I-Subclavian steal syndrome, uhlobo lwesifo se-artery (PAD), isethi yeempawu ezibangelwa ukucinywa kwelinye lamarridi e-subclavia, imirhobho emikhulu ehambisa iingalo. Ngenxa yendawo yokucima, igazi livaliwe ("libiwe") kude neengqondo kwisandla esichaphazelekayo. Ngenxa yoko, iimpawu ze-subclavian steal syndrome azibandakanyi iimpawu zengalo kuphela kodwa neempawu ze-neurological.
Sibanzi
Ukuqonda i-subclavian steal syndrome, kunceda ukwazi okuthile malunga nemithambo yegazi entloko nasentanyeni. Igazi likhishwe kwi-aorta kunye nentliziyo nganye, kwisigxina se-aortic - intonga ye-horseshoe e-aseort ephantsi kwentamo. Ukususela kwi-arch, iikholeji ze-aorta ezantsi ukuya kwisifuba nesisu.
Ingqungquthela yomchamo we-aortic inika imilambo yegazi ephazamisayo ehambisa iingalo kunye nentloko - imirhoxo ye-subclavian kunye neetriyari ze-carotid. Iingqungquthela ze-subclavian zihamba ngaphantsi kwamathambo e-collar ukuhambisa igazi ngengalo nganye. Ngaphambi kokuba unikezele iingalo, kunjalo, umzobo ngamnye we-subclavian unikezela umthambo we-vertebral, ohambisa igazi kwisiseko sobuchopho.
Ngesiseko sobuchopho, iirtrib ezimbini kunye neeraridi zombini zixubana kunye nomnye kwisakhiwo se-vascular esibizwa ngokuba yi-Circle ye-Willis. Umjikelezo kaWillis uvumela igazi ukuba likhutshwe kwisinye isitoli ukuya kwesinye, njengendlela yokukhusela izicubu zengqondo ukuba enye yeerarodid okanye i-vertebral arteries ibhetyiwe.
I-subclavian steal syndrome isebenza ngale ndlela: i- atherosclerosis ivelisa ukucima (mhlawumbi inxenye okanye igqibeleleyo) kwelinye lamatriyridi ase-subclavian ngaphambi kokuba kuthathwe umthambo we-vertebral. Ukuphuma kwegazi kwi-artebral artery echaphazelekayo kuncipha. Ngenxa yeso sizathu, igazi liphinde lihanjiswe ukusuka kwingqondo, nge-Circle ye-Willis, phantsi komthi we-vertebral ochaphazelekayo, kwaye ubuyele kumtya we-subclavian ngaphaya kwe-block.
Ngaloo ndlela, nge-subclavian steal syndrome igazi "ibiwe" ngokusuka kwingqondo ukubonelela ngengalo engenalo igazi.
Ngenxa yoko, kungekhona nje ukuba ingalo echaphazelekayo inegazi lokunciphisa igazi, kodwa kunjalo ingqondo.
Iimpawu
Iimpawu ze-subclavian steal syndrome zixhomekeke kwisilinganiselo sokucinywa kwi-subclavia, kunye nomyinge womsebenzi owenziwa ngengalo echaphazelekayo.
Ngokuqhelekileyo, akukho mpawu kuzo zonke. Kodwa, ukuba ukukhutshwa kulungile ngokwaneleyo, xa ingalo echaphazelekayo isetyenziswa, izinto ezimbini zenzeka. Okokuqala, izihlunu zengalo zibulawa yindlala ye-oksijini, zivelisa ukuhluthwa (ubuhlungu obukhulu kunye nokuqhawula). Kodwa okubaluleke ngakumbi, igazi elingaphezulu livaliwe ngaphandle kwengqondo, kwaye iimpawu ze-neurological zibangelwa ngenxa yokungena kwegazi okwaneleyo. Ezi zimpawu zengqondo zingabandakanya ukukhanya , ukuvumelanisa ukulahleka, ukujonga ukulahleka kwemibono, imibono emibini kunye nokuphazamiseka okubonakalayo, ukukhala kwiindlebe kunye ne- vertigo .
Njengoko iqondo lokukhusela likhuphuka, iimpawu zenzeka nge-exercise engaphantsi nangaphantsi kwengalo.
Ukuxilongwa
Ukufumanisa i-subclavian steal syndrome, ugqirha kufuneka ufune kuqala. Oku akunakwenzeka ngaphandle kokuba isigulane sichaza iimpawu ezibonisa ukuba ukuxilongwa.
Nangona i-subclavian steal syndrome kucingelwa, nangona kunjalo, akusoloko kunzima ukwenza ukuxilongwa.
Ngenxa yokuba kunokukhutshwa ngokukodwa kwintsimbi ye-subclavia, uxinzelelo lwegazi kwingalo echaphazelekayo luyancipha. Ngoko ke ngokuqhelekileyo umda omkhulu kwixinzelelo lwegazi phakathi kweengalo zombini. Iimpembe zengalo echaphazelekayo nazo ziyancipha.
Ukuxilongwa kungaqinisekiswa ngolu vavanyo olungabonakaliyo, olufana ne- MRI okanye i- CT scan , okanye ngeendlela zobuchopho ze-ultrasound (echo).
Unyango
Ngenxa yokuba i-subclavian steal syndrome yindlela ye-PAD, iphathwa ngendlela efanayo nangayiphi i- PAD iphathwa .
Isifo se-cardiovascular acetrosclerotic yisifo esiqhubekayo esichaphazela imithana yegazi kuwo wonke umzimba. Kubaluleke kakhulu ukuba kuqashwe onke amanyathelo okunciphisa ingozi eyaziwayo ekunciphiseni ukunyuka kwe-atherosclerosis, kubandakanywa ukuyeka ukutshaya , ukulawulwa kwegazi, ukulawulwa komfutho wegazi, ukulawula ubunzima, ukusetyenziswa nokulawula isifo sikashukela.
Iimpawu ze-subclavian steal syndrome zingaphucula ngeendlela ezinjalo. Nangona iimpawu zibalulekileyo okanye ziphikelela, oko ke, ukukhutshwa ngokwayo kungaphathwa ngendlela yokupasa, okanye nge- angioplasty kunye ne- stenting .
Imithombo:
Toole, JF, McGraw, CP. Ukuba ama-syndromes. Annu Rev Med 1975; 26: 321.
Smith, JM, Koury, HI, Hafner, CD, Welling, RE. I-Subclavian iba nesifo. Ukuhlaziywa kwamacala angama-59 alandelayo. J Cardiovasc Surg (iTorino) 1994; 35:11.
I-Chatterjee S, iNerella N, i-Chakravarty S, i-Shani J. Angioplasty yedwa kunye ne-angioplasty kunye ne-stenting ye-subclavian artery stenosis - ukuhlaziywa okucwangcisiweyo kunye nokuhlaziywa kwemeta. Ngomhla ka-2013; 20: 520.