Arteriopathy amachititsa ululu wa m'mimba, kufooka ndi mphamvu
Ochita masewera otchuka kwambiri amadziwika kuti amamva ululu ndi kutopa panthawi yochita masewera olimbitsa thupi. Posachedwapa, masewera a othamanga (makamaka oyendetsa njinga, oyendayenda, ndi triatletes) awonetsa zizindikiro za ululu wa mwendo ndi zofooka chifukwa chasayembekezereka -------- kuvulaza mitsempha ya pakhosi, kubuula, kapena mwendo wapansi .
Izi zowononga, kapena kuti arteriopathy, zikuwoneka kuti zimayambitsa mitsempha yotambasula, yopapatiza kapena kink kotero kuti panthawi yopambana kwambiri masewera othamanga atha kuchepetsa kuthamanga kwa magazi chifukwa cha kukhwimitsa kapena kusokoneza mitsempha m'mimba yathithi. Kuperewera kwa magazi, kapena ischemia, kumayambitsa kupweteka, kuwotchedwa, kufooka, ndi kusowa mphamvu pa nthawi ya masewera olimbitsa thupi. Pa maulendo oyendetsa njinga, izi zimawonongeka nthawi zambiri m'mitsempha ya Iliac , makamaka mitsempha ya kunja yakuac.
Zimayambitsa
Kafukufuku woyamba pa arteriopathy wa alangizi a alangizi a alangizi a alangizi ochokera ku France anachokera ku France m'zaka za m'ma 1980 ndipo wakhala akukula kuyambira nthawi imeneyo. Ochita kafukufuku ndi madokotala opaleshoni amaganiza kuti zinthu zingapo zingayambitse mitsempha ya kunja yakuda, kuphatikizapo:
- Kuthamanga kwa magazi kwambiri
- Kubwereza kwa hip kubwereza
- Malo okwera mabasiketi
Zonsezi zimapangitsa kuti phokoso likhale lopitirira, mobwerezabwereza pamene ali pansi.
Kupanikizika uku, kupitirira maola mazana a maphunziro apamwamba, kungapangitse kuwonongeka kwa magulu osiyanasiyana a khoma la mitsempha, kapena kungachititse kuti mitsempha ikhale yotambasula, kapena ikanike. Madokotala ena a opaleshoni apeza minofu yolimba yowonjezera mkati mwazitali za mitsempha yowonongeka. Minofuyi imangowonjezera mchere koma imathandizanso kuti musamachepetse nthawi yochita masewera olimbitsa thupi.
Zotsatira zake ndi kuchepa kwa magazi ku miyendo yomwe nthawi zambiri imawonekeratu panthawi yopambana.
Zizindikiro
Ndinachita chidwi ndi vutoli nditatha kuwona zizindikiro za kufooka, kupweteka komanso kusowa mphamvu mu ntchafu yanga yolondola pamene njinga ikuyenda bwino kwambiri. Wopikisano wokwera mpikisano kwa zaka zoposa 20, ndinadziwa kuti izi sizinali chabe kutopa kwa minofu kapena mtundu uliwonse wa zovulala zofewa. Nditayesera kufotokoza mmene ndimamvera, ndilolo lokhalo limene linkawoneka kuti ndiloyenera kukhala "kugwidwa." Ndinkaona kuti minofu yanga inali kupunduka.
Pasanapite nthawi nditangoyamba kufufuza za zizindikiro zanga, ndinapunthwa pa kafukufuku wosadziwika bwino pankhani zokhudzana ndi mavuto omwe amabwera anthu oyenda panyanja. Pambuyo pake ndinayamba kudandaula ndikufufuza madokotala kwa madokotala ndipo ndinayamba kufufuza.
Panthawiyi, ndinayankhula ndi anthu ena angapo omwe ankayenda pamsewu m'dziko lonse lapansi omwe anapezeka kuti ali ndi amithenga apakati. Onsewa anandiuza zizindikiro zofanana ndi zanga. Ananena kuti akumva kupweteka, kupweteka, kufooka ndi kusowa mphamvu - kawirikawiri mu ntchafu kapena ng'ombe - zomwe zinachoka pamene iwo anachoka ndikubwerera pamene iwo anali ovuta.
