Ingabe ngezinye izikhathi uzizwa ubuhlungu obungavamile noma ukungazweli okuphuma entanyeni yakho nasemahlombe akho kuya phansi engalweni yakho? Ingabe lobu buhlungu bubonakala buba bubi nakakhulu uma uphakamisa ingalo yakho? Abantu abaningi bacabanga ukuthi lokhu kuyinto evamile, noma ukuthi kumane nje kungumthambo omncane entanyeni yakho ocindezelwayo, kodwa imbangela ingaba yinkimbinkimbi kakhulu kunalokho ocabanga. Namuhla sizokhuluma ngesimo esingadala izimpawu ezifanayo, kodwa abantu abaningi abakaze bezwe ngaso. Leso yi-Thoracic Outlet Syndrome (TOS).
Kalula nje, iyini i-Thoracic Outlet Syndrome (TOS)?
Leli gama lingase lizwakale liyinkimbinkimbi kancane. Kodwa ake siligcine lilula. Cabanga ukuthi kunesikhala esincane esifana nomhubhe phakathi kwentamo nesifuba sethu. Ukuze sibe nembile, isikhala esingaphansi kwethambo lentamo kanye nangaphezulu kombambo wokuqala. Lesi sikhala yilokho esikubiza ngokuthi 'indawo yokukhipha isifuba' kwezokwelapha.
Lo mhubhe ubaluleke kakhulu ngoba inqwaba enkulu yezinzwa enikeza umuzwa nokunyakaza engalweni yethu (ebizwa ngokuthi i-brachial plexus ), kanye nomthambo oyinhloko ohlinzeka ngegazi engalweni ( umthambo we-subclavian ), kanye nomthambo omkhulu othwala igazi lisuka engalweni ulibuyisele enhliziyweni ( umthambo we-subclavian ) kudlula kule ndawo encane.
Ngokuvamile, lezi zinzwa nemithambo yegazi zingahamba kulesi sikhala ngaphandle kokuvinjelwa. Kodwa kuthiwani uma lo mhubhe uvalekile ngesizathu esithile? Okusho ukuthi, kwenzekani uma lezi zinzwa noma imithambo yegazi icindezelwa yimisipha ezungezile, amathambo, njll.? Yilokho esikubiza ngokuthi i-Thoracic Outlet Syndrome (TOS) . Lokhu kucindezelwa yikho okubangela izimpawu eziningi ezifana nobuhlungu, ukungakhululeki, nokuvuvukala engalweni.
Ingabe zikhona izinhlobo eziyinhloko ze-TOS?
Yebo, i-TOS ihlukaniswe ngezinhlobo ezintathu eziyinhloko kuye ngokuthi yini ebangela lokhu kucindezeleka. Ukwazi lokhu ngqo kubaluleke kakhulu ekwelapheni.
| Uhlobo lwe-TOS | Kuyini okubalulekile kanye nencazelo |
|---|---|
| I-Neurogenic Thoracic Outlet Syndrome (ukucindezelwa kwemizwa) | Lolu uhlobo oluvame kakhulu (cishe ama-95% eziguli ze-TOS). Luhilela ukucindezelwa kwe-nerve bundle egijima kusukela engalweni iye ehlombe (brachial plexus). Ngokuvamile kwenzeka kubasubathi abenza ukunyakaza okuphindaphindiwe noma kubantu abaye balimala ngokuzumayo entanyeni (njengokushaywa nge-whiplash ngenxa yengozi yemoto). |
| I-Venous Thoracic Outlet Syndrome (I-Venous Throat Syndrome) | Yilapho umthambo oyinhloko obuyisa igazi engalweni (umthambo we-subclavian) uvaleka khona. Lokhu kungabangela ukuthi igazi lihlangane engalweni, okubangela ukuthi ivuvuke ngokuzumayo futhi ibe luhlaza okwesibhakabhaka . Lokhu kuvame kakhulu kwabesilisa abasebasha, ikakhulukazi engalweni abayisebenzisa kakhulu (ingalo ebusayo). |
| I-Arterial Thoracic Outlet Syndrome (Umphimbo Womphimbo We-Arterial) | Lolu uhlobo olungavamile kakhulu (cishe u-1% weziguli ze-TOS). Lapha, umthambo oyinhloko othwala igazi engalweni (umthambo we-subclavian) uyancipha. Lokhu kunganciphisa ukugeleza kwegazi engalweni, okubangela ukuba kubande, kube mhlophe, futhi kube buhlungu. Ngezinye izikhathi, amahlule egazi angakheka ngaphakathi kwalo mthambo. Lokhu kuvame ukubangelwa yinto efana nombambo owengeziwe ozalwa nombambo wesibeletho. |
Zombili izinhlobo zemithambo yegazi kanye nezemithambo yegazi zaziwa ngokuthi i-Vascular Thoracic Outlet Syndrome . Zombili izinhlobo zivame ukudinga ukuhlinzwa. Kodwa-ke, uhlobo lwe-Neurogenic oluvame kakhulu luvame ukusabela kahle ekwelashweni ngokomzimba.
