi labo abadlala imidlalo. I-popliteal artery iyisitho esikhulu segazi esigijima sisuka ethangeni siye embotsheni ngemuva kwamadolo ethu. Lo mthambo ucindezelwa umsipha ongemuva kwedolo, okuyikho okwenzeka kulesi simo.

Cabanga ngakho njengepayipi lamanzi. Linikeza igazi emlenzeni ongezansi. Manje, lo mthambo ungancipha ngenxa yoshintsho endleleni imisipha yethu ye-gastrocnemius enamathela ngayo ethanjeni lethanga. Ikakhulukazi uma sigoba unyawo lwethu (lokhu kubizwa ngokuthi "ukujiya kwe-plantar" ngokwezokwelapha), lo mthambo we-gastrocnemius uyancipha. Khona-ke lowo mthambo uyancipha kakhulu.

Uma uzivocavoca, umthambo uqhutshelwa njalo, okubangela ukuba uqhekeke. Kwenzekani-ke? Inani legazi eliya emlenzeni liyancipha. Lokhu kubangela ukuthi izinto ezifana ne -lactic acid kanye ne-carbon dioxide ziqongelelane emisipheni nasezinzwa. Yingakho uzizwa usinda, ubuhlungu, ukukhathala, futhi ngezinye izikhathi uzizwe ungenamizwa emilenzeni nasezinyaweni zakho.

Izindaba ezinhle ukuthi lezi zimpawu zivame ukuphela zingakapheli imizuzu emithathu kuya kwemihlanu yokuyeka ukuvivinya umzimba. Kodwa-ke, uma zingalashwa, ngokuhamba kwesikhathi, lezi zimpawu zingaba zimbi kakhulu futhi zihlale isikhathi eside. Lokhu kusho ukuthi uzoqala ukuzwa ubuhlungu ngisho nangemva kokugijima ibanga elifushane, futhi kuzothatha isikhathi eside ukululama.

Ubani othinteka kakhulu yilesi simo se-PAES?

Lesi simo, esibizwa ngokuthi i-PAES, sivame ukuthinta abasubathi abasebasha abaneminyaka ephakathi kwengu-15 no-25. Le ngozi iphezulu kakhulu kulabo abahlanganyela emidlalweni ehilela ukugijima. Isibonelo:

• Umjaho (Ithrekhi)
• Ukugijima ngokunqamula izintaba
• Ibhola Lezinyawo
• I-Lacrosse
• I-hockey yasensimini

Cabanga ngengane ehlanganyela emicimbini yokugijima nenkundla yesikole, noma insizwa edlala ibhola. Banamathuba amaningi okuba nalesi simo ngoba basebenzisa imilenze yabo njalo.

Ivame kangakanani i-PAES?

I-PAES empeleni iyisimo esingavamile kakhulu . Kulinganiselwa ukuthi bangaphansi kuka-1% abantu abanaso. Ngakho-ke kunzima ukusho ukuthi bangaki abantu abanaso.

Zikhona yini ezinye izimo ezibonisa izimpawu ezifana neze-PAES?

Yebo, ikhona. I-Chronic Exertional Compartment Syndrome (CECS) iyisimo esivame kakhulu semisipha nezinzwa kune-PAES, futhi sibangelwa nokuzivocavoca. Singabangela nobuhlungu nokuvuvukala emisipheni yemilenze (futhi ngezinye izikhathi ezingalweni). Nakuba i-CECS ingathinta noma ubani, ivame kakhulu kubagijimi abasebasha kanye nalabo abadlala imidlalo ehilela ukuthintana njalo.

Ngezinye izikhathi, umuntu one-PAES angaba ne-CECS. Kutholakale ukuthi cishe abantu abangu-5% abangazange belashwe yi-PAES nabo bane-CECS. Ngakho-ke kubalulekile ukukhumbula ukuthi zombili lezi zimo zingaba khona ngesikhathi esisodwa.

Uyini umehluko phakathi kwe-PAES ne-CECS?

Udokotela wakho uzokwenza izivivinyo ezahlukene ukuze ahlukanise phakathi kwalezi zimo ezimbili.

• Kuma-PAES: Umfutho wegazi ulinganiswa emlenzeni ngesikhathi uphumule bese uhlolwa ukuze kubonakale ukuthi uyancipha yini ngemva kokuzivocavoca.
• Ku-CECS: Ingcindezi ezingxenyeni ezine zemisipha emlenzeni ilinganiswa ngaphambi nangemva kokuzivocavoca. Ku-CECS, ingcindezi kulezi zingxenye iyanda ngendlela engavamile.

