Isifo se-arterial peripheral (i-PAD) yisimo lapho enye noma eminingi ye- arteries ihambisa igazi emilenzeni, izingalo, ikhanda noma isisu zivinjelwe noma zivinjelwe kancane, ngokuvamile ngenxa ye- atherosclerosis . Uma ukugeleza kwegazi kuya emlenzeni akusekho okwanele ukuhambisana nesidingo, umuntu onama-PAD angase abone izimpawu.
Izimpawu
Uphawu oluvame kakhulu lwe-PAD "ukucaciswa." Ukuqhaqhazela ubuhlungu, ukuphazamiseka noma ukunganaki - okungafani nokucasula nje kuphela kunzima kakhulu - okwenzeka emlenzeni othintekile.
Ngokuvamile, ukuhlushwa kuvela ngesikhathi sokuvivinya umzimba, futhi kukhululeka ngokuphumula.
Njengoba i-PAD ivame ukuthinta imilenze, ukucacisa kakhulu kubonakala sengathi ubuhlungu bomlenze uma uhamba. Kuncike ekutheni umcibisholo womlenze ukuvinjelwa kutholakala, ukucaciswa komlenze kungathinta unyawo, ithole, ithanga noma amathanga. Abantu abane-PAD kwelinye lamathambo anikezela emaphethelweni angenhla bangabhekana nokuhlanzwa emandleni noma ehlombe; kanti abanye bangabhekana nezimpawu zezinzwa ngesikhathi sokuvivinya ingalo, isimo esibizwa ngokuthi "i- subclavian steal syndrome ."
Ngezinye izikhathi i-PAD izobangela ukuphikisa okuqhubekayo ngisho nokuphumula. Ukuphumula ukuphumula ngokuvamile kusho ukuthi ukuvimbela ukuvimbela komzimba kunzima kakhulu, futhi isigungu esithintekile asitholi ukutholakala kwegazi okwanele ngisho nokuphumula.
Ngoba ukucacisa akulandeli njalo iphethini evamile - okungukuthi, ubuhlungu ngesikhathi sokuzikhandla, ngokuphumula ngesikhathi sokuphumula - ukuxilongwa kwe-PAD kufanele kubhekwe noma yisiphi isikhathi umuntu oneminyaka engaphezu kwengu-50 ubudala, onobungozi bokuthi i-atherosclerosis , ukuzwa ubuhlungu obungachazeki izingalo noma imilenze.
I-PAD enamandla kakhulu ingabangela isilonda noma ngisho nesifo esiyinkimbinkimbi yesigungu esithintekayo.
Izimbangela
Ezimweni eziningi, i-PAD ibangelwa yi- atherosclerosis . Lokhu kusho ukuthi izinhlobo ezifanayo zengozi ezikhiqiza izifo ze-coronary artery (CAD) - ikakhulukazi amazinga we- cholesterol , ukubhema , umfutho wegazi ophezulu nesifo sikashukela - futhi kuveza i-PAD.
Eqinisweni, ngoba i-PAD ne-CAD ibangelwa inqubo efanayo yesifo, lapho i-PAD itholakale, kaningi kusho ukuthi i-CAD nayo ikhona.
Ngokuvamile, i-PAD ingabonakala kubantu abangenayo i-atherosclerosis. Ngokwesibonelo, i-PAD ingabangelwa ukuhlukumezeka kumalungu, ukuvezwa kwemisebe, nemithi ethile (izidakamizwa ze-ergotamine) ezisetshenziselwa ukuphatha ikhanda lomuthi we-migraine .
Ukuxilongwa
I-PAD ingatholakala ukuthi ihlolwa ngokungahlosiwe. Kwezinye izimo, i-PAD ingatholakala ngokuhlolwa kwangokwenyama, lapho ukushaywa kwe-pulse okunciphisisiwe kubonakala khona emlenzeni othintekile. Kodwa kaningi, okunye kokuhlolwa okukhethekile okudingekayo ukuze kuhlolwe i-PAD.
Ukubona i-PAD emilenzeni kungenziwa ngokusebenzisa " inkomba ye-ankle-brachial ," noma i-ABI, lapho ukucindezelwa kwegazi kulinganiswa khona futhi kuqhathaniswa ne-ankle kanye nengalo. Inkomba ephansi ye-ABI ibonisa ukunciphisa kwengcindezi yegazi emthini wegundane , okubonisa ukuthi i-PAD ikhona.
I-Plethysmography yinye inqubo esetshenziselwa ukuhlonza i-PAD. Ngalesi sivivinyo, umoya uphonswa uchungechunge lwezinkomishi ezibekwa emlenzeni, futhi kucatshangwa ukuthi ukucindezela komfutho we-artery ngaphansi kompheme ngamunye. Ukuvinjelwa endaweni ethile emthonjeni kuzoholela ekunciphiseni kwe-pulse enciphise ngaphesheya kwendawo yokuvimba.
"I-Duplex ultrasonography" yi-test ekhethekile ye-ultrasound enikeza ukulinganisela kokugeleza kwegazi emazingeni ahlukahlukene ngaphakathi kwe-artery.
Ukwehla okungazelelwe kokugeleza kwegazi kusikisela ukuvinjelwa okuyingxenye endaweni yokudonsa.
Uma udokotela wakho esolula i-PAD, eyodwa noma ngaphezulu yalezi zivivinyo ezingenasidingo ngokuvamile zanele ukwenza ukuxilongwa. Namuhla, i-ABI wuhlolo olusetshenziswa kakhulu kakhulu.
Ukwelapha
Ngenkathi i-PAD emnene noma elinganisiwe ingelashwa ngemithi kanye nezinguquko zendlela yokuphila, amacala aqinile kakhulu adinga ukuhlinzekwa ngokudlulela noma i-angioplasty ekunciphiseni ukuvimbela. Nazi imininingwane eminingi yokwelashwa kwe-PAD .
Imithombo:
Hirsch, AT, Criqui, MH, Treat-Jacobson, D, et al. Ukuhlolwa kwesifo se-peripheral disease, ukuqwashisa, nokwelashwa ekunakekelweni okuyinhloko. I-JAMA 2001; 286: 1317.
Hirsch, AT, Haskal, ZJ, Hertzer, NR, et al. I-ACC / AHA 2005 Izikhombandlela zokuphatha iziguli ezinezifo ezithathelwanayo zomzimba (umkhawulo ophansi, i-renal, i-mesenteric, ne-aortic yesisu): umbiko wokubambisana ovela ku-American Association for Vascular Surgery / Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions , I-Society for Vascular Medicine ne-Biology, Society of Radiology Interventional, kanye ne-ACC / AHA Task Force on Guidelines Practice (Ikomidi Lokubhala Ukuthuthukisa Iziqondiso Zokuphathwa Kwezilwelwane Nge-Peripheral Arterial Disease): yamukelwa yi-American Association of Cardiovascular and Pulmonary Rehabilitation ; I-National Heart, Lung, ne-Blood Institute; UmNyango Wezobuhlengikazi Bamasosha; I-TransAtlantic Inter-Society Consensus; kanye ne-Vascular Disease Foundation. Ukujikeleza kuka-2006; 113: e463.