恶性肿瘤致上腔静脉综合征冲击化疗的护理干预

目的探讨恶性肿瘤所致上腔静脉综合征冲击化疗的护理方法.方法总结50例恶性肿瘤并上腔静脉综合征患者的临床资料.结果34例患者冲击化疗后21例呼吸困难,面部、颈部及上肢水肿等症状完全缓解,13例部分缓解.结论冲击化疗的同时加强化疗用药的护理及针对性的心理护理,能更有效的缓解患者临床症状,减轻患者的痛苦,提高患者生活质量,延长生存期.     

上腔静脉综合征26例放射治疗的疗效分析

目的 观察放射治疗对肿瘤导致的上腔静脉综合征的疗效.方法 对26例肿瘤伴上腔静脉综合征患者均采用放射治疗,放疗用6 mV-X线,开始剂量为每次3.0~4.0 Gy,每天1次,每周5次,3~5次后改为常规分割.结果 26例患者经过治疗完全缓解9例,部分缓解15例,无变化2例,进展0例,总有效率为92.3%.结论 放射治疗可作为恶性肿瘤伴上腔静脉综合征治疗的首选方法,放射治疗对肿瘤引起的上腔静脉综合征具有良好的缓解效果,不良反应轻,能有效提高患者的生存质量.     

合并上腔静脉综合征的原发心脏恶性肿瘤的放射治疗

目的:探讨对合并上腔静脉综合征的原发心脏恶性肿瘤的放射治疗作用。方法:分析、总结3例合并上腔静脉综合征的原发心脏恶性肿瘤病人的治疗过程,复习相关文献。2例行术后放疗,1例行术前放疗。放射野包括病变区在内的大部分心脏,6MVX线照射,放疗剂量分别为40GY、50.4GY、40GY,结果:3例病人经治疗后心脏肿瘤均缩小,上腔静脉综合征均明显好转。1例病人存活23个月,1例存活6个月,1例已存活9个月,目前仍无瘤生存。3例病人的生活质量均有明显改善。结论:放射治疗能有效治疗心脏原发恶性肿瘤,缓解上腔静脉综合征,改善生活质量,延长生存期。     

上腔静脉综合征冲击化疗的护理

上腔静脉综合征(SVCS)系原发或继发转移性纵隔肿瘤压迫上腔静脉所致,表现为呼吸困难,颜面部浮肿,胸、颈静脉扩张,上肢紫绀或继发颅内高压,应迅速缓解压迫症状,否则将危及生命.1997年1月至2000年1月,我们根据不同组织类型,选用以大剂量环磷酰胺(HD-CTX)为主的联合化疗方案,配合放疗,治疗由恶性肿瘤引起的SVCS,效果满意,现将护理体会总结如下.……     

三维适形放疗治疗肺癌上腔静脉综合征23例

目的 探讨三维适形放疗在肺癌上腔静脉综合征治疗中的即期疗效和应用价值.方法 23例上腔静脉综合征患者第1～3周放疗为每次1.25～1.5Gy,每天2次,间隔6小时,每周连续照射5天;第4周开始适形放疗,设5～7个非共面照射野,90%等剂量线剂量为4～5Gy/次,3次/周.依肿瘤病理类型,完成根治性照射剂量65～75 Gy.结果 治疗2周、4周时症状缓解率为52.2%和89.1%,治疗后完全缓解率96.3%,未观察到严重的早期并发症.结论 适形放疗治疗较常规放射治疗并发症低,有较好的即期疗效,能被患者耐受,是治疗SVCS有效方法,值得临床推广应用.     

26例上腔静脉综合征放射治疗的临床观察

目的:探讨大剂量冲击放射治疗对晚期胸部肿瘤合并上腔静脉综合征的疗效.方法:对26例晚期胸部肿瘤合并上腔静脉综合征患者先行大剂量冲击放射治疗.每野300～500 cGy/次,连续3～5次,后改常规剂量照射,同时辅以心理指导、呼吸道管理、输液及皮肤护理等.结果:晚期胸部肿瘤合并上腔静脉综合征的患者症状缓解率达100%.其中肺癌患者15例.完全缓解13例,部分缓解2例;非霍奇金淋巴瘤7例,完全缓解6例,部分缓解1倒;食管癌4例,完全缓解2例,部分缓解2例.结论:大剂量冲击放射治疗是晚期胸部肿瘤合并上腔静脉综合征的有效治疗手段.     

