I-May Thurner syndrome, noma i-iliac vein compression syndrome, iyenzeka lapho i-artery evamile ye-aliac iwela phezu kwe-vein ye-aliac ejwayelekile, kwesineke phakathi kwe-artery nomgogodla. Lolu shintsho ku-anatomy lwandisa ithuba lokuthuthukisa i- thrombosis ejulile ye-vein (DVT) .
Izimpawu zikaMay Thurner Syndrome
Bonke abantu abane-May Thurner syndrome ngeke babe nezibonakaliso ezincane ekucindezelweni kwe-vein ye-veic ejwayelekile yesokunxele.
Ngezinye izikhathi, itholakala ngengozi lapho ukucabanga (ikakhulukazi CT scan noma i-MRI) kwenziwa ezinye izizathu. Isikhathi esiningi sitholakala ngesikhathi sokusebenza kwe-DVT yomlenze wesobunxele. Izimpawu zingafaka ubuhlungu kanye / noma ukuvuvukala. I-May Thurner syndrome ivela kaningi kulabo besifazane abaneminyaka engama-20 kuya kwengu-50.
Ingozi Ekhulayo Yezingubo Zegazi
Ukucindezeleka kwesineke esivamile esivela e-aliac kubangela ukucasuka / ukulimala emthonjeni wegazi, okuholela ekuqiniseni kwesigxobo segazi. Lokhu ukuqina kwodonga lwamathambo wegazi kubangela ukuhlanganiswa kwegazi (okubizwa nangokuthi i-stasis), okwandisa ingozi yokubunjwa kwe-clot. Lesi sici sengozi sihlangene nezinye izici eziyingozi zokubunjwa kwe-clot , njenge-contraception ye-hormonal (amaphilisi okulawula ukuzalwa) noma ukukhubazeka isikhathi eside ukuhamba ngemva kokuhlinzwa, kungase kwandise le ngozi.
Ukuxilongwa
Ukubona ukuthi i-May Thurner syndrome ingaba nzima kuncike endaweni yegazi.
Ama-clots amaningi egazi ezingalweni nasemilenzeni angabonwa kalula kwi-Doppler ultrasound, kodwa imithwalo yegazi ye-pelvis ayikho.
I-May Thurner syndrome kufanele ibhekwe njengesizathu sokungavinjelwa (ngaphandle kwesizathu esaziwayo njengengozi noma ukutheleleka) i-blood clot emlenzeni wesobunxele, ikakhulukazi uma kube khona i-clot engaphezu kweyodwa emlenzeni wesobunxele.
Ukuzibona ngokuvamile kudinga izithombe ezithize zemithwalo yegazi, njenge-CT (CAT) venography noma i-magnetic resonance venography (i-MRI ye-veins). I-intravascular ultrasound (i-ultrasound ngaphakathi kwesitsha segazi) ingaba usizo kakhulu ekuboneni ukucindezelwa kwesinxele se-aliac esivamile.
Ngemuva kokuthola uMe Thur Thurner syndrome, ochwepheshe abaningi bangancoma umsebenzi wokubheka ezinye izingozi zokubunjwa kwe-clot. Lokhu kuvame ukubizwa ngokuthi umsebenzi ophezulu we-hypercoagulable.
Izinketho zokwelapha
Uma kukhona i-clot yegazi, ukwelashwa nge-anticoagulation kuyadingeka. Ngeshwa, ukwelashwa kwesikhashana nge-anticoagulation (igazi elincane njenge-heparin, i-enoxaparin, noma i-warfarin) alanele ukuvimbela ukwakheka kwesinye isikhathi. Ukwelapha nge-"clot buster" imithi efana ne- tissue plasminogen activator (tPA) noma i-thrombectomy (ukukhishwa kwe-mechanical clot) kuvame ukudingeka ngesikhathi sokuxilongwa. Lezi zinqubo zingase zenziwe yi-radiologist engenele noma udokotela ohlinzayo.
Ukwelapha i-clot yegazi ingxenye eyodwa kuphela yokwelapha. Ukukhipha i-clot yegazi ngeke kuthathe inkinga engaphansi kwe-vein ye-aliac evamile ephoqelelwe, ibeka engozini enkulu yokubunjwa kwe-clot.
Ukuze uvimbele ukwakheka kwegazi le-clot, i- stent , i-wire mesh encane, ingafakwa ukuze igcine ivulekele. Lezi zokwelashwa (i-tPA, i-thrombectomy, ukubekwa kwe-stent) zingase zenzeke ngesikhathi esifanayo njenge-intravascular ultrasound ezivumela ukuqinisekiswa kokutholakala kwegazi kanye nokwelashwa okuqondile.
Esikhathini esisheshayo (izinyanga ezifika ku-3-6) emva kokubekwa kwe-stent, ukwelashwa kwe-anticoagulation kuzoqhubeka kodwa kungadingeki isikhathi eside.