Iimpawu zeepmonal-blockages kwiimitha zeemiphunga emiphakeni evame ukubangelwa ngamacenge egazi-ziyahlukahluka kakhulu. Ngokuxhomekeka kwimiba emalunga nemiphunga yakho kunye nobungakanani bokuvalwa, unokufumana ezinye iimpawu kunye neempawu eziqhelekileyo, njengalezi zilandelayo:
- ukuphefumula ngokukhawuleza kokuphefumula okuba kubi nakakhulu
- Intlungu yesifuba enokuba yimbi xa uphefumula
- Ubuhlungu xa ukhwehlela, udle, ugobe, okanye usike
- Ubunzima obunzima ngokuzilolonga kodwa alupheli ngokupheleleyo xa uphumla
- Isiqhamo, esinokuvelisa i-mucus yamanzi
Ezinye iimpawu kunye neempawu, ezibandakanya oku kulandelayo:
- Intlungu yomlenze okanye ukuvuvukala, okanye zombini, kaninzi kwenkonyane
- Isikhumba se-Clammy okanye isikhumba esiluhlaza okwesibhakabhaka
- Fever
- Ukuxela
- Intliziyo esheshayo okanye engavumelekanga
- Lightheadedness okanye utywala
Yintoni Eyenzeka Ngethuba Lokugqithisa KwamaPulmonary?
Ngexesha le- pulmonary embolism okanye i-PE , imeko ebonakalayo yinto yokuba i-clot yegazi iphoswa ngaphandle kwentliziyo kwimiphunga, ngokusebenzisa i- pulmonary artery . Amagatsha e-pulmonary artery ukuhambisa igazi kumphunga ngamnye kunye namacenge egazi angeniswa kwiindawo ezahlukeneyo endleleni, kwiimpahla ezenza igazi emiphakeni. Ukuba i-clot yegazi ikhulu ngokwaneleyo, inokuthi iyanamathele kwaye ikhusele ngokupheleleyo isikebhe esikhulu, esinokuba sisongela ubomi. Kwakhona kunokwenzeka ukuba i-clot yegazi ibe yincinci kangangokuthi ibonakala ingabonakali, ibangele iqela elincinane lemiphunga ukuba libe nemiphumo yalo.
Ukuxilongwa kunye noTyango
Kufuneka kwenziwe iimvavanyo ezahlukeneyo ukuze uhlolisise i-pulmonary emboli, kubandakanya ukukhishwa kwamaproseshini, iD-dimer, okanye i-angiogram ye-pulmonary.
Unyango lwe-pulmary emboli luxhomekeke kubukhulu kunye nobukhulu be-clot. Ukuba iimpawu azikho nzima, i- blood thinners ingasetyenziselwa kunye nokuthintela ukuthintela ukuphuhliswa okuqhubekayo kwamacwecwe.
Kwiimvumba ezinkulu, ezinzima, amayeza anjengeenkcukacha ezinjengalezo ezisetyenziselwa ukuvula iimpahla zentliziyo ngexesha lokuhlaselwa kwentliziyo kunokusetyenziswa.
Kutheni Izigulane Zinomdla Wengozi Ekukhunjweni KwamaPulmonary?
Xa oososayensi bafunda ingozi ye-PE, bayicinga yonke into yesifo esenza umntu ukuba abe nazo. Okokuthi, ii-PE ziyodwa yeziganeko ezininzi ezinokuthi zenzeke xa umntu ehlamba igazi kwiimvini zabo, imeko eyaziwa ngokuba yi- thromboembolism ene-venous , okanye i-VTE.
Xa kuthelekiswa noluntu jikelele, iziganeko ze- VTE kunye ne-PE ziphezulu kwizigulane ezinomdlavuza; izigulane zomhlaza zingamaxesha amane ukuba zivelise i-thromboembolism ene-venous, ebandakanya zombini u-pulmonary embolism kunye ne-deep vein thrombosis. I-deep vein thrombosis, okanye i-DVT, ibhekisela ngokucacileyo kumacenge egazi ayenze emithanjeni enzulu, ngokuqhelekileyo kwimilenze, kodwa inokuthi yenzeke kwenye indawo. Ingxaki enkulu kakhulu ye-DVT iyenzeka xa inxalenye yecala iphuma kwaye ihamba ngegazi ukuya entliziyweni kwaye emva koko imiphunga , ebangela ukukhutshwa okubizwa ngokuba yi-PE. Unokuba ne-PE ngaphandle kokuba ne-DVT, nangona kunjalo.
