Izimpawu zamakhemikhali e-pulboary-blockages emithambo ye-arteries emaphashini ngokuvamile okubangelwa ama-clots wegazi-angahluka kakhulu. Kuye ngokuthi ingakanani emaphaphu akho okubandakanyekile kanye nobukhulu bokuvinjelwa, ungase ubone ezinye izimpawu nezimpawu ezivamile, njengalezi ezilandelayo:
- ukuphefumula okuphuthumayo okuba kubi kakhulu ngokuzikhandla
- Ubuhlungu besifuba obungase bubi nakakhulu uma uphefumula kakhulu
- Ubuhlungu uma ukhwehlela, udle, ugobe noma uhambe
- Ubuhlungu obunzima ngokuzivocavoca kodwa alupheli ngokuphelele uma uphumla
- Isikhukhula, esingase sikhiphe umcengezi onamandla
Ezinye izibonakaliso nezimpawu, ezingafaka phakathi okulandelayo:
- Ubuhlungu bomlenze noma ukuvuvukala, noma kokubili, ngokuvamile emthombeni
- Isikhumba se-Clammy noma isikhumba esiluhlaza okwesibhakabhaka
- Fever
- Ukuphunga
- Ukushaya kwenhliziyo okusheshayo noma okungavamile
- Lightheadedness noma isiyezi
Kwenzekani Ngesikhathi Sokumbumbuluzwa KwamaPulmonary?
Phakathi ne -embolism ye-pulmonary noma i-PE , isimo esivamile kunazo zonke ukuthi i-clot yegazi iphuma ngaphandle kwenhliziyo emaphashini, nge- artery pulterary . Amagatsha omuthi we-pulmonary ukuhambisa igazi kumaphaphu ngamunye kanye namacimbi egazi angakwazi ukufakwa ezindaweni ezihlukahlukene endleleni, ezitsheni ezenza igazi emaphashini. Uma i-clot yegazi inkulu ngokwanele, ingabanjwa futhi igweme ngokuphelele isikebhe esikhulu, esingase sisongele ukuphila. Kungenzeka futhi ukuthi i-clot yegazi ibe encane kakhulu kangangokuthi ingabonakali, ingabonisi ingxenye encane yamaphaphu ukuzwa imiphumela yayo.
Ukuxilongwa Nokunakekelwa
Izivivinyo ezihlukahlukene zingenziwa ukuze kuhlolwe i-pulmonary emboli, kuhlanganise ukuskena kwe-ventilation-perfusion, i-D-dimer, noma i-angiogram ye-pulmonary.
Ukwelashwa kwe-pulboary emboli kuxhomeke ebuqini nasezingeni le-clot. Uma izimpawu zingekho ezinzima, abasebenzisa igazi bangasetshenziswa futhi baqaphele ukuvimbela ukuthuthukiswa okuqhubekayo kwezindwangu.
Ngama-clots amakhulu, ama-cloth aqinile, imishanguzo yokugqoka i-clot-busting njengalezo ezisetshenziselwa ukuvula izitsha zenhliziyo ngesikhathi sokuhlaselwa kwenhliziyo ingasetshenziswa.
Kungani Iziguli Ezine Cancer Zengozini Yokumbumbuluzwa Kwamafutha?
Lapho ososayensi becwaninga ingozi ye-PE, bacabangela sonke isifo sesifo esivumela umuntu ukuba abe nazo. Okusho ukuthi i-PE ingenye yezenzakalo eziningana ezingenzeka uma umuntu evula ama-blood clots emithanjeni yabo, isimo esibizwa ngokuthi i- thromboembolism ene-venous , noma i-VTE.
