Kuwonongeka kwakukulu ndikumangirira kwa madzi m'kati mwa zowonongeka, mndandanda wa ma tishu omwe amatsitsa mtima. Kuwonongeka kwapadera kungapangitse pang'onopang'ono (matenda oopsa a pericardial effusion) ndipo amachititsa zizindikiro zochepa. M'malo mwake, ngati ikukula mofulumira (nthawi yomweyo imayambitsa matenda), imayambitsa zizindikiro zowopsa komanso ndizochitika mwamsanga. Pamene madzimadzi okwanira amamera m'derali ndipo amalepheretsa kuyenda kwa mtima, chikhalidwechi chimadziwika ngati kukwera kwa mtima .
Kuwonongeka kwapadera kungabwere chifukwa cha zifukwa zambiri (zina mwa izi ziri pansipa) koma ndizofala kwambiri kwa anthu omwe ali ndi khansa ya m'mapapo. Iwo amapezeka mpaka 21 peresenti ya anthu omwe ali ndi khansa ndipo nthawi zambiri amagwirizanitsidwa ndi matenda osayenera, koma kuzindikira mofulumira ndi kugonana kumapereka mpata wothandizira. Chiwerengero cha anthu omwe amwalira chimachepa kwambiri m'zaka makumi angapo zapitazo chifukwa chodziŵika bwino ndi kusamalira mwamsanga. Pafupifupi magawo awiri pa atatu aliwonse a anthu, kuwonongeka sikungayambitse zizindikiro zoonekeratu.
Zizindikiro
Ngati muli ndi mankhwala ochepa omwe ali ochepa komanso opangidwa pang'onopang'ono, mumangodziwa za kupezeka kwake chifukwa cha zofufuza pa x-ray kapena CT. Mosiyanitsa, ngati pericardial effusion ndi yaikulu, kapena ngati ikukula mofulumira zingayambitse zizindikiro kuphatikizapo:
- Kupuma pang'ono (makamaka pogona)
- Lightheadedness
- Kupweteka pachifuwa
- Kuthamanga kwa mtima mofulumira (popeza mtima uli woletsedwa ndipo sungathe kuwombera mwamphamvu, kuthamanga kwa mtima kukuwonjezeka kuti pitirize kuthamanga magazi omwewo kumatenda)
Mwamwayi, zizindikiro za kupweteka kwapadera zimatha kufanana ndi khansa ya m'mapapo, kuchepetsa kupatsirana.
Zimayambitsa
Pali zifukwa zambiri zowonongeka. Ena mwa awa ndi awa:
- Matenda
- Zomwe zimayambitsa matenda (monga matenda a nyamakazi)
- Khansa (zonse zomwe zimafalikira ku zowonongeka kuchokera ku zigawo zina za thupi ndi zomwe zimayambira pa zojambulazo)
- Kulephera kwa impso
- Kutupa (kuphatikizapo pericarditis )
- Opaleshoni yamphongo
- Kuwononga mtima
- Mankhwala
Zina mwa mankhwala omwe angayambitse zowonongeka ndi awa:
- Mankhwala a chemotherapy Adriamycin (doxorubicin) ndi Cytoxan (cyclophosphamide)
- Matenda a chifuwa chachikulu ndi Isoniazid
- Mankhwala ogwira ntchito Dilantin (phenytoin)
- Mankhwala a Rogaine (minoxidil) omwe amagwiritsidwa ntchito poyeretsa amuna ndi kuthamanga kwa magazi
Pericardial Effusions ndi Khansa
Mankhwala a Pericardial angayambe ndi mtundu uliwonse wa khansara, koma yowonjezereka ndi khansa ya m'mapapo, kansa ya m'mawere, ndi malimymim.
Ndi khansa yamapapu, zowonongeka ndizofala kwambiri, pafupifupi theka la anthu omwe akudwala matenda opatsirana pogwiritsa ntchito khansa ya m'mapapo amatha kusakaniza. Mankhwala a mankhwala a Adjuvant amawonjezera chiopsezo chimenechi.
Pafupifupi 50 peresenti ya anthu omwe ali ndi khansara omwe ali ndi vuto lowonongeka, chiwonongeko choyamba ndi chizindikiro choyamba ndipo chimayambitsa matenda a khansara.
