Wosakoma vena cava syndrome: Zizindikiro ndi Chithandizo

Mankhwala si ndi sayansi yeniyeni, ndipo zochokera pa za maganizo ndi Mwina, koma si zoona. The matenda a wosakoma vena cava - zosayembekezereka osowa mchitidwe matenda. Iwo angayambe amuna ndi akazi pa msinkhu wina uliwonse, nthawi zambiri okalamba. Mu malo oyamba pa chiopsezo ndi amayi apakati. Pankhaniyi, chikhalidwe amakhala ndi polyhydramnios pakati, venous ndi wolumikizira hypotension. Nthawi zambiri, chipatso nthawi yomweyo lalikulu. Pamene Vienna wothinikizidwa izo worsens otaya magazi kwa chiwindi ndi impso, chiberekero, izi zimakhudza kakulidwe ka mwana. chikhalidwe ungabweretse mtolo wa minofu placental, ndipo chiopsezo chachikulu kukhala varicose mitsempha, thrombophlebitis wa malekezero a m'munsi. Ngati ntchito ikuchitika ndi gawo la Kaisara, pali Mwina mkulu wa kugwa.

Lingaliro la wosakoma vena cava

Otsika vena Vienna - chotengera waukulu. Popangidwa ndi maphatikizidwe wa lamanzere ndi lamanja iliac mtsempha ili zonse m'mimba. Vienna ili pa msinkhu wa lumbar, pakati linkawonongeka 5 and 4. Umadutsa zakulera ndi akulowa atrium bwino. Vienna amatenga magazi kuti umadutsa mitsempha pafupi, Nawalanditsa kwa minofu mtima.

Ngati munthu ali wathanzi, Vienna ndi maloboti ndondomeko kupuma, ndiye Likukula ndi kutulutsa ndipo Mapangano pa inhalation. Ichi ndi chifukwa chachikulu kwa msempha.

Cholinga cha wosakoma vena cava - mndandanda wa magazi m'munsi nthambi venous.

Chifukwa pali mavuto

Malinga ndi kafukufuku, pafupifupi 80% ya amayi apakati pambuyo masabata 25 pali mtsempha psinjika, pamlingo wamkulu kapena wamng'ono.

Ngati wina wosakoma vena cava syndrome palibe, ndiye kuthamanga mu mtsempha pa mlingo wochepa zokwanira - ichi ndi zachilendo thupi boma. Komabe, mavuto zimakhala yowazungulira m'mitsempha, mwina kuphwanya umphumphu ndi magazi ake kusintha kwambiri. Kwa nthawi yaitali thupi ndi kupirira, kupeza njira zina otaya magazi. Koma ngati kuthamanga mu mtsempha adzauka pamwamba 200 mm, izo nthawizonse mavuto. Pa nthawi ngati zimenezi, popanda chisamaliro msanga kuchipatala kuti onsene anthu kufikira ku imfa. Choncho, zizindikiro za wosakoma vena cava syndrome ayenera kudziwa kuti nthawi itanani ambulansi ngati vutoli akuyamba ku mtima kapena munthu banja.

chithunzi matenda

Chinthu choyamba chimene muyenera tcheru, - kutupa, kumene kungakhale pa nkhope khosi, m'dera la m'mphako ya. Chizindikiro chimenechi zimawonedwa odwala 2/3. Mwina nkhawa kufupika kwa mpweya, chifuwa, hoarseness, ngakhale zina ndi malo supine, ndipo chiopsezo chachikulu cha airway kutsekeka.

Komanso, wosakoma syndrome vena cava akhozanso kukopeka ndi:

- ululu mu groin ndi mimba;

- kutupa malekezero m'munsi;

- kutupa pa matako ndi kumaliseche;

- varices ziwiya yaing'ono ntchafu;

- mpheto;

- mkulu thupi kutentha;

- misomali Chimaona ndi tsitsi imfa;

- pallor zonse;

- mavuto ndi mapazi - kuchisenza kusuntha, ngakhale kuti mtunda waufupi;

- fupa fragility;

- kuthamanga kwa magazi;

- chisokonezo, mpaka ndizipeza nthawi;

- mavuto ndi kumva ndi masomphenya;

- varicose mitsempha m'thupi chapamwamba.

Zizindikiro zimenezi amakhalanso kumatheka ngati wodwalayo zimatenga kunama malo. Kumene, pa loto chete ndi mkulu amasankha N'zosachita kufunsa. Nthawi zambiri odwala kudwala izi ladzala yekha ndi mankhwala mankhwala.

Chifukwa kudwala zingaoneke

Monga matenda ambiri psinjika a wosakoma vena cava syndrome mu 80-90% milandu kugwirizana okha ndi kusalabadira umoyo wawo, ndicho fodya. Chifukwa chenicheni cha matenda silinakwaniritsidwe anakhazikitsa. Koma ambiri a matendawa amapezeka monga chizindikiro concomitant a khansa ya m'mapapo.

