I-Thoracic outlet syndrome

I-Thoracic outlet syndrome yisimo esingavamile esibandakanya:

• Ubuhlungu entanyeni nasemahlombe
• Ukuba ndikindiki nokuncinza kweminwe
• Ukubamba okubuthakathaka
• Ukuvuvukala kwesitho esithintekile
• Ukubanda kwesitho esithintekile

I-thoracic outlet yindawo ephakathi kwe-ribcage ne-collarbone.

Imithambo evela emgogodleni nasemithanjeni emikhulu yegazi yomzimba idlula esikhaleni esincane eduze kwehlombe lakho nethambo lekhola elisendleleni eya ezingalweni. Kwesinye isikhathi, asikho isikhala esanele sezinzwa zokudlula ngethambo lezimbambo nangaphezulu.

Ingcindezi (ukucindezelwa) kule mithambo yegazi noma izinzwa kungadala izimpawu ezingalweni noma ezandleni.

Ingcindezi kungenzeka uma une:

• Ubambo olwengeziwe ngaphezu kolokuqala.
• Ibhande eliqinile elingajwayelekile elixhumanisa umgogodla nezimbambo.

Abantu abanalesi sifo bavame ukulimaza le ndawo esikhathini esedlule noma basebenzise ngokweqile ihlombe.

Abantu abanezintamo ezinde namahlombe adonsile kungenzeka babe sethubeni lokuthuthukisa lesi simo ngenxa yengcindezi eyengeziwe emithanjeni yegazi.

Izimpawu ze-thoracic outlet syndrome zingafaka:

• Ubuhlungu, ukuba ndikindiki, nokushosheka ngeminwe ephinki nendandatho, nengalo yangaphakathi
• Ubuhlungu nokushoshozela entanyeni nasemahlombe (ukuthwala okuthile okusindayo kungenza ubuhlungu bube nzima kakhulu)
• Izimpawu zokusakazeka okungalungile esandleni noma engalweni (umbala oluhlaza okwesibhakabhaka, izandla ezibandayo, noma ingalo evuvukile)
• Ubuthakathaka bemisipha esesandleni

Umhlinzeki wakho wokunakekelwa kwezempilo uzokuhlola abuze ngomlando wakho wezokwelapha nezimpawu.

Ukuhlolwa okulandelayo kungenziwa ukuqinisekisa ukuxilongwa:

• I-Electromyography (EMG)
• I-CT angiogram
• I-MRI
• Isifundo se-velocity velocity Study
• I-X-ray

Ukuhlolwa kwenziwa futhi ukukhipha ezinye izinkinga, njenge-carpal tunnel syndrome noma i-nerve eyonakele ngenxa yezinkinga ezisentanyeni.

Ukwelashwa ngokomzimba kuvame ukusetshenziselwa ukwelapha i-thoracic outlet syndrome. Kuyasiza:

• Yenza imisipha yakho yamahlombe iqine
• Thuthukisa ububanzi bokunyakaza ehlombe
• Thuthukisa ukuma okungcono

Umhlinzeki wakho angakunikeza umuthi wezinhlungu.

Uma kunengcindezi emthanjeni, umhlinzeki wakho angakunika okunciphise igazi ukuvimbela i-clot yegazi.

Ungadinga ukuhlinzwa uma ukwelashwa ngokomzimba kanye nezinguquko emsebenzini kungazenzi ngcono izimpawu zakho. Udokotela ohlinzayo angenza ukusika ngaphansi kwekhwapha lakho noma ngenhla nje kwekhola lakho.

Ngesikhathi sokuhlinzwa, lokhu okulandelayo kungenziwa:

• Kususwa ubambo olwengeziwe futhi kunqunywa imisipha ethile.
• Kususwa ingxenye yembambo yokuqala ukukhipha ingcindezi endaweni.
• Ukuhlinzwa nge-Bypass kwenziwa ukuphindisela igazi elizungeze ukucindezelwa noma kususwe indawo edala izimpawu.

Udokotela wakho futhi angaphakamisa ezinye izindlela, kufaka phakathi i-angioplasty, uma umthambo uncishisiwe.

Ukuhlinzwa ukususa ubambo olungeziwe nokugqashula amabhande e-fiber aqinile kunganciphisa izimpawu kwabanye abantu. Abanye abantu banezimpawu ezibuyayo ngemuva kokuhlinzwa.

Izinkinga zingenzeka nganoma yikuphi ukuhlinzwa, futhi kuya ngohlobo lwenqubo kanye ne-anesthesia.

Izingozi ezihlobene nalokhu kuhlinzwa zifaka:

• Ukulimala kwezinzwa noma imithambo yegazi, kubangele ukuba buthakathaka kwemisipha
• Ukuwa kwamaphaphu
• Ukwehluleka ukukhulula izimpawu

• I-anatomy ye-Thoracic outlet

I-Filler AG. Ukufakwa kwe-brachial plexus nerve kanye ne-thoracic outlet syndromes. Ku: Winn HR, ed. Ukuhlinzwa Kwe-Youmans neWinn Neurological. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2017: isahluko 250.

I-Osgood MJ, iLum YW. I-Thoracic outlet syndrome: i-pathophysiology kanye nokuhlolwa kokuhlola. Ku: Sidawy AN, Perler BA, ama-eds. Rutherford’s Vascular Surgery and Endovascular Therapy. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2019: isahluko 120.