Ukuvinjelwa kwe-SVC

Ukuvinjelwa kwe-SVC ukunciphisa noma ukuvimba i-vena cava (SVC) ephakeme, okuwumthambo wesibili ngobukhulu emzimbeni womuntu. I-vena cava ephakeme ihambisa igazi lisuka engxenyeni engenhla yomzimba liye enhliziyweni.

Ukuvinjelwa kwe-SVC yisimo esingajwayelekile.

Ngokuvamile kubangelwa umdlavuza noma isimila ku-mediastinum (indawo yesifuba ngaphansi kwethambo lesifuba naphakathi kwamaphaphu).

Ezinye izinhlobo zomdlavuza ezingaholela kulesi simo zifaka:

• Umdlavuza webele
• I-Lymphoma
• Umdlavuza wamaphaphu we-Metastatic (umdlavuza wamaphaphu osakazeka)
• Umdlavuza wamasende
• Umdlavuza wegilo
• Isigaxa seTymus

Ukuvinjelwa kwe-SVC nakho kungadalwa yizimo ezingezona ezomdlavuza ezibangela isibazi. Lezi zimo zifaka:

• I-Histoplasmosis (uhlobo lokutheleleka kwefungal)
• Ukuvuvukala kwe-vein (thrombophlebitis)
• Ukutheleleka kwamaphaphu (njengesifo sofuba)

Ezinye izimbangela zokuvinjelwa kwe-SVC zifaka:

• I-aortic aneurysm (ukunwetshwa komthambo okushiya inhliziyo)
• Amahlule egazi ku-SVC
• I-consticive pericarditis (ukuqiniswa kolwelwesi oluncane lwenhliziyo)
• Imiphumela yokwelashwa kwemisebe yezimo ezithile zezokwelapha
• Ukwandiswa kwendlala yegilo (goiter)

Ama-catheters abekwe emithanjeni emikhulu yengalo ephezulu nentamo angadala amahlule egazini ku-SVC.

Izimpawu zenzeka lapho okuthile kuvimbela igazi ukuba libuyele enhliziyweni. Izimpawu zingaqala ngokuzumayo noma kancane kancane, futhi zingase zibe zimbi kakhulu lapho ugoba noma ulele phansi.

Izimpawu zokuqala zifaka:

• Ukuvuvukala okuzungeze iso
• Ukuvuvukala kobuso
• Ukuvuvukala kwabamhlophe bamehlo

Ukuvuvukala cishe kuzoba kubi kakhulu ngezikhathi zasekuseni bese kuhamba phakathi no-ekuseni.

Izimpawu ezivame kakhulu ukuphefumula okuncane (i-dyspnea) nokuvuvukala kobuso, intamo, isiqu nezingalo.

Ezinye izimpawu ezingaba khona zifaka:

• Ukwehla kokuqapha
• Isiyezi, ukuquleka
• Ubuhlungu bekhanda
• Ubuso obubomvu noma izihlathi
• Izintende ezibomvu
• Izimbungulu ezibomvu ezibomvu (ngaphakathi kwekhala, umlomo nezinye izindawo)
• Ububomvu buguquka buba luhlaza ngokuhamba kwesikhathi
• Ukuzwela kokugcwala kwekhanda noma kwendlebe
• Umbono uyashintsha

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba, okungakhombisa imithambo ekhulisiwe yobuso, intamo, nesifuba esingenhla. Umfutho wegazi uvame ukuba phezulu ezingalweni naphansi emilenzeni.

Uma kusolwa umdlavuza wamaphaphu, kungenziwa i-bronchoscopy. Ngesikhathi sale nqubo, kusetshenziswa ikhamera ukubuka ngaphakathi kwezindlela zomoya namaphaphu.

Ukuvinjelwa kwe-SVC kungabonakala ku:

• I-x-ray yesifuba
• I-CT scan yesifuba noma i-MRI yesifuba
• I-Coronary angiography (isifundo senhliziyo yegazi lenhliziyo)
• I-Doppler ultrasound (ukuhlolwa kwegagasi lomsindo lemithambo yegazi)
• I-Radionuclide ventriculography (isifundo senuzi sokunyakaza kwenhliziyo)

Inhloso yokwelashwa ukukhulula ukuvinjelwa.

I-diuretics (amaphilisi wamanzi) noma ama-steroids (izidakamizwa ezilwa nokuvuvukala) zingasetshenziselwa ukuqeda ukuvuvukala okwesikhashana.

Ezinye izindlela zokwelashwa zingafaka imisebe noma i-chemotherapy yokunciphisa isimila, noma ukuhlinzwa ukuze kususwe izicubu. Ukuhlinzwa ukwedlula ukuvinjelwa akuvamile ukwenziwa. Ukubekwa kwe-stent (ithubhu efakwe ngaphakathi kwesitsha segazi) ukuvula i-SVC kungenziwa.

Umphumela uyehluka, kuya ngesizathu kanye nenani lokuvinjelwa.

Ukuvinjelwa kwe-SVC okubangelwa isimila kuwuphawu lokuthi isimila sesisakazekile, futhi kukhombisa umbono ompofu wesikhathi eside.

Umphimbo ungavaleka, ongavimba imigwaqo yomoya.

Ingcindezi eyandisiwe ingahle ikhule ebuchosheni, iholele emazingeni aguqukile okuqonda, isicanucanu, ukuhlanza, noma ukushintsha kombono.

Shayela umhlinzeki wakho uma uba nezimpawu zokuvinjelwa kwe-SVC. Izinkinga zibucayi futhi kwesinye isikhathi zingabulala.

Ukwelashwa ngokushesha kwezinye izifo kunganciphisa ubungozi bokuvinjelwa kwe-SVC.

Ukuphakama kwe-vena cava ephakeme; I-Superior vena cava syndrome

• Inhliziyo - isigaba phakathi nendawo

UGupta A, uKim N, uKalva S, uReznik S, uJohnson DH. I-Superior vena cava syndrome. Ku: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, abahleli. I-Abeloff’s Clinical Oncology. Umhlaka 6. IPhiladelphia, PA: Elsevier; 2020: isahluko 53.

IKinlay S, iBhatt DL. Ukwelashwa kwesifo semithambo esingavaleki kahle. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 66.