Kuzwakala kanjani ukuba ne-PAES?

Uma uzivocavoca, ungase ube nezimpawu ezinjengalezi endaweni yakho yezimbotshana kanye/noma emilenzeni:

• Ubuhlungu obufana ne-cramp
• Ukhathele
• Umuzwa osindayo
• Ukuqaqamba kwemisipha
• Ukuba ndikindiki
• Ukuvuvukala

Lezi zimpawu zivame ukuphela ngemva kwemizuzu emithathu kuya kwemihlanu yokuphumula. Kodwa-ke, njengoba sishilo ekuqaleni, uma zingelashwa, lezi zimpawu zingaphinde zibuye ngokuhamba kwesikhathi futhi zithathe isikhathi eside ukululama.

Yiziphi izimbangela ze-PAES?

Kunezindlela ezimbili ngokuyinhloko lokhu kushukuma okungenzeka ngazo:

1. Ukucindezelwa kwe-anatomic: Lokhu kubonakala cishe ku-10% wamacala. Kubonakala sengathi kwenzeka kakhulu kancane kwabesilisa. Cishe ku-70% wamacala, kwenzeka emlenzeni owodwa kuphela.

2. Ukucindezelwa okungekhona okwe-anatomic, ukusebenza noma ngokomzimba: Lokhu kwenzeka kaningi kwabesifazane. Ezimweni ezingaphezu kuka-90%, kungenzeka emilenzeni yomibili.

Ukucindezelwa kwe-anatomic

Lokhu kwenzeka ngoba ingxenye yemisipha yakho ye-gastrocnemius itholakala ngaphezu noma ngaphansi kwe-popliteal artery. Mhlawumbe i-tendinous band emisipheni ingalimaza i-artery. Lokhu kungenxa yokuthi:

• Kungase kuvele isilonda noma isilonda.
• Kungase kwakheke ihlule legazi.
• Ngokuhamba kwesikhathi, umthambo ungase uvaleke ngokuphelele (uvaleke) noma imithambo engaphansi kwawo ingase ivaleke.

Ngale ndlela, kunezindlela ezine ezahlukene lapho imisipha ibekwe khona maqondana nomthambo.

Ukucindezelwa okusebenzayo noma okungokomzimba

Kulesi simo, yonke imisipha yakho ibekwe ngendlela evamile. Kodwa-ke, imisipha ivame ukunamathela ngaphezu kwethambo lethanga, noma emseleni ongaphakathi kwedolo. Ngakho-ke uma ugoba unyawo lwakho phansi (i-plantar flexion), imisipha iyadonsa ngaphakathi bese icindezela umthambo.

Ngezinye izikhathi lokhu kucindezela kungabangelwa omunye umsipha (imisipha ye-popliteus) otholakala ngaphansi komthambo. Abacwaningi bathi lokhu kucindezela okusebenzayo akutholakalanga ukuthi kubangela umonakalo emthambo.

I-PAES ihlolwa kanjani?

Uchwepheshe wemithambo yegazi angaxilonga lesi simo. Uzokuhlola futhi ahlole ukwehla emlenzeni wakho kanye nokushaya kwenhliziyo kwe-popliteal. Bangase futhi bahlole ushintsho ekushaya kwenhliziyo yakho uma ushukumisa umlenze wakho phezulu naphansi ngokuthile.

Uma une-PAES, udokotela wakho angase:

• Ungakuzwa ukushaya kwenhliziyo yakho uma uphumule.
• Kodwa uma uzivocavoca, ukushaya kwenhliziyo yakho kungase kwehle uma ugoba noma uqondisa umlenze wakho.

Yiziphi izivivinyo ezenziwayo ukuhlola i-PAES?

Lezi zivivinyo zilinganisa ukuhamba kwegazi edolweni, emlenzeni, kanye nasezinyaweni. Lezi zivivinyo zezithombe zingabonisa okulandelayo:

• Ingabe umthambo ujwayelekile?
• Ukuthi kuzokwenzeka yini ukulimala kwemithambo yegazi.
• Ingabe kukhona amahlule egazi?
• Ingabe umthambo uvuvukele (i-aneurysm - umthambo wegazi omkhulu ngo-50% kunojwayelekile).
• Ingabe imisipha iyawucindezela umthambo?

