Ukuchithwa kwe-pericardial yi-buildup ye-fluid ngaphakathi kwe-pericardium, uluhlu lwama-tissue aqondisa intliziyo. I-pericardial effusion ingathuthuka ngokukhawuleza (ukungapheli kwimizimba engapheliyo) kwaye ibangele iimpawu ezimbalwa. Kunoko, ukuba ikhula ngokukhawuleza (i-acute pericardial effusion), ihlala ibangela iimpawu ezisongela ubomi kunye nexakeka lezonyango. Xa umbane owaneleyo ukwakhiwa kule ndawo kwaye unqanda kakhulu ukunyuswa kwenhliziyo, imeko iyaziwa njenge- tamponade ye-cardia .
I-pericardial effusion ingenzeka ngezizathu ezininzi (ezinye zezi zidweliswe ngezantsi) kodwa ziqheleke kakhulu kubantu abanomdlavuza wamaphaphu. Zenzeka kwi-21 ekhulwini yabantu abanomhlaza kwaye ngokuqhelekileyo banxulumene nesifo esilungileyo, kodwa ukuqonda ngokukhawuleza kunye nokuxilongwa kukubonelela ithuba lokunyamekela. Inani lokufa liye lahla kakhulu kwiminyaka embalwa edlulayo ngenxa yokuxilongwa nokukhawuleza ngokukhawuleza. Kwi-sibini yesithathu yabantu, ukuchithwa akubangelwa nayiphi na impawu.
Iimpawu
Ukuba une-efficable pericardial encinci kwaye ithuthuke ngokukhawuleza, unokwazi kuphela ngobukho bayo ngenxa yeziphumo kwi-x ray okanye kwi-CT. Ngokwahlukileyo, ukuba i-pericardial effusion ikhulu, okanye ukuba ikhula ngokukhawuleza ingabangela iimpawu eziquka:
- Ukuphefumula (ngokukodwa ngokulala phantsi)
- Lightheadedness
- Iintlungu zesifuba
- Isantya senhliziyo esiphuthumayo (ekubeni intliziyo inqandekile kwaye ayikwazi ukubetha njengamandla, inqanaba lentliziyo landa ukwenzela ukuba kugcinwe ukuhamba kwegazi elifanayo kwizicubu)
Ngelishwa, iimpawu ze-pericardial effusion ziyakulinganisa loo mdlavuza wamaphaphu, ukulibazisa ukuxilongwa.
Izizathu
Kukho izimbangela ezininzi zeempembelelo ze-pericardial. Ezinye zezi ziquka:
- Izifo
- Izimo ezizenzekelayo ngokuzenzekelayo (ezifana ne-rheumatoid arthritis)
- Amagciwane (abo babini basasazeka kwi-pericardium ukusuka kwezinye iindawo zomzimba kunye nalabo aqala kwi-pericardium)
- Ukuhluleka kweengso
- Ukuvutha (kubandakanya i- pericarditis )
- Utyando lwebhokisi
- Ukuhlasela kwentliziyo
- Mayeza
Amanye amachiza anokubangela ukuba i-pericardial effusions iquka:
- Imithi ye-chemotherapy i-Adriamycin (doxorubicin) ne-Cytoxan (cyclophosphamide)
- Isifo sesifo sofuba saseIsoniazid
- Imithi yokubamba i-Dilantin (phenytoin)
- Amachiza eRogaine (i-minoxidil) esetyenziselwa ukulungiswa kwesimo somntu kunye noxinzelelo lwegazi oluphezulu
I-Pericardial Effusions With Cancer
I-Pericardial effusions inokwenzeka naluphi na uhlobo lomhlaza, kodwa oluqhelekileyo lubandakanya umdlavuza wamaphaphu, umdlavuza webele, kunye ne-lymphomas.
Ngomdlavuza wamaphaphu, i-pericardial effusions ixhaphake kakhulu, malunga nesiqingatha sabantu abafumana unyango lwe-radiation kumdlavuza wamaphaphu bakhula umlinganiselo othile wokungena. I-chemotherapy ye-Adjuvant ibonakala yandisa le mngcipheko.
Kwimiba engama-50 ekhulwini labantu abanomdlavuza abanomonakalo we-pericardial, i-pericardial effusion ibonakaliso lokuqala kwaye ibangela ukuxilongwa komhlaza.
