Zamkatimu ndi Zosavomerezeka za Mediastinum
Kodi mediastinum ndi chiyani chomwe chimakhalapo m'dera lino la chifuwa? Kodi ndizochitika zotani zachipatala zomwe zingachitike mu mediastinum? Kodi ndi mitundu yanji ya masewera ammimba kapena matumbo omwe amapezeka mu magawo atatu a mediastinum?
Tanthauzo: Mediastinum
Pakati pa mapapu omwe ali ndi mtima, gawo la mphepo ( trachea ), mimba , ndi ziwiya zazikulu kuphatikizapo kukwera kwa aorta (mitsempha yaikulu yomwe imanyamula magazi kuchokera kumalo otsekemera a mtima pa njira yopita ku thupi lonse) ndi mitsempha yolumikiza kumanja ndi kumanzere-makamaka ziwalo zonse mu chifuwa kupatula mapapo.
Kumakhalanso kunyumba kwa mitsempha yambiri ndi mitsempha. Mawu akuti mediastinum amatembenuzidwa ngati "midway" mu Chilatini, ponena za gawo lapakati la chifuwa.
Mutha kuona chithunzichi poona chithunzithunzi monga pansi, pamutu (sternum) monga kutsogolo, mitsempha ya mitsempha yomwe imalowa ndi kuchoka pamtima monga pamwamba, ndi nsana ya m'mbuyo.
Makhalidwe - Chisankhulo chimagawidwa m'madera atatu akulu:
- Anterior - The mediterin mediastinum ilipo kumanzere kwina ndipo ili ndi mitsempha yaing'ono komanso ma lymph nodes.
- Pakatikati - Pakatikatikatikatikati ndi pakati, pamakhala mitsempha ya mitsempha kuphatikizapo yomwe imayenda kuchokera m'mapapu kufika pamtima, komanso m'mitsempha.
- Posterior - The posterior mediastinum ili ndi mitsempha, mitsempha yambiri ya mitsempha ndi mitsempha, ndi maseŵera a m'mimba .
Zomwe Zimakhudza Mediastinum
Pali zinthu zamankhwala zambiri zomwe zingakhudze miyambo mu mediastinum.
Ena mwa awa ndi awa:
- Khansara - Khansa monga amphmasi (onse a Hodgkin's lymphoma ndi maimfa osadziwika a Hodgkins), ziwalo zina za majeremusi, ndi thymomas (khansa ya thymus gland) zimachitika mu mediastinum.
- Matenda a Benign - Matenda a Benign ya mitsempha monga teratoma ndi dermoid cysts zingachitike m'derali.
- Zilonda zam'mimba zowopsa kwambiri (khansa zam'mimba zomwe zimakhudzidwa ndi khansa) - Khansa monga khansara yamapapu ingafalikire ku mitsempha yambiri m'madera amenewa.
- Lymphadenopathy - "Kutupa" mitsempha yam'mimba mu mediastinum ikhoza kuchitika ndi matenda, makamaka matenda opatsirana.
- Aneurysms - Thoracic aortic aneurysms ndi chikhalidwe chachikulu chokhudza mediastinum.
- Kuwonongeka kwa mitsempha - Mitsempha yomwe imadutsa mu mediastinum ikhoza kuonongeka, mwachitsanzo ndi kupanikizika kuchokera ku chotupa kapena khansa ya khansa m'dera lino.
Masses a Mediastinal
Masewera apakatikati amayamba kupezeka pofufuza kuti azindikire zizindikiro zokhudzana ndi chifuwa, monga chifuwa, kupuma pang'ono, kapena zizindikiro zina. Makamu ambiri mu mediastinamu ndi ochepa ndipo alibe zizindikiro. Zomwe zikuluzikulu zingathe kupangitsa kuti munthu asapitirize kupuma (kupuma kupuma kapena kupeza mpweya wokwanira kumatenda) komanso mavuto a mtima, monga kugwa kwa magazi kapena kuchepa kwa magazi.
