Zizindikiro za mitsempha ya m'magazi m'mitsempha yamapapu yomwe nthawi zambiri imayambitsidwa ndi magazi-imatha kusiyana kwambiri. Malingana ndi kuchuluka kwa mapapo anu ndi kukula kwa kutsekedwa, mukhoza kukhala ndi zizindikiro zofanana, monga zotsatirazi:
- Kuthamanga kwadzidzidzi komwe kumakhala kovuta kwambiri
- Kupweteka mchifuwa komwe kungakhale koipa kwambiri pamene mupuma kwambiri
- Ululu mukamatsokomola, kudya, kupindika, kapena kuwerama
- Ululu umene umapweteka kwambiri ndi zochita masewera olimbitsa thupi koma sumapita kwathunthu mukapumula
- Chiwombankhanga, chomwe chingabweretse ntchentche yamagazi
Zizindikiro zina, zomwe zingaphatikizepo zotsatirazi:
- Kupweteka kwa mmimba kapena kutupa, kapena zonsezi, kawirikawiri mu ng'ombe
- Khungu la clammy kapena khungu lopaka buluu
- Fever
- Kukwapula
- Kufulumira kapena kusagwirizana kwa mtima
- Lightheadedness kapena chizungulire
Kodi N'chiyani Chimachitika Panthawi Yophatikizira Anthu?
Pakati pa pulmonary embolism kapena PE , chochitika chachikulu ndi chakuti magazi amatha kutuluka pamtima kupita kumapapu, kudzera mu mitsempha ya pulmonary . Mapuloteni a mitsempha amapereka magazi m'mapapo ndi m'magazi amagazi amatha kuikidwa pazigawo zosiyanasiyana pamsewu, m'mitsuko yomwe imachititsa magazi m'mapapo. Ngati khungu lamagazi ndi lalikulu, limatha kukanika ndi kutseka chotengera chachikulu, chomwe chikhoza kuopseza moyo. N'zotheka kuti magazi azikhala ochepa kwambiri moti amadziwika mosavuta, zomwe zimapangitsa khungu kakang'ono kuti limve zotsatira zake.
Kuzindikira ndi Chithandizo
Pali mayesero amtundu wosiyanasiyana omwe angapangidwe kuti azindikire mapulogalamu a pulmonary emboli, kuphatikizapo penti-perfusion scan, D-dimer, kapena pulmonary angiogram.
Mankhwala opangidwa ndi pulmonary emboli amadalira kukula kwake ndi kutalika kwake. Ngati zizindikiro siziri zoopsa, ochepa magazi angagwiritsidwe ntchito komanso zodziletsa kuti zisawonongeke.
Mayi akuluakulu, mankhwala obisika kwambiri monga omwe amatsegula makina a mtima pamtima.
N'chifukwa Chiyani Odwala Matenda a Kanseri Akuopsezedwa Chifukwa Chodzipangira Zam'mimba?
Asayansi akamaphunzira za chiopsezo cha PE, amalingalira kuti ali ndi matenda onse omwe amachititsa munthu kukhala nawo. Izi zikutanthauza kuti, PE ndi imodzi mwa zochitika zingapo zomwe zimachitika pamene munthu amapanga magazi m'mitsempha yawo, matenda otchedwa thromboembolism , kapena VTE.
Poyerekeza ndi anthu ambiri, chiŵerengero cha VTE ndi PE n'chokwanira kwa odwala khansa; Odwala khansa ali ndi mwayi wokwanira kukhala ndi thromboembolism, yomwe imaphatikizapo mapulitsimidwe a pulmonary ndi mitsempha ya thrombosis. Mkati mwa mitsempha yotchedwa thrombosis, kapena DVT, imatanthawuza mwachindunji kuphulika kwa magazi komwe kumapanga m'mitsempha yambiri, makamaka miyendo, koma imatha kupezeka kwinakwake. Kuvuta kwakukulu kwambiri kwa DVT kumachitika pamene gawo la chovalacho chimatha ndipo amayenda kudutsa m'magazi mpaka pamtima ndipo kenako mapapo , zomwe zimapangitsa kuti kutsekedwa kumatchedwa PE. Mukhoza kukhala ndi PE popanda kukhala ndi DVT, komabe.