Ezinye zezivivinyo ezenziwe ngalokhu yilezi:

• Inkomba ye-ankle-brachial kanye nokuzivocavoca: Lokhu kulinganisa umfutho wegazi ezingalweni zakho nasemilenzeni ngaphambi nangemva kokuzivocavoca. Ngokuvamile, umfutho wegazi ezingalweni zakho nasemilenzeni yakho uyafana, futhi womabili ayanda ngesikhathi sokuzivocavoca. Kodwa-ke, uma imithambo yakho iqina ngenkathi ugijima, umfutho wegazi lakho emilenzeni yakho ngemva kokuzivocavoca ungehla ngamaphesenti angaphezu kuka-90 omfutho wegazi lakho ezingalweni zakho.
• I-Duplex ultrasound ye-popliteal artery ene-plantar flexion: Lokhu kusebenzisa amaza omsindo ukudala isithombe se-artery nokukala ukugeleza kwegazi. Lokhu kuvumela udokotela wakho ukubona ukuthi imithambo esemlenzeni wakho izizwa kanjani lapho umlenze wakho ugobile futhi uphumule, nokubona ukuthi kukhona yini ukuqaqamba kwemisipha.
• I-computed tomographic angiography (CTA) ene-plantar flexion: Lolu futhi uhlobo lwe-CT scan. Idayi ekhethekile isetshenziselwa ukubheka isimo semithambo yegazi emlenzeni nokubona ukuthi kukhona yini ukuqaqamba kwemisipha lapho umlenze ugobile futhi uphumule.
• I-Magnetic resonance angiography (MRA) ene-plantar flexion: Lolu vivinyo lusebenzisa insimu yamagnetic kanye namagagasi omsakazo ukubheka isimo semithambo emlenzeni nokubona ukuthi kukhona yini ukuqaqamba kwemisipha lapho umlenze ugobile futhi uphumule.

Iphathwa kanjani i-PAES?

Udokotela wakho angase ahlinze.Bese ususa ingxenye encane yemisipha ye-gastrocnemius kanye ne-popliteus. Lokhu kuzonciphisa ingcindezi emthanjeni futhi kuvumele igazi ligeleze ngendlela evamile liye emlenzeni.

Lokhu kuhlinzwa kuvame ukuthatha cishe ihora. Kwenziwa ngaphansi kwe-anesthesia ejwayelekile.

Ngezinye izikhathi, ezimweni ezimbi kakhulu lapho umthambo womthambo ulimele futhi uvalekile ngenxa yokubhajwa kwe-anatomical popliteal, udokotela ohlinzayo angadinga ukuhlanza umthambo womthambo, awulungise, noma adale indlela entsha ezungeze ukuvaleka (ukudlula).

Ukuhlinzwa kuyindlela yokwelapha ephumelela kakhulu ye-PAES, njengoba kuyinqubo ephumelela kakhulu kubantu abaningi. Abantu abangaphezu kuka-90% abahlinzwa bathola ukuthuthuka okukhulu ezimpawini zabo.

Kulabo abane-PAES esebenzayo, inketho yokwelashwa okungeyona eyokuhlinzwa yi -Botulinum toxin A. Ngaphansi kwesiqondiso se-CT noma se-ultrasound, udokotela ufaka i-'Botox®' noma i-'Dysport®' emisipheni ebangela ukudikiza. Lokhu kukhubaza imisipha okwesikhashana. Ithemba liwukuthi imisipha izobe isifinyela unomphela.

Kodwa lokhu kuhlala izinyanga ezintathu kuya kweziyisithupha kuphela. Uma imisipha inganciphi, izimpawu zingabuya. Lokhu kwelashwa kuphumelele kubantu abangaphansi kuka-60% ngemva konyaka wokwelashwa.

Kuthatha isikhathi esingakanani ukululama ngemva kwalokhu kwelashwa?

Kungathatha izinyanga ezine kuya kweziyisithupha ukululama ngokuphelele ngemva kokuhlinzwa.

Ngemva kokuhlinzwa, kuzodingeka uhlale esibhedlela ubusuku bonke. Ngemuva kwalokho, kuzodingeka wenze ukwelashwa ngokomzimba (njengokuzivocavoca umzimba) amasonto amabili okuqala. Ngemva kwamasonto amabili, kuzodingeka wenze ukuzivocavoca kwamandla nokulungisa umzimba kuze kube yilapho usuphulukisiwe ngokuphelele.

Kwenzekani kumuntu one-PAES?