Ziyini izimpawu ze-TOS?
Izimpawu zincike ekutheni inzwa noma umthambo wegazi ucindezelwe yini. Lezi zimpawu zivame ukubonakala ohlangothini olulodwa (entanyeni, esifubeni esingaphezulu, ehlombe, engalweni, noma esandleni).
Izimpawu ezivame ukubonakala:
- Ubuhlungu: Lobuhlungu bungakhula uma uphakamisa ingalo yakho. Abanye abantu bangase bazizwe lokhu njengobuhlungu obuncane .
- Ukuba ndikindiki: Umuzwa "wokubhoboza nezinaliti", ofana nomuzwa lapho isandla sakho sindindi.
- Ukuba ndikindiki: Ukulahlekelwa umuzwa kwezinye izindawo zesandla.
- Ubuthakathaka: Ukuncipha kwamandla esandleni noma eminweni, ubunzima bokubamba izinto.
- Ukuvuvukala noma ukusinda: Ingalo ingase ivuvuke futhi izwakale isinda, ikakhulukazi uma umthambo unciphile.
- Umbala wesikhumba uyashintsha: Isandla singase sibe mhlophe noma sibe luhlaza okwesibhakabhaka.
- Izandla ezibandayo: Lapho umthambo uncipha futhi ukugeleza kwegazi kuncipha, isandla singase sibande kakhulu kunesinye isandla.
- Ukuphola okulibazisekile kwamanxeba eminwe: Lokhu kungase kubangelwe ukujikeleza kwegazi okungekuhle.
Cabanga ngale ndlela: imizwa ifana nezintambo zikagesi emizimbeni yethu. Uma icindezelwa, kuvela izimpawu ezifana nobuhlungu kanye nokungazweli. Imithambo yegazi ifana namapayipi amanzi. Uma ipayipi elithwala igazi (umthambo) livalekile, isandla siyabanda futhi siphucwe igazi. Uma ipayipi elibuyisela igazi (umthambo) livalekile, isandla siyavuvukala futhi sigcwale igazi. Uma ukucabanga ngakho ngale ndlela, kulula ukuqonda izimpawu.
Ingabe lobu buhlungu buhlobene nokuhlaselwa yinhliziyo?
Lona umbuzo obaluleke kakhulu. Ngenxa yokuthi i-TOS ingabangela ubuhlungu esifubeni esingaphezulu, abanye bangase besabe ukuthi lokhu ukuhlaselwa yinhliziyo noma i-angina. Kodwa-ke, kunomehluko ocacile phakathi kwalokhu okubili.
- Ubuhlungu be-TOS: Ngokuvamile buba bubi kakhulu uma uphakamisa ingalo ethintekile . Lobuhlungu abubi bubi kakhulu uma uhamba noma uzivocavoca.
- Ubuhlungu be-Angina: Lobu ubuhlungu obubangelwa ukungafiki kwegazi elanele enhliziyweni. Ngokuvamile buba bubi kakhulu ngesikhathi sokuzikhandla, njengokuhamba noma ukukhuphuka izitebhisi . Buba ngcono ngokuphumula. Bungaphinde buhambisane nezimpawu ezifana nokuphelelwa umoya nokujuluka.
Ngokufanayo, ubuthakathaka ohlangothini olulodwa lomzimba kungaba uphawu lwesifo sohlangothi. Kodwa-ke, isifo sohlangothi singadala nezimpawu ezifana nokugoba komlomo ohlangothini olulodwa, ubunzima bokukhuluma, kanye nokushintsha kombono.
