Kulepheretsa SVC

Kutsekeka kwa SVC ndikuchepa kapena kutsekeka kwa vena cava (SVC), womwe ndi mitsempha yachiwiri yayikulu mthupi la munthu. Vena cava wapamwamba amasuntha magazi kuchokera kumtunda kwa thupi kupita kumtima.

Kulepheretsa SVC ndizovuta.

Nthawi zambiri zimayambitsidwa ndi khansa kapena chotupa mu mediastinum (dera lachifuwa pansi pa chifuwa cha m'mawere ndi pakati pa mapapo).

Mitundu ina ya khansa yomwe ingayambitse matendawa ndi monga:

• Khansa ya m'mawere
• Lymphoma
• Khansara yamapapu yam'mapapo (khansa yamapapu yomwe imafalikira)
• Khansa ya testicular
• Khansa ya chithokomiro
• Chotupa chotupa

Kulepheretsa SVC kungayambitsenso chifukwa cha zinthu zopanda khansa zomwe zimayambitsa mabala. Izi ndi monga:

• Histoplasmosis (mtundu wa matenda a mafangasi)
• Kutupa kwa mtsempha (thrombophlebitis)
• Matenda opatsirana (monga chifuwa chachikulu)

Zina mwazomwe zimalepheretsa SVC kuphatikiza ndi izi:

• Aortic aneurysm (kukulitsa kwa mtsempha womwe umachoka mumtima)
• Kuundana kwamagazi mu SVC
• Constituive pericarditis (kumangitsa kolimba koonda pamtima)
• Zotsatira zothandizidwa ndi radiation pochiza matenda ena
• Kukulitsa kwa chithokomiro (goiter)

Catheters zomwe zimayikidwa m'mitsempha yayikulu yam'mwamba ndi khosi zimatha kuyambitsa magazi ku SVC.

Zizindikiro zimachitika china chake chimatseka magazi kuti abwerere kumtima. Zizindikiro zimayamba mwadzidzidzi kapena pang'onopang'ono, ndipo zimatha kuvuta mukamawerama kapena kugona pansi.

Zizindikiro zoyambirira zimaphatikizapo:

• Kutupa mozungulira diso
• Kutupa kwa nkhope
• Kutupa kwa azungu amaso

Kutupa kumatha kukula m'mawa kwambiri ndikupita pakati pa m'mawa.

Zizindikiro zofala kwambiri ndi kupuma pang'ono (dyspnea) ndi kutupa kwa nkhope, khosi, thunthu, ndi mikono.

Zizindikiro zina zotheka ndi izi:

• Kuchepetsa kuchepa
• Chizungulire, kukomoka
• Mutu
• Nkhope kapena masaya ofiira
• Mitengo yakuda
• Mbalame zotsekemera (mkati mwa mphuno, pakamwa, ndi malo ena)
• Kufiira kumasintha kukhala kobiriwira pambuyo pake
• Kumva kukhuta kwa mutu kapena khutu
• Masomphenya akusintha

Wothandizira zaumoyo adzayesa thupi, lomwe lingasonyeze mitsempha yowonjezera ya nkhope, khosi, ndi chifuwa chapamwamba. Kuthamanga kwa magazi nthawi zambiri kumakhala mmanja komanso kutsika m'miyendo.

Ngati mukukayikira kuti khansa yamapapu, bronchoscopy itha kuchitidwa. Pochita izi, kamera imagwiritsidwa ntchito kuwona mkati mwa mpweya ndi mapapo.

Kutsekedwa kwa SVC kumatha kuwonekera pa:

• X-ray pachifuwa
• Kujambula kwa CT pachifuwa kapena MRI pachifuwa
• Coronary angiography (kafukufuku wamtima wamagazi wamagazi)
• Doppler ultrasound (kuyesa kwa mawu m'mitsempha yamagazi)
• Radionuclide ventriculography (nyukiliya yophunzira za kuyenda kwa mtima)

Cholinga cha chithandizo ndikuthetsa kutsekeka.

Odzetsa (mapiritsi amadzi) kapena ma steroids (mankhwala oletsa kutupa) atha kugwiritsidwa ntchito kuti muchepetse kutupa.

Njira zina zamankhwala zitha kuphatikizira radiation kapena chemotherapy yochepetsera chotupacho, kapena opaleshoni yochotsa zotupazo. Kuchita opaleshoni yolambalala kutsekereza sikuchitika kawirikawiri. Kukhazikitsidwa kwa stent (chubu choyikidwa mkati mwa mtsempha wamagazi) kuti mutsegule SVC kumatha kuchitidwa.

Zotsatira zimasiyanasiyana, kutengera chifukwa ndi kuchuluka kwa kutsekeka.

Kulepheretsa kwa SVC komwe kumayambitsa chotupa ndi chizindikiro chakuti chotupacho chafalikira, ndipo kumawonetsa chiyembekezo chosauka kwakanthawi.

Khosilo limatha kutsekedwa, lomwe lingatseke mayendedwe apansi.

Kuwonjezeka kwapanikizika kumatha kukula muubongo, kumabweretsa kusintha kwamazindikiritso, nseru, kusanza, kapena masomphenya.

Itanani omwe akukuthandizani ngati mukukhala ndi vuto la kutsekeka kwa SVC. Zovuta ndizovuta ndipo nthawi zina zimatha kupha.

Kuchiza mwachangu zovuta zina zamankhwala kumachepetsa chiopsezo chotenga vuto la SVC.

Superior vena cava kutsekeka; Matenda apamwamba a vena cava

• Mtima - gawo kupyola pakati

Gupta A, Kim N, Kalva S, Reznik S, Johnson DH. Matenda apamwamba a vena cava. Mu: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, olemba. Chipatala cha Abeloff's Oncology. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier; 2020: chap 53.

Kinlay S, Bhatt DL. Chithandizo cha matenda osakanikirana ndi mitsempha. Mu: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, olemba. Matenda a Mtima a Braunwald: Buku Lophunzitsira la Mankhwala Amtima. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 66.