Ukuthintelwa kwe-SVC

Ukuthintelwa kwe-SVC kukunciphisa okanye ukuvaleka kwe-vena cava (SVC) ephezulu, engowesibini umthambo omkhulu emzimbeni womntu. I-vena cava ephezulu ihambisa igazi ukusuka kwisiqingatha somzimba siye entliziyweni.

Ukuthintelwa kwe-SVC yimeko enqabileyo.

Idla ngokubangelwa ngumhlaza okanye ithumba kwi-mediastinum (indawo yesifuba phantsi kwethambo lesifuba naphakathi kwemiphunga).

Ezinye iintlobo zomhlaza ezinokukhokelela kule meko zibandakanya:

• Umhlaza webele
• KwiLymphoma
• Umhlaza wemiphunga wamaphaphu (umhlaza wemiphunga osasazekayo)
• Umhlaza wamatyhalarha
• Umhlaza wedlala lengqula
• Isisu esiswini

Ukuthintelwa kwe-SVC nako kunokubangelwa ziimeko ezingenabungozi ezinokubangela ukonakala. Ezi meko zibandakanya:

• I-Histoplasmosis (uhlobo losulelo lokungunda)
• Ukudumba umthambo (thrombophlebitis)
• Usulelo lwemiphunga (njengesifo sephepha)

Ezinye izizathu zokuthintelwa kwe-SVC zibandakanya:

• I-aortic aneurysm (ukwandiswa kwemithambo eshiya intliziyo)
• Amahlwili egazi kwi-SVC
• Ukunqongophala kwe-pericarditis (ukuqiniswa kwebhanti encinci yentliziyo)
• Iziphumo zonyango lwe-radiation kwiimeko ezithile zonyango
• Ukwandiswa kwe-thyroid gland (goiter)

Iicatheters ezibekwe kwimithambo enkulu yengalo ephezulu kunye nentamo kunokubangela amahlwili egazi kwi-SVC.

Iimpawu zenzeka xa kukho into ethintela igazi ukuba libuyele entliziyweni. Iimpawu zingaqala ngequbuliso okanye ngokuthe chu, kwaye zinokuba mandundu xa ugobile okanye ulele.

Iimpawu zokuqala zibandakanya:

• Ukudumba ujikeleze iliso
• Ukudumba kobuso
• Ukudumba kwabamhlophe ngamehlo

Ukudumba kuya kuba kubi kwiiyure zasekuseni kwaye kumke kwasekuseni.

Ezona mpawu zixhaphakileyo kukuphefumla kancinci (iDyspnea) kunye nokudumba kobuso, intamo, itrunk kunye neengalo.

Ezinye iimpawu ezinokubakho zibandakanya:

• Ukuhla kwesilumkiso
• Ukuba nesiyezi, isiqaqa
• Intloko ebuhlungu
• Ubuso obomvu okanye izidlele
• Izandla zesundu ezibomvu
• Iimbumba ezibomvu ezibomvu (ngaphakathi kwempumlo, emlonyeni nakwezinye iindawo)
• Ububomvu butshintsha bube luhlaza kamva
• Ukuziva kwentloko okanye ukugcwala kwendlebe
• Umbono utshintsha

Umboneleli wezempilo uya kwenza uvavanyo lomzimba, olunokubonisa imithambo eyandisiweyo yobuso, intamo, kunye nesifuba esingaphezulu. Uxinzelelo lwegazi luhlala luphezulu ezingalweni kwaye ezisezantsi emilenzeni.

Ukuba umhlaza wemiphunga ukrokrelwa, i-bronchoscopy inokwenziwa. Ngexesha lale nkqubo, ikhamera isetyenziselwa ukujonga ngaphakathi kwomoya kunye nemiphunga.

Ukuvalwa kwe-SVC kunokubonakala kwi:

• I-x-ray yesifuba
• Ukuxilongwa kwe-CT kwesifuba okanye i-MRI yesifuba
• I-Coronary angiography (isifundo sentliziyo yegazi)
• I-Doppler ultrasound (kuvavanyo lwesandi semithambo yegazi)
• I-Radionuclide ventriculography (isifundo senyukliya sokuhamba kwentliziyo)

Injongo yonyango kukhulula ukubhloka.

I-diuretics (iipilisi zamanzi) okanye i-steroids (iziyobisi ezichasayo) zingasetyenziselwa ukunciphisa ukudumba okwethutyana.

Olunye ukhetho lonyango lunokubandakanya i-radiation okanye ichemotherapy yokunciphisa ithumba, okanye utyando lokususa amathumba. Ugqirha lokugqitha kuthintelo kunqabile ukuba lwenziwe. Ukubekwa kwesitent (ityhubhu ebekwe ngaphakathi kwisitya segazi) ukuvula i-SVC inokwenziwa.

Iziphumo ziyahluka, kuxhomekeka kwisizathu kunye nenani lokucinywa.

Ukuthintelwa kwe-SVC okubangelwa lithumba luphawu lokuba ithumba lisasazekile, kwaye kubonisa imeko yexesha elide elihlwempuzekileyo.

Umqala ungavalwa, onokuthintela iindlela zomoya.

Ukonyusa uxinzelelo kunokukhula kwingqondo, kukhokelela kumanqanaba okutshintsha kwengqondo, isicaphucaphu, ukugabha, okanye utshintsho lombono.

Fowunela umnikezeli wakho ukuba uphuhlisa iimpawu zokuthintelwa kwe-SVC. Iingxaki zinobuzaza kwaye ngamanye amaxesha zinokubulala.

Unyango olukhawulezileyo lwezinye iingxaki zonyango lunokunciphisa umngcipheko wokuphuhliswa kwe-SVC.

Uphezulu vena cava isithintelo; Superior vena cava syndrome

• Icandelo lentliziyo phakathi embindini

UGupta A, uKim N, uKalva S, uReznik S, uJohnson DH. Superior vena cava syndrome. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, ii-eds. I-Oncology yeklinikhi yase-Abeloff. Umhla wesi-6. IPhiladelphia, PA: Elsevier; 2020: isahluko 53.

I-Kinlay S, iBhatt DL. Unyango lwezifo ze-vascoronary ezithintelayo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 66.