UMay-Thurner Syndrome

-Delile

• Ziyini izimpawu ze-May-Thurner syndrome?
• Ziyini izimbangela nezici zobungozi beMay-Thurner syndrome?
• Kutholakala kanjani?
• Uphathwa kanjani uMay-Thurner syndrome?
• Ukwelashwa kwe-May-Thurner syndrome
• Ukwelashwa kwe-DVT
• Yiziphi izinkinga ezihambisana neMay-Thurner syndrome?
• Ngabe ukululama ekuhlinzweni kunjani?
• Ukuphila ne-May-Thurner syndrome

Yini i-May-Thurner syndrome?

I-May-Thurner syndrome yisimo esenza ukuthi umthambo we-iliac ongakwesobunxele emgodleni wakho unciphise ngenxa yengcindezi evela emthanjeni we-iliac ongakwesokudla.

Kuyaziwa nangokuthi:

• i-iliac vein compression syndrome
• i-iliocaval compression syndrome
• I-Cockett syndrome

Umthambo we-iliac ongakwesobunxele umthambo omkhulu emlenzeni wakho wesobunxele. Kuyasebenza ukubuyisa igazi liye enhliziyweni yakho. Umthambo we-iliac wesokudla ingumthambo oyinhloko emlenzeni wakho wesokudla. Ihambisa igazi emlenzeni wakho wesokudla.

Umthambo we-iliac olungile kwesinye isikhathi ungahlala ngaphezulu komthambo we-iliac wangakwesobunxele, ubangele ingcindezi neMay-Thurner syndrome. Le ngcindezi emthanjeni we-iliac wesobunxele ingadala ukuthi igazi ligeleze ngokungavamile, okungaba nemiphumela emibi.

Ziyini izimpawu ze-May-Thurner syndrome?

Iningi labantu abane-May-Thurner syndrome ababoni zimpawu ngaphandle kwalapho lidala i-vein thrombosis (DVT) ejulile.

Kodwa-ke, ngoba iMay-Thurner syndrome ingenza kube nzima ngegazi ukuthi lijikeleze libuyele enhliziyweni yakho, abanye abantu bangathola izimpawu ngaphandle kwe-DVT.

Lezi zimpawu zenzeka kakhulu emlenzeni wesobunxele futhi zingafaka:

• ubuhlungu bomlenze
• ukuvuvukala kwemilenze
• umuzwa wobunzima emlenzeni
• ubuhlungu bomlenze ngokuhamba (i-venous claudication)
• ukuguqulwa kwesikhumba
• izilonda zomlenze
• imithambo enwetshiwe emlenzeni

I-DVT iyi-clot yegazi enganciphisa noma ivimbe ukugeleza kwegazi emthanjeni.

Izimpawu ze-DVT zifaka:

• ubuhlungu bomlenze
• ukuthamba noma ukushaya emlenzeni
• isikhumba esibukeka sikhanyayo, sibomvu, noma sizizwa sifudumele uma usithinta
• ukuvuvukala emlenzeni
• umuzwa wobunzima emlenzeni
• imithambo enwetshiwe emlenzeni

Abesifazane baba ne-pelvic congestion syndrome. Uphawu oluyinhloko lwe-pelvic congestion syndrome ubuhlungu be-pelvic.

Ziyini izimbangela nezici zobungozi beMay-Thurner syndrome?

I-May-Thurner syndrome ibangelwa umthambo we-iliac ongakwesokudla ophezu nokufaka ingcindezi emthanjeni we-iliac ongakwesokunxele ethangeni lakho. Abahlinzeki bezempilo abaqiniseki ukuthi kungani lokhu kwenzeka.

Kunzima ukwazi ukuthi bangaki abantu abane-May-Thurner syndrome ngoba imvamisa ayinazo izimpawu. Kodwa-ke, ngokusho kocwaningo lwango-2015, kulinganiselwa ukuthi kulabo abakha i-DVT bangayibeka ku-May-Thurner syndrome.

Ngokwesifundo sango-2018, iMay-Thurner syndrome yenzeka kwabesifazane uma kuqhathaniswa nabesilisa. Ngokwengeziwe, amacala amaningi eMay-Thurner syndrome enzeka kubantu abaphakathi kweminyaka engama-20 nengama-40, ngokusho kombiko wecala lowe-2013 nokubuyekezwa.

Izici zobungozi ezingakhuphula ubungozi be-DVT kubantu abane-May-Thurner syndrome zifaka:

• ukungasebenzi isikhathi eside
• ukukhulelwa
• ukuhlinzwa
• ukoma komzimba
• ukutheleleka
• umdlavuza
• ukusetshenziswa kwamaphilisi okuvimbela inzalo

Kutholakala kanjani?

Ukuntuleka kwezimpawu zikaMay-Thurner syndrome kungenza kube nzima kubahlinzeki bezokunakekelwa kwempilo ukuthi baxilonge. Umhlinzeki wakho wezokunakekelwa kwempilo uzoqala ngokucela umlando wakho wezokwelapha futhi akuhlolisise ngokomzimba.

Umhlinzeki wakho wezokunakekelwa kwempilo uzosebenzisa izivivinyo ze-imaging ukusiza ukubona kuncipha emthanjeni wakho we-iliac wesobunxele. Kungasetshenziswa indlela engahlaseli noma engenayo.

Ezinye izibonelo zokuhlolwa kwe-imaging umhlinzeki wakho wezokunakekelwa kwempilo angakwenza zihlanganisa:

Ukuhlolwa okungavumelekile:

• i-ultrasound
• Iskena se-CT
• Ukuskena kwe-MRI
• venogram

Ukuhlolwa okuhlasela:

• i-venogram esekwe ngepayipi
• i-intravascular ultrasound, esebenzisa i-catheter ukwenza i-ultrasound ngaphakathi kwesitsha segazi

Uphathwa kanjani uMay-Thurner syndrome?

