Encinane Vena cava syndrome: Iimpawu and Treatment

Medicine asithathwa i inzululwazi ngqo, kwaye asekelwe kwiisethi le kokucingelwayo kwaye ngokuqinisekileyo, kodwa nyaniso. Esi sifo le Vena cava obuphantsi - kwisehlo ezinqabileyo practice clinical. Oko kunokuthi kwenzeke kwi amadoda nabafazi na ubudala, ngokufuthi abadala. Kwindawo yokuqala olusemngciphekweni abafazi abakhulelweyo. Kulo mzekelo, imeko uphawuleka polyhydramnios wamitha, lwemithambo kunye umfutho hypotension. Amaninzi, isiqhamo ngexesha elifanayo enkulu. Xa Vienna balakha ukuba mandundu kwegazi liya wesibindi, nezintso, isibeleko, nto leyo echaphazela uphuhliso umntwana. Imeko kungabangela inyanda izihlunu placental, yaye engozini enkulu yokuba imithambo varicose, thrombophlebitis kweqondo asezantsi. Ukuba umsebenzi ikhutshwa phandle Uqhaqho, kukho amathuba eliphezulu yokuwa.

Ingqiqo Vena cava obuphantsi

Vena obuphantsi Vienna - isitya ebanzi. Senziwe yi fusion yasekhohlo kunye ekunene umthambo iliac, ibekwe kwisisu. EVienna sise kwinqanaba empontshwa, phakathi 5 no-4 vertebra. Udlula uvalo kwaye engena intendelezo ekunene. EVienna uqokelela igazi ugqithayo kuwo imithambo ngecala, Sibahlangule kwi izihlunu intliziyo.

Ukuba umntu siphilile, Vienna uhambisana inkqubo ukuphefumla, oko kukuthi, phezu yandisa siphefumla kunye nezivumelwano ngexesha inhalation. Nguwo lo ke umahluko ukususela aorta.

Eyona njongo yale Vena cava obuphantsi - ukuqokelelwa lomzimba asezantsi igazi lwemithambo.

Kutheni kukho iingxaki

Ngokutsho manani, malunga nama-80% yabo bonke abasetyhini abakhulelweyo emva kweeveki 25 kukho ucinezelo umthambo, ukuya ithile enoba kukancinane okanye.

Ukuba kunguhata Vena cava syndrome ayikho, ngoko uxinzelelo kwi umthambo kwinqanaba ngokwaneleyo elisezantsi - oku yimeko eqhelekileyo nokomzimba. Noko ke, iingxaki ancedisana angqonge Kwangale, zingophula ingqibelelo kunye flow igazi layo utshintsho kakhulu. Kuba ixesha elithile umzimba iyakwazi ukumelana, ukufumana iindlela ezizezinye ukuhamba kwegazi. Kodwa ukuba uxinzelelo kwi iphuma iza kuvuka ngaphezu kwama-200 mm, bekusoloko kukho ingxaki. Kulapho kwezo zihlandlo, ngaphandle unyango ngoko nangoko into yokuba zonke iphele ekufeni. Ngoko ke, iimpawu encinane Vena cava syndrome kufuneka bazi ukuba ixesha ubize inqwelo ukuba ingxaki iqala kumguli okanye umntu kusapho.

picture clinical

Into yokuqala ufuna ukunikela ingqalelo, - ukudumba, leyo ibe phezu kobuso, intamo, kummandla kwingqula. Le uphawu uyaqapheleka izigulane 2/3. Ngamana likhathalele ukuphelelwa umoya, khohlo, hoarseness, nangona ukuphumla kunye nesikhundla lisalele, yaye engozini enkulu yokuba ngokuma kokuphazanyiswa.

Kwakhona, encinane Vena cava syndrome kufuneka sikhatshwe:

- intlungu nasemiphakathweni nesisu;

- ukudumba kweqondo asezantsi;

- ukudumba ezinqeni zangasese;

- varices imikhumbi ezincinane ethangeni;

- namandla;

- iqondo lobushushu emzimbeni phezulu;

- izikhonkwane zaqina kunye nokulahlekelwa iinwele;

- pallor njalo;

- iingxaki iinyawo - onzima kakhulu ukuhamba, nkqu imigama emifutshane;

- ubu amathambo;

- uxinzelelo lwegazi oluphezulu;

- isiphithiphithi, de ilahleko ngamaxesha athile;

- iingxaki lokumamela kunye nombono;

- varicose ngemithambo kumzimba ongentla.

Ezi mpawu nalo ngcono xa isigulane kuthatha indawo ilele. Kakade ke, phezu iphupha cwaka ophezulu-grade kunokuba akukho mbuzo. Ngokufuthi izigulane nalo ngezifo izaliswe kuphela ngamayeza iziyobisi.

Kutheni kubonakale ngezifo

Kanye izifo ezininzi, ucinezelo ye encinane Vena cava syndrome ngo-80-90% yamatyala ezinxulumene kuphela ukungananzi impilo yabo, oko kukuthi icuba. Oyena nobangela ngqo sifo okwangoku isekiwe. Kodwa ke inkoliso sifo kwenzeka luphawu ehamba umhlaza wemiphunga.

