Ake sifunde nge-Subclavian Steal Syndrome - isifo "esintshontsha" igazi ebuchosheni!

Ingabe ngezinye izikhathi uzizwa unesiyezi noma ungaboni kahle? Noma uzizwa sengathi ingalo yakho iyaba ndikindiki noma indikindiki, ikakhulukazi uma wenza okuthile ngezandla zakho, uphakamisa into esindayo, noma uphendulela ikhanda lakho eceleni ngokuzumayo? Uma lokhu kwenzeka, kungaba yisimo esikhuluma ngaso namuhla esibizwa ngokuthi "i-Subclavian Steal Syndrome." Igama lingase lizwakale lingavamile, njengokuthi, "Ingabe lesi yisifo sokuntshontsha?" Ungakhathazeki, ake sixoxe ngaso kalula nangokucacile.

Iyini ngempela i-Subclavian Steal Syndrome?

Kalula nje, i-subclavian steal syndrome yilapho elinye igazi okufanele liye ebuchosheni bakho "lintshontsha" lingangeni lakho. Lokhu kwenzeka ngoba umthambo wegazi we-subclavian, umthambo wegazi omkhulu ohlinzeka ngegazi engalweni yakho (ngokuvamile ongohlangothini lwesobunxele), uvalekile noma unciphile.

Cabanga ngale ndlela. Uzama ukudla ipuleti lokudla. Kufana nomuntu oseduze kwakho "ophuza" ukudla okukodwa noma okubili ozama ukukudla. Elinye igazi elinomsoco okufanele liye ebuchosheni bakho "liphuza" esandleni sakho. Ngakho-ke inani legazi elingaya ebuchosheni bakho liyancipha, njengoba nje inani lokudla ongakudla lincipha.

Njengoba lo mthambo uvaleka kakhulu, igazi ligeleza ngemithambo ye-subclavian ngengcindezi ephansi. Kodwa-ke, umfutho wegazi kweminye imithambo eseduze uphakeme. Ngenxa yalokho, ukugeleza kwegazi emthanjeni we-vertebral, osuka emthanjeni we-subclavian bese uthwala igazi uye ebuchosheni, kuyahlehla. Bese elinye lalelo gazi lingena emthanjeni we-subclavian bese liya engalweni. Yilokho okubizwa ngokuthi "ukuntshontsha."

Kukhona esinye isimo esibizwa ngokuthi "i-coronary steal syndrome". Yilapho igazi okufanele liye emisipheni yenhliziyo livinjiwe. Lokhu akwenzeki kuwo wonke umuntu, kodwa kwenzeka kubantu abathile abaye bahlinzwa ngezinhlobo ezithile zenhliziyo (ukuhlinzwa kwe-coronary artery bypass). Imbangela eyinhloko yalezi zifo zombili ukunqwabelana kwamafutha ezindongeni zemithambo yegazi, noma "i-plaque", isimo esibizwa ngokuthi "i-atherosclerosis" ngokwezokwelapha. Noma kungase kube nezinye izizathu ezibangela ukuba umthambo we-subclavian unciphe.

Sivame kangakanani lesi simo?

Abacwaningi abakwazi ukusho ngqo ukuthi bangaki abantu abane-subclavian steal syndrome, kodwa balinganisela ukuthi phakathi kuka-0.6% no-6.4% wabantu bangase babe nayo. Ngaphezu kwalokho, cishe abantu abangu-18% abanesifo semithambo yegazi engaphandle nabo banayo le syndrome.

Lesi simo sivame kakhulu kwabesilisa nakubantu abaneminyaka engaphezu kwengu-55 .

Nokho, ngenxa yezindlela ezithuthukisiwe zokuthwebula izithombe ezitholakalayo namuhla, lesi simo sesibonakala kakhulu ngisho nakubantu abangenazo izimpawu.

Ziyini izimpawu ze-subclavian steel syndrome?

Izimpawu ze-subclavian steel syndrome zivame ukuvela uma wenza umsebenzi onzima wezandla noma ngokuzumayo uphendula ikhanda lakho eceleni.Bheka ukuthi unazo yini lezi zici:

• Umbono ofiphele
• Isiyezi
• Ubuhlungu, ukungazweli, ukuqaqamba, noma umuzwa wokusinda esandleni
• Ukuquleka
• Ukulahlekelwa ukuzwa (okungavamile)
• Ukuzizwa sengathi uyazungeza (i-Vertigo)
• I-Ataxia yisimo lapho umzimba ulahlekelwa khona ibhalansi yawo futhi ungakwazi ukuhamba kahle.