Ukalamba wa munthu ndi malo a misala ya mediastinal ndi ofunika pofufuza matenda. Kwa ana, misala yapakatikati imapezeka nthawi zambiri m'mbuyo mwa mediastinum ndipo nthawi zambiri imakhala yonyozeka (osati ya khansa). Mosiyana, misala ya pakati pa anthu akuluakulu imakhala yowonjezereka m'mimba yamkati, ndipo nthawi zambiri imakhala yoopsa (khansa).
Zina mwa zifukwa za masewera a pakati pa malo akuphatikizapo:
- Anterior mediastinum - Mamimba m'madera awa angaphatikizepo thymomas (zotupa za thymus, chiwalo mu chifuwa chomwe chiri chachikulu kwambiri muunyamata koma makamaka chimatayika kwa anthu akuluakulu), maselo am'mimba, ndi masewera a chithokomiro.
- Middle mediininum - Mitsempha yamakono yowonjezera ndi yowonjezera chifukwa cha misa pakatikatikatikati. Mankhwalawa amatha kukhala okhudzana ndi khansa yapakhungu. Bronchogenic cysts amatha kuonanso kudera lino, kuphatikizapo zovuta za mtima monga aorta yotukulidwa.
- Posterior mediastinum - Khansa yotchedwa Esophageal khansa ndi zina zosayembekezereka zikhoza kuonekera m'mbuyo mwa mediastinum, ndipo mitsempha yowonjezereka ingathenso kutchulidwa apa. Zina mwazinthuzi ndi monga mitsempha ndi ectopic minofu ya chithokomiro (minofu ya chithokomiro ikukula m'dera linalake osati kunja kwa chithokomiro.
Khansara yammimba ingayambitse misa mu gawo lililonse la mediastinum. Ndikofunika kuzindikira kuti pali zowonjezera zambiri zomwe zimayambitsa zowonongeka mu mediastinum, ndipo nthawi zambiri kuyesedwa kofunikira kumafunika kuti mudziwe chifukwa chenichenicho.
Malamulo Okhudza Mediastinum
- Pneumomediastinum imatanthawuza kukhalapo kwa mpweya mu mediastinum, yomwe imagwirizana kwambiri ndi kugwa kwa mapapo (pneumothorax).
- Mediastinitis ndilo liwu loyimira matenda omwe amachitidwa ndi mediastinum.
Ndondomeko - Mediastinoscopy
Ndi khansa monga khansa ya m'mapapo ndi mafupa am'mimba, madokotala nthawi zambiri amafufuza mediastinum kuti awone ngati khansara iliyonse yafalikira kudera lino. Njira imodzi yomwe imalola opaleshoni kuganiza kuti dera limeneli limatchedwa mediastinoscopy . Ngati khansara yafalikira ku nthiti mu mediastinum nthawi zambiri imachiritsidwa mosiyana ndi khansara yomwe sinafalikire kudera lino; Kukhalapo kwa maseŵera am'thupi kumakhala kofunika kwambiri mu kansa ya m'mapapo .
Njira zamakono zowonjezereka zimakhala zofala kwa anthu omwe ali ndi khansara yamapapo, koma nthawi zina zidziwitso zomwezi zikhoza kupezeka podzera pa PET.
Zitsanzo: Chimwemwe chinali ndi ndondomeko yowonetsera ngati khansara yake yamapapu yayamba kufalikira ku maseŵera am'thupi m'mimba mwake.
> Zotsatira:
> Barrington, S., ndi R. Kluge. FBP PET for Monitoring Therapy in Hodgkin ndi Non-Hodgkin Lymphomas. European Journal of Nuclear Medicine ndi Molecular Imaging . 2017 Apr 14. (Epub patsogolo pa kusindikiza).
> Berry, M. Kupenda Masses Achimkati. Zaposachedwa. Kusinthidwa 09/28/16. http://www.uptodate.com/contents/pproach-to-adult-patient-with-a-ediastinal-mass
> Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. ndi B de Mol. Kusamalira Masses Aakulu Ambiri: Opaleshoni ndi Opaleshoni ya Anesthesiological. Journal of Thoracic Disease . 2016. 8 (3): E175-84.
> National Library of Medicine. Medline Plus. Matenda apakatikati. Kusinthidwa 05/20/16. https://medlineplus.gov/ency/article/001086.htm