I-arteriopathy ingabangela ubuhlungu bomlenze, ubuthakathaka nokungabi namandla
Abagijimi abaningi abakhulu bajwayele ukuzwa ubuhlungu obukhulu kanye nokukhathala ngesikhathi sokuzivocavoca okukhulu. Nokho, maduzane, i-subset yabagijimi (ikakhulukazi abahamba ngebhayisikili, abagibeli bemoto, kanye namathrenti) baye babika izimpawu zobuhlungu bomlenze nobuthakathaka ngenxa yezizathu ezingalindelekile -------- umonakalo emithanjeni ye-pelvis, ubuhlungu noma umlenze ophansi .
Lokhu kulimala, noma i-arteriopathy, kubonakala sengathi kubangela ukuthi imishanguzo ilula, iminyene noma i-kink ngendlela yokuthi ngesikhathi sokuzivocavoca okukhulu ukuhlangenwe nakho kwezemidlalo kunciphisa ukugeleza kwegazi ngenxa yokucindezela noma ukuvinjelwa komthambo emlenzeni othintekile. Ukuntuleka kwegazi, noma ischemia, kubangela ubuhlungu, ukushisa, ubuthakathaka, nokungabi namandla phakathi nokuzivocavoca. Emabhayisikili, lo monakalo uvame ukutholakala emithonjeni ye-aliac , ikakhulukazi umshini wangaphandle we-aliac.
Izimbangela
Ukucwaninga kokuqala kwe-aliac arteriopathy kuma-cyclists ama-elite waphuma eFrance ngawo-1980 futhi kuye kwanda njalo kusukela ngaleso sikhathi. Abacwaningi kanye nodokotela abahlinzayo bacabanga ukuthi inhlanganisela yezimbangela zingabangela ukuba imishanguzo yangaphandle ye-aliac ibonakaliswe, kubandakanya:
- Ukugeleza kwegazi okweqile kakhulu
- Ukuphindaphinda kwe-hip flexion
- Isikhundla sokuhamba ngebhayisikili
Ngokubambisana lezi zinto ziholela ekuguqulekeni okuphindaphindiwe, okuphindaphindiwe komshini ngenkathi ngaphansi kwengcindezi.
Ukucindezeleka, ngaphezu kwamakhulu amahora wokuqeqesha okuphakeme, kungabangela umonakalo emigqeni ehlukahlukene yodonga lwe-artery, noma kungabangela ukuthi umthambo ulandwe, noma ukhonjiswe. Abanye odokotela abahlinzayo baye bathola izicubu ezinzima zakhiwe ngaphakathi kwendwangu yangaphakathi yomthambo owonakele. Lezi zicubu ezinomzimba akugcini nje ukuthi zinciphise umthambo kodwa futhi ziyivimbela ekunciphiseni ngesikhathi sokuvivinya umzimba.
Umphumela wukunciphisa ukugeleza kwegazi emilenzeni evame ukubonakala ngesikhathi sokuzivocavoca okukhulu.
Izimpawu
Ngangithakazelisa kule nkinga ngemuva kokuba ngiqale ukuzwa izimpawu zobuthakathaka, ubuhlungu nokungabi namandla emthonjeni wami ongakwesokudla ngenkathi ibhayisikili ephakeme kakhulu. I-cycliste yezokuncintisana iminyaka engaphezu kwengu-20, ngangazi ukuthi lokhu kwakungeyona nje ukukhathala komzimba noma noma yiluphi uhlobo lokulimala kwezicubu ezithambile. Lapho ngizama ukuchaza lokho engikuzwayo, isiphequluli esisodwa esibonakala sengathi kufanelekile kwakuwukuthi "ukuphefumula." Ngangizizwa sengathi imizimba emlenzeni wami yayigubha.
Ngokushesha ngemva kokuqala ukucwaninga ngezibonakaliso zami ngakhuthaza ucwaningo oluthile olungavamile mayelana nezinkinga zamabhayisikili ezinkampanini, kuhlanganise nezinkinga ze-artery zamakhomikhali ezibonakala kuma-cyclist. Ngagcina ngithatha izinsolo zami kanye nenqwaba yocwaningo olwenziwe odokotela bami futhi ngaqala ukuhlolwa.
Ngalesi sikhathi, ngikhulume nabanye abahamba ngebhayisikili ezweni lonke abaye babonwa ukuthi bane-arteriopathy yangaphandle ye-aliac. Bonke bachaze izimpawu ezifanayo kimi. Babika imizwelo yobuhlungu, ukunganaki, ubuthakathaka nokuntuleka kwamandla - ngokuvamile emathangeni noma enkhanini - eyahamba lapho bewayeka futhi bebuya lapho behamba kanzima.