Ngokuqhelekileyo, la macala egazi angabumba emithanjeni yakho emzimbeni enzulu ngenxa yezizathu ezahlukeneyo, kubandakanywa oku kulandelayo:
- Ukulimala kwintsimbi yangaphakathi
- Ukulimala kwimvini ebangelwa yimvelo, iikhemikhali okanye izinto eziphilayo
- Ukuhlinzwa, ukugcina ukulimala okukhulu, ukugula okanye imeko evelisa ukuvuvukala, kunye nezimpendulo ezithile zomzimba
- Isifo okanye imeko apho ukuhamba kwegazi kuhla, njengoko emva kokuhlinzwa, okanye ngexesha lokuphumla kwexesha lokulala, okanye ngexesha lokuhamba ngexesha elide xa uhamba
- Iimeko ezithile ezibangela ukuba igazi lakho libe likhulu okanye livumeleke ukuba livalwe ngaphezu kweqhelekileyo
- Ezinye iimeko ezizuze ngefa, umzekelo, i-Vid Leiden, eyandisa ingozi yokuqhawula igazi
- I-hormone unyango okanye iipilisi zokulawula ukuzalwa
Ukuvalwa kunye nokuhlambalaza kwizigulane ezineCarcer
Amacwecwe egazi aqhelekileyo kwizigulane ezineengxaki zomhlaza, kwaye izigulane zomhlaza zingasengozini yokwanda kwegazi ngenxa yezizathu ezahlukahlukeneyo, kuquka umhlaza, ngokwawo, kunye nezokwelapha ezahlukeneyo zomhlaza. I-Chemotherapy, unyango lwe-radiation, kunye ne-hormone unyango lunokunyusa ingozi yegazi.
Kungabonakala kungenakuphikisa, kodwa ukuphazamiseka kwegazi kunokuninzi kakhulu kubantu abanomdlavuza wegazi. Oku kuya kuqondwa ngolu hlobo lulandelayo: ngokubanzi, xa kukho ingxaki kwinkqubo yokuvalwa komzimba, umntu unokubeka engozini yokuphuma kwegazi okanye ukucima, ngokuxhomekeke kwiimeko.
Indima ye-Clot-Ukukhusela iMithi
Ukunciphisa amayeza angaphakanyiswa ngamayeza aphethwe ngumhlaza, ngakumbi abo babonwa phantsi kwengozi ye-VTE; nangona kunjalo, kulabo abasemngciphekweni ophezulu we-VTE kunye nalabo abane-myeloma abafumana iziyobisi ezibizwa ngokuba yi-immunomodulators, loo mayeza anokuthintela i-clot angacingelwa, ngokweengcali zengcali.
Umgangatho ofanelekileyo wokunyamekela uyinto ebizwa ngokuba yi-heparin ye-molecular-weight-weight (LMWH), efuna iigciwane. Eminye, i-bloodline entsha yomlomo iyabonakala, kodwa kukho ubungqina obuncitshiweyo oogqirha ukuba baqalise xa becinga ukwenza utshintsho oluvela kwi-LMWH kwelinye lala mafayili omlomo.
Kuhlolisiso lwakutshanje, xa kunikwa i-LMWH ekukhethiweyo ngokuchaneka ngokumalunga ne-agent yomlomo ngokusebenza ngokulinganayo, ezininzi izigulane ezinomdlavuza zikhetha ngokucacileyo ummeli womlomo. Iingcali zithi, nokuba kunjalo, ukuba isigqibo sokutshintsha sidinga ukuqwalaselwa ngokucophelela kwintsebenziswano phakathi komhlaza wesigulane kunye nenkqubo yokonyango, kunye neengxaki zabo ezingaphantsi.
I-PE / VTE kwizigulane ezineCarcer Blood Cancers
Izifundo zakuqala zaphakamisa ukuba izicubu ezinzulu ezifana nomhlaza wesifuba nomdlavuza wamaphaphu, ngokubanzi, zinokunyusa umngcipheko wecala legazi kunomdlavuza wegazi, oquka i-leukemia , i-lymphoma kunye ne-myeloma. Kukho ezinye iiphononongo ukususela kuloo mbuzo, nangona kunjalo, kwaye kungenjalo ukuba iintlobo zegazi lomhlaza kunye neempawu zesigulane ngasinye zichaphazela umngcipheko ngeendlela ezibalulekileyo.
Iziguli eziguga ezine-Leukemia ezingapheliyo
Uphando olupapashwe ngo-2016 lucetyise ukuba izigulane ezisebekhulile nge-CML zinamazinga angaphezulu kwe-PE kunezigulane ezingenayo umdlavuza, okwakungekho into emangalisayo, kuba isifo somhlaza, ngokuqhelekileyo, kucingelwa ukuba siphumelele iingxaki zokuqhawula. Iingxaki zeengxaki zokuqhawula azizange zinyuswe kwiqela lezigulana ezithatha iziyobisi ezibizwa ngokuba yi-tyrosine kinase inhibitors (ininzi enye egama lingu-imatinib), nangona kunjalo, isichaza ukuba umngcipheko kwezi zigulane nge-CML iqhutywe kakhulu yizinto ezichaphazelekayo nomhlaza kwaye unyango.
I-Childhood Acute Lymphoblastic Leukemia
Ukugqithiswa kwepulmonary ngexesha lobuntwana akuqhelekanga, kodwa ukuphathwa kakubi (njenge-leukemia) kunokunyusa ingozi ye-VTE kunye ne-PE kubantwana. Izinto ezinobungozi obukhulu kwi-VTE kunye ne-PE ziquka i-catheter ephakathi, i-malignancies kunye ne-chemotherapy. I-VTE iyenzeka kwi-2.1-16 iphesenti yabantwana abanomdlavuza, kanti iirhafu ezichazwe kwi-VTE zivela kwi-2.6 ukuya kuma-36.7 ekhulwini.