Unyango
Unyango lwe-pericardial effusions luphindwe kabini. Okokuqala, i-pericardial effusion ifuna ukuphathwa, rhoqo ngokukhawuleza ukuba iphoxisa intliziyo. Okwesibini, imbangela ye-pericardial effusion ifuna ukuqwalaselwa.
Ngokusuleleka, iziza-antibiotics okanye imishanguzo ye-antiviral iyafuneka.
Ngokuqhaqhazela, imishanguzo yokuchasana okanye i-steroids isenokusetyenziswa. Ukuba ukuxhatshazwa kungenxa yemichiza, isilwanyana sidla ngokumiswa kunye neminye imichiza esetyenziswayo xa kunokwenzeka. Ngomdlavuza, ulawulo lomhlaza luyahlukahluka ngokwemilinganiselo yomhlaza (jonga ngezantsi).
Unyango lokusombulula i-pericardial effusion ingaquka:
- Pericardiocentesis
- Ukufakela i-shunt (ngokuphindaphindiweyo kwisisu ukuze uhlale uguqula amanzi)
- Balloon pericardiotomy
- I-Pericardiectomy (ukususa i-pericardium) nge-thoracoscopic okanye evuliwe
Ukuba umonakalo ukhulu okanye uphawu, inqubo eyaziwa njenge-thoracoscopic (VATS) ye-pericardiectomy inokwenziwa ngevidiyo.
Kubantu abanesifo esicacileyo ngenxa yezizathu ezinobungozi) (ezifana nesifo) ukuxela kwangaphambili kule nkqubo kulungile. Ukubonelelwa ngezizathu zokuphuhliswa kwefuthe elibonakalayo kubantu abanomdlavuza, ukuhlwayelwa komzimba kuhlwempuzekileyo kungakhathaliseki unyango olukhethiweyo.
Unyango
Unyango luyahlukahluka ngokuxhomekeka kwindlela enkulu umhlaza. Kwezinye iimeko, i-chemotherapy kunye neyeza zonyango ziye zanciphisa i-pericardial effusion ukuze utyando lukwazi ukuphumelela kamva. Uninzi lwexesha, nangona kunjalo, i-pericardial effusion ihambelana nezinye iinkalo zomhlaza we-metastases kunye nonyango luyinkathalo: zenzelwe izizathu zenduduzo kodwa kungengomzamo wokonyanga umdlavuza.
Prognosis
Ukugxekwa kwe-pericardial effusion kuxhomekeke kakhulu kwizathu. Ngokusuleleka, izifo ezivuthayo, okanye isifo seengtso esinokulawulwa, ukuhlaselwa kwesibhambathiso kunokuba kuhle kakhulu.
Ngomdlavuza wamaphaphu, ukuphuhliswa kwe-pericardial effusion ngumqondiso obonisa ukunyanzelisa, nangona kuncinci kakhulu.
Ingxenye yesithathu yabantu abanomdlavuza wesifo kwi-pericardium baya kufa kwi-ticonade ye-pericardial.
> Imithombo:
> Hoit, B. Ukuxilongwa kunye nokunyangwa kwe-Pericardial Effusion. Isemgangathweno. Ukuhlaziywa 05/31/17.
> Kato, R., Hayashi, H., Chiba, Y. et al. Impembelelo yePrognostic ye-Minimal Effusion Pericardial kwizigulane ezine-Advanced-Non-Small-Cell Cell Lung Cancer. Cancer Lung Cancer . 2017 Meyi 10. (Epub ngaphambi kokuprinta).
> Mizukami, Y., Ueda, N., Adachi, H., Arikura, J., noK. Kondo. Iziphumo zexesha elide emva kweVidiyo-Incedise iTraracoscopic Pericardiectomy yePericardial Effusion. Ama-Annals of Thoracic and Cardiovascular Surgery . 2017 Agasti 9. (Epub ngaphambi kokuprinta).
> INational Cancer Institute. I-Cardiopulmonary Syndromes (PDQ): I-Health Professional Version. 07/25/17.
> Ning, M., Tang, L., Gomez, D. et al. Isiganeko kunye neengxaki zokuqala kwe-Pericardial Effusion Emva kokunyanga kwama-Chemoradiation kwi-Cancer Advanced Cell-Non-Small Cell Lung Cancer. I-International Journal ye-Radiation Oncology, Biology, kunye neFizikiki . 2017. 99 (1): 70-79.