Uma kuqhathaniswa nomphakathi jikelele, izimo ze- VTE ne-PE ziphakeme ezigulini ezine-cancer; iziguli zomdlavuza ziba cishe izikhathi ezine zokuthuthukisa i-thromboembolism ene-venous, efaka kokubili ukumbumbana kwe-pulmonary kanye ne-deep vein thrombosis. I-thrombosis ejulile ye-vein, noma i-DVT, ibhekisela ngokuqondile kuma-clots egazi ayenze emithanjeni ejulile, ngokuvamile emilenzeni, kodwa nayo ingenzeka nakwezinye izindawo. Inkinga enkulu kakhulu ye-DVT iyenzeka uma ingxenye ye-clot isuka futhi ihamba ngegazi legazi enhliziyweni futhi ngemva kwalokho imaphaphu , okwenza ukuvinjelwa kuthiwa yi-PE. Ungaba ne-PE ngaphandle kokuba ne-DVT, noma kunjalo.
Ngokuvamile, lawa maqabunga egazi angase afake emithanjeni yomzimba wakho ejulile ngezizathu ezihlukahlukene, kufaka phakathi okulandelayo:
- Ukulimala emgqeni wangaphakathi we-vein
- Ukulimala emthanjeni obangelwa izici zomzimba, zamakhemikhali noma eziphilayo
- Ukuhlinzwa, ukulimala okukhulu, ukugula noma isimo esibangela ukuvuvukala, kanye nezimpendulo ezithile zomzimba
- Ukugula noma isimo lapho ukugeleza kwegazi kwehla khona, njengokungathi ngemuva kokuhlinzwa, noma ngesikhathi sokuphumula kombhede isikhathi eside, noma ngesikhathi sokuhamba indiza ngenkathi uhamba
- Izimo ezithile ezenza igazi lakho libe lomsindo noma lingase livalwe ngaphezu kwejwayelekile
- Izimo ezithile ezizuzwe njengefa, isibonelo, i-factor V Leiden, eyandisa ingozi yokugubha igazi
- Ukwelashwa kwamahomoni noma amaphilisi okulawula ukuzalwa
Ukuvala nokugcoba kwezigulane ezine-Cancer
Amakhekhe egazi ajwayelekile kubantu abanegciwane lesifo somdlavuza, kanti iziguli zomdlavuza zingase zibe yingozi enkulu yezindwangu zegazi ngenxa yezizathu ezihlukahlukene, kuhlanganise nomdlavuza, ngokwawo, kanye nemithi ehlukahlukene yomdlavuza. I-Chemotherapy, ukwelapha imisebe, kanye nokwelashwa kwe-hormone kungase kwande ingozi yezindwangu zegazi.
Kungase kubonakale kungaqondakali, kodwa ukuphazamiseka kokuphuma kwegazi kungase kuvame kakhulu kubantu abanomdlavuza wegazi. Lokhu kungaqondakala kanje: Ngokuvamile, uma kunenkinga ngesistimu yokuqhaqha komzimba, umuntu angase abe engozini yokuphuma ngokweqile noma ukugcoba, kuye ngezimo.
Indima Ye-Clot-Ukuvimbela Imithi
Imithi yokuvimbela i-clot njalo ayikhuthazwa iziguli eziphethwe umdlavuza, ikakhulukazi lezo ezithathwa njengengozi ephansi ye-VTE; Nokho, kulabo abasengozini enkulu ye-VTE kanye nalabo abane-myeloma abathola izidakamizwa ezibizwa ngokuthi ama-immunomodulators, imithi enjalo yokuvimbela i-clot ingacatshangwa, ngokusho kwamaqembu ochwepheshe.
Isimo samanje sokunakekelwa kuyinto okuthiwa i-low-molecular-weight heparin (LMWH), edinga injection. Eminye, abasha abasha begazi bomlomo bayatholakala, kodwa kukhona ubufakazi obunqunyiwe odokotela abazobhekana nabo lapho becabangela ukwenza ushintsho oluvela ku-LMWH kwenye yalezi zithunywa zomlomo.