Kodwa abantu abaningi abanazo izimpawu. Lokho kungenxa yokuthi ubuchopho babo buthola igazi elanele elivela kweminye imithambo enempilo. Abadingi ukwelashwa.

Yini ebangela i-subclavian steel syndrome?

Kunezizathu ezimbalwa eziyinhloko zalokhu:

• I-atherosclerosis - Lesi yimbangela evame kakhulu.
• Ukukhubazeka kwemithambo yegazi (ukuxhumana okungajwayelekile phakathi kwemithambo yegazi nemithambo yegazi)
• Ukusikwa kwe-aorta
• I-arteritis kaTakayasu, isimo sokuvuvukala kwemithambo yegazi
• I-Fibromuscular dysplasia ukukhula okungavamile kwezindonga zemithambo yegazi.

Lezi zimbangela zifana nalezo ezibangela i-subclavian artery stenosis.

Ubani osengozini enkulu yalokhu?

Nazi ezinye izici ezandisa ingozi yokuthola i-subclavian steel syndrome:

• Uma uke wahlinzwa ukuze kulungiswe ukuncishiswa kwe-aorta (ukuhlangana kwe-aorta).
• Uma kukhona izinkinga nge-aorta arch noma eminye yemithambo yegazi kusukela ekuzalweni.
• Ukucindezelwa komthambo we-subclavian (lokhu kuvamile kwabanye abasubathi).
• Uma kukhona ubambo olwengeziwe (ubambo lomlomo wesibeletho) endaweni yentamo.

Yiziphi izinkinga ezingavela kulesi simo?

Uma uneziphene zokuquleka ngenxa ye-subclavian steal syndrome, kungaholela ekuweni nasekulimaleni. Kungenza kube nzima nokwenza noma yimuphi umsebenzi ngengalo ethintekile.

I-subclavian steel syndrome itholakala kanjani?

Into yokuqala udokotela ayenzayo ukuze axilonge lokhu ukwenza ukuhlolwa ngokomzimba. Udokotela uzonaka kakhulu ukushaya kwenhliziyo ezandleni nasezingalweni zakho. Uzohlola nemithambo ye-carotid ezinhlangothini zombili zentamo yakho kanye nomthambo we-subclavian, efuna noma yimiphi imisindo engavamile ethi "swoosh..." (izwi elizwakalayo). Uma uzwa umsindo onjalo nge-stethoscope, kungase kube nokuvaleka kulowo mthambo.

Yiziphi izimpawu ze-"Steele Syndrome" ezibonakala ngesikhathi sokuhlolwa kwezokwelapha?

Uma une-subclavian artery syndrome, udokotela wakho uzokala umfutho wegazi lakho kuzo zombili izingalo futhi abone umehluko ekufundweni. Umfutho wegazi engalweni eyodwa ungase ube ngaphezu kwamamilimitha angu-15 e-mercury (mmHg) kunenye.

Futhi, uma ama-radial pulse ehlolwa ngesikhathi esifanayo, i-pulse ohlangothini olune-subclavian steel syndrome ingase ibonakale ibuthakathaka futhi ingase izwakale sengathi i-thud.

Yiziphi izivivinyo ezenziwayo ukuqinisekisa lokhu?

Udokotela uzoqala ngokuthatha i-ultrasound yemithambo yakho ye-subclavian. Ngemva kwalokho, kungase kwenziwe izivivinyo ezilandelayo, njengoba kudingeka:

• Ukuhlolwa kwe-MRA (magnetic resonance angiogram).
• Ukuhlolwa kwe-CT Angiogram (CT - computed tomography angiogram).
• I-angiogram yokususa ngedijithali - Lena indlela ekhethekile esusa ezinye izingxenye zomzimba esithombeni futhi yimithambo yegazi kuphela engabonakala kahle.

