Tse ka Hare le Tse sa Tšoaneng tsa Mediastinum
Mofuta oa mediastinum ke eng, ke mekhoa efe le likaroloana tse teng sebakeng sa sefuba? Ke maemo afe a bongaka a ka 'nang a etsahala ho mediastinum? Ke mefuta efe ea lipalo tsa mediastinal kapa lihlahala tse fumanehang likarolong tse tharo tsa mediastinum?
Tlhaloso: Selefouno
Se-mediastinum ke sebaka se pakeng tsa matšoafo a nang le pelo, karolo ea moea oa moea ( trachea ), setopo le lijana tse kholo ho kenyeletsa ho nyoloha ha aorta (mochini o moholo o nang le mali ho tloha ventricle ea pelo e ka letsohong le letšehali ha e e-ea 'meleng o mong le o mong) le methapo ea li-pulmonary e nepahetseng le e letšehali-haholo-holo litho tsohle tsa sefuba ntle le matšoafo.
Ho boetse ho na le li-lymph nodes tse ngata le methapo. Lentsoe "mediastinum" le fetoleloa e le "bohareng ba bobeli" ka Selatine, ha ho buuoa ka karolo e bohareng ea sefuba.
U ka bona sebaka sena ka ho bona sefahleho se le tlaase, sefuba (sternum) e le se ka pele, methapo ea mali e kenang le ho tsoa pelong e le holimo, le mokokotlo (molumo oa letheka) joaloka lehlakoreng le ka morao.
Sebopeho - Se-mediastinum se arotsoe libakeng tse 3 tse ka sehloohong:
- Anterior - Mokokotlo oa pele o teng ka lehlakoreng le letšehali 'me o na le methapo e mengata e nyenyane hammoho le lymph nodes.
- Bohareng - Karolo e kholo ea mediastinum e na le karolo e kholo ka ho fetisisa, 'me e na le pelo, methapo ea mali e kenyelletsang ho tloha matšoafong ho ea pelong le lymph nodes.
- Posterior - The posterior mediastinum e na le sophagus, methapo e mengata ea mali le methapo, le lymph nodes tsa mediastinal .
Maemo a Amehang Mediastinum
Ho na le maemo a mangata a bongaka a ka amang mehaho ea mediastinum.
Tse ling tsa tsona li kenyelletsa:
- Kankere - Kankere e kang lymphomas (bobeli ba li- lymphoma tsa Hodgkin le li-lymphomas tse seng tsa Hodgkins), li-tumor tse ling tsa kokoana-hloko ea kokoana-hloko le li-thymomas (kankere ea thymus gland) li hlahisa li-mediastinum.
- Matšoao a Benign - Likokoana-hloko tsa benign tsa likokoana-hloko tse kang li-teratomas le li-cysts tse ka hlahang sebakeng sena se ka etsahala sebakeng sena.
- Malignant lymph nodes (lymph nodes tse amehang ke kankere) - Kankere e kang kankere ea matšoafo e ka 'na ea ata ho lymph nodes sebakeng sena (lymph nodes tsa metastinal and tracheobronchial.)
- Lymphadenopathy - "Ho ruruha" lymph nodes ka har'a mediastinum e ka hlaha le mafu a itseng, haholo-holo mafu a tšoaetso ea kokoana-hloko.
- Aneurysms - Thoracic aortic aneurysms ke boemo bo tebileng bo amanang le mediastinum.
- Tšenyo ea methapo - Metsu e fetang har'a mediastinum e ka senyeha, ka mohlala ka khatello ea hlahala kapa li-lymph nodes tsa kankere sebakeng sena.
Masses a Mastastinal
Hangata matšoao a li-mediastinal a qala ho tsejoa ha ho hlahlojoa ho etsoa ho hlahloba matšoao a amanang le sefuba, joalo ka khohlela, phefumoloho e khutšoanyane, kapa matšoao a mang. Boholo ba matšoao ka har'a mediastinum ba nyenyane mme ha ba na matšoao. Ha li le khōlō li ka baka ho se sebetse ho phefumoloha (bothata ba ho hema kapa ho fumana oksijene e lekaneng le lisele) hammoho le mathata a pelo, a kang ho theoha khatello ea mali kapa ho fokotseha ha mali.