Kubaluleke kakhulu: Uma uhlangabezana nezimpawu ezifana nobuhlungu besifuba obungazelelwe, ubunzima bokuphefumula, ukujuluka, ubuthakathaka ohlangothini olulodwa lomzimba, noma ubunzima bokukhuluma, ungacabangi ukuthi kuyi-TOS bese uya egumbini lezimo eziphuthumayo esibhedlela (ETU) ngokushesha. Lezi kungaba izimpawu zokuhlaselwa yinhliziyo noma isifo sohlangothi, okudinga ukwelashwa ngokushesha.
Yini ebangela i-TOS?
Odokotela bahlukanisa izimbangela ze-TOS ngezigaba ezintathu eziyinhloko.
| Isigaba sesizathu | Incazelo nezibonelo |
|---|---|
| Ukuzalwa kabusha | Lezi izinguquko zesakhiwo ozalwa nazo. Isibonelo, abanye abantu bangase babe nombambo owengeziwe entanyeni yabo (umbambo wesibeletho). Lo mbambo owengeziwe unganciphisa isikhala endaweni yokukhipha isisu futhi ubangele ingcindezi emithanjeni noma emithanjeni yegazi. |
| Ingozi (Eyesabekayo) | Lesi simo singabangelwa ukulimala entanyeni noma esifubeni esingaphezulu. Isibonelo esivame kakhulu yi -whiplash , ebangelwa ukugxumagxuma kwentamo ngokuzumayo engozini yemoto. Ingabangelwa futhi yinto efana nethambo lentamo eliphukile. |
| Okusebenzayo | Lokhu kwenzeka ngenxa yokuphindaphinda njalo kwezinyathelo ezifanayo, ikakhulukazi imisebenzi ehilela ukuphakamisa izingalo zakho.
|
Ngezinye izikhathi, noma ngabe kukhona ingozi yokuzalwa (isb., ubambo olwengeziwe), izimpawu zingase zingaveli kuze kube yingozi noma umsebenzi ongafanele wesikhathi eside.
Ingabe lesi yisimo esibucayi? Kuzokwenzekani uma singelashwa?
Yebo, i-TOS ingabangela izinkinga ezinkulu uma ingelashwa, ikakhulukazi ngesimo sokuminyana kwemithambo yegazi.
- I-Thrombosis: Amahlule egazi angakheka engalweni ngenxa yokuncipha kwemithambo. Uma leli hlule legazi liqhuma futhi lihlala emaphashini, lingabangela isimo esibi, esisongela ukuphila esibizwa ngokuthi i-pulmonary embolism .
- Ukuvuvukala okungapheli kanye nobuhlungu: Ukuvuvukala okuqhubekayo kanye nobuhlungu esandleni.
- Ukufa kwezicubu (i-Gangrene): Uma umthambo uvaleka futhi ukugeleza kwegazi esandleni kunqamuka ngokuphelele, izicubu zeminwe zingafa.
- Amanxeba angapholi: Amanxeba eminwe angase angapholi ngenxa yokujikeleza kwegazi okungekuhle.
- Ukulimala kwemizwa okuhlala njalo: Ukucindezelwa kwemizwa isikhathi eside kungabangela umonakalo ohlala njalo.
Ngakho-ke, uma unalezi zimpawu, kubaluleke kakhulu ukubona udokotela wakho futhi ufune iseluleko, kunokumane ucabange ukuthi "lokhu kuzophela nje."
Udokotela uyixilonga kanjani i-TOS?
Ukuxilonga i-TOS ngezinye izikhathi kungaba nzima ngoba izimpawu zingafana nezezinye izimo eziningi. Udokotela wakho uzoqala akubuze ngezimpawu zakho bese ekuxilonga.
Phakathi nalokhu kuhlolwa ngokomzimba, udokotela uzokucela ukuthi wenze ukunyakaza okuthile. Isibonelo:
- Phakamisa izingalo zakho phezulu bese ubacela ukuthi bagobe futhi belule izintende zabo (Isivivinyo Sokucindezeleka Kwengalo Ephakeme).
- Bakucela ukuthi uphendule intamo yakho ngezindlela ezahlukene.
Udokotela wakho angathola umbono walokhu ngokubheka ukuthi uhlangabezana yini nezimpawu ezifana nobuhlungu noma ukungakhululeki lapho wenza lokhu kunyakaza, nokuthi kwenzeka kanjani.
