I-May Thurner syndrome, okanye i-aliac vein compress syndrome, ivela xa i-artery edibeneyo yomdaka iwela ngaphaya kwe-veic ye-veic vein, i-compressing between the artery and spine. Olu tshintsho kwi-anatomy lwandisa ithuba lokuphuhlisa i- thrombosis ye-vein (DVT) .
Iimpawu zeMay Thurner Syndrome
Bonke abantu abane-syndrome kaMay Thurner abayi kuba neempawu eziphambili kwiinkcenkceshelo zesisu esivumelekileyo se-aliac.
Ngamanye amaxesha, ifunyanwa ngengozi xa ukucinga (ikakhulukazi iT scan okanye iMRI) kwenziwa kwezinye izizathu. Uninzi lwexesha lithe lafunyanwa ngexesha lomsebenzi we-DVT yomlenze wesobunxele. Iimpawu zingabandakanya intlungu kunye / okanye ukuvuvukala. Isifo seMay Thurner senziwa ngokuqhelekileyo kubasetyhini abaneminyaka engama-20 ukuya kuma-50.
Umngcipheko okhulayo wezambatho zegazi
Ukunyanzeliswa kwentswelo ye-aliac ekhohlo ekhohlo kubangela ukucaphuka / ukulimala kwinqanawa yegazi, okubangelwa ukwanda kwodonga lwesitya segazi. Ukunyuka kwodonga lwesitya segazi kubangela ukuhlanganiswa kwegazi (ekwabizwa nangokuthi i-stasis), okwandisa umngcipheko wesakhiwo se-clot. Le ngxaki yengozi ihlanganiswe nezinye izinto ezinobungozi bokubunjwa kwe-clot , njenge-contraception hormonal (iipilisi zolawulo lokuzalwa) okanye ukungazinzi ixesha elide ukuhamba emva kokuhlinzwa, kunokuqhubeka nokwandisa le mngcipheko.
Ukuxilongwa
Ukufumanisa i-May Thurner syndrome kunokuba nzima kunokwakheka kwimida yegazi.
Iimbali zegazi ezininzi kwiingalo nasemilenzeni zingabonwa lula kwiDoppler ultrasound, kodwa imithwalo yegazi ye-pelvis ayikho.
I-May Thurner syndrome kufuneka ithathelwe ingqalelo njengesizathu sokungakhuselekanga (ngaphandle kwesizathu esaziwayo esinjengoxinzelelo okanye ukusuleleka) igazi livale emlenzeni wesobunxele, ngokukodwa ukuba kukho ikhefu elingaphezulu kwesinye ekhohlo.
Ukuxilongwa ngokubanzi kudinga ukucinga ngokuthe ngqo kwimizila yegazi ye-pelvic, njenge-CT (CAT) venography okanye i-magnetic resonance venography (i-MRI yeemvini). I-intravascular ultrasound (i-ultrasound ngaphakathi kwinqanawa yegazi) inokuba luncedo kakhulu ekuboniseni ukunyanzeliswa kwe-vein ye-veac vein.
Emva kokufumanisa i-May Thurner syndrome, uninzi lweengcali zincoma ukuba umsebenzi ukhangele ezinye izinto ezinobungozi bokubunjwa kwe-clot. Oku kudla ngokuba yi-hypercoagulable work-up.
Izinyango Zonyango
Ukuba kukho i-clot yegazi, unyango nge-antiticoagulation iyadingeka. Ngelishwa, unyango lwangexesha elide kunye ne-anticoagulation (igazi elincinci njenge-heparin, i-enoxaparin, okanye i-warfarin) alinelungelo lokuthintela ulwakhiwo olungaphezulu. Unyango oluthi "i-clot buster" imithi efana ne-plasminogen activator (tPA) okanye i-thrombectomy (ukukhishwa komatshini we-clot) kudla ngokufunekayo ngexesha lokuxilongwa. Ezi nkqubo zinokwenzeka ukuba zenziwe ngumjobi we-radiologist okanye i-articular surgeon.
Ukwelapha i-clot yegazi yinto enye yonyango. Ukususa i-clot yegazi akuyi kuluphatha ingxaki yesiseko se-veac ye-aliac esineenkxalabo ezixinekileyo, ekubeka ingozi enkulu yokubunjwa kwe-clot.
Ukuthintela ukwakheka kwamanye ama-clot form, i- stent , i-wire mesh encinci, ingafakwa ukuba igcine imvula. Ezi zonyango (tPA, thrombectomy, ukubekwa kwe-stent) zingenzeka ngexesha elifanayo njenge-intravascular ultrasound evumela ukuqinisekiswa kokuxilongwa kunye nenkcazo ecacileyo.
Ngexesha elikhawulezayo (ukuya kwiinyanga ezi-3-6) emva kokubekwa kwe-stent, unyango lwe-antiticoagulation luya kuqhutyelwa kodwa kungenakufuneka kwixesha elide.