Kwelinye izizathu kuba ngaphezu kwe-20%:

- yamathumba imvelaphi ezahlukeneyo, lymphoma, nee-, lymphoma, umhlaza webele;

- pericarditis constrictive;

- goiter retrosternal;

- silicosis;

- ubovu mediastinitis;

- abanesigulo.

ekuxilongweni

Ngokuqhelekileyo, omnye kuphela iimpawu ucinezelo ye encinane Vena cava syndrome hayi uzimisele. diagnosis ngenyameko iyafuneka.

Okokuqala, ugqirha uqokelela imbali yezonyango epheleleyo, eqhuba uhlolo. Kangakanani na 'athi "imo ngemithambo entanyeni kunye eziphelweni aphezulu, njengoko umthetho, ukuba zandiswe. iimviwo Physical kwakhona inika uluvo: i cyanosis nomonde okanye ukuxinana, nokuba womnatha lwemithambo eyandisiweyo esifubeni, akukho nokuba ukudumba, ingakumbi kumzimba ongentla.

Oqeshwe iimviwo X-ray kunye venography. iimviwo X-ray na kwenziwa ngoncedo arhente umahluko. Isisinyanzelo kuwo intlokoma Imagnethi yomhlaba kunye ayinakubalwa mphandle ukuze kungajikeleza.

Kwezinye iimeko lokufunyaniswa oluphantsi Vena cava syndrome lukhatshwa olunzulu sifundo yi zamehlo. Injongo uxilongo - ukuchonga, ukuba ikhona, ukwandiswa imithambo semehlo, ukudumba kwindawo peripapillary kunokwenzeka, ukuchaza, ukwanda koxinzelelo intraocular, nokuba kukho ngxi kwi-luvo optic.

Somfanekiso epheleleyo ukuze kufuneka:

- bronchoscopy;

- biopsy kunye isikhohlela lifmaticheskih iindawo;

- okuhlatywa sternal;

- mediastinoscopy.

amanyathelo zonyango

Unyango lwe encinane Vena cava syndrome kufana nomqondiso. Le emoyeni - nangoku comorbidities, yaye kufuneka kuqala ukunyanga esi sifo ukukhwezelela eyabangela ukubonakala onaso.

Eyona njongo ingundoqo unyango - ukuvula imikhosi reserve lwangaphakathi umzimba ukuze ukwandisa umgangatho wobomi isigulane. Into yokuqala kucetyiswa - phantse ityuwa-ezamahala ukutya neoksijini inhalation. Mhlawumbi eziya otyunjwe iziyobisi ukusuka kwiqela corticosteroids okanye womchamo.

Ukuba sifo ukuvela yangasemva ithumba, unyango eyahlukileyo ngokupheleleyo indlela.

ungenelelo kuhlinzwa kuyinto kuboniswe kwezi meko zilandelayo:

- syndrome luqhubeka ngokukhawuleza;

- akukho Ukubolekisa akananto;

- ukuvaleka Vena cava ophantsi.

ungenelelo Surgical aluyiphelisi le ngxaki, kodwa nje kuphucula ukuphuma lwemithambo.

Syndrome nokukhulelwa

Ngethuba yokumitha onke amalungu abafazi bafumana imithwalo enzima, kwandisa umthamo wegazi kwaye, ngenxa yoko, akukho kukhula. Isibeleko banzi kwaye Oluma amalungu ezingqongileyo, hayi nje kuphela kodwa imithambo yegazi. Ngelo syndrome le Vena cava enasilela abasetyhini abakhulelweyo kufuneka aphathwe ngokuqaphela okukhulu.

Iingxaki aqala into yokuba umfazi kunzima kakhulu ukuba alale ngomqolo, le meko idla luqala kwiiveki 25 yokumitha. Kukho nesiyezi kancinane, ubuthathaka, izikhathi umoya ngokwaneleyo. uxinzelelo lwegazi kukholisa lifinyele. inqabile kakhulu, kodwa ukukhulelwa unokuphulukana abazi lutho.

Ngokwendalo, kuhlobo esisiseko amanyathelo zonyango ngexesha ukhulelwe ukuba ukuthetha, kodwa eminye imithetho kunjalo kunceda ukushifta syndrome lula:

- ukuba bayeke ukwenza lonke uqheliso, eziqhutyelwa kwindawo lisalele ngasemva;

- ukulala na ukuhlala ngasemva;

- izidlo kufuneka zilungiswe phantsi inani ityuwa;

- kuyimfuneko kukunciphisa isixa amanzi aphele;

- zokuphucula ukuhamba ngakumbi, kulo mzekelo, kunciphise isihlunu phezu lesiquluba, yaye le nkqubo ikhuthaza ukukhuthazwa igazi lwemithambo phezulu;

- isincomo yi echibini lokuqubha, amanzi negalelo ukucudisa igazi kwiziphelo asezantsi.

Ipredikshini kunye nokuthintela

Oogqirha nethemba malunga izigulane kunye naso, ukuba ibanjiwe kwangoko. Kuphela imeko - esweni rhoqo yemeko yempilo kunye nokuthotyelwa nomonde zonke izindululo gqirha khona.

Njengoko amanyathelo othintelo kuthintelo ubabalo kwezifo sentliziyo. Ukuba kukho iingxaki igazi ekunqandeni, ngezifo kwaye kufuneka abe phantsi kweliso elibukhali likagqirha rhoqo, kuba ezi zigulane basengozini. Ukuba ukulahla ngisho ingcamango self-amayeza.