Lezi zivivinyo zivumela odokotela ukuthi bahlukanise ubukhulu be-subclavian steel syndrome (encane noma enzima). Basebenzisa amamaki oku-1, oku-2, kanye no-III, kanti iBanga lesi-3 liyilona elinzima kakhulu. Ziphinde zisize ekunqumeni ukuthi hlobo luni lokwelashwa oludingekayo.

Yiziphi izindlela zokwelapha i-subclavian steel syndrome?

Uma unezimpawu, kungadingeka ukuthi uhlinzwe ukuze kuthuthukiswe ukuhamba kwegazi emthanjeni we-subclavian njengokwelashwa kwe-subclavian artery stenosis. Kuye ngesimo sakho, lokhu kungaba ukuhlinzwa okuvulekile noma ukuhlinzwa kwe-endovascular (inqubo ehilela ukufaka amathuluzi amancane ngomthambo wegazi). Kufanele ugweme ukusebenzisa kakhulu ingalo ethintekile kuze kube yilapho ukuhlinzwa sekuqediwe.

Uma ungafaneleki ukuhlinzwa, udokotela wakho angase akunike ama-anticoagulant noma ama-antiplatelet.

Uma unezimpawu ezincane, zingase zithuthuke ngokuhamba kwesikhathi. Ezimweni ezinjalo, udokotela wakho angase akunike imithi yokwehlisa umfutho wegazi kanye namazinga e-cholesterol.

Into ebalulekile ukuthi abantu abangenazo izimpawu ngokuvamile abadingi ukwelashwa. Kodwa-ke, uma unokuncipha kwemithambo yakho ye-subclavian, kunethuba elikhulu lokuthi kuzoba okufanayo kweminye imithambo. Lokhu kungenxa yokuthi lolu hlobo lokuqongelela kwe-plaque (atherosclerosis) luvame ukuthinta imithambo yomzimba wonke.

Ngakho-ke, udinga ukuthola ukwelashwa kwala ma-plaque. Uma ubhema, udinga ukuyeka ukubhema, futhi ulawule umfutho wegazi wakho ophezulu kanye ne-cholesterol ephezulu . Lezi zinto zingasiza ekuvimbeleni ukuhlaselwa yinhliziyo noma isifo sohlangothi esikhathini esizayo.

Yikuphi ukwelashwa/ukuhlinzwa okukhethekile okusetshenziselwa lokhu?

Ungadinga eyodwa noma ngaphezulu yalezi zindlela:

• Ukuhlinzwa kokudala umzila we-bypass ngokuxhuma umthambo we-subclavian komunye umthambo (isibonelo, umthambo we-carotid).
• I-Angioplasty kanye ne-stenting - Lokhu kuhilela ukwandisa indawo evinjiwe ngento efana nebhaluni bese kufakwa i-stent efana ne-mesh ukuze ivinjwe futhi.
• Ukususwa kwe-atherectomy - Lokhu kusho ukususa i-plaque ngaphakathi kwemithambo yegazi.
• I-Endarterectomy - Ukususwa kwengxenye yolwelwesi lwangaphakathi lomthambo.

Ingabe izinkinga zingaba khona ngenxa yokwelashwa?

Yebo, izingozi ziyahlukahluka kuye ngokwelashwa. Zingafaka:

• Umthambo wakho we-subclavian uyancipha futhi.
• Kungakheka amahlule egazi, okungaholela ngisho nasekushayweni yisifo sohlangothi.
• Ukulimala kwemizwa noma umthambo wegazi.
• Ukuba nezinkinga ezithile ngesikhathi sokuphulukiswa.

Kuthatha isikhathi esingakanani ukululama ngemva kwalokhu kwelashwa?

Ukululama ngemva kokwelashwa kwe-subclavian steel syndrome kungathatha izinsuku ezimbalwa, isonto, noma ngisho nangaphezulu. Ukululama ngemva kokuhlinzwa ngokuvamile kuba isikhathi eside kakhulu.

Yini engingayilindela uma ngine-subclavian steel syndrome?

Abantu abangaphezu kuka-95% abathola ukwelashwa kokuhlinzwa kwe-subclavian steel syndrome abadingi ukuhlinzwa futhi. Isibalo sabo ngokuvamile sihle.

Ingabe i-subclavian steal syndrome isongela ukuphila?

