Subclavia kubata chirwere, chimiro chepachirwere chirwere chirwere (PAD), isati yezviratidzo zvinokonzerwa nekuvhara mune imwe ye subclavian arteri, mishonga yakawanda inopa maoko. Nemhaka yenzvimbo yekuvhara ropa, ropa rinovharwa ("kubiwa") kure neuropi kusvika kune ruoko rwakabata. Nemhaka yeizvi, zviratidzo zve subclavia inobata zvirwere zvinosanganisira kwete zviratidzo zvehondo chete asiwo zviratidzo zvehutano.
Overview
Kuti unzwisise subclavia kuba chirwere, zvinobatsira kuziva chimwe chinhu pamusoro pemasikirwo emuropa mumusoro nemutsipa. Ropa rinodonhedzwa muaorta nemoyo mumwe nomumwe, muAortic arch - benderedhi yakagadzirwa nemabhiza muAorta iri pasi pehuro. Kubva pamagetsi, mapoka e-aorta pasi kusvika kumapfupa nemimba.
Icho chidimbu che aortic arch chinopa mitsetse yakakosha yeropa iyo inopa maoko uye musoro - i-subclavia arteri uye mararo carotid. I-subclavia arterio inotsika pasi pemapfupa emirasi kuti ipe ropa mune rumwe ruvoko. Vasati vapa zvombo, zvisinei, imwe nhengo ye subclavia inopa hutachiona hwetsika, iyo inopa ropa kumucheto weuropi.
Pasi pedo reuropi, mabhiri maviri maviri uye mararo maviri emakarotidhi anotaurirana nemumwe mushure mekugadzirwa kwevascular inonzi Circle of Willis. Denderedzwa yaWotis inobvumira ropa kuti ridzivirire kubva kune rimwe ariti kune rimwe, senzira yekudzivirira hutano hwehuropi kana imwe yemararotid kana vertebral arteri inofanira kudziviswa.
Subclavia steal syndrome inoshanda seiyi: atherosclerosis inobvisa kuvhara (zvimwe zvisingatauri kana zvakakwana) mune imwe yema subclavia arteri pamberi pekubviswa kweiyo vertebral artery. Ropa rinoyerera kusvika kune yakasvibira arterial arteri saka rakaderera. Nokuda kwechikonzero ichi, ropa rinotungamirirwa zvakare kubva muuropi, kuburikidza neChirungu chaWeisis, pasi pechirwere chetterbral, uye kudzokera kune subclavia ariti kunze kwekuvhara.
Nokudaro, ne subclavia inobata chirwere cheropa chinonyatso "kubiwa" kubva muuropi kuti ipe ropa risina simba.
Somugumisiro, kwete chete kuti ruoko rwakabata rune ropa rakaderera, asi ndizvo zvakaita uropi.
Zviratidzo
Zviratidzo zve subclavia inobata zvirwere zvinovimba nehuwandu hwekuvhara mukati mejasi re subclavia, uye pamusoro pehuwandu hwebasa riri kuitwa nemaoko akabatwa.
Kazhinji, pangave pasina zviratidzo zvachose pazororo. Asi, kana kuvhara kwakakura zvakakwana, apo ruoko rwakabata rwuri kuratidzwa, zvinhu zviviri zvinoitika. Chokutanga, mishonga yemaoko inofa nenzara yeropaji, inobereka kupupurika (kurwadziwa kunorwadza uye kuputika). Asi zvinonyanya kukosha, ropa rakawanda rinobviswa kubva muuropi, uye zviratidzo zvehutano zvinoitika nekuda kwekushaya kukwana kweropa. Izvi zviratidzo zvepfungwa zvinogona kusanganisira kuchena , syncope (kurasikirwa kwekuziva), zviratidzo zviviri uye zvimwe zvinetso zvinotarisa, kurira munzeve, uye vertigo .
Sezvo chivharo chekuvhara kwechivharo ichiwedzera, zviratidzo zvinowanzoitwa zvishoma uye zvishomanana.
Kuziva
Kuti uongorore subclavia kuba chirwere, kutanga chiremba anofanira kuitsvaga. Izvi zvingasaitike kunze kwekuti murwere anotsanangura zviratidzo zvinoratidza kuti izvi zvinoratidzwa.
Pane imwe nguva subclavian inobata chirwere inofungidzirwa, zvisinei, kazhinji hazvisi zvakaoma kuita kuti kuongororwa.
Nemhaka yekuti pane kuvharwa kwechikamu mune rimwe subclavia arteri, ropa rega mune ruoko rwakagadzikana rakaderera. Saka pane kazhinji kacho kusiyana kukuru kweropa mukati mezvisungo zviviri. Iko kusvibira mune ruoko rwakagadzikanawo kunopera.
Kuongororwa kunogona kusimbiswa nekuongororwa kusingaoneki, kwakadai seMRI kana CT scan , kana neye ultrasound (echo) maitiro.
Kurapa
Nemhaka yokuti subclavia inobata chirwere chechimiro chePAD, inobatwa nenzira imwechete iyo chero PAD inobatwa .
Atherosclerotic cardiovascular disease chirwere chinopfuurira chinokanganisa mitsipa yeropa mumuviri wose. Zvinonyanya kukosha kushandisa mashoma ekugadzirisa matanho anozivikanwa kuti anonoke kufambira mberi kwehutachiona hwehutachiona, kusanganisira kusvuta kusvuta , kuisa ropa ropa, kutarisana nehutachiona hwehutachiona, kutarisira masero, maitiro, nekudzivirira chirwere cheshuga.
Zviratidzo zvekoroka subclavia inobata chirwere chinogona kuvandudzwa nezviyero zvakadaro. Kana zviratidzo zvichinyanya kukosha, kana zvakadaro, kuvharira pachako kunogona kurapwa nekugadzirwa kwepurogiramu yekuvhiya, kana ne angioplasty uye kupisa .
Sources:
Toole, JF, McGraw, CP. Iyo kuba syndromes. Annu Rev Med 1975; 26: 321.
Smith, JM, Koury, HI, Hafner, CD, Welling, RE. Subclavia kubata chirwere. Kuongororwa kwemashure makumi mashanu nemakumi mashanu anotevera. J Cardiovasc Surg (Torino) 1994; 35:11.
Chatterjee S, Nerella N, Chakravarty S, Shani J. Angioplasty pachake neAngioplasty uye inopisa zve subclavia arteri stenosis - kugadziriswa kwekuongorora uye meta-analysis. Am J Ther 2013; 20: 520.