Kawirikawiri, magaziwa amatha kupanga mitsempha ya thupi lanu chifukwa cha zifukwa zosiyanasiyana, kuphatikizapo zotsatirazi:
- Kuwonongeka kwa nsalu zamkati zamkati
- Kuvulala kwa mitsempha yochitidwa ndi zinthu zakuthupi, zamagulu, kapena zachilengedwe
- Kuchita opaleshoni, kuvulaza kwambiri, kukhala ndi matenda kapena matenda omwe amachititsa kutupa, komanso mayankho ena a chitetezo cha mthupi
- Matenda kapena matenda omwe magazi amatha kuchepa, monga opaleshoni, kapena kupuma kwa nthawi yayitali, kapena paulendo wautali akuyenda
- Mavuto ena omwe amachititsa kuti magazi anu azikhala owopsa kwambiri kapena osakanikirana
- Zina mwa zinthu zobadwa nazo, mwachitsanzo, zimayambitsa V Leiden, zomwe zimapangitsa kuti mutenge magazi
- Mankhwala opangira mahomoni kapena mapiritsi oletsa kubereka
Kudula ndi Kutaya Kwa Odwala Ndi Khansa
Otsatira magazi amapezeka mwa odwala matenda a kansa, ndipo odwala khansa akhoza kukhala ndi chiopsezo chochulukirapo chifukwa cha zifukwa zosiyanasiyana, kuphatikizapo khansa, yokha, komanso mankhwala osiyanasiyana a khansa. Chemotherapy, mankhwala opatsirana pogwiritsa ntchito ma radiation, komanso mankhwala opangira mahomoni onse amachititsa kuti pakhale magazi.
Zingawoneke ngati zachilendo, koma matenda otha magazi angakhale ofala kwambiri kwa anthu omwe ali ndi khansa ya magazi. Izi zikhoza kumveka motere: Nthawi zambiri, pokhapokha pali vuto ndi kutseka thupi, munthu akhoza kukhala pangozi yochulukitsa magazi kapena kutaya magazi, malinga ndi momwe zinthu zilili.
Ntchito Yophimba-Kupewa Mankhwala
Nthawi zambiri mankhwala oletsa kutsekemera ndi otetezedwa ndi khansa, makamaka omwe amawoneka kuti ali pangozi yochepa ya VTE; Komabe, mwa iwo omwe ali pachiopsezo chachikulu cha VTE ndi omwe ali ndi myeloma akulandira mankhwala otchedwa immunomodulators, mankhwala otetezera oterewa angaganizidwe, malinga ndi magulu a akatswiri.
Mlingo wamakono wa chisamaliro ndi wotchedwa hepatin-molecular-weight weight (LMWH), yomwe imafuna jekeseni. Zina, ziwalo zatsopano zamagazi zam'mimba zimapezeka, koma pali umboni wosakwanira kuti madokotala azitha kuyang'ana pamene akuganiza zopanga LMWH kukhala mmodzi wa awa olankhula.
Mu kafukufuku waposachedwapa, atapatsidwa mwayi wodzisankhira LMWH poyerekeza ndi wothandizira pakamwa ndi ofanana, odwala ambiri omwe ali ndi khansara amasankha wothandizira pakamwa. Komabe, akatswiri amanena kuti chisankho chofuna kusinthana kumafuna kulingalira mosamala zomwe zimachitika pakati pa khansa ya wodwalayo ndi njira yothandizira, ndi zovuta zomwe zimayambitsa matendawa.
PE / VTE mwa Odwala Amene Ali Ndi Khansa Yopanga Magazi
Maphunziro oyambirira amasonyeza kuti zotupa zolimba monga khansa ya m'mawere ndi khansa ya m'mapapo, makamaka, zimawonjezera chiopsezo cha magazi kusiyana ndi khansa ya magazi, kuphatikizapo khansa ya m'magazi , lymphoma, ndi myeloma. Pakhala pali maphunziro ena kuyambira pamene amatsutsana ndi lingaliro ili, komabe, mwina zikhoza kukhala choncho kuti mitundu ya khansa ya magazi ndi zizindikiro za munthu wina aliyense wodwala zimakhudza chiopsezo chanu m'njira zofunika.
Odwala Okalamba Amene Amakhala ndi Matenda Oopsa a Myeloid Leukemia
Kafukufuku wofalitsidwa mu 2016 adawauza kuti okalamba omwe ali ndi CML anali ndi ziwerengero zazikulu zoposa PE kuposa odwala omwe alibe khansa, zomwe sizinali zodabwitsa, chifukwa khansara, makamaka, imaganiziridwa kuti iwonjezere mavuto. Mavuto a kutsekemera sanawonjezeke m'gulu la odwala omwe amamwa mankhwala osokoneza bongo otchedwa tyrosine kinase inhibitors (makamaka otchedwa imatinib), komabe, akuwonetsa kuti chiopsezo mwa odwalawa ndi CML chinayendetsedwa kwambiri ndi zifukwa zomwe zimayambitsa khansara osati mankhwala.
Childhood Acute Lymphoblastic Leukemia
Kuphatikizika kwapakati pa ubwana sikunali kozolowereka, koma kukhala ndi vuto (monga khansa ya m'magazi) kungapangitse ngozi yotchedwa VTE ndi PE kwa ana. Zizindikiro zazikulu zowopsa kwa VTE ndi PE zimakhala ndi catheter yapakati, zizindikiro, ndi chemotherapy. VTE imapezeka mu 2.1-16 peresenti ya ana omwe ali ndi khansara, pamene chiwerengero cha zokhudzana ndi catheter chotchedwa VTE chikuchokera pa 2.6 mpaka 36.7 peresenti.
