I-subclavian steal syndrome, uhlobo lwe- peripheral artery disease (PAD), isethi yezimpawu ezibangelwa ukuvinjelwa komunye wemisipha ye-subclavia, imishanguzo emikhulu ehambisa izingalo. Ngenxa yendawo yokuvimba, igazi livinjelwa ("libiwe") kude nobuchopho kuya engxenyeni ethintekile. Ngenxa yalokho, izimpawu ze-subclavian steal syndrome azibandakanyi izimpawu zengalo kuphela kodwa nezimpawu ze-neurological.
Sibutsetelo
Ukuze uqonde i-subclavian steal syndrome, kuyasiza ukwazi okuthile mayelana nemithambo yegazi ekhanda nasemqaleni. Igazi likhishwa e-aorta ngenhliziyo ngayinye, emgodini we-aortic - ukugoba okwenziwe ngamahhashi e-aorta esezansi entanyeni. Kusukela ku-arch, izifundo ze-aorta phansi ukuya esifubeni nasesisu.
Ingxenyana yomcibisholo we-aortic inikeza imithwalo yegazi ebuhlungu ehlinzeka izingalo kanye nekhanda - imishanguzo ye-subclavia kanye nemithambo ye-carotid. Imishanguzo ye-subclavia ihamba ngaphansi kwamathambo ekholomu ukunikeza igazi engalweni ngayinye. Ngaphambi kokunikeza izikhali, nokho umthambo ngamunye we-subclavian unikeza umthambo we-vertebral, ohlinzeka ngegazi engxenyeni yobuchopho.
Ngaphansi kobuchopho, imishanguzo emibili ye-vertebral kanye ne-carotid yonke inxushunxisana omunye ngesakhiwo se-vascular okuthiwa i-circle of Willis. Umjikelezo kaWillis uvumela igazi ukuba liguqulwe kusuka komunye umthambo ukuya komunye, njengendlela yokuvikela izicubu zobuchopho uma omunye we-carotid noma i-vertebral arteries kufanele avinjelwe.
I-subclavian steal syndrome isebenza kanje: ukuphefumula kwesifo sofuba kubangela ukuvinjelwa (okungakhathaliseki ukuthi kuyingxenye noma kuqedile) kwelinye lamathambo e-subclavia ngaphambi nje kokususwa komthambo we-vertebral. Ukugeleza kwegazi ku-artebral ethintekile kunciphile. Ngenxa yalesi sizathu, igazi liqondiswa kabusha kusukela ebuchosheni, nge Circle of Willis, phansi umthambo we-vertebral ethintekile, futhi ubuyele emgodini we-subclavia ngaphesheya kokuvinjelwa.
Ngakho-ke, ngegazi le-subclavian steal syndrome igazi "libiwe" ngokuphumelelayo ebuchosheni ukuze linikeze ingalo engenayo igazi.
Ngenxa yalokho, ingalo echaphazelekayo ayinayo igazi elinciphile, kodwa nobuchopho bunjalo.
Izimpawu
Izimpawu ze-subclavian steal syndrome zithembele kwizinga lokuvimba emthini we-subclavia, nangomsebenzi owenziwe ngengalo ethintekile.
Ngokuvamile, kungase kube khona izimpawu nakakhulu ekuphumuleni. Kodwa, uma ukuvinjelwa kukwanele, uma ingalo ethintekile isetshenziswa, izinto ezimbili zenzeka. Okokuqala, izidumbu zengalo zibulawa yi-oksijeni, zikhiqiza ukuhlunga (ubuhlungu obunzima nokucindezeleka). Kodwa okubaluleke nakakhulu, igazi eliningi likhishwa kude nobuchopho, futhi izimpawu zezinzwa zenzeka ngenxa yokungena okwanele kwegazi. Lezi zimpawu zezinzwa zingase zihlanganise ubukhulu bokukhanya , i- syncope (ukulahlekelwa kwengqondo), umbono ophindwe kabili nezinye ukuphazanyiswa okubukwayo, ukukhala ezindlebeni, kanye ne- vertigo .
Njengoba izinga lokuvinjelwa likhuphuka, izimpawu zenzeka ngokuzivocavoca kwengalo encane.
Ukuxilongwa
Ukuze uhlolisise i-subclavian steal syndrome, udokotela kuqala udinga ukuyihlola. Lokhu kungenzeki ngaphandle kokuthi isiguli sichaze izimpawu ezikhomba ukuthi lokhu kutholakala.
Uma i-subclavian steal syndrome icatshangwa, Nokho, ngokuvamile akulula ukwenza ukuxilongwa.
Ngoba kukhona ukuvinjelwa okuyingxenye emgodini we-subclavia, ukucindezelwa kwegazi engxenyeni ethintekile kuncishisiwe. Ngakho-ke ngokuvamile kuvame umehluko omkhulu emzimbeni wegazi phakathi kwezingalo ezimbili. Imifula engxenyeni ethintekile nayo iyancipha.
Ukuxilongwa kungaqinisekiswa ngokuhlolwa okungenasidingo, okufana ne- MRI noma i- CT scan , noma amasu e-ultrasound (echo).
Ukwelapha
Ngenxa yokuthi i-subclavian steal syndrome iyindlela ye-PAD, iphathwa ngendlela efanayo nanoma iyiphi i- PAD ephathwayo .
Isifo se-atherosclerotic isifo esiqhubekayo esithinta imithwalo yegazi emzimbeni wonke. Kubaluleke kakhulu ukusebenzisa zonke izinyathelo zokunciphisa ingozi eyaziwa ukunciphisa ukuqhuma kwesifo sofuba, kuhlanganise ukuyeka ukubhema , ukuphathwa kwegazi, ukulawulwa kwesifo somfutho wegazi, ukuphathwa kwesisindo, ukuvivinya umzimba nokulawula isifo sikashukela.
Izimpawu ze-subclavia ezinomsoco we-syndrome zingathuthuka ngezinyathelo ezinjalo. Uma izimpawu ziphawuleka noma ziphikelela, noma kunjalo, ukuvimbela ngokwayo kungaphathwa ngenqubo yokuphambana nokuhlinzwa, noma nge- angioplasty ne- stenting .
Imithombo:
Toole, JF, McGraw, CP. Ukweba ama-syndromes. U-Annu Rev Med 1975; 26: 321.
Smith, JM, Koury, HI, Hafner, CD, Welling, RE. I-subclavian steal syndrome. Ukubuyekezwa kwamacala angu-59 alandelanayo. UJ Cardiovasc Surg (iTorino) 1994; 35:11.
I-Chatterjee S, iNerella N, i-Chakravarty S, i-Shani J. Angioplasty yodwa ngokumelene ne-angioplasty futhi igxila kakhulu kwe-subclavian umthamo stenosis - ukubuyekezwa okuhlelekile nokuhlaziywa kwe-meta. Am J Ther 2013; 20: 520.