Ukukhishwa kwe-pericardial yi-buildup ye-fluid ngaphakathi kwe-pericardium, ungqimba lwama-tissue aqondisa inhliziyo. I-effusion ye-pericardial ingase ithuthuke kancane (i-pericardial effusion) engapheli futhi ibangele izimpawu ezimbalwa. Esikhundleni salokho, uma ikhula ngokushesha (i-pericardial effusion), ivame ukudala izimpawu ezisongela ukuphila futhi kuyiphuthumayo yezokwelapha. Uma uketshezi okwanele kukhula kule ndawo futhi kunqanda kakhulu ukunyakaza kwenhliziyo, isimo siyaziwa ngokuthi i-tamponade yenhliziyo .
I-effusion ye-pericardial ingenzeka ngezizathu eziningi (ezinye zazo zibalwe ngezansi) kodwa zivame kakhulu kubantu abanomdlavuza wamaphaphu. Zenzeka ngamaphesenti angaba ngu-21 abantu abanomdlavuza futhi ngokuvamile bahlotshaniswa nokuhlaselwa okubi, kodwa ukutholakala ngokushesha nokuxilongwa kuhlinzeka ithuba lokunakekelwa ngokucophelela. Izinga lokufa liye lahla kakhulu emashumini ambalwa ambalwa adlule ngenxa yokuxilongwa ngokushesha nokuphathwa. Ezingxenyeni ezimbili kwezintathu zabantu, ukuchithwa akubangeli izimpawu ezicacile.
Izimpawu
Uma une-effusion ye-pericardial encane futhi ithuthukile kancane, ungayazi kuphela ukuthi ubukhona bayo ngenxa yokuthola kwi-ray ray noma i-CT scan. Ngokuphambene, uma i-pericardial effusion ikhulu, noma uma ikhula ngokushesha ingabangela izimpawu ezifaka:
- Ukuphefumula (ikakhulukazi ngokulala phansi)
- Lightheadedness
- Ubuhlungu besifuba
- Ukushaya kwenhliziyo okusheshayo (njengoba inhliziyo ivinjelwe futhi ayikwazi ukushaya njengamandla, izinga lentliziyo landa ukwenzela ukuthi kugcinwe ukugeleza kwegazi okufanayo kuya kwezicubu)
Ngeshwa, izimpawu ze-pericardial effusion zingalingisa umdlavuza wamaphaphu, ukubambezela ukuxilongwa.
Izimbangela
Kunezimbangela eziningi ze-efficable pericardial. Ezinye zazo zihlanganisa:
- Izifo
- Izimo ezizenzakalelayo (njenge-arthritis ye-rheumatoid)
- Amanqamu (kokubili lawo asakaze kwi-pericardium evela kwezinye izifunda zomzimba nalabo abaqala ku-pericardium)
- Ukuhluleka kwezinso
- Ukuvuvukala (kubandakanya i- pericarditis )
- Ukuhlinzwa kwesifuba
- Ukuhlaselwa kwenhliziyo
- Imithi
Eminye imithi engase ibangele ukusebenza kwamaphesenti ahlanganisa:
- Imithi yokwelapha i-Adriamycin (doxorubicin) ne-Cytoxan (cyclophosphamide)
- Isidakamizwa sesifo sofuba i-Isoniazid
- Imithi yokwelapha i-Dilantin (phenytoin)
- Imithi i-Rogaine (i-minoxidil) esetshenziselwa ukulinganisa iphathini yesilisa nomfutho wegazi ophezulu
Ukusebenza Kwe-Pericardial Nge Cancer
Ama-pericardial effusions angenzeka nanoma yiluphi uhlobo lomdlavuza, kodwa okuvame kakhulu kubandakanya umdlavuza wamaphaphu, umdlavuza webele, ne-lymphomas.
Ngomdlavuza wamaphaphu, ama-pericardial effusions ajwayelekile kakhulu, cishe cishe isigamu sabantu ababhekene nemithi yokwelapha imitha yomdlavuza wamaphaphu bakhulisa izinga elithile lokungena. I-Adjuvant chemotherapy ibonakala iyandisa le ngozi.
Ezingamaphesenti angaba ngu-50 abantu abanomdlavuza abane-effusion ye-pericardial, i-pericardial effusion iyisignali yokuqala futhi iholela ekuxilongweni komdlavuza.