Esicwaningweni samuva, lapho kunikezwa ukukhetha okungaqondakali kwe-LMWH ngokumelene nesikhulu somlomo esisebenza ngendlela elinganayo, iziguli eziningi ezinomdlavuza ngokuqondakalayo zakhetha i-agent yomlomo. Kodwa-ke, ochwepheshe bathi isinqumo sokushintsha sidinga ukucubungisisa ngokucophelela ukuxhumana phakathi komdlavuza wesiguli kanye nenkambo yokwelashwa, kanye nezidakamizwa ezingaphansi kwazo.
I-PE / VTE ezigulini ezinegazi elikhethekile legazi
Izifundo zakuqala zancoma ukuthi izicubu eziqinile ezifana nomdlavuza wesifuba nomdlavuza wamaphaphu, ngokuvamile, zandisa amathuba okugaya igazi kunegazi, ezihlanganisa i- leukemia , i-lymphoma, ne-myeloma. Kuye kwaba nezinye izifundo kusukela kulokhu okuphikisana nalo mqondo, noma kunjalo, futhi kungase kube sengathi izinhlobo zomdlavuza wegazi kanye nezici zesiguli ngasinye zithonya ingozi yakho ngezindlela ezibalulekile.
Iziguli Ezikhulile Ezine-Leyeloemia Ezingapheliyo
Ucwaningo olunyatheliswa ngo-2016 lwasikisela ukuthi iziguli ezindala ezine-CML zinezilinganiso ezinkulu ze-PE kuneziguli ezingenayo umdlavuza, okwakungeke kumangaze, ngoba umdlavuza, ngokuvamile, ucatshangelwa ukwandisa izinkinga zokuqeda. Amanani okuxazulula izinkinga awazange akhuliswe eqenjini leziguli ezithatha izidakamizwa okuthiwa i-tyrosine kinase inhibitors (ikakhulukazi okuthiwa i-imatinib okuthiwa yi-one) okuthiwa yi-imatinib, noma kunjalo, ephakamisa ukuthi ingozi kulezi ziguli ezine-CML yayiqhutshwa kakhulu yizici ezihambisana nomdlavuza hhayi ukwelashwa.
Ubuntwana obunzima bokuLymphoblastic Leukemia
Kuyinto engavamile ukumbumbuluza ngesikhathi sokuzalwa komntwana, kodwa ukuba ne-malignancy (njenge-leukemia) kungandisa i-VTE engozini kanye ne-PE ezinganeni. Izingozi ezinkulu ze-VTE ne-PE zibandakanya i-catheter ye-venous, i-malignancies, ne-chemotherapy. I-VTE itholakala ngamaphesenti angu-2.1-16 kwezingane ezinomdlavuza, kanti amazinga abikiwe we-VTE ahlobene ne-VTE ububanzi kusuka ku-2.6 kuya ku-36.7 wamaphesenti.
Ubufakazi obuningi be-PE ezinganeni ezinomdlavuza zigxile ezigulini ezine-NONKE, ukuhlukunyezwa kwezingane ezivame kakhulu. Ukuhlaziywa kwemeta yezingane ezine-leukemia kubikile i-VTE kumaphesenti angu-5.2 wezingane ZONKE, kodwa amazinga abikiwe avela kumaphesenti angu-1 kuya kwangu-36. Ngokuyinhloko, ukusetshenziswa kwe-L-asparaginase, kanye ne-chemotherapy regimen kuhlanganise i-anthracycline, i-vincristine, ne-steroid, yenza i-lemonemic i-lymphocytic i-acute (ALL) elula kakhulu, ikakhulukazi ezinganeni-kodwa ingase ihlobaniswe nengozi eyengeziwe ye-VTE , ngakho-ke imithi yokuvimbela i-blood clotting inganikezwa ukunciphisa le ngozi.