Abadlali abayisishiyagalolunye kulabo abayisikhombisa engakhuluma nabo abanezimpawu ezibonakalayo kuphela emlenzeni owodwa. Nginenhlanhla ukuthola ukuthi ngikutholile ngokushesha; abaningi engangikhuluma nabo babe nezimpawu zeminyaka ngaphambi kokuthola udokotela owaziyo ngale nkinga.
Ukuxilongwa
Ngokuvamile ukutholakala kwezifo kuyinkimbinkimbi ngoba odokotela abaningi abajwayele lesi simo futhi ngeke basolise izinkinga zamathambo kumdlali odlala kahle. Abagijimi abaningi ababhekwa kabi ngokuthi bane-compartment syndrome noma abasebenzisa ngokweqile, ukulimala kwezicubu futhi baqale babhekiselwa ekwelapheni ngokomzimba, okuhluleka ukuxazulula inkinga.
Kunezifundo eziningana zokucabanga ezingasiza ukuxilonga ukugxila emithanjeni emilenzeni.
Isivivinyo se-ankle-brachial (ABI) ngaphambi nangemva kokuzivocavoca yisilingo esincane esingavamile sokuthola ukuxilongwa kokuqala. Lokhu kuhlolwa kubeka ukucindezelwa kwegazi emagqumeni nasesandleni sokuphumula bese emva kokuzivocavoca. Inombolo evamile yokuphumula yama-ankle-brachial index i-1 noma i-1.1 futhi noma yini engezansi engavamile. Abadlali abane-arteriopathy ngokuvamile bafundela ngokujwayelekile lapho bephumula, kodwa ngemva kokuzivocavoca (ukuhamba ngezinyawo noma ukuhamba ngebhayisikili) ukucindezela kwe-ankle emlenzeni okhutheleko kwehla ngokuphawulekayo, okubonisa ukuncipha kwegazi.
Okunye ukuhlola okusetshenziselwa ukuthola indawo kanye nesilinganiso sokunciphisa kungafaka:
- i-duplex ultrasound yokusebenzisa
- I-computed tomography angiography (i-CTA)
- i-magnetic resonance angiography (i-MRA)
- isiphetho se-arteriography
Ukwelapha i-Iliac Arteriopathy yangaphandle
Ngaphandle kokuba umgijimi ekulungele ukuhlala ngendlela yokuphila, iziphakamiso zokwelashwa zamanje zalesi simo ukulungiswa kokuhlinzwa komshini owonakele. I-arteryopathy yangaphandle yangaphakathi isetshenziswa kaningi ngabahlinzayo abahlinzeka ngamathambo ngenqubo ehilela ukuvula noma ukususa ingxenye encane yomthamo nokubeka i-patch yokwenziwa noma i-graft tissue graft phezu komshini.
Okunye ukungenelela okuhlinzekwa okubandakanya kuhlanganisa ukuchitha umthambo owonakele noma ukumane ukhulule i-ligament inguinal noma i-psoas muscle attachments kuya komshini, okuye kwacatshangelwa ekucindezeleni noma ekukhenkheni umthambo we-aliac wangaphandle. Ukukhetha ukwelashwa okungcono kakhulu kubonakala kuncike endaweni ngqo futhi imbangela yomonakalo kanye nemigomo yesikhathi eside yomdlali.
Imiphumela Yokuhlinzwa
Bonke abashayeli bamabhayisikili engakhuluma nabo bakhetha ukungenelela okuhlinzekwa okubandakanya i-tissue graft noma i-patch. Bonke bangitshele ukuthi ukubuyiswa kwakumfushane kakhulu, nakuba amasonto amabili okuqala bevela kunzima kakhulu ukuba angakhululekile kakhulu. Omunye owayengu-Olympian wangitshela ukuthi, "Akekho owakutshela ukuthi kunzima kangakanani uma beqeda imisipha yakho yesisu."
Ngokuya ngohlobo lwenqubo yokuhlinza eyenziwe, lo mdlali ungase ahambe phakathi kwamasonto amabili, ukuhamba ngebhayisikili kalula kumqeqeshi ngesonto lesithathu futhi mhlawumbe emgwaqweni emavikini amane kuya kweyisithupha - nakuba abanye abagijimi bangitshele ukuthi ukubuyisana kwabo kuthatha okuningi izinyanga ezimbili kuya kwezintathu.