Kuchiza
Mankhwala a pericardial effusions ndi awiri. Choyamba, kupweteka kwapadera kumafuna kuchiritsidwa, nthawi zambiri mofulumira ngati ikupweteka mtima. Chachiwiri, chifukwa cha pericardial effusion chiyenera kuthandizidwa.
Ndi matenda, mankhwala opha tizilombo kapena mankhwala ochepetsa tizilombo toyambitsa matenda adzafunika.
Ndi kutupa, mankhwala oletsa kupweteka kapena steroids angagwiritsidwe ntchito. Ngati mankhwalawa amachokera chifukwa cha mankhwala, mankhwalawa amaimitsidwa ndi mankhwala ena omwe angagwiritsidwe ntchito ngati n'kotheka. Ndi khansa, kasamalidwe ka khansara amasiyana malinga ndi kukula kwa khansara (onani m'munsimu).
Mankhwala othetsera vutoli angaphatikizepo:
- Pericardiocentesis
- Kuika shunt (nthawi zambiri m'mimba nthawi zonse kumatulutsa madzi)
- Balloon pericardiotomy
- Pericardiectomy (kuchotsa peicardium) kudzera opaleshoni ya thoracoscopic kapena yotseguka
Ngati kuwonongeka kwakukulu kapena kochititsa mantha, njira yodziwika kuti VAC) yothandizira pulojekiti (VATS) pericardiectomy ingathe kuchitidwa.
Kwa anthu omwe ali ndi zizindikiro zowonongeka chifukwa cha zoopsa) (monga matenda) zizindikirozi ndi zabwino. Chifukwa cha zifukwa zomwe zimapangitsa kuti anthu azikhala ndi khansa, akuganiza kuti ndi osauka mosasamala kanthu za mankhwala omwe asankhidwa.
Chithandizo
Chithandizo chingasinthe malinga ndi momwe khansara yatha. Nthaŵi zina, mankhwala a chemotherapy ndi ma radiation achepetsa kuchepa kwadzidzidzi kotero kuti opaleshoni ikhoza kupambana. Komabe, nthawi zambiri, kugwiritsidwa ntchito kwapadera kumagwirizanitsidwa ndi madera ena a khansa yothandizira khansa komanso mankhwala amatha kupweteka: amachita zolimbikitsa koma osati pofuna kuchiza khansa.
Kuthamangitsani
Chizindikiro cha pericardial effusion chimadalira makamaka chifukwa chake. Ndi matenda, matenda opweteka, kapena matenda a impso omwe angathe kusamalidwa, zizindikiro zingakhale zabwino kwambiri.
Ndi khansara yamapapu, chitukuko cha kuwonongeka kwapadera ndi chizindikiro choyipa cholosera, ngakhale ndi zochepa zazing'ono.
Gawo lachitatu la anthu omwe ali ndi khansa ya metastases kuwonongeka ndifa kuchokera ku pericardial tamponade.
> Zotsatira:
> Hoit, B. Kuzindikira ndi Chithandizo cha Kuwonongeka kwa Pericardial. Zaposachedwa. Kusinthidwa 05/31/17.
> Kato, R., Hayashi, H., Chiba, Y. et al. Zotsatira za Kukula kwa Mphamvu za Kuchepa Kwambiri kwa Odwala Pakati pa Odwala Amene Ali ndi Matenda Ovuta Kwambiri Osakhala aang'ono-Khansa Yam'mimba. Khansara Yam'mimba Yamakono . 2017 May 10. (Epub patsogolo pa kusindikiza).
> Mizukami, Y., Ueda, N., Adachi, H., Arikura, J., ndi K. Kondo. Zotsatira Zanthawi Zonse Pambuyo pa Pulogalamu ya Pracarcopicic Pracarcopicic ya Pericardial Effusion. Annals ya Opaleshoni Yachilu ndi Opaleshoni . 2017 August 9. (Epub patsogolo pa kusindikiza).
> National Cancer Institute. Syndromes ya Cardiromulmonary (PDQ): Health Professional Version. 07/25/17.
> Ning, M., Tang, L., Gomez, D. et al. Zochitika ndi Zotsutsa za Pericardial Effusion Pambuyo pa Kuthandizira Kachilombo kwa Kachilombo Chakupita Kwambiri Osakhala Kakang'ono Kagulu Lung'onoting'ono. International Journal of Radiation Oncology, Biology, ndi Physics . 2017. 99 (1): 70-79.