Acute Promyelocytic Leukemia, uhlobo lwe-AML
Uma kuqhathaniswa nokuphuma kwegazi, ama-clots amakhulu egazi ayinkinga encane kakhulu ezigulini ezine-acute promyelocytic leukemia, uhlobo olungavamile lwe-AML. Lesi yisibonelo esihle somdlavuza wegazi lapho amasistimu e-coagulation womzimba athinteka, evame ukuholela ekukhenizeni, kepha futhi nangethuba lokuvala. Iziguli ezine-leukemia e-promyelocytic ezinamandla zingase zifike kudokotela ngezinkinga zokuphuma kwegazi njenge-nosebleed ezingeke zime, noma ukusika okungeke kume. Kodwa bangase babe nethole lokuvuvukala kusuka ku-DVT, noma ubuhlungu besifuba nokuphefumula kokuphefumula kusuka egazini legazi emaphashini noma e-PE.
Ukuvala ingozi ku-Leukemia ne-Lymphoma
Ucwaningo olwenziwa yiPetterson kanye nosebenza nabo olwanyatheliswa ngo-2015 lwaphakamisa ukuthi zonke izinhlobo zomdlavuza zivame ukwandisa ingozi ye-VTE nokuthi izinga lezinkinga ezikhulayo lihlukile kwizigaba ezihlukahlukene zomdlavuza; kulolu cwaningo oluthile, ingozi ephansi kunazo zonke ye-VTE ibonwe ngekhanda lekhanda lezintambo (4.1x) kanti ingozi enkulu kakhulu ibonwe nomdlavuza womqondo (47.3x).
Lapho leli qembu labacwaningi lizama ukulungisa iziguquguquko eziningi ukuze zithole ingozi ye-VTE ku-lymphoma (ngokuhlobene nezinye izifo zomshukela), bathola ukuthi ingozi yanda ikakhulukazi phakathi kweziguli ze-lymphoma.
I-Lymphoma yayiphakathi kwezindawo zomdlavuza ezine ezinezingozi ezikhuphuka kakhulu ze-VTE, njengezilandelayo:
- Umdlavuza we-Brain
- Umdlavuza we-Pancreatic
- Okunye ukugaya (isisu, intombazane encane, i-gallbladder, ne-bile system)
- Lymphoma
Iziguli ezine- leukemia zitholakale zengozi ephakathi kulolu cwaningo.
Ezimweni ezingu-33 ezigameko zine-lymphoma esebenzayo nezimo ezingu-18 zengxube ezine-leukemia ezisebenzayo kulolu cwaningo, kuphela amaphesenti angu-14 kuphela (ama-28%) ayenamakhemikhali angaphakathi phakathi kwezinyanga ezintathu ngaphambi komcimbi we-VTE. Iningi lamacala okugamekwa ne-leukemia esebenzayo yayine-leukemia engapheli (i-11 kwengu-18, noma amaphesenti angu-61), okungavamile ukuphathwa nge-L-asparaginase, into eyaziwayo engozini ye-VTE.
Izwi elivela
Kubalulekile ukwazi ukuthi, njengesiguli somdlavuza, ungase ube engozini enkulu yezinkinga ngezindwangu zegazi njenge-pulmonary embolism. Kodwa-ke, kubalulekile ukubeka lo mgomo ngendlela efanele. Ngokuvamile, amathuba okuthuthukisa i-embolism ye-pulmonary namanje aphansi kakhulu.
Nakuba ukuthola ukwelashwa ngokusebenzisa i-catheter ephakathi nendawo kungakhuphula ingozi ye-PE / VTE, ukwelashwa okunjalo kungase kube ukusindisa impilo kubaguli abaningi abanomdlavuza. Odokotela bayazi izingozi ze-VTE / PE ekubonisweni okuhlukahlukene komdlavuza wegazi, nangokwelashwa okuhlukahlukene kanye nokungenelela. Njengesiguli esifundisiwe, ulwazi lwakho lwezimpawu ze-PE / VTE nokuqapha kwakho kungasiza udokotela wakho enze ngokushesha, uma kunesidingo.
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