Ngaphezu kwalokho, izivivinyo ezilandelayo zingase zilandelwe ukuqinisekisa ukuxilongwa nokukhipha ezinye izimo:
- I-X-ray yesifuba: Hlola ubambo olwengeziwe (ubambo lomlomo wesibeletho).
- I-CT scan noma i-MRI scan: Ukubona ngqo ukuthi izakhiwo zentamo nesifuba zicindezelwe kuphi, kanye nemizwa nemithambo yegazi.
- I-Electromyography (EMG) / Ucwaningo Lokuqhutshwa Kwezinzwa: Ihlola ukusebenza kwezinzwa kanye nomonakalo.
- I-Angiography (i-MRA noma i-CT Angiography): Ukuhlola ukuhamba kwegazi emithanjeni yegazi nokuthi ngabe kukhona yini ukuvaleka noma ukugoba kwegazi.
Yiziphi izindlela zokwelapha i-TOS?
Ukwelashwa kuncike ohlotsheni lwe-TOS onayo, ubukhulu bezimpawu zakho, kanye nembangela.
1. Ukwelashwa Komzimba: Lokhu ukwelashwa kokuqala nokubaluleke kakhulu kwe-Neurogenic TOS. Udokotela wezokwelapha ngokomzimba uzokufundisa ukuzivocavoca okuthile ukuqinisa imisipha entanyeni nasemahlombe akho, ukwandisa ukuguquguquka, futhi kukusize ugcine ukuma okufanele. Kwabaningi, lokhu kwelashwa kunganciphisa kakhulu izimpawu.
2. Imithi:
- Ama-Painkiller: Udokotela wakho angase akunike ama-painkiller njenge-NSAID ukulawula ubuhlungu.
- Ama-Anticoagulant: Uma amahlule egazi akheke emithanjeni yegazi noma esengozini yokwakheka, kunikezwa imithi yokunciphisa igazi. Ngezinye izikhathi, imijovo ekhethekile (ukwelashwa nge-thrombolytic) inganikezwa ukuze kuncibilikiswe ihlule.
3. Ukuhlinzwa:
- I-TOS yemithambo yegazi kanye nemithambo yegazi (izinhlobo zokuminyana kwemithambo yegazi) zivame ukudinga ukuhlinzwa ngenxa yengozi ephezulu yezinkinga ezinkulu.
- Ukuhlinzwa kuyacatshangelwa futhi ezigulini ezine- Neurogenic TOS ezingasabeli ekwelashweni kokwelashwa ngokomzimba.
- Ukuhlinzwa kuhilela ukususa imbangela yokucindezelwa kwemizwa noma imithambo yegazi. Isibonelo, ukususa ubambo olwengeziwe noma ukunquma imisipha eqinile (ukuhlinzwa kokunciphisa ukucindezeleka).
Udokotela wakho uzochaza ngokuningiliziwe ukuthi udinga ukuhlinzwa, ukuthi kuhilelani, nokuthi yiziphi izingozi.
Umlayezo Wokuya Nawe Ekhaya
- Uma unobuhlungu obungapheli, ukungazweli, noma ubuthakathaka entanyeni yakho, ehlombe, noma engalweni, ungakushayi indiva lokho.
- Lezi zimpawu zingase zibangelwe yi-Thoracic Outlet Syndrome (TOS), ebangelwa ukucindezelwa kwemizwa noma imithambo yegazi esikhaleni esiphakathi kwentamo nesifuba.
- Ukungazinaki izimpawu, ikakhulukazi ezimweni ze-TOS ezihilela imithambo yegazi, kungaholela ezinkingeni ezinkulu njengokuqhekeka kwegazi.
- Qiniseka ukuthi ubona udokotela ukuze uthole ukuxilongwa okufanele kanye nokwelashwa.
- Abantu abaningi bangakwazi ukulawula izimpawu zabo ngokwelashwa ngokomzimba, futhi kwezinye izimo, kungase kudingeke ukuhlinzwa.
- Uma unezimpawu ezifana nobuhlungu besifuba obungazelelwe noma ubuthakathaka ohlangothini olulodwa lomzimba, iya ekamelweni lezimo eziphuthumayo (ETU) ngokushesha.
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