恶性肿瘤致上腔静脉综合征冲击化疗的护理干预

目的:探讨恶性肿瘤所致上腔静脉综合征冲击化疗的护理方法。方法:总结50例恶性肿瘤并上腔静脉综合征患者的临床资料。结果:34例患者冲击化疗后21例呼吸困难,面部、颈部及上肢水肿等症状完全缓解,13例部分缓解。结论:冲击化疗的同时加强化疗用药的护理及针对性的心理护理,能更有效的缓解患者临床症状,减轻患者的痛苦,提高患者生活质量,延长生存期。     

上腔静脉综合征冲击放疗的护理

上腔静脉综合征（ＳＶＣＳ）是纵隔原发或继发肿瘤直接侵犯压迫上腔静脉所致。主要治疗方法是冲击放疗合并激素、利尿及抗生素治疗。我院自１９９３年５月至１９９８年５月采用冲击放疗上腔静脉综合征３２例，现将护理经验总结如下。１临床资料１１一般资料本组３２例中...     

急性恶性上腔静脉压迫综合征的放射治疗——附20例报告

原发性或转移性纵隔肿瘤，侵犯纵隔的肺肿瘤引起上腔静脉压迫综合征属放疗急症，妥善处理至关重要，本组分析１９８９年３月至１９９４年１０月我院收治２０例急重恶性上腔静脉压缩综合征放疗的结果，连续５次大剂量（３００ＣＧＹ－５００ＣＧＹ／次）放疗后的开始缓解，整组完全缓解１２例（６０％），部分缓解４例（２０％），本结果提示处理急需ＳＶＣＳ时及时放疗是行之有效的，冲击放疗可加速症状缓解。     

急性恶性上腔静脉压迫综合征的放射治疗──附20例报告

原发性或转移性纵隔肿瘤、侵犯纵隔的肺肿瘤引起上腔静脉压迫综合症属放疗急症，妥善处理至关重要。本组分析1989年3月至1994年10月我院收治20例急重恶性上腔静脉压迫综合征放疗的结果，连续5次大剂量（300CGY－500CGY／次）放疗后开始缓解，整组完全缓解12例（60％），部分缓解4例（20％）。本结果提示处理急重SVCS时及时放疗是行之有效的，冲击放疗可加速症状缓解。     

Superior vena cava syndrome: experience in a teaching hospital

Between 1972 and 1985, 39 patients with superior vena cava syndrome were admitted to the Medical College of Georgia Hospitals. I have reviewed the hospital courses of these patients and compared clinical and laboratory findings with those reported in previous series. The syndrome was malignant in 34 patients (mean age of 50 years) and benign in five (mean age of 30 years). Duration of symptoms before diagnosis was 17 months in patients with benign disease and 18 days in those with malignant disease. Presence of symptoms for less than four weeks was associated with a high likelihood of malignancy. Invasive diagnostic procedures established a diagnosis in 33 patients, and no procedural complications occurred. Computerized tomography (CT) of the chest confirmed superior vena cava obstruction and localized the level of obstruction in all six patients in whom it was done. Information gained from venacavograms did not alter therapeutic decisions. In eight patients, establishment of a definitive histologic diagnosis altered the treatment. Treatment relieved the symptoms in 69% of the patients with malignant superior vena cava syndrome, and no patient had recurrent symptoms after therapy.     

上腔静脉阻塞综合征的护理

目的探讨上腔静脉阻塞综合征的护理方法。方法对20例恶性肿瘤并发上腔静脉阻塞综合征的护理过程进行回顾性分析,总结上腔静脉阻塞综合征的观察要点及护理方法。结果经过积极治疗和系统护理后,16例症状缓解,4例未见缓解。结论对易并发上腔静脉阻塞综合征的肿瘤患者要严密观察病情,及早发现阻塞症状并积极处理,既可缓解症状,又可延长无复发生存期。     

上腔静脉综合征的介入治疗

目的　探讨血管腔内成形技术在上腔静脉综合征 (SVCS)治疗中的应用价值。方法　 14例SVCS患者 ,男 11例 ,女 3例。病因包括 :中心型肺癌 9例 ,纵隔转移瘤 4例 ,淋巴瘤 1例。应用经导管局部溶栓 内支架成形术 (PTAS)治疗。结果　初次治疗的血管再通率为 86% ,术后 2 4～ 48h内患者的临床症状即有明显减轻 ,随访 1～ 2 0个月 (平均 8.3个月 ) ,仅 4例于术后 2周内发生支架再狭窄 ,经再次治疗效果满意。结论　血管腔内成形术是治疗上腔静脉综合征的有效方法。     

An updated narrative review on the management of the most common oncological and hematological emergencies