Lilemo tsa motho ka mong le sebaka sa 'mele oa mediastinal ke tsa bohlokoa ha ho hlahlojoa ho hlahlojoa. Ho bana, masapo a li-mediastine a etsahala hangata ka morao-rao mediastinum 'me hangata a na le bothata (eseng kankere.) Ka lehlakoreng le leng, matšoele a li-mediastinal ho batho ba baholo a tloaelehile mokhoeng oa pele,' me hangata o bolaeang kankere.
Lisosa tse ling tsa matšoao a li-mediastinal tse thehiloeng sebakeng se kenyeletsa:
- Anterior mediastinum - Ho ruruha hoa libakeng tsena ho ka kenyelletsa li-thymomas (lihlahala tsa thymus, setho sefubeng se batlang se le seholo ho tloha bongoaneng empa ha e le hantle se nyamela ho batho ba baholo), lymphomas le masapo a qoqotho.
- Mediastinum Bohareng - Lymph nodes e atolositsoeng ke sesosa se tloaelehileng sa boima bohareng ba mediastinum. Li-lymph nodes tsena li ka amahanngoa le kankere e ka tlaase. Bronchogenic cysts e ka boela ea bonoa sebakeng sena, hammoho le mefuta e sa tloaelehang ea pelo joaloka aorta e atolositsoeng.
- Posterior mediastinum - Kankere ea li-Esophageal le tse ling tse sa tloaelehang tsa tlhaho e ka bonahala ka morao-rao mediastinum, 'me li-lymph node tse atolositsoeng li ka boela tsa boleloa mona. Menyetla e meng e kenyeletsa li-sarcom le li-tishu tsa thyroid (likokoana-hloko tsa qoqotho tse ntseng li hōla sebakeng se ka ntle ho qoqotho ea qoqotho.
Kankere ea molomo e ka baka boima karolong efe kapa efe ea mediastinum. Ke habohlokoa ho hlokomela hore ho na le lisosa tse ling tse ngata tse sa tloaelehang meleng ea mediastinum, 'me hangata ho etsoa liteko tse eketsehileng ho hlalosa se bolelang hantle.
Melao e kenyeletsang Mediastinum
- Pneumomediastinum e bolela ho ba teng ha moea ka har'a mediastinum, hangata e amana le ho oa ha mapafu (pneumothorax.)
- Mediastinitis ke lentsoe le buang ka tšoaetso e amang mediastinum.
Mekhoa ea Ts'ebetso - Mediastinoscopy
Kaha kankere e tšoeroe ke kankere ea matšoafo le lymphomas, lingaka li atisa ho hlahloba li-mediastinum ho bona hore na kankere leha e le efe e hasane sebakeng sena. Tsela e 'ngoe e lumellang lingaka tsa ho buuoa ho bona hore sebaka sena se bitsoa mediastinoscopy . Haeba kankere e hasane ho li-nodes ka mediastinum hangata e tšoaroa ka tsela e fapaneng ho feta kankere e sa kang ea ata sebakeng sena; ho ba teng ha li-lymph nodes tsa meriana ho bohlokoa ho hlahloba kankere ea matšoafo .
Mediastinoscopy e ne e le mokhoa o tloaelehileng bakeng sa ba fumanoang ba e-na le kankere ea matšoafo, empa ka linako tse ling tlhahisoleseding e tšoanang e ka ba teng hona joale ka PET scan.
Mehlala: Thabo e ne e entsoe ho bona hore na kankere ea hae ea matšoafo e nametse lymph nodes mongoaneng oa hae.
> Mehloli:
> Barrington, S., le R. Kluge. FDB PET bakeng sa Tlhahlobo ea Therapy ho Hodgkin le Non-Hodgkin Lymphomas. European Journal of Nuclear Medicine le Molecular Imaging . 2017 Apr 14. (Epub pele ea khatiso).
> Berry, M. Tlhahlobo ea Masese a Bophelo. E maemong. E ntlafalitsoe 09/28/16. http://www.uptodate.com/contents/approach-to-the-adult-patient-with-a-mediastinal-mass
> Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. le B de Mol. Tsamaiso ea Masses a Maholo a Bophirimela: Ho nahanisisa ka ho Buuoa le ho Anesthesiological. Journal ea Mafu a Mahlomola . 2016. 8 (3): E175-84.
> Laebrari ea Sechaba ea Meriana ea US. Medline Plus. Li-Tumor-medium Tumors. E ntlafalitsoe ka 05/20/16. https://medlineplus.gov/ency/article/001086.htm