Ukwelapha
Ukwelashwa kwama-pericardial effusions kunamacala amabili. Okokuqala, ukukhishwa kwe-pericardial kudinga ukuphathwa, ngokuvamile kuvame uma kucindezela inhliziyo. Okwesibili, imbangela ye-effusion ye-pericardial idinga ukuxazululwa.
Ngezifo, ama-antibiotics noma imishanguzo ye-antiviral kuyodingeka.
Ngokuvuvukala, imithi elwa nokuvuvukala noma i-steroids ingasetshenziswa. Uma ukuxoshwa kubangelwa imithi, umuthi uvame ukuma futhi imithi ehlukile esetshenziswa uma kungenzeka. Ngomdlavuza, ukuphathwa komdlavuza kuzohluka ngokuya kwesilinganiso somdlavuza (bheka ngezansi).
Ukwelashwa ukuxazulula ukukhishwa kwe-pericardial kungafaka:
- I-Pericardiocentesis
- Ukufakela i-shunt (kaningi kwesisu esiswini ukuze kuhlale kukhishwa amanzi)
- I-balloon pericardiotomy
- I-Pericardiectomy (ukususa i-pericardium) nge-thoracoscopic noma ukuhlinzwa okuvulekile
Uma i-effusion ikhulu noma iphawulekayo, inqubo eyaziwa njenge-thoracoscopic (VATS) nge-pericardiectomy ingasetshenziswa.
Kubantu abanemiphumela emihle ngenxa yezizathu ezinobungozi) (njengokungenwa isifo) ukubikezelwa ngale nqubo kuhle. Njengoba kunikezwe izizathu zokuthuthukiswa kokusebenza kahle kwabantu abanomdlavuza, ukubikezela ukuthi kuhlwempu kungakhathaliseki ukwelashwa okhethiwe.
Ukwelapha
Ukwelashwa kungahluka kuye ngokuthi kunomdlavuza kangakanani. Kwezinye izimo, ukwelashwa kwe-chemotherapy kanye nokwelashwa kwemisebe yanciphisa ukunciphisa umzimba ukuze ukuhlinzwa kungaphumelela ngokuhamba kwesikhathi. Kodwa-ke, iningi le-time, i-effusion ye-pericardial ihlotshaniswa nezinye izindawo zomdlavuza wesifo somdlavuza futhi ukwelashwa kuyinkimbinkimbi: kwenziwa ngezizathu zenduduzo kodwa hhayi ngomzamo wokuphulukisa umdlavuza.
Isibikezelo
Ukuchazwa kwe-pericardial effusion kuncike kakhulu ekubambeni. Ngezifo, isifo sokuvuvukala, noma isifo sezinso esingasetshenziswa, ukubikezela kungase kube kuhle kakhulu.
Ngomdlavuza wamaphaphu, ukuthuthukiswa kwe-pericardial effusion kuyisibonakaliso esibi sokubikezela, ngisho nokusebenza okuncane kakhulu.
Ingxenye yesithathu yabantu abane-metastases yomdlavuza ku-pericardium izofa kusuka ku-ticonade ye-pericardial.
> Imithombo:
> Hoit, B. Ukuxilongwa Nokuphathwa Kwe-Pericardial Effusion. Kusesikhathini. Kubuyekezwe 05/31/17.
> Kato, R., Hayashi, H., Chiba, Y. et al. Umthelela wokubikezela we-Effect Minimal Pericardial in Iziguli ezine-Advanced Non-Small-Cell Cell Lung Cancer. Cancer Cancer Clinic . 2017 Meyi 10. (Epub ngaphambi kokuphrinta).
> Mizukami, Y., Ueda, N., Adachi, H., Arikura, J., noK. Kondo. Iziphumo Zesikhathi Eside Ngemva kwePericardiectomy ye-Thoracoscopic e-Assisted ye-Pericardial Effusion. Ama-Annal of Thoracic and Surgery Cardiovascular . 2017 Agasti 9. (Epub ngaphambi kokuphrinta).
> National Cancer Institute. I-Cardiopulmonary Syndromes (PDQ): I-Health Professional Version. 07/25/17.
> Ning, M., Tang, L., Gomez, D. et al. Isibhedlela kanye nokuqaphelisa kwe-Pericardial Effusion Ngemuva kokwelashwa kwe-Chemoradiation for Cancer Advanced Cell-Non-Small Cell Lung Cancer. I-International Journal ye-Radiation Oncology, i-Biology, ne-Physics . 2017. 99 (1): 70-79.