Akuwona wonke umuntu one-May-Thurner syndrome ezokwazi ukuthi banayo. Kodwa-ke, isimo singadinga ukwelashwa uma siqala ukuveza izimpawu.

Kubalulekile ukwazi ukuthi kungenzeka ukuba ne-May-Thurner syndrome ngaphandle kwe-DVT.

Ukuncipha kokugeleza kwegazi okuhambisana nokuncipha komthambo we-iliac ongakwesokunxele kungadala izimpawu ezifana nokuthi:

• ubuhlungu
• ukuvuvukala
• izilonda zomlenze

Ukwelashwa kwe-May-Thurner syndrome

Ukwelapha iMay-Thurner syndrome kugxile ekwenzeni ngcono ukugeleza kwegazi emthanjeni we-iliac wangakwesokunxele. Le ndlela yokwelashwa ayigcini nje ngokusiza ekunciphiseni izimpawu, kodwa futhi inganciphisa ubungozi bokuthola i-DVT.

Kunezindlela ezimbalwa lokhu okungenziwa ngazo:

• I-angioplasty ne-stenting: Ipayipi elincane elinebhaluni esicelweni salo lifakwa emthanjeni. Ibhaluni ligcwele ukuvula umthambo. Kubekwa ithubhu elincane lemeshini elibizwa ngokuthi i-stent ukugcina umthambo uvulekile. Ibhaluni lihlanjululwe futhi lasuswa, kepha i-stent ihlala endaweni.
• Ukuhlinzwa nge-Bypass: Igazi lihanjiswa kabusha lizungeze ingxenye ecindezelwe yomthambo ngokuxhunyelelwa ngokudlula.
• Ukubeka kabusha umthambo we-iliac ofanele: Umthambo we-iliac wesokudla uhanjiswa ngemuva komthambo we-iliac wangakwesokunxele, ngakho-ke awufaki ingcindezi kuwo. Kwezinye izimo, izicubu zingabekwa phakathi komthambo we-iliac ongakwesobunxele nomthambo ofanele ukukhulula ingcindezi.

Ukwelashwa kwe-DVT

Uma une-DVT ngenxa ye-May-Thurner syndrome, umhlinzeki wakho wezokunakekelwa kwempilo angasebenzisa futhi izindlela ezilandelayo zokwelapha:

• Abanciphisa igazi: Ama-thinner egazi angasiza ukuvimbela amahlule egazi.
• Imithi yokuqothula: Uma izinciphisi zegazi zinganele, imishanguzo yokuvala ama-clot ingalethwa nge-catheter ukusiza ukuqeda ihlwili. Kungathatha noma yikuphi ukusuka emahoreni ambalwa kuya ezinsukwini ezimbalwa ukuthi i-clot inyibilike.
• Isihlungi se-Vena cava: Isihlungi se-vena cava sisiza ukuvimbela amahlule egazi ekuthutheleleni emaphashini akho. I-catheter ifakwa emthanjeni entanyeni yakho noma emgodini bese ufakwa kwi-vena cava engaphansi. Isihlungi sibamba amahlule ukuze angafiki emaphashini akho. Ayikwazi ukuvimba amahlule amasha ekubunjweni.

Yiziphi izinkinga ezihambisana neMay-Thurner syndrome?

I-DVT yinkinga enkulu eyimbangela yeMay-Thurner syndrome, kepha futhi ingaba nezinkinga zayo. Lapho ihlule legazi emlenzeni liphuma, lingadabula phakathi kwegazi. Uma ifinyelela emaphashini akho, kungadala ukuvinjelwa okwaziwa ngokuthi i-pulmonary embolism.

Lesi kungaba yisimo esisongela impilo esidinga ukwelashwa okuphuthumayo.

Thola usizo ngokushesha uma uhlangabezana:

• ukuphelelwa umoya
• ubuhlungu besifuba
• ukukhwehlela ingxube yegazi namafinyila

Ngabe ukululama ekuhlinzweni kunjani?

Okunye ukuhlinzwa okuhambisana neMay-Thurner syndrome kwenziwa ngokugula okungaphandle, okusho ukuthi ungaya ekhaya ngosuku olufanayo ngemuva kokuthola. Kufanele ukwazi ukubuyela emisebenzini ejwayelekile kungakapheli izinsuku ezimbalwa kuye kwesonto.

Ngokuhlinzwa okwedlula kakhulu okuhilelekile, uzoba nobuhlungu ngemuva kwalokho. Kungathatha amasonto ambalwa ezinyangeni ezimbalwa ukutakula ngokugcwele.

Umhlinzeki wakho wezokunakekelwa kwempilo uzokuyalela ukuthi udinga ukulandelela kangaki. Uma une-stent, ungadinga isheke le-ultrasound cishe ngesonto ngemuva kokuhlinzwa, kanye nokuqapha ngezikhathi ezithile ngemuva kwalokho.

Ukuphila ne-May-Thurner syndrome

Abantu abaningi abane-May-Thurner syndrome badlula empilweni bengazi ukuthi banayo. Uma ibangela i-DVT, kunezindlela eziningi zokwelashwa eziphumelelayo. Kubalulekile ukuthi uqiniseke ukuthi uyazi izimpawu ze-embolism ye-pulmonary ukuze uthole usizo ngokushesha.

Uma unezimpawu ezingapheli ze-May-Thurner syndrome, khuluma nomhlinzeki wakho wezokunakekelwa kwezempilo mayelana nokukhathazeka kwakho. Bangasebenza eduze nawe ukuthola ukuthi unesifo esinjani futhi bakweluleke ngezindlela ezingcono zokulapha nokulawula.