Pa zifukwa zina osati oposa 20%:

- zotupa chiyambi osiyana, lymphoma, sarcoma, lymphoma, khansa ya m'mawere;

- constrictive pericarditis;

- retrosternal Chotupa chija;

- silicosis;

- purulent mediastinitis;

- fibrosis.

diagnostics

Mwachibadwa, m'modzi yekha wa zizindikiro za psinjika a wosakoma syndrome vena cava si zotsimikizika. matenda mosamala chofunika.

Choyamba, dokotala likamva mbiri wangwiro mankhwala, kuchita kuyendera. Zingathandize "kuti" dziko la mitsempha mu khosi ndi malekezero chapamwamba, monga ulamuliro, iwo kukodzedwa. Kupenda thupi komanso amapereka lingaliro: ndi cyanosis mtima kapena kuchulukana, kaya maukonde venous kukodzedwa chifuwa, ngati pali kutupa, makamaka thupi chapamwamba.

Anaikidwa kukhala X-ray kuona ndi venography. X-ray Kupenda akhoza kuchitika mothandizidwa ndi wothandizila mosiyana. Lamulo mu kumveka maginito ndi yopangidwa zimachititsa chilumbachi mwina mwauzimu.

Nthawi zina matenda a otsika syndrome vena cava limodzi ndi kuphunzira mozama ndi maso ndi. Cholinga cha matenda - kudziwa ngati, kukula kwa mitsempha retinal, nkotheka kutupa kwa malo peripapillary, kufotokoza, kuthamanga intraocular, ngati pali stagnation mu mitsempha chamawonedwe.

Kuti chithunzi thunzi chokwanira ukafunidwe:

- bronchoscopy;

- biopsy ndi sputum lifmaticheskih mfundo;

- sternal puncture;

- mediastinoscopy.

miyeso achire

Chithandizo cha wosakoma syndrome vena cava ndi symptomatic. kudwala Izi - akadali comorbidities ndiponso kufunika oyamba kuchiza matenda chimapangitsa kuti anachititsa maonekedwe a matendawa.

Cholinga chachikulu cha mankhwala - kuti yambitsa wa mkati malo mphamvu za thupi kuti azipeza khalidwe la moyo wa wodwalayo. Chinthu choyamba chimene tikulimbikitsidwa - pafupifupi mchere-free zakudya ndi mpweya inhalation. Mwina adzakhala anasankha mankhwala ku gulu la corticosteroids kapena okodzetsa.

Ngati matendawa anaonekera maziko a chotupa, chithandizo chosiyana njira.

Opaleshoni alowererepo akusonyeza milandu zotsatirazi:

- syndrome mofulumira patsogolo;

- palibe makope ina;

- blockage wa otsika vena cava.

Opaleshoni alowererepo sichimachotsa vuto, koma chabe bwino venous outflow.

Syndrome ndi mimba

M'nthawi ya gestation ziwalo zonse za akazi kuona katundu wolemera, kumawonjezera magazi voliyumu ndi, monga Motero, pali stagnation. Chiberekero Amamchulukitsira ndi compresses ziwalo osati ozungulira, komanso ziwiya magazi. Pa matenda a wosakoma vena cava mu amayi oyembekezera ayenera kulandira chithandizo ndi kusamala kwambiri.

mavuto kuyamba ndi chakuti mkazi zovuta kugona nsana wanu, chikhalidwe ichi kawirikawiri imayamba ndi masabata 25 a gestation. Pali pang'ono chizungulire, kufooka, nthawi zina si mpweya okwanira. magazi nthawi yafupika. chosowa kwambiri, koma mimba akhoza kutaya kutsitsimuka.

Mwachibadwa, chikhalidwe chachikulu miyeso achire pa mimba si kuyankhula, koma malamulo akadali kuthandiza kuloza matenda mosavuta:

- kusiya Zochita zonse, imene ikuchitikira ku malo supine kumbuyo;

- tulo alibe kukhala kumbuyo;

- chakudya ayenera kusintha kunsi mchere wambiri;

- m'pofunika kuchepetsa madzimadzi ankadya;

- kusintha bwino kuyenda kwambiri, mu nkhani iyi, yafupika minofu pa tibia, ndi ndondomeko iyi akulimbikitsa Kukwezeleza magazi venous m'mwamba;

- analimbikitsa ndi dziwe losambira, madzi kumathandiza kuti kufinya magazi kuchokera kumalekezero m'munsi.

Kuneneratu ndi kapewedwe

Madokotala chidaliro za odwala matendawa, ngati wapezeka oyambirira. The okha chikhalidwe - mosalekeza kuwunika udindo thanzi ndi kugwilizana mtima ndi malangizo onse a dokotala nawo.

Monga zodzitetezera ku kupewa mtima matenda a mtima. Ngati pali mavuto ndi clotting magazi, kudwala ndi akhale moyang'aniridwa nthawi zonse zachipatala, chifukwa odwala awa ali pa chiopsezo. Kodi kusiya ngakhale lingaliro la kudzikonda mankhwala.