Ubuninzi bo bungqina be-PE kubantwana abanomdla kugxininisa kwizigulane zabo ZONKE, ezona zixhaphakileyo zonyango. Uhlalutyo lweemeta lwabantwana abane-leukemia luchaze i-VTE kuma-5.2 ekhulwini kwabantwana abane-ALL, kodwa amaxabiso abiziweyo avela kwi-1 ukuya kuma-36 ekhulwini. Ngokukodwa, ukusebenzisa i-L-asparaginase, kunye ne-regimen ye-chemotherapy kuquka i-anthracycline, i-vincristine, kunye ne-steroid, yenza i-lemonemic i-lymphocytic i-leukemia (YONKE) isifo esinokuphilisa, ngokukodwa kubantwana-kodwa sinokubandakanywa nengozi enkulu ye-VTE , ngoko amayeza okuthintela i-clotting yegazi inganikwa ukunciphisa umngcipheko.
I-Acute Promyelocytic Leukemia, uhlobo lwe-AML
Xa kuthelekiswa nokuphuma kwegazi, iingubo ezininzi zegazi ziyingxaki engapheliyo kwizigulane ezine-acute lemonemic leukemia, uhlobo olunqabileyo lwe-AML. Lo ngumzekelo omhle womhlaza wegazi apho iinkqubo zomzimba ze-coagulation zichaphazelekayo, ngokuqhelekileyo zikhokelela ekuphumeni kwegazi, kodwa nazo zinokuthi zenze i-clotting. Izigulane ezine-acute leprosycytic leukemia zingaya kwigqirha ngeengxaki zokuphuma kwegazi ezifana neempumlo ezingenakuyeka, okanye ukusikwa okungeke kunqande. Kodwa banokuba nethole lokuvuvukala kwi-DVT, okanye intlungu yesifuba kunye nokuphefumula okuphefumulayo ukusuka kwigazi lempompo okanye kwi-PE.
Ukuvala ingozi kwiLukemia kunye neLymphoma
Ucwaningo olwenziwa nguPetterson kunye noogxa abashicilelweyo ngo-2015 belucetyiswa ukuba zonke iintlobo zomhlaza zivame ukwandisa umngcipheko we-VTE kwaye ukuba ubungakanani beengozi eyongeziweyo buhluke kwiindidi ezinkulu zomhlaza; kwisifundo esithile, umngcipheko ophantsi kakhulu we-VTE ubonwe ngeentloko zomhlaza kunye nentamo yengqayi (4.1x) kunye nomngcipheko ophezulu ubonwe ngumhlaza wengqondo (47.3x).
Xa eli qela labaphandi lizama ukulungelelanisa ukuguquguquka kwezinto ezininzi ukufumana umngcipheko we-VTE kwi-lymphoma (ngokumalunga namanye amachiza), bafumanisa ukuba umngcipheko wanda kakhulu phakathi kwezigulane ze-lymphoma.
I-Lymphoma yayiphakathi kweendawo ezine zomhlaza ezineengozi ezithe zanda kakhulu ze-VTE, njengoko zilandelayo:
- Umhlaza wengqondo
- Umhlaza wePancretic
- Olunye uhlobo lokutya (isisu, intlungu encinci, i-gallbladder, ne-bile system)
- Lymphoma
Izigulane ezine- leukemia zifunyenwe zibe mngcipheko phakathi kwesi sifundo.
Kwiimeko ezingama-33 zenzeke i-lymphoma esebenzayo kunye namatyala angama-18 anesifo se-leukemia esisebenzayo kulolu cwaningo, kuphela i-14 ye-50 (iipesenti ezingama-28) yayineenkathazo eziphambili ezinyangeni ezintathu ngaphambi kokuba kwenzeke umcimbi we-VTE. Uninzi lweziganeko zesiganeko esinomdlavuza we-leukemia (Chronic of 11, 18%), engapheliyo ngokuphathwa nge-L-asparaginase, into eyaziwayo yengozi ye-VTE.
ILizwi
Kubalulekile ukwazi ukuba, njengesigulane somhlaza, unokuba ngumngcipheko omkhulu kwiingxaki zegazi njenge-pulmonary embolism. Nangona kunjalo, kubalulekile ukubeka ingozi kulo mbono. Ngokubanzi, amathuba okuphuhlisa i-pulmonary embolism aphantsi kakhulu.
Nangona ufumana unyango nge-catheter ephakathi kwamanzi kunokunyusa umngcipheko we-PE / VTE, olunjalo unyango lunokusindisa ubomi kwizigulane ezininzi ezinomdlavuza. Oogqirha bayazi ingozi ye-VTE / PE kwimiboniso eyahlukeneyo yomhlaza wegazi, kunye neendlela ezahlukeneyo zonyango kunye nokungenelela. Njengesigulane esikolweni, ulwazi lwakho lweempawu ze PE / VTE kunye nokulinda kwakho kunokunceda ugqirha wakho enze ngokukhawuleza, xa kufuneka imfuneko.
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