Oncological emergencies are defined as an acute life-threatening event in a patient with a tumor occurring as part of their complex treatment regimen or secondarily to their underlying malignancy. These events can occur at any time from the initial diagnosis of their cancer to end-stage disease. These oncological emergencies are broadly classified into four major categories; metabolic, structural, hematological and treatment-related causes; and can be encountered in any clinical setting, ranging from primary care physician and emergency department visits to a variety of subspecialty environments.This study aims to cover an in-depth review of the underlying pathogenesis, clinical presentation, and updated management protocol of most common emergencies belonging to the above-mentioned categories. An all-language literature search was conducted on 15th October 2021 and 10th March 2022, limited to 5 years on PubMed database using the following search strings: oncological emergencies, malignant spinal cord compression, febrile neutropenia, hyperviscosity syndrome, superior vena cava syndrome, immune related adverse events, tumor lysis syndrome, hypercalcemia of malignancy, corrected calcium, malignant pericardial effusion and chemotherapy extravasation.     

Superior vena cava syndrome: An oncologic complication

Superior vena cava syndrome (SVCS) is an oncologic complication resulting from the partial or complete obstruction of the superior vena cava by tumor invasion, extrinsic compression, or thrombosis. The appearance of symptoms may be gradual or insidious. Acute onset of symptoms may result in a relative oncologic emergency. Controversy exists as to the absolute necessity of establishing a histiologic diagnosis prior to the initiation of treatment. Radiation therapy remains the primary means of treatment except for small cell lung cancer and lymphoma where chemotherapy is considered the treatment of choice. Nursing management is directed toward assessment and identification of high-risk patients, astute observation and provision of supportive care for the patient with acute SVCS, and prevention of further side effects of therapy.     

Thrombolyse par voie systémique d'une thrombose de la veine cave supérieure associée à un cathéter veineux central

We report the case of 47-year-old woman with a superior vena cava syndrome occuring one month and a half after she had been equipped with a central venous catheter. Her clinical symptoms were so severe that she was treated by intravenous streptokinase administered systemically during 24 hours. This treatment provided the resolution of symptoms without any further complication. The importance of a rapid diagnosis and early treatment are discussed.     

三维适形放疗联合高压氧治疗恶性上腔静脉阻塞症的相关研究

目的：探讨三维适形放疗联合高压氧提高恶性上腔静脉阻塞症治疗疗效的可能性。方法：采用随机分组的方法将恶性肿瘤合并上腔静脉阻塞症的患者分为单纯放疗组（单放组）与放疗加高压氧组（联合组），其中联合组和单放组各23例。结果：联合组有效率为82．6％，单放组有效率65．21％，两组之间的差异有统计学意义（P〈0．05）。两组患者治疗中不良反应差异有统计学意义，联合组优于单放组。结论：三维适形放疗联合高压氧治疗可提高恶性上腔静脉阻塞症的疗效，且不良反应有所减轻。     

Tunnelled central venous catheter-induced thrombosis: a rare case of superior vena cava syndrome

Thrombotic venous obstruction in patients with a tunnelled central venous catheter is a cause of superior vena cava syndrome that is not routinely encountered by emergency physicians. Diagnosis requires identifying patients at risk (e.g., those under treatment for cancer and those who have a tunnelled central venous catheter), recognizing the signs and symptoms of superior vena cava syndrome, usually dyspnea and dilated neck or thoracic veins, and imaging the venous obstruction using computer tomography or sonography. Management involves anticoagulation and local thrombolytic administration. We report the case of a 28-year-old woman who presented with a 2-day history of face, chest and bilateral arm swelling who had been receiving maintenance chemotherapy for acute lymphoblastic leukemia through a Hickman catheter. This case demonstrates the need to be vigilant for thrombus formation in patients with long-term, indwelling central venous catheters.     

Superior vena cava obstruction: is stenting necessary?

No therapy is currently available for patients with recurrent vascular obstruction of the superior vena cava (SVC) caused by tumor regrowth after chemotherapy or radiation therapy. Intravascular stenting is a new option for the treatment of vena cava syndrome. Forty cancer patients with SVC syndrome (SVCS) were evaluated by computed tomography (CT) and venography. The SVC or its tributaries were stenosed or thrombosed in all patients. The etiology was malignant in all but 2 cases: non-small-cell lung carcinoma (n = 28), mediastinal nodal metastasis (n = 5), lymphoma (n = 2), pleural mesothelioma (n = 2), small-cell lung carcinoma (n = 1), and postradiation fibrous mediastinitis (n = 2). Stenting was achieved in 39 of the 40 patients, and clinical symptoms subsided in 92%. Stents remained patent in 36 of these 39 patients throughout a mean follow-up of 24 weeks (range 3 days to 24 months). SVC stenting is safe, effective and allows rapid cure of SVCS and port catheter implantation in patients in poor health.