Atsikana asanu ndi mmodzi mwa asanu ndi awiri omwe ndinalankhula nawo ndi zizindikiro zodziwika bwino pamlendo umodzi. Ndinali ndi mwayi wopeza mofulumira; ambiri omwe ndalankhula nawo anali ndi zizindikiro kwa zaka zambiri asanapeze dokotala wodziwa vutoli.
Kudziwa
Kawirikawiri matendawa ndi ovuta chifukwa madokotala ambiri sadziwa bwino vutoli ndipo sangakayikire mavuto omwe ali nawo m'mathamanga wothamanga. Ochita masewera ambiri samadziwika kuti ali ndi kachilombo ka chipinda kapena kugwiritsidwa ntchito mopitirira muyeso, kuvulala kwa thupi komanso poyamba amatchulidwa kuti ndi mankhwala, omwe satha kuthetsa vutoli.
Pali maphunziro angapo olingalira omwe angathandize kuthandizira kuchepa kwa mitsempha ya miyendo.
Chiyeso cha abambo (brasial index) (ABI) musanayambe kuchita masewera olimbitsa thupi ndiyeso yowonongeka kuti mupeze chidziwitso choyamba. Kuyezetsa uku kumapangitsa kuti magazi aziponderezeka pamagolo ndi m'manja mwake ndipo kenako atatha kuchita masewera olimbitsa thupi. Mndandanda wamakono wotsalira wa kacisi ndi 1 kapena 1.1 ndipo chirichonse pansipa si chachilendo. Ochita masewera olimbitsa thupi amatha kuwerenga bwino nthawi zonse, koma atatha kuchita masewera olimbitsa thupi (kuthamanga pamtunda kapena kuthamanga kwa njinga) kupweteka kwa mitsempha pamadontho a mwendo wathithi kwambiri, kusonyeza kuchepa kwa magazi.
Mayesero ena omwe amadziwika kuti malo ndi digiti ya kuchepetsa zingaphatikizepo:
- zolimbitsa thupi za duplex ultrasound
- computed tomography angiography (CTA)
- magnetic resonance angiography (MRA)
- mapeto a arteriography
Kuchiza Chithandizo Chamkati cha Iliac Arteriopathy
Pokhapokha wothamanga atakhala wokonzeka kukhala ndi moyo wapansi, malangizowo amachiritso omwe alipo pakali pano ndi kukonzanso opaleshoni ya mitsempha yowonongeka. Mankhwalawa amachitidwa kawirikawiri ndi opaleshoni ya opaleshoni yokhala ndi njira yomwe imaphatikizapo kutsegula kapena kuchotsa chigawo chochepetseka cha mitsempha ndi kupanga chigoba chophatikiza kapena masankhulidwe achilengedwe pa mitsempha.
Njira zina zothandizira opaleshoni zimaphatikizapo kupyolera mitsempha yowonongeka kapena kungochotsa mitsempha ya inguinal kapena psoas muscle attachment kwa artery, zomwe zakhala zikuphatikizidwa pothinikiza kapena kinking zamkati zamiteri. Njira yabwino yothandizira chithandizo ikuoneka kuti imadalira malo enieni komanso chifukwa cha kuwonongeka komanso zolinga za wothamanga.
Zotsatira za Opaleshoni
Anthu onse oyendetsa maulendo omwe ndinayendetsa maulendo omwe ndinayankhula nawo ndinasankha kuchita opaleshoni yomwe inkaphatikizapo mzere wothandizira. Onsewa anandiuza kuti kuchira kunali kochepa kwambiri, ngakhale kuti milungu iwiri yoyamba ili yonse yosasokonezeka kwambiri. Munthu wina yemwe anali wa Olympian anandiuza kuti, "Palibe amene amakuuzani mmene zimavutikira akamadula m'mimba."
Malinga ndi mtundu wa opaleshoni yomwe inachitidwa, wothamanga angakhale akuyenda mkati mwa masabata awiri, njinga yapamsewu mosavuta pa wophunzitsa sabata zitatu ndipo mwinamwake pamsewu pamasabata anayi kapena asanu ndi limodzi - ngakhale ena othamanga adandiuza kuti rehab yawo idatenga zambiri miyezi iwiri kapena itatu.