Kukhona izingozi zokuhlinzeka njalo futhi le nqubo ihambisana nesethi ejwayelekile, kufaka phakathi ingozi yokutheleleka, ukulahlwa kwezicubu, ukubuya kwezibonakaliso, noma kubi kakhulu. Ngo-2007, umshayeli wamabhayisikili uRyan Cox washona ngemva kwamasonto ambalwa emva kokuhlinzwa ukuze alungise umshini wakhe we-aliac. Ngenxa yokuthi le nqubo isasanda kusha, ayikho ukuhlolwa kwemiphumela yesikhathi eside kubagibeli ababenokuhlinzwa.
Omunye umshayeli wamabhayisikili engikhulume naye uthi usezizwela izinhlungu nezinhlungu emnyakeni ngemuva kokuhlinzwa kwakhe kanti omunye wangitshela ukuthi ezinye zezimpawu zakhe zibuyele eminyakeni emihlanu emva kokuhlinzwa.
Ngenkathi cishe bonke abagijimi engikhuluma nabo bangitshela ukuthi bayathokoza ukuthi babenomsebenzi futhi bazokwenza futhi, kuyisinqumo esiyinhloko futhi angithathi kalula. Ngisenza ucwaningo lwami, ngibutha ulwazi, futhi ngixoxa nabagijimi nabahlinzayo ngezikhathi zonke. Ngithola ukuthi inqubo engcono kakhulu yokuxilonga kanye nohlobo lokuhlinzekwa okunconywe kuxhomeke kakhulu kulowo ohlinzayo ohlinzayo; bonke kubonakala sengathi banenqubo oyintandokazi noma uhlobo lokufakelwa noma ukubamba iqhaza. Ngiye "nginikezwa" uhlaka oluvela emgodini wami omncane (umvuthwandaba omkhulu eduze kwe-ankle), isiqephu seDacron, isilwane samathangi (yebo, esivela kwenkomo), i-overpass ezungeze umcibisholo omncane, ngisho ne-stent.
Ngokusobala, lokhu akuyona inqubo evamile futhi akekho owazi kahle indlela engcono kakhulu. Ngaphandle kweYurophu, izimboni ezincane ezihlinzeka ngamathambo engizixoxe nazo ziye zenza le nqubo kumabhayisikili ase-US. UDkt. Ken Cherry, udokotela ohlinzayo we-vascular eNyuvesi yaseVirina wanikeza iphepha ngalesi simo eMhlanganweni weSocial for Vascular Surgery ngo-2008.
Ngangisebenza noDokotela Jason Lee noDkt. Cornelius Olcott eStanford Hospital eCalifornia.
Ucwaningo olwengeziwe
- I-Endofibrosis yama-Arteries we-Iliac: Inkinga engaphenduliwe (PDF)
- I-arteriopathy ku-Athlete High-Performance
- Imiphumela ye-PubMed Seach
Nakuba ukwenza ucwaningo lwakho kubalulekile futhi kuyasiza kakhulu, kubalulekile ukubuza imibuzo eningi futhi uthembele odokotela abahlinzayo, ngaphambi kokunquma ngokuhlinzwa.
Umthombo
Chevalier et al of the Service de Chirurgie Vasculaire et Thoracique, Angers, France, i-artery i-endacibrosis phakathi kwamabhayisikili ama-elite, i-Annals of Vascular Surgery, ngo-1986.
CS Lim *, MS Gohel, AC Shepherd, AH Davies.I-Artery I-Artery Ukucindezelwa Kwabadiski: Izindlela, Ukuxilongwa Nokunakekelwa. I-Eur J Vasc Endovasc Surg (2009) 38, 180-186.
Bender MH, et al. Ukulinganiselwa okuhlobene nemidlalo emidlalweni ye-aliac abagijimi bokukhuthazela: i-etiology, ukuxilongwa, ukwelashwa nokuthuthukiswa kwesikhathi esizayo. Imithi yezemidlalo. 2004; 34 (7): 427-42.
C. Kral, D. Han, W. Edwards, uP. Spittell, H. Tazelaar, K. Cherry. Ukuvimbela izidakamizwa zangaphandle zangasacacile kuma-bicyclists asebenzayo: Izinto ezintsha ezishintshayo nezokuhlukahluka kwabesifazane abane. Journal of Surgery Vascular 2002; 36: 565-70.