Umboni wambiri wa PE mwa ana omwe ali ndi khansara umaganizira odwala aliwonse, omwe amavuta kwambiri. Kafukufuku wa ana omwe ali ndi khansa ya m'magazi anafotokoza VTE mu 5.2 peresenti ya ana onse, koma chiwerengero cha chiwerengerocho chinkafika pa 1 mpaka 36 peresenti. Makamaka, kugwiritsa ntchito L-asparaginase, kuphatikizapo mankhwala a chemotherapy regimen kuphatikizapo anthracycline, vincristine, ndi steroid, yachititsa acute lymphocytic khansa ya m'magazi (ALL) matenda ochiritsidwa, makamaka kwa ana-komabe angagwirizanenso ndi chiopsezo chowonjezeka cha VTE , kotero mankhwala omwe amapewa kuteteza magazi akhoza kuperekedwa kuti achepetse chiopsezo ichi.
Acute Promyelocytic Leukemia, mtundu wa AML
Poyerekeza ndi kutuluka kwa magazi, zazikulu zamagazi ndizovuta kwambiri kwa odwala okhala ndi acute promyelocytic khansa ya m'magazi, mtundu wochepa wa AML. Ichi ndi chitsanzo chabwino cha khansa yamagazi yomwe machitidwe a thupi amakhudzidwa, nthawi zambiri amachititsa kuti magazi achoke, komanso ndizotheka kubisala. Odwala okhala ndi acute promyelocytic khansa ya m'magazi akhoza kupita kwa dokotala ali ndi vuto la magazi monga mphuno yomwe siimatha, kapena kudula komwe sikudzatha. Koma amakhalanso ndi mwana wang'ombe wochokera ku DVT, kapena kupweteka kwa chifuwa ndi kupuma kwa mpweya wochokera m'magazi kapena PE.
Kutseka Mmene Mungapewere Kachiromboka ndi Lymphoma
Kafukufuku wa Petterson ndi anzake omwe adafalitsidwa mu 2015 adanena kuti mitundu yonse ya khansara imayambitsa chiopsezo cha VTE ndikuti kukula kwa chiopsezo chosiyana ndizosiyana ndi magulu akuluakulu a khansa; mu phunziro ili, vuto lalikulu kwambiri la VTE linawoneka ndi khansa ya mutu ndi ya mitsempha (4.1x) ndipo chiopsezo chachikulu chidawoneka ndi kansa ya ubongo (47.3x).
Pamene gulu la akatswiriwa adayesa kusintha machitidwe osiyanasiyana kuti azindikire kuti ali ndi VTE mu lymphoma (poyerekeza ndi khansa zina), adapeza kuti chiopsezochi chinawonjezeka makamaka pakati pa odwala matenda a lymphoma.
Lymphoma inali imodzi mwa malo anayi a khansa omwe ali ndi chiopsezo chachikulu cha VTE, monga zotsatirazi:
- Khansara ya ubongo
- Khansara yapancreatic
- Matenda ena (kutsegula m'mimba, katumbo pang'ono, gallbladder, ndi bile system)
- Lymphoma
Odwala omwe ali ndi khansa ya m'magazi anapezeka kuti ali pangozi pakati pa phunziroli.
Pa milandu 33 ya milandu yomwe ili ndi lymphoma yogwira ntchito komanso zochitika 18 zokhala ndi matenda a khansa m'maphunzirowa, 14 peresenti yokha (28 peresenti) inali ndi catheter yapakatikati mwa miyezi itatu isanakwane. Zambiri mwazifukwa zomwe zimakhala ndi khansa ya m'magazi zinali ndi matenda aakulu a khansa ya m'magazi (11 pa 18, kapena 61 peresenti), yomwe siimachiritsidwa ndi L-asparaginase, yomwe imadziwika kuti ndi VTE.
Mawu Ochokera
Ndikofunika kudziwa kuti, monga wodwala matenda a khansa, ukhoza kukhala pachiopsezo chachikulu cha mavuto a magazi monga pulmonary embolism. Komabe, nkofunikanso kuika chiopsezo ichi moyenera. Mwachidziwikire, mwayi wokhala ndi embolism wamapiritsi akadali otsika kwambiri.
Ngakhale kulandira chithandizo kudzera m'kati mwa catheter yamatumbo kungapangitse chiopsezo cha PE / VTE, mankhwalawa akhoza kupulumutsa moyo kwa odwala ambiri omwe ali ndi khansa. Madokotala amadziwa zoopsa za VTE / PE mu maulendo osiyanasiyana a khansa ya magazi, komanso ndi mankhwala osiyanasiyana komanso njira zosiyanasiyana. Monga wodwala wophunzira, chidziwitso chanu cha zizindikiro za PE / VTE ndi kudikirira kwanu kungathandize dokotala wanu kuchita mofulumira, ngati pakufunika kutero.
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