Pali nthawi zonse zoopsa za opaleshoni ndipo njirayi imabwera ndi mchitidwe woyenera, kuphatikizapo chiopsezo cha matenda, kukanidwa kwa minofu, kubwerera kwa zizindikiro, kapena kuwonjezereka. Mu 2007, Ryan Cycler anamwalira patangotha masabata angapo atatha opaleshoni kukonzanso amisiri ake. Chifukwa ndondomekoyi idakali yatsopano, palibe phunziro la zotsatira za nthawi yayitali kwa oyendetsa maulendo omwe anali ndi opaleshoni iyi.
Mmodzi wamabisitomala amene ndalankhula naye adanena kuti akumva akumva chisoni ndi zowawa chaka chimodzi atatha opaleshoni ndipo wina anandiuza kuti zizindikiro zake zabwerera zaka zisanu pambuyo pa opaleshoni.
Ngakhale kuti oseŵera onse omwe ndalankhula nawo adandiuza kuti ali okondwa kuti anachitidwa opaleshoni ndipo adzachitanso kachiwiri, ndi chisankho chachikulu ndipo wina sindimangotenga. Ndikupitiriza kufufuza kwanga, kusonkhanitsa chidziwitso, ndi kulankhula ndi othamanga ndi opaleshoni nthawi zonse. Ndikupeza kuti njira yabwino yowunikira komanso mtundu wa opaleshoni woterewu umadalira kwambiri dokotala yemwe mumamufunsa; onse akuwoneka kuti ali ndi njira zomwe amakonda kwambiri kapena mtundu wa zowonjezera. Ndapatsidwa "mzere wochokera ku mitsempha yanga yopanda phokoso (mitsempha yaikulu pafupi ndi mchiuno), chigamba cha Dacron, chibokosi cha nkhumba (inde, kuchokera ku ng'ombe), chimadutsa pafupi ndi mitsempha yochepa kwambiri, ngakhalenso stent.
Mwachiwonekere, izi sizodziwika ndipo palibe amene amadziwa njira yabwino kwambiri. Kunja kwa Ulaya, madokotala ochita opaleshoni ochepa omwe ndalankhula nawo achita zimenezi panjinga zamakwerero ku United States. Dr Ken Cherry, dokotala wa opaleshoni wamakono ku yunivesite ya Virgina anapereka pepala pa chikhalidwe ichi ku msonkhano wa Society for Vascular Surgery mu 2008.
Ndinagwira ntchito ndi Dr. Jason Lee ndi Dr. Cornelius Olcott ku Stanford Hospital ku California.
Kafukufuku Wowonjezera
- Endofibrosis ya Mitsempha ya Iliac: Vuto Lopanda Phindu (PDF)
- Arteriopathy Mnyamata Wamasewera Otchuka
- Zotsatira za PubMed Seach
Pamene mukuchita kafukufuku wanu ndiwothandiza ndipo ndiwothandiza kwambiri, ndikofunika kufunsa mafunso ambiri ndikudalira madokotala anu opaleshoni, musanachite opaleshoni.
Kuchokera
Chevalier et al of the Service de Chirurgie Vasculaire et Thoracique, Angers, France, ameri endacibrosis pakati pa okwera njinga, Annals of Vascular Surgery, 1986.
CS Lim *, MS Gohel, AC Shepherd, AH Davies.Iliac Artery Kukakamizidwa mu Oyenda Maulendo: Njira, Kuzindikira ndi Chithandizo. Eur J Vasc Endovasc Surg (2009) 38, 180-186.
Bender MH, et al. Zovuta zokhudzana ndi masewera a mitsempha ya alangizi m'masewera olimbitsa thupi: maphunziro a sayansi, matenda, matenda, komanso tsogolo labwino. Masewera a Masewera. 2004; 34 (7): 427-42.
C. Kral, D. Han, W. Edwards, P. Spittell, H. Tazelaar, K. Cherry. Zosokoneza zakuthambo zapakati pazitsulo zamakono: Zatsopano ndi zosintha zochitika zake m'mayi anai. Journal of Surgery Vascular 2002; 36: 565-70.