Cha, lesi akusona isimo esisongela impilo. Kodwa-ke, kuyisibonakaliso esibucayi! Kusho ukuthi une-atherosclerosis, isifo semithambo yegazi. Lapho i-plaque inqwabelana emithanjeni yegazi yakho, inhliziyo noma ubuchopho bakho kungase kungatholi umoya-mpilo owanele esikhathini esizayo. Lokhu kwandisa ingozi yokuhlaselwa yinhliziyo noma isifo sohlangothi.

Ingabe i-subclavian steel syndrome ingavinjelwa?

Asikwazi ukulawula ezinye zezimbangela ze-subclavian steel syndrome (njengezici zofuzo). Kodwa-ke, ukuthuthukiswa kwalesi sifo kungavinjelwa kakhulu ngokuvimbela ukunqwabelana kwama-plaque (i-atherosclerosis), okuvame ukuba yimbangela .

Ngingayinciphisa kanjani ingozi yami?

Unganciphisa ingozi yakho yokuthola lesi simo - futhi ngaleyo ndlela ingozi yakho ye-subclavian steel syndrome - ngokwenza lezi zinguquko empilweni yakho yansuku zonke:

• Gcina isisindo esinempilo esikufanele.
• Yenza umsebenzi womzimba (ukuzivocavoca) okungenani imizuzu engama-30 ngosuku ezinsukwini eziningi.
• Gwema ngokuphelele ukusetshenziswa kwemikhiqizo kagwayi (njengogwayi kanye ne-beedis).
• Yidla ukudla okunempilo kwenhliziyo (okunamafutha agcwele kanye namafutha angenawo amafutha).
• Uma unezimo ezifana ne-cholesterol ephezulu, umfutho wegazi ophezulu, nesifo sikashukela, zilawule kahle.

Ngizinakekela kanjani?

Uma une-subclavian steel syndrome, kubalulekile ukuthatha imithi yakho njengoba kuqondiswe udokotela wakho, wenze noma yikuphi ukuhlinzwa okudingekayo, futhi ulawule umfutho wegazi ophakeme, i-cholesterol ephezulu, nesifo sikashukela (uma unayo) futhi ugweme imikhiqizo kagwayi.

Kufanele ngimbone nini udokotela wami?

Ngemva kokwelashwa, kufanele uhlolwe njalo, ikakhulukazi uma izimpawu zakho zibuya. Uma udokotela wakho ecabanga ukuthi umthambo wakho we-subclavian unciphile futhi, angase acele ukuhlolwa okwengeziwe kwezithombe. Kuzodingeka uhlolwe ngenyanga eyodwa, izinyanga eziyisithupha, noma unyaka ngemuva kokwelashwa. Ngemva kwalokho, ungabona udokotela wakho cishe kanye ngonyaka.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Kungumqondo omuhle ukubuza udokotela wakho imibuzo efana nale:

• Ngidinga ukwelashwa ngokushesha kangakanani?
• Iyiphi indlela yokwelapha engcono kakhulu kimi?
• Lingakanani izinga lakho lempumelelo ekwelapheni abantu abanalesi simo?

Ngakho-ke, yini into ebaluleke kakhulu okudingeka siyikhumbule kukho konke lokhu?

Naphezu kwegama elithi "Steal" egameni lalo, i-subclavian steal syndrome iyisimo esingelapheka. Abantu abaningi abadingi ukwelashwa. Kodwa umyalezo omkhulu esiwuthola kulokhu ukuthi i-plaque buildup (atherosclerosis) iyenzeka emithanjeni yakho. Umzimba wakho ukutshela ukuthi, "Qala imikhuba enempilo yenhliziyo manje, noma uthuthukise leyo osuvele unayo." Buza udokotela wakho ngezinguquko ongazenza ukuze uthuthukise impilo yakho. Ngisho nezinguquko ezincane ongazenza namuhla zingaba nemiphumela emikhulu. Ngakho-ke, masingasabi, sithole ulwazi, futhi sibeke isisekelo sempilo enempilo, akunjalo?

i- subclavian steal syndrome, i-subclavian steal syndrome, ukwehla kokugeleza kwegazi kuya ebuchosheni, ukuba ndikindiki esandleni, isiyezi, i-atherosclerosis