Pākuʻi ʻo SVC

ʻO ka ālai ʻana o SVC kahi mea e hoʻopili a i ʻole ke ālai ʻia o ka vena cava kiʻekiʻe (SVC), ʻo ia ka lua o ka aa nui i loko o ke kino o ke kanaka. ʻO ka vena cava ʻoi loa e hoʻoneʻe i ke koko mai ka hapa kiʻekiʻe o ke kino i ka puʻuwai.

He kūlana laha ʻole ka ālai ʻana ʻo SVC.

Hoʻokumu pinepine ʻia e ka maʻi ʻaʻai a i ʻole kahi tumo i ka mediastinum (kahi o ka umauma ma lalo o ka umauma a ma waena o nā akemāmā).

ʻO nā ʻano maʻi ʻē aʻe i hiki ke alakaʻi i kēia ʻano me:

• Maʻi ʻaʻai umauma
• Lymphoma
• Ka maʻi ʻaʻai māmā Metastatic (ka maʻi ʻaʻai māmā e hoʻolaha)
• Ka maʻi ʻaʻai testicular
• Maʻi ʻaʻai thyroid
• Tumo timamu

Hiki ke kumu ʻia ke kahakaha ʻana o ka SVC e nā kūlana noncancerous e kumu ai ka scarring. Loaʻa kēia mau ʻano:

• Histoplasmosis (kahi ʻano maʻi fungal)
• Ka hoʻohaunaele o kahi aa (thrombophlebitis)
• Nā maʻi lepa (e like me ka maʻi kō)

ʻO nā kumu ʻē aʻe o ka ālai ʻana ʻo SVC me:

• Aeuric aneurysm (kahi ākea o ke aʻa e haʻalele i ka puʻuwai)
• Hoʻopili ke koko i ka SVC
• ʻO pericarditis constrictive (ke hoʻopaʻa nei i ka uhi lahilahi o ka puʻuwai)
• Nā hopena o ka radiation therapy no kekahi ʻano olakino
• Ka hoʻonui ʻana o ka kelu thyroid (goiter)

Hoʻokomo ʻia nā catheters i loko o nā veins nui o ka lima luna a me ka ʻāʻī e hoʻoulu i ke koko i ka SVC.

Kū nā ʻōuli ke pale kekahi mea i ke koko e kahe ana i ka puʻuwai. E hoʻomaka koke paha nā ʻōuli a lohi paha, a e ʻino hoʻi ke kūlou a moe paha ʻoe i lalo.

ʻO nā hōʻailona mua me:

• ʻO ka pehu a puni ka maka
• ʻO ka pehu o ka maka
• ʻO ka pehu ʻana o ke keʻokeʻo o nā maka

E ʻoi aku paha ka maikaʻi o ka ʻōhū i nā hola o ke kakahiaka a hala i ke kakahiaka.

ʻO nā ʻōuli maʻamau ka hakahaka o ka hanu (dyspnea) a me ka pehu ʻana o ka maka, ka ʻāʻī, ka lāʻau, a me nā lima.

ʻO nā hōʻailona kūpono ʻē aʻe e pili pū me:

• Hoemi i ka makaʻala
• Puʻupuʻu, maʻule
• ʻEha poʻo
• Ke alo ʻulaʻula a i ʻole nā ​​papalina
• Nā poho lima ʻulaʻula
• Nā membrane mucous ʻulaʻula (ma loko o ka ihu, waha, a me nā wahi ʻē aʻe)
• Ke hoʻololi nei ka ʻulaʻula i blueness ma hope
• Kuhi o ke poʻo a piha paha ka pepeiao
• Hoʻololi ka hihiʻo

E hana ka mea mālama ola i kahi hoʻokolohua kino, i hōʻike ʻia i hoʻonui ʻia nā veins o ka maka, ka ʻāʻī, a me ka umauma o luna. Piʻi pinepine ke kaomi koko i nā lima a haʻahaʻa i nā wāwae.

Inā kuhi ʻia ka maʻi ʻaʻai māmā, hiki ke hana ʻia i kahi bronchoscopy. I kēia kaʻina hana, hoʻohana ʻia kahi kāmela e nānā i loko o nā alaloa a me nā akemāmā.

ʻIke ʻia ka blockage o ka SVC ma:

• Pākuʻi x-ray
• CT scan o ka umauma a i ʻole MRI o ka umauma
• Coronary angiography (kahi naʻau o ke kīʻaha koko)
• Doppler ultrasound (hoʻāʻo nalu kani o nā kīʻaha koko)
• Radionuclide ventriculography (nukelea hoʻopaʻa haʻawina o ka naʻau neʻe)

ʻO ka pahuhopu o ka mālama ʻana e hoʻomāmā i ka poloka.

Hiki ke hoʻohana ʻia nā diuretics (nā wai wai) a i ʻole nā ​​steroid (anti-inflammatory drug) e hoʻomaha iki ai i ka pehu.

Hiki i nā koho lapaʻau ʻē aʻe ke hoʻopili i ka radiation a i ʻole chemotherapy e hoʻoliʻiliʻi i ka tumo, a i ʻole ke ʻoki ʻana e wehe i nā tumors. ʻAʻole hana pinepine ʻia ke ʻoki. ʻO ke kau ʻana i kahi stent (Tube i hoʻonoho ʻia i loko o kahi kīʻaha koko) e wehe ai i ka SVC.

Hoʻololi ka hopena, pili i ke kumu a me ka nui o ka paʻa.

ʻO ke kahakaha ʻana o SVC ma muli o kahi tumo ka hōʻailona o ka palahalaha ʻana o ka maʻi tumo, a he hōʻailona ia no kahi wā lōʻihi ʻilihune loa.

Hiki ke ālai ʻia ka puʻu, kahi hiki ke ālai i nā alaloa.

Hiki ke hoʻonui i ka kaomi i loko o ka lolo, e alakaʻi ai i nā pae i loli o ka noʻonoʻo, kahoʻi, ka luaʻi, a i ʻole nā ​​loli ʻike.

Kāhea i kāu mea hāʻawi inā hoʻomōhala ʻoe i nā ʻōuli o ka ālai ʻia o SVC. Kūpilikiʻi nā pilikia a hiki i kekahi manawa ke make.

ʻO ka mālama koke ʻana i nā maʻi olakino ʻē aʻe e hōʻemi i ka makaʻu o ka hoʻomohala ʻana i ka ālai ʻana o SVC.

ʻO ke kahakaha vena cava kiʻekiʻe; ʻO ka maʻi vena cava kiʻekiʻe loa

• Puʻuwai - ʻāpana ma waena o ka waena

ʻO Gupta A, ʻo Kim N, ʻo Kalva S, ʻo Reznik S, ʻo Johnson DH. ʻO ka maʻi vena cava kiʻekiʻe loa. I: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. ʻO Oncology Clinical ʻo Abboff. ʻElua huaʻōlelo Piladelapia, PA: Elsevier; 2020: chap 53.

Kinlay S, Bhatt DL. Hoʻomaʻamaʻa i ka maʻi non voronary vascular obstructive maʻi. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 66.