Nthendayi yotchedwa subclavia kuba, matenda amtundu wambiri (PAD), ndizozizindikiro zapangidwe mwa mitsempha ya subclavia, mitsempha yayikulu yomwe imapereka mikono. Chifukwa cha malo otsekedwa, magazi amachotsedwa ("kuba") kutali ndi ubongo kupita ku mkono wokhudzidwa. Chifukwa chake, zizindikiro za subclavia kuba za matenda sizimangokhala zizindikiro za manja komanso zizindikiro za ubongo.
Mwachidule
Kuti mumvetsetse matenda a subclavia, ndizothandiza kudziŵa zambiri zokhudza momwe thupi limatengera mitsempha ya mutu ndi khosi. Magazi amaloledwa mu aorta ndi chikho cha mtima aliyense, mu chigoba cha aortic - kupindika kwa mahatchi otchedwa horseshoe ku aorta yomwe ili pansi pa khosi. Kuchokera pamtambo, aorta maphunziro pansi mpaka ku chifuwa ndi mimba.
Pamwamba pa chingwe cha aortic chimapereka mitsempha yowopsya ya magazi yomwe imapereka mikono ndi mutu - mitsempha ya subclavia ndi mitsempha ya carotid. Mitsempha ya subclavia imayenda pansi pa mafupa a kolala kuti ipereke magazi pa mkono uliwonse. Musanapereke mikono, komabe mitsempha yonse ya subclavia imapangitsa kuti mitsempha yambiri iwonongeke, yomwe imapereka magazi m'munsi mwa ubongo.
Pamunsi mwa ubongo, mitsempha iwiri yamadzi ndi mitsempha iŵiri ya carotid imalankhulana wina ndi mzake mu dongosolo lomwe limatchedwa Circle ya Willis. Circle ya Willis amalola kuti magazi asasunthidwe kuchoka ku mitsempha imodzi kupita ku ina, monga njira yotetezera minofu ya ubongo ngati imodzi ya mitsempha ya carotid kapena vertebral iyenera kutsekedwa.
Mankhwala a subclavia amachititsa izi monga: matenda a atherosclerosis amachititsa kuti magazi asagwiritsidwe ntchito (mwachindunji kapena mokwanira) mu umodzi wa mitsempha ya subclavia asanayambe kuchotsa mitsempha yotchedwa vertebral. Kuthamanga kwa magazi ku mitsempha yowonongeka kumakhala kuchepetsedwa. Pachifukwachi, magazi amatsogoleredwanso kuchokera mu ubongo, kudzera mu Circle ya Willis, pansi pazitsulo zomwe zimakhudzidwa, komanso kubwerera kuchitsime cha subclavia kupyola kutseka.
Choncho, ndi subclavia kuba m'magazi magazi ndi "kubedwa" kuchokera mu ubongo kuti apereke dzanja lopanda magazi.
Zotsatira zake, sikuti kokha kagawo kamene kamakhudza magazi, koma ubongo umachitanso.
Zizindikiro
Zizindikiro za subclavia kuba ndi matenda zimadalira kuchuluka kwa kutsekedwa kwa mitsempha ya subclavia, ndi kuchuluka kwa ntchito yomwe ikugwira ndi mkono wokhudzidwa.
Kawirikawiri, sipangakhale zizindikilo nthawi zonse. Koma, ngati kutseka kuli kokwanira, pamene mkono wogwira ntchito ukugwiritsidwa ntchito, zinthu ziwiri zimachitika. Choyamba, minofu ya minofu imakhala ndi njala ya mpweya, yopanga zizindikiro (kupweteka kosautsika ndi kupweteka). Koma chofunika kwambiri, magazi ambiri amachotsedwa ku ubongo, ndipo zizindikiro za ubongo zimachitika chifukwa cha kuchepa kwa magazi. Zizindikiro izi zimaphatikizapo kumutu , syncope (kutaya chidziwitso), masomphenya awiri ndi zosokoneza zina, kuyang'ana m'makutu, ndi vertigo .
Pamene chiwerengero cha blockage chimawonjezeka, zizindikiro zimachitika ndi zochepa zedi.
Kudziwa
Pofuna kudziwa kuti subclavia imabera matenda, dokotalayo ayenera kuyamba kuyang'ana. Izi sizingatheke pokhapokha wodwalayo akulongosola zizindikiro zomwe zimasonyeza kuti izi zikudziwika.
Kamodzi kachirombo ka subclavia kamakhala kuganiziridwa, komabe sikovuta kupanga matendawa.
Chifukwa chakuti amatha kusungunuka pang'ono m'zigawo za subclavia, kuthamanga kwa magazi mu mkono wokhudzidwa kumachepetsedwa. Kotero nthawi zambiri pamakhala kusiyana kwakukulu kwa kuthamanga kwa magazi pakati pa manja awiri. Mapira omwe ali ndi mkono wathanziwo amachepetsanso.
Matendawa angatsimikizidwe ndi kuyesa kosavuta, monga MRI kapena CT scan , kapena njira za ultrasound (echo).
Chithandizo
Chifukwa subclavia kuba ndi matenda ndi mtundu wa PAD, imathandizidwa mofanana ndi njira iliyonse ya PAD yomwe imathandizidwa .
Matenda a mtima ndi matenda a mtima ndi matenda opitirirabe omwe amakhudza mitsempha ya magazi m'thupi lonse. Ndikofunikira kwambiri kugwiritsa ntchito njira zochepetsera chiopsezo chotchedwa kuchepetsa kupatsirana kwa magazi, kuphatikizapo kusuta fodya , kuthamanga kwa magazi, kulamulira matenda oopsa, kuchepetsa kulemera kwa thupi, kuchita masewero olimbitsa thupi, komanso kuchepetsa matenda a shuga.
Zizindikiro za mild subclavia kuba zodwala zikhoza kusintha ndi zowonongeka. Ngati zizindikiro zili zofunikira kapena zowonjezereka, komatu kutsekemera kumatha kuchiritsidwa ndi njira yopaleshoni, kapena ndi angioplasty ndi stenting .
Zotsatira:
Toole, JF, McGraw, CP. Kubera syndromes. Annu Rev Med 1975; 26: 321.
Smith, JM, Koury, HI, Hafner, CD, Welling, RE. Subclavia kuba ziwalo. Kubwereza kwa milandu 59 yotsatizana. J Cardiovasc Surg (Torino) 1994; 35:11.
Chatterjee S, Nerella N, Chakravarty S, Shani J. Angioplasty okha ndi angioplasty komanso amatsitsimutsa kwa subclavia mitsempha ya stenosis - ndondomeko yowonongeka ndi meta-analysis. Am J Ther 2013; 20: 520.