Uma une-functional popliteal entraption futhi ubuhlungu bomlenze wakho ngesikhathi sokuzivocavoca bungebukhulu, ungase ufune ukunciphisa ukuzivocavoca kwakho. Udokotela wakho angaqapha isimo sakho.

Kodwa-ke, njengoba sesishilo ngaphambili, ukuhlinzwa kuphumelele ngaphezu kuka-90%, futhi ingozi yokuphinda kwenzeke iphansi. Iningi labadlali libuyela emisebenzini yalo evamile ngemva kokuhlinzwa.

Uma kukhona ukuboshwa kwezicubu zomzimba, odokotela batusa ukuthi kususwe izicubu zemisipha ezingavamile ngokuhlinzwa. Lokhu kungenxa yokuthi, uma kungenziwa, umthambo ungalimala ngokuhamba kwesikhathi. Uma uphuza ukwelashwa futhi une-PAES yesakhiwo eyonakalise umthambo we-popliteal, ungase ube nobuhlungu obuqhubekayo emlenzeni uma uhamba. Ezimweni ezingavamile, umlenze ungadinga ukunqunywa. Kodwa lokho akuvamile kakhulu .

Kufanele ngiphinde ngimbone nini udokotela?

Ngemva kokuhlinzwa, kuzodingeka ubone udokotela:

• Ngenyanga.
• Ezinyangeni eziyisithupha.
• Ezinyangeni eziyishumi nambili.

Kule mihlangano:

• Kuzohlolwa nge-ultrasound yomthambo wakho olungisiwe.
• Bahlola umfutho wegazi emilenzeni yakho.

Uma umthambo wakho wemithambo usubuyele esimweni esijwayelekile, ngeke kudingeke ama-aphoyintimenti engeziwe ngaphandle kokuthi izimpawu zibuye noma udinga ukuhlinzwa kwemithambo yemithambo.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

• Ingabe ngine-PAES yokwakheka komzimba noma i-PAES esebenzayo?
• Ingabe ungincoma ukuhlinzwa ngenxa yesimo sami?

Uma usemncane futhi unesihlungu emilenzeni, qiniseka ukuthi ubona udokotela. Kungaba nezimbangela eziningana zalobu buhlungu. Uma uthola ngokushesha ukuxilongwa okunembile, kulapho ungaqala khona ukwelashwa ngokushesha. Uma une-popliteal artery entrapment syndrome, khuluma nodokotela wakho mayelana nokuthi ukuhlinzwa kuyindlela enhle yini kuwe. Lokhu kube ukwelashwa okuphumelelayo ezimweni eziningi.

Izinto ezibaluleke kakhulu okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, ake sifingqe ezinye zezinto okudingeka uzikhumbule kulokho esikhulume ngakho:

• I-PAES yisimo lapho umthambo oyinhloko ngemuva kwedolo, umsipha, uncipha futhi unciphise ukugeleza kwegazi emlenzeni.
• Lokhu kuthinta kakhulu abasubathi abasebasha , ikakhulukazi labo abagijimayo.
• Uma uzwa izimpawu ezifana nobuhlungu, ukusinda, noma ukuqaqamba endaweni yesisu ngesikhathi sokuzivocavoca, kodwa ziyancipha uma uphumula, ungase ube ne-PAES.
• Kukhona nesimo esibizwa ngokuthi i-CECS esinezimpawu ezifanayo, ngakho-ke ukuxilongwa okunembile kubalulekile.
• Lesi sifo singaqinisekiswa ngokuba nochwepheshe ozokuhlola (njenge-'Ankle-brachial index', i-'Duplex ultrasound', i-'CTA', i-'MRA').
• Ukuhlinzwa ngokuvamile kuyindlela yokwelapha ephumelela kakhulu . Abanye abantu banikezwa imijovo ye-`(i-Botulinum toxin A)`.
• Uma ingelashwa, ngokuhamba kwesikhathi, umthambo ungalimala futhi isimo singaba sibi kakhulu.
• Ngakho-ke, uma unalezi zimpawu, kubaluleke kakhulu ukufuna iseluleko sezokwelapha ngokushesha.

Ungakhathazeki, uma ubona lesi simo, kunezindlela zokwelapha ezinhle. Into eyinhloko ukubona udokotela ngokushesha, ngaphandle kokuziba izimpawu. Khona-ke ungaba nempilo futhi usebenze futhi!

I- popliteal artery entrapment syndrome, i-PAES, ubuhlungu bomlenze, ubuhlungu benqulu, ukuzivocavoca, abasubathi abasebasha, imithambo yegazi, i-popliteal artery